Flemming Konradsen

University of Copenhagen · Department of Public Health

Aims In Nordic countries, the influx of immigrant doctors and nurses has been increasing since 2005, however retention remains a challenge. The aims of this scoping review were to examine the facilitators and barriers to the retention of immigrant doctors and nurses in the Nordic countries in order to inform future studies and interventions. Metho...

BACKGROUND Similar to many resource-constrained urban settings, cesarean deliveries in Dar es Salaam, Tanzania, have increased rapidly, from 17% in 2015 to 26% in 2022. Alarmingly, at the population level, the increase was not followed by improvements in perinatal outcomes, suggesting the overuse of cesarean delivery. Prolonged labor is the leading...

Objective: Socioeconomic status deprivation is known to be associated with self-harm in Western countries but there is less information about this association in Low and Middle Income Countries (LMIC). One way of investigating this is to assess the prevalence of indicators of financial stress in people who self-harm. We have assessed the prevalenc...

Background High rates of labour augmentation with oxytocin have been found in some low- and lower-middle-income countries, causing potential perinatal harm. It is critical to understand the reasons for this overuse. Aim was to explore factors that shape practices around using oxytocin for labour augmentation in a high-volume labour ward in Dar es S...

Objective: To estimate the proportion of caesarean sections (CS) not meeting audit criteria for prolonged labour. Design: Cross-sectional. Setting: Five urban maternity units in Dar es Salaam, Tanzania. Population: Women giving birth by CS with an indication of prolonged labour, from October 1 st , 2021 to August 31 st , 2022. Exclusion criteria: r...

Modern agriculture relies on pesticides to maximise outputs. While many highly hazardous pesticides (HHPs) are banned in places like the European Union due to concerns about harm to the environment and human health, their use continues in many low- and middle-income counties (LMICs). Pesticide suicide is a public health problem unique to countries...

Introduction Pesticide self-poisoning causes severe health and socioeconomic hardship in low- and middle-income countries, including Sri Lanka. A stepped-wedge cluster randomised controlled trial (cRCT) has been designed to test whether ‘gatekeeper’ training for pesticide vendors reduces pesticide self-poisoning in rural Sri Lanka (Vendor cRCT). En...

Aim Platforms on social media are increasingly used for public health research. While social media provides an exceptional opportunity to explore communication about public health topics, this practice is not without ethical dilemmas. Our aim was to identify and unfold some of these dilemmas and to suggest possible solutions and ways forward for fu...

There is an increasing awareness of the association between tourism activity and risks of emerging mosquito-borne diseases (MBDs) worldwide. In previous studies we showed that hotels in Zanzibar may play an important role in maintaining residual foci of mosquito vectors populations of public health concern. These findings indicated larval sources r...

Risky alcohol use is a major public health problem globally and in Sri Lanka. While a reduction in alcohol consumption can result in physical, mental, and social benefits, behaviour change is difficult to achieve. Effective, context-adapted interventions are required to minimise alcohol-related harm at a community level. THEATRE is a complex, commu...

Objective Data from South Asia indicate that for 15%–20% of suicide attempts, pesticides are purchased from shops; otherwise, pesticides are obtained from an individual's house or nearby environment. We aimed to investigate the difference between individuals who directly purchase pesticides from shops for suicide attempts and suicide deaths versus...

Dams have often been constructed for hydropower, water storage and to support socioeconomic development, particularly in areas of water stress. In many places, the water stored in human-made reservoirs is essential to meet the development objectives of water supply, agriculture, industry, energy generation and other sectors. However, in the absence...

Background The World Health Organization (WHO) predicts a global shortfall of 18 million health workers by 2030, particularly in low- and middle-income countries like India. The country faces challenges such as inadequate numbers of health professionals, poor quality of personnel, and outdated teaching styles. Digital education may address some of...

Purpose: Suicide and self-harm by pesticide self-poisoning is common in low- and middle-income countries (LMICs). Alcohol is an important risk factor for self-harm; however, little is known about its role in pesticide self-poisoning. This scoping review explores the role that alcohol plays in pesticide self-harm and suicide. Methods: The review...

Introduction Alcohol consumption is a leading cause of mortality, morbidity and adverse social sequelae in Sri Lanka. Effective community-based, culturally adapted or context-specific interventions are required to minimise these harms. We designed a mixed-methods stepped wedge cluster randomised control trial of a complex alcohol intervention. This...

Background: Suicide is a global public health problem. Compared to other middle-income countries, much literature has been generated on the topic of self-harm and suicide in Sri Lanka. Harmful use of alcohol is a well-known risk factor to self-harm and suicide, however the connection needed further exploration. Aim: The aim was to investigate al...

Suicide is preventable, yet, in many settings, robust suicide prevention strategies have not been implemented. Although a commercial determinants of health lens is increasingly being applied to industries important to the field of suicide prevention, the interplay between the vested interests of commercial actors and suicide has received little att...

Little is known about young people’s behaviors and responses under outbreaks of infectious diseases such as the COVID-19 pandemic, especially in institutional settings. This research investigated the reactions of young adults residing at Danish folk high schools (FHSs) towards COVID-19 guidelines and the communicative styles used to enforce COVID-1...

