Lancet Regional Health-Americas最新文献

{"title":"Armed gang violence in Haiti: a public mental health plan to navigate the horror and overcoming trauma","authors":"Jude Mary Cénat , Daniel Derivois , Antoniel Cénat , Lewis Ampidu Clorméus , Guesly Michel , Lukinson Jean , Jean Robert Desrosiers , Rose Darly Dalexis","doi":"10.1016/j.lana.2025.101065","DOIUrl":"10.1016/j.lana.2025.101065","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101065"},"PeriodicalIF":7.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679495","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":"On the verge: outbreak risk after two years of record-breaking dengue epidemics in Brazil","authors":"Rafael Lopes , Leonardo S. Bastos","doi":"10.1016/j.lana.2025.101068","DOIUrl":"10.1016/j.lana.2025.101068","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101068"},"PeriodicalIF":7.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143678939","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":"Trump and the overdose crisis—the need for evidence-based policy","authors":"Suhanee Mitragotri , David T. Zhu","doi":"10.1016/j.lana.2025.101063","DOIUrl":"10.1016/j.lana.2025.101063","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101063"},"PeriodicalIF":7.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683126","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":"The time has come for a vaccine against Chagas disease","authors":"Santuza M. Teixeira ,&nbsp;Gabriela de A. Burle-Caldas ,&nbsp;Júlia T. Castro ,&nbsp;Ricardo T. Gazzinelli","doi":"10.1016/j.lana.2025.101059","DOIUrl":"10.1016/j.lana.2025.101059","url":null,"abstract":"<div><div>Despite many studies, there is still no vaccines for Chagas Disease (CD), which affects approximately 7 million people mainly in Latin America. To make matters worse, the only two drugs available have proved efficacy only when administered during the acute phase of the disease. Here, we discuss recent advances towards the development of a CD vaccine including (i) better understanding of the role of elements involved in immune responses and host defense against <em>Trypanosoma cruzi</em>; (ii) molecular characterization of parasite genetic diversity and the biochemical nature of <em>T. cruzi</em> antigens involved in protective immune responses; and (iii) the use of novel vaccine platforms that show high efficacy in experimental models. Other aspects such as the role of parasite-induced inflammation in the pathogenesis of CD is also under intense scrutiny. An essential issue discussed in this Viewpoint refers to the main use of a vaccine for CD, i.e., whether this vaccine should be used for prophylactic purposes, combined therapy to improve drug efficacy and parasitological cure, or to re-orient the immune and inflammatory response. Finally, we emphasize the necessity to attract the interest of both private and public pharmaceutical companies to translate all the pre-clinical studies into a much-needed CD vaccine.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101059"},"PeriodicalIF":7.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679494","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":"Confronting federal censorship of social vulnerability index","authors":"Shuo Jim Huang ,&nbsp;Rozalina G. McCoy","doi":"10.1016/j.lana.2025.101062","DOIUrl":"10.1016/j.lana.2025.101062","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101062"},"PeriodicalIF":7.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683125","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":"COVID-19 and its impact on life expectancy among First Nations people in Alberta, Canada from 2019 to 2022: a population-based study","authors":"Chris Sarin ,&nbsp;Dean T. Eurich ,&nbsp;Olivia Weaver ,&nbsp;Li Huang ,&nbsp;Sydney Rudko ,&nbsp;Cerina Dubois ,&nbsp;Oacia Fair ,&nbsp;Lisa A. Wozniak ,&nbsp;Bonnie Healy ,&nbsp;Lea Bill ,&nbsp;Lynden Crowshoe ,&nbsp;Ambikaipakan Senthilselvan ,&nbsp;Amy Colquhoun ,&nbsp;Salim Samanani","doi":"10.1016/j.lana.2025.101052","DOIUrl":"10.1016/j.lana.2025.101052","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19 differentially impacted First Nations people due to pre-existing social, racial, and systemic inequities. This study explores life expectancy of First Nations people and the perspectives of First Nations health staff on the observed trends in life expectancy during the pandemic in Alberta, Canada.</div></div><div><h3>Methods</h3><div>All First Nations people in Alberta from a First Nations-identifying dataset (1999–2022) were included in this descriptive study (n = 164,964 in 2017, 49.7% male, 50.3% female, mean age 29.4 years [standard deviation 1.46; range 26.9–31.9 years]). In partnership with First Nations health managers, knowledge users, and using appropriate methods for First Nations people, we examined how the pandemic affected life expectancy in First Nations vs non-First Nations people. First Nations health managers were asked their opinions on observed trends in mortality during the pandemic through individual conversations.