https://ejournal.ipinternasional.com/index.php/ijphe/issue/feed International Journal of Public Health Excellence (IJPHE) 2026-02-07T04:45:08+00:00 International Journal of Public Health Excellence (IJPHE) editor@ipinternasional.com Open Journal Systems <p>All material submitted to <strong>International Journal of Public Health Excellence (IJPHE)</strong> is subject to rigorous peer review using a 'double-blind' refereeing process. The Editorial Board, strengthened by regional editors in about seven countries, welcomes contributions from around the world. It is the real goal of <strong>International Journal of Public Health Excellence (IJPHE)</strong> to influence the future of public health and its acceptance nationally and internationally by publishing innovative contributions to every aspect of the public health.</p> <p>International Journal of Public Health Excellence (IJPHE), ISSN 2809-9826 (online) has a subject area as follows, but is not limited to the following health areas that are;</p> <ul> <li>Reproduction health</li> <li>Medical service</li> <li>Health statistics</li> <li>Health management</li> <li>Oral hygiene</li> <li>Medical bio</li> <li>Civilized environmental health</li> <li>Universal health</li> <li>Nursing</li> <li>Health care provider</li> <li>Health entrepreneur</li> <li>Health research</li> <li>Health innovation</li> <li>Infectious diseases and their treatment</li> <li>Medical insurance</li> <li>Medical neuroscience</li> <li>Occupational health and safety</li> <li>Public health science</li> <li>Midwifery</li> <li>Health Sciences</li> </ul> <table width="706"> <tbody> <tr> <td width="120"> <p>Journal Name</p> </td> <td width="17"> <p> : </p> </td> <td> <p><a href="https://ejournal.ipinternasional.com/index.php/ijphe"><strong>International Journal of Public Health Excellence (IJPHE)</strong></a></p> </td> </tr> <tr> <td width="120"> <p>Journal Abbr.</p> </td> <td width="17"> <p> :</p> </td> <td> <p><strong>Int Jou of PHE</strong></p> </td> </tr> <tr> <td width="120"> <p>ISSN</p> </td> <td width="17"> <p> :</p> </td> <td> <p><strong><a href="https://portal.issn.org/resource/ISSN/2809-9826">2809-9826</a> (Online)</strong></p> </td> </tr> <tr> <td width="120"> <p>DOI</p> </td> <td width="17"> <p> :</p> </td> <td> <p><strong><a href="https://search.crossref.org/?q=10.55299&amp;from_ui=yes">10.55299/ijphe</a></strong></p> </td> </tr> <tr> <td width="120"> <p>Pub. Frequency</p> </td> <td width="17"> <p> :</p> </td> <td> <p><strong>Two times in a year (December &amp; May)</strong></p> </td> </tr> <tr> <td width="120"> <p>Indexed</p> </td> <td width="17"> <p> :</p> </td> <td> <p><strong><a href="https://openurl.ebsco.com/results?bquery=2809-9826&amp;page=1&amp;link_origin=www.ebsco.com" target="_blank" rel="noopener">EBSCO</a>, <a href="https://sinta.kemdikbud.go.id/journals/profile/15048" target="_blank" rel="noopener">SINTA</a>, <a href="https://sjifactor.com/passport.php?id=23957" target="_blank" rel="noopener">SJIFactor</a>, <a href="https://search.crossref.org/?q=International+Journal+of+Public+Health+Excellence+%28IJPHE%29&amp;from_ui=yes">Crossref</a>, <a href="https://journals.indexcopernicus.com/search/journal/issue?issueId=all&amp;journalId=122964">Index Copernicus International</a>, <a href="https://app.dimensions.ai/discover/publication?search_mode=content&amp;search_text=International%20Journal%20of%20Public%20Health%20Excellence%20(IJPHE)&amp;search_type=kws&amp;search_field=full_search">Dimensions</a>, <a href="https://www.base-search.net/Search/Results?type=all&amp;lookfor=International+Journal+of+Public+Health+Excellence&amp;ling=1&amp;oaboost=1&amp;name=&amp;thes=&amp;refid=dcresen&amp;newsearch=1">BASE</a>, <a href="https://scholar.google.com/citations?hl=id&amp;authuser=1&amp;user=BaEDJ74AAAAJ">Google Scholar</a>, <a href="https://www.semanticscholar.org/search?q=International%20Journal%20of%20Public%20Health%20Excellence%20%28IJPHE%29&amp;sort=relevance">Smantic Scholar</a>, <a href="https://www.neliti.com/journals/ijphe/catalogue">Neliti</a>, <a href="https://onesearch.id/Search/Results?filter%5b%5d=repoId:IOS17394">OneSearch Indonesia</a>, <a href="https://journalstories.ai/journal/2809-9826">Journal Stories</a>, <a href="https://www.citefactor.org/journal/index/29564/international-journal-of-public-health-excellence-ijphe#.YwwbtkdBzIU">Cite