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1.
Sci Rep ; 14(1): 18458, 2024 08 09.
Artículo en Inglés | MEDLINE | ID: mdl-39122738

RESUMEN

Tuberculosis (TB) preventive treatment (TPT) effectively prevents the progression from TB infection to TB disease. This study explores factors associated with TPT non-completion in Cambodia using 6-years programmatic data (2018-2023) retrieved from the TB Management Information System (TB-MIS). Out of 14,262 individuals with latent TB infection (LTBI) initiated with TPT, 299 (2.1%) did not complete the treatment. Individuals aged between 15-24 and 25-34 years old were more likely to not complete the treatment compared to those aged < 5 years old, with aOR = 1.7, p = 0.034 and aOR = 2.1, p = 0.003, respectively. Individuals initiated with 3-month daily Rifampicin and Isoniazid (3RH) or with 6-month daily Isoniazid (6H) were more likely to not complete the treatment compared to those initiated with 3-month weekly Isoniazid and Rifapentine (3HP), with aOR = 2.6, p < 0.001 and aOR = 7, p < 0.001, respectively. Those who began TPT at referral hospitals were nearly twice as likely to not complete the treatment compared to those who started the treatment at health centers (aOR = 1.95, p = 0.003). To improve TPT completion, strengthen the treatment follow-up among those aged between 15 and 34 years old and initiated TPT at referral hospitals should be prioritized. The national TB program should consider 3HP the first choice of treatment.


Asunto(s)
Antituberculosos , Isoniazida , Tuberculosis Latente , Rifampin , Humanos , Cambodia/epidemiología , Adolescente , Adulto , Femenino , Masculino , Adulto Joven , Antituberculosos/uso terapéutico , Estudios Retrospectivos , Isoniazida/uso terapéutico , Rifampin/uso terapéutico , Rifampin/análogos & derivados , Niño , Tuberculosis Latente/tratamiento farmacológico , Tuberculosis Latente/epidemiología , Tuberculosis Latente/prevención & control , Preescolar , Tuberculosis/prevención & control , Tuberculosis/epidemiología , Tuberculosis/tratamiento farmacológico , Persona de Mediana Edad , Lactante
2.
Front Public Health ; 12: 1360441, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39109150

RESUMEN

The impact of COVID-19 on the mental health and wellbeing of adolescents is a major concern. Most research has been conducted only in more economically developed countries. Using data from two similar surveys administered during July-September, 2020 in Australia (a high-income country) and Cambodia (a low-middle income country), this paper examined the impact early in the pandemic on the mental health and wellbeing of adolescents in the two countries. We found that COVID-19 had mostly negative impacts on participants' mental health; threats to personal safety; education; support for schooling; basic necessities such as food, income, employment, and housing; and responsibilities at home. This finding suggests that even short-term disasters may have negative repercussions, and regardless of differences in wealth, culture, and government response. We found that threats to personal safety appeared to be more prevalent in Cambodia than in Australia, the impact on mental health of the Cambodian participants may have been greater than reported, and that, in both countries, support for online or distance schooling during periods of lockdown was wanting, particularly at the state and school levels. This study will contribute to our understanding of the impact of major disruptive global events on young people in both more economically developed and developing countries.


Asunto(s)
COVID-19 , Salud Mental , Humanos , COVID-19/epidemiología , COVID-19/psicología , Cambodia/epidemiología , Adolescente , Australia/epidemiología , Salud Mental/estadística & datos numéricos , Masculino , Femenino , SARS-CoV-2 , Encuestas y Cuestionarios , Pandemias
3.
Global Health ; 20(1): 62, 2024 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-39095844

