Lancet Regional Health-Americas最新文献

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Perinatal health outcomes of offspring of internal migrant women according to human development index: a registry-based cohort study of over 10 million live births from Brazil

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2025-02-12 DOI: 10.1016/j.lana.2025.101020

Thiago Cerqueira-Silva , Enny S. Paixao , Ila R. Falcao , Joanna M.N. Guimarães , Laura C. Rodrigues , Alisson Baribieri , Ibrahim Ababukar , Mauricio L. Barreto , Julia M. Pescarini

Background

Migration, driven by factors like poverty, violence, and natural disasters, is a key social determinant of health. While international migrants often have worse perinatal outcomes, research on perinatal health differences between internal migrants and non-migrants remains limited. We aimed to determine whether the offspring of women who migrate within Brazil experience poorer perinatal outcomes than those of non-migrants, according to the Human Development Index (HDI) of their municipalities of origin and destination.

Methods

We used the CIDACS Birth Cohort, consisting of women applying for social programmes in the Unified Registry for Social Programmes Cadastro Único linked with live births and mortality registries. We included live births conceived from March 2010 to February 2018. Internal migrants were women who changed their state of residence from registration in CadUnico to the birth of the child. We derived risk ratios (RR) of migration's effect according to HDI of residence before and after migration using logistic regression.

Findings

We included 10,184,021 births in the study, with 5.7% of these births from women who were internal migrants. The offspring of women who migrated to municipalities with equal/higher HDI (80% of migrations), exhibited a decreased risk of preterm births (RR: 0.94, 95% CI: 0.93–0.95), low birth weight (RR: 0.94, 95% CI: 0.92–0.95) and small for gestational age (RR: 0.92, 95% CI: 0.91–0.93), but higher risk of congenital abnormalities (RR: 1.14, 95% CI: 1.10–1.18). The offspring of women who migrated to municipalities with lower HDI had delayed access to healthcare and worse outcomes except for a lower risk of low birth weight (RR: 0.94, 95% CI: 0.92–0.96).

Interpretation

Offspring of those migrating to municipalities with equal/higher HDI tend to have better perinatal outcomes, whereas migrants to lower HDIs have a similar pattern to non-migrant women.

Funding

NIHR, Wellcome Trust, Royal Society.

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引用次数: 0

Mental health impacts of air disasters: a call for a coordinated response to Brazil’s christmas tragedy

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2025-02-12 DOI: 10.1016/j.lana.2025.101016

Felipe Ornell , Juliana Nichterwitz Scherer , Daniel Prates-Baldez , Simone Hauck , Flavio Kapczinski

引用次数: 0

Time series forecasting of Valley fever infection in Maricopa County, AZ using LSTM

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2025-02-05 DOI: 10.1016/j.lana.2025.101010

Xueting Jin , Fangwu Wei , Srinivasa Srivatsav Kandala , Tejas Umesh , Kayleigh Steele , John N. Galgiani , Manfred D. Laubichler

Background

Coccidioidomycosis (CM), also known as Valley fever, is a respiratory infection. Recently, the number of confirmed cases of CM has been increasing. Precisely defining the influential factors and forecasting future infection can assist in public health messaging and treatment decisions.

Methods

We utilized Long Short-Term Memory (LSTM) networks to forecast CM cases, based on the daily pneumonia cases in Maricopa County, Arizona from 2020 to 2022. Besides weather and climate variables, we examined the impact of people's lifestyle change during COVID-19. Factors, including temperature, precipitation, wind speed, PM₁₀ and PM_2.5 concentration, drought, and stringency index, were included in LSTM networks, considering their association with CM prevalence, time-lag effect, and correlation with other factors.

Findings

LSTM can predict CM prevalence with accurate trend and low mean squared error (MSE). We also found a tradeoff between the length of the forecasting period and the performance of the forecasting model. The models with longer forecasting periods have less accurate trends over time and higher MSEs. Two models with different lengths of forecasting periods, 10 days and 30 days, are identified with good prediction.

Interpretation

LSTM algorithms, combined with traditional statistical methods, could help with the forecasting of CM cases. By predicting the CM prevalence, our results can inform researchers, epidemiologists, clinicians, and the public in order to assist public health.

Funding

“Getting to the Source of Arizona's Valley Fever Problem: A Tri-University Collaboration to Map and Characterize the Pathogen Where It Grows” funded by the Arizona Board of Regents.

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引用次数: 0

Self-care interventions for legal and safe abortions: lessons learned from a woman-centered approach to sexual and reproductive healthcare in Uruguay

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2025-02-01 DOI: 10.1016/j.lana.2024.100981

Cecilia Stapff , Lucía Gómez Garbero , Rodolfo Gómez Ponce de León , Leonel Briozzo , Antonella Lavelanet , Manjulaa Narasimhan

Problem

In the 1990s, almost 40% of maternal deaths in Uruguay were caused by unsafe abortions.

Approach

A harm reduction model implemented in Uruguay, which addressed the risks associated with unsafe abortion practices by promoting and supporting the self-management of medical abortions by women in their homes, encouraged women’s autonomy.

Local setting

Since 2005, an accelerated decrease in maternal mortality has been recorded in Uruguay, coinciding with the implementation of two major actions: a harm reduction approach with active promotion of self-care through self-management of medical abortions; and in 2012, a change in legislation, which made abortion legal within sexual and reproductive health facilities when requested by women up to 12 weeks of pregnancy or later for specific indications.

