Lancet Global Health最新文献

{"title":"The crucial role of industry in increasing access to medical oxygen.","authors":"Jayasree K Iyer, Emma Cahuzac, Zachary Katz, Kaodili Udeh, Noha El-Ghobashy, David Lowrance, Kristoffer Gandrup-Marino, Robert Matiru","doi":"10.1016/S2214-109X(24)00556-4","DOIUrl":"10.1016/S2214-109X(24)00556-4","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e389-e391"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469656","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":"Payment in arrears: a global health inequity that must be corrected.","authors":"Kirchuffs Atengble, Rifat Atun, Lydia Aziato, Frank Baiden, Jessica L Boxall, Margaret Gyapong, Michael G Head, Victor Mogre, Pathik Pathak, Julie Reeves","doi":"10.1016/S2214-109X(24)00557-6","DOIUrl":"10.1016/S2214-109X(24)00557-6","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e405-e406"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030194","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":"Clinical evaluation of computer-aided digital x-ray detection of pulmonary tuberculosis during community-based screening or active case-finding: a case-control study.","authors":"Alex J Scott, Tahlia Perumal, Anil Pooran, Suzette Oelofse, Shameem Jaumdally, Jeremi Swanepoel, Phindile Gina, Thuli Mthiyane, Zhi Zhen Qin, Jana Fehr, Alison D Grant, Emily B Wong, Martie van der Walt, Aliasgar Esmail, Keertan Dheda","doi":"10.1016/S2214-109X(24)00516-3","DOIUrl":"https://doi.org/10.1016/S2214-109X(24)00516-3","url":null,"abstract":"<p><strong>Background: </strong>Computer-aided detection (CAD) has been recommended as a tuberculosis screening tool. However, there are limited data about its utility, specifically in a community-based setting where the targeted population and the highest burden of undetected individuals resides. The aim of this study was to evaluate the diagnostic accuracy and clinical utility of CAD during community-based active case-finding (ACF) for tuberculosis.</p><p><strong>Methods: </strong>In this case-control study, we used individual patient data from adults aged 15 years or older who resided in tuberculosis-endemic or HIV-endemic communities, pooled from five community-based ACF studies in South Africa from November, 2016 to August, 2023. Cases were defined as participants who were tuberculosis positive (diagnosed with pulmonary tuberculosis by sputum Xpert Ultra or culture positivity, or both) and controls were tuberculosis negative. Controls were randomly sampled from each study at an approximate 1:2 ratio (case to control). We assessed CAD-interpreted chest radiography (CAD4TB version 7) against a microbiological reference standard. Diagnostic accuracy of CAD was determined by sensitivity, specificity, and area under the receiver operating curve (AUC). CAD performance was additionally assessed in various subgroups. We evaluated the clinical utility of CAD and performed a preliminary cost analysis comparing the cost per tuberculosis case detected and initiated on treatment (per 10 000 individuals screened) for two community-based diagnostic strategies: Xpert Ultra in everyone screened versus Xpert Ultra only in CAD-positive individuals.</p><p><strong>Findings: </strong>Of the 20 770 individuals enrolled across all studies, 530 (2·6%) had microbiologically proven tuberculosis. Data were available for 501 (94·5%) of the individuals with tuberculosis (cases) and 938 tuberculosis-negative individuals (controls). CAD achieved an AUC of 0·83 (95% CI 0·80-0·85). At a fixed sensitivity of 90% (threshold: 5) specificity was 44·9% (95% CI 42·5-47·3) and at a fixed sensitivity of 85% (threshold: 10) specificity was 54·1% (51·7-56·5). In the subgroup analysis, CAD performed worse in people living with HIV compared with HIV-negative people (AUC of 0·76 [0·71-0·81] vs 0·85 [0·82-0·87]; p=0·0037) and in asymptomatic people compared with symptomatic people (0·79 [0·76-0·82] vs 0·85 [0·82-0·88]; p=0·0079. Nevertheless, a CAD-directed Xpert Ultra strategy reduced costs by 20-53% compared with a universal Xpert Ultra only strategy (US$2207-$3745 vs $4698 per tuberculosis case detected and initiated on treatment per 10 000 people screened), at the detriment of lower diagnostic yield (40-59% vs 65% per 10 000 individuals screened).</p><p><strong>Interpretation: </strong>In the setting of community-based ACF, CAD did not meet the WHO screening test target product profile (>90% sensitivity and >70% specificity) and performed more poorly in some subgroups. However, a cont","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e517-e527"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531985","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":"Comparative effectiveness of daily therapeutic supplementation with multiple micronutrients and iron-folic acid versus iron-folic acid alone in children with mild-to-moderate anaemia in rural India: an open-label, randomised controlled trial.","authors":"Ravi Prakash Upadhyay, Ranadip Chowdhury, Sudarshan Mundra, Sunita Taneja, Molly Jacob, Umesh Kapil, Ashish Bavdekar, Nita Bhandari","doi":"10.1016/S2214-109X(24)00559-X","DOIUrl":"https://doi.org/10.1016/S2214-109X(24)00559-X","url":null,"abstract":"<p><strong>Background: </strong>Anaemia is a major public health problem among children younger than 5 years and supplementation with iron-folic acid alone has not been found to result in desired improvements in haemoglobin concentrations. We aimed to compare the effect of supplementation with iron-folic acid plus multiple micronutrients versus iron-folic acid supplementation alone on haemoglobin concentration and cure rates in children with mild-to-moderate anaemia.