Lancet Global Health最新文献

{"title":"Market-source pathogens in traditional food markets, 2000-25: a systematic review and meta-analysis.","authors":"Hai Tong, Saira Afzal, Muhammad Uzair Mukhtar, Nazrullozoda Sulaimon, Eman E El Shanawany, Bolor Bold, Chimedtseren Bayasgalan, Benguang Zhang, Lijuan Liu, Jinxin Zheng, Shiyang Guan, Zhaoyu Guo, Lei Duan, Shan Lv, Wei Hu, Xiaonong Zhou, Xinyu Feng","doi":"10.1016/j.langlo.2026.104016","DOIUrl":"10.1016/j.langlo.2026.104016","url":null,"abstract":"<p><strong>Background: </strong>Traditional food markets, often referred to as wet markets, live poultry markets, or farmers' markets, remain a major source of animal-origin foods and fresh produce in many low-income and middle-income countries (LMICs). These markets bring humans, domestic animals, wildlife, and the environment into close contact and have been repeatedly implicated in the emergence of zoonotic and foodborne diseases. Yet, the overall global burden, pathogen spectrum, and risk gradients within these settings have not been comprehensively quantified.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of studies published between Jan 1, 2000, and Oct 31, 2025, following the PRISMA 2020 reporting guidelines. We searched major English and Chinese databases for cross-sectional or baseline studies reporting the detection of zoonotic or foodborne pathogens in traditional food markets or related retail settings. Studies were excluded if they were not conducted in traditional markets, had non-extractable data, had a sample size of fewer than 20, had intervention-related outcomes, had duplicate populations, or did not have prevalence or detection rate reporting. Data were extracted as detection records, defined as unique pathogen-sample type-market setting combinations. Study quality was assessed with the Joanna Briggs Institute tool for prevalence studies. We used random-effects meta-analysis of logit-transformed proportions to estimate pooled prevalence and 95% CIs overall and across major subgroups. Heterogeneity was assessed with I<sup>2</sup> and τ<sup>2</sup>, and meta-regression was used to examine temporal trends and associations between study quality and prevalence. Robustness was assessed with leave-one-out analyses and small-study effects. This study is registered with PROSPERO, CRD420251267834.</p><p><strong>Findings: </strong>We included 247 studies comprising 597 detection records from 41 countries across 16 regions. The global pooled prevalence of market-source pathogens in traditional markets was 15·32% (95% CI 13·96-16·80). By pathogen kingdom, pooled prevalence was 19·41% (16·21-23·08) for bacteria, 8·40% (7·15-9·83) for viruses, and 27·05% (21·91-32·89) for parasites. Regionally, prevalence was highest in southeast Asia (23·09% [18·43-28·52]), followed by south Asia (15·52% [10·06-23·20]) and east sub-Saharan Africa (14·54% [7·13-27·40]). By market type, fish and seafood markets showed the highest pooled prevalence (37·87% [26·05-51·33]), and by sample type, the highest estimates were observed in fish and seafood, raw meat, and environmental samples. Lower estimates were observed in cooked foods, fruit and vegetables, and worker samples, suggesting a gradient from animal and environmental reservoirs towards ready-to-eat foods and humans. Meta-regression showed no significant global linear temporal trend in prevalence, whereas higher methodological quality was associated with lower reported ","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"104016"},"PeriodicalIF":22.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Glob Health 2026; 14: e702-13.","authors":"","doi":"10.1016/j.langlo.2026.103962","DOIUrl":"10.1016/j.langlo.2026.103962","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103962"},"PeriodicalIF":22.