BACKGROUND Low-income and middle-income countries (LMICs) bear a heavy burden from communicable, maternal, and childhood diseases, yet access to health products addressing these burdens is lagging. We aimed to provide empirical evidence about the timelines, and influencing factors, of the end-to-end scale-up pathway of health products in LMICs. METHODS We identified products that met our prespecified

BACKGROUND Although post-tuberculosis lung disease poses a substantial threat to individuals who have recovered from pulmonary tuberculosis, data showing objective functional impairment in such people are scarce. We did a systematic review and meta-analysis to estimate respiratory impairment after pulmonary tuberculosis disease and examine differences in ventilatory defects. METHODS We systematically

BACKGROUND Probiotics are commonly given to preterm and term infants to reduce gut colonisation and prevent disease. Evidence for the beneficial effect of probiotic therapy is sparse, particularly in term infants from low-income and middle-income countries with high infant morbidity and mortality. This study aimed to assess whether a 4-week course of probiotic therapy might reduce death and hospitalisation

BACKGROUND Oral HIV pre-exposure prophylaxis (PrEP) can effectively reduce HIV incidence. A 2020-21 demonstration project assessed the feasibility and health outcomes of offering oral PrEP to men who have sex with men (MSM) in Cotonou, Benin. We evaluated the epidemiological impact and cost-effectiveness of this project and the potential scale-up of oral HIV PrEP for MSM in Cotonou. METHODS We calibrated

BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of paediatric hospital admissions worldwide, straining health systems. A lack of data on the burden of RSV infections and the impact on health systems in resource-limited settings hinders evidence-based policy decisions. Here, we aimed to assess RSV's burden on the health system in Bangladesh. METHODS From January to December, 2019, we

BACKGROUND Understanding human papillomavirus (HPV)-related cancer epidemiology in South Africa is crucial for informing cancer prevention in this high-burden country. We aimed to describe HPV-related cancer incidence in South Africa between 2011 and 2021. METHODS For this cross-sectional study, we obtained data on cancer incidence from the South African National Cancer Registry and population estimates

BACKGROUND Optimal dosing of praziquantel for schistosomiasis for children younger than 5 years is not established and some studies suggest this age group might need a higher dosing per kilogram. Our aim was to assess the safety and efficacy of a split dose of 80 mg/kg of praziquantel tablets given in a single day to preschool children versus the recommended single dose of 40 mg/kg for treatment of

BACKGROUND Although HIV incidence has considerably decreased in eastern, central, and southern Africa, new HIV infections continue to be a major public health challenge in the region. We aimed to investigate where in the HIV treatment cascade new transmissions are occurring in Malawi, Zimbabwe, and South Africa (the three countries involved in the Modelling to Inform HIV Programmes in Sub-Saharan Africa

Little is known about cancer disparities faced by diverse sexual and gender minority (SGM) populations globally, with unique barriers in many low-income and middle-income countries. This Viewpoint examines the intersectional challenges faced by SGM groups across multiple settings in accessing high-quality equitable cancer care. In India, the Hijra population (a legally recognised third gender) experiences

BACKGROUND In November, 2020, WHO authorised novel oral polio vaccine type 2 (nOPV2) use under Emergency Use Listing in response to outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2). Although no concerns were identified in nOPV2 trials, the Global Advisory Committee on Vaccine Safety requested more extensive vaccine safety data during emergency use. The Uganda Ministry of Health declared

BACKGROUND People with multidrug-resistant tuberculosis experience burdensome symptoms, clinical uncertainty, and high mortality. Palliative care is a designated essential health service under Universal Health Coverage. We aimed to test the hypothesis that receipt of additional nurse-led palliative care would improve patient-reported outcomes for patients with multidrug-resistant tuberculosis, compared

Despite impressive reductions in overall global child mortality, the rate of decline has slowed during the past decade. Current guidelines for the care of paediatric patients in low-resource settings mostly focus on broad clinical syndromes or undernutrition rather than children's individual contextualised risk. We aimed to identify readily assessable child-level characteristics that can predict mortality

Most people in low-income and middle-income countries (LMICs) now live in cities, as opposed to rural areas where access to care and provider choice is limited. Urban health-care provision is organised on very different patterns to those of rural care. We synthesise global evidence to show that health-care clinics are plentiful and easily accessible in LMIC cities and that they are seldom overcrowded

Cryptococcal meningitis is a major driver of global HIV-related mortality, and validated approaches to stratify mortality risk could help to target effective treatment strategies. We aimed to develop and validate models to predict risk of all-cause mortality in people with HIV-associated cryptococcal meningitis in sub-Saharan African countries.

