The Lancet regional health. Southeast Asia最新文献

{"title":"Clarifying methodological discrepancies in HIV retention analysis—authors’ reply","authors":"Shweta Chidrawar, Suvarna Sane, Megha Mamulwar, Shilpa Bembalkar, Sheela Godbole","doi":"10.1016/j.lansea.2025.100609","DOIUrl":"10.1016/j.lansea.2025.100609","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"38 ","pages":"Article 100609"},"PeriodicalIF":5.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213303","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 role of serum ferritin in predicting plasma leakage among adults and children with dengue in Sri Lanka: a multicentre, prospective cohort study","authors":"Chamila Mettananda ,&nbsp;Kesara Perera ,&nbsp;Natheeha Nayeem ,&nbsp;Matheesha Nayanajith ,&nbsp;Ayesha Thewage ,&nbsp;Ranjan Premaratna ,&nbsp;Anuradha Dassanayake ,&nbsp;Arunasalam Pathmeswaran ,&nbsp;Sachith Mettananda","doi":"10.1016/j.lansea.2025.100606","DOIUrl":"10.1016/j.lansea.2025.100606","url":null,"abstract":"<div><h3>Background</h3><div>Early prediction of plasma leakage helps in timely management of dengue. Currently, there are no defined early predictors of plasma leakage, and identified parameters are late predictors. Raised ferritin is associated with severe dengue, but its clinical utility early in the disease to predict severe dengue is not previously reported. We studied the efficacy of day 3 or 4 serum ferritin in predicting plasma leakage among adults and children with dengue in Sri Lanka.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study in four hospitals in Sri Lanka from June 2022 to June 2023. Consecutive and consenting patients admitted with dengue fever were included in the study. Patients with comorbidities where ferritin could be abnormal were excluded. Serum ferritin levels were prospectively measured daily until day 8 of the illness. Physician-diagnosed plasma leakage, defined as rising haematocrit ≥ 20% from baseline or ultrasound evidence of pleural effusion or ascites, was the main outcome. Data were collected using a proforma by perusing medical records. Prediction of plasma leakage by day 3 or 4 ferritin was studied using receiver operating characteristic curves (ROC).</div></div><div><h3>Findings</h3><div>We studied 209 patients with dengue, of which 118 (56.5%) were males and median age was 20 years (IQR 9.0–40.5). Out of 209 patients, 70 (33.5%) developed plasma leakage. Median [IQR] ferritin levels on day 3 (926 [400–2752]) and day 4 (1249 [588–3005]) in patients who developed plasma leakage were higher than ferritin levels in patients who did not develop plasma leakage (p &lt; 0.001) (day 3: 273 [101–620]) and (day 4: 506 [220–1226]). Performance of day 3 or 4 ferritin in predicting plasma leakage showed an area under the ROC of 0.78 (95% CI 0.70–0.85). The highest serum ferritin of day 3 or 4 had a positive predictive value of 52% and a negative predictive value of 84%.</div></div><div><h3>Interpretation</h3><div>Day 3 or 4 ferritin levels correctly predicted plasma leakage status in 78% of the study samples. Serum ferritin levels measured on day 3 or 4 can be used as an early predictor of plasma leakage in dengue.</div></div><div><h3>Funding</h3><div><span>University of Kelaniya</span> Internal Research Grants 2022 (Grant reference number: <span><span>RP/03/04/13/01/2022</span></span>).</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100606"},"PeriodicalIF":5.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147606","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":"Towards integrated cardiovascular and mental health management in primary health care in Indonesia: a policy outlook","authors":"Anwar Santoso ,&nbsp;Theresia Citraningtyas ,&nbsp;Eka Viora ,&nbsp;Wira Gotera ,&nbsp;Isti Ilmiati Fujiati ,&nbsp;Widjaja Lukito ,&nbsp;Dhanasari Vidiawati ,&nbsp;Mora Claramita ,&nbsp;Hervita Diatri ,&nbsp;Benny Prawira ,&nbsp;Angela Grace ,&nbsp;Elli Arsita ,&nbsp;Andreas Billy","doi":"10.1016/j.lansea.2025.100605","DOIUrl":"10.1016/j.lansea.2025.100605","url":null,"abstract":"<div><div>This paper argues for the need for an integrated approach towards cardiovascular diseases (CVDs) and mental health (MH) disorders. Despite non-communicable diseases (NCDs) being a