The Lancet

ImportanceRecent reports have highlighted an intense influenza activity related to the circulation of the influenza A(H3N2) subclade k variant. There is no data available on the impact of the emergence of H3N2 subclade k on the severity of the 2025-2026 epidemic or on the clinical phenotype of patients requiring admission to the intensive care unit (ICU). ObjectiveTo compare the clinical presentation, hospital mortality and virological characteristics of patients with laboratory-confirmed influ...

BackgroundSnakebite envenoming (SBE) remains a major neglected tropical disease in Sudan. Venom-induced consumption coagulopathy (VICC) is the most frequent and fatal systemic complication, particularly following envenoming by hemotoxic Echis species. Robust clinical data on VICC in Sudan are limited. MethodsWe conducted a prospective hospital-based cohort study at Sinja Teaching Hospital, Sennar state, Sudan, from March to September 2022. All patients admitted with SBE were enrolled. VICC was ...

BackgroundThe COVID-19 pandemic disproportionately affected vulnerable populations, including individuals with rare diseases (RDs) and, in the general population, those from ethnic minority backgrounds. However, the intersectional risk, and how these vulnerabilities combine, is poorly understood. A comprehensive baseline map of RD prevalence by granular ethnicity is required to investigate the pandemics true impact on these complex patient groups. MethodsThis study had two aims: (1) to generate...

Health metrics and modelling capacity have expanded to address present burden and burden attributable to risk factors in the past. There remains a gap in accessible tools that estimate avoidable burden; --that is, the future health and economic impacts of preventive and treatment interventions. This paper describes and demonstrates the Health Interventions Impact Calculator (HIIC), a free web-based analysis and visualisation tool that allows for rapid estimation of the future health and economi...

BackgroundDeath certificates record both an underlying cause and contributing conditions, yet mortality statistics predominantly report only the underlying cause. We quantify this "hidden burden" across all ICD-10 conditions in Australian mortality data using the multiple-to-underlying ratio (MUR): total death certificate mentions divided by underlying cause deaths. MethodsWe analysed Australian Bureau of Statistics Causes of Death 2023 data (N = 187,268 registered deaths) to compute the ratio ...

BackgroundNeonatal IgM antibodies reflect an in-utero immune response to Treponema pallidum and may offer added diagnostic value. This study evaluated the test performance of treponemal IgM levels measured by the research-use-only (RUO) DPP Syphilis TnT point-of-care (POC) assay for CS risk stratification. MethodsConducted from May 2023 to May 2025, this study tested neonatal serum samples from infants born to mothers with syphilis using the DPP Syphilis TnT RUO POC assay, which reports trepone...

BackgroundSmoking, unhealthy nutrition, alcohol consumption, and physical inactivity (SNAP behaviours) are major risk factors for multimorbidity but are often studied in isolation. Using longitudinal data, Suhag et al. identified clusters of older adults (aged [≥]50) with common SNAP behaviour patterns and distinct sociodemographic profiles and multimorbidity prevalence; whether and how these patterns generalise across adulthood remains unclear. AimTo conceptually replicate Suhag et al. acro...

BackgroundDuring the COVID-19 pandemic period, healthcare systems substantially reorganized their management of several diseases, including acute cardiovascular diseases (ACVD) such as heart failure, stroke, myocardial infarction, and pulmonary embolism. While previous studies have reported changes in hospitalization rates and clinical outcomes, the economic impact of the pandemic on healthcare expenditures for patients with ACVD remains poorly documented. This study aimed to quantify disruption...

BackgroundClimate change is increasingly recognised as a threat to population health and healthcare systems, yet the effects of environmental variability on pharmaceutical prescribing remain poorly characterised in the UK. Using a wide array of open-source datasets, we examine the effect of environmental, geographic and socioeconomic factors on prescribing habits in England. MethodsWe linked monthly, practice-level prescribing data for England (2010-2025) to meteorological, air-quality, floodin...

BackgroundAustralia is experiencing its worst syphilis epidemic in decades, driven by two distinct outbreaks -- a heterosexual epidemic disproportionately affecting Aboriginal and Torres Strait Islander communities in northern Australia, and a predominantly MSM-associated epidemic in urban centres. We examined the spatial dynamics of this dual epidemic, including geographic clustering, service accessibility associations, and COVID-19 impacts. MethodsWe analysed publicly available aggregate surv...

