The Lancet regional health. Southeast Asia最新文献

{"title":"Invasive mould infections of the central nervous system in the Indian population: a cohort study (2004–2025)","authors":"Harsimran Kaur ,&nbsp;Shivaprakash M. Rudramurthy ,&nbsp;Rimjhim Kanaujia ,&nbsp;Haseen Ahmad ,&nbsp;Pravin Salunke ,&nbsp;Deepak Bansal ,&nbsp;Kirti Gupta ,&nbsp;Debajyoti Chatterjee ,&nbsp;Chirag Kamal Ahuja ,&nbsp;Aastha Takkar Kapila ,&nbsp;Manish Modi ,&nbsp;Sandeep Mohindra ,&nbsp;Rajesh Chhabra ,&nbsp;Madhivanan Karthigeyan ,&nbsp;Harpreet Singh ,&nbsp;Apinderpreet Singh ,&nbsp;Ashish Agarwal ,&nbsp;Sanjay Verma ,&nbsp;Sunil Kumar Gupta ,&nbsp;Sanjay Jain ,&nbsp;Arunaloke Chakrabarti","doi":"10.1016/j.lansea.2026.100736","DOIUrl":"10.1016/j.lansea.2026.100736","url":null,"abstract":"<div><h3>Background</h3><div>Central nervous system (CNS) invasive mould infection (IMI) is a rare but life-threatening condition. Limited large-scale studies hinder the understanding of its clinical characteristics and optimal management strategies.</div></div><div><h3>Methods</h3><div>This was a cohort study. We reviewed confirmed patients of CNS IMI (January 2004–March 2025) by microbiological (direct microscopy and/or culture) and/or histopathological evidence at our tertiary care hospital. Clinical, demographic and mycological characteristics were analysed and compared.</div></div><div><h3>Findings</h3><div>Among 1321 brain abscess/biopsy samples, 127 patients (9.6%) were of fungal origin (adults, 100; paediatrics, 27). The median age was 30 (IQR: 27) years, with male predominance (71.7%). Adults were significantly infected by melanized fungi (p = 0.003). Seventy-four percent of patients had no identifiable underlying immunocompromising condition. The median duration of symptoms was 15 days (IQR: 23 days), including headache (61.4%) and seizures (50.4%). Frequency of fever was significantly higher in infection by melanized fungi (p = 0.02). Frontal lobe involvement was common in paediatric age (OR 0.379, 95% CI 0.141–1.019; p = 0.05). <em>Aspergillus</em> spp. (56.3%) and <em>Cladophialophora bantiana</em> (21.36%) were the predominant pathogens. <em>Deniquelata barringtoniae</em> was reported as a human pathogen. Voriconazole (61.4%) and liposomal amphotericin B (28.3%) were the primary antifungals used. Surgical intervention was performed in all patients. Partial excision (66.7% vs 38.0%, OR 0.306, 95% CI 0.125–0.751; p = 0.01) and use of liposomal amphotericin B (55.6% vs 21%, OR 0.213, 95% CI 0.087–0.522 p = 0.001) were common in paediatric patients. The overall mortality was 30.7%, complete excision was significantly more frequent among survivors than non-survivors (67.0% vs 30.8%; OR 0.218, 95% CI 0.097–0.492; p = 0.001). Lack of headache (p = 0.044) and partial excision surgery (p = 0.001) were independently associated with poor outcome.</div></div><div><h3>Interpretation</h3><div>We describe a compendium of CNS IMI in patients from India, highlighting distinct clinical patterns and treatment outcomes across age groups and fungal types. This warrants investigation of host and pathogen-related factors in the country.</div></div><div><h3>Funding</h3><div>Funding included <span>Department of Science and Technology-Science and Engineering Research Board</span> (DST-SERB), New Delhi, India and <span>Indian Council of Medical Research</span> (ICMR), New Delhi, India.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"46 ","pages":"Article 100736"},"PeriodicalIF":6.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147424302","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":"TB far from elimination: an enduring reality in the southeast Asia region","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2026.100750","DOIUrl":"10.1016/j.lansea.2026.100750","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"46 ","pages":"Article 100750"},"PeriodicalIF":6.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147449623","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":"“Universal health coverage and priority diseases diagnostics: a case study of Essential Package of Health Services from Pakistan”","authors":"Mohammad Zeeshan ,&nbsp;Sadia Shakoor ,&nbsp;Amna Rehana Siddiqui ,&nbsp;Rumina Hasan","doi":"10.1016/j.lansea.2026.100719","DOIUrl":"10.1016/j.lansea.2026.100719","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"45 ","pages":"Article 100719"},"PeriodicalIF":6.