Lancet Global Health最新文献

{"title":"How women with disabilities determine their gender-based violence priorities.","authors":"Edith Kagoya,Jane Nakalinzi,Diane Kingston","doi":"10.1016/s2214-109x(25)00329-8","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00329-8","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"44 1","pages":"e1811-e1812"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global antibiotic consumption and regional antimicrobial resistance, 2010-21: an analysis of pharmaceutical sales and antimicrobial resistance surveillance data.","authors":"Ligui Wang,Hui Chen,Yuanyuan Zhang,Yao Tian,Xiaoyan Hu,Jian Wu,Xiaoying Li,Huiqun Jia,Hui Wang,Chenjing Yu,Yang Yang,Liqun Fang,Hongbin Song","doi":"10.1016/s2214-109x(25)00308-0","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00308-0","url":null,"abstract":"BACKGROUNDThe rising prevalence of antimicrobial resistance driven by inappropriate antibiotic consumption has become a major global challenge. We aimed to examine spatiotemporal patterns of antibiotic consumption across countries from 2010 to 2021 and explore factors associated with the prevalence of antibiotic resistance.METHODSWe used the latest data on antibiotic consumption from the IQVIA MIDAS database, a globally standardised system for tracking pharmaceutical sales, to characterise changes in consumption patterns of WHO Access, Watch, Reserve, and non-recommended antibiotics across 74 countries and regions during 2010-21. A linear mixed model was used to identify potential socioeconomic and environmental factors associated with antimicrobial resistance detection rate across 26 European countries for 14 bacterium-antibiotic resistance pairs, using data from the European Antimicrobial Resistance Surveillance Network.FINDINGSBetween 2010 and 2021, antibiotic consumption increased in most studied countries or regions in the WHO South-East Asia region (four of five), African region (three of three), region of the Americas (seven of 13, all seven in Latin America), and the Eastern Mediterranean region (five of nine). The highest annual growth rate of antibiotic consumption was found in the eight countries of west Africa (7%; formerly known as French West Africa), followed by China (7%) and Algeria (5%). Conversely, antibiotic consumption decreased in most countries in the WHO European region (25 of 33) and the Western Pacific region (nine of 11). In 2011, amoxicillin was the most used antibiotic (28%), followed by azithromycin (10%) and doxycycline (10%). The linear mixed model revealed that, among the 26 countries, antimicrobial resistance was positively associated with both antibiotic consumption rate and annual average temperature, while being negatively associated with GDP per capita and proportion of current health expenditure.INTERPRETATIONThe global use of antibiotics has substantially changed in the past decade, with more countries meeting the WHO target for Access antibiotics. Increasing antibiotic consumption in the WHO South-East Asia and African regions and its impact on antibiotic resistance warrant close monitoring. Policies on expanding health expenditures to promote appropriate use of antibiotics should be encouraged.FUNDINGNational Key R&D Program of China and National Natural Science Foundation of China.","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"102 1","pages":"e1880-e1891"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic strategies for postpartum haemorrhage: unaddressed considerations - Authors' reply.","authors":"Sara Amaral,Henrique Provinciatto,Eduardo Maia Martins Pereira,Marcela Tatsch Terres,Ashraf Samir Habib","doi":"10.1016/s2214-109x(25)00412-7","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00412-7","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"126 1","pages":"e1815"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endemic melioidosis in Africa: Mali study sounds the alarm.","authors":"Qianfeng Xia,Hua Wu","doi":"10.1016/s2214-109x(25)00380-8","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00380-8","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"45 1","pages":"e1794-e1795"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quartile-based risk exposure in global IHD and ischaemic stroke.","authors":"Sevda Riyahifar,Maziar Moradi-Lakeh,Ali Golestani,Bagher Larijani","doi":"10.1016/s2214-109x(25)00369-9","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00369-9","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"20 1","pages":"e1809"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting from epidemiology to intervention to reduce the global burden of death after trauma laparotomy.","authors":"Liam N Phelan,J C Allen Ingabire,Parvez D Haque,James Glasbey","doi":"10.1016/s2214-109x(25)00416-4","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00416-4","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"1 1","pages":"e1782-e1783"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasmodium falciparum carriage in a population under long-term, intensive malaria control in Kedougou region, Senegal: a 1-year cohort study.","authors":"Eva Legendre,El-Hadj Konko Ciré Ba,Coralie L'Ollivier,Mady Cissoko,Abdoulaye