The Lancet regional health. Southeast Asia最新文献

{"title":"Lay health worker-delivered case management for early episodes of psychosis in Bangkok, Thailand (Lay-CARE): a single-centre, pragmatic, randomised controlled trial","authors":"Tawanchai Jirapramukpitak ,&nbsp;Suttha Supanya","doi":"10.1016/j.lansea.2025.100617","DOIUrl":"10.1016/j.lansea.2025.100617","url":null,"abstract":"<div><h3>Background</h3><div>While specialist-led early intervention services (EIS) have been shown to be effective for early-phase psychosis, the effectiveness of a non-specialist-led EIS is still unclear. The study aims to determine the effectiveness of a low-intensity case management (LICM) programme led by lay health workers for patients during early episodes of psychosis on six-month outcomes compared to usual care (UC) in Bangkok, Thailand.</div></div><div><h3>Methods</h3><div>This pragmatic randomised controlled trial (Lay-CARE) included patients aged ≥18 years with a history of a first or second episode of psychotic disorder residing in the Bangkok Metropolitan Region (Thammasat University hospital's catchment district). Participants were randomised to either LICM or UC group. LICM intervention consisted of family psychoeducation, facilitation of access to services, and home or telephone visits, whereas UC was the baseline of care participants were receiving. The intervention started in October 2020 and ended in May 2021. The 6-month endline assessment started in April 2021 and ended in May 2021. The primary outcome was social functioning measured by the Personal and Social Performance Scale Thai version. Secondary outcomes were symptom severity, service use and medication adherence. The treatment effect size was determined using the average treatment effect (ATE). Due to the nature of the intervention, blinding of participants and assessors was not possible. The trial was registered with the Thai Clinical Trial Registry (TCTR20210509001).</div></div><div><h3>Findings</h3><div>130 participants were randomised to LICM group and 125 to UC group. At the six-month endline, participants in LICM group demonstrated improved socially useful activities (ATE 0.06, 95% CI 0.00–0.13, p = 0.041), less aggressive or disturbing behaviour (ATE −0.17, 95% CI −0.27 to −0.06, p = 0.002), and better self-care (ATE 0.13 95% CI 0.05–0.22, p = 0.003) than participants in UC group. LICM intervention did not affect personal and social relationships, symptom severity, medication adherence, or service use.</div></div><div><h3>Interpretation</h3><div>In low-resource settings, LICM programme can improve areas of social functioning among patients with early episodes of psychosis over six months.</div></div><div><h3>Funding</h3><div><span>Health Systems Research Institute</span> (HSRI), Thailand (Grant No. <span><span>60-087</span></span>).</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"38 ","pages":"Article 100617"},"PeriodicalIF":5.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243099","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 comprehensive assessment of health indicators among tribal populations in Odisha, India (Odisha Tribal Family Health Survey): a community-based, cross-sectional study","authors":"Jaya Singh Kshatri ,&nbsp;Kavitha AK ,&nbsp;Tanveer Rehman ,&nbsp;Haimanti Bhattacharya ,&nbsp;Dinesh Bhuyan ,&nbsp;Asit Mansingh ,&nbsp;Uttam Kumar Sahoo ,&nbsp;Moushumi Nayak ,&nbsp;Swagatika Kanungo ,&nbsp;Debdutta Bhattacharya ,&nbsp;Sanghamitra Pati","doi":"10.1016/j.lansea.2025.100611","DOIUrl":"10.1016/j.lansea.2025.100611","url":null,"abstract":"<div><h3>Background</h3><div>Indigenous tribal communities in the state of Odisha, eastern India, face persistent health disparities driven by socio-economic marginalisation, geographical isolation, and limited healthcare access. The Odisha Tribal Family Health Survey (OTFHS) aimed to comprehensively assess the health status, socio-demographic characteristics, and healthcare utilisation patterns of Odisha’s tribal populations.