The Lancet Regional Health: Western Pacific最新文献

{"title":"Pathogen distribution and antimicrobial resistance among neonatal bloodstream infections in Southeast Asia: results from NeoSEAP, a multicentre retrospective study","authors":"Benjamin F.R. Dickson ,&nbsp;Michelle Harrison ,&nbsp;Maria Esterlita T. Villanueva-Uy ,&nbsp;Nina Dwi Putri ,&nbsp;Riyadi Adrizain ,&nbsp;Leny Kartina ,&nbsp;Gayana P.S. Gunaratna ,&nbsp;Hoang T. Tran ,&nbsp;Nguyen X. Huong ,&nbsp;Siew M. Fong ,&nbsp;Erena S. Kasahara ,&nbsp;Distyayu Sukarja ,&nbsp;Tetty Yuniati ,&nbsp;Martono Utomo ,&nbsp;Nambage S. Chandrasiri ,&nbsp;Chau H.M. Le ,&nbsp;Nguyen T.K. Trinh ,&nbsp;Ng Boon Hong ,&nbsp;Hoang N.T. Thuy ,&nbsp;Tran T.C. Tu ,&nbsp;Phoebe C.M. Williams","doi":"10.1016/j.lanwpc.2025.101617","DOIUrl":"10.1016/j.lanwpc.2025.101617","url":null,"abstract":"<div><h3>Background</h3><div>Progress in reducing morbidity and mortality due to neonatal sepsis has slowed in recent decades and is threatened by the global rise of antimicrobial resistance. The populous Southeast Asian region has a high burden of both neonatal sepsis and antimicrobial resistance (AMR). Despite this, there remains a lack of robust data on the epidemiology of neonatal sepsis and the prevalence of AMR within the region.</div></div><div><h3>Methods</h3><div>We evaluated positive blood cultures and susceptibility profiles responsible for neonatal sepsis across 10 clinical sites in five countries in South and Southeast Asia (Sri Lanka, Indonesia, The Philippines, Malaysia, and Vietnam). Retrospective data on all blood cultures collected from neonates over two years (1st January 2019–31st December 2020) were extracted from laboratory records. Data were also collected on the availability and implementation of infection prevention and control resources, and antimicrobial prescribing practices. Pooled estimates across sites and pathogens were generated, with adjustment for clustering.</div></div><div><h3>Findings</h3><div>Of 14,804 blood cultures collected over the study period, a total of 2131 positive isolates (including 1483 significant pathogens) were identified. Gram-negative bacteria predominated as causative of neonatal sepsis (78·4%; 1163/1483) with <em>Klebsiella</em> spp. (408/1483; 27·5%) and <em>Acinetobacter</em> spp. (261/1483; 17·6%) most frequently isolated overall. Adjusted pooled non-susceptibility for <em>Klebsiella</em> spp. was 86·7% (95% CI 54·0–98·5) for third-generation cephalosporins (ceftriaxone and/or cefotaxime; 3GC) and 17·1% (95% CI 8·1–24·7) for carbapenems; while non-susceptibility for <em>Escherichia coli</em> was 46·4% (95% CI 20·0–72·0) for 3GC and 15·4% (95% CI 2·7–31·0) for carbapenems. Carbapenem non-susceptibility for <em>Acinetobacter</em> spp. was 76·5% (95% CI 59·4–84·5). Gram-positive bacteria accounted for 13·2% (196/1483) of pathogens causative of neonatal sepsis, whilst <em>Candida</em> spp. accounted for 8·3% (123/1483) of culture-positive sepsis episodes.</div></div><div><h3>Interpretation</h3><div>Neonatal sepsis in tertiary hospitals in Southeast Asia is predominantly caused by gram-negative bacteria, with high rates of non-susceptibility to commonly prescribed antibiotics.</div></div><div><h3>Funding</h3><div>This study was supported by an <span>Australian National Health and Medical Research Council (NHMRC)</span> grant. The NHMRC was not involved in the design or conduct of the research.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101617"},"PeriodicalIF":8.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The design and evaluation of the opportunistic endoscopic screening (OpENS) program for upper gastrointestinal tract cancers: a real-world study in China","authors":"Kexin Sun ,&nbsp;Shun He ,&nbsp;Huadong Wang ,&nbsp;Liang Qiao ,&nbsp;Nan Zhang ,&nbsp;Jiyu Tuo ,&nbsp;Li Yuan ,&nbsp;Lingbin Du ,&nbsp;Shaokai Zhang ,&nbsp;Yuqin Liu ,&nbsp;Yong Liu ,&nbsp;Liyan Xue ,&nbsp;Shangchun Jia ,&nbsp;Wenqiang Wei ,&nbsp;Guiqi Wang","doi":"10.1016/j.lanwpc.2025.101675","DOIUrl":"10.1016/j.lanwpc.2025.101675","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The effectiveness of endoscopic screening for upper gastrointestinal (UGI) tract cancers in high-risk areas of China has been well-established. However, the practicality of extending this screening to a wider geographical area remains uncertain. To bridge this gap, we have conducted a hospital-based opportunistic endoscopic screening (OpENS) program for UGI cancers since 2018. Our objectives were to elucidate the implementation process of the OpENS program and assess its effectiveness.