Displaying publications 441 - 460 of 9183 in total

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  1. Rampal L, Liew BS, Choolani M, Shorey S
    Med J Malaysia, 2023 Nov;78(6):689-695.
    PMID: 38031208
    This paper provides a comprehensive analysis of Southeast Asian countries' responses to the COVID-19 pandemic, particularly focusing on Malaysia, Singapore, Thailand, the Philippines, Indonesia, and Myanmar. The primary objective is to explore how the pandemic has evolved in these nations, how the respective healthcare delivery systems responded, and the current COVID-19 status within each country. It presents epidemiological trends and governmental strategies adopted in combating the pandemic. The paper also outlines lessons learned and future challenges, highlighting key areas like global health diplomacy, the need for collaboration, clear government agency communication, and a stance against social discrimination. It culminates in an assessment of the postpandemic landscape, discussing the transformation of public health policies and the socio-economic implications of pandemic management.
    Matched MeSH terms: Asia, Southeastern/epidemiology; Malaysia/epidemiology
  2. Wong QYA, Lim JJ, Ng JY, Lim YYE, Sio YY, Chew FT
    J Physiol Anthropol, 2024 Jan 30;43(1):6.
    PMID: 38291494 DOI: 10.1186/s40101-024-00356-5
    BACKGROUND AND OBJECTIVE: Sleep disruption has been shown to affect immune function and thus influence allergic disease manifestation. The specific effects of sleep on allergic diseases, however, are less well-established; hence, in a unique population of young Chinese adults, we investigated the association between sleep and allergic disease.

    METHODS: Young Chinese adults recruited from Singapore in the Singapore/Malaysia Cross-Sectional Genetic Epidemiology Study (SMCGES) were analyzed. We used the International Study of Asthma and Allergies in Childhood (ISAAC) protocol and a skin prick test to determine atopic dermatitis (AD), allergic rhinitis (AR), and asthma status. Information regarding total sleep time (TST) and sleep quality (SQ) was also obtained.

    RESULTS: Of 1558 participants with a mean age of 25.0 years (SD = 7.6), 61.4% were female, and the mean total sleep time (TST) was 6.8 h (SD = 1.1). The proportions of AD, AR, and asthma were 24.5% (393/1542), 36.4% (987/1551), and 14.7% (227/1547), respectively. 59.8% (235/393) of AD cases suffered from AD-related sleep disturbances, 37.1% (209/564) of AR cases suffered from AR-related sleep disturbances, and 25.1% (57/227) of asthma cases suffered from asthma-related sleep disturbances. Only asthma cases showed a significantly lower mean TST than those without asthma (p = 0.015). Longer TST was significantly associated with lower odds of AR (OR = 0.905, 95% CI = 0.820-0.999) and asthma (OR = 0.852, 95% CI = 0.746-0.972). Linear regression analyses showed that lower TST was significantly associated with asthma (β =  - 0.18, SE = 0.076, p-value = 0.017), and AR when adjusted for AR-related sleep disturbances (β =  - 0.157, SE = 0.065, p-value = 0.016). Only sleep disturbances due to AR were significantly associated with a poorer SQ (OR = 1.962, 95% CI = 1.245-3.089).

    CONCLUSIONS: We found that sleep quality, but not sleep duration was significantly poorer among AD cases, although the exact direction of influence could not be determined. In consideration of the literature coupled with our findings, we posit that TST influences allergic rhinitis rather than vice versa. Finally, the association between TST and asthma is likely mediated by asthma-related sleep disturbances, since mean TST was significantly lower among those with nighttime asthma symptoms. Future studies could consider using objective sleep measurements coupled with differential expression analysis to investigate the pathophysiology of sleep and allergic diseases.

    Matched MeSH terms: Singapore/epidemiology; Molecular Epidemiology
  3. Salari N, Hasheminezhad R, Sedighi T, Zarei H, Shohaimi S, Mohammadi M
    BMC Womens Health, 2023 Jul 15;23(1):375.
    PMID: 37454073 DOI: 10.1186/s12905-023-02544-4
    BACKGROUND: Obesity is a pressing public health risk issue worldwide. Women, in particular, face a higher risk of obesity. Recent research has highlighted the association between obesity and female sexual dysfunction. Therefore, the objective of this study is to investigate the global prevalence of sexual dysfunction in obese and overweight women through a systematic review and meta-analysis.

