The Lancet Regional Health: Western Pacific最新文献

{"title":"Preparing for the next pandemic: insights from Aotearoa New Zealand’s Covid-19 response","authors":"Nigel P. French ,&nbsp;Howard Maxwell ,&nbsp;Michael G. Baker ,&nbsp;Fiona Callaghan ,&nbsp;Kristin Dyet ,&nbsp;Jemma L. Geoghegan ,&nbsp;David T.S. Hayman ,&nbsp;Q. Sue Huang ,&nbsp;Amanda Kvalsvig ,&nbsp;Euan Russell ,&nbsp;Pippa Scott ,&nbsp;Te Pora Thompson ,&nbsp;Michael J. Plank","doi":"10.1016/j.lanwpc.2025.101525","DOIUrl":"10.1016/j.lanwpc.2025.101525","url":null,"abstract":"<div><div>In 2020 Aotearoa New Zealand, like many other countries, faced the coronavirus pandemic armed with an influenza-based pandemic plan. The country adapted rapidly to mount a highly strategic and effective elimination response to the SARS-CoV-2 pandemic. However, implementation was hampered by gaps in pandemic preparedness. These gaps undermined effectiveness of the response and exacerbated inequitable impacts of both Covid-19 disease and control measures. Our review examines the Covid-19 response, reflecting on strengths, limitations and implications for pandemic planning. We identify three key areas for improvement: 1) development of a systematised procedure for risk assessment of a new pandemic pathogen; 2) investment in essential capabilities during inter-pandemic periods; and 3) building equity into all stages of the response. We present a typology of potential pathogens and scenarios and describe the evidence assessment process and core capabilities required for countries to respond fluidly, equitably, and effectively to a rapidly emerging pandemic threat.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101525"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642986","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":"Short term safety profile of respiratory syncytial virus vaccine in adults aged ≥ 60 years in Australia","authors":"Thuy Nguyen ,&nbsp;Lucy Dawes ,&nbsp;Yuanfei Anny Huang ,&nbsp;Evelyn Tay ,&nbsp;Michael Dymock ,&nbsp;Megan O'Moore ,&nbsp;Clare King ,&nbsp;Kristine Macartney ,&nbsp;Nicholas Wood ,&nbsp;Lucy Deng","doi":"10.1016/j.lanwpc.2025.101506","DOIUrl":"10.1016/j.lanwpc.2025.101506","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101506"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509977","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":"FURLONG study: reply on the patient reported outcome measures and thresholds","authors":"Ahu Alanya ,&nbsp;Corneel Coens ,&nbsp;Dagmara Kuliś ,&nbsp;Jaap Reijneveld","doi":"10.1016/j.lanwpc.2025.101521","DOIUrl":"10.1016/j.lanwpc.2025.101521","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101521"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594089","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":"Assessing the gaps in cardiovascular disease risk assessment and management in primary care for Māori and Pacific peoples in Aotearoa New Zealand— a systematic review","authors":"Annaliese Wheeler ,&nbsp;Jamie-Lee Rahiri ,&nbsp;Rochelle Ellison-Lupena ,&nbsp;Sandra Hanchard ,&nbsp;Karen Marie Brewer ,&nbsp;Janine Paynter ,&nbsp;Julie Winter-Smith ,&nbsp;Vanessa Selak ,&nbsp;Shanthi Ameratunga ,&nbsp;Corina Grey ,&nbsp;Matire Harwood","doi":"10.1016/j.lanwpc.2025.101511","DOIUrl":"10.1016/j.lanwpc.2025.101511","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Māori and Pacific peoples carry the highest burden of cardiovascular disease in New Zealand (NZ). This systematic review aimed to determine access to evidence-based cardiovascular disease risk assessment (CVDRA) and management in primary care for Māori and Pacific peoples compared with other ethnicities in NZ, as well as factors contributing to reduced access.