The Lancet Regional Health: Western Pacific最新文献

{"title":"New progress in HBV control and the cascade of health care for people living with HBV in China: evidence from the fourth national serological survey, 2020","authors":"Zheng Hui ,&nbsp;Wang Yu ,&nbsp;Wang Fuzhen ,&nbsp;Shen Liping ,&nbsp;Zhang Guomin ,&nbsp;Liu Jianhua ,&nbsp;Wang Feng ,&nbsp;Miao Ning ,&nbsp;Li Jian ,&nbsp;Ding Guowei ,&nbsp;Meng Tongtong ,&nbsp;Tang Lin ,&nbsp;Zhang Shuang ,&nbsp;Li Mingshuang ,&nbsp;Li Yuan ,&nbsp;Wang Xiaoqi ,&nbsp;Liu Qianqian ,&nbsp;Zhang Qian ,&nbsp;Wu Dan ,&nbsp;Yan Tingting ,&nbsp;Wang Yu","doi":"10.1016/j.lanwpc.2024.101193","DOIUrl":"10.1016/j.lanwpc.2024.101193","url":null,"abstract":"<div><h3>Background</h3><p>Since 1992, when recombinant hepatitis B vaccine was introduced in China, government health officials have used nationally representative serological surveys to monitor progress in prevention and control of hepatitis B. In 2020, we conducted the fourth seroepidemiological survey, which for the first time included medical evaluation of the clinical status of HBsAg positive subjects over the age of 15 and their medical management. We report survey results in comparison with the three previous surveys.</p></div><div><h3>Methods</h3><p>Consistent with previous national surveys, the 2020 survey used a stratified, three-stage cluster random sampling method to select for evaluation 1-69-year-olds in 120 national disease surveillance points. Blood samples were tested for HBsAg, anti-HBV surface antigen (anti-HBs), and anti-HBV core antigen (anti-HBc) in the National Hepatitis Laboratory of the Institute for Viral Disease Control and Prevention of China CDC. HBsAg positive subjects aged ≥15-year were evaluated for evidence of liver disease, and through face-to-face questionnaire-based survey, we determined the healthcare management cascade of HBV-infected individuals.</p></div><div><h3>Findings</h3><p>HBsAg prevalence in 1–69-year-olds was 5.86%; in children 1–4 years of age, seroprevalence was 0.30%; 75 million people were living with HBV nationwide. Among HBsAg-positive individuals 15 years and older, expert medical examination found that 78.03% were HBsAg carriers with no evidence of liver damage, 19.63% had chronic HBV with liver enzyme abnormalities, 0.84% had evidence of cirrhosis, and 0.15% had evidence of liver cancer. 59.78% of HBsAg + individuals were aware that they were positive before the survey, 30 million were unaware; 38.25% of those who knew they were positive (17 million) had medical indications for antiviral treatment, and 17.33% of these individuals (3 million) were being treated with antivirals.</p></div><div><h3>Interpretation</h3><p>The decline in HBsAg prevalence in the general population, from 9.72% in 1992 to 5.86% in 2020, and in 1–4-year-olds from 9.67% in 1992 to 0.30% in 2020, shows progress that continues on track toward WHO targets for prevention of new infections. Implementation of acceptable strategies to identify infected individuals and offer long-term medical monitoring and management will be important to prevent complications from hepatitis B infection and for meeting WHO cascade-of-care targets.</p></div><div><h3>Funding</h3><p><span>The study was funded by the Major Science and Technology Special Project of China’s 13th 5-Year Plan</span> (grant no. <span><span>2017ZX10105015</span></span>); Central finance-operation of public health emergency response mechanism of <span>Chinese Center for Disease Control and Prevention</span> (<span><span>131031001000200001</span></span>, <span><span>102393220020010000017</span></span>).</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001871/pdfft?md5=b9f6badec0d4ff0b1d334f1a575ae501&pid=1-s2.0-S2666606524001871-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232605","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":"Invasive fungal disease and antifungal prophylaxis in children with acute leukaemia: a multicentre retrospective Australian cohort study","authors":"Daniel K. Yeoh ,&nbsp;Christopher C. Blyth ,&nbsp;Julia E. Clark ,&nbsp;Joanne Abbotsford ,&nbsp;Claudia Corrente ,&nbsp;Sara Cook ,&nbsp;Rishi S. Kotecha ,&nbsp;Stacie S. Wang ,&nbsp;Tim Spelman ,&nbsp;Monica A. Slavin ,&nbsp;Karin A. Thursky ,&nbsp;Gabrielle M. Haeusler","doi":"10.1016/j.lanwpc.2024.101201","DOIUrl":"10.1016/j.lanwpc.2024.101201","url":null,"abstract":"<div><h3>Background</h3><p>Invasive fungal disease (IFD) is a significant complication for children receiving treatment for leukaemia, contributing to morbidity and mortality. Recent regional paediatric epidemiological IFD data are lacking. Additionally uncertainty remains regarding the optimal prophylactic approach in this context.