</div></div><div><h3>Findings</h3><div>Since 1999, First Nations people consistently had lower life expectancies compared to non-First Nations. In 2019–2021, life expectancy dropped 7.3 years (70.4 [95% confidence interval (CI) 69.48–71.24] to 63.1 [CI 62.28–64.02]) for First Nations people vs 1.4 years (82.8 [CI 82.65–82.92] to 81.4 [CI 81.22–81.51]) for non-First Nations people. Mortality was highest in young adult First Nations females relative to non-First Nations females (∼11-fold increase) during COVID-19. First Nations people had lower life expectancy across most age categories. The 20–50 year age groups had some of the highest relative mortality rates. Health managers observed similar life expectancy trends, perceiving that the pandemic exacerbated existing issues, including delayed access to care, poisonings (i.e., accidental or intentional overdoses), and pre-existing health conditions.</div></div><div><h3>Interpretation</h3><div>First Nations people in Alberta had a substantial drop in life expectancy during the pandemic compared to non-First Nations people. From the perspective of First Nations health managers, the pandemic indirectly exacerbated existing social and health issues, possibly contributing to the trend in life expectancy. Significant initiatives and resources will need to be deployed to assist First Nations communities to close these gaps.</div></div><div><h3>Funding</h3><div><span>Canadian Institutes of Health research</span> (<span><span>#PJT-178219</span></span>).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101052"},"PeriodicalIF":7.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683124","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":"Inequalities in paediatric hospitalisations for costly and prevalent conditions in Ontario, Canada: a population-based cohort study","authors":"Peter J. Gill ,&nbsp;Thaksha Thavam ,&nbsp;Jingqin Zhu ,&nbsp;Cornelia M. Borkhoff ,&nbsp;Patricia C. Parkin ,&nbsp;Eyal Cohen ,&nbsp;Teresa To ,&nbsp;Sanjay Mahant","doi":"10.1016/j.lana.2025.101056","DOIUrl":"10.1016/j.lana.2025.101056","url":null,"abstract":"<div><h3>Background</h3><div>Identifying inequalities is important for informing research, and policy efforts to reduce health disparities. This study measured the inequalities in hospitalisations for the costly and prevalent conditions in hospitalised children using association estimates.</div></div><div><h3>Methods</h3><div>Population-based cohort study using health administrative databases in Ontario, Canada between 2014 and 2019. The hospitalisation rate was determined for the costly and prevalent conditions in children. Hospitalisation inequalities by four equity stratifiers (material resources, rurality, sex, and immigrant status) were quantified using rate difference (RD), rate ratio (RR), and ratio of excess to total hospitalisation rate. Multivariable logistic regression analyses were also conducted.</div></div><div><h3>Findings</h3><div>In a population of 3·7 million children (median age 7·0 years, Interquartile range: 1·0–12·0), there were 612,597 hospitalisations. Large inequalities comparing children among least versus most resourced quintile was observed in low birth weight (RD: 1,823·3 hospitalisations per 100,000 children, 95% CI: 1,662·7, 1,983·9). Conditions with large inequalities comparing rural versus urban areas included low birth weight (RD: −1,833·2 hospitalisations per 100,000, 95% CI: −2,012·8, −1,653·6); and drug withdrawal syndrome in newborn (RR: 1·9, 95% CI: 1·7, 2·1; adjusted odds ratio (aOR): 1·4, 95% CI: 1·2, 1·5). Conditions with large inequalities comparing males versus females included low birth weight (RD: −888·3 hospitalisations per 100,000, 95% CI: −992·5, −784·02); and anorexia nervosa (RR: 0·08, 95% CI: 0·07, 0·10; aOR: 0·1, 95% CI: 0.1, 0.1). Conditions with large inequalities comparing non-refugee immigrants versus non-immigrants included major depressive disorder (RR: 2·8, 95% CI: 2·7, 2·9), and comparing refugees versus non-immigrants included drug withdrawal syndrome in newborn (RR: 0·09, 95% CI: 0·05, 0·15). Results from multivariable analyses were similar.</div></div><div><h3>Interpretation</h3><div>Newborn and mental health conditions had the largest inequalities in hospitalisations by the equity stratifiers. Findings from this study can be used to prioritise future health equity research to reduce health inequalities.</div></div><div><h3>Funding</h3><div><span>PSI Foundation</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101056"},"PeriodicalIF":7.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644578","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":"Incidence, prevalence, and mortality of localized scleroderma in Quebec, Canada: a population-based study","authors":"Stephanie Ghazal ,&nbsp;Anastasiya Muntyanu ,&nbsp;Katherine Aw ,&nbsp;Mohammed Kaouache ,&nbsp;Lauren Khoury ,&nbsp;Maryam Piram ,&nbsp;Catherine McCuaig ,&nbsp;Gaëlle Chédeville ,&nbsp;Elham Rahme ,&nbsp;Mohammed Osman ,&nbsp;Jordana Schachter ,&nbsp;Janie Bertrand ,&nbsp;Elena Netchiporouk","doi":"10.1016/j.lana.2025.101044","DOIUrl":"10.1016/j.lana.2025.101044","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Localized scleroderma is an understudied autoimmune disease characterized by fibrosis of the skin and/or subcutaneous tissue. To date, only 6 articles reported on the incidence and/or prevalence estimates globally, with significant design limitations and risk of bias. None of the studies originated from Canada or investigated mortality/geospatial epidemiology. We aimed to study the incidence, prevalence, mortality and spatiotemporal trends of localized scleroderma in Quebec, Canada, stratified by sex and age.