Lancet Global Health最新文献

{"title":"Global health and its crises: laugh, but then what?","authors":"Pablo Villalobos Dintrans, Paola Abril Campos, Adolfo Rubinstein","doi":"10.1016/j.langlo.2026.104048","DOIUrl":"10.1016/j.langlo.2026.104048","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"104048"},"PeriodicalIF":22.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814618","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":"Hypoxaemia and mortality in children with lower respiratory infection in low-income and middle-income countries: systematic review and meta-analysis.","authors":"Nadia E Hoekstra, Kristen S Joseph, Holly B Schuh, Laura Ruegsegger, Claire Twose, Tim Colbourn, Shubhada Hooli, William Checkley, Carina King, Stephen Rc Howie, Hamish R Graham, Marzia Lazzerini, Tisungane Mvalo, Heather J Zar, Eric D McCollum","doi":"10.1016/j.langlo.2026.104031","DOIUrl":"10.1016/j.langlo.2026.104031","url":null,"abstract":"<p><strong>Background: </strong>Hypoxaemic lower respiratory infections (LRIs) are a leading cause of childhood mortality, with the highest burden in low-income and middle-income countries (LMICs). Hypoxaemia-low peripheral capillary oxyhaemoglobin saturation (SpO<sub>2</sub>)-is a marker of severity, and WHO recommends hospitalisation and oxygen administration for patients with SpO<sub>2</sub> <90%. We aimed to update estimates from a 2015 systematic review and meta-analysis examining the association between hypoxaemia and mortality among children with LRIs in LMICs by incorporating studies published over the subsequent decade and evaluating mortality risk across multiple SpO<sub>2</sub> thresholds.</p><p><strong>Methods: </strong>We conducted a systematic review with meta-analysis by searching PubMed, Embase, LILACS, Global Index Medicus, Web of Science, and Scopus for peer-reviewed studies published between Jan 1, 2015, and June 18, 2025, with combined terms related to pneumonia, children, mortality, and LMICs. We also included selected earlier studies through citation checking. Eligible studies reported associations between hypoxaemia and mortality in children younger than 5 years with LRIs in LMICs. We excluded case reports and case series with fewer than five deaths, studies focused exclusively on the neonatal period, and those limited to children with specific comorbidities or to postoperative patients, for consistency with the original review. Two reviewers independently screened studies, extracted data, and assessed quality. Eligible studies were combined with those from the original review and analysed using random-effects models to estimate odds ratios (ORs) by hypoxaemia threshold subgroup. The protocol was registered on PROSPERO (CRD42023433946).</p><p><strong>Findings: </strong>We identified 7734 records; 26 new studies met inclusion criteria and were combined with 18 from the original review. The 44 studies were published between 1993 and 2024 and were primarily from Africa (25 [57%] of 44) or Asia (19 [43%]); some studies spanned multiple locations. Data from 33 studies including 155 633 participants were included in the primary meta-analysis. Hypoxaemia of any threshold was associated with higher odds of LRI mortality (OR 4·36 [95% CI 3·52-5·39]) compared with no hypoxaemia. For SpO<sub>2</sub> <90% versus 90-100%, OR for death was 4·75 (95% CI 3·42-6·58). For SpO<sub>2</sub> 90-94% versus 95-100%, mortality risk was more than twice as high (OR 2·27 [95% CI 1·22-4·25]). Heterogeneity was substantial (I<sup>2</sup> 64-85% across analyses), and eight (24%) of 33 studies in the primary meta-analysis had a high overall risk of bias; however, a sensitivity analysis restricted to studies with low or moderate risk of bias yielded similar results.