The Lancet Regional Health: Western Pacific最新文献

{"title":"Epidemiology of pulmonary embolism in China, 2021: a nationwide hospital-based study.","authors":"Kaiyuan Zhen, Yuzhi Tao, Lei Xia, Shengfeng Wang, Qian Gao, Dingyi Wang, Zhaofei Chen, Xianglong Meng, Yuting Kang, Guohui Fan, Zhu Zhang, Peiran Yang, Jixiang Liu, Yu Zhang, Chaozeng Si, Wei Wang, Jun Wan, Yuanhua Yang, Zhihong Liu, Yingqun Ji, Juhong Shi, Qun Yi, Guochao Shi, Yutao Guo, Nuofu Zhang, Zhaozhong Cheng, Ling Zhu, Zhe Cheng, Xianbo Zuo, Wanmu Xie, Qiang Huang, Shuai Zhang, Lanxia Gan, Bing Liu, Simiao Chen, Cunbo Jia, Chen Wang, Zhenguo Zhai","doi":"10.1016/j.lanwpc.2024.101258","DOIUrl":"https://doi.org/10.1016/j.lanwpc.2024.101258","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary embolism (PE) as a preventable and potentially fatal noncommunicable disease was believed to have a lower incidence in Asian populations compared to Western populations. However, the incidence and mortality rates of PE in China and the impact of venous thromboembolism (VTE) prevention system constructions on PE still lack nationwide evidence.</p><p><strong>Methods: </strong>For this nationwide hospital-based observational study, we used data from the National Hospital Quality Monitoring System (HQMS) and public database in China. We estimated the incidence and in-hospital mortality rates of PE by age group, sex, and regions of geographical and socioeconomic level. VTE prevention and management system constructions were quantified by geographical density. We then calculated the incidence and mortality rates in different conditions of VTE prevention and management system construction.</p><p><strong>Findings: </strong>During the 12 months period between January and December 2021, a total number of 200,112 PE patients and 14,123 deaths were recorded from 5101 hospitals in the HQMS database. The incidence of PE was 14.19 (200,112, 95% CI 14.13-14.26) per 100,000 population and the mortality rate was 1.00 (95% CI 0.99-1.02) per 100,000 population. The incidence of PE was higher in male patients (14.43 per 100,000 population) than in female patients (13.95 per 100,000 population). Disparities of incidence and mortality rates were shown within age groups and geographical regions. The incidence and mortality rates of PE showed decreasing trend with increasing geographical density of VTE-related facilities and VTE prevention system developments.</p><p><strong>Interpretation: </strong>China had a substantially large number of PE patients. The incidence and mortality rates of PE showed disparities in terms of sex, age, and geography. The incidence and mortality rates of PE decrease across regions with increasing levels of socioeconomic development, potentially influenced by the existing VTE prevention and management systems. Optimizing the health policies and healthcare investment in VTE prevention may help reduce the disease burden of PE.</p><p><strong>Funding: </strong>CAMS Innovation Fund for Medical Sciences (CIFMS) (2023-I2M-A-014); National High Level Hospital Clinical Research Funding (2022-NHLHCRF-LX-01-0108); National Key Research and Development Program of China (2023YFC2507200); Discipline-Innovation and Talent-Introduction Program for Colleges and Universities (111 Plan, B23038).</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"54 ","pages":"101258"},"PeriodicalIF":7.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932718","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":"Inter-city movement pattern of notifiable infectious diseases in China: a social network analysis.","authors":"Lin-Jie Yu, Peng-Sheng Ji, Xiang Ren, Yan-He Wang, Chen-Long Lv, Meng-Jie Geng, Jin-Jin Chen, Tian Tang, Chun-Xi Shan, Sheng-Hong Lin, Qiang Xu, Guo-Lin Wang, Li-Ping Wang, Simon I Hay, Wei Liu, Yang Yang, Li-Qun Fang","doi":"10.1016/j.lanwpc.2024.101261","DOIUrl":"https://doi.org/10.1016/j.lanwpc.2024.101261","url":null,"abstract":"<p><strong>Background: </strong>Co-existence of efficient transportation networks and geographic imbalance of medical resources greatly facilitated inter-city migration of patients of infectious diseases in China.