</p></div><div><h3>Methods</h3><p>In a multi-centre Australian cohort study of children diagnosed with <em>de novo</em> acute leukaemia between 1st January 2017 and 30th June 2020, we characterised antifungal prophylaxis prescribing and IFD prevalence. Impact of antifungal prophylaxis was assessed using Kaplan Meier curves and Cox-proportional hazards regression adjusting for known IFD risk factors.</p></div><div><h3>Findings</h3><p>A total of 434 children were included (47.2% female; median age 5.0 years, median follow-up 240 days). This cohort included 351 children with ALL (214 high-risk [HR-ALL]; 137 standard-risk [SR-ALL]), and 73 with AML. The prevalence of proven/probable IFD was 6.8% for AML, 14.0% for HR-ALL and 4.4% for SR-ALL. A mould was implicated as the causative pathogen in almost two thirds of cases. Antifungal prophylaxis was prescribed in 98.7% of chemotherapy cycles for AML, 56.7% for HR-ALL and 14.9% for SR-ALL. A mould-active agent was used in 77.4% of AML cycles and 21.2% of HR-ALL cycles. Mould-active prophylaxis was associated with a lower risk of IFD overall and increased IFD-free survival in AML.</p></div><div><h3>Interpretation</h3><p>These data demonstrate the persistent high regional burden of IFD in children with HR-ALL, and the potential for mould-active prophylaxis to ameliorate this. Strategies to increase uptake of appropriate prophylaxis are required in this cohort.</p></div><div><h3>Funding</h3><p>This study was supported by a <span>Perth Children’s Hospital Foundation</span> grant (PCHF9973).</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001950/pdfft?md5=86dbe90311fb4a5872915dfe4c260857&pid=1-s2.0-S2666606524001950-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173094","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":"Independent and joint associations of cardiometabolic multimorbidity and depression on cognitive function: findings from multi-regional cohorts and generalisation from community to clinic","authors":"Xuhao Zhao ,&nbsp;Xiaolin Xu ,&nbsp;Yifan Yan ,&nbsp;Darren M. Lipnicki ,&nbsp;Ting Pang ,&nbsp;John D. Crawford ,&nbsp;Christopher Chen ,&nbsp;Ching-Yu Cheng ,&nbsp;Narayanaswamy Venketasubramanian ,&nbsp;Eddie Chong ,&nbsp;Sergio Luis Blay ,&nbsp;Maria Fernanda Lima-Costa ,&nbsp;Erico Castro-Costa ,&nbsp;Richard B. Lipton ,&nbsp;Mindy J. Katz ,&nbsp;Karen Ritchie ,&nbsp;Nikolaos Scarmeas ,&nbsp;Mary Yannakoulia ,&nbsp;Mary H. Kosmidis ,&nbsp;Oye Gureje ,&nbsp;Xin Xu","doi":"10.1016/j.lanwpc.2024.101198","DOIUrl":"10.1016/j.lanwpc.2024.101198","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Cardiometabolic multimorbidity (CMM) and depression are often co-occurring in older adults and associated with neurodegenerative outcomes. The present study aimed to estimate the independent and joint associations of CMM and depression on cognitive function in multi-regional cohorts, and to validate the generalizability of the findings in additional settings, including clinical.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;Data harmonization was performed across 14 longitudinal cohort studies within the Cohort Studies of Memory in an International Consortium (COSMIC) group, spanning North America, South America, Europe, Africa, Asia, and Australia. Three external validation studies with distinct settings were employed for generalization. Participants were eligible for inclusion if they had data for CMM and were free of dementia at baseline. Baseline CMM was defined as: 1) CMM 5, ≥2 among hypertension, hyperlipidemia, diabetes, stroke, and heart disease and 2) CMM 3 (aligned with previous studies), ≥2 among diabetes, stroke, and heart disease. Baseline depression was primarily characterized by binary classification of depressive symptom measurements, employing the Geriatric Depression Scale and the Center for Epidemiological Studies-Depression scale. Global cognition was standardized as z-scores through harmonizing multiple cognitive measures. Longitudinal cognition was calculated as changes in global cognitive z-scores. A pooled individual participant data (IPD) analysis was utilized to estimate the independent and joint associations of CMM and depression on cognitive outcomes in COSMIC studies, both cross-sectionally and longitudinally. Repeated analyses were performed in three external validation studies.