Pub Date : 2025-11-01DOI: 10.1016/j.lansea.2025.100690
Adrian P. Mundt , S.M. Yasir Arafat , Chencho Dorji , Avinash Desousa , Rakesh K. Chadda , Guru S. Gowda , Cristian Orus , Muralidharan Kesavan , Athifa Ibrahim , Nagendra P. Luitel , Harischandra Gambheera , Phunnapa Kittirattanapaiboon , Stefan Priebe , Enzo Rozas-Serri
Background
This study aimed to assess indicators of psychiatric institutionalization and their changes over time across the Southeast Asia Region (SEAR).
Methods
We collected numbers of psychiatric beds, specialized forensic psychiatric beds, beds in residential facilities for people living with chronic mental illness and prison populations in the 11 SEAR member states between 1990 and 2024 using primary and secondary data sources. We calculated median rates per 100,000 population, as well as percent changes of the median rates between the first and last available data points. We also compared findings in SEAR with OECD countries.
Findings
Psychiatric bed numbers and prison population were available from 10 countries. Bed prevalence increased in seven countries, but decreased in three. The median psychiatric bed prevalence was 1.5 at the first and 2.9 per 100,000 population at the last data point (+94%). The prison population increased in nine countries, with the median rate changing from 60 to 123 (+106%). Data on specialized forensic psychiatric beds were available from seven countries, with a range of 0.0–0.5 beds at the last data point. Based on data from five countries, the median prevalence of beds in residential facilities increased from 1.3 to 2.3. Psychiatric bed prevalence was on average about 5% of that in the OECD, while prison population rates were similar to those in OECD countries.
Interpretation
Psychiatric bed provision in the SEAR is among the lowest worldwide. In contrast, incarceration rates are similar to those in high-income regions. Most countries have increased the prevalence of psychiatric beds over the past three decades, but they remain scarce, and further investments need consideration.
Funding
Agencia Nacional de Investigación y Desarrollo (ANID), Chile.
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Pub Date : 2025-11-01DOI: 10.1016/j.lansea.2025.100687
Surender Grover, Jadeer K. Muhammed, Atul Ambekar, Priyanka Saha
{"title":"Should pregabalin be regulated under the Narcotic Drugs and Psychotropic Substances (NDPS) Act of India?","authors":"Surender Grover, Jadeer K. Muhammed, Atul Ambekar, Priyanka Saha","doi":"10.1016/j.lansea.2025.100687","DOIUrl":"10.1016/j.lansea.2025.100687","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"42 ","pages":"Article 100687"},"PeriodicalIF":6.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417967","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}
Pub Date : 2025-11-01DOI: 10.1016/j.lansea.2025.100689
Bayu Satria Wiratama , Vicka Oktaria , Khoriah Indrihutami , Muhammad Hardhantyo , Ahmad Watsiq Maula , Hanevi Djasri , Rizka Dinari , Muhammad Syairaji , Suwarti , Ariel Pradipta , Dwi Utomo Nusantara , Ardiana Kusumaningrum , Andrew , Marillyn Mariana Tamburian , Ilma Safira Baehaqi , Rebecca Merrill , Henry Surendra , Fetty Wijayanti , Benjamin A. Dahl , Raph L. Hamers
Background
SARS-CoV-2 ancestral-strain vaccines have effectively reduced SARS-CoV-2-related severe illness and death worldwide. However, waning immunity over time has warranted revaccination to boost immunity. Indonesia, like most low- and middle-income countries, has not provided regular vaccine boosters post-pandemic. This study assessed the longer-term durability of protection from ancestral-strain third- and fourth-dose boosters.
Methods
We conducted a test-negative case–control study among symptomatic adults seeking SARS-CoV-2 testing at 14 purposely selected test sites in the major cities of Yogyakarta and Jakarta (March 2023–May 2024). Test-positive individuals were cases and test-negative individuals were controls. SARS-CoV-2 variants were identified using whole genome sequencing. We used multivariable logistic regression to estimate absolute or incremental vaccine effectiveness (VE) against symptomatic infection and COVID-19-related hospitalisation or death, adjusted for main confounders.
Findings
Of 2439 participants (median age 35 years, 56.2% female), 388 were cases and 2051 controls. Vaccination with two primary doses, a third-dose or fourth-dose booster did not provide sustained protection against Omicron XBB/JN.1 symptomatic infection up to median 27, 20 or 13 months since administration, respectively. However, there was sustained incremental protection from the third-dose booster (administered median 20 month prior) against hospitalisation (VE 38.3% [95% CI 3.9–60.3]) and death (55.2% [17.7–75.6]) for older individuals (aged >50 years), and against death (55.2% [12.8–76.9]) for individuals with one or more comorbidities. There was also sustained incremental protection from the fourth-dose booster (administered median 13 months prior) against hospitalisation for older individuals (50.2% [10.3–72.3]) and individuals with one or more comorbidities (74.4% [49.2–87.1]).
