Abstract:
BACKGROUND:Caesarean section prevalence is increasing in Asia and Latin America while remaining low in most African regions. Caesarean section delivery is effective for saving maternal and infant lives when they are provided for medically-indicated reasons. On the basis of ecological studies, caesarean delivery prevalence between 9% and 19% has been associated with better maternal and perinatal outcomes, such as reduced maternal land fetal mortality. However, the specific prevalence of obstetric and medical complications that require caesarean section have not been established, especially in low-income and middle-income countries (LMICs). We sought to provide information to inform the approach to the provision of caesarean section in low-resource settings. METHODS:We did a literature review to establish the prevalence of obstetric and medical conditions for six potentially life-saving indications for which caesarean section could reduce mortality in LMICs. We then analysed a large, prospective population-based dataset from six LMICs (Argentina, Guatemala, Kenya, India, Pakistan, and Zambia) to determine the prevalence of caesarean section by indication for each site. We considered that an acceptable number of events would be between the 25th and 75th percentile of those found in the literature. FINDINGS:Between Jan 1, 2010, and Dec 31, 2013, we enrolled a total of 271 855 deliveries in six LMICs (seven research sites). Caesarean section prevalence ranged from 35% (3467 of 9813 deliveries in Argentina) to 1% (303 of 16 764 deliveries in Zambia). Argentina's and Guatemala's sites all met the minimum 25th percentile for five of six indications, whereas sites in Zambia and Kenya did not reach the minimum prevalence for caesarean section for any of the indications. Across all sites, a minimum overall caesarean section of 9% was needed to meet the prevalence of the six indications in the population studied. INTERPRETATION:In the site with high caesarean section prevalence, more than half of the procedures were not done for life-saving conditions, whereas the sites with low proportions of caesarean section (below 9%) had an insufficient number of caesarean procedures to cover those life-threatening causes. Attempts to establish a minimum caesarean prevalence should go together with focusing on the life-threatening causes for the mother and child. Simple methods should be developed to allow timely detection of life-threatening conditions, to explore actions that can remedy those conditions, and the timely transfer of women with those conditions to health centres that could provide adequate care for those conditions. FUNDING:Eunice Kennedy Shriver National Institute of Child Health and Human Development.
journal_name
Lancet Glob Healthjournal_title
The Lancet. Global healthauthors
Belizán JM,Minckas N,McClure EM,Saleem S,Moore JL,Goudar SS,Esamai F,Patel A,Chomba E,Garces AL,Althabe F,Harrison MS,Krebs NF,Derman RJ,Carlo WA,Liechty EA,Hibberd PL,Buekens PM,Goldenberg RLdoi
10.1016/S2214-109X(18)30241-9subject
Has Abstractpub_date
2018-08-01 00:00:00pages
e894-e901issue
8issn
2214-109Xpii
S2214-109X(18)30241-9journal_volume
6pub_type
杂志文章,评审abstract:BACKGROUND:People who inject drugs (PWID) are a key population affected by the global HIV and hepatitis C virus (HCV) epidemics. HIV and HCV prevention interventions for PWID include needle and syringe programmes (NSP), opioid substitution therapy (OST), HIV counselling and testing, HIV antiretroviral therapy (ART), an...
journal_title:The Lancet. Global health
pub_type: 杂志文章,评审
doi:10.1016/S2214-109X(17)30373-X
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Low blood glucose concentrations are common in sick children who present to hospital in low-resource settings and are associated with increased mortality. The cutoff blood glucose concentration for the diagnosis and treatment of hypoglycaemia currently recommended by WHO (2·5 mmol/L) is not evidence-based. W...
