The Lancet regional health. Southeast Asia最新文献

{"title":"Advancing acute MI care in densely populated low- and middle-income countries (LMICs): innovative stand-alone chest pain units for expedited triage and timely management","authors":"Nadeem Qamar,&nbsp;Jawaid A. Sial,&nbsp;Tahir Sagir,&nbsp;Zair Hussain,&nbsp;Ali Zain Shah,&nbsp;Kamran Khan,&nbsp;Jehangir Ali Shah,&nbsp;Musa Karim,&nbsp;Shueeta Kumari,&nbsp;Sohail Khan,&nbsp;Sabha Bhatti,&nbsp;Abdul Hakeem","doi":"10.1016/j.lansea.2024.100488","DOIUrl":"10.1016/j.lansea.2024.100488","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of myocardial infarction (MI) and its adverse effects on health and mortality remain high in densely populated low- and middle-income countries (LMICs). To address the issue of densely populated areas and timely access to primary PCI, chest pain units (CPUs) were deployed at strategic locations in Karachi, with a populace of over 23 million people. This study describes the results of this initiative in expediting MI care.</div></div><div><h3>Methods</h3><div>Between 2017 and 2023, 18 CPUs, each with a cardiologist, technician, ECG machine, crash cart and an ambulance were placed in high density areas.</div></div><div><h3>Findings</h3><div>A total of 915,564 patients were seen at 18 CPUs over the study period. 692,444 (75.6%) were categorized as non-cardiac and subsequently discharged. 223,120 (24.6%) patients were directed for additional care. Of these, 9% had ST elevation myocardial infarction (STEMI) (19, 580), 29% NSTE ACS/Unstable angina, and 31% with various other cardiac conditions. Additionally, 31% were referred for medical outpatient evaluation. CPU inception led to a significant annual growth (16–20%) in primary PCI procedures at NICVD, totaling 20,000 by 2022–2023. The median first medical contact to device time was 100 min (IQR 80–135), while total ischemic was 232 min (IQR: 172–315; 5th −95th %le: 50–920). The overall in-hospital mortality rate for patients undergoing primary PCI was 5.58%, with a range between 5.1% and 6.9% through the study period.</div></div><div><h3>Interpretation</h3><div>Novel standalone chest pain units, operational from 2017 in Karachi, Pakistan, have expedited triage and enhanced the timely management of AMI. This initiative's transformative impact presents a model that resonates beyond borders, serving as a role model for global healthcare systems.</div></div><div><h3>Funding</h3><div>The CPU and primary PCI program is fully funded by the <span>government of Sindh</span>. No specific funding was allocated for this study.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"30 ","pages":"Article 100488"},"PeriodicalIF":5.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356869","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":"Bangladesh should engage the private sector for malaria elimination by 2030","authors":"Ryan Patrick McArdle ,&nbsp;Ching Swe Phru ,&nbsp;Mohammad Sharif Hossain ,&nbsp;Mohammad Shafiul Alam ,&nbsp;Kasturi Haldar","doi":"10.1016/j.lansea.2024.100487","DOIUrl":"10.1016/j.lansea.2024.100487","url":null,"abstract":"<div><div>Bangladesh reduced malaria incidence by 93% from 2008 to 2020 through the action of governmental and non-governmental organizations. The Bangladesh context is unique to South Asia because its successful public sector malaria control programs have historically not engaged corporate partners (as undertaken in Sri Lanka and proposed in India). However, ∼18 million people continue to live at risk of infection in Bangladesh and for-profit private healthcare providers, catalytic for malaria elimination in many countries, are expected to benefit the national program. We distilled (from a large and complex literature) nine distinct strategies important in other developing settings and weighed them in the context of Bangladesh's flourishing private health care sector, driven by patient demand, self-interest and aspirations for public good, as well as heterogeneity in providers and malaria-prevalence. We propose a new model dependent on five strategies and its immediate deployment considerations in high endemic areas, to empower Bangladesh's phased agenda of eliminating indigenous malaria transmission by 2030.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"31 ","pages":"Article 100487"},"PeriodicalIF":5.