    METHODS: In this study, a systematic search was conducted across electronic databases, including PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar. The search aimed to identify studies published between December 2000 and August 2022 that reported metabolic syndrome's impact on female sexual dysfunction.

    RESULTS: The review included nine studies with a sample size of 1508 obese women. The I2 heterogeneity index indicated high heterogeneity (I2: 97.5). As a result, the random effects method was used to analyze the data. Based on this meta-analysis, the prevalence of sexual dysfunction in women with obesity was reported as 49.7% (95%CI: 35.8-63.5). Furthermore, the review comprised five studies involving 1411 overweight women. The I2 heterogeneity test demonstrated high heterogeneity (I2: 96.6). Consequently, the random effects model was used to analyze the results. According to the meta-analysis, the prevalence of sexual dysfunction in overweight women was 26.9% (95% CI: 13.5-46.5).

    CONCLUSION: Based on the results of this study, it has been reported that being overweight and particularly obese is an important factor affecting women's sexual dysfunction. Therefore, health policymakers must acknowledge the significance of this issue in order to raise awareness in society about its detrimental effect on the female population.

    Matched MeSH terms: Obesity/epidemiology; Overweight/epidemiology
  4. Mohd Radi MF, Hashim JH, Jaafar MH, Hod R, Ahmad N, Mohammed Nawi A, et al.
    Am J Trop Med Hyg, 2018 05;98(5):1281-1295.
    PMID: 29532771 DOI: 10.4269/ajtmh.16-0922
    Severe floods increase the risk of leptospirosis outbreaks in endemic areas. This study determines the spatial-temporal distribution of leptospirosis in relation to environmental factors after a major flooding event in Kelantan, Malaysia. We conducted an observational ecological study involving incident leptospirosis cases, from the 3 months before, during, and three months after flood, in reference to the severe 2014 Kelantan flooding event. Geographical information system was used to determine the spatial distribution while climatic factors that influenced the cases were also analyzed. A total of 1,229 leptospirosis cases were notified within the three study periods where incidence doubled in the postflood period. Twelve of 66 subdistricts recorded incidence rates of over 100 per 100,000 population in the postflood period, in comparison with only four subdistricts in the preflooding period. Average nearest neighborhood analysis indicated that the cases were more clustered in the postflood period as compared with the preflood period, with observed mean distance of 1,139 meters and 1,666 meters, respectively (both at P < 0.01). Global Moran's I was higher in the postflood period (0.19; P < 0.01) as compared with the preflood period (0.06; P < 0.01). Geographic weighted regression showed that living close to water bodies increased the risk of contracting the disease. Postflooding hotspots were concentrated in areas where garbage cleanup occurred and the incidence was significantly associated with temperature, humidity, rainfall, and river levels. Postflooding leptospirosis outbreak was associated with several factors. Understanding the spatial distribution and associated factors of leptospirosis can help improve future disease outbreak management after the floods.
    Matched MeSH terms: Leptospirosis/epidemiology*; Malaysia/epidemiology
  5. Abdul Kadir R, Adnan NM
    Odontostomatol Trop, 1989 Mar;12(1):7-11.
    PMID: 2631083
    A preliminary survey on sixty-nine 7 to 12 year old Temuan tribe school children living some 30 kilometers from Kuala Lumpur was conducted. The examinations were carried out using a chair-table set up with natural daylight as the source of light. The DMF index of klein, Palmer and Knutson was used to assess the dental caries status. In spite of low fluoride content in their water supply, the findings revealed a generally low prevalence of caries experience (DMFT 1.26). The highest DMFT was in the 11 year olds. The relationship between these findings and their possible causes are discussed.
    Matched MeSH terms: Dental Caries/epidemiology*; Malaysia/epidemiology
  6. Ngui R, Lim YA, Amir NF, Nissapatorn V, Mahmud R
    Am J Trop Med Hyg, 2011 Oct;85(4):660-6.
    PMID: 21976569 DOI: 10.4269/ajtmh.2011.11-0058
    This study aims to evaluate the current seroprevalence of toxoplasmosis among indigenous communities in Peninsular Malaysia and relate its association with epidemiological data. Overall seroprevalence of Toxoplasma gondii was 37.0% with 31.0% immunoglobulin (Ig) G, 1.8% IgM, and 4.2% seropositivity for both anti-Toxoplasma antibodies. Multivariate analysis showed that age above 12 years (odds ratio [OR] = 2.70, 95% confidence interval [CI] = 1.75-4.04, P < 0.001), using untreated river and mountain water supplies (OR = 1.50, 95% CI = 1.01-2.40, P = 0.050), and close proximity with cats (OR = 1.40, 95% CI = 1.10-1.76, P = 0.010) were factors associated with toxoplasmosis. Given the high seroprevalence of toxoplasmosis among these communities who live in poor socioeconomic conditions, a comprehensive health surveillance program and screening should be initiated among women of childbearing age and pregnant women during the antenatal period for early diagnosis and treatment. The role of domestic cats and environmental contamination with oocyst in soil and water has to be highlighted and addressed in future prevention strategies for these communities.
    Matched MeSH terms: Malaysia/epidemiology; Toxoplasmosis/epidemiology*
  7. Shepard DS, Undurraga EA, Lees RS, Halasa Y, Lum LCS, Ng CW
    Am J Trop Med Hyg, 2012 Nov;87(5):796-805.
    PMID: 23033404 DOI: 10.4269/ajtmh.2012.12-0019
    Dengue represents a substantial burden in many tropical and sub-tropical regions of the world. We estimated the economic burden of dengue illness in Malaysia. Information about economic burden is needed for setting health policy priorities, but accurate estimation is difficult because of incomplete data. We overcame this limitation by merging multiple data sources to refine our estimates, including an extensive literature review, discussion with experts, review of data from health and surveillance systems, and implementation of a Delphi process. Because Malaysia has a passive surveillance system, the number of dengue cases is under-reported. Using an adjusted estimate of total dengue cases, we estimated an economic burden of dengue illness of US$56 million (Malaysian Ringgit MYR196 million) per year, which is approximately US$2.03 (Malaysian Ringgit 7.14) per capita. The overall economic burden of dengue would be even higher if we included costs associated with dengue prevention and control, dengue surveillance, and long-term sequelae of dengue.
    Matched MeSH terms: Dengue/epidemiology*; Malaysia/epidemiology
  8. Binns C, Low WY
    Asia Pac J Public Health, 2021 05;33(4):333-334.
    PMID: 33938291 DOI: 10.1177/10105395211012844
    Matched MeSH terms: Asia/epidemiology; Pacific Islands/epidemiology
  9. Ngan OMY, Sanip S
    Asia Pac J Public Health, 2021 11;33(8):983-984.
    PMID: 34243675 DOI: 10.1177/10105395211031367
    Matched MeSH terms: Hong Kong/epidemiology; Malaysia/epidemiology
  10. Walker JD, Spiro G, Loewen K, Jacklin K
    J Alzheimers Dis, 2020;78(4):1439-1451.
    PMID: 33185601 DOI: 10.3233/JAD-200704
    BACKGROUND: There remains a lack of information and understanding of the prevalence and incidence of Alzheimer's disease and related dementia in Indigenous populations. Little evidence available suggests that Indigenous peoples may have disproportionately high rates of Alzheimer's disease and related dementia (ADRD).

