Lancet Global Health最新文献

{"title":"Evaluation of a decentralised model of care on case isolation and patient outcomes during the 2018-20 Ebola outbreak in the Democratic Republic of the Congo: a retrospective observational study.","authors":"Patrick M Barks, Anton Camacho, Trish Newport, Filipe Ribeiro, Steve Ahuka-Mundeke, Richard Kitenge, Justus Nsio, Rebecca M Coulborn, Emmanuel Grellety","doi":"10.1016/S2214-109X(25)00011-7","DOIUrl":"10.1016/S2214-109X(25)00011-7","url":null,"abstract":"<p><strong>Background: </strong>Partway into the 2018-20 Ebola outbreak in the Democratic Republic of the Congo (DR Congo), a new strategy of decentralised care was initiated to address delays in care seeking, improve community acceptance, and reduce the risk of Ebola virus disease (EVD) transmission through early case isolation. Unlike centralised EVD facilities (transit and treatment centres), which operated in parallel to the existing health-care system and focused exclusively on EVD, decentralised facilities were integrated into existing health-care structures with which communities were already familiar, and designed to continue providing health care for patients with other non-EVD illnesses. Here we aim to assess the strategy of decentralised care by comparing admission delays and patient outcomes among the three types of EVD facilities (decentralised, transit, and treatment).</p><p><strong>Methods: </strong>We performed a retrospective analysis of routinely collected data from all individuals admitted to EVD facilities (12 treatment, nine transit, and 21 decentralised facilities) at any point during the Ebola outbreak from July 27, 2018, to June 24, 2020 in DR Congo. We used multivariate mixed-effect regression to model admission delays (the number of days between symptom onset and admission to an EVD facility) and patient outcomes (survived or died), as functions of facility type at first admission and date of admission, while controlling for a variety of other covariates.</p><p><strong>Findings: </strong>Over the course of the outbreak 60 465 patients were admitted to EVD facilities, of which 2289 (3·8%) were confirmed to be EVD positive. Covariate-adjusted admission delays were somewhat higher among patients presenting to transit facilities (adjusted rate ratio 1·14 [95% CI 0·95-1·32]) or treatment facilities (1·18 [1·00-1·36]) compared with decentralised facilities. Similarly, compared with decentralised facilities, adjusted case-fatality risks were slightly higher among patients presenting to transit facilities (adjusted risk ratio 1·04 [0·82-1·26]) or treatment facilities (1·03 [0·82-1·24]).</p><p><strong>Interpretation: </strong>As was observed during the 2013-16 west Africa outbreak and the 2020 outbreak in the Equateur province of DR Congo, patients suspected of EVD that presented to decentralised facilities had modestly shorter admission delays than patients presenting to centralised facility types. Case-fatality risks were slightly lower among patients presenting to decentralised facilities; however, this finding was not statistically significant and so it is difficult to assess the generalisability.</p><p><strong>Funding: </strong>Médecins Sans Frontières.</p><p><strong>Translation: </strong>For the French translation of the abstract see Supplementary Materials section.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e931-e941"},"PeriodicalIF":19.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744106","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":"Effects and costs of a multi-component menstrual health intervention (MENISCUS) on mental health problems, educational performance, and menstrual health in Ugandan secondary schools: an open-label, school-based, cluster-randomised controlled trial.","authors":"Kate A Nelson,Stephen Lagony,Catherine Kansiime,Belen Torondel,Clare Tanton,Denis Ndekezi,Levicatus Mugenyi,Ratifah Batuusa,Christopher Baleke,Katherine A Thomas,Titus Ssesanga,Robert Bakanoma,Prossy Namirembe,Aggrey Tumuhimbise,Beatrice Nanyonga,Rodah Nambi,Edward Obicho,Denis Ssenyondwa,Daria Bucci,Sophie Belfield,Agnes Akech Ocen,Shamirah Nakalema,Connie Alezuyo,Fred Matovu,Stella Neema,Nambusi Kyegombe,Giulia Greco,John Jerrim,Chris Bonell,Janet A Seeley,Helen A Weiss","doi":"10.1016/s2214-109x(25)00007-5","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00007-5","url":null,"abstract":"BACKGROUNDMenstrual health is a human rights issue, affecting many aspects of life including mental health, wellbeing, and education. We assessed the effectiveness and costs of a school-based, multi-component menstrual health intervention (MENISCUS) to improve mental health problems and educational performance among in-school adolescents.METHODSWe conducted a parallel-arm, cluster-randomised trial in secondary schools in Wakiso and Kalungu districts in Uganda. Schools were eligible for inclusion if they had both male and female students; senior 1-4 classes; day or mixed day and boarding students; at least minimal water, sanitation, and hygiene (WASH) facilities; and enrolments of 50-125 female Senior 1 students in Wakiso district and 40-125 female Senior 1 students in Kalungu district. Schools were randomised (1:1) to the intervention or control condition, stratified by district and baseline mean school examination score. The intervention included creating action groups, strengthening teacher-delivered puberty education, distributing menstrual kits, supporting student-led drama skits, providing pain-management strategies, and improving