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;875 hospitals from 710 districts/counties have participated in the OpENS program during 2019–2023. The endoscopic specialists and pathologists participating in the program were mandated to take annual training programs to acquire the fundamentals of screening techniques. Eligible patients who underwent endoscopic examinations were screened for UGI cancers. Patients diagnosed with high-grade intraepithelial neoplasia (HGIN), carcinoma in situ (CIS) and tumors in esophagus or/and stomach were defined as positive cases. Patients with HGIN and CIS were defined as early cases. All hospitals were required to submit screening data via the program's platform, with both the quality of the submitted data and the hospitals' performance being subject to a comprehensive evaluation. The age-standardized incidence rates (ASIRs) for the districts/counties where the participating hospitals were situated were derived from the cancer registry data for the year 2020. Districts/counties with ASIRs for UGI cancers over 22.0/10&lt;sup&gt;5&lt;/sup&gt; were classified as high-risk areas. The positive detection rate (PDR) and early diagnosis rate (EDR) were calculated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;After data cleaning, we included 808 hospitals from 616 districts/counties, with a collective participation of 7,066,892 individuals during 2019–2023. The overall PDR and EDR across all sites were 2.35% and 19.77%. The PDRs and EDRs were 1.02% and 23.18% in esophagus, and were 1.37% and 17.80% in stomach. The PDR was higher among males compared to females (3.59% vs 1.20%), and was increasing with age. The EDR was higher among females compared to males (20.66% vs 19.45%), peaking in the age group of 60–64 years. The PDRs and EDRs were higher in high-risk areas of UGI cancers (&lt;em&gt;p&lt;/em&gt; &lt; 0.05). After adjusting for age, sex, province, year of screening, regional UGI cancer incidence level and hospital tier, the hospitals that consecutively participated in the program for five years demonstrated higher PDRs and EDRs when compared to other hospitals (&lt;em&gt;p&lt;/em&gt; &lt; 0.05). Among the consecutively participated hospitals, tertiary-level hospitals demonstrated positive associations with the PDRs for both the esophagus and stomach when compared to secondary-level hospitals (&lt;em&gt;p&lt;/em&gt; &lt; 0.001). However, the tertiary-level hospitals showed a negative association with the EDR for the esophagus (OR = 0.91, 95% CI: 0.86–0.96, &lt;em&gt;p&lt;/em&gt; = ","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101675"},"PeriodicalIF":8.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes from haematoma evacuation for intracerebral haemorrhage in the INTERACT3 study","authors":"Xin Hu ,&nbsp;Menglu Ouyang ,&nbsp;Jianguo Xu ,&nbsp;Yi Liu ,&nbsp;Xi Li ,&nbsp;Yan Jiang ,&nbsp;Xiaoying Chen ,&nbsp;Laurent Billot ,&nbsp;Qiang Li MBiostat ,&nbsp;Alejandra Malavera ,&nbsp;Paula Muñoz Venturelli ,&nbsp;Asita de Silva ,&nbsp;Nguyen Huy Thang ,&nbsp;Kolawole W. Wahab ,&nbsp;Jeyaraj D. Pandian ,&nbsp;Mohammad Wasay ,&nbsp;Octavio M. Pontes-Neto ,&nbsp;Carlos Abanto ,&nbsp;Antonio Arauz ,&nbsp;Zongping Li ,&nbsp;Anila Anjum","doi":"10.1016/j.lanwpc.2025.101669","DOIUrl":"10.1016/j.lanwpc.2025.101669","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;There is ongoing controversy as to whether surgical intervention to haematoma evacuation benefits patients with acute intracerebral haemorrhage (ICH). This study aimed to evaluate the association of surgical intervention to evacuate the haematoma and 6-month functional outcome in participants of the third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a secondary analysis of INTERACT3, which enrolled adults (age ≥18 years) spontaneous ICH patients within 6 h after onset. INTERACT3 was an international, multicentre, prospective, stepped-wedge, cluster randomised, blinded outcome assessed, clinical trial undertaken at 121 hospitals in 10 countries between December 12, 2017 and December 31, 2021. To limit heterogeneity in the results, we restricted analyses to participants in China. The primary outcome was poor functional outcome, defined by a score of 5–6 on the modified Rankin scale (mRS), at 6 months. Secondary outcomes include a mRS score of 4–6 and mortality at 6 months. Sensitivity analysis included propensity score matched analysis and the imputation of missing outcome variables. The effect of timing on surgical outcome was also evaluated. The INTERACT3 trial was registered at &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt; (&lt;span&gt;&lt;span&gt;NCT03209258&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;) and CHiCTR.org.cn (ChiCTR-IOC-17011787).