The Lancet regional health. Southeast Asia最新文献

{"title":"Cost-effectiveness of integrated maternal HIV, syphilis, and hepatitis B screening opt-out strategies in Nepal: a modelling study","authors":"Lucie Sabin ,&nbsp;Kasim Allel ,&nbsp;Ghanshyam Gautam ,&nbsp;Naomi Saville ,&nbsp;Hassan Haghparast-Bidgoli","doi":"10.1016/j.lansea.2024.100524","DOIUrl":"10.1016/j.lansea.2024.100524","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organisation (WHO) developed a comprehensive framework encouraging an integrated approach to achieve triple elimination of vertical transmission of HIV, syphilis, and hepatitis B in Asia. Current screening practices in Nepal show significantly lower coverage for syphilis and hepatitis B compared to HIV suggesting potential for integration. In this study, we aimed to model the cost-effectiveness of triple screening during antenatal care in Nepal.</div></div><div><h3>Methods</h3><div>We modelled maternal HIV, hepatitis B, and syphilis cascade of care and their corresponding disease states using disease-specific Markov models over a 20-year horizon with a cycle length of one year. We compared dual integrated screening for HIV and syphilis and triple integrated screening for HIV, syphilis, and hepatitis B with HIV screening only. Costs were estimated from a provider's perspective. Results were presented as incremental cost-effectiveness ratios (ICERs). Univariable and probabilistic sensitivity analyses were conducted.</div></div><div><h3>Findings</h3><div>Our modelling analysis showed that dual-integrated screening for HIV and syphilis was highly cost-effective when compared to current strategy of screening for HIV only (ICERs of US$18). Triple-integrated antenatal screening for HIV, syphilis, and hepatitis B was highly cost-effective compared with dual-integrated strategy with an ICER of US$114. Moreover, 100% and 98% of the probabilistic sensitivity analysis estimates for dual- and triple-integrated screening were proven cost-effective, compared to HIV-only screening.</div></div><div><h3>Interpretation</h3><div>Our results support WHO recommendations for implementing integrated triple antenatal screening in Nepal and Asia more broadly, aiming to reduce maternal and neonatal morbidity through early detection and intervention.</div></div><div><h3>Funding</h3><div>No funding was reported.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100524"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048974","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":"Transforming neonatal nursing in India: challenges, opportunities, and the way forward","authors":"Geetanjali Kalyan ,&nbsp;Poonam Joshi ,&nbsp;Lumchio Levis Murry ,&nbsp;Marsha Campbell-Yeo ,&nbsp;Surya Kant Tiwari","doi":"10.1016/j.lansea.2024.100522","DOIUrl":"10.1016/j.lansea.2024.100522","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100522"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","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":"Methodological concerns in the ‘Economic burden of suicide deaths in India (2019)’","authors":"Anamika Pandey,&nbsp;G Anil Kumar,&nbsp;Rakhi Dandona","doi":"10.1016/j.lansea.2024.100516","DOIUrl":"10.1016/j.lansea.2024.100516","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100516"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173967","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 timely cancer treatment initiation in India: extent, determinants and trends","authors":"Pritam Halder ,&nbsp;Jyoti Dixit ,&nbsp;Nidhi Gupta ,&nbsp;Nikita Mehra ,&nbsp;Ashish Singh ,&nbsp;Pankaj Malhotra ,&nbsp;Anisha Mathew ,&nbsp;Lalit Kumar ,&nbsp;Amal Chandra Kataki ,&nbsp;Sudeep Gupta ,&nbsp;Shankar Prinja","doi":"10.1016/j.lansea.2024.100514","DOIUrl":"10.1016/j.lansea.2024.100514","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Treatment delays are significantly associated with advanced stage, poor response to treatment, increased mortality risk, poor health outcomes, increased healthcare expenditures among cancer patients. However, factors associated with these delays have not yet been robustly evaluated. In order to bridge this gap, we determined the delayed time to treatment initiation (TTI) among cancer patients in India, ascertained its determinants, and assessed the trends of delayed TTI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We analysed data collected from 6695 cancer patients seeking outpatient/daycare treatment, recruited at purposively selected seven healthcare facilities across six states of India. Data on socio-demographic and clinical characteristics including date of cancer diagnosis, date of treatment initiation, cancer site, stage and type of treatment were collected to determine the median TTI and ascertain its determinants among cancer patients in India. Time to treatment initiation was calculated as the duration (days) between diagnosis of cancer (histologically/clinically) and date of initiation of treatment. Multi-variable logistic regression was employed to analyse the relationship between the outcome variable (TTI) and each explanatory variable. A Cox Proportional Hazard (CPH) model was used to conduct time-to-event analysis, and to assess the impact of government-funded health insurance on timely cancer treatment initiation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The median (IQR) overall TTI was 20 (7–39) days, with a mean of 53.7 days (SD, 192.9). The TTI was higher for those having head and neck cancer (median TTI: 29 days, IQR: 10.5–55.5) and those receiving radiotherapy as initial treatment (27.5 days, IQR: 10–49.5). Younger patients, those educated up to graduation level and males had significantly lower odds of delayed TTI. As compared to patients who were diagnosed between 1995 and 2017, those diagnosed after 2018 had a 36% (26–46%) higher odds of timely initiation of treatment within 30 days. Upon stratifying by enrolment under PMJAY, we found that while the access for timely treatment initiation increased by 33% for those who were not enrolled, vs. 90% among those enrolled under PM-JAY. Overall, this shows significant improvement in timely initiation of cancer treatment as a result of introduction of PM-JAY.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;The study highlights the positive impact of government-funded health insurance schemes on the timely access to cancer treatment in India. Our study recommends expanding AB PM-JAY cancer packages to include cost-effective treatments, increasing population coverage under screening programs and promoting e-RUPI to reduce financial constraints associated with diagnostic services to address delayed treatment initiation due to unknown cancer stages.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;Department of Health Research, &lt;span&gt;Ministry of Health and Family Welfare&lt;/span&gt;, Ne","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100514"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11722993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973780","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":"One step forward, two steps back: urgent priorities to embed disability and queer health in medical education systems","authors":"Satendra Singh ,&nbsp;Rohin Bhatt ,&nbsp;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":"Article 100515"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","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}

