The Lancet regional health. Southeast Asia最新文献

{"title":"For every generation, vaccines must reach everyone: closing the access gap in WHO South-East Asia","authors":"Catharina C. Boehme","doi":"10.1016/j.lansea.2026.100792","DOIUrl":"10.1016/j.lansea.2026.100792","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"51 ","pages":"Article 100792"},"PeriodicalIF":6.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148736967","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":"Progression of dengue during an outbreak (2024) in Dhaka, Bangladesh: a hospital based longitudinal study","authors":"Lubaba Shahrin,&nbsp;Monira Sarmin,&nbsp;Tahmina Alam,&nbsp;Abu Sadat Mohammad Sayeem Bin Shahid,&nbsp;Md Farhad Kabir,&nbsp;Mohammad Shafiul Alam,&nbsp;Fahima Chowdhury,&nbsp;Md Taufiqur Rahman Bhuiyan,&nbsp;Afroza Akter,&nbsp;Imam Tauheed,&nbsp;Anamul Hasan,&nbsp;Marjahan Akhtar,&nbsp;S.M. Ashraf Ul Hoque,&nbsp;Sumaiya Sharmin,&nbsp;Sadia Sabrina,&nbsp;Md Rakibul Alam,&nbsp;Dilruba Sharmen Nishu,&nbsp;Mohammad Khalid Hasan,&nbsp;Shahriar Ahmed,&nbsp;Md Khairul Islam,&nbsp;Mohammod Jobayer Chisti","doi":"10.1016/j.lansea.2026.100809","DOIUrl":"10.1016/j.lansea.2026.100809","url":null,"abstract":"<div><h3>Background</h3><div>Bangladesh has experienced recurrent dengue outbreaks since 2000, driven by climatic changes and socio-demographic vulnerabilities. Limited evidence on circulating serotypes and immune diversity has hindered preparedness for severe dengue (SD). Identifying clinical and laboratory predictors of progression to severe dengue is key to strengthening outbreak response and clinical management.</div></div><div><h3>Methods</h3><div>A longitudinal cohort study was conducted in four hospitals in Dhaka between January and November 2024. Patients with confirmed dengue with warning signs were enrolled. Clinical data and blood samples were collected at enrollment, clinical deterioration/discharge, and convalescence (day 21 ± 7). Multivariable logistic regression identified factors associated with SD compared with dengue with warning signs (DWS). Associations were expressed as odds ratios (OR) with 95% confidence intervals (CIs) and p-values &lt; 0.05 considered statistically significant.</div></div><div><h3>Findings</h3><div>Among 3135 dengue patients, 354 with warning signs were enrolled. 62 (17.5%) progressed to SD, including 2 deaths. Most of the patients (60%) were aged between 21 and 40 years, and 76% were male. Lethargy was more frequent in SD patients (29%) than DWS patients (11%). DENV-2 was the predominant serotype (90%). Multivariable logistic regression, adjusted for potential confounders, identified arthralgia (95% CI: 1.04–3.98), anorexia (95% CI: 1.40–11.7), lethargy (95% CI: 1.97–10.7), diabetes mellitus (95% CI: 1.01–6.17), pleural effusion (95% CI: 4.97–21.1) and prolonged APTT (95% CI: 1.02–1.08) as independent predictors for SD.</div></div><div><h3>Interpretation</h3><div>The findings show that a few simple and easily measurable indicators can support early risk assessment and guide timely hospital admission and clinical management.</div></div><div><h3>Funding</h3><div><span>United States Agency for International Development</span> (USAID) under the <span>Crisis Modifier Grant</span> (GR-01909) in response to the dengue outbreak in Bangladesh.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"50 ","pages":"Article 100809"},"PeriodicalIF":6.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414176","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":"Toxicity during induction of pulsed versus continuous prednisolone in children with acute lymphoblastic leukaemia: a multi-centre, open label, randomised, phase 3 trial from India (2016–2022)","authors":"Parag Das,&nbsp;Nandana Das,&nbsp;Gaurav Narula,&nbsp;Amita Trehan,&nbsp;Sameer Bakhshi,&nbsp;Venkatraman Radhakrishnan,&nbsp;Rachna Seth,&nbsp;Prashant Tembhare,&nbsp;Man Updesh Singh Sachdeva,&nbsp;Anita Chopra,&nbsp;Shirley Sundersingh,&nbsp;Soumyadeep Das,&nbsp;Manash Pratim Gogoi,&nbsp;Mayur Parihar,&nbsp;Rahul Bhattacharya,&nbsp;Shripad Banavali,&nbsp;Vaskar Saha,&nbsp;Shekhar Krishnan","doi":"10.1016/j.lansea.2026.100788","DOIUrl":"10.1016/j.lansea.2026.100788","url":null,"abstract":"<div><h3>Background</h3><div>Despite the use of similar treatment protocols, induction treatment-related mortality (TRM) in children with ALL in India is 5%, compared to &lt;1% in high income countries. This study evaluated pulsed prednisolone during induction to reduce toxicity.