Lancet Regional Health-Americas最新文献

{"title":"Health impact of a hypothetical intervention on immune burden of cytomegalovirus (CMV) among older adults in the US: a prospective analysis of the Health and Retirement Study Cohort","authors":"Yuelin He ,&nbsp;Jessica Faul ,&nbsp;Kate Duchowny ,&nbsp;Chihua Li ,&nbsp;Rebecca Stebbins ,&nbsp;Grace A. Noppert","doi":"10.1016/j.lana.2025.101122","DOIUrl":"10.1016/j.lana.2025.101122","url":null,"abstract":"<div><h3>Background</h3><div>Cytomegalovirus (CMV) infection has been indicted in the etiology of multiple aging-related diseases. We aimed to quantify the proportion of diseases that could be prevented with a potential CMV treatment among US older individuals.</div></div><div><h3>Methods</h3><div>We analyzed disease prevalence among 8934 eligible individuals from the US Health and Retirement Study (HRS) in 2016–2020. In our hypothetical intervention, the treatment would improve immune control of CMV and shift the distribution of continuous CMV IgG antibody levels from the highest quartile to the lower 3 quartiles. We estimated top-quartile CMV level attributable fractions for 7 outcomes: heart diseases, stroke, high blood pressure, high cholesterol, cancers, diabetes, and difficulty with Activities of Daily Living using a novel logistic regression-based approach which allows for continuous covariate adjustment for counterfactual prevalence, stratified by gender and race/ethnicity.</div></div><div><h3>Findings</h3><div>In the study sample, a hypothetical intervention that decreased CMV IgG below the highest quartile level in 2016 would result in a 3·57 (95% Confidence Interval: 1·54, 5·60) percentage points reduction of diabetes cases and a 1·81 (95% CI: 0·75, 2·86) percentage points reduction of high blood pressure cases among Non-Hispanic White (NHW) women. Among NHW men, the same intervention would lead to a 2·43 (95% CI: 0·49, 4·37) percentage points reduction of diabetes, a 2·89 (95% CI: 0·93, 4·86) percentage points reduction of heart diseases and a 2·52 (95% CI: 1·39, 3·65) percentage points reduction of high blood pressure.</div></div><div><h3>Interpretation</h3><div>Our findings provide initial evidence for the potential population health impact of CMV intervention, specifically on high blood pressure, diabetes, and heart diseases.</div></div><div><h3>Funding</h3><div><span>National Institutes of Health</span>, <span>National Institute on Aging</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"47 ","pages":"Article 101122"},"PeriodicalIF":7.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935538","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":"Are diverse databases actually creating equity in genomics?","authors":"Chelsey R. Carter ,&nbsp;Brett Maricque","doi":"10.1016/j.lana.2025.101112","DOIUrl":"10.1016/j.lana.2025.101112","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101112"},"PeriodicalIF":7.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934858","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":"Short- and long-term increased risk of all-cause mortality in a tuberculosis cohort attributed to SARS-CoV-2 infection: a time-dependent survival analysis in Chile","authors":"Vargas-García Salvador ,&nbsp;Eduardo A. Undurraga ,&nbsp;Nadia Escobar ,&nbsp;Christian García ,&nbsp;Natalia Vergara ,&nbsp;María Elvira Balcells","doi":"10.1016/j.lana.2025.101119","DOIUrl":"10.1016/j.lana.2025.101119","url":null,"abstract":"<div><h3>Background</h3><div>Concurrent tuberculosis (TB) and COVID-19 increases the risk of mortality; however, most studies have focused primarily on short-term outcomes. We assessed the short and long-term impact of TB and SARS-CoV-2 coinfection on all-cause mortality.</div></div><div><h3>Methods</h3><div>We conducted a retrospective nationwide cohort study in Chile, including adults diagnosed with active TB from January 1st, 2020, to December 31st, 2021, with follow-up until November 30th, 2022. SARS-CoV-2 coinfection was defined as occurring from 30 days before to six months after TB diagnosis. Short-term mortality was defined as death within 90 days of TB or TB/SARS-CoV-2 diagnosis, and long-term mortality as death occurring after 90 days. We used a time-dependent Cox survival analysis, adjusting for sociodemographic factors, SARS-CoV-2 vaccination, and relevant comorbidities including HIV, diabetes and <em>Mycobacterium tuberculosis</em> drug-resistance status.