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;Of the 32,931 older adults in the 14 COSMIC cohorts, we included 30,382 participants with complete data on baseline CMM, depression, and cognitive assessments for cross-sectional analyses. Among them, 22,599 who had at least 1 follow-up cognitive assessment were included in the longitudinal analyses. The three external studies for validation had 1964 participants from 3 multi-ethnic Asian older adult cohorts in different settings (community-based, memory clinic, and post-stroke study). In COSMIC studies, each of CMM and depression was independently associated with cross-sectional and longitudinal cognitive function, without significant interactions between them (&lt;em&gt;P&lt;/em&gt;s &gt; 0.05). Participants with both CMM and depression had lower cross-sectional cognitive performance (e.g. β = −0.207, 95% CI = (−0.255, −0.159) for CMM5 (+)/depression (+)) and a faster rate of cognitive decline (e.g. β = −0.040, 95% CI = (−0.047, −0.034) for CMM5 (+)/depression (+)), compared with those without either condition. These associations remained consistent after additional adjustment for APOE genotype and were robust in two-step random-effects IPD analyses. The findings regarding the joint association of CMM and","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001925/pdfft?md5=d91ed898d77fa26b93052bf20c7c622a&pid=1-s2.0-S2666606524001925-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173669","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":"Readmission destination following cardiac surgery and its association with mortality outcomes: a population-based retrospective study","authors":"Md Shajedur Rahman Shawon ,&nbsp;Sanja Lujic ,&nbsp;Yashutosh Joshi ,&nbsp;Louisa Jorm","doi":"10.1016/j.lanwpc.2024.101189","DOIUrl":"10.1016/j.lanwpc.2024.101189","url":null,"abstract":"<div><h3>Background</h3><p>It is unclear how pre-surgery transfer relates to readmission destination among patients undergoing cardiac surgery and whether readmission to a hospital other than the operating hospital is associated with increased mortality.</p></div><div><h3>Methods</h3><p>We analysed linked hospital and death records for residents of New South Wales, Australia, aged ≥18 years who had an emergency readmission within 30 days following coronary artery bypass graft (CABG) or surgical aortic valve replacement (SAVR) in 2003–2022. Mixed-effect multi-level modelling was used to evaluate associations of readmission destination with 30-day mortality, overall and stratified by pre-surgery transfer.</p></div><div><h3>Findings</h3><p>Of 102,540 patients undergoing cardiac surgery (isolated CABG = 63,000, SAVR = 27,482, combined = 12,058), 28.7% (n = 29,398) had pre-surgery transfer, while the 30-day readmission rate was 14.7% (n = 14,708). During readmission, 35.7% (3499/9795) of those without pre-surgery transfer and 12.0% (590/4913) of those with pre-surgery transfer returned to the operating hospital. Among readmitted patients, 30-day mortality did not differ significantly for those who were readmitted to a non-index hospital, both overall (adjusted odds ratio [aOR] = 1.03 95% CI 0.75–1.41), and in analyses stratified by pre-surgery transfer (no transfer: aOR = 1.07, 95% CI 0.75–1.52; transfer: aOR = 0.88, 95% CI 0.45–1.72). Among patients who had pre-surgery transfer, 30-day mortality was similar among patients who were readmitted to the index operating hospital (reference), the initial admitting hospital (aOR = 1.00, 95% CI 0.50–2.00) or a third, different, hospital (aOR = 0.70, 95% CI 0.33–1.48).</p></div><div><h3>Interpretation</h3><p>Although many Australian patients who are readmitted following cardiac surgery are readmitted to hospitals different to the operating or initial admitting hospital, such readmissions are not associated with increased mortality.