The Lancet regional health. Southeast Asia最新文献

{"title":"Seven-day versus fourteen-day low-dose primaquine for Plasmodium vivax malaria in India: an open-label, non-inferiority, randomised, controlled trial","authors":"Rajendra Kumar Baharia, Sauman Singh-Phulgenda, Syed Mohammad Naser, Apoorv Gupta, Rutuja Chhajed, Mohammad Sharif Hossain, Karmveer Yadav, Reena Verma, Salil Kumar Pal, Parinita Halder Ranjit, Bhavin Solanki, Kamlesh Jayantilal Upadhyay, Leena Dabhi, Rajesh Sharma, Subrata Roy Chowdhury, Amitava Chakravorty, Megha Rajasekhar, Grant Lee, Hellen Mnjala, Souvik Ghosh, Robert J. Commons","doi":"10.1016/j.lansea.2026.100849","DOIUrl":"10.1016/j.lansea.2026.100849","url":null,"abstract":"<div><h3>Background</h3><div>India has a high burden of <em>Plasmodium vivax</em> malaria. Current malaria treatment guidelines recommend a total primaquine dose of 3·5 mg/kg administered over 14 days to prevent relapse in <em>P. vivax</em> infection, however, adherence is generally poor, impacting effectiveness. We aimed to determine the efficacy and safety of the same total dose of 3·5 mg/kg administered over 7 days in India.</div></div><div>India has a high burden of <em>Plasmodium vivax</em> malaria. Current malaria treatment guidelines recommend a total primaquine dose of 3·5 mg/kg administered over 14 days to prevent relapse in <em>P. vivax</em> infection, however, adherence is generally poor, impacting effectiveness. We aimed to determine the efficacy and safety of the same total dose of 3·5 mg/kg administered over 7 days in India.</div><div><h3>Methods</h3><div>We conducted an open label, non-inferiority, randomised controlled trial at two sites in India. Febrile patients older than 16 years with microscopically confirmed <em>P. vivax</em> mono-infection and normal (≥30%) G6PD activity were eligible for enrolment. Patients were randomly assigned (1:1) using block randomisation, stratified by site, to either 3·5 mg/kg primaquine over 7 days or 3·5 mg/kg primaquine over 14 days, which is the current standard of care. Primaquine was administered in combination with chloroquine as per national treatment guidelines. The primary endpoint was the cumulative incidence of symptomatic recurrent microscopy-confirmed <em>P. vivax</em> parasitaemia within 6 months. Efficacy analyses were conducted on the intention-to-treat population. The study was registered with the Clinical Trials Registry of India (CTRI/2022/12/048283).</div></div><div>We conducted an open label, non-inferiority, randomised controlled trial at two sites in India. Febrile patients older than 16 years with microscopically confirmed <em>P. vivax</em> mono-infection and normal (≥30%) G6PD activity were eligible for enrolment. Patients were randomly assigned (1:1) using block randomisation, stratified by site, to either 3·5 mg/kg primaquine over 7 days or 3·5 mg/kg primaquine over 14 days, which is the current standard of care. Primaquine was administered in combination with chloroquine as per national treatment guidelines. The primary endpoint was the cumulative incidence of symptomatic recurrent microscopy-confirmed <em>P. vivax</em> parasitaemia within 6 months. Efficacy analyses were conducted on the intention-to-treat population. The study was registered with the Clinical Trials Registry of India (CTRI/2022/12/048283).</div><div><h3>Findings</h3><div>Between September 2023 and October 2024, a total of 400 patients were enrolled (201 randomised to the 7-day group and 199 to the 14-day group). By 180 days of follow up, there were a total of four <em>P. vivax</em> recurrences, with two in each arm. The cumulative incidence of symptomatic parasitaemia by day 180 was 1·1% (95% confiden","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"53 ","pages":"Article 100849"},"PeriodicalIF":6.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141517","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":"Measles resurgence in Bangladesh: a preventable crisis in a transitioning immunisation system","authors":"Md Zakiul Hassan, Md Ariful Islam, Abir Shaqran Mahmood, Homayra Rahman Shoshi, Md Tajul Islam A. Bari, Mahmudur Rahman, Mohammod Jobayer Chisti","doi":"10.1016/j.lansea.2026.100787","DOIUrl":"10.1016/j.lansea.2026.100787","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"53 ","pages":"Article 100787"},"PeriodicalIF":6.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141520","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":"Decentralised patient-centred TB diagnostics: key considerations for India","authors":"Sivakumar Shanmugam, Madhumathi Jayaprakasam, Priya Rajendran, Hansraj Choudhary, Srinath Satyanarayana, Nivedita Gupta","doi":"10.1016/j.lansea.2026.100800","DOIUrl":"10.1016/j.lansea.2026.100800","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"53 ","pages":"Article 100800"},"PeriodicalIF":6.