Lancet Regional Health-Europe最新文献

{"title":"Türkiye: the threat on academic freedom, democracy, and migrants’ rights requires international attention","authors":"Karl Blanchet","doi":"10.1016/j.lanepe.2025.101304","DOIUrl":"10.1016/j.lanepe.2025.101304","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101304"},"PeriodicalIF":13.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quick buys for prevention and control of noncommunicable diseases","authors":"Gauden Galea ,&nbsp;Allison Ekberg ,&nbsp;Angela Ciobanu ,&nbsp;Marilys Corbex ,&nbsp;Jill Farrington ,&nbsp;Carina Ferreira-Bores ,&nbsp;Daša Kokole ,&nbsp;María Lasierra Losada ,&nbsp;Maria Neufeld ,&nbsp;Ivo Rakovac ,&nbsp;Elena Tsoy ,&nbsp;Kremlin Wickramasinghe ,&nbsp;Julianne Williams ,&nbsp;Martin McKee ,&nbsp;David Stuckler","doi":"10.1016/j.lanepe.2025.101281","DOIUrl":"10.1016/j.lanepe.2025.101281","url":null,"abstract":"<div><div>Despite their established effectiveness, uptake of the WHO best buys for tackling non-communicable diseases (NCDs) has been uneven and disappointing. Here we introduce the “quick buys”, an evidence-based set of cost-effective interventions with measurable public health impacts within five years. We reviewed 49 interventions previously established as cost-effective (&lt;$I20,000 per disability-adjusted life-year averted) to identify the earliest possible detectable effect on high-level population health targets. Using a strict evidence hierarchy, including Cochrane and systematic reviews, we estimated the effects of each intervention against global targets agreed upon by countries. Quick buys were defined as those interventions that could exhibit measurable effects within 5 years, aligning with average electoral cycles in across the WHO European Region. Of the 49 interventions, 25 qualified as quick buys, including those relating to tobacco (n = 5), alcohol (n = 4), unhealthy diet (n = 3), physical inactivity (n = 1), cardiovascular disease (n = 3), diabetes (n = 4), chronic respiratory disease (n = 1), and cancer (n = 4). These findings not only offer guidance to policymakers deciding on interventions that align with short-term political cycles but also have the potential to accelerate progress to global health targets, particularly the 2030 Sustainable Development Goal of reducing premature NCD mortality by one-third.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101281"},"PeriodicalIF":13.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “New systemic treatment paradigms in advanced biliary tract cancer and variations in patient access across Europe” [The Lancet Regional Health – Europe, volume 50, March 2025, 101170]","authors":"Lorenza Rimassa ,&nbsp;Angela Lamarca ,&nbsp;Grainne M. O'Kane ,&nbsp;Julien Edeline ,&nbsp;Mairéad G. McNamara ,&nbsp;Arndt Vogel ,&nbsp;Matteo Fassan ,&nbsp;Alejandro Forner ,&nbsp;Timothy Kendall ,&nbsp;Jorge Adeva ,&nbsp;Andrea Casadei-Gardini ,&nbsp;Lorenzo Fornaro ,&nbsp;Antoine Hollebecque ,&nbsp;Maeve A. Lowery ,&nbsp;Teresa Macarulla ,&nbsp;David Malka ,&nbsp;Elene Mariamidze ,&nbsp;Monica Niger ,&nbsp;Anu Ustav ,&nbsp;John Bridgewater ,&nbsp;Chiara Braconi","doi":"10.1016/j.lanepe.2025.101306","DOIUrl":"10.1016/j.lanepe.2025.101306","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101306"},"PeriodicalIF":13.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent mental health before, during, and after the COVID-19 pandemic in Iceland: a repeated, cross-sectional, population-based study","authors":"Erin Haskell ,&nbsp;Berglind Sigmarsdottir ,&nbsp;Ingibjorg Eva Thorisdottir ,&nbsp;Audun Valborgarson ,&nbsp;Elena Bonilla Aparicio ,&nbsp;Olli Kiviruusu ,&nbsp;Jaana Suvisaari ,&nbsp;Zheng Chang ,&nbsp;Eivind Ystrom ,&nbsp;Agnieszka Butwicka ,&nbsp;Bryndis Bjork Asgeirsdottir ,&nbsp;Heiddis Bjork Valdimarsdottir ,&nbsp;Inga Dora Sigfusdottir ,&nbsp;John Philip Allegrante ,&nbsp;Thorhildur Halldorsdottir","doi":"10.1016/j.lanepe.2025.101301","DOIUrl":"10.1016/j.lanepe.2025.101301","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents' mental health declined during the COVID-19 pandemic, yet little is known about the long-term outcomes after the pandemic's declassification as a global health emergency (5 May 2023). This study examined changes in adolescent mental health in Iceland from 2016 to 2023, using a bioecological framework to identify risk and protective factors.