Lancet Regional Health-Americas最新文献

{"title":"Introduction, establishment, and distribution of Aedes aegypti and dengue in a temperate capital of Brazil: a retrospective surveillance-based study","authors":"Danielle Andreza da Cruz Ferreira ,&nbsp;Laís Picinini Freitas ,&nbsp;Rachel Lowe ,&nbsp;Getúlio Dornelles Souza ,&nbsp;Ricardo Toshio Fujiwara ,&nbsp;Raquel Martins Lana","doi":"10.1016/j.lana.2025.101153","DOIUrl":"10.1016/j.lana.2025.101153","url":null,"abstract":"<div><h3>Background</h3><div>Dengue is spreading to southern latitudes in Brazil, where the temperate climate was once a barrier to the primary vector, <em>Aedes aegypti</em>. In this study, our objective was to reconstruct the introduction, establishment, and subsequent expansion of <em>Ae. aegypti</em> and dengue in Porto Alegre, the southernmost state capital of Brazil, located in Rio Grande do Sul state.</div></div><div><h3>Methods</h3><div>This ecological study used entomological and epidemiological surveillance data and official reports obtained from municipal health authorities of Porto Alegre, from 2001 to 2021. Descriptive analyses were employed, supplemented by space-time scan statistics to identify high-risk vector abundance and dengue case clusters.</div></div><div><h3>Findings</h3><div><em>Ae. aegypti</em> was first detected in Porto Alegre in 2001, spreading citywide by 2016. The first autochthonous dengue case was recorded in 2010, and by 2021 the disease was detected in 78% of the neighbourhoods. DENV-1 was the dominant serotype and most cases occurred among people aged 20–59. Clusters of vectors and dengue cases were more frequent during summer and autumn, but a few were also identified during winter. High-risk clusters for vectors were more frequent in the Partenon and Northwest regions and for dengue in the East, Centre, Partenon and South.</div></div><div><h3>Interpretation</h3><div><em>Ae. aegypti</em> successfully established and spread within a temperate city in Brazil. The presence of vectors, a susceptible population and socio-environmental characteristics conducive to mosquito proliferation resulted in autochthonous transmission of dengue fever after the continuous introduction of imported cases. The climatic barrier to dengue transmission in the south of Brazil has shifted southward, coinciding with the colonisation of <em>Ae. aegypti</em> and the emergence of dengue in recent years in Porto Alegre.</div></div><div><h3>Funding</h3><div><span>Generalitat de Catalunya</span>, <span>European Commission</span>, and <span>Conselho Nacional de Desenvolvimento Científico e Tecnológico</span> (CNPq).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101153"},"PeriodicalIF":7.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365894","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":"Healthcare consequences of FEMA's anticipated response limitations in 2025: a gathering storm for health systems","authors":"Attila J. Hertelendy ,&nbsp;Gregory R. Ciottone","doi":"10.1016/j.lana.2025.101163","DOIUrl":"10.1016/j.lana.2025.101163","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"47 ","pages":"Article 101163"},"PeriodicalIF":7.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329748","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":"Genetic characterization of Plasmodium vivax linked to autochthonous malaria transmission in the US (2023) using Illumina AmpliSeq technology: a genetic epidemiology study","authors":"Joel L.N. Barratt ,&nbsp;David Jacobson ,&nbsp;Edwin Pierre-Louis ,&nbsp;Marko Bajic ,&nbsp;Julia Kelley ,&nbsp;Dhruviben S. Patel ,&nbsp;Ira Goldman ,&nbsp;Zhiyong Zhou ,&nbsp;Ya Ping Shi ,&nbsp;Alison Ridpath ,&nbsp;Kimberly Mace ,&nbsp;Christina Carlson ,&nbsp;Alice Sutcliffe ,&nbsp;Qiana Butler ,&nbsp;Andrea Morrison ,&nbsp;Danielle Stanek ,&nbsp;Kelly Tomson ,&nbsp;Carina Blackmore ,&nbsp;Andrew Cannons ,&nbsp;Susan Rollo ,&nbsp;Brian H. Raphael","doi":"10.1016/j.lana.2025.101159","DOIUrl":"10.1016/j.lana.2025.101159","url":null,"abstract":"<div><h3>Background</h3><div>Malaria is a mosquito borne disease caused by parasites of the genus <em>Plasmodium.