The Lancet最新文献

{"title":"Gepotidacin shows promise for the treatment of uncomplicated gonorrhoea","authors":"Magnus Unemo, Teodora Wi","doi":"10.1016/s0140-6736(25)00680-4","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00680-4","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"183 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral gepotidacin for the treatment of uncomplicated urogenital gonorrhoea (EAGLE-1): a phase 3 randomised, open-label, non-inferiority, multicentre study","authors":"Jonathan D C Ross, Janet Wilson, Kimberly A Workowski, Stephanie N Taylor, David A Lewis, Sally Gatsi, William Flight, Nicole E Scangarella-Oman, Charles Jakielaszek, Dan Lythgoe, Marcy Powell, Salim Janmohamed, Judith Absalon, Caroline Perry","doi":"10.1016/s0140-6736(25)00628-2","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00628-2","url":null,"abstract":"<h3>Background</h3>Gepotidacin, a first-in-class, bactericidal, triazaacenaphthylene antibacterial that inhibits bacterial DNA replication, was shown to be efficacious and well tolerated in the treatment of uncomplicated urinary tract infections. We evaluated the efficacy and safety of gepotidacin for the treatment of uncomplicated urogenital gonorrhoea.<h3>Methods</h3>EAGLE-1 (<span><span>NCT04010539</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>) was a phase 3, open-label, sponsor-blinded, multicentre, non-inferiority study evaluating oral gepotidacin (two 3000 mg doses administered 10–12 h apart) compared with 500 mg intramuscular ceftriaxone plus 1 g oral azithromycin for the treatment of gonorrhoea. Eligible participants were aged 12 years and older, had a bodyweight over 45 kg, and had suspected uncomplicated urogenital gonorrhoea (including mucopurulent discharge), a positive laboratory test for <em>Neisseria gonorrhoeae</em>, or both. Participants were randomly allocated in a 1:1 ratio to each treatment group, stratified by sex (original urogenital anatomy at birth) and sexual orientation (men who have sex with men [MSM], men who have sex with women [MSW], and female) in combination, and age group (age <18 years, ≥18 to 65 years, or >65 years). The primary efficacy endpoint was microbiological success, defined as culture-confirmed bacterial eradication of <em>N gonorrhoeae</em> from the urogenital body site at test-of-cure (days 4–8). The non-inferiority margin was prespecified at –10%. The primary outcome was assessed in the microbiological intention-to-treat (micro-ITT) population, all participants randomly allocated to a study treatment who received at least one dose of their study treatment and had confirmed ceftriaxone-susceptible <em>N gonorrhoeae</em> isolated from the baseline culture of their urogenital specimen. The safety population comprised all participants who received one or more doses of any study treatment.<h3>Findings</h3>Between Oct 21, 2019, and Oct 10, 2023, 628 participants were randomly allocated (314 allocated to each treatment group). Overall, 39 (6%) of 628 participants discontinued the study prematurely (20 in the gepotidacin group and 19 in the ceftriaxone plus azithromycin group), with the primary reason being lost to follow-up. The micro-ITT population included 406 participants (202 in the gepotidacin group and 204 in the ceftriaxone plus azithromycin group). Most participants in the micro-ITT population were male (372 [92%] <em>vs</em> 34 [8%] female), and there was a higher percentage of participants who were MSM (290 [71%]) compared with participants who were MSW (82 [20%]). Participants were predominantly White (299 [74%]) or Black or African American (61 [15%]), with 70 (17%) identifying as Hispanic or Latino. Results of the primary ana","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"218 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Department of Error","authors":"","doi":"10.1016/s0140-6736(25)00730-5","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00730-5","url":null,"abstract":"<em>Sidibe M, Makgoba TC, Bishop Paul, et al. Accelerating domestic investments to end AIDS in Africa.</em> Lancet <em>2025; Published Online April 8, 2025 https://doi.org/10.1016/S0140-6736(25)00685-3—</em>In this Correspondence, paragraph four has been updated to clarify that amfAR conducted the research using World Bank Development Indicators on health spending. This correction has been made to the online version as of April 11, 2025, and the printed version is correct.","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"183 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why and how academic medicine must champion diversity, equity, inclusion, and accessibility","authors":"Arghavan Salles, Ananya Tina Banerjee, Wendy Caceres, Mamas Mamas, Oni Blackstock","doi":"10.1016/s0140-6736(25)00575-6","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00575-6","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating research into surveillance: enhancing the response to mpox","authors":"Francine Ntoumi, Nathalie Strub-Wourgaft","doi":"10.1016/s0140-6736(25)00247-8","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00247-8","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2025 report of the Lancet Countdown to 2030 for women's, children's, and adolescents' health: tracking progress on health and nutrition","authors":"Agbessi Amouzou, Aluisio J D Barros, Jennifer Requejo, Cheikh Faye, Nadia Akseer, Eran