The Lancet Regional Health: Western Pacific最新文献

{"title":"Corrigendum to “Lung cancer survival in China and world-wide: results from CONCORD-3” [The Lancet Regional Health–Western Pacific, Volume 55, Supplement 1, February 2025, 101371]","authors":"Hongcheng Zhu , Veronica Di Carlo , Fatima Khan Baloch , Claudia Allemani , Michel Coleman","doi":"10.1016/j.lanwpc.2025.101718","DOIUrl":"10.1016/j.lanwpc.2025.101718","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101718"},"PeriodicalIF":8.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323442","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":"Psychotropic medication consumption before and after onset of COVID-19 pandemic in 91 countries and regions: a time-series analysis","authors":"Caige Huang ,&nbsp;Yu Yang ,&nbsp;Yue Wei ,&nbsp;Vincent K.C. Yan ,&nbsp;Kyung Jin Lee ,&nbsp;Shek Ming Leung ,&nbsp;Francisco T.T. Lai ,&nbsp;Yi Chai ,&nbsp;Ruth Brauer ,&nbsp;David J. Castle ,&nbsp;Li Wei ,&nbsp;Joseph F. Hayes ,&nbsp;Hao Luo ,&nbsp;Dan Siskind ,&nbsp;Eric W.C. Yan ,&nbsp;Esther W.Y. Chan","doi":"10.1016/j.lanwpc.2025.101711","DOIUrl":"10.1016/j.lanwpc.2025.101711","url":null,"abstract":"<div><h3>Background</h3><div>The availability of psychotropic medications serves as a key indicator of global mental health status, underscoring the critical importance of continued monitoring. However, comprehensive studies assessing the global effect of the COVID-19 pandemic on such trends remain lacking. This study aimed to describe psychotropic consumption trends before and after the onset of the COVID-19 pandemic and investigate the pandemic's short- and long-term effects on psychotropic consumption across 91 countries and regions.</div></div><div><h3>Methods</h3><div>This study used country-level sales data of psychotropic medications between Q1, 2012, and Q2, 2023 of 91 countries and regions from the IQVIA-Multinational Integrated Data Analysis System. Average annual sales trends were estimated and expressed as defined daily dose per 1000 inhabitants per day (DDD/TID) at the overall level and stratified by medication class and country income level. Relative average annual changes were assessed for the periods 2017–2019 and 2020–2022 both overall and within specific medication classes and income groups. The pandemic's short- and long-term effects on psychotropic medication sales were examined through interrupted time series analyses using quarterly data, conducted for each country and at overall level.</div></div><div><h3>Findings</h3><div>Globally, the total consumption of psychotropic medications increased from 34.12 DDD/TID in 2020 to 36.15 DDD/TID in 2022, corresponding to a relative average increase of 2.94% [95% CI 0.97, 4.94] annually. The estimated relative change during 2020–2022 were 1.82% [1.02, 2.64] in Lower-Middle-Income-Countries (LMICs), 6.77% [−0.39, 14.45] in Upper-Middle-Income-Countries (UMICs), and 2.48% [0.72, 4.27] in High-Income-Countries (HICs). Overall psychotropic consumption showed an initial surge in Q1 2020 (level change: 1.94 DDD/TID [1.67, 2.21]), followed by a rapid decline during Q2 2020 (level change: −1.03 [−1.52, −0.54]). Most HICs exhibited a similar pattern. Following the pandemic onset, there was an increasing trend in overall psychotropic consumption (trend change: 0.13 [0.07, 0.19]). 70 of 91 countries showed an increasing slope change.</div></div><div><h3>Interpretation</h3><div>Psychotropic medication consumption increased globally after the onset of the COVID-19 pandemic. During the pandemic, consumption rates in LMICs and UMICs appeared to slow down, however, patterns of change in psychotropic medication consumption following onset of the pandemic vary on a country level. To address these disparities, strategies for equitable psychotropic medication distribution and enhanced mental health care access in LMICs and UMICs are needed to improve global mental health.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101711"},"PeriodicalIF":8.