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this systematic review with a narrative synthesis, keywords related to Māori and Pacific peoples, cardiovascular disease, and primary care were used to search MEDLINE (OVID), EMBASE, Scopus, CINAHL, NZresearch.org, National Library Catalogue (Te Puna), Index New Zealand (INNZ), and Australia/New Zealand Reference Centre, grey literature and hand search sources from 1 January 2000 to 31 December 2024. Two reviewers screened texts and three reviewers extracted data and assessed quality. High quality was defined using Western (Mixed Methods Appraisal Tool, MMAT, ≥80% compliance) and Indigenous (CONSolIDated critERtia for strengthening the reporting of health research involving Indigenous Peoples, CONSIDER) research tools. The protocol for this systematic review was registered at: &lt;span&gt;&lt;span&gt;https://doi.org/10.17605/OSF.IO/VUDE9&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 2765 texts were identified of which 69 were included. This review identified inadequate levels of CVDRA in Māori and Pacific peoples when measured against the 90% national target. While the provision of primary prevention medications was higher (antihypertensives) or similar (lipid-lowering) compared to that for other ethnic groups, adherence was lower for Māori and Pacific peoples compared to other groups. Māori and Pacific peoples were less likely than others to receive antiplatelets and lipid-lowering therapy for secondary prevention. Evidence for antihypertensives in secondary prevention and combination therapy (in primary or secondary prevention) was mixed. Māori and Pacific peoples experienced reduced access to revascularisation compared with other ethnic groups, an inequity that persisted over time. Factors contributing to CVDRA and management were provision of adequate health literacy, relationships with providers and whānau, access to care, and cultural safety. While 64% of studies were ≥80% compliant with the MMAT, suggesting high quality from a Western research perspective, 71% of studies had an adapted CONSIDER score ≤2, suggesting low quality from an Indigenous perspective. The CONSIDER domains with the highest levels of reporting were Prioritisation, and Analysis and interpretation, while Capacity and Dissemination were the least reported domains. Qualitative studies had generally higher levels of CONSIDER reporting than mixed methods and quantitative studies. Kaupapa Māori Research was of the highest quality, followed by studies focused on Māori and/or Pacific peoples, while studies not focused on Mā","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101511"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636280","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":"Evolving role of the internet in China as a medium for promoting psychological well-being and mental health: a scoping review","authors":"Yikang Zhu ,&nbsp;Letao Sun ,&nbsp;Shiwei Guan ,&nbsp;Ruimin Li ,&nbsp;Junjie Yang ,&nbsp;Yourong Cao ,&nbsp;Lanlan Zhang ,&nbsp;Ting Li ,&nbsp;Huijuan Zhang ,&nbsp;Marlys Bueber ,&nbsp;Brian J. Hall ,&nbsp;Michael R. Phillips ,&nbsp;Chunbo Li","doi":"10.1016/j.lanwpc.2025.101515","DOIUrl":"10.1016/j.lanwpc.2025.101515","url":null,"abstract":"<div><div>The rapid development of China's 5G ‘Internet Plus’ industry has led to increasing use of the Internet to provide healthcare services. Internet-based services in China are already widely used to prevent, identify, monitor, and manage mental disorders, but few of these services have been formally evaluated. To provide a clear baseline of this rapidly evolving field, we searched articles published before December 31, 2022, about internet-based interventions and surveys for mental health-related conditions in China in five international databases (Web of Science, PubMed, PsycINFO, Embase, and Cochrane Library) and four Chinese databases (CNKI, SinoMed, VIP, and WanFang). The 143 identified studies—54 in Chinese and 89 in English—described internet-based interventions and surveys in individuals with mental disorders, community residents, college students, older adults, pregnant women, and health professionals. The number of identified studies, which were mainly conducted in economically developed regions of the country, quadrupled after the 2019 onset of the COVID-19 pandemic. Available studies suggest—but do not prove—that internet-based interventions can reduce the severity of psychiatric symptoms, decrease healthcare costs, and improve the quality of life for individuals with mental disorders. Innovative smartphone