</p><p><strong>Interpretation: </strong>SpO<sub>2</sub> <90% strongly predicts mortality in children with LRIs in LMICs. Children with SpO<sub>2</sub> 90-94% also have elevated risk, suggesting ","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"104031"},"PeriodicalIF":22.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876138","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":"Long-term mortality and risk of chronic kidney disease in children following severe malaria complicated by acute kidney injury: a prospective observational study.","authors":"Kagan A Mellencamp, Ruth Namazzi, Anthony Batte, Caroline Kazinga, Claire D Liepmann, Michael J Goings, Robert O Opoka, Dibyadyuti Datta, Jie Ren, Robert Kalyesubula, Paul Bangirana, Stuart L Goldstein, Chandy C John, Andrea L Conroy","doi":"10.1016/j.langlo.2026.103984","DOIUrl":"10.1016/j.langlo.2026.103984","url":null,"abstract":"<p><strong>Background: </strong>Paediatric acute kidney injury (AKI) is a complication of severe malaria, but its long-term outcomes remain poorly defined in low-income and middle-income countries. We aimed to evaluate the long-term association between paediatric AKI and kidney outcomes and mortality following severe malaria.</p><p><strong>Methods: </strong>We pooled data from two prospective cohorts of Ugandan children (ie, those aged 6 months-12 years) admitted to hospital with severe malaria between 2008 and 2017. Children with stored admission blood samples available for creatinine measurement were included in the analysis. Surviving participants were enrolled in a follow-up study conducted from 2020 to 2023, when kidney function and survival were assessed, using Cox regression with age as the timescale to model mortality risk. Logistic regression was used to estimate the odds of chronic kidney disease (CKD), defined as two or more consecutive low estimated glomerular filtration rates 90 days or more apart, and long-term major adverse kidney events, defined as CKD or death. Adjusted analyses included the following enrolment characteristics: age, sex, height-for-age Z score, study site, study cohort, severe malaria group (ie, cerebral malaria, severe malarial anaemia, respiratory distress, complicated seizures, or prostration), and HIV status.</p><p><strong>Findings: </strong>At enrolment, the median age was 2·5 years (IQR 1·8-3·5), 622 (57·8%) of 1077 were male and 455 (42·2%) were female, with Kidney Disease: Improving Global Outcomes-defined AKI occurring in 431 (40·0%) children. Over a median of 6·5 years (3·7-8·8), 147 (13·6%) of children died, with nearly half of deaths (71 of 147) occurring after hospital discharge. Adjusted odds of long-term major adverse kidney events were higher among children with AKI (adjusted odds ratio [aOR] 3·14, 95% CI 2·23-4·43), driven by a higher mortality risk (adjusted hazard ratio [aHR] 3·36, 95% CI 2·22-5·10) that remained elevated beyond 2 years after the acute episode (aHR 4·53, 1·80-11·37). AKI survivors had higher odds of chronic kidney disease over follow-up (odds ratio 1·77, 1·07-2·93), although not significant after adjustment (aOR 1·47, 95% CI 0·84-2·56; p=0·18).</p><p><strong>Interpretation: </strong>In this paediatric population, AKI was associated with excess long-term mortality, suggesting AKI is a sentinel event that marks sustained vulnerability to death and highlights limitations of acute-care models in malaria-endemic settings.</p><p><strong>Funding: </strong>The US National Institute of Neurological Disorders and Stroke, the Fogarty International Center, the US National Institutes of Allergy and Infectious Diseases, and a Ralph W and Grace M Showalter Young Investigator Award.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103984"},"PeriodicalIF":22.