Documenting evidence on global health strategies and programmes that provide safeguards for vulnerable populations and strengthen overall pandemic preparedness is essential. This study aimed to identify factors associated with adherence to COVID-19 mitigation measures, COVID-19-related symptoms and testing, as well as pandemic-related income loss among internally displaced persons (IDPs) in urban and remote areas of Burkina Faso, Niger and Mali.

This cross-sectional study used fixed-site respondent-driven sampling (RDS).

Primary care settings across six urban and remote locations in Burkina Faso, Mali and Niger.

4144 internally displaced adults, who had been forced from their homes within 5 years of the survey, participated in the study. The survey was conducted between August and October 2021 in two selected locations in three countries: Kaya (n=700) and Ouahigouya (n=715) in Burkina Faso; Bamako (n=707) and Ménaka (n=700) in Mali; and Niamey (n=733), and Diffa (n=589) in Niger. Participants were included if they were born in the study countries, displaced due to conflict, violence or disaster, aged 18 years or older, and living or working in the study site for at least 1 month.

The primary outcomes measured were adherence to COVID-19 mitigation measures, presence of COVID-19 symptoms, COVID-19 testing and vaccination rates and pandemic-related income loss.

Among 4144 IDPs surveyed across 6 sites in Burkina Faso, Mali and Niger, over half (52%) reported experiencing at least one COVID-19 symptom in the preceding 2 weeks. However, 8% had ever been tested for COVID-19, and fewer than 5% had received a vaccine in all sites except Diffa, where 54% reported vaccination. While willingness to be vaccinated was high (ranging from 56.6% in Bamako to 89.5% in Niamey), access remained limited. Compliance with public health measures varied; for example, 41.7% of IDPs were able to maintain physical distance from non-household members, and just 60.2% reported wearing a mask. Chronic health conditions were consistently associated with higher odds of COVID-19 symptoms (Ménaka OR: 14.65; 95% CI: 7.36 to 29.17). Economic vulnerability was widespread, with more than half of IDPs in Bamako (58.1%) and Niamey (66.4%) reporting income loss due to the pandemic, and average monthly income declining by over 50% in most sites. IDPs in urban areas generally reported greater exposure to COVID-19 risk factors, while those in remote settings reported lower adherence and poorer access to basic preventive measures.

This is the first known RDS study to explore the impact of the COVID-19 pandemic on IDPs. Findings suggest that IDPs in urban areas may face heightened risks of exposure and infection, underscoring the need to prioritise them in public health efforts. Low testing and vaccination rates and significant income loss call for advocacy and economic relief to address these vulnerabilities. Future pandemic responses should integrate health interventions with targeted support, especially mitigating income loss to bolster IDPs’ resilience.

Length-for-age z-scores (LAZ) and stunting prevalence (%LAZ

We simulated a synthetic cohort with a harmonically downward-shifting LAZ trajectory from birth to 24 months of age, with mean LAZs similar to the HBGDki pooled South Asian cohorts, and without any input parameters intended to differentially affect individuals’ growth across the height distribution or at different ages. We compared HBGDki empirical estimates of age interval-specific frequencies of incident stunting onset and stunting reversal with those from the synthetic cohort. Using synthetic cohorts, we examined how estimates of incident onset and reversal were affected by missing data, magnitude of the whole-population shift in the LAZ distribution and strength of the between-time-point correlation. We also compared the 3–24 month pattern of linear growth faltering expressed as age-related trajectories of average growth delay (chronological age minus height–age), mean LAZ or stunting prevalence.

Empirical estimates of age interval-specific incident stunting onset and stunting reversal in the HBGDki cohorts were similar to those observed in a synthetic cohort. Variability in LAZ threshold-crossing event rates is explained by starting LAZ, between-time-point correlation and the magnitude of the whole-population shift in the LAZ distribution. Incident stunting onset is also affected by missing data in preceding intervals. Stunting reversal occurs due to within-child variability (ie, imperfect between-time-point correlation) in the absence of any other phenomena that cause stunted children to become non-stunted at a later age. The linear growth faltering pattern based on growth delay differed from corresponding age-related trajectories of mean LAZ or stunting prevalence.

In longitudinal studies of linear growth faltering in LMICs, LAZ threshold-crossing indicators are byproducts of whole-population shifts in LAZ and within-child variability and should be interpreted accordingly. Reporting incident stunting onset and reversal rates, or analyses in which children are grouped by the timing of LAZ threshold-crossing events, may detract from efforts to understand when and why nearly all children in LMICs grow more slowly than expected for their age. Since mean LAZ and stunting prevalence are unsuitable for quantifying the rate and timing of population-average postnatal linear growth faltering, growth delay is recommended for consideration as a preferred metric.