</em> In 2023, the United States (US) experienced nine cases of autochthonous <em>Plasmodium vivax</em> malaria transmission; seven in Florida, one in Texas, and another in Arkansas. These were the first autochthonous cases since 2003 when a cluster was identified in Florida. The aim of this study was to genetically characterize the implicated <em>P. vivax</em> isolates in order to complement epidemiologic investigations of these cases.</div></div><div><h3>Methods</h3><div>A custom Illumina AmpliSeq sequencing panel capturing 495 amplicons was designed. This panel was used to ascertain whether these 2023 cases were related, and assess if they were associated with a single or separate introduction events. Sequence data were hierarchically clustered and a Naïve Bayes classification approach was used to assign genotypes to a probable geographic origin based on 113 ‘geo-informative’ SNPs captured by the panel. Genotypes associated with the 2023 Arkansas, Texas, and Florida cases were clustered alongside those sequenced from archived blood samples from the 2003 Florida case-patients, a set of reference strains, and other travel-associated specimens. Microsatellite analysis was performed on a subset of samples from these autochthonous cases to complement the AmpliSeq analysis.</div></div><div><h3>Findings</h3><div>The 2023 autochthonous Florida cases were genetically linked as were the 2003 Florida cases. The 2023 and 2003 Florida clusters were genetically distinct, and the two Florida clusters were distinct from the 2023 Texas and Arkansas cases, which were also distinct from each other. These genotypes classified to the Central or South American region using the Naïve Bayes classifier, including those from the 2003 cluster.</div></div><div><h3>Interpretation</h3><div>These data support that at least three distinct <em>P. vivax</em> introduction events in the US in 2023, involving parasites possessing genetic signatures consistent with Central or South America.</div></div><div><h3>Funding</h3><div>This work was supported by the <span>National Center for Emerging</span> and <span>Zoonotic Infectious Diseases</span> at the <span>US Centers for Disease Control and Prevention</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101159"},"PeriodicalIF":7.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330421","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":"Infectious versus chronic conditions: time to dismantle silos in public health","authors":"Richard A. Goodman ,&nbsp;Samuel F. Posner ,&nbsp;Laurence S. Sperling ,&nbsp;Carlos del Rio ,&nbsp;Sonja A. Rasmussen","doi":"10.1016/j.lana.2025.101149","DOIUrl":"10.1016/j.lana.2025.101149","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101149"},"PeriodicalIF":7.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307619","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":"Estimating the effects of temperature on mortality and hospitalisations under RCP2.6 and RCP8.5 scenarios in the short- and long-term by region in Chile: a population-based, modelling study","authors":"Yasna Palmeiro-Silva ,&nbsp;Richard E. Chandler ,&nbsp;Ilan Kelman","doi":"10.1016/j.lana.2025.101151","DOIUrl":"10.1016/j.lana.2025.101151","url":null,"abstract":"<div><h3>Background</h3><div>In a warming world, it is generally accepted that increasing temperatures affect human health. In many regions of the world, however, these effects are poorly understood. To address this issue in Chile, we estimated the potential change in all-cause and cardiovascular and temperature-related (CVT) mortality and hospitalisations associated with four different climate scenarios by region.</div></div><div><h3>Methods</h3><div>Using Chilean health data and ERA5 reanalysis data, we modelled the relationship between historical health outcomes and monthly temperature indices using Generalised Additive Models. After evaluating the models' predictive performance, we used them to estimate changes in health outcomes associated with bias-adjusted climate projections representing four scenarios: short-term (2031–2060) and long-term (2061–2090) periods under both Representative Concentration Pathways (RCPs) 2.6 and 8.5.