Lancet Global Health最新文献

{"title":"Strengthening health-care systems to reduce child mortality.","authors":"Abubakar Umar,Catherine E Oldenburg","doi":"10.1016/s2214-109x(24)00447-9","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00447-9","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"2 1","pages":""},"PeriodicalIF":34.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486362","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":"Effect of a participatory whole-systems approach on mortality in children younger than 5 years in Jigawa state, Nigeria (INSPIRING trial): a community-based, parallel-arm, pragmatic, cluster randomised controlled trial and concurrent mixed-methods process evaluation.","authors":"Carina King,Rochelle Ann Burgess,Ayobami A Bakare,Funmilayo Shittu,Julius Salako,Damola Bakare,Obioma C Uchendu,Agnese Iuliano,Nehla Djellouli,Adamu Isah,Ibrahim Haruna,Samy Ahmar,Tahlil Ahmed,Paula Valentine,Temitayo Folorunso Olowookere,Matthew MacCalla,Hamish R Graham,Eric D McCollum,James Beard,Adegoke G Falade,Tim Colbourn,","doi":"10.1016/s2214-109x(24)00369-3","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00369-3","url":null,"abstract":"BACKGROUNDIn 2019, Nigeria reported the highest mortality rate in children younger than 5 years globally. We aimed to assess a whole-systems approach to improving child mortality in northern Nigeria.METHODSWe conducted a community-based, parallel-arm, pragmatic, cluster randomised controlled trial in Kiyawa local government area, Jigawa state, Nigeria, and a concurrent mixed-methods process evaluation using ethnography and quantitative implementation monitoring. Trial clusters were population catchment areas of 32 government primary health-care facilities. Compounds were randomly sampled, proportional to cluster size, and all women aged 16-49 years and children younger than 5 years who were permanent residents were eligible for inclusion and recruited as the evaluation population. Children younger than 7 days were recruited but excluded from analysis. Evaluation clusters were allocated to intervention or control via simple randomisation with a 1:1 ratio. Cluster names were written on paper, folded, and placed in a container by community representatives. Different community representatives took out names one by one, with the first half assigned to receive the intervention. The intervention consisted of three components: participatory learning and action (PLA) groups for men and women (including compound heads [ie, the member of the compound that residents deemed most senior]), partnership defined quality scorecard (PDQS), and health-care worker capacity building; it was delivered from March 1, 2021, to Dec 31, 2022. We could not mask participants, field staff, or intervention-delivery staff to cluster allocation but baseline, endline, and follow-up data excluded information on cluster allocation. PLA groups involved separate groups of up to 25 men or women from all villages in the intervention clusters. The primary outcome was all-cause mortality in children aged 7 days to 59 months between Oct 1, 2021, and Sept 20, 2022, referred to as the evaluation period. The trial was prospectively registered (ISRCTN 39213655) and the protocol has been published.FINDINGSWe recruited 3800 compounds at baseline, with 12 893 children contributing to analysis of the primary outcome (7316 [56·8%] of 12 893 in the intervention group and 5577 [43·3%] in the control group). 6617 (51·3%) of 12 893 children were male, 6275 (48·7%) were female, and one (<0·1%) child had missing sex data. Sampled compounds randomly came from 388 (91·3%) of 425 villages in the 32 clusters. We conducted verbal autopsies for 1182 deaths, of which 369 (31·2%) were children aged 7 days to 59 months during the evaluation period. Of these 369, 91 (24·7%) were classified as pneumonia deaths. Children contributed a median 361 days (IQR 236-365) to the analysis, with 369 (2·9%) of 12 893 children censored on their date of death, 1545 (12·0%) on their 5th birthday, and 3392 (26·3%) on the date of the most recent follow-up in which their residence or survival status was known. We found no significan","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"1 1","pages":""},"PeriodicalIF":34.