Search Results (541)

Objective: The objective of this study is to evaluate county-specific changes in standardized management and glycemic control associated with an integrated county–township–village care model among patients with type 2 diabetes mellitus (T2DM) in resource-constrained areas of China. Methods: Three intervention counties that implemented an integrated county–township–village care model in 2019 were included. County-level quarterly data from 2017 to 2022 were extracted from electronic health record systems. Two outcome measures were assessed: the standardized management rate and the glycemic control rate among patients with T2DM. Synthetic controls were constructed from non-intervention counties within the same prefecture-level city. Sensitivity analyses excluding the highest-weight donor were conducted. Results: The synthetic controls approximated pre-intervention characteristics and outcome trajectories, although fit varied across counties and outcomes. Following implementation, mean standardized management rates exceeded their synthetic counterparts by 4.57, 3.96, and 4.35 percentage points in Counties Q, Y, and F, respectively. Placebo tests provided suggestive evidence for Counties Q and Y (p = 0.100 and p = 0.111) but limited evidence for County F (p = 0.750). Mean glycemic control rates exceeded their synthetic counterparts by 4.61 and 3.81 percentage points in Counties Q and F, respectively, compared with 0.83 percentage points in County Y. Estimated differences remained positive after excluding the highest-weight donor, although their magnitudes were sensitive to donor selection in some models. Conclusions: The integrated county–township–village care model was associated with improvements in selected T2DM management outcomes, with patterns varying across counties. Our findings suggest potential value in strengthening collaboration between county hospitals and primary health care institutions in comparable resource-constrained settings. Full article

Background: During the last decades, the office workplace setting has increasingly become an inherently “obesogenic” environment, promoting unhealthy behaviors. The main objective of this study was to investigate the efficacy of a 6-month workplace combined (exercise and nutrition) intervention in obese office workers, using a randomized controlled study. An additional objective of this study was to evaluate the individual responses per participant following the program. Methods: In total, 36 obese office workers (BMI: ≥30) were randomly assigned to two equal groups: intervention (IG; age: 48.06 ± 6.60 yrs; BMI: 33.57 ± 1.58 kg/m²) and control (CG; age: 47.95 ± 5.95 yrs; BMI: 33.54 ± 1.74 kg/m²). The IG participated in a daily supervised 6-month workplace program (during working hours), including (a) exercise (flexibility, balance, strength, and aerobic) and (b) counseling and educational activities for healthy diet and hydration. The CG did not participate in any intervention. Before and after the 6-month period, the following were measured: (a) health indices (body fat, body circumferences, blood pressure, respiratory function, and lipidemic profile), (b) functional capacity indices (flexibility, balance, handgrip strength, and cardiovascular fitness), and (c) adherence to the Mediterranean diet (MedDietScore) and daily water consumption. Results: All the participants of the IG reduced body mass, body fat, and circumferences (−4.47 to −18.95%), blood pressure (−4.08 to −46.15%), lipidemic profile indicators (−2.50 to −212.67%), and heart rate recovery (−9.62 to −57.33%), while increased respiratory function (1.82–20.26%), flexibility (5.13–50%), balance (15.38–88.83%), handgrip strength (5–25%), MedDietScore (12.5–56%), and water consumption (23.08–50%). In CG, all aforementioned indices remained unchanged (p = 0.16–0.99). Conclusions: A combined workplace intervention (exercise and nutrition) constitutes an effective approach for health promotion in obese office workers. Full article

