Lancet Regional Health-Americas最新文献

{"title":"Clarifying methods and interpretations in law enforcement mortality surveillance: response to Kamal","authors":"Peter T. Tanksley , J.C. Barnes , J. Pete Blair , M. Hunter Martaindale","doi":"10.1016/j.lana.2025.101330","DOIUrl":"10.1016/j.lana.2025.101330","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101330"},"PeriodicalIF":7.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681433","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}

{"title":"The longitudinal effect of repetition and practice on the accuracy of lay anal examinations for detecting perianal and anal canal abnormalities: a prospective study","authors":"Alan G. Nyitray ,&nbsp;Timothy L. McAuliffe ,&nbsp;Jenna Nitkowski ,&nbsp;Cameron Liebert ,&nbsp;Michael D. Swartz ,&nbsp;Ashish A. Deshmukh ,&nbsp;Jared Kerman ,&nbsp;Ellen Almirol ,&nbsp;John A. Schneider ,&nbsp;J. Michael Wilkerson ,&nbsp;Lu-Yu Hwang ,&nbsp;Derek Smith ,&nbsp;Duo Yu ,&nbsp;Aniruddha Hazra ,&nbsp;Elizabeth Y. Chiao ,&nbsp;Prevent Anal Cancer Palpation Study Team","doi":"10.1016/j.lana.2025.101317","DOIUrl":"10.1016/j.lana.2025.101317","url":null,"abstract":"<div><h3>Background</h3><div>While anal cancer screening is now recommended in several countries for high-incidence populations, barriers impede screening uptake. It is well known that patient recognition of symptoms increases cancer screening uptake, and we previously demonstrated that patients can detect small masses at the perianus and in the anal canal. In this current analysis, we aimed to longitudinally assess the effect of repetition and practice on patient self-recognition of small masses.</div></div><div><h3>Methods</h3><div>Individuals and couples of sexual minority men and transgender women were taught to conduct an anal self-examination or anal companion examination (ASE/ACE) at visit 1 and then randomized to a practice or control condition. Six months later, at visit 2, the effect of practice and repetition of the ASE/ACE on detection of abnormalities was assessed by comparing the lay exam results to those of a clinician. Concordance, <em>κ,</em> and area under the receiver operating characteristic curves (AUC) was used to quantify the comparison.</div></div><div><h3>Findings</h3><div>Concordance between lay exam and clinician exam increased from visit 1 (73%, 524/714) to visit 2 (95%, 535/561) (<em>κ</em> = 0.87, 95% CI 0.82–0.92). Overall AUC at visit 2 was 0.93 (95% CI 0.90–0.96). Although there was no difference in concordance between the practice (95%, 267/281) and control arms (96%, 268/280) (p = 0.69), concordance increased with ASE/ACE repetition (p_trend &lt; 0.001) and was 98% (354/363) for individuals performing the ASE/ACE ≥2 times between visits. For individuals with incident abnormalities at visit 2, concordance was 100% (27/27). Results did not differ by age or HIV status. False positive and false negative results by the ASE/ACE were 2% (10/561) and 3% (16/561), respectively.</div></div><div><h3>Interpretation</h3><div>Because lay individuals can detect anal abnormalities, clinicians conducting an anal examination may suggest that the patient's own lay exams may detect early invasive anal cancer.</div></div><div><h3>Funding</h3><div><span>National Cancer Institute</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101317"},"PeriodicalIF":7.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690637","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}

