The Lancet regional health. Southeast Asia最新文献

{"title":"Early health technology assessment of tongue swab for non-sputum based pulmonary tuberculosis diagnosis in Thailand","authors":"Langming Mou ,&nbsp;Teerawat Wiwatpanit ,&nbsp;Apiwat Piriyapol ,&nbsp;Puwadol Chawengkul ,&nbsp;Janjira Thaipadungpanit ,&nbsp;Puttarin Kulchaitanaroaj ,&nbsp;Yot Teerawattananon ,&nbsp;Yi Wang","doi":"10.1016/j.lansea.2025.100533","DOIUrl":"10.1016/j.lansea.2025.100533","url":null,"abstract":"<div><h3>Background</h3><div>Sputum-based diagnostic methods for pulmonary tuberculosis (PTB) are challenging for patients who cannot produce sputum. Non-sputum-based approaches, such as tongue swab (TS), can address this gap. This study conducts an early Health Technology Assessment (HTA) of TS for PTB diagnosis in Thailand.</div></div><div><h3>Methods</h3><div>We conducted a landscape review, stakeholder consultation, early health economic modeling, and established a Target Product Profile (TPP). The landscape review included a comprehensive literature analysis to identify gaps and unmet needs in PTB diagnosis in Thailand. Stakeholder consultations gathered insights from TB experts to validate the information. An early health economic model evaluated the cost-effectiveness of two innovative strategies: tongue swab with Loop-Mediated Isothermal Amplification (LAMP) and tongue swab with real-time polymerase chain reaction (RTPCR). The TPP outlines three target levels to guide innovators in designing effective clinical studies.</div></div><div><h3>Findings</h3><div>The landscape review identified the clinical workflow and reimbursement process of all PTB diagnostic tests in Thailand. The gap of tuberculosis management was around diagnosis and treatment. Stakeholders indicated that PTB detection remains inefficient due to issues such as low-test accuracy, costs, delays, drug-resistance testing, and the need for specialized laboratory techniques and personnel. TS RTPCR is the best-performing strategy, outperforming other strategies for the targeted population from the modelling analysis.</div></div><div><h3>Interpretation</h3><div>TS may serve as a viable alternative worth further exploration and development. An ongoing collaboration between early HTA researchers and innovators has identified valuable information for innovation development.</div></div><div><h3>Funding</h3><div>This work was supported by <span>Thailand Science Research and Innovation</span> (TSRI), Thailand, Grant Number <span><span>FFB670043/0401</span></span> and <span>Wellcome Trust</span> grant, Grant Number <span><span>223800/Z/21/Z</span></span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100533"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147934","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 clinical care of patients in Nipah outbreaks: moving beyond ‘compassionate use’","authors":"Md Zakiul Hassan ,&nbsp;Amanda Rojek ,&nbsp;Piero Olliaro ,&nbsp;Peter Horby","doi":"10.1016/j.lansea.2024.100527","DOIUrl":"10.1016/j.lansea.2024.100527","url":null,"abstract":"<div><div>The 2024 Nipah outbreak in Kerala, India—its fifth in six years—and the recurring annual outbreaks in Bangladesh underscore the persistent threat posed by the Nipah virus (NiV) in the region. With a high mortality rate, human-to-human transmission potential, and the widespread presence of <em>Pteropus</em> bats, the natural reservoir, NiV remains a significant epidemic threat. Despite being a WHO priority pathogen, there has been no systematic effort to improve patient care for NiVD, leading to consistently poor outcomes. Current care relies on supportive measures and the ‘compassionate use’ of unapproved drugs like ribavirin and remdesivir. Drugs used ‘off-label’ during outbreaks can become the ‘standard of care’ without robust evidence of their safety or efficacy, complicating the testing of new therapies and perpetuating uncertainty about their true effectiveness. To improve NiVD care, we propose four key strategies: 1) Enhance early case detection, 2) optimize supportive care to improve outcomes and create a standard for future trials, 3) adopt a syndromic approach centered on encephalitis, and 4) explore innovative trial designs tailored to low case numbers as an alternative to ‘compassionate use’. By integrating these strategies, healthcare systems in NiV-endemic regions will be better equipped to manage both current and future outbreaks.