</p><p><strong>Methods: </strong>To characterize the migration patterns of major notifiable infectious diseases (NIDs) during 2016-2020 in China, we collected migratory cases, who had illness onset in one city but were diagnosed and reported in another, from the National Notifiable Infectious Disease Reporting System, and conducted a nationwide network analysis of migratory cases of major NIDs at the city (prefecture) level.</p><p><strong>Findings: </strong>In total, 2,674,892 migratory cases of NIDs were reported in China during 2016-2020. The top five diseases with the most migratory cases were hepatitis B, tuberculosis, hand, foot and mouth disease (HFMD), syphilis, and influenza, accounting for 79% of all migratory cases. The top five diseases with the highest proportions of migratory cases were all zoonotic or vector-borne (37.89%‒99.98%). The network analysis on 14 major diseases identified three distinct migration patterns, where provincial capitals acted as key node cities: short distance (e.g., pertussis), long distance (e.g., HIV/AIDS), and mixed (e.g., HFMD). Strong drivers for patient migration include population mobility and labor flow intensities between cities as well as the economic development level of the destination city.</p><p><strong>Interpretation: </strong>Collaborative prevention and control strategies should target cities experiencing frequent patient migration and cater to unique migration patterns of each disease. Addressing disparity in healthcare accessibility can also help alleviate case migration and thereby reduce cross-regional transmission.</p><p><strong>Funding: </strong>National Key Research and Development Program of China.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"54 ","pages":"101261"},"PeriodicalIF":7.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932725","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":"Consensus on the lung cancer management after third-generation EGFR-TKI resistance.","authors":"Qing Zhou, Hongyun Zhao, Shun Lu, Ying Cheng, Ying Liu, Mingfang Zhao, Zhuang Yu, Chengping Hu, Li Zhang, Fan Yang, Jun Zhao, Renhua Guo, Rui Ma, Yingying Du, Xiaorong Dong, Jiuwei Cui, Daniel S W Tan, Myung-Ju Ahn, Masahiro Tsuboi, Si-Yang Maggie Liu, Tony S Mok, Yi-Long Wu","doi":"10.1016/j.lanwpc.2024.101260","DOIUrl":"https://doi.org/10.1016/j.lanwpc.2024.101260","url":null,"abstract":"<p><p>Lung cancer is the most prevalent malignant tumour in the Asia-Pacific region. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancers. Among these, the rate of <i>EGFR</i> mutations in Asian patients with lung adenocarcinoma is 40-60%. Third-generation EGFR tyrosine kinase inhibitors (EGFR-TKIs) have improved the clinical management of NSCLC with <i>EGFR</i> mutations, but resistance to these drugs remains a significant challenge. Despite numerous ongoing studies, there is no standardized consensus on managing resistance to third-generation EGFR-TKIs. This consensus integrates international guidelines on EGFR-TKI management, findings from clinical studies, and experiences from the Asia-Pacific region in addressing post-resistance. Detailed recommendations are provided for classification and progression patterns, clinical testing, and post-resistance treatment strategies related to third-generation EGFR-TKI resistance. The aim of these recommendations is to offer reference opinions for the standardized management of patients exhibiting resistance to third-generation EGFR-TKIs in clinical practice.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"53 ","pages":"101260"},"PeriodicalIF":7.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932699","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":"Accelerating access to human genomics for public health: perspectives from the Western Pacific region.","authors":"","doi":"10.1016/j.lanwpc.2024.101265","DOIUrl":"https://doi.org/10.1016/j.lanwpc.2024.101265","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"53 ","pages":"101265"},"PeriodicalIF":7.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932695","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":"PM_2.5 and hospitalizations through the emergency department in people with disabilities: a nationwide case-crossover study in South Korea.","authors":"Jinah Park, Ayoung Kim, Michelle L Bell, Ziyad Al-Aly, Seoyeong Ahn, Sooyoung Kim, Dohoon Kwon, Cinoo Kang, Jieun Oh, Ho Kim, Whanhee Lee","doi":"10.1016/j.lanwpc.2024.101256","DOIUrl":"10.1016/j.lanwpc.2024.101256","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the impact of PM_2.5 on people with disabilities. We aimed to explore the association between PM_2.5 and hospitalization via the emergency department (ED admission) among people with disabilities, together with the attributable ED admission cases and costs.