RESUMEN

BACKGROUND: Cambodia's health sector faces significant challenges exacerbated by aid fragmentation, where development aid is dispersed among numerous small, uncoordinated projects. This study examines the distribution of health sector aid among Cambodia's principal donors to identify priorities, overlaps, and potential collaboration opportunities, addressing the urgent need for aid efficiency and alignment with national health priorities. METHODS: Utilizing OECD datasets and the Herfindahl-Hirschman Index (HHI) for the years 2010-2021, this study quantifies aid fragmentation within Cambodia's health sector. It analyzes aid allocations from the top five donors-United States, Australia, South Korea, Japan, and Germany-across various health projects and initiatives, evaluating the extent of fragmentation and identifying areas for potential donor collaboration. RESULTS: This study's findings highlight a pervasive issue of aid fragmentation within Cambodia's health sector, evident through the sector's low HHI score. This indicates a widespread distribution of aid across numerous small-scale initiatives, rather than targeted, unified efforts. A notable example includes Japan and Korea, which exhibit lower HHI scores, indicating a more pronounced fragmentation in their aid allocation. These countries' contributions are spread across various sectors without a dominant focus, contrasting with the United States' significant dedication to infectious disease control. However, beyond this specific area, the US's aid distribution across other priority health areas shows signs of fragmentation. This scattered approach to aid allocation, even amidst instances of focused support, illustrates the overarching challenge of aligning donor contributions with the holistic needs of Cambodia's health infrastructure. CONCLUSIONS: This investigation highlights the critical need for enhanced collaboration and strategic harmonization among international donors to mitigate aid fragmentation in Cambodia's health sector. It underscores the importance of adopting integrated and priority-aligned aid strategies to improve the efficiency and impact of health aid. By fostering synergistic partnerships and harmonizing donor efforts, there is a potential to create a more cohesive support framework that resonates with Cambodia's comprehensive health requirements and contributes to sustainable health outcomes. Such harmonization not only aligns with Sustainable Development Goal 3 by optimizing health services and outcomes but also strengthens global partnerships under Sustainable Development Goal 17, fostering a unified approach to international development.


Asunto(s)
Cooperación Internacional , Cambodia , Humanos , Sector de Atención de Salud , Conducta Cooperativa
4.
Proc Natl Acad Sci U S A ; 121(30): e2403691121, 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-39018198

RESUMEN

The global biodiversity that underpins wild food systems-including fisheries-is rapidly declining. Yet, we often have only a limited understanding of how households use and benefit from biodiversity in the ecosystems surrounding them. Explicating these relationships is critical to forestall and mitigate the effects of biodiversity declines on food and nutrition security. Here, we quantify how biodiversity filters from ecosystems to household harvest, consumption, and sale, and how ecological traits and household characteristics shape these relationships. We used a unique, integrated ecological (40 sites, quarterly data collection) and household survey (n = 414, every 2 mo data collection) dataset collected over 3 y in rice field fisheries surrounding Cambodia's Tonlé Sap, one of Earth's most productive and diverse freshwater systems. While ecosystem biodiversity was positively associated with household catch, consumption, and sold biodiversity, households consumed an average of 43% of the species present in the ecosystem and sold only 9%. Larger, less nutritious, and more common species were disproportionally represented in portfolios of commercially traded species, while consumed species mirrored catches. The relationship between ecosystem and consumed biodiversity was remarkably consistent across variation in household fishing effort, demographics, and distance to nearest markets. Poorer households also consumed more species, underscoring how wild food systems may most benefit the vulnerable. Our findings amplify concerns about the impacts of biodiversity loss on our global food systems and highlight that utilization of biodiversity for consumption may far exceed what is commercially traded.


Asunto(s)
Biodiversidad , Composición Familiar , Explotaciones Pesqueras , Peces , Animales , Cambodia , Humanos , Ecosistema , Conservación de los Recursos Naturales , Abastecimiento de Alimentos , Comercio
5.
BMC Infect Dis ; 24(1): 658, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38956495

RESUMEN

BACKGROUND: Healthcare Workers (HCWs) are susceptible to hepatitis B virus (HBV) infection and are advised to receive vaccination. However, vaccination rates remain low in developing countries. There is little data concerning Hepatitis B (HepB) vaccination and information regarding HBV knowledge among HCWs in Cambodia. This study aimed to evaluate the knowledge of HBV infection, HepB vaccine, and vaccination status with its associated factors among HCWs in Cambodia. METHODS: A Cross-sectional study was conducted among HCWs in Kampot and Kep Provinces, Cambodia, from September to October 2023 using a questionnaire survey. A total of 261 HCWs were recruited from 1,309 individuals working in all 83 health facilities using systematic random sampling methods. Statistical analyses including the χ2-test and multivariate logistic regression were conducted to identify factors associated with vaccination among the participants. RESULTS: Among 259 participants, 62.9% showed good knowledge of HBV infection, and 65.6% demonstrated good knowledge of the HepB vaccine. 59.8% of the participants had received the HepB vaccine, while 40.2% remained unvaccinated. Analysis showed that HCWs working at Provincial Health Department/Operational Districts and Provincial Referral Hospital/Referral Hospitals were more likely to be vaccinated compared to those at Health Centers [AOR = 6.5; CI = 1.1-39.5, p = 0.0403; AOR = 2.8, CI = 1.0-7.8, p = 0.0412], respectively. Furthermore, individuals with good knowledge of the HBV infection and vaccine were more likely to receive the vaccine compared to those with inadequate knowledge [AOR = 6.3; CI = 3.3-12.3, p < .0001; AOR = 3.7, CI = 1.9-7.4, p = 0.0001], respectively. Within the unvaccinated HCWs, 32% reported high vaccine costs as a barrier, 33% mentioned workplace vaccine was not for adults, and 59% reported insufficient education on adult HepB vaccination. CONCLUSIONS: The HepB vaccination coverage among HCWs is at 59.8%, which is below the World Health Organization's (WHO) recommendation rate of 100%. Knowledge of HBV infection and HepB vaccine were good predictive factors for vaccination. The high cost of vaccine, workplace vaccine not for adults, and insufficient education on adult vaccination were found as barriers to vaccination. This study underscores the importance of providing education to HCWs on HBV infection and the HepB vaccine. Furthermore, it highlights the need for a policy that ensures free vaccination for HCWs.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Personal de Salud , Vacunas contra Hepatitis B , Hepatitis B , Vacunación , Humanos , Cambodia/epidemiología , Hepatitis B/prevención & control , Masculino , Femenino , Estudios Transversales , Personal de Salud/estadística & datos numéricos , Adulto , Vacunas contra Hepatitis B/administración & dosificación , Vacunación/estadística & datos numéricos , Encuestas y Cuestionarios , Persona de Mediana Edad , Adulto Joven , Cobertura de Vacunación/estadística & datos numéricos
6.
Sci Rep ; 14(1): 17348, 2024 07 29.
Artículo en Inglés | MEDLINE | ID: mdl-39069597

