Category: Nevin Manimala

Malar J. 2026 Jun 26. doi: 10.1186/s12936-026-06014-8. Online ahead of print.

ABSTRACT

Malaria remains a significant public health challenge in Bangladesh with ongoing transmission driven primarily by Plasmodium falciparum and Plasmodium vivax. Understanding its current prevalence and parasite distribution is essential for guiding control and elimination strategies. This study aims to estimate the pooled prevalence of malaria and its major parasite species across the country. A comprehensive literature search was conducted in PubMed, Science Direct, EMBASE and Google Scholar for studies published between 2005 to 2025. Eligible studies were assessed for quality using the Joanna Briggs Institute (JBI) tool. Pooled prevalence estimates were calculated using random-effects models while heterogeneity and inconsistencies were evaluated using the I² index and Cochran’s Q-test. Publication bias was assessed with funnel plots and Egger’s test. Of 10,152 identified studies, 14 met inclusion criteria. The pooled malaria prevalence in Bangladesh was 16% (95% CI 6%-37%) with high heterogeneity (I² = 99.6%, p = 0). Subgroup analyses showed prevalence’s of 14% (95% CI 9%-21%) for P. vivax, 80% (95% CI 68%-88%) for P. falciparum and 7% (95% CI 4%-13%) for mixed infections. Malaria prevalence was higher in males (20%, 95% CI 7%-47%) than females (12%, 95% CI 3%-35%). Funnel plot asymmetry was observed but Egger’s test indicated no significant publication bias. Sensitivity analyses confirmed the robustness of the findings. However, the findings should be interpreted with caution as reliance on microscopy and rapid diagnostic tests may have limited the detection of non-falciparum, mixed-species and submicroscopic malaria infections. This study highlights the substantial malaria burden in Bangladesh, driven mainly by P. falciparum and P. vivax and underscores the need for targeted, species-specific and gender-sensitive interventions to accelerate malaria control and elimination.

PMID:42363176 | DOI:10.1186/s12936-026-06014-8

Int J Equity Health. 2026 Jun 26. doi: 10.1186/s12939-026-02918-8. Online ahead of print.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, socially disadvantaged populations in France faced higher risks of infection and severe forms of COVID-19, particularly among marginalized groups such as Travellers, a population predominantly composed of nationals residing in either static or mobile caravans. In France, few studies have investigated Travellers’ experiences and preventive behaviours, with existing research limited to a small number of epidemiological outcomes prior to the pandemic. This study addresses this gap by exploring how living conditions and social exclusion shaped Travellers’ experiences of the pandemic and their responses to government measures.

METHODS: We conducted a sequential explanatory mixed-methods study, combining questionnaires and semi-structured interviews among Travellers in the region of Nouvelle-Aquitaine, France. Quantitative data assessed health status, prevention practices including COVID-19 vaccination and living conditions. Qualitative data provided deeper insight into Travellers’ experiences, perceptions and attitudes towards the government’ handling of the health crisis. Questionnaire data were analysed using descriptive statistics and multivariable logistic regression to identify factors associated with COVID-19 vaccination (≥ 1 dose). Interview data were analysed using Braun and Clarke’s six-phase thematic analysis framework.

RESULTS: Among 406 participants, 52.6% reported probable COVID-19 infection (based on a positive test or clinical symptoms) since the onset of the pandemic, of whom 9.2% reported to have been hospitalized. 30.0% of participants reported COVID-19 vaccination compared with 85% in the French general population. Vaccination was associated with being a woman, older age, living in stable housing, prior measles-mumps-rubella vaccination, receiving clear information from health authorities, and trust in the French government’s pandemic response. Interviewees reported that overcrowded, underserved living conditions hindered adherence to preventive measures, while fear of infection disrupted social interactions, increased feelings of confinement, and heightened psychological distress.

CONCLUSIONS: The COVID-19 pandemic disproportionately impacted Traveller communities in France, with structural vulnerabilities increasing both exposure and severe outcomes. These findings highlight the need for inclusive public health responses to avoid increasing preexisting health inequalities in future pandemic crisis. Effective strategies should integrate community perspectives, engage healthcare and social professionals, and tailor vaccination approaches to the specific vulnerabilities and socio-historical contexts shaping behaviours in marginalised populations.