Adolescents living with HIV are at a high nutritional risk. Ensuring optimal nutrition and food security is fundamental for promoting the health of adolescents and youth living with HIV/AIDS (AYLHIV), preventing HIV disease progression and improving quality of life. The objective of this scoping review is to map and identify the current literature concerning nutrition and food-related interventions addressing AYLHIV.

The study will follow the Joanna Briggs Institute methodology for scoping reviews. We will search for relevant studies in the following databases: MEDLINE, EMBASE, Web of Science and Google Scholar. We will perform additional searches of the grey literature using snowball search and citation tracking and manual searches of institutional websites. Titles and abstracts will then be screened by two independent reviewers for assessment against the inclusion criteria. Disagreements will be resolved through discussion. A data extraction form will be used to guide the data extraction.

This review will involve the collection and analysis of secondary sources that have been published and/or are publicly available. Therefore, ethics approval is not required. The results will be published in an international peer-reviewed journal, presented at scientific conferences and disseminated through digital science communication platforms.

The protocol is registered in the Open Science Framework: https://doi.org/10.17605/OSF.IO/HGBKV.

To increase the sustainability of healthcare, clinical trials must assess the environmental impact of interventions alongside clinical outcomes. This should be guided by Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) and Consolidated Standards of Reporting Trials (CONSORT) extensions, which will be developed by The Implementing Climate and Environmental Outcomes in Trials Group. The objective of the scoping review is to describe the existing methods for reporting and measuring environmental outcomes in randomised trials. The results will be used to inform the future development of the SPIRIT and CONSORT extensions on environmental outcomes (SPIRIT-ICE and CONSORT-ICE).

This protocol outlines the methodology for a scoping review, which will be conducted in two distinct sections: (1) identifying any existing guidelines, reviews or methodological studies describing environmental impacts of interventions and (2) identifying how environmental outcomes are reported in randomised trial protocols and trial results. A search specialist will search major medical databases, reference lists of trial publications and clinical trial registries to identify relevant publications. Data from the included studies will be extracted independently by two review authors. Based on the results, a preliminary list of items for the SPIRIT and CONSORT extensions will be developed.

This study does not include any human participants, and ethics approval is not required according to the Declaration of Helsinki. The findings from the scoping review will be published in international peer-reviewed journals, and the findings will be used to inform the design of a Delphi survey of relevant stakeholders.

Registered with Open Science 28 of February 2025.

The aim was to assess point-in-time stock availability and pricing of drugs used for postpartum haemorrhage management (oxytocin, misoprostol, heat-stable carbetocin and tranexamic acid (TXA)).

Cross-sectional point-in-time survey using an adapted version of the WHO/Health Action International methodology.

In public, for-profit and not-for-profit private health facilities and in pharmacies in the Democratic Republic of the Congo (DRC), India and Kenya.

211 health facilities in the DRC (n=63), India (n=76) and Kenya (n=72).

Availability was calculated as a mean percentage of facility types where each medicine was observed on the day of data collection. Average procurement prices were calculated by obtaining the current purchase price per drug at each facility and then averaging prices across all facility types.

Availability of the four medicines was limited, and only oxytocin in the DRC met the WHO’s benchmark of 80%. Across all countries, availability of oxytocin, misoprostol and TXA was lower in public health facilities than in other facility types, indicating an important gap. Where the four medicines were available, non-quality-assured products were predominant across the three countries. The average facility procurement prices in India and Kenya were reported to be lower than those in the DRC.

Availability of oxytocin, misoprostol, heat-stable carbetocin and TXA was suboptimal and varied by facility type and geography, and similar trends were found across the four drugs. This indicates that access strategies should be tailored to each drug, geographical area and facility type. Strategies to improve commodity access in public-sector facilities will be especially important, as well as improving the availability of quality-assured products, possibly through value-based procurement practices.

Health emergencies continue to stimulate greater interest in health systems and services, particularly their ability to respond to such shock. While studies have been done on health system response to health emergencies, there has been no attempt to synthesise this body of evidence to inform future emergency preparedness and response plan, particularly in low- and middle-income countries (LMICs) where health systems are deemed to be weak. This paper aims to provide a systematic review protocol for synthesising evidence on health system response to health emergencies in LMICs.