Background/Objectives: Physical education teachers play an important role in school health promotion, but their own occupational health has received limited attention. Their work involves movement demonstration, prolonged standing, equipment handling, sport participation, vocal projection, noise exposure, and outdoor or indoor environmental demands. This scoping review aimed to map evidence on occupational health complaints and disorders among physical education teachers and closely related exercise-teaching professionals meeting a functional occupational definition. Methods: A scoping review was conducted using PubMed/MEDLINE, Scopus, Web of Science, SPORTDiscus, and ERIC, with ScienceDirect as an additional publisher platform. Google Scholar, ResearchGate, and reference-list screening were used as supplementary discovery sources. Records from database inception to 30 May 2026 were considered without language restrictions. School-based physical education teachers were the primary population; related gym/fitness, aquatic, university, and student-teaching professionals were eligible only when their occupational role centered on structured physical education, sport, exercise, or movement instruction. Empirical quantitative, qualitative, mixed-methods, and eligible grey literature reports were included when they contained extractable original data. Data were charted by study characteristics, outcome domain, measurement method, and main findings; because of marked heterogeneity, a narrative synthesis was performed. Results: Thirty-eight studies met the inclusion criteria. School-based physical education teachers predominated, while a smaller number of studies represented related instructional settings. Musculoskeletal disorders and injury-related complaints were the most frequently reported outcomes, especially affecting the lower back, knees, ankles/feet, shoulders, neck, and hips. Vocal and laryngeal problems, hearing and noise-related complaints, respiratory and upper-airway symptoms, and cardiometabolic risk factors were also identified. Across domains, observational studies repeatedly reported associations involving physical loading, high vocal demand, noise, environmental conditions, and age or professional seniority. Because most evidence was cross-sectional or descriptive, these patterns do not establish causal relationships. Conclusions: The mapped literature identifies a multidimensional set of occupational health concerns in physical education teaching and closely related instructional work. Generalization is strongest for school-based physical education teachers, while non-school groups provide context-specific supporting evidence. Prospective, longitudinal, and intervention evidence remains limited. Future research should use longitudinal designs, standardized outcome definitions, objective clinical and environmental assessments, and clearer exposure measurement. Preventive strategies such as ergonomic training, injury prevention, vocal-health education, acoustic improvements, noise monitoring, respiratory-risk reduction, and cardiometabolic screening warrant further evaluation in this occupational population. Full article

In the field of Prognostics and Health Management (PHM), deep learning methods have shown excellent remaining useful life (RUL) prediction ability because of their powerful data fitting ability. Such methods require a large amount of failure history to train, but for industrial assets, their life-cycle data are often insufficient, and effective repairs or replacements are frequently carried out before the failure occurs. On the one hand, these suspension history data cannot be directly used by traditional deep learning methods, resulting in the certain loss of degradation information. On the other hand, the internal structure of industrial assets and the types of features are complex and diverse. Traditional methods use Euclidean space to represent relevant data, ignoring the correlation between features. Therefore, we develop a semi-supervised adversarial graph prediction (SAGP) framework that combines adversarial learning, graph neural networks, and semi-supervised training, using both failure and suspension histories for RUL prediction. Based on graph neural networks, SAGP can effectively obtain the degradation information in the failure and suspension history by representing the degradation data in the form of graphs and setting multi-objective functions. Through semi-supervised learning, SAGP looks for failure and suspension histories similar to the current state and generates simulated data through adversarial training to improve the robustness of the model and finally achieve RUL prediction. Tool, engine, and bearing datasets are used to verify the accuracy and reliability of the SAGP model. Full article

