Lancet Global Health最新文献

{"title":"Management of possible serious infections in young infants.","authors":"Shally Awasthi,M Jeeva Sankar","doi":"10.1016/s2214-109x(25)00326-2","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00326-2","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"98 1","pages":"e1786-e1787"},"PeriodicalIF":34.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314631","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":"Stepping out of the shadows: addressing sexual violence in older adults.","authors":"Anne Nobels","doi":"10.1016/s2214-109x(25)00402-4","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00402-4","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"101 1","pages":""},"PeriodicalIF":34.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319207","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":"Differences in sexual violence against younger and older adults in complex humanitarian settings: a retrospective analysis from Médecins Sans Frontières in 2019-24.","authors":"Elburg Van Boetzelaer,Tesfahun Biru,Amina Idris,Patrick Keating,Marion Staunton,Favila Escobio,Umberto Pellecchia,Judith Van de Kamp,Amrish Baidjoe,Jason W Nickerson,Martins Dada,Oscar H Franco,Grazia Caleo,Meggy Verputten,Joyce L Browne,Hanna Reinholdz","doi":"10.1016/s2214-109x(25)00318-3","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00318-3","url":null,"abstract":"BACKGROUNDSexual violence against older adults in humanitarian settings is poorly documented, leading to gaps in prevention and delivery of support services. This study aimed to document differences in assault characteristics between younger and older adults, by sex and displacement and disability status and region.METHODSThis retrospective, descriptive observational, multi-country study included survivors aged 20 years or older who accessed sexual violence services supported by Médecins Sans Frontières in humanitarian settings across 11 countries between Nov 1, 2019, and Nov 1, 2024. Assault characteristics (context and circumstances of the assault and perpetrator characteristics) were compared between younger (20-49 years) and older survivors (50 years and older) stratified by sex and region using regression analyses. Among older survivors, analyses were mutually adjusted for age group, displacement, and disability status.FINDINGSWe included data from 35 248 survivors who accessed care in the study (33 548 [95·2%] survivors were aged 20-49 years and 1700 [4·8%] were aged 50 years or older). 34 007 (96·5%) participants were female and 1241 (3·5%) were male. Rape was the most frequently reported type of sexual violence across sexes and age groups, including in older female survivors compared with younger female survivors (odds ratio [OR] 2·01 [95% CI 1·34-3·22]). Compared with their younger counterparts, older female survivors were more likely to report assault during armed attacks (OR 1·85 [95% CI 1·65-2·07]), by multiple assailants (OR 1·66 [1·50-1·84]), by armed groups (OR 1·21 [1·09-1·34]), while gathering food or wood (OR 1·51 [1·36-1·68]), and with regional variation, and less likely to report sexual violence from an intimate partner (OR 0·29 [0·23-0·36]). Older male survivors were more likely to report sexual violence other than rape (OR 2·85 [95% CI 1·51-5·07]), and to report a female assailant (OR 1·65 [1·01-2·78]). Older female survivors with disabilities were more likely to report sexual violence from an intimate partner (adjusted [a]OR 3·57 [95% CI 1·42-7·84]), and repeat assaults by the same assailant (aOR 4·01 [1·68-8·57]).INTERPRETATIONThis study reveals distinct patterns of sexual violence among older women, particularly assaults by multiple unknown armed assailants during survival tasks, and among older men, whose experiences often fall outside dominant sexual violence narratives. Disability and displacement further compound the vulnerability of older adults, influencing the type, context, and recurrence of violence. Findings underscore the urgent need for age-sensitive and disability-sensitive sexual violence support strategies in humanitarian settings.FUNDINGNone.TRANSLATIONSFor the Arabic, Spanish and French translations of the abstract see Supplementary Materials section.","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"31 1","pages":""},"PeriodicalIF":34.