The WHO building blocks of health system functioning will be used as a conceptual framework for the review. The review will be conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Nine electronic databases will be searched: Medline, Embase, Ovid Emcare, Scopus, ScienceDirect, Academic Search Complete, HINARI, CINAHL and African Index Medicus. The search will be supplemented by citation searching, searching reference lists of included articles, search for grey literature in Google Scholar and relevant websites. Studies focusing on health system response to health emergencies in LMICs, published in English and between 2007 and 2025, will be eligible for inclusion. A narrative synthesis will be performed on all the included studies. Studies will be mapped and categorised into the WHO six building blocks of health system functioning, exploring relationships between and within studies, identifying the response mechanisms of the health system during health emergencies and their barriers and facilitators.

The data to be used do not include individual patient data, so ethical approval is not required. The results of the systematic review will be disseminated through a peer-reviewed journal publication, presentations at conferences and seminars.

CRD42024556271

This study aimed to assess eye check-up practice and associated factors among patients with diabetes attending primary hospitals in the Central Gondar Zone, Northwest Ethiopia.

A multicentre hospital-based cross-sectional study.

This study was conducted at primary hospitals in Central Gondar Zone, Northwest Ethiopia, from 10 June 2024 to 10 July 2024.

The study included 689 consecutive adult patients with diabetes who met the inclusion criteria.

Participants were diagnosed with diabetes mellitus by a general practitioner. Optometrists conducted interviews, reviewed medical records and administered a pretested, structured questionnaire. Binary logistic regression was performed to identify associated factors, with significance considered at a p

A total of 689 participants were involved in this study, with a response rate of 98.4%. The proportion of good eye check-up practice was 20.6% (95% CI: 17.6% to 23.8%). Factors associated with good eye check-up practice included urban residence (adjusted OR, AOR=4.10, 95% CI: 1.72 to 9.82), diabetes duration of 12+ years (AOR=4.98, 95% CI: 1.43 to 17.38), previous eye disease (AOR=3.78, 95% CI: 1.79 to 7.95), good knowledge of diabetic retinopathy (AOR=3.22, 95% CI: 1.42 to 7.29), higher family income (AOR=3.80, 95% CI: 1.27 to 11.36), referral from a diabetic clinic (AOR=3.48, 95% CI: 1.58 to 7.67) and a favourable attitude (AOR=3.75, 95% CI: 1.46 to 9.65).

This study revealed a low proportion of good eye check-up practices among patients with diabetes. Urban residency, longer duration of diabetes, higher income, clinic referrals, history of eye disease, knowledge of diabetic retinopathy and a favourable attitude were significantly associated with good eye check-up practices. Therefore, targeted health education and strengthened referral systems are recommended to improve regular eye check-up practices among individuals with diabetes.

Hepatic impairment, especially hepatitis, is a growing public health concern in the general population globally. Viral hepatitis, a key driver of liver impairment, remains endemic in many countries across sub-Saharan Africa (SSA). We conducted an umbrella review to assess the prevalence of viral hepatitis among the general population in SSA.

We conducted an umbrella review, using standardised methods to assess multiple systematic reviews and meta-analyses (SRMAs) on the prevalence of viral hepatitis.

We systematically searched PubMed and Embase to retrieve systematic reviews published from 2013–2024.

We retrieved systematic reviews published during 2013–2024 that examined the prevalence of viral hepatitis among the general population within SSA.

Two independent reviewers used standardised methods to search, screen and identify included studies. We conducted an umbrella review, which was a comprehensive and systematic collation and assessment of SRMAs focused on the prevalence of viral hepatitis in SSA.

The final analysis included 21 studies. Among these, one study focused on hepatitis A, 13 on hepatitis B, 10 on hepatitis C, 2 on hepatitis D and 1 on hepatitis E. Only one study reported the overall prevalence of hepatitis A and E in SSA as 90 200 and 46 860 per 100 000 population, respectively. Across SSA, hepatitis B exhibited a pooled prevalence ranging from 6000 to 18 900, while hepatitis C ranged from 720 to 7820 and hepatitis D from 50 to 28 990 per 100 000 population. Heterogeneity was high and ranged from I²=63.14% to 99%.

We present an umbrella review on viral hepatitis prevalence in SSA, providing an overall view of study quality, effect sizes, heterogeneity and bias across the search field. We found that the prevalence of viral hepatitis in many SSA countries is higher than the global estimate. However, these results are mainly based on seropositivity tests; nonetheless, the findings from this study provide an overarching picture of the burden of viral hepatitis within populations in SSA.