</div></div><div><h3>Methods</h3><div>Youth in Iceland surveys were administered nationwide to 13-15-year-olds in 2016, 2018, 2020, 2021, 2022 and 2023, with an average 75% response rate across the years. The surveys included measures on depressive symptoms, anxiety and hostility (Symptom Checklist-90), parental social support (Perceived Parental Support Scale), screen time, and stress/trauma exposure (Negative Life Events Scale). Stepwise-reduced mixed-effects models assessed the association of age, gender, time and risk/protective factors and their effect on mental health. Multiple imputation addressed missing data, and Bonferroni corrections adjusted for multiple testing.</div></div><div><h3>Findings</h3><div>62,011 adolescents participated: 48.2% female (n = 29,890), 50.0% male (n = 31,002), 1.8% non-binary (n = 1119). Depressive symptoms showed signs of improvement post-pandemic (2023) compared to 2021 (β 0.19, 95% CI 0.13–0.24), yet remained higher than pre-pandemic levels (2016: β −0.38, 95% CI −0.44 to −0.33; 2018: β −0.26, 95% CI −0.31 to −0.20). Anxiety and hostility also increased and remained higher than pre-pandemic levels in 2023 (anxiety: 2016 β −0.29, 95% CI −0.35 to −0.24, 2018 β −0.20, 95% CI −0.26 to −0.15; hostility: 2016 β −0.26, 95% CI −0.31 to −0.20, 2018 β −0.12, 95% CI −0.18 to −0.07). Across all the models examining the predictors from diverse bioecological spheres, <u>l</u>ow parental social support, high social media use, and bad grades were consistently associated with poor mental health, regardless of mental health outcome and gender.</div></div><div><h3>Interpretation</h3><div>The COVID-19 pandemic has had a serious and continuing negative effect on adolescents’ mental health. Targeted interventions are needed to address the increase in mental health problems during the COVID-19 pandemic, with a focus on enhancing parental support and managing screen use.</div></div><div><h3>Funding</h3><div><span>Icelandic Research Fund</span> (217612-051); <span>NordForsk</span> (147386).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101301"},"PeriodicalIF":13.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of influenza vaccination in preventing severe COPD exacerbations and pneumonia before, during, and after the COVID-19 pandemic: a retrospective cohort study","authors":"Sophia Eilat Tsanani ,&nbsp;Shani Yorav ,&nbsp;Shlomit Yaron ,&nbsp;Talish Razi ,&nbsp;Matan Yechezkel ,&nbsp;Ronen Arbel ,&nbsp;Dan Yamin","doi":"10.1016/j.lanepe.2025.101307","DOIUrl":"10.1016/j.lanepe.2025.101307","url":null,"abstract":"<div><h3>Background</h3><div>Influenza vaccination is recommended to reduce complications and hospitalisations in individuals with COPD. Recent fluctuations in COPD-related hospitalisations underscore the need to evaluate vaccine effectiveness in preventing severe exacerbations and pneumonia across pre-, during-, and post-COVID-19 periods.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of Clalit Health Services members with COPD, comparing influenza-vaccinated individuals to matched unvaccinated controls. To reduce bias, we matched vaccinated individuals with unvaccinated controls across 648 subgroups by age, sex, exacerbation history, comorbidities, and vaccination tendency. The primary outcome was hospitalisation for exacerbations or pneumonia during each influenza season (2017–2024), categorised into pre- (2017–2020), during (2020–2022), and post-COVID-19 (2022–2024) periods. We defined each influenza season based on weekly surveillance data reporting influenza circulation, ensuring that comparisons accurately corresponded to the actual periods of influenza virus activity. Subgroup analyses stratified participants by low or high risk based on prior-year exacerbations.