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708222","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":"Disability, conflict, and emergencies: 17 years on.","authors":"Aseel Hamid, Katrina Scior, Maria Kett","doi":"10.1016/j.langlo.2026.104063","DOIUrl":"10.1016/j.langlo.2026.104063","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"104063"},"PeriodicalIF":22.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714051","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":"Large reductions in HIV services for key populations in sub-Saharan Africa","authors":"Suzue Saito,Mansoor Farahani","doi":"10.1016/j.langlo.2026.104098","DOIUrl":"https://doi.org/10.1016/j.langlo.2026.104098","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"17 1","pages":"104098"},"PeriodicalIF":34.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088070","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":"Symptom-agnostic endpoints in tuberculosis vaccine efficacy trials","authors":"Morten Ruhwald,Alemnew F Dagnew,Gavin Churchyard,Adam Penn-Nicholson,Puneet Dewan,Alberto L Garcia-Basteiro,Emily B Wong,Willem A Hanekom,Mark Hatherill,Reinout van Crevel,Saskia den Boon,Patricia Hall-Eidson,Rein M G J Houben,Ann M Ginsberg,Frank Cobelens,Katherine C Horton,Richard G White","doi":"10.1016/j.langlo.2026.104079","DOIUrl":"https://doi.org/10.1016/j.langlo.2026.104079","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"11 1","pages":"104079"},"PeriodicalIF":34.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088071","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 burden and long-term outcomes of diagnosed and underdiagnosed COPD across diverse communities from high-income, middle-income, and low-income countries: the Prospective Urban Rural Epidemiology (PURE) study","authors":"MyLinh Duong,Ente Kang,Sumathy Rangarajan,Shameena Ramacham Parambath,Annika Rosengren,Sanjeev Nair,Fernando Lanas,Xuedi Ma,Zhiguang Liu,Lap Ah Tse,Prem K Mony,Hassan Mir,Marc Evans M Abat,P V M Lakshmi,Khalid F Alhabib,Batyrbek Assembekov,Alvaro Avezum,Ahmad Bahonar,Olga Barbarash,Jephat Chifamba,Maria Luz Diaz,Mirrakhimov Erkin,Camilo Felix,Romaina Iqbal,Rasha Khatib,Patricio Lopez-Jaramillo,Nafisa Mat-Nasir,Aytekin Oguz,Elisabeth Catherina Swart,Karen Yeates,Rita Yusuf,Afzalhussein Yusufali,Katarzyna Zatońska,Koon K Teo,Salim Yusuf,Maria L Diaz,Agustina Galatte,Maria Sol Hererra Mauricio Salvador,Mohammad O Rahman,Rita Yusuf,Syed AKS Ahmed,Afreen Z Khan,Nazratun Nayeem,S N Mitra,Shahidul Islam,Fuad Pasha,A Avezum,P Neves,R Nunes,AHK Triboni,LO Santos,ERP Sousa,LFA Silva,Gustavo BF Oliveira,Koon Teo,Aaron Donst,Gene Lim,Belise Bideri,Ben Connolly,MaryAnne Di Marino,Sara Copeland,Marie-Ève Piché,Paul Poirier,Ginette Turbide,Anne Sophie Bourlaud,Audrey Auclair,Myriam Pettigrew,Scott A Lear,Rochelle A Nocos,Sydney K Li,Andreas Wielgosz,Thais Coutinho,Karen N Suarez,Sam J Abbott-Tate,Fernando Lanas,Pamela Serón,María J Oliveros,Fairuz Cazor,Yazmin Palacios,Jessica Hidalgo,Camilo Acosta,Liu Lisheng,Li Wei,Hu Bo,Yin Lu,Zhu Jun,Liang Yan,Sun Yi,Wang Yang,Deng Qing,Wang Xingyu,Cheng Xiaoru,Wang Chuangshi,Li Sidong,Liu Weida,Lang Xinyue,Liu Zhiguang,LA Tse Shelly,Han Guoliang,Lu Fanghong,Hou Yan,Liao Xiaoyang,Chen Di,Zhang Peng,Li Ning,Lei Rensheng,Fu Minfan,Liu Yu,Xing Xiaojie,Yang Youzhu,Xiang Quanyong,Tang Jinhua,Liu Zhengrong,Qiang Deren,Han Aiying,Yang Jinkui,Wu Xinbin,Liu Chunmei,He Guomin,Zhao Qian,Resalaiti Aobulikasimu,Wang Hui,Zhi Yahong,Wang Yali,Ma Haibin,Ma Yuanting,Hu Lihua,Zhang Li,Liu Guoqing,Wang Junying,Jin Hui,You Kai,Peng Tao,Su Jing,Zhao Yingxin,Patricio Lopez-Jaramillo,Paul Anthony Camacho,Maritza Perez-Mayorga,Johanna Otero-Wandurraga,Carlos Cure-Cure,Jose Luis Accini,Edgar Arcos,Caludia Narvaez,Aristides Sotomayoy,Henry Garcia,Gregorio Sanchez-Vallejo,Fresia