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global radiotherapy demands and corresponding radiotherapy-professional workforce requirements in 2022 and predicted to 2050: a population-based study.","authors":"Hongcheng Zhu,Melvin Lee Kiang Chua,Imjai Chitapanarux,Orit Kaidar-Person,Catherine Mwaba,Majed Alghamdi,Andrés Rodríguez Mignola,Natalia Amrogowicz,Gozde Yazici,Zouhour Bourhaleb,Humera Mahmood,Golam Mohiuddin Faruque,Muthukkumaran Thiagarajan,Abdelkader Acharki,Mingwei Ma,Martin Harutyunyan,Hutcha Sriplung,Yuntao Chen,Rolando Camacho,Zhen Zhang,May Abdel-Wahab","doi":"10.1016/s2214-109x(24)00355-3","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00355-3","url":null,"abstract":"BACKGROUNDAddressing the challenge of cancer control requires a comprehensive, integrated, and global health-system response. We aimed to estimate global radiotherapy demands and requirements for radiotherapy professionals from 2022 to 2050.METHODSWe conducted a population-based study using data from the Global Cancer Observatory (GLOBOCAN) 2022 and predicted global radiotherapy demands and workforce requirements in 2050. We obtained incidence figures for 29 types of cancer across 183 countries and derived the cancer-specific radiotherapy use rate using the 2013 Collaboration for Cancer Outcomes Research and Evaluation model. We delineated the proportion of people with cancer who require radiotherapy and can be accommodated within the existing installed capacity, assuming an optimal use rate of 50% or 64%, in both 2022 and 2050. A use rate of 50% corresponds to the global average and a use rate of 64% considers potential re-treatment scenarios, as indicated by the 2013 Collaboration for Cancer Outcomes Research and Evaluation (CCORE) radiotherapy use rate model. We established specified requirements for teletherapy units at a ratio of 1:450 patients, for radiation oncologists at a ratio of 1:250 patients, for medical physicists at a ratio of 1:450 patients, and for radiation therapists at a ratio of 1:150 patients in all countries and consistently using these ratios. We collected current country-level data on the radiotherapy-professional workforce from national health reports, oncology societies, or other authorities from 32 countries.FINDINGSIn 2022, there were an estimated 20·0 million new cancer diagnoses, with approximately 10·0 million new patients needing radiotherapy at an estimated use rate of 50% and 12·8 million at an estimated use rate of 64%. In 2050, GLOBOCAN 2022 data indicated 33·1 million new cancer diagnoses, with 16·5 million new patients needing radiotherapy at an estimated use rate of 50% and 21·2 million at an estimated use rate of 64%. These findings indicate an absolute increase of 8·4 million individuals requiring radiotherapy from 2022 to 2050 at an estimated use rate of 64%; at an estimated use rate of 50%, the absolute increase would be 6·5 million individuals. Asia was estimated to have the highest radiotherapy demand in 2050 (11 119 478 [52·6%] of 21 161 603 people with cancer), followed by Europe (3 564 316 [16·8%]), North America (2 546 826 [12·0%]), Latin America and the Caribbean (1 837 608 [8·7%]), Africa (1 799 348 [8·5%]), and Oceania (294 026 [1·4%]). We estimated that the global radiotherapy workforce in 2022 needed 51 111 radiation oncologists, 28 395 medical physicists, and 85 184 radiation therapists and 84 646 radiation oncologists, 47 026 medical physicists, and 141 077 radiation therapists in 2050. We estimated that the largest proportion of the radiotherapy workforce in 2050 would be in upper-middle-income countries (101 912 [38·8%] of 262 624 global radiotherapy professionals).INTERPRETATIONUrgent st","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"17 1","pages":""},"PeriodicalIF":34.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439511","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":"Population attributable fractions for risk factors for dementia in seven Latin American countries: an analysis using cross-sectional survey data.","authors":"Regina Silva Paradela,Ismael Calandri,Natalia Pozo Castro,Emanuel Garat,Carolina Delgado,Lucia Crivelli,Kristine Yaffe,Cleusa P Ferri,Naaheed Mukadam,Gill Livingston,Claudia Kimie Suemoto","doi":"10.1016/s2214-109x(24)00275-4","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00275-4","url":null,"abstract":"BACKGROUNDApproximately 40% of dementia cases worldwide are attributable to 12 potentially modifiable risk factors. However, the proportion attributable to these risks in Latin America remains unknown. We aimed to determine the population attributable fraction (PAF) of 12 modifiable risk factors for dementia in seven countries in Latin America.METHODSWe used data from seven cross-sectional, nationally representative surveys with measurements of 12 modifiable risk factors for dementia (less education, hearing loss, hypertension, obesity, smoking, depression, social isolation, physical inactivity, diabetes, excessive alcohol intake, air pollution, and traumatic brain injury) done in Argentina, Brazil, Bolivia, Chile, Honduras, Mexico, and