Mohd Ishtiaq Anasir, Khayri Kamel, Nor Malizza G Adypatti, Mohammad Syafiq Jamaluddin, Farah Amira Ahmad, Siti Nurhidayah Norhisham, Muhammad Zulfazli Mohamad Sukri, Nur Rafiqah Rosli, Siti Norazrina Saif, Nurul Izzati Basarudin, Mohamad Azzam-Sayuti, Akmal Hayat Abdul Karim, Mahirah Kamil Puat, Ravindran Thayan, Rozainanee Mohd Zain
{"title":"Whole-genome sequencing of SARS-CoV-2 from residual viral RNA present on positive rapid antigen test kits for genomic surveillance.","authors":"Mohd Ishtiaq Anasir, Khayri Kamel, Nor Malizza G Adypatti, Mohammad Syafiq Jamaluddin, Farah Amira Ahmad, Siti Nurhidayah Norhisham, Muhammad Zulfazli Mohamad Sukri, Nur Rafiqah Rosli, Siti Norazrina Saif, Nurul Izzati Basarudin, Mohamad Azzam-Sayuti, Akmal Hayat Abdul Karim, Mahirah Kamil Puat, Ravindran Thayan, Rozainanee Mohd Zain","doi":"10.5365/wpsar.2025.16.1.1140","DOIUrl":"10.5365/wpsar.2025.16.1.1140","url":null,"abstract":"","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":"16 1","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pierre-Yves Beauchemin, Eystein Grusd, Erin E Noste, Anthony Cook, Jan-Erik Larsen, Aristides Poblete Alonzo, Misheel Enkhdalai, Sean T Casey
{"title":"Satellite communications in health emergencies: no longer a luxury.","authors":"Pierre-Yves Beauchemin, Eystein Grusd, Erin E Noste, Anthony Cook, Jan-Erik Larsen, Aristides Poblete Alonzo, Misheel Enkhdalai, Sean T Casey","doi":"10.5365/wpsar.2025.16.1.1217","DOIUrl":"10.5365/wpsar.2025.16.1.1217","url":null,"abstract":"","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":"16 1","pages":"1-2"},"PeriodicalIF":1.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tambri Housen, Barry Ropa, James Flint, Tony Merritt, Rachel Hammersley-Mather, Alois Pukienei, Rosheila Dagina, Bethseba Peni, Martha Pogo, David N Durrheim
{"title":"Focusing field epidemiology training on national health priorities in Papua New Guinea: consultative prioritization, from health workers to policy-makers.","authors":"Tambri Housen, Barry Ropa, James Flint, Tony Merritt, Rachel Hammersley-Mather, Alois Pukienei, Rosheila Dagina, Bethseba Peni, Martha Pogo, David N Durrheim","doi":"10.5365/wpsar.2025.16.1.1105","DOIUrl":"10.5365/wpsar.2025.16.1.1105","url":null,"abstract":"","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":"16 1","pages":"1-5"},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Darren H Venturina, Apple Charm A Agulto, Alireza S Faiyaz, Ray Justin C Ventura, Mariz Zheila C Blanco-Payuyo, John Bobbie Roca
{"title":"Foodborne illness from tuba-tuba seeds among school-aged children, Philippines: a call for community education.","authors":"Darren H Venturina, Apple Charm A Agulto, Alireza S Faiyaz, Ray Justin C Ventura, Mariz Zheila C Blanco-Payuyo, John Bobbie Roca","doi":"10.5365/wpsar.2025.16.1.1186","DOIUrl":"10.5365/wpsar.2025.16.1.1186","url":null,"abstract":"<p><strong>Objective: </strong>On 2 September 2023, the Regional Epidemiology and Surveillance Unit of the Department of Health's Center for Health Development in Calabarzon, Philippines, received a report of foodborne illness due to the ingestion of tuba-tuba (<i>Jatropha curcas</i>) seeds in Talao Talao Village, Lucena City. The objective of this study was to describe the public health event.</p><p><strong>Methods: </strong>A descriptive study was conducted. Cases were defined as previously well individuals who developed at least one of the following symptoms after eating tuba-tuba seeds: vomiting, abdominal pain, diarrhoea, headache or dizziness. Health records were reviewed, and key informant interviews and environmental surveys were conducted.</p><p><strong>Results: </strong>Ten cases were identified, ranging in age from 10 to 12 years. The onset of symptoms ranged from 1 to 4 hours after consumption. Six of the cases were taken to the hospital, although two went home before being admitted; all recovered after 3 days. The most common symptom was vomiting (100%); other symptoms included abdominal pain, diarrhoea, dizziness and headache.