</div></div><div><h3>Findings</h3><div>The cohort included 3721 adults (median age: 47 years, interquartile range [IQR]: 32–61); of whom 63·4% were male, and 79·4% had pulmonary TB. The median follow-up was 586 days (IQR: 401–820), with 680 deaths (18·3%) recorded. A SARS-CoV-2 coinfection was identified in 393 individuals (10·5%); the mortality in this group was higher in short-term (≤90 days: 14·5% vs. 11·4%) and long-term (&gt;90 days: 11·5% vs. 5·9%) compared to TB alone. Coinfection increased the risk of all-cause mortality during the entire follow-up (aHR [adjusted Hazard Ratio]: 2·8, 95% CI: 2·26–3·47), over three-fold in the short-term (aHR 3·4, 95% CI: 2·57–4·51) and nearly two-fold in the long-term (aHR: 1·72, 95% CI: 1·18–2·52). Excess mortality persisted beyond the first year (aHR: 2·04, 95% CI: 1·09–3·82). SARS-CoV-2 vaccination reduced mortality risk in the TB cohort by 35% (95% CI: 19–46%).</div></div><div><h3>Interpretation</h3><div>Tuberculosis and SARS-CoV-2 coinfection was associated with significantly increased all-cause mortality in both the short and long-term, with elevated risk persisting beyond TB treatment completion. These findings highlight the need for continued post-treatment follow-up and prioritization of SARS-CoV-2 vaccination among individuals with TB.</div></div><div><h3>Funding</h3><div><span>ANID-FONDECYT</span>, Chile, and <span>CONAHCYT</span>, Mexico.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101119"},"PeriodicalIF":7.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928472","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":"Incidence and mortality of endometrial cancer in the Appalachian Eastern Kentucky continues to rise due to obesity, metabolic syndromes, and corresponding health disparities","authors":"Tessa L. Wrightson ,&nbsp;Robert C. Miller","doi":"10.1016/j.lana.2025.101124","DOIUrl":"10.1016/j.lana.2025.101124","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"47 ","pages":"Article 101124"},"PeriodicalIF":7.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928024","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 responding to violence and abuse in Brazil: a quasi-experimental difference-in-differences analysis","authors":"Estela Capelas Barbosa ,&nbsp;Stephanie Pereira ,&nbsp;Loraine J. Bacchus ,&nbsp;Manuela Colombini ,&nbsp;Gene Feder ,&nbsp;Lilia Blima Schraiber ,&nbsp;Ana Flávia Pires Lucas d'Oliveira","doi":"10.1016/j.lana.2025.101114","DOIUrl":"10.1016/j.lana.2025.101114","url":null,"abstract":"<div><h3>Background</h3><div>Domestic violence against women (DVAW) is a public health issue and a breach of human rights, yet evidence on effective interventions remains limited, particularly in low-income and middle-income countries. This study aimed to evaluate changes in identification and referral to specialist support associated with system-level strategies implemented within Brazilian primary healthcare (PHC) to strengthen the response to DVAW. The strategies comprised an intervention called Healthcare Responding to Violence and Abuse (HERA).</div></div><div><h3>Methods</h3><div>Using a quasi-experimental design, HERA was implemented in eight PHC clinics, while 33 served as controls. Data on DVAW identification and referral were obtained from the national Epidemiological Surveillance System. Difference-in-differences analysis, using negative binomial regression, assessed HERA's impact, controlling for patient inflow, clinical supervision, COVID-19 lockdown, region, and clinic. Results are reported as marginal effects with 95% confidence intervals (CI).</div></div><div><h3>Findings</h3><div>There was an increase in the probability of DVAW identification (0.47; 95% CI 0.18–0.77) and referral to support services (0.38; 95% CI 0.03–0.73), when adjusting for panel effects and time. The results were even larger when further controlling for additional variables (0.82 for identification [95% CI 0.44–1.21] and 0.87 for referrals [95% CI 0.47–1.29]).</div></div><div><h3>Interpretation</h3><div>HERA strategies increased DVAW identification and referral in PHC settings. Clinics implementing HERA were already more likely to identify and refer cases before the implementation, suggesting that HERA's strategies may be more effective in clinics that find DVAW interventions more acceptable, at least in Brazil.