Background: Poor utilization of maternal healthcare services remains a public health concern in most low and middle-income countries (LMICs), including Afghanistan. Late, inadequate, or no utilization of antenatal care (ANC) services pose a great concern. Objectives: This study assessed the predictors of ANC service utilization among Afghan pregnant women, using secondary data from the Afghanistan Health Survey 2018 (AHS2018). Methods: In this study, we used data from 10,855 ever-married women, aged 13–49 years, who gave birth in the two years prior to the survey or those women who were currently pregnant. The outcome variable was defined as a binary variable on ANC utilization (≥1 ANC visit equals 1, and zero otherwise). We fitted a binary logistic regression model and examined the associations between ANC utilization and explanatory variables, providing findings based on univariate and multivariate analysis. STATA version 17 was employed for the data analysis. Results: Overall, 63.2%, 22.0%, and 3.1% of women had at least one ANC visit, ≥4 ANC visits, and ≥8 ANC visits during their last pregnancy, respectively. Higher odds of ANC utilization were observed in women who could read and write (AOR = 1.55, 95%CI: 1.36–1.77), whose husbands could read and write (AOR = 1.42, 95%CI: 1.29–1.56), who knew 1 sign (AOR = 1.93, 95%CI: 1.74–2.14), 2 signs (AOR = 2.43, 95%CI: 2.17–2.71) and ≥ 3 signs (AOR = 1.55, 95%CI: 1.36–1.77) of complicated pregnancy, and those with almost daily access to radio (AOR = 1.19, 95%CI: 1.08–1.327) and TV (AOR = 1.92, 95%CI: 1.73–2.13). We also found that women with one (AOR = 0.64, 95%CI: 0.49–0.84) and more than one (AOR = 0.60, 95%CI: 0.47–0.76) parity status, those for whom in-laws and others decided for their birthplace [(AOR = 0.85, 95%CI: 0.74–0.97) and (AOR = 0.63, 95%CI: 0.55–0.72), respectively], and those that resided in rural areas (AOR = 0.89, 95%CI: 0.79–1.00) had reduced odds of ANC utilization. Conclusion: ANC service utilization is unacceptably low by pregnant women in Afghanistan. The predictors of ANC utilization identified by the study should be considered in the design of future interventions to enhance antenatal care utilization in Afghanistan.

Mental health disorders have become a growing public health concern among individuals recovering from COVID-19. Long COVID, a condition where symptoms persist for an extended period, can predict psychological problems among COVID-19 patients. This study aimed to investigate the prevalence of long COVID and mental health status among Thai adults who had recovered from COVID-19, identify the association between the mental health status and long COVID symptoms, and investigate the risk factors associated with the correlation between long COVID and mental health outcomes. A cross-sectional study was conducted among 939 randomly selected participants in Nakhon Si Thammarat province, southern Thailand. The Depression, Anxiety, and Stress Scale-21 was used to investigate mental health symptoms, and a checklist comprised of thirteen common symptoms was used to identify the long COVID among participants. Logistic regression models were used to investigate the risk factors associated with mental health status and long COVID symptoms among participants. Among the 939 participants, 104 (11.1%) had depression, 179 (19.1%) had anxiety, and 42 (4.8%) were stressed. A total of 745 participants (79.3%) reported experiencing at least one symptom of long COVID, with fatigue (72.9%, SE±0.02), cough (66.0%, SE±0.02), and muscle pain (54.1%, SE±0.02) being the most frequently reported symptoms. All long COVID symptoms were significantly associated with mental health status. Shortness of breath, fatigue, and chest tightness were the highest risk factors for mental health status among COVID-19 patients. The final multivariable model indicated that female patients (OR = 1.89), medical history (OR = 1.92), and monthly income lower than 5,000 Thai baht (OR = 2.09) were associated with developing long COVID symptoms and mental health status (all p<0.01). This study provides valuable insights into the potential long-term effects of COVID-19 on mental health and enhances understanding of the mechanisms underlying the condition for predicting the occurrence of mental health issues in Thai COVID-19 patients.

