The Lancet Regional Health: Western Pacific最新文献

{"title":"Genetic factors driving the Mycoplasma pneumoniae outbreak among children post-COVID-19 in China: a whole genome analysis","authors":"Weiwei Jiao ,&nbsp;Jie Wang ,&nbsp;Cuidan Li ,&nbsp;Peihan Wang ,&nbsp;Sihong Xu ,&nbsp;Jing Bi ,&nbsp;Liya Yue ,&nbsp;Fang Liu ,&nbsp;Lin Sun ,&nbsp;Hui Qi ,&nbsp;Tingting Jiang ,&nbsp;Xue Tian ,&nbsp;He Tang ,&nbsp;Xu Li ,&nbsp;Min Li ,&nbsp;Xuemei Yang ,&nbsp;Xiaoxuan Yang ,&nbsp;Yuting Sun ,&nbsp;Haitao Niu ,&nbsp;Wenbao Zhang ,&nbsp;Fei Chen","doi":"10.1016/j.lanwpc.2025.101578","DOIUrl":"10.1016/j.lanwpc.2025.101578","url":null,"abstract":"<div><h3>Background</h3><div><em>Mycoplasma pneumoniae (M. pneumoniae)</em> is a leading cause of community-acquired pneumonia in children. Post-COVID-19, a significant resurgence of <em>M. pneumoniae</em> infections has been observed in China, but whole-genome analyses on the genetic mechanisms driving this resurgence remain limited.</div></div><div><h3>Methods</h3><div>We performed whole-genome sequencing on 169 <em>M. pneumoniae</em> isolates from Beijing and Baoding, collected before and after COVID-19. All <em>M. pneumoniae</em> genomes from GenBank were included for analysis. Genotypes were identified using multilocus variable-number tandem-repeat analysis (MLVA), multilocus sequence typing (MLST), phylogenetic analysis. Genomic conservation and transmission patterns were assessed via SNP distance.</div></div><div><h3>Findings</h3><div>We identified a post-COVID-19 resurgence of <em>M. pneumoniae</em> infections among children, with infection rates peaking at 60%–70% in late 2023, higher than during the pandemic (10%–20%) and pre-pandemic (∼30%). Genomic analysis revealed distinct genotypes, with T1-2 (4-5-7-2) dominating in Beijing, and both T1-2 and T2-2 (3-5-6-2) prevalent in Baoding. Minimal SNP distances and genomic conservation indicated rapid spread of <em>M. pneumoniae</em>. Genomic analysis uncovered key genetic factors driving the outbreak: near-100% macrolide resistance and increased prevalence of the 4-5-7-2 genotype (enriched in virulence and metabolism-related genes).</div></div><div><h3>Interpretation</h3><div>This study provides a comprehensive genomic analysis of genetic factors driving the outbreak. With near-100% macrolide resistance in China, urgent changes in treatment policies are needed. The rising prevalence of 4-5-7-2 and its functional advantages warrant close monitoring. Our findings offer insights into the outbreak causes and guide future prevention and control strategies.</div></div><div><h3>Funding</h3><div><span>National Key R&amp;D Program of China</span>; Training Plan for <span>High level Public Health Technical Talents</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"59 ","pages":"Article 101578"},"PeriodicalIF":7.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937416","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":"Role of late gadolinium enhancement in the risk stratification of pediatric hypertrophic cardiomyopathy: based on a Chinese cohort","authors":"Xingrui Chen ,&nbsp;Wei Xiangli ,&nbsp;Xuan Ma ,&nbsp;Yun Tang ,&nbsp;Jiaxin Wang ,&nbsp;Zhixiang Dong ,&nbsp;Kankan Zhao ,&nbsp;Zhuxin Wei ,&nbsp;Xi Jia ,&nbsp;Pengyu Zhou ,&nbsp;Yujie Liu ,&nbsp;Yanyan Song ,&nbsp;Chen Cui ,&nbsp;Minjie Lu ,&nbsp;Kai Yang ,&nbsp;Xiuyu Chen ,&nbsp;Shujuan Yang ,&nbsp;Shihua Zhao","doi":"10.1016/j.lanwpc.2025.101573","DOIUrl":"10.1016/j.lanwpc.2025.101573","url":null,"abstract":"<div><h3>Background</h3><div>Recently, late gadolinium enhancement (LGE) has been identified as an important risk factor in pediatric hypertrophic cardiomyopathy (HCM). However, its prognostic significance in pediatric HCM remains to be fully validated, particularly in Asian population. This study aims to assess the prognostic value of LGE and explore its incremental utility in predicting sudden cardiac death (SCD) in pediatric HCM using data from a Chinese cohort.