</div></div><div><h3>Findings</h3><div>Among 88,446 COPD patients, severe exacerbations and pneumonia decreased by 20% during the COVID-19 pandemic (2020–2022) but returned to baseline post-pandemic (2022–2024). Vaccine effectiveness in reducing these outcomes was 30% (95% CI: 24–35%) pre-pandemic (2017–2020) but was limited during the pandemic (10%, 95% CI: −5 to 22%) and post-pandemic (−2%, 95% CI: −15 to 8%). High-risk individuals, representing 30% of the COPD population, accounted for over 85% of cases, with vaccine effectiveness showing similar trends across risk groups.</div></div><div><h3>Interpretation</h3><div>While influenza vaccination remains recommended to reduce complications associated with influenza, its effectiveness in preventing severe exacerbations or pneumonia may be limited during and after the COVID-19 pandemic in individuals with COPD. Additional preventive measures, such as social distancing, should be integrated into public health efforts, especially during periods of heightened respiratory infection circulation and for high-risk individuals.</div></div><div><h3>Funding</h3><div>This work was supported by the <span>European Research Council</span>, project #949850 and the <span>Israel Science Foundation</span> (ISF), grant No. 3409/19, within the Israel Precision Medicine Partnership program.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101307"},"PeriodicalIF":13.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical presentation, diagnostics, and outcomes of infants with congenital and postnatal tuberculosis: a multicentre cohort study of the Paediatric Tuberculosis Network European Trials Group (ptbnet)","authors":"Florian Götzinger ,&nbsp;Alejandra Alonso Caprile ,&nbsp;Antoni Noguera-Julian ,&nbsp;Andrea Lo Vecchio ,&nbsp;Fernando Baquero-Artigao ,&nbsp;Teresa del Rosal ,&nbsp;Folke Brinkmann ,&nbsp;Françoise Mouchet ,&nbsp;Svetlana Velizarova ,&nbsp;Karsten Kötz ,&nbsp;Nicole Ritz ,&nbsp;Danilo Buonsenso ,&nbsp;Rinn Song ,&nbsp;Robindra Basu Roy ,&nbsp;Tea Nieminen ,&nbsp;Cornelius Rau ,&nbsp;Vira Chechenieva ,&nbsp;Steven Welch ,&nbsp;Petra Kaiser-Labusch ,&nbsp;Marieke Emonts ,&nbsp;Nuria Martinez-Alier","doi":"10.1016/j.lanepe.2025.101303","DOIUrl":"10.1016/j.lanepe.2025.101303","url":null,"abstract":"<div><h3>Background</h3><div>According to estimates, globally more than 200,000 pregnant women develop tuberculosis (TB) annually. Despite this, data on perinatal TB remain scarce. This study aimed to describe perinatal TB, comprising congenital (cTB) and postnatal (pTB) TB, in a European setting.</div></div><div><h3>Methods</h3><div>Retrospective cohort study via the Paediatric Tuberculosis Network European Trials Group (ptbnet) capturing and comparing cases of cTB and pTB diagnosed at 104 participating European healthcare institutions between 1995 and 2019.</div></div><div><h3>Findings</h3><div>Forty-six cases reported by 20 centres were included in the final analysis (cTB, n = 27; pTB, n = 19). Median age at symptom onset was one week in cTB (IQR: 0–1 weeks), and 12 weeks in pTB patients (IQR: 5–18 weeks). Prematurity was more common in cTB than pTB patients [57.9% (11/19); 95% CI: 36.3–76.9% vs. 21.1% (4/19); 95% CI: 8.5–43.3%; p = 0.049], and the average birth weight was significantly lower [1680 g; IQR: 932–2805 g vs. 2890 g; IQR: 2461–3400 g; p = 0.0043]. Microbiological confirmation was achieved in most patients [85.2% (23/27); 95% CI: 67.5–94.1% vs. 78.9% (15/19); 95% CI: 56.7–91.5%; p = 0.70]. The sensitivity of interferon-gamma release assays was poor in both groups [25.0% (3/12) 95% CI: 8.9–53.2% vs. 35.7% (5/14) 95% CI: 16.3–61.2%; p = 0.68]; in contrast, the sensitivity of the tuberculin skin tests (at 5 mm cut-off) was significantly higher in pTB patients [16.7% (2/12) 95% CI: 4.7–44.8% vs. 66.7% (10/15); 95% CI: 41.7–84.8%; p = 0.0185]. Approximately half of the patients required intensive care support [51.9% (14/27) 95% CI: 34.0–69.3% vs. 47.4% (9/19); 95% CI: 27.3–68.3%; p &gt; 0.99]. Four (4/46; 8.7%) patients died, and four (4/46; 8.7%) had severe long-term sequelae.