RESUMEN

Cambodia's goal to eliminate malaria by 2025 is challenged by persistent transmission in forest and forest fringe areas, where people are exposed to Anopheles mosquito bites during the day and night. Volatile pyrethroid spatial repellents (VPSRs) and insecticide-treated clothing (ITC) could address these gaps. This study evaluated the outdoor application of one passive transfluthrin-based VPSR, four etofenprox-ITCs paired with a picaridin topical repellent, and a combination of VPSR and ITC against wild Anopheles landing in Cambodia. A 7 × 7 Latin-square study was conducted over 49 collection nights in temporary open structures in Mondulkiri Province. All interventions substantially reduced Anopheles landing, with protective efficacy ranging from 61 to 95%. Mathematical modeling showed significant reductions in vectoral capacity, especially with the combined ITC and VPSR and VPSR alone, albeit with decreased effectiveness over time. These interventions have the potential to reduce outdoor and daytime Anopheles biting, offering valuable contributions to malaria elimination efforts in Cambodia and the Greater Mekong Subregion, contingent upon achieving effective coverage and adherence.


Asunto(s)
Anopheles , Bosques , Repelentes de Insectos , Malaria , Control de Mosquitos , Mosquitos Vectores , Piretrinas , Cambodia , Animales , Repelentes de Insectos/farmacología , Malaria/prevención & control , Malaria/transmisión , Anopheles/efectos de los fármacos , Mosquitos Vectores/efectos de los fármacos , Piretrinas/farmacología , Control de Mosquitos/métodos , Humanos , Insecticidas/farmacología , Mordeduras y Picaduras de Insectos/prevención & control , Ciclopropanos , Fluorobencenos
7.
PLoS Negl Trop Dis ; 18(7): e0012269, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38985826

RESUMEN

BACKGROUND: Ticks, as critical vectors of a variety of pathogens, pose a significant public health challenge globally. In Southeast Asia (SEA), ticks are responsible for transmitting a diverse array of pathogens affecting humans and animals. The geographical and ecological diversity of SEA provides a unique environment that supports a wide range of tick species, which complicates the management and study of tick-borne diseases (TBDs). METHODOLOGY/PRINCIPAL FINDINGS: This article synthesizes findings from the first international symposium on ticks and TBDs in Southeast Asia, held in Phnom Penh on June 22 and 23, 2023. It highlights regional efforts to understand tick ecology and pathogen transmission. This paper proposes to present a summary of the various presentations given during the symposium following 3 main parts. The first one is devoted to the state of knowledge regarding ticks and TBDs in SEA countries, with presentations from 6 different countries, namely Cambodia, Indonesia, Laos, Malaysia, Thailand, and Vietnam. The second part focuses on the development of new research approaches on tick-borne pathogens (TBPs) and TBDs. The last part is a summary of the round table discussion held on the final day, with the aim of defining the most important challenges and recommendations for researches on TBP and TBD in the SEA region. CONCLUSIONS/SIGNIFICANCE: Key topics discussed include advancements in diagnostic tools, such as MALDI-TOF MS and proteomics, and the development of sustainable strategies for tick management and disease prevention. The symposium facilitated the exchange of knowledge and collaborative networks among experts from various disciplines, promoting a unified approach to tackling TBDs in the region. The symposium underscored the need for enhanced surveillance, diagnostics, and inter-regional cooperation to manage the threat of TBDs effectively. Recommendations include the establishment of a regional database for tick identification and the expansion of vector competence studies. These initiatives are crucial for developing targeted interventions and understanding the broader implications of climate change and urbanization on the prevalence of TBDs.