major public health problem and thus a prime concern for primary health centres, the strong interplay between CVDs and MH conditions as two major NCDs is largely overlooked. Management for MH and CVDs tends to be dichotomized between mental and physical health. This paper continues a publication by a Southeast Asian panel by using Indonesia as a national case study. The paper describes the results of a discussion by an interdisciplinary team of national experts on barriers to NCD management in current policy and clinical implementation. The thematic review provides a basis for the recommendation for an integrated cardiovascular and mental health approach to optimize policy for NCD prevention and management.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100605"},"PeriodicalIF":5.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138620","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":"South Asia’s diabetes crisis needs families: how can we advance from informal care to integrated engagement?","authors":"Shahmir H. Ali ,&nbsp;Sudip Bhattacharya ,&nbsp;Abhijit Chanda ,&nbsp;Biswadeep Dhar","doi":"10.1016/j.lansea.2025.100607","DOIUrl":"10.1016/j.lansea.2025.100607","url":null,"abstract":"<div><div>Type 2 diabetes (T2D) is an escalating concern in South Asia, with prevalence surging over the past two decades. Family members often significantly influence T2D outcomes and management, yet involvement remains informal, unstructured, and unrecognized within healthcare systems. This viewpoint calls for a more structured, equitable approach to family engagement in T2D care, outlining three models (family-supported, family-wide, and family-led) that can optimize the role of family in T2D care. Given the diversity of household structures, interventions must be adaptable to varying family dynamics. While family involvement can enhance care, challenges such as cultural barriers, gender and age disparities, and inconsistent healthcare guidance must be addressed. Providers need training and clear protocols to engage families, while policies must ensure that caregivers are equipped with adequate support. Digital tools, including social media and telemedicine, offer promising ways to enhance family support in T2D management. Ultimately, South Asia must move beyond reliance on informal care to system-integrated family engagement that recognizes and empowers those often at the frontlines of care.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"38 ","pages":"Article 100607"},"PeriodicalIF":5.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134361","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":"Analysis of kidney and liver exchange transplantation in India (2000–2025): a multicentre, retrospective cohort study","authors":"Vivek B. Kute ,&nbsp;Himanshu V. Patel ,&nbsp;Subho Banerjee ,&nbsp;Feroz Aziz ,&nbsp;Suraj M. Godara ,&nbsp;Shyam B. Bansal ,&nbsp;Anil K. Bhalla ,&nbsp;Pranjal Modi ,&nbsp;Ashish Sharma ,&nbsp;Viswanath Billa ,&nbsp;Sajith Narayanan ,&nbsp;Priyadarshi Ranjan ,&nbsp;Manish Singla ,&nbsp;Arvinder S. Soin ,&nbsp;Subhash Gupta ,&nbsp;Sandeep Guleria ,&nbsp;Prashant Bhangui ,&nbsp;Ankur Gupta ,&nbsp;Deepak S. Ray ,&nbsp;Divyesh P. Engineer ,&nbsp;Aneesh Srivastava","doi":"10.1016/j.lansea.2025.100597","DOIUrl":"10.1016/j.lansea.2025.100597","url":null,"abstract":"<div><h3>Background</h3><div>In India, where deceased organ donation rates are relatively low, living donor transplantation programmes face challenges due to ABO incompatibility and sensitisation. Approximately one-third of healthy, willing living donors are incompatible with their intended recipients due to these factors. No large-scale data are currently available on kidney exchange (KE) or liver exchange (LE) transplants in low- and middle-income countries, including India.