</p><p><strong>Methods: </strong>We applied a time-stratified case-crossover design adjusting ozone, holiday, and temperature using seven years (2015-2021) of claim-based data on ED admissions from the Korean National Health Insurance Database. The analysis included all ED admission cases of beneficiaries with disabilities living in Korea (physical, intellectual, and mental disabilities; brain lesion disorders; blindness or vision loss; deafness or hearing loss; and autism) as well as selected controls without disabilities.</p><p><strong>Findings: </strong>There were 900,311 ED admissions among the 3,624,590 people with disabilities. The odds ratios of ED admissions associated with a 10 μg/m³ increase in PM_2.5 were 1.039 (95% CI: 1.036-1.042) in people with disabilities and 1.022 (95% CI: 1.019-1.025) in people without disabilities. Individuals with mental disability, intellectual disability, and brain lesion disorder showed higher risk estimates compared to other disabilities. The risk estimates of ED admissions for cardiovascular and genitourinary diseases were more prominent among people with disabilities than those without disabilities.</p><p><strong>Interpretation: </strong>The impacts of PM_2.5 on ED admissions was generally higher in the population with disabilities than those without disabilities, especially for certain causes of admission. These results could contribute to establishing targeted action plans including early warning system referring different threshold concentrations.</p><p><strong>Funding: </strong>National Research Foundation.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"53 ","pages":"101256"},"PeriodicalIF":7.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886026","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":"The prevalence and profiles of adverse childhood experiences and their associations with adult mental health outcomes in China: a cross-sectional study.","authors":"Peilin Xu, Zhaorui Liu, Yifeng Xu, Tao Li, Guangming Xu, Xiangdong Xu, Limin Wang, Yongping Yan, Shuiyuan Xiao, Lingjiang Li, Tingting Zhang, Jie Yan, Yaqin Yu, Xiufeng Xu, Zhizhong Wang, Bo Wang, Wanjun Guo, Yueqin Huang","doi":"10.1016/j.lanwpc.2024.101253","DOIUrl":"10.1016/j.lanwpc.2024.101253","url":null,"abstract":"<p><strong>Background: </strong>Adverse childhood experiences (ACEs) are common and associated with mental disorders. However, the prevalence and co-occurrence of ACEs and their association with mental health outcomes among Chinese adults have not been well demonstrated.</p><p><strong>Methods: </strong>China Mental Health Survey, a cross-sectional nationally representative survey consisting of 28,140 adults, was conducted from July 2013 to March 2015. Twelve ACEs and mental health outcomes, including mood disorder, anxiety disorder, substance-use disorder, and suicide were measured using the Composite International Diagnostic Interview (CIDI) 3.0 in a weighted representative subsample of 9378 respondents. Latent class analysis was used to identify the co-occurrence profiles of ACEs, and logistic regression was applied to examine the association between ACEs and mental health outcomes. Population-attributable fractions (PAFs) were calculated to quantify the attribution of ACEs to these outcomes.</p><p><strong>Findings: </strong>Among the 9378 respondents, the weighted count (proportion) of females was 4642 (49.5%), with a weighted mean (SD) age of 43.0 (15.8) years. In this study, 27.1% of respondents showed at least one ACE, with multiple ACEs common (37.6%) among those affected. Neglect was the most prevalent ACE (11.3%), followed by physical abuse (9.1%). Latent class analysis identified four co-occurrence profiles: low risk of ACEs, maltreatment, caregiver's maladjustment and parental loss. The strongest association with mental health outcomes was found in the caregiver's maladjustment group (OR, 4.9; 95% CI, 3.2-7.6). Estimates of PAFs indicated that all ACEs together explained 39.4% (95% CI, 31.3%-47.4%) of observed mental health outcomes. Gender differences were noted in prevalence and associations with outcomes.