The Lancet regional health. Southeast Asia最新文献

{"title":"Proposal for improving clinical care of patients in Nipah outbreaks","authors":"Yi Tian , Ting Chen","doi":"10.1016/j.lansea.2025.100537","DOIUrl":"10.1016/j.lansea.2025.100537","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100537"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149179","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":"Biological subphenotypes in patients hospitalized with suspected infection in Thailand: a secondary analysis of a prospective observational study","authors":"Prapassorn Poolchanuan ,&nbsp;Taylor D. Coston ,&nbsp;Viriya Hantrakun ,&nbsp;Parinya Chamnan ,&nbsp;Gumphol Wongsuvan ,&nbsp;Pavan K. Bhatraju ,&nbsp;Narisara Chantratita ,&nbsp;Direk Limmathurotsakul ,&nbsp;T. Eoin West ,&nbsp;Shelton W. Wright","doi":"10.1016/j.lansea.2025.100536","DOIUrl":"10.1016/j.lansea.2025.100536","url":null,"abstract":"<div><h3>Background</h3><div>Subphenotypes of infected patients have been reported in Europe and North America, but few studies have investigated populations in Southeast Asia. We sought to identify and differentiate subphenotypes of patients hospitalized with suspected infection in rural Thailand using biological markers implicated in the dysregulated host response.</div></div><div><h3>Methods</h3><div>In a cohort of prospectively enrolled patients hospitalized with suspected infection in northeastern Thailand, we measured 15 circulating biomarkers from a random selection of 585 subjects and developed latent profile models to identify subphenotypes. Patient characteristics were compared after subphenotype assignment, and a parsimonious model was developed to identify patient subphenotypes.</div></div><div><h3>Findings</h3><div>We identified and assigned 585 patients to three subphenotypes termed latent biological profile (LBP)-1 (52%), LBP-2 (39%) and LBP-3 (9%). Patients assigned to LBP-3 had a higher risk of 28-day mortality compared to those in LBP-1 and LBP-2 (adjusted relative risk 1.8, 95% confidence interval [CI] 1.1–2.9, P = 0.02). Patient clinical characteristics and biomarker concentrations also differed by subphenotype assignment. A parsimonious three-biomarker model identified subphenotypes in an internal validation cohort (LBP-1: area under the receiver operating curve [AUC] 0.96, 95% CI: 0.94–0.98; LBP-2: AUC 0.77, 95% CI 0.71–0.83; LBP-3: AUC 0.99, 95% CI 0.98–1.00).</div></div><div><h3>Interpretation</h3><div>We identified three biological subphenotypes of patients with suspected infection in rural Thailand, where the burden of infection is high but understudied. Patient subphenotype assignment was characterized by distinct clinical outcomes and biological profiles which could inform contextualized future study design.</div></div><div><h3>Funding</h3><div>The US <span>National Institutes of Health</span>, the <span>Wellcome Trust</span>, and the Firland Foundation.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100536"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149180","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":"Turning the tide with better data to address stillbirths in India","authors":"Rakhi Dandona ,&nbsp;G Anil Kumar ,&nbsp;Tanmay Mahapatra","doi":"10.1016/j.lansea.2024.100509","DOIUrl":"10.1016/j.lansea.2024.100509","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100509"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175771","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":"Genetic variants and type 2 diabetes in India: a systematic review and meta-analysis of associated polymorphisms in case-control studies","authors":"Lokendra Rathod ,&nbsp;Sameera Khan ,&nbsp;Sweta Mishra ,&nbsp;Deepanker Das ,&nbsp;Kaustubh Bora ,&nbsp;Swasti Shubham ,&nbsp;Samradhi Singh ,&nbsp;Manoj Kumar ,&nbsp;Rajnarayan R. Tiwari ,&nbsp;Archana Tiwari ,&nbsp;Pradyumna Kumar Mishra ,&nbsp;Devojit Kumar Sarma","doi":"10.1016/j.lansea.2024.100518","DOIUrl":"10.1016/j.lansea.2024.100518","url":null,"abstract":"<div><h3>Background</h3><div>India, with the largest population and second-highest type 2 diabetes mellitus (T2DM) prevalence, presents a unique genetic landscape. This study explores the genetic profiling of T2DM, aiming to bridge gaps in existing research and provide insights for further explorations.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of literature published up to September 2024 using databases like PubMed, Web of Science, Scopus, and Google Scholar to identify SNPs associated with T2DM in case–control studies within the Indian population. Data extraction followed a rigorously designed checklist independently verified by two reviewers. The quality of the studies assessed by utilizing Newcastle Ottawa scale, and heterogeneity through Cochran's Q, τ², H² and <em>I</em>^<em>2</em> statistics. Fixed effect and random effect model was employed for meta-analysis based on heterogeneity, and publication bias was assessed by funnel plot analysis, Egger's and Begg's statistical test. In SNPs with adequate studies meta-regression was used to assess source of heterogeneity. Statistical analyses were performed using Stata 18.0 software.