BackgroundHeartland virus (HRTV) is an emerging tick-borne virus capable of causing severe illness and death. The burden of disease is likely underestimated due to limited seroprevalence studies, lack of commercially available diagnostic tests, and an overlapping clinical syndrome with more commonly diagnosed bacterial diseases such as spotted fever group rickettsiosis or ehrlichiosis. MethodsActive surveillance for Heartland virus disease was conducted at a large academic center from March to ...

BackgroundDuring the early phase of the Covid-19 pandemic in England, people with pre-existing conditions that put them at severe clinical risk if infected were advised to drastically reduce face-to-face contacts in a policy known as "shielding". The impact of this policy in preventing COVID-19 hospitalisations and deaths has not been evaluated at the national level using transmission-dynamic modelling. MethodsWith the approval of NHS England, we present a retrospective cohort evaluation of the...

BACKGROUNDOn 14 August 2024, WHO Director-General declared a public health emergency of international concern (PHEIC) following a sharp increase in mpox cases linked to the emergence of monkeypox virus (MPXV) clade Ib. We characterise imported and autochthonous cases of MPXV clade I reported in the WHO European Region since August 2024. METHODSBetween 14 August 2024 and 23 November 2025, we collected key information of MPXV clade I infections reported by member states of the WHO European Region...

Ebola virus disease (EVD) survivors often present with clinical sequelae after acute disease resolution, called post-Ebola syndrome (PES). Why some survivors develop these sequelae and others do not is poorly defined. Altered metabolism has been noted in acute EVD but not studied in PES. We identified differential expression of metabolites involved in multiple metabolic pathways in EVD survivors with PES. This included the tricarboxylic acid cycle, amino acid, nucleotide, and short chain fatty a...

BackgroundAfrica continues to have a significant public health problem with mpox, where endemic transmission persists and overlaps with a high burden of other infectious diseases. Although their epidemiology and clinical impact are still poorly understood throughout the continent, coinfections with human immunodeficiency virus (HIV) and varicella-zoster virus (VZV) can affect the clinical picture, severity of the disease, and accuracy of the diagnosis. MethodsFollowing PRISMA criteria, we regis...

ObjectivesThere is a deficit of information available to guide longer-term healthcare planning in meeting health needs and ensuring financial sustainability. This study attempts to address this gap through projecting future population health state and demographics and associated healthcare resources required to satisfy expected demands over the next two decades. MethodsA mathematical model is developed for projecting a populations future age and health state, subject to births, deaths, immigrat...

ObjectiveCongenital syphilis remains a preventable cause of fetal and neonatal morbidity and mortality, despite the availability of inexpensive diagnostics and effective treatment. We aimed to evaluate the maternal and congenital syphilis burden at the Instituto Nacional Materno Perinatal, Perus national referral center for maternal and perinatal care. MethodsWe conducted a retrospective analysis of aggregated, de-identified surveillance data from January 2023 to December 2025. Maternal prevale...

BackgroundCo-occurring substance use and mental health disorders (COD) represent a growing public health concern, yet healthcare utilization studies with a large sample size remain limited. This study examined healthcare utilization patterns and sociodemographic correlates among COD adults using data from the All of Us Research Program (2018-2023). MethodsElectronic health record data were analyzed for adults aged [≥]18 years with confirmed diagnoses of substance use and mental health disord...

Infection with pnuemococcus bacteria is generally mild but can be more severe in the young and elderly, causing invasive pneumococcal disease (IPD) and community-acquired pneumonia (CAP). Although paediatric pneumococcal conjugate vaccine (PCV) programmes and elderly pneumococcal polysaccharide vaccine (PPV) programmes have reduced cases, we estimate that pneumococcal infection still leads to direct health care costs of around {pound}68M and approximately 16 thousand QALY losses in England per y...

BackgroundMpox has spread to 35 countries in Africa, yet many face challenges achieving nationwide PCR-based testing due to cost and limited access in remote and rural areas. Point-of-care antigen-based rapid diagnostic tests (AgRDTs) may help improve diagnostic access. ObjectivesTo evaluate the diagnostic accuracy of five mpox AgRDTs manufactured by Beijing Hotgen Biotech (China), Contipharma (Belgium), Hangzhou Testsea Biotechnology (China), Guangdong Wesail Biotech (China), and NG Biotech (F...