</div></div><div><h3>Methods</h3><div>ICiCLe-ALL-14 (CTRI/2015/12/006434), an open-label, randomised, multicentre trial. Children ≤ 10-years with newly diagnosed B-cell precursor ALL, risk-stratified to standard- or intermediate-risk, were randomised (1:1) to receive prednisolone 60 mg/m²/day, for 4 weeks with taper (R1A) or on days 1–14 and 22–28 (R1B) during induction. Primary outcomes were grade 3–5 toxicities. Secondary outcomes were complete remission (CR) rates, measurable residual disease (MRD) at end of induction (EoI), event-free (EFS), and overall survival (OS).</div></div><div><h3>Findings</h3><div>Of 3315 patients screened at 6 centres, 2505 were eligible and 1246 randomised (623 per group). Thirty (2.4%) patients died during induction: 22/623 (3.5%) and 8/623 (1.3%) in R1A and R1B respectively (absolute risk difference 2.3%, 95% CI 0.54–4.1; p = 0.0149). Relative risk of induction death was 2.75 (95% CI 1.2–6.1) for R1A versus R1B. Grade 3–5 toxicities occurred in 46.4% (289/623) and 45.4% (283/623) of patients (p = 0.7762). CR rates were 98.8% (581/588) and 98.0% (594/606); MRD ≥ 0.01% at EoI was 26.2% and 27.9%; 3-year EFS 72.7% (95% CI 68.2–76.7) and 72.2% (67.6–76.3); OS 85.0% (81.5–87.8) and 87.0% (83.6–89.3) in R1A and R1B respectively. Multivariable analysis confirmed higher risk of induction death with continuous prednisolone (HR 3.06, 95% CI 1.4–6.9, p = 0.0069) and anthracycline use (HR 5.44, 95% CI 1.6–18.9 p = 0.0077).</div></div><div><h3>Interpretation</h3><div>Pulsed prednisolone (R1B) during induction significantly reduced treatment-related deaths, particularly early deaths from infections compared to continuous dosing (R1A), without compromising CR rates, MRD clearance, EFS, or OS. Anthracycline use was an independent risk factor for induction mortality. Higher white cell count and anthracycline use independently predicted grade 3–4 toxicity.</div></div><div><h3>Funding</h3><div>This study was funded partly by the <span>Indian Council of Medical Research</span> (Reference <span><span>79/159/2015/NCD-III</span></span>), the <span>National Cancer Grid</span> (Reference <span><span>2016/001</span></span>), <span>DBT-Wellcome India Alliance</span> (Margdarshi <span><span>IA/M/12/1/500261</span></span>) and a centre grant from the <span>Tata Consultancy Services Foundation</span> to the trial centre.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"50 ","pages":"Article 100788"},"PeriodicalIF":6.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451122","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":"Meningitis: is vaccine introduction enough?","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2026.100818","DOIUrl":"10.1016/j.lansea.2026.100818","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"50 ","pages":"Article 100818"},"PeriodicalIF":6.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148567085","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":"No escape: crisis of extreme heat indoors","authors":"The Lancet Regional Health – South East Asia","doi":"10.1016/j.lansea.2026.100799","DOIUrl":"10.1016/j.lansea.2026.100799","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"49 ","pages":"Article 100799"},"PeriodicalIF":6.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148231382","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":"Seroprevalence of Mycobacterium leprae antibodies among school children in Indonesia in 2023: a cross-sectional study","authors":"Louise Pierneef ,&nbsp;Munawir Muhammad ,&nbsp;Gaby Wassenaar ,&nbsp;Daniel Edbert ,&nbsp;Hana Krismawati ,&nbsp;Sitti Wahyuni ,&nbsp;Soegianto Ali ,&nbsp;Maria Mardalena Martini Kaisar ,&nbsp;Paul Corstjens ,&nbsp;Annemieke Geluk","doi":"10.1016/j.lansea.2026.100779","DOIUrl":"10.1016/j.lansea.2026.100779","url":null,"abstract":"<div><h3>Background</h3><div>Leprosy remains a significant public health issue in endemic regions, including areas in Indonesia. Transmission of <em>Mycobacterium leprae (M. leprae)</em> continues as clear from the almost stable annual number of new leprosy cases amongst which around 5% are children. To interrupt transmission of <em>M. leprae</em>, it is essential to identify and treat infection sources. This study aimed to assess anti-<em>M. leprae</em> phenolic glycolipid-I (PGL-I) IgM seroprevalence among school-aged children in rural and urban Indonesia, as a proxy for recent transmission. Additionally, associations between seropositivity and gender, socioeconomic status (SES), and helminth infection were investigated.