</div></div><div><h3>Methods</h3><div>We conducted a multicentre, retrospective cohort study including KE (2000–2024) from 65 centres and LE (2007–2025) from 7 centres across India. The living donors were near-related donors without altruistic and deceased donors. Demographic and clinical data of both donors and recipients were included in the study. The reasons for KE/LE, post-transplant outcomes with respect to patient and graft survival, rejection episodes, and donor outcomes were analysed. Kidney allocation system guidelines were: (i) Thorough pre-transplant work-up of DRP was completed before allocation to avoid chain collapse. (ii) A policy of non-anonymous allocation was practised (in contrast to anonymous allocation in high-income countries), where pairs can create a rapport during evaluation and surgery. (iii) Simple two-way exchanges, and simultaneous surgeries were considered for less experienced transplant centres in order to avoid donor renege.</div></div><div><h3>Findings</h3><div>A total of 1839 KE and 259 LE transplants were included in the study. The distribution of KE transplants included, 1594 (87%), 147 (8%), 44 (2%), 20 (1%), 24 (1%), and 10 (0.5%) transplants from 2-way, 3-way, 4-way, 5-way, 6-way and 10-way KE, respectively. Reasons for joining KE in transplanted pairs were ABO incompatibility 1610 (87%), compatible pairs 126 (7%), and sensitisation 103 (6%). There was notable gender imbalance, as more males were KE recipients 1504 (82%) and more females were donors 1469 (80%). The majority of LE were 2-way swaps (125 two-way vs. 3 three-way swaps), predominately involving male recipients (222 male vs. 37 females) and for ABO incompatibility.</div></div><div><h3>Interpretation</h3><div>Our largest-to-date cohort study supports that swap transplants are medically simple, but logistically complex. Access to KE or LE was unequally distributed and likely under-used. If replicated, our experience could increase access to transplants and help combat the looming threat of commercial transplants.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100597"},"PeriodicalIF":5.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116988","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":"Neuromelioidosis outbreak in Tamil Nadu, India: an investigation of transmission with genomic insights","authors":"Angel Miraclin Thirugnanakumar ,&nbsp;Prabu Rajkumar ,&nbsp;Karthik Gunasekaran ,&nbsp;Pavithra Mannam ,&nbsp;Manickam Ponnaiah ,&nbsp;Girish Kumar Chethrapilly Purushothaman ,&nbsp;Aravind Velmurugan ,&nbsp;Ayyan Raj Neeravi ,&nbsp;Jobin John Jacob ,&nbsp;Solomon D. Cruz ,&nbsp;Bhagteshwar Singh ,&nbsp;Prabhakar Appaswamy Thirumal ,&nbsp;Anitha Jasper ,&nbsp;Malu Mohan ,&nbsp;Devika Shanmugasundaram ,&nbsp;Ananth Abraham ,&nbsp;Senthil Thangarajan ,&nbsp;Tony Panicker ,&nbsp;Bijesh Nair ,&nbsp;Aravintharaj Selvakumar ,&nbsp;Manoj Murhekar","doi":"10.1016/j.lansea.2025.100602","DOIUrl":"10.1016/j.lansea.2025.100602","url":null,"abstract":"<div><h3>Background</h3><div>In May 2023, we investigated a cluster of neuromelioidosis notified from Tamil Nadu state in southern India to describe case characteristics and identify the infection source.</div></div><div><h3>Methods</h3><div>We searched for probable cases presenting with fever and brainstem syndrome, supported by radiological findings suggestive of neuromelioidosis. Cases were confirmed by isolation of <em>Burkholderia pseudomallei</em> from tissue, blood, or cerebrospinal fluid (CSF), or by PCR. The cases were described by time (epidemic curve), place (spot map), and person (clinical characteristics). Infection sources and virulence markers were identified by genome sequencing of the clinical and environmental isolates. Whole genome sequencing data were analysed to investigate the expression of <em>Burkholderia mallei</em>-like <em>bimA</em>_<em>Bm</em> gene, and a phylogenetic tree was constructed to study sequence similarity to the global isolates.</div></div><div><h3>Findings</h3><div>We identified 21 probable cases between July 2022 and April 2023 (median age = 33 years; 11 females; five confirmed) across four districts in Northern Tamil Nadu. Seventeen cases were from a single district and 10 reported prior dental treatment at a clinic. Cases with dental exposure had higher fatality (8/10 vs. 1/11) and shorter time to death (median 17 days vs. 1 death at day 56) than sporadic cases. The <em>bimA</em>_<em>Bm</em> gene, which is associated with neurotropism, was identified in all three clonal isolates (two from the cases and one from the environmental isolate from the in-use saline bottle). Whole genome sequencing identified the ST1553 strain as being associated with the current outbreak. Genetic analysis of 209 isolates available in the public database with metadata revealed that ST1553, the strain responsible for the outbreak, clustered with isolates from India and Australia that expressed the <em>B. mallei-like bimA</em>_<em>Bm</em> <em>allele</em>.