The Lancet regional health. Southeast Asia最新文献

{"title":"Perspectives on the decriminalisation of suicide in Pakistan: historical context, societal impacts, and the way forward","authors":"Mariyam Sibghatullah,&nbsp;Komal Dayani,&nbsp;Mekaiel Zia,&nbsp;Taha Sabri","doi":"10.1016/j.lansea.2025.100568","DOIUrl":"10.1016/j.lansea.2025.100568","url":null,"abstract":"<div><div>This Viewpoint provides a comprehensive review of the historical context, legal frameworks, and societal implications associated with the criminalisation of suicide in Pakistan, along with the process that was utilised for the decriminalisation of suicide. The context focuses on the importance of decriminalising suicide, presenting evidence and insights into how the criminalisation of suicide has impacted individuals, families, and the healthcare system. The process of decriminalising suicide in Pakistan focuses on the public awareness strategies, emphasising the key role that the stories of people with lived experience of mental illness played in shifting the societal attitudes and misconceptions related to suicide. Through discussions of the challenges faced in the process of repealing Section 325 of the Pakistan Penal Code (PPC), we emphasise the need for continued public awareness efforts to address the religious misconceptions related to suicide. With the implementation of the law still pending, we argue that decriminalising suicide aligns with the development of a National Suicide Prevention Strategy. The Viewpoint also presents recommendations for government representatives, public health professionals, policymakers, and other stakeholders to utilise our learnings to develop a robust suicide prevention strategy with a multisectoral approach, strengthening the medical system to respond to mental health emergencies.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"35 ","pages":"Article 100568"},"PeriodicalIF":5.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705326","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":"South-East Asia regional neglected tropical disease framework: improving control of mycetoma, chromoblastomycosis, and sporotrichosis","authors":"Dallas J. Smith ,&nbsp;Hardyanto Soebono ,&nbsp;Niraj Parajuli ,&nbsp;Marlous L. Grijsen ,&nbsp;Alyson M. Cavanaugh ,&nbsp;Tom Chiller ,&nbsp;Prajwal Pudasaini ,&nbsp;Terlinda C. Barros ,&nbsp;Arunaloke Chakrabarti","doi":"10.1016/j.lansea.2025.100561","DOIUrl":"10.1016/j.lansea.2025.100561","url":null,"abstract":"<div><div>Mycetoma, chromoblastomycosis, and sporotrichosis are fungal neglected tropical diseases (NTDs) recognized by the World Health Organization. These implantation diseases cause substantial morbidity, disability, decreased quality of life, and can lead to long-term complications including tissue fibrosis, skin cancer, and amputation. The 2024–2030 South-East Asia Regional NTD Strategic Framework includes mycetoma but neglects the full extent of mycetoma endemicity in the region. Furthermore, the framework excludes chromoblastomycosis and sporotrichosis. We describe the data demonstrating fungal NTDs being of public health concern in this region and more widely distributed than acknowledged in the framework. Additionally, we propose modifications to public health interventions and services for fungal NTDs including an active case search approach through community health workers. Severe disease from fungal NTDs in South-East Asia can be eliminated by improving burden data quality, early diagnosis, accessible treatment, and integration with other common and neglected skin diseases.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"35 ","pages":"Article 100561"},"PeriodicalIF":5.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705327","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":"Effectiveness of different border control strategies for reducing mpox importation risk: a modelling study","authors":"Shihui Jin ,&nbsp;Tong Guan ,&nbsp;Akira Endo ,&nbsp;Gregory Gan ,&nbsp;A. Janhavi ,&nbsp;Gang Hu ,&nbsp;Keisuke Ejima ,&nbsp;Jue Tao Lim ,&nbsp;Borame L. Dickens","doi":"10.1016/j.lansea.2025.100565","DOIUrl":"10.1016/j.lansea.2025.100565","url":null,"abstract":"<div><h3>Background</h3><div>The Clade Ib monkeypox virus can be more transmissible through non-sexual routes compared to the previous Clade IIb strain. With imported cases sporadically reported globally, concerns have emerged about the potential of widespread transmission in the general community after importation events. Border control measures, such as screening and quarantining of arriving travellers, may help mitigate this risk and prevent localised outbreaks in the event of global spread.