The Lancet regional health. Southeast Asia最新文献

{"title":"At a crossroads: HIV response in southeast Asia","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2025.100671","DOIUrl":"10.1016/j.lansea.2025.100671","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"40 ","pages":"Article 100671"},"PeriodicalIF":6.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026871","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":"Exploring the association between multi-dimensional poverty and antibiotic resistance: findings from a mixed-methods study in Pakistan","authors":"Iltaf Hussain ,&nbsp;Muhammad Fawad Rasool ,&nbsp;Jamshid Ullah ,&nbsp;Muhammad Nafees ,&nbsp;Inzemam Khan ,&nbsp;Muhtar Kadirhaz ,&nbsp;Miaomiao Xu ,&nbsp;Chengzhou Tang ,&nbsp;Yi Dong ,&nbsp;Wei Zhao ,&nbsp;Jie Chang ,&nbsp;Yu Fang","doi":"10.1016/j.lansea.2025.100656","DOIUrl":"10.1016/j.lansea.2025.100656","url":null,"abstract":"<div><h3>Background</h3><div>Poverty is a potential contributor to antibiotic resistance; however, the previous studies have not adequately addressed the role of poverty in shaping antibiotic resistance through social inequalities. Considering this, the current study evaluated the role of multi-dimensional poverty in antibiotic resistance.</div></div><div><h3>Methods</h3><div>A mixed-method study was conducted in three provinces of Pakistan using multistage sampling to recruit physician-confirmed urinary tract infection (UTI) patients from public laboratories. Antibiotic resistance data were collected from susceptibility reports, while poverty was measured using the multi-dimensional poverty index (MPI). Water, sanitation and hygiene (WASH) practices were assessed through a self-developed, validated questionnaire. Survey-weighted logistic regression analysis examined the association between MPI and antibiotic resistance.</div></div><div><h3>Findings</h3><div>A total of 698 patients were recruited, with more than half being in some level of deprivation (total = 413, vulnerable: 117, deprived: 76, severely deprived: 220). Multidimensional poverty was independently associated with increased odds of multidrug resistance (MDR). The risk of MDR was significantly increase across the deprivation level in unadjusted analysis (vulnerable; OR: 1.94, 95% CI 1.11–3.39, deprived; OR: 2.05, 95% CI 1.06–3.98, and severely deprived: OR: 1.80, 95% CI 1.04–3.09). After adjusting for antibiotics misuse and poor WASH practices, the association persisted. In the fully adjusted model, the risk of MDR was further increased in the poorer-subgroups, (vulnerable; aORs: 3.03, 95% CI 1.33–6.73, deprived; aOR: 3.01, 95% CI 1.26–7.15, and severely deprived; aOR: 4.28 95% CI 1.74–10.49). The qualitative interviews (n = 34) from patients highlighted that financial barriers drove self-medication with leftover antibiotics and treatment non-adherence. Poor WASH infrastructure was described as a systemic contributor to infection spread. In addition, patients in the poorer subgroups were presented with delayed treatment seeking.</div></div><div><h3>Interpretation</h3><div>The risk of antibiotic resistance increases with the increasing levels of deprivation; however, we should not assume that higher deprivation directly drives antibiotic resistance. Instead, structural barriers such as limited healthcare access, poor WASH infrastructure, and financial constraints create an environment where self-medication, treatment non-adherence, and infection transmission occur across all poverty levels, not just because of individual choices. These findings emphasize the need for interventions that address healthcare inequities, improve WASH infrastructure, and regulate antibiotic access, combined with behavior-changing interventions.</div></div><div><h3>Funding</h3><div>This work was funded by the <span>“Young Talent Support Plan”</span> of the <span>Health Science Center</span>, <span>Xi’an Jiao","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"41 ","pages":"Article 100656"},"PeriodicalIF":6.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903270","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":"Developing a sustainable patient navigation model for breast cancer care in India: a survivor-led pilot project","authors":"Soumen Das ,&nbsp;Tanmoy Kumar Mandal ,&nbsp;Anowar Ali Mallick","doi":"10.1016/j.lansea.2025.100661","DOIUrl":"10.1016/j.lansea.2025.100661","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"40 ","pages":"Article 100661"},"PeriodicalIF":6.