PMID:42363165 | DOI:10.1186/s12939-026-02918-8

BMC Med Inform Decis Mak. 2026 Jun 26. doi: 10.1186/s12911-026-03655-2. Online ahead of print.

ABSTRACT

BACKGROUND: Toxic encephalopathy (TE) is a serious neurological complication among critically ill patients and is associated with considerable disability and mortality. Early risk prediction is essential for timely intervention and improved outcomes. However, evidence on prognostic modeling in TE remains limited. The primary objective of this study was to develop and validate a prognostic nomogram for predicting 28-day mortality in critically ill patients diagnosed with TE and to evaluate its clinical utility.

METHODS: Adult patients diagnosed with TE were retrospectively selected from the MIMIC-IV database based on relevant International Classification of Diseases (ICD) codes. Baseline demographic, clinical, and laboratory variables were extracted, and candidate predictors were selected through univariate logistic regression analyses based on clinical relevance and statistical significance. Subsequently, a multivariable logistic regression model was developed and presented as a nomogram. The value of the predictive model was evaluated using the area under the ROC curve (AUC), calibration curve, and decision curve analysis (DCA). Its potential clinical applicability was further assessed with a clinical impact curve (CIC).

RESULTS: A total of 3039 patients with TE were included, among whom 526 (17.3%) died within 28 days. The cohort was randomly divided into training and validation cohorts at a 7:3 ratio. The final model incorporated age (OR = 1.022, 95% CI: 1.013-1.032), heart rate (OR = 1.007, 95% CI: 1.001-1.013), hemoglobin (OR = 0.904, 95% CI: 0.852-0.958), albumin (OR = 0.677, 95% CI: 0.546-0.836), PaO₂ (OR = 0.998, 95% CI: 0.996-0.999), SOFA score (OR = 1.094, 95% CI: 1.043-1.148), APACHE II score (OR = 1.038, 95% CI: 1.011-1.066), and acute kidney injury (OR = 1.520, 95% CI: 1.132-2.501). The nomogram exhibited acceptable discriminative ability, with AUC values of 0.750 (95% CI: 0.725-0.776) and 0.757 (95% CI: 0.715-0.799) in the training and validation cohorts, respectively, along with satisfactory calibration. Furthermore, decision curve analysis (DCA) and clinical impact curve (CIC) results supported its clinical utility for individualized risk stratification.

CONCLUSION: Utilizing the MIMIC-IV database, we constructed and validated a prognostic nomogram to predict 28-day mortality in critically ill patients with TE. This tool may help clinicians identify high-risk individuals and optimize monitoring and supportive care.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42363142 | DOI:10.1186/s12911-026-03655-2

BMC Med Educ. 2026 Jun 26. doi: 10.1186/s12909-026-09766-8. Online ahead of print.

ABSTRACT

BACKGROUND: Although oxygen therapy (OT) is a fundamental and life-saving intervention in the management of hypoxemia, it may lead to serious complications when applied incorrectly or in an uncontrolled manner. The aim of this study is to evaluate the knowledge levels and attitudes of healthcare professionals working in a tertiary hospital in Somalia regarding OT administered to non-intubated patients.

METHODS: This descriptive cross-sectional study was conducted between 17 February and 2 March 2025 at Mogadishu Recep Tayyip Erdoğan Training and Research Hospital. A structured 23-item survey evaluating knowledge and attitudes related to OT was administered face-to-face to healthcare professionals consisting of nurses, resident physicians, and attending physicians. Knowledge levels were classified as poor (< 60%), moderate (60-79%), and good (≥ 80%) based on the percentage of correct responses. p < 0.05 was considered statistically significant.

RESULTS: A total of 195 healthcare professionals participated in the study (42.6% nurses, 35.9% resident physicians, and 21.5% attending physicians). Overall, 49.2% of the participants (95% CI: 42.2% – 56.2%) reported knowing how to administer OT, though knowledge levels were predominantly poor across all professional groups regarding specific technical parameters, and 70% of nurses and 90% of physicians stated that OT training should be received (p = 0.223). The rate of receiving training before starting duty was higher among nurses (71.1%) than among residents (44.3%) (p = 0.003). As training sources, nurses more frequently reported school and orientation training, while attending physicians more frequently reported conferences/course programs (p < 0.001). Guideline use rates were similar across groups and were generally limited. Knowledge levels regarding low- and high-flow OT systems, indications, and monitoring parameters were poor in all groups. Knowledge of oxygen toxicity was higher among physicians than nurses (p = 0.001), and no significant difference was found among the groups in terms of awareness of morbidity and mortality (p = 0.189).

