Pub Date : 2024-10-28DOI: 10.1016/j.lana.2024.100925
Hugo Perazzo, Estevão Portela Nunes, Sandra W. Cardoso, Valdilea G. Veloso, Beatriz Grinsztejn
Evidence is lacking on alignment of current guidance from the Region of the Americas (AMR) countries with the new guidelines for people with hepatitis B virus (HBV) infection published by the World Health Organization (WHO) in March 2024. We gathered the most updated guidance on HBV infection from organisations/societies and seven countries from AMR. Most guidelines were aligned with the new WHO recommendation to treat persons with elevated ALT and HBV-DNA levels ≥2,000 IU/ml or with HIV-coinfection, hepatocellular carcinoma family history, extra-hepatic manifestations, or immunosuppression. The new WHO 2024 guidelines introduced treatment for persistently abnormal ALT in the absence of HBV-DNA, with TDF and/or entecavir as first-line therapy. TDF in pregnant women with high HBV-DNA levels was recommended to prevent mother-to-child transmission (MTCT). These guidelines advised prophylaxis to pregnant women with positive HBsAg where HBV-DNA is unavailable. WHO 2024 and updated guidelines from most AMR countries had simplified and expanded criteria for HBV treatment and MTCT prevention.
美洲地区（AMR）国家的现行指南与世界卫生组织（WHO）于 2024 年 3 月发布的乙型肝炎病毒（HBV）感染者新指南的一致性缺乏证据。我们收集了美洲地区七个国家的组织/协会提供的有关 HBV 感染的最新指南。大多数指南都与世卫组织的新建议保持一致，即对谷丙转氨酶（ALT）升高、HBV-DNA 水平≥2,000 IU/ml 或合并 HIV 感染、肝细胞癌家族史、肝外表现或免疫抑制的患者进行治疗。世卫组织 2024 年新指南引入了对无 HBV DNA 的 ALT 持续异常的治疗，将 TDF 和/或恩替卡韦作为一线疗法。建议对 HBV DNA 水平较高的孕妇使用 TDF，以预防母婴传播（MTCT）。这些指南建议，在没有 HBV-DNA 的情况下，对 HBsAg 阳性的孕妇进行预防治疗。世卫组织 2024 年指导方针和大多数 AMR 国家更新的指导方针简化并扩大了 HBV 治疗和母婴传播预防的标准。
{"title":"Alignment of countries in the Americas with the latest WHO guidelines for hepatitis B virus (HBV) infection: a review","authors":"Hugo Perazzo, Estevão Portela Nunes, Sandra W. Cardoso, Valdilea G. Veloso, Beatriz Grinsztejn","doi":"10.1016/j.lana.2024.100925","DOIUrl":"10.1016/j.lana.2024.100925","url":null,"abstract":"<div><div>Evidence is lacking on alignment of current guidance from the Region of the Americas (AMR) countries with the new guidelines for people with hepatitis B virus (HBV) infection published by the World Health Organization (WHO) in March 2024. We gathered the most updated guidance on HBV infection from organisations/societies and seven countries from AMR. Most guidelines were aligned with the new WHO recommendation to treat persons with elevated ALT and HBV-DNA levels ≥2,000 IU/ml or with HIV-coinfection, hepatocellular carcinoma family history, extra-hepatic manifestations, or immunosuppression. The new WHO 2024 guidelines introduced treatment for persistently abnormal ALT in the absence of HBV-DNA, with TDF and/or entecavir as first-line therapy. TDF in pregnant women with high HBV-DNA levels was recommended to prevent mother-to-child transmission (MTCT). These guidelines advised prophylaxis to pregnant women with positive HBsAg where HBV-DNA is unavailable. WHO 2024 and updated guidelines from most AMR countries had simplified and expanded criteria for HBV treatment and MTCT prevention.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100925"},"PeriodicalIF":7.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533674","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}
Pub Date : 2024-10-24DOI: 10.1016/j.lana.2024.100914
Romina Fakhraei , Deshayne B. Fell , Darine El-Chaâr , Nisha Thampi , Beate Sander , Kevin Antoine Brown , Natasha Crowcroft , Shelly Bolotin , Jon Barrett , Elizabeth K. Darling , Nahuel Fittipaldi , Theresa Lamagni , Allison McGeer , Michelle Murti , Manish Sadarangani , Kevin L. Schwartz , Abdool Yasseen , Matthew Tunis , William Petrcich , Kumanan Wilson
Background
Group B Streptococcus (GBS) significantly contributes to neonatal sepsis and meningitis, with varying disease rates reported globally and limited population-based data. We estimated infant GBS disease burden in Ontario, Canada and assessed the association of maternal GBS screening (35–37 weeks' gestation) and intrapartum antibiotic prophylaxis (IAP) provision with infant disease rates.