Cotes,Jose Patricio Jopez-Lopez,Darly Espinosa,Maria Angelica Muñoz,Olga Lucia Bello,Maria L Chacon-Manosalva,Julieth Tatiana Vasquez-Arcila,Prem K Mony,Mario Vaz,Sumathi Swaminathan,Ankalmadagu V Bharathi,Kiruba Shankar,Anura V Kurpad,Krishnaswamy G Jayachitra,Raju Anthony,Karamala Murali,Chengi Balaji,Krishnappa Amaranadh,Ponnuswamy Vijayalakshmi,Siddaraju Monisha,Siddayana S Harshitha,Subramani Kiruba,Sirana Sandhya,Mittoor Wooha,Nitesh Kumar,Viswanathan Mohan,Ranjit Mohan Anjana,Mohan Deepa,Kumar Parthiban,Lakshmanan Dhanasekaran,Sundaram Sureshkumar,Manivel Nandhakumar,Munusamy Kumar,Doss Kalaivani,Elumalai Karthick,Narendra Sai Ajith,Rajeev Gupta,Indu Mohan,Rooma Bhargava,Madhusudan Sharma,Devendra Sharma,Raman Kutty Velappallil,Vijayakumar Krishnapillai,Sanjeev Nair,Kamala Rammohan,Manu Muraleedharan Sarojini,Arunlal Anitha Rajappan Nair,Veena Veena,Divya Santhakumari,Sucharitha Kamalam,Jith Sreerangan,Rajesh Kumar,Manmeet Kaur,Pinnaka Venkata Maha Lakshmi,Vivek Sagar,Rupali Mahajan,Rupinder Singh,Kamaljeet Singh,Kamaldev Sharma,Babita Chauhan,Kamaldeep Singh,Roya Kelishadi,Ahmad Bahonar,Noushin Mohammadifard,Hossein Heidari,Kairat Davletov,Batyrbek Assembekov,Bauyrzhan Amirov,Erkin Mirrakhimov,Saamay Abilova,Umid Zakirov,Ulan Toktomamatov,Erkaiym Bektasheva,Azamat Asanbaev,Nursultan Asanaliev,Rysbek Mamat uulu,Nafiza Mat-Nasir,Khalid Yusoff,Tengku Saifuddin Tengku Ismail,Kien Keat Ng,Ambigga Devi Devi,Anis Safura Ramli,Norashikin Mohamed Nor-Ashikin,Razif Dasiman,Yasin Md Mazapuspavina,Farnaza Ariffin,Maizatullifah Miskan,Hasidah Abdul-Hamid,Suraya Abdul-Razak,Nik Munirah Nik Mohd-Nasir,Siti Fatimah Badlishah-Sham,Mohamed Syarif Mohamed-Yassin,Fadhlina Majid,Najmin Abu Bakar,Nurhaliza Zainon,Rasyidah Salleh,Nurshamin Mohd Ghazali,Mardhiah Baharom,Hazimah Zulkifli,Rafezah Razali,Sarina Ali,Boon Peng Hoh,Rosnah Ismail,Noorhassim Ismail,Mohd Hasni Jaafar,Azmi Mohd Tamil,Zaleha Md Isa,Khairul Hazdi Yusof,Noraidah Saian,Nurul Afifah Jusoh,Nur Nadia Mohamed,Farah Adilla Fauzi,Fatin Azierah Fauzi Siti Norzulikha Rahim,Rasha Khatib,Umaiyeh Khammash,Rita Giacaman,Manal Warad,Romaina Iqbal,Nizahat Zehra Zaidi,Rashida Rasheed,Noor-us-Sabah,Saiqa Nisar,Syeda Almas Bilal,Muhammad Awais,Rabia Yasin,Khawar Kazmi,Shehzad Ali,Muhammad Asim,Mohan Jumma,Sana Bachal,Hina Sharif,Nighat Almas,J Jaime Miranda,Antonio Bernabe-Ortiz,William Checkley,Germán Málaga,Robert H Gilman,Rodrigo M Carrillo-Larco,María Lazo-Porras,Lia M Palileo-Villanueva,Antonio L Dans,Marc Evans M Abat,Louie P Pudol,Chareece Z Pudol,Madenn S Segarra,Mary Joy S Romero,Charlene C Abaquin,Kristaleen Mae Manguiat,Mary Stephanie Malayang,Andrzej Szuba,Katarzyna Zatonska,Alicja Basiak-Rasała,Katarzyna Poltyn -Zaradna,Maria Wolyniec,Olga L Barbarash,Galina V Artamonova,Evgeny D Bazdyrev,Olga M Polikutina,Olga V Gruzdeva,Daria P Tsygankova,Tamara A Vinichenko,Olga V Nachratova,Alyena S Agienko,Yulia S Shot,KF AlHabib,MQ Alshamiri,HB Altaradi,M Abdulrahman,R Nouri,Iolanthé M Kruger,Aletta E Schutte,Edelweiss Wentzel-Viljoen,Annamarie Kruger,Thandi Puoane,Rina Swart,Ehimario Igumbor,Lungiswa P Tsolekile,Nasheeta Peer,Bonaventure A Egbujie,A Rosengren,A Gustavsson,M Andreasson,J Kembro Johansson,I Segerqvist,M Lindgren,Karen Yeates,Oresto Munishi,Nicola West,Gissela Nyakunga,Aytekin Oguz,Nese Imeryuz,Yuksel Altuntas,Ahmet Temizhan,Kubilay Karsidag,Burcu T Calik,Arzu K Akalin,Ozge T Caklili,Mirac V Keskinler,Afzalhussein M Yusufali,Hamda H Khansaheb,Tom Loney,Madiha H S Abdelmotagali,Douaa F Youssef,Olfat Z S Ahmad,Suad H Ahmed,Alwai Alsheikh-Ali,Marwan Zidan,Emain F El-Sayed,Mai H Awadalla,Jephat Chifamba,Tatenda Ncube,Brian Ncube,Casper Chimhete,Tavengwa Manenji,Lennon Gwaunza","doi":"10.1016/j.langlo.2026.104055","DOIUrl":"https://doi.org/10.1016/j.langlo.2026.104055","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"150 1","pages":"104055"},"PeriodicalIF":34.