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145993551","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":"Burden of subclinical coronary atherosclerosis among asymptomatic adults: the REACH–Rural India Study","authors":"Avinash Kumar Raghupathy ,&nbsp;Mohanraj Sundaresan ,&nbsp;Pudhiavan Arun ,&nbsp;Dharam J. Kumbhani ,&nbsp;Manoj Kumar Baskar ,&nbsp;Haritha Thambi ,&nbsp;Parthasarathy Ayothi ,&nbsp;Karthika Durairaj ,&nbsp;Samrat Ashok Vasudevan ,&nbsp;Srinidhi Narayani Seenivasan ,&nbsp;Buvaneswari Gajendran ,&nbsp;Gowdham Manivel ,&nbsp;Gowri Subramaniam ,&nbsp;Madhavi Sambandam ,&nbsp;Velmurugan Ganesan ,&nbsp;Balakumaran Jeyakumaran ,&nbsp;Jeevithan Shanmugam ,&nbsp;Krishnan Swaminathan ,&nbsp;Arulraj Ramakrishnan ,&nbsp;Mathew Cherian ,&nbsp;Thomas Alexander","doi":"10.1016/j.lansea.2026.100726","DOIUrl":"10.1016/j.lansea.2026.100726","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery calcification (CAC) serves as a robust marker of subclinical atherosclerosis and an independent predictor of cardiovascular disease (CVD). Despite its clinical significance, population-based evidence on CAC prevalence and its determinants in rural India remains limited. This study aimed to estimate the prevalence of CAC and evaluate its association with cardiometabolic risk factors among adults aged 35–65 years in a rural Indian population.</div></div><div><h3>Methods</h3><div>A total of 3006 individuals aged 35–65 years were selected and invited to participate in the REACH (Risk Evaluation of Subclinical Coronary Health)–Rural India Study. From 2022 to 2024, the study enrolled asymptomatic adults with no history of cardiovascular events from rural communities in the Coimbatore and Tirupur districts of Tamil Nadu, India. Data collection included sociodemographic and clinical profiling, laboratory testing, and carotid intima-media thickness (cIMT). CAC was quantified using the Agatston scoring method from dual-source CT scans.</div></div><div><h3>Findings</h3><div>In total 2961 participants included in the final analysis (mean age 49.8 ± 8.3 years; 52.8% women), the overall prevalence of coronary artery calcification (CAC) was 25.6%. Prevalence was significantly higher in men (33.5%) than in women (18.5%) (p &lt; 0.001). The prevalence of severe CAC (Agatston score &gt;400) was threefold higher in men and most common in those aged 56–65 years. However, no detectable CAC was observed among women aged 35–45 years. The distribution of CAC scores was as follows: 7.0% had minimal CAC (1–10), 11.4% mild (11–100), 5.2% moderate (101–400), and 1.9% severe (&gt;400). Multivariable logistic regression showed that diabetes, hypertension, overweight/obesity, and abnormal CIMT were independently associated with CAC. Among men, current smoking was also significantly associated (OR = 1.51; 95% CI: 1.18–1.93). In total, 83.5% of individuals with CAC had one or more cardiovascular risk factors. No significant associations were observed between CAC and elevated creatinine, reduced eGFR and peripheral artery disease (PAD) after full adjustment.</div></div><div><h3>Interpretation</h3><div>This study reveals a substantial burden of CAC in a rural Indian population, with prevalence patterns comparable to urban cohorts in Western countries. The findings underscore the need to incorporate CAC screening in individuals with metabolic risk factors, especially in underserved populations, to identify early subclinical atherosclerosis and reduce CVD risk.</div></div><div><h3>Funding</h3><div><span>Indian Council of Medical Research</span> (ICMR), (REF No. 5/4/1-9/2020-NCD-1).</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"45 ","pages":"Article 100726"},"PeriodicalIF":6.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230109","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":"Long-term sequelae and functional outcomes in the largest cohort of Nipah virus survivors in Bangladesh","authors":"Wasik Rahman Aquib ,&nbsp;Utpal K. Mondal ,&nbsp;Arifa Nazneen ,&nbsp;Dewan Imtiaz Rahman ,&nbsp;Shadman Sakib Choudhury ,&nbsp;Tonmoy Sarkar ,&nbsp;Smita Sarker ,&nbsp;S.M. Zafor Shafique ,&nbsp;Ariful Islam ,&nbsp;Arifur Rahman Bablu ,&nbsp;Muhammad Rashedul Alam ,&nbsp;Faruq Abdulla ,&nbsp;Nazrul Islam ,&nbsp;Md. Kamal Hossain ,&nbsp;Ayesha Siddika ,&nbsp;Carolyn Clark ,&nbsp;Vijay Zala ,&nbsp;Neil Cherian ,&nbsp;Kamal Ibne Amin Chowdhury ,&nbsp;Sharmin Sultana ,&nbsp;Syed Moinuddin Satter","doi":"10.1016/j.lansea.2026.100729","DOIUrl":"10.1016/j.lansea.2026.100729","url":null,"abstract":"<div><h3>Background</h3><div>Since 2001, Bangladesh has experienced recurrent outbreaks of Nipah virus (NiV) infection. While acute-phase manifestations are well documented, long-term clinical and functional sequelae poorly characterized.