    OBJECTIVE: Given this information, this study systematically explores what risk factors may be associated with ADRD in Indigenous populations.

    METHODS: A search of all published literature was conducted in October 2016, March 2018, and July 2019 using Medline, Embase, and PsychINFO. Subject headings explored were inclusive of all terms related to Indigenous persons, dementia, and risk. All relevant words, phrases, and combinations were used. To be included in this systematic review, articles had to display an association of a risk factor and ADRD. Only studies that reported a quantifiable measure of risk, involved human subjects, and were published in English were included.

    RESULTS: Of 237 articles originally identified through database searches, 45 were duplicates and 179 did not meet a priori inclusion criteria, resulting in 13 studies eligible for inclusion in this systematic review.

    CONCLUSION: The large number of potentially modifiable risk factors reported relative to non-modifiable risk factors illustrates the importance of socioeconomic context in the pathogenesis of ADRD in Indigenous populations. The tendency to prioritize genetic over social explanations when encountering disproportionately high disease rates in Indigenous populations can distract from modifiable proximal, intermediate, and distal determinants of health.

    Matched MeSH terms: Australia/epidemiology; Canada/epidemiology; Cardiovascular Diseases/epidemiology; Diabetes Mellitus/epidemiology; Epilepsy/epidemiology; Guam/epidemiology; Craniocerebral Trauma/epidemiology; Hypertension/epidemiology; Malaysia/epidemiology; Obesity/epidemiology; Smoking/epidemiology
  11. Azami MM, Pauzi NAS, Hamdan N, Sidik MR, Tulis AN, Hassan R, et al.
    Vet Res Commun, 2025 Jan 15;49(2):77.
    PMID: 39809923 DOI: 10.1007/s11259-025-10645-8
    African swine fever (ASF), a severe and highly contagious haemorrhagic viral disease of pigs, is becoming a major threat not only in Malaysia but around the world. The first confirmed case of ASF in Malaysia was reported in February 2021. Despite the emergence of ASF in Malaysia, genetic information on this causative pathogen for the local livestock is still limited. This study aimed to genetically characterize the African swine fever virus (ASFV) responsible for the 2021 outbreak in Malaysia. The genome of the ASFV isolated during the first outbreak in Malaysia was analysed as ASFV/Sabah/Malaysia/1160/21 which has 190,594 base pairs, with a nitrogenous bases (GC) content of 40.33% and 195 predicted Open Reading Frames (ORF). The complete genome sequence was compared with other annotated ASFV genomes retrieved from database of National Center for Biotechnology Information (NCBI) to obtain information based on target gene B646L, E183L, intergenic region (IGR) between I73R and I329L (IGRI73R-I329L), EP402R and B602L. The ASFV/Sabah/Malaysia/1160/21 genome had a high similarity percentage to the reference genome, Georgia 2007 and all Southeast Asian strains. Phylogenetic analysis revealed that the ASFV strain belonged to genotype II, serogroup 8, CVR1 and showed high characteristics of IGR variant II based on IGRI73R-I329L. This study expands our understanding of genetic diversity and provides significant insights into the genomic characteristics and variation of ASFV strains that are circulating in Malaysia.
    Matched MeSH terms: Borneo/epidemiology; Malaysia/epidemiology
  12. Sethi N, Narayanan V, Saaid R, Ahmad Adlan AS, Ngoi ST, Teh CSJ, et al.
    BMC Pregnancy Childbirth, 2025 Jan 20;25(1):40.
    PMID: 39833700 DOI: 10.1186/s12884-025-07144-8
    INTRODUCTION: Bacterial vaginosis (BV) is one of the most common genital tract infections among women of reproductive age. The existence of BV among pregnant women has momentously attracted the attention of both clinicians and the scientific community due to its potential link with adverse clinical outcomes in pregnancy.

    METHODS: To evaluate the prevalence, risk factors, and adverse outcomes of bacterial vaginosis among pregnant women, a comprehensive systematic review was conducted based on the preferred reporting items for systematic review and meta-analyses (PRISMA) criteria. PubMed, ScienceDirect, ClinicalTrials.gov and Cochrane database searches were conducted independently by two authors until May 13th, 2023.

    RESULTS: The search strategies yielded a total of 2237 records; among them, 12 studies met the inclusion criteria and were included in the qualitative synthesis. Majority of the included studies demonstrated a high prevalence of BV among African women. The risk of developing BV during pregnancy was highest among women with multiple sexual partners. Additionally, factors including age, socioeconomic status, unhygienic practices, ethnicity, 2nd trimester, spontaneous abortion, vaginal douching, symptoms, and history of sexually transmitted infections (STIs) were also associated with a higher prevalence of BV. Overall, 7 studies reported adverse outcomes during pregnancy which was directly associated with BV. Based on the review, it was found that PROM, PTB, and LBW were the most frequently reported adverse outcomes in pregnant women with BV.

    CONCLUSION: In summary, the high prevalence of bacterial vaginosis necessitates a global surveillance approach to delineate the health risks imposed on both mother and child, and promote cost-effective strategic measures to alleviate the undesired consequences of BV during pregnancy.

