The Lancet regional health. Southeast Asia最新文献

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49th Annual Meeting of the Indian Society of Human Genetics and International Conclave on Neurogenetics (ISHG-2025): India’s march towards low-cost rare disease therapeutics 印度人类遗传学学会第49届年会和国际神经遗传学秘密会议(ISHG-2025):印度向低成本罕见疾病治疗迈进
IF 5
The Lancet regional health. Southeast Asia Pub Date : 2025-07-05 DOI: 10.1016/j.lansea.2025.100632
Mathivanan Jothi , B.K. Thelma , Monojit Debnath
{"title":"49th Annual Meeting of the Indian Society of Human Genetics and International Conclave on Neurogenetics (ISHG-2025): India’s march towards low-cost rare disease therapeutics","authors":"Mathivanan Jothi , B.K. Thelma , Monojit Debnath","doi":"10.1016/j.lansea.2025.100632","DOIUrl":"10.1016/j.lansea.2025.100632","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"39 ","pages":"Article 100632"},"PeriodicalIF":5.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563306","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}
引用次数: 0
Drug resistance mutations among people living with HIV and ART failure in Bangladesh: a cross-sectional study 孟加拉国艾滋病毒感染者的耐药性突变和抗逆转录病毒治疗失败:一项横断面研究
IF 5
The Lancet regional health. Southeast Asia Pub Date : 2025-07-04 DOI: 10.1016/j.lansea.2025.100629
Sezanur Rahman , Md Safiullah Sarker , Md Mobarok Hossain , Md Abir Hossain , Mohammad Fakhruddin , Rubel Howlader , Golam Sarwar , Sharful Islam Khan , Mustafizur Rahman
{"title":"Drug resistance mutations among people living with HIV and ART failure in Bangladesh: a cross-sectional study","authors":"Sezanur Rahman ,&nbsp;Md Safiullah Sarker ,&nbsp;Md Mobarok Hossain ,&nbsp;Md Abir Hossain ,&nbsp;Mohammad Fakhruddin ,&nbsp;Rubel Howlader ,&nbsp;Golam Sarwar ,&nbsp;Sharful Islam Khan ,&nbsp;Mustafizur Rahman","doi":"10.1016/j.lansea.2025.100629","DOIUrl":"10.1016/j.lansea.2025.100629","url":null,"abstract":"<div><h3>Background</h3><div>While maintaining a low HIV prevalence among the general population, Bangladesh is among the few countries in the Asia–Pacific region where the incidence of people living with HIV (PLWH) continues to increase. The National Anti-Retroviral Therapy Program still relies on a ‘Test and Treat’ strategy and faces challenges in treating drug-resistant HIV. This study aims to assess the HIV viral load and drug resistance mutations among key populations (KPs) under anti-retroviral therapy (ART) in Bangladesh.</div></div><div><h3>Methods</h3><div>A total of 110 KPs from 20 drop-in-centers across 11 districts in Bangladesh were enrolled from March 2019 to November 2020 for viral load (VL) testing using Xpert® HIV-1 Viral Load kits. Samples with high VL (≥1000 copies/mL) underwent pol gene sequencing to identify drug resistance mutations.</div></div><div><h3>Findings</h3><div>Most of the participants were men who have sex with men (MSM, 49.1%) followed by men sex workers (MSW, 34.5%), and transgender women (TGW, 13.6%). The median age of the participants was 28 years (IQR: 24–35) and 80% of them were from the capital city, Dhaka. The median time for ART was 11.5 months (IQR: 4.5–29.1), where 15 participants were naïve to ART. Overall, high VL was observed in 23.8%, and virologic failure was in 17.9% among PLWH who were treated for &gt;30 days. HIV-1 subtype C was predominant (43.8%), followed by A1 (25%), CRF01_AE (25%), and CRF02_AG (6.2%). Seven participants showed resistance against Efavirenz, the common drug received from ART centres, and three of them were additionally resistant against Tenofovir Disoproxil Fumarate. Other drugs supplied by ART centres were also found resistant for participants; i.e. 6 against Emtricitabine, 6 against Lamivudine, and 1 against Etravirine. The spatial distribution indicated HIV transmission occurred within and between KPs and drop-in-centers. Additionally, samples that received different ART also clustered together.</div></div><div><h3>Interpretation</h3><div>Evidence suggests that KPs are at a higher risk of virologic failure in Bangladesh, emphasizing the need for routine VL and drug resistance mutation tests as part of the national ART program. This study also advocates for exploring barriers to ART adherence and implementing personalized ART strategies in national ART programs.</div></div><div><h3>Funding</h3><div>The Global Fund.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"40 ","pages":"Article 100629"},"PeriodicalIF":5.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557068","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}
