{"title":"Transforming neonatal nursing in India: challenges, opportunities, and the way forward.","authors":"Geetanjali Kalyan, Poonam Joshi, Lumchio Levis Murry, Marsha Campbell-Yeo, Surya Kant Tiwari","doi":"10.1016/j.lansea.2024.100522","DOIUrl":"https://doi.org/10.1016/j.lansea.2024.100522","url":null,"abstract":"<p><p>Neonatal care is essential for the well-being of newborns, particularly premature or critically ill patients. Despite advancements in medical technology and evidence-based practice, India faces significant challenges in neonatal nursing, including resource limitations, inconsistent training, and inadequate policy support. This paper examines the current state of neonatal nursing in India, highlighting disparities between urban and rural areas, and comparing them to global practices. It explores systemic issues affecting neonatal care, such as inadequate educational frameworks, a shortage of trained faculty, and insufficient clinical exposure. We outline a comprehensive approach to address these challenges, including the introduction of Neonatal Nurse Practitioner programs, enhancements in specialized training, promotion of evidence-based practices, and integration of technology. We also emphasize the need for stronger policy support and increased funding to improve the neonatal care infrastructure. By adopting these recommendations, India can make significant strides towards improving neonatal outcomes and aligning itself with global health targets.</p>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"100522"},"PeriodicalIF":5.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933792","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":"Genetic variants and type 2 diabetes in India: a systematic review and meta-analysis of associated polymorphisms in case-control studies.","authors":"Lokendra Rathod, Sameera Khan, Sweta Mishra, Deepanker Das, Kaustubh Bora, Swasti Shubham, Samradhi Singh, Manoj Kumar, Rajnarayan R Tiwari, Archana Tiwari, Pradyumna Kumar Mishra, Devojit Kumar Sarma","doi":"10.1016/j.lansea.2024.100518","DOIUrl":"10.1016/j.lansea.2024.100518","url":null,"abstract":"<p><strong>Background: </strong>India, with the largest population and second-highest type 2 diabetes mellitus (T2DM) prevalence, presents a unique genetic landscape. This study explores the genetic profiling of T2DM, aiming to bridge gaps in existing research and provide insights for further explorations.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of literature published up to September 2024 using databases like PubMed, Web of Science, Scopus, and Google Scholar to identify SNPs associated with T2DM in case-control studies within the Indian population. Data extraction followed a rigorously designed checklist independently verified by two reviewers. The quality of the studies assessed by utilizing Newcastle Ottawa scale, and heterogeneity through Cochran's Q, τ<sup>2</sup>, H<sup>2</sup> and <i>I</i> <sup><i>2</i></sup> statistics. Fixed effect and random effect model was employed for meta-analysis based on heterogeneity, and publication bias was assessed by funnel plot analysis, Egger's and Begg's statistical test. In SNPs with adequate studies meta-regression was used to assess source of heterogeneity. Statistical analyses were performed using Stata 18.0 software.</p><p><strong>Findings: </strong>Our search identified 1309 articles, with 67 included in the systematic review and 35 in the meta-analysis. These 67 case-control studies, involving 33,407 cases and 30,762 controls, analyzed 167 SNPs across 61 genes. Of these, 89 SNPs mapped to 46 genes showed significant associations with T2DM risk (<i>P</i> < 0.05), including 67 linked to increased risk and 16 with protective effects. Geographical analysis highlighted inter- and intra-regional variations. Meta-analysis of 25 SNPs revealed 12 SNPs with high T2DM risk compatibility. <i>TCF7L2</i> gene exhibited a strong compatibility with an overall OR of 1.44 (95% CI 1.36-1.52) and <i>S-value</i> 112.41, while <i>TCF7L2</i> variants rs7903146 and rs12255372, with OR 1.56 (95% CI 1.43-1.66) and <i>S-value</i> 89.036, OR of 1.36 (95% CI 1.17-1.35) with an <i>S</i>-<i>value</i> of 15.45 respectively.</p><p><strong>Interpretation: </strong>Our study highlights the importance of considering the diverse ethnic groups of India for development of targeted and effective T2DM management strategies.</p><p><strong>Funding: </strong>Department of Biotechnology (DBT) and Indian Council of Medical Research (ICMR), Government of India.</p>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"100518"},"PeriodicalIF":5.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908025","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":"Why the STD/MSM labelling of mpox could backfire and set back global containment efforts?","authors":"Thekkumkara Surendran Anish, Anaswara Naveen, Reghukumar Aravind","doi":"10.1016/j.lansea.2024.100517","DOIUrl":"10.1016/j.lansea.2024.100517","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"100517"},"PeriodicalIF":5.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883757","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}