</div></div><div><h3>Interpretation</h3><div>There was substantial mortality and morbidity in this patient cohort, despite the high-resource setting. cTB was associated with premature birth and low birth weight. In contrast to microbiological tests, immunological tests perform poorly in perinatal TB, and should therefore not be used as rule-out tests.</div></div><div><h3>Funding</h3><div>No study-specific funding.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101303"},"PeriodicalIF":13.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Barcelona baseline risk score to predict long-term prognosis after a first demyelinating event: a prospective observational study","authors":"Carmen Tur ,&nbsp;Pere Carbonell-Mirabent ,&nbsp;Susana Otero-Romero ,&nbsp;Álvaro Cobo-Calvo ,&nbsp;María Jesús Arévalo ,&nbsp;Helena Ariño ,&nbsp;Georgina Arrambide ,&nbsp;Cristina Auger ,&nbsp;René Carvajal ,&nbsp;Joaquín Castilló ,&nbsp;Manuel Comabella ,&nbsp;Ingrid Galán ,&nbsp;Luciana Midaglia ,&nbsp;Carlos Nos ,&nbsp;Agustín Pappolla ,&nbsp;Deborah Pareto ,&nbsp;Jordi Río ,&nbsp;Breogán Rodríguez-Acevedo ,&nbsp;Estibaliz Saez de Gordoa ,&nbsp;Ángela Vidal-Jordana ,&nbsp;Mar Tintoré","doi":"10.1016/j.lanepe.2025.101302","DOIUrl":"10.1016/j.lanepe.2025.101302","url":null,"abstract":"<div><h3>Background</h3><div>In multiple sclerosis (MS), predicting at symptom onset who will develop early and severe disability is an unmet need with significant therapeutic implications. Here we propose the Barcelona-Baseline Risk Score (BRS) model to predict long-term disease outcomes in a flexible and generalisable manner.</div></div><div><h3>Methods</h3><div>Using prospectively acquired data from the Barcelona first-attack cohort, we created the Barcelona-BRS model as a set of six Weibull survival models of time to an Expanded Disability Status Scale score of 3.0, built with flexible combinations of predictors, including sex, age at first attack, and number and topography of T2 lesions, among others, adaptable to data availability. Data-driven risk groups were identified and compared in terms of long-term clinical and MRI outcomes, including relapse-associated worsening (RAW), progression independent of relapse activity (PIRA), conversion to secondary progressive MS (SPMS), lesional and brain volumetric data, and patient-reported/administered clinical scores, through Kaplan–Meier and mixed-effects models. Finally, we externally validated our model in a completely unseen cohort.</div></div><div><h3>Findings</h3><div>We included 1074 patients (737 [69%] female, mean age: 31.7 years) with a first demyelinating attack. Over a median follow-up of 11.9 years, 375 (35%), 298 (28%), and 94 (8.8%) developed RAW, PIRA, and SPMS, respectively. Weibull models included age at first attack, number of brain T2 lesions, and disability at first visit as main predictors. Four data-driven groups of increasing risk of unfavourable outcomes were created: Light-Green-BRS (N = 258), Dark-Green-BRS (N = 319), Orange-BRS (N = 321), and Red-BRS (N = 176), which, over time, behaved significantly differently across disability, quality of life, and MRI measures, being the Red-BRS the group with worst outcomes (p &lt; 0.01). The results in the external validation cohort (N = 139, 100 female [72%], 34 years) mirrored those of the original one.</div></div><div><h3>Interpretation</h3><div>The robustness, flexibility, and generalisability of the Barcelona-BRS model support its consideration as a ready-to-use tool for clinical practice.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101302"},"PeriodicalIF":13.