Approximately one-third of the global population cooks over open fires in the home, which are responsible for millions of deaths per year globally. The aim of this longitudinal cohort study was to develop, implement, and evaluate an intervention to improve the cooking behaviors of women in a rural Nicaraguan community. The study employed the Community Health Action Model for Participatory Behavior Change (CHAMP-BC) framework to develop a novel approach to improving cooking behaviors and reducing symptoms associated with household air pollution. The study was conducted from October 2007 to March 2018. Community health needs assessments and community forums were conducted. Readiness to change surveys were administered. Pre- and post-test cookstove implementation surveys were conducted. One hundred sixty-seven primary cooks, primarily women (99%), consented to participate in the improved cookstove program and were followed from baseline for up to seven years post-intervention. There were significant improvements in cough (p < 0.0001), chest illness (p < 0.0001), shortness of breath (p < 0.0001), headaches (p < 0.0001), and eye irritation (p < 0.0001). The novel CHAMP-BC framework enhanced the research approach by empowering women to change their cooking behaviors while providing them with the autonomy and agency necessary for decision-making regarding evidence-based methods to improve their health.

Smallholder farmers' exposure to pesticide can be minimized by their hygiene behaviour during pesticide application. The aim of this study was to determine knowledge of the risks, hygiene habits and perceived health issues associated with pesticide mixing and application among smallholder farmers in Nigeria. A cross-sectional study was conducted on 162 smallholder farmers from Ibarapa North Local Government Area, using a validated structured questionnaire through a two-stage sampling method. Data were analyzed using descriptive statistics and chi-square test at p = 0.05. Farmers' mean age was 42.4 ± 12.3 years, 85.0% were male while 32.9% had tertiary education. Most (95.1%) farmers acknowledged that pesticides affect human health and 63.1% read, understood and followed pesticides label. Notably, only 4.9% acknowledged that banned or restricted pesticides cannot be used. Respondents identified pesticide exposure routes as inhalation (74.7%), dermal (15.4%), oral (1.9%) and eye contact (0.6%). Mean knowledge score was 7.9 ± 2.7 and 54.3% had poor knowledge of pesticide risk. Majority of farmers had direct skin contact with pesticide (83.3%) while 21.3% wore pesticide contaminated farm cloth home. Respondents' use of personal protective equipment (PPE) during pesticide mixing and application were: goggles (10.1%), coverall (29.0%), head cover (22.9%) and gloves (41.8%). Additionally, unsafe disposal of empty pesticide containers on farm was common among the farmers (42.6%). Mean hygiene habit score was 5.8 ± 1.9 and 85.2% had unsafe hygiene habit. Respondents' (90.9%) who had poor knowledge of pesticide risk was significantly (p = 0.025) higher among those who had unsafe hygiene habit during pesticide mixing and application. Reported symptoms by farmers included: dizziness > itchy eye > headache = skin irritation > nausea = coughing, during or after pesticide mixing and application. Farmers' knowledge about pesticide risk and safe hygiene habit was poor. Farmers' health may be at risk, hence appropriate hygiene habit and use of PPE should be strictly adhered to during pesticide mixing and application.

Introduction Mexico has seen a high number of COVID-19 cases and deaths among children. The majority of cases were in Mexico City and the State of Mexico. There is heterogeneity in the clinical and epidemiological parameters of risk or protection at the national and international levels in this age group. The objective of the study is to identify the epidemiological and clinical factors associated with severe COVID-19, hospitalization, pneumonia at admission, and mortality among children and adolescents. Materials and methods A retrospective, analytical, and multicenter study based on hospital patients was conducted between 2020 and 2023 in four general and regional hospitals of the Mexican Social Security Institute (IMSS), Mexico. A total of 1,698 subjects diagnosed with COVID-19, aged between one and 17 years of both sexes, were included. Multiple binary logistic regressions were performed and stratified by laboratory diagnosis, obtaining simple and adjusted ORs for the clinical and epidemiological variables associated with severe COVID-19. Results The model adjusted and stratified by laboratory diagnosis for COVID-19 severity showed that obesity had an OR of 2.46 (95% CI, 1.37-4.43), being under five years of age had an OR of 2.01 (95% CI, 1.43-2.84), headache had an OR of 2.00 (95% CI, 1.18-3.39) and dyspnea had an OR of 1.82 (95% CI, 1.06-3.11). In the unadjusted analysis, male sex was associated with an OR of 1.82 (95% CI, 1.4-2.2) for severity. Conclusion The results suggest that being under five years of age, being overweight or obese, and experiencing cough, headache, and dyspnea are risk factors for COVID-19 complications in the hospital setting, based on clinical diagnosis. These findings have very limited applicability to mild community-acquired cases. Prospective cohort studies are needed to confirm these findings and include pediatric anthropometric standards.