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323452","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":"Cardiovascular complications in acute dengue infection: a population-based cohort study","authors":"Liang En Wee ,&nbsp;Wei Zhi Tan ,&nbsp;Jo Yi Chow ,&nbsp;Jue Tao Lim ,&nbsp;Calvin Chiew ,&nbsp;Po Ying Chia ,&nbsp;Lee Ching Ng ,&nbsp;Mohammed Rizwan Amanullah ,&nbsp;Jonathan Yap ,&nbsp;Khung Kheong Yeo ,&nbsp;Mark Yan Yee Chan ,&nbsp;Derek J. Hausenloy ,&nbsp;Yee Sin Leo ,&nbsp;David Chien Lye ,&nbsp;Kelvin Bryan Tan","doi":"10.1016/j.lanwpc.2025.101713","DOIUrl":"10.1016/j.lanwpc.2025.101713","url":null,"abstract":"<div><h3>Background</h3><div>Acute dengue-virus (DENV) infection, while associated with mild disease in most instances, is anecdotally associated with more severe cardiovascular complications. However, more accurate estimates of cardiac complications are required to evaluate the actual burden of dengue-associated morbidity, given significant contribution of cardiovascular events to overall morbidity and rising incidence of DENV-infection attributable to climate change.</div></div><div><h3>Methods</h3><div>A population-based cohort of DENV-infected Singaporean adults (2017–2023) and population-based controls (without DENV-infection) was constructed using the national-dengue-registry. Overlap weights were employed to balance baseline covariates. Logistic regression was used to estimate odds of cardiovascular events in DENV-infected cases versus uninfected controls up to 30 days from T₀ (notification-date in DENV-infected adults; randomly assigned in population-based controls following distribution of T₀ amongst DENV-infected cases).</div></div><div><h3>Findings</h3><div>65,207 DENV-infected cases and 1,616,865 uninfected controls were included. Higher odds of any cardiovascular event (adjusted-odds-ratio, aOR = 10.63 [95% CI = 7.56, 15.48]), major-adverse-cardiac-event (MACE) (aOR = 2.92 [95% CI = 1.81–4.88]), dysrhythmia (aOR = 18.44 [95% CI = 11.25 = 32.96]) and ischemic-heart-disease (aOR = 3.00 [95% CI = 1.83–5.15]) were observed up to 30 days post-DENV-infection, versus uninfected controls. Odds of acute cardiovascular events remained higher in both ambulatory/hospitalised DENV-infected cases, DENV-IgG-positive/negative cases, and across DENV1/2 and DENV3-predominant transmission, versus uninfected controls. However, overall excess burden (EB) of acute cardiovascular events in DENV-infected adults was modest, with &lt;1 excess event per-100-cases except amongst those aged ≥60 years (EB = 1.25 [95% CI = 1.05–1.44]).</div></div><div><h3>Interpretation</h3><div>Acute DENV-infection was associated with higher odds of cardiovascular events up to 30 days post-infection; though excess-burden was modest. Older adults at higher risk should be monitored for cardiac complications following acute DENV-infection.</div></div><div><h3>Funding</h3><div>National-Medical-Research-Council, Singapore.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101713"},"PeriodicalIF":8.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323444","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":"Digital technologies in enhancing hierarchical vision health management for the next 1000 days of children’s life: multi-component economic evaluation","authors":"Shanshan Jin ,&nbsp;Weiling Bai ,&nbsp;Mayinuer Yusufu ,&nbsp;Ruyue Li ,&nbsp;Kaiwen Zhang ,&nbsp;Fengju Zhang ,&nbsp;Li Li ,&nbsp;Haidong Zou ,&nbsp;Ningli Wang ,&nbsp;Hanruo Liu","doi":"10.1016/j.lanwpc.2025.101695","DOIUrl":"10.1016/j.lanwpc.2025.101695","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Visual impairment in the next 1000 days of children’s life presents heavy medical and economic burdens. It is urgent to bridge the gap between early intensive healthcare engagement and school-based services to ensure timely detection during the pre-disease period. Digital technologies have shown promise but lack for economic evidence interventions targeting early childhood. Thus, we proposed and evaluated the economic value of a full-process digital-empowered hierarchical vision management strategy (FDH strategy) for preschool-age children in China.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A decision-analytic Markov model was constructed to identify the cost-utility, cost-effectiveness and economic burdens among no intervention, traditional screening strategy, tele-screening strategy and FDH strategy for a hypothetical cohort which consists of 100,000 preschool children (3 years old). The parameters were obtained from published sources. Primary outcomes include incremental cost-utility ratios (ICURs), incremental cost-effectiveness ratios (ICERs), and net monetary benefit (NMB). ICURs were calculated using quality-adjusted life-years (QALYs), and ICERs using disability-adjusted life-years (DALYs). These outcomes were analyzed separately for rural and urban