Lancet Regional Health-Americas最新文献

{"title":"Corrigendum to “The rising tide of HIV among young men who have sex with men in Brazil: insights from the Conectad@s study”–The Lancet Regional Health—Americas, 2024; Volume 36, 100798, August 2024; DOI: 10.1016/j.lana.2024.100798","authors":"Cristina M. Jalil , Emilia M. Jalil , Brenda Hoagland , Sandra W. Cardoso , Rodrigo Scarparo , Carolina Coutinho , Mayara Secco Torres Silva , Valdilea G. Veloso , Erin C. Wilson , Willi McFarland , Thiago S. Torres , Beatriz Grinsztejn","doi":"10.1016/j.lana.2025.101220","DOIUrl":"10.1016/j.lana.2025.101220","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"50 ","pages":"Article 101220"},"PeriodicalIF":7.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118295","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":"Validation of VaxEstim, a Bayesian model for rapid estimation of measles–mumps–rubella vaccination coverage at outbreak onset: a cross-sectional study","authors":"Rosemary A. Martoma ,&nbsp;Joshua C. Martoma ,&nbsp;Maimuna S. Majumder","doi":"10.1016/j.lana.2025.101253","DOIUrl":"10.1016/j.lana.2025.101253","url":null,"abstract":"<div><h3>Background</h3><div>Accurate estimation of vaccination coverage at the onset of an outbreak is critical for guiding timely public health responses. Conventional methods often rely on delayed or incomplete data that obscure immunity gaps. During the 2022–2023 central Ohio measles outbreak, Columbus Public Health estimated measles–mumps–rubella (<strong>MMR</strong>) coverage at 80–90% despite incomplete reporting. Martoma et al. developed VaxEstim, a statistical model that generated an early estimate of two-dose MMR coverage in the outbreak-exposed population at 53.0% (95% credible interval [<strong>CrI</strong>] 21.0–77.0) using limited publicly available case-based data. A subsequent epidemiological investigation by Martoma et al. defined the outbreak-exposed population as children &lt;15 years of age, of Somali descent, residing in Columbus (Ohio, USA), and receiving care within a primary care network (<strong>PCN</strong>).</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional validation study using electronic medical records from the PCN of 133,476 children &lt;15 years of age. This cohort included 9864 children of Somali descent residing in Columbus, who comprised the previously defined outbreak-exposed population. Two-dose MMR coverage was defined as ≥2 valid doses by the outbreak onset date of October 8, 2022. VaxEstim's predicted coverage was compared with observed coverage in this group.</div></div><div><h3>Findings</h3><div>Observed two-dose MMR coverage among the outbreak-exposed population was 42.4% (4181 of 9864; 95% CI 41.4–43.4), compared with VaxEstim's early-phase prediction of 53.0% (95% CrI 21.0–77.0). The wide credible interval reflects uncertainty typical of early outbreak phases. Model performance showed a mean absolute error of 0.106 and a mean squared error of 0.0113.</div></div><div><h3>Interpretation</h3><div>This study externally validates the VaxEstim prediction against observed coverage in this outbreak-exposed population. The model accurately predicted substantial underimmunisation, underscoring its potential to guide rapid, targeted public health action.</div></div><div><h3>Funding</h3><div><span>National Institute of General Medical Sciences</span>, <span>National Institutes of Health</span>; <span>National Science Foundation</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101253"},"PeriodicalIF":7.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119280","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":"Protective and risk factors of suicide in Native American youth: cross-sectional findings from a mixed-methods study","authors":"Teresa Brockie ,&nbsp;Joseph P. Gone ,&nbsp;Katie E. Nelson ,&nbsp;Anna S. Mueller ,&nbsp;Michelle Kahn-John ,&nbsp;Wuraola Olawole ,&nbsp;Nancy Perrin","doi":"10.1016/j.lana.2025.101245","DOIUrl":"10.1016/j.lana.2025.101245","url":null,"abstract":"<div><h3>Background</h3><div>Native American (American Indian/Alaska Native) youth have the highest rates of suicide and suicide clusters in the United States, and appropriate responses are lacking. This study examined protective and risk factors for suicide in a remote Northern Plains reservation with a recent cluster.</div></div><div><h3>Methods</h3><div>A mixed-methods study was conducted on the Fort Belknap Indian Reservation, Montana, in 2022 using a community-engaged approach. Quantitative results from the 251-item questionnaire are presented, which were derived from a culturally adapted socio-ecological model. Aaniiih and Nakoda youth 14–24 years of age, living on/near Fort Belknap were recruited.