Asunto(s)
Enfermedades por Picaduras de Garrapatas , Garrapatas , Animales , Enfermedades por Picaduras de Garrapatas/epidemiología , Enfermedades por Picaduras de Garrapatas/transmisión , Humanos , Garrapatas/fisiología , Asia Sudoriental/epidemiología , Cambodia/epidemiología
8.
PLoS One ; 19(7): e0307964, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39074133

RESUMEN

Surface freshwater is a vital resource that is declining globally, predominantly due to climate and land use changes. Cambodia is no exception and the loss threatens many species, such as the giant ibis a Critically Endangered waterbird. We aimed to quantify the spatial and temporal (2000-2020) change of surface water availability across northern and eastern Cambodia and to assess the impact of this on the giant ibis. We used a Random Forest Classifier to determine the changes and we tested the impact of land use and geographical covariates using spatially explicit regression models. We found an overall reduction of surface water availability of 4.16%. This was predominantly driven by the presence of Economic Land Concessions and roads which increased the probability of extreme drying and flooding events. The presence of protected areas reduced these probabilities. We found changes in precipitation patterns over the wider landscape did not correlate with changes in surface water availability, supporting the overriding influence of land use change. 98% of giant ibis nests recorded during the time period were found within 25m of surface water during the dry season, highlighting their dependency on surface water. The overall surface water decline resulted in a 25% reduction in dry season suitable habitat for the giant ibis. Although absolute changes in surface water over the whole area were relatively small, the impact on the highest quality habitat for ibis is disproportionate and therefore threatens its populations. Defining the threats to such an endangered species is crucial for effective management.


Asunto(s)
Bosques , Estaciones del Año , Clima Tropical , Cambodia , Animales , Ecosistema , Conservación de los Recursos Naturales , Aves/fisiología , Agua Dulce , Cambio Climático
9.
Am J Trop Med Hyg ; 111(2): 277-280, 2024 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-38889712

RESUMEN

In resource-scarce settings, melioidosis is associated with up to 80% mortality. Studies of melioidosis in Cambodia report primarily on pediatric populations with localized infection; however, literature describing Cambodian adults with severe melioidosis is lacking. We present a case series of 35 adults with sequence-confirmed Burkholderia pseudomallei bacteremia presenting to a provincial referral hospital in rural Cambodia. More than 90% of the patients had diabetes, an important risk factor for developing melioidosis. Inappropriate antimicrobial therapy was significantly associated with lower odds of survival. Improved diagnostic testing and greater access to first-line antibiotics for acute melioidosis treatment present potential targets for intervention to reduce mortality associated with this disease in resource-limited settings.


Asunto(s)
Antibacterianos , Bacteriemia , Burkholderia pseudomallei , Melioidosis , Humanos , Melioidosis/tratamiento farmacológico , Melioidosis/mortalidad , Melioidosis/epidemiología , Melioidosis/microbiología , Burkholderia pseudomallei/aislamiento & purificación , Burkholderia pseudomallei/efectos de los fármacos , Cambodia/epidemiología , Factores de Riesgo , Masculino , Femenino , Estudios Retrospectivos , Adulto , Bacteriemia/mortalidad , Bacteriemia/tratamiento farmacológico , Bacteriemia/microbiología , Persona de Mediana Edad , Antibacterianos/uso terapéutico , Anciano , Adulto Joven
10.
mBio ; 15(7): e0080524, 2024 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-38912775

