The Lancet Regional Health: Western Pacific最新文献

{"title":"Prioritizing high-risk populations for soil-transmitted helminth control in the Western Pacific Region","authors":"Kefyalew Addis Alene , Haileab Fekadu Wolde , Beth Gilmour","doi":"10.1016/j.lanwpc.2025.101618","DOIUrl":"10.1016/j.lanwpc.2025.101618","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"60 ","pages":"Article 101618"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518611","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 association between sexually transmitted infections and pregnancy outcomes in the Northern Territory, Australia: a population-based cohort study","authors":"Jennifer Dunne ,&nbsp;Gizachew A. Tessema ,&nbsp;Matthew Legge ,&nbsp;Sylvester Dodzi Nyadanu ,&nbsp;Aditi Roy ,&nbsp;Amanuel T. Gebremedhin ,&nbsp;Jacqueline Hendriks ,&nbsp;Tricia Reid-Moore ,&nbsp;Gavin Pereira","doi":"10.1016/j.lanwpc.2025.101610","DOIUrl":"10.1016/j.lanwpc.2025.101610","url":null,"abstract":"<div><h3>Background</h3><div>Often asymptomatic in nature, sexually transmitted infections (STIs) are highly prevalent in women of reproductive ages, leading to adverse perinatal outcomes. This study investigated the association between STIs during pregnancy and the risk of adverse perinatal outcomes using comprehensive population-linked data from the Northern Territory (NT), Australia.</div></div><div><h3>Methods</h3><div>This population-based retrospective cohort study examined births (live births and stillbirths) from the NT Perinatal Data Collection and the NT Notifiable Diseases register from 2005 to 2020. All singleton births (N = 59,465) were included, along with infectious disease notifications of four STIs that occurred during pregnancy: chlamydia, gonorrhoea, trichomoniasis, and syphilis. Relative risks (RR) for associations between STIs during pregnancy with adverse perinatal outcomes (pre-labour rupture of membranes, preterm birth, small-for-gestational age, stillbirth) were estimated using robust Poisson regression models.</div></div><div><h3>Findings</h3><div>For babies born with congenital syphilis (n = 23), there was an association with preterm birth (RR 3.34, 95% confidence interval (CI) 1.80–6.17) and small-for-gestational age (RR 2.22, 95% CI 1.34–3.67). Small-for-gestational age was associated with maternal chlamydia (RR 1.86, 95% CI 1.54–2.24), maternal gonorrhoea (RR 1.76, 95% CI 1.46–2.12), and maternal trichomoniasis (RR 1.10, 95% CI 1.01–1.20). Associations were also observed between gonorrhoea and stillbirth (RR 1.97, 95% CI 1.19–3.27), and trichomoniasis with preterm birth (RR 1.23, 95% CI 1.09–1.39).</div></div><div><h3>Interpretation</h3><div>STIs during pregnancy showed notable associations with adverse birth outcomes. Congenital syphilis most severely affected outcomes, tripling preterm birth risk and doubling small-for-gestational age risk. These findings underscore the importance of addressing barriers to STI screening and treatment prior to and during pregnancy.</div></div><div><h3>Funding</h3><div><span>National Health and Medical Research Council</span> and the <span>Western Australian Future Health Research and Innovation Fund</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"60 ","pages":"Article 101610"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534436","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":"Use of the International Classification of Diseases to Perinatal Mortality (ICD-PM) with verbal autopsy to determine the causes of stillbirths and neonatal deaths in rural Cambodia: a population-based, prospective, cohort study","authors":"Kaajal Patel ,&nbsp;Sopheakneary Say ,&nbsp;Daly Leng ,&nbsp;Sophanou Khut ,&nbsp;Sothearith Duong ,&nbsp;Chou Ly ,&nbsp;Arthur Riedel ,&nbsp;Koung Lo ,&nbsp;Verena Carrara ,&nbsp;Claudia Turner","doi":"10.1016/j.lanwpc.2025.101626","DOIUrl":"10.1016/j.lanwpc.2025.101626","url":null,"abstract":"<div><h3>Background</h3><div>Perinatal mortality remains a significant global health challenge, particularly in low- and middle-income countries (LMICs). Accurate cause-of-death data are essential to inform effective interventions but are often scarce. This study aimed to identify causes of stillbirths and neonatal deaths in rural Cambodia using verbal autopsy (VA) and the WHO International Classification of Diseases to Perinatal Mortality (ICD-PM).