The Lancet

Julie Cassan,Agathe Claude,Mariuca de Hillerin,Audrey Fontaine,Paige Goodwin,Emily Halstead,Maya-Lhanze Lama,Yanis M'zali,Kim Paulin,Leonard Raimbault,Robin Tocqueville-Perrier,Riya Verma,Chloe Villaret

doi : 10.1016/S0140-6736(21)00523-7

CORRESPONDENCE| VOLUME 397, ISSUE 10282, P1350, APRIL 10, 2021

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Department of Error

doi : 10.1016/S0140-6736(21)00727-3

DEPARTMENT OF ERROR| VOLUME 397, ISSUE 10282, P1350, APRIL 10, 2021

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Department of Error

doi : 10.1016/S0140-6736(21)00777-7

DEPARTMENT OF ERROR| VOLUME 397, ISSUE 10282, P1350, APRIL 10, 2021

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Efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 variant of concern 202012/01 (B.1.1.7): an exploratory analysis of a randomised controlled trial

Katherine R W Emary,Tanya Golubchik,Parvinder K Aley,Cristina V Ariani,Brian Angus,Sagida Bibi,Beth Blane,David Bonsall,Paola Cicconi,Sue Charlton,Elizabeth A Clutterbuck,Andrea M Collins,Tony Cox,Thomas C Darton,Christina Dold,Alexander D Douglas,Christopher J A Duncan,Katie J Ewer,Amy L Flaxman,Saul N Faust,Daniela M Ferreira,Shuo Feng,Adam Finn,Pedro M Folegatti,Michelle Fuskova,Eva Galiza,Anna L Goodman,Catherine M Green,Christopher A Green,Melanie Greenland,Bassam Hallis,Paul T Heath,Jodie Hay,Helen C Hill,Daniel Jenkin,Simon Kerridge,Rajeka Lazarus,Vincenzo Libri,Patrick J Lillie,Catherine Ludden,Natalie G Marchevsky,Angela M Minassian,Alastair C McGregor,Yama F Mujadidi,Daniel J Phillips,Emma Plested,Katrina M Pollock,Hannah Robinson,Andrew Smith,Rinn Song,Matthew D Snape,Rebecca K Sutherland,Emma C Thomson,Mark Toshner,David P J Turner,Johan Vekemans,Tonya L Villafana,Christopher J Williams,Adrian V S Hill,Teresa Lambe,Sarah C Gilbert,Merryn Voysey,Maheshi N Ramasamy,Andrew J Pollardon behalf of the COVID-19 Genomics UK consortium,the AMPHEUS Project,and the Oxford COVID-19 Vaccine Trial Group

doi : 10.1016/S0140-6736(21)00628-0

ARTICLES| VOLUME 397, ISSUE 10282, P1351-1362, APRIL 10, 2021

A new variant of SARS-CoV-2, B.1.1.7, emerged as the dominant cause of COVID-19 disease in the UK from November, 2020. We report a post-hoc analysis of the efficacy of the adenoviral vector vaccine, ChAdOx1 nCoV-19 (AZD1222), against this variant.

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The SANAD II study of the effectiveness and cost-effectiveness of levetiracetam, zonisamide, or lamotrigine for newly diagnosed focal epilepsy: an open-label, non-inferiority, multicentre, phase 4, randomised controlled trial

Anthony Marson,Girvan Burnside,Richard Appleton,Dave Smith,John Paul Leach,Graeme Sills,Catrin Tudur-Smith,Catrin Plumpton,Dyfrig A Hughes,Paula Williamson,Gus A Baker,Silviya Balabanova,Claire Taylor,Richard Brown,Dan Hindley,Stephen Howell,Melissa Maguire,Rajiv Mohanraj,Philip E Smithon behalf of the SANAD II collaborators

doi : 10.1016/S0140-6736(21)00247-6

ARTICLES| VOLUME 397, ISSUE 10282, P1363-1374, APRIL 10, 2021

Levetiracetam and zonisamide are licensed as monotherapy for patients with focal epilepsy, but there is uncertainty as to whether they should be recommended as first-line treatments because of insufficient evidence of clinical effectiveness and cost-effectiveness. We aimed to assess the long-term clinical effectiveness and cost-effectiveness of levetiracetam and zonisamide compared with lamotrigine in people with newly diagnosed focal epilepsy.

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The SANAD II study of the effectiveness and cost-effectiveness of valproate versus levetiracetam for newly diagnosed generalised and unclassifiable epilepsy: an open-label, non-inferiority, multicentre, phase 4, randomised controlled trial

doi : 10.1016/S0140-6736(21)00246-4

ARTICLES| VOLUME 397, ISSUE 10282, P1375-1386, APRIL 10, 2021

Valproate is a first-line treatment for patients with newly diagnosed idiopathic generalised or difficult to classify epilepsy, but not for women of child-bearing potential because of teratogenicity. Levetiracetam is increasingly prescribed for these patient populations despite scarcity of evidence of clinical effectiveness or cost-effectiveness. We aimed to compare the long-term clinical effectiveness and cost-effectiveness of levetiracetam compared with valproate in participants with newly diagnosed generalised or unclassifiable epilepsy.