Effective, low-cost clinical interventions to improve facility-based care during childbirth are critical to reduce maternal and perinatal mortality and morbidity in low-resource settings. While health interventions for low- and lower-middle-income countries are often developed and implemented top-down, needs and circumstances vary greatly across lo...

While facility births are increasing in many low-resource settings, quality of care often does not follow suit; maternal and perinatal mortality and morbidity remain unacceptably high. Therefore, realistic, context-tailored clinical support is crucially needed to assist birth attendants in resource-constrained realities to provide best possible evi...

Background Despite worldwide use, reviews of oxytocin for labor augmentation include mainly studies from high-income countries. Meanwhile, oxytocin is a potentially harmful medication and risks may be higher in low-resource settings. Objective We conducted a systematic review and meta-analysis of practices, benefits and risks of oxytocin for labor...

Introduction Every year, more than 800 000 people die from suicides of which an estimated 20% are from pesticide ingestion. Multiple studies have estimated that around 77%–80% of these pesticide suicides occur in low/middle-income countries. The full burden of pesticide suicides in African countries remains poorly documented, one reason being the l...

Global efforts to control Aedes mosquito-transmitted pathogens still rely heavily on insecticides. However, available information on vector resistance is mainly restricted to mosquito populations located in residential and public areas, whereas commercial settings, such as hotels are overlooked. This may obscure the real magnitude of the insecticid...

Introduction: Pesticide self-poisoning kills an estimated 110 000-168 000 people worldwide annually. Data from South Asia indicate that in 15%-20% of attempted suicides and 30%-50% of completed suicides involving pesticides these are purchased shortly beforehand for this purpose. Individuals who are intoxicated with alcohol and/or non-farmers repr...

To understand how the digitalization of higher education influences the inter-relationship between students, teachers, and their broader contexts, research must account for the social, cultural, political, and embodied aspects of teaching and learning in digital environments. Digital ethnography is a research method that can generate rich contextua...

Background: Over 90% of youth suicide deaths occur in low- and middle-income countries. Despite this relatively little is known about risk factors in this context. Aims: Investigate risk factors for deliberate self-harm (non-fatal) in young people in rural Sri Lanka. Methods: A prospective cohort study of 22,401 individuals aged 12-18 years wi...

Understanding the dynamics of larval habitat utilization by mosquito communities is crucial for the design of efficient environmental control strategies. The authors investigated the structure of mosquito communities found at hotel compounds in Zanzibar, networks of mosquito interactions with larval habitats and robustness of mosquito communities t...

Background A field survey was performed to investigate local environmental factors promoting occurrence and abundance of Aedes aegypti and Ae. bromeliae mosquitoes at hotel compounds in the south-east coastal region of Zanzibar Island. Methods The potential risk factors were determined using generalized linear mixed models. Aedes (Stegomyia) spp....

Background Effective control of emerging mosquito-borne viral diseases such as dengue, chikungunya, and Zika requires, amongst other things, a functional healthcare system, ready and capable of timely detection and prompt response to incipient epidemics. We assessed the readiness of Zanzibar health facilities and districts for early detection and m...

Background Disease surveillance is a cornerstone of outbreak detection and control. Evaluation of a disease surveillance system is important to ensure its performance over time. The aim of this study was to assess the performance of the core and support functions of the Zanzibar integrated disease surveillance and response (IDSR) system to determin...

Soil-transmissible helminthes (STH) infections are among the most common sanitation-related public health problems in poor periurban settlements of tropical regions of low- and middle-income countries. In Ghana, research studies documenting the incidence rate, intensity, and occupational risk factors of STH infections among adults are scanty. A pro...

Background In Zanzibar, little is known about the arboviral disease vector Aedes aegypti in terms of abundance, spatio-temporal distribution of its larval habitats or factors associated with its proliferation. Effective control of the vector requires knowledge on ecology and habitat characteristics and is currently the only available option for red...

Background Reducing suicides is a key Sustainable Development Goal target for improving global health. Highly hazardous pesticides are among the leading causes of death by suicide in low-income and middle-income countries. National bans of acutely toxic highly hazardous pesticides have led to substantial reductions in pesticide-attributable suicide...

Resource-deprived coastal peri-urban settlements in Southern Ghana are characterized by indiscriminate solid waste disposal and open defecation practices. Persons engaged in waste handling in such communities perform their activities with little or no personal protective equipment. They are thus confronted with the risk of faecal pollution of the h...

Objectives Suicide by pesticide self‐poisoning is a major public health challenge in low‐ and middle‐income countries. While effectiveness studies are required to test alternative prevention approaches, economic evidence is lacking to inform decision‐making in research priority setting. Therefore, this study aimed to estimate the costs of a shop‐ba...

Objective In South Asia, up to one in five individuals who ingest pesticides for self‐poisoning and survive purchased them from a shop immediately prior to the event. Thus far, no research has taken place to determine whether interventions implemented through the pesticide sellers might be acceptable or effective, despite the hundreds of thousands...