{"title":"Drivers and barriers for the implementation of value-based healthcare in Latin America: a cross-country qualitative policy analysis","authors":"Michael Touchton ,&nbsp;Héctor Arreola-Ornelas ,&nbsp;Klaudia A. Arizmendi-Barrera ,&nbsp;Valentina Vargas Enciso ,&nbsp;Felicia Marie Knaul","doi":"10.1016/j.lana.2025.101307","DOIUrl":"10.1016/j.lana.2025.101307","url":null,"abstract":"<div><h3>Background</h3><div>Value-Based Healthcare (VBHC) represents a paradigm shift from the traditional fee-for-service model to a fee-for-value model, aiming to optimize patient outcomes relative to cost. This study assesses the transition to VBHC in three Latin American countries: Argentina, Brazil, and Mexico. By identifying barriers and opportunities to unlock value in these health systems, it provides recommendations for advancing VBHC across the region.</div></div><div><h3>Methods</h3><div>Multiple methods were used integrating targeted literature reviews, key informant interviews, and qualitative indicators scoring based on the Harvard High-Value Health System (HVHS) Model. Data were collected from academic and national health databases, government reports, and international health organizations. Thematic analysis was conducted to synthesize findings from the literature and interviews, while qualitative indicators were assessed using the HVHS Model.</div></div><div><h3>Findings</h3><div>Brazil and Mexico have made progress in adopting VBHC principles, particularly in digital health and integrated care models. Brazil's Health Value Score (HVS) pilot and the Adequate Childbirth Project are key initiatives demonstrating the potential for improving patient outcomes and resource allocation. Mexico's Telemedicine Program has improved access to specialized care in remote areas. However, both countries face challenges such as fragmented healthcare systems, procurement practices that undermine value, and limited data interoperability. For example, Brazil's health Ministry has yet to establish a national or regional policy on VBHC. Argentina has shown progress in digital data systems and analytics, driven by the National Strategy of Digital Health 2018–2024, but faces significant challenges in healthcare financing, outcome measurement, and performance benchmarking.</div></div><div><h3>Interpretation</h3><div>Advancing VBHC in Latin America requires comprehensive policy reforms, infrastructure investment, and collaboration among patients as well as the public, private, and non-profit sectors. Key recommendations include implementing standardized cost and outcome measurement frameworks, investing in health information technology, reforming procurement regulations to prioritize value, and providing training and support for healthcare providers. Addressing these challenges will enable the region to implement VBHC effectively, fostering more efficient, equitable, and sustainable, technologically flexible healthcare systems.</div></div><div><h3>Funding</h3><div>We acknowledge support from the U.S. Chamber of Commerce and the Global Innovation Hub.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101307"},"PeriodicalIF":7.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681414","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}

{"title":"Beyond F508del: equity as the next frontier in cystic fibrosis","authors":"Renata Wrobel Folescu Cohen ,&nbsp;Patrícia Fernandes Barreto Machado Costa ,&nbsp;Katty Anne Carvalho Marins ,&nbsp;Monica Muller Taulois ,&nbsp;Natalia Dias Barboza ,&nbsp;Célia Chaves ,&nbsp;Zilton Vasconcelos ,&nbsp;Tania Wrobel Folescu","doi":"10.1016/j.lana.2025.101328","DOIUrl":"10.1016/j.lana.2025.101328","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101328"},"PeriodicalIF":7.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690745","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}

{"title":"Brazil's successful regulation of E-cigarettes: a valuable learning opportunity for other countries","authors":"André Salem Szklo ,&nbsp;Vera da Costa e Silva","doi":"10.1016/j.lana.2025.101329","DOIUrl":"10.1016/j.lana.2025.101329","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101329"},"PeriodicalIF":7.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681434","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}