Background: The Mediterranean Diet (MD) is linked to better cardiometabolic and inflammatory health, but its relationships with appetite-related hormones, body composition, and behavioral health remain unclear in physically active young adults from understudied Arab settings. Objective: To examine associations between MD adherence and cardiometabolic, inflammatory, hormonal, body-composition, and behavioral-health profiles, including sleep quality, physical activity, perceived recovery, and health-related quality of life (HRQoL), among physically active young adults in Jordan. Methods: Eighty adults aged 18–35 years (44 men and 36 women) were recruited from fitness centers and campuses in Amman. MD adherence was assessed using the validated Moroccan Arabic version of the 14-item Mediterranean Diet Adherence Screener (MEDAS; adherent ≥ 8). Fasting lipid profile, C-reactive protein (CRP), interleukin-6 (IL-6), leptin, and ghrelin were measured using enzymatic and ELISA methods. Anthropometric and body-composition measures were assessed using stadiometry and multifrequency bioelectrical impedance analysis. Sleep quality, physical activity, perceived recovery, and HRQoL were assessed using validated questionnaires. Results: 60% of participants were non-adherent to the MD. In exploratory analyses, non-adherence was associated with higher odds of abnormal triglycerides (adjusted OR = 9.17, 95% CI: 2.08–40.38). After additional adjustment for percent body fat, the association with abnormal CRP remained significant (adjusted OR = 5.39, 95% CI: 1.34–21.61), whereas the association with abnormal leptin was attenuated and no longer statistically significant (adjusted OR = 3.47, 95% CI: 0.75–16.07). The leptin finding was sensitive to adjustment for adiposity, while residual confounding remains possible for the CRP association. Non-adherent participants had higher BMI, body fat mass, and percent body fat, and lower physical HRQoL. No statistically significant associations were detected for ghrelin, resting blood pressure, or resting heart rate. The IL-6 findings were inconclusive because 62.5% of measurements were below the assay detection limit. Conclusions: Greater MD adherence was associated with a more favorable cardiometabolic and body-composition profile in this exploratory cross-sectional sample. These hypothesis-generating findings highlight the importance of considering dietary quality alongside physical activity and require confirmation in larger prospective studies with more comprehensive confounder adjustment. Full article

Background/Objectives: Because function typically improves after stroke, the devices people need, and for how long, may change along the recovery trajectory. This exploratory study examined retrospective accounts of assistive device use, discontinuation, replacement, and nonpurchase across two post-onset stages, hospitalization and home and community reintegration. Methods: Ten community-dwelling adults with chronic stroke (mean disability duration 13.9 years) were interviewed twice at home, with caregivers contributing where present, and reconstructed their device histories from recall; the resulting accounts are treated as joint participant–caregiver reports. Instruments followed the Human–Activity–Assistive Technology (HAAT) model; field notes and completed device checklists were analyzed by inductive qualitative content analysis, and facilitators and barriers were classified with the World Health Organization people-centered assistive technology (5P) framework. Aggregate figures for the stroke subsample of the 2020 National Survey on Persons with Disabilities (n = 662) are reported as national context rather than as independent confirmation. Results: Participants reported having used a mean of 11.2 device types, yet named only 1.3 devices that were needed but not purchased. Discontinuation was concentrated among devices used during inpatient rehabilitation: standing frames (9/9), walkers (5/5), and manual wheelchairs (8/10) had been set aside. Functional improvement was the only reason recorded for walkers, but for standing frames and manual wheelchairs it was recorded alongside cost, bulk, replacement, and, in one case, continuing unmet need, so its independent contribution could not be established. A second cluster reflected the poor fit of body-worn devices to a changing hemiplegic limb (ankle-foot orthoses, 4/6). The nonpurchase barrier reported most often was inability to find a suitable product on the market. Conclusions: These retrospective accounts from ten participants cannot support policy conclusions. They generate hypotheses, requiring prospective testing, about whether ownership-based funding with fixed durability periods fits stage-limited need and whether rental provision, prescription-based provision for orthoses, and targeted product development would fit it better. Full article

