The Lancet Regional Health: Western Pacific最新文献

{"title":"Cancer survivorship in the Western Pacific: from differences to shared-goals and from challenges to opportunities","authors":"Raymond Javan Chan ,&nbsp;Reegan Knowles ,&nbsp;Carolyn Taylor ,&nbsp;Nirmala Bhoo Pathy ,&nbsp;Ke Yu ,&nbsp;Karolina Lisy ,&nbsp;Julia Lai-Kwon ,&nbsp;Miyako Tsuchiya ,&nbsp;Yan Lou ,&nbsp;Wendy Lam ,&nbsp;Michael Jefford","doi":"10.1016/j.lanwpc.2025.101749","DOIUrl":"10.1016/j.lanwpc.2025.101749","url":null,"abstract":"<div><div>The Western Pacific region consists of 38 countries and approximately one quarter of the world population. Over 17 million people in the region have a personal history of cancer, necessitating effective survivorship care approaches for optimal outcomes and experiences. There are substantial differences in population and income and resource availability between countries within the region which impacts cancer survivorship care. Likewise, varying healthcare systems and models of survivorship care (e.g., primary care-led, patient-led etc.) affect the survivorship experience and outcome of people affected by cancer. Despite differences across Western Pacific countries, issues facing cancer survivors are similar, with shared challenges including lack of focus on survivorship care, adoption of a holistic approach, and workforce availability. Various approaches to cancer survivorship are being developed and implemented across the region, but a region-wide, coordinated approach is needed, involving thoughtful leadership and sharing of ideas to achieve better outcomes.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101749"},"PeriodicalIF":8.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577834","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":"Area-level socioeconomic status inequalities shape patterns of antimicrobial resistance in China, 2014–2023: a Bayesian spatiotemporal modelling analysis","authors":"Yi Yang ,&nbsp;Jiani Jiang ,&nbsp;Can Chen ,&nbsp;Rongrong Qu ,&nbsp;Yi Liu ,&nbsp;Chen Xu ,&nbsp;Xiangkun Zeng ,&nbsp;Xiaofan Li ,&nbsp;Yi Li ,&nbsp;Weili Lin ,&nbsp;Lili Huang ,&nbsp;Mi Zhou ,&nbsp;Mengsha Chen ,&nbsp;Rong Zhang ,&nbsp;Shigui Yang ,&nbsp;Ning Dong","doi":"10.1016/j.lanwpc.2025.101745","DOIUrl":"10.1016/j.lanwpc.2025.101745","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial resistance (AMR) represents an escalating global health challenge, with socioeconomic status (SES) being a significant influencing factor. This study aimed to quantify area-level SES and assess its association with drug-resistant bacteria in China.</div></div><div><h3>Methods</h3><div>AMR data were collected from China Antimicrobial Resistance Surveillance System (CARSS, 2014–2023). Area-level SES across China was captured by County-level Area Deprivation Index (CADI) and Townsend Deprivation Index (TDI). Spatiotemporal distributions of drug-resistant bacteria were explored by spatial autocorrelation and spatiotemporal scan analyses. Key AMR risk factors were identified by GeoDetector analysis. Six Bayesian models were established through the Bayesian spatiotemporal modelling analysis. The Bayesian Spatiotemporal Interaction Hierarchy Model (BSTIHM), demonstrating superior estimative accuracy, was selected to forecast nationwide AMR patterns.</div></div><div><h3>Findings</h3><div>AMR profiles were obtained for totally 34,442,268 isolates of thirteen types of drug-resistant bacteria. The distributions of these bacteria exhibited manifest spatiotemporal heterogeneity nationwide. Both CADI and TDI consistently revealed a distinct socioeconomic gradient, with low area-level SES in western regions, medium in central regions, and high in eastern regions. Spatiotemporal clusters of drug-resistant bacteria were mainly observed in low SES regions. Lower area-level SES (odds ratio (OR) range: 1.054–1.254) and higher antimicrobial usage intensity (OR range: 1.022–1.174) contributed to higher risk of all thirteen types of drug-resistant bacteria. Meanwhile, total wastewater discharge (OR range: 1.064–1.280), PM_2.5 (OR range: 1.031–1.135), and number of healthcare technicians per 10,000 people (OR range: 1.035–1.310) were correlated with risks of most drug-resistant bacteria. Estimated risks for all thirteen types of drug-resistant bacteria were increased in low and middle area-level SES regions based on the BSTIHM.