Metabolic Dysfunction Associated Steatohepatitis (MASH) in Oceania, Central America, and the Caribbean.

Metabolic dysfunction-associated steatotic liver disease and its progressive form, metabolic dysfunction-associated steatohepatitis, are expanding across Australia, Central America, and the Caribbean, driven by obesity, diabetes, and social disadvantage. The authors synthesize contemporary epidemiology, highlighting rising prevalence, projected surges in advanced disease and mortality, and heterogeneity by most relevant sociodemographic characteristics. They outline pragmatic, resource-adaptable care pathways that begin with Fibrosis-4 in primary care and escalate to elastography or direct fibrosis biomarkers, noting access bottlenecks outside metropolitan hubs and smaller islands. They summarize models of care-multidisciplinary and nurse-led clinics and mobile and community-health worker programs-and emphasize lifestyle modification.