引用次数: 0
Identification of protein targets for dyslipidaemia and cardiovascular diseases among people with South Asian ancestry: a mendelian randomisation study 南亚血统人群血脂异常和心血管疾病的蛋白靶点鉴定:一项孟德尔随机研究
IF 5
The Lancet regional health. Southeast Asia Pub Date : 2025-07-04 DOI: 10.1016/j.lansea.2025.100621
Siwei Wu , Devendra Meena , Alexander Smith , Jingxian Huang , Georg W. Otto , Yi-Hsuan Ko , James Yarmolinsky , Dipender Gill , Anand Rohatgi , Abbas Dehghan , Ioanna Tzoulaki
{"title":"Identification of protein targets for dyslipidaemia and cardiovascular diseases among people with South Asian ancestry: a mendelian randomisation study","authors":"Siwei Wu ,&nbsp;Devendra Meena ,&nbsp;Alexander Smith ,&nbsp;Jingxian Huang ,&nbsp;Georg W. Otto ,&nbsp;Yi-Hsuan Ko ,&nbsp;James Yarmolinsky ,&nbsp;Dipender Gill ,&nbsp;Anand Rohatgi ,&nbsp;Abbas Dehghan ,&nbsp;Ioanna Tzoulaki","doi":"10.1016/j.lansea.2025.100621","DOIUrl":"10.1016/j.lansea.2025.100621","url":null,"abstract":"<div><h3>Background</h3><div>South Asians are considered to be at higher risk of dyslipidaemia, a modifiable risk factor for cardiovascular diseases (CVDs). We aimed to identify protein targets for dyslipidaemia and CVDs among people with South Asian ancestry.</div></div><div><h3>Methods</h3><div>We used a two-sample mendelian randomisation (MR) approach, supplemented with MR-Egger, weighted median, colocalisation, and generalised MR (GMR), to evaluate the effect of 2800 plasma proteins on high/low/non-high-density lipoprotein cholesterol (HDL-C/LDL-C/non-HDL-C), total cholesterol, and triglycerides. Observational analyses were conducted on MR findings with strong colocalisation (posterior probability ≥ 80%) and GMR evidence. Univariate MR assessed lipid-associated proteins' effect on CVDs. Finally, we compared the effects of plasma proteins on lipids between South Asian and European populations.</div></div><div><h3>Findings</h3><div>We identified 29 genetically proxied proteins potentially causal to at least one lipid measure, 12 of which showed strong colocalisation and GMR evidence, including angiopoietin-related protein 3 (ANGPTL3), proprotein convertase subtilisin/kexin type 9 (PCSK9), and cadherin EGF LAG seven-pass G-type receptor 2 (CELSR2). Notably, PCSK9 demonstrated a stronger association with LDL-C in Europeans compared to South Asians (βEuropean = 0.37; 95% CI 0.36, 0.38, βSouth Asian = 0.16; 95% CI 0.11, 0.21). Observational analysis suggested statistically significant interaction between PCSK9 levels with LDL-C levels in South Asians with South Asians having a significantly lower effect compared to other ethnicities (PCSK9∗South Asian; β = −0.14; 95% CI -0.174, −0.107). Additionally, we showed that CELSR2 is also linked with coronary artery disease in South Asians.</div></div><div><h3>Interpretation</h3><div>Our study highlighted potential causal links between plasma proteins, dyslipidaemia, and CVDs in South Asians and highlighted protein targets, including CELSR2, PCSK9, ANGPTL3, and Apolipoprotein(a) (LPA). Notably, our study indicated that PCSK9 has a significantly weaker effect on LDL-C in South Asians than Europeans.</div></div><div><h3>Funding</h3><div>This work is supported by the <span>British Heart Foundation</span> Research Excellence Award (4) (<span><span>RE/24/130023</span></span>). IT and AR are supported by <span>NIH</span> <span><span>R01 HL162300-02</span></span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"39 ","pages":"Article 100621"},"PeriodicalIF":5.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548542","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}
引用次数: 0