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Of 5772 participants (mean age 62.0 ± 12.5 years) at 82 sites in China, 1411 (24.4%) received surgery in which craniotomy (72.6%) was the most common approach. After adjustment for confounding variables, surgery to evacuate the haematoma was associated with lower odds of a poor functional outcome (odds ratio 0.71, 95% CI 0.55–0.92; p = 0.010) and mortality (odds ratio 0.55, 95% CI 0.40–0.75; p = 0.0001) at 6 months. The association was consistent in propensity score matching analysis and sensitivity analysis by imputation. We did not detect significant differences in outcome between those who received surgery on the same day of hospital arrival compared to those who received surgery on the second or later days. In analysis limited to participants with supratentorial ICH and with a haematoma volume 30 mL or more, evacuation of the haematoma was associated with lower odds of poor functional outcome (n = 1234, odds ratio 0.68, 95% CI 0.46–0.99; p = 0.042) and mortality (n = 1291, OR 0.45, 95% CI 0.29–0.69; p = 0.0003).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;This secondary analysis of the INTERACT3 indicates that evacuation of the haematoma is associated with better chances of surviving free of severe disability after acute ICH. With the evolution of instrument and techniques, further trial should address the role of haematoma evacuation in deep ICH patients, the time window and difference between mini-invasive techniques.&lt;/div&gt;&lt;/div&gt;","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101669"},"PeriodicalIF":8.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity comparison of an Escherichia coli-produced 9-valent human papillomavirus vaccine and Gardasil9 in Chinese women aged 18–26 years: three-year follow-up data from a randomised clinical trial","authors":"Guo-Hua Zhong ,&nbsp;Zhao-Feng Bi ,&nbsp;Kai Chu ,&nbsp;Li Zhang ,&nbsp;Lu Chen ,&nbsp;Kong-Xin Zhu ,&nbsp;Jia-Li Quan ,&nbsp;Chu Nie ,&nbsp;Qi Chen ,&nbsp;Ling-Xian Qiu ,&nbsp;Jin-Bo Xu ,&nbsp;Jia-Xue Li ,&nbsp;Ming-Lei Zhang ,&nbsp;Sheng Liu ,&nbsp;Ling-Ling Nie ,&nbsp;Kun Li ,&nbsp;Ying-Ying Su ,&nbsp;Shou-Jie Huang ,&nbsp;Qiu-Fen Zhang ,&nbsp;Wei-Jin Huang ,&nbsp;Ning-Shao Xia","doi":"10.1016/j.lanwpc.2025.101671","DOIUrl":"10.1016/j.lanwpc.2025.101671","url":null,"abstract":"<div><h3>Background</h3><div>Cecolin9, a second-generation 9-valent HPV vaccine derived from the WHO-prequalified Cecolin, has received marketing authorisation in China in May 2025. The non-inferiority of type-specific immune responses between Cecolin9 and Gardasil9 has been previously established at month 7 in Chinese women aged 18–26 years (<span><span>NCT04782895</span><svg><path></path></svg></span>). This study aimed to compare the plateau antibody levels between the two vaccines three years post the first dose.</div></div><div><h3>Methods</h3><div>This was a prospective extension study of a randomised, single-blind trial conducted in China (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT06197802</span><svg><path></path></svg></span>). All the participants included in the base study were invited to participate in this extension. Blood samples were collected at year 3 (median follow-up time of 34 months) for neutralising antibody detection, assessed by a triple-colour pseudovirion-based neutralisation assay. The primary outcome, geometric mean concentrations (GMCs), was analysed within three-dose recipients without major protocol violations, seronegative for the relevant type at baseline, and with available serum results at year 3. Non-inferiority of the GMC ratios (Cecolin9 <em>vs</em> Gardasil9) was determined as the lower bound of the two-sided 95% confidence interval (CI) in excess of 0.5.