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141519","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":"Towards a regional and national cardiothoracic biobank in India: translating a Dutch model to address a poorly characterised disease burden","authors":"Nimrat Grewal,&nbsp;Mohammed Idhrees,&nbsp;Bashi Velayudhan,&nbsp;Mohamad Bashir","doi":"10.1016/j.lansea.2026.100860","DOIUrl":"10.1016/j.lansea.2026.100860","url":null,"abstract":"<div><div>Cardiothoracic disease in India presents earlier and against a different biological background than in the high-income populations from which most evidence and guidelines derive. Coronary disease occurs about a decade earlier in South Asians; rheumatic heart disease remains endemic, with India carrying a quarter to a half of the global burden; and acute type A aortic dissection presents in the mid-to-late forties, with a higher reported proportion of connective-tissue disease than Western registries. The biological substrate of these conditions in Indian patients is largely uncharacterised, and South Asian populations are underrepresented in the datasets driving precision cardiovascular medicine. We argue that a prospectively designed, ethically governed cardiothoracic biobank, collecting surgical tissue, blood and longitudinal clinical data at operation, is foundational national research infrastructure, and we describe what it can deliver, a transferable Dutch model (the IHLCN biobank), an ethical governance and data-transfer framework, and a phased regional-to-national path.</div></div><div>Cardiothoracic disease in India presents earlier and against a different biological background than in the high-income populations from which most evidence and guidelines derive. Coronary disease occurs about a decade earlier in South Asians; rheumatic heart disease remains endemic, with India carrying a quarter to a half of the global burden; and acute type A aortic dissection presents in the mid-to-late forties, with a higher reported proportion of connective-tissue disease than Western registries. The biological substrate of these conditions in Indian patients is largely uncharacterised, and South Asian populations are underrepresented in the datasets driving precision cardiovascular medicine. We argue that a prospectively designed, ethically governed cardiothoracic biobank, collecting surgical tissue, blood and longitudinal clinical data at operation, is foundational national research infrastructure, and we describe what it can deliver, a transferable Dutch model (the IHLCN biobank), an ethical governance and data-transfer framework, and a phased regional-to-national path.</div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"53 ","pages":"Article 100860"},"PeriodicalIF":6.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141521","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":"The epidemiology of thalassaemia syndromes in Southeast Asia","authors":"Frédéric B. Piel,&nbsp;Suthat Fucharoen,&nbsp;Mohammad Sorowar Hossain,&nbsp;Kittiphong Paiboonsukwong,&nbsp;Anuja Premawardhena,&nbsp;Bishow N. Adhikari,&nbsp;Ne Win,&nbsp;Fathmath Jeehan Saleem,&nbsp;Gregorio Rangel,&nbsp;Roshan Colah","doi":"10.1016/j.lansea.2026.100863","DOIUrl":"10.1016/j.lansea.2026.100863","url":null,"abstract":"<div><div>Thalassaemia syndromes are inherited haemoglobin disorders caused by mutations affecting α- and β-globin chains, ranging in severity from asymptomatic to transfusion-dependent. This Series paper synthesises epidemiological data across ten WHO Southeast Asia Region (SEAR) countries, combining local expertise with a rapid literature review. Due to the high prevalence of α- and β-thalassaemia variants, as well as haemoglobin E, the SEAR carries a disproportionately high burden and faces specific challenges. Although a small number of mutations tends to dominate in each country, the range of underlying mutations and deletions is complex. Beyond molecular studies, epidemiological data remain limited in most SEAR countries. Key challenges include blood supply shortages, consanguinity, gender-based disparities in healthcare access, population migration redistributing mutation profiles, and poor awareness. Recommendations to reduce the health burden of thalassaemia syndromes in the SEAR include setting up national registries, expanding premarital and prenatal screening, improving blood supply coordination, and promoting culturally sensitive education. Without targeted investments and policy commitment, most SEAR populations will remain unable to benefit from recent therapeutic advances, including emerging gene therapies.</div></div><div>Thalassaemia syndromes are inherited haemoglobin disorders caused by mutations affecting α- and β-globin chains, ranging in severity from asymptomatic to transfusion-dependent. This Series paper synthesises epidemiological data across ten WHO Southeast Asia Region (SEAR) countries, combining local expertise with a rapid literature review. Due to the high prevalence of α- and β-thalassaemia variants, as well as haemoglobin E, the SEAR carries a disproportionately high burden and faces specific challenges. Although a small number of mutations tends to dominate in each country, the range of underlying mutations and deletions is complex. Beyond molecular studies, epidemiological data remain limited in most SEAR countries. Key challenges include blood supply shortages, consanguinity, gender-based disparities in healthcare access, population migration redistributing mutation profiles, and poor awareness. Recommendations to reduce the health burden of thalassaemia syndromes in the SEAR include setting up national registries, expanding premarital and prenatal screening, improving blood supply coordination, and promoting culturally sensitive education. Without targeted investments and policy commitment, most SEAR populations will remain unable to benefit from recent therapeutic advances, including emerging gene therapies.</div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"53 ","pages":"Article 100863"},"PeriodicalIF":6.