Lancet Regional Health-Americas最新文献

{"title":"Regulatory bodies must critically assess their role in the wellness wave of supplement marketing","authors":"Alessandro R. Marcon","doi":"10.1016/j.lana.2025.101348","DOIUrl":"10.1016/j.lana.2025.101348","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101348"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840106","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":"Building a health system resilience framework: national, state, regional, and local perspectives","authors":"Marco Antonio Catussi Paschoalotto ,&nbsp;Eduardo Alves Lazzari ,&nbsp;Rudi Rocha ,&nbsp;Adriano Massuda ,&nbsp;Marcia C. Castro","doi":"10.1016/j.lana.2025.101334","DOIUrl":"10.1016/j.lana.2025.101334","url":null,"abstract":"<div><div>Health system resilience (HSR) is essential to sustaining equitable essential functions under acute and chronic stressors in decentralized systems. We developed and validated a Brazil-tailored HSR framework that distinguishes steady-state performance from resilience-specific capacities and assigns responsibilities across federal, state, regional, and municipal levels. Using a three-phase qualitative deductive–inductive approach with 48 international and national experts, we identified nine dimensions, 18 subdimensions, and 65 indicators that prioritise governance coherence, surge workforce strategies, emergency regulation, real-time monitoring, and access to critical technologies. The framework clarifies boundaries between general health system performance and adaptive, absorptive, and transformative functions, and specifies how managers can apply it in practice through structured scoping, mapping, scoring, prioritisation, planning, and monitoring steps. Although designed for Brazil's Unified Health System (SUS), the development logic generalises to other decentralised contexts with appropriate re-allocation of responsibilities and calibration to national financing rules. This policy-facing tool supports actionable resilience strengthening in complex, multi-level systems.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101334"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737800","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":"Mapping the expressions and impacts of racism on health in Brazil: a scoping review","authors":"Priscila de Morais Sato ,&nbsp;Fernanda Lopes ,&nbsp;Sonora English ,&nbsp;Silvana Oliveira da Silva ,&nbsp;James Berson Lalane ,&nbsp;Thilagawathi Abi Deivanayagam ,&nbsp;Rute Ramos da Silva Costa ,&nbsp;Elizângela Baré ,&nbsp;Indira Ramos Gomes ,&nbsp;Delan Devakumar","doi":"10.1016/j.lana.2025.101323","DOIUrl":"10.1016/j.lana.2025.101323","url":null,"abstract":"<div><div>We conducted a scoping review to examine how racism affects the health of minoritized populations in Brazil. A comprehensive search was carried out, and identified articles underwent independent double screening. The 145 included studies consistently highlighted structural health inequities, with White advantage functioning as a protective factor. Institutional racism restricts healthcare access and availability, exacerbating minoritized populations’ vulnerability to violence and disease through discrimination and substandard care. Spatial segregation further exposes minoritized populations to harmful environmental conditions and limited infrastructure, while traditional and migrant communities experience marginalization, social isolation, increased disease exposure, and poorer livelihoods. Interpersonal racism negatively impacts mental and physical health across the lifespan, with gender and socioeconomic conditions intersecting and shaping these experiences. The study provides critical insights for practice, policy, and research by demonstrating how racism at multiple levels shapes health inequities in Brazil and by emphasizing the need for human rights-centred, redistributive interventions that promote justice, equity, and inclusive care for minoritized populations.</div><div>Funding: This publication was funded by Edital 02/2025—PRPPG/UFBA (<span>Scientific Publications Support Program</span>) and by the <span>CNPq Productivity in Research Scholarship</span> (process number 306359/2024-3).