Lancet Global Health最新文献

{"title":"Enhancing medical oxygen security in Ethiopia: a model for global health.","authors":"Mekdes Daba Feyssa, Mebratu Massebo Cherinet, Elubabor Buno Teko, Ashenafi Beza Wasse","doi":"10.1016/S2214-109X(24)00529-1","DOIUrl":"10.1016/S2214-109X(24)00529-1","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e401-e402"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investing in local capacity and grassroots innovation to bridge gaps in medical oxygen access and security.","authors":"Millicent Alooh, Gerald Paul Douglas, Tadesse Waktola Gamessa, Phoebe Nelima Khagame, June Kazira Madete, Varun Manhas, Timothy Mayamiko Mtonga, Shri Lak Nanjan Chandran, Zerihun Ketema Tadesse","doi":"10.1016/S2214-109X(24)00484-4","DOIUrl":"10.1016/S2214-109X(24)00484-4","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e399-e400"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Glob Health 2025; 13: e112-20.","authors":"","doi":"10.1016/S2214-109X(25)00044-0","DOIUrl":"10.1016/S2214-109X(25)00044-0","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e421"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mpox vaccination strategies in DR Congo.","authors":"Oyelola A Adegboye, Andrew M Adamu, Adeshina I Adekunle, Theophilus I Emeto, Anyebe B Onoja, Paul F Horwood","doi":"10.1016/S2214-109X(25)00005-1","DOIUrl":"https://doi.org/10.1016/S2214-109X(25)00005-1","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e416"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mpox vaccination strategies in DR Congo.","authors":"Elisabeth Paul, Garrett W Brown, Samuel Lwamushi Makali, Valéry Ridde, David Bell","doi":"10.1016/S2214-109X(25)00047-6","DOIUrl":"https://doi.org/10.1016/S2214-109X(25)00047-6","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e417"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomedical engineers are crucial for effective health-care systems.","authors":"Mambidzeni Madzivire, Millicent Alooh, Lucio Flavio de Magalhães Brito, Tazeen Bukhari, Nitesh Kumar Jangir, Robert Neighbour, Robert Ssekitoleko, Z Maria Oden","doi":"10.1016/S2214-109X(24)00510-2","DOIUrl":"10.1016/S2214-109X(24)00510-2","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e396-e398"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident type 2 diabetes and its risk factors in men and women aged 40-60 years from four sub-Saharan African countries: results from the AWI-Gen study.","authors":"Raylton P Chikwati, Nigel J Crowther, Michèle Ramsay, Lisa K Micklesfield, Shane A Norris, Kagiso P Seakamela, Engelbert A Nonterah, Godfred Agongo, Shukri F Mohamed, Isaac Kisiangani, Palwende R Boua, Alisha N Wade","doi":"10.1016/S2214-109X(24)00520-5","DOIUrl":"https://doi.org/10.1016/S2214-109X(24)00520-5","url":null,"abstract":"<p><strong>Background: </strong>The incidence of type 2 diabetes in sub-Saharan Africa is expected to increase, but few longitudinal studies have characterised its risk factors. This study aimed to determine the incidence of type 2 diabetes over 33 481 person-years and identify its principal risk factors in middle-aged adults (ie, those aged 40-60 years) from four sub-Saharan African countries.</p><p><strong>Methods: </strong>Longitudinal data were available from 6553 participants aged 40-60 years at baseline from study centres in South Africa, Kenya, Ghana, and Burkina Faso. Sociodemographic, behavioural, clinical, and biochemical data were collected at baseline and after an interval of 5-6 years. The prevalence of type 2 diabetes was determined at each timepoint and diabetes incidence was calculated. A two-stage individual participant data meta-analysis was used to identify baseline risk factors for incident diabetes.</p><p><strong>Findings: </strong>The overall incidence of type 2 diabetes was 14·6 (95% CI 13·4-16·0) cases per 1000 person-years. The incidence was highest in South Africa with 21·8 (19·5-24·4) cases per 1000 person-years, and lowest in west Africa with 5·5 (4·4-6·9) cases per 1000 person-years. Baseline glucose (adjusted odds ratio 1·37; 95% CI 1·16-1·42), being male (1·32; 1·12-1·54), family history of type 2 diabetes (1·22; 1·01-1·46), unemployment (1·19; 1·03-1·37), hypertension (1·21; 1·01-1·45), BMI (1·03; 1·02-1·04), and waist circumference (1·02; 1·01-1·03), were associated with a higher risk of incident type 2 diabetes, while adequate baseline physical activity (0·87; 0·76-1·00) was associated with lower risk.