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Quebec populational health administrative databases were used to identify localized scleroderma cases from 1989 to 2019. Crude incidence rate, age-standardized incidence rate, prevalence and mortality analyses were conducted using negative binomial random walk models. Spatial analyses were conducted using a Poisson Besag-York-Mollié regression model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;There were 6063 incident localized scleroderma cases identified over the total period of the study (mean age 53.0, standard deviation [SD] 20.2 years at diagnosis). The overall age and sex-standardized incidence rate was 3.25/100,000 person-years [95% Confidence Interval (CI) 3.17–3.33]. Among 6063 incident cases, 4510 (74.4%) were female and 1553 (25.6%) were male, yielding a female-to-male ratio of approximately 3:1. In females, we noted an initial increase in age-standardized incidence rate followed by a plateau and a decrease after 2013 (average annual percent change −2.0 [95% CI −3.7 to −0.2]%). In males, a steady decrease in age-standardized incidence rate was observed (average annual percent change −3.3 [95% CI −5.0 to −1.8]%). The highest incidence rate was observed in the 60–79 year-old age group for females and the 80+ group for males. Age-standardized incidence rate varied geographically with hotspots identified in the south of Quebec. The average prevalence was 24.5/100,000 [95% CI 24.3–24.8]. The overall standardized mortality ratio was comparable for females (1.04 [95% CI 0.95–1.14]) and males (1.14 [95% CI 0.98–1.33]) and decreased steadily over time for both sexes (from 1.31 [95% CI 1.06–1.58] in 1996 to 0.81 [95% CI 0.66–0.98] in 2019). Standardized mortality ratio analysis revealed excess death only in females aged 40–59 years.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;From 1989 onward, we report an initial increase in the age and sex-standardized incidence rate of localized scleroderma in Quebec followed by a recent decrease after 2013, as well as a generally increasing prevalence from 1996 to 2019. Standardized mortality ratio analysis confirmed the clinical observation that localized scleroderma is a morbid rather than life-threatening disease. We demonstrate an uneven geographic distribution of localized scleroderma incidence in Quebec.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;This project was funded by &lt;span&gt;Canadian Dermatology Foundation&lt;/span&gt;, &lt;span&gt;National Scleroderm","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101044"},"PeriodicalIF":7.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644150","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":"Brazilian advancements in alcohol consumption monitoring in the age of disinformation","authors":"Raquel B. De Boni,&nbsp;Ana Paula da Cunha,&nbsp;Norhan Sumar,&nbsp;Roberta Raupp","doi":"10.1016/j.lana.2025.101060","DOIUrl":"10.1016/j.lana.2025.101060","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101060"},"PeriodicalIF":7.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644577","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":"Barriers and solutions in women’s health research and clinical care: a call to action","authors":"Judith G. Regensteiner ,&nbsp;Melissa McNeil ,&nbsp;Stephanie S. Faubion ,&nbsp;C. Noel Bairey-Merz ,&nbsp;Martha Gulati ,&nbsp;Hadine Joffe ,&nbsp;Rita F. Redberg ,&nbsp;Stacey E. Rosen ,&nbsp;Jane EB. Reusch ,&nbsp;Wendy Klein ,&nbsp;LEADERS Steering Committee","doi":"10.1016/j.lana.2025.101037","DOIUrl":"10.1016/j.lana.2025.101037","url":null,"abstract":"<div><div>It is now recognized that there are significant differences between the sexes affecting prevalence, incidence, and severity over a broad range of diseases, although the extent of the differences is not fully elucidated. Until the early 1990s, women were excluded from most clinical trials and the limited research including women focused primarily on diseases affecting fertility and reproduction. For these reasons, the prevention, diagnosis, and treatment of chronic diseases in women continue to be based primarily on historical findings in men, and sex-specific clinical guidelines are often lacking. Many illnesses, ranging from cardiovascular disease to cancer to mental health issues, for example, differ by sex in terms of prevalence and adverse effects. Research is needed to understand how medically relevant biological sex differences optimally inform sex-specific prevention, diagnosis, and treatment strategies for women and men. In this way, sex-specific clinical guidelines can be developed where warranted, using evidence-based data.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101037"},"PeriodicalIF":7.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619604","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}