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851748","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 health ethics in international collaborative research during policy transition: what can we learn from the proposed newborn hepatitis B vaccine trial in Guinea-Bissau?","authors":"Keymanthri Moodley, Stuart Rennie, Brian D Earp","doi":"10.1016/j.langlo.2026.103980","DOIUrl":"10.1016/j.langlo.2026.103980","url":null,"abstract":"<p><p>International collaborative research in Africa has raised ethical challenges for decades. The proposed newborn hepatitis B vaccine trial in Guinea-Bissau is the latest case to crystallise concerns around potential exploitation of disadvantaged populations, drawing comparisons to Tuskegee and other research abuses. We argue that the decision to stop the trial was appropriate, but that the reasons most invoked in public debate are incomplete. The trial was designed to happen during a defined window before Guinea-Bissau's planned rollout of the universal birth-dose vaccination in 2027-28, when randomisation between the WHO-recommended birth dose and the existing local standard of care remained possible. Under what conditions, if any, could such research-comparing a local versus global standard of care during health policy transition-be ethically justified? We propose four conditions and assess the proposed trial against them. The trial potentially satisfies some of our proposed conditions but does not meet others owing to an absence of maternal hepatitis B screening despite high background prevalence, methodological shortcomings that threaten the interpretability of results, and governance deficiencies, including an absence of sponsor-country ethics review (required by the Declaration of Helsinki). We treat this trial as a cautionary tale offering important lessons for future research in low-resource settings undergoing policy transitions.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103980"},"PeriodicalIF":22.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206673","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":"Small island developing states on the frontline.","authors":"The Lancet Global Health","doi":"10.1016/j.langlo.2026.104087","DOIUrl":"https://doi.org/10.1016/j.langlo.2026.104087","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"14 9","pages":"104087"},"PeriodicalIF":22.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888633","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":"Cost-effectiveness of providing pre-exposure and post-exposure prophylaxis for the prevention of HIV via online pharmacies in western Kenya: a modelling study.","authors":"Akash Malhotra, Nishali Patel, David Kaftan, Yilin Chen, Cory Arrouzet, Arden Saravis, Catherine Kiptinness, Tabitha Kareithi, Kenneth Ngure, Katrina F Ortblad, Monisha Sharma","doi":"10.1016/j.langlo.2026.103977","DOIUrl":"10.1016/j.langlo.2026.103977","url":null,"abstract":"<p><strong>Background: </strong>Oral pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) provision via online pharmacies (henceforth online PrEP and PEP) offers promise in increasing biomedical HIV prevention coverage. In this study, we aimed to estimate the cost-effectiveness of online PrEP and PEP scale-up in western Kenya.</p><p><strong>Methods: </strong>We adapted a network-based model, EMOD-HIV, to simulate online PrEP and PEP implementation from 2026 to 2036; costs and use of online PrEP and PEP and client characteristics were informed by the ePrEP Kenya pilot study, which evaluated online PrEP and PEP provision in Nairobi and Mombasa, Kenya. Other parameters were obtained from surveillance data and published literature. Eligible clients were aged 15-49 years reporting condomless sex with non-marital partners. We assumed online PrEP and PEP provision was implemented through public-private partnership, with the Kenya Ministry of Health providing PrEP and PEP drugs and service delivery costs paid by the online pharmacy (and charged to clients). We estimated HIV infections, HIV-related deaths, and disability-adjusted life-years (DALYs) averted compared with the baseline scenario of background oral PrEP only. We calculated incremental cost-effectiveness ratios (ICERs) assessing only costs incurred by the Kenya Ministry of Health over 35 years and used a supply-side threshold of US$500 per DALY averted. We calculated 95% uncertainty intervals (UIs) across 100 parameter sets.