</p><p><strong>Discussion: </strong>This investigation confirmed that tuba-tuba seeds were the cause of symptoms among school-aged children in Lucena City. To prevent similar events in the future, we recommend intensifying educational campaigns at both the community and school levels, as tuba-tuba is common in the area.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":"16 1","pages":"1-5"},"PeriodicalIF":1.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"COVID-19 infection control practices in designated quarantine hotels in Hong Kong Special Administrative Region SAR (China), 2020-2022: key elements in preparing for the next pandemic.","authors":"Edmond Siu-Keung, Hong Chen, Shuk Kwan Chuang","doi":"10.5365/wpsar.2025.16.1.1167","DOIUrl":"10.5365/wpsar.2025.16.1.1167","url":null,"abstract":"<p><strong>Problem: </strong>Despite the widespread use of designated quarantine hotels to minimize the transmission of COVID-19 from imported cases, there is scant literature on the infrastructure and operational requirements of such facilities.</p><p><strong>Context: </strong>Travellers to Hong Kong Special Administrative Region (SAR) (China) were required to undergo quarantine in designated hotels for up to 21 days. Prior to operation, all these hotels were modified and hotel staff received structured training in infection control practices.</p><p><strong>Action: </strong>We conducted retrospective reviews of the procedures and operational protocols that were followed to convert and manage commercial hotels as quarantine hotels during the early part of the pandemic. We also reviewed the training provided and compliance monitoring. Finally, we reviewed intra-hotel outbreak investigations that were conducted between April 2021 and June 2022.</p><p><strong>Outcome: </strong>Designated quarantine hotels received 842 510 quarantined travellers from December 2020 to October 2022. Ten outbreaks were reported, affecting 28 guests (0.003%) and two staff. Prompt epidemiological investigation and action stopped further transmission.</p><p><strong>Discussion: </strong>In Hong Kong Special Administrative Region SAR (China), designated quarantine hotels successfully minimized COVID-19 transmission from imported cases to the community and should be considered as part of integrated response plans for future pandemics. Based on our COVID-19 pandemic experience, we recommend specifying requirements for quarantine centres and hotels to ensure adequate ventilation inside guest rooms and corridors, functioning drainage systems and the adoption of stringent infection control practices. We also recommend the installation of closed-circuit television cameras in all common areas to support compliance monitoring and outbreak investigation.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":"16 1","pages":"1-7"},"PeriodicalIF":1.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mariya Itaki, Masayuki Endo, Hiroyuki Asakura, Mami Nagashima, Yoshiko Somura, Aki Takahashi, Aya Kayebeta, Ikumi Takahashi, Yuichiro Yahata
{"title":"Hepatitis A outbreak among men who have sex with men, Shinjuku, Japan, 2018.","authors":"Mariya Itaki, Masayuki Endo, Hiroyuki Asakura, Mami Nagashima, Yoshiko Somura, Aki Takahashi, Aya Kayebeta, Ikumi Takahashi, Yuichiro Yahata","doi":"10.5365/wpsar.2025.16.1.1088","DOIUrl":"10.5365/wpsar.2025.16.1.1088","url":null,"abstract":"<p><strong>Objective: </strong>In 2018, the Shinjuku City Department of Health detected excess cases of hepatitis A virus (HAV) infection. The objectives of this investigation were to characterize the outbreak, identify transmission routes among inpatient cases and make recommendations to control and prevent HAV infection among men who have sex with men.</p><p><strong>Methods: </strong>Information about cases of HAV infection was collected from the National Epidemiological Surveillance for Infectious Diseases system and inpatient interviews conducted by public health nurses in 2018.