</div></div><div><h3>Methods</h3><div>A four-year prospective study (2018–2022) in Preah Vihear province, Cambodia, established a community health worker-based pregnancy surveillance system. Verbal autopsy was conducted on stillbirths and neonatal deaths, with dual physician analysis to interpret VA data. To classify causes of death, ICD-PM was applied with adaptations made for stillbirths with unknown timing of death.</div></div><div><h3>Findings</h3><div>A total of 522 deaths (229 stillbirths, 293 neonatal deaths) were recorded, and 79.1% (413) had a VA. Applying ICD-PM, primary causes of death were identified for 36.6% of stillbirths and 95.0% of neonatal deaths. The leading cause of death was hypoxia for intrapartum stillbirths (78.3%), low birth weight and prematurity for early neonatal deaths (40.9%), and infection for late neonatal deaths (51.4%). Complications during labour and delivery were the leading maternal contributing condition for intrapartum stillbirths (63.3%) and early neonatal deaths (42.4%). Unknown timing of death was assigned to 12.0% of stillbirths.</div></div><div><h3>Interpretation</h3><div>Application of ICD-PM with VA-derived data provides valuable insights into causes of stillbirths and neonatal deaths. However, adaptations are necessary to address ICD-PM's limitations, particularly to classify unknown timing of death. Our findings can contribute to global efforts to improve the reporting of perinatal mortality data.</div></div><div><h3>Funding</h3><div>This study is nested in the Saving Babies' Lives study, which was supported by funding from <span>Angkor Hospital for Children</span>, <span>Civil Society in Development</span>, <span>Fu Tak Iam Foundation</span>, <span>Manan Trust</span>, <span>T&amp;J Meyer Family Foundation</span>, <span>Vitol Foundation</span>, <span>IF Foundation</span>, and <span>Wellcome Trust</span> [<span><span>220211</span></span>]. This research was funded in part by the <span>Wellcome Trust</span> [<span><span>220211/Z/20/Z</span></span>].</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"60 ","pages":"Article 101626"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631869","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":"Overcoming barriers in tuberculosis control: a case study from a remote community of South Australia","authors":"Joseph Inauen ,&nbsp;Adrienne Storken ,&nbsp;Carolyn Gill ,&nbsp;Michelle Brigham ,&nbsp;Martin Kelly ,&nbsp;Simone Barry","doi":"10.1016/j.lanwpc.2025.101604","DOIUrl":"10.1016/j.lanwpc.2025.101604","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"60 ","pages":"Article 101604"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535123","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":"Sociodemographic patterns of COVID-19 mortality: the 2020 Japanese census-linked mortality database","authors":"Hirokazu Tanaka ,&nbsp;Kota Katanoda ,&nbsp;Tomoki Nakaya ,&nbsp;Yasuki Kobayashi","doi":"10.1016/j.lanwpc.2025.101609","DOIUrl":"10.1016/j.lanwpc.2025.101609","url":null,"abstract":"<div><h3>Background</h3><div>Owing to the lack of sociodemographic mortality statistics in Japan, linking existing individual statistical data could be cost-effective and, therefore, highly sustainable for monitoring health inequalities regarding urgent health issues. We investigated nationwide coronavirus disease 2019 (COVID-19) cause-specific mortality by sociodemographic characteristics compared with all-cause mortality in Japan, using our unique linkage method among non-institutionalised citizens.</div></div><div><h3>Methods</h3><div>Using the 2020 Japanese census-linked mortality database, we calculated age-standardised mortality rates from all-cause and COVID-19 by region, marital status, household size (‘living alone’ to ‘five or more’), educational level, area deprivation index (ADI: municipality-level population quantiles), and occupational class. We then applied multivariable modified Poisson regression analysis to investigate the relationship between all-cause and COVID-19 mortality with sociodemographic characteristics, excluding occupational class. All analyses were performed by sex and period (i.e., during Delta variant dominance in 2021 and Omicron variant dominance in 2022). ADI analyses also accounted for metropolitan residency (the Tokyo and Osaka metropolitan areas vs. non-metropolitan areas).