</div></div><div><h3>Findings</h3><div>In total, 197 youth completed the questionnaire; average age was 16.6 years (SD = 2.60). One hundred (51%) youth were female and 90 (46%) male; 6.1% of data points were missing. Positive family relationships, communal mastery, benevolent childhood experiences, and emotional intelligence were protective, decreasing odds of suicide ideation. Childhood and family risk factors correlated with increased odds of suicidal ideation, including verbal abuse, low community support, sexual abuse, and witnessing community violence. Utilizing multivariable modeling, emotional intelligence (protective factor), and early initiation of substance use, verbal abuse, PTSD, and historical losses (risk factors) were significant factors for suicide ideation, when controlling for all other factors.</div></div><div><h3>Interpretation</h3><div>Adverse childhood experiences, early initiation of substance use, and PTSD increase suicide ideation and attempts. When youth experience positive and supportive family relationships, odds of suicide ideation are lower, which highlight pivotal areas for intervention and response.</div></div><div><h3>Funding</h3><div><span>William T. Grant</span> and <span>Doris Duke Family Foundations</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101245"},"PeriodicalIF":7.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119278","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":"Twenty-five years of pertussis outbreaks in the Peruvian Amazon: a call to strengthen equity in vaccination and control","authors":"Juan C. Celis-Salinas ,&nbsp;Edgar A. Ramírez-García ,&nbsp;Victor E. Fiestas Solórzano ,&nbsp;Martín Casapía-Morales","doi":"10.1016/j.lana.2025.101255","DOIUrl":"10.1016/j.lana.2025.101255","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101255"},"PeriodicalIF":7.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119281","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":"Digital neonatal neurocritical care in Brazil: a retrospective multicentre cohort study of over 11,000 remotely monitored infants","authors":"Gabriel Fernando Todeschi Variane ,&nbsp;Danieli Mayumi Kimura Leandro ,&nbsp;Silvia Schoenau de Azevedo ,&nbsp;Rafaela Fabri Rodrigues ,&nbsp;Leticia Brito Sampaio ,&nbsp;Paula Natale Girotto ,&nbsp;Maurício Magalhães ,&nbsp;Alexandre Netto ,&nbsp;Marcelo Jenné Mimica ,&nbsp;Valerie Y. Chock ,&nbsp;Krisa Page Van Meurs","doi":"10.1016/j.lana.2025.101233","DOIUrl":"10.1016/j.lana.2025.101233","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal brain injury is a major global health challenge, disproportionately affecting low- and middle-income countries (LMIC), where access to specialized care remains limited. Technology-driven neuroprotective strategies may allow the dissemination of specialized care to resource-constrained settings. This study describes the implementation of a digital health strategy to deliver specialized neurocritical care to multiple neonatal intensive care units (NICUs) in Brazil.</div></div><div><h3>Methods</h3><div>Retrospective observational multicenter cohort study analyzing data from July 2017 to June 2024, from 79 NICUs across Brazil. A digital health strategy was implemented, incorporating real-time video amplitude-integrated and raw electroencephalography (video-aEEG/EEG), near-infrared spectroscopy (NIRS), and vital signs monitoring, supported by neonatology and pediatric neurology experts available 24/7. Education and training of bedside providers were accomplished by initial in-person sessions, followed by online training. An immersive reality tool was piloted to conduct consultations between the central monitoring and bedside teams.</div></div><div><h3>Findings</h3><div>11,333 neonates received neurocritical care with 727,858 h of remotely recorded brain monitoring and 124,967 interactions between monitoring centers and bedside teams. Most neonates were male (57.7%), the median gestational age was 37 weeks (IQR 32–39), and the mean birth weight was 2667 g (SD ± 635 g). The most common neuromonitoring indications were suspected seizures (23.3%), moderate or severe hypoxic-ischemic encephalopathy (15.9%), and mild hypoxic-ischemic encephalopathy (13.3%). In the study population, electrographic seizures were identified in 18.4%, and a single antiseizure medication achieved seizure control in 56.1%. The first line antiseizure medication was phenobarbital (97%). Pathologic aEEG/EEG background pattern was seen in 24.9%, and sleep-wake cycling was absent in 41.2%. Simultaneous video-aEEG/EEG and NIRS monitoring data were acquired from 1688 infants. Immersive reality was successfully piloted in 2023 in a single center, enhancing consultations between central monitoring and bedside teams and standardizing the training of healthcare professionals performing the modified Sarnat exam.