settings. Broad sensitivity analyses were performed to test the robustness of base-case analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Among all strategies evaluated, the FDH strategy was the most economically attractive option. It produced an ICUR of $780 (95% CI: 130–912) and an ICER of $5753 (95% CI: 1615–6894) in rural settings; it also exhibited had the lowest cost per QALY gained and per DALY averted in urban settings. Similarly, the FDH strategy had the highest NMB, with values increasing from $75 to $10,207 (rural) and $146 to $11,267 (urban) over the 15-year period. In rural areas, the FDH strategy reduced total myopia prevalence by 26.51%, high myopia by 15.35%, and combined strabismus, amblyopia and hyperopia by 12.6%. In urban areas, the corresponding reductions were 19.94%, 15.03%, and 5.97%. By further comparison, without LLM-based health promotion, costs were higher for achieving health benefits, which resulted in a cost increase of $146 per QALY gained and $2214 per DALY averted in rural settings; in urban settings, the increase was $273 per QALY gained and $1321 per DALY averted. All the above results were robust according to the sensitivity analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Multi-component health economics evaluations confirm the FDH strategy is highly cost-effective at a national level. This offers a valuable insight and economic rationale for promoting equitable, accessible, and sustainable eye health care during early childhood for countries with limited ophthalmic resources.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;This study was supported by grants from &lt;span&gt;National Natural Science Foundation of China&lt;/span&gt; (&lt;span&gt;&lt;span&gt;8217105","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101695"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268918","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":"China's revised infectious diseases law: a step towards stronger global pandemic preparedness","authors":"Yi Zhang ,&nbsp;Jialin Li ,&nbsp;Annemieke van den Dool","doi":"10.1016/j.lanwpc.2025.101708","DOIUrl":"10.1016/j.lanwpc.2025.101708","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101708"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269494","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":"Calcium supplementation and the risk of dementia in the Perth Longitudinal Study of Aging Women: a post-hoc analysis of a randomised clinical trial for fracture prevention","authors":"Negar Ghasemifard ,&nbsp;Joshua R. Lewis ,&nbsp;Simone Radavelli-Bagatini ,&nbsp;Simon M. Laws ,&nbsp;Blossom C.M. Stephan ,&nbsp;Jonathan M. Hodgson ,&nbsp;Kun Zhu ,&nbsp;Richard L. Prince ,&nbsp;Marc Sim","doi":"10.1016/j.lanwpc.2025.101694","DOIUrl":"10.1016/j.lanwpc.2025.101694","url":null,"abstract":"<div><h3>Background</h3><div>Concerns have been raised around whether calcium supplements increase dementia risk. This post-hoc analysis of a five-year double-blind, placebo-controlled randomised trial of calcium supplements for primary fracture prevention evaluated the long-term risk for dementia in older women, randomised to either calcium supplements or placebo.</div></div><div><h3>Methods</h3><div>1460 community-dwelling dementia-free Australian women (≥70 years) were randomised to 1200 mg/day calcium carbonate (n = 730) or placebo (n = 730) for five years and were observed for an additional 9.5 years afterwards. Over 14.5 years, all-cause dementia events (comprising dementia-related hospitalisations and/or deaths) were identified from linked health records. The influence of calcium supplementation on dementia outcomes were examined using Kaplan–Meier survival curves and Cox regression under intention-to-treat (ITT) and per-protocol (PP, ≥80% tablet compliance, n = 830; 50.6% calcium supplements) criteria.</div></div><div><h3>Findings</h3><div>Mean baseline age was 75.1 ± 2.7 years. Dementia events were recorded in 269 women (18.4%), comprising 243 hospitalisations (16.6%) or 114 deaths (7.8%). No differences in the cumulative dementia-free survival rates were observed between groups in ITT and PP analyses. Compared to placebo, calcium supplements did not increase risk of dementia-related events (unadjusted ITT hazard ratio [HR] 0.90, 95% confidence interval (CI) 0.71–1.15), hospitalisations (HR 0.89, 95% CI 0.69–1.15) or deaths (HR 0.78, 95% CI 0.54–1.13). Similar results were observed in PP analyses.