The Lancet regional health. Southeast Asia最新文献

{"title":"Language as a catalyst for success: a blueprint for standardized terminology and multilingual health literacy in Pakistan","authors":"Humza Irfan , Areeb Farooq , Mohammad Usama Toseef","doi":"10.1016/j.lansea.2025.100544","DOIUrl":"10.1016/j.lansea.2025.100544","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100544"},"PeriodicalIF":5.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Access to timely cancer treatment initiation in India: extent, determinants and trends” [The Lancet Regional Health – Southeast Asia, Volume 32, January 2025, 100514]","authors":"Pritam Halder , Jyoti Dixit , Nidhi Gupta , Nikita Mehra , Ashish Singh , Pankaj Malhotra , Anisha Mathew , Lalit Kumar , Amal Chandra Kataki , Sudeep Gupta , Shankar Prinja","doi":"10.1016/j.lansea.2025.100543","DOIUrl":"10.1016/j.lansea.2025.100543","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100543"},"PeriodicalIF":5.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes among HIV positive babies below 18 months of age, diagnosed under the Early Infant Diagnosis (EID) programme, India: a mixed-methods study","authors":"Suchit Kamble ,&nbsp;Nilesh Gawde ,&nbsp;Shilpa Bembalkar ,&nbsp;Noopur Goel ,&nbsp;Mohan Thorwat ,&nbsp;Kalyani Nikhare ,&nbsp;Sushmita Kamble ,&nbsp;Radhika Brahme ,&nbsp;Swapna Pawar ,&nbsp;Harsh Kubavat ,&nbsp;Bhawanisingh Kushwaha ,&nbsp;Vinita Verma ,&nbsp;Chinmoyee Das ,&nbsp;Raman Gangakhedkar","doi":"10.1016/j.lansea.2025.100540","DOIUrl":"10.1016/j.lansea.2025.100540","url":null,"abstract":"<div><h3>Background</h3><div>Early Anti-Retroviral Therapy (ART) initiation among infants with perinatally acquired HIV is known to impact clinical outcomes and survival. Early Infant Diagnosis (EID) was initiated in programme settings in India in 2010. Its impact on the clinical outcomes of infants covered under the programme and associated determinants have not been reported.</div></div><div><h3>Methods</h3><div>This was a mixed-methods study. Quantitative clinical data of 310 children on ART with HIV diagnosis before 18 months of age was collected from the treatment cards across 30 ART centres from 11 states of India using a retrospective cohort design. A total of 67 In-depth interviews with healthcare providers and managers helped to understand the underlying causes.</div></div><div><h3>Findings</h3><div>Out of 310 infants, 200 (64.5%) were on ART, and 36 (11.6%) were lost to follow-up, and 25 (8.1%) had died. The median age at HIV diagnosis was 231.5 (130, 405) days, and the median age at ART initiation was 309 (198, 456) days. Three-year survival was 91%. Baseline CD4 count less than 1500 cells/mm³ had a higher hazard for mortality (hazard ratio 11.39 (CI: 1.45, 89.45), p = 0.021) as well as for either mortality or development of opportunistic infections (hazard ratio 4.87 (CI: 1.56, 15.15), p = 0.006). WHO clinical stages III and IV had hazard ratios of 2.42 ((CI: 1.43, 4.09), p = 0.001) for mortality and 1.92 ((CI: 1.28, 2.88), p = 0.001) for death or development of opportunistic infections. Demand-side issues such as stigma and discrimination at family, community, and societal levels, desperation about the survival of the child, supply-side factors such as remote access to paediatric ART centres, and lack of paediatric ART medicine formulations were associated with ART treatment.</div></div><div><h3>Interpretation</h3><div>Overall survival was good for those who continued on treatment, but mortality was high for those with poor immunological and clinical parameters. Retention in care needs to be ensured for better clinical outcomes.</div></div><div><h3>Funding</h3><div>The study was commissioned by the National AIDS Control Programme (T.11020/98/2014-NACO (R&amp;D)) and funded through The <span>Global Fund Against AIDS, TB and Malaria (GFATM)</span> grant.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100540"},"PeriodicalIF":5.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143197124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing patterns in cataract surgery indications, outcomes, and costs, 2012–2023: a retrospective study at Aravind Eye Hospitals, India","authors":"Sachin Gupta ,&nbsp;Ravindran D. Ravilla ,&nbsp;Haripriya Aravind ,&nbsp;Shivkumar Chandrashekharan ,&nbsp;Thulasiraj D. Ravilla","doi":"10.1016/j.lansea.2025.100530","DOIUrl":"10.1016/j.lansea.2025.100530","url":null,"abstract":"<div><h3>Background</h3><div>Data on the evolving characteristics of patients seeking cataract surgery, surgical techniques used, preoperative vision, postoperative visual outcomes, and surgery costs provide critical insights for improving care delivery and making progress towards global eye care targets. We aimed to establish long-term trends in these factors.