Katile,Maïssane Mehadji,Paul Serre,Cheikh Sokhna,Stéphane Ranque,Fode Danfakha,Marc-Karim Bendiane,Issaka Sagara,Jean Gaudart,Jordi Landier","doi":"10.1016/s2214-109x(25)00271-2","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00271-2","url":null,"abstract":"BACKGROUNDIn Sahelian Africa, successful interventions against malaria include vector control, improved access to care, and seasonal malaria chemoprevention (SMC) in children. However, malaria incidence has increased in the past 5 years. Up-to-date evidence is necessary to design additional interventions and restore progress towards elimination. In this study, we aimed to describe subclinical Plasmodium falciparum infections in the general population and understand the changes in prevalence, parasite densities, and clinical incidence across age groups and seasons, and to identify factors associated with P falciparum carriage in Kedougou, Senegal's most affected region.METHODSWe included all individuals older than 6 months from randomly selected households of four villages in a 1-year open cohort. During four surveys spanning the dry and wet seasons, we collected sociodemographic and behavioural data, and detected P falciparum using quantitative PCR on capillary dried blood samples. We analysed risk factors associated with P falciparum carriage using multilevel logistic regression.FINDINGSWe included 763 participants from 69 households, and they were followed up from April 13, 2021, to March 30, 2022. P falciparum prevalence was lowest in SMC-eligible children (aged <10 years) and remained below 10% across wet and dry seasons. Older age groups had similar dry season prevalence at baseline (10-15%). During the wet season, prevalence increased in individuals aged 15-24 years (32·1%) and 35-49 years (24·7%). The highest clinical burden was in participants aged 10-14 years (527 cases per 1000 person-years) and 15-19 years (631 cases per 1000 person-years), over five-fold higher than children aged 6 months to 4 years (93 cases per 1000 person-years). Outdoor night-time activity was associated with P falciparum infection.INTERPRETATIONIn this setting, ongoing intensive control reduced malaria in SMC-eligible children. Older individuals bear an important clinical burden and harbour high prevalence during the wet season. Elimination-oriented interventions must tackle the parasite reservoir, involving whole communities and specifically young adults.FUNDINGExcellence Initiative of Aix-Marseille University-A*MIDEX, a French Investissements d'Avenir programme: the MARS project (A*Midex International 2018).TRANSLATIONFor the French translation of the abstract see Supplementary Materials section.","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"16 1","pages":"e1935-e1945"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of chronic hepatitis B in Ethiopia: 1-year results from a real-life, multicentre, prospective cohort study.","authors":"Lasse Rossvoll,Hailemichael Desalegn,Fikadu Girma Gudissa,Dawit Birhanu,Ahmed Hussen,Waqtola Cheneke,Asiya Jeylan,Endashaw Abebe Debela,Muhammed Yusuf,Ahmed Sugule,Nafkot Berhanu,Esayas Kebede Gudina,Stian Ms Orlien,Alexander J Stockdale,Nega Berhe,Asgeir Johannessen","doi":"10.1016/s2214-109x(25)00309-2","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00309-2","url":null,"abstract":"BACKGROUNDIn the global efforts to combat chronic hepatitis B virus (HBV) infection, the African continent is falling behind. Simplified treatment guidelines are recommended by WHO in low-income and middle-income countries, but it is unclear how this approach works in real life. We aimed to address this knowledge gap using a simplified treatment programme in Ethiopia.METHODSWe did a prospective cohort study in four public hospitals in Ethiopia. We enrolled HIV-negative adults (age ≥18 years) with chronic HBV infection and applied simplified treatment criteria on the basis of clinical assessment, aspartate aminotransferase-to-platelet ratio index (APRI), alanine aminotransferase, and point-of-care HBV DNA. The primary endpoint was 1-year treatment outcome (active in care, dead, or lost to follow-up), and secondary endpoints were virological and biochemical treatment response. We used Cox proportional hazards regression models to identify predictors of death and logistic regression models to explore associating factors with decompensated cirrhosis. This study is registered with ClinicalTrials.gov, NCT02344498.FINDINGSBetween Dec 8, 2021, and Dec 31, 2023, we enrolled 6010 participants (2953 [49·1%] female and 3057 [50·9%] male; median age 30 years [IQR 25-38]), of whom 1672 (27·8%) were eligible for treatment. 1138 (18·9%) started tenofovir disoproxil fumarate treatment before July 1, 2023, and were included in the 1-year analysis. 