To estimate the burden, trends, and inequalities of brain and central nervous system cancer (CNS cancer) among adults at global, regional and national level from 1992 to 2021.

Population-based study.

Adults aged 20–64 years from 21 regions and 204 countries and territories (Global Burden of Disease and Risk Factors Study 2021) from 1992 to 2021.

Our primary outcomes comprised age-standardised prevalence, incidence, mortality and disability-adjusted life-years (DALYs) for CNS cancers. The analytical framework incorporated temporal trend analysis through annual percentage change (APC) and average APC (AAPC) metrics, complemented by Bayesian age-period-cohort modelling to assess demographic influences. We employed predictive modelling with decomposition techniques to evaluate contributions from age structure shifts, population dynamics and risk factor modifications, while spatiotemporal Gaussian process regression enabled robust smoothing and trend estimation across continuous time-space dimensions. The study specifically applied frontier analysis methodologies to examine epidemiological patterns of prevalence, incidence, mortality and DALYs within the 20–64 years adult population.

From 1992 to 2021, the global age-standardised prevalence (AAPC 1.04 (95% CI 0.91 to 1.18); p

From 1992 to 2021, the global age-standardised prevalence and incidence of CNS cancer among adults aged 20–64 years increased, while age-standardised DALYs and mortality decreased. The most significant increase in prevalence and incidence was observed among those aged 20–24 years. The most significant decrease in DALYs and mortality was observed among those aged 40–44 years. The rate of increase in prevalence and incidence was lower in high SDI countries compared with low-SDI countries. DALYs and mortality began to decline in high-SDI countries, but these indicators continue to rise in low-SDI nations. Our predictive analysis found that from 2021 to 2050, the number of CNS cancer cases among people aged 20–64 years will be on the rise globally, which is expected to increase from 186 891 to 245 942, an increase of 31.6%.

Significant inequalities exist in age-standardised prevalence, incidence, DALYs and mortality of CNS cancer among countries with varying sociodemographic indices. These disparities highlight the urgent need for targeted clinical guidelines and equitable distribution of global health resources.

Early childhood development (ECD) lays the foundation for lifelong health, academic success and social well-being, yet over 250 million children in low- and middle-income countries are at risk of not reaching their developmental potential. Traditional measures fail to fully capture the risks associated with a child’s development outcomes. Artificial intelligence techniques, particularly machine learning (ML), offer an innovative approach by analysing complex datasets to detect subtle developmental patterns.

To map the existing literature on the use of ML in ECD research, including its geographical distribution, to identify research gaps and inform future directions. The review focuses on applied ML techniques, data types, feature sets, outcomes, data splitting and validation strategies, model performance, model explainability, key themes, clinical relevance and reported limitations.

Scoping review using the Arksey and O‘Malley framework with enhancements by Levac et al.

A systematic search was conducted on 16 June 2024 across PubMed, Web of Science, IEEE Xplore and PsycINFO, supplemented by grey literature (OpenGrey) and reference hand-searching. No publication date limits were applied.

Included studies applied ML or its variants (eg, deep learning (DL), natural language processing) to developmental outcomes in children aged 0–8 years. Studies were in English and addressed cognitive, language, motor or social-emotional development. Excluded were studies focusing on robotics; neurodevelopmental disorders such as autism spectrum disorder, attention-deficit/hyperactivity disorder and communication disorders; disease or medical conditions; and review articles.

Three reviewers independently extracted data using a structured MS Excel template, covering study ML techniques, data types, feature sets, outcomes, outcome measures, data splitting and validation strategies, model performance, model explainability, key themes, clinical relevance and limitations. A narrative synthesis was conducted, supported by descriptive statistics and visualisations.

Of the 759 articles retrieved, 27 met the inclusion criteria. Most studies (78%) originated from high-income countries, with none from sub-Saharan Africa. Supervised ML classifiers (40.7%) and DL techniques (22.2%) were the most used approaches. Cognitive development was the most frequently targeted outcome (33.3%), often measured using the Bayley Scales of Infant and Toddler Development-III (33.3%). Data types varied, with image, video and sensor-based data being most prevalent. Key predictive features were grouped into six categories: brain features; anthropometric and clinical/biological markers; socio-demographic and environmental factors; medical history and nutritional indicators; linguistic and expressive features; and motor indicators. Most studies (74.1%) focused solely on prediction, with the majority conducting predictions at age 2 years and above. Only 41% of studies employed explainability methods, and validation strategies varied widely. Few studies (7.4%) conducted external validation, and only one had progressed to a clinical trial. Common limitations included small sample sizes, lack of external validation and imbalanced datasets.