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142326993","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":"Implementing the Robson Classification for caesarean sections in Pakistan: experience, challenges, and lessons learned","authors":"Lubna Hassan ,&nbsp;Ana Pilar Betran ,&nbsp;Lauren Woodbury ,&nbsp;Qudsia Uzma ,&nbsp;Karima Gholbzouri ,&nbsp;Ellen Thom ,&nbsp;Tahira Ezra Reza","doi":"10.1016/j.lansea.2024.100479","DOIUrl":"10.1016/j.lansea.2024.100479","url":null,"abstract":"<div><div>The Robson Classification System is recognised as a first step for optimising the use of caesarean section and as a strategy for continuous quality improvement in maternal and newborn health. This Viewpoint provides a detailed account of the strategy adopted and lessons learned from a collaborative initiative to institutionalise the Robson Classification into Pakistan's health system. We developed a training package which emphasised capacity building of senior clinicians to act as master trainers. We also developed a mobile application for data collection and analysis. Training workshops took place in 2020 in a selection of public sector, tertiary-level, teaching hospitals from across the country and data was collected on all births in participating hospitals' obstetric units for a full year. Pakistan is poised for scale-up with the Robson Classification embedded in 57% of Pakistan's public, tertiary, teaching hospitals. A core group of master trainers is positioned in every province, and a robust dataset is available. However, integration into any health system cannot be thought of as a finite project. It requires government commitment, training and an ongoing process with built-in data quality assurance and feedback to clinicians.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"30 ","pages":"Article 100479"},"PeriodicalIF":5.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328036","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":"Reimagining India's National Telemedicine Service to improve access to care","authors":"Biswanath Ghosh Dastidar ,&nbsp;Anant R. Jani ,&nbsp;Shailesh Suri ,&nbsp;Vikranth Harthikote Nagaraja","doi":"10.1016/j.lansea.2024.100480","DOIUrl":"10.1016/j.lansea.2024.100480","url":null,"abstract":"<div><p>India's free-to-use National Telemedicine Service, eSanjeevani, has provided over 276 million consultations and shown promise to reduce systemic inequalities in access to care. However, recent reports of dropping footfall have raised questions about the potential of eSanjeevani to bridge service provision gaps in India. We reveal important problems linked to the design and practice of triage and tele-referral nationally within eSanjeevani, corroborated by the experience of one of the co-authors’ practice of Obstetrics and Gynaecology on the platform since 2022. Some of these factors include sub-optimal integration of general practitioners within the tele-referral pathway; inadequate training of health-workers leading to inappropriate and ineffective consultations; outdated or absent technological support; the absence of mechanisms for re-referrals; and lack of feedback loops. We propose measures to re-imagine eSanjeevani to become a more effective tool towards improving public health outcomes and achieving universal health coverage in India.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"30 ","pages":"Article 100480"},"PeriodicalIF":5.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001306/pdfft?md5=35274016ca1b13b1b87df940e8e28716&pid=1-s2.0-S2772368224001306-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240442","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":"Evolving dengue serotype distribution with dominance of dengue virus- 3 in Bangalore: critical insights for vaccine efficacy and implementation","authors":"Shruthi Uppoor ,&nbsp;Tina Damodar ,&nbsp;Lonika Lodha ,&nbsp;Madhusudhan Huluvadi Nagarajaiah ,&nbsp;Reeta S. Mani","doi":"10.1016/j.lansea.2024.100485","DOIUrl":"10.1016/j.lansea.2024.100485","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"30 ","pages":"Article 100485"},"PeriodicalIF":5.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001355/pdfft?md5=55f00a94c524bac853fa80a3597d27ee&pid=1-s2.0-S2772368224001355-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232710","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":"Thailand – how far are we from achieving a healthy and sustainable diet? A longitudinal ecological study","authors":"Alice Beckmann ,&nbsp;Carola Strassner ,&nbsp;Karunee Kwanbunjan","doi":"10.1016/j.lansea.2024.100478","DOIUrl":"10.1016/j.lansea.2024.100478","url":null,"abstract":"<div><h3>Background</h3><p>Newly industrialized countries like Thailand have been influenced by globalization, westernization, and urbanization over the last decades, leading to changes in dietary habits as well as food production. Consequences of these changes include rising non-communicable diseases (NCDs) and environmental degradation, which are defined as the leading global challenges today. The objectives of this study are to identify Thailand's dietary changes, considering health and sustainability aspects, and to determine correlations between these changes and NCD cases as well as environmental impacts (GHG emissions, land-, nitrogen-, phosphorus-use). In this way, diet-related adjustments can be identified to promote planetary and human health.