Methods
Our population-based cohort study included pregnant individuals and their offspring from April 2012 to March 2018, utilising the provincial birth registry linked to health administrative data. GBS cases were ascertained through culture results and diagnostic codes. We calculated incidence rates for early-onset disease (EOD: 0–6 days), late-onset disease (LOD: 7–89 days), and ultra-LOD (ULOD: 90–365 days). Adjusted incidence rate ratios (aIRR) were derived via log-binomial regression to compare infant GBS rates according to screening and IAP-receipt.
Findings
Among 776,148 liveborn infants, we identified 803 with GBS, with multiples exhibiting a threefold incidence increase. Incidence rates of EOD, LOD and ULOD were 0.49, 0.46 and 0.07 per 1000 livebirths, respectively. Of eligible pregnancies, 94% were screened; 23% screened positive, and 81% of them received IAP. Nearly 12% of term EOD infants had mothers who missed IAP despite screening positive. Maternal screening was associated with lower rates of any infant GBS disease (aIRR: 0.60; 95% CI: 0.45, 0.80). Among screen-positive births, IAP-receipt was associated with reduced rates of EOD (aIRR: 0.72, 95% CI: 0.48, 1.29) and LOD/ULOD (aIRR: 0.69; 95% CI: 0.46, 1.05), but confidence intervals included 1.0.
Interpretation
Our study, the largest Canadian investigation into infant GBS disease, highlights both widespread adoption and ongoing challenges of the current prevention strategy.
{"title":"Burden of infant group B Streptococcus disease and impact of maternal screening and antibiotic prophylaxis in Ontario, Canada: a population-based cohort study","authors":"Romina Fakhraei , Deshayne B. Fell , Darine El-Chaâr , Nisha Thampi , Beate Sander , Kevin Antoine Brown , Natasha Crowcroft , Shelly Bolotin , Jon Barrett , Elizabeth K. Darling , Nahuel Fittipaldi , Theresa Lamagni , Allison McGeer , Michelle Murti , Manish Sadarangani , Kevin L. Schwartz , Abdool Yasseen , Matthew Tunis , William Petrcich , Kumanan Wilson","doi":"10.1016/j.lana.2024.100914","DOIUrl":"10.1016/j.lana.2024.100914","url":null,"abstract":"<div><h3>Background</h3><div>Group B <em>Streptococcus</em> (GBS) significantly contributes to neonatal sepsis and meningitis, with varying disease rates reported globally and limited population-based data. We estimated infant GBS disease burden in Ontario, Canada and assessed the association of maternal GBS screening (35–37 weeks' gestation) and intrapartum antibiotic prophylaxis (IAP) provision with infant disease rates.</div></div><div><h3>Methods</h3><div>Our population-based cohort study included pregnant individuals and their offspring from April 2012 to March 2018, utilising the provincial birth registry linked to health administrative data. GBS cases were ascertained through culture results and diagnostic codes. We calculated incidence rates for early-onset disease (EOD: 0–6 days), late-onset disease (LOD: 7–89 days), and ultra-LOD (ULOD: 90–365 days). Adjusted incidence rate ratios (aIRR) were derived via log-binomial regression to compare infant GBS rates according to screening and IAP-receipt.</div></div><div><h3>Findings</h3><div>Among 776,148 liveborn infants, we identified 803 with GBS, with multiples exhibiting a threefold incidence increase. Incidence rates of EOD, LOD and ULOD were 0.49, 0.46 and 0.07 per 1000 livebirths, respectively. Of eligible pregnancies, 94% were screened; 23% screened positive, and 81% of them received IAP. Nearly 12% of term EOD infants had mothers who missed IAP despite screening positive. Maternal screening was associated with lower rates of any infant GBS disease (aIRR: 0.60; 95% CI: 0.45, 0.80). Among screen-positive births, IAP-receipt was associated with reduced rates of EOD (aIRR: 0.72, 95% CI: 0.48, 1.29) and LOD/ULOD (aIRR: 0.69; 95% CI: 0.46, 1.05), but confidence intervals included 1.0.</div></div><div><h3>Interpretation</h3><div>Our study, the largest Canadian investigation into infant GBS disease, highlights both widespread adoption and ongoing challenges of the current prevention strategy.</div></div><div><h3>Funding</h3><div><span>Canadian Institutes of Health Research</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100914"},"PeriodicalIF":7.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533672","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}
Pub Date : 2024-10-24DOI: 10.1016/j.lana.2024.100909
Chad K. Porter , Charmagne G. Beckett , Elizabeth Cooper , Lindsey White , David Wallace , Silvia Jakubski , David Boulifard , Megan Schilling , Peifang Sun , Jan Marayag , Amethyst Marrone , Edgar O. Nunez-Hernandez , Sindhu Vangeti , Clare Miller , Yongchao Ge , Irene Ramos , Carl Goforth , Stuart C. Sealfon , Andrew G. Letizia
Background
Long-term SARS-CoV-2 adverse health outcomes are of significant concern, especially among young adults with the potential for the greatest long-term morbidity. We sought to assess and characterize these outcomes in a cohort of Marines.