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional serosurvey among 637 children (ages 6–15) from schools in urban and rural areas of Sulawesi, Java, and Sumba, Indonesia. The PGL-I QURapid, a field-friendly and quantitative lateral flow assay, was used to detect anti-PGL-I IgM in fingerstick blood and plasma samples. Socioeconomic and health data, including helminth infection status and body-mass index z-scores (z-BMI), were also collected.</div></div><div><h3>Findings</h3><div>The overall seroprevalence of anti-PGL-I IgM in children was 12.2% with significantly higher seroprevalence in rural (Southwest Sumba: 31.0%, Pangkajene: 11.2%) compared to urban areas (North Jakarta: 3.8%, Makassar city: 3.1%). Moreover, seroprevalence amongst children from low-SES schools was significantly higher (13.7%) than among those from high-SES schools (4.1%, <em>P</em> = 0.007). The presence of helminth infections were associated with significantly higher anti-PGL-I IgM levels (<em>P</em> &lt; 0.0001), with 22.4% of helminth-infected children testing seropositive compared to 8.8% of non-infected children (<em>P</em> &lt; 0.001).</div></div><div><h3>Interpretation</h3><div>Our findings demonstrate a high anti-PGL-I IgM seroprevalence among rural, low-SES, and helminth-infected children in Indonesia, indicating elevated levels of <em>M. leprae</em> infection within these groups which again represents increased transmission rates in the population. These results underscore the need for integrated disease control strategies addressing both leprosy and helminthiasis, particularly in rural and economically disadvantaged areas. The PGL-I QURapid demonstrated to be an effective tool in serosurveys, able to aid the identification of areas with high <em>M. leprae</em> transmission rates (such as Sumba) and thereby support the implementation of targeted interventions in endemic regions.</div></div><div><h3>Funding</h3><div>This study was funded by a grant from the <span>Q.M. Gastmann-Wichers Foundation</span> (AG) and an internal grant from <span>Atma Jaya Catholic University of Indonesia</span> (MMMK).</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"49 ","pages":"Article 100779"},"PeriodicalIF":6.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148167931","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":"Multiple sclerosis diagnosis in south Asia: fundamentals first","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2026.100780","DOIUrl":"10.1016/j.lansea.2026.100780","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"48 ","pages":"Article 100780"},"PeriodicalIF":6.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936036","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 “The limitations and fallacies of relying on glycosylated haemoglobin for diagnosing and monitoring diabetes in Indian populations” [The Lancet Regional Health – Southeast Asia Volume 45, February 2026, 100724]","authors":"Shambo Samrat Samajdar ,&nbsp;Shashank R. Joshi ,&nbsp;Anoop Misra ,&nbsp;Naval K. Vikram","doi":"10.1016/j.lansea.2026.100751","DOIUrl":"10.1016/j.lansea.2026.100751","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"47 ","pages":"Article 100751"},"PeriodicalIF":6.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702790","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":"Why HbA1c remains the pragmatic choice for monitoring in India's public health system","authors":"Joshua Chadwick,&nbsp;Ganeshkumar Parasuraman","doi":"10.1016/j.lansea.2026.100756","DOIUrl":"10.1016/j.lansea.2026.100756","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"47 ","pages":"Article 100756"},"PeriodicalIF":6.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702789","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":"Autism spectrum disorder: strengthening screening for optimal outcomes","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2026.100771","DOIUrl":"10.1016/j.lansea.2026.100771","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"47 ","pages":"Article 100771"},"PeriodicalIF":6.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702803","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}