Satendra Singh, Rohin Bhatt, Mohammed Ahmed Rashid
{"title":"One step forward, two steps back: urgent priorities to embed disability and queer health in medical education systems.","authors":"Satendra Singh, Rohin Bhatt, Mohammed Ahmed Rashid","doi":"10.1016/j.lansea.2024.100515","DOIUrl":"10.1016/j.lansea.2024.100515","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"100515"},"PeriodicalIF":5.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857209","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}
Rohini Dutta, Priyansh Nathani, Priti Patil, Rakhi Ghoshal, Shagun Tuli, Juul M Bakker, Alex J van Duinen, Nobhojit Roy, Adeline A Boatin, Anita Gadgil
{"title":"State-wise variation and inequalities in caesarean delivery rates in India: analysis of the National Family Health Survey-5 (2019-2021) data.","authors":"Rohini Dutta, Priyansh Nathani, Priti Patil, Rakhi Ghoshal, Shagun Tuli, Juul M Bakker, Alex J van Duinen, Nobhojit Roy, Adeline A Boatin, Anita Gadgil","doi":"10.1016/j.lansea.2024.100512","DOIUrl":"10.1016/j.lansea.2024.100512","url":null,"abstract":"<p><strong>Background: </strong>India's caesarean delivery (CD) rate of 21.5% suggests adequate national access to CD but may mask significant disparities. We examined variation in CD rates across states (geography), wealth, and health care sector (public versus private). We also aimed to determine relative inequality in CD rates across wealth quintiles.</p><p><strong>Methods: </strong>The current study was a cross-sectional analysis of CD rates from the National Family Health Survey-5 (2019-2021) disaggregated by asset-based household wealth quintiles for each state and by healthcare sector (public versus private). Data from 724,115 women aged 15-49 years across 28 states and eight union territories were analysed. Women who reported their most recent live birth within the past five years were included. Relative inequality was measured by comparing CD rates in the richest versus the poorest quintiles.</p><p><strong>Findings: </strong>Disaggregating the national CD rate of 21.5% showed substantial variation in CD rate across states, ranging from 5.2% in Nagaland to 60.7% in Telangana and across wealth quintiles, ranging from 0% to 76.7% (Assam). CD facility rates were higher in private than public facilities across all wealth quintiles. Over two-thirds of states (69%) had at least twice the CD rate in the richest wealth quintile versus the poorest quintile. Relative inequality in CD rates between the richest and poorest was 5.3 nationally and was higher in public (4.0) versus private (1.4) facilities.</p><p><strong>Interpretation: </strong>The national CD rate in India masks complex geographical, wealth, and sector-related inequalities in CD utilisation. Accounting for these variations is imperative when interpreting national-level rates to better assess the equity in the distribution of CD services.</p><p><strong>Funding: </strong>None.</p>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"100512"},"PeriodicalIF":5.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883754","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}
Viviane Valdes , Eileen F. Sullivan , Fahmida Tofail , Lisa M. Thompson , Shahria H. Kakon , Talat Shama , Rashidul Haque , Charles A. Nelson
{"title":"Trajectories and social determinants of child cognitive development: a prospective cohort study from infancy through middle childhood in Dhaka, Bangladesh","authors":"Viviane Valdes , Eileen F. Sullivan , Fahmida Tofail , Lisa M. Thompson , Shahria H. Kakon , Talat Shama , Rashidul Haque , Charles A. Nelson","doi":"10.1016/j.lansea.2024.100511","DOIUrl":"10.1016/j.lansea.2024.100511","url":null,"abstract":"<div><h3>Background</h3><div>Over a third of children globally do not meet their developmental potential, and children living in low and middle-income countries (LMICs) are most vulnerable. Understanding the contextual factors that influence cognitive development for children in LMICs is crucial to inform and develop interventions. We sought to characterize developmental trajectories of cognition in Bangladeshi children and identify salient social determinants.