</p></div><div><h3>Methods</h3><p>In this longitudinal ecological study, relative differences between the average food consumption in Thailand and the reference values of a healthy and sustainable diet, the Planetary Health Diet (PHD), were calculated. Furthermore, a bivariate correlation analysis was conducted, using data, based on Food and Agriculture Organization's (FAO's) data, results from the Global Burden of Disease Study (GBD), and PHD's reference values.</p></div><div><h3>Findings</h3><p>The consumption quantities of meat, eggs, saturated oils, and sugar increased significantly since 1961. The food groups, that have exceeded PHD's upper reference values, include sugar (+452%), red meat (+220%), grains (+143%), saturated oils (+20%) and eggs (+19%), while vegetables (–63%), and unsaturated oils (–61%) have fallen below PHD’s lower limits. Concerning the bivariate correlation analyses, all investigated variables show significant correlations. The most significant correlations were found in NCD cases (r = 0.903, 95% CI 0.804–0.953), nitrogen use (r = 0.872, 95% CI 0.794–0.922), and land use (r = 0.870, 95% CI 0.791–0.921), followed by phosphorus use (r = 0.832, 95% CI 0.733–0.897), and green-house gas (GHG) emissions (r = 0.479, 95% CI 0.15–0.712).</p></div><div><h3>Interpretation</h3><p>The results show, that the determined differences of unhealthy or unsustainable food groups have increased concurrently with NCD cases and environmental impacts over the last decades in Thailand. A shift towards a reduced intake of sugar, red meat, grains, saturated oils and eggs along with an increase in vegetables and unsaturated oils, might support environmental and human health.</p></div><div><h3>Funding</h3><p>None.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"29 ","pages":"Article 100478"},"PeriodicalIF":5.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001288/pdfft?md5=863d76851f59511c7fdabb427637cdbf&pid=1-s2.0-S2772368224001288-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228959","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":"Learning from the Indian National Family Health Survey to assess population based oral, cervix and breast cancer screening in low-and-middle income countries","authors":"Kakoli Borkotoky ,&nbsp;Lucky Singh ,&nbsp;Prashant Kumar Singh ,&nbsp;Shalini Singh","doi":"10.1016/j.lansea.2024.100483","DOIUrl":"10.1016/j.lansea.2024.100483","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"30 ","pages":"Article 100483"},"PeriodicalIF":5.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001331/pdfft?md5=eb0fc5792e768b2d38fc19c56bafa58b&pid=1-s2.0-S2772368224001331-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230441","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":"177Lu-PSMA-617 for metastatic prostate cancer in India","authors":"Aruni Ghose ,&nbsp;Soirindhri Banerjee ,&nbsp;Partha S. Choudhury ,&nbsp;Akash Maniam ,&nbsp;Manoj Gupta ,&nbsp;Giuseppe L. Banna ,&nbsp;Nikhil Vasdev ,&nbsp;Amit Ghose ,&nbsp;Vanita Noronha ,&nbsp;Swarupa Mitra","doi":"10.1016/j.lansea.2024.100484","DOIUrl":"10.1016/j.lansea.2024.100484","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"30 ","pages":"Article 100484"},"PeriodicalIF":5.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001343/pdfft?md5=79ebe0cbbeba4ae054e8756e59d949f4&pid=1-s2.0-S2772368224001343-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172464","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":"Anthropometric indices in predicting 10-year cardiovascular risk among males and females aged 40–74 years in south and southeast Asia: analysis of 12 WHO STEPS survey data","authors":"Md Tauhidul Islam ,&nbsp;Anika Tasneem Chowdhury ,&nbsp;Md Shahjahan Siraj ,&nbsp;Abu Yousuf Md Abdullah ,&nbsp;Tapas Mazumder ,&nbsp;Mercedes Trask ,&nbsp;Mohammad Radwanur Talukder ,&nbsp;Syed Moshfiqur Rahman","doi":"10.1016/j.lansea.2024.100481","DOIUrl":"10.1016/j.lansea.2024.100481","url":null,"abstract":"<div><h3>Background</h3><p>The relevance of anthropometric indices in predicting cardiovascular disease (CVD) or CVD risk factors is established across different countries, particularly in the high-income countries. However, past studies severely lacked representation from the south and southeast Asian countries. The main aim of this study was to determine the performance of conventional and new anthropometric indices to best predict 10-year cardiovascular disease (CVD) risk in south Asian and southeast Asian populations.