</p><p><strong>Interpretation: </strong>ACEs are highly prevalent and interrelated in China, attributing to over one-third of the mental disorder burden. In resource-limited settings, prioritizing the reduction of the most prevalent and impactful ACEs through education and policy can more effectively alleviate the disease burden.</p><p><strong>Funding: </strong>The National Twelfth Five-Year Plan for Science and Technology Support from the Chinese Ministry of Science and Technology (grant numbers 2012BAI01B01 & 2015BAI13B00), and the National Key R&D Program of China (grant numbers 2017YFC0907800 and 2017YFC0907801).</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"53 ","pages":"101253"},"PeriodicalIF":7.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882894","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":"Impact of Australia's No Jab, No Pay policy on vaccination uptake - a before-after study in two national birth cohorts.","authors":"Frank Beard, Alexandra J Hendry, Heather F Gidding, Aditi Dey, Kristine Macartney, Julie Leask, Peter McIntyre","doi":"10.1016/j.lanwpc.2024.101259","DOIUrl":"10.1016/j.lanwpc.2024.101259","url":null,"abstract":"<p><strong>Background: </strong>Data on impact of financial penalties for non-vaccination are sparse. Australia has required full vaccination for government family assistance payment eligibility since 1998. In 2016, the No Jab, No Pay (NJNP) policy removed registered non-medical objection as exemption option and increased eligibility assessment to yearly. We aimed to examine NJNP impact on vaccine uptake in children.</p><p><strong>Methods: </strong>Individual-level Australian Immunisation Register data were used to assemble two-year-wide pre-/post-NJNP birth cohorts aged 1-<3 years, stratified by registered objection (yes/no) and vaccination status (zero-dose/partially vaccinated/fully vaccinated). At 5-<7 years, we measured odds ratios (ORs) and 95% confidence interval (CIs) for vaccination outcomes post-versus pre-NJNP and compared observed post-NJNP numbers with those expected if proportions pre-NJNP applied.</p><p><strong>Findings: </strong>Pre-NJNP of 562,316 children aged 1-<3 years, 92.1% were fully vaccinated, 4.9% partially vaccinated and 3.0% zero-dose; objection was registered for 1.1% overall (23.9% of zero-dose). Post-NJNP of 615,607 aged 1-<3 years, 92.7% were fully vaccinated, 4.7% partially vaccinated, 2.6% zero-dose; objection was registered for 1.5% overall (37.7% of zero-dose). By 5-<7 years of age, full vaccination was significantly higher post-than pre-NJNP in children with registered objection (zero-dose 14.6% versus 1.2% [OR 14.1; 95% CI 10.5-18.9]; partially vaccinated 41.7% versus 8.4% [OR 7.9; 95% CI 6.4-9.7]) and without objection (zero-dose 10.1% versus 4.9% [OR 2.2; 95% CI 2.0-2.4]; partially vaccinated 39.2% versus 34.5% [OR 1.2; 95% CI 1.1-1.3]). Post-NJNP we estimated 49,510 more children (3.7% with registered objection) to be fully vaccinated than expected. Odds of remaining zero-dose were 0.38 (95% CI 0.34-0.42) with versus 0.66 (0.63-0.70) without registered objection and fewer children (9,206, 1.5%) were persistently zero-dose post-than pre-NJNP (10,696, 1.9%).</p><p><strong>Interpretation: </strong>Full vaccination by age 5-<7 years increased post-NJNP irrespective of baseline vaccination/objection status. Relative increases were much higher among children with registered objection than without, but partially vaccinated children without objection largely accounted for numerical increases, suggesting increased eligibility assessment was more important than changes in exemption criteria.</p><p><strong>Funding: </strong>Australian Government Department of Health and Aged Care.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"54 ","pages":"101259"},"PeriodicalIF":7.