Factor</a>, <a href="https://garuda.kemdikbud.go.id/journal/view/26416">GARUDA Kemdikbudristek RI</a>, &amp; <a href="https://www.researchgate.net/search?q=rahmah%20juliani%20siregar">Researgate</a></strong></p> </td> </tr> <tr> <td width="120"> <p>Publisher</p> </td> <td width="17"> <p> :</p> </td> <td> <p><a href="https://ipinternasional.com/"><strong>PT Inovasi Pratama Internasional</strong></a></p> </td> </tr> </tbody> </table> https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1739 Development and Pilot Testing of a Childbirth Readiness Questionnaire (CRQ) for Third-Trimester Pregnant Women In Indonesia 2026-01-08T08:08:52+00:00 Nurul Jannah jannah.phdscholar@lincoln.edu.my Gunavathy Selvarajh gunavathy@lincoln.edu.my <p>Childbirth readiness is a multidimensional construct encompassing physical, psychological, social, and spiritual preparedness, yet contextually appropriate instruments for Indonesian pregnant women remain limited. This study aimed to develop and pilot test the Childbirth Readiness Questionnaire (CRQ) for third-trimester pregnant women in Indonesia. A methodological pilot design was employed, including expert review (n = 5) and field testing with 110 pregnant women. Content validity was evaluated using the Item Content Validity Index (I-CVI), while preliminary construct performance was examined through descriptive statistics and corrected item–total correlations. Internal consistency reliability was assessed using Cronbach’s alpha. All nine items demonstrated acceptable content validity (I-CVI ≥ 0.80) and adequate item–total correlations (r = 0.34–0.61). The overall scale showed satisfactory internal consistency (α = 0.82). Dimension-level descriptive scores supported the conceptual structure of physical–cognitive, psychological–spiritual, and social support readiness. These findings indicate that the CRQ has promising preliminary psychometric properties and is feasible for assessing childbirth readiness among Indonesian third-trimester pregnant women. Further validation with larger and more diverse samples is required to confirm its factorial structure and generalizability</p> 2026-01-08T00:00:00+00:00 Copyright (c) 2026 Nurul Jannah, Gunavathy Selvarajh https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1740 Development of the Third-trimester Pregnancy Knowledge Questionnaire (TPKQ): A Pilot Study 2026-01-09T14:51:01+00:00 Nurul Jannah jannah.phdscholar@lincoln.edu.my Gunavathy Selvarajh gunavathy@lincoln.edu.my <p>Background: Maternal knowledge during the third trimester is critical for timely care-seeking and preparation for childbirth, yet standardized instruments specific to this phase remain limited. Objective: This study aimed to develop and pilot test the Third-trimester Pregnancy Knowledge Questionnaire (TPKQ). Methods: A methodological pilot study involved four experts and 110 third-trimester pregnant women. Items were derived from literature and organized into four dimensions: danger signs and care-seeking, birth preparation and delivery planning, preventive care before birth, and maternal conditions affecting labor outcomes. Content validity was assessed using Item and Scale Content Validity Indexes, response-based validity via corrected item–total correlations, and internal consistency with Cronbach’s alpha. Results: The TPKQ includes 10 multiple-choice items with dichotomous scoring. All items showed acceptable content validity (I-CVI = 0.75–1.00; S-CVI/Ave = 0.93), adequate discrimination (r = 0.36–0.46), and good reliability (α = 0.81). Dimension scores suggested higher knowledge of danger signs and lower knowledge of preventive care. Conclusion: The TPKQ demonstrates preliminary validity and reliability</p> 2026-01-09T00:00:00+00:00 Copyright (c) 2026 Nurul Jannah, Gunavathy Selvarajh https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1635 Screening IVA Test Effort to Increase Intention for Early Detection Cancer Cervix in Panyabungan, Mandailing Natal 2026-01-09T15:06:02+00:00 Ayu Ulfah Nur Lubis ayuulfa02@gmail.com Wahyuni Harahap ayuulfa02@gmail.com Kiki Khoiriyani ayuulfa02@gmail.com Doriani Harahap ayuulfa02@gmail.com <p>Cervical cancer remains one of the leading causes of death among women in Indonesia, largely due to delays in treatment due to lack of knowledge of early detection. IVA (Visual Inspection with Acetic Acid) examination is a simple, affordable, and effective screening method to recognize early symptoms of cervical cancer, especially in communities with limited access to advanced health facilities.