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088072","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":"Hookworm and Strongyloides stercoralis infections in school-age children and cohabiting dogs in Cambodia following 5 years of bi-annual mass drug administration: a cross-sectional observational study.","authors":"Patsy A Zendejas-Heredia, Molyden Vann, Solinna Sar, Chethna Ten, Chanmakara Mean, Shannon M Hedtke, Samantha J Kufel, Lucas G Huggins, Warwick N Grant, Robin B Gasser, Rekol Huy, Martin Walker, Rebecca J Traub, Virak Khieu, Vito Colella","doi":"10.1016/j.langlo.2026.104033","DOIUrl":"https://doi.org/10.1016/j.langlo.2026.104033","url":null,"abstract":"<p><strong>Background: </strong>Despite sustained control efforts, soil-transmitted helminths remain a major public health burden in endemic regions, with companion animals, particularly dogs, acting as potential reservoirs further complicating elimination efforts. In this study we aimed to assess infection levels in school-age children following 5 years of bi-annual school-based deworming and to investigate the contribution of dogs to ongoing zoonotic transmission in rural Cambodia.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted across 14 villages and five primary schools in Ta Ches commune, Kampong Chhnang province, Cambodia. These primary schools were receiving bi-annual preventive chemotherapy and villages within the commune were chosen based on the residential locations of the children attending these schools. All children aged 6-15 years enrolled in grades 1-6 attending the five participating schools and dog owners residing in the 14 villages were invited to participate. No random sampling or stratification was applied. Human and dog faecal samples were collected and screened using quantitative PCR. Samples from either children or dogs containing insufficient faecal material for DNA extraction were excluded. DNA sequencing and robust statistical approaches were performed to investigate zoonotic transmission dynamics between children and cohabiting dogs. The primary outcome of this study was the level of soil-transmitted helminth infections.</p><p><strong>Findings: </strong>Between Dec 2, and Dec 15, 2019, 706 children and 474 cohabiting dogs were included in the study. Soil-transmitted helminths were detected in 320 (45% [95% CI 42-49]) of 706 children, with hookworm infections predominating (302 [43%; 40-47]). Moderate-heavy infections exceeded the 2% WHO threshold needed for elimination. In 10 (71%; 50-93) of 14 villages, children and dogs harboured Ancylostoma ceylanicum, Strongyloides stercoralis, or a combination of the two, with combined zoonotic infections in 47 (15%; 11-19) children. We found that A ceylanicum and S stercoralis sequences from dogs and children clustered together with no clear distinction. However, the higher S stercoralis haplotype diversity in children compared with dogs suggests that S stercoralis transmission in our human population is complex, likely involving a potentially prevalent human-to-human transmission.</p><p><strong>Interpretation: </strong>Despite 5 years of targeted bi-annual mass drug administration, hookworms and S stercoralis remain a major public health issue in Cambodia. Our findings highlight the limitations of school-based deworming strategies and underscore the need for integrated molecular surveillance and One Health interventions to achieve the 2030 soil-transmitted helminths elimination targets.</p><p><strong>Funding: </strong>The University of Melbourne McKenzie Fellowship and the Soulsby Foundation.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"104033"},"PeriodicalIF":22.