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101323"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737867","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 rates of twelve chronic diseases/conditions in US adults: findings from a population-based study","authors":"Richard L. Nahin ,&nbsp;Termeh Feinberg ,&nbsp;Hanna Grol-Prokopczyk ,&nbsp;Flavia P. Kapos ,&nbsp;Kerri Murray ,&nbsp;Remle Scott ,&nbsp;Anna Zajacova","doi":"10.1016/j.lana.2025.101342","DOIUrl":"10.1016/j.lana.2025.101342","url":null,"abstract":"<div><h3>Background</h3><div>There are no contemporary studies simultaneously examining the incidence of multiple chronic diseases/conditions in US adults. We estimated one-year incidence rates for 12 chronic diseases/conditions with high public burden.</div></div><div><h3>Methods</h3><div>Data were from the nationally representative National Health Interview Survey 2019–2020 Longitudinal Cohort (N = 10,415). We assessed incidence rates for anxiety, arthritis, asthma, cancer, chronic obstructive pulmonary disease (COPD), chronic pain, coronary heart disease (CHD), depression, diabetes, high cholesterol, hypertension, and obesity. We calculated overall and sex-specific age-standardized incidence rates per 1000 person-years (PY) and examined associations with baseline age, sex, race/ethnicity, education, insurance, and smoking status.</div></div><div><h3>Findings</h3><div>In the sample, 51.7% ([95% CI: 50.3–53.1]; N = 5624, representing 129.7 million adults) were female, 20.5% ([95% CI: 20–22.2]; N = 3405, representing 21.1 million adults) were aged 65+ years, 63.2% ([95% CI: 60.9–65.4]; N = 7495, representing 158.5 million adults) were Non-Hispanic White, 16.5% ([95% CI: 14.7–18.4]; N = 1153, representing 41.5 million adults) were Hispanic/Latino, 28.8% ([95% CI: 27.4–30.2]; N = 4228, representing 72.3 million adults) graduated college, and 72.4 ([95% CI: 70.8–73.9]; N = 7287, representing 167.0 million adults) had private health insurance. One-year incidence rates were lowest for diabetes, COPD and CHD: 13.8/1000 PY (95% CI: 10.8–16.8), 14.4/1000 PY (95% CI: 11.8–17.0), and 14.7/1000 PY (95% CI: 12.7–17.0), respectively. The highest rates were observed for high cholesterol and chronic pain, 85.7/1000 PY (95% CI: 79.4–91.9) and 85.3/1000 PY (95% CI: 78.7–92.0), respectively, while all other rates were between these extremes. Females had higher rates of anxiety (69.6 [95% CI: 60.5–75.7] vs 36.4 [95% CI: 29.8–43.1]) and depression (63.7 [95% CI: 55.1–72.3] vs 34.5 [95% CI: 28.4–40.7]), while males had higher rates of hypertension (77.3 [95% CI: 72.3–82.3] vs 56.5 [95% CI: 48.7–64.3]). Incidence-related risk factors differed across diseases/conditions, with age the most consistent predictor.</div></div><div><h3>Interpretation</h3><div>This comprehensive assessment documented striking variation in chronic disease/condition incidence. The findings provide essential evidence for prioritizing and coordinating prevention initiatives across the chronic disease/condition spectrum.</div></div><div><h3>Funding</h3><div><span>US National Institutes of Health</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101342"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925435","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":"Rapid weight gain in first 2 years of life and BMI trajectories from 3 to <10 years: a population-based longitudinal study of 1.7 million Brazilian children","authors":"Carolina Santiago-Vieira ,&nbsp;Leah Li ,&nbsp;Rita de Cássia Ribeiro Silva ,&nbsp;Juliana Freitas de Mello e Silva ,&nbsp;Enny S. Paixão ,&nbsp;Maurício L. Barreto ,&nbsp;Gustavo Velasquez-Melendez","doi":"10.1016/j.lana.2025.101326","DOIUrl":"10.1016/j.lana.2025.101326","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is considered a disease with negative health impacts at all life stages. Changes in growth patterns, such as postnatal rapid weight gain (RWG), can be important predictors of growth trajectories in children. We investigated the association between RWG during the first two years of life and subsequent BMI trajectories from the age 3–to 9 years, and whether the association differed by birth weight group.