In Japan, the diphtheria-tetanus-acellular pertussis (DTaP) vaccine (TRIBIK®; BIKEN Co., Ltd., Japan) is the pertussis-containing vaccine used for adults, and the package insert specifies subcutaneous (SC) administration. Given the relatively high antigen content of TRIBIK®, local reactogenicity may be a concern. We evaluated whether intramuscular (IM) administration could reduce adverse reactions among healthcare workers. We conducted a prospective observational study among physicians and nurses at a tertiary children's hospital in Japan. Participants selected SC or IM administration and received 0.5 mL TRIBIK®. Local reactions (pain by numerical rating scale [NRS], erythema, induration) and systemic symptoms (fever, fatigue, headache, appetite loss) within 7 days were collected via online questionnaires. Forty-five healthcare workers were enrolled (SC, n = 18; IM, n = 27), with no significant differences in baseline characteristics. The IM group reported significantly lower injection-site pain than the SC group (median NRS 1.0 vs 3.0; p = 0.021). The incidence of erythema and induration was also significantly lower with IM administration (p = 0.016 and p < 0.01, respectively). Systemic adverse events did not differ significantly between the two groups, and no participant required medical consultation. IM administration was associated with reduced local reactogenicity without increased systemic events in Japanese healthcare workers. Allowing IM administration could improve tolerability and support occupational pertussis booster programs in Japan; larger studies including immunogenicity are warranted.

Chlamydia psittaci (C psittaci) is an important causative agent of community-acquired pneumonia (CAP). However, conventional pathogen detection methods are often ineffective in the early diagnosis of CAP, making C psittaci pneumonia challenging to detect. C psittaci ranges from mild, self-limited to acute respiratory failure, and the early identification of this disease can be challenging. Targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid has the potential to improve the pathogen identification in C psittaci pneumonia. This retrospective study aims to systematically evaluate the clinical characteristics and etiological diagnostic value of tNGS in patients with C psittaci pneumonia, providing further insights into the diagnosis and management of this disease. We performed a retrospective analysis of samples obtained from 40 patients diagnosed with C psittaci pneumonia using tNGS at Zhengzhou People's Hospital between January 2024 and March 2025. The clinical characteristics, laboratory findings, radiological features, and treatment strategies for each patient were systematically evaluated. The analysis revealed that C psittaci pneumonia was frequently associated with avian or poultry exposure. Predominant clinical manifestations included fever, cough, sputum production, headache, and fatigue. Laboratory tests commonly indicated elevated neutrophil percentage, C-reactive protein, procalcitonin, and interleukin-6 levels, alongside reduced median lymphocyte percentage, eosinophil percentage, and albumin levels. Chest computed tomography scans revealed the presence of unilateral or bilateral pulmonary infiltrates. Upon tNGS-based pathogen identification, antimicrobial therapy was promptly adjusted to doxycycline and moxifloxacin, which resulted in favorable clinical outcomes. Although C psittaci-induced CAP lacks pathognomonic symptoms, characteristic laboratory markers may aid its early identification. The tNGS was found to be a rapid and accurate diagnostic tool and demonstrated substantial clinical utility in the timely detection of C psittaci pneumonia. Future studies with larger sample sizes and prospective designs are warranted to validate these findings.