school water and sanitation facilities. The control condition was provision of printed government menstrual health materials. Schools, participants, and implementors, including the study clinician who monitored adverse events, could not be masked to allocation status. Primary outcomes were mental health problems using the Strength and Difficulties Questionnaire (SDQ) Total Difficulties Score and independently assessed educational performance at individual level, assessed in all female participants at endline. We estimated cluster-intention-to-treat intervention effects using mixed-effects models accounting for school clustering and adjusted for randomisation strata and baseline school-level means of outcomes. The study was registered at the ISRCTN registry, ISRCTN45461276 and is completed.FINDINGS60 randomly selected schools (44 from Wakiso and 16 from Kalungu) were randomly assigned (30 per group) to the intervention or the control group, and none withdrew. Between March 21 and July 5, 2022, 3841 female students participated in baseline assessments (89·7% of those eligible) and between June 5 and Aug 22, 2023, 3356 participated in endline assessments (1666 in the control group and 1690 in the intervention group). Female participants had a median age of 16 years (IQR 15-16). At endline, there was no evidence of a difference in mental health problems (mean SDQ score, 10·8 in the intervention group vs 10·7 in the control group; adjusted mean difference [aMD] 0·05 [95% CI -0·40 to 0·50]) nor educational performance (mean z score, 0·20 in the intervention group vs 0·12 in the control group; aMD 0·05 [95% CI -0·10 to 0·19]), despite improvements to menstrual health. The annual implementation cost was US$85 per Senior 2 female student. One participant had a serious adverse event (severe anaemia secondary to excess vagina","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"19 1","pages":"e888-e899"},"PeriodicalIF":34.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885515","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":"Insufficient clinical diagnostic capacity results in blind-spots when prioritising country-specific health needs and evaluating effectiveness of health interventions.","authors":"Susan Meiring,Anne von Gottberg","doi":"10.1016/s2214-109x(25)00108-1","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00108-1","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"9 1","pages":"e781-e782"},"PeriodicalIF":34.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885505","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 impact of aid sanctions on maternal and child mortality, 1990-2019: a panel analysis.","authors":"Ruth M Gibson, Paul H Wise, Joseph L Dieleman, Yoto V Yotov, Aleksandra Kirilakha, Gary L Darmstadt, Eran Bendavid, Constantinos Syropoulos, Michele Barry, Sebastien Bradley","doi":"10.1016/S2214-109X(25)00058-0","DOIUrl":"10.1016/S2214-109X(25)00058-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Aid sanctions are a type of financial punishment imposed on a country by other countries or international organisations in response to a political coup, armed conflict, or human rights abuses. Humanitarian catastrophes in Burkina Faso, Sudan, and Myanmar have brought aid sanctions to the centre of the foreign affairs strategy debate because of their inadvertent negative effects on human health. Our analysis investigates the effects of aid sanctions from 1990 to 2019 on maternal and child mortality. These questions are particularly relevant in the context of the abrupt shift in US foreign aid policy in 2025, leading to aid prohibitions that might resemble aid sanctions in their effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were drawn from a broad set of sources, including population health metrics databases, established sanctions databases, and a novel global dataset on aid sanctions created for this study. We assessed the prevalence of the use of aid sanctions worldwide during 1990-2019 and estimated their impact on official development assistance (ODA) and development assistance for health (DAH). We investigated the effect of aid sanctions on infant (age &lt;1 year), children younger than 5 years (hereafter referred to as under-5), maternal (within 42 days of the end of pregnancy), and all-age mortality rates using panel difference-in-differences ordinary least squares estimation. We applied linear regression methods and included country and year fixed effects, country-specific time trends, and multiple control variables. We also conducted a series of sensitivity analyses, including entropy balancing, to confirm the validity of our results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;During our study period, 67 low-income or middle-income countries (LMICs) and sovereign territories (hereafter referred to as countries) were targeted by 88 unique aid sanction episodes. Relative to our control group of 66 never-sanctioned countries, aid sanctions reduced ODA by an estimated US$213·07 million per year (95% CI 502·28 to -76·12) for the average target country and reduced DAH by $16·42 million (32·57 to 0·27)--a 17% reduction in DAH. Aid sanctions resulted in an additional 129·3 infant deaths per 100 000 livebirths (11·7 to 246·9), an additional 47·1 under-5 deaths per 100 000 livebirths (-2·8 to 97·0), and an additional 10·9 (2·2-19·6) maternal deaths per 100 000 livebirths, per year. Relative to mean in-sample mortality rates, aid sanctions thus increased infant, under-5, and maternal mortality rates by 3·1%, 3·6%, and 6·4%, respectively, on an annual basis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;Over the period 1990-2019, infant, under-5, and maternal mortality rates among LMICs declined at average annualised rates of 2·6%, 3·2%, and 2·0%, respectively. Aid sanction episodes lasting 5 years-the median duration observed in our sample-would thus negate nearly 30% of the overall improvements in infant and under-5 mortality seen in the","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e820-e830"},"PeriodicalIF":19.