Lancet Regional Health-Americas最新文献

{"title":"Characterisation of the respiratory syncytial virus seasonality and its environmental factors in the Americas—a multi-country observational study using routine surveillance networks","authors":"Paula Couto ,&nbsp;Harry Campbell ,&nbsp;You Li ,&nbsp;Marc Rondy ,&nbsp;Juliana Leite ,&nbsp;Angel Rodriguez","doi":"10.1016/j.lana.2025.101166","DOIUrl":"10.1016/j.lana.2025.101166","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory Syncytial Virus (RSV) is an important cause of bronchiolitis and pneumonia in young children. Circulation patterns represent challenges for immunoprophylaxis, requiring tailored interventions to address RSV activity linked to climate. We assessed RSV seasonality across the Americas and its relation to environmental factors and influenza circulation.</div></div><div><h3>Methods</h3><div>RSV seasonality was assessed using data reported in 2010–2019 to a multi-country respiratory surveillance network. Time-series analysis identified temporal patterns and trends. Negative binomial, Moving Epidemics Method, and WHO Moving Averages Models were compared to assess seasonality. Correlation and regression were used for associations of RSV with environmental and influenza predictors.</div></div><div><h3>Findings</h3><div>During 2010–2019, 32 countries in the Americas reported 14,308,503 respiratory samples, with 446,648 RSV-positive (3.12%) samples. RSV seasonal epidemics progressed from south to north. In South America, RSV seasons began in early May, peaking in August. RSV seasonality was less distinct in Caribbean; RSV started in September and peaked in October–November. Central Americas’ RSV season lagged behind influenza, whereas in the Andes, it peaked earlier. At higher latitudes, RSV epidemics occurred earlier with shorter durations. RSV circulation negatively correlated with lower temperatures (−0.43; p &lt; 0.0001), and precipitation (−0.04; p = 0.0035); and was positively correlated with decreased longitude (0.12; p &lt; 0.0001) and barometric pressure (0.15; p &lt; 0.0001), and was associated with lower elevation (0.02; p = 0.10), and westerly locations (0.12; p &lt; 0.0001).</div></div><div><h3>Interpretation</h3><div>Subregional and interannual variations in RSV seasonality were influenced by environmental factors, underscoring the importance of ongoing surveillance. Collaborative efforts improve surveillance, shaping evidence-based strategies for preventive product introductions and effective RSV control.</div></div><div><h3>Funding</h3><div>The publication of this work was supported by the <span>United States Centers for Disease Control and Prevention</span> through a cooperative agreement with the <span>Pan American Health Organization</span>/<span>World Health Organization</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101166"},"PeriodicalIF":7.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570195","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":"Mortality of metallo-β-lactamase-producing Enterobacterales bacteremias with combined ceftazidime–avibactam plus aztreonam vs. other active antibiotics: a multicenter target trial emulation","authors":"Ivan Alfredo Huespe ,&nbsp;Emilio Felipe Huaier Arriazu ,&nbsp;Marisa Sanchez ,&nbsp;Vanina Stanek ,&nbsp;Javier Alberto Pollán ,&nbsp;Susana Bauque ,&nbsp;Débora Ávila Poletti ,&nbsp;Verónica Monzón ,&nbsp;Paola Novelli Poisson ,&nbsp;María Virginia Boutet ,&nbsp;Eleonora Cunto ,&nbsp;Viviana Chediack ,&nbsp;Melina Tatiana Beloso ,&nbsp;Victoria Rucci ,&nbsp;Marina Lagostena ,&nbsp;Ricardo Cabrera ,&nbsp;María José Gutiérrez ,&nbsp;María Georgina Gómez ,&nbsp;Sebastián Gabriel Arias ,&nbsp;Clarisa Taffarel ,&nbsp;Pascual Valdez","doi":"10.1016/j.lana.2025.101175","DOIUrl":"10.1016/j.lana.2025.101175","url":null,"abstract":"<div><h3>Background</h3><div>Bacteremias caused by metallo-β-lactamase (MBL)-producing Enterobacterales are a critical challenge due to their limited treatment options. Although ceftazidime-avibactam (CAZAVI) combined with aztreonam (ATM) has shown in vitro efficacy, no prior studies have rigorously compared its clinical effectiveness to Other Active Antibiotics (OAAs). This study aims to evaluate the efficacy and safety of CAZAVI + ATM vs. OAAs in a large cohort of MBL bacteremia.