Asia-Pacific Journal of Public Health最新文献

This study investigated the association of COVID-19 booster vaccine hesitancy with health literacy (HL) and the number of information sources used in Japan. Using data from a longitudinal survey of 6601 vaccinated participants, multivariable logistic regression was used to estimate adjusted odds ratios (AORs). Of the participants, 6.6% were hesitant toward the booster. Higher HL was associated with lower odds of hesitancy (AOR = 0.85, 95% CI = 0.77-0.94). Of its subscales, communicative (AOR = 0.86, 95% CI = 0.79-0.95) and critical (AOR = 0.90, 95% CI = 0.83-0.99) literacy were significantly associated with lower hesitancy, but functional literacy was not. Using more diverse information sources (>3 vs. ≤3) was also associated with lower hesitancy (AOR = 0.70, 95% CI = 0.57-0.87). Higher communicative and critical HL and the use of diverse information sources were associated with lower booster hesitancy. Enhancing these capabilities may be a key strategy for increasing vaccination rates.

Micronutrient sufficiency is essential for health, yet many Chinese adults fall short of recommended intake levels. Using data from 12 382 adults in the China Health and Nutrition Survey, this study examined the prevalence of micronutrient sufficiency-defined by 2023 Dietary Reference Intakes for six vitamins and seven minerals-and its associations with subjective well-being (SWB), health care costs, and mortality. Only 10% of adults met sufficiency criteria. Sufficient intake was associated with higher odds of life satisfaction (OR = 1.12, 95% CI [1.02, 1.24], P < .05), with stronger effects in women (OR = 1.16, 95% CI [1.02, 1.32]) and those aged 40 to 49 (OR = 1.44, 95% CI [1.15, 1.79]). No significant association was found with mortality (HR = 1.02, 95% CI [0.75, 1.38]). However, sufficiency was linked to a 7% annual reduction in health care costs (-140.4 Yuan), largely mediated by improved SWB. These results highlight the low prevalence of adequate micronutrient intake and suggest potential benefits for mental well-being and health care savings, supporting the need for targeted nutrition policies in China.

Undergraduate public health programs have expanded in Asia, yet little is known about how national contexts shape curriculum design and workforce preparation. This study compares the undergraduate public health curricula of Taiwan and Vietnam to examine how governance structures, health system priorities, and workforce needs influence educational models. A comparative curriculum analysis was conducted using official program documents, supported by interviews with senior faculty to contextualize policy and institutional factors. Courses were categorized into major domains to assess required and elective distributions, thematic emphases, specialization pathways, and internship structures. Taiwan's curriculum emphasizes flexibility and specialization, with extensive electives and strong representation in environmental and occupational health, epidemiology, and quantitative analysis, alongside pathways linked to professional certification. Vietnam's curriculum is standardized and community-oriented, emphasizing foundational medical sciences, communicable disease control, health promotion, and sequenced community-based internships that reflect its vertically organized preventive health system. Differences in experiential learning and credentialing opportunities further distinguish workforce preparation in the two countries. The findings show that curriculum architecture mirrors broader national development priorities and system capacities. The study underscores the importance of competency-based and context-responsive curriculum reform and provides insights for strengthening public health workforce readiness across the Asia-Pacific region.

Measles remain endemic in Pakistan despite global vaccine efforts to prevent its transmission. This study sought to identify the patterns of measles cases in Pakistan, understand the reasons for its recurrence, and determine the optimal timing for measles vaccine campaigns in Pakistan to be most effective. As such, a time series analysis of the monthly measles incidence in Pakistan from 2014 to 2024, obtained from World Health Organization's international measles database, was performed to identify temporal patterns in infections. An increasing trend was identified in the monthly measles cases overtime, along with seasonal swings of low occurrences during the summer, with average lows reaching 304 cases, and a rise during the winter months, with average highs reaching 1038 cases. An automated SARIMA model was further applied to forecast the future incidence of measles, which revealed a three-fold increase in measles cases in the next 2 years, compared with 2023-2024. Low routine vaccine coverage, topped with climate change related migration and subsequent crowding in urban spaces were found to be major contributors to measles transmission in the country. Findings suggest that supplementary vaccination campaigns are essential and if held in August-September, can mitigate the anticipated rise in measles transmission beginning October every year.

Southeast Asia plays a vital role in the global alcohol trade, with rapid economic growth and increasing intra-regional travel contributing to shifts in alcohol consumption. This descriptive review of publicly available data sources aims to assess the extent to which alcohol control policies in Southeast Asia align with the World Health Organization (WHO)'s SAFER framework. Data on alcohol consumption, gross domestic product (GDP) per capita, religious demographics, and life expectancy were obtained from recent publicly available sources, including the World Bank Group and the WHO. Policy data were collected from official legal documents in each country's official language(s). Measures targeting drink-driving, alcohol availability, and alcohol advertising were most frequently implemented. All countries had some form of alcohol taxation, although levels and structures varied. Treatment services for alcohol use disorders were seldom available. The findings highlight key policy gaps and regional disparities in alcohol regulation. These insights may guide policymakers and stakeholders in developing more effective and harmonized alcohol control strategies. Limitations of the review include the lack of detailed data on policy enforcement and the exclusion of alcohol-related policies not covered by the SAFER framework.

