The protection of children as victims of sexual violence is a state constitutional obligation requiring comprehensive legal protection. The Witness and Victim Protection Institution (LPSK), established under Law Number 31 of 2014, is mandated to restore victims' rights, yet its assistance is not always available from the outset, as shown by a 2024 child rape case in the Jambi Regional Police jurisdiction handled without LPSK assistance, the problem this study addresses. This study analyzes LPSK's role in protecting children as victims of sexual violence, examines the forms of protection provided, and compares its regulation under positive law and Islamic law. This study uses a normative juridical method with a conceptual approach, statute approach, and case approach, analyzed qualitatively-descriptively. Results show LPSK carries out preventive and repressive protection through eight programs; Jambi Regional Police data recorded 144 protection applications from 2022 to 2025, a declining trend not necessarily reflecting fewer actual cases, while effectiveness remains constrained by limited access to reproductive health services and weak restitution execution. Positive law regulates protection in stages through Law Number 12 of 2022 and Law Number 35 of 2014, while Islamic law situates child protection within maqasid al-sharia, especially hifz al-nafs and hifz al-nasl. Both legal systems, despite differing normative approaches, place children as subjects who must be fully protected.
Abstract Background Optimal nutrition in the first 24 months of life is vital for child development. While socioeconomic factors associated with feeding practices are well-documented, evidence regarding the psychosocial correlates of minimum meal frequency (MMF) in Eastern Ethiopia remains scarce. Objective To assess the magnitude of minimum meal frequency and identify Health Belief Model (HBM) constructs and sociodemographic factors associated with minimum meal frequency among children aged 6–23 months in Harar City, Eastern Ethiopia. Methods A facility-based analytical cross-sectional study was conducted from December 2023 to January 2024 among 514 mothers/caregivers of children aged 6–23 months attending three randomly selected public health centers in Harar City. Participants were selected using systematic random sampling. Minimum meal frequency was defined according to WHO guidelines: ≥2 meals (breastfed, 6–8 months); ≥3 meals (breastfed, 9–23 months); ≥4 feeds (non-breastfed, 6–23 months). The Health Belief Model (HBM) was applied to assess psychosocial factors, including perceived susceptibility, severity, benefits, barriers, and self-efficacy. Data were collected using a structured questionnaire administered via KoboToolbox. Bivariable and multivariable logistic regression analyses were performed, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were used to identify factors associated with MMF. Results The prevalence of MMF was 61.5% (95% CI: 57.3–65.7). Achieving MMF was significantly associated with being breastfed (AOR = 3.20; 95% CI: 1.80–5.68), child age 6–8 months (AOR = 1.85; 95% CI: 1.10–3.12), and maternal primary education (AOR = 2.40; 95% CI: 1.05–5.45). Other significant correlates included high maternal knowledge (AOR = 3.40; 95% CI: 1.40–8.10), household food security (AOR = 3.10; 95% CI: 1.40–6.70), and postnatal care (PNC) attendance (AOR = 3.10; 95% CI: 1.70–5.50), and higher household wealth. HBM constructs were also independently associated with MMF: high maternal self-efficacy (AOR = 2.05; 95% CI: 1.30–3.25) and high perceived susceptibility (AOR = 1.45; 95% CI: 1.05–2.20) were associated with higher odds of meeting MMF requirements. Conclusions A substantial proportion of children did not meet recommended feeding frequency. Maternal psychosocial factors, particularly self-efficacy and perceived susceptibility, were significantly associated with feeding practices, alongside key sociodemographic and health service-related factors. Interventions should move beyond food security toward building caregiver confidence and utilizing PNC as a key touchpoint for behavioural change.
In mafia families, children are educated in violence, revenge, and gender stereotypes. The research question is: What can be done to guarantee these children the right to education, the right to become citizens, to learn democratic values, the right to be men without killing and women without obeying? The studies carried out have discovered a possible answer in the recent judgment of the Juvenile Court of Reggio Calabria, which has mandated the revocation of parental responsibility in cases in which injury to children is proven. These limitations to parental rights have the purpose of allowing institutions to stop a system of behavior that is harmful to the proper development of the personality of the child and that transmits negative cultural values from father to son. This way can play an important role for democracy in creating the context for progressive social change. Man acquires morality from the environment in which he grows, so it is really dangerous for children growing up in families in which boys are predestined to follow in their father's footsteps and girls are sometimes compelled to marry the sons of other bosses, binding separate clans together through blood relations. So, by removal, it is possible for mafia children to discover new realities and new way of life, by new structure that connects them to the society. Socrates in the Platonic Apology says that laws educate and make better youth generations.