</div></div><div><h3>Methods</h3><div>231 primary HCM patients ≤18 years of age with cardiac magnetic resonance (CMR) were retrospectively and consecutively enrolled in a single center. The composite outcomes included SCD or equivalent events and heart failure-related events.</div></div><div><h3>Findings</h3><div>Of 231 patients (median age 15, IQR: 12–16), LGE was present in 195 (84.4%) with a median LGE extent of 4.7% (IQR: 2.0%–9.2%). During a median follow-up of 62 months (IQR: 39–85), 26 (11.3%) patients reached composite outcomes, and 13 (5.6%) patients experienced SCD events. Kaplan–Meier analysis showed a significantly increased risk of composite outcomes (log-rank P &lt; 0.001) and SCD (log-rank P &lt; 0.001) in the group with LGE extent ≥5%. In multivariable Cox analysis adjusted by clinical and imaging factors, LGE extent was independently associated with composite outcomes (adjusted HR: 1.15; P &lt; 0.001) and SCD (adjusted HR: 1.11; P = 0.009). For SCD events, the addition of LGE extent could improve the model performance of HCM Risk-Kids model (C-statistics: 0.65 versus 0.79, P = 0.015) and PRIMaCY model (C-statistics: 0.62 versus 0.82, P = 0.002), respectively.</div></div><div><h3>Interpretation</h3><div>In Chinese pediatric HCM, LGE serves as a risk factor in predicting adverse outcomes and may enhance SCD risk stratification strategies.</div></div><div><h3>Funding</h3><div>This study was funded by the <span>National Key Research and</span> Development Program of China (<span><span>2021YFF0501400</span></span> and <span><span>2021YFF0501404</span></span>), the Key Project of the <span>National Natural Science Foundation of China</span> (<span><span>82430066</span></span>), and the <span>Yunnan Province Science and Technology</span> Platform and Talent Project (<span><span>202305AF150033</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101573"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069988","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":"Breaking the cycle of panic and neglect: better preparedness for the next pandemic","authors":"The Lancet Regional Health – Western Pacific","doi":"10.1016/j.lanwpc.2025.101586","DOIUrl":"10.1016/j.lanwpc.2025.101586","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101586"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166910","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":"Evolution of strategic framework of policies related to dementia care and prevention in China from 2000 to 2024","authors":"Yu-ting Luo ,&nbsp;Xin Guan ,&nbsp;Qian Xiong ,&nbsp;Huali Wang","doi":"10.1016/j.lanwpc.2025.101561","DOIUrl":"10.1016/j.lanwpc.2025.101561","url":null,"abstract":"<div><h3>Background</h3><div>Dementia has emerged as a critical public health issue on the global policy agenda. Over the past 25 years, China has increasingly recognized the significant challenges posed by dementia and has made substantial strides in formulating relevant policies. This study aims to analyze the strategic framework of China’s dementia policy development to provide valuable insights for other low- and middle-income countries as they draft their national action plans.</div></div><div><h3>Methods</h3><div>Policy documents were systematically searched and retrieved from the official websites of pertinent policy agencies. The evolutionary phases of dementia policies were identified based on the timeline of policy issuance. A comparative thematic analysis was conducted to explore the evolution of policy content. Additionally, WordCloud analysis was utilized to examine the frequency of relevant terms within these documents. Co-occurrence network diagrams were then created to illustrate the evolving trends in the relationships among key terms and activities related to dementia care.