Bowel Disorder Incidence and Rectal Spacer Use in Patients With Prostate Cancer Undergoing Radiotherapy.

Importance: The polyethylene glycol-based hydrogel spacer (PHS) system temporarily separates the rectum from the prostate in patients undergoing radiotherapy (RT) for prostate cancer (PCa).

Objective: To compare incidence of bowel disorders and related procedures in patients receiving RT with and without PHS.

Design, Setting, And Participants: This retrospective cohort study used 4 datasets: Medicare 5% Standard Analytic Files, Medicare 100% Standard Analytic Files, Merative MarketScan Commercial Database, and Premier Healthcare Database.

Risk Factors for Adverse Outcomes Following Ureteroscopy for Stone Management in US Medicare Patients.

Objective: To evaluate the proportion of US Medicare patients undergoing ureteroscopy (URS) for kidney stone management at risk for adverse outcomes and analyze the association between risk factors and adverse events.

Methods: Data from Medicare patients aged ≥65 who underwent URS between 2019 and 2023 were analyzed. Nine risk factors were examined for their prevalence and association with sepsis and intensive care unit (ICU) admission within 30 days, extended length of stay (LOS) during the index procedure, and death within 90 days.

Closing the gap on vaccine uptake in developing countries: Is there a role for cash incentives?

Vaccination saves lives, yet vaccine uptake remains insufficient particularly in developing countries. While various approaches have been used to improve vaccine uptake, this review focuses on the potential of cash incentives to address this issue in developing countries. We examine the role and criticism of cash incentives and offer suggestions for reducing health disparities through targeting.

Cost savings associated with extended battery longevity in cardiac resynchronization therapy defibrillators.

Background: Cardiac resynchronization therapy-defibrillators (CRT-D) are devices established as treatment for symptomatic heart failure patients at risk of sudden cardiac death. Battery depletion poses a significant clinical and economic burden; extended service life may reduce costs because of generator changes and associated complications.

Objective: This study estimated cost-savings associated with extended battery longevity in Medicare patients receiving CRT-D implantation.

Trends of the second measles vaccine (MCV2) over time after its launch as part of routine immunization in Nigeria: a brief research report.

Introduction: Nigeria has one of the highest measles burdens and the lowest vaccination coverage in the world. Geographical disparity in the coverage has also been persistent. Between 2019 and 2021, the Nigerian government introduced the second Measles vaccine (MCV2) into routine immunization (RI).

Cost-effectiveness of a simplified acute malnutrition program: a secondary analysis of the OptiMA randomized clinical trial in the Democratic Republic of the Congo.

Acute malnutrition (AM) causes large loss of life and disability in children in Africa. Researchers are testing innovative approaches to increase the efficiency of treatment programs This paper presents results of a cost-effectiveness analysis of one such program in the Democratic Republic of the Congo (DRC) based on a secondary analysis of a randomized controlled trial Optimizing Treatment for Acute Malnutrition (OptiMA), conducted in DRC in 2018-20. A total of 896 children aged 6-59 months with a mid-upper arm circumference (MUAC) <125 mm or with oedema were treated and followed for 6 months.

Estimating immunization coverage at the district level: A case study of measles and diphtheria-pertussis-tetanus-Hib-HepB vaccines in Ethiopia.

Ethiopia has made significant progress in the last two decades in improving the availability and coverage of essential maternal and child health services including childhood immunizations. As Ethiopia keeps momentum towards achieving national immunization goals, methods must be developed to analyze routinely collected health facility data and generate localized coverage estimates. This study leverages the District Health Information Software (DHIS2) platform to estimate immunization coverage for the first dose of measles vaccine (MCV1) and the third dose of diphtheria-pertussis-tetanus-Hib-HepB vaccine (Penta3) across Ethiopian districts ("woredas").

Association between achieving adequate antenatal care and health-seeking behaviors: A study of Demographic and Health Surveys in 47 low- and middle-income countries.

Background: Antenatal care (ANC) is essential for ensuring the well-being of pregnant women and their fetuses. This study models the association between achieving adequate ANC and various health and health-seeking indicators across wealth quintiles in low- and middle-income countries (LMICs).

Methods And Findings: We analyzed data from 638,265 women across 47 LMICs using available Demographic and Health Surveys from 2010 to 2022.

How did the introduction of the measles-containing vaccine second dose (MCV2) affect measles vaccine uptake? - evidence from Nigeria.

Nigeria has the highest burden of measles worldwide, as measles vaccine uptake remains low. Recently, the second dose of the measles-containing vaccine (MCV2) was introduced as part of the routine immunization (RI) program, and this study examined how it changed the uptake of the measles vaccine and the factors associated with vaccination behavior. The Nigeria Multiple Indicator Cluster Survey (MICS) 2021 was used to compare measles vaccination uptake as well as factors associated with vaccination uptake between children before MCV2 introduction (cohort 1) and after the introduction (cohort 2).

Evolution in key indicators of maternal and child health across the wealth gradient in 41 sub-Saharan African countries, 1986-2019.

Background: Aggregate trends can be useful for summarizing large amounts of information, but this can obscure important distributional aspects. Some population subgroups can be worse off even as averages climb, for example. Distributional information can identify health inequalities, which is essential to understanding their drivers and possible remedies.

Factors associated with knowledge and use of home pregnancy test kits in Uganda.

Early detection of pregnancy status may help women initiate earlier antenatal care and healthy pregnancy behaviors, which could lead to healthier mothers and infants. Pregnancy tests are inexpensive and easy to use; meanwhile, little attention has been given to understanding women's knowledge and use of home pregnancy tests, especially in developing countries. We analyze cross-sectional data collected from 1,008 women ages 18-35, living in Northern Uganda in 2019, who are most likely to be uncertain about their pregnancy status.