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895721","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":"Leveraging the influenza sentinel surveillance platform for SARS-CoV-2 monitoring in Bangladesh (2020–2024): a prospective sentinel surveillance study","authors":"Md Ariful Islam ,&nbsp;Md Zakiul Hassan ,&nbsp;Zubair Akhtar ,&nbsp;Saju Bhuiya ,&nbsp;Tanzir Ahmed Shuvo ,&nbsp;Probir Kumar Ghosh ,&nbsp;Asadullah ,&nbsp;Md Abdullah Al Jubayer Biswas ,&nbsp;Mustafizur Rahman ,&nbsp;Mohammad Jubair ,&nbsp;Mst Noorjahan Begum ,&nbsp;Yeasir Karim ,&nbsp;Mohammed Ziaur Rahman ,&nbsp;Mohammad Enayet Hossain ,&nbsp;Mohammad Niaz Morshed Khan ,&nbsp;Tahmina Shirin ,&nbsp;Shah Niaz Md Rubaid Anwar ,&nbsp;Ahmed Nawsher Alam ,&nbsp;Mohammad Ferdous Rahman Sarker ,&nbsp;Monalisa ,&nbsp;Fahmida Chowdhury","doi":"10.1016/j.lansea.2025.100657","DOIUrl":"10.1016/j.lansea.2025.100657","url":null,"abstract":"<div><h3>Background</h3><div>There is limited global evidence on whether influenza sentinel surveillance platforms can be effectively adapted for long-term SARS-CoV-2 monitoring in low-resource contexts. We explored the utility of the hospital-based influenza sentinel surveillance (HBIS) platform for monitoring SARS-CoV-2 in Bangladesh by comparing SARS-CoV-2 detection in HBIS platform with national COVID-19 platform and assessing how its integration into influenza surveillance aligns with national trends.</div></div><div><h3>Methods</h3><div>From March 2020 to December 2024, we analysed data from patients with severe acute respiratory infection (SARI) and influenza-like illness (ILI) enrolled in HBIS. Socio-demographic and clinical data were recorded, and nasopharyngeal and oropharyngeal swabs were tested for influenza and SARS-CoV-2 using rRT-PCR. Whole-genome sequencing was performed on a subset of SARS-CoV-2–positive samples. Data from national COVID-19 platform were obtained from the Directorate General of Health Services, Bangladesh, and were compared with HBIS platform data using epidemic curves and Pearson correlation analysis.</div></div><div><h3>Findings</h3><div>Among 25,366 (SARI: 20,226; ILI: 5140) patients, 13.0% (3310) tested positive for influenza, 6.6% (1680) for SARS-CoV-2, and 0.2% (43) were co-infected. SARS-CoV-2 positivity in HBIS (6.8%), including 0.2% co-infections, was lower than the national average (13.1%), but showed a strong correlation with national trends (Pearson <em>r</em> = 0.86, P &lt; 0.001). Sequencing of 234 SARS-CoV-2 strains detected the beta and delta variants in April and May 2021, respectively, and omicron subvariants circulating from 2022 to 2024, aligning with the national COVID-19 platform.</div></div><div><h3>Interpretation</h3><div>SARS-CoV-2 positivity trends in HBIS platform closely aligned with the national COVID-19 platform, demonstrating its potential as a sustainable platform for COVID-19 monitoring. Our findings underscore the feasibility of influenza sentinel surveillance as an early warning system for future COVID-19 outbreaks or other respiratory viruses of pandemic concern in Bangladesh and similar settings.</div></div><div><h3>Funding</h3><div><span>Centers for Disease Control and Prevention</span> (CDC), Atlanta, Georgia, USA (U01GH002259).</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"41 ","pages":"Article 100657"},"PeriodicalIF":6.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879082","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":"Health system drivers of caesarean deliveries in south Asia: a scoping review","authors":"Angel Sudha Veparala ,&nbsp;Dorothy Lall ,&nbsp;Prashanth N. Srinivas ,&nbsp;Kajal Samantaray ,&nbsp;Bruno Marchal","doi":"10.1016/j.lansea.2025.100651","DOIUrl":"10.1016/j.lansea.2025.100651","url":null,"abstract":"<div><div>Caesarean section (CS) rates are rising across south Asia, often without medical indication, posing significant public health concerns. This Review applied a framework-guided evidence synthesis using a scoping review approach, structured by the Socio-Ecological Model (SEM), to examine health system drivers of CS. Seventy-five studies were included, mainly from India, Bangladesh, and Pakistan. At the individual level, maternal education, socioeconomic status, and birth order influenced CS use. Community-level drivers included family preferences and media exposure. At the provider level, decision-making was shaped by financial incentives, medico-legal concerns, and scheduling convenience. Other system-level drivers, such as private sector dominance, limited regulation, and insurance coverage, were associated with increased CS rates. While most findings aligned with the SEM, some extended beyond its scope. The Review highlights the need for coordinated policy responses across levels, including payment reforms, regulatory oversight, and improved antenatal counselling, to ensure CS use aligns with clinical need rather than socio-economic or institutional pressures.