There is growing interest in using ML for ECD research, but current research lacks geographical diversity, external validation, explainability and practical implementation. Future work should focus on developing inclusive, interpretable and externally validated models that are integrated into real-world implementation.

This study aimed to investigate the relationship between coping strategies and compassion fatigue among healthcare professionals in Central Uganda.

A facility-based cross-sectional study conducted between June and July 2023. Three tools were used for data collection: a socio-demographic survey, the Professional Quality of Life Scale (ProQOL-5) and the Brief-Coping, Orientation to Problem Experienced tool. Participants were asked to recall experiences from the previous 30 days.

The study was conducted in five prominent hospitals in Central Uganda.

A total of 548 healthcare providers, including 191 physicians, 256 nurses and 103 technicians.

Compassion fatigue scores.

Most participants were under 29 years old (50.9%) and women (62.0%). High levels of compassion fatigue were reported by 37.8% of participants. Active coping, self-distraction and denial were associated with higher compassion fatigue, while informational support, positive reframing and venting were linked to lower fatigue levels. Seeking social support effectively reduced compassion fatigue.

The findings highlight significant compassion fatigue among healthcare providers in Central Uganda, impacting their well-being and patient care. Coping strategies like active problem-solving and social support are promising in mitigating compassion fatigue. Interventions should focus on reducing self-distraction, enhancing problem-solving skills and fostering supportive work environments to improve healthcare workers’ well-being and patient care quality.

The study evaluated healthcare professionals’ adherence to guidelines on quality neonatal resuscitation practices in Ghana.

This study employed an observational design. A validated observational checklist for neonatal resuscitation was used to assess the adherence to quality neonatal resuscitation guidelines among healthcare professionals.

The study was conducted among healthcare professionals in six healthcare facilities, consisting of five government-owned healthcare facilities and a private non-profit health facility across the northern, middle and coastal belts of Ghana.

The study participants were 75 healthcare professionals across the six sampled healthcare facilities.

Outcome measures of interest are: initial preparation prior to resuscitation; stimulation and airway maintenance; positive pressure ventilation; coordinated positive pressure ventilation with chest compression and postresuscitation infection prevention and control measures.

The results revealed that 53% of the healthcare professionals demonstrated good (scored 80%–100%) adherence to guidelines on quality neonatal resuscitation practices; the remaining scored moderate 36% (scored 50%–79%) and 11% (scored 0%–49%) poor adherence. Binary logistic regression analysis revealed that increased staffing levels and a bachelor’s degree or higher were positively associated with the performance of positive pressure ventilation (adjusted OR (aOR) 19.3 (95% CI 2.430799, 152.8657), p=0.005) and (aOR 9.9 (95% CI 1.070278, 92.38303), p=0.043), respectively. Furthermore, professional nurses and medical practitioners were more likely to adhere to coordinated positive pressure ventilation with chest compressions than auxiliary nursing staff (aOR 13.2 (95% CI 1.917858, 92.61999), p=0.009) and (aOR 15.7 (95% CI 1.227859, 200.1105), p=0.034).

The results showed that 53% of healthcare professionals demonstrated good adherence for neonatal resuscitation practices. Addressing the identified gaps and inequalities in neonatal resuscitation practice will improve healthcare professionals’ knowledge and skills in neonatal resuscitation, which ultimately helps to reduce neonatal deaths among babies in Ghana.

Violence against girls and women (VAWG) is a public health problem and a violation of human rights. The prevalence of different forms of VAWG indicates that this is a recurring global issue that provokes economic, social and health consequences. In this paper, we outline a scoping review protocol to characterise risk factors for VAWG from an intersectional and intergenerational perspective and discuss the consequences of such experiences for women’s health.