</p><p><strong>Results: </strong>There were 131 HAV cases in 2018. Of these, 98% (129/131) were male, of whom 81% (105/129) were men who have sex with men. Hospitalization was required for 40 cases (31%). The age groups with the highest proportion of cases were 30-39 and 40-49 years (each 34%; 44/131). Two cases (2%) had received the second dose of the HAV vaccine, but only 10 days before symptom onset; all others had received no doses. The sequence type subgroup 13, an RIVM-HAV-16-090-like strain, was seen in 51 cases (39%). Of the 40 hospitalized cases, 21 (53%) participated in an interview conducted using a semistructured questionnaire. Altogether, of 21 cases, 12 (57%) had coinfection with HIV, 13 (62%) had casual sexual contact within the preceding 2 months and 10 (48%) had used social networking services (SNS) to find a sexual partner.</p><p><strong>Discussion: </strong>In Shinjuku, this outbreak almost exclusively affected the population of men who have sex with men. The detected outbreak strain has previously been reported in outbreaks among men who have sex with men in China, Taiwan (China) and Europe. For HAV prevention, the most important measures are raising awareness of the risk of HAV as a sexually transmitted infection via SNS and promoting immunization at the appropriate time.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":"16 1","pages":"1-10"},"PeriodicalIF":1.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vivek Jason Jayaraj, Diane Woei-Quan Chong, Faridah Binti Jafri, Nur Adibah Binti Mat Saruan, Gurpreet Kaur Karpal Singh, Ravikanth Perumal, Shakirah Binti Jamaludin, Juvina Binti Mohd Janurudin, Siti Rohana Binti Saad
{"title":"Estimating the impact of the COVID-19 pandemic on infectious disease notifications in Klang district, Malaysia, 2020-2022.","authors":"Vivek Jason Jayaraj, Diane Woei-Quan Chong, Faridah Binti Jafri, Nur Adibah Binti Mat Saruan, Gurpreet Kaur Karpal Singh, Ravikanth Perumal, Shakirah Binti Jamaludin, Juvina Binti Mohd Janurudin, Siti Rohana Binti Saad","doi":"10.5365/wpsar.2025.16.01.1097","DOIUrl":"10.5365/wpsar.2025.16.01.1097","url":null,"abstract":"<p><strong>Objective: </strong>The COVID-19 pandemic disrupted disease surveillance systems globally, leading to reduced notifications of other infectious diseases. This study aims to estimate the impact of the COVID-19 pandemic on the infectious disease surveillance system in Klang district, Selangor state, Malaysia.</p><p><strong>Methods: </strong>Data on notifiable diseases from 2014 to 2022 were sourced from the Klang District Health Office. The 11 diseases with more than 100 notifications each were included in the study. For these 11 diseases, a negative binomial regression model was used to explore the effect of the pandemic on case notifications and registrations by year, and a quasi-Poisson regression model was used to explore the changes by week.</p><p><strong>Results: </strong>The results showed a reduction in the number of notifications and registrations for all 11 diseases combined during the pandemic compared with previous years. Changes between expected and observed notifications by week were heterogeneous across the diseases.</p><p><strong>Discussion: </strong>These findings suggest that restrictive public health and social measures in Klang district may have impacted the transmission of other infectious diseases during the COVID-19 pandemic. The differential impact of the pandemic on disease notifications and reporting highlights the large ancillary effects of restrictive public health and social measures and the importance of building resilience into infectious disease surveillance systems.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":"16 1","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lalitha Sundaresan, Sheena G Sullivan, David J Muscatello, Daneeta Hennessy, Stacey L Rowe