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100527"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048979","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":"Violence against children: what can we do?","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2025.100541","DOIUrl":"10.1016/j.lansea.2025.100541","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100541"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377599","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":"Post-vaccination campaign evaluation of systemic and mucosal immunity of trivalent oral poliovirus vaccine in Karachi, Pakistan (2020–2021): a cross-sectional study","authors":"Ali Faisal Saleem ,&nbsp;Visalakshi Jeyaseelan ,&nbsp;Zaubina Kazi ,&nbsp;Mahjabeen Zehra ,&nbsp;Muhammad Masroor Alam ,&nbsp;Grace Macklin ,&nbsp;Rocio Lopez Cavestany ,&nbsp;Sajid Muhammad ,&nbsp;Najeeb Rehman ,&nbsp;Ondrej Mach","doi":"10.1016/j.lansea.2025.100531","DOIUrl":"10.1016/j.lansea.2025.100531","url":null,"abstract":"<div><h3>Background</h3><div>The transmission of wild poliovirus (WPV1) and circulating vaccine-derived poliovirus (cVDPV) continues to be a major Public Health Emergency of International Concern. Currently, only Afghanistan and Pakistan remain polio-endemic for WPV1. In response to the co-circulation of VDPV2 with WPV1, the Technical Advisory Group of WHO had recommended two nationwide campaigns of trivalent oral poliovirus vaccine (tOPV) for children aged &lt;5 years in Pakistan in 2020. We assessed the humoral and mucosal immune responses in children who received two doses of tOPV (during vaccination campaigns) in Karachi, Pakistan.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted in four peri-urban sites (Cattle Colony, Ibrahim Hyderi, Ali Akber Shah, Rehri Goth) Karachi, Pakistan. Venous blood samples from children aged between 1 month and 5 years were obtained. Children who were acutely ill, requiring hospitalisation, with primary immunodeficiency, or with a chronic medical illness, were excluded from the study. Stool and serum testing was performed at the National Institute of Health, Pakistan. Sera samples were analysed using microneutralization assays to quantify polio antibodies for all three serotypes: type 1, 2, and 3. The stool samples collected at baseline, 7, 14, and 28 days (after each tOPV dose) were tested for the presence of poliovirus.</div></div><div><h3>Findings</h3><div>Of 285 eligible children, 225 had received both tOPV doses and provided three analysable blood samples, and 193 children provided seven viable stool samples. The seroconversion rate for type 2 was 72% (44/61, 95% CI: 59.8–81.8) after the first tOPV dose; cumulative seroconversion after two doses was 93.4% (95% CI: 84.3–97.4). Seven days after the first and second tOPV campaigns, 32.7% and 18.6% excreted Sabin (vaccine) poliovirus type 2, respectively.</div></div><div><h3>Interpretation</h3><div>The study demonstrated enhanced mucosal immunity as well as a high type 2 seroconversion rate and antibody seroprevalence after two tOPV campaigns.</div></div><div><h3>Funding</h3><div><span>WHO</span>, <span>Geneva</span>, Switzerland.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"33 ","pages":"Article 100531"},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124135","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":"Proposal for improving clinical care of patients in Nipah outbreaks","authors":"Yi Tian ,&nbsp;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":"Expression of concern—Economic burden of suicide deaths in India (2019): a retrospective, cross-sectional study [The Lancet Regional Health – Southeast Asia, Volume 29, October 2024, 100477]","authors":"The Editors for The Lancet Regional Health – Southeast Asia","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"37 ","pages":"Article 100553"},"PeriodicalIF":5.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239713","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}