In Germany, the childhood vaccination schedule in 2015-2020 included 13 vaccines, for which primary immunization series was recommended to be completed by 24 months of age. Childhood vaccination coverage is monitored through health insurance claims data and pre-school entry examinations. These cross-sectional systems provide limited information on individual vaccination trajectories, catch-up vaccination, and completion of the recommended vaccination schedule. We used cross-sectional (n = 2044) and longitudinal (n = 583) data from the KUNO-Kids health study (KKHS) from Regensburg, Germany (birth cohorts 2015-2020). We assessed vaccination coverage, catch-up vaccination, and completion of the entire primary immunization series according to the schedule recommended by the German Standing Committee on Vaccination (STIKO) at three follow-up time-points: 6 months, 2 years, and 4 years. Analyses included only children eligible for each assessment. At the 2-year follow-up, our cohort's vaccination coverage for all individual recommended vaccines remained below the 90-95% targets set by STIKO and the World Health Organization for 24 months of age. Vaccination coverage for all vaccines increased between the 2- and 4-year follow-up assessments for all vaccines. Coverage was lower for vaccines requiring multiple doses during the first year of life, such as the hexavalent vaccine (71-76%), than for vaccines initiated around 12 months of age and requiring fewer doses, such as MMR (86-87%). Among children with incomplete vaccination at 2 years, catch-up by 4 years was higher for MMR than for the hexavalent vaccine. Completion of the entire recommended vaccination schedule was achieved by only 50-55% of children at the 6-month and 2-year follow-ups but increased to 59-76% by the 4-year follow-up. Despite considerable catch-up before school entry, schedule adherence remained suboptimal, suggesting that vaccination schedule complexity in the first year of life may influence adherence. Interventions targeting this age group, including vaccination reminder systems and health education initiatives, should be implemented.
Margarida Arede, Susanne Brandstetter, Andreas Beyerlein et al.
Background: Universal childhood immunization is among the most cost-effective public health interventions, yet full-immunization coverage in India continues to fall short of the 85% target envisaged under the Universal Immunization Programme (UIP), with substantial dropout and missed opportunities contributing to preventable morbidity and mortality. Objectives: To assess the immunization status of children aged 0–5 years admitted to the paediatric department of a tertiary care hospital in Ahmedabad and its association with socio-demographic determinants, and to identify the reasons for failure of immunization. Methods: A hospital-based, cross-sectional, purposive-sampling study was conducted in the Department of Paediatrics of a tertiary care hospital, Ahmedabad, over 24 months (December 2016–November 2018). Five hundred children aged 0–60 months were enrolled. Immunization status was ascertained by structured maternal/paternal interview, cross-verified against immunization (Mamta) cards, and classified as completely, partially, or non-immunized as per the National Immunization Schedule. Data were analysed on Microsoft Excel using Pearson's chi-square test; p<0.05 was considered significant. Results: Of 500 children (266 male, 234 female), 66.6% were completely immunized, 27.2% partially immunized, and 6.2% non-immunized. Coverage was highest for the birth dose (BCG+OPV+HepB, 85.8%) and lowest for measles-2/booster-1 (57.7%). The BCG-to-measles-1 dropout rate was 16.2% and the Pentavalent-1-to-3 dropout was 11.4%. Complete immunization was significantly associated with joint family structure, institutional delivery, delivery attended by a doctor, higher parental education, and higher family income (all p<0.05); gender, birth order, and possession of an immunization card were not significantly associated. Among the 167 partially/non-immunized children, the leading parent-reported reasons for failure were unawareness of the need for subsequent vaccination (26.3%), child sickness at the scheduled time (14.4%), and lack of faith in immunization (11.9%). Conclusion: Immunization coverage among hospitalised children in Ahmedabad remains below the UIP target and is driven largely by modifiable knowledge, attitude and health-system barriers rather than vaccine unavailability. Structured parental counselling from the antenatal period, reminder and tracking systems, and strengthened interpersonal communication by frontline health workers could substantially narrow the coverage gap.
