Abstract:Wastewater-based epidemiology offers scalable monitoring for antimicrobial resistance (AMR), especially where clinical genomic coverage is limited. We implemented monthly wastewater sampling in five secondary cities and quantified key resistance genes using targeted qPCR panels. Temporal analysis revealed seasonal spikes linked to outpatient antibiotic dispensing trends and hospital discharge peaks. Cross-site comparisons identified persistent hotspots around mixed residential-healthcare catchments. Integrating environmental signals with routine pharmacy and laboratory records improved early warning capacity for AMR management. The study demonstrates that wastewater surveillance can support regionally coordinated stewardship strategies and complements patient-level monitoring within a One Health framework.
Abstract:Biomass cooking in enclosed highland homes remains a major source of indoor particulate exposure for children. In this prospective community trial, 286 households underwent baseline air quality monitoring and pediatric symptom tracking, followed by low-cost ventilation retrofits in intervention clusters. Fine particulate levels declined substantially in retrofit homes, with concurrent reductions in reported nighttime wheeze episodes over six months. Effect sizes were strongest in households with combined chimney extension and cross-vent openings. Implementation costs remained within locally acceptable ranges, enabling potential scale-up through municipal health grants. The results support practical engineering-health collaborations for reducing pediatric respiratory burden in cold-climate regions.
Abstract:Early-career nurses increasingly rely on short-term digital credit products to manage income volatility, yet health implications are understudied. We surveyed 911 nurses across tertiary and district hospitals, collecting debt behavior, shift schedules, and validated sleep indices. High revolving digital debt was associated with poorer sleep efficiency and increased daytime fatigue, independent of night-shift frequency. Mediation analysis suggested perceived financial insecurity as a primary pathway linking debt exposure to sleep disruption. Focus groups identified supportive scheduling, financial counseling, and payroll timing reforms as practical interventions. Findings highlight financial determinants of occupational well-being and the need for hospital policies that address both clinical workload and economic stress.
Abstract:Environmental contamination from artisanal and industrial mining can compromise food safety and community health. This study combined vegetable sampling and household symptom surveillance in peri-mining villages over two harvest cycles. Elevated cadmium and lead concentrations were detected in specific leafy vegetables irrigated from downstream channels. Households with frequent consumption of high-residue produce reported greater prevalence of recurrent abdominal pain and dyspeptic symptoms after adjusting for sanitation factors. Risk mapping identified exposure hotspots aligned with informal waste runoff paths. Community co-designed mitigation strategies, including alternative irrigation points and crop substitution, showed promising short-term reductions in estimated dietary intake of toxic metals.
Abstract:Service gaps in specialist psychiatric care contribute to avoidable relapse among patients with bipolar disorder. We evaluated a community telepsychiatry follow-up program implemented through district hospitals and nurse coordinators. Over 12 months, 312 enrolled patients received structured virtual reviews, medication adherence prompts, and crisis escalation pathways. Compared with historical controls, relapse-related admissions decreased and treatment adherence scores improved significantly. Qualitative interviews highlighted reduced travel burden and better family engagement in care planning. Challenges included intermittent connectivity and privacy concerns in shared households. Despite these constraints, the model demonstrates that hybrid telepsychiatry can strengthen longitudinal mental health care in under-resourced systems.
Abstract:Adolescent cognitive outcomes are shaped by nutrition, schooling, and socioeconomic stressors, yet evidence from coastal fishing communities remains limited. This cross-sectional study assessed dietary diversity, ferritin, vitamin B12, and omega-3 indices among 624 students from six shoreline municipalities. Standardized cognitive tests showed consistent associations between low ferritin and reduced executive function scores, independent of household income and attendance. Mixed-effects models indicated that omega-3 status partially mediated memory performance, particularly in female participants. School meal enhancement scenarios using locally available fish and fortified legumes were projected to improve mean composite scores within one academic year. Results support integrated nutrition-education interventions tailored to maritime livelihoods.
Abstract:Rising urban temperatures disproportionately affect populations in densely built informal settlements. We analyzed daily emergency respiratory admissions and satellite-derived land surface temperatures from 2019 to 2025 in four metropolitan districts. Distributed lag models identified significant heat-associated increases in asthma exacerbation and acute bronchitis visits, with strongest effects among children and older adults. Neighborhoods with low vegetation and corrugated roofing showed amplified risk. Policy simulations suggest that targeted cooling corridors, shaded transit stops, and community hydration points could reduce seasonal admissions by up to 14%. The findings emphasize integrating microclimate adaptation into municipal health planning for climate-vulnerable communities.
Abstract:This study evaluates a lightweight machine learning framework for early maternal anemia risk screening in low-resource antenatal clinics. Data from 1,842 pregnancies across three provinces were harmonized using open-source electronic forms and point-of-care hemoglobin tests. Gradient-boosted models outperformed logistic baselines while remaining deployable on low-cost Android devices. Calibration analysis showed robust performance across age and parity groups, and nurse-led workflow simulations demonstrated reduced triage delays. Findings indicate that constrained AI models can support clinical decision-making without replacing physician assessment. The approach offers a practical pathway for earlier intervention and improved referral efficiency in geographically isolated settings.
Abstract:Active and passive surveillance data from health facilities in the Yungas region were analyzed to characterize cutaneous leishmaniasis epidemiology between 2020-2025. A total of 1,847 confirmed cases were identified, with annual incidence rates ranging from 185 to 312 per 100,000 population. Peak transmission occurred during rainy season months, with agricultural workers and children showing highest attack rates. Leishmania braziliensis was identified in 89% of characterized samples, informing treatment guidelines and prevention strategies.
Abstract:A cross-sectional survey assessed self-medication practices and knowledge about antibiotic resistance among 628 university students in Colombo district, Sri Lanka. Self-medication was reported by 72% of respondents, with antibiotics being the most commonly self-administered drugs (34%). Only 38% of students correctly identified antimicrobial resistance as a public health threat. Pharmacy students showed significantly better knowledge compared to non-health science students, suggesting need for public health education on appropriate antibiotic use.