ObjectivesHIV, hepatitis B and hepatitis C remain significant causes of morbidity and mortality in low resource settings. The Emergency department (ED)-based screening has proven effective in decreasing the spread of undiagnosed disease.Materials and methodsThe spot test and ELFA(VIDAS) based tests for HBsAg, HCV and HIV was done for the patients who were brought to the trauma centre post traumatic injuries for treatment. These patients are otherwise healthy individuals but just the victims of accidents or any traumatic injuries.ResultsThe time period of study is from April 2019 to September 2024 i.e. 5 years and 5 months. The viral marker tests were done for the patients as screening and mandatory tests. Total samples received for HBsAg were 6976: 210 reactive (3%), 6766 non-reactive. Total samples received for HCV 6764:189 reactive (2.7%), 6575 non-reactive and total samples received for HIV were 6700: 118 reactive (1.7%), 6582 non-reactive.ConclusionsSince this was a mandatory test for viral markers so we can access the prevalence and also an accidental positivity of the infections in healthy people in the community. Higher seroprevalence is seen in accidently injured patients who are coming from community, hence there seems an unmet need of research in this field so that such individuals do not pose threat to themselves as well as community.

Supporting service delivery through the private sector is a policy priority for improving maternal and child health service delivery for UHC. Despite the increased attention, it is not clear how pay-for-performance interventions within the private sector perform post-donor transition. This study aimed to examine the impact of donor transition on private service providers' ability to deliver maternal and newborn health in Uganda. An exploratory qualitative study was conducted in Uganda's Rwenzori and Lango sub-regions, which benefited from a USAID project to reduce maternal and newborn deaths from 2012 to 2016 in Rwenzori and 2015-2020 in the Lango sub-region. A purposive sample of 52 respondents (Rwenzori = 26, Lango = 16, National = 10) took part in the study. A thematic analysis technique was followed, guided by the components of the health systems dynamics framework, with data management supported by Atlas. ti a qualitative data management software. Overall, results reflect a mix of progress and setbacks following the cessation of donor funding to the participating private health service providers. The subnational governance to provide oversight to the private sector was strengthened, which extended into the post-transition period. Despite setbacks in the provision of a comprehensive MNCH package, such as a drastic reduction in patient volumes, reduced scope of services offered and inconsistent supply of emergency medicines, the popularisation of MNCH services among the private sector players created awareness of the same post-transition. The information systems built with donor support contributed to improved data reporting from the private sector, which was sustained post-transition. Human resources for health among private sector players were greatly affected post-transition, although the same benefited the public sector with an experienced pool of health workers from which they recruited into public service. Despite the continued use of equipment procured during donor support, the medicines and supplies were greatly affected by funding cessation. Equally affected was the financing following donor cessation to the private sector players post-transition. Despite the mixed results following donor cessation of funding to the private sector, these results have important implications for supporting private sector players to improve MNCH services in low-resource settings. The governance, health information systems, and service delivery experiences are critical aspects worth emulating for better engagement of the private sector in strengthening MNCH service delivery. Not applicable.

