Journal of Research in Health Sciences
Volume:25 Issue: 4, Fall 2025

Prematurity and neonatal hypotrophy (defined as a Z-score below -2 for weight, length, or head circumference) increase the risk of perinatal morbidity, mortality, and long-term developmental disorders. This study examines the growth trajectories of Moroccan preterm infants and investigates the factors influencing their overall growth outcomes at six months, including weight, length, and head circumference. Study Design: A retrospective longitudinal cohort study.

This study was conducted at the National Reference Center for Neonatology and Nutrition in Rabat from April to October 2023. It included 686 premature newborns (24–36 weeks) hospitalized for≥48 hours, with complete anthropometric data and follow-up of six months. Exclusion criteria were major malformations, chromosomal abnormalities, metabolic disorders, and incomplete data. ANOVA and multivariate logistic regression identified independent predictors of weight growth outcomes at six months (WAZ≥-2), adjusting for confounders (gestational age, gender, hospitalization, multiparity, phototherapy, antibiotics, and early food diversification). Results are reported as odds ratios (ORs) with 95% confidence intervals (CI). Growth curves were generated with Python. Significance was set at P<0.05.

Gestational age of≥32 weeks (OR=6.66, 95% CI: 1.21, 36.72; P=0.029) and multiparity (OR=12.09, 95% CI: 2.12, 68.93; P=0.005) predicted growth outcomes, while a hospital stay of≥10 days reduced the likelihood (OR=0.05, 95% CI: 0.01, 0.27; P=0.001). Male gender and antibiotic use showed non-significant trends (P=0.053).

Close monitoring and targeted nutritional strategies are essential to improve postnatal growth in preterm infants.

Substance use is common among street adolescents and is strongly associated with sexual risk behavior as well as vulnerability to sexually transmitted infections. Therefore, this study was conducted to explore patterns of substance use and the association with sexual risk behavior among street adolescents in Central Java, Indonesia. Study Design: A cross-sectional study.

In this cross-sectional study, data were collected from 248 street adolescents through face-to-face interviews using a validated questionnaire. Data analysis was conducted using descriptive statistics, chi-square tests, and multivariate logistic regression in SPSS version 25.0.

More than a quarter of adolescents reported engaging in high-risk sexual behavior. Heavy smoking, alcohol use, and frequent exposure to pornography were prevalent. Alcohol use was significantly associated with sexual risk behavior, with adjusted odds ratios ranging from 3.26 to 4.38 across Models I–III. Furthermore, frequent exposure to pornography showed a strong association, with odds ratios of 3.02 (Model I) and 4.20 (Model II). These associations remained significant after adjusting for demographic and behavioral variables.

Substance use, particularly alcohol consumption, and frequent exposure to pornography were significantly associated with sexual risk behavior among street adolescents. Therefore, interventions should be developed to address the specific needs of this population. Adolescents engaged in high-risk behavior, such as substance use and sexual risk behavior, required high attention and specific treatment options.

The urban poor represent a vulnerable population within society, particularly in terms of maternal health. Economic and access-related limitations often prevent this group from accessing healthcare services, especially in the institutional delivery process. This study aimed to analyze the barriers to institutional delivery among Indonesia’s poor urban society. Study Design: This study employed a cross-sectional design.

Data were obtained from the 2023 Indonesian Health Survey, including 7,548 participants. Eight independent variables were analyzed, including age, education, marital status, employment, wealth, insurance, and parity, with institutional delivery used as the dependent variable. Binary logistic regression was employed for analysis.

Approximately 38.1% of Indonesian pregnant women had non-institutional deliveries. All age groups showed a higher likelihood of non-institutional delivery compared to those aged≥45. Lower education levels were associated with a heightened probability of choosing non-institutional delivery. Married women were 0.704 times less likely than divorced or widowed women to give birth in non-institutional settings (AOR: 0.704; 95% CI: 0.693-0.716). Unemployed women had 1.218 times higher likelihood of engaging in non-institutional delivery compared to employed women (AOR: 1.218; 95% CI: 1.1210-1.226). The poorest women were 0.973 times less likely than the poorer group to have non-institutional delivery (AOR: 0.973; 95% CI: 0.967-0.980). Uninsured women were 2.364 times more likely than insured women to give birth outside of healthcare institutions(AOR: 2.364; 95% CI: 2.345-2.379). Women with all other parity levels were less likely than grand multiparous women to have non-institutional deliveries.