RESUMEN

Piperaquine (PPQ) is widely used in combination with dihydroartemisinin as a first-line treatment against malaria. Multiple genetic drivers of PPQ resistance have been reported, including mutations in the Plasmodium falciparum chloroquine resistance transporter (pfcrt) and increased copies of plasmepsin II/III (pm2/3). We generated a cross between a Cambodia-derived multidrug-resistant KEL1/PLA1 lineage isolate (KH004) and a drug-susceptible Malawian parasite (Mal31). Mal31 harbors a wild-type (3D7-like) pfcrt allele and a single copy of pm2/3, while KH004 has a chloroquine-resistant (Dd2-like) pfcrt allele with an additional G367C substitution and multiple copies of pm2/3. We recovered 104 unique recombinant parasites and examined a targeted set of progeny representing all possible combinations of variants at pfcrt and pm2/3. We performed a detailed analysis of competitive fitness and a range of PPQ susceptibility phenotypes with these progenies, including PPQ survival assay, area under the dose response curve, and a limited point IC50. We find that inheritance of the KH004 pfcrt allele is required for reduced PPQ sensitivity, whereas copy number variation in pm2/3 further decreases susceptibility but does not confer resistance in the absence of additional mutations in pfcrt. A deep investigation of genotype-phenotype relationships demonstrates that progeny clones from experimental crosses can be used to understand the relative contributions of pfcrt, pm2/3, and parasite genetic background to a range of PPQ-related traits. Additionally, we find that the resistance phenotype associated with parasites inheriting the G367C substitution in pfcrt is consistent with previously validated PPQ resistance mutations in this transporter.IMPORTANCEResistance to piperaquine, used in combination with dihydroartemisinin, has emerged in Cambodia and threatens to spread to other malaria-endemic regions. Understanding the causal mutations of drug resistance and their impact on parasite fitness is critical for surveillance and intervention and can also reveal new avenues to limiting the evolution and spread of drug resistance. An experimental genetic cross is a powerful tool for pinpointing the genetic determinants of key drug resistance and fitness phenotypes and has the distinct advantage of quantifying the effects of naturally evolved genetic variation. Our study was strengthened since the full range of copies of KH004 pm2/3 was inherited among the progeny clones, allowing us to directly test the role of the pm2/3 copy number on resistance-related phenotypes in the context of a unique pfcrt allele. Our multigene model suggests an important role for both loci in the evolution of this multidrug-resistant parasite lineage.


Asunto(s)
Antimaláricos , Ácido Aspártico Endopeptidasas , Resistencia a Medicamentos , Proteínas de Transporte de Membrana , Plasmodium falciparum , Proteínas Protozoarias , Quinolinas , Plasmodium falciparum/genética , Plasmodium falciparum/efectos de los fármacos , Proteínas Protozoarias/genética , Proteínas Protozoarias/metabolismo , Resistencia a Medicamentos/genética , Antimaláricos/farmacología , Quinolinas/farmacología , Ácido Aspártico Endopeptidasas/genética , Ácido Aspártico Endopeptidasas/metabolismo , Proteínas de Transporte de Membrana/genética , Malaria Falciparum/parasitología , Malaria Falciparum/tratamiento farmacológico , Humanos , Alelos , Cambodia , Mutación , Piperazinas
11.
J Water Health ; 22(6): 1033-1043, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38935454

RESUMEN

The misuse of antibiotics and the emergence of antimicrobial resistance (AMR) is a concern in the aquaculture industry because it contributes to global health risks and impacts the environment. This study analyzed the AMR of sentinel bacteria associated with striped catfish (Pangasisanodon hypophthalmus) and giant snakehead (Channa micropeltes), the two main fish species reared in the pond culture in Cambodia. Phenotypic and genotypic characterization of the recovered isolates from fish, water, and sediment samples revealed the presence of bacteria, such as 22 species belonging to families Aeromonadaceae, Enterobacteriaceae, and Pseudomonadaceae. Among 48 isolates, Aeromonas caviae (n = 2), Aeromonas hydrophila (n = 2), Aeromonas ichthiosmia (n = 1), Aeromonas salmonicida (n = 4) were detected. A. salmonicida and A. hydrophilla are known as fish pathogens that occur worldwide in both fresh and marine water aquaculture. Antibiotic susceptibility testing revealed antibiotic resistance patterns of 24 (50 %) isolates among 48 isolates with higher multiple antibiotic resistance index (> 0.2). All the isolates of Enterobacteriaceae were susceptible to ciprofloxacin. Ciprofloxacin is a frontline antibiotic that is not recommended to use in aquaculture. Therefore, its use has to be strictly controlled. This study expands our knowledge of the AMR status in aquaculture farms which is very limited in Cambodia.


