Lancet Global Health最新文献

{"title":"Maternal near misses: need for solid metrics and estimates.","authors":"Kapila Jayaratne,Dulani Samaranayake","doi":"10.1016/s2214-109x(24)00368-1","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00368-1","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"12 1","pages":"e1738-e1739"},"PeriodicalIF":34.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451468","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 effect of intensive praziquantel administration on vaccine-specific responses among schoolchildren in Ugandan schistosomiasis-endemic islands (POPVAC A): an open-label, randomised controlled trial.","authors":"Gyaviira Nkurunungi,Jacent Nassuuna,Agnes Natukunda,Ludoviko Zirimenya,Bridgious Walusimbi,Christopher Zziwa,Caroline Ninsiima,Joyce Kabagenyi,Prossy N Kabuubi,Govert J van Dam,Paul L A M Corstjens,John Kayiwa,Moses Kizza,Alex Mutebe,Esther Nakazibwe,Florence A Akello,Moses Sewankambo,Samuel Kiwanuka,Stephen Cose,Anne Wajja,Pontiano Kaleebu,Emily L Webb,Alison M Elliott,","doi":"10.1016/s2214-109x(24)00280-8","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00280-8","url":null,"abstract":"BACKGROUNDVaccine responses differ between populations and are often impaired in rural and low-income settings. The reasons for this are not fully understood, but observational data suggest that the immunomodulating effects of parasitic helminths might contribute. We hypothesised that Schistosoma mansoni infection suppresses responses to unrelated vaccines, and that suppression could be reversed-at least in part-by intensive praziquantel administration.METHODSWe conducted an open-label, randomised controlled trial of intensive versus standard intervention against S mansoni among schoolchildren aged 9-17 years from eight primary schools in Koome islands, Uganda. Children were randomly allocated to either an intensive group or a standard group with a computer-generated 1:1 randomisation using permuted blocks sizes 4, 6, 8, and 10. Participants in the intensive group received three praziquantel doses (approximately 40 mg/kg) 2 weeks apart before first vaccination at week 0, and every 3 months thereafter. Participants in the standard group were given one dose of approximately 40 mg/kg praziquantel after the week 8 primary endpoint. Participants in both groups received the BCG vaccine (Serum Institute of India, Pune, India) at week 0; the yellow fever (Sanofi Pasteur, Lyon, France), oral typhoid (PaxVax, London, UK), and first human papillomavirus (HPV) vaccination (Merck, Rahway, NJ, USA) at week 4; and the HPV booster and tetanus-diphtheria vaccine (Serum Institute of India) at week 28. The primary outcome was vaccine response at week 8 (except for tetanus and diphtheria, which was assessed at week 52). The primary analysis population was participants who were infected with S mansoni at baseline, determined retrospectively using either plasma circulating anodic antigen (CAA) or stool PCR. The safety population comprised all randomly allocated participants. The trial was registered at the ISRCTN Registry (ISRCTN60517191) and is complete.FINDINGSBetween July 9 and Aug 14, 2019, we enrolled 478 participants, with 239 children per group. 276 (58%) participants were male and 202 (42%) participants were female. Among participants who were positive for S mansoni at baseline (171 [72%] in the intensive group and 164 [69%] in the standard group) intensive praziquantel administration significantly reduced pre-vaccination infection intensity (to median 30 CAA pg/mL [IQR 7-223] vs 1317 [243-8562], p<0·001) compared with standard treatment. Intensive praziquantel administration also reduced week 8 HPV-16-specific IgG response (geometric mean ratio 0·71 [95% CI 0·54-0·94], p=0·017), but had no effect on other primary outcomes. Among all participants (regardless of S mansoni status at baseline) intensive praziquantel administration significantly improved week 8 BCG-specific IFNγ ELISpot response (1·20 [1·01-1·43], p=0·038). Recognised adverse effects of praziquantel were reported more frequently in the intensive group. There were no recorded serious adverse events","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"103 1","pages":"e1826-e1837"},"PeriodicalIF":34.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451445","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 loop-mediated isothermal amplification test for yaws: a multi-country diagnostic accuracy evaluation.","authors":"Becca L Handley,Camila González-Beiras,Serges Tchatchouang,Kouadio Aboh Hugues,Laud Antony Basing,Aboubacar Sylla,Mireille S Kouamé-Sina,Ivy Amanor,Philippe Ndzomo,Axel Aloumba,Mohammed Bakheit,Claudia Müller,Nadine Borst,Emelie Landmann,Helena Gmoser,Tamara Härpfer,Lisa Becherer,Simone Lüert,Sieghard Frischmann,Sarah Burl,Earnest Njih Tabah,Tania Crucitti,Adingra Tano Kouadio,Daniel Kojo Arhinful,Patrick Awondo,Solange Ngazoa Kakou,Sara Eyangoh,Kennedy Kwasi Addo,Sascha Knauf,Oriol Mitjà,Emma Michèle Harding-Esch,Michael Marks","doi":"10.1016/s2214-109x(24)00324-3","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00324-3","url":null,"abstract":"BACKGROUNDTo meet the