Background Tetanus remains a vaccine-preventable but potentially fatal disease, with control relying on vaccination coverage, maternal/neonatal protection, adult boosters, wound prophylaxis, and clinical management. This study characterized the global research landscape, thematic evolution, and emerging frontiers of tetanus literature from 2005 to 2025. Methods English-language articles and reviews were retrieved from the Web of Science Core Collection (WoSCC) and Scopus, with the final search conducted on May 12, 2026. Records were merged, deduplicated, and manually screened. Bibliometrix, VOSviewer, CiteSpace, and Scimago Graphica were used for descriptive analyses and visualization of collaboration, keyword co-occurrence, co-citation, and burst patterns. Citation-trend and reference co-citation analyses were restricted to WoSCC records. A manually verified clinical-treatment subset underwent supplementary keyword analysis. Results Of 28,912 retrieved records, 8307 publications met the inclusion criteria, comprising 7689 articles and 618 reviews. Annual publication output remained relatively stable, with a modest increase after 2010. The United States contributed the most publications (2578; 31.03%), followed by the United Kingdom, India, Germany, and China. The Centers for Disease Control and Prevention was the most productive institution, and Vaccine was the leading journal (643 publications). Three broad thematic domains emerged: toxin biology and immune mechanisms, vaccines and immunization strategies, and public health implementation and population protection. Recent keyword bursts highlighted vaccination coverage, pregnancy, women, vaccine hesitancy, and public health, while mechanistic and immunological research remained active. The clinical-treatment subset included 675 publications and emphasized intensive care, antitoxin and immunoglobulin therapy, autonomic dysfunction, and mortality. Conclusions Recent tetanus research fronts increasingly emphasize immunization delivery and population protection, alongside continuing mechanistic research. Clinical management constitutes a distinct but less prominent subdomain. These findings provide a publication-level overview to inform future evidence synthesis and research planning but should be interpreted alongside clinical, epidemiological, and surveillance evidence.
Maternal and child health service utilisation and pregnancy risk-prevention behaviour remain challenging in geographically isolated and border areas. These outcomes are interrelated because knowledge and attitudes may shape health decisions, while financial, geographical, and social resources determine the ability to translate decisions into action. Purpose: This study aimed to analyse the association of predisposing, enabling, and reinforcing factors with maternal and child health (MCH) service utilisation and pregnancy risk-prevention behaviour among pregnant women in the Melonguane Community Health Centre catchment area, Talaud Islands Regency. Method: An analytical cross-sectional study was conducted among 152 pregnant women from February to May 2026 using total sampling. Data were collected through interviewer-administered questionnaires. Associations were analysed using Chi-square or Fisher’s Exact tests at p<0.05. Multivariable regression was not performed. Results: Knowledge and positive attitudes were significantly associated with both outcomes (p<0.001). JKN coverage, distance to the health centre, transport access, spousal support, and health education were also significantly associated with both outcomes, while household income and community health worker involvement were associated with MCH utilisation. Implications: Maternal health interventions should integrate health education, financial protection, improved geographical and transport access, and family- and community-based support. Conclusion: MCH service utilisation and pregnancy risk-prevention behaviour are associated with interacting individual, enabling, and reinforcing factors. Because the cross-sectional design cannot establish causality and bivariate analysis cannot identify dominant determinants, future studies should use multivariable and longitudinal or intervention designs.
Introduction Childhood vaccination remains one of the most effective public health interventions, yet coverage is often lowest in settings affected by conflict and structural disadvantage. Cameroon has faced overlapping humanitarian crises in its Far North, North-West, and South-West regions, but evidence comparing determinants of full vaccination between conflict-affected and non-conflict regions remains limited. This study explores determinants of full vaccination status in 12–23 months children in Cameroon, stratified by conflict regions. Methods We conducted a secondary analysis of the 2018 Cameroon Demographic and Health Survey, including 1,824 living children aged 12–23 months. Full basic vaccination was defined as receipt of one dose of BCG, three doses of pentavalent vaccine, three doses of polio vaccine, and one dose of measles vaccine. Survey-weighted logistic regression was used to identify factors associated with full vaccination overall and by conflict status. Results Overall, 53.08% of children were fully vaccinated. Coverage was lower in conflict-affected than in non-conflict regions (45.29% versus 55.97%). In unadjusted analysis, conflict status was associated with lower odds of full vaccination, but this association was no longer significant in the adjusted model. At the national level, higher odds of full vaccination were associated with richer household wealth, maternal secondary or higher education, antenatal care attendance, and postnatal care. In conflict-affected regions, maternal secondary or higher education, postnatal care, and facility delivery remained significant predictors of full vaccination. Discussion Full vaccination coverage in Cameroon remains below desirable levels, with lower crude coverage in conflict-affected regions. However, after adjustment, conflict status was not independently associated with full vaccination, suggesting that socioeconomic conditions and contact with maternal health services are more important determinants. Strengthening antenatal and postnatal care and reducing socioeconomic barriers may improve vaccination coverage, especially in fragile settings.