</div></div><div><h3>Methods</h3><div>A retrospective, multicenter, target trial emulation was conducted across 17 hospitals in Argentina between January 2016 and October 2024. Patients with confirmed MBL bacteremia who initiated active antibiotic treatment within 24 h of MBL identification and 96 h of blood sampling were included. Inverse probability of treatment weighting (IPTW) was used to reduce indication bias, and the analysis accounted for hospital clustering within Argentina's public, private, and social security health systems. The primary outcome was 30-day all-cause mortality, with secondary outcomes including clinical failure (relapse, complications, or death) and adverse events.</div></div><div><h3>Findings</h3><div>Among 243 patients (93 receiving CAZAVI + ATM and 150 receiving OAAs), the 30-day mortality rate was 35% in the CAZAVI + ATM group vs. 47% in the OAA group (adjusted odds ratio [OR] 0·63, 95% CI 0·43–0·91, p &lt; 0·01). Clinical failure occurred in 46% of the CAZAVI + ATM group and 53% of the OAA group (adjusted hazard ratio [HR] 0·65, 95% CI 0·44–0·97; p = 0·03). Adverse events were lower with CAZAVI + ATM (9·6% vs. 22·8%, p = 0·014).</div></div><div><h3>Interpretation</h3><div>These findings suggest CAZAVI + ATM might be associated with lower mortality, reduced clinical failure, and fewer adverse events compared to OAAs in patients with MBL-type Enterobacterales bacteremia. Further prospective studies are warranted to confirm these observations.</div></div><div><h3>Funding</h3><div>No specific funding was provided for this study.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"49 ","pages":"Article 101175"},"PeriodicalIF":7.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556838","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":"Primary health care data-based early warning system for dengue outbreaks: a nationwide case study in Brazil","authors":"Rejane Santos-Silva ,&nbsp;Pilar Tavares Veras Florentino ,&nbsp;Thiago Cerqueira-Silva ,&nbsp;Vinicius de Araújo Oliveira ,&nbsp;Juracy Bertoldo Junior ,&nbsp;George C.G. Barbosa ,&nbsp;Gerson O. Penna ,&nbsp;Viviane S. Boaventura ,&nbsp;Pablo I. Pereira Ramos ,&nbsp;Manoel Barral-Netto ,&nbsp;Izabel Marcilio","doi":"10.1016/j.lana.2025.101165","DOIUrl":"10.1016/j.lana.2025.101165","url":null,"abstract":"<div><h3>Background</h3><div>Traditional surveillance presents limitations for early outbreak detection. Primary health care (PHC) administrative data applied to syndromic surveillance offers a cost-effective way to integrate early warning systems (EWS). We evaluate the potential of an EWS for dengue outbreaks using PHC data in Brazil.</div></div><div><h3>Methods</h3><div>We applied the Early Aberration Reporting System (EARS-C1 and EARS-C2) to arbovirus-related PHC encounters from October 1, 2022, to March 1, 2024, to establish an EWS across 5570 municipalities. We assessed EWS timeliness, sensitivity, and positive predictive value (PPV) against fixed-incidence dengue outbreak thresholds.</div></div><div><h3>Findings</h3><div>Arbovirus-related PHC encounters occurred in 5364 (96.3%) and dengue cases in 5269 (94.6%) Brazilian municipalities. PHC-based warnings anticipated 48.5% (100 cases/100,000 inhabitants), and 68.4% (300/100,000) of outbreaks detected by existing surveillance. Timeliness was higher in municipalities with over 100,000 inhabitants.</div></div><div><h3>Interpretation</h3><div>The EARS algorithm applied to PHC data anticipated outbreaks up to four weeks before suspected case reporting. Its use of routine data ensures broader coverage and scalability. This study demonstrates the feasibility of integrating PHC data into an EWS for early dengue outbreak detection in Brazil.</div></div><div><h3>Funding</h3><div><span>Rockefeller Foundation’s Health Initiative</span> and <span>Fundação de Amparo à Pesquisa do Estado da Bahia</span>, Brazil.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101165"},"PeriodicalIF":7.