</p><p><strong>Methods: </strong>In this individually randomised controlled trial conducted in rural Haryana, India, children (aged 6-59 months) with mild-to-moderate anaemia (haemoglobin ≥7 to <11 g/dL) were randomly assigned (1:1) to receive either daily iron-folic acid plus multiple micronutrients or iron-folic acid alone for 90 days. The primary outcomes were mean haemoglobin concentration and the proportion of children cured of anaemia (haemoglobin ≥11 g/dL) at 90 days, assessed in the intention-to-treat population, which included all randomly assigned participants for whom primary outcome assessments were done. Safety was assessed in all randomly assigned participants. The trial was registered with the Clinical Trial Registry-India, CTRI/2020/10/028298.</p><p><strong>Findings: </strong>Between March 1, 2021, and March 7, 2022, 1300 children were randomly assigned to the iron-folic acid plus multiple micronutrients group (n=648) or the iron-folic acid alone group (n=652). At baseline, 93 (20%) of 472 children had vitamin B₁₂ deficiency (≤203 pg/mL), 16 (3%) of 475 children had serum folate deficiency (<4 ng/mL), and 44 (9%) of 468 children had zinc deficiency (<66 μg/dL). 611 children in the iron-folic acid plus micronutrients group and 626 children in the iron-folic acid alone group had a blood sample collected at the end of the 90-day supplementation period and were included in the primary outcome assessment. At 90 days, no differences in mean haemoglobin concentration were identified between the treatment groups (mean difference 0·06 [95% CI -0·05 to 0·16]). 489 (80%) of 611 children in the iron-folic acid plus micronutrients group and 492 (79%) of 626 children in the iron-folic acid alone group were cured of anaemia (risk ratio 1·02 [95% CI 0·90 to 1·16]). Compliance rates in both groups exceeded 75%. Black stools were the most common side-effect observed in both groups (640 [99%] of 648 children in iron-folic acid plus micronutrients group and 643 [99%] of 652 children in the iron-folic acid alone group).</p><p><strong>Interpretation: </strong>In children with mild-to-moderate anaemia, supplementation with multiple micronutrients and iron-folic acid did not result in significant benefits compared with iron-folic acid alone. Efforts that focus on ensuring high compliance with iron-folic acid supplementation alone might achieve satisfactory rates of anaemia recovery.</p><p><strong>Funding: </strong>Indian Council of Medical Research and the Government of India.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e497-e507"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531988","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":"Vertical transmission of hepatitis B virus in the WHO African region: a systematic review and meta-analysis.","authors":"Nicholas Riches, Marc Y R Henrion, Peter MacPherson, Camilla Hahn, Rabson Kachala, Thomas Mitchell, Daniel Murray, Wongani Mzumara, Owen Nkoka, Alison J Price, Jennifer Riches, Aoife Seery, Noel Thom, Anne Loarec, Maud Lemoine, Gibril Ndow, Yusuke Shimakawa, Peyton Thompson, Camille Morgan, Shalini Desai, Philippa Easterbrook, Alexander J Stockdale","doi":"10.1016/S2214-109X(24)00506-0","DOIUrl":"10.1016/S2214-109X(24)00506-0","url":null,"abstract":"<p><strong>Background: </strong>More new infections with hepatitis B virus (HBV) occur annually in the WHO African region than in the rest of the world combined. We did a systematic review and meta-analysis to estimate the prevalence of hepatitis B surface antigen (HBsAg) in pregnant women and vertical transmission events in the region.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, Africa Index Medicus, and Africa Journals Online for publications between Jan 1, 1992, and Jan 7, 2024, with no language restrictions. HBsAg prevalence and vertical transmission (HBsAg positivity in children aged 6-12 months) were estimated with the use of binomial mixed models with logit links, stratified by infant vaccination status. We estimated HBsAg prevalence for subregions of Africa and for the WHO African region by weighting by estimated livebirths for each subregion. We estimated transmission events using WHO and UNICEF vaccine coverage data and UN population estimates.</p><p><strong>Findings: </strong>We included 113 studies reporting on HBsAg prevalence from 190 983 pregnant women and 11 studies reporting on vertical transmission. HBsAg prevalence in women receiving antenatal care in the WHO African region (based on 2014-23 data) was 6·2% (95% CI 5·3-7·2). No relationship between risk of bias and HBsAg prevalence was observed. In 2022, an estimated 172 000 vertical transmission events (95% CI 82 000-383 000) occurred (0·4% of livebirths), a fall from a peak of 339 000 (149 000-634 000; 1·2% of all livebirths) in 2001. Increasing birth dose vaccination coverage to the WHO target of 90% could reduce vertical transmission by 43·7% (95% CI 11·6-78·0) to 97 000 events per year (95% CI 58 000-160 000). Adding maternal antiviral prophylaxis with 90% coverage could reduce transmission by 86·3% (95% CI 78·4-94·6) to 24 000 events per year (95% CI 14 000-39 000; 0·06% of livebirths) and achieve WHO elimination targets.