</div></div><div><h3>Methods</h3><div>Retrospective analysis of all cataract surgeries performed at Aravind Eye Hospitals during 2012–2023.</div></div><div><h3>Findings</h3><div>In 3.6 M cataract surgeries, the mean preoperative uncorrected visual acuity improved from 1.32 logMAR units (Snellen fraction ≈ 6/120) in 2012 to 1.15 (Snellen fraction ≈ 6/85) in 2023. The trend was observed in females and males, with females presenting with worse vision than males, in all age groups, and among outreach, subsidized and paying patients. Postoperative visual acuity outcomes steadily improved, with larger gains in Manual Small Incision Cataract Surgeries than in phacoemulsification. Mean prices for paying patients rose slightly faster than the Consumer Price Index for health. Surgeries supported by insurance and government assistance increased from 4.4% in 2012 to 28.7% in 2023. Male patients consistently paid about 10% higher prices than female patients because they chose more expensive intraocular lenses.</div></div><div><h3>Interpretation</h3><div>Over this period, patients sought cataract surgery sooner, received better surgical outcomes, and were willing to pay more for the improvements. However, female patients continued to face inequities, presenting with worse vision, and receiving lower expenditures for surgery, indicating the need for targeted approaches to address sex inequity both on the demand generation and treatment provision sides.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100530"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thank you to The Lancet Regional Health - Southeast Asia’s clinical and statistical peer reviewers in 2024","authors":"","doi":"10.1016/j.lansea.2025.100542","DOIUrl":"10.1016/j.lansea.2025.100542","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100542"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nature, prevalence and determinants of mental health problems experienced by adolescents in south Asia: a systematic review","authors":"Chethana Mudunna ,&nbsp;Medhavi Weerasinghe ,&nbsp;Thach Tran ,&nbsp;Josefine Antoniades ,&nbsp;Lorena Romero ,&nbsp;Miyuru Chandradasa ,&nbsp;Jane Fisher","doi":"10.1016/j.lansea.2025.100532","DOIUrl":"10.1016/j.lansea.2025.100532","url":null,"abstract":"<div><h3>Background</h3><div>Adolescence is a sensitive phase of human development where individuals, aged 10–19 years, are particularly vulnerable to developing mental health problems (MHPs). South Asia, home to 24% of the world's population, is mostly comprised of low- and middle-income countries (LMIC). Most of the world's young people live in LMICs. This systematic review aims to assess the available evidence on the nature, prevalence and determinants of MHPs experienced by adolescents in south Asia.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, searches were conducted in four online databases (Ovid Medline, Ovid EMBASE, Ovid Global Health, Ovid PsycInfo), titles, abstracts, and full-texts were screened, data extracted and quality assessed. Extracted data were categorised into school-based studies (SBS) and non-school-based studies (NSBS). Data were further stratified according to country, MHPs and narratively synthesised.</div></div><div><h3>Findings</h3><div>Of the 5847 records identified in the searches, 117 met inclusion criteria. Most (n = 87) were SBS. Key MHPs reported across countries include anxiety disorders and depression. Wide ranges of prevalence rates were reported for anxiety in Indian SBS (1.5–81.6%) and NSBS (1.8–88.1%), and for depression, Pakistani SBS (21–79%) and Indian NSBS (0.4–98.5%). Determinants include individual characteristics; violent victimisation; poor family/home/school environment/peer relationships; already experiencing MHPs and substance use/abuse. Increased physical activity, adequate nutrition, safe/positive homes/family environment, being unmarried females, higher maternal education, peer support/friendship, higher education level and engaging in extra-curricular activities were protective of mental well-being.