</div></div><div><h3>Funding</h3><div><span>NIHR Global Health Research Group Award</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"47 ","pages":"Article 101114"},"PeriodicalIF":7.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917266","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":"Fostering leadership and gender equality in climate action among underserved, rural and Indigenous women: a qualitative exploration of opportunities and limitations in Peru","authors":"Elaine C. Flores ,&nbsp;Annie F. Flores ,&nbsp;Blenda Abarca-Diaz ,&nbsp;Roberto Camizan-Castro ,&nbsp;Edinson Mendoza-Lozada ,&nbsp;Floro Ortiz-Contreras ,&nbsp;Ritsuko Kakuma","doi":"10.1016/j.lana.2025.101109","DOIUrl":"10.1016/j.lana.2025.101109","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Climate change has profound impacts on women's health and wellbeing, particularly in the Global South, which is disproportionately affected by environmental threats. Peru, one of the most biodiverse and culturally rich countries worldwide, is uniquely vulnerable to these effects due to its diverse ecosystems each facing distinct climate challenges. Yet research on the lived experiences of rural and Indigenous Peruvian women facing these impacts is scarce. We aim to explore the perspectives and experiences of underserved Peruvian women regarding the effects of climate change, and the needs, assets, and community responses to these threats.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Between April and May 2022, we conducted 48 in-depth walking interviews with adult women from the Peruvian north coast, Amazon rainforest, and central and southern Andes regions. Using purposive and iterative snowball sampling, we recruited community key informants. We analysed the data thematically.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Our analysis identified four main themes: (1) Local understanding of environmental changes, (2) Gendered impacts of climate change, (3) Women's participation in environmental governance, and (4) Pathways for gender-responsive climate action. Participants described vivid observations of environmental shifts, often attributing these to local human activities. Women reported increased caregiving responsibilities and economic vulnerabilities due to climate-related events. Barriers to women's participation in environmental decision-making were identified, including traditional gender roles and lack of voice in community forums. Participants highlighted the need for capacity building, leadership development, and integration of indigenous knowledge in climate action.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;This study underscores the imperative of centring gender equity and social justice in climate change adaptation and environmental governance. Findings highlight the urgent need to address systemic barriers, rebuild institutional trust, and adopt an intersectional, community-centric approach responsive to marginalised women's realities and priorities. Health systems should prepare for the mental health impacts of climate-related events on women, particularly increased anxiety and depression linked to resource insecurity and caregiving burdens. Policymakers should develop gender-responsive disaster preparedness plans, strengthen women's representation in environmental decision-making bodies, and create culturally appropriate climate communication strategies that integrate Indigenous knowledge systems. Implementation of targeted leadership training programs for women and establishing community-based environmental monitoring systems would enhance climate resilience while addressing gender inequities.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;This research was funded by &lt;span&gt;ECF's postdoctoral fellowship&lt;/span&gt; from the &lt;sp","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101109"},"PeriodicalIF":7.