</div></div><div><h3>Findings</h3><div>Of the 487 participants enrolled in the base study, 82.8% (403/487) completed the three-year follow-up visit. The mean age at the first vaccination was 22.2 years among the 200 Cecolin9 recipients and 22.1 years among the 203 Gardasil9 recipients, respectively. The GMC ratios (Cecolin9 <em>vs</em> Gardasil9) for all nine HPV types ranged from 0.78 (95% CI 0.64–0.95) to 1.91 (95% CI 1.54–2.37), with the lower bounds of 95% CIs spanning from 0.64 to 1.54. Furthermore, sustained seropositivity rates were similar between groups, ranging from 84.7% to 100.0% in the Cecolin9 cohort and 86.2% to 100.0% in the Gardasil9 cohort. Notably, both groups presented consistent antibody decay trends over the observation period.</div></div><div><h3>Interpretation</h3><div>The Cecolin9 cohort demonstrated sustained non-inferior HPV type-specific plateau antibody levels compared to the Gardasil9 cohort, supporting Cecolin9's potential for enduring protection.</div></div><div><h3>Funding</h3><div><span>National Key Research and Development Plan</span>, the <span>National Natural Science Foundation of China</span>, <span>Beijing Natural Science Foundation</span>, <span>Fundamental Research Funds for the Central Universities</span>, the Fieldwork Funds for graduate students of <span>Xiamen University</span>, and <span>Xiamen Innovax</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101671"},"PeriodicalIF":8.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of restricted retail merchandising of discretionary food and beverages on population diet: post-trial follow-up of a pragmatic randomised controlled trial","authors":"Emma McMahon ,&nbsp;Sarah Dickie ,&nbsp;Khia De Silva ,&nbsp;Megan Ferguson ,&nbsp;Mark D. Chatfield ,&nbsp;Edward Miles ,&nbsp;Anthony Gunther ,&nbsp;Thomas Wycherley ,&nbsp;Leia Minaker ,&nbsp;Anna Peeters ,&nbsp;Catherine L. Mah ,&nbsp;Emma Chappell ,&nbsp;Julie Brimblecombe","doi":"10.1016/j.lanwpc.2025.101673","DOIUrl":"10.1016/j.lanwpc.2025.101673","url":null,"abstract":"<div><h3>Background</h3><div>Healthy Stores 2020 tested a co-designed strategy restricting retailer merchandising of unhealthy foods in a community-level pragmatic, partially randomised, parallel group trial in 20 remote Australian Aboriginal and Torres Strait Islander community stores. We aimed to evaluate the impact of Healthy Stores 2020 on free sugar sales 24-weeks post-trial.</div></div><div><h3>Methods</h3><div>Twenty stores were randomly assigned by a statistician using a single sequence of random assignments to the intervention group, in which a strategy restricted merchandising of unhealthy food (either six or seven strategy components), or to a control group of usual retail practice. The trial was done in partnership with an Indigenous organisation operating in remote Australia. In the post-trial period (24 weeks), immediately following the 25-week RCT, intervention stores (n = 10) continued the strategy but with no external implementation support, and control stores (n = 10) continued usual practice. The primary outcome was impact on purchases (weekly sales data) of free sugars from all foods and beverages (g/MJ) using mixed models. Secondary outcomes included total food and beverage dollars and gross profit (AUD$) and strategy implementation (number of strategies with full implementation assessed via photographic data collected). Trial registration, ACTRN12618001588280.</div></div><div><h3>Findings</h3><div>We observed a difference in sales of total free sugars to energy between the treatment and control groups post-trial (−4.6%, 95% CI −7.1, −1.9). Between group differences in total food and beverage and gross profit dollars were 7.0% (0.9, 13.5) and 11.4% (4.6, 18.6), respectively. Two intervention stores had full implementation of all strategy components and eight intervention stores had compliance with at least four of the seven strategy components at post-trial end.</div></div><div><h3>Interpretation</h3><div>A health-enabling retail intervention showed an effect on sugar reduction in the post-trial period without adversely impacting profit.</div></div><div><h3>Funding</h3><div><span>Australian National Health and Medical Research Council</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101673"},"PeriodicalIF":8.