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Open defecation is ongoing in Nepal despite the rise in efforts for increasing latrine coverage and its use. Understanding the reasons for open defecation would complement the ongoing efforts to achieve the 'open defecation free' status in Nepal. This study aimed at exploring different motivations of people who practice open defecation in a village in Nepal. This study was conducted among the people from the Hattimudha village in Morang district of eastern Nepal, who practiced open defecation. Maximum variation sampling method was used to recruit participants for 20 in-depth interviews and 2 focus group discussions. We adopted a content analysis approach to analyze the data. We categorized different reasons for open defecation as motivation by choice and motivation by compulsion. Open defecation by choice as is expressed as a medium for socializing, a habit and an enjoyable outdoor activity that complies with spiritual and religious norms. Open defecation by compulsion include reasons such as not having a latrine at home or having an alternative use for the latrine structures. Despite having a private latrine at home or access to a public latrine, people were compelled to practice open defecation due to constraints of norms restricting latrine use and hygiene issues in general. For women the issues with privacy and issues refraining women to use the same latrine as men compelled women to look for open defecation places. Open defecation is either a voluntary choice or a compulsion. This choice is closely linked with personal preferences, cultural and traditional norms with special concerns for privacy for women and girls in different communities. The ongoing campaigns to promote latrine construction and its use needs to carefully consider these factors in order to reduce the open defecation practices and increase the use of sanitary latrines.

Background Obesity and overweight are prevailing concerns in modern society, but high BMI shows an established correlation with the risk of cancers that impacts not only medical issues but also economic performance. This study analyzes the economic loss due to high BMI-caused cancers (HBCCs). Methods This study used the comprehensive Global Burden of Disease (GBD) 2021 database and estimated the economic loss of HBCCs through the Value of Statistical Life approach (VSLA), incorporating a willingness-to-pay metric. Health burdens are expressed in age-standardized DALYs and death rates, and economic burdens are shown in dollars lost (2021 PPP) calculated from total DALYs. A joinpoint regression analysis was utilized to capture the temporal trends, cancer incidence, and economic losses attributed to high BMI across various countries and income levels. We calculated the average annual percentage change (AAPC) in total economic loss to evaluate the trend over the study period. Results There is a growing trend in both economic loss and disease burden of HBCCs on a global level. Colon and rectum cancer (CRC) show the highest economic loss ($2593.159 million, UI: 1109.04–4119.61, to $7294.52 million, UI: 3134.75–11,511.13), with pancreatic (AAPC: 10.47*, CI: 8.01–13.51) and liver cancer (AAPC: 8.08*, CI: 5.77–10.35) being the fastest growing cause. The cancer burden for all measures positively correlates with the country’s income level; high-income countries are the only group to experience a decreasing trend in the health burden, but they are still increasing in economic burden. Differences in loss of certain types of cancer and gender gap are observed in different income tiers. Conclusions These findings indicate a significant upward trend in economic loss, highlighting the urgency for strengthened policy measures. It is crucial for policymakers to implement effective risk reduction and resilience-building strategies to mitigate future economic loss and better protect vulnerable communities.

Background Suboptimal water, sanitation, and hygiene (WASH) practices constitute a serious public health risk, affecting one-third of the world's population. Remarkable progress has been made to improve WASH; however, challenges remain, with rapid population growth adding pressure on WASH systems. This study explores the current state of WASH practices and diseases in Africa, identifies challenges, and proposes public health recommendations for sustainable implementation. Main body The staggering burden of WASH-related diseases in low- and middle-income countries (LMICs), particularly in Africa, threatens public health, with millions of deaths and disability-adjusted life years (DALYs) attributed to poor WASH practices annually. Notable challenges plaguing WASH practices in the region include poverty, malnutrition, poor data reporting, illiteracy, climate change, and poor healthcare financing. This results in adverse health consequences, including waterborne infections like cholera, typhoid, dysentery, and diarrheal diseases. Additionally, neglected tropical diseases (NTDs) such as intestinal worms, schistosomiasis, trachoma, lost productivity, and environmental pollution from soil and underground water contamination have been implicated. Geographical disparities, cultural norms, and inadequate funding further complicate efforts to improve WASH infrastructure and practices. Globally concerted efforts are required to address these issues and permit WASH practices to protect human health by preventing infectious diseases and contributing to economic growth. Strong financial frameworks, skills training, and tools like WASH Fit are recommended for a stronger WASH approach in Africa. Conclusion The consequences of poor WASH extend beyond public health, impacting economic growth, gender equality, and environmental sustainability. WaterAid’s policy recommendations prioritizing government administration, institutional capacity enhancement, and more financial resources are expedient.