</p></div><div><h3>Funding</h3><p>This study was funded by a <span>National Health and Medical Research Foundation</span> of Australia (NHMRC) Project Grant (<span><span>#1162833</span></span>).</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001834/pdfft?md5=5411c0f6f61f7aa07ead12847456584c&pid=1-s2.0-S2666606524001834-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142137241","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":"Acceptability of a nationwide scabies mass drug administration (MDA) program in Fiji: a qualitative interview-based study","authors":"Elke Mitchell ,&nbsp;Aminiasi Tavui ,&nbsp;Sarah Andersson ,&nbsp;Susanna Lake ,&nbsp;Aminiasi Koroivueti ,&nbsp;Josefa Koroivueta ,&nbsp;Ripeka Kaurasi ,&nbsp;Vinaisi Bechu ,&nbsp;John Kaldor ,&nbsp;Andrew Steer ,&nbsp;Lucia Romani","doi":"10.1016/j.lanwpc.2024.101194","DOIUrl":"10.1016/j.lanwpc.2024.101194","url":null,"abstract":"<div><h3>Background</h3><p>Fiji has among the highest global reported prevalence of scabies. Mass drug administration (MDA) has been identified as a potentially effective strategy to control scabies, but acceptability of MDA from the perspectives of people receiving and delivering scabies MDA programs remains underexplored in Fiji and globally.</p></div><div><h3>Methods</h3><p>A qualitative study was conducted after completion of the national MDA campaign. Participants included 44 community members and 12 key informants across the Central and Western Divisions of Fiji. Semi-structured face-to-face and virtual interviews were conducted in August and September 2023. An interpretive research approach was adopted, and data were analysed using deductive and inductive techniques.</p></div><div><h3>Findings</h3><p>We identified several barriers and facilitators to scabies MDA acceptability. Facilitators included prior experiences of scabies and knowledge of the potential health benefit of MDA, community attitudes to MDA and neighbours’ adherence practices, endorsement of MDA by community leaders, community consultation and exposure to community sensitisation, and involvement of local key informants during planning and implementation. Barriers included a lack of trust in MDA campaigns, religious beliefs, limited reach of community sensitisation, and challenges to implementing MDA in urban locations.</p></div><div><h3>Interpretation</h3><p>This is the first qualitative study documenting acceptability of a nationwide scabies-MDA globally. It identified diverse socio-structural factors that influenced MDA implementation and acceptability. Future MDA programs could benefit from widespread community sensitisation, tailored approaches to urban and rural MDA design and delivery, and the inclusion of communities in the co-design and implementation of MDA programs.</p></div><div><h3>Funding</h3><p>The <span>National Health</span> and <span>Medical Research Council</span> (NHMRC) investigator grant—LR and the <span>Macquarie Group Foundation</span> 50th Celebration Awards–AS.</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001883/pdfft?md5=303e22bedb7e223428e87bd210877d60&pid=1-s2.0-S2666606524001883-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142137242","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":"Burden of cardiovascular disease among the Western Pacific region and its association with human resources for health, 1990–2021: a systematic analysis of the Global Burden of Disease Study 2021","authors":"Huan Wang ,&nbsp;Xiaoran Yu ,&nbsp;Jianhui Guo ,&nbsp;Sheng Ma ,&nbsp;Yunfei Liu ,&nbsp;Yifei Hu ,&nbsp;Jing Li ,&nbsp;Yi Song ,&nbsp;Zhiyong Zou","doi":"10.1016/j.lanwpc.2024.101195","DOIUrl":"10.1016/j.lanwpc.2024.101195","url":null,"abstract":"<div><h3>Background</h3><p>A comprehensive profile of cardiovascular disease (CVD) burden and human resources for health (HRH) distribution in the WHO Western Pacific region has yet to be presented. Studies on the relationship between HRH and CVD in this region are limited. We aimed to describe CVD trends and HRH density in the Western Pacific region and explore the association of HRH with CVD burden.