Interpretation
Ancestral-strain vaccine boosters provided durable, moderate protection against severe or fatal outcomes from Omicron XBB/JN.1 infection for older and comorbid individuals. The findings highlight the benefits of improving access to revaccination for vulnerable groups in Indonesia.
{"title":"Durability of protection of ancestral-strain COVID-19 third- and fourth-dose vaccine boosters against Omicron XBB/XBB.1 and JN.1 symptomatic infection, hospitalisation and mortality in Indonesian adults (2023–2024): a test-negative case–control study","authors":"Bayu Satria Wiratama , Vicka Oktaria , Khoriah Indrihutami , Muhammad Hardhantyo , Ahmad Watsiq Maula , Hanevi Djasri , Rizka Dinari , Muhammad Syairaji , Suwarti , Ariel Pradipta , Dwi Utomo Nusantara , Ardiana Kusumaningrum , Andrew , Marillyn Mariana Tamburian , Ilma Safira Baehaqi , Rebecca Merrill , Henry Surendra , Fetty Wijayanti , Benjamin A. Dahl , Raph L. Hamers","doi":"10.1016/j.lansea.2025.100689","DOIUrl":"10.1016/j.lansea.2025.100689","url":null,"abstract":"<div><h3>Background</h3><div>SARS-CoV-2 ancestral-strain vaccines have effectively reduced SARS-CoV-2-related severe illness and death worldwide. However, waning immunity over time has warranted revaccination to boost immunity. Indonesia, like most low- and middle-income countries, has not provided regular vaccine boosters post-pandemic. This study assessed the longer-term durability of protection from ancestral-strain third- and fourth-dose boosters.</div></div><div><h3>Methods</h3><div>We conducted a test-negative case–control study among symptomatic adults seeking SARS-CoV-2 testing at 14 purposely selected test sites in the major cities of Yogyakarta and Jakarta (March 2023–May 2024). Test-positive individuals were cases and test-negative individuals were controls. SARS-CoV-2 variants were identified using whole genome sequencing. We used multivariable logistic regression to estimate absolute or incremental vaccine effectiveness (VE) against symptomatic infection and COVID-19-related hospitalisation or death, adjusted for main confounders.</div></div><div><h3>Findings</h3><div>Of 2439 participants (median age 35 years, 56.2% female), 388 were cases and 2051 controls. Vaccination with two primary doses, a third-dose or fourth-dose booster did not provide sustained protection against Omicron XBB/JN.1 symptomatic infection up to median 27, 20 or 13 months since administration, respectively. However, there was sustained incremental protection from the third-dose booster (administered median 20 month prior) against hospitalisation (VE 38.3% [95% CI 3.9–60.3]) and death (55.2% [17.7–75.6]) for older individuals (aged >50 years), and against death (55.2% [12.8–76.9]) for individuals with one or more comorbidities. There was also sustained incremental protection from the fourth-dose booster (administered median 13 months prior) against hospitalisation for older individuals (50.2% [10.3–72.3]) and individuals with one or more comorbidities (74.4% [49.2–87.1]).</div></div><div><h3>Interpretation</h3><div>Ancestral-strain vaccine boosters provided durable, moderate protection against severe or fatal outcomes from Omicron XBB/JN.1 infection for older and comorbid individuals. The findings highlight the benefits of improving access to revaccination for vulnerable groups in Indonesia.</div></div><div><h3>Funding</h3><div>US <span>Centers for Diseases Control and Prevention.</span></div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"42 ","pages":"Article 100689"},"PeriodicalIF":6.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466923","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}
Outcome of newly diagnosed, transplant eligible, multiple myeloma (MM) patients have improved significantly during the past two decades. A small proportion of patients are long term survivors beyond 10 years. We evaluated clinical and laboratory characteristics of these long term survivors.
Methods
Four hundred and thirty eight consecutive MM patients underwent autologous stem cell transplantation (ASCT) between 1995 and 2019. Patients median age was 52 years, (range, 20–73) and 291 (66.4%) were males. 35.3% had ISS stage III disease. 96 (21.9%) patients were long term survivors (LTS), defined as those alive 120 months or more.
