The Lancet Regional Health: Western Pacific最新文献

{"title":"Prevalence, persistence, and severity of 12-month and 30-day DSM-5 disorders in the World Mental Health Hong Kong Study","authors":"Corine S.M. Wong ,&nbsp;Candi M.C. Leung ,&nbsp;Shiyi Wu ,&nbsp;Francis P. Flores ,&nbsp;Yoona Kim ,&nbsp;Xiao Xiao ,&nbsp;Solomon B.K. Wong ,&nbsp;Wing Chung Chang ,&nbsp;Wai Chi Chan ,&nbsp;Nancy Xiaonan Yu ,&nbsp;Calvin P.W. Cheng ,&nbsp;Albert K.K. Chung ,&nbsp;Edwin H.M. Lee ,&nbsp;Wai Tat Chiu ,&nbsp;William G. Axinn ,&nbsp;Ronald C. Kessler ,&nbsp;Michael Y. Ni","doi":"10.1016/j.lanwpc.2025.101757","DOIUrl":"10.1016/j.lanwpc.2025.101757","url":null,"abstract":"<div><h3>Background</h3><div>The World Mental Health Hong Kong (WMHHK) Study aims to estimate 12-month and 30-day prevalence, persistence, severity, and correlates of DSM-5 anxiety, mood, and externalising disorders in Hong Kong, a densely populated city impacted by consecutive population-level stressors, including social unrest and the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>Face-to-face interviews, either in-person or video-based online, were conducted from November 2022 to March 2024 with a population-representative sample of 3053 adults aged 18 years and above. Diagnostic assessment utilised the World Mental Health Composite International Diagnostic Interview for DSM-5 (CIDI-5), evaluating ten mental disorders: anxiety (panic disorder, generalised anxiety disorder, post-traumatic stress disorder, obsessive-compulsive and related disorders), mood (major depressive disorder, persistent depressive disorder, bipolar spectrum disorders), and externalising (intermittent explosive disorder, alcohol use disorder, substance use disorder) disorders. Persistence was defined as 12-month prevalence among lifetime cases and 30-day prevalence among 12-month cases. Sociodemographic correlates were analysed using multivariable logistic regression.</div></div><div><h3>Findings</h3><div>Twelve-month and 30-day prevalence of any DSM-5 mental disorder were 10.6% (95% CI: 9.5–11.8) and 7.8% (95% CI: 6.7–8.9), respectively. Twelve-month prevalence was highest for anxiety disorders (8.0%, 95% CI: 7.1–8.9), followed by mood (4.3%, 95% CI: 3.4–5.2) and externalising (1.7%, 95% CI: 0.9–2.4) disorders. Twelve-month persistence among lifetime cases was 49.0%, overall and higher for anxiety (55.6%) than mood (39.0%) or externalising (35.3%) disorders. Younger and middle-aged adults, and who were not currently married, had elevated risks, while lower education was associated with greater disorder severity. Comorbidity was associated with increased persistence and severity across disorders.</div></div><div><h3>Interpretation</h3><div>This study shows a substantial mental health burden in Hong Kong during the post-pandemic period, highlighting the need for tailored public mental health programmes to address urban stressors in this unique context.</div></div><div><h3>Funding</h3><div><span>WYNG Foundation</span>, Hong Kong; <span>State Key Laboratory of Brain and Cognitive Sciences</span>, The <span>University of Hong Kong</span>, Hong Kong Special Administrative Region, China; <span>Hong Kong Jockey Club Charities Trust</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101757"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615787","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":"From process to publication: the conduct and reporting of co-design in health research in the Western Pacific region","authors":"Yaqoot Fatima ,&nbsp;Michelle Olaithe ,&nbsp;Shannon Edmed ,&nbsp;Bushra Nasir","doi":"10.1016/j.lanwpc.2025.101766","DOIUrl":"10.1016/j.lanwpc.2025.101766","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101766"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681863","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":"Temporal trends in sepsis hospitalisations and mortality in Aotearoa New Zealand, 2000–2019: a population-based study","authors":"Sharla McTavish ,&nbsp;Jane Zhang ,&nbsp;June Atkinson ,&nbsp;Amanda Kvalsivg ,&nbsp;Alice Hyun Min Kim ,&nbsp;Colin McArthur ,&nbsp;Paul Huggan ,&nbsp;Michael G. Baker","doi":"10.1016/j.lanwpc.2025.101767","DOIUrl":"10.1016/j.lanwpc.2025.101767","url":null,"abstract":"<div><h3>Background</h3><div>Globally, sepsis remains a substantial public health concern. To inform policy development and interventions for sepsis prevention, treatment, and surveillance in Aotearoa New Zealand (Aotearoa), we describe population-level epidemiological trends in hospitalised sepsis and mortality over two decades by major sociodemographic characteristics.