Many Rohingya in Myanmar fled targeted violence to Malaysia, where ∼120 000 now live. They lack legal status and access to education, formal employment, and affordable healthcare. We aimed to explore Rohingya perspectives and the lived experiences of their socio-legal environment and how this impacted their access to healthcare, to better understand the root causes of poor health outcomes and inform refugee health policies and interventions. This qualitative study used a structural violence lens and included 49 semi-structured interviews with purposively sampled Rohingya men and women in Malaysia. We used abductive thematic analysis, including inductive and deductive coding. We generated four themes: (i) national policies; (ii) societal discrimination and identity obligations; (iii) humanitarian aid provision; and (iv) healthcare access. The first two included the socio-political barriers that the Rohingya experienced in accessing livelihoods, education, and healthcare, with women experiencing compounded oppression due to structural and community norms limiting their capabilities. The third highlighted inequitable aid-refugee power relations driven by unregulated and marketized responses. The fourth examined healthcare access outcomes. Structural factors impacted healthcare access for the Rohingya, significantly limiting their ability to achieve good health in Malaysia. Efforts to promote inclusivity require a paradigm shift from conventional to social justice-driven approaches, with regular monitoring and reconfiguration of activities to ensure effectiveness.

Environmental emergencies and conflicts are major drivers of human and animal displacements, increasing the spread of communicable diseases. In such contexts, livestock keepers are among the most vulnerable communities. As a matter of fact, when animals are moved, tensions between groups may escalate and disease spread can intensify. In contrast, when livestock are left behind, households face severe economic decline and increased poverty. This article explores the phenomenon of forced displacements at the human-animal interface, potential gaps and opportunities. This narrative review is based on a search of PubMed and grey literature. Peer-reviewed literature published from 2015 to March 2025 and reports and documents from governmental institutions, non-governmental organizations (NGOs) and press websites in English, French, German, Hindi, Italian, Portuguese and Spanish were considered eligible for analysis. Thirty-four peer-reviewed papers met the inclusion criteria. The majority of the studies were based in the African Continent on the main migration routes, addressing mainly vector-borne diseases, capacity-building needs and a lack of research. Grey literature was incorporated alongside peer-reviewed papers as governments, intergovernmental organizations, NGOs and the press represent relevant actors in implementing coping strategies and raising awareness on forced animal displacements. This narrative review highlights the need for primary data collection and interdisciplinary collaboration adopting a route-based and equity-oriented One Health approach.

Strengthening health leadership and management capacity in low- and middle-income countries (LMICs) is critical for building resilient health systems. The Dr. Lee Jong-wook Fellowship Program (LJWFP), implemented by the Korea Foundation for International Healthcare, was designed to equip public health administrators with competencies in policy implementation and system strengthening. However, long-term behavioural impacts of such programs are rarely evaluated beyond satisfaction and knowledge gains. This study assessed the long-term impact of the 2022 LJWFP cohort on competency achievement, satisfaction and workplace application using the Kirkpatrick evaluation framework. This mixed methods study analysed data from 13 fellows who participated in the 2022 LJWFP. Quantitative data were collected through pre- and post-training assessments, participant surveys and supervisor and peer evaluations. Qualitative evidence was obtained through follow-up assessments and structured field visits. Descriptive statistics summarized key outcomes and Pearson's correlation analysis examined associations among competency achievement, training satisfaction and workplace application over a 2-y follow-up period. The program demonstrated high training satisfaction, with substantial gains in knowledge and competency. The correlation between competency achievement and satisfaction was moderate and statistically significant (r=0.488, p<0.05), whereas the relationship between competency and field application was moderate but not statistically significant (r=0.445, p<0.05). A strong, statistically significant correlation was observed between satisfaction and field application (r=0.776, p<0.001), suggesting that participants who were more satisfied with the training were more likely to apply their learning in practice. The program effectively enhanced leadership skills and supported post-training applications. Future iterations should integrate mentorship and follow-up mechanisms, expand digital learning tools and measure system-level impact longitudinally. These findings highlight the value of context-tailored fellowships in advancing public health leadership and governance in LMICs.