</div></div><div><h3>Methods</h3><div>We developed an agent-based model to simulate individual disease progression and testing. We then evaluated the effectiveness of nine border control strategies in reducing importation risk. The simulations incorporated varying disease prevalence levels (0.001%, 0.005%, and 0.01%) in the country of origin.</div></div><div><h3>Findings</h3><div>The proposed border-control measures would reduce missed cases by 40.1% (39.1%–41.0%), 49.8% (48.8%–50.8%), and 58.1% (57.1%–59.0%) for pre-departure, on-arrival, and both tests, respectively. Replacing the on-arrival test with a 7-day quarantine and post-quarantine testing would lower the proportion to 21.8% (20.9%–22.6%). Quarantine-only strategies showed a linear increase in effectiveness against duration, reaching a 90.4% (89.8%–91.0%) reduction with a 28-day quarantine.</div></div><div><h3>Interpretation</h3><div>When disease prevalence in the country of origin is low (0.001%), less restrictive approaches such as single on-arrival testing or a 14-day quarantine can maintain very low imported case counts of one or below. At higher prevalences, 7-day quarantining followed by post-quarantine testing, or 28-day quarantining is required to maintain similar effects. Border management will require risk assessments between importation risk, based on origin country prevalence, and the negative impacts of control on travellers.</div></div><div><h3>Funding</h3><div>This work was supported by <span>Ministry of Education Reimagine Research</span> Grant; <span>PREPARE</span>, <span>Ministry of Health</span>; the <span>Japan Science and Technology Agency</span> (JST) (<span><span>JPMJPR22R3</span></span> to AE); the <span>Japan Society for the Promotion of Science</span> (JSPS) (<span><span>JP22K17329</span></span> to AE), and <span>National University of Singapore</span> Start-Up Grant (to AE); <span>Nanyang Technological University</span>, Singapore—<span>Imperial Research Collaboration Fund</span> (<span><span>INCF-2023-007</span></span> to JTL).</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"35 ","pages":"Article 100565"},"PeriodicalIF":5.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697688","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":"Smoke economics: lessons from tobacco ban for e-cigarette regulation in Bhutan","authors":"Monu Tamang ,&nbsp;Benu Prasad Dahal","doi":"10.1016/j.lansea.2025.100560","DOIUrl":"10.1016/j.lansea.2025.100560","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"35 ","pages":"Article 100560"},"PeriodicalIF":5.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696711","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":"Stigmatisation of mortuary workers in India: insights from four hospitals in West Bengal","authors":"Saswata Sen ,&nbsp;Rina Das ,&nbsp;Tapobrata Guha Roy ,&nbsp;Somnath Das","doi":"10.1016/j.lansea.2025.100559","DOIUrl":"10.1016/j.lansea.2025.100559","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"35 ","pages":"Article 100559"},"PeriodicalIF":5.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683939","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":"Adoption of Alcohol Health Warning Labels (AHWLs) across South East Asia: current status and recommendations for future","authors":"Swarndeep Singh ,&nbsp;Yatan Pal Singh Balhara","doi":"10.1016/j.lansea.2025.100557","DOIUrl":"10.1016/j.lansea.2025.100557","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"35 ","pages":"Article 100557"},"PeriodicalIF":5.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591822","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":"Improving access to safe water and groundwater sustainability","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2025.100558","DOIUrl":"10.1016/j.lansea.2025.100558","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100558"},"PeriodicalIF":5.