Lancet Regional Health-Americas最新文献

{"title":"Overlap and predominance of cancer over cardiovascular deaths: insights about the epidemiological transition in Brazil","authors":"Raphael Mendonça Guimarães , Camila Drumond Muzi","doi":"10.1016/j.lana.2024.100947","DOIUrl":"10.1016/j.lana.2024.100947","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"40 ","pages":"Article 100947"},"PeriodicalIF":7.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social and health factors associated with unfavourable treatment outcomes in children and adolescents with drug-sensitive tuberculosis in Brazil: a national retrospective cohort study","authors":"Victor Santana Santos ,&nbsp;Jamile Rodrigues Cosme de Holanda ,&nbsp;Ruy Dantas Silveira Gois-Neto ,&nbsp;Ethel Leonor Noia Maciel ,&nbsp;Fernanda Dockhorn Costa Johansen ,&nbsp;José Nildo de Barros Silva-Júnior ,&nbsp;Wesley Adson Costa Coelho Correio ,&nbsp;José Roberto Lapa e Silva ,&nbsp;José Rodrigo Santos Silva ,&nbsp;Ricardo Queiroz Gurgel ,&nbsp;Tom Wingfield","doi":"10.1016/j.lana.2024.100938","DOIUrl":"10.1016/j.lana.2024.100938","url":null,"abstract":"<div><h3>Background</h3><div>Although tuberculosis (TB) poses a significant global health threat to children and adolescents, there is limited information on the factors associated with TB treatment outcomes in this group. This study investigated the social and health factors associated with unfavourable treatment outcomes in children and adolescents with TB in Brazil, a high TB burden country.</div></div><div><h3>Methods</h3><div>We conducted a population-based national retrospective cohort study of children (0–9 years) and adolescents (10–17 years) with TB in Brazil notified to the national <em>Sistema de Informação de Agravos de Notificação</em> (Sinan) from Jan 1, 2001, to Dec 31, 2022. Unfavourable treatment outcomes were defined as loss to follow-up, treatment failure, and death. Logistic regression and multinomial models examined the association between social and health factors, unfavourable treatment outcomes overall, and loss to follow-up and death, respectively.</div></div><div><h3>Findings</h3><div>A total of 88,270 children and adolescents with TB were included of whom 25,600 (30.6%) had healthcare worker-supervised directly observed therapy (DOT). Of these, 9303 (10.5%) individuals experienced unfavourable TB treatment outcomes. For children, HIV infection (adjusted Odds Ratio 2.4, 95% confidence interval 1.9–3.1) and did not receive DOT (2.3, 1.9–2.7) were associated with unfavourable treatment outcomes. For adolescents, alcohol use (1.6, 1.2–2.0), illicit drug use (4.2, 3.4–5.1), tobacco use (1.6, 1.3–2.1), HIV infection (2.7, 2.2–3.4), and not receiving DOT (2.6, 2.3–2.9) were associated with unfavourable TB treatment outcome. Receiving social protection through government cash transfers protected against death (0.5, 0.3–0.9).</div></div><div><h3>Interpretation</h3><div>In Brazil, TB treatment success rates were comparable to WHO End TB Strategy targets (90%). Substance use, HIV infection, and the absence of supervised treatment were the main factors associated with unfavourable treatment outcomes. Strategies to improve equity of TB treatment outcomes in this vulnerable group, including integrated HIV-TB services, DOT in healthcare facilities or communities, and holistic, person-centred healthcare and social protection, should be evaluated.</div></div><div><h3>Funding</h3><div><span>Department of Health and Social Care</span> (DHSC), the <span>Foreign, Commonwealth &amp; Development Office</span> (FCDO), the <span>Medical Research Council</span> (MRC) and <span>Wellcome, UK</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"40 ","pages":"Article 100938"},"PeriodicalIF":7.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess burden of antibiotic-resistant bloodstream infections: evidence from a multicentre retrospective cohort study in Chile, 2018–2022","authors":"Kasim Allel ,&nbsp;Anne Peters ,&nbsp;Hassan Haghparast-Bidgoli ,&nbsp;Maria Spencer-Sandino ,&nbsp;Jose Conejeros ,&nbsp;Patricia Garcia ,&nbsp;Koen B. Pouwels ,&nbsp;Laith Yakob ,&nbsp;Jose M. Munita ,&nbsp;Eduardo A. Undurraga","doi":"10.1016/j.lana.2024.100943","DOIUrl":"10.1016/j.lana.2024.100943","url":null,"abstract":"<div><h3>Background</h3><div>Antibiotic-resistant bloodstream infections (ARB BSI) cause an enormous disease and economic burden. We assessed the impact of ARB BSI caused by high- and critical-priority pathogens in hospitalised Chilean patients compared to BSI caused by susceptible bacteria.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study from 2018 to 2022 in three Chilean hospitals and measured the association of ARB BSI with in-hospital mortality, length of hospitalisation (LOS), and intensive care unit (ICU) admission. We focused on BSI caused by <em>Acinetobacter baumannii</em>, Enterobacterales, <em>Staphylococcus aureus</em>, Enterococcus species, and <em>Pseudomonas aeruginosa</em>. We addressed confounding using propensity scores, inverse probability weighting, and multivariate regressions. We stratified by community- and hospital-acquired BSI and assessed total hospital and productivity costs.