Background: Information on methods of suicide is available online, and access to information on methods of suicide appears to contribute to a small but significant proportion of suicides. There is limited documentation of how methods of suicide are being profiled, as well as what content exists in other languages than English. Aim: We aimed to anal...

Background: Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means restriction, through a series of government regulations and bans removing highly hazardous pesticides from agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provide data for further pesti...

Background: Media reporting may influence suicidal behavior. In-depth exploration of how self-harm and suicide are portrayed in newspaper articles in a middle-income country such as Sri Lanka is lacking. Aims: We aimed to explore how self-harm and suicide are portrayed in Sri Lankan printed newspapers. Method: Seven English- and Sinhala-language Sr...

On-site sanitation systems, the commonest sanitation technologies in low-income countries, are central to the elimination of open defecation in such countries. Nevertheless, their selection and application in the physical and socio-economic environment of low-income settings could be a complex and challenging task. Poorly designed and constructed f...

Background: Pesticide self-poisoning as a method of suicide is a major global health problem. Objectives: To estimate the cost and per patient cost of treating pesticide self-poisoning at different hospital levels in a Sri Lankan district, and to examine the distribution of cost components. Another objective was to investigate changes in total cost...

Background Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means restriction, through means restriction, through a series of government regulations and bans removing highly hazardous pesticides from agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provi...

Aedes mosquitoes are the principal dengue vector in Taiwan, where the use of insecticides is a key element in the national control strategy. However, control efforts are constrained by the development of resistance to most insecticides, including pyrethroids. In this study, mutations in the voltage-gated sodium channel (VGSC) gene resulting in knoc...

Introduction: The agricultural Green Revolution in the 1950s and 60s is thought to have averted many deaths from famine. However, it also introduced highly hazardous pesticides such as parathion and endrin into poor rural communities that were totally unequipped to store or use them safely. Pesticide self-poisoning rapidly became one of the two mos...

Harmful alcohol drinking can have health and socio-economic consequences. However, consumption is also associated with pleasure and symbolic meanings. Alcohol intake is increasing in Sri Lanka. In-depth explorations of alcohol patterns are needed to inform interventions and policies. Qualitative data were collected over 11 months in 2014 and 2015 i...

Background Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through regulation of a series of agricultural pesticides. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provide data for further pesticide regulation. Methods We performed a secondary analysis of data collected...

Background: Urban Kaohsiung City (KC), in southern Taiwan, has experienced annual dengue epidemics for decades despite considerable vector control efforts. Substantial research has been undertaken to characterize Aedes aegypti breeding habitats, but no systematic assessment has been completed for Aedes albopictus present in KC. Methods: A cross-...

Background Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means restriction, through means restriction, through a series of government regulations and bans removing highly hazardous pesticides from agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provi...

Background Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means restriction, through means restriction, through a series of government regulations and bans removing highly hazardous pesticides from agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provi...

Purpose Lower socioeconomic position (SEP) is associated with an increased risk of suicidal behaviour in high income countries, but this association is not established in low- and middle-income countries (LMIC). Methods We investigated the association of SEP with suicidal behaviour in a prospective cohort study of 168,771 Sri Lankans followed up f...

Background: Evidence from high income countries (HICs) suggests that individuals who present to hospital after self-harm are an important target for suicide prevention, but evidence from low and middle-income countries (LMICs) is lacking. We aimed to investigate the risk of repeat self-harm and suicide, and factors associated with these outcomes,...

The rate of ventilation through the vent pipe of a ventilated improved pit latrine is the main technical factor that determines its efficiency in odour control aside the maintenance and cleaning practices of the users. Even though the factors affecting the ventilation rate have been well researched, they have not been previously related in a mathem...

The ventilated improved pit (VIP) latrine has the potential to address the challenge of access to improved sanitation in built-up low-income settings. However, its conventional technical design fails to address the needs and preferences of some users. The objective of this paper was to test the technical performance of modified engineering designs...

Background There are an estimated 258 million international migrants worldwide. In Asia low-skilled workers often emigrate on a temporary basis (2–3 years) without their families. There is significant concern over the mental health and wellbeing of left-behind families in this region. No previous study has examined whether the risk of suicidal beha...

Background Aedes aegypti carries several viruses of public health importance, including the dengue virus. Dengue is the most rapidly spreading mosquito-borne viral disease in the world. Prevention and control of dengue mainly rely on mosquito control as there is no antiviral treatment or a WHO-approved vaccine. To reduce the Ae. aegypti population,...

Distribution of containers (N), positive (POS) or negative (NEG) for pupal Ae. aegypti (AE) in the urban setting of Kaohsiung City and rural Pingtung County, Taiwan, 2013–2015. (DOCX)

Zero-inflated model vs. zero-truncated model. (DOCX)

Distribution of water holding containers between setting and function (setting x function). (DOCX)

Data of all identified water holding containers (N = 897) in urban Kaohsiung City and rural Pingtung County, Taiwan. (XLSX)

Distribution of containers (N), positive (POS) or negative (NEG) for juvenile Ae. aegypti (AE) in the urban setting of Kaohsiung City and rural Pingtung County, Taiwan, 2013–2015. (DOCX)