Multi-sectoral nutrition (MSN) approaches coordinate interventions across sectors such as health, agriculture, education, and social protection to improve nutrition outcomes, and have gained prominence in low- and middle-income countries (LMICs). Measuring co-coverage - the clustering of multiple interventions at the individual and household level - remains uncommon yet offers a viable method for tracking MSN intervention coverage. This scoping review examined existing analytic approaches and applications for assessing co-coverage of health and nutrition interventions. We searched Web of Science Core Collection, PubMed, and EBSCOhost for studies that used, described, or developed co-coverage methods to measure nutrition- and health-related intervention coverage. Titles and abstracts were screened by two independent reviewers using Covidence, followed by full-text screening based on pre-defined criteria. Screening 4,478 abstracts yielded 73 eligible studies applying 8 distinct methods to quantify co-coverage across health and nutrition interventions. Most studies were observational (90%) and conducted in LMICs, particularly Sub-Saharan Africa and South Asia, with publications increasing over the past decade. Data were primarily drawn from surveys (93%), particularly Demographic and Health Surveys (41 studies). Commonly included individual-level interventions in co-coverage indices were antenatal care (ANC, 66 studies) or ANC components, child immunizations (48 studies), and skilled birth attendance (42 studies). Evidence on measuring a range of multisectoral interventions at the household level was limited. Intervention selection was often guided by established frameworks or guidelines. Coverage indices were calculated using simple counts, weighted averages, and scoring systems. While 18 studies validated their indices through methods such as Cohen's kappa and sensitivity analyses, most relied on previously used approaches without specific validation. These findings underscore the considerable variability in co-coverage methodologies and the need for greater harmonization and validation to enable consistent monitoring of multisectoral nutrition progress.

Duffy-null-associated neutrophil count (DANC) refers to a below-normal absolute neutrophil count (ANC < 1.5 × 10[3]/L), present most commonly in African American individuals. Neutropenia is a result of a lack of Fya and Fyb antigens on red blood cells. These patients do not have an increased risk of infection and may have an ANC < 1.5 × 10[3]/L at baseline. This unique case presents Duffy-null-associated neutropenia in the setting of chronic myeloid leukemia (CML). A 64-year-old African American female presented to the emergency department on May 17, 2021, for fatigue and was found to have a white blood cell (WBC) count of 65.3 × 10[9]/L. Hematology and oncology referral led to a diagnosis of CML. Subsequently, she began treatment with imatinib (Gleevec) 400 mg daily. One month into treatment, she was neutropenic, with an ANC of 0.6 × 10[3]/L. For the next several years, this patient repeatedly had treatment holds and dose reductions in response to recurrent neutropenia. When BCR-ABL1 transcript level continued to increase, indicating poor treatment response, she was referred to Medical University of South Carolina (MUSC). After several treatment changes due to adverse effects, she began treatment with asciminib 80 mg daily. BCR-ABL1 transcript level with asciminib was consistently below 0.1%, indicating successful treatment response. Despite this milestone, she continued to have episodes of neutropenia, prompting a check for Duffy antigen presence. Testing confirmed the lack of Fya and Fyb antigens, indicating Duffy-null status. This case demonstrates the importance of identifying Duffy-null individuals. Despite achieving major molecular response, the patient had persistent neutropenia, leading to the investigation of Duffy-null status. It is hypothesized that underlying Duffy-null status may have caused neutropenia, rather than an adverse reaction to treatment. Early detection of Duffy-null status can prevent dose reductions in therapy and delayed remission. Particularly with African American patients, a better framework for addressing Duffy-null neutropenia may benefit long-term outcomes in the setting of cancer therapy.