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin resistance and the risk of incident depression: the role of age, glycemic status, and adiposity in a prospective cohort study","authors":"Dae Jong Oh ,&nbsp;Chaiho Jeong ,&nbsp;Junhyung Kim ,&nbsp;Eun Soo Kim ,&nbsp;Kang-Seob Oh ,&nbsp;Young Chul Shin ,&nbsp;Dong-Won Shin ,&nbsp;Sang-Won Jeon ,&nbsp;Sung Joon Cho","doi":"10.1016/j.lanwpc.2025.101672","DOIUrl":"10.1016/j.lanwpc.2025.101672","url":null,"abstract":"<div><h3>Background</h3><div>Despite emerging evidence, the causal relationship between insulin resistance and depression remains controversial. This study aimed to investigate whether insulin resistance is associated with increased risk of incident depression and whether the association is affected by potential moderators.</div></div><div><h3>Methods</h3><div>This multi-centered prospective cohort study analyzed health screening data from 233,452 Korean adults participating in the Kangbuk Samsung Health Study from 2011 to 2022. At baseline, all participants indicated no major psychiatric or neurologic disorders and had not used antidepressant or diabetes medications. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR). Incident depression was defined as having a Center for Epidemiologic Studies Depression Scale score of ≥16.</div></div><div><h3>Findings</h3><div>Participants (age = 36.1 ± 8.6 years, 54.1% male) were followed up for 4.8 ± 2.9 years. During the 1,124,268 person-years of follow-up duration, 38,801 cases of incident depression were identified. Multivariate Cox proportional hazards analysis revealed a positive dose-dependent association between HOMA-IR level and the risk of incident depression (hazard ratio [HR] for highest vs. lowest quartile = 1.15, 95% confidence interval [CI] = 1.11–1.19). This association was particularly strong in younger adults under 40 years and in individuals with euglycemia, overweight, and low muscle-to-fat ratio.</div></div><div><h3>Interpretation</h3><div>Insulin resistance may be a modifiable risk factor for depression, underscoring the importance of early screening and management of insulin resistance to potentially reduce the burden of depression, especially among at-risk subgroups.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101672"},"PeriodicalIF":8.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who is at risk of a respiratory syncytial virus hospitalisation? A linked, population-based birth cohort analysis in children aged less than 5 years.","authors":"Mohinder Sarna, Christopher C Blyth, Belaynew W Taye, Huong Le, Peter Richmond, Kathryn Glass, Avram Levy, Cara Minney-Smith, Daniel Oakes, Jeffrey Cannon, Melinda France, Hannah C Moore","doi":"10.1016/j.lanwpc.2025.101654","DOIUrl":"10.1016/j.lanwpc.2025.101654","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infections globally in children under five years. With the development of RSV prevention strategies, understanding risk factors and relation to age and population is useful for deciding the type of program implemented.</p><p><strong>Methods: </strong>We used a probabilistically-linked population cohort of children born in Western Australia from 2010 to 2020 and hospitalised before age five years from 2010 to 2021. The primary outcome was the first laboratory-confirmed RSV-hospitalisation. Risk factor exposures included perinatal, socio-demographic, household, environmental, congenital, and comorbid conditions antecedent to RSV-hospitalisation. Adjusted hazard ratios (aHR) and population attributable fractions (PAF) were calculated using survival analysis techniques and Cox regression.</p><p><strong>Findings: </strong>Risk factors for RSV-hospitalisation in 365,582 children included demographic (male sex, Aboriginal ethnicity), perinatal (younger maternal age, maternal asthma, prematurity, maternal prenatal smoking) household/environmental (household size, season of birth), and comorbid and congenital conditions (cardiovascular defects, Trisomy 21 and cerebral palsy). Aboriginal and preterm children had an excess risk of hospitalisation at every age group. Larger households and being born moderate-late preterm had the highest PAFs (36.90% [95% CI: 35.01%, 38.74%] and 7.40% [95% CI: 6.75%, 8.04%]). While the risk of hospitalisation for children with some comorbid and congenital conditions was high (immunological conditions, aHR: 3.94 [95% CI: 2.98, 5.23], respiratory system defects, aHR: 3.13 [95% CI: 1.87, 5.25]), the PAFs were relatively small (1.70% [95% CI: 1.53%, 1.86%] and 0.40% [95% CI: 0.30%, 0.49%]).