Lancet Global Health最新文献

{"title":"Severe anaemia and invasive bacterial infections in Kenyan children: a 26-year hospital surveillance observational study.","authors":"Kelvin Mokaya Abuga, John Muthii Muriuki, Agnes M Mutua, Kennedy Mwai Wambui, Neema Mturi, Shebe Mohammed, John Kalama Fondo, Salim Mwarumba, Caroline J Ngetsa, Charles R Newton, Kathryn Maitland, Philip Bejon, Calman A MacLennan, Manfred Nairz, J Anthony G Scott, Thomas N Williams, Sarah H Atkinson","doi":"10.1016/j.langlo.2026.103976","DOIUrl":"10.1016/j.langlo.2026.103976","url":null,"abstract":"<p><strong>Background: </strong>Severe anaemia is a major cause of hospital admission and mortality in children living in sub-Saharan Africa, but data on its association with invasive bacterial infection are sparse. We aimed to characterise severe anaemia and its association with invasive bacterial infection in Kenyan children.</p><p><strong>Methods: </strong>In this retrospective observational study, we systematically collected admission data for children aged 1 month to 14 years admitted to Kilifi County Hospital, Kenya, between Aug 1, 1998, and July 31, 2024. We excluded children with missing haemoglobin data. We examined prevalence, trends, and factors associated with severe anaemia and very severe anaemia, and the association between severe or moderate anaemia and odds of bacteraemia. Anaemia severity was defined using WHO age-specific thresholds.</p><p><strong>Findings: </strong>Of the 84 348 admissions, representing 64 499 unique children (28 232 [43·8%] females and 36 265 [56·2%] males), included in our analysis, 16 715 (19·8%) admissions had severe anaemia. Severe anaemia was associated with multiple, co-occurring risk factors, including sickle cell disease, malaria, HIV, and malnutrition. As malaria transmission declined (2004-09), the age distribution of severe anaemia shifted towards older children; cases in children aged 5-14 years increased from 16·4% during the high-transmission era (1998-2003) to 44·7% during the low-transmission era (2010-24). Compared with mild or no anaemia, severe anaemia was associated with higher odds of in-hospital mortality (adjusted odds ratio 2·1 [95% CI 1·9-2·3]) and bacteraemia (2·7 [2·5-3·0]), particularly with non-typhoidal Salmonella (6·1 [4·6-8·1]), Escherichia coli (5·7 [4·2-7·7]), Haemophilus influenzae (4·3 [3·0-6·4]), Streptococcus pneumoniae (3·5 [2·9-4·2]), and Klebsiella pneumoniae (2·4 [1·4-4·0]). Moderate anaemia was also associated with increased odds of bacteraemia and mortality.</p><p><strong>Interpretation: </strong>Severe anaemia in hospitalised Kenyan children is multifactorial, increasingly affects older children, and is strongly associated with pathogen-specific bacteraemia and increased mortality. These findings support prompt evaluation for bacteraemia and closer clinical management in severely anaemic children to improve survival.</p><p><strong>Funding: </strong>Wellcome and the Science for Africa Foundation to the DELTAS Africa programme.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103976"},"PeriodicalIF":22.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363273","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":"WHO estimates of the global, regional, and national burden of eight foodborne non-diarrhoeal enteric disease hazards, 2000-21: an updated data synthesis.","authors":"Shannon E Majowicz, Elaine Scallan Walter, Sara M Pires, Yuki Minato, Luria L Founou, Brecht Devleesschauwer, Carlotta di Bari, Arie H Havelaar, Louise Vaes, Teresa Estrada-Garcia, Charlee Roberts, Tesfaye Gobena, Ashok Kumar, Fadi Al Natour, Robin J Lake, Gabriela F Nane, Kim Fernandez, John A Crump, Martyn D Kirk","doi":"10.1016/j.langlo.2026.103981","DOIUrl":"10.1016/j.langlo.2026.103981","url":null,"abstract":"<p><strong>Background: </strong>Foodborne diseases cause substantial illness and death globally. We updated WHO estimates of the burden caused by non-diarrhoeal enteric disease hazards: Brucella spp; Clostridium botulinum; hepatitis A virus; Listeria monocytogenes; Mycobacterium bovis,Mycobacteriumcaprae, and Mycobacteriumorygis; invasive non-typhoidal Salmonella enterica (iNTS); S enterica serotypes Paratyphi A, B, and C; and S enterica serotype Typhi (S Typhi).</p><p><strong>Methods: </strong>We estimated illnesses, deaths, and disability-adjusted life-years (DALYs) for 194 countries for 2000-21 using data from systematic reviews, the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study 2021, a structured expert judgement study, and WHO country consultations. We used disease-specific computational models and hierarchical metaregression modelling with geographical clustering, a global linear time trend, and uncertainty propagation.</p><p><strong>Findings: </strong>In 2021, transmission of these eight hazards by food collectively caused 24·0 million illnesses (95% uncertainty interval 16·9-31·7), 106 000 deaths (63 900-169 000), and 7·26 million DALYs (4·15-12·0). S Typhi, iNTS, and hepatitis A virus caused most DALYs. The greatest burden was in the WHO African region, followed by the South-East Asia region. Mortality was 5·2 times higher and DALY rates were 8·3 times higher in children younger than 5 years compared with people aged 5 years and older. The burden for all hazards, except L monocytogenes, decreased from 2000 to 2021, with S Typhi replacing iNTS as the leading cause of foodborne DALYs.</p><p><strong>Interpretation: </strong>Non-diarrhoeal enteric diseases still cause considerable foodborne disease burden, despite decreases over time. Vulnerable populations, particularly children in low-income countries, bear the greatest burden. Integrated efforts including vaccination, food safety, clean water, sanitation, hygiene, and improved health-care access are required.</p><p><strong>Funding: </strong>WHO.