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Micro- and macrovascular function in the highest city in the world: a cross sectional study 世界海拔最高城市的微血管和大血管功能:一项横断面研究
IF 7
Lancet Regional Health-Americas Pub Date : 2024-09-25 DOI: 10.1016/j.lana.2024.100887
Yann Savina , Aurélien P. Pichon , Lucas Lemaire , Connor A. Howe , Mathilde Ulliel-Roche , Sarah Skinner , Elie Nader , Nicolas Guillot , Émeric Stauffer , Matthieu Roustit , Ivan Hancco , Paul Robach , François Esteve , Vincent Pialoux , Elisa Perger , Gianfranco Parati , Philip N. Ainslie , Stéphane Doutreleau , Philippe Connes , Samuel Verges , Julien V. Brugniaux
{"title":"Micro- and macrovascular function in the highest city in the world: a cross sectional study","authors":"Yann Savina ,&nbsp;Aurélien P. Pichon ,&nbsp;Lucas Lemaire ,&nbsp;Connor A. Howe ,&nbsp;Mathilde Ulliel-Roche ,&nbsp;Sarah Skinner ,&nbsp;Elie Nader ,&nbsp;Nicolas Guillot ,&nbsp;Émeric Stauffer ,&nbsp;Matthieu Roustit ,&nbsp;Ivan Hancco ,&nbsp;Paul Robach ,&nbsp;François Esteve ,&nbsp;Vincent Pialoux ,&nbsp;Elisa Perger ,&nbsp;Gianfranco Parati ,&nbsp;Philip N. Ainslie ,&nbsp;Stéphane Doutreleau ,&nbsp;Philippe Connes ,&nbsp;Samuel Verges ,&nbsp;Julien V. Brugniaux","doi":"10.1016/j.lana.2024.100887","DOIUrl":"10.1016/j.lana.2024.100887","url":null,"abstract":"<div><h3>Background</h3><div>Since vascular responses to hypoxia in both healthy high-altitude natives and chronic mountain sickness (a maladaptive high-altitude pathology characterised by excessive erythrocytosis and the presence of symptoms—CMS) remain unclear, the role of inflammation and oxidative/nitrosative stress on the endothelium-<em>dependent</em> and -<em>independent</em> responses in both the micro- and macrocirculation, in healthy Andeans at different altitudes and in CMS patients, was examined.</div></div><div><h3>Methods</h3><div>94 men were included: 18 lowlanders (LL), 38 healthy highlanders permanently living at 3800 m (n = 21—HL-3800) or in La Rinconada, the highest city in the world (5100–5300 m) (n = 17—HL-5100/No CMS). Moreover, 14 participants with mild (Mild CMS) and 24 with moderate to severe CMS (Mod/Sev CMS) were recruited. All undertook two reactivity tests: i) local thermal hyperaemia (microcirculation) and ii) flow-mediated dilation (macrocirculation). Endothelium-<em>independent</em> function (glyceryl trinitrate) was also assessed only in La Rinconada.</div></div><div><h3>Findings</h3><div>Conductance and skin blood flow velocity during the microcirculation test, as well as macrocirculation progressively decreased with altitude (LL &gt; HL-3800 &gt; HL-5100/No CMS). CMS also induced a decrease in macrocirculation (HL-5100/No CMS &gt; Mild CMS = Mod/Sev CMS), while glyceryl trinitrate restored vascular function. Both oxidative stress and nitric oxide metabolites increased with altitude only. Principal component analysis revealed that increasing inflammation with altitude was associated with a progressive decline in both micro- and macrovascular function in healthy highlanders.</div></div><div><h3>Interpretation</h3><div>Both micro and macrovascular function are affected by chronic exposure to hypoxia, the latter being further compounded by CMS.</div></div><div><h3>Funding</h3><div>The “Fonds de dotation AGIR pour les maladies chroniques”, the “Air Liquide Foundation”, and the “French National Research Agency”.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"38 ","pages":"Article 100887"},"PeriodicalIF":7.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319139","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}
引用次数: 0
Oropouche fever fatalities and vertical transmission in South America: implications of a potential new mode of transmission 南美洲的奥罗普切热死亡病例和垂直传播:潜在新传播方式的影响
IF 7
Lancet Regional Health-Americas Pub Date : 2024-09-25 DOI: 10.1016/j.lana.2024.100896
Ranjit Sah , Shriyansh Srivastava , Rachana Mehta , Sharib Raza Khan , Sachin Kumar , Prakashini Satpathy , Aroop Mohanty , Carolina Ferraz , Jack Feehan , Vasso Apostolopoulos , Camila Luna , Alfonso J. Rodriguez-Morales