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885973","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":"Suicidality at the intersection of sex, sexual orientation, and gender expression among secondary school students in Hong Kong: a population-based study.","authors":"Zixu Li, Paul Siu Fai Yip","doi":"10.1016/j.lanwpc.2024.101252","DOIUrl":"10.1016/j.lanwpc.2024.101252","url":null,"abstract":"<p><strong>Background: </strong>Previous suicide research has seldom examined the collective impact of multiple social identities/positions, and suicidality among sexual and gender minority adolescents remains understudied in Chinese contexts. Using intersectionality as both a theoretical and analytical framework, we investigate the combined effects of sex, gender expression, and sexual orientation on suicidal ideation and suicide attempts among secondary school students in Hong Kong.</p><p><strong>Methods: </strong>Data from 8023 adolescents (mean age = 14.76, SD = 1.66; 44.56% girls) who participated in the 2021 wave of the Youth Sexuality Study (YSS) were included in analysis. Multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) estimated the prevalence of suicidal ideation and suicide attempts for adolescents across various combinations of social identities/positions (i.e., sex x gender expression x sexual orientation), assessed the extent to which these identities/positions accounted for the total variance in suicide behaviors, and examined the interactive intersectional effects (i.e., two-way or higher-level interactions) between the identities/positions.</p><p><strong>Findings: </strong>Girls categorized as non-heterosexual with nonconforming gender expression, girls categorized as non-heterosexual with neutral gender expression, and boys categorized as non-heterosexual with nonconforming gender expression reported the highest prevalence of suicidal ideation and suicide attempts. The total variance in suicidal ideation and suicide attempts attributable to the identities/positions were 12.60% and 10.50%, respectively. However, there were no significant interactive intersectional effects.</p><p><strong>Interpretation: </strong>Adolescents with multiple marginalized identities/positions showed the highest prevalence of suicidal ideation and suicide attempts. Comprehensive suicide prevention strategies should go beyond individual-level risk factors and promote holistic systemic changes. Intervention solely targeting one identity/position may not be sufficient.</p><p><strong>Funding: </strong>The data used in this study is made available by Family Planning Association of Hong Kong and the Research Subcommittee for the Youth Sexuality Study 2021. The work was supported by the Department of Health of the Hong Kong SAR Government.</p>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"53 ","pages":"101252"},"PeriodicalIF":7.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882892","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":"Impact of extreme temperature on congenital heart disease mortality: a population-based nationwide case-crossover study","authors":"Qiyu He ,&nbsp;Xinyue Lang ,&nbsp;Huayan Shen ,&nbsp;Jiangmei Liu ,&nbsp;Sirui Zhou ,&nbsp;Jing Wei ,&nbsp;Xinjie Lin ,&nbsp;Yuze Liu ,&nbsp;Kai Ma ,&nbsp;Zheng Dou ,&nbsp;Zhou Zhou ,&nbsp;Maigeng Zhou ,&nbsp;Shoujun Li","doi":"10.1016/j.lanwpc.2024.101244","DOIUrl":"10.1016/j.lanwpc.2024.101244","url":null,"abstract":"<div><h3>Background</h3><div>The association between congenital heart disease (CHD) and non-optimal temperatures has received limited investigation. We aimed to investigate the impact of extreme temperatures on CHD mortality.</div></div><div><h3>Methods</h3><div>We reviewed the National Mortality Surveillance System of China and retrieved death records attributable to CHD from 2013 to 2021. Temperature and air pollutants data were obtained from the ERA5-Land reanalysis dataset and the ChinaHighAirPollutants database. A two-stage case-crossover study design was implemented. Sensitivity and subgroup analyses were performed to test the robustness of findings and determine the vulnerable population.</div></div><div><h3>Findings</h3><div>A total of 32,168 CHD deaths were included, showing a significant association between cold and CHD mortality, while there was little effect for heat. The odd ratio (OR) ranged from 1.05 (95% confidence interval: 1.00–1.10) to 1.15 (1.03–1.29) across country, with a more pronounced impact in non-monsoon regions up to 1.67 (1.20–2.32). Cold extremes accounted for an attributable fraction of 4.09 per 1000 CHD death nationwide and 13.30 per 1000 CHD deaths in non-monsoon regions. Sensitivity analyses utilizing apparent temperature and adjusting for air pollutants confirmed the robustness of the main findings. Female and pediatric CHD patients were identified as the vulnerable population to cold extremes.