Asunto(s)
Acuicultura , Farmacorresistencia Bacteriana , Microbiología del Agua , Cambodia , Bagres/microbiología , Especies Centinela , Fenotipo , Genotipo , Aeromonadaceae/clasificación , Aeromonadaceae/aislamiento & purificación , Aeromonadaceae/fisiología , Enterobacteriaceae/clasificación , Enterobacteriaceae/aislamiento & purificación , Enterobacteriaceae/fisiología , Pseudomonadaceae/clasificación , Pseudomonadaceae/aislamiento & purificación , Pseudomonadaceae/fisiología , Aeromonas caviae/aislamiento & purificación , Aeromonas caviae/fisiología , Aeromonas hydrophila/aislamiento & purificación , Aeromonas hydrophila/fisiología , Ciprofloxacina/farmacología , Ciprofloxacina/uso terapéutico , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Enfermedades de los Peces/tratamiento farmacológico , Enfermedades de los Peces/microbiología , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Infecciones por Bacterias Gramnegativas/veterinaria , Monitoreo del Ambiente
12.
Child Care Health Dev ; 50(4): e13291, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38895948

RESUMEN

BACKGROUND: Epidemiological and nutritional modifications are causing an increase in stunting in many low- and middle-income countries (LMIC), which will eventually result in juvenile diseases and mortality. Therefore, this study aimed to identify the influential factors contributing to stunting among under-five children in Cambodia. METHODS: A secondary dataset consisting of 3268 under-five children was extracted from the latest Cambodian Demographic and Health Survey (CDHS)-2021/2022 dataset. The Chi-square test and Boruta algorithm were used for covariate selection, and logistic regression approaches were used to determine the influence of demographic, socioeconomic and other factors on the presence of stunting. RESULTS: Findings revealed that about 21% of under-five children were stunted, and the prevalence of stunting was higher in rural areas than in urban areas. The prevalence of child stunting was lower in families with highly educated parents. A child whose father had a secondary education had 0.71 times lower (adjusted odds ratio [AOR]: 0.71, 95% CI: 0.520-0.969) chance of stunting than a child whose father had no education. Findings revealed that Ratnak Kiri, Mondul Kiri, Stung Treng, Pursat and Kampot had a greater prevalence of stunting than other places, ranging from 27.11% to 35.70%, whereas Banteay Meanchey, Phnom Penh and Kandal had the lowest rates, ranging from 12.80% to 16.00%. Results of the Boruta algorithm and logistic regression suggested that under-five stunting is significantly influenced by factors such as the child's age, size at birth, mother's age at first birth, mother's body mass index (BMI), father's educational status, cooking fuel, and wealth index. CONCLUSIONS: It is necessary to take initiatives for reducing the prevalence of stunted children prioritising the identified factors that ultimately help to reduce the burden of child health. The authors believed that the findings of this study will be helpful for policymakers in designing the appropriate policies and actions to achieve the Sustainable Development Goals (SDGs) by reducing stunting among under-five children in Cambodia.


Asunto(s)
Trastornos del Crecimiento , Encuestas Epidemiológicas , Factores Socioeconómicos , Humanos , Trastornos del Crecimiento/epidemiología , Cambodia/epidemiología , Masculino , Preescolar , Femenino , Lactante , Prevalencia , Población Rural/estadística & datos numéricos , Factores de Riesgo , Recién Nacido , Población Urbana/estadística & datos numéricos , Estado Nutricional
13.
Emerg Infect Dis ; 30(7): 1493-1495, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38916864

RESUMEN

To determine antimicrobial susceptibility of Neisseria gonorrhoeae, we analyzed phenotypes and genomes of 72 isolates collected in Cambodia in 2023. Of those, 9/72 (12.5%) were extensively drug resistant, a 3-fold increase from 2022. Genomic analysis confirmed expansion of newly emerging resistant clones and ongoing resistance emergence across new phylogenetic backbones.


Asunto(s)
Antibacterianos , Gonorrea , Pruebas de Sensibilidad Microbiana , Neisseria gonorrhoeae , Organización Mundial de la Salud , Neisseria gonorrhoeae/efectos de los fármacos , Neisseria gonorrhoeae/genética , Cambodia/epidemiología , Humanos , Gonorrea/microbiología , Gonorrea/epidemiología , Gonorrea/tratamiento farmacológico , Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Filogenia , Masculino , Femenino , Adulto
14.
Compr Child Adolesc Nurs ; 47(2): 115-130, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38922696