Corrigendum to “Effect of antiretroviral therapy on retention of people living with HIV in India (2012–2017): a retrospective, cohort study,” [The Lancet Regional Health Southeast Asia. Volume 34, 100552, March 2025] 《抗逆转录病毒治疗对印度艾滋病毒感染者滞留率的影响(2012-2017):一项回顾性队列研究》的勘误表[《柳叶刀》东南亚区域卫生》。第34卷,100552,2025年3月]
IF 5
The Lancet regional health. Southeast Asia Pub Date : 2025-07-01 DOI: 10.1016/j.lansea.2025.100622
Shweta Chidrawar , Suvarna Sane , Megha Mamulwar , Shilpa Bembalkar , Rachna Thakur , Tarun Bhatnagar , Srikanth P. Tripathy , Shrinivasa B. Marinaik , Damodar Sahu , Subrata Biswas , Shanta Datta , Yogesh Sabde , Rajnarayan Tiwari , Deepak Khismatrao , Bhawani Singh Kushwaha , Anoop Kumar Puri , Chinmoyee Das , Sheela V. Godbole
{"title":"Corrigendum to “Effect of antiretroviral therapy on retention of people living with HIV in India (2012–2017): a retrospective, cohort study,” [The Lancet Regional Health Southeast Asia. Volume 34, 100552, March 2025]","authors":"Shweta Chidrawar ,&nbsp;Suvarna Sane ,&nbsp;Megha Mamulwar ,&nbsp;Shilpa Bembalkar ,&nbsp;Rachna Thakur ,&nbsp;Tarun Bhatnagar ,&nbsp;Srikanth P. Tripathy ,&nbsp;Shrinivasa B. Marinaik ,&nbsp;Damodar Sahu ,&nbsp;Subrata Biswas ,&nbsp;Shanta Datta ,&nbsp;Yogesh Sabde ,&nbsp;Rajnarayan Tiwari ,&nbsp;Deepak Khismatrao ,&nbsp;Bhawani Singh Kushwaha ,&nbsp;Anoop Kumar Puri ,&nbsp;Chinmoyee Das ,&nbsp;Sheela V. Godbole","doi":"10.1016/j.lansea.2025.100622","DOIUrl":"10.1016/j.lansea.2025.100622","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"38 ","pages":"Article 100622"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518665","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}
引用次数: 0
The cognitive toll of household air pollution: cross–sectional associations between polluting cooking fuel use, cognitive functions and brain MRI in a rural aging population from Karnataka, India 家庭空气污染的认知代价:印度卡纳塔克邦农村老龄化人口中污染性烹饪燃料使用、认知功能和脑MRI之间的横断面关联
IF 5
The Lancet regional health. Southeast Asia Pub Date : 2025-06-28 DOI: 10.1016/j.lansea.2025.100624
Sumedha Mitra , Manogna Sagiraju , Hitesh Pradhan , David Yao , Jayant M. Pinto , Jonas S. Sundarakumar , CBR-SANSCOG Study Team
{"title":"The cognitive toll of household air pollution: cross–sectional associations between polluting cooking fuel use, cognitive functions and brain MRI in a rural aging population from Karnataka, India","authors":"Sumedha Mitra ,&nbsp;Manogna Sagiraju ,&nbsp;Hitesh Pradhan ,&nbsp;David Yao ,&nbsp;Jayant M. Pinto ,&nbsp;Jonas S. Sundarakumar ,&nbsp;CBR-SANSCOG Study Team","doi":"10.1016/j.lansea.2025.100624","DOIUrl":"10.1016/j.lansea.2025.100624","url":null,"abstract":"<div><h3>Background</h3><div>Household air pollution (HAP) from polluting cooking fuels, a rampant issue in rural India, is suspected to be a significant modifiable risk factor for cognitive impairment; however, evidence supported by neuroimaging in this population, is lacking.</div></div><div><h3>Methods</h3><div>Baseline cross-sectional data (n = 4145) of participants aged ≥45 years from the ongoing Centre for Brain Research-Srinivaspura Aging, Neuro Senescence, and COGnition (CBR-SANSCOG) study in a rural South Indian aging population, was utilised. HAP exposure was proxied via polluting cooking fuel or technology use (only clean vs. at least one polluting vs. only polluting cooking technology use). Global and domain-specific cognitive functioning was assessed using computerised culturally adapted test batteries. A subset (n = 994) underwent brain MRI (3T) to estimate regional brain volumes and white matter hyperintensities (WMHs) burden. Fully adjusted linear regression models were used to test the associations between HAP exposure, cognition, and brain MRI parameters.</div></div><div><h3>Findings</h3><div>Only polluting cooking technology users had significantly lower scores in global cognition (β<sub>std.</sub> = −0.28 [−0.44, −0.11], p<sub>adj</sub> [FDR corrected p-value] = 0.002), visuospatial ability (β<sub>std.</sub> = −0.28 [−0.48, −0.08], p<sub>adj.</sub> = 0.013), and executive functions (β<sub>std.</sub> = −0.25 [−0.44, −0.07], p<sub>adj.</sub> = 0.019), whereas at least one polluting cooking technology users had lower scores in global cognition only (β<sub>std.