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082354","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":"Burden of schistosomiasis in Ethiopia following 10 years of preventive chemotherapy: a national cross-sectional geostatistical survey.","authors":"Gemechu T Leta, Geremew Tasew, Birhanu Getachew, Carolyn Henry, Adugna Abera, Tesfahun B Mengiste, Hailemariam Difabachew, Markos S Ali, Kalkidan M Begashaw, Alison Ower, Molly Anderson, Karen Palacio, Alexandra Carlin, Pancy Poon, Neerav Dhanani, Kimberly Fornace, William E Oswald, Hope Simpson, Max T Eyre, Hiwot Solomon, Getachew Tollera, Mesay Hailu, Joseph Ws Timothy, Rachel L Pullan, Fiona M Fleming, Fikre S Gebretsadik","doi":"10.1016/j.langlo.2026.104037","DOIUrl":"https://doi.org/10.1016/j.langlo.2026.104037","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Current strategies aim to eliminate schistosomiasis as a public health problem globally by 2030. As this target approaches, up-to-date knowledge of the burden and distribution of schistosomiasis is crucial. After a decade of control measures in Ethiopia, there are currently no high-resolution data with which to evaluate progress and guide interventions. Through a nationwide survey, we aimed to map the fine-scale distribution of schistosomiasis in Ethiopia to guide programmatic decision making at the kebele (subdistrict) level.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional geostatistical survey was conducted across ten regions of Ethiopia using spatially regulated sampling. Children aged 9-14 years were selected, using sex-stratified systematic random sampling, from schools or communities. Stool samples, collected from children in all ten regions, were assessed for Schistosoma mansoni using the Kato-Katz thick smear technique. Schistosoma haematobium infection was assessed by urine filtration and a urine dipstick test from samples obtained from children in three endemic regions. We fitted geostatistical models incorporating environmental covariates from five domains: sociodemographic, bioclimate, geology, land cover, and exposure to contaminated water. We generated 1 km&lt;sup&gt;2&lt;/sup&gt; prevalence maps and estimated the probability of exceeding WHO preventive chemotherapy thresholds at the kebele level. The primary outcomes were the prevalences of infection and heavy-intensity infection with S mansoni and S haematobium.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between June 20, 2021, and Oct 22, 2024, 121 593 children were enrolled at 4258 sites. Complete datasets for S mansoni analysis were available from 119 559 children surveyed at 4100 sites, among whom 26 885 were also assessed for S haematobium. The mean age of the children was 11·4 years (SD 1·7), with 57 046 (47·7%) female and 62 513 (52·3%) male. The combined survey prevalence of both Schistosoma species analysed was 5·4% (95% CI 5·0-5·9): 5·2% (4·8-5·7) for S mansoni and 1·0% (0·8-1·3) for S haematobium. Compared with baseline defined woreda-level prevalence categories, areas with a prevalence of at least 10% have declined, reducing the number of people above the threshold for requiring annual preventive chemotherapy from 25·6 million to 10·8 million. 1622 (11·0%) of 14 763 assessed kebeles were above the threshold for annual preventive chemotherapy, and the predicted probability of correct classification was at least 70% for 11 600 (78·6%) of the 14 763 kebeles. The prevalence of heavy-intensity infection among the survey population was 0·2% (95% CI 0·2 to 0·3) overall (0·2% [0·2 to 0·3] for S mansoni and &lt;0·1% [&lt;0·1 to &lt;0·1] for S haematobium), below the WHO elimination as a public health problem target of 1%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;This national, high-resolution map of schistosomiasis in Ethiopia shows marked progress towards elimination. The m","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"104037"},"PeriodicalIF":22.