</p><p><strong>Findings: </strong>Online PrEP and PEP was projected to reach population coverage of 0·7% (95% UI 0·7-0·8) for PEP and 0·3% (0·2-0·3) for PrEP and avert 13·9% (10·1-17·1) of HIV infections over 10 years. HIV-related deaths were reduced by 4·3% (95% UI 2·0-6·9) over the 35-year time horizon. The intervention was cost-effective from the Kenya Ministry of Health perspective (ICER $212 [95% UI 15-1409] per DALY averted). In a scenario assuming only online PEP availability (to isolate the effect of PEP), 11·6% (95% UI 8·6-15·2) of HIV infections were averted (ICER $210 [95% UI 41-3798] per DALY averted). The intervention remained cost-effective when varying PrEP and PEP effectiveness and assuming HIV testing and treatment disruptions.</p><p><strong>Interpretation: </strong>Online PrEP and PEP can avert substantial HIV infections, even with low population coverage. PEP was responsible for most intervention health benefits, likely due to high observed demand for PEP compared with PrEP in the pilot study. Leveraging private retailers can be efficient for scaling up HIV prevention in an era of shrinking donor funding.</p><p><strong>Funding: </strong>Gates Foundation.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103977"},"PeriodicalIF":22.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690178","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, regional, and national burden of exposure to chewing tobacco, 1990–2023: a systematic analysis of the Global Burden of Disease Study 2023","authors":"Gabriela Fernanda Gil,Jason A Anderson,Xiaochen Dai,Luisa S Flor,Oliver J McElvaney,Brooks W Morgan,Erin C Mullany,Erin M O'Connell,Bhoomadevi A,Hasan Aalruz,Rashad Abdul-Ghani,Rizwan Suliankatchi Abdulkader,Parisa Abedi,Olugbenga Olusola Abiodun,Olumide Abiodun,Nagah M Abourashed,Dariush Abtahi,Fuad Hamdi A Abuadas,Mohammad H Abuadas,Rana Kamal Abu-Farha,Ahmed Abu-Zaid,Anirudh Balakrishna Acharya,Apurba Acharya,Swetha Acharya,Babatope Oluwadamilare Adebiyi,Miracle Ayomikun Adesina,Juliana Bunmi Adetunji,Usha Adiga,Aanuoluwapo Adeyimika Afolabi,Muhammad Sohail Afzal,Feleke Doyore Agide,Aqeel Ahmad,Khabir Ahmad,Khurshid Ahmad,Sajjad Ahmad,Ayman Ahmed,Md Faisal Ahmed,Naveed Ahmed,Shahzaib Ahmed,Sara Akeel,Akil Akhtar,Tomi Akinyemiju,Omar Al Omari,Mohammad Al Qadire,Yazan Al Thaher,Mohammad Ahmmad Mahmoud Al Zoubi,Timothy Olukunle Aladelusi,Mohammed Sultan Al-Ak'hali,Mohammad Khursheed Alam,Rasmieh Mustafa Al-Amer,Turki M Alanzi,Shams Moh'd Fares Khalaf Al-Anzi,Ahmad M Al-Bashaireh,Mohammed S Aldossary,Raouf Alebshehy,Aqeel M Alenazi,Fahad D Algahtani,Abdelazeem M Algammal,Khalid F Alhabib,Fadwa Naji Alhalaiqa,Amidu Alhassan,Ashraf Alhumaidi,Inayat Ali,Irfan Ali,Kamran Ali,Mohammad Daud Ali,Rafat Ali,Syed Shujait Ali,Syed Mohamed Aljunid,Sameer Abdulmalik Alkubati,Wesam Taher Almagharbeh,Mohammed J Almalki,Sabah Al-Marwani,Margret Beaula Alocious Sukumar,Mahmoud A Alomari,Jaber S Alqahtani,Mohammad R Alqudimat,Ahmad Rajeh Al-Qudimat,Ahmed Yaseen Alqutaibi,Sahel Majed Alrousan,Mohammed Amjed Alsaegh,Najim Z Alshahrani,Ali Salman Al-Shami,Zaid Altaany,Awais Altaf,Hassan Alwafi,Yaser Mohammed Al-Worafi,Hany Aly,Mohammad Sharif Ibrahim Alyahya,Abdulmohsen Hamdan Al-Zalabani,Karem H Alzoubi,Adel S Al-Zubairi,Revati Amin,Tarek Tawfik Amin,Etsay Woldu Anbesu,Syam S Andra,Abhishek Anil,Ah Sruthi Anil Kumar,Prapti Anjana,Kabilan Annadurai,Saeid Anvari,Razique Anwer,Gururaj Arakeri,Aleksandr Y Aravkin,Harshit Arora,Monika