</div></div><div><h3>Findings</h3><div>We studied 1218 adult patients experiencing 1349 BSI episodes, with 47.3% attributed to ARB. Predominant pathogens were <em>Staphylococcus aureus</em> (33% Methicillin-resistant ‘MRSA’), Enterobacterales (50% Carbapenem-resistant ‘CRE’), and <em>Pseudomonas aeruginosa</em> (65% Carbapenem-resistant ‘CRPA’). Approximately 80% of BSI were hospital-acquired. ARB was associated with extended LOS (incidence risk ratio IRR = 1.14, 95% CI = 1.05–1.24), increased ICU admissions (odds ratio OR = 1.25; 1.07–1.46), and higher mortality (OR = 1.42, 1.20–1.68) following index blood culture across all BSI episodes. In-hospital mortality risk, adjusted for time-varying and fixed confounders, was 1.35-fold higher (1.16–1.58) for ARB patients, with higher hazard ratios for hospital-acquired MRSA and CRE at 1.37 and 1.48, respectively. Using a societal perspective and a 5% discount rate, we estimated excess costs for ARB at $12,600 per patient, with an estimated annual excess burden of 2270 disability-adjusted life years (DALYs) and $9.6 (5.0–16.4) million.</div></div><div><h3>Interpretation</h3><div>It is urgent to develop and implement interventions to reduce the burden of ARB BSIs, particularly from MRSA and CRE.</div></div><div><h3>Funding</h3><div>Agencia Nacional de Investigación y Desarrollo <span>ANID</span>, Chile.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"40 ","pages":"Article 100943"},"PeriodicalIF":7.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biobanking for health in Latin America: a call to action","authors":"J. Adrián Rivera-Alcántara ,&nbsp;Carlos A. Aguilar-Salinas ,&nbsp;Alexandro J. Martagon","doi":"10.1016/j.lana.2024.100945","DOIUrl":"10.1016/j.lana.2024.100945","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"41 ","pages":"Article 100945"},"PeriodicalIF":7.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Domestic violence in American Indian and Alaska Native populations: a new framework for policy change and addressing the structural determinants of health","authors":"Tassy Parker ,&nbsp;Allyson Kelley ,&nbsp;Lee Redeye ,&nbsp;Marcello A. Maviglia","doi":"10.1016/j.lana.2024.100933","DOIUrl":"10.1016/j.lana.2024.100933","url":null,"abstract":"<div><div>There are 574 federally recognized Tribes in the United States. Tribes have experienced increased rates of domestic violence (DV) due to structural determinants like gender violence, loss of control, discrimination, marginalization, oppression, and political violence. American Indian and Alaska Native girls and women experience the highest rates of DV and abuse in the US, yet policy change, funding, and advocacy has been slow to address high DV rates. In this commentary, we comprehensively review the structural determinants of DV in American Indian and Alaska Native populations. We review policies and the complexities of criminal jurisdiction in Tribal nations and provide key recommendations to build a new framework that addresses DV in American Indian Alaska Native women in the future. Less than half of federally recognized Tribes receive funding through the Family Violence Prevention and Services Act. Structural determinants explain why housing and funding are advocacy issues, where unequal access and differential effects lead to increased risk for DV. We advocate for future work that addresses the interplay of multiple structural determinants while advocating for funding and culturally safe research and support to address DV in American Indian Alaska Native populations.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"40 ","pages":"Article 100933"},"PeriodicalIF":7.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micronutrient deficiencies according to sociodemographic factors and nutritional status among Panamanian children aged six to 59 months in 2019: a cross–sectional population–based study","authors":"Alicia Sosa Pedreschi ,&nbsp;Flavia Fontes ,&nbsp;José R. De León C ,&nbsp;Reina Roa ,&nbsp;Roger Montenegro Mendoza","doi":"10.1016/j.lana.2024.100932","DOIUrl":"10.1016/j.lana.2024.100932","url":null,"abstract":"<div><h3>Background</h3><div>Micronutrient deficiencies have serious lifelong consequences. This study aimed to estimate the prevalence of anaemia, iron deficiency anaemia, iron deficiency, and vitamin A deficiency, according to sociodemographic factors and nutritional status among Panamanian children aged six to 59 months in 2019.</div></div><div><h3>Methods</h3><div>We used data from the National Health Survey of Panama (ENSPA), a population–based, cross–sectional study, with a nationally representative subsample to evaluate haemoglobin, C–reactive protein (CRP), ferritin, and retinol levels among children aged six to 59 months. The data are shown weighted.