Lancet Regional Health-Americas最新文献

{"title":"Transfusion-transmitted infections: risks and mitigation strategies for Oropouche virus and other emerging arboviruses in Latin America and the Caribbean","authors":"Andres Moreira-Soto ,&nbsp;Ignacio Postigo-Hidalgo ,&nbsp;Ximena Tabares ,&nbsp;Yannik Roell ,&nbsp;Carlo Fischer ,&nbsp;Eduardo Gotuzzo ,&nbsp;Thomas Jaenisch ,&nbsp;José Eduardo Levi ,&nbsp;Yaniv Lustig ,&nbsp;Jan Felix Drexler","doi":"10.1016/j.lana.2025.101089","DOIUrl":"10.1016/j.lana.2025.101089","url":null,"abstract":"<div><div>Arboviruses impose a major public health burden in Latin America and the Caribbean due to widespread and potentially severe infections causing microcephaly and long-lasting arthralgia. Beyond canonical vector-borne transmission, the magnitude and risk factors for transfusion-transmitted infections (TTIs) are unclear. In this narrative report, we use analyses of virological data such as infection symptomatology, viremic periods, and viral loads, to argue that dengue, Oropouche, Zika, yellow fever, and Chikungunya viruses pose an under-investigated risk of TTIs. An analysis of socioeconomic data showed that blood donation rates in Latin America and the Caribbean correlated with gross domestic product (r = 0.53, <em>p</em> = 0.0021) and health expenditure (r = 0.5, <em>p</em> = 0.0045), highlighting that resource limitations impact blood screening. Risk maps based on vector occurrence and ecological variables showed that Central America and Northwest coastal Brazil are high-risk zones, making surveillance, vector control, vaccination, and cost-effective blood screening crucial for mitigating TTIs, including Zika and potentially Oropouche viruses in pregnant women.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101089"},"PeriodicalIF":7.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903600","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":"Physical activity and BMI inequalities throughout childhood: a Brazilian birth cohort study","authors":"Shelby A. Keye ,&nbsp;Pedro Curi Hallal ,&nbsp;Inacio Crochemore-Silva ,&nbsp;Marlos Rodrigues Domingues ,&nbsp;Giulia Salaberry Leite ,&nbsp;Otávio Amaral de Andrade Leão","doi":"10.1016/j.lana.2025.101111","DOIUrl":"10.1016/j.lana.2025.101111","url":null,"abstract":"<div><h3>Background</h3><div>Utilising the 2015 Pelotas (Brazil) Birth Cohort, the current study investigated differences in physical activity (PA) and BMI-for-age between sex, race, and socioeconomic status (SES) at ages 1 (n = 4018), 2 (n = 4014), 4 (n = 4010), and 7 (n = 3867).</div></div><div><h3>Methods</h3><div>Demographics collected via surveys included sex at birth, skin colour, a proxy for race, at 4 years, and an assets index collected at all ages to determine SES. Height and weight estimated BMI-for-age and PA via wrist-worn accelerometers. Means and 95% confidence intervals described PA and BMI-for-age, using t-tests, ANOVAs, and chi-squared tests to determine significant differences. Trajectory models compared longitudinal patterns from 1 to 7 years.</div></div><div><h3>Findings</h3><div>Starting at age 2, Black and Brown children and poorer children engaged in more PA. Poorer children presented lower BMI-for-age at ages 4 and 7. Trajectory models revealed that boys, Black and Brown, and poorer children represented increasing and high PA groups. Boys and Black and Brown children were most prevalent in higher BMI-for-age trajectory groups.</div></div><div><h3>Interpretation</h3><div>The current study revealed PA and BMI-for-age inequalities across multiple demographic variables during early life. These results may reveal when inequalities may arise and reveal time points to intervene for populations at risk of poor health-related quality of life.