</div></div><div><h3>Findings</h3><div>A total of 36 policy documents were included in this study. Three distinct phases were identified over the past 25 years: an incipient phase (2000–2014), a development phase (2015–2018), and a boom phase (2019–2024). Themes within dementia policies have progressively expanded and enriched across these phases. There has been a notable shift in focus from “intervention” during the incipient phase to “dementia prevention” in the boom phase, with themes such as “screening and evaluation” and “public education” gaining prominence. Stakeholder involvement has diversified to include entities like “community,” “institutions,” and “social workers.” Moreover, the scope of potential beneficiaries has broadened from “patients” to encompass “family members” and “caregivers.” The number of nodes related to dementia policies has increased, and their interconnections have strengthened over time.</div></div><div><h3>Interpretation</h3><div>Over 25 years, the themes, content, and stakeholders involved in China’s dementia-related policies have expanded significantly. Furthermore, the interconnection among key terms and content has grown stronger. These findings offer valuable references for advancing national dementia initiatives and updating dementia action plans in low- and middle-income countries.</div></div><div><h3>Funding</h3><div><span>Jiangxi Province Key Research</span> Base Program for Philosophy and Social Sciences (<span><span>23ZXSKJD28</span></span>) and <span>Beijing Medical Award Foundation</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101561"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901925","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":"Unveiling pathways to enhance hypertension and diabetes care in rural China: a mixed methods study using the care cascade model","authors":"Xuejun Yin ,&nbsp;Zhenzhong Wang ,&nbsp;Jia Li ,&nbsp;Jiawen Ke ,&nbsp;Bin Jing ,&nbsp;Wenshuai Feng ,&nbsp;Qinglan Liu ,&nbsp;Jingsong Yang ,&nbsp;Alon Rasooly ,&nbsp;David Beran ,&nbsp;Kunihiro Matsushita ,&nbsp;Nizal Sarrafzadegan ,&nbsp;Yuxiu Li ,&nbsp;Luzhao Feng ,&nbsp;Ruitai Shao","doi":"10.1016/j.lanwpc.2025.101574","DOIUrl":"10.1016/j.lanwpc.2025.101574","url":null,"abstract":"<div><h3>Background</h3><div>Significant gaps remain in the screening, diagnosis, treatment, and control of hypertension and diabetes. This study aimed to assess the care cascade for these conditions in rural China, identifying barriers and facilitators at each stage to inform strategies for improving care delivery.</div></div><div><h3>Methods</h3><div>A sequential exploratory mixed methods study was conducted from July 2023 to June 2024 across three rural counties in China (Linqu, Gongyi, Wugang). The qualitative phase included in-depth interviews with policymakers, healthcare providers, and patients to identify contextual barriers and facilitators across each care cascade stage. Insights from the qualitative phase informed the design of a subsequent quantitative survey tool. The survey was administered to a stratified, non-random sample of rural residents to quantitatively assess factors identified in the qualitative phase.</div></div><div><h3>Findings</h3><div>Qualitative interviews were conducted with 82 participants, including 10 policymakers, 36 healthcare providers, and 36 patients with hypertension and/or diabetes. There were 7488 rural residents aged 35–74 years who completed the quantitative survey. Of these, 2668 (35.6%) had hypertension alone, 516 (6.9%) had diabetes alone, and 977 (13.0%) had both conditions. The care cascade for all conditions revealed significant gaps, with high rates of uncontrolled disease: 87.6% for hypertension, 72.3% for diabetes, and 96.6% for those with both conditions. Integrated qualitative and quantitative analyses highlighted key barriers at the patient level, including misconceptions about disease severity, low perceived need for care, and fear of diagnosis and lifelong medication use. Provider and system-level challenges, such as limited diagnostic capacity and inconsistent follow-up, were exacerbated by resource constraints in primary care. Facilitators included strong patient–provider relationships, targeted health education initiatives, the use of digital tools, and chronic disease reimbursement policies.