</div></div><div><h3>Interpretation</h3><div>Calcium supplementation for five years did not increase the risk of all-cause dementia events over 14.5 years in community-dwelling older women. Findings do not support concerns that calcium supplementation increases long-term risk of dementia.</div></div><div><h3>Funding</h3><div><span>National Health and Medical Research Council of Australia</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101694"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417069","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":"Trends of lipid-lowering drug utilization, treatment intensity and LDL-C target attainment in adults with diabetes and non-dialysis chronic kidney disease in Hong Kong","authors":"Yanting Huang ,&nbsp;Aimin Yang ,&nbsp;Mai Shi ,&nbsp;Jiazhou Yu ,&nbsp;Hongjiang Wu ,&nbsp;Juliana N.M. Lui ,&nbsp;Alice P.S. Kong ,&nbsp;Ronald C.W. Ma ,&nbsp;Andrea O.Y. Luk ,&nbsp;Calvin Ke ,&nbsp;Juliana C.N. Chan ,&nbsp;Elaine Chow","doi":"10.1016/j.lanwpc.2025.101696","DOIUrl":"10.1016/j.lanwpc.2025.101696","url":null,"abstract":"<div><h3>Background</h3><div>With evolving treatment targets, concerns over renal safety for some statins and new lipid-lowering drugs (LLDs), we aimed to evaluate the trends of statins and non-statin LLDs [ezetimibe, and proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i)] utilization in individuals with diabetes and non-dialysis chronic kidney disease (CKD) in Hong Kong.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 332,975 Chinese individuals with diabetes and non-dialysis CKD using data from Hong Kong Hospital Authority in 2002–2019. We analyzed the annual average dosage, treatment intensity (low-intensity: &lt;30% Low density lipoprotein-cholesterol (LDL-C) reduction; moderate-intensity: 30%–49%; high-intensity: ≥50%) and attained LDL-C targets defined by annual average LDL-C value. We evaluated the age-sex standardized trends of statin and common non-statin LLD use for primary and secondary prevention across age, sex and CKD stages.</div></div><div><h3>Findings</h3><div>Statin-users increased from 17.6% in 2002 to 71.3% in 2019 with similar trends across age, sex and CKD stages G3–5 except for the 18–49 age group having the highest proportion of non-users of LLD (39%). By 2019, the usage of ezetimibe (1.19%) and PCSK9i (0.01%) remained low. Amongst statin-users, 27.2% received moderate-intensity therapy for primary prevention and 11.2% received high-intensity therapy for secondary prevention. In 2019, 33.3% of LLD-users achieved LDL-C &lt; 1.8 mmol/L for primary prevention and 21.3% achieved LDL-C &lt; 1.4 mmol/L for secondary prevention.</div></div><div><h3>Interpretation</h3><div>Despite the increasing use of statins, treatment gaps remain with respect to treatment intensity and LDL-C target attainment in diabetes and non-dialysis CKD calling for increased use of combination statin and ezetimibe or PCSK9i to close the treatment gaps.</div></div><div><h3>Funding</h3><div>Dr. Aimin Yang was supported by a <span>CUHK Impact Research Fellowship Scheme</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101696"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222339","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":"‘Playing to extinction’: the commercial determinants of gambling-related harm, suicidality and suicide","authors":"Angela Rintoul ,&nbsp;Suzanne McLaren ,&nbsp;Kerrie Shandley ,&nbsp;Britt Klein","doi":"10.1016/j.lanwpc.2025.101685","DOIUrl":"10.1016/j.lanwpc.2025.101685","url":null,"abstract":"<div><div>This paper presents a model of the commercial determinants of health in the context of gambling-related harm, suicidality and suicide. It outlines the ways the gambling ecosystem undermines suicide prevention efforts by driving harmful engagement with gambling. Using the dominant, orthodox discourse of ‘responsible gambling’, the ecosystem relies on the effects of addiction to underpin, sustain, and grow its power. Attempts to introduce effective interventions to prevent gambling-related harms are often blocked by the gambling ecosystem actors, using an evidence base that is biased by its focus on individual level causation and the attendant ‘responsible gambling’ responses. This emphasis on individual responsibility diverts attention from the practices of the industry, generates stigma and shame for those harmed, downplays serious harms caused by gambling, and contributes to the suicide toll. As most gambling activity is unrecorded, and systems for monitoring harms are underdeveloped, the true extent of these consequences have been largely invisible. This makes it more difficult to hold governments to account to regulate and prevent gambling-related harms, including suicidality and suicide. With growing evidence of harms linked to gambling, including suicide and increasing public concern, we present measures that could be adopted to disrupt these determinants and improve accountability to prevent harms and save lives.