</div></div><div><h3>Funding</h3><div>The present study was funded initially by the <span>Wellcome Trust</span> (<span><span>095582</span></span>), and partially by the <span>Conselho Nacional de Desenvolvimento Científico e Tecnológico</span>, <span>Fundacao de Amparo a Pesquisa do Estado do Rio Grande do Sul</span>, <span>Children’s Pastorate</span>, and the <span>Department of Science and Technology</span> (<span>DECIT</span>/<span>Brazilian Ministry of Health</span>).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101111"},"PeriodicalIF":7.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899537","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":"Correction to “Association between city-level sociodemographic and health factors and the prevalence of antimicrobial-resistant gonorrhea in the US, 2000–2019: a spatial–temporal modeling study” The Lancet Regional Health—Americas 2025; 43, 101006]","authors":"Jingwen Li ,&nbsp;Rachel E. Murray-Watson ,&nbsp;Sancta B. St Cyr ,&nbsp;Yonatan H. Grad ,&nbsp;Joshua L. Warren ,&nbsp;Reza Yaesoubi","doi":"10.1016/j.lana.2025.101079","DOIUrl":"10.1016/j.lana.2025.101079","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101079"},"PeriodicalIF":7.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887422","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":"Chile at risk: the silent spread of Aedes aegypti and the need for proactive research investment","authors":"Cristian A. Alvarez Rojas","doi":"10.1016/j.lana.2025.101116","DOIUrl":"10.1016/j.lana.2025.101116","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101116"},"PeriodicalIF":7.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887330","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":"Corrigendum to “Confronting federal censorship of social vulnerability index” – The Lancet Regional Health—Americas 2025; volume 44; 101062; DOI: 10.1016/j.lana.2025.101062","authors":"Shuo Jim Huang,&nbsp;Rozalina G. McCoy","doi":"10.1016/j.lana.2025.101121","DOIUrl":"10.1016/j.lana.2025.101121","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101121"},"PeriodicalIF":7.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892241","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":"Opioid and stimulant co-prescribing: our efforts and remaining open questions—authors' reply","authors":"Wenyu Song ,&nbsp;Seungyeon Lee ,&nbsp;David W. Bates ,&nbsp;Richard D. Urman ,&nbsp;Ping Zhang","doi":"10.1016/j.lana.2025.101118","DOIUrl":"10.1016/j.lana.2025.101118","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101118"},"PeriodicalIF":7.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883186","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":"Resurgence of Plasmodium vivax malaria in French Guiana (2023–2024): a multifactorial crisis in the Amazonian region—response to Salazar et al.","authors":"Loïc Epelboin ,&nbsp;Margot Oberlis ,&nbsp;Yann Lambert ,&nbsp;Luisiane Carvalho ,&nbsp;Maylis Douine","doi":"10.1016/j.lana.2025.101074","DOIUrl":"10.1016/j.lana.2025.101074","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101074"},"PeriodicalIF":7.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883187","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 significant impact of meconium ileus on clinical outcomes among Brazilian individuals with cystic fibrosis—a retrospective analysis of a patient registry","authors":"Luiz Vicente Ribeiro F. da Silva-Filho ,&nbsp;Gianluca Belchior ,&nbsp;Angela Tavares Paes ,&nbsp;Nicole Costa Soriano Freire ,&nbsp;Cintia Steinhaus ,&nbsp;Matias Epifanio","doi":"10.1016/j.lana.2025.101099","DOIUrl":"10.1016/j.lana.2025.101099","url":null,"abstract":"<div><h3>Background</h3><div>Meconium ileus (MI) is one of the earliest manifestations of cystic fibrosis (CF), affecting 15–20% of individuals. The impact of MI on health outcomes has yet to be elucidated and may vary based on the amount of health care resources. The aim of this study was to investigate the clinical impact of MI on outcomes among Brazilian CF individuals using data from the Brazilian Cystic Fibrosis Patient Registry.