Background/Objectives: Health literacy extends beyond individual competencies and encompasses how people engage with health systems. The Health Literacy Questionnaire (HLQ) is a widely used multidimensional instrument designed to assess different health literacy aspects across nine distinct domains. This study aimed to examine structural validity and internal consistency of the Polish version of the HLQ among primary care service users. Methods: The HLQ was used in a cross-sectional survey among 360 adults (mean age 51.76 years, SD 17.48) attending four primary care clinics in Poland. The assessment included confirmatory factor analysis (CFA) and internal consistency tests. Results: A nine-factor CFA model was applied to the HLQ items, without allowing cross-loadings or correlated residuals. The fit indices confirmed good model fit: χ²_WLSMV (df = 866) = 1175.63, p < 0.001; CFI = 0.98; TLI = 0.98; RMSEA = 0.038; and SRMR = 0.056. The factor loadings ranged from 0.55 to 0.94, indicating acceptable item–factor relationships across all domains. Internal consistency was satisfactory across all nine domains, with composite reliability ranging from 0.76 to 0.87 and Cronbach’s alpha from 0.78 to 0.88. Conclusions: The findings provide preliminary evidence supporting structural validity and internal consistency of the Polish HLQ in this sample of primary care service users and suggest the potential value of the instrument for multi-dimensional assessment of health literacy in similar Polish primary care populations. Future studies should evaluate additional measurement properties of the tool, as well as the performance of the instrument in nationally representative samples and across diverse clinical settings. Full article

Background/Objectives: Pain is a major public health burden shaped by social and structural factors, yet cross-national evidence on how social determinants influence pain prevalence across socioeconomically diverse European settings remains limited. This study aimed to examine the associations between social determinants and the prevalence of pain in four European countries, and to explore how these associations vary by national context. Methods: We conducted a multinational secondary analysis of cross-sectional data from the third wave of the European Health Interview Survey (EHIS), using Eurostat microdata for Serbia, Bulgaria, Norway and Finland (n = 34,882 respondents aged ≥15 years). Pain prevalence was examined in relation to sociodemographic characteristics, health status, chronic conditions and behavioural determinants. LASSO-selected logistic regression models were fitted separately for each country. Results: Pain prevalence varied markedly across countries, ranging from 35.4% in Serbia to 69.9% in Finland (p < 0.001). Musculoskeletal disorders showed strong associations with pain in countries where this factor was retained in the models (OR range, 3.40–4.26), while accidents/injuries (OR range, 1.43–2.66), greater daily life limitations (OR range, 1.55–2.52), poorer self-rated health (OR range, 1.66–2.22), and female gender (OR range, 1.38–1.91) were consistently associated with higher odds of pain in all countries. The associations of education, employment, income, household composition, and behavioural factors with pain varied across national contexts and may reflect country-specific socioeconomic conditions. Conclusions: Pain prevalence was associated with a broad range of social, demographic and health-related factors, with the magnitude and direction of associations varying across national contexts. Pain prevention and management strategies should address both clinical characteristics and the broader social determinants of health, tailored to the national socioeconomic environment. Full article

Background: Early exposure to tobacco smoke can harm children’s developing respiratory systems, increasing the risk of acute and long-term health consequences. This study examined the association of maternal and indoor smoking with acute respiratory infection (ARI) in under-five children living in eight Asia-Pacific countries. Methods: We analysed Demographic and Health Survey data collected between 2015 and 2022. A logistic regression model was fitted separately to each country’s data to obtain the odds of ARI in children for maternal tobacco use, daily indoor smoking, and occasional indoor smoking. Then, a meta-analysis using the Der Simonian and Laird method was used to obtain a pooled odds ratio (pOR) of ARI across the included countries. Results: We included a weighted sample of 302,841 children, among whom the prevalence of ARI was 4.12% (95% CI: 4.05, 4.19). The pooled prevalence of maternal tobacco use and daily indoor smoking was 3.45% (95% CI: 3.38, 3.51) and 29.61% (95% CI: 29.45, 29.77), respectively. In random-effects meta-analyses, exposure to daily indoor smoking (pOR = 1.13; 95% CI: 1.02, 1.25) and occasional indoor smoking (pOR = 1.23; 95% CI: 1.13, 1.35) were both associated with increased odds of ARI, as was maternal tobacco use (pOR = 1.67; 95% CI: 1.21, 2.31). Conclusions: Secondhand smoke exposure was associated with higher odds of ARI among under-five children, underscoring the need for smoke-free home policies across Asia-Pacific countries, particularly as the tobacco industry expands marketing and lobbying against such policies in low-income settings. Full article