</div></div><div><h3>Findings</h3><div>This analysis included 80,135,688 non-institutionalised Japanese individuals (aged 30–89 years) linked to 1,895,080 all-cause deaths between October 2020 and December 2022, including 34,213 COVID-19-related deaths. After controlling for sociodemographic characteristics, marital status (e.g., for single men, mortality rate ratio: 2.02 (95% confidence intervals [CI]: 1.90–2.14), compared with married men), and low education level (e.g., low-educated women: 1.49 [95% CI: 1.38–1.61], compared with high-educated women) were associated with increased COVID-19 mortality, similar to the trends in all-cause deaths. Additionally, having a large household was associated with increased COVID-19 mortality rate ratio (e.g., women living with five or more people: 1.69 [95% CI: 1.54–1.84], compared with women living alone; p for trend &lt; 0.0001: using ordinal variables of household size). These patterns were consistent across sexes and variant periods. COVID-19 mortality was not significantly associated with ADI (mortality rate ratio for men in the most deprived municipalities compared with in the least deprived municipalities: 0.95 [95% CI: 0.89–1.01], p for trend = 0.069; women: 0.97 [95% CI: 0.90–1.06], p for trend = 0.285), contrasting with all-cause mortality rate ratios, which increased with deprivation. ADI-related trends varied by variant period and metropolitan status.</div></div><div><h3>Interpretation</h3><div>In Japan, sociodemographic patterns of COVID-19 mortality for the non-institutionalised population related to marital status and education reflect underlying health inequalities—all-cause mortality","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"60 ","pages":"Article 101609"},"PeriodicalIF":8.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738465","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":"Burden of scabies and bacterial skin infection in Kiribati: results of a national population-based survey 2023","authors":"Rebecca F. Anderson ,&nbsp;Temea Bauro ,&nbsp;Susanna J. Lake ,&nbsp;Marou Tikataake ,&nbsp;Matthew Parnaby ,&nbsp;Jeremy Hill ,&nbsp;Tanebu J. Tong-Kaunibwe ,&nbsp;Anneke C. Grobler ,&nbsp;Revite Kirition ,&nbsp;Andrew C. Steer","doi":"10.1016/j.lanwpc.2025.101636","DOIUrl":"10.1016/j.lanwpc.2025.101636","url":null,"abstract":"<div><h3>Background</h3><div>Scabies is a treatable neglected tropical disease with a high burden in Pacific island countries. Scabies is strongly associated with bacterial skin infection, which can lead to long-term sequelae. There is a paucity of epidemiologic data from Kiribati relating to scabies and bacterial skin infection.</div></div><div><h3>Methods</h3><div>We conducted a community-based cross-sectional survey over three weeks in November 2023 to determine the national prevalence of scabies and bacterial skin infection. Participants were recruited from ten evaluation units across all five divisions of Kiribati, including several outer islands from different island groups. All residents of visited households were eligible to participate. Trained nurses conducted clinical assessments, including focused clinical history and skin examination, for scabies and/or bacterial skin infection. Diagnosis of scabies was based on the 2020 International Alliance for the Control of Scabies diagnostic criteria. Assessment of 10,515 participants was completed. We calculated weighted prevalence, risk ratio (RR), and risk difference (RD), with 95% confidence intervals (CI), for scabies and bacterial skin infection, accounting for clustering by household.</div></div><div><h3>Findings</h3><div>The overall weighted prevalence of scabies was 24.9% (95% CI 22.3–27.8). The highest prevalence was observed among infants aged less than 1 year at 47.2% (95% CI 40.8–53.7). Scabies was classified as moderate to severe in 64.9% (95% CI 59.1–70.2) of cases. The overall prevalence of bacterial skin infection was 7.9% (95% CI 6.8–9.2). The population attributable fraction of bacterial skin infection associated with scabies was 79.5% (95% CI 76.4–82.6).</div></div><div><h3>Interpretation</h3><div>Our findings highlight the high burden of scabies and bacterial skin infection in Kiribati and the need for public health action to reduce the impact of both conditions.</div></div><div><h3>Funding</h3><div>The study was funded by the <span>Cameron Foundation</span> (Australia) and the World Scabies Program, <span>Murdoch Children's Research Institute</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"60 ","pages":"Article 101636"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604348","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":"Waning immunity, prevailing non-vaccine type ptxP3 and macrolide-resistant strains in the 2024 pertussis outbreak in China: a multicentre cross-sectional descriptive study","authors":"Jiehao Cai ,&nbsp;Qiyi Liu ,&nbsp;Biquan Chen ,&nbsp;Yue Jiang ,&nbsp;Xiaoyan Zeng ,&nbsp;Jiebin Huang ,&nbsp;Daojiong Lin ,&nbsp;Huanyou Li ,&nbsp;Jinqiang Zhang ,&nbsp;Zhiqiang Zhuo ,&nbsp;Yanping Zhang ,&nbsp;Panpan Lv ,&nbsp;Qiang Wang ,&nbsp;Wenhong Zhang ,&nbsp;Mingliang Chen ,&nbsp;Mei Zeng","doi":"10.1016/j.lanwpc.2025.101628","DOIUrl":"10.1016/j.lanwpc.2025.101628","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;In the spring and summer of 2024, an unexpected large outbreak of pertussis hit China, with the annual incidence of pertussis (34.03/100,000) more than 12-fold higher than that of 2023 (2.71/100,000). We aimed to assess clinical and molecular epidemiological patterns and unravel the reasons behind the 2024 pertussis outbreak.