</div></div><div><h3>Methods</h3><div>We used the data of a population-based cohort from the Cadastro Único (CadÚnico) of the Federal Government, the linkage of the National Live Births System (SINASC) and the National Food and Nutritional Surveillance System (SISVAN). The sample comprised 1.7 million Brazilian children aged from zero to nine years from 2008 to 2017. Mixed-effects models were used to estimate mean age-trajectories for BMI by RWG group.</div></div><div><h3>Findings</h3><div>Children who experienced RWG during the first two years of life had higher mean BMI trajectories from 3 to 9 years, compared to those who did not. The difference was seen across all birth weight groups, and was more evident for the children with high birth weight. At age 9, the BMI difference between RWG and non-RWG children was 1.31 kg/m² (boys) and 1.43 kg/m² (girls) for children with adequate birth weight, 1.27 kg/m² (boys) and 1.35 kg/m² (girls) for low birth weight, and 2.25 kg/m² (boys) and 2.86 kg/m² (girls) for macrosomia.</div></div><div><h3>Interpretation</h3><div>Children who experienced RWG during the first two years of life had higher BMI trajectories than children who did not. The finding highlighted the importance of monitoring child growth, which allows the early identification of potential growth deviations and the implementation of necessary interventions to ensure that children grow healthy and reach their full developmental potential.</div></div><div><h3>Funding</h3><div>Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—CAPES, CAPES/Print/UFBA; <span>University College London</span> (UCL); <span>National Institute for Health Research</span> (NIHR) <span>Great Ormond Street Hospital Biomedical Research Centre</span>; Fundação de Amparo à Pesquisa do Estado de Minas Gerais—FAPEMIG; <span>National Council for Scientific and Technological Development</span>—CNPq; CNPq/CGFP/DECIT/SECTICS; Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde do Ministério da Saúde; <span>Wellcome Trust</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101326"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683868","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":"Selective nonreporting of 5-min Apgar scores and its safety assessment of out-of-hospital births: a population-based study of United States’ birth data, 2016–2023 a population based study","authors":"Amos Grünebaum ,&nbsp;Ruth Landau ,&nbsp;Frank A. Chervenak","doi":"10.1016/j.lana.2025.101350","DOIUrl":"10.1016/j.lana.2025.101350","url":null,"abstract":"<div><h3>Background</h3><div>The safety of out-of-hospital birth in the United States remains contested. A neglected methodological issue is the selective nonreporting of 5-min Apgar scores, which may conceal adverse outcomes and bias safety comparisons. This study examined whether Apgar score missingness differs systematically by birth setting and whether such “informative missingness” alters risk estimates.</div></div><div><h3>Methods</h3><div>We conducted a population-based analysis of 3,066,021 term, normal-birthweight, midwife-attended singleton births in the United States (2016–2023). Birth settings included hospitals, freestanding birth centers, and planned home births. Missing 5-min Apgar scores were quantified, and deterministic sensitivity analyses modeled the impact of varying assumptions about unrecorded low scores (&lt;4 and &lt;7). Hospital births served as the reference group.</div></div><div><h3>Findings</h3><div>Five-minute Apgar scores were missing in 0.13% of hospital, 1.9% of birth-center, and 3.1% of home births. Severe compromise (Apgar &lt;4) occurred in 0.17%, 0.20%, and 0.26%, respectively. When half of missing scores were imputed as &lt;4, adjusted odds of severe compromise increased to 7.7 for home and 4.9 for birth-center births vs. hospitals.</div></div><div><h3>Interpretation</h3><div>This study evaluates documentation integrity of US births. Selective nonreporting of 5-min Apgar scores at out-of-hospital births introduces major bias, distorting apparent safety of out-of-hospital births. Complete and enforceable outcome reporting is essential for scientific validity and ethically sound informed consent.