The Lancet regional health. Southeast Asia最新文献

{"title":"Is universal depression screening cost-effective across all Indian states? Addressing parameter uncertainty","authors":"Ziyi Niu , Wenyan Tang , Jiafeng Zhang","doi":"10.1016/j.lansea.2025.100712","DOIUrl":"10.1016/j.lansea.2025.100712","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"44 ","pages":"Article 100712"},"PeriodicalIF":6.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977226","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":"Zero leprosy is within reach: eliminating leprosy in low-endemic settings demands political will","authors":"Anil Fastenau","doi":"10.1016/j.lansea.2025.100703","DOIUrl":"10.1016/j.lansea.2025.100703","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"44 ","pages":"Article 100703"},"PeriodicalIF":6.2,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690498","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":"Prevalence of hypoxemia among sick children, aged under-five years, seeking healthcare at primary health facilities in Uttar Pradesh, India: an observational-cohort study","authors":"Shally Awasthi ,&nbsp;Divas Kumar ,&nbsp;Anuj Kumar Pandey ,&nbsp;Girdhar Gopal Agarwal ,&nbsp;Anmol Jacob ,&nbsp;Kovid Sharma ,&nbsp;Monika Agarwal ,&nbsp;Hélène Langet ,&nbsp;Gaurav Kumar ,&nbsp;Gillian A. Levine ,&nbsp;Silvia Cicconi ,&nbsp;Michael Ruffo ,&nbsp;Mira Emmanuel-Fabula ,&nbsp;Fenella Beynon ,&nbsp;Fabian Schär ,&nbsp;Kaspar Wyss ,&nbsp;Valérie D'Acremont ,&nbsp;TIMCI Collaborator Group","doi":"10.1016/j.lansea.2025.100706","DOIUrl":"10.1016/j.lansea.2025.100706","url":null,"abstract":"<div><h3>Background</h3><div>Hypoxemia or low blood oxygen saturation (SpO₂) increases risk of mortality in children aged under-five years. Integrated Management of Neonatal and Childhood Illness guidelines in India recommend referral to higher centre at SpO₂ &lt;90%. The primary objective was to assess prevalence of hypoxemia among sick under-five, seeking healthcare at rural primary health facilities in Uttar Pradesh, India. Secondary objective assessed completion of referral (defined as reaching higher referral facilities) in hypoxemic children by day-7.</div></div><div><h3>Methods</h3><div>Secondary data analyses from pulse oximetry (POx) arm of a cluster randomized trial. Hypoxemia, defined as SpO₂ &lt;94%, was assessed on day-0 and completion of referral through telephonic follow-up on day-7 (+2 days). Severe hypoxemia was defined as SpO₂ &lt;90%. Registration number: CTRI/2022/03/041325.</div></div><div><h3>Findings</h3><div>From 20-June-2022 to 21-April-2023, 24,966 children were enrolled, among whom SpO₂ readings were available for 94·4% (n = 23,560) children. Prevalence of hypoxemia was 1·3% (308/23,560) and severe hypoxemia was 29·2% (90/308). Lost to follow-up among hypoxemic was 9·4% (29/308). Among hypoxemic 27·9% (86/308) and among severe hypoxemic 46·7% (42/90) children were referred. Referral completion among hypoxemic was 20·3% (16/79) and severe hypoxemic 23·8% (10/40). Mortality in hypoxemic children was 3·9% (11/279), vs 0·05% (11/20,292) in non-hypoxemic ones.</div></div><div><h3>Interpretation</h3><div>Prevalence of hypoxemia is low among sick children presenting to rural health facilities of northern India. Less than one-third of hypoxemic children (and less than half of severely hypoxemic) were referred to higher facility, and only one in five completed referrals. Therefore, identifying and addressing the factors associated with these findings, would strengthen the integration of POx in primary healthcare facilities.</div></div><div><h3>Funding</h3><div>This work is supported by Unitaid as part of the <span>Tools for Integrated Management of Childhood Illness</span> (TIMCI) project under grant number n°2019-35-TIMCI to PATH.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"43 ","pages":"Article 100706"},"PeriodicalIF":6.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790035","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":"Adapting WHO drowning prevention strategies for children in Indonesia: barriers, enablers, and policy perspectives for LMICs","authors":"Muthia Cenderadewi ,&nbsp;Richard C. Franklin ,&nbsp;Prima B. Fathana ,&nbsp;Susan G. Devine","doi":"10.1016/j.lansea.2025.100697","DOIUrl":"10.1016/j.lansea.2025.100697","url":null,"abstract":"<div><div>Drowning is among the top five causes of child mortality in some parts of Indonesia yet remains neglected in national health policy. This study explored how World Health Organization (WHO)-recommended drowning prevention strategies can be adapted in Indonesia through seven focus group discussions with 62 parents of children under five and community leaders across coastal and inland villages in West Nusa Tenggara Province. Participants identified barriers including financial constraints, rural inaccessibility, and sociocultural norms, alongside enablers such as community support for swimming lessons, supervised childcare, and first-aid training. Findings highlight the need for affordable and culturally appropriate interventions. Policy priorities include integrating swimming lessons into school curricula, subsidising community-based swimming programs, establishing supervised childcare centres, expanding first-aid training for community members as bystanders, and strengthening cross-sector coordination.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"43 ","pages":"Article 100697"},"PeriodicalIF":6.