{"title":"Oropouche fever fatalities and vertical transmission in South America: implications of a potential new mode of transmission","authors":"Ranjit Sah ,&nbsp;Shriyansh Srivastava ,&nbsp;Rachana Mehta ,&nbsp;Sharib Raza Khan ,&nbsp;Sachin Kumar ,&nbsp;Prakashini Satpathy ,&nbsp;Aroop Mohanty ,&nbsp;Carolina Ferraz ,&nbsp;Jack Feehan ,&nbsp;Vasso Apostolopoulos ,&nbsp;Camila Luna ,&nbsp;Alfonso J. Rodriguez-Morales","doi":"10.1016/j.lana.2024.100896","DOIUrl":"10.1016/j.lana.2024.100896","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"38 ","pages":"Article 100896"},"PeriodicalIF":7.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318603","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}
引用次数: 0
Brazil takes a leap towards the elimination of HTLV-1 vertical transmission 巴西在消除 HTLV-1 垂直传播方面实现飞跃
IF 7
Lancet Regional Health-Americas Pub Date : 2024-09-21 DOI: 10.1016/j.lana.2024.100888
Carolina Rosadas , Draurio Barreira , Pamela C. Gaspar , Mayra G. Aragón , Adijeane Oliveira , Tatiane Assone , Angelica E. Miranda
{"title":"Brazil takes a leap towards the elimination of HTLV-1 vertical transmission","authors":"Carolina Rosadas ,&nbsp;Draurio Barreira ,&nbsp;Pamela C. Gaspar ,&nbsp;Mayra G. Aragón ,&nbsp;Adijeane Oliveira ,&nbsp;Tatiane Assone ,&nbsp;Angelica E. Miranda","doi":"10.1016/j.lana.2024.100888","DOIUrl":"10.1016/j.lana.2024.100888","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100888"},"PeriodicalIF":7.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24002151/pdfft?md5=af3e0b899406e71f89e28096e8e0828b&pid=1-s2.0-S2667193X24002151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274157","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}
引用次数: 0
Which diagnostic test to use for Testing and Treatment strategies in Plasmodium vivax low-transmission settings: a secondary analysis of a longitudinal interventional study 在间日疟原虫低传播环境中使用哪种诊断检测来制定检测和治疗策略:对一项纵向干预研究的二次分析
IF 7
Lancet Regional Health-Americas Pub Date : 2024-09-15 DOI: 10.1016/j.lana.2024.100883
Hélène Tréhard , Lise Musset , Yassamine Lazrek , Michael White , Stéphane Pelleau , Ivo Mueller , Felix Djossou , Alice Sanna , Jordi Landier , Jean Gaudart , Emilie Mosnier
{"title":"Which diagnostic test to use for Testing and Treatment strategies in Plasmodium vivax low-transmission settings: a secondary analysis of a longitudinal interventional study","authors":"Hélène Tréhard ,&nbsp;Lise Musset ,&nbsp;Yassamine Lazrek ,&nbsp;Michael White ,&nbsp;Stéphane Pelleau ,&nbsp;Ivo Mueller ,&nbsp;Felix Djossou ,&nbsp;Alice Sanna ,&nbsp;Jordi Landier ,&nbsp;Jean Gaudart ,&nbsp;Emilie Mosnier","doi":"10.1016/j.lana.2024.100883","DOIUrl":"10.1016/j.lana.2024.100883","url":null,"abstract":"<div><h3>Background</h3><p>The lack of sensitive field tests to diagnose blood stages and hypnozoite carriers prevents Testing and Treatment (TAT) strategies to achieve <em>Plasmodium vivax</em> elimination in low-transmission settings, but recent advances in Polymerase Chain Reaction (PCR) and serology position them as promising tools. This study describes a PCR-based TAT strategy (PCRTAT) implemented in Saint Georges (SGO), French Guiana, and explores alternative strategies (seroTAT and seroPCRTAT) to diagnose and treat <em>P. vivax</em> carriers.</p></div><div><h3>Methods</h3><p>The PALUSTOP cohort study implemented in SGO (September 2017 to December 2018) screened participants for <em>P. vivax</em> using PCR tests and treated positive cases. Serology was also performed. Passive detection of <em>P. vivax</em> infection occurred during follow-up. Participants were categorised into overlapping treatment groups based on 2017 PCR and serological results. Strategies were described in terms of participants targeted or missed, primaquine contraindications (pregnancy, G6PD severe or intermediate deficiency), and sociodemographic characteristics.</p></div><div><h3>Findings</h3><p>In 2017, 1567 inhabitants were included, aged 0–92 years. A total of 90 (6%) were <em>P. vivax</em> carriers and 390 seropositive (25%). PCRTAT missed 282 seropositive individuals while seroTAT would have missed 21 PCR-positive cases. Primaquine contraindications ranged from 12% to 17% across strategies.