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041555","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":"Burden of non-communicable diseases and their attributable risk factors in Africa from 1990 to 2023: a systematic analysis for the Global Burden of Disease Study 2023.","authors":"","doi":"10.1016/j.langlo.2026.103964","DOIUrl":"https://doi.org/10.1016/j.langlo.2026.103964","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The rapid rise in the burden of non-communicable disease (NCDs) in African communities has resulted in a considerable mortality, disability, and economic burden. A comprehensive evaluation of incidence, deaths, disability-adjusted life-years (DALYs), and attributable risk factors related to NCDs by sex, and geographical location is essential for informing policy decisions aimed at controlling these diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used a comprehensive analysis based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 methodology to estimate the incidence, mortality, DALYs (estimated as the sum of years of life lost and years lived with disability [YLDs]), and attributable risk factors of NCDs in Africa. Data were systematically searched for and extracted from various sources, including vital registration, verbal autopsy, surveillance systems, police reports, censuses, surveys, minimally invasive tissue sampling, and sibling history. The analysis employed the Cause of Death Ensemble model, DisMod-MR 2.1, and spatiotemporal Gaussian process regression to estimate both fatal and non-fatal health metrics associated with NCDs in Africa overall, and by region and country.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;In 2023, NCDs in Africa accounted for an estimated 2·33 billion (95% uncertainty interval 2·22-2·50) incident cases, 4·70 million (4·47-4·93) deaths, and 263 million (234-293) DALYs. Although absolute numbers increased between 1990 and 2023, age-standardised rates (per 100 000 population) decreased modestly: incidence rate by 2·7% (0·2-5·0), mortality rate by 9·0% (2·5-15·5), and DALY rate by 6·4% (1·2-12·0). The five leading Level 3 causes of death in Africa in 2023 were ischaemic heart disease (801 000 [653 000-965 000]), stroke (700 000 [544 000-863 000]), chronic kidney disease (293 000 [224 000-359 000], hypertensive heart disease (246 000 [170 000-337 000]), and diabetes (245 000 [190 000-314 000]) for all sexes and ages. Leading Level 2 causes of YLDs were mental disorders (30·9 million [22·0-42·2]) and musculoskeletal disorders (17·1 million [12·5-22·7]). Overall, 35·1% (32·4-38·2) of DALYs and 57·4% (54·2-60·4) of deaths due to NCDs were attributable to the 88 GBD 2023 risk factors. High systolic blood pressure contributed the largest proportion at 26·2% (21·6-30·9) of all NCD deaths in Africa, followed by dietary risks (14·7% [5·1-21·6]) and air pollution (14·2% [11·6-16·9]).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;Our findings underscore the complex and evolving nature of the NCD burden in Africa, where modest declines in age-standardised mortality and DALY rates since 1990 have been substantially offset by rising absolute counts of deaths and DALYs-a paradox driven predominantly by rapid population growth and demographic changes. That more than half of all NCD deaths and over a third of DALYs remain attributable to modifiable risk factors-principally high systolic ","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103964"},"PeriodicalIF":22.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018446","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}