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional assessment of 52 adult NiV survivors in Bangladesh between November 2021 and February 2022 to document the persistence, severity, and functional impact of post infection symptoms. Symptom history, clinical evaluation, and functional status were assessed using structured questionnaires and the Washington Group Extended Set on Functioning (WG-ES).</div></div><div><h3>Findings</h3><div>All the survivors reported fever during acute illness, with frequent symptoms including headache (71%), severe weakness (67%), and altered mental status (44%). Following recovery, survivors reported a wide range of symptoms including sleep disturbance (58%), gait disturbance (54%), chronic fatigue (52%), memory and concentration difficulties (54%) and myoclonus (48%). Neurological, musculoskeletal, and respiratory symptoms persisted with varying severity and chronicity. Functional assessments revealed notable disability in several domains, particularly anxiety (48%), mobility (31%), and cognition (25%). Although post-infection symptoms were common, 65% of survivors met criteria for disability in at least one functional domain, and 48% had disabilities across multiple domains.</div></div><div><h3>Interpretation</h3><div>These findings highlight the substantial and enduring burden experienced by NiV survivors in Bangladesh. The range and persistence of sequelae in this cohort appear broader than previously documented in Malaysia–Singapore survivor studies; however, methodological differences limit formal comparison. As the largest clinical and functional assessment of NiV survivors to date, this study provides essential evidence to inform long-term care strategies and underscores the need for survivor-focused rehabilitation and monitoring in outbreak-prone settings.</div></div><div><h3>Funding</h3><div>This study was supported by the <span>Coalition for Epidemic Preparedness Innovations</span> (CEPI) (Grant No: <span><span>GR-02160</span></span>). The funding body had no role in the study design; data collection, management, analysis, or interpretation; writing of the manuscript; or the decision to submit the manuscript for publication. The views and conclusions expressed in this manuscript are those of the authors and should not be construed as representing the official viewpoints of CEPI or the U.S. Centers for Disease Control and Prevention.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"45 ","pages":"Article 100729"},"PeriodicalIF":6.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230066","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":"MASLD: time to optimise regional research priorities","authors":"The Lancet Regional Health – Southeast Asia","doi":"10.1016/j.lansea.2026.100732","DOIUrl":"10.1016/j.lansea.2026.100732","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"45 ","pages":"Article 100732"},"PeriodicalIF":6.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313349","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":"Thank you to The Lancet Regional Health – Southeast Asia's clinical and statistical peer reviewers in 2025","authors":"","doi":"10.1016/j.lansea.2026.100740","DOIUrl":"10.1016/j.lansea.2026.100740","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"45 ","pages":"Article 100740"},"PeriodicalIF":6.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421422","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":"Burden of MASLD and liver fibrosis: evidence from Phenome India cohort","authors":"Meghana Arvind ,&nbsp;Anshul Verma ,&nbsp;Sreeshma Raj K ,&nbsp;Satyartha Prakash ,&nbsp;Vignesh S. Kumar ,&nbsp;Mohammad Azhar Uddin ,&nbsp;Ayushi Narayan ,&nbsp;Mamta Rathore ,&nbsp;Nancy Rawat ,&nbsp;Ankita Sahu ,&nbsp;Yogesh Kumar ,&nbsp;Pulkit Hasmukhbhai Leuva ,&nbsp;Monika Sharma ,&nbsp;Rajesh S ,&nbsp;Dwaipayan Saha ,&nbsp;Ankita Mridha ,&nbsp;Ishant Jyoti Nath ,&nbsp;Ashique Hussain ,&nbsp;Borsha Rajkumari ,&nbsp;Mamta Thapa ,&nbsp;Rashmi Arya","doi":"10.1016/j.lansea.2026.100723","DOIUrl":"10.1016/j.lansea.2026.100723","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic-dysfunction-associated steatotic liver disease (MASLD) is rising globally, including in India, yet community-based data remain scarce. We address this critical knowledge gap by assessing the prevalence, distribution, and characteristics of MASLD subgroups and fibrosis, leveraging the Phenome India cohort.