{"title":"Monitoring mortality in the setting of COVID-19 pandemic control in Victoria, Australia: a time series analysis of population data.","authors":"Lalitha Sundaresan, Sheena G Sullivan, David J Muscatello, Daneeta Hennessy, Stacey L Rowe","doi":"10.5365/wpsar.2025.16.01.1091","DOIUrl":"10.5365/wpsar.2025.16.01.1091","url":null,"abstract":"<p><strong>Objective: </strong>Mortality surveillance was established in the state of Victoria just before the COVID-19 pandemic. Here, we describe the establishment of this surveillance system, justify the modelling approach selected, and provide examples of how the interpretation of changes in mortality rates during the pandemic was influenced by the model chosen.</p><p><strong>Methods: </strong>Registered deaths occurring in Victoria from 1 January 2015 to 31 December 2020 were sourced from the Victoria Death Index. Observed mortality rates were compared to a raw historical 5-year mean and to predicted means estimated from a seasonal robust regression. Differences between the observed mortality rate and the historical mean (∆MR) and excess mortality rate from the observed and predicted rates were assessed.</p><p><strong>Results: </strong>There were 20 375 COVID-19 cases notified in Victoria as of 31 December 2020, of whom 748 (3.7%) died. Victorians aged ≥ 85 years experienced the highest case fatality ratio (34%). Mean observed mortality rates in 2020 (MR: 11.6; 95% confidence interval [CI]: 11.4, 11.9) were slightly reduced when compared with the annual rate expected using the historical mean method (mean MR: 12.2; 95% CI: 12.1-12.3; ∆MR: -0.57; 95% CI: -0.77, -0.38), but not from the rate expected using the robust regression (estimated MR: 11.7; 95% prediction interval [PI]: 11.5, 11.9; EMR: -0.05; 95% CI: -0.26, 0.16). The two methods yielded opposing interpretations for some causes, including cardiovascular and cancer mortality.</p><p><strong>Discussion: </strong>Interpretation of how pandemic restrictions impacted mortality in Victoria in 2020 is influenced by the method of estimation. Time-series approaches are preferential because they account for population trends in mortality over time.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":"16 1","pages":"1-11"},"PeriodicalIF":1.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Takeshi Arashiro, Regina Pascua Berba, Joy Potenciano Calayo, Marie Kris, Reby Marie Garcia, Shuichi Suzuki, Cecile Dungog, Jonathan Rivera, Greco Mark Malijan, Kristal An Agrupis, Mary Jane Salazar, Mary Ann Salazar, Jinho Shin, Martin Hibberd, Koya Ariyoshi, Chris Smith
{"title":"Sociobehavioural factors associated with SARS-CoV-2 infection and COVID-19 vaccine effectiveness against medically attended, symptomatic SARS-CoV-2 infection in the Philippines: a prospective case-control study (FASCINATE-P study).","authors":"Takeshi Arashiro, Regina Pascua Berba, Joy Potenciano Calayo, Marie Kris, Reby Marie Garcia, Shuichi Suzuki, Cecile Dungog, Jonathan Rivera, Greco Mark Malijan, Kristal An Agrupis, Mary Jane Salazar, Mary Ann Salazar, Jinho Shin, Martin Hibberd, Koya Ariyoshi, Chris Smith","doi":"10.5365/wpsar.2025.16.1.1131","DOIUrl":"10.5365/wpsar.2025.16.1.1131","url":null,"abstract":"<p><strong>Objective: </strong>We examined sociobehavioural factors associated with SARS-CoV-2 infection and estimated COVID-19 vaccine effectiveness against symptomatic SARS-CoV-2 infection in the Philippines. Such studies are limited in low- and middle-income countries, especially in Asia and the Pacific.</p><p><strong>Methods: </strong>A case-control study was conducted in two hospitals in Manila, Philippines, from March 2022 to June 2023. Sociobehavioural factors and vaccination history were collected. PCR-positive individuals were cases, while PCR-negative individuals were controls. Adjusted odds ratios (aORs) were calculated to examine associations between sociobehavioural factors/vaccination and medically attended SARS-CoV-2 infection.