</div></div><div><h3>Findings</h3><div>Scenario-based health outcomes show clear north-south variations. Compared to historical levels, all-cause mortality increases by ∼1.5% in northern regions but decreases by ∼1% in southern regions across scenarios. CVT mortality decreases (0.2–3.6%), especially in the south; however, Arica and Tarapacá in the north show sharp increases (up to 30%) under warmer scenarios. Conversely, all-cause and CVT hospitalisations increase in northern/central regions (higher in summer, lower in winter), while southern/austral regions show slight decreases (∼1%).</div></div><div><h3>Interpretation</h3><div>These findings highlight the need for region-specific analyses and public health strategies in Chile. Northern regions might require plans that reduce the risk of heat-related mortality and morbidity, while southern regions might adjust healthcare services because of potential shifts in healthcare needs.</div></div><div><h3>Funding</h3><div><span>National Agency for Research and Development</span>, Chile and <span>University College London</span>, UK.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101151"},"PeriodicalIF":7.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297793","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":"Decision tools for schools using continuous indoor air quality monitors: a case study of CO2 in Boston Public Schools","authors":"Beverly Ge ,&nbsp;Koen Tieskens ,&nbsp;Priam Vyas ,&nbsp;Maria Pilar Botana Martinez ,&nbsp;Yirong Yuan ,&nbsp;Katherine H. Walsh ,&nbsp;Lauren Main ,&nbsp;Lauren Bolton ,&nbsp;Masanao Yajima ,&nbsp;Maria Patricia Fabian","doi":"10.1016/j.lana.2025.101148","DOIUrl":"10.1016/j.lana.2025.101148","url":null,"abstract":"<div><h3>Background</h3><div>Indoor environments in schools affect children’s health and learning, but without indoor air quality (IAQ) monitoring, staff have limited data to inform interventions. We aimed to demonstrate the utility of comprehensive real-time classroom IAQ monitoring for informing interventions and investments in schools.</div></div><div><h3>Methods</h3><div>We created analytical datasets of classroom carbon dioxide (CO₂) from a groundbreaking network of 3659 commercial IAQ monitors installed across a U.S. school district. We analysed patterns and trends in 125 school buildings over the 2022–2023 school year. Working with Boston Public Schools (BPS) staff, we co-created visualisations suitable for school decision-making and for research.</div></div><div><h3>Findings</h3><div>Over the school year, 245 million CO₂ measurements were recorded. The average school-day CO₂ concentration was 841 ppm (SD: 405 ppm) and the 99.9th percentile of daily maxima was 5080 ppm. Concentrations varied by over an order of magnitude within and between schools. Elevated levels occurred in all buildings, although schools with central mechanical ventilation had lower concentrations and variability than schools without. We show multiple visualisations of monitoring data using threshold-based exposure metrics.</div></div><div><h3>Interpretation</h3><div>Our academic-school partnership enabled actionable research in support of IAQ improvements. The heterogeneity of CO₂ levels across BPS classrooms and between schools underscores the need for continuous classroom-level monitoring and demand-controlled ventilation. Results and protocols are generalisable to other schools and researchers. Our work paves the road for future studies of IAQ and student health and learning.</div></div><div><h3>Funding</h3><div><span>Boston University Initiative on Cities</span>, <span>Boston University School of Public Health</span>, <span>National Institutes of Health</span>, <span>National Science Foundation</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101148"},"PeriodicalIF":7.