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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 在一个由SARS-CoV-2感染引起的结核病队列中,全因死亡率的短期和长期风险增加:智利的一项时间依赖性生存分析
IF 7
Lancet Regional Health-Americas Pub Date : 2025-05-10 DOI: 10.1016/j.lana.2025.101119
Vargas-García Salvador , Eduardo A. Undurraga , Nadia Escobar , Christian García , Natalia Vergara , María Elvira Balcells
{"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}
引用次数: 0
Incidence and mortality of endometrial cancer in the Appalachian Eastern Kentucky continues to rise due to obesity, metabolic syndromes, and corresponding health disparities 由于肥胖、代谢综合征和相应的健康差异,东肯塔基州阿巴拉契亚地区子宫内膜癌的发病率和死亡率继续上升
IF 7
Lancet Regional Health-Americas Pub Date : 2025-05-10 DOI: 10.1016/j.lana.2025.101124
Tessa L. Wrightson , Robert C. Miller
{"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}
引用次数: 0
Healthcare responding to violence and abuse in Brazil: a quasi-experimental difference-in-differences analysis 巴西应对暴力和虐待的医疗保健:一项准实验性差异中差异分析
IF 7
Lancet Regional Health-Americas Pub Date : 2025-05-08 DOI: 10.1016/j.lana.2025.101114
Estela Capelas Barbosa , Stephanie Pereira , Loraine J. Bacchus , Manuela Colombini , Gene Feder , Lilia Blima Schraiber , Ana Flávia Pires Lucas d'Oliveira
{"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}
引用次数: 0
Fostering leadership and gender equality in climate action among underserved, rural and Indigenous women: a qualitative exploration of opportunities and limitations in Peru 在服务不足的农村和土著妇女中培养气候行动中的领导力和性别平等:对秘鲁的机会和限制的定性探索
IF 7
Lancet Regional Health-Americas Pub Date : 2025-05-08 DOI: 10.1016/j.lana.2025.101109
Elaine C. Flores , Annie F. Flores , Blenda Abarca-Diaz , Roberto Camizan-Castro , Edinson Mendoza-Lozada , Floro Ortiz-Contreras , Ritsuko Kakuma
{"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}
引用次数: 0
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) 阿根廷侵袭性肺炎球菌病:2018-2022年COVID-19大流行血清型、抗菌素耐药性和潜在影响回顾性观察研究概况
IF 7
Lancet Regional Health-Americas Pub Date : 2025-05-07 DOI: 10.1016/j.lana.2025.101113
Jonathan Zintgraff , Paula Gagetti , Nahuel Sánchez Eluchans , Paulina Marchetti , María Alicia Moscoloni , Lucia Irazu , Claudia S. Lara
{"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}
引用次数: 0
Twenty years of breast cancer epidemiology and treatment patterns in São Paulo, Brazil—observed versus expected treatment utilization in a retrospective cohort 巴西圣保罗20年乳腺癌流行病学和治疗模式:回顾性队列观察与预期治疗利用
IF 7
Lancet Regional Health-Americas Pub Date : 2025-05-07 DOI: 10.1016/j.lana.2025.101115
Haydee Verduzco-Aguirre , Fernanda Mallucelli Favorito , Fabio Ynoe de Moraes , Gustavo Marta , Camila Tagle , Carlos Henrique dos Anjos , André Mattar , Brooke E. Wilson
{"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}
引用次数: 0
Atrial fibrillation in the Americas 美洲的房颤
IF 7
Lancet Regional Health-Americas Pub Date : 2025-05-06 DOI: 10.1016/j.lana.2025.101110
Jason G. Andrade , Larry R. Jackson II , Juan Carlos Diaz , Mina Chung , Jody Hurwitz , Carlos A. Morillo , Gregory Y.H. Lip , Nestor Lopez-Cabanillas
{"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}
引用次数: 0
Transfusion-transmitted infections: risks and mitigation strategies for Oropouche virus and other emerging arboviruses in Latin America and the Caribbean 输血传播感染:拉丁美洲和加勒比地区Oropouche病毒和其他新出现的虫媒病毒的风险和缓解战略
IF 7
Lancet Regional Health-Americas Pub Date : 2025-05-05 DOI: 10.1016/j.lana.2025.101089
Andres Moreira-Soto , Ignacio Postigo-Hidalgo , Ximena Tabares , Yannik Roell , Carlo Fischer , Eduardo Gotuzzo , Thomas Jaenisch , José Eduardo Levi , Yaniv Lustig , Jan Felix Drexler
{"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}
引用次数: 0
Physical activity and BMI inequalities throughout childhood: a Brazilian birth cohort study 儿童时期的身体活动和身体质量指数不平等:一项巴西出生队列研究
IF 7
Lancet Regional Health-Americas Pub Date : 2025-05-03 DOI: 10.1016/j.lana.2025.101111