applications could potentially improve the quality and expand the scope of internet-based interventions, making them a key component in ongoing efforts to prevent and monitor mental illness, enhance the self-management of mental disorders, and alleviate psychological distress among adolescents and other at-risk populations. However, achieving this long-term goal will require establishing standardised methods of administering internet-based interventions, training mental health professionals to implement and monitor the interventions, identifying methods of maintaining the confidentiality of collected information, and rigorously assessing the effectiveness of the interventions based on periodic assessment of uniform outcome measures. Clinical and policy research about expanding internet-based mental health interventions should focus on confidentiality, efficacy, and cost-effectiveness.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101515"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724373","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 long-term impact of COVID-19 on mental health and the moderation effect of sex and loneliness amongst resettled refugees: findings from BNLA cohort study","authors":"Meng Zheng ,&nbsp;Shameran Slewa-Younan ,&nbsp;Thomas P. Nguyen ,&nbsp;Pilar Rioseco ,&nbsp;Andre M.N. Renzaho ,&nbsp;Wen Chen","doi":"10.1016/j.lanwpc.2025.101516","DOIUrl":"10.1016/j.lanwpc.2025.101516","url":null,"abstract":"<div><h3>Background</h3><div>Vulnerability to mental health problems is well-established in refugees, attributed to the interplay between pre-and post-migration stressors. COVID-19 pandemic was recognized as a universal stressor with potential to further impact refugees’ mental health. This longitudinal study sought to investigate the mental health impact of COVID-19 and its moderators in resettled refugees in Australia.</div></div><div><h3>Methods</h3><div>Data from Waves 1 (2013–2014, pre-pandemic), 5 (2017–2018, pre-pandemic) and 6 (2023, post-pandemic) of the Building a New Life in Australia were utilized in this study. High risk of severe mental illness (HR-SMI) and post-traumatic stress disorder (PTSD) were measured by K6 and PTSD-8 scales. Using generalized linear mixed model, we examined the mental health impacts of COVID-19 pandemic and moderation effect of sex and loneliness. The difference in changes in predicted probability of HR-SMI and PTSD across Waves 1 to 5 and Waves 5 to 6 between moderator-based subgroups were calculated.</div></div><div><h3>Findings</h3><div>A total of 2399 resettled refugees participated. The weighted prevalence of HR-SMI (Δ6-5 5.0%) or PTSD (Δ6-5 3.2%) was increased after the pandemic, different from the trend from Waves 1 to 5 (HR-SMI stable trend; PTSD decreased trend). Compared to Wave 5, Wave 6 had a significant effect on HR-SMI (AOR 1.54 [95% CI 1.17–2.04]), especially among females (2.04 [95% CI 1.16–3.56]); causing an additional 8.82% change in predicted probability than males. A significant effect of Wave 6 on PTSD was only found in respondents with loneliness (2.17 [95% CI 1.17–4.05]), causing an additional 14.92% change in predicted probability than those without loneliness.</div></div><div><h3>Interpretation</h3><div>Rates of mental illness increased among resettled refugees in Australia from prepandemic to four years post-COVID-19 and were moderated by loneliness and being female. This highlights the need for ongoing, targeted psycho-social support for specific refugee sub-groups.</div></div><div><h3>Funding</h3><div><span>Guangdong Basic and Applied Basic Research Foundation</span> (<span><span>2022B1515020094</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101516"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594091","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":"Health outcomes one year after Omicron infection among 12,789 adults: a community-based cross-sectional study","authors":"Hui Zhang ,&nbsp;Peng Yang ,&nbsp;Xiaoying Gu ,&nbsp;Ying Sun ,&nbsp;Rongling Zhang ,&nbsp;Daitao Zhang ,&nbsp;Jiaojiao Zhang ,&nbsp;Yeming Wang ,&nbsp;Chunna Ma ,&nbsp;Min Liu ,&nbsp;Jiaxin Ma ,&nbsp;Aili