CONCLUSIONS: This study provides descriptive and hypothesis-generating data highlighting significant knowledge gaps regarding OT among healthcare professionals in a resource-limited setting. The findings suggest a critical need for standardized protocols and continuous training programs, though future prospective studies are required to determine the causal relationships between these knowledge gaps and actual clinical practice or patient outcomes.

PMID:42363139 | DOI:10.1186/s12909-026-09766-8

BMC Pregnancy Childbirth. 2026 Jun 26. doi: 10.1186/s12884-026-09463-w. Online ahead of print.

ABSTRACT

BACKGROUND: Recent studies indicate that negative body image adversely affects the physical and psychological well-being of pregnant women and undermines family harmony, thereby jeopardizing maternal and infant health. Despite its significant impact, this issue has received scant scholarly attention in China. Body image is not formed in isolation; according to the socio-cultural model, it is constructed through the dynamic interplay of socio-cultural context, family interactions, media messages, and social comparisons. Therefore, it is imperative to investigate the current status and influencing factors of body image among pregnant women in China to establish an evidence base for developing culturally targeted interventions.

METHODS: An exploratory sequential mixed-methods design was employed. Phase 1 involved semi-structured in-depth interviews with 17 pregnant women, analyzed using reflexive thematic analysis to develop themes. Phase 2 consisted of a questionnaire survey with 160 pregnant women, utilizing a self-designed questionnaire, the Chinese version of the Body Image in Pregnancy Scale (BIPS), the Perceived Social Support Scale (PSSS), and the Simplified Coping Style Questionnaire (SCSQ). SPSS 25 was utilized for statistical analysis. The qualitative findings directly informed the focus and variable selection for the quantitative phase.

RESULTS: Three qualitative themes emerged: key factors influencing body image, consequences and outcomes of body image, and the desire for recognition and support. Quantitatively, body image dissatisfaction was moderate (BIPS score: 97.78 ± 15.57). Multiple linear regression identified greater gestational weight gain (β = 0.691, p = 0.008), lower family support (β = -0.804, p = 0.015), and parity (β = -6.819, p = 0.022) as significant predictors of poorer body image. Qualitative insights provided contextual depth to these statistical associations.

CONCLUSIONS: Body image dissatisfaction was moderate among Chinese pregnant women and is influenced by weight gain, family support, and parity. The exploratory sequential design allowed for a deep understanding of lived experiences before quantitative measurement, ensuring the relevance of the measured constructs. Interventions should focus on weight management education and enhancing family support, particularly for first-time mothers, while also addressing and challenging the broader socio-cultural expectations surrounding unrealistic body ideals during pregnancy and the postpartum period.

PMID:42363134 | DOI:10.1186/s12884-026-09463-w

BMC Womens Health. 2026 Jun 26. doi: 10.1186/s12905-026-04623-8. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer remains a major public health concern in Tunisia. Despite national efforts, significant gaps persist in women’s knowledge and uptake of early detection practices. Understanding the determinants of these behaviors is critical for improving screening coverage. This study aimed to identify factors associated with breast self-examination (BSE) and mammography screening among women attending primary healthcare centers in Monastir, Tunisia.

METHODS: We conducted a cross-sectional study in the governorate of Monastir from May to October 2023. Data were collected using a structured questionnaire specifically developed for the study objectives. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of BSE and mammography uptake. Data were analyzed using IBM SPSS statistics version 21.