journal_title:The Lancet. Global health
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2214-109X(20)30388-0
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Policies for early detection of breast cancer, including clinical breast examinations and mammographic screening, were introduced in Brazil in 2004, but their effect on disease stage at diagnosis is unclear. We aimed to assess whether these policies have led to a decrease in the prevalence of late-stage brea...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30151-2
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Global efforts to increase births at health-care facilities might not reduce maternal or newborn mortality if quality of care is insufficient. However, little systematic evidence exists for the quality at health facilities caring for women and newborn babies in low-income countries. We analysed the quality o...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(16)30180-2
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Timely access to emergency care can substantially reduce mortality. International benchmarks for access to emergency hospital care have been established to guide ambitions for universal health care by 2030. However, no Pan-African database of where hospitals are located exists; therefore, we aimed to complet...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(17)30488-6
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Brazil ranks second worldwide in total number of COVID-19 cases and deaths. Understanding the possible socioeconomic and ethnic health inequities is particularly important given the diverse population and fragile political and economic situation. We aimed to characterise the COVID-19 pandemic in Brazil and a...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30285-0
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Breast cancer has distinct causes, prognoses, and outcomes and effects in patients at premenopausal and postmenopausal ages. We sought to assess the global burden and trends in breast cancer by menopausal status. METHODS:We did a population-based analysis of global breast cancer incidence and mortality amon...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30215-1
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The rise in contraceptive use has largely been driven by short-acting methods of contraception, despite the high effectiveness of long-acting reversible contraceptives. Several countries in Latin America and the Caribbean have made important progress increasing the use of modern contraceptives, but important...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30481-9
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Trials of intermittent preventive treatment (IPTp) of malaria in pregnant women that compared dihydroartemisinin-piperaquine with the standard of care, sulfadoxine-pyrimethamine, showed dihydroartemisinin-piperaquine was superior at preventing malaria infection, but not at improving birthweight. We aimed to ...
journal_title:The Lancet. Global health
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2214-109X(20)30119-4
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:2·6 million stillbirths occur annually worldwide. The association between malaria in pregnancy and stillbirth has yet to be comprehensively quantified. We aimed to quantify the association between malaria in pregnancy and stillbirth, and to assess the influence of malaria endemicity on the association. METH...
journal_title:The Lancet. Global health
pub_type: 杂志文章,meta分析,评审
doi:10.1016/S2214-109X(17)30340-6
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:In accordance with the age parameters specified in Sustainable Development Goal target 3.4, current policy and monitoring of non-communicable disease (NCD) mortality trends focus on people aged 30-69 years. This approach excludes the majority of NCD deaths, which occur at older ages. We aimed to compare card...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30069-5
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Detection of dengue virus antibodies is important for understanding future dengue virus risk and for prevaccination screening. We aimed to evaluate the performance of a dengue IgG indirect ELISA in determining dengue seroprevalence in a cohort of children in the Philippines, using a focus reduction neutralis...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30392-2
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The intermittent administration of seasonal malaria chemoprevention (SMC) is recommended to prevent malaria among children aged 3-59 months in areas of the Sahel subregion in Africa. However, the cost-effectiveness and cost savings of SMC have not previously been evaluated in large-scale studies. METHODS:We...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30475-7
更新日期:2021-02-01 00:00:00
abstract::Child stunting is a global problem and is only modestly responsive to dietary interventions. Numerous observational studies have shown that water quality, sanitation, and handwashing (WASH) in a household are strongly associated with linear growth of children living in the same household. We have completed three rando...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30268-2
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:On Dec 1, 2006, Mexico's public health-care insurance scheme, Seguro Popular, implemented the Medical Insurance Century XXI (SMSXXI) programme, to provide insurance to children younger than 5 years without social security. SMSXXI aims to increase access to health services, decrease out-of-pocket health expen...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30326-2
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The risk of severe COVID-19 if an individual becomes infected is known to be higher in older individuals and those with underlying health conditions. Understanding the number of individuals at increased risk of severe COVID-19 and how this varies between countries should inform the design of possible strateg...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30264-3
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Insufficient physical activity is a leading risk factor for non-communicable diseases, and has a negative effect on mental health and quality of life. We describe levels of insufficient physical activity across countries, and estimate global and regional trends. METHODS:We pooled data from population-based ...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30357-7
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Total domestic and international funding for malaria is inadequate to achieve WHO global targets in burden reduction by 2030. We describe the trends of investments in malaria-related research in sub-Saharan Africa and compare investment with national disease burden to identify areas of funding strength and p...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(17)30245-0
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Buruli ulcer can cause disfigurement and long-term loss of function. It is underdiagnosed and under-reported, and its current distribution is unclear. We aimed to synthesise and evaluate data on Buruli ulcer prevalence and distribution. METHODS:We did a systematic review of Buruli ulcer prevalence and used ...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30171-8
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Social protection interventions might improve tuberculosis outcomes and could help to control the epidemic in Brazil. The aim of this study was to evaluate the independent effect of the Bolsa Familia Programme (BFP) on tuberculosis treatment outcomes in Brazil. METHODS:We prospectively recruited and followe...