This scoping review's objective was to describe how lay individuals have been trained to deliver evidence-based services to manage mental and behavioral health disorders. Health service delivery by lay individuals is commonly used for managing mental and behavioral health disorders in low-resource settings. Prior systematic reviews have examined the characteristics of lay health workers, the types of services they provide, and the efficacy of their services; however, a significant gap exists in documenting the training these individuals receive. Participants were lay individuals trained to provide services to community residents, excluding individuals with formal training in health service delivery and delivery in residential settings. The concept was training programs for the delivery of evidence-based services to individuals and excluded services involving pharmacology. The context was mental and behavioral health disorders, excluding cognitive deficits. Our search included MEDLINE, CINAHL, APA PsycINFO, Scopus, Web of Science, and gray literature sources. The search included articles published between 1960 and November 2024 that were in English or Spanish or had English translations available. Data analysis used a mix of descriptive and qualitative approaches. Since missing data in the existing literature were considered a finding itself, we did not contact authors to provide information on elements missing from the data extraction form. After completing the evidence selection process, we extracted data from 204 studies. Included studies used a wide variety of terms to describe lay health workers. Consistent with prior literature, this scoping review identified 2 categories of lay individuals who have been trained to deliver mental and behavioral health services: general lay health workers (described as trusted community members) and peer workers (lay individuals with personal experience of mental and behavioral health disorders). The number of studies has increased over time, with the first paper published in 1974. Overall, the largest percentage of studies (41.3%) were conducted in the United States. Comparing the literature conducted in low- and middle-income countries with those in high-income countries, the general lay health worker model predominated in low- and middle-income countries, while the peer model was more common in high-income countries. The most common psychotherapeutic techniques that lay health workers were trained to deliver were cognitive behavior therapy, motivational interviewing, and behavioral activation; however, one-quarter of the studies did not indicate which techniques were taught in the training. Due to missing data and variations in design, it was difficult to estimate the time spent training lay individuals for the chosen interventions or to develop a definitive profile of the demographic characteristics of lay health workers/peers. Finally, only 27 studies (13.2%) mentioned stigma reduction as part of the training. There has been great variability in the training of lay individuals to provide mental and behavioral health services. This leaves many gaps in the literature and will make it hard to draw conclusions regarding best practices. Future research can use the information reported in this scoping review to identify relevant studies and to complement existing data reporting templates (eg, Template for Intervention Description and Replication [TIDieR]) to assess the evidence for best practices in training lay individuals for mental and behavioral health service delivery. OSF https://osf.io/eaqcr/overview.

Respiratory infections and diarrheal diseases are major causes of illness and school absences for school-aged children. Both can be prevented by handwashing with soap. Unfortunately, at most schools in low-resource settings, soap and water are rarely present and, if present, rarely used. As part of a longer-term project, we have been working with the Tamil Nadu school system on improving the hygiene practices of students since 2015. We have designed a handwashing curriculum to educate students at low-resource schools in India to promote behavior change among these students and their teachers. The purpose of this study is to measure how effective this curriculum is in improving handwashing outcomes. From October 2019 through March 2020, we ran a cluster-randomized trial of a school-based hand hygiene intervention for students in grades 3 to 5 in Tamil Nadu public schools. Schools in the treated group implemented a handwashing curriculum to educate students about the importance of handwashing and to create routines within the school. During baseline, midline and endline, enumerators conducted surprise visits at schools to observe whether soap was present in classrooms and whether students were washing their hands with soap before lunch. The intervention occurred at treatment schools between baseline and midline. The observed presence of in-use soap and handwashing before lunch more than doubled at treated schools after the intervention. Both outcomes were also roughly 30 percentage points higher at treated schools than at control schools at midline, providing some indication that a hygiene intervention can succeed in a low-resource setting. Our results indicate that the intervention was successful at improving handwashing with soap. Since the intervention used the school system's own trainers and teachers, it should be scalable. As such, a hygiene intervention like the one we implemented can succeed in a low-resource setting. Longer-term follow-up is important to see what reminders help schools and students sustain the new behavior. AEARCTR-0005182 (AEA RCT Registry, Initial Registration Date was December 15, 2019).