Childhood exposure to armed conflict and nutritional health outcomes in Nigeria.

Background: Armed conflicts are associated with an increased risk of food insecurity, the leading cause of malnutrition in low-and-middle-income countries. Multiple studies have uncovered significant influences of childhood malnutrition on children's overall health and development. As a result, it is increasingly important to understand how childhood experience of armed conflict intersects with childhood malnutrition in conflict-prone countries like Nigeria.

Vaccine hesitancy against COVID-19 vaccine over time in Nigeria.

Introduction: While COVID-19 pandemic is an ongoing threat for our lives, the rapid development of effective vaccines against COVID-19 provided us hopes for manageable disease control. However, vaccine hesitancy across the globe is a concern which could attenuate efforts of disease control. This study examined the extent and trend of vaccine hesitancy in Nigeria.

Out-of-pocket expenditures and financial risks associated with treatment of vaccine-preventable diseases in Ethiopia: A cross-sectional costing analysis.

Background: Vaccine-preventable diseases (VPDs) remain major causes of morbidity and mortality in low- and middle-income countries (LMICs). Universal access to vaccination, besides improved health outcomes, would substantially reduce VPD-related out-of-pocket (OOP) expenditures and associated financial risks. This paper aims to estimate the extent of OOP expenditures and the magnitude of the associated catastrophic health expenditures (CHEs) for selected VPDs in Ethiopia.

Joint distribution of child mortality and wealth across 30 sub-Saharan African countries over 2000-2019.

Background: While reductions in child mortality have been observed across sub-Saharan African countries in the last 30 years, narrowing the gaps in under-five mortality across socioeconomic groups also requires an understanding of the multiple associations between health and welfare and socioeconomic drivers. We examined the probability density distributions in under-five mortality within countries and joint pathways of under-five mortality and wealth over time.

Methods: We used 69 Demographic and Health Surveys and 19 Malaria Indicator Surveys from 30 sub-Saharan African countries, with each country having at least two surveys conducted since 2000.

Zero-Dose, Under-Immunized, and Dropout Children in Nigeria: The Trend and Its Contributing Factors over Time.

Introduction: This study analyzes the trend of prevalence of, and factors contributing to, children with incomplete vaccination status, namely zero-dose, under-immunized, and dropout children, over time from 2003 to 2018 in Nigeria, one of the countries with the highest number of children with incomplete vaccination.

Methods: Nigeria Demographic and Health Survey data from 2003 to 2018 were analyzed to calculate the prevalence of children with incomplete vaccination status by geographical zone over time and to investigate the factors contributing to the change in the prevalence of such children over time based on the Blinder-Oaxaca decomposition analysis.

Results: The prevalence of children with incomplete vaccination status substantially decreased from 2003 to 2018 in most of zones in Nigeria.

Geospatial and Time Trend of Prevalence and Characteristics of Zero-Dose Children in Nigeria from 2003 to 2018.

Introduction: While recent years have observed a substantial improvement in vaccination coverage among children in developing countries, many children are still left out and remain unvaccinated. This study analyzes the trend of the prevalence and characteristics of zero-dose children in Nigeria over time.

Methods: Using data from the Demographic and Health Survey in Nigeria from 2003 to 2018, I analyzed the prevalence and determinants of zero-dose children who had not received any DTP vaccine by geographical zone and over time.

Geographical and time trends of measles incidence and measles vaccination coverage and their correlation in Nigeria.

Nigeria has one of the highest measles burdens in the world. While measles-containing vaccine is proven to be effective in reducing measles cases, empirical studies on the correlation between measles incidence and measles vaccine coverage in Nigeria has been limited. The aim of this study was to conduct a detailed analysis on measles incidence, measles vaccine coverage, and their correlation between 2012 and 2021.

COVID-19 Vaccine Hesitancy and Trust in Government in Nigeria.

Introduction: COVID-19 has been impacting our lives globally, including in Nigeria. While the COVID-19 vaccine is available free of charge, vaccination coverage remains low. This study evaluates the relationship between trust in government and COVID-19 vaccine hesitancy.

The relationships between adverse life events, depression, economic activities, and human capital investment in Nigeria.

This paper examines the links between adverse events, depression, and decision-making in Nigeria. It investigates how events such as conflicts, shocks, and deaths of family members can affect short-term mental health, as well as longer-term decisions on economic activities and human capital investments. First, the findings show that exposure to conflict has the largest and strongest relationship with depression, associated with a 21-26 percentage point increase in the probability of depressive symptomatology.

Evaluation of catastrophic health expenditure risk due to measles in Nigeria.

Measles can have a substantial negative impact not only on people's health but also on their finances, especially in developing countries. This study evaluates the household risk of catastrophic health expenditure (CHE) due to measles, according to regions and wealth quintiles. The CHE risk due to measles was computed based on (1) the likelihood of health service utilization to treat measles, (2) out-of-pocket (OOP) expenditure and indirect costs associated with disease treatment, and (3) household consumption expenditures.

Catastrophic health expenditure and its determinants among Nigerian households.

Health expenditure can be substantial, especially in countries without national health insurance schemes, and it can negatively affect people's welfare. This study uses recent data to evaluate the extent to which Nigerian households suffer from catastrophic health expenditure (CHE) and evaluates its determinants. We used the Living Standards Survey 2018-2019 to estimate the headcount of Nigerian households that experience CHE-the proportion of health expenditures exceeding a certain ratio of such expenditures to non-food expenditures.