</div></div><div><h3>Interpretation</h3><div>By combining qualitative and quantitative methods, the study identifies distinct care cascades for hypertension, diabetes, and comorbid hypertension and diabetes patients. The study highlights the need for integrated, context-specific strategies, including enhanced health education, stronger primary care systems, and the adoption of electronic health systems to improve the continuity of care in rural China.</div></div><div><h3>Funding</h3><div>This study was supported by the <span>Chinese Academy of Medical Sciences</span> through the following grants: <span>Central Research Institute Fund</span> (Grant Nos. <span><span>2022-ZHCH330-01</span></span> and <span><span>2021-RC330-004</span></span>) and the <span>Disciplines Construction Project: Population Medicine</span> (Grant No. <span><span>WH10022022010</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101574"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069467","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":"Estimating changes in life expectancy in Hong Kong during the COVID-19 pandemic: a longitudinal ecological study","authors":"Alexandra H.T. Law ,&nbsp;Anne M. Presanis ,&nbsp;Justin K. Cheung ,&nbsp;Peng Wu ,&nbsp;C. Mary Schooling ,&nbsp;Benjamin J. Cowling ,&nbsp;Jessica Y. Wong","doi":"10.1016/j.lanwpc.2025.101571","DOIUrl":"10.1016/j.lanwpc.2025.101571","url":null,"abstract":"<div><h3>Background</h3><div>Hong Kong has one of the longest life expectancies in the world but was heavily impacted by COVID-19 in 2022. We aimed to estimate patterns in mortality rates and changes in life expectancy in Hong Kong during the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>We constructed sex-specific life tables from 1998 to 2023 using parametric bootstrapping to account for statistical uncertainty in mortality rates. We used Arriaga’s decomposition method to estimate age- and cause-specific contributions to overall changes in life expectancy for 2020–2023, with 2019 as the reference year. We also estimated cause-specific mortality rates.</div></div><div><h3>Findings</h3><div>Hong Kong reported 50,666 deaths in 2020, 51,354 in 2021, 63,692 in 2022, and 54,731 in 2023. Estimates of life expectancy in males and females in 2020 and 2021 were similar to the pre-pandemic trend from 1998 to 2019 but declined significantly in 2022. Compared to the pre-pandemic trend, the 2022 values of 80.4 years for males and 86.4 years for females corresponded to reductions by 2.22 (95% CI: 2.08, 2.36) years in males and 2.30 (95% CI: 2.17, 2.43) years in females. The loss in life expectancy in 2022 was mainly attributed to increased respiratory mortality rates, with a negative contribution to life expectancy of 1.47 and 1.26 years for males and females respectively. In 2023 life expectancy increased by 0.60 (95% CI: 0.46, 0.75) years in males and by 1.10 (95% CI: 0.95, 1.26) years in females.</div></div><div><h3>Interpretation</h3><div>In 2022 a very high respiratory mortality rate in older adults in Hong Kong during the COVID-19 pandemic was associated with a reduction in life expectancy by more than 2 years. In 2023 life expectancy increased towards the pre-pandemic trend.</div></div><div><h3>Funding</h3><div><span>Health and Medical Research Fund</span>, Hong Kong.