</p><p><strong>Results: </strong>The analysis included 2489 individuals (574 positive cases, 23.1%; 1915 controls, 76.9%; median age [interquartile range]: 35 [27-51] years). Although education and household income were not associated with infection, being a health-care worker was (aOR: 1.45; 95% confidence interval [CI]: 1.03-2.06). The odds of infection were higher among individuals who attended gatherings of five or more people compared to those who attended smaller gatherings (aOR: 2.58; 95% CI: 1.14-5.83). Absolute vaccine effectiveness for vaccination status was not estimated due to a high risk of bias, for example, unascertained prior infection. Moderate relative vaccine effectiveness for the first booster (32%; 95% CI: -120-79) and the second booster (48%; 95% CI: -23-78) were observed (both with wide CI), albeit with a waning trend after half a year.</p><p><strong>Discussion: </strong>The higher odds of infection among health-care workers emphasize the importance of infection prevention and control measures. Moderate relative vaccine effectiveness with a waning trend reiterates the need for more efficacious vaccines against symptomatic infection caused by circulating variants and with longer duration of protection.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":"16 1","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rathavy Tung, Rattana Kim, Matthews Mathai, Kannitha Cheang, Howard L Sobel
{"title":"Implementation of maternal death audits and changes in maternal health care in Cambodia, 2010-2017.","authors":"Rathavy Tung, Rattana Kim, Matthews Mathai, Kannitha Cheang, Howard L Sobel","doi":"10.5365/wpsar.2024.15.4.1127","DOIUrl":"10.5365/wpsar.2024.15.4.1127","url":null,"abstract":"<p><strong>Objective: </strong>Cambodia is one of seven countries globally that met Millennium Development Goal 5A: reduction of maternal deaths by at least 75% between 1990 and 2015. The maternal death audit (MDA) was instituted in 2004 to support the improvement of maternal care. We evaluated progress in MDA implementation and maternal health services in Cambodia between 2010 and 2017.</p><p><strong>Methods: </strong>International experts and the national MDA committee members assessed all case abstracts, investigation questionnaires and audit meeting minutes covering all maternal deaths reported in Cambodia in 2010 and 2017 for quality of classification, data, care and recommendations. They convened provincial MDA committees to conduct similar assessments and develop evidence-based recommendations. Differences in data from the two years were assessed for significance using χ<sup>2</sup> and Fisher's exact tests.</p><p><strong>Results: </strong>In 2010 and 2017, 176 and 59 maternal death cases were reported, respectively. Cases were more likely in 2017 than in 2010 to have antenatal care (90.0% vs 68.2%, <i>P</i> = 0.004), give birth in a facility (81.6% vs 55.3%, <i>P</i> = 0.01) and receive a prophylactic uterotonic (95.7% vs 73%, <i>P</i> < 0.02) for postpartum haemorrhage and magnesium sulfate (66.7% vs 37%, <i>P</i> = 0.18) for preeclampsia/eclampsia. However, additional interventions and improved timeliness of referral with equipped and competent staff were identified as critical. Data quality prevented the classification of one fourth of cases during both periods. The quality of MDA recommendations improved from 2.8% in 2011 to 42% in 2018.</p><p><strong>Discussion: </strong>Improvements in maternal care are reflected in the increased antenatal care, facility births and better postpartum haemorrhage and preeclampsia/eclampsia management. However, additional care management improvements are needed. The MDA reporting needs to improve data completeness and make more specific recommendations to address causes of death.</p>","PeriodicalId":31512,"journal":{"name":"Western Pacific Surveillance and Response","volume":"15 4","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}