Gestational diabetes mellitus (GDM) is a major maternal health concern associated with adverse outcomes for mothers and their offspring. In Latin America and the Caribbean (LAC), its burden is heightened by socioeconomic inequalities, limited prenatal care, and high obesity rates, while evidence for other determinants remains fragmented and heterogeneous. This scoping review aimed to identify, describe, and categorize existing research on the prevalence, incidence, determinants, and risk factors of GDM in LAC. We conducted a scoping review following JBI guidance and PRISMA-ScR. Embase, MEDLINE/PubMed, Web of Science, SciELO, and LILACS were searched from inception to December 2025. Eligible studies included observational studies reporting GDM prevalence, incidence, diagnostic criteria, or risk factors in LAC. Two reviewers independently screened records and extracted data. Findings were synthesized descriptively. Fifty‑six studies from nine LAC countries were included, mainly from Brazil and Mexico. Studies were predominantly cross-sectional, cohort, and case-control designs conducted in hospital or prenatal care settings. Diagnostic approaches varied, with IADPSG (39.3%), WHO (25.0%), and ADA (16.1%) as the most frequently used criteria. GDM prevalence ranged from 3.0% to 61.0%, and incidence estimates varied substantially. The most frequently reported determinants and risk factors were advanced maternal age, overweight and obesity, family history of diabetes, previous GDM, prior macrosomia, and hypertension. Behavioral and social determinants were less frequently assessed. Variability in GDM prevalence across LAC highlights the need for standardized regional screening and prospective, population-based research. Reducing the regional GDM burden requires integrating clinical interventions targeting modifiable risk factors and improved continuity of care.
BACKGROUND Despite global commitments to youth-friendly sexual and reproductive health services (SRHS), service delivery gaps persist in sub-Saharan Africa. In Nigeria, health system limitations interact with sociocultural and gender norms, creating barriers to youth SRHS access. OBJECTIVE This study explored service providers' perspectives on delivering SRHS to youths aged 10-24 years in southern Nigeria, focusing on their experiences, challenges and adaptive strategies. METHODS A qualitative descriptive study was conducted using semi-structured Zoom interviews with 19 purposively selected service providers from selected public primary healthcare centres (PHCs). Participants came from community health, nursing, midwifery and other clinical backgrounds. Interviews were audio-recorded, transcribed verbatim and analysed using Braun and Clarke's reflexive thematic analysis. RESULTS Four themes were identified: 1) Striving for comprehensive youth SRHS amid resource constraints, reflecting provider commitment despite staffing, infrastructure and supply challenges; 2) Navigating socio-cultural norms in youth SRH provision, showing how taboos, religious beliefs and gender norms shaped delivery; 3) Provider resilience and commitment in a challenging context, reflected in personal sacrifices and creative solutions; and 4) Limited integration of social support services, highlighting missed opportunities for holistic youth support. CONCLUSIONS Providers demonstrated resilience and resourcefulness, but reliance on individual commitment may mask structural deficiencies and cannot substitute for system-level support. Strengthening youth SRHS requires workforce support, improved infrastructure, standardised youth-friendly protocols, provider training and multisectoral collaboration to improve quality and accessibility. Findings are context-specific to one local government area in southern Nigeria but offer insights for service strengthening in similar low-resource settings.
BACKGROUND The arid Central Australia will continue to experience increasing hotter temperatures. OBJECTIVES This research assessed associations between heatwaves and all cause, and cause-specific emergency department (ED) visits for cardiovascular diseases, infectious diseases, kidney and urinary tract diseases (KD), mental disorders and respiratory diseases. METHODS Daily ED visits data, 2010 to 2021, from Alice Springs Hospital, Central Australia, were obtained. Nine heatwave definitions based on combinations of mean temperature thresholds (≥90th, ≥95th, and ≥97th percentile) and durations (≥2, ≥3, and ≥4 consecutive days) during warm months were assessed in quasi-Poisson regression models. The ≥ 95th percentile for ≥2 consecutive days was the primary exposure, with remaining definitions assessed in exploratory analyses. RESULTS A total of 50,324 ED visits were recorded. Heatwaves, ≥95th percentile of daily mean temperature for ≥2 days and ≥90th percentile temperature for ≥2 days, were associated with modest increases in all cause ED visits at lag 0 (HW2 relative risk - RR 1.02, 95% CI 0.97-1.07) compared to non-heatwave days. Significant increases in KD‑related ED visits were consistently observed for several heatwave thresholds including primary heatwaves exposure over several lag days (at lag 0-2 days cumulative RR 1.37, 95% CI 1.02-1.83). Increased risks of ED visits from heatwaves were also observed among people aged > 45 years. CONCLUSIONS These findings suggest differential effects of heatwaves on ED visits in the single hospital in Central Australia and highlight need for emergency services preparedness within remote health service systems that is backed up by local demographic and health profiles.
