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[Perspectives] Pascale Ondoa: strengthening laboratory medicine in Africa

Sa, 27/11/2021 - 00:00
“Our core aim is to build laboratory systems to address the health agenda as defined by Africa”, says Pascale Ondoa, who for the past 5 years has been Director of Science and New Initiatives at the African Society for Laboratory Medicine (ASLM). Part of this role is to direct technical advice and provide leadership to help shape health strategy and laboratory medicine improvement at the country level. “A lot of our work involves the coordination of partners and experts, so that investments from agencies like PEPFAR, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Fleming Fund, and others generate substantial and sustainable impact.

[Perspectives] A history of US engagement in the HIV/AIDS response

Sa, 27/11/2021 - 00:00
>In late September, 2021, US President Joe Biden tapped John Nkengasong to lead the US President's Emergency Plan for AIDS Relief (PEPFAR). If approved for the role as Ambassador-at-Large and Coordinator of US Government Activities to Combat HIV/AIDS Globally, Nkengasong will inherit a programme at a point of inflection. PEPFAR has been leaderless since Deborah Birx decamped in February, 2020, to coordinate the White House's COVID-19 response under the administration of Donald Trump. She left PEPFAR ahead of the findings from UNAIDS in July, 2020, that highlighted uneven progress towards 2020 milestones in the global bid to end the AIDS epidemic by 2030.

[Perspectives] A reproductive justice response to HIV/AIDS and COVID-19

Sa, 27/11/2021 - 00:00
Lana is a young Black woman living with HIV in Kingston, Jamaica. A mother of young children, she was concerned about what COVID-19 would mean for her pre-existing diagnosis. During the COVID-19 pandemic she has struggled to find psychosocial support groups, consistent access to antiretrovirals, and employment opportunities to maintain her health and support herself and her family. Pam, a middle-aged HIV-positive woman in Detroit, MI, USA, is a caregiver and local HIV organiser who provides emotional and social support to other newly diagnosed people.

[Obituary] Michael Llewellyn Rutter

Sa, 27/11/2021 - 00:00
First professor of child psychiatry in the UK. He was born in Brummana, Lebanon, on Aug 15, 1933, and died of cancer in London, UK, on Oct 23, 2021, aged 88 years.

[Correspondence] Pollution and the developing brain

Sa, 27/11/2021 - 00:00
The Editorial about the social determinants of brain health1 does a superb job of pointing out the powerful association between social disadvantage—poverty, childhood adversity, and violence—and mental disorders. It argues cogently that there is need for psychopharmacologically oriented psychiatric practitioners to join forces with epidemiologists and sociologists to seek holistic approaches to the prevention and treatment of mental illness. Well said!

[Correspondence] Mandatory UK folic acid fortification

Sa, 27/11/2021 - 00:00
Paul Haggarty's Comment is welcome in drawing attention to the recent decision by the UK Government to fortify non-wholemeal wheat flour with folic acid (vitamin B9).1 Mandatory folic acid fortification will help prevent the birth defects spina bifida and anencephaly and other neural tube defects (NTDs). The Government's decision is a positive step but we have a number of concerns.

[Correspondence] Quality assurance of remote clinical assessments in the NHS

Sa, 27/11/2021 - 00:00
COVID-19 has accelerated the proportion of digital patient consultations across community and hospital settings, bringing both challenge and opportunity to health-care organisations and their staff. Within our own work, one such opportunity was the increased ability to record and review consultation audio, benefiting not just organisational quality assurance and complaint and incident investigation but also providing meaningful feedback to support clinicians’ continuous professional development.

[Correspondence] Beyond COVID-19: scaling up and sustaining mobile health in Africa

Sa, 27/11/2021 - 00:00
In their Perspective,1 N Hélène Sawadogo and colleagues highlight the challenges of mobile health care in Africa with the MOS@N project, which provided medical support to pregnant women but ran out of funding 3 years into operation. Securing longer-term funding to sustain mobile health is a challenge in Africa.2 Social innovations such as BIMA (Ghana), AccesAfya (Kenya), Idocta (Cameroon), and Healthforce (South Africa) use telemedicine to improve access to quality health care but have not managed to scale up.

[Correspondence] Beyond COVID-19: scaling up and sustaining mobile health in Africa – Authors' reply

Sa, 27/11/2021 - 00:00
We thank Yap Boum for taking the time to respond to our Perspective.1

[Correspondence] COVID-19 and myocardial infarction

Sa, 27/11/2021 - 00:00
Ioannis Katsoularis and colleagues1 found that COVID-19 is a risk factor for myocardial infarction and stroke through self-controlled case series evaluation, a method that has been used to establish the risk of myocardial infarction associated with influenza infection.2,3 Regarding myocardial infarction, as the investigators recognised, one of the possible limitations of this research is the inaccurate diagnosis and codification of myocardial injury or myocarditis as myocardial infarction, particularly because the current myocardial infarction definition (and diagnostic methods) differ from the definition at the time of the registry outcome validation study.