The landscape of primary care services in low-income and middle-income country cities is diverse and dynamic, yet the quality of care received is too often low and the financial cost to the patient high. In the second Paper in this Series, we argue that shaping the primary care market is likely to provide larger returns to scale than individual quality improvement initiatives. Among other things, the

In previous clinical trials, oral fexinidazole treatment showed a favourable safety profile, while being easily administered and effective for most adult and paediatric patients with gambiense human African trypanosomiasis. The aim of this open-label cohort study was to investigate the effectiveness and safety of fexinidazole in a wider population of patients and to explore the feasibility of treating

Menstrual health is a human rights issue, affecting many aspects of life including mental health, wellbeing, and education. We assessed the effectiveness and costs of a school-based, multi-component menstrual health intervention (MENISCUS) to improve mental health problems and educational performance among in-school adolescents.

The RTS,S/AS01E malaria vaccine was introduced in selected communities of Ghana, Kenya, and Malawi in 2019 under a WHO-coordinated pilot programme. The scarcity of background disease incidence rates might hamper the assessment of vaccine safety and effectiveness. We aimed to determine the incidence rates of malaria, meningitis, and death, and health outcomes leading to hospital admission in children

Mental health conditions contribute substantially to the global burden of disease, affecting quality of life and leading to increased health-care expenses and mortality. Accurate data on the prevalence and correlates of these disorders are crucial for policy making, advocacy, and improving population health, but there are notable gaps in the available data on the magnitude of mental health difficulties

Ischaemic heart disease (IHD) and ischaemic stroke are leading causes of death worldwide. Although extensively studied, previous research has predominantly addressed these two diseases in isolation. Comorbidity research faces challenges both at the patient level and in terms of study methods. We aimed to characterise the global co-occurrence pattern of IHD and ischaemic stroke from a spatial perspective

Rhodesiense human African trypanosomiasis is a neglected disease with epidemic potential that can rapidly become lethal if left untreated. The aim of this study was to show that fexinidazole could offer an alternative to existing treatments (melarsoprol for stage 2 and suramin for stage 1 rhodesiense human African trypanosomiasis), using a benchmark study design.

Diagnosis of iron deficiency commonly relies on measurement of serum ferritin concentrations. WHO guidelines identify serum ferritin thresholds for iron deficiency among healthy individuals of less than 15 μg/L for women and less than 12 μg/L for children under 5 years, based on expert opinion. We report thresholds for iron deficiency for apparently healthy non-pregnant women and young children based

RTS,S/AS01E has been successfully administered to over two million children since 2019 through the Malaria Vaccine Implementation Programme (MVIP). In this Article, we report the safety results of a study evaluating RTS,S/AS01E safety and effectiveness in real-world settings.

Burns are a global issue that can result in lifelong multimorbidities and disproportionately affect people in low-resource settings. Prioritising research of importance to patients and health-care professionals improves evidence-based care. This prioritisation setting partnership was undertaken in global burn care (focusing on thermal non-electrical burns) by establishing a James Lind Alliance research

Non-traumatic coma in African children is a common life-threatening presentation often leading to hospital attendance. We aimed to estimate the distribution of non-traumatic coma causes and outcomes, including disease-specific outcomes, for which evidence is scarce.

Children in febrile coma in Africa are frequently hospitalised, with poorer outcomes than those in high-income settings. Cerebral malaria is historically the most common cause of febrile coma. Due to limited diagnostic and radiological resources and a decrease in malaria prevalence, there might be under-recognition of non-malarial coma. However, prospective data are scarce. We aimed to determine causes

Typhoid fever remains a substantial public health challenge in low-income and middle-income countries. By 2023, typhoid conjugate vaccines (TCVs) had been introduced in six countries globally, with more than 50 million doses distributed. Now that TCVs are being deployed, there is a need for observational studies to assess vaccine effectiveness in the field. We aimed to evaluate the validity of different

An effective adult vaccine is needed to control tuberculosis. We evaluated the safety and immunogenicity of a live-attenuated Mycobacterium tuberculosis vaccine (MTBVAC).