</p></div><div><h3>Methods</h3><p>Estimates of CVD deaths and disability-adjusted life years (DALYs) were obtained from the Global Burden of Disease Study (GBD) 2021, and the annual density of HRH was retrieved from GBD 2019. We presented trends in CVD burden and HRH density across 31 Western Pacific countries. Spearman rank correlation analysis and generalized linear models were used to examine associations between CVD burden and HRH density.</p></div><div><h3>Findings</h3><p>In 2021, CVD caused six million deaths and 125 million DALYs in the Western Pacific region, accounting for 39.4% and 22.5% of all-cause deaths and DALYs. From 1990 to 2021, the number of CVD deaths and DALYs increased by 94.9% and 57.3% in this region, whereas the age-standardized rate of CVD deaths and DALYs declined in all countries. In 2021, stroke and ischemic heart disease were the leading causes in the Western Pacific region, and a 32-year increase in CVD burden was primarily driven by aortic aneurysm, lower extremity peripheral arterial disease, endocarditis, and atrial fibrillation and flutter. In 2019, there was an approximately 20-fold difference in HRH density across 31 countries from the lowest in Papua New Guinea to the highest in Australia. HRH density was negatively related to the age-standardized rate of CVD deaths (<em>r</em>_<em>s</em> = −0.74) and DALYs (<em>r</em>_<em>s</em> = −0.73), especially strong associations between CVD burden and the density of dentistry personnel, aides &amp; emergency medical workers, and medical laboratory technicians.</p></div><div><h3>Interpretation</h3><p>CVD remains a pressing public health issue in the Western Pacific region where noticeable shortages in health workers exist. The negative associations between CVD burden and HRH density suggest that health workers, especially dentistry personnel, aides &amp; emergency medical staff, and medical laboratory technicians merit more investment to reduce the CVD burden.</p></div><div><h3>Funding</h3><p><span>National Natural Science Foundation of China</span> (82073573 to ZZ; 82273654 to YS).</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001895/pdfft?md5=6ce83c95676fa659f7287ab12f3ea232&pid=1-s2.0-S2666606524001895-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142129879","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":"Regional health priorities for dementia: a roadmap for the Western Pacific","authors":"Hannah C. Timmins ,&nbsp;Vincent C.T. Mok ,&nbsp;Seung Hyun Kim ,&nbsp;Nortina Shahrizaila ,&nbsp;Jia-Ying Sung ,&nbsp;Gen Sobue ,&nbsp;Sheila Agustini ,&nbsp;Stephanie Ward ,&nbsp;Kaarin J. Anstey ,&nbsp;Dayna-Lee Talbot ,&nbsp;Srestha Mazumder ,&nbsp;Sicong Tu ,&nbsp;Rachel H. Tan ,&nbsp;Cindy Shin-Yi Lin ,&nbsp;Claire O’Callaghan ,&nbsp;Johannes C. Michaelian ,&nbsp;Yun-Hee Jeon ,&nbsp;David Foxe ,&nbsp;Sharon L. Naismith ,&nbsp;Olivier Piguet ,&nbsp;Matthew C. Kiernan","doi":"10.1016/j.lanwpc.2024.101179","DOIUrl":"10.1016/j.lanwpc.2024.101179","url":null,"abstract":"<div><div>In the Western Pacific Region, the prevalence of dementia is expected to increase, however, the diversity of the region is expected to present unique challenges. The region has varying levels of preparedness, with a limited number of countries having a specific national dementia plan and awareness campaigns. Diversity of risk and healthcare services within the region is exerting impact on diagnosis, treatment, care, and support, with most countries being under resourced. Similarly, the ability to monitor dementia-related indicators and progress research, particularly relating to treatment and clinical trial access needs to be addressed. Countries require comprehensive national plans that lay out how resources will be allocated to improve dementia literacy, train, and support carers, mobilise resources to reduce risk factors and improve research capabilities. These plans need to be informed by consumers and tailored to the region to develop an inclusive society for people living with dementia and their families.