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101685"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417065","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 heterogeneity in the association between social isolation and all-cause mortality among Japanese older adults: JAGES longitudinal panel study","authors":"Frances Rom Lunar ,&nbsp;Naoki Kondo ,&nbsp;Yukiko Honda ,&nbsp;Atsushi Nakagomi ,&nbsp;Toshiaki Komura ,&nbsp;Kosuke Inoue ,&nbsp;Koichiro Shiba","doi":"10.1016/j.lanwpc.2025.101691","DOIUrl":"10.1016/j.lanwpc.2025.101691","url":null,"abstract":"<div><h3>Background</h3><div>Social isolation has been linked to higher mortality; however, it remains unknown how this association varies across individuals and social groups.</div></div><div><h3>Methods</h3><div>We used a nationwide cohort study of ∼20,000 older adults with a 9·4-year follow-up period (Japan Gerontological Evaluation Study, 2013–2022), adjusting for 60 pre-baseline covariates. We also used a national insurance database to ascertain 4299 all-cause deaths. Using a causal machine-learning method, we estimated the heterogeneous association between social isolation and mortality.</div></div><div><h3>Findings</h3><div>Social isolation was more prevalent among those with lower education and income and associated on average with 69·5-day shorter survival time (restricted mean survival time [RMST] difference; 95% CI: −111, −28·4). There was evidence of heterogeneity where social isolation was associated with even shorter survival days in some subgroups (e.g., −205 days among the bottom quintile of the estimated RMST differences [95% CI: −321, −87·8]). These subgroups tended to be older, men, and have lower education. The adverse association of social isolation and mortality was particularly stronger when lower education was combined with higher income, especially among women. Individuals with lower levels of education accounted for a larger share of deaths attributable to social isolation (58·5% of excess deaths).</div></div><div><h3>Interpretation</h3><div>Social isolation may be more harmful among those from socially disadvantaged backgrounds, and a combination of some characteristics can synergistically amplify its effects on mortality. Proper population-level interventions informed with the evidence of effect heterogeneity might not only improve health on average but also mitigate existing health disparities.</div></div><div><h3>Funding</h3><div><span>Japan Society for the Promotion of Science</span>, <span>Health Labour Sciences Research Grants</span>, <span>Research Funding for Longevity Sciences from the National Center for Geriatrics and Gerontology</span>, Research Institute of Science and Technology from the <span>Japan Science and Technology</span>, <span>Japan Health Promotion &amp; Fitness Foundation</span>, <span>Department of Active Ageing</span>, <span>Niigata University Graduate School of Medical and Dental Sciences</span>, Tokyo Medical and Dental University Priority Research Areas Grant and National Research Institute for Earth Science and Disaster Resilience.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101691"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222434","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 World Health Organization (WHO) Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) reports continuously high levels of ceftriaxone resistance across Viet Nam, 2024","authors":"Pham Thi Lan ,&nbsp;Thuy Thi Phan Nguyen ,&nbsp;Vu Tuan Anh ,&nbsp;Daniel Golparian ,&nbsp;Nguyen Thi Thuy Van ,&nbsp;Ismael Maatouk ,&nbsp;Magnus Unemo","doi":"10.1016/j.lanwpc.2025.101709","DOIUrl":"10.1016/j.lanwpc.2025.101709","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"63 ","pages":"Article 101709"},"PeriodicalIF":8.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268916","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}