</p></div><div><h3>Interpretation</h3><p>Serology and PCR are promising tools for targeted treatment strategies in <em>P. vivax</em> low-transmission settings, when field compatible sensitive tests will be available. Both seem necessary to capture blood stages and potential hypnozoite carriers, while avoiding mass treatment. However, high primaquine contraindications rates need consideration for successful elimination.</p></div><div><h3>Funding</h3><p>Supported by <span>European Funds for Regional Development</span>, <span>French Guiana Regional Health Agency</span>, <span>Pan American Health Organization</span>, <span>WHO</span>, <span>French Ministry for Research</span>.</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"38 ","pages":"Article 100883"},"PeriodicalIF":7.0,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24002102/pdfft?md5=b76863e227d785e1a018441a19b4dead&pid=1-s2.0-S2667193X24002102-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233826","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}
引用次数: 0
Impact of being taken into out-of-home care: a longitudinal cohort study of First Nations and other child welfare agencies in Manitoba, Canada 接受家庭外照料的影响:对加拿大马尼托巴省原住民和其他儿童福利机构的纵向队列研究
IF 7
Lancet Regional Health-Americas Pub Date : 2024-09-11 DOI: 10.1016/j.lana.2024.100886
Marni Brownell , Nathan C. Nickel , Kayla Frank , Lisa Flaten , Scott Sinclair , Stephanie Sinclair , Nora Murdock , Jennifer E. Enns , Jamie Pfau , Anita Durksen , Colette Scatliff , Heather Prior , Randy Walld , Lorna Turnbull , Karine Levasseur , Teresa Mayer , Jennifer Chartrand , Chris Nash , Elizabeth Decaire , Hygiea Casiano , Therese A. Stukel
{"title":"Impact of being taken into out-of-home care: a longitudinal cohort study of First Nations and other child welfare agencies in Manitoba, Canada","authors":"Marni Brownell ,&nbsp;Nathan C. Nickel ,&nbsp;Kayla Frank ,&nbsp;Lisa Flaten ,&nbsp;Scott Sinclair ,&nbsp;Stephanie Sinclair ,&nbsp;Nora Murdock ,&nbsp;Jennifer E. Enns ,&nbsp;Jamie Pfau ,&nbsp;Anita Durksen ,&nbsp;Colette Scatliff ,&nbsp;Heather Prior ,&nbsp;Randy Walld ,&nbsp;Lorna Turnbull ,&nbsp;Karine Levasseur ,&nbsp;Teresa Mayer ,&nbsp;Jennifer Chartrand ,&nbsp;Chris Nash ,&nbsp;Elizabeth Decaire ,&nbsp;Hygiea Casiano ,&nbsp;Therese A. Stukel","doi":"10.1016/j.lana.2024.100886","DOIUrl":"10.1016/j.lana.2024.100886","url":null,"abstract":"<div><h3>Background</h3><p>Across Canada, Child Protection Services (CPS) disrupt Indigenous families by apprehending their children at alarmingly high rates. The harms borne by children in out-of-home care (OoHC) have been extensively documented. We examined the impact of OoHC on Manitoba children's health and legal system outcomes to provide rigorous evidence on how discretionary decision-making by CPS agencies can affect these outcomes.</p></div><div><h3>Methods</h3><p>In partnership with First Nations researchers, we used linked administrative data to identify Manitoba children (born 2007–2018) served by First Nations and other Manitoba CPS agencies. We compared those taken into OoHC (n = 19,324) with those never in care but with an open CPS file due to child protection concerns (n = 27,290). We used instrumental variable analysis (CPS agency rates of OoHC as the instrument) to obtain odds ratios (aOR) and 95% confidence intervals adjusted for child, maternal, and family factors.</p></div><div><h3>Findings</h3><p>Mean age (yrs ± standard deviation) at first CPS contact for children taken into OoHC was 2.8 ± 3.7 (First Nations) and 3.0 ± 3.8 (other), and for children never in care was 4.5 ± 4.5 (First Nations) and 5.1 ± 4.7 (other). Among children served by a First Nations agency, males made up 50.6% (n = 5496) in OoHC and 51.0% (n = 6579) never in care. Among children served by other agencies, males made up 51.0% (n = 4324) in OoHC and 51.0% (n = 7428) never in care. Odds of teen pregnancy (First Nations aOR 3.69, 1.40–9.77; other aOR 5.10, 1.83–14.25), teen birth (First Nations aOR 3.23, 1.10–9.49; other aOR 5.06, 1.70–15.03), and sexually transmitted infections (other aOR 7.21, 3.63–14.32) were higher for children in care than children never in care, as were odds of being accused (other aOR 2.71, 1.27–5.75), a victim (other aOR 1.68, 1.10–2.56), charged with a crime (other aOR 2.68, 1.21–5.96), or incarcerated (First Nations aOR 3.64, 1.95–6.80; other aOR 1.19, 1.19–8.04).