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199962","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":"Thalassaemia prevention in Asia: progress, challenges, and future directions","authors":"Michael Angastiniotis,&nbsp;Suthat Fucharoen,&nbsp;Kittiphong Paiboonsukwong,&nbsp;Ha Thanh Nguyen,&nbsp;Thi Thu Ha Nguyen,&nbsp;Hai Yang Law,&nbsp;Pustika Amalia Wahidiyat,&nbsp;Sourideth Sengchanh,&nbsp;Norehan Johari,&nbsp;Chean Sophâl,&nbsp;Maria Liza T. Naranjo,&nbsp;Nita Radhakrishnan,&nbsp;Khaled M. Musallam,&nbsp;Androulla Eleftheriou","doi":"10.1016/j.lansea.2026.100810","DOIUrl":"10.1016/j.lansea.2026.100810","url":null,"abstract":"<div><div>Thalassaemia remains a major public health burden in Asia, where high carrier frequencies, diverse mutation spectra, and variable healthcare capacity continue to influence disease prevention and control. This Series paper summarises the status of thalassaemia prevention programmes across 14 Asian countries and highlights the key challenges and opportunities affecting their implementation. Singapore, Malaysia, the Maldives, and Thailand have established the most structured prevention strategies, incorporating combinations of public awareness, carrier screening, genetic counselling, and prenatal diagnosis, with measurable success most clearly demonstrated in Singapore and, to a specific extent, Thailand. In contrast, many other countries in the region continue to face fragmented services, limited national coordination, shortages of trained personnel, inadequate epidemiological data, and financial, technological, cultural, and social barriers. Differences in prevention efforts broadly reflect wider disparities in health system development. Strengthening national prevention programmes should be viewed as both a public health priority and a cost-effective investment in reducing long-term disease burden.</div></div><div>Thalassaemia remains a major public health burden in Asia, where high carrier frequencies, diverse mutation spectra, and variable healthcare capacity continue to influence disease prevention and control. This Series paper summarises the status of thalassaemia prevention programmes across 14 Asian countries and highlights the key challenges and opportunities affecting their implementation. Singapore, Malaysia, the Maldives, and Thailand have established the most structured prevention strategies, incorporating combinations of public awareness, carrier screening, genetic counselling, and prenatal diagnosis, with measurable success most clearly demonstrated in Singapore and, to a specific extent, Thailand. In contrast, many other countries in the region continue to face fragmented services, limited national coordination, shortages of trained personnel, inadequate epidemiological data, and financial, technological, cultural, and social barriers. Differences in prevention efforts broadly reflect wider disparities in health system development. Strengthening national prevention programmes should be viewed as both a public health priority and a cost-effective investment in reducing long-term disease burden.</div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"53 ","pages":"Article 100810"},"PeriodicalIF":6.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199961","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":"Rabies elimination in Southeast Asia: uneven progress, time to step up","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2026.100882","DOIUrl":"10.1016/j.lansea.2026.100882","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"53 ","pages":"Article 100882"},"PeriodicalIF":6.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149211636","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":"Access to abortion and subsequent fertility preferences and reproductive outcomes in Nepal (2019–2024): a prospective cohort study","authors":"Christina Misunas,&nbsp;Diana Greene Foster,&nbsp;Rachel Murro,&nbsp;Mahesh C. Puri,&nbsp;Corinne H. Rocca","doi":"10.1016/j.lansea.2026.100832","DOIUrl":"10.1016/j.lansea.2026.100832","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Access to abortion is central to people’s ability to act on their fertility preferences, yet little research has examined whether the ability to avoid having an unwanted birth shapes subsequent fertility outcomes or enables people to align future childbearing with their preferences. This study examines whether and how access to a desired abortion is associated with fertility preferences and reproductive outcomes over the subsequent years.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Access to abortion is central to people’s ability to act on their fertility preferences, yet little research has examined whether the ability to avoid having an unwanted birth shapes subsequent fertility outcomes or enables people to align future childbearing with their preferences. This study examines whether and how access to a desired abortion is associated with fertility preferences and reproductive outcomes over the subsequent years.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We analyzed data from the &lt;em&gt;Nepal Turnaway Study&lt;/em&gt;, a five-year prospective cohort study of women seeking abortion, comparing those who obtained an abortion with those who were denied and subsequently gave birth. We examined fertility preferences over time using mixed-effects multinomial logistic regression, time to subsequent pregnancy and birth using flexible parametric survival models, and cumulative births using mixed-effects Poisson regression. Finally, we assessed whether subsequent births were undesired prior to conception using mixed-effects logistic regression.