&nbsp; This&nbsp; service&nbsp; activity&nbsp; aims&nbsp; to&nbsp; provide comprehensive education on cervical Cancer prevention efforts through a promotive and preventive approach based on VIA. Counseling is conducted to productive-aged women with interactive methods that include material delivery, group discussions, and simulation of general examination procedures. The results showed an increase in participants' understanding of the importance of routine screening, recognition of early symptoms, and preventive measures that can be taken independently. This program is expected to be able to foster public awareness of the importance of early detection and become part of a strategy to empower women in maintaining their reproductive health in a sustainable manne</p> 2026-01-09T00:00:00+00:00 Copyright (c) 2026 Ayu Ulfah Nur Lubis, Wahyuni Harahap, Kiki Khoiriyani, Doriani Harahap https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1706 Study of The Effect of Fatigue Level on Reducing the Injury Level in Netball Players 2026-01-22T05:50:22+00:00 Immas Aqilla Fadia fadiaphysio31@gmail.com Mohd Haidzir Abd Manaf fadiaphysio31@gmail.com Ida Hasni binti Shaari fadiaphysio31@gmail.com <p>Athletic performance is often affected by fatigue, which can significantly impact neuromuscular function, power output, and overall movement efficiency. Chronic ankle instability orChronic Ankle Instability (CAI)This is a common condition, particularly among athletes, including netball players. It causes structural and functional impairments, such as ligament laxity and weakened muscle support around the joint.ObjectiveThis study aimed to analyze the effects of a fatigue-inducing protocol on jump height, peak power, peak velocity, and reaction time in netball players. The research method used a quantitative pre-post test design with retrospective data analysis. This study used a fatigue protocol to simulate game-like conditions and analyze performance.<em>Counter Movement Jump</em>(CMJ) before and after fatigue using SPSS software. Paired sample t-tests and correlation analyses were performed to assess performance changes. The results showed that although peak velocity did not show statistically significant changes after fatigue, both peak power and jump height decreased significantly, and fatigue impacted lower limb explosive performance. The difference in jump height with fatigue testing before and after the intervention was statistically significant (p&lt;0.001) indicating a significant change in jump height after the fatigue protocol. Correlation analysis showed that there was no significant relationship between CAI and fatigue-induced performance decline.In conclusion,There is a significant effect of fatigue levels on reducing injury rates in netball players.</p> 2026-01-22T00:00:00+00:00 Copyright (c) 2026 Immas Aqilla Fadia, Mohd Haidzir Abd Manaf, Ida Hasni binti Shaari https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1724 Automatic Pill Counting Using YOLOv8 to Improve Medication Distribution Accuracy 2026-01-23T07:37:30+00:00 Dinial Utami Nurul Qomariah dinial.utami@polije.ac.id Ade Irma Elvira dinial.utami@polije.ac.id Arvita Agus Kurniasari dinial.utami@polije.ac.id Bima Wahyu Maulana dinial.utami@polije.ac.id <p><em>Object detection is a critical component in various modern applications, including healthcare systems, smart agriculture, and industrial automation. The main challenge in developing detection systems lies in achieving high accuracy and strong generalization capabilities under diverse image conditions. This study aims to implement and evaluate the YOLOv8 model, a detection method known for its speed and efficiency. The model is trained using two scenarios—10 epochs and 50 epochs—to examine the impact of training duration on system performance. Evaluation results show that training for 10 epochs produces very good performance, with a precision of 0.98, recall of 0.94, and mAP of 0.98. Increasing the training to 50 epochs yields even more optimal results, achieving a precision of 0.99, recall of 1.00, and mAP of 0.99. Based on these findings, YOLOv8 demonstrates