</div></div><div><h3>Methods</h3><div>A community-based survey was conducted between July 2022 and July 2023, covering 9711 households across 389 clusters in 14 tribal-dominated districts in Odisha. The study included 30,292 participants from 53 notified tribal groups. The study included participants of all age groups (from neonates to the elderly, aged 0 years and above), with 56% of the sample comprising females. Individuals belonging to one of the notified tribes who were permanent residents and provided written consent were included, while bedridden individuals and those with recognisable cognitive impairments were excluded. Data collection involved the use of structured tools at the household and individual levels, anthropometric measurements, point-of-care tests (including blood pressure, random blood glucose, and haemoglobin levels, as well as haemoglobinopathy screening), and laboratory analyses of blood serum samples (for liver function, kidney function, and lipid and iron profiles).</div></div><div><h3>Findings</h3><div>OTFHS revealed that 88.0% of children aged 12–23 months were fully vaccinated and over 40% of children younger than five years were stunted or underweight. Anaemia affected 71.3% of children aged 6–59 months, with prevalence remaining high among adolescents (76.1% of females, 56.9% of males) and adults (77.5% of women, 42.1% of men). 93.0% of women had bank accounts and 91.4% of births occurred in healthcare facilities. Gaps persisted in antenatal care (40.3% completed four or more visits) and hygienic menstrual practices (35.8% of women).</div></div><div><h3>Interpretation</h3><div>OTFHS offers crucial disaggregated data, guiding targeted health improvements and policy reforms essential for bridging health equity gaps. The specific focus on Indigenous populations and a broader look at the social determinants alongside health indicators reflect the multi-dimensional nature of healthcare interventions needed for vulnerable groups.</div></div><div><h3>Funding</h3><div><span>Scheduled Castes and Scheduled Tribes Research and Training Institute</span> (SCSTRTI), Odisha, India.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"38 ","pages":"Article 100611"},"PeriodicalIF":5.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231715","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":"Outcomes of children with juvenile idiopathic arthritis receiving biological disease-modifying anti-rheumatic drugs: a retrospective single-centre experience from India","authors":"Pavneet Kaur ,&nbsp;Farheen Kizhakkeveettil Saheer ,&nbsp;Bala Siva Rama Krishna J ,&nbsp;Banoth Sreeshanth ,&nbsp;Ayisha Kavil Peedika ,&nbsp;Bareddy Sai Thrisha Reddy ,&nbsp;Ashish Datt Upadhyay ,&nbsp;Rakesh Lodha ,&nbsp;Sushil Kumar Kabra ,&nbsp;Narendra Bagri","doi":"10.1016/j.lansea.2025.100612","DOIUrl":"10.1016/j.lansea.2025.100612","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to study the outcomes (remission, flare and adverse events) of biological disease-modifying anti-rheumatic drugs (bDMARD) in children with JIA from a low-middle-income country setting, and explore the factors associated with these outcomes.</div></div><div><h3>Methods</h3><div>The Pediatric Rheumatology Clinic bDMARD register (2009 to August 2024) was screened to enrol children with JIA and at least 3 months follow-up whilst on bDMARDs. Participant characteristics and clinical responses were collected in a pre-designed proforma to evaluate the primary objective i.e., studying outcomes among children with JIA on bDMARDs. The secondary objective was to study factors associated with time-to-remission (TTR) and flare-after-stopping-bDMARDs.