Lancet Regional Health-Americas最新文献

{"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, 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 , Seungyeon Lee , David W. Bates , Richard D. Urman , 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 , Margot Oberlis , Yann Lambert , Luisiane Carvalho , 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}

{"title":"Actions against the double burden of malnutrition in Peru: a community-informed system dynamics model","authors":"Paraskevi Seferidi ,&nbsp;Laura Guzman-Abello ,&nbsp;Ellis Ballard ,&nbsp;Hilary M. Creed-Kanashiro ,&nbsp;Luis Huicho ,&nbsp;J Jaime Miranda ,&nbsp;Christopher Millett ,&nbsp;Antonio Bernabe-Ortiz","doi":"10.1016/j.lana.2025.101102","DOIUrl":"10.1016/j.lana.2025.101102","url":null,"abstract":"<div><h3>Background</h3><div>Peru's progress in reducing stunting has stagnated since 2018, while the country is facing increasing levels of overnutrition, leading to a double burden of malnutrition. However, this shift in nutrition burden is not reflected in Peru's nutrition policy agenda. This study aims to identify leverage points for actions against population-level double burden of malnutrition in Peru.</div></div><div><h3>Methods</h3><div>We developed a system dynamics model that simulates changes in overweight and stunting over time in Peru through changes in food system drivers. The model was conceptually informed by policymakers, practitioners and community members in Peru and used quantitative and qualitative data from secondary sources and published literature.</div></div><div><h3>Findings</h3><div>The model indicated that several overnutrition policies, including policies targeting food availability and affordability, may decelerate but not halt the increase of overweight in the country, mainly due to industry resistance. However, in the long term, the reallocation of resources towards overnutrition policies may inadvertently hinder progress towards stunting targets. Transforming nutrition policy governance, from siloed overnutrition and undernutrition policies towards a common policy framework against the double burden of malnutrition was the only modelled scenario that halted the rise in overnutrition, while keeping Peru on course to reach its stunting goals.</div></div><div><h3>Interpretation</h3><div>Transition away from policy landscapes that focus on single nutrition outcomes towards synergistic actions that target malnutrition in all forms is a long-term solution towards achieving global nutrition goals. Such policy transitions are especially important in low and middle-income countries like Peru, which are affected by the double burden of malnutrition.</div></div><div><h3>Funding</h3><div>This study was supported by a research grant from the <span>Biotechnology and Biological Sciences Research Council</span> (BBSRC) (grant reference: BB/T009004/1).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101102"},"PeriodicalIF":7.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854696","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":"Implications of adverse and benevolent childhood experiences on the physical and mental health of Mexican adults: a population-based study","authors":"Daniela León Rojas ,&nbsp;Fabiola Castorena Torres ,&nbsp;Nissa Yaing Torres-Soto ,&nbsp;Irene Martín-Estal ,&nbsp;Veronica Mundo Rosas ,&nbsp;Brenda Martinez Tapia ,&nbsp;Julieta Rodríguez-de-Ita","doi":"10.1016/j.lana.2025.101092","DOIUrl":"10.1016/j.lana.2025.101092","url":null,"abstract":"<div><h3>Background</h3><div>Adverse childhood experiences (ACEs) are linked to negative physical and mental health outcomes. Limited information on their influence exists in Latin America and middle-income countries like Mexico. This study aimed to determine the prevalence and impact of ACEs and benevolent childhood experiences (BCEs) on Mexican population health.</div></div><div><h3>Methods</h3><div>From September to November 2023, this cross-sectional study recruited a nationally representative sample of adults aged 18–65, randomly selected from urban and rural areas. Sociodemographic data, ACEs, BCEs, physical and mental health history, and clinical assessments for depression, anxiety, post-traumatic stress disorder, and eating disorders were collected.</div></div><div><h3>Findings</h3><div>Of 1448 participants recruited, 1115 (77%) were women, 1278 (88·2%) reported at least one ACE, while 328 (22·6%) had four or more. Physical (840; 58·6%) and emotional neglect (518; 35·7%) were the most frequent. Four or more ACEs increased the odds of obesity (OR 1·8, 95% CI 1·2–2·8), hypertension (OR 1·6, 95% CI 1·1–2·2), depression (OR 4·7, 95% CI 3·6–6·1) and anxiety (OR 4·1, 95% CI 3·2–5·3) among others. Common BCEs included having at least one supportive caregiver (1298; 89·6%) and feeling comfortable with oneself (1272; 87·8%). BCEs decreased the odds of physical and mental health diagnoses.</div></div><div><h3>Interpretation</h3><div>ACEs are highly prevalent and significantly impact the health of Mexican population. BCEs protect against these effects. Considering ACEs in public policies can help establish interventions to prevent adversity and promote positive childhood experiences.</div></div><div><h3>Funding</h3><div><span>Fundación FEMSA</span>, Centro de Primera Infancia from <span>Tecnológico de Monterrey and Fundación FEMSA</span> and <span>Tecnologico de Monterrey Challenge-Based Research Funding Program</span> 2022.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101092"},"PeriodicalIF":7.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850867","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":"Understanding the broader impacts of non-fatal firearm violence trauma in the United States: a scoping review","authors":"Deanna M. Giraldi ,&nbsp;Susan Swingler ,&nbsp;David S. Kirk ,&nbsp;Sara F. Jacoby ,&nbsp;G.J. Melendez-Torres ,&nbsp;Elinore J. Kaufman ,&nbsp;David K. Humphreys","doi":"10.1016/j.lana.2025.101091","DOIUrl":"10.1016/j.lana.2025.101091","url":null,"abstract":"<div><div>Exposure to firearm violence produces ripples of impact that extend far beyond the physical wounds of direct survivors. This scoping review aimed to describe the breadth of the last 25 years of literature on short-term, long-term, and cumulative impacts of firearm violence in the United States across physical, psychological, social, and economic domains. We searched PubMed, Embase, Scopus, PsycINFO, CINAHL, ProQuest Social Science Premium (ASSIA, NCJRS, and ERIC) and Web of Science until March 2024. Among 3172 articles, 87 met inclusion criteria. Our findings suggest that research most often explores short-term and psychological impacts on direct survivor-witnesses. The review highlights notable gaps, particularly regarding long-term and cumulative impacts among both the immediate social networks of survivor-witnesses and their wider communities. Further research is necessary for the effective development of trauma-informed interventions and the provision of economic resources aimed at supporting a growing population of survivors and communities affected by violence.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101091"},"PeriodicalIF":7.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848002","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}