Seven barrier factors to institutional delivery were younger age, low education, divorced/widowed marital status, unemployment, lower wealth status, lack of insurance, and grand multiparity.

Cohabitation is vulnerable from a legal perspective. However, legal marriage does not exempt women from experiencing sexual abuse, while marriage is often misused as a justification. This study aimed to examine the impact of marital status on the incidence of sexual violence against women within couples. Study Design: A cross-sectional study.

The secondary analysis examined the 2022 Ghana Demographic and Health Survey, which included data from 8811 respondents. The study used sexual violence and marital status as outcome and exposure variables, respectively. Meanwhile, five control variables, including age, marital status, education, employment, wealth, and recent sexual activity, were analyzed in this study. Finally, the results were analyzed by binary logistic regression (P<0.05) using SPSS 21.

Sexual violence was reported by 5.3% of women living with a partner and 2.6% of married women (P<0.001). Based on marital status, women in a cohabitation relationship were 1.57 times more likely to experience sexual violence than married ones (adjusted odds ratio [AOR]: 1.857, 95% confidence interval: 1.857–1.858). Several factors were also significantly associated with increased risk of sexual violence, including urban residence (AOR: 1.139), younger age (e.g., 20–24 years: AOR: 1.766), lower education/no education (AOR: 2.045), unemployment (AOR: 1.415), lack of pregnancy (AOR: 1.221), recent sexual activity (AOR: 1.266), and women in middle-income and richer groups (AOR: 1.175 and AOR: 1.414).

The evaluation revealed that marital status was related to sexual violence against women among Ghanaian couples. Women living in cohabitation with a partner were more likely to experience sexual violence than married women.

The increasing prevalence of hypertension (HTN), accompanied by a decreasing quality of life (QoL), requires appropriate interventions to avoid its impacts and the occurrence of chronic conditions. The purpose of this study was to assess the effect of the intervention model education on the QoL of hypertensive patients compared to HTN self-management training and no intervention. Study Design: A quasi-experimental study.

The sample consisted of 138 hypertensive patients, divided into an HTN intervention model education group (n=46), an HTN management training group (n=46), and a group without treatment (n=46). The study used a quasi-experimental design with a control group. All groups received a pre-test, and after 6 weeks, they all received a post-test with the WHOQOL-BREF questionnaire.

The HTN intervention model education group and the HTN self-management training group had a significant effect on the QoL of hypertensive patients (P=0.0001), while the control group showed no effect (P=0.310). The Kruskal-Wallis test demonstrated a significant difference in the three interventions, and the highest difference was observed in the HTN intervention model education group.

The HTN intervention model education was the main choice because it involved not only the patient himself but also policies, health workers, cadres, and families, as well as the presence of booklets.

Tuberculosis (TB) remains a significant global health crisis, regaining its status as the leading cause of death in 2023. Quantifying its economic burden is essential for crafting effective public health strategies. This study aimed to estimate the economic burden of TB in Iran. Study Design: This study employed a cross-sectional design.

A prevalence-based approach was used to estimate the economic burden of TB in Iran, accounting for cost variations across TB types and cost categories. Costs were categorized as direct medical, direct non-medical, and indirect, and were calculated for suspected TB patients as well as for those with drug-sensitive TB, multidrug-resistant TB, and extensively drug-resistant TB. Data were extracted from various sources, including the National Tuberculosis Registration System, national TB diagnosis and treatment guidelines in Iran, official medical service tariffs, and previous studies.