    Matched MeSH terms: Pregnancy Outcome/epidemiology; Premature Birth/epidemiology
  13. Liam CK, Ng SC
    Ann Acad Med Singap, 1990 Nov;19(6):837-40.
    PMID: 2130750
    In this retrospective study, 81 patients were diagnosed to have deep vein thrombosis (DVT) at the University Hospital, Kuala Lumpur over a ten year period from 1977 to 1986. Fifty-six patients had their DVT confirmed by venograms. The left side was affected in 79.5% of venographically proven cases of DVT of the lower limbs above the popliteal vein. The incidence of clinically apparent DVT following surgery was 0.21 per 1,000 operations. The incidence of pregnancy-related DVT was 0.039%. DVT was 3 times more frequent in the puerperium than in the antenatal period. The overall incidence of symptomatic pulmonary embolism was 13.6% of the cases of DVT.
    Matched MeSH terms: Malaysia/epidemiology; Thrombosis/epidemiology
  14. Bhore SJ
    Cien Saude Colet, 2020 Nov;25(11):4347-4350.
    PMID: 33175043 DOI: 10.1590/1413-812320202511.33622018
    On 31st May of every year, in honour of the 'World No Tobacco Day (WNTD),' the international community does organise various events and encourages avoiding all forms of Tobacco consumption. To commemorate WNTD-2018, the World Health Organization (WHO) has promoted awareness to highlight the link between Tobacco and cardiovascular disease (CVD). Because, Tobacco use is the second leading cause of CVD, after high blood pressure. In addition to CVD, Tobacco use is also known to cause many non-communicable diseases, including chronic obstructive pulmonary disease (COPD), lung cancer and other complicated disorders caused by smoking. In fact, non-communicable diseases are now emerging as the primary disease burden. Globally, Tobacco use kills about 7 million people each year, and if the trend remains the same, then it will kill more than 8 million people per year by 2030. On the contrary, despite promoting awareness, the Tobacco industry is growing with little or no regulation. However, in the long run, the global community will not be able to afford business as usual as Tobacco has a direct impact on human health, environmental health and sustainable development.
    Matched MeSH terms: Smoking/epidemiology; Tobacco Use/epidemiology
  15. Wartel TA, Prayitno A, Hadinegoro SR, Capeding MR, Thisyakorn U, Tran NH, et al.
    Asia Pac J Public Health, 2017 Jan;29(1):7-16.
    PMID: 28198645 DOI: 10.1177/1010539516675701
    We described and quantified epidemiologic trends in dengue disease burden in 5 Asian countries (Indonesia, Thailand, Malaysia, Philippines, and Vietnam) and identified and estimated outbreaks impact over the last 3 decades. Dengue surveillance data from 1980 to 2010 were retrieved from DengueNet and from World Health Organization sources. Trends in incidence, mortality, and case fatality rate (CFR) were systematically analyzed using annual average percent change (AAPC), and the contribution of epidemic years identified over the observation period was quantified. Over the 30-year period, incidence increased in all countries (AAPC 1980-2010: 6.7% in Thailand, 10.4% in Vietnam, 12.0% in Indonesia, 18.1% in Malaysia, 24.4% in Philippines). Mortality also increased in Indonesia, Malaysia, and Philippines (AAPC: 6.8%, 7.0%, and 29.2%, respectively), but slightly decreased in Thailand and Vietnam (AAPC: -1.3% and -2.5%), and CFR decreased in all countries (AAPC: -4.2% to -8.3%). Epidemic years, despite representing less than a third of the observation period, contributed from 1 to 3 times more cases versus nonepidemic years. Implementation of more sensitive surveillance methods over the study period may have contributed to a reporting or ascertainment bias in some countries. Nonetheless, these data support the urgent need for novel, integrated, or otherwise effective dengue prevention and control tools and approaches.