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103981"},"PeriodicalIF":22.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260142","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":"Response to DellaPergola and Zlochin.","authors":"Michael Spagat, Jon Pedersen, Khalil Shikaki, Michael Robbins, Eran Bendavid, Håvard Hegre, Debarati Guha-Sapir","doi":"10.1016/j.langlo.2026.103992","DOIUrl":"10.1016/j.langlo.2026.103992","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103992"},"PeriodicalIF":22.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228846","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; 12: e1936-44.","authors":"","doi":"10.1016/j.langlo.2026.104028","DOIUrl":"10.1016/j.langlo.2026.104028","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"104028"},"PeriodicalIF":22.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260136","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":"Health data poverty in low-income and middle-income countries: a challenge for climate justice.","authors":"Felipe Silva Neves, Larissa Loures Mendes, Paula Martins Horta, Raquel Canuto","doi":"10.1016/j.langlo.2026.103990","DOIUrl":"10.1016/j.langlo.2026.103990","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103990"},"PeriodicalIF":22.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212747","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 representativeness and interviewer-level heterogeneity in the Gaza Mortality Survey.","authors":"Sergio DellaPergola, Mark Zlochin","doi":"10.1016/j.langlo.2026.103991","DOIUrl":"10.1016/j.langlo.2026.103991","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103991"},"PeriodicalIF":22.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228694","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":"Severe anaemia in African children: look beyond under-fives.","authors":"Feiko O Ter Kuile, Chandy C John","doi":"10.1016/j.langlo.2026.103995","DOIUrl":"10.1016/j.langlo.2026.103995","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103995"},"PeriodicalIF":22.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363239","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":"WHO estimates of the global, regional, and national disease burden of nine foodborne chemicals, 2000-21: an updated data synthesis.","authors":"Lea S Jakobsen, Antonio Agudo, Louise Vaes, Mohammed Al Huthiel, Fadi Al Natour, Carlotta di Bari, Brecht Devleesschauwer, Gabriela F Nane, Sara M Pires, Sofie Theresa Thomsen, Hernan Gomez Redondo, Herman Gibb, Robin J Lake, Arie H Havelaar, Charlee Roberts, Yuki Minato, Luc Ingenbleek","doi":"10.1016/j.langlo.2026.103986","DOIUrl":"10.1016/j.langlo.2026.103986","url":null,"abstract":"<p><strong>Background: </strong>We updated WHO estimates of the global, regional, and national foodborne disease burden caused by chemical hazards. We estimated incidence, mortality, and disability-adjusted life-years (DALYs) of aflatoxins B1 and M1, inorganic arsenic, lead, methylmercury, cadmium, dioxin, peanut allergy, and cassava cyanide for 2000-21.</p><p><strong>Methods: </strong>We used data from systematic reviews, established dose-response relationships, the Global Burden of Disease Study 2021, and, where applicable, a structured expert judgment study. We used disease-specific models and a hierarchical meta-regression model with geographical clustering and global linear time trend with uncertainty propagation.</p><p><strong>Findings: </strong>In 2021, the nine foodborne chemicals caused 6·26 million (95% uncertainty interval [UI] 3·36-10·30) cases, 1·12 million (0·40-2·10) deaths, and 29·8 million (12·9-53·1) DALYs globally. Inorganic arsenic and lead caused the highest burden. Cardiovascular diseases due to inorganic arsenic and lead caused 88·9% of foodborne chemical deaths and 76·5% of foodborne chemical DALYs. The greatest DALY rate was estimated for the South-East Asia region, with 789 DALYs (272-1660) per 100 000 people mostly due to inorganic arsenic and lead (94·2%). The region of the Americas carried the highest foodborne chemical DALY rate in children younger than 5 years, with 749 DALYs (435-1260) per 100 000 children, mainly due to the effect of methylmercury on intellectual disability (91·0%). DALY rates from dioxin showed the steepest decrease from 2000 to 2021.</p><p><strong>Interpretation: </strong>Dietary exposure to chemicals causes a substantial global disease burden. An integrated response with ongoing non-communicable disease prevention efforts is key. Granular assessment including subnational exposure contexts is essential to ensure equity.</p><p><strong>Funding: </strong>WHO.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103986"},"PeriodicalIF":22.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266753","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":"Mexico's Servicio Universal de Salud: a pathway to integration and universal health coverage?","authors":"Edson Serván-Mori, Diego Cerecero-García, Octavio Gómez-Dantés","doi":"10.1016/j.langlo.2026.103996","DOIUrl":"10.1016/j.langlo.2026.103996","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103996"},"PeriodicalIF":22.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212772","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":"WHO foodborne disease estimates 2000-21: bridging the burdens of infectious and non-communicable diseases.","authors":"Yuki Minato, Luc Ingenbleek, Charlee Roberts, Richard Kumapley, Arie H Havelaar, Elaine Borghi, Luz María De-Regil","doi":"10.1016/j.langlo.2026.103987","DOIUrl":"10.1016/j.langlo.2026.103987","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"103987"},"PeriodicalIF":22.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266741","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}