</p><p><strong>Interpretation: </strong>Vertical transmission is an important contributor to HBV transmission in the WHO African region. Scaling up of hepatitis B birth dose vaccination and antiviral prophylaxis is urgently needed, which could achieve elimination of vertical transmission.</p><p><strong>Funding: </strong>Wellcome Trust.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e447-e458"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532000","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":"Oral PrEP safety in pregnancy with longitudinal follow-up of children for 36 months.","authors":"Dvora Joseph Davey, Thokozile R Malaba","doi":"10.1016/S2214-109X(24)00531-X","DOIUrl":"https://doi.org/10.1016/S2214-109X(24)00531-X","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e379-e380"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532012","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":"Associations between the Bolsa Familia conditional cash transfer programme and substance use disorder hospitalisations: a quasi-experimental study of the 100 Million Brazilian Cohort.","authors":"Lidiane Toledo, Erika Fialho, Flávia Alves, Maurício L Barreto, Vikram Patel, Daiane B Machado","doi":"10.1016/S2214-109X(24)00508-4","DOIUrl":"10.1016/S2214-109X(24)00508-4","url":null,"abstract":"<p><strong>Background: </strong>Although low socioeconomic status is a recognised risk factor for substance use disorders (SUDs), the potential of socioeconomic interventions, such as conditional cash transfer programmes, to mitigate this burden remains poorly explored. Our study investigated whether the Brazilian conditional cash transfer, the Bolsa Familia Program (BFP) was associated with reduced SUD hospitalisations (ie, both admission to and treatment within hospital).</p><p><strong>Methods: </strong>This quasi-experimental study used national administrative hospitalisation and BFP payroll records linked to the 100 Million Brazilian Cohort baseline from 2008 to 2015. We used Poisson regression models with inverse probability of treatment weighting, using the propensity score, to evaluate the association of the BFP with SUD hospitalisations.</p><p><strong>Findings: </strong>The study included 35 926 326 individuals registered at baseline from 2008 to 2015. BFP benefit was associated with a lower risk of SUD hospitalisations overall (incidence rate ratios [IRR] 0·83, 95% CI 0·81-0·85). BFP benefit was also associated with both a lower risk of alcohol-related hospitalisations (0·74, 0·71-0·77) and a lower risk of hospitalisations due to other substances except alcohol (0·89, 0·86-0·92). Both male and female beneficiaries had a lower risk of SUD hospitalisation compared with non-beneficiaries. We observed an increased gradient of protection against SUD hospitalisations among beneficiaries of the BFP as municipal deprivation increased. The reduction was 10% (IRR 0·90, 0·87-0·92) in less deprived municipalities and 41% (0·59, 0·49-0·71) in highly deprived municipalities.</p><p><strong>Interpretation: </strong>Receiving BFP benefit was associated with lower risk of SUD hospitalisation, implicating conditional cash transfers as a potential tool to respond to SUD-related issues in individuals experiencing poverty. This protective association could be mediated by alleviating poverty, fulfilling basic needs, improving socioeconomic status, enhancing health access, and promoting education.</p><p><strong>Funding: </strong>National Institute of Mental Health-National Institutes of Health.</p><p><strong>Translation: </strong>For the Portuguese translation of the abstract see Supplementary Materials section.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e508-e516"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531968","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":"Global access to medical oxygen: embedding nursing involvement.","authors":"Di Brown, Dires Birhanu, Michael Lauri, Obse Lubo, Patrick Kimutai Too, Keshni Naidu, Vinitha Ravinsdran, Mary Samor","doi":"10.1016/S2214-109X(24)00499-6","DOIUrl":"10.1016/S2214-109X(24)00499-6","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e394-e395"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469495","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":"Advanced HIV disease and epidemic control in sub-Saharan Africa.","authors":"Jessica E Justman, Maureen Syowai","doi":"10.1016/S2214-109X(25)00020-8","DOIUrl":"https://doi.org/10.1016/S2214-109X(25)00020-8","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e375-e376"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531902","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":"Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security.","authors":"Hamish R Graham, Carina King, Ahmed Ehsanur Rahman, Freddy Eric Kitutu, Leith Greenslade, Masooma Aqeel, Tim Baker, Lucio Flavio de Magalhães Brito, Harry Campbell, Karen Czischke, Mike English, Adegoke G Falade, Patricia J Garcia, Mireia Gil, Stephen M Graham, Amy Z Gray, Stephen R C Howie, Niranjan Kissoon, Ramanan Laxminarayan, Inês Li Lin, Michael S Lipnick, Dianne B Lowe, David Lowrance, Eric D McCollum, Tisungane Mvalo, Jacquie Oliwa, Stefan Swartling Peterson, Rediet Shimeles Workneh, Heather J Zar, Shams El Arifeen, Freddie Ssengooba","doi":"10.1016/S2214-109X(24)00496-0","DOIUrl":"10.1016/S2214-109X(24)00496-0","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e528-e584"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469654","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}