</div></div><div><h3>Findings</h3><div>One-hundred-fifteen children (59.1% boys) with 168 patient-years of bDMARD use were enrolled for this single-centre study. Enthesitis-related arthritis was the commonest subtype of JIA (n = 44, 38.3%). The most commonly used bDMARD was adalimumab (n = 43, 37.3%). The median (IQR) delay to initiation of bDMARD from the perceived need was 2 (0–6) months, primarily due to financial impediments (n = 81, 70.4%). Fifteen (13%) children screened positive for tuberculosis infection. One hundred ten (95.6%) children achieved remission on bDMARD, after a median (IQR) of 7.5 (4–12) weeks. Macrophage activation syndrome at initiation was significantly associated (HR 3.6 (1.3–10.0), p = 0.03) with a longer time-to-remission. bDMARDs were stopped in n = 68/115 (59.1%) after a median (IQR) 15 (9.6–26.5) months, of whom n = 33/68 (48.5%) flared at 6 (3.5–12) months of follow-up. A longer time-to-remission (OR 1.12 (1.02–1.23), p = 0.01) was significantly associated with flare after stopping bDMARDs. Forty-two (36.5%) patients experienced adverse events. The most striking adverse events were serious infections requiring hospitalisation (n = 13, 11.3%) and tuberculosis (n = 4, 3.5%). All children who developed tuberculosis were on TNFi (Adalimumab).</div></div><div><h3>Interpretation</h3><div>Though children on bDMARDs showed comparable remission rates, we noted a higher frequency of serious infections and tuberculosis, compared to the experience described from high-income countries. These observations highlight the need for further surveillance of outcomes of bDMARD use among children with JIA in an LMIC setting.</div></div><div><h3>Funding</h3><div>There has been no financial support for this work.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"38 ","pages":"Article 100612"},"PeriodicalIF":5.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222301","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":"Challenging inadequate and fragmented primary health care financing: findings from Bangladesh, Indonesia, Maldives, and Nepal","authors":"Aungsumalee Pholpark ,&nbsp;Hsu Myat Mon ,&nbsp;Leonard Thomas Lim ,&nbsp;Tsolmongerel Tsilaajav ,&nbsp;Valeria de Oliveira Cruz ,&nbsp;Piya Hanvoravongchai","doi":"10.1016/j.lansea.2025.100613","DOIUrl":"10.1016/j.lansea.2025.100613","url":null,"abstract":"<div><div>Strengthening primary health care (PHC) is essential for achieving universal health coverage, with effective financing playing a critical role in its success. Despite the increasing emphasis on PHC investment, securing sustainable public financing remains a significant challenge in the countries of the South-East Asia (SEA) Region. This study provides an overview of PHC financing arrangements in Bangladesh, Indonesia, Maldives, and Nepal, highlighting key challenges in these four countries. Data sources included the document review (87 documents included across the four countries) and key informant interviews (21 in total). Findings highlight the diverse approaches to PHC financing across the four countries, bringing out common and country-specific challenges. Our findings suggest that while PHC has been receiving more attention in policy agendas, underlying PHC financing functions still face many challenges. Some constraints stem from the existing health financing models within these countries, indicating a need for targeted reforms.</div></div><div><h3>Funding</h3><div><span>WHO South-East Asia Regional Office</span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"38 ","pages":"Article 100613"},"PeriodicalIF":5.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222472","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":"Clarifying methodological discrepancies in HIV retention analysis—authors’ reply","authors":"Shweta Chidrawar,&nbsp;Suvarna Sane,&nbsp;Megha Mamulwar,&nbsp;Shilpa Bembalkar,&nbsp;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":"A randomised trial to assess the efficacy of add on therapy with aspirin or clopidogrel to the standard medical therapy alone in patients with tubercular meningitis: ACT TBM","authors":"Rohit Bhatia ,&nbsp;Ritu Shree ,&nbsp;Manish Modi ,&nbsp;Abhishek Anand ,&nbsp;Ajay Garg ,&nbsp;Partha Haldar ,&nbsp;Madakasira Vasantha Padma Srivastava ,&nbsp;Neeraj Singla ,&nbsp;Manoj Goyal ,&nbsp;Supriya Supriya ,&nbsp;Kusum Sharma ,&nbsp;Naveet Wig ,&nbsp;Mamta Bhushan Singh ,&nbsp;Saman Fatima ,&nbsp;Imnameren Longkumer ,&nbsp;Tanupriya Bindal ,&nbsp;Achal Srivastava ,&nbsp;Venugopalan Y. Vishnu ,&nbsp;Ashutosh Biswas ,&nbsp;Sanjeev Sinha ,&nbsp;Chirag Ahuja","doi":"10.1016/j.lansea.2025.100604","DOIUrl":"10.1016/j.lansea.2025.100604","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Benefit of antiplatelet therapy for stroke prevention or treatment among patients of Tubercular meningitis (TBM) is uncertain. We hypothesised that add-on therapy with aspirin or clopidogrel to standard treatment will be safe and effective in reducing clinical stroke and/or cerebral infarction in patients with TBM.