{"title":"Unveiling immunity gaps and determining a suitable age for a third dose of the measles-containing vaccine: a strategic approach to accelerating measles elimination","authors":"Somya Mehra ,&nbsp;Sajikapon Kludkleeb ,&nbsp;Chutikarn Chaimayo ,&nbsp;Pornsawan Leaungwutiwong ,&nbsp;Saranath Lawpoolsri ,&nbsp;Wirichada Pan-ngum ,&nbsp;Kulkanya Chokephaibulkit ,&nbsp;Thundon Ngamprasertchai","doi":"10.1016/j.lansea.2024.100523","DOIUrl":"10.1016/j.lansea.2024.100523","url":null,"abstract":"<div><h3>Background</h3><div>In highly measles immunized countries, immunity gaps in adolescents and young adults are a key issue posing an obstacle to measles elimination. This study aims to identify the gaps by estimating the age-stratified probability of seropositivity, and to ascertain a suitable age for the administration of a third dose of a measles-containing vaccine (MCV3) to effectively fill these gaps.</div></div><div><h3>Methods</h3><div>We retrospectively obtained measles serological results from hospital setting among among individuals aged 13–39 years and developed a serocatalytic dynamic probability model, stratifying seropositivity due to vaccination or natural infection. We calibrated the model to age-stratified seropositivity data within a Bayesian setting using the Metropolis–Hastings algorithm. A scenario analysis to determine a suitable age for MCV3 administration was also performed.</div></div><div><h3>Findings</h3><div>The overall prevalence of measles seropositivity was 65.6% (95% confidence interval [CI]: 61.5–69.6). Posterior predictive curves for the age-stratified seroprevalence exhibited a decreasing trend from ages 13–20 years but an upward trend from 26 to 30 years. The age at which a given individual’s serostatus reached a 50% probability of seronegativity was found to be approximately 18–20 years depending on the annual measles force of infection.</div></div><div><h3>Interpretation</h3><div>Our findings highlight a significant measles immunity gap in young adults aged 20–26 years, posing an increased risk of transmission. A MCV3 at the age of 18–20 years potentially closes the gap and aids measles elimination programmes.</div></div><div><h3>Funding</h3><div>This work was supported by <span>Faculty of Tropical Medicine</span> (MCTM, ICTM grant), <span>Mahidol University</span> (to T.N.) and APC fee was supported by <span>Mahidol University</span> (to T.N.). S.M. and W.P. were funded in whole, or in part, by the <span>Wellcome Trust</span> [Grant number <span><span>220211</span></span>]. For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100523"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985528","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 ,&nbsp;Anaswara Naveen ,&nbsp;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":"Article 100517"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","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}

{"title":"The seven dangerous days: Thailand's biannual road traffic accident surges linked to inequality","authors":"Nakaret Kungsukun ,&nbsp;Suphasan Kaeoaudom ,&nbsp;Apichai Wattanapisit","doi":"10.1016/j.lansea.2024.100513","DOIUrl":"10.1016/j.lansea.2024.100513","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100513"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857213","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":"Oral health in southeast Asia: addressing inaccessibility","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2024.100528","DOIUrl":"10.1016/j.lansea.2024.100528","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100528"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175770","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":"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 ,&nbsp;Priyansh Nathani ,&nbsp;Priti Patil ,&nbsp;Rakhi Ghoshal ,&nbsp;Shagun Tuli ,&nbsp;Juul M. Bakker ,&nbsp;Alex J. van Duinen ,&nbsp;Nobhojit Roy ,&nbsp;Adeline A. Boatin ,&nbsp;Anita Gadgil","doi":"10.1016/j.lansea.2024.100512","DOIUrl":"10.1016/j.lansea.2024.100512","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Findings</h3><div>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.</div></div><div><h3>Interpretation</h3><div>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.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100512"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","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}