Mental health literacy (MHL) plays a crucial role in the early identification, management, and prevention of mental health problems, especially among young adults. For future health and education professionals, robust MHL is a foundational component of clinical readiness, ensuring they are adequately prepared to recognize early signs of psychological distress, mitigate stigma, and facilitate timely referrals in healthcare and community settings. This study aimed to examine the internal structure and psychometric properties of the Mental Health Literacy Questionnaire for Young Adults (MHLq-YA) within a Spanish university population. An initial sample of 425 university students enrolled in Nursing and Education programs was recruited. Following data screening for invariant and aberrant responding, the final analytical sample comprised 416 participants. Confirmatory Factor Analysis (CFA) supported a four-factor structure (Knowledge, Stereotypes, Help-Seeking, and Self-Help) with an adequate and structural fit to the data, supporting its multidimensionality with an adequate model fit (CFI = 0.949, TLI = 0.944, RMSEA = 0.068). Evidence of convergent and discriminant validity was observed in three of the four dimensions, while the relationship between Knowledge and Self-Help warranted theoretical interpretation. Convergent validity was supported for three dimensions (Stereotypes, Help-Seeking, and Self-Help), whereas the Knowledge dimension showed comparatively weaker convergent validity (AVE = 0.436). Discriminant validity was supported for all factor pairs under the HTMT criterion, although the stricter Fornell–Larcker criterion was not met for the Knowledge–Self-Help pair, reflecting a conceptual and empirical overlap between these two dimensions that is discussed as a structural limitation of the model. Item Response Theory (IRT) analyses revealed high measurement precision in the lower and moderate ranges of the latent traits, particularly for the Help-Seeking and Self-Help subscales. Ceiling effects and cross-loadings in specific items were resolved through a stepwise model re-specification. The final 26-item version demonstrated robust psychometric performance. These findings support the MHLq-YA as a valid and reliable tool for assessing mental health literacy in academic settings. Crucially, it allows educators to identify gaps in clinical preparedness before students interact with actual patients or vulnerable populations. Ultimately, these results inform targeted interventions to improve mental health awareness, help-seeking behavior, and the overall quality of future clinical care provided by university students. Full article

Food recommendation systems must satisfy dietary preferences and nutritional, health, and ingredient constraints. In constrained food knowledge-base question answering, unequal positive training-answer frequency may influence ranking without necessarily reflecting query–recipe fit. We develop D-pFoodReQ by replacing the pFoodReQ answer ranker with BAMnet-D while retaining its food-knowledge and constraint-processing pipeline. BAMnet-D introduces a separate answer-frequency branch alongside semantic matching, applies candidate-set-relative loss reweighting, and uses a counterfactual-inspired intervention that sets the explicit frequency input to zero during validation and testing. Across three runs using the same protocol on the pFoodReQ benchmark, D-pFoodReQ achieved an F1 score of 62.96 ± 2.06%, compared with 61.33 ± 2.27% for pFoodReQ. Its mean average precision and mean average recall were 66.50 ± 0.54% and 65.38 ± 0.66%, respectively. On 1355 questions for which no gold answer appeared as a positive training label, D-pFoodReQ attained a mean answer-set F1 nearly identical to that of pFoodReQ while achieving higher Recall@5 and NDCG@5. Ablation and output-composition analyses indicated that loss reweighting alone did not account for the full improvement, while retaining the explicit frequency term was associated with a larger share of answers observed as positive training labels. These results support answer-frequency-aware ranking for constrained food knowledge-base question answering. Full article