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279669","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":"Main challenges to cancer care in Latin America: an analysis through breast cancer lenses","authors":"Gonzalo Gomez-Abuin ,&nbsp;Pablo Mandó ,&nbsp;Guiseppe Curigliano ,&nbsp;Carlos H. Barrios","doi":"10.1016/j.lana.2025.101147","DOIUrl":"10.1016/j.lana.2025.101147","url":null,"abstract":"<div><div>The manuscript underscores the intricate challenges in breast cancer (BC) care across Latin America, characterized by economic, social, and healthcare system disparities. Limited high-quality cancer registries hinder research and policy development, exacerbating uneven access to medical care and BC mortality disparities. The healthcare systems' fragmentation results in delays in critical interventions, affecting a significant proportion of young women diagnosed at advanced stages. The scarcity of comprehensive healthcare data and the absence of coordinated efforts intensify these challenges. The manuscript advocates for collaborative initiatives, supporting local research groups and fostering communication among countries to address BC care disparities. It emphasizes the vital role of national care plans and universal healthcare systems, aligning with global objectives to reduce BC mortality and enhance healthcare access for all women in Latin America, irrespective of socioeconomic status.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101147"},"PeriodicalIF":7.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270497","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":"Colombian consensus on the care of critically ill patients with suspected or confirmed severe yellow fever","authors":"Alex Julián Forero-Delgadillo ,&nbsp;Jeison Andrés Morales-Olivera ,&nbsp;Julián Fernando Celis-Guzmán ,&nbsp;Omar Eduardo Zapata-Díaz ,&nbsp;Gustavo Adolfo González-Varona ,&nbsp;Camilo Alberto Acevedo-Bedoya ,&nbsp;Rómulo Salazar-Fernández ,&nbsp;Jaime Orlando Ordoñez ,&nbsp;Henry Robayo-Amortegui ,&nbsp;Alejandro Quintero-Altare ,&nbsp;Diana Catalina Ramírez-Reyes ,&nbsp;Juan Diego Melo-Pedraza ,&nbsp;Juan Olivella-Gomez ,&nbsp;Jessica María Forero ,&nbsp;Abraham Katime-Zuñiga ,&nbsp;Wilmer E. Villamil-Gomez ,&nbsp;Alfonso J. Rodriguez-Morales ,&nbsp;Ricardo Buitrago-Bernal ,&nbsp;Fernando Bozza ,&nbsp;Luis Felipe Reyes","doi":"10.1016/j.lana.2025.101144","DOIUrl":"10.1016/j.lana.2025.101144","url":null,"abstract":"<div><div>Yellow fever is an arboviral disease transmitted by <em>Aedes</em>, <em>Haemagogus</em> and <em>Sabethes</em> mosquitoes. It features both urban and jungle transmission cycles. Its incidence has risen in Colombia due to deforestation, human expansion, and climate change. The disease can progress from a nonspecific febrile stage to a severe intoxication phase, characterised by multiple organ failure and high mortality rates. This consensus establishes criteria for early identification and management of severe yellow fever and recommendations for admission to the Intensive Care Unit in cases of liver dysfunction, kidney failure, or shock. An individualised haemodynamic resuscitation strategy is emphasised to avoid volume overload and not delay the use of norepinephrine in persistent hypotension. Additionally, we recommend addressing haematological and respiratory complications, including platelet transfusion restrictions and strict intra-abdominal pressure monitoring. In more severe cases, plasma exchange and renal replacement therapies are recommended. Based on evidence and the GRADE methodology, implementing these strategies aims to improve survival and reduce morbidity in critically ill yellow fever patients.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"48 ","pages":"Article 101144"},"PeriodicalIF":7.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263329","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 viral playbook threatening the National Institutes of Health: a call to inoculate the immune system of American science","authors":"Frederick L. Altice","doi":"10.1016/j.lana.2025.101145","DOIUrl":"10.1016/j.lana.2025.101145","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"47 ","pages":"Article 101145"},"PeriodicalIF":7.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255402","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 rise and fall of carfentanil in Toronto's unregulated drug supply","authors":"Mohammad Karamouzian","doi":"10.1016/j.lana.2025.101152","DOIUrl":"10.1016/j.lana.2025.101152","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"47 ","pages":"Article 101152"},"PeriodicalIF":7.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262705","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}