</p></div><div><h3>Methods</h3><p>The present study examined data from 14,532 participants in three south Asian and 13,846 participants (all aged between 40 and 74 years) in six southeast Asian countries, drawn from twelve cross-sectional studies (WHO STEPwise approaches to NCD risk factor surveillance [STEPS] survey data from 2008 to 2019). A Predictive performance of ten anthropometric indices were examined for predicting 10-year CVD risk ≥ 10% (CVD-R ≥ 10%). The 10-year CVD-R ≥ 10% was calculated by utilising the WHO CVD risk non-laboratory-based charts. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal anthropometric index.</p></div><div><h3>Findings</h3><p>Among the ten anthropometric indices, a body shape index (ABSI), body adiposity index (BAI), body roundness index (BRI), hip index (HI), and waist-height ratio (WHtR) performed best in predicting 10-year CVD risk among south Asian males and females. Improved performances were found for ABSI, BRI, conicity index (CI), WHtR, and waist-hip ratio (WHR) for 10-year CVD-R ≥ 10% predictions among southeast Asian males. Contrastingly, among southeast Asian females, ABSI and CI demonstrated optimal performance in predicting 10-year CVD-R ≥ 10%.</p></div><div><h3>Interpretation</h3><p>The performance of anthropometric indices in predicting CVD risk varies across countries. ABSI, BAI, BRI, HI, and WHtR showed better predictions in south Asians, whereas ABSI, BRI, CI, WHtR, and WHR displayed enhanced predictions in southeast Asians.</p></div><div><h3>Funding</h3><p>None.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"29 ","pages":"Article 100481"},"PeriodicalIF":5.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001318/pdfft?md5=d218fee105d08df194888f8292dc4b64&pid=1-s2.0-S2772368224001318-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172017","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":"Economic burden of suicide deaths in India (2019): a retrospective, cross-sectional study","authors":"Anukrati Nigam ,&nbsp;Madhurima Vuddemarry ,&nbsp;Siddhesh Zadey","doi":"10.1016/j.lansea.2024.100477","DOIUrl":"10.1016/j.lansea.2024.100477","url":null,"abstract":"<div><h3>Background</h3><p>India has the highest number of suicide deaths in the world. Suicide prevention requires policy attention and resource allocation. Evidence of economic losses due to disease burden can influence such allocations. We assessed the economic burden and its distribution across states and demographic groups in India.</p></div><div><h3>Methods</h3><p>We used the human capital approach in this retrospective cross-sectional analysis to assess the economic burden of suicide in India for the year 2019 for 28 Indian states and 3 union territories (UTs). We calculated the monetary value for the years of life lost disaggregated by states, age groups, and sexes. For sensitivity, we present a library of estimates using different discount rates, life expectancy thresholds, and estimates specific to the populations that can participate in the workforce.</p></div><div><h3>Findings</h3><p>The national economic burden of suicide was US$ 16,749,079,455 (95% Uncertainty Interval: 11,913,034,910–22,404,233,468). The top three states, Karnataka, Tamil Nadu, and Maharashtra, contributed to 44.82% of the total burden in India. The age group 20–34 years had the largest suicide burden and contributed to 53.05% of the overall national economic burden (US$ 8,885,436,385 [6,493,912,818–11,694,138,884]). Twenty states and UTs had a greater economic burden for females than males.</p></div><div><h3>Interpretation</h3><p>The current analysis ascertains a high economic burden of suicide among the Indian youth and females, necessitating concerted multisectoral efforts and immediate investments.</p></div><div><h3>Funding</h3><p>None.</p></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"29 ","pages":"Article 100477"},"PeriodicalIF":5.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772368224001276/pdfft?md5=f3f420bf992727bc720efd9e7e068098&pid=1-s2.0-S2772368224001276-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172021","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}