    Matched MeSH terms: Asia, Southeastern/epidemiology; Dengue/epidemiology*
  16. Binns C, Low WY
    Asia Pac J Public Health, 2019 11;31(8):677-678.
    PMID: 31762300 DOI: 10.1177/1010539519889539
    Matched MeSH terms: African Swine Fever/epidemiology*; Asia/epidemiology
  17. Zhang F, Harapan H, Rajamoorthy Y, Lu Y, Wagner AL
    Asia Pac J Public Health, 2023 May;35(4):308-310.
    PMID: 37119037 DOI: 10.1177/10105395231171957
    Matched MeSH terms: Indonesia/epidemiology; Malaysia/epidemiology
  18. Binns C, Low WY, Wai Hoe VC
    Asia Pac J Public Health, 2021 11;33(8):810-811.
    PMID: 34763537 DOI: 10.1177/10105395211051322
    Matched MeSH terms: Asia/epidemiology; Pacific Islands/epidemiology
  19. Salleh MZ, Nik Zuraina NMN, Deris ZZ, Mohamed Z
    PeerJ, 2025;13:e18986.
    PMID: 40017659 DOI: 10.7717/peerj.18986
    Pseudomonas aeruginosa continues to be a significant contributor to high morbidity and mortality rates worldwide, particularly due to its role in severe infections such as hospital-acquired conditions, including ventilator-associated pneumonia and various sepsis syndromes. The global increase in antimicrobial-resistant (AMR) P. aeruginosa strains has made these infections more difficult to treat, by limiting the effective drug options available. This systematic review and meta-analysis aim to provide an updated summary of the prevalence of AMR P. aeruginosa over the past 5 years. A systematic search was performed across three major electronic databases-PubMed, ScienceDirect, and Web of Science-yielding 40 eligible studies published between 2018 and 2023. Using a random-effects model, our meta-analysis estimated that the overall prevalence of P. aeruginosa in Asia and Africa over the past 5 years was 22.9% (95% CI [14.4-31.4]). The prevalence rates for multidrug-resistant (MDR) and extensively drug-resistant (XDR) P. aeruginosa strains were found to be 46.0% (95% CI [37.1-55.0]) and 19.6% (95% CI [4.3-34.9]), respectively. Furthermore, the prevalence rates of extended-spectrum β-lactamase- and metallo-β-lactamase-producing P. aeruginosa were 33.4% (95% CI [23.6-43.2]) and 16.0% (95% CI [9.8-22.3]), respectively. Notably, resistance rates to β-lactams used for treating pseudomonal infections were alarmingly high, with rates between 84.4% and 100.0% for cephalosporins, and over 40% of P. aeruginosa isolates showed resistance to penicillins. Our analysis identified the lowest resistance rates for last-resort antimicrobials, with 0.3% (95% CI [0.0-1.3]) resistance to polymyxin B and 5.8% (95% CI [1.5-10.2]) to colistin/polymyxin E. The low resistance rates to polymyxins suggest that these antibiotics remain effective against MDR P. aeruginosa. However, the findings also highlight the critical public health threat posed by antimicrobial-resistant P. aeruginosa, particularly concerning β-lactam antibiotics. This underscores the need for effective and carefully planned intervention strategies, including the development of new antibiotics to address the growing challenge of resistance. Developing robust antibiotic treatment protocols is essential for better management and control of pseudomonal infections globally. Therefore, continued research and international collaboration is vital to tackle this escalating public health challenge. This study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), under registration number CRD42023412839.
    Matched MeSH terms: Africa/epidemiology; Asia/epidemiology
  20. Lundberg AL, Soetikno AG, Wu SA, Ozer E, Welch SB, Liu Y, et al.
    JMIR Public Health Surveill, 2025 Feb 21;11:e53214.
    PMID: 39804185 DOI: 10.2196/53214
    BACKGROUND: This study updates the COVID-19 pandemic surveillance in East Asia and the Pacific region that we first conducted in 2020 with 2 additional years of data for the region.

