Introduction: Scrub typhus is a neglected life threatening acute febrile illness caused by bacteria Orientia tsutsugamushi and it is a vector-borne zoonotic disease. In 2009, scrub typhus outbreak at Gedu has awakened Bhutan on the awareness and testing of the disease.Information and data of the study highlights the need for in depth surveillance, awareness among prescribers and initiate preventive measures in the country. Methods: We used retrospective descriptive study through review of laboratory registers across three health centres in Zhemgang district, south central Bhutan. The laboratories registers have been transcribed into CSV file using Microsoft excel. Variables of interest were collected from the registers and then analysed using open statistical software R, (R Core Team (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria.) And use of mStats package, (MyoMinnOo (2020). mStats: Epidemiological DataAnalysis. R package version 3.4.0.) Results: Of the total 922 tests prescribed for suspected scrub typhus in the three health centers in Zhemgang, only 8.2 % (n=76) were tested positive. Of these, Panbang Hospital had highest reported positive for scrub typhus with 56.6 %( n=43) followed by Yebilaptsa Hospital 35.5 %( n=27) and Zhemgang Hospital with 7.9 %( n=6). The female gender is comparably more affected as opposed to male with 57.9% (n=44) of the positive cases being female. The prevalence of scrub typhus seems to be affected by the seasonal variation as the months of Spring, Summer and Autumn together accounts for 98.7%(n=75) of total positive cases. The year 2019 noted significant scrub typhus cases accounting to 89.5 %(n=68) of the total positive cases over the two years. Conclusions:The overall tests tested positive of the scrub typhus infection within two years was 8.2%.

Background: In Rwanda, Community Health Workers (CHWs) serve a crucial function in providing community-based maternal and neonatal health (CBMNH) services. However, limited access to refresher training contributes to knowledge gaps among CHWs, affecting their confidence and ability to execute their roles effectively. This study aimed to evaluate the impact of eLearning on enhancing and maintaining CHWs’ knowledge of CBMNH. Methods: This prospective cohort study, conducted from April-October 2021 in two Rwandan districts, evaluated knowledge acquisition and retention among 36 Community Health Workers (CHWs) participating in an eLearning course. Knowledge scores were measured using a structured questionnaire administered pre-training, post-training, and at a six-month follow-up. Descriptive analysis and paired t-tests were used to assess mean score differences, exploring the effectiveness of this eLearning approach. Results: This study demonstrated an improvement in Community Health Workers’ (CHWs) performance scores following eLearning training, with an average rise from 86.5% to 98.2%. The improvement was sustained at a six-month follow-up. Statistical significance was found between age category and CHWs’ pre and post-test performance (p=0.01, p=0.04 respectively), and between years of experience and pre-test scores (p=0.02), highlighting demographic influences on training outcomes. Conclusions: The results of this study suggest that eLearning is an effective method for enhancing and retaining CHWs’ knowledge of CBMNH. The findings support the use of eLearning as a valuable strategy for strengthening the capacity of CHWs in Rwanda and other countries with similar contexts.

This research explores the experience of people living with leprosy at leprosy settlements in Nigeria. This is a concurrent mixed methods design whereby questionnaires, focus groups and interviews are conducted simultaneously. Seven leprosy communities were visited, one from Nigeria’s six geographical zones and the Federal capital area. This study included 35 leprosy patients, 21 family members, seven community leaders, and seven officers in charge of the leprosy settlements. Also questioned were two heads of organisations involved with leprosy control in Nigeria. Majority (93.7%) of the respondents have access to healthcare in the health centres. Majority (95.2%) are interested in learning self-care practices for skin-related neglected diseases. About three-fourths (74.6%) receive free healthcare and accent that PLWL are admitted into the same ward as other patients. Whilst funding is a growing concern for leprosy control, the data from the interview confirmed that there is little support from the government but more from non-governmental organisations and implementing partners in Nigeria for people living with leprosy. Experts demonstrated that leprosy now ranks high among neglected diseases. The Nigerian government must work with partners to ensure the improvement and sustainability of leprosy control programs.