Relevant changes

This example demonstrates that progress in public policies is possible through the combined efforts of civil society, healthcare professionals and policy makers. The initiative expanded the entry points to the healthcare system while strengthening women’s autonomy.

Lessons learned

Increased access to self-care interventions for SRH contributed to advancing achievement of universal health coverage and the highest, most attainable standards of health.

Funding

The authors have no financial relationships relevant to this article to disclose.

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引用次数: 0

Is Trump again preparing a pathway for disease spread?

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2025-02-01 DOI: 10.1016/j.lana.2025.100993

Christopher David Simms

引用次数: 0

Children are family members too: can we continue to keep the door closed for them? 孩子也是家庭成员：我们能继续为他们关上大门吗？

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2025-02-01 DOI: 10.1016/j.lana.2024.100970

Bruna Brandao Barreto , Mariana Luz , Dimitri Gusmao-Flores

引用次数: 0

Decarceration and COVID-19 infections in U.S. Immigration and Customs Enforcement detention facilities: a simulation modeling study 美国移民和海关执法局拘留设施的隔离和COVID-19感染：一项模拟建模研究

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2025-02-01 DOI: 10.1016/j.lana.2024.100971

Christopher Weyant , Jaimie P. Meyer , Daniel Bromberg , Chris Beyrer , Frederick L. Altice , Jeremy D. Goldhaber-Fiebert

Background

U.S. Immigration and Customs Enforcement (ICE) facilities had high rates of COVID-19 infections and mortality during the global pandemic. We sought to quantify how many COVID-19 infections could have been averted through different decarceration strategies.

Methods

We developed a set of stochastic simulation models of SARS-CoV-2 transmission in ICE facilities. Employing incremental mixture importance sampling (IMIS), we calibrated them to empirical targets derived from publicly available case time series for ICE facilities, and publicly available facility population censuses prior to vaccine availability (May 6, 2020 to December 31, 2020). The models included infection importation from extra-facility sources. We evaluated reduction of the incarcerated population by 10–90%. People who were decarcerated faced background cumulative risks of infection and detection based on a weighted average of county-level estimates from the covidestim model, which is a Bayesian evidence synthesis model.

Findings

Without decarceration, the infection rate was 5.05 per 1000 person-days (95% CrI 3.40–6.81) and case rate was 1.53 per 1000 person-days (95% CrI 1.04–2.02). Rates declined linearly when decarceration did not reduce contacts of people remaining in facilities and faster than linearly when it did reduce contacts. At all decarceration levels, rates were substantially higher when contacts were not reduced. Even with 90% decarceration, infection rates for people remaining in facilities were higher than or comparable to otherwise similar free-living people.

Interpretation

The decline in COVID-19 infection rates with decarceration was linear or faster than linear depending on how decarceration was implemented. Our findings highlight infection risks associated with incarceration, which compound other health harms of incarceration.

Funding

Stanford’s COVID-19 Emergency Response Fund; the National Institute on Drug Abuse; and the National Institute of Mental Health.

背景：在全球大流行期间，美国移民和海关执法局（ICE）设施的COVID-19感染率和死亡率很高。我们试图量化通过不同的去碳化策略可以避免多少COVID-19感染。方法：建立ICE设施中SARS-CoV-2传播的随机模拟模型。采用增量混合重要性抽样（IMIS），我们将其校准为来自ICE设施公开可用病例时间序列的经验目标，以及疫苗可用前（2020年5月6日至2020年12月31日）公开可用的设施人口普查。这些模型包括从设施外来源输入的感染。我们评估了监禁人口减少10-90%的情况。根据新冠肺炎模型（贝叶斯证据综合模型）对县级估计的加权平均值，被隔离的人面临感染和检测的背景累积风险。结果：未脱碳时，感染率为5.05 / 1000人天（95% CrI 3.40-6.81），病例率为1.53 / 1000人天（95% CrI 1.04-2.02）。当去隔离没有减少留在设施中的人的接触时，发病率呈线性下降，而当去隔离减少接触时，发病率呈线性下降。在所有的脱焦水平上，当接触没有减少时，脱焦率要高得多。即使有90%的脱碳率，留在设施中的人的感染率也高于或与其他类似的自由生活的人相当。解释：根据去碳化的实施方式，去碳化后COVID-19感染率的下降是线性的或快于线性的。我们的研究结果强调了与监禁相关的感染风险，这与监禁的其他健康危害相结合。资助：斯坦福大学COVID-19应急基金；国家药物滥用研究所；以及国家心理健康研究所

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Bridging the gap of cardiovascular disease burden in the Americas: a call for action

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2025-02-01 DOI: 10.1016/j.lana.2025.101023

Daniel Diaz , Diana Z. Velazquez-Valdez , Pavel E. Hernandez-Carreño , Saul A. Beltran-Ontiveros , Edgar L. Gonzalez-Gonzalez , Lina S. Palacio-Mejia

引用次数: 0

Venous thromboembolism (VTE) prevention program implementation in a community oncology practice: author response to Yang et al

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2025-02-01 DOI: 10.1016/j.lana.2024.100980

Steven Ades, Chris Holmes

引用次数: 0

Los Angeles County in flames: responsibilities on fire

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2025-02-01 DOI: 10.1016/j.lana.2025.101005

Orison O. Woolcott

引用次数: 0

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