</div></div><div><h3>Interpretation</h3><div>For the first time, this nationwide study demonstrated the significant impact of cold extremes on CHD mortality, particularly in non-monsoon regions, and among female and pediatric subgroups. These findings may suggest that healthcare professionals advise CHD patients to avoid exposure to cold extremes, and provide insight into healthcare policy adjustment.</div></div><div><h3>Funding</h3><div>This study was supported by the <span>CAMS Innovation Fund for Medical Sciences</span> (CIFMS, 2023-I2M-C&amp;T-B-059), the <span>Capital Health Research and Development</span> of Special Fund (2022-1-4032) and the <span>National High Level Hospital Research Funding</span> (2022-GSP-GG-19).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"53 ","pages":"Article 101244"},"PeriodicalIF":7.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748187","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":"The burden of type 2 diabetes attributable to air pollution across China and its provinces, 1990–2021: an analysis for the Global Burden of Disease Study 2021","authors":"Chunnan Li ,&nbsp;Jinlei Qi ,&nbsp;Peng Yin ,&nbsp;Xinhui Yu ,&nbsp;Haoran Sun ,&nbsp;Maigeng Zhou ,&nbsp;Wannian Liang","doi":"10.1016/j.lanwpc.2024.101246","DOIUrl":"10.1016/j.lanwpc.2024.101246","url":null,"abstract":"<div><h3>Background</h3><div>Temporal trends and geographical disparities in type 2 diabetes burden attributable to air pollution, including ambient and household, are not fully understood within China. This study aims to estimate the burden of type 2 diabetes attributable to air pollution at national and provincial levels from 1990 to 2021.</div></div><div><h3>Methods</h3><div>We assessed air pollution exposure across 33 Chinese provinces, autonomous regions, municipalities, and special administrative regions, focusing on two common forms of air pollution: ambient particulate matter pollution (defined as the annual gridded concentration of PM_2.5) and household air pollution (defined as the percentage of households using solid cooking fuels and their corresponding exposure to PM_2.5). We employed the methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to estimate the attribution of air pollution on type 2 diabetes deaths and disability-adjusted life years (DALYs) by age, sex, year, and province.</div></div><div><h3>Findings</h3><div>In 2021, about a fifth of the national type 2 diabetes burden was attributable to air pollution, with an age-standardised estimate of 1.76 deaths and 110.79 DALYs per 100,000 population, higher in males. Ambient PM_2.5 contributed to 16.89% of deaths and 16.36% of DALYs, while household air pollution contributed to 3.24% of deaths and 3.07% of DALYs. From 1990 to 2021, type 2 diabetes mortality rates due to ambient PM_2.5 pollution increased by 264.23%, whereas those from household air pollution decreased by 80.8%. In 2021, Beijing had the highest population attributable fraction (PAFs) of DALYs due to ambient PM_2.5 pollution at 19.63%, while Tibet had the highest PAFs for household air pollution at 13.72%. The age-standardised DALYs rates for type 2 diabetes due to ambient PM_2.5 varied widely across provinces, from 143.8 per 100,000 people in Tianjin to 21.6 per 100,000 people in Tibet.</div></div><div><h3>Interpretation</h3><div>Air pollution, especially ambient PM_2.5, is a significant risk factor for type 2 diabetes in China. Urgent action is needed to enhance air pollution control and develop locally adapted preventive strategies to reduce the burden of air pollution-related type 2 diabetes.</div></div><div><h3>Funding</h3><div><span>Sanming Project of Medicine in Shenzhen</span> (NO. <span><span>SZSM202111001</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"53 ","pages":"Article 101246"},"PeriodicalIF":7.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698778","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}