</div></div><div><h3>Interpretation</h3><div>Area-level SES is a pivotal driver of AMR risk, which might be caused by antibiotic overuse and environmental pollution. Targeted investments in healthcare and environmental systems in lower area-level SES regions are essential to effectively reduce AMR burden.</div></div><div><h3>Funding</h3><div>National Key R&amp;D Program of China, National Natural Science Foundation of China, Natural Science Foundation of Zhejiang Province, and Natural Science Foundation of Jiangsu Province.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101745"},"PeriodicalIF":8.1,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519338","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":"Global need, regional action: opportunities to improve cancer survivorship care in the Western Pacific","authors":"Michael Jefford ,&nbsp;Fiona Crawford-Williams ,&nbsp;Carolyn Taylor ,&nbsp;Miyako Takahashi ,&nbsp;Wendy W.T. Lam ,&nbsp;Alexandre Chan ,&nbsp;Bogda Koczwara ,&nbsp;Yan Lou ,&nbsp;Raymond J. Chan","doi":"10.1016/j.lanwpc.2025.101748","DOIUrl":"10.1016/j.lanwpc.2025.101748","url":null,"abstract":"<div><div>The Western Pacific region faces a significant cancer burden with over 12.8 million cancer survivors. Cancer survivorship care remains inconsistent across the region but is important regardless of diversity in healthcare systems and resources within countries. Cultural factors deeply influence survivorship experiences; thus, recognition of the importance of traditional medicine and the role of community-based support in survivorship care is needed. In this viewpoint, we highlight opportunities for regional collaboration to improve cancer survivorship outcomes, and advocate for incorporation of survivorship priorities into national cancer control plans. We call for coordinated action involving international organizations, local governments, and cancer survivor voices to deliver responsive, equitable survivorship care. Education, policy reform, and multinational partnerships are essential to address disparities and improve outcomes across the region.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101748"},"PeriodicalIF":8.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486314","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":"Risk of dengue following prior SARS-CoV-2 infection: a population-based cohort study","authors":"Liang En Wee ,&nbsp;Jue Tao Lim ,&nbsp;An Ting Tay ,&nbsp;Borame Dickens ,&nbsp;Pei Ma ,&nbsp;Calvin Chiew ,&nbsp;Po Ying Chia ,&nbsp;Yee Sin Leo ,&nbsp;Lee Ching Ng ,&nbsp;David Chien Lye ,&nbsp;Kelvin Bryan Tan","doi":"10.1016/j.lanwpc.2025.101727","DOIUrl":"10.1016/j.lanwpc.2025.101727","url":null,"abstract":"<div><h3>Background</h3><div>DENV-infection and SARS-CoV-2 are now endemic in tropical regions; interactions may exist, given antigenic cross-reactivity and cross-protection. Risk of subsequent DENV-infection following prior COVID-19 was evaluated in a population-based adult cohort.</div></div><div><h3>Methods</h3><div>Retrospective cohort study including all Singaporeans ≥18 years. National registries were used to construct contemporaneous SARS-CoV-2-infected/test-negative cohorts from 1st Sept 2021–31st Dec 2022 during Delta/Omicron emergence. COVID-19 vaccination status was classified using the national-immunization-registry. Risk of DENV-infection recorded in the national registry 31–300 days post-COVID-19 was contrasted against test-negatives using overlap-weighted Cox regression. Risk of other infections (invasive-pneumococcal-disease/tuberculosis/melioidosis/leptospirosis) were assessed as negative-outcome controls, and risk of DENV-infection post-influenza vaccination was assessed as a negative-exposure control.</div></div><div><h3>Findings</h3><div>1,324,250 COVID-19 cases (predominantly vaccine-breakthrough mild Omicron infections) and 1,434,851 test-negatives were included. Significantly increased risk of DENV-infection was observed 31–300 days post-COVID-19 (adjusted-hazards-ratio, aHR = 1.10[95%CI = 1.05–1.15]), during a DENV3 surge. Excess-burden of DENV-infection post-COVID-19 was 0.36 cases (95%CI = 0.11–0.61) per-1000-individuals. Risks of subsequent DENV-infection were numerically highest in unvaccinated COVID-19 cases but not elevated in doubly-boosted cases (≥4 vaccine-doses). Risk of negative-outcome controls (other-infections) was not significantly elevated 31–300 days post-COVID-19, and risk of DENV-infection was not significantly elevated post-influenza vaccination.