</p><p><strong>Interpretation: </strong>The high incidence of type 2 diabetes in this middle-aged sub-Saharan Africa population is influenced by several modifiable risk factors that should inform interventions to mitigate the disease burden.</p><p><strong>Funding: </strong>National Institutes of Health, Department of Science and Innovation (South Africa), and the South African Medical Research Council.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e459-e466"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical oxygen: a necessity or a luxury in humanitarian settings?","authors":"Aurélie Godard, Revati Phalkey, Susan Shepherd, Sara Rossi, Mesfin Teklu Tessema, James S Lee","doi":"10.1016/S2214-109X(24)00509-6","DOIUrl":"10.1016/S2214-109X(24)00509-6","url":null,"abstract":"","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":" ","pages":"e392-e393"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of advanced HIV disease in sub-Saharan Africa: a multi-country analysis of nationally representative household surveys.","authors":"Dominik Stelzle, Ajay Rangaraj, Joseph N Jarvis, Nirina H Razakasoa, George Perrin, Daniel Low-Beer, Meg Doherty, Nathan Ford, Shona Dalal","doi":"10.1016/S2214-109X(24)00538-2","DOIUrl":"10.1016/S2214-109X(24)00538-2","url":null,"abstract":"<p><strong>Background: </strong>Advanced HIV disease (AHD) is a critical stage in the progression of HIV infection and is associated with heightened susceptibility to opportunistic infections, malignancies, and other life-threatening complications. Estimates of the burden of AHD in sub-Saharan Africa are scarce but are needed for programme planning which includes the allocation of resources and the monitoring of outcomes. The aim of the study was to assess the prevalence of and the number of people living with HIV with AHD.</p><p><strong>Methods: </strong>In this nationally representative study, we analysed data from 13 Population-based HIV Impact Assessment (PHIA) household surveys conducted between 2016 and 2021 to determine the proportion of adults living with HIV who have AHD (defined as CD4 count <200 cells per mm³). We analysed the prevalence of AHD by various demographic and socioeconomic factors; we then estimated the number of individuals with AHD in sub-Saharan Africa by combining these proportions with the latest UNAIDS HIV estimates for the region by the treatment and care cascade. We also assessed policies related to the provision of the recommended package of care for the diagnosis and management of AHD.</p><p><strong>Findings: </strong>A total of 28 040 people living with HIV were included in this study from 13 PHIA surveys. 19 364 were females (weighted percentage 64·5%) and 8676 (35·5%) were males, and the median age of participants was 38 years (IQR 30-47). Pooled across the 13 countries, 9·8% (95% CI 9·3-10·3) had a CD4 cell count of less than 200 cells per mm³. AHD was more common among males than females (13·2% vs 8·0%) and differed across the treatment cascade: 15·4% among people living with HIV who did not know their HIV status, 20·9% among people who knew their status but were not on antiretroviral treatment (ART), 29·5% among people who were on ART but not virally suppressed, and 4·3% among people who were virally suppressed. Extrapolating these results to sub-Saharan Africa yielded an estimated 1·88 million people living with AHD (uncertainty interval [UI] 1·58-2·20); 920 000 (UI 770 000-1·07 million) females and 970 000 (UI 810 000-1·13 million) males.</p><p><strong>Interpretation: </strong>Despite advances in ART that have transformed HIV into a manageable chronic condition, a substantial number of people continue to develop AHD. These figures highlight the need for urgent and innovative programmatic improvements in monitoring, prevention, testing, and diagnosis of AHD in the context of well-established and maturing ART programmes.