</div></div><div><h3>Findings</h3><div>A total of 625 children representing a population of 62,100 children (females 45.0%, 27,971/62,100; 95% CI: 37.3–53.1), aged six to 59 months were assessed. Nationally, the prevalence of anaemia was 15.5% (9604/62,100; 95% CI: 11.5–20.6), iron deficiency anaemia was 8.0% (4950/62,100; 95% CI: 5.1–12.2), iron deficiency was 26.2% (16,259/62,100; 95% CI: 20.7–32.5), and vitamin A deficiency was 3.4% (2087/62,100; 95% CI: 2.1–5.3). Children from indigenous areas exhibited a higher prevalence of all micronutrient deficiencies studied, and nationally 40.9% (2316/5656; 95% CI: 22.1–62.9) of the children with overweight/obesity exhibited at least one micronutrient deficiency.</div></div><div><h3>Interpretation</h3><div>Our results highlight important disparities in the prevalence of nutritional deficiencies among children in different living areas. Public health strategies should focus on these vulnerable populations, as the first years of life are crucial for adequate growth and development.</div></div><div><h3>Funding</h3><div>This work was supported by an institutional research grant via the <span>Ministry of Economy and Finance</span> of Panama (<span><span>019910.002</span></span>). The ENSPA study was funded by the <span>Inter-American Development Bank</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"40 ","pages":"Article 100932"},"PeriodicalIF":7.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female homicides in Brazil: global burden of disease study, 2000–2018","authors":"Nadia Machado de Vasconcelos ,&nbsp;Juliana Bottoni de Souza ,&nbsp;Adauto Martins Soares Filho ,&nbsp;Polyanna Helena Coelho ,&nbsp;Sofia Reinach ,&nbsp;Caroline Stein ,&nbsp;Crizian Saar Gomes ,&nbsp;Luisa Sorio Flor ,&nbsp;Emmanuela Gakidou ,&nbsp;Antonio Luiz Pinho Ribeiro ,&nbsp;Deborah Carvalho Malta","doi":"10.1016/j.lana.2024.100935","DOIUrl":"10.1016/j.lana.2024.100935","url":null,"abstract":"<div><h3>Background</h3><div>Female homicides are a public health-relevant issue, and its spatial distribution may evidence socioeconomic vulnerabilities. This study aims to analyze the temporal and spatial trends of female homicides in Brazil and investigate socioeconomic-demographic factors associated with it.</div></div><div><h3>Methods</h3><div>This is an ecological, descriptive, and analytical epidemiological study investigating the age-standardized female homicide rate in all Brazilian municipalities between 2000 and 2018, divided into three periods. Spatial and temporal analyses were conducted using the Global Moran's Index and LISA to identify clusters of high and low rates. Rates were also calculated by population size and means of violence across macro-regions. For the last period, a multivariable linear regression model analyzed the association of female homicide rates with social, economic, and geographic factors.</div></div><div><h3>Findings</h3><div>Female homicide rates in Brazil remained high during the studied period, with differences in trends between regions. Among the potentially associated factors, it was observed that male homicide rate, the high percentage of violent deaths among black women and those with low levels of education, in addition to the low Gross Domestic Product (GDP) <em>per capita</em>, were positively associated with female homicide, whereas larger cities were negatively associated.</div></div><div><h3>Interpretation</h3><div>These findings show that Brazil is a country with a high risk of female homicide. Nevertheless, the vulnerability of women is unequally distributed in the country. Female homicides are mostly caused by domestic conflicts but can also be influenced by changes in the urban and social contexts.</div></div><div><h3>Funding</h3><div>This project is funded by the <span>Bill &amp; Melinda Gates Foundation</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"40 ","pages":"Article 100935"},"PeriodicalIF":7.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surge of mental health issues of Chinese Americans under both popular and policy-driven racism","authors":"Xiang Qi","doi":"10.1016/j.lana.2024.100941","DOIUrl":"10.1016/j.lana.2024.100941","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"41 ","pages":"Article 100941"},"PeriodicalIF":7.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leticia de Oliveira — a voice against gender-biased research opportunities","authors":"Orison O. Woolcott","doi":"10.1016/j.lana.2024.100934","DOIUrl":"10.1016/j.lana.2024.100934","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100934"},"PeriodicalIF":7.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital mental health interventions: an opportunity to enhance care while preserving human connection","authors":"Daisy R. Singla","doi":"10.1016/j.lana.2024.100940","DOIUrl":"10.1016/j.lana.2024.100940","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100940"},"PeriodicalIF":7.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}