</div></div><div><h3>Methods</h3><div>We undertook a retrospective, population-based descriptive study of all sepsis-associated hospitalisation (SAH) in Aotearoa between 2000 and 2019 using previously published case identification strategies and <em>International Classification of Diseases, Tenth Revision</em> (ICD-10) codes to identify SAHs in the National Minimum Dataset. Incidence and mortality rates, and case fatality risks were calculated along with analyses of trends over the 20-year observation period. Rate estimates were standardised to the age structure of the total population identified in the 2018 New Zealand Census.</div></div><div><h3>Findings</h3><div>We identified 266,105 unique SAH cases and 27,402 associated deaths, with an average age-standardised incidence rate (ASIR) of 320.4 admissions per 100,000 population and an age-standardised mortality rate (ASMR) of 34.2 deaths per 100,000 population. An average annual ASIR increase of 4.5% was observed, from 217.3 admissions in 2000 to 386.9 admissions per 100,000 population in 2019. ASMR decreased annually from 37.1 deaths in 2000 to 31.3 deaths per 100,000 population in 2019. Case fatality risk decreased from 15.9 deaths in 2000 to 8.1 deaths per 100 admissions in 2019, primarily driven by improvements in patient survival in ≥40-year age groups. Significant SAH incidence and mortality disparities were observed between patient populations, particularly by age, ethnicity and socioeconomic deprivation. Māori and Pacific Peoples had SAH incidence rates that were 1.7 and 2.3 times, respectively, higher than those of NMPA ethnicity, and had mortality rates that were 1.6 and 1.7 times higher. Similarly, those living in areas of high socioeconomic deprivation were twice as likely to develop SAH, and their SAH mortality rate was twice as high as that of those living in areas of the least socioeconomic deprivation.</div></div><div><h3>Interpretation</h3><div>Sepsis is common in Aotearoa and makes a substantial contribution to population mortality. Significant variation in incidence and mortality rate estimates was observed between patient populations, with higher rates in those &lt;1 year and ≥70 years, of Māori or Pacific ethnicity, and those living in areas of high socioeconomic deprivation. Our findings highlight the burden of SAH and the need for targeted interventions to address sepsis prevention, surveillance and support for sepsis survivors in Aotearoa.</div></div><div><h3>Funding</h3><div><span>Health Research Council</span> of New Zealand.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101767"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736760","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 landscape of healthcare-associated infections in China, 2015–2019: a nation-wide observational study","authors":"Hong-Wu Yao ,&nbsp;Chen-Long Lv ,&nbsp;Yao Tian ,&nbsp;Yu-Zheng Zhang ,&nbsp;Zheng-Hao Yu ,&nbsp;Ming-Mei Du ,&nbsp;Cheng-Xue Ma ,&nbsp;Ji-Jiang Suo ,&nbsp;Shuo Zhao ,&nbsp;Yu Zhang ,&nbsp;Yu-Bin Xing ,&nbsp;An-Ran Zhang ,&nbsp;Yan-Ling Bai ,&nbsp;Bo-Wei Liu ,&nbsp;Zhong-Qiang Yan ,&nbsp;Ju-Yuan Liu ,&nbsp;Meng Cai ,&nbsp;Rui Huo ,&nbsp;Jian Lin ,&nbsp;Chun-Ping Chen ,&nbsp;Yun-Xi Liu","doi":"10.1016/j.lanwpc.2025.101775","DOIUrl":"10.1016/j.lanwpc.2025.101775","url":null,"abstract":"<div><h3>Background</h3><div>Healthcare-associated infections (HAIs), complicated by antimicrobial resistance continue to affect all countries with unprecedented threat, especially for developing countries. Our objective was to explore the epidemiological features, spatiotemporal heterogeneity and associated factors of HAIs and HAI related multi-drug resistant organisms (MDROs) in China.