</p><p><strong>Funding: </strong>None.</p>","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e437-e446"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of serious health-related suffering from 1990 to 2021: an update to The Lancet Commission on global access to palliative care and pain relief.","authors":"Felicia M Knaul, Héctor Arreola-Ornelas, Xiaoxiao J Kwete, Afsan Bhadelia, William E Rosa, Michael Touchton, Oscar Méndez-Carniado, Valentina Vargas Enciso, Tania Pastrana, Joseph R Friedman, Stephen R Connor, Julia Downing, Dean T Jamison, Eric L Krakauer, David Watkins, Renzo Calderon-Anyosa, Rodrigo Garcia-Santisteban, Renu S Nargund, Jim Cleary, Liliana De Lima, Nahla Gafer, Liz Grant, Christian Ntizimira, Pedro E Pérez-Cruz, M R Rajagopal, Dingle Spence, Paul Vila, Lukas Radbruch","doi":"10.1016/S2214-109X(24)00476-5","DOIUrl":"10.1016/S2214-109X(24)00476-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The Lancet Commission on global access to palliative care and pain relief introduced the concept of serious health-related suffering (SHS) to measure the worldwide dearth of palliative care. This Article provides an extended analysis of SHS from 1990 to 2021 and the corresponding global palliative care need.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This Article is the first to apply the SHS 2·0 method published in 2024, incorporating prevalence data from the Global Burden of Diseases, Injuries, and Risk Factors Study to improve non-decedent estimates that account for country-level epidemiological variation; adjusting for non-decedent double counting of HIV/AIDS, cancer, cerebrovascular disease, and dementia; improving the non-decedent estimates for cancer using survivorship data from the Global Cancer Observatory and for HIV/AIDS incorporating access to antiretroviral therapy; differentiating by sex; considering more specific age groups allowing for better estimates, especially in children; and adding endocrine, metabolic, blood, and immune disorders to the health conditions causing SHS. We describe SHS trends globally and within country income groups, differentiating among decedents and non-decedents, by health conditions, sex, and across child and adult age groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The SHS global burden increased by 74% between 1990 and 2021 to almost 73·5 million individuals, with population growth accounting for only half of that increase. Low-income and middle-income countries (LMICs) accounted for 80% of SHS, with an increase of 83% from 1990 to 2021 compared with a 46% increase in high-income countries (HICs). Between 1990 and 2021, the decedent burden increased by 35%, whereas SHS in non-decedents more than doubled, accounting for 63% of SHS by 2021. The proportion of SHS from communicable diseases declined, especially in LMICs; however, the absolute number stayed relatively stable and even increased from 2019 to 2021 with the start of the COVID-19 pandemic. SHS from non-communicable diseases drastically increased, led by cancer (excluding leukaemia), cardiovascular diseases, and dementia in HICs. HIV/AIDS continued to be a major contributor, accounting for a substantial share of SHS in sub-Saharan Africa. The share of SHS in children decreased from 25% of SHS in 1990 to 14% in 2021 and accounted for 33% of SHS in low-income countries, compared with 2% in HICs. In 2021, SHS in low-income countries was concentrated in female individuals aged 20-49 years (affecting 59% of this population); in HICs, SHS was concentrated in female individuals aged 70 years and older (affecting 54% of this population and probably related to dementia).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;SHS and the associated need for palliative care is a major and persistent but not insurmountable challenge for health systems worldwide. Our findings highlight the urgency to both reduce the avoidable SHS burden through prevention and t","PeriodicalId":48783,"journal":{"name":"Lancet Global Health","volume":"13 3","pages":"e422-e436"},"PeriodicalIF":19.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}