[Correspondence] COVID-19 and myocardial infarction – Authors' reply

Sa, 27/11/2021 - 00:00
We thank Daniel Caldeira and Fausto Pinto for their comments regarding our study1 focusing on COVID-19 and myocardial infarction. We did acknowledge the difficulties in distinguishing between different types of myocardial injuries in the discussion. The International Classification of Diseases versions 9 and 10 unfortunately do not distinguish between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI), which is a limitation of our study.

[Department of Error] Department of Error

Sa, 27/11/2021 - 00:00
The HIP ATTACK Investigators. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial. Lancet 2020; 395: 698–708—In this Article, numbers of patients in the subgroup analysis have been corrected, including in the Results and Discussion text and in the appendix. These corrections have been made to the online version as of Nov 25, 2021.

[Department of Error] Department of Error

Sa, 27/11/2021 - 00:00
Ponikowski P, Kirwan B-A, Anker SD, et al. Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double-blind, randomised, controlled trial. Lancet 2020; 396: 1895–904—In this Article, Stephan von Haehling's affiliations should have included “DZHK (German Center for Cardiovascular Research), Göttingen partner site, Göttingen, Germany”. Department names within the University Medical Center Göttingen should also have been included for Stephan von Haehling and Tim Friede.

[Department of Error] Department of Error

Sa, 27/11/2021 - 00:00
Prasad A. Stephani Hatch: rethinking power in health-care research. Lancet 2021; 398: 1559—In this Profile, the second sentence of the fourth paragraph has been corrected to read “…Health and Social Equity Hub for which she is a Co-Principal Investigator”. This correction has been made to the online version as of Nov 25, 2021.

[Department of Error] Department of Error

Sa, 27/11/2021 - 00:00
Watts G. Gwynifer Clare Wenger. Lancet 2021; 398: 1562—In this Obituary, Richard Hadley has been corrected to Roger Hadley in the final sentence. This correction has been made to the online version as of Nov 25, 2021.

[Department of Error] Department of Error

Sa, 27/11/2021 - 00:00
Abu Dayyeh BK, Maselli DB, Rapaka B, et al. Adjustable intragastric balloon for treatment of obesity: a multicentre, open-label, randomised clinical trial. Lancet 2021; 398: 1965–73—In this Article, where missing, 95% CIs, SDs, and n/N have been added. Additionally, findings for alanine aminotransferase concentrations have been added to the Results. These corrections have been made to the online version as of Nov 25, 2021, and the printed version is correct.

[Clinical Picture] Unexplained uterine atrophy following neoadjuvant chemotherapy in fertility sparing management of cervical cancer

Sa, 27/11/2021 - 00:00
A 31-year-old nulliparous woman attended our hospital for treatment of squamous cell carcinoma of the cervix. She had previously presented with vaginal bleeding and a 28 mm lesion had been found on clinical examination and shown on MRI. We aimed to adopt a fertility sparing strategy—neoadjuvant chemotherapy followed by conservative surgery of the body of the uterus—since biopsy samples of both pelvic sentinel lymph nodes showed no signs of metastatic spread.

[Perspectives] 2021 Global Health Film Festival: platform for change

Gi, 25/11/2021 - 00:30
The 20th-century political philosopher Hannah Arendt understood the power of storytelling. “No philosophy, no analysis, no aphorism, be it ever so profound, can compare in intensity and richness of meaning with a properly narrated story”, she wrote in her essay collection Men in Dark Times. Small wonder, Arendt observed, that in totalitarian states, artists, intellectuals, and writers are some of the first individuals to be silenced. For stories that captivate people's hearts and minds may galvanise them into subversive action.

[Editorial] Afghanistan: the international community must act

Sa, 20/11/2021 - 00:00
“It is going to be hell on Earth.” Afghanistan is set to become the world's worst humanitarian crisis according to David Beasley, head of the World Food Programme. Nearly half of Afghans need humanitarian aid. 22·8 million people could face acute hunger this winter, with 8·7 million at emergency levels of food insecurity. A resulting refugee crisis is likely to affect Afghanistan, the region, and the rest of the world. In desperation, people are selling their assets, and some are resorting to child labour and child marriage.

[Comment] Offline: The flies of our remorse

Sa, 20/11/2021 - 00:00
Eugene Richardson's Epidemic Illusions (2020) is subtitled On the Coloniality of Global Public Health. Although listed as the book's author, he prefers to describe himself as “a single node in a vast, interconnected net of support, mentoring, toleration, encouragement, inspiration, and generosity”. He lists over 140 “other nodes”—individuals, organisations, and groups—to whom he owes a debt, with “the twin goals of epistemic reconstitution and improvement of human well-being”. Although not a handbook explaining how to decolonise medicine and global health, Richardson has delivered what may be the first attempt to explore what decolonisation might achieve.