The protocol will be conducted according to the Joanna Briggs Institute Methodology for Scoping Reviews and will involve six consecutive steps: (1) formulating the research question, (2) search strategy, (3) study selection, (4) eligibility criteria, (5) data extraction, (6) data analysis and presentation of results and (7) stakeholder consultation. The search strategy will include eight indexed databases (PubMed, BVS, Scopus, Web of Science, EMBASE, Cinahl, Cochrane Library and PsycInfo) and recommendations from professional organisations and international agencies. The search will be limited to publications in English, Spanish and Portuguese, according to the Health Sciences Descriptors/Medical Subject Headings and free terms. Two independent researchers will select articles based on the inclusion criteria, and a third author will be consulted to establish consensus. Data extraction will involve a form with information on study characteristics, methodological issues and main results from the sources of evidence. Extracted data will be analysed using descriptive and content analysis. The NVIVO 14 software will be used to organise and validate the data. The protocol was registered in the Open Science Framework (DOI 10.17605/OSF.IO/P6H2S).

Ethical approval is not required as data from publicly available literature sources will be used. The results will be disseminated through publications in scientific journals and presentations of the evidence to stakeholders.

The open, prospective Community-Based chronic Care Lesotho (ComBaCaL) cohort is the first study to comprehensively investigate socioeconomic indicators, common chronic diseases and their risk factors in a remote rural setting in Lesotho. It serves as a platform for implementing nested trials using the Trials within Cohorts (TwiCs) design to assess community-based chronic care interventions. In this study, we present the cohort’s sociodemographic and chronic disease risk factor profile, including self-reported HIV prevalence and hypertension and diabetes care cascades.

Since February 2023, community health worker (CHWs) supported by a clinical decision support and data collection application have enrolled inhabitants from 103 randomly selected rural villages in Butha-Buthe and Mokhotlong districts in Northeast Lesotho. As of 31 May 2024, the cohort includes 5008 households with 14 735 participants (55% female, median age 19 years). The cohort’s socioeconomic status is low with an International Wealth Index of 26, a monthly household income of US$42.4 and low levels of formal education. Among the 7917 adult participants, 42.5% are overweight or obese, with higher rates among women, and 33.1% smoke tobacco, with higher rates among men. Self-reported HIV prevalence is 15.1% with a 98.4% treatment rate. Hypertension prevalence is 17% with a 56% control rate and diabetes prevalence is 4% with a 39% control rate.

The cohort’s low socioeconomic status is linked to multiple health risks including insufficient access to clean energy, essential healthcare services, adequate sanitary facilities and secure food supply. Besides the expected high HIV prevalence, we found significant hypertension, diabetes and cardiovascular risk factor prevalences. While treatment and control rates for diabetes and hypertension are higher than in similar settings, they remain below global targets.

Ongoing cluster-randomised TwiCs, which will be completed in 2025, are assessing the effectiveness of community-based, CHW-led care interventions for diabetes and hypertension. CHWs will continue to closely monitor the cohort and integrate additional measurements such as HIV testing. This will provide further insights into the dynamics and interactions of chronic diseases and inform the development of future nested trials on innovative community-based prevention and care interventions.

NCT05596773.

The global population is ageing with percentages of older adult individuals aged 65 years and older projected to increase from 17% in 2020 to 22% in 2040. Therefore, comprehensive approaches that integrate health and social care are increasingly vital to address the needs of the older population and promote healthy ageing. The WHO defines healthy ageing as maintaining functional ability and well-being in later life, emphasising holistic health beyond disease absence. Older adults’ health outcomes are influenced by social determinants of health (SDH) encompassing factors across various domains including healthcare access, education access, social and community context, neighbourhood and built environments and economic stability. Research on healthy ageing is mainly focused on healthcare achievements, but designing comprehensive measures requires attention to the full spectrum of SDH. This protocol describes the scoping review that aims to collate and critically appraise published articles on SDH measures in older adults to promote healthy ageing.

The scoping review will follow Arksey-O’Malley five-stage scoping review method and the Joanna Briggs Institute’s Scoping Review Methods Manual. Studies available in English-language published from 1 January 2015, the year the WHO’s first World Report on Ageing and Health was published, and up to 1 February 2025, will be identified from databases including PubMed, Scopus, CINAHL and Cochrane Database for Systematic Reviews. Two reviewers will screen titles and abstracts, followed by independent full-text screenings for inclusion. After data extraction, a narrative synthesis will be performed. Experts in the field will be consulted to ensure the results’ feasibility and relevance.

Ethical approval is not required for this review since it relies on available data. The results of the review will be disseminated through publication in journals and presentations at local, regional and global healthy ageing conferences or any related conferences.

