Objectives To examine how national innovation and policy configurations enabled vaccine development in Brazil, Cuba, India, and Iran, and to distil lessons for low- and middle-income country (LMIC) vaccine sovereignty.
Methods Narrative review of peer-reviewed and grey literature (2020–2023), guided by a structured search and screening approach; synthesis mapped to national and sectoral innovation system perspectives and technology readiness levels.
Results Cuba and Iran leveraged mission-oriented public research and development (R&D) and domestic platforms; India combined indigenous R&D with large-scale licensed manufacturing; Brazil’s scientific capacity was constrained by fragmented governance and supply-chain dependence. Adaptive regulation (e.g., emergency use authorization/conditional approvals), targeted technology transfer, and South–South partnerships accelerated progress but raised longer-term questions about intellectual property (IP) control and economic sustainability.
Conclusion Institutional coherence, strategic IP management, and regional manufacturing alliances are as critical as scientific capacity for LMIC vaccine self-reliance. Policy priorities include pre-negotiated tech-transfer frameworks, regulatory preparedness, and investment in public R&D linked to distributed manufacturing.
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Objectives Scrub typhus, caused by Orientia tsutsugamushi, is a climate-sensitive vector-borne disease with high incidence in the Republic of Korea. This study examined long-term epidemiological trends and changing meteorological influences in the context of climate change.
Methods A retrospective time-series study was conducted using national surveillance data on 149,289 scrub typhus cases (2001–2024) across 4 surveillance phases. Temporal trends in age-standardized incidence rates were evaluated using Joinpoint regression. Associations between monthly meteorological variables and incidence were assessed with Spearman correlation analysis and time-series regression analysis using distributed lag non-linear models.
Results The national incidence increased until 2017 and has decreased since 2018, whereas the AAPC rebound to 4.32% during phase IV (2019–2024). The proportion of female cases decreased, while that of adults ≥70 years increased significantly. In phase IV, the average annual percent change increased in central and urban regions. The lag effect of meteorological factors lengthened from 4 to 6 months, with mean temperature (Tmean) and relative humidity (RH) representing the primary predictors. Phase III (2013–2018) displayed the highest cumulative relative risk (RR) for Tmean at 25.2 °C (RR, 5.86; 95% confidence interval [CI], 2.56–13.42), whereas in phase IV, only moderate RH (58%) remained significantly associated with incidence (RR, 1.68; 95% CI, 1.29–2.20).
Conclusion Over the past 2 decades, the influence of meteorological factors on scrub typhus has shifted, with recent years marked by greater uncertainty under increasing climate variability and instability. For timely risk prediction and targeted prevention, adaptive surveillance systems that integrate dynamic climate indicators—capturing the intensity, frequency, and variability of extreme weather events—are needed.
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Objectives This study measured the impact of prenatal intimate partner violence (p-IPV) on maternal mental health and suspected developmental delays (SDDs) in children at 6 months of age in central Vietnam.
Methods Data were drawn from a community-based birth cohort of 285 mother–child dyads in Hue citycity, central Vietnam. The exposure factor was p-IPV, assessed using the revised conflict tactics scale (CTS2). Maternal mental health was measured with the patient health questionnaire-9. Child development at 6 months was screened using the Vietnamese version of the Ages and Stages Questionnaire, 3rd Edition (ASQ-3). Robust Poisson regression was used to estimate associations of p-IPV with maternal mental health and SDDs.
Results Among the women, 18.9% reported experiencing p-IPV. SDDs were identified in 13% of the children, with communication delays being the most prevalent (10.9%). The association between p-IPV and SDDs remained significant after adjustment for confounders in multilevel models, with the highest relative risk (RR) observed in the fully adjusted model (RR, 2.43; 95% confidence interval [CI], 1.08–5.48). p-IPV exposure was significantly associated with postpartum depression in the crude and partially adjusted models, but this association became non-significant after full adjustment—most notably after accounting for prenatal depression, which remained a predictor of postpartum depression (RR, 1.15; 95% CI, 1.06–1.25).
Conclusion p-IPV is significantly associated with increased risk of postpartum depression and developmental delays in early infancy. Integrating IPV screening and targeted interventions into prenatal care may contribute to improved developmental outcomes in children and better maternal health.
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Objectives This study examined the associations between digital literacy and self-rated health (SRH), depression, and life satisfaction among older adults in the Republic of Korea.