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"40 ","pages":"Article 100651"},"PeriodicalIF":6.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144880142","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":"Immunogenicity and safety of ‘Comvigen’, a bivalent SARS-CoV-2 vaccine, in comparison to Comirnaty bivalent vaccine in Thailand: a phase 2, non-inferiority randomised trial","authors":"Watsamon Jantarabenjakul ,&nbsp;Rapisa Nantanee ,&nbsp;Thanyawee Puthanakit ,&nbsp;Sivaporn Gatechompol ,&nbsp;Anchalee Avihingsanon ,&nbsp;Suda Punrin ,&nbsp;Terapong Tantawichien ,&nbsp;Sorachai Nitayaphan ,&nbsp;Arunee Thitithanyanont ,&nbsp;Supranee Buranapraditkun ,&nbsp;Anan Jongkaewwattana ,&nbsp;Chutitorn Ketloy ,&nbsp;Eakachai Prompetchara ,&nbsp;Saranath Lawpoolsri ,&nbsp;Wassana Wijagkanalan ,&nbsp;Mohamad-Gabriel Alameh ,&nbsp;Lina Hong ,&nbsp;Mijo Samija ,&nbsp;Drew Weissman ,&nbsp;Kiat Ruxrungtham ,&nbsp;Nanthida Wonglertnirant","doi":"10.1016/j.lansea.2025.100650","DOIUrl":"10.1016/j.lansea.2025.100650","url":null,"abstract":"<div><h3>Background</h3><div>Strengthening mRNA vaccine development in LMICs is essential for enhancing global pandemic preparedness. This study evaluated the safety and immunogenicity of Comvigen, a bivalent SARS-CoV-2 vaccine, in comparison to the Comirnaty bivalent vaccine (Comirnaty).</div></div><div><h3>Methods</h3><div>This phase II, randomised, open-label, non-inferiority trial was conducted in Thailand across four centres. Participants (n = 450) were randomly assigned (2:1) to receive either Comvigen (50 μg) or Comirnaty (30 μg), using block randomisation (size = 9). Eligible participants had completed at least 2 doses of any approved COVID-19 vaccine, with the last mRNA-vaccine dose given over 3 months before enrolment. The non-inferiority margin of a geometric mean ratio (GMR) of 0.67. The primary immunogenicity endpoint was pseudovirus neutralisation titres (psVNT-50) against SARS-CoV-2 wild-type and Omicron BA.4/BA.5 at Day 29. Safety outcomes included local and systemic adverse reactions up to six months post-vaccination. Immunogenicity analyses were conducted on the Per-Protocol (PP) population and the modified Intent-to-Treat (mITT) population; safety analyses included all participants. Laboratory personnel were blinded to vaccine assignment (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>: <span><span>NCT05930730</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>Between October and November 2023, 450 participants were enrolled (median age of 36 years, IQR 30–45). At day 29, the geometric mean titre (GMT) of psVNT-50 against wild-type virus increased from 475.9 to 2062.9 for Comvigen and from 458.8 to 1905.1 for Comirnaty (GMR 1.1, 95% CI: 1.0–1.2), meeting non-inferiority criteria. Against Omicron BA.4/BA.5, GMTs were 3909.8 for Comvigen and 3288.6 for Comirnaty (GMR 1.2, 95% 1.0–1.4). Local and systemic reactions were more frequent with Comvigen (91% vs. 78%, p = 0.0002, 79% vs. 70%, p = 0.028) but were mild or moderate and transient with no difference in fever (6% vs. 5%, p = 0.84).</div></div><div><h3>Interpretation</h3><div>Comvigen demonstrated non-inferiority immunogenicity to Comirnaty and had a comparable safety profile, supporting mRNA vaccine development for global access and pandemic preparedness.</div></div><div><h3>Funding</h3><div>Covid-19 Pandemic Emergency Fund granted by <span>Thailand's National Economic and Social Development Council</span> provided major funding. Supplementary funding was provided by <span>National Vaccine Institute (NVI)</span>, Thailand; Center of Excellence in Vaccine Research and Development (Chula VRC), <span>Faculty of Medicine, Chulalongkorn University</span>; <span>Chulalongkorn University Second Century Fund (C2F)</span>; BioNet-Asia and Public Donation through Covid-19 vaccine development fund of the <span>Faculty of Medicine, Chulalongkorn University</span> and the <span>Thai Red Cross Society</span>, Thailand.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"40 ","pages":"Article 100650"},"PeriodicalIF":6.