</sub> = −0.10 [−0.15, −0.04], p<sub>adj.</sub> &lt;0.001), compared to the clean cooking technology users. Upon sex-stratification, only female polluting cooking technology users had lower global cognitive scores (β<sub>std.</sub> = −0.11 [−0.20, −0.03], p<sub>adj.</sub> = 0.018) and lower hippocampus volumes (β<sub>std.</sub> = −0.18 [−0.35, −0.01], p = 0.030).</div></div><div><h3>Interpretation</h3><div>Polluting cooking technology users may be at a higher risk for cognitive impairment. Rural females, who tend to be more exposed than males, could have greater vulnerability to HAP's adverse effects on the brain. Policies promoting clean cooking fuel/technology adoption are imperative.</div></div><div><h3>Funding</h3><div>CBR-SANSCOG study is funded by the <span>Centre for Brain Research</span>, India.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"39 ","pages":"Article 100624"},"PeriodicalIF":5.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510761","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}
引用次数: 0
Development and internal validation of clinical prediction models for scrub typhus and doxycycline-treatable causes in paediatric acute encephalitis syndrome in Karnataka, India: a multicentre, prospective study 印度卡纳塔克邦儿童急性脑炎综合征中丛林斑疹伤寒和多西环素可治疗原因临床预测模型的开发和内部验证:一项多中心前瞻性研究
IF 5
The Lancet regional health. Southeast Asia Pub Date : 2025-06-26 DOI: 10.1016/j.lansea.2025.100626
Tina Damodar , Maria Jose , Uddhava V. Kinhal , Bhagteshwar Singh , Surbhi Telang , Akhila Lekha , Srilatha Marate , Namratha Prabhu , Chitra Pattabiraman , Prathyusha Parthipulli Vasuki , A.V. Lalitha , Fulton Sebastian Dsouza , Sushma Veeranna Sajjan , Gangasamudra Veerappa Basavaraja , Mallesh Kariyappa , Benedict Daniel Michael , Reeta S. Mani , Tom Solomon , Vykuntaraju K. Gowda , Vasanthapuram Ravi , Ruwanthi Kolamunnage-Dona
{"title":"Development and internal validation of clinical prediction models for scrub typhus and doxycycline-treatable causes in paediatric acute encephalitis syndrome in Karnataka, India: a multicentre, prospective study","authors":"Tina Damodar ,&nbsp;Maria Jose ,&nbsp;Uddhava V. Kinhal ,&nbsp;Bhagteshwar Singh ,&nbsp;Surbhi Telang ,&nbsp;Akhila Lekha ,&nbsp;Srilatha Marate ,&nbsp;Namratha Prabhu ,&nbsp;Chitra Pattabiraman ,&nbsp;Prathyusha Parthipulli Vasuki ,&nbsp;A.V. Lalitha ,&nbsp;Fulton Sebastian Dsouza ,&nbsp;Sushma Veeranna Sajjan ,&nbsp;Gangasamudra Veerappa Basavaraja ,&nbsp;Mallesh Kariyappa ,&nbsp;Benedict Daniel Michael ,&nbsp;Reeta S. Mani ,&nbsp;Tom Solomon ,&nbsp;Vykuntaraju K. Gowda ,&nbsp;Vasanthapuram Ravi ,&nbsp;Ruwanthi Kolamunnage-Dona","doi":"10.1016/j.lansea.2025.100626","DOIUrl":"10.1016/j.lansea.2025.100626","url":null,"abstract":"<div><h3>Background</h3><div>Scrub typhus and other doxycycline-treatable infections are significant contributors of acute encephalitis syndrome (AES) in India. Limited surveillance in South India has hindered their recognition and the inclusion of doxycycline in treatment protocols. We aimed to systematically investigate infectious aetiologies of AES in children from Karnataka, India, and develop clinical prediction models for diagnosing scrub typhus and guiding clinical decisions for doxycycline therapy.</div></div><div><h3>Methods</h3><div>This multicentre, prospective study enrolled children aged &gt;28 days to 18 years with AES presenting to three tertiary care hospitals in Bengaluru, India. Primary outcomes were microbiological diagnosis of AES and clinical prediction models for diagnosing scrub typhus and identifying patients with doxycycline-treatable causes. Models were developed using multivariable logistic regression, internally validated, and simplified into point-scoring systems. Model performance was evaluated using c-statistics, calibration slopes, and calibration-in-the-large, adhering to TRIPOD guidelines.