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548512","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":"Trump's second presidency begins: evaluating effects on the US health system","authors":"Scott L. Greer ,&nbsp;Holly Jarman ,&nbsp;Rachel Kulikoff ,&nbsp;Miranda Yaver","doi":"10.1016/j.lana.2025.101173","DOIUrl":"10.1016/j.lana.2025.101173","url":null,"abstract":"<div><div>The first hundred days of the second Trump administration was unprecedented, with the administration taking remarkably aggressive, often questionably legal actions across health policy. This article uses the Health Systems Performance Assessment Framework to identify key policies regarding resources, financing, governance, and service delivery and their impact on the cost, quality, access, and equity of the US health system. The evaluation is largely negative. The administration, in its very energetic first hundred days, has already undermined resources, financing, and in particular governance in areas as diverse as oversight of long-term care, scientific research, and vaccination policy. Administration rhetoric and budget proposals called for severe reductions in health care access and actions to terminate services for particular groups, such as immigrants or gender minorities. Many of the particular actions, such as mass layoffs of specialist scientific and regulatory staff, will be difficult to reverse.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101173"},"PeriodicalIF":7.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548513","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":"Prevalence of blindness and visual impairment among yanomami Indigenous people in the Brazilian Amazon region: a cross-sectional observational study at CASAI-Y","authors":"Maria Christina Chagas Ferreira,&nbsp;Marcos Antonio Pellegrini,&nbsp;Bianca Jorge Sequeira","doi":"10.1016/j.lana.2025.101161","DOIUrl":"10.1016/j.lana.2025.101161","url":null,"abstract":"<div><h3>Background</h3><div>Indigenous populations in the Americas experience significant health inequities, especially in remote areas. Among the Yanomami, a highly mobile Indigenous people living in the Amazon, ocular health data are scarce. This study aimed to estimate the prevalence and causes of visual impairment and blindness among the Yanomami, contributing to public health planning for isolated populations.</div></div><div><h3>Methods</h3><div>A cross-sectional observational study was conducted between June and August 2024 at the Yanomami Indigenous Health House (CASAI-Y), in Boa Vista, Brazil. A total of 158 self-identified Yanomami individuals aged ≥5 years were evaluated through comprehensive eye exams including presenting visual acuity (PVA), best-corrected visual acuity (BCVA), autorefractometry, dynamic refractometry, tonometry, fundus photography, and slit-lamp examination. Visual impairment was classified according to the ICD-11 criteria.</div></div><div><h3>Findings</h3><div>The prevalence of moderate or worse visual impairment and blindness based on PVA was 15.8%, decreasing to 8.2% with BCVA. Cataract and uncorrected refractive error were the leading causes of visual loss. Visual impairment was more frequent among men and individuals aged &gt;40 years. Statistically significant improvements in visual acuity were achieved with refractive correction (p &lt; 0.001). Cultural and logistical barriers were identified as major limitations to access.</div></div><div><h3>Interpretation</h3><div>The high burden of preventable visual impairment in the Yanomami population underscores the need for accessible and culturally adapted eye care services. Corrective lenses and cataract surgery could substantially improve quality of life. Targeted strategies including mobile screening, Indigenous health agents and teleophthalmology should be prioritized to prevent avoidable blindness.</div></div><div><h3>Funding</h3><div>No funding.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101161"},"PeriodicalIF":7.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548511","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 and economic impact of the availability of innovative therapies for advanced lung cancer in men in Latin America: a population-based secondary data study","authors":"Andrés F. Cardona ,&nbsp;Natalia Sánchez ,&nbsp;Liliana Gutiérrez-Babativa ,&nbsp;Leonardo Rojas ,&nbsp;Jairo Zuluaga ,&nbsp;Stella Martínez ,&nbsp;Lucia Viola ,&nbsp;Carlos Carvajal ,&nbsp;Juliana Bogoya ,&nbsp;Laura Prieto-Pinto ,&nbsp;Daniel Samacá-Samacá ,&nbsp;Antonio Robles ,&nbsp;Joshua Kock ,&nbsp;Claudio Martín ,&nbsp;Luis Corrales ,&nbsp;Luis E. Raez ,&nbsp;Vladmir Cordeiro de Lima ,&nbsp;Suraj Samtani ,&nbsp;Oscar Arrieta","doi":"10.1016/j.lana.2025.101172","DOIUrl":"10.1016/j.lana.2025.101172","url":null,"abstract":"<div><h3>Background</h3><div>Over the last decade, the development of innovative cancer treatments has accelerated and has been associated with improved mortality trends; however, local regulatory approval times are extensive. This study estimated the clinical and economic impact of delays in the approval of innovative therapies for the treatment of advanced lung cancer in men in five Latin American countries.