The successful application of large-scale transformer models in Natural Language Processing (NLP) is often hindered by the substantial computational cost and data requirements of full fine-tuning. This challenge is particularly acute in low-resource settings, where standard fine-tuning can lead to catastrophic overfitting and model collapse. To address this, Parameter-Efficient Fine-Tuning (PEFT) methods have emerged as a promising solution. However, a direct comparative analysis of their trade-offs under unified low-resource conditions is lacking. This study provides a rigorous empirical evaluation of three prominent PEFT methods: Low-Rank Adaptation (LoRA), Infused Adapter by Inhibiting and Amplifying Inner Activations (IA 3 ), and a Representation Fine-Tuning (ReFT) strategy. Using a DistilBERT base model on low-resource versions of the AG News and Amazon Reviews datasets, the present work compares these methods against a full fine-tuning baseline across accuracy, F1 score, trainable parameters, and GPU memory usage. The findings reveal that while all PEFT methods dramatically outperform the baseline, LoRA consistently achieves the highest F1 scores (0.909 on Amazon Reviews). Critically, ReFT delivers nearly identical performance (~98% of LoRA's F1 score) while training only ~3% of the parameters, establishing it as the most efficient method. This research demonstrates that PEFT is not merely an efficiency optimization, but a necessary tool for robust generalization in data-scarce environments, providing practitioners with a clear guide to navigate the performance—efficiency trade-off. By unifying these evaluations under controlled conditions, this study advances beyond fragmented prior research and offers a systematic framework for selecting PEFT strategies.

Background: Hypoxia is a critical yet under-recognised driver of poor outcomes in coronavirus disease 2019 (COVID-19). Early detection with cheap pulse oximetry is feasible in resource-limited settings. Aim: This study estimated the prevalence of hypoxia at admission and its role in predicting mortality in three facilities in diverse resource settings in Kenya. Setting: The study was conducted in three Kenyan hospitals. Methods: We retrospectively analysed 1124 COVID-19 patient hospitalisation records (October 2020 – December 2021). Hypoxia was defined as the saturation of peripheral oxygen (SpO2) ≤ 94% at admission. Differences in categorical variables were assessed using the χ2 test. We used a multivariable Cox proportional hazards model to identify mortality predictors and Kaplan–Meier methods to estimate survival probabilities, with or without oxygen supplementation. Results: Hypoxia was present in 81.4% of patients; 39.9% had no dyspnoea. Hypoxic patients compared to non-hypoxic patients were older (≥ 60 years: 44.6% vs. 24.4%) and had higher rates of dyspnoea (60.1% vs. 36.9%), hypertension (40.4% vs. 25.8%), and tachycardia (38.2% vs. 24.6%) (all p < 0.001). Only 68.6% of hypoxic patients received oxygen. Mortality was higher among hypoxic (38.0%) vs. non-hypoxic patients (13.6%, p < 0.001). Hypoxia independently predicted mortality (adjusted hazard ratio [aHR]: 1.9; 95% confidence interval [CI]: 1.2–2.8), particularly in older adults (aHR: 1.8) and those with dyspnoea (aHR: 1.5). Survival probabilities were worse for hypoxic patients regardless of dyspnoea or oxygen supplementation (p < 0.001). Conclusion: Hypoxia was prevalent and significantly increased the mortality risk among hospitalised COVID-19 patients. Contribution: Routine SpO2 monitoring and targeted hypoxia management are critical in low-resource settings, particularly for vulnerable patients.

Background: Depression is a leading cause of disability worldwide, with a treatment gap exceeding 85% in low-resource settings like Nigeria. Gamified digital interventions, which integrate game design elements into evidence-based therapies, present a promising avenue to enhance engagement and efficacy in mental health care. Objective: This study aimed to systematically evaluate the implementation, acceptability, and effectiveness of gamified interventions for depression within the Nigerian context. Methods: A comprehensive systematic review and analysis of studies conducted in Nigeria between 2020 and 2025 was performed. We synthesized data from randomized controlled trials, observational studies, and mixed-methods research, focusing on depression symptom severity (measured by PHQ-9 and HAM-D), treatment adherence, and user engagement metrics. Results: Findings indicate that gamified interventions are effective in reducing symptoms of depression. Cognitive Behavioral Therapy (CBT)-based gamified apps significantly reduced PHQ-9 scores (mean reduction: 4.2 points; 95% CI: -5.1 to -3.3). Interventions incorporating social interaction elements demonstrated superior outcomes (β = -0.65, p < 0.01). Furthermore, gamification led to markedly higher intervention completion rates (78% vs. 52% for standard care, p < 0.01) and user satisfaction (85% vs. 62%, p < 0.01). Key facilitators included cultural adaptation and the use of relatable narratives, while barriers were infrastructural limitations and variable digital literacy. Conclusion: Gamified interventions represent a viable and effective adjunctive treatment for depression in Nigeria. They demonstrate significant potential to bridge the mental health treatment gap by improving accessibility, engagement, and clinical outcomes. Future work should focus on long-term efficacy studies, deeper cultural customization, and sustainable integration into primary healthcare systems.