Arora,Umesh Raj Aryal,Mohammad Ashfaque,Tahira Ashraf,Muhammad Shahzad Aslam,Yuni Asri,Anil Raj Assariparambil,Omer Atac,Seyyed Shamsadin Athari,Samuel Babajide Atoyebi,Alok Atreya,Avinash Aujayeb,Manal Awad,Kemal Lemnuro Awol,Ahmad Ayed,Syed Babar Jamal Bacha,Ashish D Badiye,Riadh Badraoui,Youngoh Bae,Nasser Bagheri,Khlood K Baghlaf,Abdul Rasheed Bahar,Yasemin Bahar,Razieh Bahreini,Parvathy Balachandran,Raju Balaji,Yatan Pal Singh Balhara,Biswajit Banik,Hiba Jawdat Barqawi,Amadou Barrow,Fadi Basha,Md Abu Bashar,Almaz Nibret Belay,Uzma Iqbal Belgaumi,Abdulrahman Babatunde Bello,Ibrahim Olajide Bello,Kelemu Zelalem Berhanu,Pankaj Bhardwaj,Sonu Bhaskar,Ashok Kumar Bhati,Sudip Bhattacharya,Bijit Biswas,Eyob Ketema Bogale,Archith Boloor,Dejana Braithwaite,Zahid A Butt,Senthilkumar C,Sanjay C J,Zhong Cao,Felix Carvalho,Márcia Carvalho,Sandra Carvalho,Joao Mauricio Castaldelli-Maia,Maria Sofia Cattaruzza,Sandip Chakraborty,Rama Mohan Chandika,Vijay Kumar Chattu,Sirshendu Chaudhuri,Akhilanand Chaurasia,Snehal Prakash Chavhan,Meng Xuan Chen,Saravanan Chinnaiyan,Bryan Chong,Sonali Gajanan Choudhari,Dinh-Toi Chu,Isaac Sunday Chukwu,Sunghyun Chung,Alexandru Corlateanu,Claudia Cosma,Natalia Cruz-Martins,Omid Dadras,Namrata Dagli,Gloria Dalla Costa,Mouni Damineni,Lalit Dandona,Rakhi Dandona,Samuel Demissie Darcho,Yagnik Dave,Marco Del Riccio,Ismail Dergaa,Vinoth Gnana Chellaiyan Devanbu,Syed Masudur Rahman Dewan,Arkadeep Dhali,Amol S Dhane,Bibha Dhungel,Kimia Didehvar,Hoa Thi Do,Pranavi Dohare,Sushil Dohare,Cátia Domingues,Jasmin Dönicke,Ojas Prakashbhai Doshi,Jiang Du,Emeka W Dumbili,Senbagam Duraisamy,Siddhartha Dutta,Kristina Edvardsson,Michael Ekholuenetale,Suhaib El Khatib,Iman El Sayed,Mohamed Ahmed Eladl,Omar Abdelsadek Abdou Elmeligy,Ashraf A El-Metwally,Abdelgawad Salah Eltahawy,Collins Nduka Esomchi,Elochukwu Ezenwankwo,Devaraj Ezhilarasan,Adeniyi Francis Fagbamigbe,Ali Faramarzi,Mohammad Fareed,Carla Sofia E Sá Farinha,Munazza Fatima,Alireza Feizkhah,Feten Fekih-Romdhane,Nuno Ferreira,Anteneh Fikrie,Filippos T Filippidis,Florian Fischer,James L Fisher,Muktar A Gadanya,Márió Gajdács,Balasankar Ganesan,Balasubramanian Ganesh,Shivaprakash Gangachannaiah,Fernando Jr Barroga Garcia,Rupesh K Gautam,Haftay Gebremedhin,Mizan Habtemichael Gebresilassie,Khalid Yaser Ghailan,Lobna Gharaibeh,Sailaja Ghimire,Sama Ghoba,Ehsan Gholami,Zainab Gholami,Thinh Gia Gia Nguyen,Artyom Urievich Gil,Gamze Gökulu,Pouya Goleij,Divya Gopinath,Michal Grivna,Bin Guan,Zenawi Hagos Gufue,Damitha Asanga Gunawardane,Sasidhar Gunturu,Anish Kumar Gupta,Bhawna Gupta,Himanshu Gupta,Prakash C Gupta,Rajeev Gupta,Sunanda Gupta,Yonas Deressa Guracho,Parham Habibzadeh,Yohannes Gebreegziabher Haile,Ferdous Hakim,Esam Halboub,Sajid Hameed,Nasrin Hanifi,Arief Hargono,Ahmed I Hasaballah,Faizul Hasan,Ikramul Hasan,Shamimul Hasan,Towhid Hasan,Nada Tawfig Hashim,Ahmad Shoeb Hashmi,Md Saquib Hasnain,Nageeb Hassan,Simon I Hay,Behzad Heibati,Mohammad Heidari,Zaw Myo Hein,Mohamed Fawzi Hemida,Brenda Yuliana Herrera-Serna,Yuta Hiraike,Ashley Mark Hopkins,Lubna Hossain,Sahadat Hossain,Mehdi Hosseinzade,Weijun Huang,Javid Hussain,Bing-Fang Hwang,Luigi Francesco Iannone,Segun Emmanuel Ibitoye,Olayinka Stephen Ilesanmi,Irena M Ilic,Milena D Ilic,Mohammad Tarique Imam,Mustapha Immurana,Lalu Muhammad Irham,CV Irshad,M Mofizul Islam,Farhad Islami,Juan S Izquierdo-Condoy,Jaison Jacob,Abhishek Jaiswal,Mihajlo Jakovljevic,Qazi Mohammad Sajid Jamal,Rajiv Janardhanan,Ruwan Duminda Jayasinghe,Achala Upendra Jayatilleke,Gwang Hun Jeong,Bijay Mukesh Jeswani,Zixiang Ji,Shuai Jin,Jobin Jose,Alex Joseph,Nitin Joseph,Charity Ehimwenma Joshua,Hema Shree K,Vaishali K,Billingsley Kaambwa,Zubair Kabir,Vidya Kadashetti,Dler Hussein Kadir,Pradnya Vishal Kakodkar,Ebbie Kalan,Mehnaz Kamal,Mona Kanaan,Jiseung Kang,Kehinde Kazeem Kanmodi,Surya Kant,Neeti Kapoor,Shalini Kapoor,Debasish Kar,Sujita Kumar Kar,Neila Karagezova,Mohmed