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924723","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":"Invasive pneumococcal disease in Argentina: a snapshot from a retrospective observational study on serotypes, antimicrobial resistance, and the potential impact of the COVID-19 pandemic (2018–2022)","authors":"Jonathan Zintgraff ,&nbsp;Paula Gagetti ,&nbsp;Nahuel Sánchez Eluchans ,&nbsp;Paulina Marchetti ,&nbsp;María Alicia Moscoloni ,&nbsp;Lucia Irazu ,&nbsp;Claudia S. Lara","doi":"10.1016/j.lana.2025.101113","DOIUrl":"10.1016/j.lana.2025.101113","url":null,"abstract":"<div><h3>Background</h3><div><em>Streptococcus pneumoniae</em> is a leading cause of morbidity and mortality and poses a significant public health threat globally. This study aimed to characterise changes in serotype distribution, <em>in vitro</em> antimicrobial susceptibility, and the frequency of invasive pneumococcal disease (IPD) in paediatric and adult populations in Argentina during the pre-COVID (2018–2019) and post-COVID (2021–2022) eras.</div></div><div><h3>Methods</h3><div>We conducted a national laboratory-based surveillance study analysing 1304 <em>S. pneumoniae</em> isolates sourced from Argentina's National Surveillance Program for invasive pneumococcal disease. Isolates were stratified by age and serotype, with antimicrobial susceptibility evaluated where applicable.</div></div><div><h3>Findings</h3><div>A significant decrease in isolates was observed in 2020, followed by a resurgence beginning in 2021, peaking in 2022. The most prevalent serotypes in children (&lt;5 years) over the past five years included 3 (11%; 54/494), 24F (8%; 39/494), 19A (7%; 35/494), 12F (6%; 30/494), and 14/23B (4%; 20/494). In adults (≥18 years), the leading serotypes were 3 (17%; 92/542), 8 (14%; 76/542), 7F (5%; 27/542), 9N (4%; 22/542), and 19A (4%; 22/542). Notably, antimicrobial resistance levels were significant, with children showing higher resistance rates (26% multidrug resistance) compared to adults (8%), Among PCV13 serotypes, 19A was predominantly associated with multidrug resistance, while non-PCV13 serogroup 24 was prevalent among resistant isolates.</div></div><div><h3>Interpretation</h3><div>The fluctuations in serotype circulation, particularly among children under five, suggest evolving dynamics post-COVID-19. Although it remains uncertain if these changes are directly linked to the pandemic or reflect broader trends, the data highlight an urgent need for continued surveillance and potential adaptations in vaccination strategies.</div></div><div><h3>Funding</h3><div>No funding was received for this study.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101113"},"PeriodicalIF":7.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916382","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 years of breast cancer epidemiology and treatment patterns in São Paulo, Brazil—observed versus expected treatment utilization in a retrospective cohort","authors":"Haydee Verduzco-Aguirre ,&nbsp;Fernanda Mallucelli Favorito ,&nbsp;Fabio Ynoe de Moraes ,&nbsp;Gustavo Marta ,&nbsp;Camila Tagle ,&nbsp;Carlos Henrique dos Anjos ,&nbsp;André Mattar ,&nbsp;Brooke E. Wilson","doi":"10.1016/j.lana.2025.101115","DOIUrl":"10.1016/j.lana.2025.101115","url":null,"abstract":"<div><h3>Background</h3><div>Over half of new breast cancer cases occur in low- and middle-income countries, with disparities in survival outcomes due to late-stage diagnoses, healthcare access gaps, and biological differences. This retrospective cohort study examined trends in survival, stage distribution, and treatment utilization for breast cancer in Brazil, an upper middle-income country.</div></div><div><h3>Methods</h3><div>Patients newly diagnosed with invasive breast cancer between 2000 and 2019 were identified from São Paulo’s Oncocenter Foundation registry. Data on demographics, diagnosis stage, diagnosis-to-treatment intervals, and treatments received were analyzed in 5-year blocks. Median overall survival was estimated using the Kaplan–Meier method. Actual treatment utilization was compared to model-based estimates of optimal utilization derived from the National Comprehensive Cancer Network Guidelines’ Enhanced and Maximal Resource Modules.</div></div><div><h3>Findings</h3><div>We included 125,005 patients, with a median age at diagnosis of 55 years (interquartile range 46–75); 99.4% (n = 124,218) were female. The proportion with early disease remained stable over time (61.7% in 2000–2004, 62.4% 2015–2019). Median overall survival increased from 10.7 years (2000–2004) to 11.7 years (2010–2014); median survival for 2015–2019 was not reached. Median overall survival was 20.8, 15.1, 6.8, and 2.0 years for stages I–IV, respectively. Median diagnosis-to-treatment interval more than doubled over time. From 2000 to 2004 to 2015–2019, chemotherapy use decreased from 71.5% to 68.9%; radiotherapy use decreased from 64.0% to 56.5%, and surgery utilization decreased from 80.3% to 74.8%; endocrine therapy use varied between 54% and 62%. Gaps between observed and model-based estimates of treatment utilization were seen across all stages.