Methods Data were obtained from the 2023 National Survey of Older Koreans (n=9,951). Digital literacy was evaluated based on participants’ ability to use 8 smartphone functions and their perceived difficulty adapting to a digital society. Dependent variables included SRH, depression (measured using the short form of Geriatric Depression Scale), and life satisfaction (assessed through a composite score across 7 domains). Multiple logistic regression was applied for SRH and depression, while linear regression was conducted for life satisfaction, adjusting for sociodemographic and health-related covariates.
Results Higher digital literacy was significantly associated with better SRH and greater life satisfaction. Compared to participants with no digital skills, those with moderate or high digital literacy had higher odds of reporting good SRH and significantly higher life satisfaction scores. Older adults who reported difficulty adapting to a digital society demonstrated significantly lower SRH and life satisfaction. However, after adjusting for covariates, the association between digital literacy and depression was not statistically significant.
Conclusion Higher digital literacy is linked to better SRH and greater life satisfaction. Moreover, digital literacy reduced the explanatory power of socioeconomic variables, suggesting that it serves as an important behavioral determinant. These findings underscore the importance of promoting digital literacy as a means of improving health equity and well-being in aging populations.
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Objectives Adherence to anti-tuberculosis treatment is essential for achieving successful outcomes and preventing the emergence of drug-resistant strains. This study aimed to evaluate adherence levels and identify factors associated with non-adherence among tuberculosis patients in the Béni Mellal-Khénifra region of Morocco. We hypothesized that sociodemographic, clinical, and behavioral factors influence adherence.
Methods A facility-based cross-sectional study was conducted from January 2023 to December 2024 in 2 Tuberculosis and Respiratory Disease Diagnostic Centers in the Béni Mellal-Khénifra region. A total of 481 patients who had been on treatment for at least 2 months were recruited using convenience sampling. Data were collected through structured, pre-tested questionnaires administered in face-to-face interviews and verified against treatment cards and medical records. Adherence was defined as taking ≥90% of prescribed doses. Multivariable logistic regression was used to identify independent predictors of non-adherence.
Results Among the 481 participants, 8.1% were non-adherent. Significant predictors of non-adherence included forgetfulness (adjusted odds ratio [AOR], 38.84; 95% confidence interval [CI], 11.35–132.88), adverse effects (AOR, 14.26; 95% CI, 3.17–64.13), male sex (AOR, 6.77; 95% CI, 1.45–31.60), rural residence (AOR, 4.42; 95% CI, 1.37–14.25), self-adjusted dosing (AOR, 5.83; 95% CI, 1.20–28.34), stopping treatment after symptom improvement (AOR, 6.56; 95% CI, 1.34–32.14), and missed follow-up visits (AOR, 6.74; 95% CI, 1.56–29.19).
Conclusion Although overall adherence was high, 8.1% of patients were non-adherent. Strategies to improve adherence should focus on addressing forgetfulness, managing side effects, enhancing access in rural areas, and reinforcing patient education and follow-up systems to improve treatment outcomes in this and similar settings.
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Objectives This study aimed to assess the impact of high-level versus low-level construal messages about the coronavirus disease 2019 (COVID-19) Vaccine Injury Compensation Program (CVICP) on public attitudes toward the program and COVID-19 vaccination.
Methods A randomized controlled experimental design was employed. Adults aged 18 to 64 residing in the Republic of Korea were randomly assigned to either an experimental group (high-level construal message) or a control group (low-level construal message). Both groups viewed a 2-minute video about the CVICP, with construal level as the sole variable. Pre- and post-intervention questionnaires evaluated attitudes toward the CVICP and COVID-19 vaccination, including satisfaction, perceived necessity, and perceived effectiveness in enhancing vaccine acceptance. Data were analyzed using the paired t-test, repeated measures 2-way analysis of variance, and multiple linear regression.
Results The experimental group showed statistically significant improvements across all 6 attitude measures following exposure to the high-level construal message. By contrast, the control group demonstrated significant improvement in only 3 attitudes: satisfaction with the CVICP, willingness to recommend vaccination, and willingness for future vaccination. A significant difference between groups was observed for perceived effectiveness of the CVICP in enhancing vaccine acceptance (p=0.01), with high-level construal messaging being more impactful.
Conclusion High-level construal messages are more effective than low-level messages in shaping public perceptions and addressing vaccine hesitancy. Policymakers and health authorities should incorporate high-level construal elements into communication strategies to build trust and support for vaccination programs.
