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177Lu-PSMA-617 for metastatic prostate cancer in India 177Lu-PSMA-617 在印度治疗转移性前列腺癌
IF 5 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-12 DOI: 10.1016/j.lansea.2024.100484
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引用次数: 0
Economic burden of suicide deaths in India (2019): a retrospective, cross-sectional study 印度自杀死亡的经济负担(2019 年):一项回顾性横断面研究
IF 5 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-12 DOI: 10.1016/j.lansea.2024.100477

Background

India has the highest number of suicide deaths in the world. Suicide prevention requires policy attention and resource allocation. Evidence of economic losses due to disease burden can influence such allocations. We assessed the economic burden and its distribution across states and demographic groups in India.

Methods

We used the human capital approach in this retrospective cross-sectional analysis to assess the economic burden of suicide in India for the year 2019 for 28 Indian states and 3 union territories (UTs). We calculated the monetary value for the years of life lost disaggregated by states, age groups, and sexes. For sensitivity, we present a library of estimates using different discount rates, life expectancy thresholds, and estimates specific to the populations that can participate in the workforce.

Findings

The national economic burden of suicide was US$ 16,749,079,455 (95% Uncertainty Interval: 11,913,034,910–22,404,233,468). The top three states, Karnataka, Tamil Nadu, and Maharashtra, contributed to 44.82% of the total burden in India. The age group 20–34 years had the largest suicide burden and contributed to 53.05% of the overall national economic burden (US$ 8,885,436,385 [6,493,912,818–11,694,138,884]). Twenty states and UTs had a greater economic burden for females than males.

Interpretation

The current analysis ascertains a high economic burden of suicide among the Indian youth and females, necessitating concerted multisectoral efforts and immediate investments.

Funding

None.

背景印度是世界上自杀死亡人数最多的国家。预防自杀需要政策关注和资源分配。有证据表明,疾病负担造成的经济损失会影响资源分配。我们在这项回顾性横断面分析中使用了人力资本方法,评估了 2019 年印度 28 个邦和 3 个中央直辖区(UT)的自杀经济负担。我们计算了按邦、年龄组和性别分列的生命损失年数的货币价值。为提高敏感性,我们使用不同的贴现率、预期寿命阈值和可参加工作人口的特定估算值提供了一个估算库。卡纳塔克邦、泰米尔纳德邦和马哈拉施特拉邦这三个邦占印度总负担的 44.82%。20-34 岁年龄组的自杀负担最大,占全国总经济负担的 53.05%(8,885,436,385 美元 [6,493,912,818-11,694,138,884] )。有 20 个邦和中央直辖区的女性经济负担大于男性。释义当前的分析确定了印度青年和女性自杀的高经济负担,因此需要多部门协同努力并立即进行投资。
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引用次数: 0
Anthropometric indices in predicting 10-year cardiovascular risk among males and females aged 40–74 years in south and southeast Asia: analysis of 12 WHO STEPS survey data 预测南亚和东南亚 40-74 岁男性和女性 10 年心血管风险的人体测量指数:对 12 项世界卫生组织 STEPS 调查数据的分析
IF 5 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-12 DOI: 10.1016/j.lansea.2024.100481

Background

The relevance of anthropometric indices in predicting cardiovascular disease (CVD) or CVD risk factors is established across different countries, particularly in the high-income countries. However, past studies severely lacked representation from the south and southeast Asian countries. The main aim of this study was to determine the performance of conventional and new anthropometric indices to best predict 10-year cardiovascular disease (CVD) risk in south Asian and southeast Asian populations.

Methods

The present study examined data from 14,532 participants in three south Asian and 13,846 participants (all aged between 40 and 74 years) in six southeast Asian countries, drawn from twelve cross-sectional studies (WHO STEPwise approaches to NCD risk factor surveillance [STEPS] survey data from 2008 to 2019). A Predictive performance of ten anthropometric indices were examined for predicting 10-year CVD risk ≥ 10% (CVD-R ≥ 10%). The 10-year CVD-R ≥ 10% was calculated by utilising the WHO CVD risk non-laboratory-based charts. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal anthropometric index.