Findings
Compared to others, LTS patients more frequently had ISS stage I (42% vs 28.5%, p < 0.001), serum albumin ≥3.5 g/dl (72% vs 57%, p < 0.005), platelet count ≥150,000/μL (88% vs 71%, p < 0.001), eGFR ≥40 ml/min (85.4% vs 75%, p < 0.01), and bone marrow plasma cells ≤40% (60% vs 49%, p < 0.03). Transplant within 12 months of diagnosis (73% vs 51.5%, p < 0.001) and in first remission (89.6% vs 71.3%, p < 0.001) were more common in LTS. Post-ASCT response was superior: CR (80% vs 65.5%, p < 0.004), CR + VGPR (94.8% vs 82.5%, p < 0.001). At median follow-up of 115 months, median overall survival was 264 months and progression-free survival 158 months.
Interpretation
This study identifies a distinct subgroup of MM patients with long-term survival, characterized by favourable baseline features, early and effective treatment, and deep post-transplant responses, with a median progression-free survival exceeding 13 years.
Funding
No funding was received for present study.
背景：在过去的二十年中，新诊断的、符合移植条件的多发性骨髓瘤（MM）患者的预后有了显著改善。一小部分患者是10年以上的长期幸存者。我们评估了这些长期幸存者的临床和实验室特征。方法1995 - 2019年，连续438例MM患者行自体干细胞移植（ASCT）。患者中位年龄52岁（20 ~ 73岁），男性291例（66.4%）。35.3%为ISS III期。96例（21.9%）患者为长期幸存者（LTS），定义为存活120个月或更长时间的患者。结果：与其他患者相比，LTS患者更多出现ISS I期（42% vs 28.5%, p < 0.001）、血清白蛋白≥3.5 g/dl （72% vs 57%, p < 0.005）、血小板计数≥150000 /μL （88% vs 71%, p < 0.001）、eGFR≥40ml /min （85.4% vs 75%, p < 0.01）、骨髓浆细胞≤40% （60% vs 49%, p < 0.03）。诊断后12个月内移植（73% vs 51.5%, p < 0.001）和首次缓解（89.6% vs 71.3%, p < 0.001）在LTS中更为常见。asct后的反应更好：CR (80% vs 65.5%, p < 0.004), CR + VGPR （94.8% vs 82.5%, p < 0.001）。中位随访115个月，中位总生存期为264个月，无进展生存期为158个月。本研究确定了一个长期生存的MM患者亚组，其特点是良好的基线特征，早期有效的治疗，移植后深度反应，中位无进展生存期超过13年。本研究未获资助。
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Chronic kidney disease of unknown cause (CKDu) has been reported in “hotspots” around the world and linked to occupational heat stress, exposure to agrochemicals and environmental toxins. This was a systematic, statewide, population-based, observational study of agricultural workers in Tamil Nadu, to estimate the prevalence of chronic kidney disease (CKD) and CKDu.
Methods
The state of Tamil Nadu was divided into five agroclimatic zones and stratified multi-stage cluster sampling was performed to select a representative study population. All participants underwent clinical evaluation and laboratory testing (Phase 1). Repeat sampling was performed after 3 months for all individuals with an eGFR <60 mL/min per 1.73 m2 during initial sampling (Phase 2).
Findings
Among 3350 participants who were screened, the number of participants with eGFR ≤60 mL/min per 1.73 m2 at the end of Phase 1 and Phase 2 were 584 and 178, respectively. The overall prevalence of CKD was therefore 5.31% (95% CI 4.58–6.13), with the prevalence of CKDu being 2.66% (95% CI 2.14–3.26). The factors that were significantly associated with CKD were increased age, diabetes, hypertension, absence of formal education, anaemia, smokeless tobacco use, and weekly hours of outdoor work. Notably, 406 participants with an eGFR ≤60 mL/min per 1.73 m2 during Phase 1 had a normal eGFR when re-measured during Phase 2. These episodes of transient subclinical AKI could potentially contribute to CKD.
Interpretation
The prevalence of CKD among agricultural workers in Tamil Nadu is 5.31%, with about half of these due to CKDu. The effect of transient subclinical AKI on CKD progression needs further study.
Funding
Tamil Nadu Health System Reform Program, Department of Health and Family Welfare, Government of Tamil Nadu.