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included data from individuals with CF from 53 reference centres in Brazil. Data from individuals with a history of MI during the neonatal period were compared to those of the non-MI individuals. Demographic data, genotype, lung function, nutritional data, microbiological data and survival data were compared between groups. The impact of MI on lung function and anthropometric outcomes was evaluated using mixed effects models after adjusting for age. Individual survival data were analyzed by Kaplan–Meier curves, log-rank tests and Cox proportional hazards models.</div></div><div><h3>Findings</h3><div>Among the 5128 individuals included in the registry, 369 (7·2%) were diagnosed with MI at birth. The occurrence of MI was associated with an earlier diagnosis of CF but a lower mean Z score for weight (−0·32, 95% CI −0·46 to −0·18, p &lt; 0·0001) and height (−0·28 95% CI −0·40 to −0·15, p &lt; 0·0001). Lung function was significantly lower among those affected by MI (reduction of −4·3% 95% CI −8·0 to −0·5, p = 0·028) up to the age of 18 years. A greater prevalence of <em>Pseudomonas aeruginosa</em> colonization was observed in the MI group (79·1% (272/344) versus 64·5% (2818/4367); p &lt; 0·0001). Survival was significantly worse in the MI group, and the results of the Cox regression model revealed that the impact of MI on mortality was significant after controlling for other risk factors (HR = 1·84, 95% CI 1·50–2·25, p &lt; 0·0001).</div></div><div><h3>Interpretation</h3><div>CF individuals affected by MI had more severe and earlier declines in lung function, slower rates of weight and height gain, and lower survival rates. These findings underscore the importance of early identification and tailored management strategies for this high-risk subgroup.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101099"},"PeriodicalIF":7.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879209","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":"Baseline variables associated with subsequent HIV seroconversion among gay, bisexual and other men who have sex with men and transgender women: a prospective, multicenter PrEP demonstration study (ImPrEP)","authors":"Carlos F. Caceres ,&nbsp;Heather Pines ,&nbsp;Kelika A. Konda ,&nbsp;Annick Borquez ,&nbsp;Ronaldo Moreira ,&nbsp;Iuri Leite ,&nbsp;Pedro Amparo ,&nbsp;Marcelo Cunha ,&nbsp;Thiago S. Torres ,&nbsp;Juan V. Guanira ,&nbsp;Jean-Pierre Jirón ,&nbsp;Brenda Hoagland ,&nbsp;Heleen Vermandere ,&nbsp;Marcos Benedetti ,&nbsp;Hamid Vega ,&nbsp;Carlos M. Benites ,&nbsp;Cristina Pimenta ,&nbsp;Beatriz Grinztejn ,&nbsp;Valdiléa Veloso ,&nbsp;Karen Campos","doi":"10.1016/j.lana.2025.101098","DOIUrl":"10.1016/j.lana.2025.101098","url":null,"abstract":"<div><h3>Background</h3><div>Ongoing implementation of HIV pre-exposure prophylaxis (PrEP) in Latin America should consider lessons learned from implementation projects such as ImPrEP (Brazil/Mexico/Peru, 2018–2021). In this analysis we assessed the effect of variables ascertained in early appointments on HIV seroconversion among ImPrEP participants.</div></div><div><h3>Methods</h3><div>ImPrEP enrolled HIV-negative men who have sex with men and transgender women (MSM/TGW) aged 18+ years reporting recent condomless anal sex, anal sex with HIV-positive partners, transactional sex, or sexually transmitted infections (STI). Participants received a 30-day PrEP supply; at the 30-day visit and quarterly thereafter they completed behavioural assessments, underwent HIV testing, and received 3-month PrEP supplies if HIV-negative. PrEP adherence was measured using the medication possession ratio (MPR) at the 30-day visit. We used Cox's proportional hazards regression to examine the effect of our sociodemographic, behavioural, STI, and early PrEP care engagement variables of interest on time to HIV seroconversion.