Hepatitis E virus (HEV) is a major cause of viral hepatitis in humanitarian and resource-limited settings. Internally displaced persons (IDPs) are especially vulnerable due to overcrowding and inadequate water, sanitation, and hygiene (WASH) conditions. However, spatial variation in HEV exposure within camps remains poorly characterized. The objective of the current study was to determine the seroprevalence, spatial distribution, and environmental correlates of HEV exposure among IDPs in Al-Azaza Camp, Blue Nile State, Sudan. A cross-sectional study was conducted among 1078 IDPs from August to December 2021. Serum samples were tested for anti-HEV IgG and IgM using ELISA. Household environmental and behavioral data were collected through questionnaires and observation. GPS coordinates were mapped in ArcGIS Pro to assess spatial clustering. Multivariable logistic regression identified independent predictors of seropositivity. Overall HEV seroprevalence was 76.4%, with low IgM positivity (1.85%), suggesting limited recent transmission. Significant spatial clustering was observed, driven mainly by IgG-positive cases. Independent risk factors included proximity to open defecation sites, unsafe water storage, poor solid waste disposal, and animal husbandry. HEV exposure was widespread and spatially clustered, reflecting cumulative transmission. Targeted, sustained improvements in WASH infrastructure are crucial to reduce ongoing risk among displaced populations.

Cholera continues to be a global threat, particularly in regions affected by conflict and environmental shocks, such as Sudan. Such humanitarian crises disrupt sanitation, water, and health systems, exacerbating cholera transmission. Overcrowded camps from displacement, poor hygiene, and weak surveillance further contribute to the outbreaks even beyond national borders. This paper explores armed conflict-driven crises and population movement as epidemiological drivers of cholera. It highlights the critical need for integrated, multisectoral strategies combining vaccination, water, sanitation, and hygiene infrastructure, and early detection systems. The interventions are necessary for mitigating outbreaks and building long-term resilience in such fragile settings.

Former OCP countries like Senegal have made important progress towards eliminating onchocerciasis. Senegal has engaged in post-MDA activities, mainly entomological surveillance, but the country initially struggled to collect the recommended number of blackflies in all the country' transmission zones. Here we implemented a simple approach in the entomological surveillance protocol to increase the number of S. damnosum collected. The study was conducted over two consecutive years, 2022 and 2023, in the main S. damnosum capture points located along the Gambie and the Faleme river basins. We reviewed environmental data, analysed and interpreted previous blackflies capture data, and processed field visits to identify optimal periods of blackfly capture in each capture point. After the implementation of our approach, the number of blackflies captured increased by approximately 42% in 2023 when compared to 2022 captures. The numbers of blackflies captured increased from 71 999 and 23 666 respectively in Gambia and Falemé in 2022, to 101 276 and 34 780 in 2023. Our results revealed that simple and effective microplanning of blackfly capture periods can support onchocerciasis post-MDA surveillance activities by increasing the number of blackflies captured.

This study aimed to update the global estimates of microsporidia prevalence, species/genotype distribution and clinical correlates among human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. A systematic search of international databases was conducted for studies published between 1 January 2017 and 11 October 2025. Pooled prevalence and odds ratios (ORs) were calculated using a random effects model with 95% confidence intervals (CIs). Thirty-nine studies from 18 countries (24 cross-sectional, 15 case-control) were included. The pooled prevalence of microsporidia among HIV/AIDS patients was 12% (95% CI 8.9 to 16), significantly higher than in controls (1.9%; odds ratio 5.7 [95% CI 3.33 to 9.74]). A higher pooled prevalence of microsporidia infection was observed in studies published after 2020 (15.9%), in those with sample sizes ≤100 participants (19.2%), in patients with CD4 counts ≤200cells/μl (58.4%) and in males (64.9%). The highest country-specific prevalence rates were reported from Malaysia (60.9%), Mexico (48.3%), Malawi (37.0%) and South Africa (32.9%). Enterocytozoon bieneusi was the predominant species, accounting for 24 identified genotypes, followed by Encephalitozoon intestinalis, E. cuniculi and E. hellem. Microsporidia remain a significant opportunistic pathogen in HIV/AIDS patients. Strengthened molecular surveillance, standardized diagnostic protocols and integration of microsporidia screening into HIV/AIDS care are essential to improve outcomes and control transmission.