</div></div><div><h3>Interpretation</h3><div>Overall survival in patients with breast cancer in São Paulo has improved over time. However, significant treatment gaps and increasing diagnosis-to-treatment intervals suggest systemic barriers to optimal care delivery.</div></div><div><h3>Funding</h3><div>No funding received.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"47 ","pages":"Article 101115"},"PeriodicalIF":7.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916908","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":"Atrial fibrillation in the Americas","authors":"Jason G. Andrade ,&nbsp;Larry R. Jackson II ,&nbsp;Juan Carlos Diaz ,&nbsp;Mina Chung ,&nbsp;Jody Hurwitz ,&nbsp;Carlos A. Morillo ,&nbsp;Gregory Y.H. Lip ,&nbsp;Nestor Lopez-Cabanillas","doi":"10.1016/j.lana.2025.101110","DOIUrl":"10.1016/j.lana.2025.101110","url":null,"abstract":"<div><div>Atrial Fibrillation is the most common sustained cardiac arrhythmia, and is associated with significant impairments in quality of life. Regional variations and challenges in the management of atrial fibrillation are present throughout the Americas. Atrial fibrillation incidence and prevalence varies widely, with significant regional differences in the consequences of atrial fibrillation (disability adjusted life years, and mortality). While the contemporary goals are similar, the management of atrial fibrillation is highly variable across the Americas, driven by regional differences in access to medical services, diagnostics, treatments and technologies, as well as country-specific differences in health-care expenditures. Healthcare policies to address these within and between country barriers will lead to improved care and a reduction in the economic burden of atrial fibrillation. Failure to remediate health inequities will exacerbate the burden of healthcare resources attributed toward the management of this disease.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"47 ","pages":"Article 101110"},"PeriodicalIF":7.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911863","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":"Transfusion-transmitted infections: risks and mitigation strategies for Oropouche virus and other emerging arboviruses in Latin America and the Caribbean","authors":"Andres Moreira-Soto ,&nbsp;Ignacio Postigo-Hidalgo ,&nbsp;Ximena Tabares ,&nbsp;Yannik Roell ,&nbsp;Carlo Fischer ,&nbsp;Eduardo Gotuzzo ,&nbsp;Thomas Jaenisch ,&nbsp;José Eduardo Levi ,&nbsp;Yaniv Lustig ,&nbsp;Jan Felix Drexler","doi":"10.1016/j.lana.2025.101089","DOIUrl":"10.1016/j.lana.2025.101089","url":null,"abstract":"<div><div>Arboviruses impose a major public health burden in Latin America and the Caribbean due to widespread and potentially severe infections causing microcephaly and long-lasting arthralgia. Beyond canonical vector-borne transmission, the magnitude and risk factors for transfusion-transmitted infections (TTIs) are unclear. In this narrative report, we use analyses of virological data such as infection symptomatology, viremic periods, and viral loads, to argue that dengue, Oropouche, Zika, yellow fever, and Chikungunya viruses pose an under-investigated risk of TTIs. An analysis of socioeconomic data showed that blood donation rates in Latin America and the Caribbean correlated with gross domestic product (r = 0.53, <em>p</em> = 0.0021) and health expenditure (r = 0.5, <em>p</em> = 0.0045), highlighting that resource limitations impact blood screening. Risk maps based on vector occurrence and ecological variables showed that Central America and Northwest coastal Brazil are high-risk zones, making surveillance, vector control, vaccination, and cost-effective blood screening crucial for mitigating TTIs, including Zika and potentially Oropouche viruses in pregnant women.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101089"},"PeriodicalIF":7.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903600","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}