Although uncommon, invasive meningococcal disease (IMD) is a serious and life-threatening illness. In the United States (US), incidence is highest among infants aged <1 year, but research characterizing pediatric IMD burden is limited. This study aimed to evaluate health outcomes and economic burden (healthcare resource utilization [HCRU] and costs [associated with health outcomes and HCRU]) in US individuals aged <11 years with IMD and without IMD, and their caregivers, from the patient and payer (commercial and Medicaid insurance) perspective. Retrospective claims analysis utilizing real-world data (1/1/2005–12/31/2022) from the MarketScan® Commercial and Multi-State Medicaid Databases compared health outcomes, HCRU (e.g., inpatient and outpatient admissions, surgical procedures, pharmacy claims), and costs (associated with health outcomes and HCRU) in commercially and Medicaid-insured infants (aged <1 year), toddlers (aged 1–4 years), and children (aged 5–10 years) with IMD versus those without IMD (matched 1:5), and their caregivers. Length of follow-up was variable, divided into acute/post-acute phases for individuals with IMD. Infants, toddlers, and children with IMD versus without IMD generally experienced more negative health outcomes and HCRU, and higher associated costs. Common health outcomes among infants with IMD included neurological, physical, and neurodevelopmental/mental health disorders. In the commercially insured cohort, infants with IMD had more inpatient admissions, specialist office visits, and surgical procedures than those without IMD. In the Medicaid-insured cohort, HCRU was higher for infants with IMD versus without IMD. Costs associated with health outcomes and HCRU were higher for infants with IMD versus those without IMD, regardless of insurance cohort. Health outcomes, HCRU, and HCRU-associated costs did not differ for caregivers to individuals with IMD versus without IMD. In this retrospective claims analysis from a dual US patient and payer perspective, infants, toddlers, and children with IMD experienced substantial negative health outcomes and economic burden, regardless of insurance status. Preventive interventions in childhood may lessen the impact of IMD on individuals, families, and healthcare systems. Invasive meningococcal disease (IMD), though uncommon, is a serious and life-threatening illness. In the United States (US), IMD is most common in infants. Using medical insurance information, this study assessed health conditions, healthcare services, and costs reported in US infants (aged <1 year), toddlers (aged 1–4 years), and children (aged 5–10 years) with IMD and their caregivers, compared with similar individuals who did not have IMD. Infants, toddlers, and children were grouped by insurance plan (commercial or Medicaid). Costs were evaluated from the patient and medical insurance perspective. Because IMD is particularly common in infants, we focused mostly on findings in the infant age group, although results were similar for toddlers and children. Neurological disorders were the most common health condition observed in infants with IMD from both the commercially insured and Medicaid-insured groups. Additionally, infants with IMD who had Medicaid insurance used all healthcare services more than Medicaid-insured infants without IMD. Infants with IMD who had commercial insurance had more inpatient admissions, specialist office visits, and surgical procedures than commercially insured infants without IMD. Medical costs for the commercially and Medicaid-insured infants with IMD were greater than the medical costs for infants without IMD, though infants with commercial insurance paid more than infants with Medicaid insurance. No differences were found between caregivers to individuals with IMD and without IMD. Early preventive measures such as vaccination during childhood may reduce the negative consequences of IMD, such as long-lasting health conditions and financial responsibilities, on individuals, families, and healthcare systems.
Oscar Herrera-Restrepo, Elizabeth Packnett, Megan Richards et al.
The HPV Prevention and Control Board convened its 18th technical meeting in Antwerp, Belgium (June 2025) to review the evidence on universal HPV vaccination and the role of anal cancer screening in the elimination of HPV-associated cancers. While HPV prevention has historically focused on cervical cancer in women, growing evidence supports extending both primary and secondary prevention to male cohorts and non-cervical anatomical sites. HPV causes approximately 148,072 cancer cases in men annually in the world - likely a substantial undercount - affecting primarily the oropharynx, anus, and penis. Men's lower seroconversion rates after natural HPV infection and sustained HPV prevalence across age groups makes vaccination an essential tool to prevent HPV-related disease in this population. Community-randomised trial evidence confirms that universal vaccination delivers stronger herd protection than girls-only strategies and may accelerate elimination of the most oncogenic types within 15-30 years. While modelling analyses identify high coverage in girls as the most efficient strategy for cervical cancer elimination, universal vaccination is justified on broader public health grounds, including equity, programme resilience, reduced vaccine hesitancy, and prevention of non-cervical cancers. Country experiences from Scotland and Cameroon highlight persistent equity gaps and the critical role of community engagement. Given the direct epidemiological link between HPV infection in males - particularly gay, bisexual, and other men who have sex with men and immunocompromised populations, such as people living with HIV - and anal cancer risk, the meeting identified anal cancer screening as the most advanced non-cervical secondary prevention strategy warranting immediate attention. The ANCHOR trial demonstrated that treating anal high-grade squamous intraepithelial lesions reduces anal cancer incidence by 57%. Despite the publication of the first evidence-based U.S. Health and Human Services and International Anal Neoplasia Society guidelines in 2024, implementation remains constrained by high-resolution anoscopy capacity, workforce shortages, stigma, and limited evidence on optimal screening algorithms. The meeting concluded that integrating universal vaccination with targeted anal cancer screening - supported by equitable access, biomarker development, and living guidelines that evolve with emerging evidence - is essential to reducing HPV-related cancer burden in both women and men.
F. Ricardo Burdier, Laia Bruni, Anna R. Giuliano et al.