Peru. Data were collected between 2015 and 2021. Sample sizes ranged from 5995 to 107 907 participants (aged ≥18 years). We calculated risk factor prevalence and communalities in each country and used relative risks from previous meta-analyses to derive weighted PAFs. Pooled PAFs for Latin America were obtained using random effect meta-analyses.FINDINGSThe overall proportion of dementia cases attributed to 12 modifiable risk factors varied across Latin American countries: weighted PAF 61·8% (95% CI 37·9-79·5) in Chile, 59·6% (35·8-77·3) in Argentina, 55·8% (35·7-71·5) in Mexico, 55·5% (35·9-70·4) in Bolivia, 53·6% (33·0-69·3) in Honduras, 48·2% (28·1-63·9) in Brazil, and 44·9% (25·8-61·2) in Peru. The overall PAF for dementia was 54·0% (48·8-59·6) for Latin America. The highest weighted PAFs in Latin American countries overall were for obesity (7%), physical inactivity (6%), and depression (5%).INTERPRETATIONThe estimated PAFs for Latin American countries were higher than previous global estimates. Obesity, physical inactivity, and depression were the main risk factors for dementia across seven Latin American countries. These findings have implications for public health and individually targeted dementia prevention strategies in Latin America. Although these results provide new information about Latin American countries, demographics and representativeness variations across surveys should be considered when interpreting these findings.FUNDINGNone.","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"10 1","pages":"e1600-e1610"},"PeriodicalIF":34.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275285","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":"Combined interventions for the testing and treatment of HIV and schistosomiasis among fishermen in Malawi: a three-arm, cluster-randomised trial.","authors":"Augustine T Choko,Kathryn L Dovel,Sekeleghe Kayuni,Donaldson F Conserve,Anthony Buttterworth,Amaya L Bustinduy,J Russell Stothard,Wala Kamchedzera,Madalo Mukoka-Thindwa,James Jafali,Peter MacPherson,Katherine Fielding,Nicola Desmond,Elizabeth L Corbett","doi":"10.1016/s2214-109x(24)00283-3","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00283-3","url":null,"abstract":"BACKGROUNDUndiagnosed HIV and schistosomiasis are highly prevalent among fishermen in the African Great Lakes region. We aimed to evaluate the efficacy of lakeside interventions integrating services for HIV and male genital schistosomiasis on the prevalence of schistosomiasis, uptake of antiretroviral therapy (ART) for HIV, and voluntary male medical circumcision (VMMC) among fishermen in Malawi.METHODSWe conducted a three-arm, cluster-randomised trial in 45 lakeshore fishing communities (clusters) in Mangochi, Malawi. Clusters were defined geographically by their home community as the place where fishermen leave their boats (ie, a landing site). Eligible participants were male fishermen (aged ≥18 years) who resided in a cluster. Clusters were randomly allocated (1:1:1) through computer-generated random numbers to either enhanced standard of care (SOC), which offered invitation with information leaflets to a beach clinic offering HIV testing and referral, and presumptive treatment for schistosomiasis with praziquantel; peer education (PE), in which a nominated fisherman was responsible for explaining the study leaflet to promote services to his boat crew; or peer distribution education (PDE), in which the peer educator explained the leaflet and distributed HIV self-test kits to his boat crew. The beach clinic team and fishermen were not masked to intervention allocation; however, investigators were masked until the final analysis. Coprimary composite outcomes were the proportion of participants who had at least one Schistosoma haematobium egg observed on light microscopy from 10 mL of urine filtrate and the proportion who had self-reported initiating ART or scheduling VMMC by day 28. Outcomes were analysed by intention to treat; multiple imputation for missing outcomes was done; random-effect binomial models adjusting for baseline imbalance and clustering were used to compute unadjusted and adjusted risk differences, risk ratios (RRs) and 95% CIs, and intracluster correlation coefficients for each outcome. This trial is registered with ISRCTN, ISRCTN14354324.FINDINGSBetween March 1, 2022, and Jan 29, 2023, 45 (65·2%) of 69 clusters assessed for eligibility were enrolled in the trial, with 15 clusters per arm. Of the 6036 fishermen screened at baseline, 5207 (86·3%) were eligible for participation: 1745 (87·6%) of 1991 in the enhanced SOC group, 1687 (81·9%) of 2061 in the PE group, and 1775 (89·5%) of 1984 in the PDE group. Compared with the prevalence of active schistosomiasis in the enhanced SOC group (292 [16·7%] of 1745), 241 (13·6%) of 1775 fishermen in the PDE group (adjusted RR 0·80 [95% CI 0·69-0·94]; p=0·0054) and 263 (15·6%) of 1687 fishermen in the PE group (0·92 [0·79-1·07]; p=0·28) had schistosomiasis at day 28. 