{"title":"Wealth-based inequalities in family planning and perinatal coverage among adolescent and young women: analyses of national surveys from Latin America and the Caribbean","authors":"Antonio Sanhueza ,&nbsp;Sonja Caffe ,&nbsp;Emmanuel Gonzalez-Bautista ,&nbsp;Liliana Carvajal Velez ,&nbsp;Oscar J. Mujica ,&nbsp;Luis Paulo Vidaletti ,&nbsp;Cesar G. Victora ,&nbsp;Aluisio J.D. Barros","doi":"10.1016/j.lana.2025.101318","DOIUrl":"10.1016/j.lana.2025.101318","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to describe the coverage of key family planning (FP) and perinatal health indicators and to measure the associated social inequalities among adolescent and young women in the Latin American and Caribbean (LAC) region.</div></div><div><h3>Methods</h3><div>Nationally representative data from 20 LAC countries were analyzed using Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted between 2011 and 2016. Data were disaggregated by age group (15–19 and 20–24 years). Coverage was estimated for six key indicators, including FP, antenatal care (ANC), skilled birth attendance (SBA), and postnatal care (PNC). Socioeconomic inequalities in coverage were assessed using the Slope Index of Inequality (SII) and the Concentration Index (CIX).</div></div><div><h3>Findings</h3><div>Around 2015, median national coverage exceeded 90% for most ANC and PNC indicators, except for ANC with four or more visits and FP. Among adolescents, ANC coverage ranged from 44.6% in Uruguay (95% CI: 13.6–80.4) to 99.2% in Cuba (97.9–99.7); FP coverage was lowest in Guyana (16.7%, 11.7–23.3) and Haiti (28.7%, 22.7–35.6). Significant pro-rich inequalities were observed. The widest inequalities were observed, for ANC in Panama (SII = 46.5) and Haiti (SII = 48.8); for ANC quality in Guatemala (SII = 61.1); for SBA in Panama (SII = 90.0), and for FP inequalities in Guatemala (SII = 33.0).</div></div><div><h3>Interpretation</h3><div>Adolescents and young women in LAC face persistent and unequal coverage of FP and perinatal services. These baseline findings underscore the urgent need for youth-friendly, equity-focused interventions to meet SDG targets.</div></div><div><h3>Funding</h3><div>No direct funding was received.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101318"},"PeriodicalIF":7.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681432","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}

{"title":"Neighborhood disadvantage and adolescent sleep health: a longitudinal population-based study","authors":"Li Niu ,&nbsp;Luyao Tan ,&nbsp;Angela Diaz ,&nbsp;Yunyu Xiao ,&nbsp;Yan Li ,&nbsp;Yijie Wang","doi":"10.1016/j.lana.2025.101320","DOIUrl":"10.1016/j.lana.2025.101320","url":null,"abstract":"<div><h3>Background</h3><div>Neighborhood disadvantage may adversely affect adolescent sleep health, yet causal evidence is limited and whether these effects differ by sex and pubertal development remain unclear. This study examined the potential causal effect of neighborhood disadvantage on adolescent sleep duration and variability over a two-year period.</div></div><div><h3>Methods</h3><div>This cohort study analyzed data from 5045 adolescents (mean age 9.96 years at baseline) in the Adolescent Brain Cognitive Development (ABCD) Study, a longitudinal, population-based sample in the United States. Three indicators of neighborhood disadvantage were assessed: Area Deprivation Index (ADI), air pollution, and nighttime noise, each dichotomized at the 80th percentile to indicate high exposure. Sleep outcomes were derived from Fitbit devices worn continuously for 21 days two years after baseline, including sleep duration and night-to-night variability (defined as the standard deviation of sleep duration across nights). Bayesian causal forests were used to estimate average treatment effects (ATEs) and subgroup-specific effects by sex and pubertal status. Analyses adjusted for the propensity to reside in a high-advantage neighborhood, accounting for individual and household factors including income-to-needs ratio, parental education, and race/ethnicity.</div></div><div><h3>Findings</h3><div>Adolescents living in neighborhoods with high ADI (ATE −0.11, 10th percentile: −0.18, 90th percentile: −0.05), high air pollution (ATE −0.08, −0.14 to −0.02), and high nighttime noise (ATE −0.07, −0.13 to −0.01) had shorter sleep duration two years after baseline. High ADI was also associated with greater night-to-night sleep variability (ATE 0.17, 0.10–0.23). Stratified analyses revealed that boys were more susceptible to reduced sleep duration, girls to greater sleep variability, and adolescents with more advanced pubertal status were more affected across both outcomes.</div></div><div><h3>Interpretation</h3><div>Neighborhood disadvantage has lasting adverse effects on adolescent sleep health, with differential vulnerability by sex and pubertal stage. These findings underscore the need for developmentally tailored policies and interventions that address neighborhood environments to promote healthy sleep during adolescence.</div></div><div><h3>Funding</h3><div>This study was supported by the <span>National Natural Science Foundation of China,</span> the <span>Fundamental Research Funds for the Central Universities</span>, the <span>National Institute of Mental Health</span>, and the <span>American Foundation for Suicide Prevention</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101320"},"PeriodicalIF":7.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681431","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}