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694190","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":"Infant-level and child-level predictors of mortality in low-resource settings: the WHO Child Mortality Risk Stratification Multi-Country Pooled Cohort.","authors":"","doi":"10.1016/S2214-109X(25)00045-2","DOIUrl":"https://doi.org/10.1016/S2214-109X(25)00045-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite impressive reductions in overall global child mortality, the rate of decline has slowed during the past decade. Current guidelines for the care of paediatric patients in low-resource settings mostly focus on broad clinical syndromes or undernutrition rather than children's individual contextualised risk. We aimed to identify readily assessable child-level characteristics that can predict mortality risk in a range of community and health-care settings in high-burden settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The WHO Child Mortality Risk Stratification Multi-Country Pooled Cohort (WHO-CMRS) included pooled data from individual children enrolled in observational or randomised controlled trials in low-income and middle-income countries. The criteria for inclusion of a dataset were documentation of age, weight, vital status, and date of death, and at least two observations per participant younger than 60 months. To calculate odds ratios, we built generalised linear mixed effects regression (glmer) models with each child and each study as random intercepts and time interval as the offset. In all analyses, the outcome was defined as death within the respective observation period of the child. From the glmer models, we predicted absolute risk of death per child-month associated with risk exposures separately and combined with anthropometry according to the following age groups: 0-5 months, 6-11 months, 12-23 months, and 24-59 months. Studies were grouped according to population types studied: the general population, populations selected based on anthropometric criteria, and populations selected based on the presence of illness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;We analysed pooled data from WHO-CMRS, including 75 287 children from 33 studies done in 17 countries between Jan 1, 2001, and Dec 31, 2021. During a total of 69 085 child-years of follow-up, 2805 (3·7%) children died. Age younger than 24 months, low anthropometry, preterm birth, low birthweight, and absence of breastfeeding (either was breastfeeding not offered or an underlying illness interfered with breastfeeding practices) were each associated with increased mortality: risks declined with increasing age. The highest absolute mortality risk was among the youngest children (age 0-5 months), with a weight-for-age Z score of less than -3 (ie, a predicted absolute risk of 11·0 [95% CI 6·2-19·5] per 1000 child-months in general population studies). Risks were additive: underlying risk exposures such as low birthweight and preterm birth added to the mortality risks in children with anthropometric deficit. For example, children aged 0-5 months with a weight-for-age Z score of less than -3 and a history of preterm birth had a predicted absolute mortality risk of 40·1 (95% CI 22·0-72·1). However, overall mortality and the association between child-level characteristics and mortality differed according to the type of study population and child age.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Inte","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 5","pages":"e843-e858"},"PeriodicalIF":19.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043929","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":"Every baby counts: eliminating all preventable child deaths.","authors":"Elizabeth M McClure,Sarah Saleem","doi":"10.1016/s2214-109x(25)00140-8","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00140-8","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"222 1","pages":"e779-e780"},"PeriodicalIF":34.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885503","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":"Correction to Lancet Glob Health 2025; 13: e309-18.","authors":"","doi":"10.1016/s2214-109x(25)00117-2","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00117-2","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"34 1","pages":"e807"},"PeriodicalIF":34.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885513","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":"Improving mental health with more equitable surveillance data.","authors":"Corina Benjet","doi":"10.1016/s2214-109x(25)00052-x","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00052-x","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"222 1","pages":"e785-e786"},"PeriodicalIF":34.