</div></div><div><h3>Findings</h3><div>Our search identified 1309 articles, with 67 included in the systematic review and 35 in the meta-analysis. These 67 case–control studies, involving 33,407 cases and 30,762 controls, analyzed 167 SNPs across 61 genes. Of these, 89 SNPs mapped to 46 genes showed significant associations with T2DM risk (<em>P</em> &lt; 0.05), including 67 linked to increased risk and 16 with protective effects. Geographical analysis highlighted inter- and intra-regional variations. Meta-analysis of 25 SNPs revealed 12 SNPs with high T2DM risk compatibility. <em>TCF7L2</em> gene exhibited a strong compatibility with an overall OR of 1.44 (95% CI 1.36–1.52) and <em>S-value</em> 112.41, while <em>TCF7L2</em> variants rs7903146 and rs12255372, with OR 1.56 (95% CI 1.43–1.66) and <em>S-value</em> 89.036, OR of 1.36 (95% CI 1.17–1.35) with an <em>S</em>-<em>value</em> of 15.45 respectively.</div></div><div><h3>Interpretation</h3><div>Our study highlights the importance of considering the diverse ethnic groups of India for development of targeted and effective T2DM management strategies.</div></div><div><h3>Funding</h3><div><span>Department of Biotechnology</span> (DBT) and <span>Indian Council of Medical Research</span> (ICMR), Government of India.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100518"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908025","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":"Empowering women oncologists in India—are we there yet?","authors":"Aparna Sreevatsa ,&nbsp;Shona Nag ,&nbsp;Shabnam Bashir ,&nbsp;Bhawna Sirohi","doi":"10.1016/j.lansea.2024.100502","DOIUrl":"10.1016/j.lansea.2024.100502","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100502"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143128823","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":"Cost-effectiveness of integrated maternal HIV, syphilis, and hepatitis B screening opt-out strategies in Nepal: a modelling study","authors":"Lucie Sabin ,&nbsp;Kasim Allel ,&nbsp;Ghanshyam Gautam ,&nbsp;Naomi Saville ,&nbsp;Hassan Haghparast-Bidgoli","doi":"10.1016/j.lansea.2024.100524","DOIUrl":"10.1016/j.lansea.2024.100524","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organisation (WHO) developed a comprehensive framework encouraging an integrated approach to achieve triple elimination of vertical transmission of HIV, syphilis, and hepatitis B in Asia. Current screening practices in Nepal show significantly lower coverage for syphilis and hepatitis B compared to HIV suggesting potential for integration. In this study, we aimed to model the cost-effectiveness of triple screening during antenatal care in Nepal.</div></div><div><h3>Methods</h3><div>We modelled maternal HIV, hepatitis B, and syphilis cascade of care and their corresponding disease states using disease-specific Markov models over a 20-year horizon with a cycle length of one year. We compared dual integrated screening for HIV and syphilis and triple integrated screening for HIV, syphilis, and hepatitis B with HIV screening only. Costs were estimated from a provider's perspective. Results were presented as incremental cost-effectiveness ratios (ICERs). Univariable and probabilistic sensitivity analyses were conducted.</div></div><div><h3>Findings</h3><div>Our modelling analysis showed that dual-integrated screening for HIV and syphilis was highly cost-effective when compared to current strategy of screening for HIV only (ICERs of US$18). Triple-integrated antenatal screening for HIV, syphilis, and hepatitis B was highly cost-effective compared with dual-integrated strategy with an ICER of US$114. Moreover, 100% and 98% of the probabilistic sensitivity analysis estimates for dual- and triple-integrated screening were proven cost-effective, compared to HIV-only screening.</div></div><div><h3>Interpretation</h3><div>Our results support WHO recommendations for implementing integrated triple antenatal screening in Nepal and Asia more broadly, aiming to reduce maternal and neonatal morbidity through early detection and intervention.</div></div><div><h3>Funding</h3><div>No funding was reported.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100524"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048974","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":"Transforming neonatal nursing in India: challenges, opportunities, and the way forward","authors":"Geetanjali Kalyan ,&nbsp;Poonam Joshi ,&nbsp;Lumchio Levis Murry ,&nbsp;Marsha Campbell-Yeo ,&nbsp;Surya Kant Tiwari","doi":"10.1016/j.lansea.2024.100522","DOIUrl":"10.1016/j.lansea.2024.100522","url":null,"abstract":"<div><div>Neonatal care is essential for the well-being of newborns, particularly premature or critically ill patients. Despite advancements in medical technology and evidence-based practice, India faces significant challenges in neonatal nursing, including resource limitations, inconsistent training, and inadequate policy support. This paper examines the current state of neonatal nursing in India, highlighting disparities between urban and rural areas, and comparing them to global practices. It explores systemic issues affecting neonatal care, such as inadequate educational frameworks, a shortage of trained faculty, and insufficient clinical exposure. We outline a comprehensive approach to address these challenges, including the introduction of Neonatal Nurse Practitioner programs, enhancements in specialized training, promotion of evidence-based practices, and integration of technology. We also emphasize the need for stronger policy support and increased funding to improve the neonatal care infrastructure. By adopting these recommendations, India can make significant strides towards improving neonatal outcomes and aligning itself with global health targets.