Mother-to-child transmission (MTCT) is a primary source of hepatitis B virus (HBV) infection in endemic regions. The World Health Organization (WHO) aims to reduce HBV seroprevalence among children under five to less than 0.1% by 2030. In Malaysia, the seroprevalence of hepatitis B surface antigen (HBsAg) in children has declined to 0.4%, but additional measures are needed. A pilot study in Sarawak, Malaysia, screened 474 pregnant women for HBsAg. Those with high MTCT risk received tenofovir disoproxil fumarate from 28 weeks of gestation to 12 weeks postpartum. Infants received timely birth-dose HBV vaccine and hepatitis B immunoglobulin (HBIG) where indicated. Among screened women, 1.9% were HBsAg positive, with 55.6% newly diagnosed. No MTCT cases were observed. Risk factors included maternal age over 35, household exposure, and sexual transmission risk. These findings demonstrate the feasibility of WHO's PMTCT strategies in low-resource settings, supporting nationwide expansion in Malaysia.

Occupational stress among public transport workers, particularly bus conductors, remains underexplored in literature. This cross-sectional study included 524 Sri Lanka Transport Board bus conductors in the Colombo District of Sri Lanka. A culturally adapted effort-reward imbalance (ERI) questionnaire was used to assess stress. Cluster sampling was employed, and Cronbach α was used to indicate reliability. Chi-square tests were used to analyze depot-level variations, and multivariate regression was used to identify stress determinants. The prevalence of occupational stress was 48.3%, with significant depot-level differences (P < 0.05). Older workers (>40 years) and nonsmokers had significantly lower stress levels, whereas irregular meal patterns (adjusted odds ratio [aOR] = 2.24, increased awareness of duty responsibilities (aOR = 4.59) and external challenges (threats) (aOR = 3.49) were significantly associated with increased stress. Systemic ERIs, exacerbated by psychosocial strain and hazardous conditions, emphasize vulnerabilities in conductor roles. Policy interventions should prioritize workplace health promotion programs that integrate stress management and ergonomic enhancement. In the medium term, automated ticketing and passenger conduct regulations can be implemented. In the long term, fair salary revisions and public recognition should be established to sustain the workforce's motivation.

This systematic review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, aimed to synthesize evidence on the effect of contracting the management of primary health care (PHC) services on utilization, coverage, quality of care, and equity in low- and lower-middle-income countries. Published research and gray literature were searched using PubMed, Ovid Medline, and Google Scholar with relevant keywords. Outcome indicators included overall utilization or coverage for any sickness, maternal care, child care, quality of care, and equitable utilization. Meta-analysis was performed using STATA to calculate pooled estimates of percentage differences in outcomes. A total of 47 137 titles were screened, of which 18 studies met the final inclusion criteria. The review found that PHC contracting significantly increased utilization of PHC services for any sickness by 17%, facility deliveries by 19%, and family planning services by 12%. No significant effect was observed for community antenatal care or skilled birth attendance. Positive effects were also seen for patient satisfaction, while equitable utilization of services showed mixed results. Overall, contracting demonstrated benefits in improving service utilization, coverage, quality of care, and equity. However, assessments that are more rigorous are needed to strengthen the quality of evidence.

The Council of Indigenous Peoples in Taiwan has established tribal-based Cultural Health Stations offering basic health services and social activities for Indigenous communities. However, little is known about the factors influencing participation. This pilot study examined the reasons for attendance among older adults from five Paiwan communities in eastern Taiwan. A structured questionnaire, informed by Andersen's Behavioral Model of Health Services Use and shaped through community consensus, was administered to 211 elders, 77 of whom were attending Cultural Health Stations. Participants who attended were generally older, female, living alone, not engaged in paid work or farming, and reported positive perceptions of the activities. Common reasons for non-attendance included time constraints, preference for alternative social settings, and dissatisfaction with the programs. Multivariable logistic regression analysis revealed that being aged 75 years or older, living alone, and reporting a higher self-rated ability to manage health issues were positively associated with attendance. In contrast, having paid employment was negatively associated. Findings from the open-ended questions suggested attendees appreciated services and activities but requested more cultural content. Non-attendees expressed that activities should be inclusive of different age groups and ability levels, culturally connected to local communities, and mindful that many elders still need to work. These findings highlight the importance of incorporating elders' perspectives in the planning and evaluation of community-based services and may inform policy improvements for Indigenous elder care in Taiwan. However, it is also necessary to consider the economic circumstances of elders, design culturally centered activities, and respond to their interest in courses related to cultural transmission to ensure services are both accessible and meaningful.