</div></div><div><h3>Interpretation</h3><div>Increased risk of DENV-infection (primarily DENV3) was observed up to 300 days post-SARS-CoV-2 infection (predominantly Omicron). While not irrefutable proof for possible antibody-dependent enhancement of DENV3-infection post-Omicron COVID-19, given modest effect sizes, future studies can shed more light on potential interactions. Public health strategies (e.g., vaccination) remain important in tropical/subtropical regions where COVID-19/DENV are now endemic.</div></div><div><h3>Funding</h3><div><span>National-Medical-Research-Council</span>, Singapore.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101727"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466901","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":"Screening and diagnostic strategies for active pulmonary tuberculosis among people in prison in Malaysia: a prospective diagnostic study","authors":"Lu Zhang ,&nbsp;Frederick L. Altice ,&nbsp;Adeeba Kamarulzaman ,&nbsp;Ahsan Ahmad ,&nbsp;Sangeeth Kaur ,&nbsp;Saidatul Hanida Mohd Yukhi ,&nbsp;Nor Akma Ibrahim ,&nbsp;J. Lucian Davis ,&nbsp;Zailiza bt Suli ,&nbsp;Sheela V. Shenoi","doi":"10.1016/j.lanwpc.2025.101712","DOIUrl":"10.1016/j.lanwpc.2025.101712","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization (WHO) recommends tuberculosis (TB) screening in prisons but data on specific strategies are lacking.</div></div><div><h3>Methods</h3><div>Men sequentially entering Kajang Prison, Malaysia's largest prison, underwent standardized WHO symptom screening (SS), chest X-ray (CXR), and c-reactive protein (CRP ≥5 mg/L) screening tests while acid-fast bacilli (AFB) smears and Xpert were diagnostic tests. The reference standard was culture. We defined three screening strategies and compared their sensitivity, specificity, positive predictive value, negative predictive value, receiver operator curves, and area under the curve (AUC).</div></div><div><h3>Findings</h3><div>We enrolled 588 people in prison, mean age 43 (range: 21–68) years, 60 (10.2%) with HIV, 493 (83.8%) with opioid use disorder, and 265 (45.1%) with HCV. Among these, 34 (5.8%) were diagnosed with culture-positive active pulmonary TB (PTB). For screening, the sensitivity of SS, CRP ≥5 mg/L, and CXR demonstrating PTB was 38.2% (95% CI 22.2–56.4), 47.1% (95% CI 29.8–64.9), and 91.2% (95% CI 76.3–98.1). Among people without HIV, “SS-CXR” had the highest AUC (74.7% [95% CI 68.6–80.7]). For people with HIV, however, “SS-CRP” had the highest AUC (85.5% [95% CI 79.4–91.5]). For diagnosis, Xpert had a higher sensitivity (82.4% [95% CI 65.5–93.2] and specificity (95.5% [95% CI 93.4–97.1]) than AFB smear. Compared to “SS-Xpert”, both “SS-CXR-Xpert” and “SS-CRP-Xpert” had a significantly higher AUC in people without HIV (84.2% p &lt; 0.0001 and 72.9% p = 0.023, respectively) and people with HIV (87.3% p = 0.022 and 88.2% p = 0.018, respectively).</div></div><div><h3>Interpretation</h3><div>Among people in prison, adding CXR or CRP to symptom screen was more effective than symptom screen alone. In addition to symptom screen, CRP performed better than CXR among people with HIV while CXR was more valuable than CRP among people without HIV.</div></div><div><h3>Funding</h3><div>U.S. <span>National Institute on Drug Abuse</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101712"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517452","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":"Epidemiological analysis of infectious diseases in older people in China from 2014 to 2022: a population-based study","authors":"Sheng-Hong Lin ,&nbsp;Chen-Long Lv ,&nbsp;Meng-Jie Geng ,&nbsp;Rui-Cheng Gao ,&nbsp;Yan-Qun Sun ,&nbsp;Yan-He Wang ,&nbsp;Ya-Ming Zheng ,&nbsp;Tian Tang ,&nbsp;Chun-Xi Shan ,&nbsp;Yao Tian ,&nbsp;Yun-Bo Qiu ,&nbsp;Jun Ma ,&nbsp;Yan Zhang ,&nbsp;Yu-Feng Yang ,&nbsp;Qiang Xu ,&nbsp;Guo-Lin Wang ,&nbsp;Yan-Ping Zhang ,&nbsp;Qun Li ,&nbsp;Li-Ping Wang ,&nbsp;Peng-Tao Bao ,&nbsp;Wei Liu","doi":"10.1016/j.lanwpc.2025.101729","DOIUrl":"10.1016/j.lanwpc.2025.101729","url":null,"abstract":"<div><h3>Background</h3><div>The whole world is undergoing an unprecedented rapid population aging, and the accompanying threat of infectious diseases epidemic among the older people will pose a serious challenge to the national public health.