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577524","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":"Challenges associated with dapsone for leprosy treatment in Indonesia - urgent need for access to alternative antimicrobial drugs","authors":"Hana Krismawati ,&nbsp;Maria Harianja ,&nbsp;Antonius Oktavian ,&nbsp;Claus Bøgh ,&nbsp;Messe R. Ataupah ,&nbsp;Ruth D. Laiskodat ,&nbsp;Arry Pongtiku ,&nbsp;Annemieke Geluk ,&nbsp;J. Kevin Baird ,&nbsp;Raph L. Hamers ,&nbsp;Hardyanto Soebono ,&nbsp;Stephen L. Walker ,&nbsp;Marlous L. Grijsen","doi":"10.1016/j.lansea.2025.100555","DOIUrl":"10.1016/j.lansea.2025.100555","url":null,"abstract":"<div><div>Leprosy is effectively treated with multi-drug therapy (MDT), a regimen containing three antibiotic drugs, including dapsone - a sulfone drug associated with potentially life-threatening adverse drug reactions. Specifically, dapsone hypersensitivity syndrome (DHS), linked to HLA-B∗13:01 polymorphism, and hemolytic anemia associated with glucose-6-phosphate dehydrogenase deficiency (G6PDd).</div><div>Both of these pharmacogenetic polymorphisms can be prevented through diagnostic screening before MDT initiation averting potential complications. However, in leprosy-endemic areas like Indonesia, access to these tests often remains inaccessible due to high costs and limited laboratory capacity. Additionally, alternative dapsone-sparing treatment regimens are usually unavailable or unaffordable, restraining individuals onto suboptimal dual-therapy with rifampicin and clofazimine, which has uncertain efficacy. We raise concerns regarding the safety of dapsone-containing MDT without routine pharmacogenetic screening and the unavailability of alternative regimens. We call for action to address persisting global health inequities in care delivery, ensuring all individuals receive the safest and most effective leprosy treatment options.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100555"},"PeriodicalIF":5.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488316","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":"A population-representative serosurvey estimating vaccine-induced immunity against measles, rubella, hepatitis B and severe acute respiratory syndrome coronavirus 2 in Timor-Leste","authors":"Paul Arkell ,&nbsp;Maria Y. Tanesi ,&nbsp;Nelson Martins ,&nbsp;Nelia Gomes ,&nbsp;Tessa Oakley ,&nbsp;Vanessa Solano ,&nbsp;Michael David ,&nbsp;Salvador Amaral ,&nbsp;Sarah L. Sheridan ,&nbsp;Teem-Wing Yip ,&nbsp;Anthony D.K. Draper ,&nbsp;Nevio Sarmento ,&nbsp;Endang Soares da Silva ,&nbsp;Lucsendar Alves ,&nbsp;Suellen Nicholson ,&nbsp;Vicki Stambos ,&nbsp;Kate Pedrina ,&nbsp;Carlito Freitas ,&nbsp;Filipe de Neri Machado ,&nbsp;Celia A. Gusmão ,&nbsp;Joshua R. Francis","doi":"10.1016/j.lansea.2024.100525","DOIUrl":"10.1016/j.lansea.2024.100525","url":null,"abstract":"<div><h3>Background</h3><div>Serosurveillance can be used to assess population immunity to vaccine-preventable diseases (VPDs). This study aimed to determine seroprevalence of four VPDs across Timor-Leste and identify immunity gaps.</div></div><div><h3>Methods</h3><div>A population-representative three-stage cluster random sample of census-enumerated households were visited between October 2021 and February 2023. Occupants aged above one year were tested for measles immunoglobulin G (IgG), rubella IgG, hepatitis B surface antibody (HBsAb), hepatitis B core antibody (HBcAb) and severe acute respiratory syndrome 2 (SARS-CoV-2) IgG, using serological assays with <em>a priori</em> determined cut-offs. Sample- and response-weighted mixed effects logistic regression models were used to estimate seroprevalence in relevant age-strata.</div></div><div><h3>Findings</h3><div>Of 2613 eligible households, 1908 (73.0%) participated. Of 8427 occupants, 4750 (56.4%) participated. Measles IgG seroprevalence was low among children, particularly those aged 10–14 (33.2%, 95% confidence interval (CI) 27.8–38.6%). Rubella IgG seroprevalence was high in all ages (93.2%, 95% CI 92.2–94.2%). SARS-CoV-2 IgG seroprevalence was high, including in young children not eligible for vaccination (74.0%, 95% CI 70.4–77.6%). HBsAb seroprevalence was lowest among adolescents aged 15–19 (12.1%, 95% CI 6.8–17.5%) but higher among younger children, who also had low HBcAb seroprevalence.