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101571"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916864","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":"Corrigendum to Previously published supplementary Abstract papers in issue 55S1","authors":"","doi":"10.1016/j.lanwpc.2025.101566","DOIUrl":"10.1016/j.lanwpc.2025.101566","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101566"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941969","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":"Survival in Duchenne muscular dystrophy in Australia: a 50 year retrospective cohort study","authors":"Zoe E. Davidson ,&nbsp;Suzanna Vidmar ,&nbsp;Amanda Griffiths ,&nbsp;Mark E. Howard ,&nbsp;David J. Berlowitz ,&nbsp;Elizabeth F. Jones ,&nbsp;Tim Scully ,&nbsp;Darran Treanor ,&nbsp;Bikram Singh ,&nbsp;David Prior ,&nbsp;Matilde G. Frost ,&nbsp;Robin Forbes ,&nbsp;Natassja Billich ,&nbsp;Justine Adams ,&nbsp;Kate Carroll ,&nbsp;Tuqa Al Lawati ,&nbsp;Hannah Bourne ,&nbsp;Andrew J. Kornberg ,&nbsp;Monique M. Ryan ,&nbsp;Ian R. Woodcock ,&nbsp;Michael M.H. Cheung","doi":"10.1016/j.lanwpc.2025.101568","DOIUrl":"10.1016/j.lanwpc.2025.101568","url":null,"abstract":"<div><h3>Background</h3><div>There is limited evidence describing the changing natural history of DMD in Australia.</div></div><div><h3>Methods</h3><div>This retrospective cohort study collated information on clinical management and disease milestones from medical records of males with DMD attending a paediatric hospital between 1973 and 2019 and linked this to information from two adult tertiary hospitals. Data were stratified by decade of birth and Kaplan Meier analyses were conducted to describe median time to key disease milestones.</div></div><div><h3>Findings</h3><div>The cohort included 356 individuals with DMD with year of birth ranging from 1958 to 2014 and median (interquartile range, IQR) follow up time from diagnosis of 10.5 (4.1, 15.7) years. Use of corticosteroids, angiotensin-converting enzyme inhibitors (ACE-I), echocardiography and respiratory support increased over time. Mean age of diagnosis decreased from 6.4 years in those born before 1970 to 3.4 years in those born 2010–2019. Median (IQR) survival increased over time from 18.2 (15.2, 20.4) years in those born before 1970 to 24.0 (20.3, 27.5) years in those born between 1990 and 1999. Increased life expectancy was observed in individuals using corticosteroids, ACE-I and respiratory support.</div></div><div><h3>Interpretation</h3><div>Survival in individuals with DMD has increased over the last five decades, likely due to changes in clinical management. Given the increased population surviving to adulthood, there is a need to enhance clinical services and surveillance to support neuromuscular disease in Australia, especially in transitional care and adult populations.</div></div><div><h3>Funding</h3><div><span>Independent Research Grant</span>, <span>Pfizer Australia</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101568"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922146","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":"Ongoing epidemic of scarlet fever in Shanghai and the emergence of M1UK lineage group A Streptococcus: a 14-year surveillance study across the COVID-19 pandemic period","authors":"Jiehao Cai ,&nbsp;Xingyu Zhou ,&nbsp;Chi Zhang ,&nbsp;Yue Jiang ,&nbsp;Panpan Lv ,&nbsp;Yibin Zhou ,&nbsp;Mingliang Chen ,&nbsp;Mei Zeng","doi":"10.1016/j.lanwpc.2025.101576","DOIUrl":"10.1016/j.lanwpc.2025.101576","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The surge of group A &lt;em&gt;Streptococcus&lt;/em&gt; (GAS) infections in regional countries warranted attention in the post-COVID-19 era. The resurgence of notifiable scarlet fever in China has been a public health issue since 2011. We conducted a consecutive 14-year surveillance study to analyse dynamic epidemiological profiles of scarlet fever from the perspective of epidemic trend and molecular evolution of GAS strains.