</div></div><div><h3>Interpretation</h3><div>Applying digital solutions for specialized neurocritical care and training across distant and resource-limited centers is feasible and has the potential to promote equity and increase quality of care for high-risk infants.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101233"},"PeriodicalIF":7.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099794","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":"Towards HPV elimination: closing the gender gap by vaccinating and screening men","authors":"Bingmeng Xie ,&nbsp;Lifeng Xiao ,&nbsp;Lin Peng","doi":"10.1016/j.lana.2025.101251","DOIUrl":"10.1016/j.lana.2025.101251","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"50 ","pages":"Article 101251"},"PeriodicalIF":7.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104582","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":"Argentina's mental health at a crossroads: retrenchment and local resistance","authors":"Alejandra Barcala","doi":"10.1016/j.lana.2025.101250","DOIUrl":"10.1016/j.lana.2025.101250","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101250"},"PeriodicalIF":7.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099792","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":"Clinical effectiveness of HPV vaccine by age at vaccination: a matched case-control study","authors":"Carlos R. Oliveira ,&nbsp;Eugene D. Shapiro ,&nbsp;Sangini S. Sheth ,&nbsp;Mallory K. Ellingson ,&nbsp;Nicholaus P. Johnson ,&nbsp;Erin L. Sullivan ,&nbsp;Troy D. Querec ,&nbsp;Elizabeth R. Unger ,&nbsp;Linda M. Niccolai","doi":"10.1016/j.lana.2025.101225","DOIUrl":"10.1016/j.lana.2025.101225","url":null,"abstract":"<div><h3>Background</h3><div>Important questions remain about the extent to which human papillomavirus (HPV) vaccines are realizing their full potential in real-world settings. This study aimed to assess how age at the time of vaccination influences its effectiveness against HPV-attributable high-grade cervical lesions (HGCL).</div></div><div><h3>Methods</h3><div>In this matched case-control study conducted in New Haven County, Connecticut, cases were vaccine-eligible women diagnosed with HGCL associated with HPV 16 or 18 from 1/1/2010 to 12/31/2019. Controls were women with normal Pap smear results, matched to cases by age, medical practice, and date of Pap test. Participants were interviewed and records were reviewed to ascertain vaccination history and possible confounders including sexual behaviors. Vaccine effectiveness (VE) by age at the time of vaccination was assessed using matched odds ratios (OR) and 95% confidence intervals (CI) derived from multivariable conditional logistic regression models. VE was calculated as (1 − OR) × 100%.</div></div><div><h3>Findings</h3><div>A total of 524 women (132 cases and 392 controls) were included. The adjusted VE of &gt;1 dose of HPV vaccine was 54% (95% CI: 8–77%, p = 0·03). When the first dose was given at ≤18 years of age VE was 75% (95% CI: 13–93%, p = 0·03), and when vaccinated &gt;18 years VE was 43% (95% CI: −22 to 74%, p = 0·15).</div></div><div><h3>Interpretation</h3><div>These data demonstrate that the full benefit of HPV vaccines may not be realized when administered at older ages. Continued and strengthened efforts should be made to ensure that recommendations for HPV vaccination of younger adolescents are followed.</div></div><div><h3>Funding</h3><div><span>National Institutes of Health</span>, <span>American Cancer Society</span>, <span>Robert E. Leet and Clara Guthrie Patterson Trust</span>, and <span>Centers for Disease Control and Prevention</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101225"},"PeriodicalIF":7.