Background: Multimodal interventions combining physical exercise and cognitive stimulation may improve sleep and healthy aging among older adults. However, little is known about how participants experience these interventions. This study explored the experiences and perceptions of older adults who participated in physical exercise, combining physical exercise and cognitive training, or health education programs designed to improve sleep. Methods: A qualitative process evaluation using reflexive thematic analysis was conducted following a randomized controlled trial in Toledo, Spain. Twenty-one community-dwelling adults aged ≥65 years from the control, physical exercise (Otago), and combined exercise plus CogniFit^® groups completed semistructured interviews. The interviews were audio-recorded, transcribed from the recordings, and analyzed using reflexive thematic analysis. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: Six themes emerged: participation experience, perceived changes in sleep, benefits beyond sleep, evaluation of program components, facilitators and barriers, and maintenance of healthy habits. The participants reported high levels of satisfaction across all the groups. Beyond perceived changes in sleep, participants described perceived benefits related to physical well-being, cognitive stimulation, social interaction, and healthier habits. The participants also identified facilitators and barriers affecting engagement and maintenance. Exercise was valued for its simplicity and adaptability, whereas cognitive training was considered stimulating despite initial technological challenges. The main barriers were preexisting health conditions and difficulties using digital technology. Many participants intended to maintain the healthy habits acquired during the intervention. Conclusions: The participants who completed the qualitative interviews generally described positive experiences across the three groups. These findings provide insights relevant to the design of person-centered and accessible interventions and highlight factors that may influence engagement and maintenance in community settings. Full article

Background/Objectives: Fecal occult blood testing (FOBT) is a cornerstone of colorectal cancer (CRC) screening. The current quantitative FOBTs, however, were centralized, which limited their accessibility in preliminary screening implemented by community health. This study aimed to establish a rapid, highly sensitive quantitative FOB-detection method based on near-infrared fluorescence immunochromatography, hereinafter referred to as point-of-care fecal immunochemical testing (POCT-FIT), and to evaluate its performance against a centralized testing system in population-based CRC screening. Methods: Anti-human hemoglobin monoclonal antibodies were labeled with near-infrared fluorescent nanospheres (excitation 770 nm; emission 794 nm), and FOB test strips were prepared using immunochromatography. A fluorescence immunochromatography analyzer was used to scan the fluorescence intensities of the test line (T) and control line (C). The ratio of the fluorescence intensity on the T-line to that on the C one (T/C) was calculated at different hemoglobin concentrations, and a standard curve was generated over the span of 50 to 2000 ng/mL. A total of 115 clinical fecal samples were collected for methodological comparison with the commercially available OC-Sensor system (Eiken Chemical Co., Ltd., Tokyo, Japan). In a non-paired CRC screening program implemented by community health in Wenzhou, 3163 participants were assigned to the centralized testing group (OC-Sensor system) and 5211 participants to the POCT-FIT group (near-infrared fluorescence immunochromatography method). A positive threshold was set up at 100 ng/mL. Colonoscopy and histopathological results served as the gold standard. Results: The testing results of the two groups for the 115 samples showed that there is a strong linear correlation (R = 0.9959) and good agreement between the two methods. In the screening of community health, CRC prevalence was 2.78% (88/3163) in the centralized group (OC-Sensor) and 1.00% (52/5211) in the decentralized one (POCT-FIT). Sensitivities for CRC were 98.9% (95% CI: 95.8–99.9%) and 100% (95% CI: 93.2–100%), respectively, with no statistically significant difference; specificities were 29.2% (95% CI: 27.6–30.8%) and 27.3% (95% CI: 26.1–28.5%), with the centralized group being slightly higher (p = 0.001). Positive and negative likelihood ratios were comparable between the two methods. Conclusions: The sensitivity of the POCT-FIT method was comparable to that of the OC-Sensor method, and its negative results were associated with a lower probability of missed CRC, which may help reduce medical insurance expenditure for CRC treatment. POCT-FIT is simple to operate and portable, and the price of the disposable immunochromatographic test strip is much lower than that of the turbidimetric method (centralized testing system). Thus, it meets the practical needs of settings with low daily testing numbers (such as preliminary community health or resource-limited and sparsely populated areas) and serves as an effective complement to centralized testing. Full article