</div></div><div><h3>Interpretation</h3><div>We confirmed a large cluster of neuromelioidosis from South India, likely representing sporadic cases from environmental sources and cases linked to an iatrogenic source at a dental clinic. Rapid and high case fatality among dental cases supports the direct trans-neural spread of <em>B. pseudomallei</em> to the brainstem following inoculation via contaminated saline. Expression of <em>B. mallei-like bimA</em>_<em>Bm</em> <em>allele may have contributed to the increased neurological manifestations of melioidosis.</em></div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100602"},"PeriodicalIF":5.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105363","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":"Indian Council of Medical Research (ICMR)-Sickle cell disease (SCD) Stigma Scale for India (ISSSI): development and psychometrics","authors":"Bontha V. Babu ,&nbsp;Yogita Sharma ,&nbsp;Parikipandla Sridevi ,&nbsp;Deepa Bhat ,&nbsp;Shaily B. Surti ,&nbsp;Jatin Sarmah ,&nbsp;Madhusmita Bal ,&nbsp;Manoranjan Ranjit ,&nbsp;Rabindra K. Jena","doi":"10.1016/j.lansea.2025.100603","DOIUrl":"10.1016/j.lansea.2025.100603","url":null,"abstract":"<div><h3>Background</h3><div>Sickle Cell Disease (SCD) places a significant psychological and social burden on patients and their caregivers, often leading to stigma that further diminishes their quality of life. Despite the huge burden of SCD and associated stigma in India, not much research has been done, and no stigma measurement tool is available. Hence, the Indian Council of Medical Research (ICMR) has undertaken a multi-centric study to develop the ICMR-SCD Stigma Scale for India (ISSSI).</div></div><div><h3>Methods</h3><div>A systematic approach was employed, beginning with item generation, content validity assessment, pretesting and psychometric validation. This process included exploratory factor analysis demonstrating strong factor loadings. Subsequently, confirmatory factor analysis was conducted to assess model fit, leading to refined scales of 16 items for patients and 17 items for caregivers.</div></div><div><h3>Findings</h3><div>This study explicitly developed and validated the ISSSI for Indian SCD patients (ISSSI-Pt) and their caregivers (ISSSI-Cg). The finalized scales capture multidimensional aspects of stigma, including familial and reproductive, social disclosure, illness burden, interpersonal, and healthcare interaction challenges. The findings underscore the scales’ psychometric robustness and utility in clinical and research settings.</div></div><div><h3>Interpretation</h3><div>The methodological rigour employed in the scale development makes it a robust tool for understanding SCD-related stigma among Indian SCD patients and their caregivers in clinical and research contexts. The development of the ISSSI represents a significant advancement in understanding and addressing the multifaceted stigma associated with SCD in India. Future studies should apply these scales across diverse cultural and linguistic contexts to enhance their generalizability and impact.</div></div><div><h3>Funding</h3><div><span>Indian Council of Medical Research</span> (Grant Number: <span><span>NTF/SCD-Stigma/2022/SBHSR</span></span>).</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100603"},"PeriodicalIF":5.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105332","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":"A milestone for women's health in Nepal: the landmark HPV vaccination campaign","authors":"Rajesh Sambhajirao Pandav ,&nbsp;Abhiyan Gautam ,&nbsp;Nilgun Aydogan ,&nbsp;Ramesh Kant Adhikari ,&nbsp;Bibek Kumar Lal","doi":"10.1016/j.lansea.2025.100600","DOIUrl":"10.1016/j.lansea.2025.100600","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100600"},"PeriodicalIF":5.