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319230","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":"Women's retrospective reports of childhood sexual abuse in cross-sectional household surveys: a multi-country secondary analysis of two data collection methods.","authors":"Jack Cagney,Emmanuela Gakidou,Joht Singh Chandan,Felicia Marie Knaul,Nicholas Metheny,Claudia Garcia-Moreno","doi":"10.1016/s2214-109x(25)00332-8","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00332-8","url":null,"abstract":"BACKGROUNDUnder-reporting and non-disclosure hinder the accurate collection of self-reported experiences of childhood sexual abuse. Although population-based household surveys often use direct (ie, face-to-face) interviews to assess childhood sexual abuse exposure retrospectively, some use confidential methods to encourage disclosure. Both methods show promise, but their comparative effectiveness remains underexplored. This study aimed to synthesise and compare childhood sexual abuse prevalence estimates derived from direct and confidential data collection methods across countries.METHODSFor this secondary analysis, we used publicly available, cross-sectional report data from the WHO multi-country study on women's health and domestic violence against women and its subsequent adaptations (ie, national surveys on violence against women). Adaptation studies were included if their methods or questionnaires were adapted from the WHO multi-country study; they reported childhood sexual abuse case counts or prevalence estimates by the mode of data collection (ie, direct interview or confidential card); and they used a nationally representative sampling framework. After extracting prevalence estimates and sample sizes by collection method, we applied the Wilson score interval to calculate 95% uncertainty intervals (which were used as a proxy for statistical significance in the absence of individual-level data). Within each location, we then tested for significant differences in prevalence estimates derived from direct interviews, confidential self-report cards, and a combined approach. Using the direct interview data as the reference, we calculated the absolute and relative differences in prevalence between the data collection methods.FINDINGSWe used representative data from 36 surveys and 30 countries and territories, all collected between 2000 and 2019. Overall, the prevalence of childhood sexual abuse measured by confidential cards was 5·7 percentage points greater than the prevalence measured by direct interviews. In 28 (85%) of the 33 studies that reported confidential card responses, the prevalence via confidential report was significantly higher than the direct interview. At the country level, the smallest observed absolute differences were in Viet Nam (1·0 percentage points in 2010) and Türkiye (1·9 percentage points in 2008), whereas the largest were in Jamaica (11·1 percentage points) and the Solomon Islands (22·1 percentage points). In relative terms, the pooled confidential estimate was 121·2% higher than the direct question, reflecting more than a two-fold increase in disclosure.INTERPRETATIONSurveys should provide respondents with an opportunity to confidentially disclose childhood sexual abuse, which could increase disclosure, lead to more accurate prevalence estimates, and, in turn, inform expanded primary and secondary prevention efforts.FUNDINGGates Foundation.","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"11 1","pages":""},"PeriodicalIF":34.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145311516","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":"Scaling HPV vaccination in Africa to eliminate cervical cancer by 2030.","authors":"Adidja Amani,Paul Bloem,Emily Kobayashi,Brian Atuhaire,Charles Shey Wiysonge,Benido Impouma","doi":"10.1016/s2214-109x(25)00349-3","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00349-3","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"28 1","pages":""},"PeriodicalIF":34.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145311517","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":"New guidelines for the prevention, diagnosis, and treatment of postpartum haemorrhage: ending the geography of risk.","authors":"Aris T Papageorghiou,Anne-Beatrice Kihara,Jacqueline Dunkley-Bent,Sadiah Ahsan,Ferdousi Begum,María Fernanda Escobar Vidarte,Caroline Homer,Olufemi T Oladapo, ","doi":"10.1016/s2214-109x(25)00404-8","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00404-8","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"30 1","pages":""},"PeriodicalIF":34.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241104","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":"Prevention first, preparedness always: a holistic approach for managing postpartum haemorrhage.","authors":"Franka Cadee,Jeffrey L Jacobs,Anne-Beatrice Kihara,Annie Hortense Atchoumi,Fatu Forna,Uchenna Igbokwe,Anna Af Ugglas","doi":"10.1016/s2214-109x(25)00400-0","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00400-0","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"21 1","pages":""},"PeriodicalIF":34.