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Bilateral elongated styloid processes: Eagle syndrome

Brihaspati Sigdel,Mitesh Karn,Kusheshwar Sah

doi : 10.1016/S0140-6736(21)00531-6

CLINICAL PICTURE| VOLUME 397, ISSUE 10282, P1387, APRIL 10, 2021

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Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda

Cesar G Victora,Parul Christian,Luis Paulo Vidaletti,Giovanna Gatica-Dom?nguez,Purnima Menon,Robert E Black

doi : 10.1016/S0140-6736(21)00394-9

SERIES|MATERNAL AND CHILD UNDERNUTRITION PROGRESS| VOLUME 397, ISSUE 10282, P1388-1399, APRIL 10, 2021

13 years after the first Lancet Series on maternal and child undernutrition, we reviewed the progress achieved on the basis of global estimates and new analyses of 50 low-income and middle-income countries with national surveys from around 2000 and 2015. The prevalence of childhood stunting has fallen, and linear growth faltering in early life has become less pronounced over time, markedly in middle-income countries but less so in low-income countries. Stunting and wasting remain public health problems in low-income countries, where 4·7% of children are simultaneously affected by both, a condition associated with a 4·8-times increase in mortality. New evidence shows that stunting and wasting might already be present at birth, and that the incidence of both conditions peaks in the first 6 months of life. Global low birthweight prevalence declined slowly at about 1·0% a year. Knowledge has accumulated on the short-term and long-term consequences of child undernutrition and on its adverse effect on adult human capital. Existing data on vitamin A deficiency among children suggest persisting high prevalence in Africa and south Asia. Zinc deficiency affects close to half of all children in the few countries with data. New evidence on the causes of poor growth points towards subclinical inflammation and environmental enteric dysfunction. Among women of reproductive age, the prevalence of low body-mass index has been reduced by half in middle-income countries, but trends in short stature prevalence are less evident. Both conditions are associated with poor outcomes for mothers and their children, whereas data on gestational weight gain are scarce. Data on the micronutrient status of women are conspicuously scarce, which constitutes an unacceptable data gap. Prevalence of anaemia in women remains high and unabated in many countries. Social inequalities are evident for many forms of undernutrition in women and children, suggesting a key role for poverty and low education, and reinforcing the need for multisectoral actions to accelerate progress. Despite little progress in some areas, maternal and child undernutrition remains a major global health concern, particularly as improvements since 2000 might be offset by the COVID-19 pandemic.

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Mobilising evidence, data, and resources to achieve global maternal and child undernutrition targets and the Sustainable Development Goals: an agenda for action

Rebecca A Heidkamp,Ellen Piwoz,Stuart Gillespie,Emily C Keats,Mary R D'Alimonte,Purnima Menon,Jai K Das,Augustin Flory,Jack W Clift,Marie T Ruel,Stephen Vosti,Jonathan Kweku Akuoku,Zulfiqar A Bhutta

doi : 10.1016/S0140-6736(21)00568-7

SERIES|MATERNAL AND CHILD UNDERNUTRITION PROGRESS| VOLUME 397, ISSUE 10282, P1400-1418, APRIL 10, 2021

As the world counts down to the 2025 World Health Assembly nutrition targets and the 2030 Sustainable Development Goals, millions of women, children, and adolescents worldwide remain undernourished (underweight, stunted, and deficient in micronutrients), despite evidence on effective interventions and increasing political commitment to, and financial investment in, nutrition. The COVID-19 pandemic has crippled health systems, exacerbated household food insecurity, and reversed economic growth, which together could set back improvements in undernutrition across low-income and middle-income countries. This paper highlights how the evidence base for nutrition, health, food systems, social protection, and water, sanitation, and hygiene interventions has evolved since the 2013 Lancet Series on maternal and child nutrition and identifies the priority actions needed to regain and accelerate progress within the next decade. Policies and interventions targeting the first 1000 days of life, including some newly identified since 2013, require renewed commitment, implementation research, and increased funding from both domestic and global actors. A new body of evidence from national and state-level success stories in stunting reduction reinforces the crucial importance of multisectoral actions to address the underlying determinants of undernutrition and identifies key features of enabling political environments. To support these actions, well-resourced nutrition data and information systems are essential. The paper concludes with a call to action for the 2021 Nutrition for Growth Summit to unite global and national nutrition stakeholders around common priorities to tackle a large, unfinished undernutrition agenda—now amplified by the COVID-19 crisis.

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