</div></div><div><h3>Methods</h3><div>We used a longitudinal design and included 542 children living in Dhaka, Bangladesh. Social determinants (maternal and paternal education, housing risks, household assets, and food security) were assessed at baseline visits using a combination of oral interviews and home assessments. Cognitive development was assessed at 6 months, 2, 3, 4, 5, and 7 years. A total of 1397 cognitive assessments were completed across all participants. Growth curve models and mixed effect models were used.</div></div><div><h3>Findings</h3><div>In children living above the poverty line, there was increasing deviation from expected cognitive scores from 6 months to 2 years (−12.85, <em>p</em> < 0.001) with stable scores from 2 to 7 years. For those below the poverty line, there were widening disparities from expectations in scores from 6 months to 4 years (−24.58, <em>p</em> < 0.001) with stable scores from 4 to 7 years. Higher levels of maternal education (<em>t</em> = 2.22, <em>p</em> = 0.03) and more food security (<em>t</em> = 4.48, <em>p</em> < 0.001) were protective for cognition longitudinally. Interaction effects between poverty level and maternal education and food security respectively were observed.</div></div><div><h3>Interpretation</h3><div>Cognitive development trajectories showed increasing disparities from expectations in the first two years of life, with more pronounced and lasting effects through 4 years for children below the poverty line. Maternal education and food security had promotive/protective effects on longitudinal cognitive development scores for the full sample. Maternal education and food security had stronger effects on cognitive development for children living below the poverty line compared to those living above the poverty line.</div></div><div><h3>Funding</h3><div>Funding for the study was provided by a grant from the <span>Bill and Melinda Gates Foundation</span> (OPP1111625) to CAN.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100511"},"PeriodicalIF":5.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702624","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":"Identifying clustering of cholera cases using geospatial analysis in Kolkata and surrounding districts: data from patients at tertiary care referral hospitals","authors":"Rounik Talukdar , Suman Kanungo , Kei Kitahara , Goutam Chowdhury , Debmalya Mitra , Asish Kumar Mukhopadhyay , Alok Kumar Deb , Pallavi Indwar , Biswanath Sharma Sarkar , Sandip Samanta , Basilua Andre Muzembo , Ayumu Ohno , Shin-ichi Miyoshi , Shanta Dutta","doi":"10.1016/j.lansea.2024.100510","DOIUrl":"10.1016/j.lansea.2024.100510","url":null,"abstract":"<div><h3>Background</h3><div>Cholera cases have increased globally across the Eastern Mediterranean, Africa, Southeast Asia, and parts of Europe since early 2024. This study aims to identify cholera hotspots and understand the spatial distribution of cholera in Kolkata and surrounding regions, a key cholera reservoir. Additionally, we examine sociodemographic factors and aspects related to water, sanitation, and hygiene (WASH).</div></div><div><h3>Methods</h3><div>Cholera clusters were detected using kernel density estimation and spatial autocorrelation through Global Moran’s-I statistics, with local cluster patterns examined using Local Moran’s-I statistics. Cholera cases from August 2021 to December 2023, treated at two tertiary care facilities in Kolkata: Infectious Diseases and Beleghata General Hospital and Dr. B C Roy Post Graduate Institute of Paediatric Sciences Hospital were included. Additionally, through a case–control study, 196 culture-confirmed cholera cases and 764 age/sex-matched neighborhood controls were enrolled, to investigate cholera risk factors.</div></div><div><h3>Findings</h3><div>Spatial analysis revealed a concentration of 196 cholera cases in Kolkata and its surrounding regions of Howrah, Hooghly, and North and South 24 Parganas. Hotspot analysis showed significant clustering in several Kolkata wards (31, 33, 56, 46, 57, 58, 59, 61, 66, 71, and 107), particularly in the northern, central, and east Kolkata wetlands areas (Global Moran’s I statistic = 0.14, p < 0.001). These clusters had proximity between cases, with a median distance of 187.7 m, and 25.5% of cases as close as 73.9 m apart, suggesting localized transmission. Hotspots were identified with an average distance of 1600 m between them. Local Moran’s I analysis found dense “high–high” clusters in these areas (p < 0.01), with a mean Moran’s I index of 0.3, (range 0.1–4.6). The case–control study revealed that males were more likely to contract cholera, with an adjusted odds ratio of 2.4 (p < 0.01). There was no significant association found between cholera infection and sociodemographic factors or various WASH practices.