excellent adaptability to the dataset and is suitable for real-time detection applications that require high accuracy</em></p> 2026-01-23T00:00:00+00:00 Copyright (c) 2026 Dinial Utami Nurul Qomariah, Ade Irma Elvira, Arvita Agus Kurniasari, Bima Wahyu Maulana https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1790 The Construct of Health Communication Effectiveness and Its Dimensions: A Confirmatory Factor Analysis within Hospital Settings in Middle Eastern Conflict Zones 2026-01-27T04:39:48+00:00 Suranta Bill Fatric Ginting Surantaginting5@gmail.com Eldha Novarina Tarigan surantaginting5@gmail.com Joyce Yulianti Silalahi Surantaginting5@gmail.com Luthfiah Mawar Surantaginting5@gmail.com M. Agung Rahmadi Surantaginting5@gmail.com Helsa Nasution Surantaginting5@gmail.com <p>This study aims to empirically substantiate the dimensional structure of health communication effectiveness in hospitals operating within conflict zones in the Middle East through a Confirmatory Factor Analysis (CFA) approach. Secondary data were compiled from 847 medical records and patient surveys drawn from twelve hospitals in Syria, Iraq, and Yemen between 2019 and 2023. The six-dimension CFA model demonstrated exceptionally robust statistical adequacy, indicated by χ²/df = 2.134, CFI = 0.954, TLI = 0.947, RMSEA = 0.042 (90% confidence interval: 0.038-0.046), and SRMR = 0.039. Information clarity emerged as the strongest dimension with a factor loading of λ = 0.891, followed by provider empathy, responsiveness, communication competence, accessibility, and cultural sensitivity, all of which were significant at p &lt; 0.001. Construct reliability was high, with CR = 0.943 and AVE = 0.735. These findings reinforce the work of Epstein et al. (2010) and Street et al. (2009) on the critical importance of patient-centered communication, while extending the current discourse by integrating cultural sensitivity and trauma-informed communication principles that have not yet been examined in conflict settings. This study offers a novel contribution by comprehensively validating the health communication construct in the context of extreme armed conflict</p> 2026-01-27T00:00:00+00:00 Copyright (c) 2026 Fatric Ginting Suranta Bill, Eldha Novarina Tarigan, Joyce Yulianti Silalahi, Luthfiah Mawar, M. Agung Rahmadi, Helsa Nasution https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1798 Multidimensional Structure Of Maternal Sleep Quality In The Third Trimester: Psychometric Evaluation 2026-02-04T03:57:19+00:00 Nurul Jannah jiangxinalanda@gmail.com Gunavathy Selvarajh gunavathiy@lincoln.edu.my <p><strong>Beground :</strong> Sleep disturbances are highly prevalent during late pregnancy and have been associated with maternal mental health vulnerability and adverse perinatal outcomes. Emerging evidence suggests that sleep quality in the third trimester is context-specific and may not represent a single, uniform construct. However, the latent structure of maternal sleep quality in late pregnancy has not been sufficiently examined using a theory-driven psychometric approach.</p> <p><strong>Methods :</strong> A community-based cross-sectional study was conducted among women in the third trimester of pregnancy (≥28 weeks). The Maternal Sleep Quality Index for the Third Trimester – Indonesian Version (MSQI-T3-ID), a newly developed eight-item self-report instrument, was administered. The hypothesized three-dimensional structure—Sleep Initiation and Continuity, Pregnancy-Specific Disturbance, and Daytime Impact and Fatigue—was evaluated using Confirmatory Factor Analysis within a Structural Equation Modeling framework.</p> <p><strong>Results :</strong> Confirmatory factor analysis supported a multidimensional model of maternal sleep quality in late pregnancy. The model demonstrated acceptable fit indices (CFI = 0.95; TLI = 0.93; RMSEA = 0.094; SRMR = 0.027). All items loaded significantly on their respective latent dimensions, with standardized factor loadings ranging from 0.91 to 0.99 (p &lt; .001), indicating a coherent internal structure.</p> <p><strong>Conclusion :</strong> The findings provide empirical support for conceptualizing sleep quality in late pregnancy as a multidimensional construct. This study provides initial structural validity evidence for a brief, trimester-specific sleep quality instrument.