The Lancet regional health. Southeast Asia最新文献

{"title":"Neocolonial echoes in healthcare: ethical quandaries of the Nepal-UK nurse recruitment memorandum of understanding","authors":"","doi":"10.1016/j.lansea.2024.100493","DOIUrl":"10.1016/j.lansea.2024.100493","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427776","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":"Assessing the impact of the National Clean Air Programme in Uttar Pradesh's non-attainment cities: a prophet model time series analysis","authors":"","doi":"10.1016/j.lansea.2024.100486","DOIUrl":"10.1016/j.lansea.2024.100486","url":null,"abstract":"<div><h3>Background</h3><div>Uttar Pradesh, India's largest state, faces critical pollution levels, necessitating urgent action. The National Clean Air Programme (NCAP) targets a 40% reduction in particulate pollution by 2026. This study assesses the impact of NCAP on 15 non-attainment cities in Uttar Pradesh using the Prophet forecasting model.</div></div><div><h3>Methods</h3><div>Monthly data on AQI and <span><math><mrow><msub><mtext>PM</mtext><mn>10</mn></msub></mrow></math></span> concentrations from 2016 to 2023 were sourced from the Uttar Pradesh Pollution Control Board. Significant changes in mean AQI and <span><math><mrow><msub><mtext>PM</mtext><mn>10</mn></msub></mrow></math></span> levels from 2017 to 2023 were evaluated using the Friedman test. Prophet models forecast <span><math><mrow><msub><mtext>PM</mtext><mn>10</mn></msub></mrow></math></span> concentrations for 2025–26, with relative percentage changes calculated and model evaluation metrics assessed.</div></div><div><h3>Findings</h3><div>Most cities exhibited unhealthy air quality. Jhansi had the lowest AQI (72.73) in 2023, classified as ‘moderate’ by WHO standards. Gorakhpur consistently showed ‘poor’ AQI levels, peaking at 249.31 in 2019. Western Uttar Pradesh cities such as Ghaziabad, Noida, and Moradabad had significant pollution burdens. Predictions showed Bareilly with over a 70% reduction in <span><math><mrow><msub><mtext>PM</mtext><mn>10</mn></msub></mrow></math></span> levels, Raebareli 58%, Moradabad 55%, Ghaziabad 48%, Agra around 41%, and Varanasi 40%, meeting NCAP targets. However, Gorakhpur and Prayagraj predicted increases in <span><math><mrow><msub><mtext>PM</mtext><mn>10</mn></msub></mrow></math></span> levels by 50% and 32%, respectively. Moradabad's model showed the best performance with an <span><math><mrow><msup><mi>R</mi><mn>2</mn></msup></mrow></math></span> of 0.81, MAE of 17.27 <span><math><mrow><mi>μ</mi><mi>g</mi><mo>/</mo><msup><mi>m</mi><mn>3</mn></msup></mrow></math></span>, and MAPE of 0.10.</div></div><div><h3>Interpretation</h3><div>Forecasting <span><math><mrow><msub><mtext>PM</mtext><mn>10</mn></msub></mrow></math></span> concentrations in Uttar Pradesh's non-attainment cities offers policymakers substantial evidence to enhance current efforts. While existing measures are in place, our findings suggest that intensified provisions may be necessary for cities predicted to fall short of meeting program targets. The Prophet model's forecasts can pinpoint these at-risk areas, allowing for targeted interventions and regional adjustments to strategies. This approach will help promote sustainable development customized to each city's specific needs.</div></div><div><h3>Funding</h3><div>No funding was issued for this research.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428166","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":"Tackling cardiometabolic disease in southeast Asia: local research to inform local practice","authors":"","doi":"10.1016/j.lansea.2024.100491","DOIUrl":"10.1016/j.lansea.2024.100491","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425133","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":"Advancing acute MI care in densely populated low- and middle-income countries (LMICs): innovative stand-alone chest pain units for expedited triage and timely management","authors":"","doi":"10.1016/j.lansea.2024.100488","DOIUrl":"10.1016/j.lansea.2024.100488","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of myocardial infarction (MI) and its adverse effects on health and mortality remain high in densely populated low- and middle-income countries (LMICs). To address the issue of densely populated areas and timely access to primary PCI, chest pain units (CPUs) were deployed at strategic locations in Karachi, with a populace of over 23 million people. This study describes the results of this initiative in expediting MI care.</div></div><div><h3>Methods</h3><div>Between 2017 and 2023, 18 CPUs, each with a cardiologist, technician, ECG machine, crash cart and an ambulance were placed in high density areas.</div></div><div><h3>Findings</h3><div>A total of 915,564 patients were seen at 18 CPUs over the study period. 692,444 (75.6%) were categorized as non-cardiac and subsequently discharged. 