Isaqali Karobari,Manoj Kumar Kashyap,Chukwudi Keke,Asaad Khalid,Maseer Khan,Moien Ab Khan,Muhammad Arslan Khan,Muhammad Umer Khan,Serab Khan,Sumaiya Khan,Zahid Khan,Zelal Kharaba,Sameer Uttamaro Khasbage,Samira Khoshvaght,Mahmood Khosrowjerdi,P Ratan Khuman,Min Seo Kim,Marta A Kisiel,Shivakumar KM,Prakash Babu Kodali,Oleksii Korzh,Archana Koul,Sindhura Lakshmi Koulmane Laxminarayana,Kewal Krishan,Abhishek Krishna,Deepak Krishnamurthy,Nitya Krishnasamy,Pranav S Kshtriya,Chong-Han Kua,Garry Kuan,Claudia E Kuehni,Omar Kujan,Mukhtar Kulimbet,Ashok Kumar,Dhasarathi Kumar,Diwakar Kumar,G Anil Kumar,Laksh Kumar,Mohan Kumar,Nithin Kumar,Pawan Kumar,Pradeep Kumar,Rakesh Kumar,Tushar Kumar,V Udaya Kumar,Om P Kurmi,Maria Dyah Kurniasari,Krishna Prasad Kurpad,Taeho Kwak,Chandrakant Lahariya,Hanpeng Lai,Timo Lajunen,Agung Dwi Laksono,Yilma Markos Larebo,Savita Lasrado,Munjae Lee,Seung Won Lee,Hui Li,Jiaying Li,Qiang Li,Si Li,Xingang Li,Zhengrui Li,Yanxue Lian,Daniel Lindholm,Bingsheng Liu,Gang Liu,Jue Liu,José Francisco López-Gil,Giancarlo Lucchetti,Abhilash Ludhiadch,Pincheng Luo,Hung N Luu,Miltiadis D Lytras,Monika Machoy-Rakoczy,Ahmed A Madfa,Samatar Abshir Mahamed,Mansour Adam Mahmoud,Kashish Malhotra,Lokesh Manjani,Farheen Mansoor,Miquel Martorell,Yasith Mathangasinghe,Medha Mathur,Neeta Mathur,Khurshid A Mattoo,Enkeleint A Mechili,John Robert Carabeo Medina,Jitendra Kumar Meena,Ravi Mehrotra,Vini Mehta,Satish Melwani,Aamir Raoof Memon,Godfred Antony Menezes,Ritesh G Menezes,Tarig H Merghani,Tomislav Mestrovic,Chamila Dinushi Kukulege Mettananda,Mohamed M M Metwally,Muhammad Agus Mikrajab,Giuseppe Minervini,Erkin M Mirrakhimov,Vinaytosh Mishra,Sanjeev Misra,Tridip Mitra,Farduus Ibraahim Mohamed,Nouh Saad Mohamed,Ibrahim Mohammadzadeh,Zaidan Mohammed,Syam Mohan,Nagaishwarya Moka,Ali H Mokdad,Hirbaye Mokona,Himel Mondal,Rafael Silveira Moreira,Rohith Motappa,Sumaira Mubarik,Amartya Mukhopadhyay,Malaisamy Muniyandi,Christopher J L Murray,Krishna Murti,Vignesh Murugan,David Musoke,Sathish Muthu,Karikalan Nagarajan,Kiran P P Nagdeo,Ganesh R Naik,Gopal Nambi,Vinay Nangia,Shumaila Nargus,Mohammad Zakaria Nassani,Zuhair S Natto,Biswa Prakash Nayak,Kinjal Nayak,Andrew Kamsoko Ndakotsu,Sabina Onyinye Nduaguba,Samata Nepal,Marie Ng,Cuong Tat Nguyen,Duy Cao Nguyen,Huong Lan Thi Nguyen,Trang Nguyen,Ali Nikoobar,Vikram Niranjan,Fred Nugen,Wahyu Pudji Nugraheni,Nazik Nurelhuda,Bogdan Oancea,Ramez M Odat,Fabio Massimo Oddi,Ismail A Odetokun,Olusegun Olatunji Ojedoyin,Osaretin Christabel Okonji,Andrew T Olagunju,Jeby Jose Olickal,Ahmed Omar Bali,Hope Onohuean,Miracle Chinonso Oparah,Michal Ordak,Augustus Osborne,Tope Oyelade,Mahesh P A,Alicia Padron-Monedero,Raul Felipe Palma-Alvarez,Alok Kumar Panda,Deepshikha Pande Katare,Ashok Pandey,Sanjib Raj Pandey,Ioannis Pantazopoulos,Shahina Pardhan,Tarang Parekh,Romil R Parikh,Arpit Parmar,Pragnesh Parmar,Sameena Parveen,Roberto Passera,Bhargav Umeshchandra Patel,Satyananda Patel,Shivani Patel,Vipin Patidar,Ashlesh Patil,Dimitrios Patoulias,Uttam Paudel,Shrikant Pawar,Saikiran Pendem,Prince Peprah,Gavin Pereira,Olumuyiwa James Peter,Tung Thanh Pham,Edoardo Pirera,Roman V Polibin,Ramesh Poluru,Thantrira Porntaveetus,Amit Porwal,Priyanka Porwal,Pranil Man Singh Pradhan,Elton Junio Sady Prates,Harsh Priya,Bharathi M Purohit,Jagadeesh Puvvula,Ibrahim Qattea,Raghu Anekal Radhakrishnan,Venkatraman Radhakrishnan,Yashpal Singh Raghav,Pracheth Raghuveer,Fakher Rahim,Sajjad Rahimi,Firman Suryadi Rahman,Md Ferdous Rahman,Mohammad Hifz Ur Rahman,Mosiur Rahman,Amita Rai,Sunil Kumar Raina,Jeffrey Pradeep Raj,Mahmoud Mohammed Ramadan,Majed Ramadan,Kadar Ramadhan,Shakthi Kumaran Ramasamy,Pramod W Ramteke,Lokesh Rana,Shailendra Singh Rana,Chhabi Lal Ranabhat,Kumuda Rao,Sowmya J Rao,Devarajan Rathish,Tapash Ranjan Rautray,Salman Rawaf,Abdul Rehman,Mina Rezaei,Nazila Rezaei,Ravi Rohilla,Susanne Röhr,Chanapong Rojanaworarit,Himanshu Sekhar