RESUMEN

Globally, children have been adversely affected by the wide variety of impacts of SARS-CoV-2 (Coronavirus | COVID-19). Vulnerable children who depend on the support of education and health and social care systems were left unprotected as these systems were weakened by the pandemic. COVID-19 has exposed the already fragile situations in which many children and young people live and that thousands of children and young people would need ongoing support but remained invisible to statutory authorities. COVID-19 has also been a stark reminder of the vulnerability of individuals and societies and it has exposed deep divisions, inequalities, and injustices between different countries and groups of people. M'Lop Tapang is a local nonprofit organization registered with the Royal Government of Cambodia. This report discusses the efforts of M'Lop Tapang following the declaration of the COVID-19 global pandemic in early 2020, to address the local community needs; to ensure the voices of children remained heard; and to promote children's rights remaining a priority throughout the remainder of the pandemic.What is already known on this topicVulnerable children are dependent on remaining visible to education and health and social care systems to ensure they are safeguarded and protected.Poor safety, financial instability, unemployment, challenges to children's rights and displacement all have the potential to increase vulnerabilities and intensify inequalities.The COVID-19 global pandemic has widened the global lens for the nursing profession and to effect change, children's nurses need to think globally and act locally.What this study addsThis study provides insights into the challenges faced by children and families in Sihanoukville, Cambodia, during the early part of the SARS-CoV-2 (COVID19) pandemic in 2020-2021.The economic impact of COVID-19 on children and families living in Sihanoukville, Cambodia, between 2020 and 2021 is reviewed.The learning from the pragmatic and rapid interventions of M'Lop Tapang, Sihanoukville during the early phase of the SARS-CoV-2 (COVID-19) pandemic, are of use in other countries around the world in future epidemic or pandemic situations.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Cambodia , Niño , Adolescente , SARS-CoV-2 , Pandemias
15.
Sci Rep ; 14(1): 14719, 2024 06 26.
Artículo en Inglés | MEDLINE | ID: mdl-38926408

RESUMEN

Dietary diversity among children is a crucial factor influencing their nutritional status; therefore, this paper uses data from four rounds of the Cambodia Demographic and Health Survey (CDHS) to examine the minimum dietary diversity among children aged 6-23 months. Multilevel binary regression is used to evaluate the variation in minimum dietary diversity at the cluster and province levels. The results show that nearly half of Cambodian children consistently lacked access to vitamin A-rich fruits and vegetables. Although the prevalence of inadequate minimum dietary diversity (MDD) among children significantly dropped from 76% in 2005 to 51% in 2021-2022, it is still high and needs attention. A decomposition analysis (Blinder-Oaxaca decomposition) was further used to understand the drivers of this temporal change in dietary diversity. The empirical results show that clusters represented the most significant source of geographic variation with respect to all eight food groups and MDD. Nutritional policy should improve education and awareness, reduce socio-economic disparities, leverage media, and promote full antenatal care to improve dietary diversity in Cambodia. Initiatives targeting the enhancement of insufficient minimum dietary diversity intake should encompass individual aspects and be customized to suit geographic and community settings.


Asunto(s)
Dieta , Encuestas Epidemiológicas , Estado Nutricional , Humanos , Cambodia , Lactante , Femenino , Masculino , Frutas , Verduras , Factores Socioeconómicos
16.
mBio ; 15(6): e0006324, 2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38752787

RESUMEN

The pathogenesis of dengue involves a complex interplay between the viral factor and the host immune response. A mismatch between the infecting serotype and the adaptive memory response is hypothesized to lead to exacerbated immune responses resulting in severe dengue. Here, we aim to define in detail the phenotype and function of different regulatory T cell (Treg) subsets and their association with disease severity in a cohort of acute dengue virus (DENV)-infected Cambodian children. Treg frequencies and proliferation of Tregs are increased in dengue patients compared to age-matched controls. Tregs from dengue patients are skewed to a Th1-type Treg phenotype. Interestingly, Tregs from severe dengue patients produce more interleukin-10 after in vitro stimulation compared to Tregs from classical dengue fever patients. Functionally, Tregs from dengue patients have reduced suppressive capacity, irrespective of disease severity. Taken together, these data suggest that even though Treg frequencies are increased in the blood of acute DENV-infected patients, Tregs fail to resolve inflammation and thereby could contribute to the immunopathology of dengue. IMPORTANCE: According to the World Health Organization, dengue is the fastest-spreading, epidemic-prone infectious disease. The extent of dengue virus infections increased over the years, mainly driven by globalization-including travel and trade-and environmental changes. Dengue is an immunopathology caused by an imbalanced immune response to a secondary heterotypic infection. As regulatory T cells (Tregs) are essential in maintaining immune homeostasis and dampening excessive immune activation, this study addressed the role of Tregs in dengue immunopathology. We show that Tregs from dengue patients are highly activated, skewed to a Th1-like Treg phenotype and less suppressive compared to healthy donor Tregs. Our data suggest that Tregs fail to resolve ongoing inflammation during dengue infection and hence contribute to the immunopathology of severe dengue disease. These data clarify the role of Tregs in dengue immunopathogenesis, emphasizing the need to develop T cell-based vaccines for dengue.