{"title":"Rapid weight gain in first 2 years of life and BMI trajectories from 3 to <10 years: a population-based longitudinal study of 1.7 million Brazilian children","authors":"Carolina Santiago-Vieira ,&nbsp;Leah Li ,&nbsp;Rita de Cássia Ribeiro Silva ,&nbsp;Juliana Freitas de Mello e Silva ,&nbsp;Enny S. Paixão ,&nbsp;Maurício L. Barreto ,&nbsp;Gustavo Velasquez-Melendez","doi":"10.1016/j.lana.2025.101326","DOIUrl":"10.1016/j.lana.2025.101326","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is considered a disease with negative health impacts at all life stages. Changes in growth patterns, such as postnatal rapid weight gain (RWG), can be important predictors of growth trajectories in children. We investigated the association between RWG during the first two years of life and subsequent BMI trajectories from the age 3–to 9 years, and whether the association differed by birth weight group.</div></div><div><h3>Methods</h3><div>We used the data of a population-based cohort from the Cadastro Único (CadÚnico) of the Federal Government, the linkage of the National Live Births System (SINASC) and the National Food and Nutritional Surveillance System (SISVAN). The sample comprised 1.7 million Brazilian children aged from zero to nine years from 2008 to 2017. Mixed-effects models were used to estimate mean age-trajectories for BMI by RWG group.</div></div><div><h3>Findings</h3><div>Children who experienced RWG during the first two years of life had higher mean BMI trajectories from 3 to 9 years, compared to those who did not. The difference was seen across all birth weight groups, and was more evident for the children with high birth weight. At age 9, the BMI difference between RWG and non-RWG children was 1.31 kg/m² (boys) and 1.43 kg/m² (girls) for children with adequate birth weight, 1.27 kg/m² (boys) and 1.35 kg/m² (girls) for low birth weight, and 2.25 kg/m² (boys) and 2.86 kg/m² (girls) for macrosomia.</div></div><div><h3>Interpretation</h3><div>Children who experienced RWG during the first two years of life had higher BMI trajectories than children who did not. The finding highlighted the importance of monitoring child growth, which allows the early identification of potential growth deviations and the implementation of necessary interventions to ensure that children grow healthy and reach their full developmental potential.</div></div><div><h3>Funding</h3><div>Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—CAPES, CAPES/Print/UFBA; <span>University College London</span> (UCL); <span>National Institute for Health Research</span> (NIHR) <span>Great Ormond Street Hospital Biomedical Research Centre</span>; Fundação de Amparo à Pesquisa do Estado de Minas Gerais—FAPEMIG; <span>National Council for Scientific and Technological Development</span>—CNPq; CNPq/CGFP/DECIT/SECTICS; Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde do Ministério da Saúde; <span>Wellcome Trust</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101326"},"PeriodicalIF":7.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683868","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}