</p></div><div><h3>Interpretation</h3><p>Being in OoHC worsened children's health and legal system outcomes. The importance of reducing the number of children taken into care was emphasized in briefings to provincial and First Nations governments. The government response will be monitored.</p></div><div><h3>Funding</h3><p><span>Social Sciences and Humanities Research Council</span> (no. 890-2018-0029).</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"38 ","pages":"Article 100886"},"PeriodicalIF":7.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24002138/pdfft?md5=19b5b66c6bc19406a9c25c9a929cd5f7&pid=1-s2.0-S2667193X24002138-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168460","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}
引用次数: 0
The US elections as a determinant of global health 美国大选是全球健康的决定因素
IF 7
Lancet Regional Health-Americas Pub Date : 2024-09-11 DOI: 10.1016/j.lana.2024.100884
Muhammad Jawad Noon , Xinshu She , Benjamin Mason Meier
{"title":"The US elections as a determinant of global health","authors":"Muhammad Jawad Noon ,&nbsp;Xinshu She ,&nbsp;Benjamin Mason Meier","doi":"10.1016/j.lana.2024.100884","DOIUrl":"10.1016/j.lana.2024.100884","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100884"},"PeriodicalIF":7.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24002114/pdfft?md5=101d30eca7201a5d9881ecf08fc3096a&pid=1-s2.0-S2667193X24002114-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142167743","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}
引用次数: 0
Supervised safe consumption sites — lessons and opportunities for North America 有监督的安全消费场所--北美的经验教训和机遇
IF 7
Lancet Regional Health-Americas Pub Date : 2024-09-11 DOI: 10.1016/j.lana.2024.100889
David T. Zhu , Simar S. Bajaj , Thomas Kerr
{"title":"Supervised safe consumption sites — lessons and opportunities for North America","authors":"David T. Zhu ,&nbsp;Simar S. Bajaj ,&nbsp;Thomas Kerr","doi":"10.1016/j.lana.2024.100889","DOIUrl":"10.1016/j.lana.2024.100889","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100889"},"PeriodicalIF":7.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24002163/pdfft?md5=43d20199c6e3563ae82a46929d0cc148&pid=1-s2.0-S2667193X24002163-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142167744","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}
引用次数: 0
Clinical features of Chagas disease progression and severity 南美锥虫病进展和严重程度的临床特征
IF 7
Lancet Regional Health-Americas Pub Date : 2024-09-01 DOI: 10.1016/j.lana.2024.100832
Maria Carmo P. Nunes , Caryn Bern , Eva H. Clark , Antonio L. Teixeira , Israel Molina
{"title":"Clinical features of Chagas disease progression and severity","authors":"Maria Carmo P. Nunes ,&nbsp;Caryn Bern ,&nbsp;Eva H. Clark ,&nbsp;Antonio L. Teixeira ,&nbsp;Israel Molina","doi":"10.1016/j.lana.2024.100832","DOIUrl":"10.1016/j.lana.2024.100832","url":null,"abstract":"<div><p>Chagas disease, the most common form of nonischaemic cardiomyopathy globally, is one of the leading causes of morbidity and mortality in Latin America. Chagas cardiomyopathy has a wide clinical spectrum and prognosis, which is primarily determined by the severity of left ventricular dysfunction. Chagas disease also affects the brain, particularly manifesting as cardioembolic strokes and cognitive impairments. Disease progression is influenced by various factors such as anti-parasite treatments, host–parasite interactions, and other determinants.</p><p>This review explores Chagas disease, covering clinical presentations, the range of severity of Chagas cardiomyopathy, and neurological manifestations. We investigate factors that influence the progression of cardiomyopathy, including anti-parasitic treatments, interactions between hosts and parasites, and the influence of social determinants on the course of the disease. This review analyses key prognostic factors associated with the progression and mortality of Chagas cardiomyopathy, offering insights into this potentially fatal illness.