</div></div><div><h3>Findings</h3><div>Between February 2020 and February 2023, 714 children were screened, of whom 587 were included. Of these, 315 (54%) had a microbiological diagnosis. Scrub typhus accounted for 138/315 (44%), and doxycycline-treatable causes were diagnosed in 193/315 (61%) of these cases. Key predictors associated with both scrub typhus and doxycycline-treatable causes were age, illness duration, lymphadenopathy, oedema, hepatomegaly, lymphocyte count, platelet count, and serum albumin levels. Adjusted c-statistics were 0.83 (95% CI: 0.78–0.87) for the scrub typhus model and 0.75 (95% CI: 0.7–0.81) for the doxycycline model, with calibration slopes of 0.85 (0.82–0.88) and 0.83 (0.78–0.87), respectively. CITL values were −0.03 (−0.06–0) and 0.05 (0.02–0.09). Points-based scores predicted probabilities ranging from 5% to 99.8% (scrub typhus model) and 20%–99% (doxycycline-treatable model).</div></div><div><h3>Interpretation</h3><div>Scrub typhus was the most common microbiological diagnosis, and most patients had a doxycycline-treatable cause, underscoring the need to prioritise doxycycline in empirical treatment protocols in South India. The models demonstrated strong performance; however external validation is necessary for broader applicability.</div></div><div><h3>Funding</h3><div><span>DBT</span>/<span>Wellcome Trust India Alliance Fellowship</span> <span><span>IA/CPHE/18/1/503960</span></span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"39 ","pages":"Article 100626"},"PeriodicalIF":5.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480651","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}
引用次数: 0
Past, present, and future: a situational analysis of infectious disease modelling in Thailand 过去、现在和未来:泰国传染病模型的情景分析
IF 5
The Lancet regional health. Southeast Asia Pub Date : 2025-06-26 DOI: 10.1016/j.lansea.2025.100618
Manit Sittimart, Chayapat Rachatan, Panchanok Muenkaew, Saudamini Vishwanath Dabak
{"title":"Past, present, and future: a situational analysis of infectious disease modelling in Thailand","authors":"Manit Sittimart,&nbsp;Chayapat Rachatan,&nbsp;Panchanok Muenkaew,&nbsp;Saudamini Vishwanath Dabak","doi":"10.1016/j.lansea.2025.100618","DOIUrl":"10.1016/j.lansea.2025.100618","url":null,"abstract":"<div><div>Infectious disease modelling (IDM) is a useful tool supporting evidence to inform policies on disease outbreaks. Understanding situation, existing capacities and needs will enable countries to prepare and use the evidence derived from IDM for future outbreaks. This report maps Thailan's IDM landscape, identifies key stakeholders, and provides recommendations to develop a supportive ecosystem. We found that there is a moderate capacity to conduct and use IDM in Thailand. Users of IDM are spread across ministries and government level, while IDM evidence suppliers operate in departments in a few universities. Key challenges concern availability and quality of data, human resource capacity, integration of initiatives and communication mechanisms between evidence users and providers, and sustainable funding for IDM activities. Investing in human and data infrastructure, including IDM ecosystem development, could enhance Thailand's capacity to synthesise and use evidence for future outbreak preparedness, while also contributing to regional efforts in health security and outbreak response.</div></div><div><h3>Funding</h3><div>This study was supported by a grant from the <span>Rockefeller Foundation</span> [2022 ARO 004] and the <span>National Science, Research and Innovation Fund</span>, <span>Thailand Science Research and Innovation</span> (TSRI).</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"39 ","pages":"Article 100618"},"PeriodicalIF":5.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490216","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}
引用次数: 0
Identifying bellwether sewershed sites for sustainable disease surveillance in Bengaluru, India: a longitudinal study 确定印度班加罗尔可持续疾病监测的领头羊排污点:一项纵向研究
IF 5
The Lancet regional health. Southeast Asia Pub Date : 2025-06-17 DOI: 10.1016/j.lansea.2025.100619
Rebecca Fern Daniel , Subash K. Kannan , Namrta Daroch , Sutharsan Ganesan , Farhina Mozaffer , Vishwanath Srikantaiah , Lingadahalli Subrahmanya Shashidhara , Rakesh Mishra , Farah Ishtiaq