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885543","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":"A roadmap for integrating nutritional assessment, counselling, and support into the care of people with tuberculosis.","authors":"Pranay Sinha, Madhavi Bhargava, Madeline E Carwile, Madolyn R Dauphinais, Phumeza Tisile, Chelsie Cintron, Lindsey M Locks, Janika Hauser, Matt Oliver, Scott K Heysell, Saurabh Mehta, Julia L Finkelstein, Kobto G Koura, J Peter Cegielski, Rein M G J Houben, C Finn McQuaid, Anurag Bhargava","doi":"10.1016/S2214-109X(25)00021-X","DOIUrl":"10.1016/S2214-109X(25)00021-X","url":null,"abstract":"<p><p>Undernutrition-the leading risk factor for tuberculosis worldwide-is associated with impaired immunity, more extensive disease, delayed sputum conversion, and worse treatment outcomes, including mortality. In this Health Policy, we propose a comprehensive roadmap for integrating nutritional assessment, counselling, and support into tuberculosis treatment as part of person-centred care. At treatment initiation, we recommend standard nutritional assessment with anthropometric measurements and haemoglobin estimation, in addition to macronutrient and micronutrient support alongside nutritional counselling. Weight should be monitored during treatment and lack of weight gain at the end of the intensive phase should prompt an investigation of causes, such as food insecurity, poor treatment adherence, malabsorption, uncontrolled diabetes, or drug resistance. At the end of treatment, we recommend reassessing anthropometric measures to assess nutritional recovery. People with tuberculosis who remain underweight should receive close follow-up to detect early relapse. We call for annual reporting of nutritional metrics by WHO, explicit inclusion of nutritional assessment and care in national strategic plans, domestic or international support of nutritional programmes for people with tuberculosis, increased support for operational research initiatives, and integration of nutritional care into the WHO Multisectoral Accountability Framework at national and regional levels.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e967-e973"},"PeriodicalIF":19.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694188","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":"Incidence rates of malaria, meningitis, and mortality in children younger than 5 years: a prospective cohort study in Ghana and Kenya before the roll-out of the RTS,S/AS01E malaria vaccine from 2016 to 2022.","authors":"Kwaku Poku Asante,Marie-Cécile Bozonnat,Miloje Savic,Seth Owusu-Agyei,Seyram Kaali,Walter Otieno,Owusu Boahen,Mathilda Tivura,Lucas Otieno,Prince Darko Agyapong,Patrick Odum Ansah,Valentine Sing'oei,Janet Oyieko,Elisha Adeniji,Nana Akosua Ansah,Samuel Bernard Ekow Harrison,Esther Oguk,David Dosoo,Lode Schuerman,Michael Bandasua Kaburise,Dennis Azabra Awuni,Kingsley Kayan,Cristina Cravcenco,François Roman,Valérie Haine","doi":"10.1016/s2214-109x(25)00022-1","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00022-1","url":null,"abstract":"BACKGROUNDThe RTS,S/AS01E malaria vaccine was introduced in selected communities of Ghana, Kenya, and Malawi in 2019 under a WHO-coordinated pilot programme. The scarcity of background disease incidence rates might hamper the assessment of vaccine safety and effectiveness. We aimed to determine the incidence rates of malaria, meningitis, and death, and health outcomes leading to hospital admission in children younger than 5 years enrolled before RTS,S/AS01E implementation. Interim results from EPI-MAL-002 up to Oct 5, 2018, were reported previously. Here, we report results from the final analysis of the pre-vaccine introduction study.METHODSThis disease surveillance study combined two approaches: (1) prospective cohort event monitoring (home visits scheduled to mimic a future four-dose RTS,S/AS01E vaccination schedule [ie, a simulated vaccination schedule], with additional visits after the simulated schedule and continuous disease monitoring of outpatient visits and hospital admission) in children enrolled in two age groups (6-12 weeks [6-12W] and 5-17 months [5-17M]), and (2) hospital-based disease surveillance for children not enrolled in the prospective cohort, in three sites in Ghana and Kenya. Key outcomes were rates of meningitis, malaria, adverse events of special interest, other adverse events leading to hospital admission, all-cause mortality, and malaria-attributable mortality.FINDINGSThe final analysis included 23 427 children: 9032 in the 6-12W age group, 9694 in the 5-17M age group, and 4701 in hospital-based disease surveillance. In the 5-17M age group (corresponding to the WHO-recommended age for RTS,S/AS01E vaccination), the incidence rates of meningitis and cerebral malaria within an at-risk period of 1 year after the simulated vaccination schedule were both equal to 28 (95% CI 9-65) per 100 000 person-years. There were 11 (0·1%) children with an adverse event of special interest during hospital admission. In the 5-17M age group, the all-cause mortality rate was 643 (95% CI 531-771) per 100 000 person-years.INTERPRETATIONObserved incidence of meningitis and cerebral malaria were in the previously published range, whereas childhood mortality was lower, suggesting that the recent efforts to reduce mortality in children younger than 5 years have been impactful. Data from this study have public health use and will form the baseline evidence for ongoing evaluation of the benefit-risk of RTS,S/AS01E.FUNDINGGSK and PATH.","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"1 1","pages":"e859-e869"},"PeriodicalIF":34.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885516","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}