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality related to multidrug-resistant microorganism infections: differentiating crude mortality from attributable mortality","authors":"Ángel Asensio,&nbsp;Mireia Cantero,&nbsp;Lina Marcela Parra","doi":"10.1016/j.lanepe.2025.101308","DOIUrl":"10.1016/j.lanepe.2025.101308","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101308"},"PeriodicalIF":13.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Early childcare arrangements and children's internalizing and externalizing symptoms: an individual participant data meta-analysis of six prospective birth cohorts in Europe” [The Lancet Regional Health – Europe, Volume 45, October 2024, 101036]","authors":"Katharine M. Barry ,&nbsp;Demetris Avraam ,&nbsp;Tim Cadman ,&nbsp;Ahmed Elhakeem ,&nbsp;Hanan El Marroun ,&nbsp;Pauline W. Jansen ,&nbsp;Anne-Marie Nybo-Andersen ,&nbsp;Katrine Strandberg-Larsen ,&nbsp;Llúcia González Safont ,&nbsp;Raquel Soler-Blasco ,&nbsp;Florencia Barreto-Zarza ,&nbsp;Jordi Julvez ,&nbsp;Martine Vrijheid ,&nbsp;Barbara Heude ,&nbsp;Marie-Aline Charles ,&nbsp;Alexandre Ramchandar Gomajee ,&nbsp;Maria Melchior","doi":"10.1016/j.lanepe.2025.101285","DOIUrl":"10.1016/j.lanepe.2025.101285","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101285"},"PeriodicalIF":13.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enterovirus circulation in the WHO European region, 2015–2022: a comparison of data from WHO's three core poliovirus surveillance systems and the European Non-Polio Enterovirus Network (ENPEN)","authors":"Heli Harvala ,&nbsp;Caroline K. Johannesen ,&nbsp;Kimberley S.M. Benschop ,&nbsp;Eugene V. Saxentoff ,&nbsp;Shahin Huseynov ,&nbsp;José E. Hagan ,&nbsp;Thea K. Fischer","doi":"10.1016/j.lanepe.2025.101292","DOIUrl":"10.1016/j.lanepe.2025.101292","url":null,"abstract":"<div><h3>Background</h3><div>While the association of polioviruses with paralytic disease is well-documented and closely monitored via the Global Polio Eradication initiative, monitoring of the circulation and role of other non-polio enteroviruses in paralytic and non-paralytic disease has not received the same priority. We have assessed assess the role and potential effectiveness of the current enterovirus surveillance systems in the final stages of polio eradication.</div></div><div><h3>Methods</h3><div>We compared data on enterovirus circulation and clinical associations reported to the World Health Organization (WHO) Regional Office for Europe via the acute flaccid paralysis (AFP), clinical enterovirus, and environmental surveillance systems along with that collected by the European Non-Polio Enterovirus Network (ENPEN), 2015–2022.</div></div><div><h3>Findings</h3><div>This 8-year study analysed data from 63,659 samples from diagnosed enterovirus infections reported by 48 European countries, of which 27,699 were successfully typed (43.5%). This revealed the circulation of 67 individual enterovirus types primarily reported via ENPEN (85%; 19,712/23,220), whereas most poliovirus infections were reported via WHO (99.9%; 4484/4489). Only 20% of non-polio enterovirus positive AFP cases reported to WHO were successfully typed (105/544). Clinical data linked to these cases underscored the severity of paralytic non-polio enterovirus infections with 12 deaths compared to three deaths caused by poliovirus infections during the same study period.</div></div><div><h3>Interpretation</h3><div>The study documents non-polio enterovirus infections as a frequent cause of paralysis in Europe. Implementation of standardized monitoring and reporting of all enteroviruses identified from severely ill patients, including those with paralysis, would enhance our understanding of the burden of non-polio enterovirus infections without compromising poliovirus surveillance.</div></div><div><h3>Funding</h3><div>This study was funded by <span>WHO</span> Regional Office for Europe and received financial support from the <span>Bill and Melinda Gates Foundation</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"53 ","pages":"Article 101292"},"PeriodicalIF":13.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}