CONCLUSION: Patient satisfaction in Ghana's tertiary hospitals is driven more by structural and socioeconomic conditions, institutional performance and perceived service reliability than by demographic characteristics. Strengthening reliability in service delivery and reducing inter-hospital disparities are critical for advancing patient-centered care and achieving SDG 3.

CONCLUSION: These findings indicate that although awareness of the disease is high, levels of knowledge, attitudes, and practices remain moderate, which could be a barrier to efficiently prevent and control brucellosis spread. This highlights the need for targeted education and interventions to improve our understanding of the disease and to address high-risk behaviors that contribute to its transmission in the region.

Human immunodeficiency virus 1 (HIV-1) is a retrovirus which has infected 90 million people and resulted in over 40 million deaths. Despite advances in diagnostics, treatment, and prophylaxis, HIV-1 continues to spread due to undiagnosed and untreated infections. Traditional monitoring methods are ineffective when access to testing is limited or people do not seek care, particularly given the long period between infection and symptom onset, allowing undetected transmission to continue. Here, we...

IntroductionWhile prior research has examined individual health-related social needs (HRSNs) in relation to preventive care, few studies have investigated how cumulative social needs affect cancer screening behaviors. This study examines how individual and combined HRSNs affect breast and cervical cancer screening completion.MethodsParticipants included 1,964 female patients overdue for breast or cervical cancer screening, receiving care at Federally Qualified Health Centers. The dependent...

CONCLUSION: Malaria and STH infections remain a major cause of haematological abnormalities in children under five. Early red cell alterations, especially macrocytosis and hypochromia, preceded obvious anaemia and were more strongly influenced by host factors than by parasite density, underscoring the need for integrated control and careful haematological assessment in endemic settings.

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ObjectiveThis cross-sectional study examined how types of disability and comorbidities influence retention in care (RIC) among people with HIV (PWH) in Houston/Harris County, Texas, USA.MethodsData from 1142 participants in the Houston Medical Monitoring Project (2015-2021) were analyzed. Descriptive statistics, bivariate analyses, and multivariable logistic regression were used to evaluate factors associated with RIC.ResultsApproximately 74.9% of participants were retained in care. Compared to...

CONCLUSIONS: In the setting of multiple disease outbreaks, the characteristics of infected patients may be largely similar. Some people with dual infection may show unusual test results or symptom patterns compared with those with only one infection. Large public health studies with robust reporting systems and laboratory screening are vital for early detection of dual infections. Public health strategies to educate providers and outreach teams enhance response during concurrent outbreaks....

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CONCLUSIONS: PHS predictors differed by HIV status. The current findings highlight the importance of leveraging SSP and drug use treatment to combat HIV stigma effectively.

A quantitative understanding of local transmission dynamics is essential for designing effective prevention strategies. In this study, we developed a computational workflow to identify viral introductions and trace locally circulating clusters. We analyzed over 26,000 SARS-CoV-2 genomes and their associated metadata, collected between January and October 2021, to explore introduction and local dispersal patterns in Greater Houston, a major metropolitan area known for its demographic diversity....

CONCLUSIONS: While 50% of the city experienced power outages from high winds, total ED visits, acute cardiac events, and heat-related illness were statistically higher in the first 3 days after Beryl than expected. Houston developed targeted messaging to mitigate these events in future disasters.

CONCLUSIONS: In this study, we introduce the Source Sink Score, which determines whether a localized outbreak serves as a source or sink for other regions, and the Local Import Score, which assesses whether the outbreak has transitioned to local transmission rather than being maintained by continued introductions. These epidemiological statistics provide actionable insights for developing public health interventions tailored to the needs of affected areas.

Measles is a potentially deadly viral infection spread via respiratory droplets from infected individuals. Outbreaks occur when vaccine coverage drops below the threshold of herd, or community, immunity. Using a sequencing-based approach, we report the prospective (January 7, 2025) detection of measles in nucleic acid extracts from 2 wastewater treatment plants in Houston, Texas, with a population of more than 218 000 residents. The sequencing data from 2 samples contained 53 unique reads...

Long-acting antiretroviral (LAARV) agents have the potential to enhance treatment and prevention by eliminating the need for daily oral medications and increasing available options. This paper reviewed recent evidence on LAARVs and explores the opportunities and challenges of implementing these innovative prevention and treatment strategies in Sub-Saharan Africa (SSA). Several clinical trials and studies on the effectiveness, drug-drug interactions, and resistance of LAARVs in key populations in...

Salmonella enterica serovar Enteritidis (S. Enteritidis) is one of the most common causes of bacterial foodborne infections worldwide. It has an extensive host range, including birds and humans, making it one of the most adaptable Salmonella serovars. This study aims to define the virulence gene profile of S. Enteritidis and identify genes critical to its host specificity. Currently, there is limited understanding of the molecular mechanisms that allow S. Enteritidis to continue as an important...

CONCLUSIONS: The novel procedure integrated real-time monitoring data and geospatial data science to enhance the design and adaptive delivery of a community-based randomized trial. Adaptive selection effectively prioritized the most in-need communities and allowed for a rigorous evaluation of community-based interventions in a multilevel trial. This methodology has broad applicability and can be adapted to other public health intervention and prevention programs, providing a powerful tool for...

In the United States (US), sexuality-based stigma continues to undermine HIV prevention and care efforts. We assessed sexual behavior stigma burden across family, healthcare, and social domains and determined associations with HIV-related outcomes among cisgender gay, bisexual, and other men who have sex with men (MSM) in nine US metropolitan statistical areas. MSM (N = 4,086) recruited at places of MSM social congregation via venue-based, time-sampling procedures completed a survey on sexual...

OBJECTIVES: Pre-exposure prophylaxis (PrEP) is a key biomedical intervention for ending the HIV epidemic in the United States, but its uptake is impeded by systemic barriers, including fragmented workflows and ineffective data coordination. This study aims to design PrEPLinker, a blockchain-based, client-centered platform to enhance care to address these challenges by improving care coordination and enabling clients to securely manage their identity and PrEP-related data.

Wastewater surveillance of vaccine-preventable diseases may provide early warning of outbreaks and identify areas to target for immunization. To advance wastewater monitoring of measles, mumps, and rubella viruses, we developed and validated a multiplexed RT-ddPCR assay for the detection of their RNA. Because the measles-mumps-rubella (MMR) vaccine is an attenuated live virus vaccine, we also developed an assay that distinguishes between wild-type and vaccine strains of measles in wastewater and...