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;From 2011 to 2024, epidemiological data on notifiable cases of scarlet fever and 3370 GAS isolates from children with scarlet fever were analysed. Incidence rates were calculated as the mean rate per 100,000 population with 95% CIs. Whole genome sequencing was performed on 332 &lt;em&gt;emm&lt;/em&gt;12 and 248 &lt;em&gt;emm&lt;/em&gt;1 isolates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;From 2011 to 2024, a total of 25,539 cases of scarlet fever were reported in Shanghai. The mean incidence declined from 17.1/100,000 population (95%CI 9.7–24.3, pre-COVID-19 period) to 4.8/100,000 population (2.0–10.1, post-COVID-19 period). Children aged 4–9 years represented 85.6% of cases. Sixteen &lt;em&gt;emm&lt;/em&gt; types were identified with predominance of &lt;em&gt;emm&lt;/em&gt;12 (66.4%) and &lt;em&gt;emm&lt;/em&gt;1 (29.8%). The annual proportions of &lt;em&gt;emm&lt;/em&gt;12 and &lt;em&gt;emm&lt;/em&gt;1 alternatively fluctuated with a cycle of six years. GAS isolates displayed &gt;90% resistance rate to erythromycin, clindamycin, and tetracycline. The distribution of &lt;em&gt;emm&lt;/em&gt; types, antimicrobial resistance rates and profiles, and differences in superantigen genes carried by the &lt;em&gt;emm&lt;/em&gt;12 and &lt;em&gt;emm&lt;/em&gt;1 isolates were similar in the pre- and post-COVID-19 periods. Phylogenetic analysis indicated 96.7% of &lt;em&gt;emm&lt;/em&gt;12 isolates belonged to Clade II, harbouring ICE-&lt;em&gt;emm&lt;/em&gt;12 and ΦHKU.vir. Among the &lt;em&gt;emm&lt;/em&gt;1 isolates, the proportions of the ST1274 isolates increased from 10.5% (pre-COVID-19 period) to 73.7% (post-COVID-19 period). Four novel M1&lt;sub&gt;UK&lt;/sub&gt; isolates were found in Shanghai, with distinctive characteristics of presence of &lt;em&gt;speC&lt;/em&gt; and &lt;em&gt;ssa&lt;/em&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Persistent and periodic predominance of &lt;em&gt;emm&lt;/em&gt;12 and &lt;em&gt;emm&lt;/em&gt;1 types was responsible for the annual epidemic of scarlet fever in Shanghai. A marked decline in the incidence of scarlet fever in the last 5 years in Shanghai may be associated with enhanced type-specific immunity among the susceptible population and enhanced infection control measures, awareness, and actions in child institutions in the post-COVID-19 era. The emergence of the M1&lt;sub&gt;UK&lt;/sub&gt; isolates with some distinctive characteristics and ST1274 lineage warrants further attention and continuous surveillance in China.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;Shanghai municipal three-year action plan for strengthening the construction of the public health system 2023–2025 (GWVI-2.1.2); Research project of &lt;span&gt;Shanghai Minhang District Health Commission&lt;/span&gt; ","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101576"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935758","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":"Lessons for future outbreaks from successful contact tracing systems in Asia","authors":"Joanna X.R. Tan ,&nbsp;Hitoshi Oshitani ,&nbsp;Lam Phung Khanh ,&nbsp;Charuttaporn Jitpeera ,&nbsp;Luca Ferretti ,&nbsp;Alex R. Cook","doi":"10.1016/j.lanwpc.2025.101563","DOIUrl":"10.1016/j.lanwpc.2025.101563","url":null,"abstract":"<div><div>Countries around the world had utilized contact tracing to support public health responses to curb transmission during the COVID-19 pandemic. In particular, countries in East and Southeast Asia had been effective in their contact tracing responses. To understand their successes, the contact tracing systems of Japan, Thailand, Singapore and Vietnam were comparatively analyzed, including the technical aspects of contact tracing approaches, detection and response structures. Through the comparative analysis, we uncovered the key elements within these successful systems, namely speed, capture and accuracy, designed specific for the countries’ settings. For the system to work efficiently, we found that maintaining the balance across speed, capture and accuracy while adapting to the disease epidemiology and environment was essential. Contact tracing will remain a vital strategy to control the next epidemic with a pandemic potential. The lessons learnt could provide guiding principles to help enhance contact tracing systems and prepare for future outbreaks.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101563"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916863","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}