The Lancet Regional Health: Western Pacific最新文献

{"title":"Temporal trends in incidence, clinical characteristics and outcomes among young adults with heart failure: a territory-wide study from 2014 to 2023 on 19,537 patients","authors":"Wen-Li Gu ,&nbsp;Tiew-Hwa Katherine Teng ,&nbsp;Claire Lawson ,&nbsp;Jasper Tromp ,&nbsp;Wouter Ouwerkerk ,&nbsp;Jia-Yi Huang ,&nbsp;Chanchal Chandramouli ,&nbsp;Jing-Nan Zhang ,&nbsp;Ran Guo ,&nbsp;Wan Ting Tay ,&nbsp;Hao-Chen Xuan ,&nbsp;Yap Hang Chan ,&nbsp;Ambarish Pandey ,&nbsp;Carolyn S.P. Lam ,&nbsp;Kai-Hang Yiu","doi":"10.1016/j.lanwpc.2025.101687","DOIUrl":"10.1016/j.lanwpc.2025.101687","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF), traditionally considered a disease of the elderly, is increasingly common in younger people, but temporal data remain scarce. This cohort study aimed to examine temporal trends in incidence, comorbidities, risk factor profiles, and clinical outcomes among young HF patients.</div></div><div><h3>Methods</h3><div>Using a territory-wide administrative database in Hong Kong, we identified 19,537 young adults aged &lt;65 years with incident HF between 2014 and 2023. Data on baseline characteristics, echocardiographic parameters, comorbidities and prescribed medications were retrieved. Annual standardised incidence rates (IRs) of HF were calculated by direct age- and sex-standardisation. Comparisons were made between two 5-year periods: 2014–2018 and 2019–2023. Multivariable regression models were applied to assess temporal shifts in risk factor profiles. The primary outcome was one-year all-cause mortality, with incidence rates reported per 100 person-years. Kaplan–Meier survival curves were plotted to illustrate survival trends.</div></div><div><h3>Findings</h3><div>Among the cohort (median age 57.1 years, 69% men), IRs of young HF increased by 20% (IRR 1.20, 95% CI 1.13–1.27) from 2014 to 2023. Concurrent with fewer comorbidities, young HF patients in 2019–2023 were more likely to present with obesity, cardiomyopathy, lower socioeconomic status, and be aged 45–65 years, contrasting with the conventional risk factors (including history of sudden cardiac arrest) predominant in the 2014–2018 cohort (all <em>p</em> &lt; 0.001). Additionally, the 2019–2023 cohort demonstrated elevated subtype of HF with reduced ejection fraction (HFrEF) and increased use of guideline-directed medical therapy (GDMT). A modest reduction in one-year mortality was observed between the two periods (15.6 [14.8, 16.5] vs. 14.6 [13.8, 15.5] events per 100 person-years).</div></div><div><h3>Interpretation</h3><div>The incidence of HF among young adults increased substantially between 2014 and 2023. During this period, the risk factor profile shifted considerably, with a pronounced rise in HFrEF subtype. Despite improved therapeutic management and better use of GDMT, reductions in one-year mortality were modest. Proactive public health strategies are urgently needed to address these emerging challenges in this population.</div></div><div><h3>Funding</h3><div>This work was funded by grants from the <span>National Natural Science Foundation</span> of China (No. <span><span>82270400</span></span>) and the <span>Natural Science Foundation of Guangdong Province</span> (No. <span><span>2023A1515010731</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101687"},"PeriodicalIF":8.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105412","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":"Leadership and investment to strengthen child and adolescent mental health in LMICs from the Western Pacific Region","authors":"Manasi Kumar","doi":"10.1016/j.lanwpc.2025.101677","DOIUrl":"10.1016/j.lanwpc.2025.101677","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101677"},"PeriodicalIF":8.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219750","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":"Cost–effectiveness analysis of prostate-specific antigen screening in China: a middle-income population-based microsimulation study","authors":"Jiacheng Liu ,&nbsp;Yuanshi Jiao ,&nbsp;Yueting Huang ,&nbsp;Yongle Zhan ,&nbsp;Ruofan Shi ,&nbsp;Xiaohao Ruan ,&nbsp;Chi Yao ,&nbsp;Ruochen Ma ,&nbsp;Salida Ali ,&nbsp;Tsun Tsun Chun ,&nbsp;Da Huang ,&nbsp;Danfeng Xu ,&nbsp;Qian Zhang ,&nbsp;Di Gu ,&nbsp;Xue Li ,&nbsp;Rong Na","doi":"10.1016/j.lanwpc.2025.101683","DOIUrl":"10.1016/j.lanwpc.2025.101683","url":null,"abstract":"<div><h3>Background</h3><div>The significance of prostate-specific antigen (PSA) in reducing the health burden of prostate cancer is widely deliberated. We conducted this study, utilising real-world data, to develop a comprehensive, cost-effectiveness analysis model for PSA screening. By evaluating various screening strategies, we aim to provide policymakers with robust research evidence to inform future PSA screening policies.</div></div><div><h3>Methods</h3><div>We constructed a microsimulation model to assess 56 conventional population-wide PSA screening strategies based on data from a five-year trial with 104,751 participants, a 20-year multicentre database and parameters collected across China, along with approaches involving genetic risk stratification based on family history, polygenic risk scores, and high-penetrance genes. Clinical outcomes including incidence, metastasis-incidence ratio (M/I ratio), and annual case-fatality rate (CFR) were evaluated. Cost-effectiveness was evaluated using incremental quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). Sensitivity and scenario analyses were conducted to test the robustness of the results.