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851949","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":"Epidemiology and determinants of stillbirth disparities in India: a geospatial hotspot clustering study using integrated population-level data.","authors":"U Venkatesh, Om Prakash Bera, Ashoo Grover, Siddhant Shastri, Sayantan Chakraborty","doi":"10.1016/j.lansea.2025.100647","DOIUrl":"10.1016/j.lansea.2025.100647","url":null,"abstract":"<p><strong>Background: </strong>Stillbirth is a significant public health issue worldwide, with India bearing a substantial burden. While male fetuses are biologically more vulnerable, the geographic distribution of sex-specific stillbirth rates remains underexplored. This study investigates district-level stillbirth patterns across India and evaluates their spatial association with maternal, socio-demographic, and delivery care factors.</p><p><strong>Methods: </strong>This ecological study employed data integration using the Civil Registration System (CRS-2020) and the National Family Health Survey (NFHS-5) to compile district-level estimates of stillbirth rates (SBRs) along with maternal, delivery care, and socio-demographic indicators. SBR was calculated as the number of stillbirths per 1000 total births for each sex. Spatial autocorrelation was assessed using Global and Local Moran's I. Additionally, univariate and bivariate Local Indicators of Spatial Association (LISA) were conducted separately for male and female stillbirth rates to examine spatial clustering and associations with selected correlates, identifying hotspot and cold-spot regions across districts.</p><p><strong>Findings: </strong>The nationwide stillbirth rate (SBR) in 2020 was 6.548 per 1000 total births (female: 6.54; male: 6.63). Stillbirth rates were higher among urban mothers compared to rural mothers. Northern India, particularly Chandigarh, Jammu & Kashmir, and Rajasthan, recorded the highest SBR. Spatial analysis identified stillbirth hotspots primarily in Northern and Central India. Univariate Moran's I indicated strong spatial clustering for maternal factors, including below-normal BMI (Moran's I = 0.62) and iron-folic acid supplementation (Moran's I = 0.551). Bivariate Moran's I showed similar spatial trends for both sexes, with stillbirth rates positively correlated with anemia (female: 0.087; male: 0.078) and institutional births in public facilities (female: 0.084; male: 0.086), and negatively correlated with literacy (female: -0.069; male: -0.063) and cesarean deliveries in private facilities (female: -0.055; male: -0.090).</p><p><strong>Interpretation: </strong>This study found no significant geospatial disparity in sex-specific stillbirth rates across Indian districts, with similar clustering patterns for both sexes. Key determinants included literacy, wealth status, anemia, and cesarean deliveries. District-specific strategies, guided by geospatial insights, are essential for focused public health measures. Strengthening stillbirth registration and utilizing advanced spatial methods are crucial for improved monitoring and intervention planning.</p><p><strong>Funding: </strong>No funding was issued for this research.</p>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"40 ","pages":"100647"},"PeriodicalIF":6.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877135","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":"Correspondence to editorial “Oral health in southeast Asia: addressing inaccessibility”","authors":"Romain Lan ,&nbsp;Laurie Fraticelli ,&nbsp;Denis Bourgeois ,&nbsp;Florence Carrouel","doi":"10.1016/j.lansea.2025.100550","DOIUrl":"10.1016/j.lansea.2025.100550","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"39 ","pages":"Article 100550"},"PeriodicalIF":6.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827576","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":"Melioidosis: a call for recognition as a neglected tropical disease under the Southeast Asia regional neglected tropical disease framework","authors":"Prasanta Raghab Mohapatra ,&nbsp;Bijayini Behera","doi":"10.1016/j.lansea.2025.100625","DOIUrl":"10.1016/j.lansea.2025.100625","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"39 ","pages":"Article 100625"},"PeriodicalIF":6.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827577","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":"Sample representativeness and temporal comparability in SEAR study, and achieving equitable health insurance coverage — Authors' reply","authors":"Sudheer Kumar Shukla ,&nbsp;Pratheeba John ,&nbsp;Nishikant Singh ,&nbsp;Navin Singh","doi":"10.1016/j.lansea.2025.100648","DOIUrl":"10.1016/j.lansea.2025.100648","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"39 ","pages":"Article 100648"},"PeriodicalIF":6.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826875","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}