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a randomised, open-label, superiority trial with blinded outcome assessment. Patients with suspected TBM were randomised to receive either add-on oral aspirin 75 mg, clopidogrel 75 mg along with ATT (anti-tubercular treatment) or only ATT. Clinical follow up, MRI brain, and MR Angiogram were performed at baseline, one and three months from randomisation. Primary outcome was reduction in occurrence of clinical stroke and/or imaging-based cerebral infarction at one and three months. Safety outcome was the occurrence of major or minor bleeding. Key secondary outcomes included mortality at one and three months and modified Rankin scale (mRS) at three months.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 237 patients with TBM were randomised (77 in the aspirin group, 77 in the clopidogrel group, and 83 in the standard treatment group). At one month, clinical stroke outcome was available for 66 (85.7%), 72 (93.5%) and 69 (83.1%) patients and MRI brain was available for 61 (79.2%), 65 (84.4%) and 62 (74.7%) patients, respectively. Clinical stroke was observed in one (1.5%) in aspirin group, none (0.0%) in clopidogrel group, and three (4.3%) patients in standard group (across group comparison p = 0.2); imaging-based cerebral infarction was observed in six (9.8%), eight (12.3%), and seven (11.3%) patients, respectively (across group comparison p = 0.9). At three months, clinical stroke outcome in aspirin, clopidogrel and standard groups was available for 60 (77.9%), 63 (81.8%) and 59 (71.1%) patients and MRI brain was available for 57 (74.0%), 60 (77.9%) and 55 (66.3%) patients, respectively. Clinical stroke was observed in two (3.3%), one (1.6%), and two (3.4%) patients (across group comparison p = 0.8) and imaging-based infarction was observed in two (3.5%), three (5.0%), and two (3.6%) patients, respectively (across group comparison p = 0.9). Using intention-to-treat approach following a complete cases analysis method, primary outcome at one month was observed in six (9.1%) in aspirin group, eight (11.1%) in clopidogrel group, and ten (14.3%) in standard group (across group comparison p = 0.6, aspiring vs. standard: adjusted relative risk [aRR] 0.56 [95% CI 0.21–1.47], clopidogrel vs. standard: aRR 0.72 [95% CI 0.30–1.67]) and four (6.7%), four (6.1%), and three (5.1%) respectively at three months (across group comparison p = 0.9, aspirin vs. standard: aRR 0.98 [95% CI 0.20–4.82], clopidogrel vs. standard: aRR 0.43 [95% CI 0.06–2.87]). Major bleeding was observed in two patients: one each in clopidogrel (1.3%) and standard group (1.3%). Minor bleeding was observed ","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100604"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239491","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":"Corrigendum to “Unveiling the cancer epidemic in India: a glimpse into GLOBOCAN 2022 and past patterns” [The Lancet Regional Health–Southeast Asia 2025;34: 100546]","authors":"Khushwant Singh,&nbsp;Ashoo Grover,&nbsp;Kavitha Dhanasekaran","doi":"10.1016/j.lansea.2025.100583","DOIUrl":"10.1016/j.lansea.2025.100583","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100583"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239490","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":"Inclusivity for people living with disability: the gap between understanding and implementing","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2025.100614","DOIUrl":"10.1016/j.lansea.2025.100614","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100614"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239712","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}