WHO target of eradicating yaws by 2030, highly sensitive and specific diagnostic tools are needed. A multiplex Treponema pallidum-Haemophilus ducreyi loop-mediated isothermal amplification (TPHD-LAMP) test holds promise as a near-patient diagnostic tool for yaws and H ducreyi. We conducted a prospective evaluation in Cameroon, Côte d'Ivoire, Ghana, and the Republic of the Congo to determine the diagnostic accuracy of the TPHD-LAMP test, as well as to assess its acceptability, feasibility, and cost.METHODSActive case searching within schools and communities was used to locate participants with clinically suspicious laws-like lesions. Individuals with serologically confirmed active yaws provided paired lesion swabs between March, 2021, and April, 2023. For each participant, one swab was tested with the TPHD-LAMP at a local district laboratory and the other with reference quantitative PCR (qPCR) tests conducted at national reference laboratories. The primary outcome was TPHD-LAMP test sensitivity and specificity compared with qPCR. Laboratory technicians were interviewed using a multiple-choice survey to gauge acceptability and feasibility of the TPHD-LAMP test. Costs of each test were calculated.FINDINGSOf 3085 individuals with at least one suspected yaws lesion, 531 (17%) were serologically confirmed. We enrolled 493 participants with seropositive yaws and a further 32 with negative serology. The sensitivity of the TPHD-LAMP test for detecting T pallidum was 63% (95% CI 56-70) and the specificity was 66% (95% CI 61-71). Sensitivity and specificity for T pallidum improved to 73% (63-82; p=0·0065) and 75% (68-80; p=0·0003), respectively, in H ducreyi-negative samples. Interviews highlighted challenges in user-friendliness and practicality of the TPHD-LAMP test. The cost of the test per sample was one third of that of qPCR, although the TPHD-LAMP test entailed higher costs to establish the assay.INTERPRETATIONThis was the first multi-country diagnostic evaluation of a molecular test for yaws. The TPHD-LAMP testing, in its current form, falls short of the WHO target product profile criteria for yaws diagnostics. These findings highlight the importance of assessing new diagnostics in real-world conditions to ensure their suitability for programmatic use.FUNDINGThe EDCTP2 programme supported by the EU.","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"6 1","pages":"e1891-e1898"},"PeriodicalIF":34.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451456","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":"Accelerating the evidence for built environment health interventions.","authors":"Amanda Alderton","doi":"10.1016/S2214-109X(24)00337-1","DOIUrl":"10.1016/S2214-109X(24)00337-1","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e1742-e1743"},"PeriodicalIF":19.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356538","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":"Optimism in the tobacco endgame.","authors":"Alain Braillon, Adam Edward Lang","doi":"10.1016/S2214-109X(24)00360-7","DOIUrl":"10.1016/S2214-109X(24)00360-7","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e1761"},"PeriodicalIF":19.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299134","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 2024; 12: e1794-806.","authors":"","doi":"10.1016/s2214-109x(24)00426-1","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00426-1","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"26 1","pages":"e1763"},"PeriodicalIF":34.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451463","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":"Hepatitis E vaccination: continued benefit for pregnant women in vulnerable settings.","authors":"Melanie Marti, Kristine Macartney, Rebecca F Grais, Rakesh Aggarwal","doi":"10.1016/S2214-109X(24)00290-0","DOIUrl":"10.1016/S2214-109X(24)00290-0","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e1758"},"PeriodicalIF":19.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735440","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 cause of nodding syndrome remains unknown.","authors":"Arthur W D Edridge, Michael Boele van Hensbroek","doi":"10.1016/S2214-109X(24)00365-6","DOIUrl":"10.1016/S2214-109X(24)00365-6","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e1756"},"PeriodicalIF":19.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356542","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":"Assessing the built environment through photographs and its association with obesity in 21 countries: the PURE Study.","authors":"Daniel J Corsi, Simone Marschner, Scott Lear, Perry Hystad, Annika Rosengren, Rosnah Ismail, Karen Yeates, Sumathi Swaminathan, Thandi Puoane, Chuangshi Wang, Yang Li, Sumathy Rangarajan, Iolanthé M Kruger, Jephat Chifamba, K Vidhu Kumar, Indu Mohan, Kairat Davletov, Galina Artamonov, Lia M Palileo-Villanueva, Nafiza Mat-Nasir, Katarzyna Zatonska, Aytekin Oguz, Ahmad Bahonar, Khalid F Alhabib, Afzalhussein Yusufali, Patricio Lopez-Jaramillo, Fernando Lanas, Agustina Galatte, Álvaro Avezum, Martin Mckee, Salim Yusuf, Clara K Chow","doi":"10.1016/S2214-109X(24)00287-0","DOIUrl":"10.1016/S2214-109X(24)00287-0","url":null,"abstract":"<p><strong>Background: </strong>The built environment can influence human health, but the available evidence is modest and almost entirely from urban communities in high-income countries. Here we aimed to analyse built environment characteristics and their associations with obesity in urban and rural communities in 21 countries at different development levels participating in the Prospective Urban and Rural Epidemiology (PURE) Study.