Bendavid, Cauane Blumenberg, Josephine Borghi, Sama El Baz, Frederik Federspiel, Leonardo Z Ferreira, Elizabeth Hazel, Sam Heft-Neal, Franciele Hellwig, Li Liu, Melinda Munos, Catherine Pitt, Yushra Ribhi Shawar, Jeremy Shiffman, Yvonne Tam, Ties Boerma","doi":"10.1016/s0140-6736(25)00151-5","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00151-5","url":null,"abstract":"&lt;h2&gt;Section snippets&lt;/h2&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Executive summary&lt;/h2&gt;In line with previous progress reports by Countdown to 2030 for Women's, Children's, and Adolescents' Health, this report analyses global and regional trends and inequalities in health determinants, survival, nutritional status, intervention coverage, and quality of care in reproductive, maternal, newborn, child and adolescent health (RMNCAH) and nutrition, as well as country health systems, policies, financing, and prioritisation. The focus is on low-income and middle-income countries (LMICs)&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Section 1: a changing context for women's, children's, and adolescents' health&lt;/h2&gt;The health of women, children, and adolescents in LMICs is influenced by complex, interconnected determinants. Population dynamics, economic factors, education, power asymmetries (eg, gender inequity), armed conflicts, food security and food environments, climate change, geopolitical shifts, national politics, and technological advancements interact in intricate ways, shaping health systems and posing various health risks for women, children, and adolescents. Each determinant can influence&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Mortality&lt;/h2&gt;The 2023 UN Interagency Group for Child Mortality Estimation report on child mortality was unequivocal.&lt;sup&gt;20&lt;/sup&gt; Although global progress in reducing child and adolescent mortality has continued, the pace slowed down in most regions during the first 7 years of the SDG period. The annual rate of reduction in mortality in children younger than 5 years (hereafter referred to as under-5 mortality) and neonatal mortality rates from 2015–22 was only about half that achieved from 2000–15. The report found&lt;/section&gt;&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Section 3: coverage, equity, and service quality&lt;/h2&gt;Countdown has historically focused on tracking levels and trends in health intervention coverage (defined as the percentage of individuals within a population who require a specific intervention and have actually received it), with an emphasis on inequalities. Monitoring national coverage levels of essential interventions provides insight into how well countries are doing overall in achieving the SDG target of universal health coverage and providing life-saving care to women, children, and&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Section 4: health systems and supportive policies&lt;/h2&gt;Well functioning health systems are essential for the provision of life-saving interventions for women, children, and adolescents.&lt;sup&gt;181&lt;/sup&gt; This section addresses policies and several dimensions of health systems functionality. Health financing is presented in section 5 as it encompasses external aid, a measure of global prioritisation of RMNCAH.Health systems are rooted in each country's context, are dynamic, and must be responsive to changing population health needs. Countries must regularly adapt&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerating vaccine development in Africa: lessons from HIV research","authors":"Nicaise Ndembi, Shelly Karuna, Jessica Cowden, Alberto Cagigi, Anthony Pilorget, Amber Moodley, Julie Ake, Sandhya Vasan, Nelson Michael, Jerome H Kim","doi":"10.1016/s0140-6736(25)00564-1","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00564-1","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tom Beauchamp","authors":"Jacqui Thornton","doi":"10.1016/s0140-6736(25)00692-0","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00692-0","url":null,"abstract":"<span><figure><span><img alt=\"\" height=\"343\" src=\"https://ars.els-cdn.com/content/image/1-s2.0-S0140673625006920-fx1.jpg\"/><ol><li><span><span>Download: <span>Download high-res image (173KB)</span></span></span></li><li><span><span>Download: <span>Download full-size image</span></span></span></li></ol></span></figure></span>","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rigour, independence, and precaution in reporting sodium risk","authors":"Bill Jeffery, Norm RC Campbell","doi":"10.1016/s0140-6736(25)00415-5","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00415-5","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"183 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Department of Error","authors":"","doi":"10.1016/s0140-6736(25)00727-5","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00727-5","url":null,"abstract":"<em>Cluver L, Makangila G, Hillis S, et al. Protecting Africa's children from extreme risk: a runway of sustainability for PEPFAR programmes.</em> Lancet <em>2025; published online April 8. https://doi.org/10.1016/S0140-6736(25)00401-5</em>—In figure 2B of this Health Policy, the colour scale was inverted. This correction has been made to the online version as of April 10, 2025, and will be made to the printed version.","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}