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099793","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":"Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity","authors":"Jad Zeitouni ,&nbsp;Nosayaba Osazuwa-Peters ,&nbsp;Yusuf Dundar ,&nbsp;Gregory Zimet ,&nbsp;Mark A. Varvares","doi":"10.1016/j.lana.2025.101243","DOIUrl":"10.1016/j.lana.2025.101243","url":null,"abstract":"<div><div>Since its 2006 FDA approval, the Human Papillomavirus (HPV) vaccine has transformed the prevention of cervical, oropharyngeal, and other HPV-associated cancers in the United States. Despite notable progress, with 78.2% of adolescents initiating and 62.9% completing vaccination, support for the vaccine is at a critical point. Because the Department of Health and Human Services (HHS) mainly provides recommendations, state-level action is crucial. Only five states and territories have adopted school-entry HPV vaccination requirements, but with varying enforcement policies. Uptake varies across the U.S., from Massachusetts' 79.8% completion to Mississippi's 39.1%. Evidence shows that school-entry requirements can significantly improve vaccination rates. As we approach the vaccine's twentieth anniversary, maintaining the current gains and achieving the 80% Healthy People 2030 target for series completion demands a multipronged approach. State policies must become more robust, especially if federal support wanes. Preventing HPV-related cancers for future generations depends on continued progress. By prioritizing policy that strengthens prevention and access, states can safeguard this progress.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"51 ","pages":"Article 101243"},"PeriodicalIF":7.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061149","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":"Genomic characterization, origin, and local transmission of Oropouche virus in Bolivia in 2024","authors":"Joel Alejandro Chuquimia Valdez ,&nbsp;Ighor Arantes ,&nbsp;Sebastián Sasías Martínez ,&nbsp;Cleidy Orellana Mendoza ,&nbsp;Nelly Mendoza Loayza ,&nbsp;Jhonatan D. Marquina ,&nbsp;Helen Castillo Laura ,&nbsp;Roxana Salamanca Kacic ,&nbsp;Maya Xochitl Espinoza Morales ,&nbsp;Lionel Gresh ,&nbsp;Mariela Martínez Gómez ,&nbsp;Juliana Leite ,&nbsp;Leticia Franco ,&nbsp;Jairo Méndez-Rico ,&nbsp;Gonzalo Bello ,&nbsp;Felipe Gomes Naveca ,&nbsp;Leidy Roxana Loayza Mafayle","doi":"10.1016/j.lana.2025.101221","DOIUrl":"10.1016/j.lana.2025.101221","url":null,"abstract":"<div><h3>Background</h3><div>The Oropouche virus (OROV) is an arthropod-borne virus that causes an acute febrile illness, like other arboviral diseases. In 2024, Oropouche cases sharply increased in several countries of the Americas, including Bolivia. Here, we investigate the origin and spread of OROV in the Bolivian Amazon region.</div></div><div><h3>Methods</h3><div>Full-length OROV genomes from 34 positive samples collected in the three affected Bolivian departments during the 2024 outbreak were sequenced using an amplicon-based approach. Maximum Likelihood (ML) phylogenetic analyses of separate viral segments were conducted to identify the responsible viral lineage. Bayesian phylogeographic analysis of concatenated viral segments was used to reconstruct the viral spatiotemporal dispersion pattern within the country.</div></div><div><h3>Findings</h3><div>The first Oropouche cases in Bolivia 2024 were reported using samples collected from the Pando department during mid-January, and the peak of Oropouche cases occurred in mid-April. The phylogenetic analysis of OROV genomes revealed that all cases detected in Bolivia belong to the novel reassortant OROV clade that drove the recent epidemic in Brazil. Our phylogeographic analysis detected at least two exportation events from the Brazilian state of Acre to the Bolivian municipalities of Guayaramerín and Riberalta, both located in the Beni department, with subsequent dissemination to municipalities of Pando and La Paz departments. Viral introductions likely occurred between early October and early November 2023, indicating a lag of approximately three months between the introduction of OROV and its detection.</div></div><div><h3>Interpretation</h3><div>Our findings confirm that OROV spread at least twice from the western Brazilian Amazon to the neighboring Bolivian department of Beni in late 2023, successfully establishing regional transmission chains. These findings underscore the critical need for active OROV surveillance across the border Amazonian region between Brazil and Bolivia. They also confirm the potential for sustained OROV transmission within the Bolivian Amazon, highlighting the importance of preparedness for future outbreaks.</div></div><div><h3>Funding</h3><div>This publication was in part supported by the Cooperative Agreement Number <span><span>NU50CK000639</span></span> awarded to the <span>Pan American Health Organization</span> and funded by the <span>Centers for Disease Control and Prevention</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"50 ","pages":"Article 101221"},"PeriodicalIF":7.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060457","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}