223,120 (24.6%) patients were directed for additional care. Of these, 9% had ST elevation myocardial infarction (STEMI) (19, 580), 29% NSTE ACS/Unstable angina, and 31% with various other cardiac conditions. Additionally, 31% were referred for medical outpatient evaluation. CPU inception led to a significant annual growth (16–20%) in primary PCI procedures at NICVD, totaling 20,000 by 2022–2023. The median first medical contact to device time was 100 min (IQR 80–135), while total ischemic was 232 min (IQR: 172–315; 5th −95th %le: 50–920). The overall in-hospital mortality rate for patients undergoing primary PCI was 5.58%, with a range between 5.1% and 6.9% through the study period.</div></div><div><h3>Interpretation</h3><div>Novel standalone chest pain units, operational from 2017 in Karachi, Pakistan, have expedited triage and enhanced the timely management of AMI. This initiative's transformative impact presents a model that resonates beyond borders, serving as a role model for global healthcare systems.</div></div><div><h3>Funding</h3><div>The CPU and primary PCI program is fully funded by the <span>government of Sindh</span>. No specific funding was allocated for this study.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356869","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":"Bangladesh should engage the private sector for malaria elimination by 2030","authors":"","doi":"10.1016/j.lansea.2024.100487","DOIUrl":"10.1016/j.lansea.2024.100487","url":null,"abstract":"<div><div>Bangladesh reduced malaria incidence by 93% from 2008 to 2020 through the action of governmental and non-governmental organizations. The Bangladesh context is unique to South Asia because its successful public sector malaria control programs have historically not engaged corporate partners (as undertaken in Sri Lanka and proposed in India). However, ∼18 million people continue to live at risk of infection in Bangladesh and for-profit private healthcare providers, catalytic for malaria elimination in many countries, are expected to benefit the national program. We distilled (from a large and complex literature) nine distinct strategies important in other developing settings and weighed them in the context of Bangladesh's flourishing private health care sector, driven by patient demand, self-interest and aspirations for public good, as well as heterogeneity in providers and malaria-prevalence. We propose a new model dependent on five strategies and its immediate deployment considerations in high endemic areas, to empower Bangladesh's phased agenda of eliminating indigenous malaria transmission by 2030.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142326993","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":"Implementing the Robson Classification for caesarean sections in Pakistan: experience, challenges, and lessons learned","authors":"","doi":"10.1016/j.lansea.2024.100479","DOIUrl":"10.1016/j.lansea.2024.100479","url":null,"abstract":"<div><div>The Robson Classification System is recognised as a first step for optimising the use of caesarean section and as a strategy for continuous quality improvement in maternal and newborn health. This Viewpoint provides a detailed account of the strategy adopted and lessons learned from a collaborative initiative to institutionalise the Robson Classification into Pakistan's health system. We developed a training package which emphasised capacity building of senior clinicians to act as master trainers. We also developed a mobile application for data collection and analysis. Training workshops took place in 2020 in a selection of public sector, tertiary-level, teaching hospitals from across the country and data was collected on all births in participating hospitals' obstetric units for a full year. Pakistan is poised for scale-up with the Robson Classification embedded in 57% of Pakistan's public, tertiary, teaching hospitals. A core group of master trainers is positioned in every province, and a robust dataset is available. However, integration into any health system cannot be thought of as a finite project. It requires government commitment, training and an ongoing process with built-in data quality assurance and feedback to clinicians.