Rout,Shubhanjali Roy,Rohini Ruhil,Chandan S N,Cameron John Sabet,Mamta Sachdeva Dhingra,Basema Ahmad Saddik,Mohammad Reza Saeb,Umar Saeed,Dominic Sagoe,Indranil Saha,Amirhossein Sahebkar,Vaibhav Sahni,Ambika Sahoo,Mirza Rizwan Sajid,Joseph W Sakshaug,Afeez Abolarinwa Salami,Mohamed A Saleh,Janmejaya Samal,Abdallah M Samy,Siddaram Shivaji Sarate,Aswini Saravanan,Yaser Sarikhani,Mohammad Sarmadi,Gargi Sachin Sarode,Sachin C Sarode,Mukesh Kumar Sathya Narayanan,Aanchal Satija,Shakta Mani Satyam,Ganesh Kumar Saya,Christophe Schinckus,Art Schuermans,Siddharthan Selvaraj,Mohammad H Semreen,Subramanian Senthilkumaran,Yashendra Sethi,Seyed Mohammad Seyed Alshohadaei,Ahmed Nabil Shaaban,Arash Shaban-Nejad,Muhammed Shabil,Sweni Shah,Sunder Sham,Muhammad Aaqib Shamim,Alfiya Shamsutdinova,Abhishek Shankar,Mohammed Shannawaz,Bhoopesh Kumar Sharma,Manoj Sharma,Ravi Kumar Sharma,Shreya Sharma,Vishal Sharma,Somia Shehzadi,Mahdi Sheikh,Mahabalesh Shetty,Pavanchand Shetty,Premalatha K Shetty,Hui-Zhong Shi,Arun Shirali,Shirindokht Shirazi,Kawkab Shishani,Aminu Shittu,Ivy Shiue,Ambreen Shoaib,Aman Shrestha,Sunil Shrestha,Dharmsheel Shrivastav,Kerem Shuval,Negussie Boti Sidamo,Abhinav Singh,Amit Singh,Bhim Pratap Singh,Brij Pal Singh,Jasvinder A Singh,Jawahar Singh,Poornima Suryanath Singh,Prashant Kumar Singh,Ragini D Singh,Surjit Singh,Virendra Singh,Gisha Sivan,Gowri Sivaramakrishnan,Valentin Yurievich Skryabin,Farrukh Sobia,Md Salman Sohel,Lencho Kajela Solbana,Solikhah Solikhah,Mansi Soni,Joan B Soriano,Michele Sorrentino,Chandrashekhar T Sreeramareddy,Vipul Srivastava,Paschalis Steiropoulos,Marjia Sultana,Zhong Sun,Shanthosh Priyan Sundaram,Johan Sundström,Jithin Surendran,Chandan Kumar Swain,Celine Tabche,Mohammad Tabish,Iman M Talaat,Avni Tambi,Mircea Tampa,Benjamin Kye Jyn Tan,Ingan Ukur Tarigan,Aigul Yelgondiyevna Tazhiyeva,Gebremaryam Temesgen,Reem Temsah,Masayuki Teramoto,Kavumpurathu Raman Thankappan,Rekha Thapar,Madi Tleshev,Thang Huu Tran,Domenico Trico,Aristidis Tsatsakis,Evangelia Eirini Tsermpini,Abdul Rohim Tualeka,Himayat Ullah,Brigid Unim,Bhaskaran Unnikrishnan,Abdulkadir Usman Sambo,Berna Uzun,Hande Uzunçıbuk,Rakesh V R,Sai Mahesh Vajjala,Zahir Vally,Jef Van Den Eynde,Joe Varghese,Siddhartha Alluri Varma,Sampara Vasishta,Vishnu Priya Veeraraghavan,Balachandar Vellingiri,U Venkatesh,Narayanaswamy Venketasubramanian,Akshaya Kumar Verma,Vignesh Vikram,David Villarreal-Zegarra,Liang Wang,Shu Wang,Yaojie Wang,Fei-Long Wei,Dakshitha Praneeth Wickramasinghe,Nuwan Darshana Wickramasinghe,Faustine Williams,Shulan Wu,Hong Xiao,Wanqing Xie,Zemenu Shiferaw Yadita,Kaiqi Yang,Renjulal Yesodharan,Arzu Yiğit,Vahit Yiğit,Biksegn Asrat Yirdaw,S Yogeshkumar,Dong Keon Yon,Naohiro Yonemoto,Chuanhua Yu,Monal Yuwanati,Muhammad Sohail Zafar,Emilia Zainal Abidin,Fathiah Zakham,Hamed Zandian,Michael Zastrozhin,Saad Zbiri,Mohammed G M Zeariya,Alemu Birara Zemariam,Eyael M Zeru,Haijun Zhang,Zhiqiang Zhang,Zhi-Jiang Zhang,Lei Zheng,Ming-Hua Zheng,Carl Zhou,Mohamed Ali Zoromba,Ahed H Zyoud,Emmanuela Gakidou","doi":"10.1016/j.langlo.2026.104043","DOIUrl":"https://doi.org/10.1016/j.langlo.2026.104043","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"1 1","pages":"104043"},"PeriodicalIF":34.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149088080","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":"Redesigning service delivery for the next phase of HIV prevention.","authors":"Tara Danielle Mangal","doi":"10.1016/j.langlo.2026.104035","DOIUrl":"10.1016/j.langlo.2026.104035","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"104035"},"PeriodicalIF":22.