Methods
We used a cohort of US Marines from a previous longitudinal, prospective observational study of acute SARS-CoV-2, most of whom were enrolled prior to infection. A panel study was established to assess for post-acute sequelae of COVID-19 (PASC), defined as symptoms at least 4 weeks after symptom onset or diagnosis. Symptoms were assessed through questionnaires and validated quality of health metrics. Periodic US Marine Corps fitness testing metrics provided an additional standardized functional assessment and were compared to a pre-pandemic cohort.
Findings
Globally dispersed Marine participants (n = 899) seen an average of 330 days following initial enrollment were predominately male (n = 825, 91.7%), White (n = 613, 71.6%) or Black (n = 149, 17.4%) with a median age of 18 years (interquartile range: 18–19). Among 798 SARS-CoV-2 infected participants, 197 (24.7%) developed PASC. The most prevalent symptoms were loss of taste and/or smell (n = 82; 41.6%), shortness of breath (n = 74; 37.6%), and cough (n = 45; 22.8%). Those with PASC had higher rates and severity of somatic (p < 0.0001), general depressive (p < 0.0001), and anxiety (p = 0.005) symptoms. Compared to a historic cohort of Marines, participants with PASC scored worse on their physical fitness assessments due to slower run times (p = 0.002). Those with PASC continued to have decreased physical performance one year after completing initial training.
Interpretation
In this population of healthy young adult US Marines with mostly either asymptomatic or mild acute COVID-19, one fourth reported physical, cognitive, or psychiatric long-term sequelae of infection. The Marines affected with PASC showed evidence of long-term decrease in functional performance suggesting that SARS-CoV-2 infection may negatively affect health for a significant proportion of young adults.
Funding
Defense Health Agency and Defense Advanced Research Projects Agency.
{"title":"Clinical and functional assessment of SARS-CoV-2 sequelae among young marines – a panel study","authors":"Chad K. Porter , Charmagne G. Beckett , Elizabeth Cooper , Lindsey White , David Wallace , Silvia Jakubski , David Boulifard , Megan Schilling , Peifang Sun , Jan Marayag , Amethyst Marrone , Edgar O. Nunez-Hernandez , Sindhu Vangeti , Clare Miller , Yongchao Ge , Irene Ramos , Carl Goforth , Stuart C. Sealfon , Andrew G. Letizia","doi":"10.1016/j.lana.2024.100909","DOIUrl":"10.1016/j.lana.2024.100909","url":null,"abstract":"<div><h3>Background</h3><div>Long-term SARS-CoV-2 adverse health outcomes are of significant concern, especially among young adults with the potential for the greatest long-term morbidity. We sought to assess and characterize these outcomes in a cohort of Marines.</div></div><div><h3>Methods</h3><div>We used a cohort of US Marines from a previous longitudinal, prospective observational study of acute SARS-CoV-2, most of whom were enrolled prior to infection. A panel study was established to assess for post-acute sequelae of COVID-19 (PASC), defined as symptoms at least 4 weeks after symptom onset or diagnosis. Symptoms were assessed through questionnaires and validated quality of health metrics. Periodic US Marine Corps fitness testing metrics provided an additional standardized functional assessment and were compared to a pre-pandemic cohort.</div></div><div><h3>Findings</h3><div>Globally dispersed Marine participants (n = 899) seen an average of 330 days following initial enrollment were predominately male (n = 825, 91.7%), White (n = 613, 71.6%) or Black (n = 149, 17.4%) with a median age of 18 years (interquartile range: 18–19). Among 798 SARS-CoV-2 infected participants, 197 (24.7%) developed PASC. The most prevalent symptoms were loss of taste and/or smell (n = 82; 41.6%), shortness of breath (n = 74; 37.6%), and cough (n = 45; 22.8%). Those with PASC had higher rates and severity of somatic (p < 0.0001), general depressive (p < 0.0001), and anxiety (p = 0.005) symptoms. Compared to a historic cohort of Marines, participants with PASC scored worse on their physical fitness assessments due to slower run times (p = 0.002). Those with PASC continued to have decreased physical performance one year after completing initial training.