Successful dengue solutions require community collaboration between agencies engaged in human health, vector control and the environment. In Thailand, village health volunteers emphasize the need for a health working group to interact, collaborate, and coordinate actions. The objectives of this study were to acquire an understanding of dengue solutions, as well as the larval indices surveillance system of village health volunteers in high- and low-risk dengue villages. After 12 months of training in dengue prevention and setting larval indices surveillance systems, an analytical cross-sectional survey was conducted. A total of 117 villages were included in the 18 primary care facilities within one district in southern Thailand, and they were divided into 71 high-risk and 46 low-risk dengue villages. Sample size was determined using the G*power formula. The content validity index and reliability values of Cronbach's alpha coefficient for the questionnaires were 0.91 and 0.83, respectively. A random sampling approach was used to acquire data. The chi-square test, t-test, and odds ratio were used to assess the sample's level of understanding. The study included 1302 village health volunteers, including 895 and 407 from high- and low-risk dengue communities, respectively. In total, 87.9% were female, 51.6% were 20–35 years old, 48.8% had worked as a village health volunteer for 11–20 years, 27.1% had an upper elementary education, and 59.1% had dengue in the previous 12 months. Understanding of the dengue solution and larval indices surveillance system varied across high- and low-risk dengue villages. Village health volunteers with a high level of understanding of the dengue solution and larval indies surveillance system were 1.064 and 1.504 times more likely to stay in high-risk dengue villages, respectively (odds ratio [OR] = 1.064, 95% confidence interval [CI]:0.798–1.419, p = 0.672 and OR = 1.504, 95% CI:1.044–2.167, p = 0.028). Village health volunteers require ongoing training to understand the prevention and control of dengue and larval indices surveillance systems, promote awareness, and monitor dengue in both high- and low-risk dengue villages.

Background: Non-adherence to antihypertensive medications (AHMs) is a widespread problem. Cardiovascular morbidity and mortality reduction is possible via better adherence rates among hypertensive patients. Objectives: This study aimed to assess the prevalence of non-adherence to AHMs and its predictors among hypertensive patients who attended Mirwais Regional Hospital in Kandahar, Afghanistan. Methods: A cross-sectional study using random sampling method was conducted among hypertensive patients, aged ≥18 years in Mirwais Regional Hospital at a 6-month follow-up between October and December 2022. To assess non-adherence to AHMs, we employed the Hill-Bone Medication Adherence scale. A value below or equal to 80% of the total score was used to signify non-adherence. A multivariable binary logistic regression model was used to identify predictors of non-adherence to AHMs. Results: We used data from 669 patients and found that 47.9% (95%CI: 44.1–51.8%) of them were non-adherent to AHMs. The majority (71.2%) of patients had poorly controlled blood pressure (BP). The likelihood of non-adherence to AHMs was significantly higher among patients from low monthly-income households [Adjusted odds ratio (AOR) 1.70 (95%CI: 1.13–2.55)], those with daily intake of multiple AHMs [AOR 2.02 (1.29–3.16)], presence of comorbid medical conditions [AOR 1.68 (1.05–2.67), lack of awareness of hypertension-related complications [AOR 2.40 (1.59–3.63)], and presence of depressive symptoms [AOR 1.65 (1.14–2.38)]. Conclusion: Non-adherence to AHMs was high. Non-adherence to AHMs is a potential risk factor for uncontrolled hypertension and subsequent cardiovascular complications. Policymakers and clinicians should implement evidence-based interventions to address factors undermining AHMs adherence in Afghanistan.

Background: Dengue has been spreading in Thailand for more than 50 years, and the community prevention of dengue transmission is an important strategy to help reduce outbreaks. The larval indices surveillance system is one of the most significant prevention methods at the household and district levels. Objective: This study sought to develop a larval indices surveillance system based on a specific community context. Method: Community participation action research (CPAR) studies represent a new approach to studying the high-risk dengue area of Lansaka district, Nakhon Si Thammarat province, Thailand. This study was conducted for 2 years (from 2013 to 2015) and applied the integrated concepts of 1) community capacity building, 2) epidemiology, 3) research design for health development, and 4) an online computer program. The method included five phases: 1) community preparation, 2) situation assessment, 3) the development of the surveillance system, 4) implementation, and 5) evaluation. Results: The model was designed in partnership with all the stakeholders from 44 villages across 5 sub-districts. The surveillance system consisted of seven steps at the household level based on primary care surveillance centers (PCSCs), as well as four components at the district level based on district surveillance centers (DSCs). The dengue morbidity rate decreased from 164, 151, and 135 cases/100,000 people in 2014, 2015, and 2016, respectively. Moreover, knowledge of both dengue and larval indices among village health volunteers (VHVs) increased significantly (p < .01). Conclusions: The results from the new system showed a decrease in both the larval indices level and morbidity rate; however, the levels remained higher than the standard. The active surveillance system requires continuous monitoring at both the household and district levels.