</p> <p><strong>Keywords&nbsp;</strong>: Maternal sleep quality; Third trimester pregnancy; Psychometric validation.</p> 2026-02-04T00:00:00+00:00 Copyright (c) 2026 Nurul Jannah, Gunavathy Selvarajh https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1803 Analysis Of Nursing Practices For STEMI Patients With The Innovational Intervention Of A Combination Of Swedish Massage With Olive Oil And Warm Water 2026-02-04T04:18:46+00:00 Nur Sausan Fauziah nurrsausan02@gmail.com Zulmah Astuti za874@umkt.ac.id Ulfatul Muflihah um207@umkt.ac.id Dwi Widyastuti dw530@umkt.ac.id <p>ST-Elevation Myocardial Infarction (STEMI) is part of Acute Coronary Syndrome (ACS), a cardiovascular condition in which a coronary artery is completely occluded, preventing oxygen from reaching the heart muscle. This study aimed to determine the effect of Swedish massage therapy combined with warm water on hemodynamic stability. This study employed a case study design comparing an intervention patient and a control patient diagnosed with STEMI who had unstable hemodynamic status in the ICCU. After the implementation of Swedish massage and warm water therapy in the intervention patient for three consecutive days, the patient’s hemodynamic parameters such as blood pressure, heart rate, mean arterial pressure, and respiratory rate remained within stable limits, showing no significant increases or decreases. This outcome differed from the control patient, who received only pharmacological therapy. The analysis deminstated a difference in hemodynamic outcomes between patients who received the combined intervention and those in the control group.</p> 2026-02-04T00:00:00+00:00 Copyright (c) 2026 Nur Sausan Fauziah, Zulmah Astuti, Ulfatul Muflihah, Dwi Widyastuti https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1733 Classification of Lung Diseases Using The Naive Bayes Classifier Method at Madani Hospital Medan in 2025 2026-02-05T03:53:05+00:00 Refi Sulistiasari refi.sulistiasari@fk.uisu.ac.id Handi Effendi refi.sulistiasari@fk.uisu.ac.id Agus Sumedi refi.sulistiasari@fk.uisu.ac.id Marlina Elfa Lubis refi.sulistiasari@fk.uisu.ac.id Zaim Anshari refi.sulistiasari@fk.uisu.ac.id <p>The lungs are one of the human organs that are very important in the respiration process. There are several types of lung diseases, including Asthma, Bronchitis, Dyspnea Pleural Effusion, Empyema, Emphysema, Pulmonary Fibrosis, Lung Cancer, Interstitial Lung Disease, Pleurisy, Pneumonia, COPD, Tuberculosis. In this case there are difficulties in the process of classifying lung diseases, because the symptoms shown by sufferers of lung disease have similarities between one lung disease and another. The purpose of this study is to classify lung diseases using the Naive Bayes Classifier method. This method was chosen because it only requires a little training data to determine the estimated parameters needed in the classification process. This research was conducted at Madani General Hospital, Medan Area District, Medan City, North Sumatra, from February 1, 2025 to April 1, 2025. The data taken were medical records of lung disease patients from January 1, 2025 to February 1, 2025, totaling 134 patient data containing 19 disease symptoms and 6 disease diagnoses. From the test results using the Rapidminer application and data separation in the form of 34 test data and 100 training data with a data ratio of 7:3, an accuracy value of 97.06 was obtained</p> 2026-02-06T00:00:00+00:00 Copyright (c) 2026 Refi Sulistiasari, Handi Effendi, Agus Sumedi, Marlina Elfa Lubis, Zaim Anshari https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1771 Integration of Tropical Disease Screening in Reproductive Health Services at Amplas Community Health Center, North Sumatra 2026-02-05T04:02:32+00:00 Irwandi Syahlis s.irwandi@gmail.com Zaim Anshari s.irwandi@gmail.com Mayang Sari Ayu s.irwandi@gmail.com Marlina Elfa Lubis s.irwandi@gmail.com Miftahul Mardiyah s.irwandi@gmail.com <p>Tropical diseases remain important determinants of reproductive health in endemic regions; However, screening for these infections is rarely integrated into reproductive health services at the primary care level. This fragmentation contributes to low early detection and an increased risk of complications among women of reproductive age. This community service program aims to develop