The Lancet regional health. Southeast Asia最新文献

{"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}

{"title":"The burden of atrial fibrillation and unmet needs of its management in Southeast Asia and South Asia","authors":"Rungroj Krittayaphong ,&nbsp;Yodying Kaolawanich ,&nbsp;Arintaya Phrommintikul ,&nbsp;Mahesan Guruparan ,&nbsp;Kumaran Subaschandran ,&nbsp;Charantharayil Gopalan Bahuleyan ,&nbsp;Narayanan Namboodiri ,&nbsp;Gregory Y.H. Lip","doi":"10.1016/j.lansea.2025.100549","DOIUrl":"10.1016/j.lansea.2025.100549","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100549"},"PeriodicalIF":5.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452907","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":"Insights from ESMO Asia Congress 2024","authors":"Thittayil Suresh Apoorv","doi":"10.1016/j.lansea.2025.100554","DOIUrl":"10.1016/j.lansea.2025.100554","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100554"},"PeriodicalIF":5.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463844","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":"Unveiling the cancer epidemic in India: a glimpse into GLOBOCAN 2022 and past patterns","authors":"Khushwant Singh,&nbsp;Ashoo Grover,&nbsp;Kavitha Dhanasekaran","doi":"10.1016/j.lansea.2025.100546","DOIUrl":"10.1016/j.lansea.2025.100546","url":null,"abstract":"<div><h3>Background</h3><div>The Global Cancer Observatory (GLOBOCAN) 2022 estimates highlight cancer as a significant global health problem. In the South-East Asia-region, India ranks third in terms of cancer incidence, second for mortality, and 121 in terms of crude rates globally. As cancer risks increase with age, particularly affecting older individuals, this study explores the current cancer burden in India by analyzing the cancer landscape across different age groups, determining the population's risk of cancer diagnosis and death, and projecting the future cancer burden aligned with past mortality patterns.</div></div><div><h3>Methods</h3><div>This is a comprehensive-retrospective, cross-sectional study examining 36 cancer types, by gender, and across four-distinct age groups (childhood, reproductive, middle age, geriatric) in India, using the GLOBOCAN 2022 database. The study further analyzes the past mortality patterns (2000–2022) and future cancer landscape of India by determining annual percent change (APC), through Multijoinpoint regression analysis.</div></div><div><h3>Findings</h3><div>The five most prevalent cancers affecting both genders collectively account for 44% of cancer burden in India. Notably, females exhibit higher crude incidence (104.5) and crude mortality (64.2) rates compared to males (91.5 and 62.2), based on 0.676 billion females and 0.731 billion males’ populations in 2022. The middle-aged and geriatric-cohorts account the heaviest (70%) cancer burden with higher crude rates (315.9–543.1 incidents, 215.6–407.8 mortalities). Alarmingly, cancer-related mortalities have increased faster among females (1.2–4.4% APC) than males (1.2–2.4% APC) over the past decade, and are expected to continue rising over coming two decades.</div></div><div><h3>Interpretation</h3><div>Approximately three out of every five individuals in India succumb to death following a cancer diagnosis, as per the GLOBOCAN 2022 incidence (1,413,316) to mortality (916,827) ratio. Childhood and reproductive age-group individuals bear the lowest risk of developing (0.12–2.4%) and dying (0.08–1.3%) from cancer compared to their middle-aged and geriatric counterparts, having highest risks of developing (8.3–10.3%) and dying (5.5–7.7%) from cancer. As the population of India transitions from the reproductive age group to the middle age and geriatric age group, the India is anticipated to witness the highest cancer burden of all-time in near future, potentially exacerbated by the looming epidemic.</div></div><div><h3>Funding</h3><div>No funding received.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100546"},"PeriodicalIF":5.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452910","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":"Trends in female breast cancer among adolescent and young adults in Southeast Asia","authors":"Jenny Chen ,&nbsp;Frances Dominique V. Ho ,&nbsp;Erin Jay G. Feliciano ,&nbsp;James Fan Wu ,&nbsp;Kara Magsanoc-Alikpala ,&nbsp;Edward Christopher Dee","doi":"10.1016/j.lansea.2025.100545","DOIUrl":"10.1016/j.lansea.2025.100545","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"34 ","pages":"Article 100545"},"PeriodicalIF":5.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420630","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}