</div></div><div><h3>Methods</h3><div>Using public data, we estimated the relationship between available innovative therapies (AIT) and age-specific mortality rate (ASMR) for Argentina, Brazil, Chile, Colombia, and Mexico through a regression model. Based on the difference between the number of FDA-approved therapies and the number approved by each local agency, we calculated the avoidable deaths (ADs) if innovation had been available. We estimated the Years of Life Lost (YLLs) using the life expectancy, the median age of death, and the ADs. Productivity loss (PL) was calculated using each country’s retirement age and yearly Gross Domestic Product per capita (GDPc) in 2022 constant USD.</div></div><div><h3>Findings</h3><div>Total ADs, YLLs, and PL were 8694, 114,477, and USD 439,179,876, respectively. Argentina had the highest impact of AIT on ASMR. Brazil’s results showed a high clinical and economic impact, primarily due to its large population. Chile’s high GDPc led to high PL. Colombia and Mexico showed a high clinical impact, suggesting a benefit of early approval. Differences in availability and approval times have increased with the number of FDA-approved therapies, yet local time gaps have recently increased.</div></div><div><h3>Interpretation</h3><div>Our study shows the substantial clinical and economic impact of delays in approving innovative therapies, underscoring the potential of improving regulatory processes to increase the availability of lung cancer treatments. Accelerating the introduction of innovative therapies for advanced lung cancer in Latin America represents a significant opportunity to enhance survival rates, instilling hope and optimism while also avoiding substantial PL.</div></div><div><h3>Funding</h3><div>This study was conducted as a research partnership between Roche and CTIC. No funding was received. Authors participated in the study design, data collection, data analysis, interpretation, and writing of the report.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"49 ","pages":"Article 101172"},"PeriodicalIF":7.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524258","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":"Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, Canada","authors":"Romina Fakhraei ,&nbsp;Deshayne B. Fell ,&nbsp;Darine El-Chaâr ,&nbsp;Nisha Thampi ,&nbsp;Beate Sander ,&nbsp;Kevin Antoine Brown ,&nbsp;Natasha Crowcroft ,&nbsp;Shelly Bolotin ,&nbsp;Jon Barrett ,&nbsp;Elizabeth K. Darling ,&nbsp;Nahuel Fittipaldi ,&nbsp;Theresa Lamagni ,&nbsp;Allison McGeer ,&nbsp;Michelle Murti ,&nbsp;Manish Sadarangani ,&nbsp;Kevin L. Schwartz ,&nbsp;Abdool Yasseen ,&nbsp;Matthew Tunis ,&nbsp;William Petrcich ,&nbsp;Kumanan Wilson","doi":"10.1016/j.lana.2025.101170","DOIUrl":"10.1016/j.lana.2025.101170","url":null,"abstract":"<div><h3>Background</h3><div>Group B <em>Streptococcus</em> (GBS) is a leading infectious cause of neonatal morbidity and mortality worldwide, yet data on longer-term outcomes in children remain limited. We aimed to assess the risk of neurodevelopmental impairments (NDIs) in GBS survivors and to explore effect modification by sex and prematurity.</div></div><div><h3>Methods</h3><div>We performed a population-based cohort study of liveborn infants in Ontario between April 2012 and March 2018, using linked birth registry, laboratory, and health administrative databases. GBS disease in the first year of life was ascertained through culture results and diagnostic codes. NDIs, encompassing cognitive, motor, sensory (hearing, vision), and social/behavioural domains, were ascertained up to five years of age using diagnostic codes. Cox regression was used to estimate adjusted hazard ratios (aHR) for overall, domain-specific, and multidomain NDIs, comparing children with and without GBS disease during infancy.</div></div><div><h3>Findings</h3><div>Of 764,934 infants, 771 had a history of GBS disease. GBS survivors had a twofold increased risk of any NDI (adjusted hazard ratio [aHR]: 2.18 [95% CI: 1.88, 2.54]) and higher rates of cognitive (aHR: 2.79 [95% CI: 2.37, 3.30]), motor (aHR: 7.08 [95% CI: 2.93, 17.08]), social/behavioural (aHR: 1.60 [95% CI: 1.20, 2.14]), and sensory (aHR: 1.64 [95% CI: 1.02, 2.64]) impairments. Male children and those born preterm (&lt;37 weeks) had disproportionately higher risks of GBS-associated NDIs.