and implement an integrated model for tropical disease screening within reproductive health services at Puskesmas Amplas, Medan City. The program employed a pre–post intervention design involving women of reproductive age (15–49 years) selected through stratified random sampling. The intervention included clinical screening, health education, and the strengthening of referral and integrated recording systems. The results demonstrated a significant increase in early detection coverage and participants' knowledge, with a substantial proportion of respondents identified as having previously undetected risk factors for tropical diseases. Implementation of the integrated service model also enhanced the capacity of primary healthcare providers in delivering promotional and preventive services. These findings indicate that integrating tropical disease screening into reproductive health services is an effective and scalable approach to strengthening primary healthcare systems in endemic areas and improving community reproductive health outcomes</p> 2026-02-06T00:00:00+00:00 Copyright (c) 2026 Irwandi Syahlis, Zaim Anshari, Mayang Sari Ayu, Marlina Elfa Lubis, Miftahul Mardiyah https://ejournal.ipinternasional.com/index.php/ijphe/article/view/1663 Global Epidemiology and Phenotypic Diversity of 21-Hydroxylase–Deficient Congenital Adrenal Hyperplasia: A 25-Year Comparative Review Across Ethnicities, Genotypes, and National Cohorts 2026-02-07T04:45:08+00:00 Nada Soliman nadaatsoliman@hotmail.com Ashraf T. Soliman atsoliman56@gmail.com Fawzia Alyafei fawzia2005@yahoo.com Shayma Ahmed SMohammed5@hamad.qa Noor Hamed NHamed@hamad.qa Nada Alaaraj nadaalaaraj@gmail.com Shaymaa Elsayed dr.shaymaa_elsayed@yahoo.com Dina Fawzy dinafawzy1988@yahoo.com Ahmed Elawwa ahmedelawa@yahoo.com <p>Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) represents the most common inherited disorder of adrenal steroid biosynthesis worldwide. Over the past 25 years, advances in newborn screening, molecular diagnostics, and genotype–phenotype characterization have produced large shifts in the global epidemiological landscape. However, marked disparities persist between countries and ethnic groups, reflecting founder mutations, consanguinity, migration patterns, and differences in healthcare coverage. Exclusion criteria included mixed-etiology CAH without subtype separation and cohorts lacking validated genetic testing. Quality assessment relied on established criteria for observational epidemiology and registry-based studies. Birth prevalence showed extreme global heterogeneity, ranging from 1:23,000 in New Zealand to 1:1,200 in Egypt and as high as 1:282 among Arctic Indigenous founder populations. Ethnicity strongly influenced incidence, with Asian, Hispanic/Latino, and European populations generally displaying moderate rates (5–10 per 100,000 births), while Middle Eastern and North African populations demonstrated markedly higher incidence due to elevated consanguinity rates and clustering of severe CYP21A2 alleles. Cross-country phenotype analysis revealed that salt-wasting predominated in Egypt, China, India, Turkey, Argentina, and several Eastern European cohorts, whereas European cohorts—especially Portugal and the UK—showed higher proportions of nonclassic or milder phenotypes. Genotype–phenotype mapping demonstrated consistent associations: null and severe Group A mutations with the SW phenotype, I2 splice and I172N variants with SV presentations, and V281L with NC disease. Sex differences were notable: females more commonly presented in infancy due to virilization, while males frequently remained undetected until adrenal crises or testicular adrenal rest tumors. National screening programs significantly shifted age of diagnosis and reduced infant morbidity and mortality. Global epidemiology of CAH continues to display substantial geographic and ethnic variability, driven by population genetics, healthcare disparities, and screening strategies. Understanding these differences is essential for improving early detection, tailoring genotype-informed care, guiding newborn screening expansion, and reducing long-term complications</p> 2026-02-07T00:00:00+00:00 Copyright (c) 2026 Nada Soliman, Ashraf T. Soliman, Fawzia Alyafei, Shayma Ahmed, Noor Hamed, Nada Alaaraj, Shaymaa Elsayed, Dina Fawzy, Ahmed Elawwa