Objectives The aim of this study was to investigate the relationship between diabetes medication self-efficacy and quality of life in older adults with diabetes.
Methods The study included 192 older adults who attended the diabetes clinic of a public hospital in Istanbul. Data were collected between June and October 2024. Participants were informed about the study and provided both verbal and written consent. Data collection instruments comprised a sociodemographic questionnaire, the diabetes medication self-efficacy scale, and the quality of life scale for older adults.
Results Of the participants, 98 (51.0%) were women and 105 (54.7%) were aged 65 to 74 years. The mean diabetes medication self-efficacy score was 38.95±10.31, and the mean quality of life score was 18.24±6.37. A weak but statistically significant positive correlation was observed between the autonomy and satisfaction subscale of quality of life and the necessity subscale of self-efficacy (p<0.05).
Conclusion This study, which examined the relationship between self-efficacy in diabetes management and quality of life in older adults, provides valuable guidance for clinical practice aimed at improving care for this population.
Objectives
This study aimed to validate the psychometric properties of the recently developed knowledge, attitudes, and perceptions questionnaire for community-based surveillance of infectious diseases (KAP-CBS-ID questionnaire), using confirmatory factor analysis (CFA) and item response theory (IRT).
Methods
A cross-sectional study using multistage sampling recruited 470 schoolteachers from Kelantan, Malaysia. The self-administered KAP-CBS-ID questionnaire consists of 3 domains: knowledge (31 items), attitudes (23 items), and perceptions (21-items). Two-parameter logistic (2-PL) IRT analysis and CFA were performed to validate the knowledge section. For attitudes and perceptions sections, CFA proceeded using a 4-factor model to evaluate both model fit and construct validity.
Results
Two-PL IRT analysis of the knowledge section resulted in elimination of 14 items due to inadequate discrimination or difficulty parameters. The 3-factor CFA model demonstrated good fit indices for knowledge (root mean square error of approximation [RMSEA], 0.028; comparative fit index [CFI], 0.945; Tucker-Lewis index [TLI], 0.941) without any modifications. The attitudes section required re-specification, ultimately yielding 21 items across 4 factors with acceptable fit indices (standardized root mean square residual [SRMR], 0.067; RMSEA, 0.055; CFI, 0.937; TLI, 0.927). Similarly, the perceptions section was refined to 17 items across 4 factors, showing good model fit (SRMR, 0.055; RMSEA, 0.059; CFI, 0.962; TLI, 0.954). Factor loadings ranged from 0.33 to 0.98, while Raykov’s rho reliability estimates ranged from 0.71 to 0.93. Factor determinacy exceeded 80% for all factors.
Conclusion
The KAP-CBS-ID is a valid and reliable instrument for assessing community representatives’ knowledge, attitudes, and perceptions regarding community-based surveillance of infectious diseases.
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Objectives This study aimed to investigate the association of demographic variables and serum calcium with hypercalciuria among the Meitei adult population of Manipur, Northeast India.
Methods A cross-sectional study was conducted involving 413 participants (272 females and 141 males) aged 19 to 60 years. Participants were selected through a multistage sampling method from 5 valley districts of Manipur. Demographic and biochemical parameters were collected, including serum calcium, creatinine, and spot urine calcium and creatinine levels. One-way analysis of variance, Tukey’s post hoc test, chi-square test, multinomial logistic regression, and receiver operating characteristic (ROC) curve analysis were performed. The area under the ROC curve was calculated to determine the cut-off value of random urine calcium.
Results The overall prevalence of hypercalciuria was 18.64%. The incidence of hypercalciuria increased with age; 41 to 60 age group were 3 times more likely to develop hypercalciuria than those in the 19 to 40 age group (95% confidence interval [CI], 1.86–5.47; p<0.001). A significant association (p<0.05) was also found between serum calcium and urine calcium levels. Hypocalcemic individuals were 3.5 times more likely to have hypercalciuria than normocalcemic individuals (95% CI, 1.33–9.31; p=0.01). ROC analysis revealed a predictive cut-off value of 23.07 mg/dL for random urine calcium.
Conclusion This study demonstrates a high prevalence of hypercalciuria exceeding the global average. Given that Manipur has also been reported to have a high prevalence of kidney stones, this finding indicates a considerable health risk. Early intervention could therefore improve public health outcomes related to calcium and mineral metabolism.
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