</div></div><div><h3>Methods</h3><div>We extracted individual data on 21 notifiable infectious diseases (NIDs) among individuals aged ≥60 years from the Chinese Infectious Disease Surveillance and Control Project (CISDCP) from 2014 to 2022 in the mainland of China. We comprehensively analyzed the epidemiological characteristics of NIDs in older people and estimated the impact of age, year, and the COVID-19 pandemic.</div></div><div><h3>Findings</h3><div>A total of 8,604,064 cases of 21 major NIDs were reported, with an overall annual incidence of 362·10/100,000. Sexually transmitted or bloodborne diseases (STBDs, 45·23%) were the most common diseases. Notably, ranking of syphilis rose from fourth to third, while HIV/AIDS moved from eighth to seventh; respiratory diseases (34·88%) showed sustained declines. Tuberculosis remained the most common respiratory diseases despite a 6·4% annual decline (APC, P &lt; 0·001); gastrointestinal or enteroviral diseases (GEDs, 18·35%) showed sustained declines, except for infectious diarrhea and hepatitis E; vector-borne or zoonotic diseases (VBZDs, 1·54%) remained low, though brucellosis increased during COVID-19 pandemic. Inflection point analysis revealed that 13 diseases, such as tuberculosis, infectious diarrhea, hepatitis B, and others, exhibited a quadratic distribution (inverted “V” shape) in age-specific incidence as age increased. Difference was noticeable between regions, with the older people in Inner Mongolia-Xinjiang region and South China region continuing to carry a disproportionate burden from NIDs.</div></div><div><h3>Interpretation</h3><div>Although China's success in infectious disease control in older people. Effective prevention and control strategies are needed for highest incidence diseases, such as tuberculosis, hepatitis B, and infectious diarrhea, especially in high-incidence regions and among critical age points.</div></div><div><h3>Funding</h3><div><span>National Major Research</span> &amp; <span>Development Program of China</span> (<span><span>2022YFC2604000</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101729"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466900","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":"Exclusionary election rhetoric and its impact on migrant health research in Japan","authors":"Tadashi Yamashita ,&nbsp;Akihito Uezato","doi":"10.1016/j.lanwpc.2025.101740","DOIUrl":"10.1016/j.lanwpc.2025.101740","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101740"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467662","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":"Adverse health outcomes among migrant workers and transnational families in the Asia–Pacific: a systematic review and meta-analysis","authors":"Rosita Chia-Yin Lin ,&nbsp;Karen Lau ,&nbsp;Kathryn Mackey ,&nbsp;Natasha Roya Matthews ,&nbsp;Maushmi Selvamani ,&nbsp;Morais Beatriz ,&nbsp;Bouaddi Oumnia ,&nbsp;Chaelin Kim ,&nbsp;Azusa Iwamoto ,&nbsp;Masami Fujita ,&nbsp;Ursula Trummer ,&nbsp;Tran Ngoc Dang ,&nbsp;Alena Kamenshchikova ,&nbsp;Cathy Zimmerman ,&nbsp;Sally Hargreaves","doi":"10.1016/j.lanwpc.2025.101720","DOIUrl":"10.1016/j.lanwpc.2025.101720","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Labour migration is a growing global phenomenon, with migrant workers known to be more likely to experience exploitative and precarious work, impacting their health. Despite hosting over 27 million international migrant workers, the Asia–Pacific region remains underrepresented in global health evidence, limiting the development of targeted, region-specific health interventions. This study aims to investigate the health status of migrant workers and their transnational families in the Asia–Pacific region.