背景不明原因慢性肾脏病（CKDu）已在世界各地的“热点”报道，并与职业性热应激，暴露于农用化学品和环境毒素有关。这是一项系统的、全州范围的、基于人群的、对泰米尔纳德邦农业工人的观察性研究，旨在估计慢性肾脏疾病（CKD）和CKDu的患病率。方法将泰米尔纳德邦划分为5个农业气候带，采用分层多阶段整群抽样的方法，选取具有代表性的研究人群。所有参与者都进行了临床评估和实验室测试（第一阶段）。3个月后对所有初始采样时eGFR为60 mL/min / 1.73 m2的个体进行重复采样（第二阶段）。在筛选的3350名参与者中，在1期和2期结束时eGFR≤60 mL/min / 1.73 m2的参与者人数分别为584人和178人。因此，CKD的总患病率为5.31% (95% CI 4.58-6.13)， CKDu的患病率为2.66% （95% CI 2.14-3.26）。与CKD显著相关的因素是年龄增加、糖尿病、高血压、缺乏正规教育、贫血、无烟烟草使用和每周户外工作时间。值得注意的是，406名在第一阶段eGFR≤60 mL/min / 1.73 m2的参与者在第二阶段重新测量eGFR时正常。这些短暂的亚临床AKI发作可能会导致CKD。泰米尔纳德邦农业工人CKD患病率为5.31%，其中约一半由CKDu引起。短暂性亚临床AKI对CKD进展的影响有待进一步研究。资助泰米尔纳德邦政府卫生和家庭福利部泰米尔纳德邦卫生系统改革方案。
{"title":"CKDu-AGRI Study—a population-based cross-sectional study of chronic kidney disease and chronic kidney disease of unknown aetiology among agricultural workers in Tamil Nadu, India","authors":"Natarajan Gopalakrishnan , Subramaniam Sudharshini , Ramanathan Sakthirajan , Thanigachalam Dineshkumar , Tanuj Moses Lamech , Anavarathan Somasundaram , Seshadri Jayalakshmi , Uma Maheswari , Sivadoss Raju , Mookaiah Seenivasan , Venkatesh Arumugam , Nandakumar Nachimuthu , Janani Surya , Suliankatchi Abdulkader Rizwan , Vishwanathan Ramasubramaniam , Rajendran Kasirajan Manorajan , Ayyakkannu Indirani Nigazh , Sivaprakasam T. Selvavinayagam","doi":"10.1016/j.lansea.2025.100683","DOIUrl":"10.1016/j.lansea.2025.100683","url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease of unknown cause (CKDu) has been reported in “hotspots” around the world and linked to occupational heat stress, exposure to agrochemicals and environmental toxins. This was a systematic, statewide, population-based, observational study of agricultural workers in Tamil Nadu, to estimate the prevalence of chronic kidney disease (CKD) and CKDu.</div></div><div><h3>Methods</h3><div>The state of Tamil Nadu was divided into five agroclimatic zones and stratified multi-stage cluster sampling was performed to select a representative study population. All participants underwent clinical evaluation and laboratory testing (Phase 1). Repeat sampling was performed after 3 months for all individuals with an eGFR <60 mL/min per 1.73 m<sup>2</sup> during initial sampling (Phase 2).</div></div><div><h3>Findings</h3><div>Among 3350 participants who were screened, the number of participants with eGFR ≤60 mL/min per 1.73 m<sup>2</sup> at the end of Phase 1 and Phase 2 were 584 and 178, respectively. The overall prevalence of CKD was therefore 5.31% (95% CI 4.58–6.13), with the prevalence of CKDu being 2.66% (95% CI 2.14–3.26). The factors that were significantly associated with CKD were increased age, diabetes, hypertension, absence of formal education, anaemia, smokeless tobacco use, and weekly hours of outdoor work. Notably, 406 participants with an eGFR ≤60 mL/min per 1.73 m<sup>2</sup> during Phase 1 had a normal eGFR when re-measured during Phase 2. These episodes of transient subclinical AKI could potentially contribute to CKD.</div></div><div><h3>Interpretation</h3><div>The prevalence of CKD among agricultural workers in Tamil Nadu is 5.31%, with about half of these due to CKDu. The effect of transient subclinical AKI on CKD progression needs further study.</div></div><div><h3>Funding</h3><div><span>Tamil Nadu Health System Reform Program</span>, <span>Department of Health and Family Welfare</span>, <span>Government of Tamil Nadu</span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"42 ","pages":"Article 100683"},"PeriodicalIF":6.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417966","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}
Pub Date : 2025-10-25DOI: 10.1016/j.lansea.2025.100685
Satyajit Kundu , Rajat Das Gupta
{"title":"A missing piece in Bangladesh's nutrition agenda: indigenous children and adolescents in the Chittagong Hill Tracts","authors":"Satyajit Kundu , Rajat Das Gupta","doi":"10.1016/j.lansea.2025.100685","DOIUrl":"10.1016/j.lansea.2025.100685","url":null,"abstract":"","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"42 ","pages":"Article 100685"},"PeriodicalIF":6.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364242","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}
Pub Date : 2025-10-10DOI: 10.1016/j.lansea.2025.100681
Sandersan Onie , Patrick Berlinquette , Stephanie Onie , Jessica Nilam , Jiemi Ardian , Anna Surti Ariani , Juneman Abraham , Daiane B. Machado , Mark Sinyor , Michelle Torok , Fiona Shand , Mark Larsen
Background
Suicide is a global public health issue, with over 75% of deaths occurring in low- and middle-income countries (LMICs), where access to mental health services is often limited. In Indonesia, where stigma is high and professional support scarce, there is a critical need for scalable, non-traditional approaches to reach individuals at risk. One such approach is using online search engine advertisements to engage individuals searching for suicide-related content and encourage help-seeking.