Crimean-Congo hemorrhagic fever (CCHF) is a lethal viral disease that has severe public health effects throughout Africa and a case fatality rate of 10%-40%. CCHF virus was first discovered in Crimea in 1944 and has since caused a substantial disease burden in Africa. The shortage of diagnostic tools, ineffective tick control efforts, slow adoption of preventive measures, and cultural hurdles to public education are among the problems associated with continued CCHF virus transmission. Progress in preventing virus spread is also hampered by the dearth of effective serodiagnostic testing for animals and absence of precise surveillance protocols. Intergovernmental coordination, creation of regional reference laboratories, multiinstitutional public education partnerships, investments in healthcare infrastructure, vaccine development, and a One Health approach are strategic methods for solving prevention challenges. Coordinated efforts and financial commitments are needed to combat Crimean-Congo hemorrhagic fever and improve all-around readiness for newly developing infectious illnesses in Africa.

Background Microvascular decompression (MVD) is the gold-standard surgical treatment for cranial nerve compression disorders, including trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN). This review synthesizes historical milestones, recent advances, and evolving techniques in MVD, with a primary focus on these conditions. Methods A comprehensive literature review was conducted using databases such as PubMed, SpringerLink, Google Scholar, BioMed Central, Scopus, and ScienceDirect. Studies published between 1970 and 2024 were analyzed, emphasizing surgical techniques, clinical outcomes, and technological innovations in MVD. Articles addressing TN, HFS, GPN, and other cranial nerve disorders treated with MVD were selected for detailed evaluation. Results MVD demonstrates high efficacy, with 80–90% of patients achieving immediate symptom relief. Nevertheless, 15–25% of patients experience symptom recurrence, though long-term outcomes remain favorable. Fully endoscopic MVD has shown potential for enhanced intraoperative visualization, particularly in complex anatomical regions; however, its impact on surgical precision and clinical outcomes is still under investigation. Moreover, innovations in visualization technologies, including three-dimensional exoscopic systems and artificial intelligence-assisted surgery, continue to improve procedural safety and outcomes. Despite these advancements, complications such as hearing loss (1–2%) and cerebrospinal fluid leakage (2–4%) persist, highlighting the need for continuous refinement of techniques. Conclusions MVD is evolving with the integration of cutting-edge technologies, resulting in improved clinical outcomes and reduced complication rates. Emerging innovations such as robotic-assisted MVD and gene therapies for cranial nerve disorders, including TN and GPN, promise even greater efficacy and precision. However, further research is necessary to standardize surgical protocols and address disparities in healthcare systems globally. Graphical Abstract

Skin cancer mortality disproportionately affects low‐ and lower‐middle‐income regions despite the prevalence being lower than in high‐income countries. Considering the need to diagnose it early for the best outcomes, this review addresses the barriers preventing it from being diagnosed and treated promptly and proposes possible solutions. Some of the barriers we found include the low number of dermatologists and pathologists, inadequate facilities, lack of education, the cost of healthcare, the denial of needing professional help, the fear and stigmatization of a skin cancer diagnosis, and the reliance on non‐medical therapies. Meanwhile, solutions we identified are training programs for healthcare professionals and the public, technological advancements (including nanotechnology‐based treatments, telemedicine, and social media use, the development and implementation of artificial intelligence programs), international collaborations, research, and increasing the number of cancer registries and national cancer control plans. Despite these solutions not being foolproof, they will lead to earlier cancer diagnosis, more individuals seeking skin check‐ups, better knowledge of skin cancer, improving the quality of life of vulnerable populations, and decrease in mortality.