</div></div><div><h3>Interpretation</h3><div>GBS disease in infancy is associated with a higher risk of NDIs by age five years, particularly for male children and those born preterm. Primary prevention strategies are needed to mitigate long-term developmental impacts of early-life GBS disease.</div></div><div><h3>Funding</h3><div><span>Canadian Institutes of Health Research</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101170"},"PeriodicalIF":7.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522069","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":"Cultural adaptation of a digital therapeutic for insomnia for Spanish-speaking Hispanic adults in the United States: a qualitative study","authors":"Carmela Alcántara ,&nbsp;Luciana Giorgio Cosenzo ,&nbsp;Sarah V. Diaz ,&nbsp;Darwin Arias ,&nbsp;Joseph E. Schwartz ,&nbsp;Ian M. Kronish ,&nbsp;Nathalie Moise","doi":"10.1016/j.lana.2025.101158","DOIUrl":"10.1016/j.lana.2025.101158","url":null,"abstract":"<div><h3>Background</h3><div>Digital therapeutics represent an innovative and scalable means for addressing inequities in access to behavioural healthcare. However, the adaptation of digital health technologies for minoritised communities to promote equitable uptake remains elusive, and the procedures and outcomes are often not systematically detailed. Our aim was to describe the equity-centred, theory-informed process we undertook to culturally adapt, for Spanish-speaking Hispanic adults, the first Food and Drug Administration authorized, self-guided, prescription digital therapeutic for insomnia.</div></div><div><h3>Methods</h3><div>We used an integrated four-stage model of cultural adaptation to guide the process and a cultural adaptation taxonomy of common elements to report findings. A bilingual (Spanish/English) community advisory board provided critical input. In Stages 1–3, ten focus groups and 13 individual interviews were conducted to obtain feedback on cultural adaptations and digital components. In Stage 4, a pilot study was undertaken to assess usability of the adaptations. Qualitative data were analysed using thematic content analysis and coded by type of adaptation.</div></div><div><h3>Findings</h3><div>53 Hispanic adults with chronic insomnia were invited to participate in all stages; Mean age = 53.6 years (SD = 11.4), 64.2% women, 49% less than college, and 62.3% reported low technological confidence. Cultural adaptations were made in each taxonomy component (83 total); the adapted program had high usability (System Usability Scale = 95/100). Surface-level adaptations (34.9% of changes made based on observable characteristics), which included changes to the characters (storylines, images), activities, and content to reflect the within-Hispanic group heterogeneity. Deep-level adaptations (65.1% of changes made based on sociocultural factors) included the integration of sociocultural values (<em>familismo</em>) and environment/burdens (stressors, social determinants, immigrant status) into the intervention content, and more in-App guidance/instruction to facilitate navigation for low health and digital literacy.</div></div><div><h3>Interpretation</h3><div>We produced a digital therapeutic for insomnia for Hispanic adults across the digital literacy spectrum with high acceptability, usability, and potential to confer clinical benefits.</div></div><div><h3>Funding</h3><div>This project was supported by <span>AHRQ</span> HS024274 and a Provost Grant from <span>Columbia University</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101158"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522558","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":"How to fight against cancer in the amazon: ideas and perspectives from the oncology 2025","authors":"Paulo Assumpção ,&nbsp;Elisa Pucu","doi":"10.1016/j.lana.2025.101181","DOIUrl":"10.1016/j.lana.2025.101181","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"47 ","pages":"Article 101181"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524263","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":"Reevaluating vitamin A for measles management in high-income settings","authors":"Parminder S. Suchdev ,&nbsp;Nancy F. Krebs ,&nbsp;Sherry A. Tanumihardjo","doi":"10.1016/j.lana.2025.101168","DOIUrl":"10.1016/j.lana.2025.101168","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101168"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522557","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}