Li ,&nbsp;Yingying Wang ,&nbsp;Xiao Ma ,&nbsp;Xiaojing Cui ,&nbsp;Yimin Wang ,&nbsp;Zhibo Liu ,&nbsp;Wei Wang ,&nbsp;Zhi Zheng ,&nbsp;Yong Li ,&nbsp;Bin Cao","doi":"10.1016/j.lanwpc.2025.101507","DOIUrl":"10.1016/j.lanwpc.2025.101507","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Characterizing the paradigm and impact of long COVID is crucial for addressing this worldwide health challenge. This study aimed to investigate the prevalence of long COVID one year after primary Omicron infection and characterize differences in long-term health consequence between participants with persistent long COVID and those who fully recovered.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This a community-based cross-sectional study conducted from December 2023 to March 2024 at the China-Japan Friendship Hospital and 16 administrative districts in Beijing. 12,789 participants infected with Omicron between December 2022 and January 2023 were recruited through stratified multistage random sampling and included in the final analysis. Of them, 376 participants with persistent long COVID and 229 without long COVID were matched for further physical examinations. The primary outcome was the prevalence of long COVID one year after infection. Secondary outcomes included muscle strength, exercise capacity, health-related quality of life (HRQoL), mental health, work status, laboratory tests, and examinations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Among 12,789 participants (media [IQR] age, 48.4 [37.3 to 61.4] years; 7817 females [61.1%]), 995 of them (7.8%) experienced long COVID within one year, with 651 (5.1%) having persistent symptoms. Fatigue (598/995 [60.1%]) and post-exertional malaise (367/995 [36.9%]) were the most common symptoms. Brain fog had the lowest resolution proportion as 4.2% within one year. The odds of long COVID increased with reinfections (odds ratios for one reinfection 2.592 [95% CI: 2.188 to 3.061]; two or more: 6.171 [3.227 to 11.557]; all p &lt; 0.001). Participants with persistent long COVID had markedly lower muscle strength (upper-limb: 26.9 ± 12.4 vs. 29.1 ± 14.5 Kg; lower-limb: 40.0 [27.0 to 62.0] vs. 43.0 [28.0 to 59.0] s), worse exercise capacity and poorer HRQoL, and meaningful difference in laboratory tests results compared to those without long COVID. They also exhibited significantly higher proportions of abnormal lung function (FEV&lt;sub&gt;1&lt;/sub&gt; %pred&lt;80%: 13.0% vs. 2.0%; DLco %pred&lt;80%: 32.7% vs. 19.9%) and lung imaging abnormalities (23.5% vs. 13.6%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;The considerable health burden of long COVID and the progression of neurological symptoms following Omicron infection warrant close monitoring. Utilizing professional questionnaires and developing reliable diagnostic tools are necessary for improving diagnosis and treatment of long COVID.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;This work was supported by &lt;span&gt;Beijing Research Center for Respiratory Infectious Diseases&lt;/span&gt; (&lt;span&gt;&lt;span&gt;BJRID2024-012&lt;/span&gt;&lt;/span&gt;), &lt;span&gt;Chinese Academy of Medical Sciences Innovation Fund&lt;/span&gt; for Medical Sciences (&lt;span&gt;&lt;span&gt;2022-I2M-CoV19-005&lt;/span&gt;&lt;/span&gt;/&lt;span&gt;&lt;span&gt;CIFMS 2021-I2M-1-048&lt;/span&gt;&lt;/span&gt;), the &lt;span&gt;National Natural Science Foundation of Chi","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101507"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724507","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":"Clinical Oncology Society of Australia Annual Scientific Meeting, November 13–15, 2024","authors":"Jashelle Caga-Meller","doi":"10.1016/j.lanwpc.2024.101273","DOIUrl":"10.1016/j.lanwpc.2024.101273","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101273"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724599","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":"Shifting the way we conceptualise, research and intervene childhood obesity in China and Southeast Asian countries","authors":"Bai Li ,&nbsp;Boyd