{"title":"The impact of large-scale release of Wolbachia mosquitoes on dengue incidence in Campo Grande, Brazil: an ecological study","authors":"Fabiani de Morais Batista ,&nbsp;Paloma M. Carcamo ,&nbsp;Elisabeth Nelson ,&nbsp;Antonio Brandão da Silva Neto ,&nbsp;Daniel Henrique Tsuha ,&nbsp;Veruska Lahdo ,&nbsp;Vagner Ricardo dos Santos ,&nbsp;Gabriel Sylvestre Ribeiro ,&nbsp;Renato da Silva Lopes ,&nbsp;Pilar Amadeu ,&nbsp;Marcos Vinicius Ferreira Mendes Blanco ,&nbsp;Thiago Rodrigues da Costa ,&nbsp;Karlos Diogo de Melo Chalegre ,&nbsp;Thais Irene Souza Riback ,&nbsp;Cátia Cabral da Silva ,&nbsp;Otavio T. Ranzani ,&nbsp;Derek A.T. Cummings ,&nbsp;Jason R. Andrews ,&nbsp;Albert I. Ko ,&nbsp;Matt D.T. Hitchings ,&nbsp;Julio Croda","doi":"10.1016/j.lana.2025.101327","DOIUrl":"10.1016/j.lana.2025.101327","url":null,"abstract":"<div><h3>Background</h3><div>The introduction of the <em>w</em>Mel strain of <em>Wolbachia</em> into <em>Aedes aegypti</em> mosquitoes significantly reduces dengue virus transmission. We evaluated the impact of large-scale releases of <em>Wolbachia</em>-infected <em>Ae. aegypti</em> on dengue incidence in Campo Grande, a large urban city in the Central-West region of Brazil, in the first deployment of <em>Wolbachia</em> as an official dengue-control strategy by the Brazilian federal government.</div></div><div><h3>Methods</h3><div>Mosquitoes infected with <em>w</em>Mel <em>Wolbachia</em> were released in geographically phased deployments throughout Campo Grande from December 2020 through December 2023. An ovitrap surveillance network monitored <em>Wolbachia</em> prevalence in local <em>Ae. aegypti</em> populations during and after releases. Mixed-effects negative binomial regression was used to evaluate neighborhood-level monthly notified dengue incidence (2008–2024) as a function of monthly <em>w</em>Mel exposure status, comparing fully treated (<em>w</em>Mel prevalence stably ≥60%) and partially treated (ongoing releases or <em>w</em>Mel &lt;60%) with untreated periods, accounting for seasonal variation.</div></div><div><h3>Findings</h3><div>More than 100 million <em>Wolbachia</em>-infected mosquitoes were released, achieving a post-intervention mean <em>Wolbachia</em> prevalence of 86.4% (95% CI 84.0–88.9), with 89% of intervention areas reaching stable <em>Wolbachia</em> levels ≥60%. Stable establishment of <em>w</em>Mel at ≥60% prevalence was associated with a 63.2% (95% CI 51.9–71.9) reduction in dengue incidence.</div></div><div><h3>Interpretation</h3><div>Our results demonstrate successful large-scale <em>Wolbachia</em> establishment in <em>Ae. aegypti</em> populations and a substantial epidemiological impact on dengue incidence in an urban Brazilian setting. This study provides robust evidence supporting <em>Wolbachia</em> deployment as an effective, sustainable public health intervention and validates its implementation as a federal government-supported dengue control strategy in Brazil.</div></div><div><h3>Funding</h3><div>This work was supported by the <span>Brazilian Ministry of Health</span> and the <span>Oswaldo Cruz Foundation</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101327"},"PeriodicalIF":7.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645849","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}

{"title":"Towards a Latin American neuropsychiatry: challenges and opportunities","authors":"Jesús Ramírez Bermúdez ,&nbsp;Sheila Castro-Suarez ,&nbsp;Luciana D'Alessio ,&nbsp;Jorge Holguín Lew ,&nbsp;Louise Makarem Oliveira ,&nbsp;Mônica Sanches Yassuda ,&nbsp;Hernando Santamaría-García ,&nbsp;Andrea Slachevsky ,&nbsp;William Tamayo Agudelo ,&nbsp;Julio Torales ,&nbsp;Norha Vera San Juan ,&nbsp;Vaughan Bell","doi":"10.1016/j.lana.2025.101322","DOIUrl":"10.1016/j.lana.2025.101322","url":null,"abstract":"<div><div>From the impact of armed conflict and political violence to the neuropsychiatric consequences of neglected tropical diseases, Latin America has a unique profile of region-specific risk factors that mean it is not always well-served by neuropsychiatric practice developed in high-income regions. Here, we review the region-specific neuropsychiatric characteristics of traumatic brain injury, stroke, epilepsy, dementia, functional neurological disorder, infectious diseases, environmental health risks, and substance use. Additionally, we identify structural challenges for neuropsychiatric health and suggest pathways to develop a specifically Latin American neuropsychiatry as a cross-disciplinary, multi-professional field based on practical steps to strengthen research capacity, training, clinical practice, and care delivery. Latin America should be a priority for neuropsychiatry, and we argue for a Latin American neuropsychiatry that has much to offer the region and much to contribute worldwide.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101322"},"PeriodicalIF":7.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645847","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}