</p><p><strong>Methods: </strong>Photographs were acquired with a standardised approach. We used the previously validated Environmental Profile of a Community's Health photo instrument to evaluate photos for safety, walkability, neighbourhood beautification, and community disorder. An integrated built environment score (ie, a minimum of 0 and a maximum of 20) was used to summarise this evaluation across built environment domains. Associations between built environment characteristics, separately and combined in the integrated built environment score, and obesity (ie, a BMI >30kg/m<sup>2</sup>) were assessed using multilevel regression models, adjusting for individual, household, and community confounding factors. Attenuation in the associations due to walking was examined.</p><p><strong>Findings: </strong>Analyses include 143 338 participants from 530 communities. The mean integrated built environment score was higher in high-income countries (13·3, SD 2·8) compared with other regions (10·1, 2·5) and urban communities (11·2, 3·0). More than 60% of high-income country communities had pedestrian safety features (eg, crosswalks, sidewalks, and traffic signals). Urban communities outside high-income countries had higher rates of sidewalks (176 [84%] of 209) than rural communities (59 [28%] of 209). 15 (5%) of 290 urban communities had bike lanes. Litter and graffiti were present in 372 (70%) of 530 communities, and poorly maintained buildings were present in 103 (19%) of 530. The integrated built environment score was significantly associated with reduced obesity overall (relative risk [RR] 0·58, 95% CI 0·35-0·93; p=0·025) for high compared with low scores and for increasing trend (0·85, 0·78-0·91; p<0·0001). The trends were statistically significant in urban (0·85, 0·77-0·93; p=0·0007) and rural (0·87, 0·78-0·97; p=0·015) communities. Some built environment features were associated with a lower prevalence of obesity: community beautification RR 0·75 (95% CI 0·61-0·92; p=0·0066); bike lanes RR 0·58 (0·45-0·73; p<0·0001); pedestrian safety RR 0·75 (0·62-0·90; p=0·0018); and traffic signals RR 0·68 (0·52-0·89; p=0·0055). Community disorder was associated with a higher prevalence of obesity (RR 1·48, 95% CI 1·17-1·86; p=0·0010).</p><p><strong>Interpretation: </strong>Community built environment features recorded in photographs, including bike lanes, pedestrian safety measures, beautification, traffic density, and disorder, were related to obesity after adjusting for confounders, and stronger associations were found in urban ","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e1794-e1806"},"PeriodicalIF":19.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machines matter too: including biomedical engineering partnerships in global health initiatives.","authors":"Tolulope Kehinde,Jesse Biwott,Gregory Sund,J Matthew Kynes","doi":"10.1016/s2214-109x(24)00294-8","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00294-8","url":null,"abstract":"As the global burden of disease shifts from communicable to non-communicable diseases and trauma-related debility, the global health-care community has increasingly advocated for equitable access to surgical services. Much of this attention has focused on bolstering clinical and research expertise through the expansion of clinical training programmes and research resources. However, despite the crucial role of equipment, including medical devices, in safe clinical care, comparatively little attention has been paid to sustainably bridging the biomedical and technical gaps that exist in global health. Although closing these gaps with locally driven solutions is the goal, the reality in many settings is that partnerships between institutions in high-income countries and low-income and middle-income countries currently remain necessary. Thus, this Viewpoint provides guidelines conscious to biomedical engineering for institutions looking to expand or begin global health initiatives with the Partners In Health Five S's-staff, stuff, space, systems, and social support-framework for health systems strengthening as a guide. We focus first on initiatives involving staff, stuff, and space, encouraging institutions to ask, listen, and enable, through a set of questions and actionable recommendations. Then, we urge institutions to strengthen systems and social support, underscoring the need for wider societal scaffolding to support and sustain initiatives beyond initial efforts.","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"64 1","pages":"e1905-e1909"},"PeriodicalIF":34.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451454","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}