RESULTS: Among 439 women included, 80.6% reported awareness of BSE as an early detection method and 53.1% reported performing it monthly. In multivariate analysis, awareness of BSE (Adjusted odds ratio: AOR = 6.38; 95% CI: 3.41-11.90), having a family history of breast cancer (AOR = 2.03; 95% CI: 1.07-3.87) and older age (AOR = 1.042; 95% CI: 1.024-1.060) were independent associated factors with BSE practice. Among 192 women aged over 45 years, 35% had undergone mammography at least once. In multivariate analysis, the factors associated with mammography screening were BSE practice (AOR = 2.60; 95% CI: 1.22-5.55) and the knowledge of the recommended age for mammography initiation (AOR = 2.28; 95% CI: 1.17-4.45).

CONCLUSION: The practice of BSE and especially mammography among participants remains relatively low. Targeted education and awareness-raising efforts are therefore essential to increase the use of breast cancer screening and early detection methods.

PMID:42363129 | DOI:10.1186/s12905-026-04623-8

BMC Cancer. 2026 Jun 26. doi: 10.1186/s12885-026-16308-4. Online ahead of print.

ABSTRACT

This study evaluates within-subject temporal differences between tumor and body temperatures using three cancer models: melanoma, breast cancer, and colon cancer, to monitor the effects of immunotherapy and chemotherapy on temperature differences. In the melanoma arm, TRP-2 immunotherapy led to increased tumor temperatures compared to the control group, with significant overall treatment separation observed at 58 h into the treatment protocol. For breast cancer, AC-Taxol chemotherapy resulted in a drop in body temperature for both treatment and control groups, with significant treatment group separation on tumor vs. body observed at 96 h. In colon cancer, anti-PD-1 immunotherapy showed an upward trend in tumor temperatures, with significant separation from the control group at 94 h. A series of statistical tests, including mixed-model repeated measures and non-parametric tests, revealed significant differences in temperature trends between treatment and control groups for all cancer types. Furthermore, examination of radial smoothing repeated measures models revealed how the clinical application of this technology could be applied. These results suggest that temperature-based monitoring may be an effective tool for assessing therapeutic responses in cancer treatments, highlighting the utility of thermal measurements in evaluating immunotherapy and chemotherapy efficacy.

PMID:42363127 | DOI:10.1186/s12885-026-16308-4

BMC Med Educ. 2026 Jun 26. doi: 10.1186/s12909-026-09107-9. Online ahead of print.

ABSTRACT

BACKGROUND: Acute oncology e-learning for staff who treat and care for people with cancer in the United Kingdom exists; however standardised, acute oncology competence assessment does not. This study reports the development and evaluation of a standardised acute oncology competence assessment integrated within an existing e-learning resource, which ultimately aims to improve cancer patient safety outcomes across the UK. The e-learning and assessment were developed for multidisciplinary staff working in any clinical setting where patients with cancer may present with urgent or emergency symptoms. For example, acute medical units, accident and emergency, same day emergency care, primary care and pre-hospital settings, such as paramedic services and general practice, as well an introductory resource for staff new to working in oncology.

METHODS: The study team, multidisciplinary professionals and cancer-specialist educators from across the UK co-designed a Digital Competence Assessment for ‘practice Level 1’. An existing ‘Introduction to Acute Oncology E-learning Module’ was revised to include the novel Digital Competence Assessment (together the e-learning and competence assessment were termed: The Level 1 Acute Oncology Passport). This was piloted and evaluated across the UK during Phase 2. Quantitative data from pre (n = 376) and post (n = 176) Level 1 Acute Oncology Passport responses were analysed using descriptive and inferential statistics. Free-text responses were analysed using content analysis.

RESULTS: There was a significant increase in learners’ level of confidence about their acute oncology knowledge and skills pre and post e-learning and digital competence assessment. The Level 1 Acute Oncology Passport was evaluated as relevant, pitched at the correct level and an appropriate measure for assessing acute oncology knowledge and skills competencies. The main challenge reported was lack of study time. There was also a desire for support of acute oncology knowledge and skills development in the workplace, alongside or following e-learning.

CONCLUSIONS: Acute oncology is an important area of practice for improving outcomes for people with cancer, but for acute oncology to be effective it requires a knowledgeable and skilled workforce. The acute oncology learning needs of staff caring for people with cancer in other countries are likely to be similar to the UK. Although respondents were staff who opted to complete the online learning, assessment and evaluation survey, our e-learning and digital assessment of competence Passport was found to be engaging, relevant and acceptable, demonstrating the value of co-design. It also increased learners’ confidence and knowledge about acute oncology. However, dedicated time and support are needed for healthcare staff to develop knowledge and skills to ensure safe outcomes for people with cancer. We suggest that similar education and competence assessment resources are needed to address acute oncology learning needs among the broader cancer care workforce.