</div></div><div><h3>Interpretation</h3><div>In this population of healthy young adult US Marines with mostly either asymptomatic or mild acute COVID-19, one fourth reported physical, cognitive, or psychiatric long-term sequelae of infection. The Marines affected with PASC showed evidence of long-term decrease in functional performance suggesting that SARS-CoV-2 infection may negatively affect health for a significant proportion of young adults.</div></div><div><h3>Funding</h3><div><span>Defense Health Agency</span> and <span>Defense Advanced Research</span> Projects Agency.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100909"},"PeriodicalIF":7.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533671","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}
Pub Date : 2024-10-23DOI: 10.1016/j.lana.2024.100922
Carlos Dornels Freire de Souza , Rodrigo Feliciano do Carmo
{"title":"Elimination of lymphatic filariasis in Brazil: a public health milestone for citizenship","authors":"Carlos Dornels Freire de Souza , Rodrigo Feliciano do Carmo","doi":"10.1016/j.lana.2024.100922","DOIUrl":"10.1016/j.lana.2024.100922","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100922"},"PeriodicalIF":7.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533668","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}
Pub Date : 2024-10-23DOI: 10.1016/j.lana.2024.100923
Daniela Laranja Gomes Rodrigues , Gisele Silvestre Belber , Frederica Valle de Queiroz Padilha , Lucas Bassolli de Oliveira Alves , Álvaro Avezum , Marcos Aurélio Maeyama , Alexsandra Vitti , Greta Barriquel Pompermaier , Tanise Balvedi Damas , Mariana Selbach Selbach Otero , Raquel Souza de Aguiar , Renata Almeida de Andrade , Ligia Fonseca Spinel , Ana Paula Neves Marques Pinho , Haliton Alves de Oliveira Junior
Background
This study addresses the rising burden of type 2 diabetes mellitus, and explores the potential of teleconsultation, as an alternative for diabetes management. The primary objective was to test the hypothesis that teleconsultation is non-inferior to face-to-face consultation in terms of glycaemic control measured as glycated haemoglobin (HbA1c) (non-inferiority margin for the upper confidence interval for the difference between groups of 0,5% in HbA1c) for type 2 diabetes mellitus patients referred from Primary Healthcare to Specialized Care within the SUS.
Methods
TELECONSULTA, is a randomized, pragmatic, phase 2, single-centre, open-label, non-inferiority trial conducted in Joinville, Brazil. A total of 278 participants diagnosed with type 2 diabetes were randomized through mandatory teleconsulting services from primary care health units. The randomization was 1:1 to teleconsultation or face to face consultation. The study was registered at the Brazilian Clinical Trial Register—REBEC, under the code RBR-8gpgyd. Study status is “Completed”.
Findings
This study included 278 participants in the intention-to-treat (ITT) analysis. The median age was 61 (54–68) years, 167 (60%) were women. The between-groups comparative average reduction in HbA1c was −0.6% (90% CI −1.0; −0.1) at 3-months and −0.5% (90% CI −0.9; 0.0) at 6-months in Modified Intention-to-Treat (mITT) population with imputed data, showing the non-inferiority of teleconsultation. Results with no missing data imputation and in the per protocol population were similar. The frequency of hypoglycaemia and other adverse events was well balanced between groups.
Interpretation
The results underscore the transformative potential of telemedicine in addressing the complexities of diabetes management within the framework of a universal healthcare system, contributing with valuable insights for healthcare policymakers and practitioners seeking innovative solutions to tackle the growing diabetes epidemic.
Funding
This study was funded by the Brazilian Ministry of Health, through the Unified Health System–Institutional Development Support Program (PROADI-SUS).