</div></div><div><h3>Interpretation</h3><div>The pattern of measles immunity is consistent with low virus transmission and suboptimal childhood vaccine uptake. These data have informed supplementary immunisation activities. High rubella IgG seroprevalence suggests recent or ongoing virus transmission and a need for congenital rubella syndrome surveillance. Hepatitis B data provide evidence of recent improvements in vaccine-induced immunity and protection. This study demonstrates how serosurveillance can directly influence national vaccine strategies.</div></div><div><h3>Funding</h3><div>This study was funded by the <span>Department for Foreign Affairs and Trade</span>, Australian Government (Complex Grant Agreement Number 75889).</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100525"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479202","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":"Effect of antiretroviral therapy on retention of people living with HIV in India (2012–2017): a retrospective, cohort study","authors":"Shweta Chidrawar ,&nbsp;Suvarna Sane ,&nbsp;Megha Mamulwar ,&nbsp;Shilpa Bembalkar ,&nbsp;Rachna Thakur ,&nbsp;Tarun Bhatnagar ,&nbsp;Srikanth P. Tripathy ,&nbsp;Shrinivasa B. Marinaik ,&nbsp;Damodar Sahu ,&nbsp;Subrata Biswas ,&nbsp;Shanta Datta ,&nbsp;Yogesh Sabde ,&nbsp;Rajnarayan Tiwari ,&nbsp;Deepak Khismatrao ,&nbsp;Bhawani Singh Kushwaha ,&nbsp;Anoop Kumar Puri ,&nbsp;Chinmoyee Das ,&nbsp;Sheela V. Godbole","doi":"10.1016/j.lansea.2025.100552","DOIUrl":"10.1016/j.lansea.2025.100552","url":null,"abstract":"<div><h3>Background</h3><div>India's free antiretroviral therapy (ART) programme was initiated in 2004. People living with HIV who were registered with ART centres (ARTC) were initiated on ART based on the CD4 count cutoffs as per prevailing guidelines. The others with higher counts remained on six-monthly follow up. We estimated retention rates among people living with HIV receiving ART in the programme and their determinants during 2012–2017.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, the records of people living with HIV aged ≥15 years, registered between April 2012 and March 2017 (reference period) in 81 of 396 ARTC across 33 Indian states were reviewed. ‘People living with HIV not on ART’ were defined as all those who were registered but not eligible for ART initiation or not started ART through the reference period. ‘People living with HIV on ART’ were those who were already on ART or initiated on ART as per prevailing guidelines. Relevant data from the clinic records were extracted and analysed for ‘Not on ART’ and ‘On ART’ groups separately using life-table method, Cox proportional hazards model to estimate retention probability and potential determinants.</div></div><div><h3>Findings</h3><div>Of 154,154 registered people living with HIV, 82.3% received ART (‘on ART’) during 2012–2017. Proportion retained was lower among ‘not on ART’ vs ‘on ART’ people living with HIV and was statistically significant (71.1% vs 88.9%, p &lt; 0.001). Five-year retention probability was 57% for ‘not on ART’ and 81% for ‘on-ART’ people living with HIV (p &lt; 0.001). The incidence of cases who were lost to follow up was 12.9 and 4.3/100 person-years among ‘not on ART’ &amp; ‘on ART’ people living with HIV, respectively. Determinants of becoming lost to follow up (Adjusted HR, 95% CI) included ‘being in not on ART’ (Adjusted HR: 2.95, 95% CI: 2.85–3.05) ‘being male’ (1.08, 1.05–1.11); ‘having CD4 count 351–500 cells/mm³’ at registration (1.21, 1.16–1.26); and ‘having tuberculosis’ (1.15, 1.10–1.19).</div></div><div><h3>Interpretation</h3><div>New programmatic strategies for improving retention of people living with HIV in care may benefit by focussing on males, younger ages (15–29 years), CD4 counts during registration, history of or new TB diagnoses and early intervention within the first year.</div></div><div><h3>Funding</h3><div>This study was supported with NOA# SAMS/NACP/IE-ART/NARI/2017/09 dated March 27, 2017, awarded by Strategic Alliance Management Services Pvt. Ltd. (SAMS) with funding support from the <span>Global Fund</span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100552"},"PeriodicalIF":5.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479203","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}