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a systematic review and meta-analysis (PROSPERO: CRD42024528561) of primary studies published between Jan 1, 2013, and April 1, 2024. We searched MEDLINE, Embase, PsycINFO, and Ovid Global Health for studies reporting work-related morbidity and mortality among international migrant workers and their transnational families in the Asia–Pacific region. A narrative synthesis identified occupational risks; a meta-analysis estimated pooled prevalence of morbidity among migrant workers and relative risks compared to local workers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Of 2877 studies identified, 54 met inclusion criteria, including 38 eligible for meta-analysis, encompassing 86,620 individuals across 17 Asia–Pacific countries. Among migrant workers (n = 64,172), 88.4% experienced occupational injuries and illnesses including work-related injuries, pesticide poisoning symptoms and respiratory diseases (n = 45,661), with 75% of migrant workers in this large dataset working in high-risk sectors such as manufacturing, construction, and services (including drivers and restaurant workers). 3.8% reported symptoms of mental health disorders such as anxiety and depression (n = 1975), and 3.8% had musculoskeletal disorders (n = 1973). The pooled prevalence of at least one work-related morbidity was 37% (95% CI: 27–47; &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;&lt;em&gt;2&lt;/em&gt;&lt;/sup&gt; = 99.0%), with a pooled relative risk of 1.29 (95% CI: 1.10–1.52; &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;&lt;em&gt;2&lt;/em&gt;&lt;/sup&gt; = 47.4%) compared with local workers. Among transnational families left behind in the migrant worker's country of origin (n = 22,448), 50.1% reported mental health issues (n = 1520), and 31.4% experienced undernutrition (n = 954). Key contributing factors to poor health outcomes of migrant workers included long working hours, workplace hazards, precarious working conditions, and healthcare access barriers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Migrant workers in the Asia–Pacific face substantial risks of a wide range of occupational injuries and illnesses. Although some studies support the “healthy migrant effect,” this advantage clearly diminishes over time due to cumulative exposure to occupational and structural stressors. Strengthening occupational safety, regulating working hours, and improving healthcare access, are urgent priorities for countries hosting large migrant worker populations and employers of migrant workers.&lt;/div&gt;&lt;/div&gt;","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101720"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419429","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":"Cardiometabolic health and risk of dementia and brain atrophy: a community-based prospective cohort study of 0.5 million adults in China","authors":"Clara Bueno Lopez ,&nbsp;Andri Iona ,&nbsp;Daniel Avery ,&nbsp;Iain Turnbull ,&nbsp;Ling Yang ,&nbsp;Huaidong Du ,&nbsp;Yiping Chen ,&nbsp;Ningmei Zhang ,&nbsp;Junshi Chen ,&nbsp;Pei Pei ,&nbsp;Jun Lv ,&nbsp;Canquing Yu ,&nbsp;Dianjianyi Sun ,&nbsp;Liming Li ,&nbsp;Derrick Bennett ,&nbsp;Cornelia van Dujin ,&nbsp;Robert Clarke ,&nbsp;Zhengming Chen ,&nbsp;Fiona Bragg ,&nbsp;China Kadoorie Biobank Collaborative Group","doi":"10.1016/j.lanwpc.2025.101743","DOIUrl":"10.1016/j.lanwpc.2025.101743","url":null,"abstract":"<div><h3>Background</h3><div>Cardiometabolic health has been associated with dementia risk but prospective evidence is limited in China where the burden of cardiometabolic disease and dementia are rising. We investigate the relevance of markers of cardiometabolic health for risk of dementia and brain atrophy.</div></div><div><h3>Methods</h3><div>China Kadoorie Biobank is a prospective cohort study involving 512,724 adults aged 30–79 years, recruited in 2004–2008 from 10 diverse regions. During ∼12 years’ follow-up, 1099 dementia and 1418 brain atrophy cases were recorded through linked death registries and health insurance databases. Cox regression yield adjusted hazard ratios (HRs) for incident dementia and brain atrophy associated with markers of cardiometabolic health.</div></div><div><h3>Findings</h3><div>The incidence rate for dementia and brain atrophy was 19.0 and 25.4 per 100,000 person-years, respectively, higher at older ages, and among males. Prior hypertension (adjusted HR 1.21 [95% CI 1.05–1.39]), diabetes (1.36 [1.13–1.65]) and stroke (2.52 [2.14–2.96]) were associated with higher risks of dementia and brain atrophy (1.30 [1.15–1.47], 1.32 [1.12–1.55], 2.43 [2.12–2.78], respectively). Prior IHD was associated with brain atrophy (1.69 [1.47–1.95]), but not dementia (1.17 [0.97–1.41]).</div></div><div><h3>Interpretation</h3><div>These findings provide evidence of the relevance of markers of cardiometabolic health for dementia among adults in China, highlighting the importance of preventative strategies for cardiometabolic diseases that may lead to benefits for brain health.