{"title":"Teleconsultation on patients with type 2 diabetes in the Brazilian public health system: a randomised, pragmatic, open-label, phase 2, non-inferiority trial (TELECONSULTA diabetes trial)","authors":"Daniela Laranja Gomes Rodrigues , Gisele Silvestre Belber , Frederica Valle de Queiroz Padilha , Lucas Bassolli de Oliveira Alves , Álvaro Avezum , Marcos Aurélio Maeyama , Alexsandra Vitti , Greta Barriquel Pompermaier , Tanise Balvedi Damas , Mariana Selbach Selbach Otero , Raquel Souza de Aguiar , Renata Almeida de Andrade , Ligia Fonseca Spinel , Ana Paula Neves Marques Pinho , Haliton Alves de Oliveira Junior","doi":"10.1016/j.lana.2024.100923","DOIUrl":"10.1016/j.lana.2024.100923","url":null,"abstract":"<div><h3>Background</h3><div>This study addresses the rising burden of type 2 diabetes mellitus, and explores the potential of teleconsultation, as an alternative for diabetes management. The primary objective was to test the hypothesis that teleconsultation is non-inferior to face-to-face consultation in terms of glycaemic control measured as glycated haemoglobin (HbA1c) (non-inferiority margin for the upper confidence interval for the difference between groups of 0,5% in HbA1c) for type 2 diabetes mellitus patients referred from Primary Healthcare to Specialized Care within the SUS.</div></div><div><h3>Methods</h3><div>TELECONSULTA, is a randomized, pragmatic, phase 2, single-centre, open-label, non-inferiority trial conducted in Joinville, Brazil. A total of 278 participants diagnosed with type 2 diabetes were randomized through mandatory teleconsulting services from primary care health units. The randomization was 1:1 to teleconsultation or face to face consultation. The study was registered at the Brazilian Clinical Trial Register—REBEC, under the code RBR-8gpgyd. Study status is “Completed”.</div></div><div><h3>Findings</h3><div>This study included 278 participants in the intention-to-treat (ITT) analysis. The median age was 61 (54–68) years, 167 (60%) were women. The between-groups comparative average reduction in HbA1c was −0.6% (90% CI −1.0; −0.1) at 3-months and −0.5% (90% CI −0.9; 0.0) at 6-months in Modified Intention-to-Treat (mITT) population with imputed data, showing the non-inferiority of teleconsultation. Results with no missing data imputation and in the per protocol population were similar. The frequency of hypoglycaemia and other adverse events was well balanced between groups.</div></div><div><h3>Interpretation</h3><div>The results underscore the transformative potential of telemedicine in addressing the complexities of diabetes management within the framework of a universal healthcare system, contributing with valuable insights for healthcare policymakers and practitioners seeking innovative solutions to tackle the growing diabetes epidemic.</div></div><div><h3>Funding</h3><div>This study was funded by the <span>Brazilian Ministry of Health</span>, through the <span>Unified Health System</span>–<span>Institutional Development Support Program</span> (PROADI-SUS).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100923"},"PeriodicalIF":7.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533673","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}
Pub Date : 2024-10-23DOI: 10.1016/j.lana.2024.100928
Joshua E. Lane , Yisong Geng
{"title":"Active shooters and gun-free zones: emotional versus legal motivations","authors":"Joshua E. Lane , Yisong Geng","doi":"10.1016/j.lana.2024.100928","DOIUrl":"10.1016/j.lana.2024.100928","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100928"},"PeriodicalIF":7.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533669","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}
Pub Date : 2024-10-23DOI: 10.1016/j.lana.2024.100912
Malia Duffy , Robyn Churchill , Lily P. Kak , Maura Reap , Jerome T. Galea , Kathleen O'Donnell Burrows , Jennifer Yourkavitch
{"title":"Strengthening perinatal mental health is a requirement to reduce maternal and newborn mortality","authors":"Malia Duffy , Robyn Churchill , Lily P. Kak , Maura Reap , Jerome T. Galea , Kathleen O'Donnell Burrows , Jennifer Yourkavitch","doi":"10.1016/j.lana.2024.100912","DOIUrl":"10.1016/j.lana.2024.100912","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100912"},"PeriodicalIF":7.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533675","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}
Pub Date : 2024-10-23DOI: 10.1016/j.lana.2024.100930
Attila J. Hertelendy , Gregory R. Ciottone
{"title":"Averting flood-related deaths and injuries from hurricanes: enhancing hospital resilience","authors":"Attila J. Hertelendy , Gregory R. Ciottone","doi":"10.1016/j.lana.2024.100930","DOIUrl":"10.1016/j.lana.2024.100930","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"40 ","pages":"Article 100930"},"PeriodicalIF":7.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527490","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}
Pub Date : 2024-10-23DOI: 10.1016/j.lana.2024.100920
Gary Joseph , Charles C. Branas , Sandra Rupnarain , Monica Riutort , Christopher N. Morrison
Background
Intimate partner violence (IPV) against women is a global health issue and a breach of human rights. However, the literature lacks understanding of how socioeconomic and geographic disparities influence women's attitudes toward IPV in Guyana over time. This study aimed to assess trends in women's attitudes about IPV in Guyana.