Background/Objectives: Maternal systemic lupus erythematosus (SLE) is associated with preterm birth, but whether maternal disease activity influences early neonatal hematologic profiles beyond developmental immaturity remains unclear. We compared hematologic parameters between SLE-exposed preterm infants and maturity-matched controls and explored findings according to maternal SLE flare during pregnancy. Methods: This single-center retrospective matched-cohort study included 13 SLE-exposed preterm infants and 39 controls matched 1:3 by gestational age, birth weight, and sex. White blood cell (WBC) count, absolute neutrophil count (ANC), hemoglobin concentration, and platelet count were assessed at birth, around postnatal day 5, and at their nadir during hospitalization. Group differences were estimated using linear regression models including matched-set identifiers as fixed effects. Flare-stratified and hepatic analyses were exploratory, without adjustment for multiple comparisons. Results: Overall matched-set analyses showed no clear differences in WBC count, ANC, hemoglobin, or platelet values between SLE-exposed infants and controls. The estimated difference in nadir ANC was -405/μL (95% confidence interval [CI], -985 to 174/μL; p = 0.164). In the maternal-flare subgroup, nadir WBC count was lower than in its matched controls (difference, -2.31 × 10[3]/μL; 95% CI, -3.96 to -0.65 × 10[3]/μL; p = 0.009), as was nadir ANC (difference, -672/μL; 95% CI, -1260 to -85/μL; p = 0.028). Corresponding matched-set differences were not evident at birth or around postnatal day 5. The non-flare subgroup did not show a consistent pattern of leukocyte suppression. Conclusions: Maternal SLE exposure was not clearly associated with an overall difference in neonatal hematologic profiles within matched sets. Maternal SLE flare may identify a subgroup with lower WBC and neutrophil nadirs, but this exploratory finding requires confirmation in larger studies.

Background/Objectives: Deep neck infection (DNI) can be difficult to distinguish from localized upper aerodigestive disease during emergency department (ED) evaluation. We assessed routinely available laboratory markers in adults presenting with throat or neck symptoms and examined whether the associations were reproduced in an imaging-defined subgroup. Methods: This single-center retrospective cohort included 1640 adults with prespecified throat- or neck-related presentations between January 2021 and May 2026. The primary outcome was DNI confirmed using prespecified diagnostic evidence from contrast-enhanced neck CT, endoscopic/fibroscopic evaluation, or ultrasonographic evaluation with aspiration or drainage when applicable. A clinical model incorporating demographics, presenting symptoms, symptom duration, and initial vital signs was compared with the same model after addition of inflammatory laboratory markers. A secondary analysis was restricted to 662 patients who underwent contrast-enhanced neck CT. Results: DNI was confirmed in 273 patients (16.6%). In 1166 complete cases (268 events), the 10-fold cross-validated AUC increased from 0.644 for the clinical model to 0.788 for the clinical model augmented with ANC and CRP (ΔAUC, 0.144; 95% CI, 0.109-0.179; likelihood-ratio p < 0.001). In this augmented model, ANC (aOR per 5 × 10[9]/L, 1.49; 95% CI, 1.25-1.79) and CRP (aOR per two-fold increase, 1.51; 95% CI, 1.37-1.65) remained associated with DNI. In the CT-defined subgroup, the corresponding cross-validated AUC increased from 0.562 to 0.685 (ΔAUC, 0.123; 95% CI, 0.077-0.167). Derived inflammatory indices showed no clear advantage over conventional markers. Conclusions: ANC and CRP remained associated with confirmed DNI after adjustment for clinical characteristics, and their addition improved discrimination beyond structured clinical assessment. More complex derived indices offered no clear advantage over conventional markers. Model performance remained insufficient for stand-alone diagnostic or imaging decisions.

National survey data indicate that only around one quarter of women in Malawi attend their first antenatal care (ANC) visit during the first trimester. This study explores women's perceptions of ANC in Chizenga village, Chikwawa, a rural setting with high maternal mortality and low ANC uptake. Using an interpretivist qualitative design, 14 pregnant women aged 18-44 years were recruited through purposive sampling. Semi-structured interviews were conducted in Chichewa, translated into English, and analysed using thematic analysis to identify patterns across the dataset and develop themes grounded in participants' accounts. Findings indicate that while women valued ANC and recognised its role in reducing maternal and neonatal mortality, most initiated care after the first trimester. Key themes included understanding of pregnancy health and ANC, nutritional constraints despite awareness, gendered dynamics in ANC attendance, the perceived influence of witchcraft, experiences of respectful and disrespectful care, and structural barriers related to distance and transport. Socioeconomic constraints, particularly distance, transport costs, and limited health literacy, contributed to delayed ANC attendance. Nevertheless, women demonstrated resilience and a strong commitment to maternal health, with some walking over 22 kilometres to access services. Participants voiced a need for increased ANC education and proposed community-based solutions such as health worker outreach and improved access to services. The study calls for context-sensitive policy interventions, including community-based health education, outreach antenatal services, and improved transport support, to ensure equitable access to respectful antenatal care.