Findings

Among the ten anthropometric indices, a body shape index (ABSI), body adiposity index (BAI), body roundness index (BRI), hip index (HI), and waist-height ratio (WHtR) performed best in predicting 10-year CVD risk among south Asian males and females. Improved performances were found for ABSI, BRI, conicity index (CI), WHtR, and waist-hip ratio (WHR) for 10-year CVD-R ≥ 10% predictions among southeast Asian males. Contrastingly, among southeast Asian females, ABSI and CI demonstrated optimal performance in predicting 10-year CVD-R ≥ 10%.

Interpretation

The performance of anthropometric indices in predicting CVD risk varies across countries. ABSI, BAI, BRI, HI, and WHtR showed better predictions in south Asians, whereas ABSI, BRI, CI, WHtR, and WHR displayed enhanced predictions in southeast Asians.

Funding

None.

背景人体测量指数在预测心血管疾病或心血管疾病风险因素方面的相关性已在不同国家得到证实,尤其是在高收入国家。然而,以往的研究严重缺乏南亚和东南亚国家的代表性。本研究的主要目的是确定传统和新型人体测量指数在预测南亚和东南亚人群10年心血管疾病(CVD)风险方面的最佳表现。方法本研究检查了三个南亚国家的14532名参与者和六个东南亚国家的13846名参与者(年龄均在40岁至74岁之间)的数据,这些数据来自12项横断面研究(2008年至2019年世界卫生组织非传染性疾病风险因素监测[STEPS]调查数据)。A 考察了十项人体测量指数对预测 10 年心血管疾病风险≥ 10%(CVD-R ≥ 10%)的预测性能。10 年心血管疾病风险≥10% 是通过世界卫生组织心血管疾病风险非实验室图表计算得出的。研究结果在 10 个人体测量指数中,体形指数 (ABSI)、体脂肪指数 (BAI)、体圆度指数 (BRI)、臀围指数 (HI) 和腰高比 (WHtR) 在预测南亚男性和女性 10 年心血管疾病风险方面表现最佳。在东南亚男性中,ABSI、BRI、圆锥形指数(CI)、腰高比(WHtR)和腰臀比(WHR)在预测10年心血管疾病风险≥10%时表现更好。相反,在东南亚女性中,ABSI 和 CI 在预测 10 年 CVD-R≥10% 时表现最佳。ABSI、BAI、BRI、HI和WHtR对南亚人的预测效果更好,而ABSI、BRI、CI、WHtR和WHR对东南亚人的预测效果更强。
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引用次数: 0
The South Asian phenotype: greater clarity would help to improve cardiometabolic health 南亚表型:进一步明确有助于改善心脏代谢健康
IF 5 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-11 DOI: 10.1016/j.lansea.2024.100482
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引用次数: 0
Incidence of Kawasaki disease among children in Chandigarh, India during 2015–2019: a trend analysis 2015-2019 年印度昌迪加尔儿童川崎病发病率:趋势分析
IF 5 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-10 DOI: 10.1016/j.lansea.2024.100474

Background

Only limited information exists regarding the epidemiology of Kawasaki disease (KD) in low-income and middle-income countries. The present study provides the incidence of KD during 2015–2019 in Chandigarh, north India. Our centre follows the largest KD cohort in India.

Methods

Children with KD at Chandigarh diagnosed during January 2015–December 2019 were enrolled in the study. Annual incidence rates were determined using decadal growth rates of the National Census 2011. We computed the incidence of KD in children aged <5, and <15 years. We also undertook linear trend analysis using our incidence data from 1994 to 2019.

Findings

During 2015–2019, 83 patients (66 males, 17 females) were diagnosed with KD in Chandigarh. Incidence rates during these 5 years were 5.64, 9.25, 9.11, 9.87, and 9.72/100,000 in children aged <5 years, and 2.65, 4.44, 3.86, 5.07, 4.74/100,000 in children aged <15 years. The median age at diagnosis was 48 months (range: 12 days to 15 years). Compared to previous data (2009–2014), there was a 53.1% increase in annual incidence of KD in children aged <5 years, and a 53.7% increase in children aged <15 years. Coronary artery abnormalities during acute phase were noted in 16.9%, and in 7.2% of patients at 6 weeks of follow-up. The trend analysis indicated a monthly rise of 0.002 cases per 100,000 children aged <5 years, and 0.0165 cases per 100,000 children aged <15 years.