Emerging adulthood is a new life stage characterised by identity exploration, instability, self-focus, a feeling of ‘being in-between’ and the perception of a range of possibilities. Emerging adults may experience difficulties in their well-being during this complex stage. Adaptive emotion regulation can improve levels of well-being. Previous studies have shown that new technologies can enhance social-emotional competencies in this population. The purpose of the study is to design and implement a serious game, emoWELL, which improves knowledge and the use of adaptive skills of emotion regulation to improve well-being during emerging adulthood.

The participants will be 385 emerging adults aged 18–29 years. They will be randomly assigned to either the control or experimental group. The experimental group will complete the emoWELL serious game. The game takes place on a train ride with several stops where the player will learn about emotion regulation. To assess the effectiveness of emoWELL, psychological assessment instruments validated in the Spanish population will be used. The primary expected outcomes include characteristics of emerging adulthood, emotion regulation (emotion dysregulation, emotion regulation strategies and cognitive reappraisal and expressive suppression) and psychological well-being. The secondary expected outcomes are self-esteem, psychological distress, loneliness and optimism. The assessment will occur at two different time points: pretest (T1) and post-test (T2) to observe improvements in the variables of interest.

The study has been approved by the Ethics Committee of the Universitat de València (2013883) and will follow the standards of the Declaration of Helsinki for data collection. The findings will be shared with the scientific community. The intellectual property registration number is as follows: UV-SW-202460R.

NCT06049407.

This study aims to assess the level of cardiovascular disease (CVD) risk and its associated determinants among hypertensive patients in Jigjiga, Somali Region, Ethiopia using the WHO 10-year CVD risk score.

An institution-based cross-sectional study design was employed.

Hypertensive patients aged 40–74 years in two public hospitals in Jigjiga, Somali Region, Ethiopia, from 20 December 2023 to 20 February 2024.

Randomly selected 344 hypertensive patients aged 40–74 years with a duration of 1 year or more from the time of diagnosis and at least having 6-month follow-up.

10-year CVD risk level was assessed by using WHO 10-year CVD risk score. Risk levels were categorised as low (

Associated factors influencing CVD risk.

The study included 341 hypertensive individuals, with a 99.1% response rate. Of the respondents, 58.9% were men. The overall prevalence of CVD risk within the coming 10 years was 134 (39.3%; 95% CI: 34.1% to 44.5%). Multivariable logistic regression analysis identified age, khat chewing, smoking and comorbid conditions as significant independent predictors of CVD risk. Specifically, individuals aged 60–69 years had an adjusted OR (AOR) of 3.97 (95% CI: 1.94 to 8.16) and those aged 70–74 years had an AOR of 2.99 (95% CI: 1.57 to 5.71). Khat chewers had an AOR of 2.58 (95% CI: 1.22 to 5.46), smokers an AOR of 3.44 (95% CI: 1.59 to 7.48) and individuals with comorbidities an AOR of 2.42 (95% CI: 1.47 to 3.99).

There is a significant increase in 10-year CVD risk among hypertensive patients in the study area. Age, khat chewing, smoking and comorbidities were independent predictors. Regular CVD risk screening for older patients, focused health education to reduce khat and tobacco use and integrated management of comorbidities are essential to lower future cardiovascular risk.

Globally, about 74% of deaths are attributed to non-communicable diseases (NCDs). Tobacco use is one of the key risk factors of NCDs. Tobacco taxes can discourage the use of tobacco. However, how increasing tobacco taxation may reduce the burden of NCDs is not well studied.

This study examines whether higher cigarette taxes are associated with reduced premature deaths—death before the age of 70—from NCDs using multicountry panel data.

The study analysed country-level panel data of 152 countries from 2008 to 2020 collected from various sources. The annual burden of NCDs was measured by the proportion of deaths due to NCDs before age 70 in each country. The tax rate on cigarettes—both specific and total—was used as a key explanatory variable. Other covariates include MPOWER score net of taxes, tobacco prevalence and other country-level characteristics. Panel data regressions with various combinations of country and year fixed effects were used to estimate the association between tobacco taxation and the burden of NCDs.

Cigarette tax was significantly (p

The study provides important evidence that increasing tobacco taxation could be an effective tool in reducing the burden of NCDs. Countries aiming to curb the burden of NCDs could consider raising tobacco taxes.

This study aims to assess the economic feasibility and broader policy implications of the Korea International Cooperation Agency’s (KOICA) official development assistance (ODA) projects for the COVID-19 emergency response in Uzbekistan through a cost–benefit analysis. The primary research question is to evaluate whether the interventions provide sufficient economic returns relative to their costs while informing future pandemic preparedness of response strategies.