</div></div><div><h3>Funding</h3><div>None declared.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101350"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840622","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":"Geographical and racial and/or ethnic disparities in pediatric ARDS mortality in the USA, 2016–2022: a triennial national database retrospective cohort analysis","authors":"Garrett Keim ,&nbsp;Paula Magee ,&nbsp;Cody Gathers ,&nbsp;Anireddy R. Reddy ,&nbsp;Charlotte Z. Woods-Hill ,&nbsp;Nadir Yehya","doi":"10.1016/j.lana.2025.101355","DOIUrl":"10.1016/j.lana.2025.101355","url":null,"abstract":"<div><h3>Background</h3><div>Disparities in pediatric critical care outcomes are recognized, but national data describing Pediatric Acute Respiratory Distress Syndrome (PARDS) prevalence, mortality and temporal trends are limited. We described prevalence, and regional and racial/ethnic mortality disparities for algorithm-defined ARDS, a surrogate for PARDS in US children from 2016 to 2022.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study using the 2016, 2019, and 2022 Kids' Inpatient Database (KID). Algorithm-defined ARDS was identified with an ICD-10 approach requiring acute respiratory failure from pulmonary, sepsis, or shock etiologies requiring invasive mechanical ventilation ≥24 h. The primary outcome was in-hospital mortality. Exposures were US region and Race/Ethnicity, modeled individually and jointly. Mixed-effect logistic regression models, adjusting for income quartile, APR-DRG severity of illness, hospital type, and complex chronic conditions, estimated adjusted mortalities and risk differences.</div></div><div><h3>Findings</h3><div>Algorithm-defined ARDS occurred in about 42,000 hospitalizations per year, with prevalence increasing from 0.68% (95% CI 0.67–0.69) in 2016 to 0.75% (0.74–0.75) in 2022. Overall mortality was 12.9% (12.5–13.3) in 2016, 12.5% (12.1–12.9) in 2019, and 13.7% (13.3–14.1) in 2022. In the joint model, relative to Northeastern White children (predicted 10.9%, 95% CI 9.72–12.1), risks were higher for Black children in the South (predicted 14.2%, ARD 3.27%, 1.74–4.79) and West (14.6%, ARD 3.69%, 1.39–6.00); Hispanic children in the West (12.6%, ARD 1.70%, 0.09–3.31), and children of Other race/ethnicity in the South (16.5%, ARD 5.57%, 3.14–7.99) and West (14.0%, ARD 3.11%, 0.96–5.25). Disparities did not meaningfully change from 2016 to 2019, while mortality increased from 2019 to 2022.</div></div><div><h3>Interpretation</h3><div>Algorithm-defined ARDS among hospitalized US children remains common and highly fatal. Persistent regional and racial/ethnic disparities highlight systemic drivers of inequity and the need for targeted interventions.</div></div><div><h3>Funding</h3><div>This work was supported by the <span>National Heart, Lung, and Blood Institute, National Institutes of Health</span> (Award K23HL177271, PI: Keim).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101355"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884484","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 right to health: indigenous data sovereignty in Canada during and beyond the COVID-19 pandemic","authors":"Alya Govorchin ,&nbsp;Maëve Leduc ,&nbsp;Clifford G. Atleo ,&nbsp;Dawn Hoogeveen ,&nbsp;Irina Borgos ,&nbsp;Lyana Patrick","doi":"10.1016/j.lana.2025.101335","DOIUrl":"10.1016/j.lana.2025.101335","url":null,"abstract":"<div><div>The COVID-19 pandemic disproportionately impacted Indigenous Peoples in Canada, highlighting preexisting health inequities. These disparities were exacerbated by inadequate data management policies across Canadian governments, which contribute to inaccurate health information and access challenges for Indigenous Nations. Indigenous data sovereignty, which recognizes the right of Indigenous Peoples to govern their own data, has been identified as essential for achieving self-determination and improving health outcomes. We focus on British Columbia (BC) given its unique health and data governance structure with First Nations. This policy paper examines the challenges related to health data management that arose during COVID-19 in BC, and the regulatory barriers hindering Indigenous health equity. We present four policy recommendations that address data issues as a promising avenue to reducing health inequities in Canada. This includes supporting research by and with Indigenous Peoples, promoting ethical responsibilities of non-Indigenous researchers, implementing anti-racism policies, and adopting Indigenous data management frameworks.