{"title":"Identifying bellwether sewershed sites for sustainable disease surveillance in Bengaluru, India: a longitudinal study","authors":"Rebecca Fern Daniel ,&nbsp;Subash K. Kannan ,&nbsp;Namrta Daroch ,&nbsp;Sutharsan Ganesan ,&nbsp;Farhina Mozaffer ,&nbsp;Vishwanath Srikantaiah ,&nbsp;Lingadahalli Subrahmanya Shashidhara ,&nbsp;Rakesh Mishra ,&nbsp;Farah Ishtiaq","doi":"10.1016/j.lansea.2025.100619","DOIUrl":"10.1016/j.lansea.2025.100619","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Throughout the COVID-19 pandemic, wastewater surveillance emerged as an important tool as an important tool by providing data that are more representative of the population than case reporting, which is often biased towards individuals with health-seeking behaviour or access to healthcare. With changing phases of the pandemic, decreased testing, and varying viral shedding rates, it is crucial to have a robust, sustainable, and flexible wastewater surveillance system that can serve as an independent signal of disease outbreaks. We aimed to identify ‘bellwether’ sewershed sites for sustainable disease surveillance in Bengaluru, India.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted this longitudinal study from December 2021 to January 2024 at 26 centralised sewershed sites in Bengaluru city (∼11 million inhabitants). We quantified weekly SARS-CoV-2 RNA concentrations to track infection dynamics and identify ‘bellwether’ sewershed sites. This was achieved by integrating established metrics for wastewater analysis, calculating sample-to-sample percentage rate of change, and applying algorithms to differentiate signal from noise, thereby validating factors contributing to the precision and reliability of outbreak predictions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Using 2873 wastewater samples, we applied a modified algorithm (COVID-SURGE algorithm) to identify ‘bellwether’ sewershed sites using longitudinal wastewater data on SARS-CoV-2 from 26 sewershed sites in Bengaluru. We utilised an Excel-based calculator (COVID-SURGE calculator) for user-entered wastewater data that differentiates signal from noise (underlying variability) based on the algorithm, with adjustments made to the input format of viral data and a specified limit of detection (LOD) value from the reverse transcriptase-quantitative PCR kit. We identified 11 ‘bellwether’ sites: four with large catchment sizes (KC Valley 1, KC Valley 2, Rajacanal, Doddabelee); four with medium sizes (Agaram, Nagasandra, KR Puram, Yelahanka); and three with small sizes (Chikkabegur, Chikkabanavara, Lalbagh). These were the best performers and can serve as a useful subset of sewage treatment plants for an early warning system at the city level.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Using wastewater metrics helps in selecting permanent sewershed sites and identifying sub-sites that can be scaled up during peak outbreak periods to detect disease hotspots, or scaled down during lean periods, especially when clinical data are unavailable. In a post-pandemic world, particularly in low-resource settings, focusing on the best-performing sewershed sites will ensure high-quality data that captures valid signals amid the noise from wastewater, conserves resources, and optimises public health actions beyond SARS-CoV-2.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;This work has been supported by funding from the &lt;span&gt;Rockefeller Foundation&lt;/span&gt; (grant &lt;span&gt;&lt;span&gt;2021 HTH018&lt;/span&gt;&lt;/spa","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"39 ","pages":"Article 100619"},"PeriodicalIF":5.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298580","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}
引用次数: 0
The case for the complete decriminalisation of abortion care in Nepal and beyond 在尼泊尔和其他地方,堕胎护理完全非刑事化的案例
IF 5
The Lancet regional health. Southeast Asia Pub Date : 2025-06-17 DOI: 10.1016/j.lansea.2025.100616
Sabrina Germain , Mara Malagodi , Roshani Regmi , Radhika Saxena , Shivani Shinde