    OBJECTIVE: First, we aimed to measure whether there was an expansion or contraction of the pandemic in East Asia and the Pacific region when the World Health Organization (WHO) declared the end of the COVID-19 public health emergency of international concern on May 5, 2023. Second, we used dynamic and genomic surveillance methods to describe the dynamic history of the pandemic in the region and situate the window of the WHO declaration within the broader history. Finally, we aimed to provide historical context for the course of the pandemic in East Asia and the Pacific region.

    METHODS: In addition to updates of traditional surveillance data and dynamic panel estimates from the original study, this study used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data to identify the appearance and duration of variants of concern. We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Finally, we conducted a 1-sided t test to determine whether the regional weekly speed was greater than an outbreak threshold of 10. We ran the test iteratively with 6 months of data across the sample period.

    RESULTS: Several countries in East Asia and the Pacific region had COVID-19 transmission rates above an outbreak threshold at the point of the WHO declaration (Brunei, New Zealand, Australia, and South Korea). However, the regional transmission rate had remained below the outbreak threshold for 4 months. In the rolling 6-month window t test for regional outbreak status, the final P value ≤.10 implies a rejection of the null hypothesis (at the α=.10 level) that the region as a whole was not in an outbreak for the period from November 5, 2022, to May 5, 2023. From January 2022 onward, nearly every sequenced SARS-CoV-2 specimen in the region was identified as the Omicron variant.

    CONCLUSIONS: While COVID-19 continued to circulate in East Asia and the Pacific region, transmission rates had fallen below outbreak status by the time of the WHO declaration. Compared to other global regions, East Asia and the Pacific region had the latest outbreaks driven by the Omicron variant. COVID-19 appears to be endemic in the region, no longer reaching the threshold for a pandemic definition. However, the late outbreaks raise uncertainty about whether the pandemic was truly over in the region at the time of the WHO declaration.

    Matched MeSH terms: Far East/epidemiology; Pacific Islands/epidemiology
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