</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"37 ","pages":"Article 100832"},"PeriodicalIF":7.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24001595/pdfft?md5=1e1c3795e760a4f6d873f3394953c4bf&pid=1-s2.0-S2667193X24001595-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229272","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}
引用次数: 0
Effects of mobility, immunity and vaccination on SARS-CoV-2 transmission in the Dominican Republic: a modelling study 流动性、免疫力和疫苗接种对多米尼加共和国 SARS-CoV-2 传播的影响:模拟研究
IF 7
Lancet Regional Health-Americas Pub Date : 2024-09-01 DOI: 10.1016/j.lana.2024.100860
Emilie Finch , Eric J. Nilles , Cecilia Then Paulino , Ronald Skewes-Ramm , Colleen L. Lau , Rachel Lowe , Adam J. Kucharski
{"title":"Effects of mobility, immunity and vaccination on SARS-CoV-2 transmission in the Dominican Republic: a modelling study","authors":"Emilie Finch ,&nbsp;Eric J. Nilles ,&nbsp;Cecilia Then Paulino ,&nbsp;Ronald Skewes-Ramm ,&nbsp;Colleen L. Lau ,&nbsp;Rachel Lowe ,&nbsp;Adam J. Kucharski","doi":"10.1016/j.lana.2024.100860","DOIUrl":"10.1016/j.lana.2024.100860","url":null,"abstract":"<div><h3>Background</h3><p>COVID-19 dynamics are driven by a complex interplay of factors including population behaviour, new variants, vaccination and immunity from prior infections. We quantify drivers of SARS-CoV-2 transmission in the Dominican Republic, an upper-middle income country of 10.8 million people. We then assess the impact of the vaccination campaign implemented in February 2021, primarily using CoronaVac, in saving lives and averting hospitalisations.</p></div><div><h3>Methods</h3><p>We fit an age-structured, multi-variant transmission dynamic model to reported deaths, hospital bed occupancy, and seroprevalence data until December 2021, and simulate epidemic trajectories under different counterfactual scenarios.</p></div><div><h3>Findings</h3><p>We estimate that vaccination averted 7210 hospital admissions (95% credible interval, CrI: 6830–7600), 2180 intensive care unit admissions (95% CrI: 2080–2280) and 766 deaths (95% CrI: 694–859) in the first 6 months of the campaign. If no vaccination had occurred, we estimate that an additional decrease of 10–20% in population mobility would have been required to maintain equivalent death and hospitalisation outcomes. We also found that early vaccination with CoronaVac was preferable to delayed vaccination using a product with higher efficacy.</p></div><div><h3>Interpretation</h3><p>SARS-CoV-2 transmission dynamics in the Dominican Republic were driven by a substantial accumulation of immunity during the first two years of the pandemic but, despite this, vaccination was essential in enabling a return to pre-pandemic mobility levels without considerable additional morbidity and mortality.</p></div><div><h3>Funding</h3><p><span>Medical Research Council</span>, <span>Wellcome Trust</span>, <span>Royal Society</span>, <span>US CDC</span> and Australian <span>National Health and Medical Research Council</span>.</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"37 ","pages":"Article 100860"},"PeriodicalIF":7.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X2400187X/pdfft?md5=97443b4e7e5bd7d4ce03d546e8419abe&pid=1-s2.0-S2667193X2400187X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097211","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}
引用次数: 0
The epidemiology of Chagas disease in the Americas 恰加斯病在美洲的流行病学
IF 7
Lancet Regional Health-Americas Pub Date : 2024-09-01 DOI: 10.1016/j.lana.2024.100881
Zulma M. Cucunubá , Sebastián A. Gutiérrez-Romero , Juan-David Ramírez , Natalia Velásquez-Ortiz , Soledad Ceccarelli , Gabriel Parra-Henao , Andrés F. Henao-Martínez , Jorge Rabinovich , María-Gloria Basáñez , Pierre Nouvellet , Fernando Abad-Franch
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