</div></div><div><h3>Methods</h3><div>We used national surveillance data that were collected from 6867 sampled hospitals during 2015–2019 to determine the annual incidence of HAIs, key HAI-related quality indicators and associated factors.</div></div><div><h3>Findings</h3><div>During 2015–2019, total of 4,959,230 HAIs were reported in sampled hospitals in China, with the overall incidence and prevalence estimated as 1.1 and 2.3 per 100 inpatients, which showed decline trend over time. Carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB) had the highest overall detection rate (51.1%), followed by methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) (31.0%), carbapenem-resistant <em>Pseudomonas aeruginosa</em> (CRPA) (22.8%), and carbapenem-resistant <em>Klebsiella pneumonia</em> (CRKP) (12.4%). Detection rates of MRSA, carbapenem-resistant <em>Escherichia coli</em> (CREC), and vancomycin-resistant <em>Enterococcus faecium</em> (VREfm) reduced, in contrast with an increasing trend for CRKP. Higher risk of HAIs was associated with hospitals located in urban areas (incidence rate ratio [IRR]: 1.39, p &lt; 0.001), in regions with higher GDP per capita (IRR: 1.03, p &lt; 0.001), with more beds (IRR: 1.64 and 2.16 for 500−1500 and ≥ 1500 beds respectively, p &lt; 0.001), as well as in south region of China (IRR: 1.23, p &lt; 0.001). The reduced annual rates of HAIs were observed after 2017 (IRR: 0.92, p &lt; 0.001), when 12 new standards targeted for HAIs were implemented.</div></div><div><h3>Interpretation</h3><div>The study increases the understanding of HAIs and antimicrobial resistance. It highlights high-risk areas of HAIs and MDROs of concern, where targeted measures to continuously enhance management and policies implementation of HAIs are needed.</div></div><div><h3>Funding</h3><div><span>The Foundation of State Key Laboratory of Pathogen and Biosecurity of China</span> (Grant No. <span><span>SKLPBS2443</span></span>) and <span>Infection Prevention and Control Research Project of “Gan·Dong China”</span> (Grant No. <span><span>GY2023022-A</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101775"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789940","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":"Economic evaluation of potential national childhood screening strategies for type 1 diabetes in Australia","authors":"Winnie Chen ,&nbsp;Kirsten Howard ,&nbsp;Sarah Norris ,&nbsp;Natasha Nassar ,&nbsp;Maria E. Craig ,&nbsp;Kirstine J. Bell","doi":"10.1016/j.lanwpc.2025.101755","DOIUrl":"10.1016/j.lanwpc.2025.101755","url":null,"abstract":"<div><h3>Background</h3><div>Type 1 diabetes (T1D) is an autoimmune condition affecting children. We aimed to investigate the costs and cost-effectiveness of potential national childhood screening strategies for T1D compared to no screening (usual care).</div></div><div><h3>Methods</h3><div>Screening costs were obtained from trial-based estimates. A Markov microsimulation model was developed to identify the most cost-effective childhood T1D screening strategy. The three screening strategies modelled were: Strategy 1) newborn genetic risk-stratification with bloodspot sampling, followed by autoantibody screening in at-risk children; Strategy 2) infant genetic risk-stratification using saliva sampling, followed by autoantibody screening in at-risk children; Strategy 3) population-wide autoantibody screening at two childhood ages. The model tracked 100,000 individuals from birth to 30 years of age. One-way and probabilistic sensitivity analyses were conducted.