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235897","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":"Deaths from febrile coma in African children can be reduced now - Author's reply.","authors":"Stephen T J Ray,Charlotte E Fuller,Terrie Taylor,Karl Seydel,Michael J Griffiths","doi":"10.1016/s2214-109x(25)00322-5","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00322-5","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"7 1","pages":"e1666-e1667"},"PeriodicalIF":34.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093525","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":"Strengthening community protection: a call for localised preparedness, response, and resilience for public health emergencies.","authors":"Andreas Jansen,Kai von Harbou,Amanda McClelland,Petra Khoury,Mohannad Al Nsour,Sadaf Lynes,Rand Salman,Frode Forland,Nedret Emiroglu,Catherine Smallwood,Johanna Hanefeld","doi":"10.1016/s2214-109x(25)00353-5","DOIUrl":"https://doi.org/10.1016/s2214-109x(25)00353-5","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"5 1","pages":""},"PeriodicalIF":34.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226656","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 potential of kidney transplantation to reduce mortality from chronic kidney disease: a global, cross-sectional, modelling study.","authors":"Alan Zambeli-Ljepović, Somkanya Tungsanga, Anukul Ghimire, Aminu K Bello, Ikechi G Okpechi, Mekdim Tadesse Siyoum, Fransia Arda Mushi, Frank Asiimwe, Peace Bagasha, Vincent Okungu, Stefano M Bertozzi, Thomas J Hoffmann, David Thomson, Elmi Muller, John W Scott, Shareef Syed, Nancy Ascher, Peter Stock, John Rose","doi":"10.1016/S2214-109X(25)00222-0","DOIUrl":"10.1016/S2214-109X(25)00222-0","url":null,"abstract":"<p><strong>Background: </strong>Globally, the burden of chronic kidney disease and ensuing need for kidney replacement therapy (KRT)-dialysis or kidney transplantation-are increasing. Despite the mortality benefit of transplantation over dialysis, dialysis services are expanding more rapidly than access to transplantation. We aimed to cross-sectionally assess the association between country-level KRT rates and chronic kidney disease mortality to facilitate evidence-based prioritisation of KRT modalities.</p><p><strong>Methods: </strong>For all countries with publicly available data, we collected income level and gross domestic product per capita (GDP-PC) from the World Bank (data from 2022), age-standardised chronic kidney disease prevalence and mortality from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD; data from 2021), and dialysis prevalence and kidney transplantation incidence from the International Society of Nephrology-Global Kidney Health Atlas (ISN-GKHA) and Global Observatory on Donation and Transplantation (data from 2022). To account for varying chronic kidney disease prevalence among countries, we divided each of the latter three variables by the chronic kidney disease prevalence to obtain national dialysis rates, kidney transplantation rates, and the mortality-prevalence ratio, respectively. We modelled mortality-prevalence ratio as a multivariable function of GDP-PC and KRT rates. We used this model to estimate how increased kidney transplantation rates might affect chronic kidney disease mortality.</p><p><strong>Findings: </strong>Among 203 countries and territories with epidemiological data available from both the GBD and ISN-GKHA, median age-standardised chronic kidney disease prevalence was 7·78% (IQR 6·54-9·48%). Data availability was associated with income level (p<0·0001). Higher GDP-PC was associated with higher KRT rates (p<0·0001 for both dialysis and kidney transplantation) and lower mortality-prevalence ratio (p<0·0001). On multivariable analysis, decreases in mortality-prevalence ratio were independently associated with GDP-PC (coefficient -0·258; 95% CI -0·413 to -0·103; p=0·0031) and kidney transplantation rates (-574; -1090 to -43·5; p=0·039), but not dialysis rates (10·8; -29·5 to -6·27; p=0·22). Conservative increases in kidney transplantation rates could avert 290 000 chronic kidney disease deaths annually.</p><p><strong>Interpretation: </strong>We provide, to our knowledge, the first compilation of evidence that countries with higher kidney transplantation rates have lower mortality-prevalence ratio, regardless of GDP-PC; dialysis does not have a similar association. GDP-PC-based disparities in data availability, kidney transplantation rates, and mortality-prevalence ratio are expected to worsen with anticipated increases in prevalence of chronic kidney disease. To mitigate this risk, policy makers should leverage international guidelines and partnerships to increase access to safe and et","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e1691-e1700"},"PeriodicalIF":19.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975285","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}