Low engagement with digital technologies is increasingly recognized as a health-related correlate in later life, yet the psychosocial variables linking it to mental and cognitive health remain unclear. Guided by the stress-process model, this cross-sectional study examined whether the associations of low digital engagement (LDE) with depressive symptoms and probable cognitive impairment were consistent with indirect pathways through self-perceived burden, self-perceived uselessness, and loneliness. We analyzed data from 1703 community-dwelling adults aged 55 to 85 years in Shanghai, China, collected between 2022 and 2023. Two path models specified self-perceived burden and self-perceived uselessness as parallel first-stage mediators and loneliness as a second-stage mediator: a linear model for depressive symptoms (CES-D-10) and a logit model for probable cognitive impairment (AD8 ≥ 2), each adjusting for sociodemographic, lifestyle, and health covariates (5000 bootstrap replications). Greater LDE was associated with more depressive symptoms (b = 0.062, 95% CI: 0.011, 0.113) and higher odds of probable cognitive impairment (OR = 1.040 per point, 95% CI: 1.014, 1.067). For depressive symptoms, the total indirect association accounted for 75.2% of the total association: significant specific indirect components included burden (30.3%), uselessness (15.6%), and the serial chains via burden and loneliness (8.7%) and via uselessness and loneliness (7.0%). The direct association was not statistically significant. For probable cognitive impairment, the direct association remained significant, and the significant indirect components were limited to the burden route. Formal contrasts indicated no significant difference between the burden and uselessness routes. The association between LDE and loneliness was attenuated to non-significance once the self-evaluative variables were included. Reverse models fit the data equally well. These cross-sectional associations generate hypotheses for future longitudinal and intervention research in rapidly digitizing urban settings. Full article

Background/Objectives: Human immunodeficiency virus (HIV) and tuberculosis (TB) remain major public health challenges in sub-Saharan Africa, which bears the highest burden of HIV/TB co-infection. Evidence is limited on whether the severity of virological failure is associated with workplace absenteeism among employed adults with HIV/PTB co-infection. This study examined workplace absenteeism across two viral-load categories among employed adults with documented virological failure in the Govan Mbeki sub-district. Methods: A retrospective record review with secondary data analysis was conducted among 286 employed mine workers with HIV/PTB co-infection and a viral load ≥1000 copies/mL after at least six months of antiretroviral therapy (ART). Clinical data were extracted from medical, laboratory, and TB-treatment records and linked to workplace sick-leave registers; limited participant contact was used only to clarify essential missing information. The analytic dataset had an observed minimum viral load of 1200 copies/mL. Viral load was categorised as 1200–10,000 versus ≥10,001 copies/mL. Absenteeism was the number of recorded sick-leave days during the preceding three months and, for logistic regression, was classified as low (5–10 days) versus high (11–15 days). Multivariable logistic regression was adjusted for age, sex, education, and structural/socioeconomic barrier score. Results: Mean absenteeism was 10.05 days (SD = 2.44). Of 286 participants, 181 (63.3%) had a viral load ≥10,001 copies/mL and 105 (36.7%) had a viral load of 1200–10,000 copies/mL. High absenteeism occurred in 129 participants (45.1%) and lower absenteeism in 157 (54.9%). Viral load category was not associated with high absenteeism after adjustment (aOR = 1.21, 95% CI: 0.76–1.92; p = 0.432). The model was not statistically significant (χ² = 6.41, df = 5, p = 0.269), explained 3.0% of the variance (Nagelkerke R² = 0.030), and had an acceptable Hosmer–Lemeshow fit (p = 0.913). Conclusions: Within this selected employed cohort with virological failure, high-level virological failure and absenteeism were both common, but no evidence of an independent association between viral-load category and high absenteeism was detected. The cross-sectional temporal structure, healthy-worker selection, limited exposure contrast, and residual confounding constrain causal interpretation. Integrated public health and workplace interventions are suggested to improve both treatment outcomes and workforce participation in high-burden settings. Full article