Shelby A. Keye , Pedro Curi Hallal , Inacio Crochemore-Silva , Marlos Rodrigues Domingues , Giulia Salaberry Leite , Otávio Amaral de Andrade Leão
{"title":"Physical activity and BMI inequalities throughout childhood: a Brazilian birth cohort study","authors":"Shelby A. Keye ,&nbsp;Pedro Curi Hallal ,&nbsp;Inacio Crochemore-Silva ,&nbsp;Marlos Rodrigues Domingues ,&nbsp;Giulia Salaberry Leite ,&nbsp;Otávio Amaral de Andrade Leão","doi":"10.1016/j.lana.2025.101111","DOIUrl":"10.1016/j.lana.2025.101111","url":null,"abstract":"<div><h3>Background</h3><div>Utilising the 2015 Pelotas (Brazil) Birth Cohort, the current study investigated differences in physical activity (PA) and BMI-for-age between sex, race, and socioeconomic status (SES) at ages 1 (n = 4018), 2 (n = 4014), 4 (n = 4010), and 7 (n = 3867).</div></div><div><h3>Methods</h3><div>Demographics collected via surveys included sex at birth, skin colour, a proxy for race, at 4 years, and an assets index collected at all ages to determine SES. Height and weight estimated BMI-for-age and PA via wrist-worn accelerometers. Means and 95% confidence intervals described PA and BMI-for-age, using t-tests, ANOVAs, and chi-squared tests to determine significant differences. Trajectory models compared longitudinal patterns from 1 to 7 years.</div></div><div><h3>Findings</h3><div>Starting at age 2, Black and Brown children and poorer children engaged in more PA. Poorer children presented lower BMI-for-age at ages 4 and 7. Trajectory models revealed that boys, Black and Brown, and poorer children represented increasing and high PA groups. Boys and Black and Brown children were most prevalent in higher BMI-for-age trajectory groups.</div></div><div><h3>Interpretation</h3><div>The current study revealed PA and BMI-for-age inequalities across multiple demographic variables during early life. These results may reveal when inequalities may arise and reveal time points to intervene for populations at risk of poor health-related quality of life.</div></div><div><h3>Funding</h3><div>The present study was funded initially by the <span>Wellcome Trust</span> (<span><span>095582</span></span>), and partially by the <span>Conselho Nacional de Desenvolvimento Científico e Tecnológico</span>, <span>Fundacao de Amparo a Pesquisa do Estado do Rio Grande do Sul</span>, <span>Children’s Pastorate</span>, and the <span>Department of Science and Technology</span> (<span>DECIT</span>/<span>Brazilian Ministry of Health</span>).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101111"},"PeriodicalIF":7.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899537","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}
引用次数: 0
Correction to “Association between city-level sociodemographic and health factors and the prevalence of antimicrobial-resistant gonorrhea in the US, 2000–2019: a spatial–temporal modeling study” The Lancet Regional Health—Americas 2025; 43, 101006] 修正“2000-2019年美国城市级社会人口统计学和健康因素与耐药淋病流行之间的关系:一项时空建模研究”《柳叶刀-区域卫生-美洲2025》;43岁,101006年)
IF 7
Lancet Regional Health-Americas Pub Date : 2025-05-01 DOI: 10.1016/j.lana.2025.101079
Jingwen Li , Rachel E. Murray-Watson , Sancta B. St Cyr , Yonatan H. Grad , Joshua L. Warren , Reza Yaesoubi
{"title":"Correction to “Association between city-level sociodemographic and health factors and the prevalence of antimicrobial-resistant gonorrhea in the US, 2000–2019: a spatial–temporal modeling study” The Lancet Regional Health—Americas 2025; 43, 101006]","authors":"Jingwen Li ,&nbsp;Rachel E. Murray-Watson ,&nbsp;Sancta B. St Cyr ,&nbsp;Yonatan H. Grad ,&nbsp;Joshua L. Warren ,&nbsp;Reza Yaesoubi","doi":"10.1016/j.lana.2025.101079","DOIUrl":"10.1016/j.lana.2025.101079","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101079"},"PeriodicalIF":7.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887422","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}
引用次数: 0
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