The Lancet regional health. Southeast Asia最新文献

{"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}

{"title":"Minimum service standards assessment tool and the hospital strengthening program: a novel first step towards the quality improvement of Nepal’s national hospital system","authors":"Rita Pokhrel ,&nbsp;Abigail Knoble ,&nbsp;Pratibha Gautam ,&nbsp;Mohammad Kashim Shah ,&nbsp;Pravin Paudel ,&nbsp;Archana Amatya ,&nbsp;Madan Kumar Upadhyaya ,&nbsp;Ruma Rajbhandari","doi":"10.1016/j.lansea.2025.100548","DOIUrl":"10.1016/j.lansea.2025.100548","url":null,"abstract":"<div><div>District hospitals in Nepal, as in other Low- and Lower - Middle Income Countries (LLMICs), struggle to provide quality care due to inadequate investments in equipment, human resources, and hospital infrastructure. To address these challenges, under the leadership of the Ministry of Health and Population (MoHP), Nick Simons Institute (NSI) developed and implemented the novel Minimum Service Standards (MSS) assessment tool in close partnership with the Government of Nepal. The MSS tool routinely assesses a hospital’s readiness to provide mandated care and identify gaps, which are then closed via a small annual grant to the health facility, together providing the knowledge and resources to improve hospital readiness and service availability. Since its inception in 2014, the program has expanded to 130 government hospitals as of April 2024. The program provides a blueprint for hospitals to pursue excellence and has tracked and motivated substantial improvements in services since 2014, such as basic laboratory investigations (+46%), cesarean sections (+40%), and spinal anesthesia (+32%). The program has impacted healthcare policy due to the close collaboration with the MoHP, influencing budget allocation, insurance payments, and hospital upgrade criteria, cementing its sustainability and long term impact.</div></div><div><h3>Funding</h3><div>No external funding</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100548"},"PeriodicalIF":5.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463989","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":"Community mobilisation and incentivisation as a pathway to sustainable TB control","authors":"Inayat Ali","doi":"10.1016/j.lansea.2025.100551","DOIUrl":"10.1016/j.lansea.2025.100551","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100551"},"PeriodicalIF":5.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452908","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}