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328036","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":"Reimagining India's National Telemedicine Service to improve access to care","authors":"","doi":"10.1016/j.lansea.2024.100480","DOIUrl":"10.1016/j.lansea.2024.100480","url":null,"abstract":"<div><p>India's free-to-use National Telemedicine Service, eSanjeevani, has provided over 276 million consultations and shown promise to reduce systemic inequalities in access to care. However, recent reports of dropping footfall have raised questions about the potential of eSanjeevani to bridge service provision gaps in India. We reveal important problems linked to the design and practice of triage and tele-referral nationally within eSanjeevani, corroborated by the experience of one of the co-authors’ practice of Obstetrics and Gynaecology on the platform since 2022. Some of these factors include sub-optimal integration of general practitioners within the tele-referral pathway; inadequate training of health-workers leading to inappropriate and ineffective consultations; outdated or absent technological support; the absence of mechanisms for re-referrals; and lack of feedback loops. We propose measures to re-imagine eSanjeevani to become a more effective tool towards improving public health outcomes and achieving universal health coverage in India.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001306/pdfft?md5=35274016ca1b13b1b87df940e8e28716&pid=1-s2.0-S2772368224001306-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240442","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":"Evolving dengue serotype distribution with dominance of dengue virus- 3 in Bangalore: critical insights for vaccine efficacy and implementation","authors":"","doi":"10.1016/j.lansea.2024.100485","DOIUrl":"10.1016/j.lansea.2024.100485","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001355/pdfft?md5=55f00a94c524bac853fa80a3597d27ee&pid=1-s2.0-S2772368224001355-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232710","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":"Thailand – how far are we from achieving a healthy and sustainable diet? A longitudinal ecological study","authors":"","doi":"10.1016/j.lansea.2024.100478","DOIUrl":"10.1016/j.lansea.2024.100478","url":null,"abstract":"<div><h3>Background</h3><p>Newly industrialized countries like Thailand have been influenced by globalization, westernization, and urbanization over the last decades, leading to changes in dietary habits as well as food production. Consequences of these changes include rising non-communicable diseases (NCDs) and environmental degradation, which are defined as the leading global challenges today. The objectives of this study are to identify Thailand's dietary changes, considering health and sustainability aspects, and to determine correlations between these changes and NCD cases as well as environmental impacts (GHG emissions, land-, nitrogen-, phosphorus-use). In this way, diet-related adjustments can be identified to promote planetary and human health.</p></div><div><h3>Methods</h3><p>In this longitudinal ecological study, relative differences between the average food consumption in Thailand and the reference values of a healthy and sustainable diet, the Planetary Health Diet (PHD), were calculated. Furthermore, a bivariate correlation analysis was conducted, using data, based on Food and Agriculture Organization's (FAO's) data, results from the Global Burden of Disease Study (GBD), and PHD's reference values.</p></div><div><h3>Findings</h3><p>The consumption quantities of meat, eggs, saturated oils, and sugar increased significantly since 1961. The food groups, that have exceeded PHD's upper reference values, include sugar (+452%), red meat (+220%), grains (+143%), saturated oils (+20%) and eggs (+19%), while vegetables (–63%), and unsaturated oils (–61%) have fallen below PHD’s lower limits. Concerning the bivariate correlation analyses, all investigated variables show significant correlations. The most significant correlations were found in NCD cases (r = 0.903, 95% CI 0.804–0.953), nitrogen use (r = 0.872, 95% CI 0.794–0.922), and land use (r = 0.870, 95% CI 0.791–0.921), followed by phosphorus use (r = 0.832, 95% CI 0.733–0.897), and green-house gas (GHG) emissions (r = 0.479, 95% CI 0.15–0.712).</p></div><div><h3>Interpretation</h3><p>The results show, that the determined differences of unhealthy or unsustainable food groups have increased concurrently with NCD cases and environmental impacts over the last decades in Thailand. A shift towards a reduced intake of sugar, red meat, grains, saturated oils and eggs along with an increase in vegetables and unsaturated oils, might support environmental and human health.</p></div><div><h3>Funding</h3><p>None.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001288/pdfft?md5=863d76851f59511c7fdabb427637cdbf&pid=1-s2.0-S2772368224001288-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228959","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":"Learning from the Indian National Family Health Survey to assess population based oral, cervix and breast cancer screening in low-and-middle income countries","authors":"","doi":"10.1016/j.lansea.2024.100483","DOIUrl":"10.1016/j.lansea.2024.100483","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001331/pdfft?md5=eb0fc5792e768b2d38fc19c56bafa58b&pid=1-s2.0-S2772368224001331-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230441","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}