Interpretation

The incidence of KD has continued to show an upward trend in Chandigarh over the period 2015–2019. This may indicate a true rise in the occurrence of KD or may reflect better disease ascertainment as a result of greater awareness about KD amongst healthcare professionals.

Funding

None.

背景有关中低收入国家川崎病(KD)流行病学的信息非常有限。本研究提供了 2015-2019 年印度北部昌迪加尔的 KD 发病率。我们的中心跟踪了印度最大的 KD 队列。方法:研究招募了 2015 年 1 月至 2019 年 12 月期间在昌迪加尔确诊的 KD 患儿。年发病率根据 2011 年全国人口普查的十年增长率确定。我们计算了 5 岁和 15 岁儿童的 KD 发病率。我们还利用 1994 年至 2019 年的发病率数据进行了线性趋势分析。研究结果2015 年至 2019 年期间,昌迪加尔有 83 名患者(66 名男性,17 名女性)被诊断为 KD。在这5年中,5岁儿童的发病率分别为5.64、9.25、9.11、9.87和9.72/100,000,15岁儿童的发病率分别为2.65、4.44、3.86、5.07和4.74/100,000。确诊时的中位年龄为48个月(范围:12天至15岁)。与之前的数据(2009-2014年)相比,5岁儿童的KD年发病率增加了53.1%,15岁儿童的发病率增加了53.7%。16.9%的患者在急性期发现冠状动脉异常,7.2%的患者在随访6周时发现冠状动脉异常。趋势分析表明,每 10 万名 5 岁儿童中每月增加 0.002 例,每 10 万名 15 岁儿童中每月增加 0.0165 例。这可能表明KD的发病率确实有所上升,也可能反映出医疗保健专业人员对KD的认识有所提高,从而更好地确定了疾病。
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引用次数: 0
Engaging non-state providers towards PHC in South Asia: considerations for policymakers 让非国家提供者参与南亚初级保健:决策者的考虑因素
IF 5 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 DOI: 10.1016/j.lansea.2024.100454
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引用次数: 0
Strengthening primary health care through community health workers in South Asia 通过南亚社区保健工作者加强初级保健
IF 5 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 DOI: 10.1016/j.lansea.2024.100463

The growing health challenges in South Asia require further adaptations of community health worker (CHW) programs as a key element of primary health care (PHC). This paper provides a comparative analysis of CHW programs in five countries (Bangladesh, India, Nepal, Pakistan, and Sri Lanka), examines successes and challenges, and suggests reforms to better ensure highly performing CHW programs. To examine CHW programs in the region, we conducted a narrative review of the peer-reviewed and grey literatures, as well as eliciting opinions from experts. Common roles of CHWs include health education, community mobilization, and community-based services, particularly related to reproductive, maternal, neonatal, and child health. Some countries utilize CHWs for non-communicable diseases and other emerging health issues. To maximize the potential contribution of CHWs to achieving Universal Health Coverage, we recommend future research and policy focus on strengthening existing health systems to support the expansion of CHWs roles and better integrating of CHWs into national PHC systems. This is Paper 4 in the Series on Primary Health Care in South Asia, addressing areas that have the potential to revitalize health systems in South Asian countries.

Funding

The authors received financial support from the Department of Health Systems Development, WHO South-East Asia Regional Office (WHO SEAR).