Of 210,544 individuals screened, 7,221 were diagnosed with TB, of whom 81.0% had pulmonary TB and 19.0% had extrapulmonary TB. Drug-sensitive TB accounted for 99.4% of cases, multidrug-resistant TB 0.6%, and extensively drug-resistant TB 0.0%. Diagnostic costs represented 48.0% of the total economic burden (approximately Int’l$4.71 million), while post-diagnosis costs totaled Int’l$5.15 million. Overall, economic burden, including all diagnostic and treatment expenses, amounted to approximately Int’l$9.86 million.

This study underscores the significant economic burden of TB in Iran, encompassing both pre-diagnosis and post-diagnosis expenses, with direct medical costs representing the largest component. Effective healthcare strategies and comprehensive public health approaches are crucial to reducing these costs and improving patient outcomes.

Tuberculosis (TB) remains a global health concern with high mortality despite treatment options. Understanding the underlying risk factors for TB mortality is essential for guiding effective control strategies. This study examined sociodemographic and clinical factors related to TB mortality in Hamadan province, Iran, to inform control strategies. Study Design: A cross-sectional study.

This study evaluated data (March 2011–March 2022) obtained from a provincial TB surveillance database, encompassing smear-positive pulmonary TB (SPT), smear-negative pulmonary TB (SNT), and extrapulmonary TB (EPT) patients. Demographic and clinical characteristics were investigated, and the death rate for each group was calculated by dividing the number of TB-related deaths by the total number of diagnosed TB cases for that group during the study period. Logistic regression was applied to computed unadjusted and adjusted odds ratios (ORs) with a 95% confidence interval for the death rate using Stata 17 (P<0.05).

Among the 942 patients included in the study, 49%, 21%, and 30% were diagnosed with SPT, SNT, and EPT, respectively. The risk of mortality was the highest among SPT patients, with EPT cases showing significantly lower odds of death (OR: 0.38, P<0.001) compared to SPT. Among SPT patients, mortality was associated with older age (OR: 1.04, P<0.001) and positive sputum smear at month 2 (OR: 19.72, P<0.001). Human immunodeficiency virus (HIV) positivity significantly increased the death rate in SNT patients (P=0.037). In EPT patients, mortality was linked to male gender (P=0.042), referral unit (P=0.023), TB hospitalization (P=0.018), and advanced age (P<0.001).

Targeted interventions focusing on early diagnosis, HIV management, and care for high-risk groups (e.g., elderly) are essential to reduce TB mortality in Hamadan province. However, the findings should be interpreted with caution due to limitations, such as reliance on retrospective registry data, potential information bias, and missing data, particularly regarding HIV status.

The trend of human immunodeficiency virus (HIV) disease progress is different for every patient. Some patients may experience events during the course of their disease that can affect disease progression and death. The main objective of the present study was to investigate the effect of risk factors in progression of HIV disease, taking into account intermediate events, using a multistate model. Study Design: A retrospective cohort study.

The current study used information from 673 HIV-infected adult patients registered at the Hamadan Provincial Health Center in Iran, between 1997 and 2023. A multistate framework was described to investigate the progression of HIV disease over time. Three states (HIV-infected, acquired immunodeficiency syndrome [AIDS], and death) and three possible transitions (from HIV to AIDS, from HIV to death, and from AIDS to death) were considered in this framework. An illness-death multistate model was applied to determine the effect of risk factors on these transitions.

The results revealed that receiving antiretroviral therapy (ART) significantly decreased the hazard of transition from HIV to AIDS, whereas older age, tuberculosis (TB) co-infection, and treatment with the final guideline intensified the hazard of the mentioned transition. Low education, older age, and unprotected sexual transmission increased the risk of transition from HIV to death, while receiving ART and treatment with the final guideline decreased the risk of this transition. Receiving ART, being employed, having a history of prison, and being treated with the final guideline could decrease the hazard of transition from AIDS to death, whereas TB co-infection increased the hazard of this transition.

Implementing strategies for early diagnosis, timely treatment, adherence to treatment, as well as screening and TB treatment, especially at younger ages, can be useful in reducing AIDS progression and mortality.