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690162","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":"Screening, brief intervention, and referral to treatment compared with treatment as usual for alcohol use in an integrated refugee settlement in Zambia: a hybrid, type 1, randomised controlled trial.","authors":"M Claire Greene, Henry Loongo, Kristina Metz, Mbaita Shawa, Nkumbu Mtongo, Irving Lukoma, Princess Chiluba, Veronica Chibemba, Shira Kamono, Namuchana Mushabati, Mary Chibambula, Kim Watson, Kelsey Vaughan, Lina Demis, Stephanie Skavenski, Laura K Murray, Peter Ventevogel, Anja Busse, Wietse A Tol, Nadine Ezard, David Mwanza, Gabriel Lungu, Muzi Kamanga, Jeremy C Kane","doi":"10.1016/j.langlo.2026.103989","DOIUrl":"10.1016/j.langlo.2026.103989","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Alcohol and other drug use represent a leading cause of preventable death and disability globally, disproportionately burdening low-resource settings. Alcohol and other drug use interventions remain neglected in humanitarian health research and programming. We evaluated the effectiveness of a multicomponent intervention in reducing alcohol use in a refugee setting in Zambia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a parallel, individually randomised trial in the Mantapala refugee settlement in Zambia. Eligible participants were Congolese refugees and Zambian host community members, aged 15 years and older, with Alcohol Use Identification Test (AUDIT) scores of 8 or more for males and 4 or more for females. Participants were allocated (1:1) to screening, brief intervention, and referral to treatment (SBIRT) or treatment as usual via a computer-generated randomisation scheme with allocation concealment by opaque envelopes. SBIRT included screening, a brief intervention, and indicated referral to psychotherapy for alcohol and other drug use and mental health conditions delivered by trained non-specialists. Treatment as usual comprised referral to primary health centre staff trained in basic management and care for alcohol use problems. The primary outcome was AUDIT score evaluated at 6 months. Linear mixed models and an intention-to-treat approach were used following multiple imputation. Implementation was assessed qualitatively and through cost-effectiveness analysis. Due to the nature of the trial, participants counsellors, and research assistants were unmasked at enrolment, although data analysts remained masked via dummy coding of the study group. The trial was registered on ClinicalTrials.gov (NCT05471921) and is completed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between April 26, 2023, and Feb 29, 2024, 443 participants were screened for eligibility, 43 were excluded, and 400 were enrolled and randomly assigned (199 to the SBIRT group and 201 to the treatment as usual group). 299 (75%) of the 400 participants completed the 6-month assessment and 310 (78%) completed the 12-month assessment. The mean age of participants was 36·9 years (SD 12·1) and 287 (72%) participants were male and 113 (28%) were female. 232 (58%) of the 400 participants were Congolese refugees. AUDIT scores reduced from baseline to 6 months among the SBIRT group (-12·6 [95% CI -14·3 to -11·0]) and the treatment as usual group (-8·1 [-9·8 to -6·3]). The difference in mean change between groups was significantly greater in the SBIRT group than in the treatment as usual group at 6 months (-4·6 [95% CI -6·9 to -2·2]; p&lt;0·0001; d=0·56) and 12 months (-3·5 [95% CI -5·8 to -1·1]; p=0·0030; d=0·43). The incremental cost per improvement in AUDIT at 6 months was US$158. There were no study-related adverse events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;To our knowledge, this is the first known trial in a humanitarian setting of an intervention finding a si","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103989"},"PeriodicalIF":22.