</div></div><div><h3>Methods</h3><div>In this prospective study, we recruited 10,267 adults across 37 laboratories of the Council of Scientific and Industrial Research (CSIR) from 27 Indian cities. All permanent staff members of the CSIR, including current employees, retirees, and their spouses who responded to the recruitment campaign and provided voluntary consent, were considered for participation in the Phenome India Cohort. Steatosis and fibrosis were assessed using Transient Elastography, along with associated clinical, biochemical, cytokine and anthropometric data. Overall, crude and age-adjusted prevalence rates were estimated in the study population and various subgroups.</div></div><div><h3>Findings</h3><div>Of 10,267 individuals screened, 7764 were included, 3712 (47.8%) fulfilled MASLD criteria, corresponding to an age-adjusted prevalence of 38.9% (95% CI 37.2–40.6). Significant fibrosis, defined as liver stiffness measurement (LSM) ≥8.2 kPa (≥F2), was more frequent in MASLD (6.3% [234 of 3688]) than in cases without-MASLD (1.7% [69 of 4027]), corresponding to an age-adjusted prevalence of 4.1% in MASLD. Overall age-adjusted prevalence of significant fibrosis was 2.4%, which clustered in older adults (&gt;60 years) and in those with diabetes or obesity class II, with evidence of possible regional variation.</div></div><div><h3>Interpretation</h3><div>MASLD affected over one-third of participants. Site-specific disparities were observed, which suggest the need for large-scale longitudinal studies to elucidate region-specific risk factors and temporal trends. Community-based awareness and targeted public health interventions across diverse geographical and socio-cultural settings in India may help curb the rising burden.</div></div><div><h3>Funding</h3><div>The work was funded by <span>CSIR, India</span> grant HCP47.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"45 ","pages":"Article 100723"},"PeriodicalIF":6.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183663","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":"Corrigendum to ““Miles to go before I seek”: distance to the health facility and health care use among older adults in India” [The Lancet Regional Health Southeast Asia. Volume 37, 100579, April 2025]","authors":"Sheuli Misra ,&nbsp;Jeetendra Yadav ,&nbsp;Abhinav Sinha ,&nbsp;Krushna Chandra Sahoo ,&nbsp;Shweta Tanwar ,&nbsp;Sneh Shalini ,&nbsp;Arohi Chauhan ,&nbsp;Sanghamitra Pati","doi":"10.1016/j.lansea.2025.100702","DOIUrl":"10.1016/j.lansea.2025.100702","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"45 ","pages":"Article 100702"},"PeriodicalIF":6.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286627","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":"Performance and utility of contact tracing for COVID-19 in the WHO South-East Asia Region: implications for future pandemic preparedness","authors":"Melanie Bannister-Tyrrell ,&nbsp;Kirsty Teague ,&nbsp;Daniel Ll Strachan ,&nbsp;Anna Barrett ,&nbsp;Tiara Marthias ,&nbsp;Clare E. Strachan ,&nbsp;Pawinee Doungngern ,&nbsp;Nishant Thakur ,&nbsp;Mushtofa Kamal ,&nbsp;Hannah Brindle ,&nbsp;Yuka Jinnai ,&nbsp;Masaya Kato ,&nbsp;Florian Vogt","doi":"10.1016/j.lansea.2026.100728","DOIUrl":"10.1016/j.lansea.2026.100728","url":null,"abstract":"<div><div>Contact tracing was widely implemented during the COVID-19 pandemic, but its real-world performance and utility for decision-making remain poorly understood. A qualitative study was conducted to appraise the performance and utility of contact tracing for COVID-19 in the WHO South-East Asia Region, based on interviews with government and non-governmental organisation technical staff and decision makers in Indonesia, Nepal and Thailand. Our findings highlight the good performance of contact tracing when sufficiently resourced and when case load is low, but reveal declining utility as case incidence increases. This study presents key definitions and a pragmatic approach for appraising contact tracing performance and utility throughout a major health emergency response. Countries should prospectively define objectives for contact tracing, establish monitoring and evaluation frameworks, adjust their contact tracing approaches informed by risk assessments, and consider other available public health interventions when its performance and utility decline.</div></div><div><h3>Funding</h3><div><span>Governments of Germany and Australia</span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"45 ","pages":"Article 100728"},"PeriodicalIF":6.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230018","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}