</div></div><div><h3>Findings</h3><div>Newborn bloodspot genetic risk-stratified screening (strategy 1) was the most cost-effective strategy. Incremental cost-effectiveness ratios (ICERs) were $50,682 per quality-adjusted life year (QALY) gained for strategy 1, $85,440 per QALY gained for strategy 2, and $133,285 per QALY gained for strategy 3. In the optimal strategy (strategy 1), the cost was $480,798 per screen-detected T1D and $12,183 per episode of diabetic ketoacidosis avoided. Results were sensitive to changes in time horizon, discount rates, and cost of the screening tests.</div></div><div><h3>Interpretation</h3><div>Of the three modelled T1D screening strategies, newborn bloodspot genetic risk-stratified screening was the most cost-effective. Varying cost inputs may change this hierarchy. Our economic evaluation will be useful for informing future T1D childhood screening policy in Australia and other high-income countries.</div></div><div><h3>Funding</h3><div>JDRF Australia.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101755"},"PeriodicalIF":8.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577790","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 changing epidemiology of syphilis: new strategies for new challenges in China","authors":"Guiying Cao ,&nbsp;Huang Jing ,&nbsp;Cai Jie ,&nbsp;Min Liu","doi":"10.1016/j.lanwpc.2025.101752","DOIUrl":"10.1016/j.lanwpc.2025.101752","url":null,"abstract":"<div><div>Syphilis was nearly eliminated from China in the 1960s; however, it has resurgent and continued to spread in the country since the 1980s. Surveillance data from China revealed that the notification rate of syphilis increased 11.88% annually between 2004 and 2019, with an notification rate of 38.37 per 100,000 population in 2019. This paper aims to summarize the national policies and plans for syphilis since the 1980s; the full-cycle management strategy for the publicity and education, screening, diagnosis and treatment, management, and surveillance and monitoring of syphilis; the epidemiology of syphilis; and challenges in the prevention and control in China. Finally, we propose a series of new strategies to better manage syphilis to help eliminate the infection in China.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101752"},"PeriodicalIF":8.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577838","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":"Comprehensive epidemiological analysis of severe fever with thrombocytopenia syndrome in Japan, 2013–2023: descriptive observational study","authors":"Tomohiro Ohno ,&nbsp;Hirofumi Kato ,&nbsp;Yusuke Kobayashi ,&nbsp;Masami Kitaoka ,&nbsp;Minako Kanesaki ,&nbsp;Shimpei Murai ,&nbsp;Masaru Jinushi ,&nbsp;Mitsuki Aoki ,&nbsp;Takuri Takahashi ,&nbsp;Tomoe Shimada ,&nbsp;Taro Kamigaki ,&nbsp;Tomimasa Sunagawa","doi":"10.1016/j.lanwpc.2025.101747","DOIUrl":"10.1016/j.lanwpc.2025.101747","url":null,"abstract":"<div><h3>Background</h3><div>Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne zoonotic disease that poses a serious public health challenge in several Asian countries. In this study, we aimed to describe the recent epidemiological characteristics of SFTS in Japan using denominator-based test data.</div></div><div><h3>Methods</h3><div>We analysed reported SFTS case-patients in Japan using national surveillance data from March 2013 to April 2024. The case-fatality ratio (CFR) was calculated using the National Vital Statistics Surveillance System (NVSSS) for 2013–2022. Trends in test numbers and positivity rates were examined using data from annual reports and public health institute surveys.</div></div><div><h3>Findings</h3><div>During the study period, 931 case-patients were reported, including 11 veterinary healthcare workers. The annual notification rate rose from 3.12 per ten million in 2013 to 10.46 in 2023, with 30 (64%) estimated infection prefectures, primarily in western and central Japan. The NVSSS CFRs remained high at approximately 20%. Test numbers and positive results increased from 2013 (n = 350, n = 41) to 2022 (n = 923, n = 95); however, positivity decreased from 12% to 10%.