230 (13·2%) in the enhanced SOC group, 281 (16·7%) in the PE group, and 215 (12·1%) in the PDE group initiated ART or were scheduled for VMMC. ART initiation or VMMC scheduling was not significantly increased with the PDE int","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"36 1","pages":"e1673-e1683"},"PeriodicalIF":34.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275290","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":"Evaluating national infection prevention and control minimum requirements: evidence from global cross-sectional surveys, 2017-22.","authors":"Ermira Tartari,Sara Tomczyk,Anthony Twyman,Ana Paula Coutinho Rehse,Mohamed Gomaa,Maha Talaat,Aparna Singh Shah,Howard Sobel,Joao Paulo Toledo,Benedetta Allegranzi","doi":"10.1016/s2214-109x(24)00277-8","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00277-8","url":null,"abstract":"BACKGROUNDWHO infection prevention and control (IPC) minimum requirements provide standards to reduce the risk of infection during health-care delivery. We aimed to investigate the global implementation of these requirements at national levels and the progress of doing so across 2021-22 compared with 2017-18 to identify future directions for interventions.METHODSNational IPC focal points were invited to complete an online survey measuring IPC minimum requirements from July 19, 2021, to Jan 31, 2022. The primary outcome was the proportion of countries meeting IPC minimum requirements. Country characteristics associated with this outcome were assessed with beta regression. Subset analyses were conducted to compare the 2021-22 indicators with a WHO IPC survey conducted in 2017-18 and to assess the correlation of the proportion of IPC minimum requirements met with the results of other WHO metrics.FINDINGS106 countries (ie, 13 low income, 27 lower-middle income, 33 upper-middle income, and 33 high income) participated in the survey (56% response rate). Four (4%) of 106 met all IPC minimum requirements. The highest scoring IPC core component was multimodal improvement strategies and the lowest was IPC education and training. The odds of meeting IPC minimum requirements was higher among high-income countries compared with low-income countries (adjusted odds ratio 2·7, 95% CI 1·3-5·8; p=0·020). Compared with the 2017-18 survey, there was a significant increase in the proportion of countries reporting an active national IPC programme (65% to 82%, p=0·037) and a dedicated budget (26% to 44%, p=0·037). Evaluation of the IPC minimum requirements compared with other survey instruments revealed a low positive correlation.INTERPRETATIONTo build resilient health systems capable of withstanding future health threats, urgently scaling up adherence to WHO IPC minimum requirements is essential.FUNDINGWHO.TRANSLATIONSFor the French and Spanish translations of the abstract see Supplementary Materials section.","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"16 1","pages":"e1620-e1628"},"PeriodicalIF":34.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275298","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 distraction of a pan-regimen approach to tuberculosis.","authors":"Oxana Rucsineanu, Jennifer Furin","doi":"10.1016/S2214-109X(24)00328-0","DOIUrl":"10.1016/S2214-109X(24)00328-0","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e1565-e1566"},"PeriodicalIF":19.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005611","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":"Ebola disease outbreak caused by the Sudan virus in Uganda, 2022: a descriptive epidemiological study.","authors":"Zainah Kabami, Alex R Ario, Julie R Harris, Mackline Ninsiima, Sherry R Ahirirwe, Jane R Aceng Ocero, Diana Atwine, Henry G Mwebesa, Daniel J Kyabayinze, Allan N Muruta, Atek Kagirita, Yonas Tegegn, Miriam Nanyunja, Saudah N Kizito, Daniel Kadobera, Benon Kwesiga, Samuel Gidudu, Richard Migisha, Issa Makumbi, Daniel Eurien, Peter J Elyanu, Alex Ndyabakira, Helen Nelly Naiga, Jane F Zalwango, Brian Agaba, Peter C Kawungezi, Marie G Zalwango, Patrick King, Brenda N Simbwa, Rebecca Akunzirwe, Mercy W Wanyana, Robert Zavuga, Thomas Kiggundu","doi":"10.1016/S2214-109X(24)00260-2","DOIUrl":"10.1016/S2214-109X(24)00260-2","url":null,"abstract":"<p><strong>Background: </strong>Uganda has had seven Ebola disease outbreaks, between 2000 and 2022. On Sept 20, 2022, the Ministry of Health declared a Sudan virus disease outbreak in Mubende District, Central Uganda. We describe the epidemiological characteristics and transmission dynamics.