</p><p><strong>Interpretation: </strong>While children with comorbid conditions were at higher risk of RSV-hospitalisation, the importance of socio-demographic risk factors, particularly modifiable factors such as maternal prenatal smoking and household transmission, should not be undervalued. Our analysis provides information for funders, vaccine policy makers, parents/carers, and immunisation providers.</p><p><strong>Funding: </strong>This work was supported by a Wesfarmers Centre for Vaccines and Infectious Diseases Seed grant and a Stan Perron Charitable Foundation grant (00046ProgPart).</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"61 ","pages":"101654"},"PeriodicalIF":8.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bhutan and the Philippines forge new partnership to tackle antimicrobial resistance.","authors":"Charles Coughlan, Sonam Zangmo, Ana Ria Sayo","doi":"10.1016/j.lanwpc.2025.101667","DOIUrl":"10.1016/j.lanwpc.2025.101667","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"61 ","pages":"101667"},"PeriodicalIF":8.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending Healthier SG to Singapore's migrant workforce.","authors":"Bingwen Eugene Fan","doi":"10.1016/j.lanwpc.2025.101658","DOIUrl":"10.1016/j.lanwpc.2025.101658","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"61 ","pages":"101658"},"PeriodicalIF":8.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying localized heatwave impact on mortality: a multi-country modeling study in the Asia-Pacific region.","authors":"Junwen Tao, Zhiwei Xu, Hung Chak Ho, Hao Zheng, Xiuya Xing, Jihong Hu, Shilu Tong, Ho Kim, Mohammad Zahid Hossain, Hong Su, Cunrui Huang, Jian Cheng","doi":"10.1016/j.lanwpc.2025.101653","DOIUrl":"10.1016/j.lanwpc.2025.101653","url":null,"abstract":"<p><strong>Background: </strong>Heatwave is a global health threat. However, existing heatwave definitions often rely on fixed temperature thresholds without incorporating region-specific health outcomes or population acclimatization, limiting their applicability across diverse climatic and demographic contexts. We aimed to assess the impact of localized heatwave on mortality based on a proposed framework of health-based heatwave definition.</p><p><strong>Methods: </strong>Based on daily data on death and weather from 25 cities in Australia, China, South Korea, and Thailand, we proposed a health-based excess heat factor (HEHF) to define the localized heatwave. First, a tiered health risk-based (THR) approach was used to fit the heatwave-mortality association to detect the region-specific temperature threshold for heatwave. Then, the HEHF was derived from a three-day-averaged temperature exceeding the region-specific heatwave threshold multiplied by the acclimatization index, reflecting the difference between recent (past three-day) and preceding (past thirty-day) average temperatures. Finally, the mortality burden attributable to heatwaves was estimated to compare the performance of distinct heatwave definitions including the HEHF, percentile-based definition, and country-specific official definition.</p><p><strong>Findings: </strong>A total of 2,255,634 deaths from four countries were analyzed. Heatwave of all definitions was associated with an increased mortality risk in four countries, with a higher risk estimated by HEHF. The HEHF not only detected a health-based, localized, and time-varying temperature threshold for the heatwave but also captured a continuous pattern of mortality risk associated with changes in heatwave intensity. Compared with percentile-based and country-specific official definitions, using the HEHF also yielded a larger proportion of deaths attributable to heatwaves, accounting for 8.68% (95% CI: 7.19%, 10.50%) in China, 4.50% (95% CI: 3.33%, 5.58%) in Thailand, 2.99% (95% CI: 1.54%, 4.33%) in Australia, and 1.98% (95% CI: 1.24%, 2.71%) in South Korea. The subtropical zone exhibited a higher attributable fraction than temperate and tropical zones.</p><p><strong>Interpretation: </strong>This multi-country study has developed a generalizable and health-based framework for defining the localized heatwave, assisting in assessing and comparing health impact of heatwaves across regions and climates.</p><p><strong>Funding: </strong>National Natural Science Foundation of China.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"61 ","pages":"101653"},"PeriodicalIF":8.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}