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100522"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933792","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":"Methodological concerns in the ‘Economic burden of suicide deaths in India (2019)’","authors":"Anamika Pandey,&nbsp;G Anil Kumar,&nbsp;Rakhi Dandona","doi":"10.1016/j.lansea.2024.100516","DOIUrl":"10.1016/j.lansea.2024.100516","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100516"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173967","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":"Access to timely cancer treatment initiation in India: extent, determinants and trends","authors":"Pritam Halder ,&nbsp;Jyoti Dixit ,&nbsp;Nidhi Gupta ,&nbsp;Nikita Mehra ,&nbsp;Ashish Singh ,&nbsp;Pankaj Malhotra ,&nbsp;Anisha Mathew ,&nbsp;Lalit Kumar ,&nbsp;Amal Chandra Kataki ,&nbsp;Sudeep Gupta ,&nbsp;Shankar Prinja","doi":"10.1016/j.lansea.2024.100514","DOIUrl":"10.1016/j.lansea.2024.100514","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Treatment delays are significantly associated with advanced stage, poor response to treatment, increased mortality risk, poor health outcomes, increased healthcare expenditures among cancer patients. However, factors associated with these delays have not yet been robustly evaluated. In order to bridge this gap, we determined the delayed time to treatment initiation (TTI) among cancer patients in India, ascertained its determinants, and assessed the trends of delayed TTI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We analysed data collected from 6695 cancer patients seeking outpatient/daycare treatment, recruited at purposively selected seven healthcare facilities across six states of India. Data on socio-demographic and clinical characteristics including date of cancer diagnosis, date of treatment initiation, cancer site, stage and type of treatment were collected to determine the median TTI and ascertain its determinants among cancer patients in India. Time to treatment initiation was calculated as the duration (days) between diagnosis of cancer (histologically/clinically) and date of initiation of treatment. Multi-variable logistic regression was employed to analyse the relationship between the outcome variable (TTI) and each explanatory variable. A Cox Proportional Hazard (CPH) model was used to conduct time-to-event analysis, and to assess the impact of government-funded health insurance on timely cancer treatment initiation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The median (IQR) overall TTI was 20 (7–39) days, with a mean of 53.7 days (SD, 192.9). The TTI was higher for those having head and neck cancer (median TTI: 29 days, IQR: 10.5–55.5) and those receiving radiotherapy as initial treatment (27.5 days, IQR: 10–49.5). Younger patients, those educated up to graduation level and males had significantly lower odds of delayed TTI. As compared to patients who were diagnosed between 1995 and 2017, those diagnosed after 2018 had a 36% (26–46%) higher odds of timely initiation of treatment within 30 days. Upon stratifying by enrolment under PMJAY, we found that while the access for timely treatment initiation increased by 33% for those who were not enrolled, vs. 90% among those enrolled under PM-JAY. Overall, this shows significant improvement in timely initiation of cancer treatment as a result of introduction of PM-JAY.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;The study highlights the positive impact of government-funded health insurance schemes on the timely access to cancer treatment in India. Our study recommends expanding AB PM-JAY cancer packages to include cost-effective treatments, increasing population coverage under screening programs and promoting e-RUPI to reduce financial constraints associated with diagnostic services to address delayed treatment initiation due to unknown cancer stages.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;Department of Health Research, &lt;span&gt;Ministry of Health and Family Welfare&lt;/span&gt;, Ne","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100514"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11722993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973780","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":"One step forward, two steps back: urgent priorities to embed disability and queer health in medical education systems","authors":"Satendra Singh ,&nbsp;Rohin Bhatt ,&nbsp;Mohammed Ahmed Rashid","doi":"10.1016/j.lansea.2024.100515","DOIUrl":"10.1016/j.lansea.2024.100515","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"32 ","pages":"Article 100515"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857209","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}