</p><p><strong>Methods: </strong>For this descriptive study, cases were classified as suspected, probable, or confirmed using Ministry of Health case definitions. We investigated all reported cases to obtain data on case-patient demographics, exposures, and signs and symptoms, and identified transmission chains. We conducted a descriptive epidemiological study and also calculated basic reproduction number (R_o) estimates.</p><p><strong>Findings: </strong>Between Aug 8 and Nov 27, 2022, 164 cases (142 confirmed, 22 probable) were identified from nine (6%) of 146 districts. The median age was 29 years (IQR 20-38), 95 (58%) of 164 patients were male, and 77 (47%) patients died. Symptom onsets ranged from Aug 8 to Nov 27, 2022. The case fatality rate was highest in children younger than 10 years (17 [74%] of 23 patients). Fever (135 [84%] of 160 patients), vomiting (93 [58%] patients), weakness (89 [56%] patients), and diarrhoea (81 [51%] patients) were the most common symptoms; bleeding was uncommon (21 [13%] patients). Before outbreak identification, most case-patients (26 [60%] of 43 patients) sought care at private health facilities. The median incubation was 6 days (IQR 5-8), and median time from onset to death was 10 days (7-23). Most early cases represented health-care-associated transmission (43 [26%] of 164 patients); most later cases represented household transmission (109 [66%]). Overall R_o was 1·25.</p><p><strong>Interpretation: </strong>Despite delayed detection, the 2022 Sudan virus disease outbreak was rapidly controlled, possibly thanks to a low R_o. Children (aged <10 years) were at the highest risk of death, highlighting the need for targeted interventions to improve their outcomes during Ebola disease outbreaks. Initial care-seeking occurred at facilities outside the government system, showing a need to ensure that private and public facilities receive training to identify possible Ebola disease cases during an outbreak. Health-care-associated transmission in private health facilities drove the early outbreak, suggesting gaps in infection prevention and control.</p><p><strong>Funding: </strong>None.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e1684-e1692"},"PeriodicalIF":19.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120898","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":"Revolution in microbiological diagnostics needs LMIC solutions.","authors":"William Calero-Cáceres","doi":"10.1016/s2214-109x(24)00362-0","DOIUrl":"https://doi.org/10.1016/s2214-109x(24)00362-0","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"28 1","pages":"e1588"},"PeriodicalIF":34.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275287","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":"Delivering non-communicable disease services through primary health care in selected south Asian countries: are health systems prepared?","authors":"Syed Masud Ahmed, Anand Krishnan, Obaida Karim, Kashif Shafique, Nahitun Naher, Sanjida Ahmed Srishti, Aravind Raj, Sana Ahmed, Lal Rawal, Alayne Adams","doi":"10.1016/S2214-109X(24)00118-9","DOIUrl":"10.1016/S2214-109X(24)00118-9","url":null,"abstract":"<p><p>In the south Asian region, delivering non-communicable disease (NCD) prevention and control services through existing primary health-care (PHC) facilities is urgently required yet currently challenging. As the first point of contact with the health-care system, PHC offers an ideal window for prevention and continuity of care over the life course, yet the implementation of PHC to address NCDs is insufficient. This review considers evidence from five south Asian countries to derive policy-relevant recommendations for designing integrated PHC systems that include NCD care. Findings reveal high political commitment but poor multisectoral engagement and health systems preparedness for tackling chronic diseases at the PHC level. There is a shortage of skilled human resources, requisite infrastructure, essential NCD medicines and technologies, and dedicated financing. Although innovations supporting integrated interventions exist, such as innovations focusing on community-centric approaches, scaling up remains problematic. To deliver NCD services sustainably, governments must aim for increased financing and a redesign of PHC service.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e1706-e1719"},"PeriodicalIF":19.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047354","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}