</div></div><div><h3>Findings</h3><div>All strategies led to QALY gains and were considered cost-effective under a willingness-to-pay threshold equal to China's per capita GDP ($12,510.12 per QALY). The most intensive protocol (45–74 years, annually, with age-specific PSA cutoffs) had an ICER of 5535.25USD/QALY, yielding 2.79 incremental QALYs compared to non-screening, reducing M/I ratio from 39.05% to 1.04%, and CFR from 6.14% to 2.85%. The genetic risk-specific protocol offered comparable QALYs (2.79 vs. 2.76) and ICERs (5287.23 vs. 4904.90USD/QALY), allowing for 66.8% of average-risk individuals with extended screening intervals or postponed screening start age.</div></div><div><h3>Interpretation</h3><div>PSA screening in China has the potential to improve overall health outcomes in a cost-effective manner. Personalised screening based on genetic risk may provide an efficient alternative to uniform strategies, potentially reducing unnecessary interventions among those at lower risk. This study provides a solid evidence base for Chinese policymakers to consider establishing a cost-effective, risk-stratified PCa screening programme.</div></div><div><h3>Funding</h3><div><span>Shenzhen-Hong Kong-Macau S&amp;T Programme</span>, HKU Seed Fund, RJH Cultivating Star Programme, HK <span>UGC Research</span> Impact Fund and Guangdong High-Level Talents Programme.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101683"},"PeriodicalIF":8.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105413","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":"Blood pressure control in Asia: from evidence to practice","authors":"The Lancet Regional Health – Western Pacific","doi":"10.1016/j.lanwpc.2025.101705","DOIUrl":"10.1016/j.lanwpc.2025.101705","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101705"},"PeriodicalIF":8.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219749","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":"Policies, resources, and interventions for child and adolescent mental health in China: a scoping review","authors":"Yiqun Luan ,&nbsp;Yuhe Wang ,&nbsp;Lingjun Chu ,&nbsp;Stephanie Zhang ,&nbsp;Xiwang Fan ,&nbsp;Chikyu Tsin ,&nbsp;Zihua Yu ,&nbsp;Kexin Chen ,&nbsp;Xinran Wang ,&nbsp;Yijing Zhang ,&nbsp;Yizhe Wang ,&nbsp;Linyu Gao ,&nbsp;Nan Jiang ,&nbsp;Juanzhi Zhang ,&nbsp;Eteri Machavariani ,&nbsp;Yujia Qiu ,&nbsp;Na Zhong ,&nbsp;Min Zhao ,&nbsp;Guohong Li ,&nbsp;Jiang Long ,&nbsp;Chunling Lu","doi":"10.1016/j.lanwpc.2025.101635","DOIUrl":"10.1016/j.lanwpc.2025.101635","url":null,"abstract":"<div><div>Child and adolescent mental health (CAMH) disorders have become a public health concern in China, yet evidence on resource allocation remains limited. This scoping review synthesizes English- and Chinese-language peer-reviewed and grey literature to assess four domains related to CAMH: legislation and policy, financing and health insurance coverage, service delivery and utilization, and available interventions. While China has established a comprehensive legislative and policy framework for CAMH, resources remain insufficient to fully implement it. In 2020, per-adolescent (aged 10–19 years) spending on mental health curative care in China was 27.6 RMB (equivalent to $4.6 in 2023 USD), with households covering 58.1% and the government only 14%. Insurance rarely covers psychotherapy or counselling for children and adolescents. CAMH workforce and infrastructure remain limited and concentrated in urban areas. Intervention studies are mostly small-sample and focus on short-term outcomes. Evidence on cost-effectiveness is scarce. Key recommendations include expanding health insurance coverage, improving CAMH workforce and infrastructure, especially in underserved regions, and strengthening evidence-based policymaking through establishing a national-level monitoring system and conducting large-sample, long-term studies.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101635"},"PeriodicalIF":8.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219829","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":"Advancing child and adolescent mental health in the Western Pacific through international collaboration","authors":"Jiang Long ,&nbsp;Chunling Lu","doi":"10.1016/j.lanwpc.2025.101679","DOIUrl":"10.1016/j.lanwpc.2025.101679","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101679"},"PeriodicalIF":8.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219831","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":"The epidemiology and hypervirulence of Klebsiella pneumoniae ST23 unveil epidemic risks in China and worldwide","authors":"Haijian Zhou ,&nbsp;Chongye Guo ,&nbsp;Zhigang Cui ,&nbsp;Jinrui Hu ,&nbsp;Xiaoli Du ,&nbsp;Yan Sun ,&nbsp;Linhuan Wu ,&nbsp;Biao Kan","doi":"10.1016/j.lanwpc.2025.101661","DOIUrl":"10.1016/j.lanwpc.2025.101661","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"62 ","pages":"Article 101661"},"PeriodicalIF":8.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895261","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}