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580881","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":"PCR-confirmed Buruli ulcer incidence over a 16-year period in Benin: a nationwide, retrospective, observational study.","authors":"Harvey Johnson, Télésphore Brou, Esaïe Anagonou, Gérard Kpoton, Marie Robbe-Saule, Franck Mignawande, Jean Gabin Houezo, Delphin Degla, Yves Barogui, Julia Aguia, Christian Steunou, Line Ganlonon, Akimath Habib, Perrin Catraye, Lotus Hotegni, Ange Dossou, Caroline Baumy, Alexandra Boccarossa, Sébastien Fleuret, Vincent Dubee, Estelle Marion, Matthieu Eveillard, Laurent Marsollier, Ghislain Emmanuel Sopoh","doi":"10.1016/j.langlo.2026.104017","DOIUrl":"10.1016/j.langlo.2026.104017","url":null,"abstract":"<p><strong>Background: </strong>Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans, primarily affecting rural populations in west and central Africa. Between 2004 and 2023, reported Buruli ulcer cases declined sharply across the continent from 5871 to 1573. Determining whether this decline reflects real epidemiological change or surveillance artifacts is crucial for global Buruli ulcer control. We aimed to quantify the incidence of Buruli ulcer in Benin, to analyse observed epidemiological changes, and to relate them to environmental and climate changes.</p><p><strong>Methods: </strong>We did a nationwide, retrospective, observational study using data recorded by Benin's National Buruli Ulcer Control Programme at four specialised health-care centres in southern Benin over 16 years (2008-24). Data were collected prospectively at the time of patient care. 2568 patients with PCR-confirmed Buruli ulcer were included. Annual incidence trends were examined by age, sex, municipality, and clinical form of the lesion. Environmental and climatic variables, including water surface area, temperature, urbanisation, and land use, were integrated with patient data to assess ecological associations. In parallel, a large-scale environmental survey investigated the presence of M ulcerans DNA in aquatic ecosystems. Data census and population projections were obtained from the National Institute of Statistics and Demography of Benin; environmental variables were derived from spatial analyses conducted using open-access geospatial databases.</p><p><strong>Findings: </strong>The incidence of Buruli ulcer decreased by nearly 80% during the study period, from 1·37 per 10 000 inhabitants (SD 0·21 per 10 000 inhabitants) in 2010-16 to 0·24 per 10 000 inhabitants in 2024, with the steepest decrease in children aged 15 years and younger. Historical age and sex differences in incidence largely disappeared over the period. The decrease in incidence coincided with a 25-30% reduction in open water surfaces and a more than 1°C rise in mean air temperature. M ulcerans DNA was undetectable in 122 aquatic sites sampled between 2021 and 2024.</p><p><strong>Interpretation: </strong>To our knowledge, this study provides the first comprehensive, country-wide evidence of a sustained decline in Buruli ulcer incidence in Africa. Environmental changes, particularly climate warming and water surface reduction, might have contributed to this trend. Continued surveillance is essential to confirm whether Buruli ulcer foci are disappearing and to ensure early detection of potential re-emergence.</p><p><strong>Funding: </strong>French Ministry of Higher Education through the Doctoral School of Biology and Health, University of Angers, the French National Research Agency, and INSERM.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"104017"},"PeriodicalIF":22.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585772","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 infection prevention in long-term care facilities in low-income and middle-income countries.","authors":"Chidozie Declan Iwu, Chinwe Iwu-Jaja, Sean Mark Patrick, Anthony Ifeanyi Okoh, Charles Shey Wiysonge","doi":"10.1016/j.langlo.2026.104047","DOIUrl":"10.1016/j.langlo.2026.104047","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"104047"},"PeriodicalIF":22.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632314","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}