南亚日益严峻的卫生挑战要求进一步调整作为初级卫生保健 (PHC) 关键要素的社区保健员 (CHW) 计划。本文对五个国家(孟加拉国、印度、尼泊尔、巴基斯坦和斯里兰卡)的社区保健员项目进行了比较分析,探讨了成功与挑战,并提出了改革建议,以更好地确保社区保健员项目的高效实施。为了研究该地区的社区保健工作者项目,我们对同行评议和灰色文献进行了叙述性综述,并征求了专家的意见。社区保健工作者的常见角色包括健康教育、社区动员和社区服务,尤其是与生殖、孕产妇、新生儿和儿童健康相关的服务。一些国家利用社区保健工作者处理非传染性疾病和其他新出现的健康问题。为了最大限度地发挥社区保健工作者对实现全民健康覆盖的潜在贡献,我们建议未来的研究和政策重点应放在加强现有卫生系统以支持扩大社区保健工作者的作用,并更好地将社区保健工作者纳入国家初级保健系统。本文是 "南亚初级卫生保健丛书 "的第4篇论文,探讨了有可能振兴南亚国家卫生系统的领域。
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引用次数: 0
Corrigendum to “Development and evaluation of a training of trainers intervention for nursing professionals during COVID-19 pandemic in India” [The Lancet Regional Health – Southeast Asia 25 (2024) 100413] 印度 COVID-19 大流行期间针对护理专业人员的培训员培训干预措施的开发与评估》[《柳叶刀区域健康-东南亚》25 (2024) 100413] 更正
IF 5 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 DOI: 10.1016/j.lansea.2024.100468
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引用次数: 0
Primary health care in South Asia: a time for reform 南亚的初级保健:改革正当时
IF 5 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 DOI: 10.1016/j.lansea.2024.100467
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引用次数: 0
Reorienting health systems towards Primary Health Care in South Asia 调整南亚卫生系统的方向,实现初级保健
IF 5 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 DOI: 10.1016/j.lansea.2024.100466

This series, “Primary health care in South Asia”, is an effort to provide region-specific, evidence-based insights for reorienting health systems towards PHC. Led by regional thinkers, this series draws lessons from five countries in South Asia: Bangladesh, India, Nepal, Pakistan, and Sri Lanka. This is the last paper in the series that outlines points for future action. We call for action in three areas. First, the changing context in the region, with respect to epidemiological shifts, urbanisation, and privatisation, presents an important opportunity to appraise existing policies on PHC and reformulate them to meet the evolving needs of communities. Second, reorienting health systems towards PHC requires concrete efforts on three pillars-integrated services, multi-sectoral collaboration, and community empowerment. This paper collates nine action points that cut across these three pillars. These action points encompass contextualising policies on PHC, scaling up innovations, allocating adequate financial resources, strengthening the governance function of health ministries, establishing meaningful public-private engagements, using digital health tools, reorganising service delivery, enabling effective change–management processes, and encouraging practice-oriented research. Finally, we call for more research-policy-practice networks on PHC in South Asia that can generate evidence, bolster advocacy, and provide spaces for cross-learning.

Funding

WHO SEARO funded this paper. This source did not play any role in the design, analysis or preparation of the manuscript.

本系列 "南亚的初级卫生保健 "旨在提供针对具体地区的、以证据为基础的见解,以调整卫生系统的方向,实现初级卫生保健。在地区思想家的引领下,本系列从南亚的五个国家吸取经验教训:孟加拉国、印度、尼泊尔、巴基斯坦和斯里兰卡。本文是该系列的最后一篇文章,概述了未来行动的要点。我们呼吁在三个领域采取行动。首先,该地区在流行病学变化、城市化和私有化等方面不断变化的环境为评估现有的初级保健政策和重新制定这些政策以满足社区不断变化的需求提供了重要机会。其次,调整医疗系统的方向,使之面向初级保健,需要在三大支柱方面做出具体努力--综合服务、多部门合作和社区赋权。本文整理了贯穿这三大支柱的九个行动要点。这些行动要点包括:根据具体情况制定初级卫生保健政策、扩大创新规模、分配充足的财政资源、加强卫生部的管理职能、建立有意义的公私合作关系、使用数字卫生工具、重组服务提供方式、促进有效的变革管理进程以及鼓励以实践为导向的研究。最后,我们呼吁在南亚地区建立更多的初级卫生保健研究-政策-实践网络,以生成证据、加强宣传并提供相互学习的空间。该来源在本文的设计、分析或撰稿过程中未发挥任何作用。
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引用次数: 0
期刊
The Lancet regional health. Southeast Asia
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