PMID:42363126 | DOI:10.1186/s12909-026-09107-9

BMC Pediatr. 2026 Jun 26. doi: 10.1186/s12887-026-07191-w. Online ahead of print.

ABSTRACT

BACKGROUND: Inclusive adapted physical activity and parasport programs support physical and psychosocial well-being of children experiencing disability. Easter Seals offers opportunities for children of all abilities to engage in physical activity through introductory parasports.

PURPOSE: Our evaluation aimed to understand caregiver’s perspectives on quality participation in Easter Seals programs.

METHODS: We collected quantitative and qualitative data through surveys followed by semi-structured interviews to further explore survey data findings. Survey data were analyzed using descriptive statistics and interviews using reflexive thematic analysis.

RESULTS: Surveys highlighted caregiver-perceived participant satisfaction and a caregiver-perceived positive impact of programs on participants’ physical and psychosocial well-being. Five themes were generated: (1) caregiver support and dedication, (2) meaningful participation, (3) mastery of skills, (4) thriving alongside peers, and (5) hopes for the future.

CONCLUSION: Findings illustrate the importance of thoughtfully designed programs, focused on quality participation, for children experiencing disability and their families.

PMID:42363123 | DOI:10.1186/s12887-026-07191-w

BMC Infect Dis. 2026 Jun 26. doi: 10.1186/s12879-026-13670-3. Online ahead of print.

ABSTRACT

BACKGROUND: Prolonged antiretroviral therapy (ART) in people living with HIV (PLWH) is associated with progressive bone mineral density (BMD) loss and an elevated risk of osteoporosis and fragility fractures. However, validated diagnostic tools for osteoporosis tailored to elderly PLWH remain scarce. This study aimed to develop and internally validate a nomogram-based diagnostic prediction model for osteoporosis in elderly PLWH (postmenopausal women and men aged ≥ 50 years) receiving ART.

METHODS: This retrospective cross-sectional study enrolled elderly PLWH who had initiated ART at a single center between September 2010 and July 2022 and had received ART for ≥ 12 months. BMD was assessed by dual-energy X-ray absorptiometry (DXA) during a cross-sectional survey conducted from January to June 2022, and osteoporosis was defined according to the World Health Organization criteria (T-score ≤ – 2.5). Predictor selection was performed using the least absolute shrinkage and selection operator (LASSO) regression. Multivariable logistic regression was subsequently applied to construct a diagnostic prediction nomogram. Model performance was evaluated using the concordance index (C-index), calibration plots, and decision curve analysis (DCA). Internal validation was conducted using bootstrapping with 1,000 resamples.

RESULTS: Among 256 eligible patients, 102 (39.8%) were diagnosed with osteoporosis. LASSO regression identified six predictors with nonzero coefficients, and one additional predictor (baseline CD4 count) was incorporated based on clinical evidence, yielding a seven-variable nomogram: Sex, Ratio of Age and BMI, Duration of ART, Baseline CD4 + count, tenofovir disoproxil fumarate (TDF) regimen, β-C-terminal telopeptide of type I collagen (β-CTX), and procollagen type I N-terminal propeptide (PINP). The model achieved a C-index of 0.709 (95% confidence interval [CI]: 0.645-0.773) with good calibration (mean absolute error: 0.014). Internal validation yielded a bias-corrected C-index of 0.695. DCA demonstrated positive net clinical benefit across threshold probabilities ranging from 0.0 to 0.7.

CONCLUSION: We developed and internally validated a nomogram incorporating seven clinical and biochemical predictors including Ratio of Age and BMI, Duration of ART, TDF Regimen, β-CTX, PINP, Sex and Baseline CD4 count for the diagnosis of osteoporosis in elderly PLWH receiving ART. The model demonstrated acceptable discrimination, satisfactory calibration and favorable clinical utility. External validation in independent, multi-center cohorts is warranted before clinical implementation.

PMID:42363121 | DOI:10.1186/s12879-026-13670-3