{"title":"The case for the complete decriminalisation of abortion care in Nepal and beyond","authors":"Sabrina Germain ,&nbsp;Mara Malagodi ,&nbsp;Roshani Regmi ,&nbsp;Radhika Saxena ,&nbsp;Shivani Shinde","doi":"10.1016/j.lansea.2025.100616","DOIUrl":"10.1016/j.lansea.2025.100616","url":null,"abstract":"<div><div>Our Viewpoint makes the case for the complete decriminalisation of abortion in Nepal (and beyond) as a key strategy to removing barriers to abortion care. The criminal framing of abortion—even if subject to exceptions—creates legal barriers to accessing abortion, which then compound socio-cultural and medical barriers. Nepal represents fertile ground for abortion law reform centred on complete decriminalisation due to its pioneering constitutional approach to sexual and reproductive health rights. However, even in Nepal's liberal context, the enduring partial criminalisation of abortion hinders abortion access, especially for historically marginalised groups and in remote areas. This Viewpoint recommends complete decriminalisation in Nepal and South and Southeast Asian countries facing similar socio-legal barriers to abortion access. Our position as legal experts echoes calls for the complete decriminalisation of abortion by national and international medical professional bodies, which we hope will inform regional strategies to improve access to safe abortions.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"38 ","pages":"Article 100616"},"PeriodicalIF":5.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297198","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}
引用次数: 0
Cancer registries in Pakistan: a scoping review 巴基斯坦癌症登记:范围审查
IF 5
The Lancet regional health. Southeast Asia Pub Date : 2025-06-14 DOI: 10.1016/j.lansea.2025.100615
Sehar Salim Virani , Kaleem Sohail Ahmed , Megan Springer , Muzamil Hussain , Leslie Christensen , Farah Asif , Shahid Pervez , Zehra Fadoo , Asim Belgaumi , Syed Nabeel Zafar
{"title":"Cancer registries in Pakistan: a scoping review","authors":"Sehar Salim Virani ,&nbsp;Kaleem Sohail Ahmed ,&nbsp;Megan Springer ,&nbsp;Muzamil Hussain ,&nbsp;Leslie Christensen ,&nbsp;Farah Asif ,&nbsp;Shahid Pervez ,&nbsp;Zehra Fadoo ,&nbsp;Asim Belgaumi ,&nbsp;Syed Nabeel Zafar","doi":"10.1016/j.lansea.2025.100615","DOIUrl":"10.1016/j.lansea.2025.100615","url":null,"abstract":"<div><div>Cancer incidence is increasing globally. Although Pakistan does not have a unified national cancer registry, several institutional and regional cancer registries can provide vital information for cancer planning. Following the Joanna Briggs Institute and PRISMA-ScR guidelines, we conducted a comprehensive search across multiple databases and grey literature. Data were extracted regarding registry characteristics, data collection methods, and study details, and findings were summarised narratively to highlight key attributes and data gaps. Of 3714 unique abstracts screened, 102 studies met inclusion criteria, including 92 reporting registry data and 10 describing registry characteristics without patient-level data. Seventeen cancer registries were identified, with varying scope and geographical coverage. Only 19 of Pakistan's 129 cities contribute data to at least one registry. Data collection methods ranged from paper-based forms to advanced software systems. The Karachi Cancer Registry was noted for its high research output. Funding sources were limited, and several registries faced operational challenges. This Review highlights Pakistan's fragmented cancer registry landscape. While important policy-level data can be obtained from existing registries, there is an urgent need for strategic efforts and stakeholder collaboration to establish a national cancer registry system. Such a system could enhance cancer surveillance, inform public health efforts, and serve as a model for similar initiatives in south and southeast Asia.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"38 ","pages":"Article 100615"},"PeriodicalIF":5.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279521","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}
引用次数: 0
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