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101335"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737799","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":"Nonmetastatic nasopharyngeal carcinoma: in search of safer therapies","authors":"The Lancet Regional Health – Americas","doi":"10.1016/j.lana.2026.101420","DOIUrl":"10.1016/j.lana.2026.101420","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101420"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272127","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 impact of large-scale release of Wolbachia mosquitoes on dengue incidence in Campo Grande, Brazil: an ecological study","authors":"Fabiani de Morais Batista ,&nbsp;Paloma M. Carcamo ,&nbsp;Elisabeth Nelson ,&nbsp;Antonio Brandão da Silva Neto ,&nbsp;Daniel Henrique Tsuha ,&nbsp;Veruska Lahdo ,&nbsp;Vagner Ricardo dos Santos ,&nbsp;Gabriel Sylvestre Ribeiro ,&nbsp;Renato da Silva Lopes ,&nbsp;Pilar Amadeu ,&nbsp;Marcos Vinicius Ferreira Mendes Blanco ,&nbsp;Thiago Rodrigues da Costa ,&nbsp;Karlos Diogo de Melo Chalegre ,&nbsp;Thais Irene Souza Riback ,&nbsp;Cátia Cabral da Silva ,&nbsp;Otavio T. Ranzani ,&nbsp;Derek A.T. Cummings ,&nbsp;Jason R. Andrews ,&nbsp;Albert I. Ko ,&nbsp;Matt D.T. Hitchings ,&nbsp;Julio Croda","doi":"10.1016/j.lana.2025.101327","DOIUrl":"10.1016/j.lana.2025.101327","url":null,"abstract":"<div><h3>Background</h3><div>The introduction of the <em>w</em>Mel strain of <em>Wolbachia</em> into <em>Aedes aegypti</em> mosquitoes significantly reduces dengue virus transmission. We evaluated the impact of large-scale releases of <em>Wolbachia</em>-infected <em>Ae. aegypti</em> on dengue incidence in Campo Grande, a large urban city in the Central-West region of Brazil, in the first deployment of <em>Wolbachia</em> as an official dengue-control strategy by the Brazilian federal government.</div></div><div><h3>Methods</h3><div>Mosquitoes infected with <em>w</em>Mel <em>Wolbachia</em> were released in geographically phased deployments throughout Campo Grande from December 2020 through December 2023. An ovitrap surveillance network monitored <em>Wolbachia</em> prevalence in local <em>Ae. aegypti</em> populations during and after releases. Mixed-effects negative binomial regression was used to evaluate neighborhood-level monthly notified dengue incidence (2008–2024) as a function of monthly <em>w</em>Mel exposure status, comparing fully treated (<em>w</em>Mel prevalence stably ≥60%) and partially treated (ongoing releases or <em>w</em>Mel &lt;60%) with untreated periods, accounting for seasonal variation.</div></div><div><h3>Findings</h3><div>More than 100 million <em>Wolbachia</em>-infected mosquitoes were released, achieving a post-intervention mean <em>Wolbachia</em> prevalence of 86.4% (95% CI 84.0–88.9), with 89% of intervention areas reaching stable <em>Wolbachia</em> levels ≥60%. Stable establishment of <em>w</em>Mel at ≥60% prevalence was associated with a 63.2% (95% CI 51.9–71.9) reduction in dengue incidence.</div></div><div><h3>Interpretation</h3><div>Our results demonstrate successful large-scale <em>Wolbachia</em> establishment in <em>Ae. aegypti</em> populations and a substantial epidemiological impact on dengue incidence in an urban Brazilian setting. This study provides robust evidence supporting <em>Wolbachia</em> deployment as an effective, sustainable public health intervention and validates its implementation as a federal government-supported dengue control strategy in Brazil.</div></div><div><h3>Funding</h3><div>This work was supported by the <span>Brazilian Ministry of Health</span> and the <span>Oswaldo Cruz Foundation</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101327"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645849","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}