A scoping review of climate resilient health system strategies in low-resource settings.

Social norms research in low resource settings: Opportunities ahead.

Substance use among youth is a significant public health issue, particularly in low resource settings in Sub-Saharan Africa (SSA), where it contributes to HIV transmission and poor engagement in HIV care. This study employs machine learning (ML) techniques to develop models for predicting problematic substance use (PSU) among youth living with HIV (YLHIV) in Uganda, aiming to identify important multilevel risk factors and compare predictive performance of ML algorithms. Utilizing a cross-sectional dataset of 200 YLHIV aged 18-24 in Uganda, we trained and evaluated six predictive models, through 10-fold cross validation. Model performance was assessed using area under receiver operating characteristic curve (AUROC), and precision recall curve (AUPRC). Subsequent feature importance analysis revealed key predictors of PSU. The random forest model achieved the best discriminative performance with an AUROC of 0.78 (0.01) and AUPRC of 0.75 (0.02). Key predictors of PSU spanned individual, interpersonal, and community dimensions including depression, sexual risk-taking behaviors, monthly income, adverse childhood experiences, family involvement in selling alcohol, friends enabling access to alcohol, exposure to community educational campaigns against alcohol, household size, and knowledge of alcohol effects on HIV treatment. Our findings highlight ML's potential in predicting PSU among YLHIV and provide insights to guide targeted interventions and support policy formulations mitigating PSU effects on HIV management.

Defying Deprivation: Neurosurgical Outcomes and 75% 6-Month Survival in 96 Primary Brain Tumor Cases Amid Yemen's Humanitarian Crisis.

You only work with what you know: Healthcare providers' experiences using non-pharmacological interventions in managing sickle cell crisis pain in adolescents.

This study investigates the relationship between national birth rate and female dementia incidence globally, considering demographic and socioeconomic confounders. Data from 204 countries were analyzed using bivariate correlation, partial correlation, principal component analysis, and multiple linear regression. Female dementia incidence rate (FDIR) was the dependent variable. Birth rate served as the main predictor, with ageing (life expectancy), genetic predisposition (Biological State Index), economic affluence (GDP PPP), and urban living as confounders. Birth rate demonstrated a significant inverse correlation with female dementia incidence (Pearson's r = -0.772, p < 0.001), remaining robust after adjusting for confounders (partial r = -0.548, p < 0.001). Stepwise regression confirmed birth rate as the strongest independent predictor, explaining 61.6% of the variance in FDIR. Genetic predisposition and ageing were also significant, while economic affluence and urban living had minimal effects. The inverse relationship was more pronounced in developing countries and low-income regions. Lower birth rates were strongly associated with higher female dementia incidence globally. Birth rate should be considered a critical demographic factor in dementia risk prediction and public health planning, particularly in ageing and low-resource settings.

Optimizing MRI utilization in resource-limited settings: A study of referral patterns at a tertiary center in Zimbabwe.

Enhancing parenting skills for pregnant women with depressive symptoms: a randomised controlled trial of triple P for baby in Kenya.

Small-scale protocol for magnetic coagulation testing.

Management challenges of advanced colorectal cancer in a young adult from a low-resource setting: A case report

Histopathologic diagnosis of mediastinal seminoma in a low-resource setting: A case report on navigating limited access to molecular testing

Exploring the evidence that supports the benefits of the multidisciplinary team in inflammatory bowel disease.

Community interpretation of a consent form and willingness to participate in a Nipah virus vaccine trial in Bangladesh.