journal_title:The Lancet. Global health
pub_type: 杂志文章,多中心研究
doi:10.1016/S2214-109X(18)30478-9
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lympha...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30286-2
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Children who are HIV-exposed uninfected (HEU) have higher morbidity and mortality than children who are HIV-unexposed and uninfected despite safer breastfeeding and improved maternal health with maternal antiretroviral therapy. We present the first global estimates of the population of children who are HEU (...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30448-6
更新日期:2020-01-01 00:00:00
abstract::Development assistance for health (DAH), the value of which peaked in 2013 and fell in 2015, is unlikely to rise substantially in the near future, increasing reliance on domestic and innovative financing sources to sustain health programmes in low-income and middle-income countries. We examined innovative financing in...
journal_title:The Lancet. Global health
pub_type: 杂志文章,评审
doi:10.1016/S2214-109X(17)30198-5
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Progress in reproductive, maternal, newborn, and child health (RMNCH) in Kenya has been inconsistent over the past two decades, despite the global push to foster accountability, reduce child mortality, and improve maternal health in an equitable manner. Although several cross-sectional assessments have been ...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(17)30246-2
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Avahan is a large-scale, HIV preventive intervention, targeting high-risk populations in south India. We assessed the cost-effectiveness of Avahan to inform global and national funding institutions who are considering investing in worldwide HIV prevention in concentrated epidemics. METHODS:We estimated cost...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(14)70277-3
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:In 2002-04, we did a randomised controlled trial in southern Nepal, and reported that children born to mothers taking multiple micronutrient supplements during pregnancy had a mean birthweight 77 g greater than children born to mothers taking iron and folic acid supplements. Children born to mothers in the s...
journal_title:The Lancet. Global health
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2214-109X(14)70314-6
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Tuberculosis is recognised as a major cause of morbidity and mortality in children, with most cases in children going undiagnosed and resulting in poor outcomes. Household contact management, which aims to identify children with active tuberculosis and to provide preventive therapy for those with HIV or thos...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30401-7
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:In malarious areas, pregnant women are more likely to have detectable malaria than are their non-pregnant peers, and the excess risk of infection varies with gravidity. Pregnant women attending antenatal clinic for their first visit are a potential pragmatic sentinel group to track the intensity of malaria t...
journal_title:The Lancet. Global health
pub_type: 杂志文章,meta分析,评审
doi:10.1016/S2214-109X(15)00049-2
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Faltering in linear growth and neurobehavioural development during early childhood are often assumed to have common causes because of their consistent association. This notion has contributed to a global focus on the promotion of nutrition during pregnancy and childhood to improve both conditions. Our aim wa...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30361-4
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Global rollout of dolutegravir-based antiretroviral therapy (ART) has been hampered in part by insufficient safety data in pregnancy. We compared birth outcomes among women initiating dolutegravir-based ART with those among women initiating efavirenz-based ART in pregnancy in Botswana. METHODS:In this obser...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30218-3
更新日期:2018-07-01 00:00:00