Background: As adolescent suicide rates have increased, there has been a nationwide focus on legislation requiring school districts to create suicide prevention policies. There is a lack of tools to make a quantitative assessment of the quality and breadth of school-district suicide prevention policies. Thus, we developed a proof-of-concept instrument, the School District Suicide Policy Evaluation Tool (SDSPET). Methods: The SDSPET is derived from the “Model School District Policy on Suicide Prevention,” a document compiled by four nationally recognized suicide organizations. As a preliminary validation of the SDSPET, four independent raters used the SDSPET in a systematic analysis of suicide prevention policies for all school districts in Utah. Results: Inter-rater reliability was calculated to be 98.8% with intraclass correlation analysis. Analysis revealed a right-skewed distribution of policy scores, and a median total score was 2.25 out of 36 possible criteria. Conclusion: This proof-of-concept study demonstrates the utility of the SDSPET in quantifying the shortcomings of school-district policies on suicide while generating specific recommendations for improvement. With further validity testing, we expect this tool to be beneficial to school district administrators, education policymakers, and those studying suicide interventions and outcomes in school-aged children and adolescents.

This study analyzes how national intersectoral public policy experiences have been adopted and implemented using a Health in All Policies (HiAP) approach in the past two decades. It seeks to provide evidence on enabling factors that triggered three effective intersectoral public policies to improve population health in Mexico by improving nutritional, educational, and healthcare access conditions, reducing road traffic injuries, and addressing obesogenic feeding practices. We followed a qualitative approach to analyze the three intersectoral public policies selected as case studies. First, we designed an analytical framework to assess how intersectoral public policies are adopted, implemented, and sustained. The proposed framework is based on peer-reviewed articles and grey public policy literature. Second, we used information from eleven semi-structured interviews to key stakeholders conducted in previous research to identify more specific enablers and barriers of the three intersectoral policies selected according to predefined analytical categories used in the questionnaire. The analysis showed three overall key findings. First, sound empirical evidence is essential for adopting a HiAP approach. Second effective intersectoral mechanisms enhance implementation feasibility. Third, results-based monitoring and evaluation contribute to the continuity of the analyzed intersectoral public policies. Finally, political support is needed throughout the policy process to maintain governance capacity and deliver results. Finally, we drew five global policy lessons that may be applicable in similar public policy settings in other countries. First, both technical and political enablers help set the intersectoral agenda. Second, effective communication is instrumental in convincing all stakeholders to address public health-related policy issues. Third, political support at the highest level possible and the federal government’s capacity are essential to implement sound policies. Fourth, several enablers exist for enhancing collaboration between ministries during implementation. Finally, monitoring and evaluation results are necessary for sustaining intersectoral policies beyond administrations.

Background: Research indicates a relationship between nutrition, physiological characteristics, and mental health. It was already reported that Israeli-Arab adolescents consume more fast food, sweets, and candies than Jews. Higher energy drink consumption by Israeli-Arab adolescents emerged. Though, data on the topic still needs to be updated. The current study examined possible associations between energy drink consumption, anxiety, and well-being in Israeli-Arab adolescents. We also investigated these associations concerning fast food consumption, physical activity, and sleep hours. Methods: One hundred and fourteen adolescents (59 females) aged 12–18 from several cities & villages in northern Israel were recruited to study. A cross-sectional exploratory study assessed adolescents’ energy drink consumption, nutritional and lifestyle habits, well-being, and anxiety using self-reported questionnaires. Anthropometric measurements - weight, height, and waist circumference were also assessed. Results: Gender and energy drink consumption were associated with psychological status. Energy drink consumers reported a lower well-being index and a higher anxiety index than non-consumers. Energy drink consumers ate significantly more fast food per week than non-consumers. In addition, sleep hours were correlated with anxiety levels. These results differed between genders. Conclusions: Our study shows complex associations between energy drink consumption and mental health indices. These associations can serve as a basis for further research into this topic.