532 (46·7%) participants were active in care after 1 year, 58 (5·1%) died, and 508 (44·6%) were lost to follow-up. Of the participants active in care after 1 year, 321 (78·3%) of 410 had virological suppression (HBV DNA ≤10 IU/mL) and 289 (67·5%) of 428 had normal ALT (≤40 U/L). Independent predictors of death were decompensated cirrhosis (adjusted hazard ratio [HR] 8·74 [95% CI 5·01-15·27]) and age (per 1-year increment; adjusted HR 1·03 [1·01-1·05]). Decompensated cirrhosis was associated with male sex (adjusted odds ratio [OR] 1·68 [95% CI 1·17-2·40]), increasing age (per 1-year increment; adjusted OR 1·02 [1·01-1·03]), regular khat use (adjusted OR 1·54 [1·11-2·12]), and HBV DNA concentration greater than 200 000 IU/mL (adjusted OR 1·52 [1·10-2·11]).INTERPRETATIONAbout half of the participants who initiated HBV treatment were still active in care after 1 year, and most of whom had virological and biochemical response to treatment. However, the high proportion lost to follow-up underscores the need for better strategies and tools to improve retention in HBV care.FUNDINGThe South-Eastern Norway Regional Health Authority and the John C Martin Foundation.","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"65 1","pages":"e1914-e1923"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ethics of global health communication in the artificial intelligence era: avoiding poverty porn 2.0.","authors":"Arsenii Alenichev,Sonya de Laat,Mark Hann,Patricia Kingori,Koen Peeters Grietens","doi":"10.1016/s2214-109x(25)00313-4","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00313-4","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"17 1","pages":"e1803-e1804"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness, cost-effectiveness, budget impact, and return on investment of scaling up tuberculosis screening and preventive treatment in Brazil, Georgia, Kenya, and South Africa: a modelling study.","authors":"Juan F Vesga,Mona Salaheldin Mohamed,Monica Shandal,Elias Jabbour,Nino Lomtadze,Mmamapudi Kubjane,Anete Trajman,Gesine Meyer-Rath,Zaza Avaliani,Wesley Rotich,Daniel Mwai,Julio Croda,Hlengani T Mathema,Immaculate Kathure,Rhoda Pola,Fernanda Dockhorn Costa,Norbert O Ndjeka,Maka Danelia,Maiko L Tonini,Nelly Solomonia,Daniele M Pelissari,Dennis Falzon,Cecily Miller,Ines Garcia Baena,Nimalan Arinaminpathy,Kevin Schwartzman,Saskia Den Boon,Jonathon R Campbell","doi":"10.1016/s2214-109x(25)00321-3","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00321-3","url":null,"abstract":"BACKGROUNDClosing the tuberculosis diagnostic gap and scaling up tuberculosis preventive treatment (TPT) are two global priorities to end tuberculosis. We aimed to estimate the cost-effectiveness, budget impact, and societal return on investment of a comprehensive intervention to improve tuberculosis screening and prevention in Brazil, Georgia, Kenya, and South Africa-four distinct epidemiological settings.METHODSIn this modelling study, in partnership with national tuberculosis programmes we defined a set of interventions (the intervention package) related to tuberculosis screening and TPT in three priority populations: people with HIV, household contacts, and a country-defined high-risk population (people deprived of liberty [Brazil], people accessing care for injection drug use [Georgia], people in informal settlements in nine districts with a high prevalence of tuberculosis [Kenya], and people in the 22 subdistricts with the highest prevalence of tuberculosis [South Africa]). We developed transmission models calibrated to country-specific epidemiology and collated cost data for tuberculosis-related activities and patient costs in 2023 US dollars (US$). We compared the intervention package scaled up to reach all priority populations by 2030 to a status quo scenario based on projected tuberculosis epidemiology over a 27-year time horizon (Jan 1, 2024, to Dec 31, 2050); to delineate the impact of intervention components, we also evaluated the intervention package without TPT. Outcomes were health system and societal costs, number of tuberculosis episodes, tuberculosis deaths, and disability-adjusted life years (DALYs). We calculated the budget impact, health system cost per DALY averted, and societal return on the health system investment for each country. Outcomes were discounted at 3% per annum.FINDINGSWith the status quo scenario, by 2050, tuberculosis incidence is projected to be 41 per 100 000 population (95% uncertainty range 32-53) in Brazil, 45 per 100 000 population (36-60) in Georgia, 214 per 100 000 population (146-266) in Kenya, and 261 per 100 000 population (133-406) in South Africa. The percentage of all tuberculosis episodes prevented by implementing the intervention package in all priority populations is projected to be 15·0% (12·8-17·5) in Brazil, 14·3% (13·1-15·8) in Georgia, 21·3% (15·2-27·6) in Kenya, and 26·4% (21·1-31·8) in South Africa by 2050. If implemented without TPT (ie, tuberculosis disease screening alone), corresponding reductions were lower at 10·4% (8·6-12·2) in Brazil, 10·2% (9·5-11·2) in Georgia, 12·6% (9·5-15·9) in Kenya, and 16·8% (13·0-20·4) in South Africa. In 2030, the percentage of the national tuberculosis programme budget required for the intervention package was 62% in Brazil, 10% in Georgia, 67% in Kenya, and 44% South Africa. The incremental cost per DALY averted of the intervention package compared with the status quo in all priority populations is $386 in Brazil, $491 in Georgia, $53 in Kenya, and","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"65 1","pages":"e1857-e1868"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}