Methods
This study analysed data from an online Google Ads campaign conducted in Indonesia in March 2023, targeting individuals searching for suicide-related keywords. The campaign was co-designed with local experts and people with lived experience. We compared its engagement and cost-effectiveness to similar campaigns previously conducted in the USA and Australia. The primary outcome was total engagement rate (engagements/impressions), and the secondary outcome was effective cost per engagement (adjusted for purchasing power and inflation).
Findings
The Indonesian campaign achieved an engagement rate of 11.04%, which was 18 times higher than the US campaign (0.61%) and 15 times higher than the Australian campaign (0.72%). It also had an effective cost per engagement five times lower than those in the USA and Australia. All campaigns outperformed industry standards for health and medical advertising.
Interpretation
Search engine advertising is a rapid, cost-effective, and scalable tool to connect individuals in Indonesia with suicide prevention support. These findings underscore the importance of context-specific research in LMICs, where interventions may have greater impact than predicted from high-income country data.
Funding
The study was funded by the Australian Department of Foreign Affairs and Trade, Australian-Indonesian Institute (AII2020322), an NHMRC Investigator Grant (GNT2034904), Suicide Prevention Australia Innovation Grant, and the Lynch Family Foundation Research Fellowship in Global Health Equity.
{"title":"Search engine ads for suicide prevention: analysis of engagement from Indonesia relative to Australia, the USA, and the medical industry standards","authors":"Sandersan Onie , Patrick Berlinquette , Stephanie Onie , Jessica Nilam , Jiemi Ardian , Anna Surti Ariani , Juneman Abraham , Daiane B. Machado , Mark Sinyor , Michelle Torok , Fiona Shand , Mark Larsen","doi":"10.1016/j.lansea.2025.100681","DOIUrl":"10.1016/j.lansea.2025.100681","url":null,"abstract":"<div><h3>Background</h3><div>Suicide is a global public health issue, with over 75% of deaths occurring in low- and middle-income countries (LMICs), where access to mental health services is often limited. In Indonesia, where stigma is high and professional support scarce, there is a critical need for scalable, non-traditional approaches to reach individuals at risk. One such approach is using online search engine advertisements to engage individuals searching for suicide-related content and encourage help-seeking.</div></div><div><h3>Methods</h3><div>This study analysed data from an online Google Ads campaign conducted in Indonesia in March 2023, targeting individuals searching for suicide-related keywords. The campaign was co-designed with local experts and people with lived experience. We compared its engagement and cost-effectiveness to similar campaigns previously conducted in the USA and Australia. The primary outcome was total engagement rate (engagements/impressions), and the secondary outcome was effective cost per engagement (adjusted for purchasing power and inflation).</div></div><div><h3>Findings</h3><div>The Indonesian campaign achieved an engagement rate of 11.04%, which was 18 times higher than the US campaign (0.61%) and 15 times higher than the Australian campaign (0.72%). It also had an effective cost per engagement five times lower than those in the USA and Australia. All campaigns outperformed industry standards for health and medical advertising.</div></div><div><h3>Interpretation</h3><div>Search engine advertising is a rapid, cost-effective, and scalable tool to connect individuals in Indonesia with suicide prevention support. These findings underscore the importance of context-specific research in LMICs, where interventions may have greater impact than predicted from high-income country data.</div></div><div><h3>Funding</h3><div>The study was funded by the <span>Australian Department of Foreign Affairs and Trade</span>, <span>Australian-Indonesian Institute</span> (<span><span>AII2020322</span></span>), an <span>NHMRC Investigator Grant</span> (<span><span>GNT2034904</span></span>), <span>Suicide Prevention Australia Innovation Grant</span>, and the <span>Lynch Family Foundation Research Fellowship in Global Health Equity</span>.</div></div>","PeriodicalId":75136,"journal":{"name":"The Lancet regional health. Southeast Asia","volume":"42 ","pages":"Article 100681"},"PeriodicalIF":6.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270150","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}
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