</div></div><div><h3>Interpretation</h3><div>The annual SFTS notification rate increased, and infection regions expanded between 2013 and 2023, with persistently high CFRs and increased testing. Veterinary healthcare workers appear to be a potential high-risk group. These findings highlight that SFTS remains a public health concern in Japan, requiring a comprehensive health strategy.</div></div><div><h3>Funding</h3><div>This work was supported by the Japan Society for the Promotion of <span>Science Kakenhi</span> Grants-in-Aid for Young Scientists (grant number: <span><span>24K19277</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101747"},"PeriodicalIF":8.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577791","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":"Sex-differences in the intergenerational transmission of mental disorders among schizophrenia probands: familial risk and protective factors in a population-based study","authors":"Zhi Sheng ,&nbsp;Tianhang Zhou ,&nbsp;Chunyu Du ,&nbsp;Tingfang Wu ,&nbsp;Liping Wen ,&nbsp;Xianmei Yang ,&nbsp;Wencai Chen ,&nbsp;Xuehong Ma ,&nbsp;Hua Deng ,&nbsp;Ling Ge ,&nbsp;Changchun Zhang ,&nbsp;Xu Hong ,&nbsp;Rui He ,&nbsp;Xiangdong Du ,&nbsp;Lingyan Zhu ,&nbsp;Hu Xiang ,&nbsp;Sijing Chen ,&nbsp;Jiachen Liu ,&nbsp;Yongzhuo Ding ,&nbsp;Guangming Liang ,&nbsp;Xin Yu","doi":"10.1016/j.lanwpc.2025.101750","DOIUrl":"10.1016/j.lanwpc.2025.101750","url":null,"abstract":"<div><h3>Background</h3><div>Parental schizophrenia confers intergenerational mental health risks. The sex-specific transmission patterns remain poorly quantified. This study examined parent-reported transmission rate and familial risk factors among Chinese offspring of schizophrenia probands.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, we enrolled 27,315 schizophrenia probands and 35,772 offspring. Psychiatric disorder diagnoses of offspring were parent-reported and subsequently verified via the medical management system. Age- and sex-standardized rate referenced China's 2020 census. Robust Poisson regression generated adjusted rate ratios (aRR). Multivariable logistic models were used to identify risk factors for young offspring. This study was registered with ClinicalTrials (<span><span>NCT07005245</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>The parent-reported transmission rate in offspring was 2.68% (95% CI, 2.52%–2.85%), dominated by schizophrenia spectrum disorders (1.42%). Standardized rates reached 2.53% (95% CI, 2.01%–3.05%) after demographic standardization. Offspring risk increased by 86.0% when conception occurred post-parental illness onset. Firstborn status (aRR = 1.67), low-income household (aRR = 1.43), and being a male child (aRR = 1.14) were significantly associated with elevated risk. Sex-specific parental age effects were also observed. In the subgroup analysis of underage (&lt;17 years) offspring, maternal transmission was associated with post-parental-onset birth (OR = 2.48, <em>p</em> &lt; 0.001), lower household income (OR = 2.32, <em>p</em> &lt; 0.001), and prenatal antipsychotic exposure (OR = 1.69, <em>p</em> &lt; 0.001). Paternal transmission was related to father-only caregiving (OR = 2.15, <em>p</em> &lt; 0.001), lower household income (OR = 1.97, <em>p</em> &lt; 0.001), and male offspring (OR = 1.79, <em>p</em> = 0.001). Dual-parent care demonstrated a robust protective effect across both maternal and paternal schizophrenia groups (OR = 0.75, 95% CI, 0.51–1.10).</div></div><div><h3>Interpretation</h3><div>Our findings highlighted critical interactions between familial aggregation, sex-differentiated perinatal exposures, and caregiving environments. Policy priorities should integrate sex-stratified genetic counselling, prenatal medication monitoring, and family support programs targeting caregiving inequalities.</div></div><div><h3>Funding</h3><div>This study was supported by the <span>National Natural Science Foundation of China</span> (32070589).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101750"},"PeriodicalIF":8.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577789","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":"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}