A cost–benefit analysis using quantitative methods was performed to assess the financial impact of the COVID-19 ODA projects.

The study was conducted in Uzbekistan, focusing on KOICA’s COVID-19 emergency response projects from January 2020 to December 2021.

The intervention involved the implementation of KOICA’s COVID-19 emergency response activities, including early diagnosis support, establishment of rapid response bases, provision of medical equipment and emergency relief efforts in Uzbekistan.

The primary outcome measure is the net present value (NPV) and benefit/cost ratio of the project. Secondary outcome measures are the project’s effectiveness in terms of death prevention, reduction in medical costs and timely COVID-19 testing.

The analysis revealed a total programme cost of US$11 353 173, with a net benefit ranging from US$21 026 032 to US$34 573 403, and a benefit/cost ratio between 1.85 and 3.05. A detailed examination of costs and benefits highlighted the programme’s positive NPV and benefit/cost ratio, indicating its economic feasibility. The study also underscored the programme’s effectiveness in preventing deaths, reducing medical costs and providing timely COVID-19 testing.

The findings confirm that KOICA’s COVID-19 emergency response projects in Uzbekistan were economically viable and effective. The study highlights the importance of integrating economic evaluations into ODA assessments, particularly for emergency response and infectious disease control. It recommends expanding the use of quantitative analysis to optimise resource allocation and improve decision-making in future global health crises.

Fathers are intricately bound to the experience of adolescent mothers and their children. Yet, fathers of children born to adolescent mothers, particularly within the context of HIV, remain neglected in the literature. These exploratory analyses provide insight into the characteristics of fathers of children born to adolescent mothers affected by HIV in South Africa.

Eastern Cape Province, South Africa.

Cross-sectional data from a prospective cohort study.

Young mothers (10–24 years of age) and their children (0–68 months). All mothers completed detailed study questionnaires, including standardised and study-specific measures, relating to their self, their children and the fathers of their children. Summary statistics are presented based on maternal self-report of father characteristics. ² tests and t-tests (Fisher’s exact/Kruskal-Wallis tests, where appropriate) were additionally used to explore sample characteristics (including father characteristics, maternal experience and child characteristics) according to paternal age and father involvement in childcare (defined by responses to four maternal self-report questions). Father characteristics were also explored according to maternal HIV status and maternal mental health status.

40% of fathers were adolescents (10–19 years) at the birth of their children. Overall, father involvement was low (19.5%). Compared with noninvolved fathers, involved fathers were more likely to be older when their child was born (21 years vs 20 years, t=4.30, p=0.04), to be in a relationship with the mothers of their children (74.8% vs 47.2%, ²=40.8, p≤0.0001), to reside with their children and their mothers (14.7% vs 3.7%, ²=49.3, p≤0.0001) and to attend the first antenatal appointment (4.3% vs 1.5%, ²=5.21, p=0.02). A quarter (25.4%; 227/894) of the adolescent mothers in the sample were living with HIV. The prevalence of maternal HIV was found to be higher among adolescent mothers of children born to older fathers compared with adolescent fathers (31.7% vs 15.9%, ²=28.3, p≤0.001). Likewise, depressive symptoms were more prevalent among adolescent mothers of children born to older fathers compared with adolescent fathers (9.9% vs 5.3%, ²=6.08, p=0.01). Adolescent mothers reporting poor mental health were less likely to be in a relationship with the fathers of their children (41.8% vs 54.1%, ²=7.32, p=0.03) and more likely to experience domestic violence perpetrated by the fathers of their children (8.2% vs 3.3%, ²=6.07, p=0.01) and to engage in arguments about finances with the fathers of their children (30.0% vs 17.0%, ²=10.8, p=0.001). While some differences in individual subscales were identified, overall composite scores of child cognitive development did not differ according to father age or father involvement.

Analyses provide the first preliminary description of the fathers of children born to adolescent mothers affected by HIV in South Africa. Fathers are inherently tied to the experiences of adolescent mothers and their children. Father involvement with their children was low. Further research is required to explore the potential barriers to father involvement and pathways to overcome these. Efforts to bolster father engagement, such as the inclusion of fathers within maternal and child service provision, may have benefits for fathers, adolescent mothers and their children. There was a high prevalence of adolescent fatherhood in the study. Adolescent fathers may have specific needs requiring tailored intervention for adolescent parent families. The need for the inclusion of fathers within policy, programming and research remains.