</div></div><div><h3>Interpretation</h3><div>Prevalence of MHPs among south Asian adolescents appears high. Determinants include social, cultural, environmental and socioeconomic factors often beyond individual control. Mental health policies and programs and research appropriate to the cultural context, that address social determinants of MHPs and evidence gaps, are needed to tackle the significant mental health burden among south Asian adolescents.</div></div><div><h3>Funding</h3><div>Authors CM and MW are supported by a <span>Monash University Research Training Program Scholarship</span>. JF is supported by the Finkel Professorial Fellowship funded by the <span>Finkel Family Foundation</span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100532"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"p-Values and confidence intervals as compatibility measures: guidelines for interpreting statistical studies in clinical research","authors":"Alessandro Rovetta ,&nbsp;Luca Piretta ,&nbsp;Mohammad Ali Mansournia","doi":"10.1016/j.lansea.2025.100534","DOIUrl":"10.1016/j.lansea.2025.100534","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100534"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a universal film intervention in reducing violence against children and increasing positive parenting among migrant and displaced caregivers from Myanmar: a community-based cluster randomised trial","authors":"Amanda Sim ,&nbsp;Khaing Zar Lwin ,&nbsp;Stephanie Eagling-Peche ,&nbsp;G.J. Melendez-Torres ,&nbsp;Seema Vyas ,&nbsp;Francisco Calderon ,&nbsp;Tawanchai Jirapramukpitak ,&nbsp;Jamie Lachman ,&nbsp;Sureeporn Punpuing ,&nbsp;Andrea Gonzalez ,&nbsp;Mary Soan ,&nbsp;Nway Nway Oo ,&nbsp;Ivet Castello Mitjans ,&nbsp;Greg Tyrosvoutis ,&nbsp;Eve Puffer","doi":"10.1016/j.lansea.2024.100526","DOIUrl":"10.1016/j.lansea.2024.100526","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Parenting interventions have been shown to reduce violence against children and promote positive parenting, but evidence on interventions to achieve population-level reach and impact is limited in low-resource settings. We assessed the impact of a universal film intervention for migrant and displaced caregivers from Myanmar living in Thailand.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We implemented a two-arm, cluster randomised trial in Tak province, Thailand, on the border with Myanmar. 44 communities were stratified by district and randomly allocated to intervention or control (1:1) using a computer-generated list of random numbers. Intervention group participants received a screening of a 66-min narrative drama film about parenting, followed by a 30–40-min discussion and a 5-min video and poster summarising key messages. Control group participants received information about local health and social services. Eligible participants were primary caregivers aged 18 years or older with a child aged 4–17 years at enrolment. Participants were surveyed at baseline, endline approximately 4 weeks post-intervention, and follow-up approximately 4 months post-intervention. Primary outcomes were caregiver self-reported use of physical and psychological violence and positive parenting, analysed using both imputed and non-imputed multilevel models estimating differences between study arms at endline and follow-up. Due to the nature of the intervention, participants and assessors were not masked. The trial was prospectively registered with Thai Clinical Trials Registry TCTR20230222005.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between February and June 2023, 2249 participants in 44 communities completed baseline assessments and were randomly assigned to intervention (n = 1116) and control (n = 1133). 2023 caregivers (n = 998 in intervention and n = 1025 in control) completed the four-week endline survey and 1909 caregivers (n = 961 in intervention and n = 948 in control) completed the four-month follow-up. Intention to treat analyses showed the intervention reduced physical violence (IRR 0.91, 95% CI 0.85–0.97) and increased positive parenting (β 0.46, 95% CI −0.03 to 0.95). No meaningful differences were observed for psychological violence between intervention and control groups, with imprecisely estimated effects close to zero (β 0.47, 95% CI −0.62 to 1.57). Small effects were observed for the secondary and exploratory outcomes of parenting knowledge, belief in the need for harsh punishment, engagement in early learning, family functioning, and social support. Subgroup analyses suggest that the intervention may be more effective at reducing physical violence among female caregivers and caregivers of female children and younger children. There were no reported adverse effects.