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We analyzed data from the &lt;em&gt;Nepal Turnaway Study&lt;/em&gt;, a five-year prospective cohort study of women seeking abortion, comparing those who obtained an abortion with those who were denied and subsequently gave birth. We examined fertility preferences over time using mixed-effects multinomial logistic regression, time to subsequent pregnancy and birth using flexible parametric survival models, and cumulative births using mixed-effects Poisson regression. Finally, we assessed whether subsequent births were undesired prior to conception using mixed-effects logistic regression.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Among 1742 participants seeking abortion, 1467 had an abortion or miscarried (the &lt;em&gt;no-birth-to-index-pregnancy&lt;/em&gt; group) and 275 were denied and gave birth (the &lt;em&gt;gave-birth-to-index-pregnancy&lt;/em&gt; group). Initially (at year one through year four), the &lt;em&gt;no-birth-to-index-pregnancy&lt;/em&gt; group was more open to pregnancy than the &lt;em&gt;gave-birth-to-index-pregnancy&lt;/em&gt; group; by year five, their fertility preferences converged. Four years after return to fecundability, the cumulative incidence of a subsequent pregnancy was 41.8% in the &lt;em&gt;no-birth-to-index-pregnancy&lt;/em&gt; group and 18.3% in the &lt;em&gt;gave-birth-to-index-pregnancy&lt;/em&gt; group (difference: 23.5 percentage points; 95% CI: 17.3–29.7), and of a subsequent birth was 30.8% and 10.0%, respectively (difference: 20.8 percentage points; 95% CI: 15.1–26.6).","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"52 ","pages":"Article 100832"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951333","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":"Abortion access in South Asia: counting cost and impact beyond maternal morbidity and mortality","authors":"Sushanta Kumar Banerjee,&nbsp;Medha Gandhi","doi":"10.1016/j.lansea.2026.100838","DOIUrl":"10.1016/j.lansea.2026.100838","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"52 ","pages":"Article 100838"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951330","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":"Prevalence and risk factors for stillbirths in India: secondary analysis of ICMR-Stillbirth Pooled India Cohort (ICMR-SPIC)","authors":"","doi":"10.1016/j.lansea.2026.100841","DOIUrl":"10.1016/j.lansea.2026.100841","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Despite substantial reductions in stillbirth rate (SBR) over the past two decades, India continues to bear one of the highest burden of stillbirths worldwide. The available national evidence on stillbirth is fragmented, regionally variable, and often limited in scope. We aimed to determine stillbirth burden and risk factors leveraging a pooled cohort from ten prospective studies conducted across various settings in India.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Despite substantial reductions in stillbirth rate (SBR) over the past two decades, India continues to bear one of the highest burden of stillbirths worldwide. The available national evidence on stillbirth is fragmented, regionally variable, and often limited in scope. We aimed to determine stillbirth burden and risk factors leveraging a pooled cohort from ten prospective studies conducted across various settings in India.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We established the Indian Council of Medical Research–Stillbirth Pooled India Cohort (ICMR-SPIC), combining individual-level data from ten prospective cohort studies conducted across multiple sites of India. The pooled dataset included prospective pregnancy cohort studies conducted across India between 1994 and 2023 from rural, urban, hospital, and community settings, with participant recruitment and follow-up periods varying across individual studies. After exclusions, 227,821 pregnancies were included. Harmonised analytical datasets were constructed, and weighted SBR was estimated. Multivariable mixed-effects modified Poisson regression was used to evaluate the association between stillbirth and independent maternal and antenatal risk factors. Population attributable fractions (PAFs) were calculated for modifiable exposures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We established the Indian Council of Medical Research–Stillbirth Pooled India Cohort (ICMR-SPIC), combining individual-level data from ten prospective cohort studies conducted across multiple sites of India. The pooled dataset included prospective pregnancy cohort studies conducted across India between 1994 and 2023 from rural, urban, hospital, and community settings, with participant recruitment and follow-up periods varying across individual studies. After exclusions, 227,821 pregnancies were included. Harmonised analytical datasets were constructed, and weighted SBR was estimated. Multivariable mixed-effects modified Poisson regression was used to evaluate the association between stillbirth and independent maternal and antenatal risk factors. Population attributable fractions (PAFs) were calculated for modifiable exposures.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 3935 stillbirths occurred among 227,821 pregnancies, yielding a pooled weighted stillbirth rate of 14.8 per 1000 births (95% CI: 13.4–16.3). Independent risk factors included maternal age (&gt;30 years) (aIRR 1.64, 95% CI: 1.55–1.72; PAF 3.23%, 95% CI: 2.97–3.48), informal maternal education (aIRR 1.45, 95% CI: 1.32–1.58; PAF 8.86%, ","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"52 ","pages":"Article 100841"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951331","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}