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694089","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 immunogenicity: durability, dosing, and target populations for XBB.1.5 subunit COVID-19 boosters","authors":"Jun Norkaew ,&nbsp;Chadaporn Nuchjunreed Gordon ,&nbsp;Schawanya Kaewpitoon Rattanapitoon ,&nbsp;Nathkapach Kaewpitoon Rattanapitoon","doi":"10.1016/j.lansea.2025.100674","DOIUrl":"10.1016/j.lansea.2025.100674","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"43 ","pages":"Article 100674"},"PeriodicalIF":6.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790021","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":"Methodological issue in a dental neuromelioidosis outbreak investigation—authors’ reply","authors":"Angel Miraclin Thirugnanakumar ,&nbsp;Prabu Rajkumar ,&nbsp;Karthik Gunasekaran ,&nbsp;Manickam Ponnaiah ,&nbsp;Girish Kumar Chethrapilly Purushothaman ,&nbsp;Balaji Veeraraghavan ,&nbsp;Manoj Murhekar","doi":"10.1016/j.lansea.2025.100659","DOIUrl":"10.1016/j.lansea.2025.100659","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"43 ","pages":"Article 100659"},"PeriodicalIF":6.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790022","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":"Oral health and its expanding role in systemic disease, cancer outcomes, and public health","authors":"Vaibhav Sahni,&nbsp;Abhishek Shankar","doi":"10.1016/j.lansea.2025.100627","DOIUrl":"10.1016/j.lansea.2025.100627","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"43 ","pages":"Article 100627"},"PeriodicalIF":6.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790023","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":"Strengthening WHO's South-East Asia Regional Office: from crisis to opportunity?","authors":"Swarup Sarkar ,&nbsp;Diah Saminarsih ,&nbsp;J.V.R. Prasada Rao ,&nbsp;Kent Buse","doi":"10.1016/j.lansea.2025.100684","DOIUrl":"10.1016/j.lansea.2025.100684","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"43 ","pages":"Article 100684"},"PeriodicalIF":6.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790025","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 domino effect: projecting the effects of US funding cuts to health aid in the global south","authors":"Rechel Shrisunder,&nbsp;Dwight Figueiredo","doi":"10.1016/j.lansea.2025.100700","DOIUrl":"10.1016/j.lansea.2025.100700","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"43 ","pages":"Article 100700"},"PeriodicalIF":6.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624637","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":"Comprehensive primary health care for cost-effective scale-up of depression screening in India: an economic modelling study","authors":"Neha Purohit ,&nbsp;Shubh Mohan Singh ,&nbsp;Girish N. Rao ,&nbsp;Kathirvel Soundappan ,&nbsp;Atul Kotwal ,&nbsp;Shankar Prinja","doi":"10.1016/j.lansea.2025.100701","DOIUrl":"10.1016/j.lansea.2025.100701","url":null,"abstract":"<div><h3>Background</h3><div>The Government of India envisions integrating population-based depression screening within the framework of comprehensive primary health care. This study assesses the economic impact and cost-utility of implementing universal depression screening for different age groups (≥30 years and ≥20 years) compared to the current practice of opportunistic diagnosis and management of symptomatic patients.</div></div><div><h3>Methods</h3><div>A hybrid model comprising of a decision tree and Markov model was developed for economic evaluation. The input parameters were acquired through comprehensive literature search, stakeholder consultations, analysis of the data from National Mental Health Survey, and the National Sample Survey, besides primary data collected from 259 patients for quality of life. The analysis was performed from both abridged societal (consideration of direct costs) and societal perspective (consideration of direct as well as indirect costs). In line with Indian economic evaluation standards, a screening strategy was deemed cost-effective if its incremental cost-utility ratio (ICUR) was below the per capita gross domestic product (GDP) threshold of ₹1,71,498 ($2182).</div></div><div><h3>Findings</h3><div>The gain in QALYs per person from universal screening ranged from 0·0273 (0·0265–0·0281) to 0·0295 (0·0287–0·0303), depending on the target age group. The program is expected to generate net savings of ₹291 billion ($3·7 billion) to ₹482 billion ($6·1 billion), equivalent to 0·19% to 0·32% of GDP. Furthermore, the ICURs were below the threshold, with ≥20 years aged cohort screening (₹43,995, $620) being more cost-effective than the screening in ≥30 years aged population (₹48,746, $560) from the abridged societal perspective. However, the program ceases to yield positive net health benefits if the sensitivity of the PHQ-2 decreases to 26%, or if the combined sensitivity of the sequential PHQ-2 and PHQ-9 approach falls below 35%. The intervention is likely to result in cost savings if at least 60% of patients seeking treatment after screening use public health facilities.</div></div><div><h3>Interpretation</h3><div>Integrating depression screening and management into the government primary healthcare system provides substantial public health and economic benefits, supporting the case for a PHC-oriented health system. Expanding coverage to individuals aged 20 years and above, along with ensuring high diagnostic accuracy through quality training and supportive supervision, will be key to sustaining and maximizing the programme's impact.</div></div><div><h3>Funding</h3><div>The study was supported by funding from the <span>Department of Health Research</span>, <span>Ministry of Health and Family Welfare</span>, <span>Government of India</span></div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"43 ","pages":"Article 100701"},"PeriodicalIF":6.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694091","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}