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Universal parenting interventions using a film-based entertainment-education approach can effectively reduce physical vio","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100526"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping neonatal vulnerability using the Small Vulnerable Newborn (SVN) framework—secondary analysis of PRISMA Pakistan study","authors":"Hajra Malik ,&nbsp;Nida Yazdani ,&nbsp;Sameeta Kumari,&nbsp;Sheikh Asad Jamal,&nbsp;Muhammad Kashif,&nbsp;Azqa Mazhar,&nbsp;Zahra Hoodbhoy","doi":"10.1016/j.lansea.2025.100535","DOIUrl":"10.1016/j.lansea.2025.100535","url":null,"abstract":"<div><h3>Background</h3><div>Despite progress in global neonatal mortality, South Asia continues to lag behind in reducing neonatal deaths. The Small Vulnerable Newborn (SVN) framework has been proposed to integrate preterm birth (PT), small for gestational age (SGA), and low birth weight. However, there is lack of data on the burden and risk factors of SVN in Pakistan, a country which has one of the highest neonatal deaths globally. This study aimed to estimate the incidence of SVN, and identify risk factors among pregnant women in Pakistan.</div></div><div><h3>Methods</h3><div>This secondary analysis leverages data from PRISMA (Pregnancy Risk Infant Surveillance, and Measurement Alliance)—Pakistan. Women presenting ≤20 weeks gestation and, with birth weights recorded within 72 h post-delivery were analysed. Newborns were classified into categories of SVN. Multinomial and binomial regression models were used to examine associations between maternal characteristics and SVN categories, as well as neonatal mortality.</div></div><div><h3>Findings</h3><div>The overall incidence of SVN was 46% (n = 771) with Term + SGA being the most common category (n = 461, 27.5%), followed by PT + AGA (n = 210, 12.5%) and PT + SGA (n = 41, 2.5%). Maternal undernutrition (MUAC &lt;23 cm) increased the risk of SVN by 17% (aRR 1.17, 95% CI 1.05–1.31). SVN also emerged as a significant predictor of neonatal mortality, quadrupling the risk (aRR 4.52, 95% CI 2.42–8.46).</div></div><div><h3>Interpretation</h3><div>This study adds to the growing body of evidence on Pakistan's alarming burden of SVN, with every second newborn at risk. Identification and targeted interventions are imperative to mitigate adverse birth outcomes and optimize child growth and development.</div></div><div><h3>Funding</h3><div>No funding was received for this secondary data analysis.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100535"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving clinical care of patients in Nipah outbreaks: moving beyond ‘compassionate use’","authors":"Md Zakiul Hassan ,&nbsp;Amanda Rojek ,&nbsp;Piero Olliaro ,&nbsp;Peter Horby","doi":"10.1016/j.lansea.2024.100527","DOIUrl":"10.1016/j.lansea.2024.100527","url":null,"abstract":"<div><div>The 2024 Nipah outbreak in Kerala, India—its fifth in six years—and the recurring annual outbreaks in Bangladesh underscore the persistent threat posed by the Nipah virus (NiV) in the region. With a high mortality rate, human-to-human transmission potential, and the widespread presence of <em>Pteropus</em> bats, the natural reservoir, NiV remains a significant epidemic threat. Despite being a WHO priority pathogen, there has been no systematic effort to improve patient care for NiVD, leading to consistently poor outcomes. Current care relies on supportive measures and the ‘compassionate use’ of unapproved drugs like ribavirin and remdesivir. Drugs used ‘off-label’ during outbreaks can become the ‘standard of care’ without robust evidence of their safety or efficacy, complicating the testing of new therapies and perpetuating uncertainty about their true effectiveness. To improve NiVD care, we propose four key strategies: 1) Enhance early case detection, 2) optimize supportive care to improve outcomes and create a standard for future trials, 3) adopt a syndromic approach centered on encephalitis, and 4) explore innovative trial designs tailored to low case numbers as an alternative to ‘compassionate use’. By integrating these strategies, healthcare systems in NiV-endemic regions will be better equipped to manage both current and future outbreaks.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100527"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}