Antimicrobial resistance is a hidden threat lurking behind the COVID-19 pandemic which has claimed thousands of lives prior to the emergence of the global outbreak. With a pandemic on the scale of COVID-19, antimicrobial resistance has the potential to become a double-edged sword with the overuse of antibiotics having the potential of taking us back to the pre-antibiotic era. Antimicrobial resistance is majorly attributed to widespread and unnecessary use of antibiotics, among other causes, which has facilitated the emergence and spread of resistant pathogens. Our study aimed to conduct a rapid review of national treatment guidelines for COVID-19 in 10 African countries (Ghana, Kenya, Uganda, Nigeria, South Africa, Zimbabwe, Botswana, Liberia, Ethiopia, and Rwanda) and examined its implication for antimicrobial resistance response on the continent. Our findings revealed that various antibiotics, such as azithromycin, doxycycline, clarithromycin, ceftriaxone, erythromycin, amoxicillin, amoxicillin-clavulanic acid, ampicillin, gentamicin, benzylpenicillin, piperacillin/tazobactam, ciprofloxacin, ceftazidime, cefepime, vancomycin, meropenem, and cefuroxime among others, were recommended for use in the management of COVID-19. This is worrisome in that COVID-19 is a viral disease and only a few COVID-19 patients would have bacterial co-infection. Our study highlighted the need to emphasize prudent and judicious use of antibiotics in the management of COVID-19 in Africa.

Sudan's economy has been greatly affected by the armed conflict through 15 different channels at both micro and macro levels. The requested fund to save live of sudanese population is 2.6 billion US$ from which only 33% was allocated. The humanitarian crisis in Sudan has lead to contraction in economy and thus agriculture, health, water supply, education, and bankig which all resulted in increased mortality and morbidity rates, food insecurity, violation in human rights and inflation. There is a rising humanitarian need for assistance, in addition to urgent interventions to stop war and cease fire. International law must be enforced through international organizations, the voice of Sudanese civil society must be coordinated if not united, and several measures must be taken after the conflict resolved to address the impacts of conflict.

Adolescent e-cigarette use is of public health interest in England, yet the influence of household environmental factors remains poorly understood. This cross-sectional study examined the association between secondhand tobacco smoke exposure in the home and regular e-cigarette use among adolescents. We analysed data from 12 297 adolescents aged 11–15 years who participated in the 2023 wave of the Smoking, Drinking and Drug Use among Young People in England (SDD) survey. The primary exposure was self-reported frequency of secondhand smoke exposure in the home or someone else’s home, categorized into five levels. The outcome was regular e-cigarette use, defined as vaping at least once per week. Logistic regression models estimated crude and adjusted associations, controlling for age, gender identity, ethnicity, family affluence, and household or peer smoking. Regular e-cigarette use was reported by 5.8% (n = 716) of the sample. Compared to those never exposed, adolescents exposed to secondhand smoke ‘daily or most days’ had significantly higher odds of regular e-cigarette use [adjusted odds ratio (aOR) = 7.25; 95% confidence interval (CI): 5.62–9.34; P < .001]. A clear dose–response relationship was observed across exposure categories (P for trend <.001), with increasing exposure linked to progressively higher odds of vaping. Among adolescents who had never smoked cigarettes, daily or near‑daily exposure to household secondhand smoke was still strongly associated with regular e‑cigarette use (aOR = 5.04; 95% CI: 3.64–6.99; P < .001). Frequent secondhand tobacco smoke exposure in the home is a strong and independent correlate of regular e-cigarette use among adolescents in England.

The Association of South-East Asian Nations (ASEAN) member states (AMS) are among the countries most at risk to the impacts of climate change on health and outbreaks being a major hotspot of emerging infectious diseases. To map the current policies and programs on the climate change adaptation in the ASEAN health systems, with particular focus on policies related to infectious diseases control. This is a scoping review following the Joanna Briggs Institute (JBI) methodology. Literature search will be conducted on the ASEAN Secretariat website, government websites, Google, and six research databases (PubMed, ScienceDirect, Web of Science, Embase, World Health Organization (WHO) Institutional Repository Information Sharing (IRIS), and Google Scholar). The article screening will be based on specified inclusion and exclusion criteria. Policy analysis will be conducted in accordance with the WHO operational framework on climate-resilient health systems. Findings will be analyzed in the form of narrative report. The reporting of this scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Ethical approval is not required for this study as this is a scoping review protocol. Findings from this study will be disseminated through electronic channels.