</div></div><div><h3>Interpretation</h3><div>The findings emphasize the importance of targeted interventions, especially in identified hotspots, to mitigate cholera transmission. Addressing Socio-economic, and environmental factors especially improvement in WASH practices may further enhance prevention effects.</div></div><div><h3>Funding</h3><div>The author KK, received funding from the program of the <span>Japan Initiative</span> for Global Research Network on Infectious Diseases, (grant id: <span><span>JP23wm0125004</span></span>), from the <span>Ministry of Education, Culture, Sports, Science and Technology</span> in Japan, and <span>Japan Agency for Medical Research and Development</span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"31 ","pages":"Article 100510"},"PeriodicalIF":5.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705593","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}
Yang Chen , Bi Huang , Peter Calvert , Yang Liu , Ying Gue , Dhiraj Gupta , Garry McDowell , Jinbert Lordson Azariah , Narayanan Namboodiri , Govindan Unni , Jayagopal Pathiyil Balagopalan , Gregory Yoke Hong Lip , Bahuleyan Charantharayil Gopalan
{"title":"Phenotypes of South Asian patients with atrial fibrillation and holistic integrated care management: cluster analysis of data from KERALA-AF Registry","authors":"Yang Chen , Bi Huang , Peter Calvert , Yang Liu , Ying Gue , Dhiraj Gupta , Garry McDowell , Jinbert Lordson Azariah , Narayanan Namboodiri , Govindan Unni , Jayagopal Pathiyil Balagopalan , Gregory Yoke Hong Lip , Bahuleyan Charantharayil Gopalan","doi":"10.1016/j.lansea.2024.100507","DOIUrl":"10.1016/j.lansea.2024.100507","url":null,"abstract":"<div><h3>Background</h3><div>Patients with atrial fibrillation (AF) frequently experience multimorbidity. Cluster analysis, a machine learning method for classifying patients with similar phenotypes, has not yet been used in South Asian AF patients.</div></div><div><h3>Methods</h3><div>The Kerala Atrial Fibrillation Registry is a prospective multicentre cohort study in Kerala, India, and the largest prospective AF registry in South Asia. Hierarchical clustering was used to identify different phenotypic clusters. Outcomes were all-cause mortality, major adverse cardiovascular events (MACE), and composite bleeding events within one-year follow-up.</div></div><div><h3>Findings</h3><div>3348 patients were included (median age 65.0 [56.0–74.0] years; 48.8% male; median CHA<sub>2</sub>DS<sub>2</sub>-VASc 3.0 [2.0–4.0]). Five clusters were identified. Cluster 1: patients aged ≤65 years with rheumatic conditions; Cluster 2: patients aged >65 years with multi-comorbidities, suggestive of cardiovascular-kidney-metabolic syndrome; Cluster 3: patients aged ≤65 years with fewer comorbidities; Cluster 4: heart failure patients with multiple comorbidities; Cluster 5: male patients with lifestyle-related risk factors. Cluster 1, 2 and 4 had significantly higher MACE risk compared to Cluster 3 (Cluster 1: OR 1.36, 95% CI 1.08–1.71; Cluster 2: OR 1.79, 95% CI 1.42–2.25; Cluster 4: OR 1.76, 95% CI 1.31–2.36). The results for other outcomes were similar. Atrial fibrillation Better Care (ABC) pathway in the whole cohort was low (10.1%), especially in Cluster 4 (1.9%). Overall adherence to the ABC pathway was associated with reduced all-cause mortality (OR 0.26, 95% CI 0.15–0.46) and MACE (OR 0.45, 95% CI 0.31–0.46), similar trends were evident in different clusters.</div></div><div><h3>Interpretation</h3><div>Cluster analysis identified distinct phenotypes with implications for outcomes. There was poor ABC pathway adherence overall, but adherence to such integrated care was associated with improved outcomes.</div></div><div><h3>Funding</h3><div>Kerala Chapter of <span>Cardiological Society of India</span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"31 ","pages":"Article 100507"},"PeriodicalIF":5.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654083","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":"Exploring sex toy use among 18–45-year-old Indian adults: insights from a nationwide online survey","authors":"Pauras Mhatre , Antara Agrawal , Pratham Agrawal , Gaurang Narayan , Priyanka Kataria , Pragati Rathod , Sarita Wadhva","doi":"10.1016/j.lansea.2024.100508","DOIUrl":"10.1016/j.lansea.2024.100508","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100508"},"PeriodicalIF":5.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657282","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}