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;PCR-confirmed pertussis cases were enrolled from five sentinel hospitals in Shanghai, Anhui, Hainan, Fujian, and Inner Mongolia between 1 January and 30 September 2024. The epidemiological data of PCR-confirmed cases, as well as the clinical data and vaccination history of hospitalized cases were collected. Nasopharyngeal swab samples were collected from partial pertussis cases and their household contacts for &lt;em&gt;Bordetella pertussis&lt;/em&gt; culture during the local peak months. Antimicrobial susceptibility testing and whole genome sequencing were performed on all 394 isolates to evaluate six antibiotic susceptibility and characterize the antigenic, virulent, and phylogenetic characteristics of the circulating isolates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 14,874 cases of pertussis were PCR-confirmed in the 5 sentinel hospitals, peaking in April to July. Infants represented 9.6% of cases and children aged 4–10 years represented 74.3% of cases in the five hospitals. Of the 7238 (48.7%) cases with vaccination data, 6563 (90.7%) were fully vaccinated. Breakthrough pertussis cases were mainly observed in fully vaccinated children since the age of 7 months. Among the 828 (5.6%) cases hospitalized for pertussis, 71.7% (594/828) cases had complications (pneumonia 69.7%, 577/828), 5.7% (47/828) were admitted to intensive care unit and 0.24% (2/828) cases died. Sixty-four per cent (403/630) of families had both the patient and at least one family member PCR-positive for &lt;em&gt;B. pertussis&lt;/em&gt;. In total, 394 &lt;em&gt;B. pertussis&lt;/em&gt; isolates were recovered from the 1921 nasopharyngeal swab samples. Ninety-nine point seven per cent (393/394) of isolates displayed high-level resistance to azithromycin (MIC range, 16–256 μg/ml), and 48.0% (189/394) isolates were susceptible to trimethoprim-sulfamethoxazole (MIC range, &lt;0.008/0.152–0.5/9.5 μg/ml). All the isolates were susceptible to levofloxacin, doxycycline, ceftazidime, and cefoperazone/sulbactam. All the isolates were assigned to ST-2 and 99.5% (392/394) belonged to the MT28-Shanghai clone by SNP-based analysis, carrying &lt;em&gt;ptxP3&lt;/em&gt; AgST4, 23S rRNA-13 (with erythromycin resistance), and &lt;em&gt;prn&lt;/em&gt;150. 23.4% (92/394) of isolates were predicted to be PRN-deficient.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;The waning vaccine-derived protection and the prevailing macrolide-resistant MT28 clone harboring non-vaccine type &lt;em&gt;ptxP3&lt;/em&gt; are responsible for the 2024 large outbreak of pertussis in China. Our findings highlight the urgent need for revising national pertussis vaccination strategies and traditiona","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"60 ","pages":"Article 101628"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557356","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":"High rates of hepatitis B vertical transmission in Kiribati: a warning sign for meeting 2030 WHO elimination targets in the Pacific Islands?","authors":"Alice Lee ,&nbsp;Thomas Russell ,&nbsp;David Hilmers","doi":"10.1016/j.lanwpc.2025.101624","DOIUrl":"10.1016/j.lanwpc.2025.101624","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"60 ","pages":"Article 101624"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548466","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":"Mapping the prevalence of soil-transmitted helminth infections in the Western Pacific Region: a spatial modelling study","authors":"Beth Gilmour ,&nbsp;Haileab Fekadu Wolde ,&nbsp;Kinley Wangdi ,&nbsp;Angela Cadavid Restrepo ,&nbsp;Tsheten Tsheten ,&nbsp;Matthew Kelly ,&nbsp;Archie C.A. Clements ,&nbsp;Darren Gray ,&nbsp;Colleen L. Lau ,&nbsp;Fe Esperanza Espino ,&nbsp;Susana Vaz Nery ,&nbsp;Adam W. Bartlett ,&nbsp;Alemneh Mekuriaw Liyew ,&nbsp;Temesgen Yihunie Akalu ,&nbsp;Kefyalew Addis Alene","doi":"10.1016/j.lanwpc.2025.101581","DOIUrl":"10.1016/j.lanwpc.2025.101581","url":null,"abstract":"<div><h3>Background</h3><div>Soil-Transmitted Helminth (STH) infections are a significant health issue in the Western Pacific Region (WPR). This study aims to produce high-resolution spatial prediction STH prevalence maps for the WPR.