Methods
Data from three nationally representative surveys from 2009, 2014 to 2019 were analysed. The prevalence of women's attitudes about IPV was assessed, specifically in response to going out without telling their partners, neglecting their children, arguing with their partner, refusing sex with their partner, or burning food prepared for family meals. A series of stratified subgroup analyses were also completed. We assessed trends in IPV using the slope index of inequality (SII) and the concentration index of inequality (CIX). We used multilevel mixed-effects logistic regression to assess factors associated with women's attitudes justifying IPV.
Findings
The prevalence of women's attitudes justifying IPV for any of the five reasons declined from 16.4% (95% CI: 15.1–17.8) in 2009 to 10.8% (95% CI: 9.7–12.0) in 2019. Marked geographic and socioeconomic inequalities were observed among subgroups. The SII for any of the five reasons decreased from −20.02 to −14.28, while the CIX remained constant over time. Key factors associated with women's attitudes about IPV were area of residence, sex of the household head, marital status, respondent's level of education, wealth index quintile, and the frequency of reading newspapers/magazines.
Interpretation
From 2009 to 2019, Guyana was able to reduce women's attitudes justifying IPV against women by 34.1% and shortened subgroup inequalities. However, the prevalence remained high in 2019, with persisted inequalities among subgroups. Effective strategies, including the use of media to raise awareness, promotion of community-based approaches, and educational campaigns focusing on geographic and socioeconomic disparities, are essential for continuing to reduce the prevalence of IPV and associated inequalities.
Funding
The study was funded in part by the National Institutes of Health, Fogarty International Center grant number D43TW012189.
{"title":"Women's attitudes towards intimate partner violence in Guyana: a population-based study","authors":"Gary Joseph , Charles C. Branas , Sandra Rupnarain , Monica Riutort , Christopher N. Morrison","doi":"10.1016/j.lana.2024.100920","DOIUrl":"10.1016/j.lana.2024.100920","url":null,"abstract":"<div><h3>Background</h3><div>Intimate partner violence (IPV) against women is a global health issue and a breach of human rights. However, the literature lacks understanding of how socioeconomic and geographic disparities influence women's attitudes toward IPV in Guyana over time. This study aimed to assess trends in women's attitudes about IPV in Guyana.</div></div><div><h3>Methods</h3><div>Data from three nationally representative surveys from 2009, 2014 to 2019 were analysed. The prevalence of women's attitudes about IPV was assessed, specifically in response to going out without telling their partners, neglecting their children, arguing with their partner, refusing sex with their partner, or burning food prepared for family meals. A series of stratified subgroup analyses were also completed. We assessed trends in IPV using the slope index of inequality (SII) and the concentration index of inequality (CIX). We used multilevel mixed-effects logistic regression to assess factors associated with women's attitudes justifying IPV.</div></div><div><h3>Findings</h3><div>The prevalence of women's attitudes justifying IPV for any of the five reasons declined from 16.4% (95% CI: 15.1–17.8) in 2009 to 10.8% (95% CI: 9.7–12.0) in 2019. Marked geographic and socioeconomic inequalities were observed among subgroups. The SII for any of the five reasons decreased from −20.02 to −14.28, while the CIX remained constant over time. Key factors associated with women's attitudes about IPV were area of residence, sex of the household head, marital status, respondent's level of education, wealth index quintile, and the frequency of reading newspapers/magazines.</div></div><div><h3>Interpretation</h3><div>From 2009 to 2019, Guyana was able to reduce women's attitudes justifying IPV against women by 34.1% and shortened subgroup inequalities. However, the prevalence remained high in 2019, with persisted inequalities among subgroups. Effective strategies, including the use of media to raise awareness, promotion of community-based approaches, and educational campaigns focusing on geographic and socioeconomic disparities, are essential for continuing to reduce the prevalence of IPV and associated inequalities.</div></div><div><h3>Funding</h3><div>The study was funded in part by the <span>National Institutes of Health</span>, <span>Fogarty International Center</span> grant number <span><span>D43TW012189</span></span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"39 ","pages":"Article 100920"},"PeriodicalIF":7.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533670","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号