Background: Monitoring progress and inequality in childhood immunization coverage at both national and sub-national levels is essential for refining equity-oriented health programs and ensuring equitable access to care towards achieving global targets in African countries. Methods and Findings: Using approximately 1 million records from 104 nationally representative Demographic and Health Surveys (DHS) conducted in 38 African countries (2000–2019), we estimated childhood immunization coverage for key indicators (BCG, MCV1, DPT3, Polio3, and Full immunization), stratified by socioeconomic status. Variations of Bayesian spatio-temporal analysis using Besag, Besag–York–Mollié (BYM) and BYM2 models were employed to assess and project the trends from 2000 to 2030. We evaluated the probability of achieving Universal Health Coverage (80% coverage) and Immunization Agenda (90% coverage) by 2030, at national and sub-national levels. Finally, we conducted a comprehensive inequality analysis using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII) to assess changes over the study period. Childhood immunization coverage improved significantly across most African countries from 2000 to 2019. However, projections suggest that 12 countries are unlikely to achieve global targets for full immunization by 2030 at the national level if current trends continue. Notably, high-Socio-Demographic Index (SDI) countries such as South Africa, Egypt, and Congo Brazzaville are projected to miss immunization targets across all sub-national regions. While socioeconomic inequalities were widespread in 2000, they are projected to decline or stabilize in 36 countries by 2030, with Eswatini, Morocco, Rwanda, and Burkina Faso expected to eliminate disparities. In contrast, Nigeria and Angola are projected to face increasing inequalities or persistent large gaps. Regional disparities in both coverage and inequality remain pronounced, particularly in Central and Western Africa, where coverage remains low and inequality remains high despite overall national-level improvements. The analysis was limited to DHS surveys 2000–2019, excluding more recent data during the COVID-19 period and potentially overestimating trends in data-sparse settings. Conclusions: This study highlights both progress and persistent challenges in childhood immunization coverage, along with inequalities across 38 African countries. Persistent regional disparities and socioeconomic inequalities require multifaceted strategies that account for demographic, geographic, economic, and political factors to ensure equitable immunization. Greater efforts are needed to close these gaps and support global health goals for the African nations.

There is limited information on whether the COVID-19 pandemic was associated with decreased breast cancer screening uptake and if COVID-19 vaccination was associated with an increase in screening uptake. Our study explored the uptake of breast cancer screening in Japan after the COVID-19 pandemic and assessed its association with the COVID-19 vaccination. We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), a web-based prospective cohort survey, and we included 6110 women without cancer history who were aged 40 to 74 years that participated in the 2012 and 2022 surveys. We examined the regular breast cancer screening uptake before and after the pandemic and employed a multivariable Poisson regression model to seek any association between COVID-19 vaccination and screening uptake. Of 6110, 38.2% regularly participated in screening before the pandemic and 46.9% did so after the pandemic. Individuals unvaccinated due to health reasons (incidence rate ratio (IRR) = 0.47, 95% CI: 0.29–0.77, p = 0.003) and for other reasons (IRR = 0.73, 95% CI: 0.62–0.86, p < 0.001) were less likely to undergo screening compared to fully vaccinated individuals. There was no long-term decrease in breast cancer screening uptake after the pandemic in Japan. Vaccination was linked to increased uptake, but there was no dose relationship.

Background: Psychiatric disorders significantly impact pediatric populations globally, affecting individual development, education and societal integration. In Nigeria, where nearly half of the population is under the age of 15, there remains a substantial gap in our understanding of the burden of these disorders within this demographic. This systematic review was conducted to quantify the prevalence of psychiatric disorders among Nigerian children and adolescents in clinical and community settings. Methods: We identified and examined original research articles available in PUBMED/Medline, EMBASE, and AJOL from January 2010 to August 2024, and selected studies that evaluated the prevalence of psychiatric disorders among children and adolescents ( 75%). The most common psychiatric disorders across the different settings were major depression among children and adolescents attending primary care (prevalence = 7.6%; 95% CI: 1.0; 40.5; three studies; 1,278 individuals), separation anxiety disorder among primary school children (prevalence = 14%; 95% CI: 9.5, 19.6; one study; 200 pupils), and behavioral disorders among secondary school students (prevalence = 15.1%; 95% CI: 14.4, 15.8; one study; 9,450 adolescents). Conclusion: The prevalence of psychiatric disorders among Nigerian children and adolescents is substantial, underscoring the critical need for enhanced mental health services.

Background: Breast cancer incidence has historically been higher in Western countries; however, rates have increased substantially in East Asia, with variation by age and generation. Direct comparisons between native Asians and their US counterparts remain limited. We examined the effects of age–period–cohort (APC) on breast cancer incidence among native Japanese women, with comparisons with Japanese Americans, native Korean women, Korean Americans, and US White and Black women. Methods: We analyzed population-based cancer registry data from Japan (1985–2019), Korea (1993–2017), Hawaii (1988–2017), Los Angeles County (1988–2017), and Surveillance, Epidemiology, and End Results 8 (1985–2019). Women 25 to 84 years of age were grouped into 5-year age groups and calendar periods, and APC analyses were conducted using the NCI APC web-based tool. Results: Incidence increased with age in all populations; however, the patterns differed. Native Japanese and Koreans had the lowest overall rates with an early-midlife peak, whereas Japanese Americans resembled US Whites, with incidence increasing into older ages. Period and cohort effects were strongest among native Japanese and Koreans, with sustained increases among women born after 1950. Annual incidence increases were highest among native Koreans (5.3%) and native Japanese (3.8%), followed by Korean Americans (2.8%) and Japanese Americans (1.6%), whereas US Whites were stable or declining and US Blacks showed modest increases. Conclusions: These findings indicate an ongoing epidemiologic transition in East Asia and demonstrate how migration and generational change shape breast cancer risk across populations. Impact: Direct comparison of native and US Asian populations reveals migration-related divergence in breast cancer risk.

OBJECTIVES: Global data often link greater socioeconomic deprivation to higher coronavirus disease 2019 (COVID-19) mortality. However, whether decentralized governance can mitigate this disparity by enabling tailored, equitable local responses remains unclear. We assessed whether Japan’s decentralized pandemic response moderated the association between area-level socioeconomic deprivation and COVID-19 mortality across municipalities.METHODS: We analyzed 20,760 COVID-19 deaths from all Japanese municipalities during 2020-2021. We computed standardized mortality ratios using national age-specific and sex-specific rates to derive expected counts. We then fit a Bayesian spatial Poisson regression model with the log of expected counts as an offset to estimate smoothed relative risks (RRs). The Area Deprivation Index (ADI) represented the primary predictor; structured and unstructured random effects captured spatial correlation and residual variability.RESULTS: Mapping of smoothed RRs, categorized into quintiles, revealed higher mortality risk in northern, central, and western municipalities, with lower risk in southern and scattered central regions. Contradicting global trends, deprivation and COVID-19 mortality demonstrated an inverse association (ADI coefficient, -0.095; 95% credible interval, -0.173 to -0.018), indicating that more deprived municipalities exhibited lower RRs for COVID-19 mortality (9.1% reduction per 1-unit increase in ADI).CONCLUSIONS: The inverse relationship between area deprivation and COVID-19 mortality in Japan contrasts with global patterns. Although Japan’s decentralized health system ensured equitable access to COVID-19 treatment, lower mortality in more deprived areas likely reflects additional protective factors, including population density patterns and community-specific adaptations. These findings underscore the complex interplay between socioeconomic conditions and health outcomes during global health emergencies.