</div></div><div><h3>Methods</h3><div>Bayesian model-based geostatistical frameworks were developed for each STH species (<em>Ascaris lumbricoides</em>, <em>Trichuris trichiura</em>, <em>Strongyloides stercoralis</em>, and hookworm) to estimate infection prevalence at a spatial resolution of 1 km². A systematic review created a comprehensive database of STH prevalence surveys, which informed the geostatistical frameworks. Logistic regression models incorporating both fixed covariate effects and spatial random effects were applied to identify drivers of spatial distribution for each species.</div></div><div><h3>Findings</h3><div>We analysed 227 surveys from 3122 locations across 15 countries in the WPR. Between 1998–2011 and 2012–2021 substantial reductions in the pooled prevalence of hookworm (21.3%–3.7%), <em>A. lumbricoides</em> (21.7%–6.5%) and <em>T. trichiura</em> (22.5%–9.7%) were observed, while <em>S. stercoralis</em> prevalence increased (13.3%–18.4%). High-resolution spatial prediction maps revealed notable geographical variations in STH prevalence, with persistent hotspots identified in China, Cambodia, Malaysia, and Vietnam. Altitude and distance to health facilities were positively associated with the prevalence of hookworm and <em>A. lumbricoides</em>, while sand content in soil was positively associated with all STH species. In contrast, coarse soil fragments and organic carbon content were negatively associated with the prevalence of <em>T. trichiura</em> and <em>A. lumbricoides</em>.</div></div><div><h3>Interpretation</h3><div>The high-resolution spatial prediction maps produced in this study can inform resource prioritization to accelerate STH elimination efforts.</div></div><div><h3>Funding</h3><div><span>National Health and Medical Research Council</span> (1153727 ACE-NTD).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"60 ","pages":"Article 101581"},"PeriodicalIF":8.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738573","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":"Blueprint to achieve national exclusive breastfeeding targets by 2030 among Aboriginal Australian women","authors":"Utpal K. Mondal ,&nbsp;Jamie Newman ,&nbsp;Colin MacDougall ,&nbsp;Peter Gibbs ,&nbsp;Sok Cheon Pak ,&nbsp;Phil Naden ,&nbsp;Bernd Kalinna ,&nbsp;Muhammad J.A. Shiddiky ,&nbsp;Md Ferdous Rahman ,&nbsp;Allen G. Ross","doi":"10.1016/j.lanwpc.2025.101616","DOIUrl":"10.1016/j.lanwpc.2025.101616","url":null,"abstract":"<div><div>Exclusive breastfeeding (EBF) for six months provides significant health benefits for both mothers and infants, protecting babies from infection, supporting cognitive development, and reducing the risk of obesity and chronic diseases. Additionally, EBF lowers mother's risk of postpartum complications, type 2 diabetes, breast and ovarian cancers. Globally, the prevalence of EBF among infants under six months has reached 48%, nearing the World Health Assembly's 2025 target of 50%. However, the six-month EBF rate for Indigenous mothers in Australia remains low (18.8%), falling significantly below the national target of 50% set for 2025. There are notable disparities across Australian states and territories, with only the Northern Territory (NT) meeting this target. The NT's success is attributed to substantial state-level investment in healthcare for Indigenous Australians, with the highest per capita spending ($11,082 AUD/person/annum) and the highest proportion of Aboriginal and Torres Strait Islander health practitioners (256 per 100,000 population). Additionally, Aboriginal Community Controlled Health Organisations (ACCHOs) have played a vital role in delivering culturally safe, community-led breastfeeding programs, contributing to higher EBF rates. These findings suggest that the NT's approach could serve as a ‘blueprint’ for improving breastfeeding outcomes nationwide. With continued federal support and a comprehensive national policy, achieving the national EBF target for First Nations Peoples by 2030 may be attainable.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"60 ","pages":"Article 101616"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549314","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}