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Is equity meaningfully incorporated into pandemic preparedness and response? A scoping review and critical analysis of Ebola andCOVID-19 outbreak responses in Uganda 2019-2023
(Taylor and Francis Group, 2025-12-31) Redondo G; Murray L; Bromhead C; Makumbi I
Societal inequities produce vulnerabilities that infectious disease can exploit. Current approaches to pandemic prevention, detection and response are led by the International Health Regulations IHR and the Global Health Security Agenda. However, to contain the spread of infectious diseases, localised action to address systemic inequities must be considered. The purpose of this scoping review and equity analysis is to 1) Synthesise the available information on Uganda’s Ebola Virus Disease (EVD) and COVID-19 preparedness and outbreak responses between 2019 and 2023, and 2) Critique if and how Uganda’s Ministry of Health incorporated concepts of health equity in its EVD and COVID-19 interventions, while building national capacity to identify and prevent public health emergencies. This scoping review and critical analysis was conducted following the five-stage process defined by Levac et al. After identification and screening, the scoping review was based on six preparedness and response plans, three after-action reviews, and 20 grey literature and peer-reviewed articles. The findings revealed that the EVD and COVID-19 preparedness and response plans in Uganda show the country’s commitment and readiness for early detection and response to infectious disease outbreaks. However, further examination of the plans reveals missed opportunities to address systemic inequities. The ongoing mpox outbreak, declared a PHEIC by WHO on July 23, 2022, with significant impacts in African countries including Uganda, further underscores the need for a paradigm shift in managing infectious disease outbreaks. Such a shift may be similar to that experienced by the field of disaster risk reduction, which underwent a significant transformation at the Sendai Conference in 2015 towards a more holistic and proactive approach that addresses underlying systemic issues and focuses on building resilience. The exclusive focus on biomedical strategies to manage infectious diseases fails to address the social aspects of transmission, the local perceptions of illness, and community vulnerabilities often associated with social and historical perspectives. The social determinants of health disparities should be incorporated into pandemic planning and response. This will contribute to fostering equitable health outcomes and resilience in the face of the multifaceted challenges posed by future pandemics and environmental changes.
Prevalence of gestational diabetes according to commonly used data sources: An observational study
(BioMed Central Ltd (part of Springer Nature), London, 2019-12) Lawrence RL; Wall CR; Bloomfield FH
Background: It is well recognized that prevalence of gestational diabetes mellitus (GDM) varies depending on the population studied and the diagnostic criteria used. The data source used also can lead to substantial differences in the reporting of GDM prevalence but is considered less frequently. Accurate estimation of GDM prevalence is important for service planning and evaluation, policy development, and research. We aimed to determine the prevalence of GDM in a cohort of New Zealand women using a variety of data sources and to evaluate the agreement between different data sources.
Methods: A retrospective analysis of prospectively collected data from the Growing Up in New Zealand Study, consisting of a cohort of 6822 pregnant women residing in a geographical area defined by three regional health boards in New Zealand. Prevalence of GDM was estimated using four commonly used data sources. Coded clinical data on diabetes status were collected from regional health boards and the Ministry of Health's National Minimum Dataset, plasma glucose results were collected from laboratories servicing the recruitment catchment area and coded according to the New Zealand Society for the Study of Diabetes diagnostic criteria, and self-reported diabetes status collected via interview administered questionnaires. Agreement between data sources was calculated using the proportion of agreement with 95% confidence intervals for both a positive and negative diagnosis of GDM.
Results: Prevalence of GDM combining data from all sources in the Growing Up in New Zealand cohort was 6.2%. Estimates varied from 3.8 to 6.9% depending on the data source. The proportion of agreement between data sources for presence of GDM was 0.70 (95% CI 0.65, 0.75). A third of women who had a diagnosis of GDM according to medical data reported having no diabetes in interview administered questionnaires.
Conclusion: Prevalence of GDM varies considerably depending on the data source used. Health services need to be aware of this and to understand the limitations of local data sources to ensure service planning and evaluation, policy development and research are appropriate for the local prevalence. Improved communication of the diagnosis may assist women's self-management of GDM.
Adherence to Dietary and Lifestyle Guidelines Among Women With a History of Gestational Diabetes Mellitus and the Influence of a Student-Led Dietetic Clinics
(Wiley Periodicals LLC, Hoboken, USA, 2025-02-23) Illenberger K; Sekula J; Lawrence R
Women with a history of gestational diabetes mellitus have an increased risk of developing type 2 diabetes. Healthy diet and lifestyle habits may contribute to reducing this risk. This study aimed to describe dietary intake and lifestyle habits of women with a history of gestational diabetes mellitus and determine the impact of nutrition and lifestyle counseling on dietary intake and lifestyle goals. This retrospective cohort study included 32 women with a history of gestational diabetes mellitus 6 months postpartum who attended the student-led nutrition clinic between 01 June 2021 and 31 August 2022. Dietary intake, lifestyle, and physical activity habits were extracted from student dietitians' notes. The mid-p-value McNemar's test was used to determine whether attendance at the student-led dietetic clinic was associated with a change in the proportion of women meeting the guidelines. Fifteen percent (n = 5) of women did not meet any food group recommendations prior to any interventions. Most women (46.8%) engaged in less than the recommended level of physical activity and more than a quarter (28.1%) did not engage in any physical activity at their initial consultation. After attending at least one consultation, a greater proportion of women met recommendations for at least one food group (41.1% vs. 18.7%, p = 0.256) and a greater proportion of women met physical activity guidelines (60% vs. 25%, p = 0.125). In this cohort of postpartum women with a history of gestational diabetes mellitus, adherence to the Ministry of Health Eating and Activity guidelines was poor. Positive changes towards adherence are possible after attendance at a student-led nutrition and dietetic clinic.