Swinburn","doi":"10.1016/j.lanwpc.2025.101502","DOIUrl":"10.1016/j.lanwpc.2025.101502","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101502"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509978","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":"Trends in stroke incidence, death, and disability outcomes in a multi-ethnic population: Auckland regional community stroke studies (1981–2022)","authors":"Valery L. Feigin ,&nbsp;Rita Krishnamurthi ,&nbsp;Balakrishnan Nair ,&nbsp;Ilari Rautalin ,&nbsp;Varsha Parag ,&nbsp;Craig S. Anderson ,&nbsp;Bruce Arroll ,&nbsp;P. Alan Barber ,&nbsp;Suzanne Barker-Collo ,&nbsp;Derrick Bennett ,&nbsp;Paul Brown ,&nbsp;Dominque A. Cadilhac ,&nbsp;Jeroen Douwes ,&nbsp;Daniel Exeter ,&nbsp;Anna Ranta ,&nbsp;Yogini Ratnasabapathy ,&nbsp;Andrew Swain ,&nbsp;El-Shadan Tautolo ,&nbsp;Braden Te Ao ,&nbsp;Amanda Thrift ,&nbsp;Bronwyn Tunnage","doi":"10.1016/j.lanwpc.2025.101508","DOIUrl":"10.1016/j.lanwpc.2025.101508","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Reliable data on trends of stroke incidence and outcomes over time are necessary for assessing the effectiveness of public health and clinical strategies, and for allocating healthcare resources. We assessed the levels and trends in incidence, mortality, early case fatality and disability for stroke in a defined, ethnically mixed population over 40 years.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;To analyse data from five population-based stroke incidence studies in adult residents (age ≥15 years) of the Greater Auckland Region of New Zealand (NZ) (1.35 million) over 12-month calendar periods for 1981–1982, 1991–1992, 2002–2003, 2011–2012, and 2021–2022. Fatal and non-fatal, hospitalised and non-hospitalised stroke events (first-ever and recurrent) were identified through multiple overlapping sources using clinical World Health Organization (WHO) diagnostic criteria and neuroimaging to define three major pathological types of stroke: ischaemic stroke (IS), primary intracerebral haemorrhage (PICH), subarachnoid haemorrhage (SAH), and stroke of undetermined type (SUT). Crude and age-standardised annual incidence, mortality, 28-day case fatality and disability level, and 40-year trends were calculated by age, sex, and ethnicity assuming a Poisson distribution. For comparison of our findings, we carried out a pooled analysis of methodologically comparable population-based stroke epidemiology estimates in high-income countries over the last two decades.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Overall, there were 7462 first-ever strokes (9917 events) over the 40-year period (4,682,012 person-years). From 1981–1982 to 2021–2022, age-standardised stroke incidence rates decreased from 156/100,000 (95% confidence interval [CI] 143; 170) to 124/100,000 (119; 130) and mortality rates from 98/100,000 (88; 110) to 28/100,000 (26; 31) in nearly all age, sex, and ethnic groups. Moreover, from 2002–2003 to 2021–2022, there was an increase in stroke incidence of 1.28% per year (95% CI 0.38–2.17) in people aged 15–54 years, with the mean age of people with stroke decreasing from 73.0 (SD ± 13.8) in 2002–2003 to 71.6 (SD ± 14.9) in 2011–2012 and 70.7 (SD ± 15.2) years in 2021–2022 (p for trend &lt;0.0001). The risk of stroke in Māori and Pacific people in 2021–2022 was almost 1.5 and 2.0 times greater than that in NZ Europeans. Ethnic disparities in the risk of stroke and age of stroke onset remained stable over the study period. From 1981–1982 to 2021–2022, 28-day stroke case fatality declined from 33.1% to 12.1% (p &lt; 0.0001). There was a trend towards reducing 28-day case-fatality (from 31.6% [95% CI 27.6; 35.7] in 1981–1982 to 11.4% [10.0; 12.7] in 2021–2022) and an increasing proportion of stroke survivors with good functional outcome at discharge/28-days post-stroke (increased from 45.7% (95% CI 41.3; 50.0) in 1981–1982 to 60.2% (58.1; 62.3) in 2021–2022).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Stroke incidence, 1-year mortality an","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101508"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594090","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}