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358058","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":"Understanding dementia in the Western Pacific: a region-specific approach to prevention","authors":"Jessica Gong","doi":"10.1016/j.lanwpc.2024.101202","DOIUrl":"10.1016/j.lanwpc.2024.101202","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358078","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":"Post-diagnosis dementia care in the Western Pacific region: assessment of needs and pathways to optimal care","authors":"Yun-Hee Jeon ,&nbsp;David Foxe ,&nbsp;Guk-Hee Suh ,&nbsp;Huali Wang ,&nbsp;Jacqueline C. Dominguez ,&nbsp;Rex Maukera ,&nbsp;Sengchanh Kounnavong ,&nbsp;Olivier Piguet","doi":"10.1016/j.lanwpc.2024.101182","DOIUrl":"10.1016/j.lanwpc.2024.101182","url":null,"abstract":"<div><div>The Western Pacific region is home to approximately 25% of the world's population. In the absence of cures for dementia, it is essential to focus on appropriate and accessible care pathways for people living with dementia and their families. This approach will ultimately result in timely diagnosis and improved care and support.</div><div>Ensuring adequate dementia care and support pathways has been a longstanding issue in many developed countries and is becoming a more prominent issue in countries with rising dementia prevalence rates but comparatively limited health resources.</div><div>This Viewpoint provides an overview of system-level post-diagnosis dementia care, from diagnosis to rehabilitation, across some of the region's lower (Laos, Solomon Islands, Philippines) and upper (China) middle income and high income (South Korea, Australia) countries. Gaps and challenges in post-diagnosis dementia care, as well as suggestions for optimal care, are discussed. This Viewpoint highlights highly variable system level post-diagnosis dementia care in the region.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358057","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":"Missed opportunities for hypertension screening of older people in the Philippines: cross-sectional analysis of nationally representative individual-level data","authors":"Aleli D. Kraft ,&nbsp;Joseph J. Capuno ,&nbsp;Kayleen Gene R. Calicdan ,&nbsp;Grace T. Cruz ,&nbsp;Owen O'Donnell","doi":"10.1016/j.lanwpc.2024.101188","DOIUrl":"10.1016/j.lanwpc.2024.101188","url":null,"abstract":"<div><h3>Background</h3><p>Guidelines recommend routine blood pressure measurement at health facilities. We estimated the potential for opportunistic screening for hypertension at health facilities to change the level and distribution of diagnosed hypertension in the older population of the Philippines.</p></div><div><h3>Methods</h3><p>We used a representative, nationwide sample of Filipinos aged 60 years and older and classified respondents as a) <em>hypertensive</em> if they had high (≥140/90 mm Hg) blood pressure (BP) or were taking BP medication, b) <em>diagnosed</em> if told have high BP by a doctor, and c) a <em>missed opportunity for diagnosis</em> if they were hypertensive, undiagnosed and had an outpatient visit to a health facility in the past 12 months. We assumed c) would be diagnosed if health facilities operated opportunistic screening. We estimated percentages of hypertensives diagnosed and with a missed opportunity overall, by wealth quintile and covariates, with age-sex and, then, full adjustment.</p></div><div><h3>Findings</h3><p>We estimated that opportunistic screening at health facilities would increase the percentage of hypertensives diagnosed from 62.7% (95% CI: 58.2, 67.0) to 74.4% (95% CI: 70.9, 77.6). The increase would be larger in richer groups due to lower (private) healthcare utilization by poorer, undiagnosed hypertensives.</p></div><div><h3>Interpretation</h3><p>Opportunistic screening for hypertension, if effectively implemented at health facilities, would substantially increase diagnosis but exacerbate inequality unless barriers discouraging poorer, older Filipinos from accessing outpatient and primary care were lowered.</p></div><div><h3>Funding</h3><p><span>Economic Research Institute for ASEAN and East Asia</span>, <span>Swiss Agency for Development and Cooperation</span>/<span>Swiss National Science Foundation</span> grant <span><span>400640_160374</span></span>.</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001822/pdfft?md5=6e59f9621971c2c5b329e16771413001&pid=1-s2.0-S2666606524001822-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136430","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}