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089500","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":"Zoonotic disease outbreaks reported under India's Integrated Disease Surveillance Programme, 2018–2023: a cross-sectional analysis of national surveillance data","authors":"Mogan Kaviprawin ,&nbsp;Mohankumar Raju ,&nbsp;Manikandanesan Sakthivel ,&nbsp;Archana Ramalingam","doi":"10.1016/j.lansea.2025.100601","DOIUrl":"10.1016/j.lansea.2025.100601","url":null,"abstract":"<div><h3>Background</h3><div>Timely analysis of zoonotic outbreak surveillance data is critical for assessing the effectiveness of outbreak detection and reporting systems, a priority for global health security. We described the zoonotic disease outbreaks notified under the Integrated Disease Surveillance Program (IDSP) in India between 2018 and 2023 to identify temporal trends and spatial variation.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study by reviewing zoonotic disease outbreak line-list data from IDSP weekly outbreak reports and analyzed by year, region, and timeliness of reporting. We conducted a mixed Poisson regression to estimate the change (β coefficient) in outbreaks over the years and visualized maps in R software.</div></div><div><h3>Findings</h3><div>Of the 6948 outbreaks reported in IDSP, 583 (8.3%) were zoonotic, with a median of seven monthly zoonotic outbreaks. Outbreaks significantly increased over the years (β coefficient = 0.07 [0.02–0.12]). Japanese encephalitis accounted for 29.5% of zoonotic outbreaks, followed by leptospirosis (18.7%) and scrub typhus (13.9%). The northeast region contributed 35.8% of zoonotic disease outbreaks, followed by the southern (31.7%) and western regions (15.4%). One-third (34.6%) of outbreaks were reported late, and they declined over the years (52.6% in 2019, 40.9% in 2021, and 5.2% in 2023). The follow-up reports were unavailable for 97.2% of zoonotic outbreaks notified.</div></div><div><h3>Interpretation</h3><div>We documented the regions with high notification of zoonotic disease outbreaks under India's national-level outbreak surveillance system. Critical gaps in weekly outbreak reports were identified, particularly the lack of follow-up documentation. To address these gaps, we recommend strengthening disease-specific surveillance systems in hotspot regions.</div></div><div><h3>Funding</h3><div>The present study is non-funded.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100601"},"PeriodicalIF":5.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089387","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":"Addressing influenza in Bangladesh: closing evidence and policy gaps with strategic interventions","authors":"Md Zakiul Hassan ,&nbsp;Saleh Haider ,&nbsp;Mohammad Abdul Aleem ,&nbsp;Md Ariful Islam ,&nbsp;Tanzir Ahmed Shuvo ,&nbsp;Saju Bhuiya ,&nbsp;Mahbubur Rahman ,&nbsp;Mahmudur Rahman ,&nbsp;Tahmina Shirin ,&nbsp;Fahmida Chowdhury","doi":"10.1016/j.lansea.2025.100592","DOIUrl":"10.1016/j.lansea.2025.100592","url":null,"abstract":"<div><div>Since the establishment of the National Influenza Surveillance Program in 2007, Bangladesh has significantly progressed in monitoring influenza through national and international collaboration. However, this collaboration has not been translated into actionable control policies, which coupled with low vaccination coverage, impose a substantial health and economic burden in Bangladesh. Critical gaps remain in understanding the influenza burden among high-risk populations and the barriers influencing their vaccine uptake. These gaps hinder the development of evidence-based strategies for prevention and control, consequently leaving the country vulnerable to a potentially catastrophic influenza epidemic. These challenges require a multifaceted approach, including continuous local data collection on disease burden and vaccine barriers, vaccine cost-effectiveness analyses, and the design of context-specific interventions. Leveraging existing infrastructures offers opportunities to develop tailored strategies for high-risk populations. A robust national influenza policy is imperative to mitigate the burden and reduce future pandemic threats.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100592"},"PeriodicalIF":5.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084259","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}