</div></div><div><h3>Findings</h3><div>Compared to participants in Brazil, the hazard ratio for HIV seroconversion was higher among those in Peru (HR = 7.91, 95% CI: 4.74–13.20). Compared to participants aged ≥35 years, the HR for HIV seroconversion was higher for those aged 18–24 (aHR = 4.84, 95% CI: 2.55–9.17 and 25–34 (aHR = 2.43, 95% CI: 1.21–4.91). HIV seroconversion was also associated with transgender identity (aHR = 2.28, 95% CI: 1.12–4.66), transactional sex (aHR = 1.88, 95% CI: 1.18–2.99), receptive condomless anal sex (aHR = 2.42, 95% CI: 1.42–4.12), STI diagnosis (aHR = 1.93, 95% CI: 1.25–2.99), and a MPR &lt; 0.6 (aHR = 2.64, 95% CI: 1.52–4.60).</div></div><div><h3>Interpretation</h3><div>While moderate-high, HIV incidence among ImPrEP participants represented a considerable reduction from figures observed among MSM/TGW not using PrEP/PEP. Interventions to improve PrEP adherence are needed among new Latin American PrEP users, especially if baseline factors associated with seroconversion are present. Long-acting injectable PrEP can also become useful for this population.</div></div><div><h3>Funding</h3><div>This study was funded by <span>UNITAID</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101098"},"PeriodicalIF":7.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868838","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":"Adherence to treatment for tuberculosis infection in children using a comprehensive care strategy: a prospective cohort study with a historical control group","authors":"Iader Rodríguez-Márquez ,&nbsp;Dione Benjumea-Bedoya ,&nbsp;Andrea Victoria Restrepo-Gouzy ,&nbsp;Claudia Patricia Beltrán-Arroyave ,&nbsp;Diana Marín ,&nbsp;Fernando Nicolás Montes-Zuluaga ,&nbsp;Juan Carlos Alzate-Ángel ,&nbsp;Lina Marcela Cadavid-Álvarez ,&nbsp;Lizeth Andrea Paniagua-Saldarriaga ,&nbsp;Teresa Realpe ,&nbsp;Yesenia Perea-Torres ,&nbsp;Lisandra María Arango-García ,&nbsp;Natalia Pérez-Doncel ,&nbsp;María Patricia Arbeláez-Montoya ,&nbsp;Jaime Robledo","doi":"10.1016/j.lana.2025.101094","DOIUrl":"10.1016/j.lana.2025.101094","url":null,"abstract":"<div><h3>Background</h3><div>Low adherence to treatment for tuberculosis infection (TBI) in children threatens tuberculosis (TB) control goals. This research focuses on children with close contact to TB and TBI. This study evaluated adherence to treatment of TBI using a comprehensive care strategy (CCS) for close-contact children with pulmonary TB compared with standard of care (SOC).</div></div><div><h3>Methods</h3><div>A prospective cohort study with a historical control group was conducted on children under five, who were close contacts of patients with bacteriologically confirmed pulmonary TB in three Colombian cities (study registration number: <span><span>NCT04331262</span><svg><path></path></svg></span>). The CCS comprised clinical evaluations, rifampicin for four months, multidisciplinary care, and logistical support, while the SOC followed program regulations with isoniazid for nine months. The primary outcome was the proportion of children completing 100% treatment during follow-up, and the secondary outcome was treatment-related adverse events (AEs).</div></div><div><h3>Findings</h3><div>213 children in the SOC group and 86 children in the CCS group were analyzed. The treatment adherence in the SOC group was 40·8% (95% CI 34%; 48%), while in the CCS group it was 76·7% (95% CI 66%; 85%). Children exposed to CCS had 87% higher probability of adherence to TBI treatment compared to SOC (RR 1·87; 95% CI 1·52; 2·31). The incidence of AEs was lower in the CCS group (n = 3) than in those receiving SOC (n = 24).</div></div><div><h3>Interpretation</h3><div>The CCS increases adherence to treatment for TBI in children safely compared to SOC. Future cost-effectiveness studies will help implement this strategy in programmatic settings.</div></div><div><h3>Funding</h3><div><span>Colombian Ministry of Science, Technology and Innovation</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101094"},"PeriodicalIF":7.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854754","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}