</div></div><div><h3>Funding</h3><div><span>Wellcome Trust</span>, <span>MRC</span>, <span>BHF</span>, CR-UK, <span>Kadoorie Charitable Foundation</span>, Chinese MoST and NSFC.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101743"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569019","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":"Prevalence and associated factors of obesity, hypertension, and diabetes in French Polynesia: results from a nationwide cross-sectional study","authors":"Martin Paries ,&nbsp;Iotefa Teiti ,&nbsp;Maite Aubry ,&nbsp;Etienne Patin ,&nbsp;Yoann Madec ,&nbsp;Kiyojiken Chung ,&nbsp;Pauline Boucheron ,&nbsp;Stéphane Lastère ,&nbsp;Maëlia Etoundi ,&nbsp;Tuterarii Paoaafaite ,&nbsp;Lisa Dian ,&nbsp;Raphaëlle Bos ,&nbsp;André Wattiaux ,&nbsp;Caroline Michaux ,&nbsp;Henri-Pierre Mallet ,&nbsp;Lluis Quintana-Murci ,&nbsp;Arnaud Fontanet ,&nbsp;Van-Mai Cao-Lormeau","doi":"10.1016/j.lanwpc.2025.101746","DOIUrl":"10.1016/j.lanwpc.2025.101746","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Non-communicable diseases (NCDs) represent a major global health challenge, particularly in the Pacific. This study assessed the prevalence and associated factors of obesity, hypertension, and diabetes among adults in French Polynesia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A cross-sectional survey (2019–2021) was conducted on a nationally representative sample of adults across all five archipelagos (Tuamotu, Gambier, Marquesas, Austral, and Society including the Leeward and Windward Islands). Data included anthropometrics, blood pressure, biochemical markers (lipids, renal function), sociodemographic, lifestyle, and health history. NCDs were defined as hypertension (systolic BP &gt;140 mmHg, diastolic BP &gt;90 mmHg, and/or self-report of anti-hypertension medication use), diabetes (HbA1c &gt;6·5%, and/or self-report of previous medical diagnosis), and obesity (using either BMI ≥30 kg/m&lt;sup&gt;2&lt;/sup&gt; or a revised definition incorporating ethnicity-specific thresholds and additional anthropometric criteria).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 1893 adults were included (987 women; 906 men). Among them, 669 (weighted prevalence: 35·5%, 95% CI: 33–38) had hypertension, 214 (weighted prevalence: 12·2%, 95% CI: 10–14) had diabetes (including 53 undiagnosed, weighted prevalence: 3·1%, 95% CI: 2–4), and 1022 (weighted prevalence: 51·1%, 95% CI: 48–54) or 847 (weighted prevalence: 42·7%, 95% CI: 40–46) were classified as obese, using BMI-based or revised definitions, respectively. Among those with revised obesity, 439 (weighted prevalence: 52·2%, 95% CI: 48–57) presented metabolic abnormalities typically associated with the condition, while 408 (weighted prevalence: 47·8%, 95% CI: 43–52) were metabolically healthy, a phenotype that declined with age.&lt;/div&gt;&lt;div&gt;Women were less likely than men to have hypertension (OR = 0·59, 95% CI: 0·45–0·78), but more likely to present BMI-based obesity (OR = 1·61, 95% CI: 1·23–2·11). Hypertension odds were higher in Leeward versus Windward Islands (OR = 1·61, 95% CI: 1·24–2·09). Revised obesity was associated with low fruit/vegetable intake (OR = 1·53, 95% CI: 1·13–2·09), high meat consumption (OR = 1·52, 95% CI: 1·10–2·10), high fish consumption (OR = 1·54, 95% CI: 1·10–2·16), and low physical activity (OR = 1·58, 95% CI: 1·15–2·15). Obesity increased the odds of diabetes (OR = 2·99, 95% CI: 1·97–4·53) and hypertension (OR = 2·38, 95% CI: 1·80–3·14). Lower odds of obesity were observed in self-declared Polynesians of mixed ancestry (OR = 0·64, 95% CI: 0·42–0·96) and European immigrants (OR = 0·21, 95% CI: 0·07–0·61), as well as lower odds of diabetes in European immigrants (OR = 0·04, 95% CI: 0·01–0·19) compared to self-identified Polynesians.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;The high prevalence of obesity, a key driver of hypertension and diabetes, highlights the need for both population-wide prevention and targeted interventions across all archipelagos. Using standar","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101746"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569020","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}