New Zealand women’s experiences of managing gestational diabetes through diet: a qualitative study
(BioMed Central Ltd, part of Springer Nature (London), 2021-12) Lawrence RL; Ward K; Wall CR; Bloomfield FH
Background: For women with gestational diabetes mellitus (GDM) poor dietary choices can have deleterious consequences for both themselves and their baby. Diet is a well-recognised primary strategy for the management of GDM. Women who develop GDM may receive dietary recommendations from a range of sources that may be inconsistent and are often faced with needing to make several dietary adaptations in a short period of time to achieve glycaemic control. The aim of this study was to explore how women diagnosed with GDM perceive dietary recommendations and how this information influences their dietary decisions during pregnancy and beyond.
Methods: Women diagnosed with GDM before 30 weeks’ gestation were purposively recruited from two GDM clinics in Auckland, New Zealand. Data were generated using semi-structured interviews and thematic analysed to identify themes describing women’s perceptions and experiences of dietary recommendations for the management of GDM.
Results: Eighteen women from a diverse range of sociodemographic backgrounds participated in the study. Three interconnected themes described women’s perceptions of dietary recommendations and experiences in managing their GDM through diet: managing GDM is a balancing act; using the numbers as evidence, and the GDM timeframe. The primary objective of dietary advice was perceived to be to control blood glucose levels and this was central to each theme. Women faced a number of challenges in adhering to dietary recommendations. Their relationships with healthcare professionals played a significant role in their perception of advice and motivation to adhere to recommendations. Many women perceived the need to follow dietary recommendations to be temporary, with few planning to continue dietary adaptations long-term.
Conclusions: The value of empathetic, individually tailored advice was highlighted in this study. A greater emphasis on establishing healthy dietary habits not just during pregnancy but for the long-term health of both mother and baby is needed.
Six microlensing planets detected via sub-day signals during the 2023–2024 season
(EDP Sciences on behalf of The European Southern Observatory (Ulis, France), 2025-10) Han C; Lee C-U; Udalski A; Bond IA; Albrow MD; Chung S-J; Gould A; Jung YK; Hwang K-H; Ryu Y-H; Shvartzvald Y; Shin I-G; Yee JC; Zang W; Yang H; Cha S-M; Kim D; Kim D-J; Kim S-L; Lee D-J; Lee Y; Park B-G; Pogge RW; Mróz P; Szymański MK; Skowron J; Poleski R; Soszyński I; Pietrukowicz P; Kozłowski S; Rybicki KA; Iwanek P; Ulaczyk K; Wrona M; Gromadzki M; Mróz MJ; Jaroszyński M; Kiraga M; Abe F; Bennett DP; Bhattacharya A; Fukui A; Hamada R; Silva SI; Hirao Y; Koshimoto N; Matsubara Y; Miyazaki S; Muraki Y; Nagai T; Nunota K; Olmschenk G; Ranc C; Rattenbury NJ; Satoh Y; Sumi T; Suzuki D; Terry SK; Tristram PJ; Vandorou A; Yama H
Aims. We present analyses of six microlensing events: KMT-2023-BLG-0548, KMT-2023-BLG-0830, KMT-2023-BLG-0949, KMT-2024-BLG-1281, KMT-2024-BLG-2059, and KMT-2024-BLG-2242. These were identified in KMTNet data from the 2023–2024 seasons, selected for exhibiting anomalies shorter than one day – potential signatures of low-mass planetary companions. Motivated by this, we conducted detailed investigations to characterize the nature of the observed perturbations.
Methods. Detailed modeling of the light curves reveals that the anomalies in all six events are caused by planetary companions to the lenses. The brief durations of the anomalies are attributed to various factors: a low planet-to-host mass ratio (KMT-2024-BLG-2059, KMT-2024-BLG-2242), a wide planet-host separation (KMT-2023-BLG-0548), small and elongated caustics restricting the source’s interaction region (KMT-2023-BLG-0830, KMT-2024-BLG-1281), and a partial caustic crossing (KMT-2023-BLG-0949).
Results. We estimated the physical parameters of the lens systems using Bayesian analysis. For KMT-2023-BLG-0548, the posterior distribution of the lens mass shows two distinct peaks: a low-mass solution indicating a sub-Jovian planet orbiting an M dwarf in the Galactic disk, and a high-mass solution suggesting a super-Jovian planet around a K-type dwarf in the bulge. KMT-2023-BLG-0830 hosts a Neptune-mass planet orbiting an M dwarf in the Galactic bulge. KMT-2023-BLG-0949 involves a super-Jovian planet orbiting a ∼0.5 M☉ host located at ∼6 kpc. KMT-2024-BLG-2059Lb is a super-Earth with a mass about seven times that of Earth, orbiting an early M dwarf of ∼0.5 M☉. KMT-2024-BLG-1281L hosts a planet slightly more massive than Neptune, orbiting an M dwarf of ∼0.3 M☉. The short timescale and small angular Einstein radius of KMT-2024-BLG-2242 suggest a ∼0.07 M☉ primary, likely a brown dwarf, with a planet of Uranus- or Neptune-like mass.