Asunto(s)
Virus del Dengue , Dengue , Fenotipo , Linfocitos T Reguladores , Células TH1 , Humanos , Linfocitos T Reguladores/inmunología , Dengue/inmunología , Niño , Masculino , Virus del Dengue/inmunología , Células TH1/inmunología , Femenino , Interleucina-10/inmunología , Interleucina-10/genética , Preescolar , Adolescente , Cambodia , Activación de Linfocitos
17.
Int J Numer Method Biomed Eng ; 40(7): e3830, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38700070

RESUMEN

This study aimed to explore the variability in nasal airflow patterns among different sexes and populations using computational fluid dynamics (CFD). We focused on evaluating the universality and applicability of dimensionless parameters R (bilateral nasal resistance) and ϕ (nasal flow asymmetry), initially established in a Caucasian Spanish cohort, across a broader spectrum of human populations to assess normal breathing function in healthy airways. In this retrospective study, CT scans from Cambodia (20 males, 20 females), Russia (20 males, 18 females), and Spain (19 males, 19 females) were analyzed. A standardized CFD workflow was implemented to calculate R-ϕ parameters from these scans. Statistical analyses were conducted to assess and compare these parameters across different sexes and populations, emphasizing their distribution and variances. Our results indicated no significant sex-based differences in the R parameter across the populations. However, moderate sexual dimorphism in the ϕ parameter was observed in the Cambodian group. Notably, no geographical differences were found in either R or ϕ parameters, suggesting consistent nasal airflow characteristics across the diverse human groups studied. The study also emphasized the importance of using dimensionless variables to effectively analyze the relationships between form and function in nasal airflow. The observed consistency of R-ϕ parameters across various populations highlights their potential as reliable indicators in both medical practice and further CFD research, particularly in diverse human populations. Our findings suggest the potential applicability of dimensionless CFD parameters in analyzing nasal airflow, highlighting their utility across diverse demographic and geographic contexts. This research advances our understanding of nasal airflow dynamics and underscores the need for additional studies to validate these parameters in broader population cohorts. The approach of employing dimensionless parameters paves the way for future research that eliminates confounding size effects, enabling more accurate comparisons across different populations and sexes. The implications of this study are significant for the advancement of personalized medicine and the development of diagnostic tools that accommodate individual variations in nasal airflow.


Asunto(s)
Hidrodinámica , Humanos , Masculino , Femenino , Adulto , Resistencia de las Vías Respiratorias/fisiología , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Persona de Mediana Edad , Cavidad Nasal/fisiología , Cavidad Nasal/diagnóstico por imagen , Cavidad Nasal/anatomía & histología , Simulación por Computador , Cambodia , España
18.
Arch Psychiatr Nurs ; 50: 60-66, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38789235

RESUMEN

OBJECTIVE: This study aimed to identify the prevalence of postpartum depression (PPD) and the factors associated with PPD in Kampong Chhnang Province, Cambodia. STUDY DESIGN: A cross-sectional study. PARTICIPANTS: This study included 440 Cambodian women at 6-8 weeks postpartum who visited health centers between July and September 2021. MATERIALS AND METHODS: Data were collected through face-to-face interviews by midwives and nurses using a structured questionnaire. The Edinburgh Postnatal Depression Scale (EPDS) in the Khmer language was used to screen for PPD, and suspected PPD was defined as a total EPDS score ≥ 10. Logistic regression analyses were performed to identify the factors associated with suspected PPD. FINDINGS: The average age of participants was 28.6 years old. The prevalence of suspected-PPD was 30.2 % (n = 133). Factors associated with suspected PPD were income dissatisfaction (adjusted odds ratio (AOR) = 2.66, 95 % confidence interval (CI) 1.27-5.56, P = 0.010), unintended pregnancy (AOR = 1.99, 95 % CI 1.10-3.61, P = 0.023), and a partner employed as a manual laborer (AOR = 3.85, 95 % CI 1.11-13.33, P = 0.034), farmer (AOR = 3.69, 95 % CI 1.11-12.31, P = 0.034), and factory worker (AOR = 5.43, 95 % CI 1.38-21.41, P = 0.016). In addition, poor relationship with partners (AOR = 2.14, 95 % CI 1.17-3.94, P = 0.014), poor relationship with mother-in-law (AOR = 3.51, 95 % CI 1.70-7.21, P < 0.001), and a history of depression before pregnancy (AOR = 6.34, 95 % CI 1.59-25.34, P = 0.009) were significantly associated with suspected-PPD. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This study highlighted the need for mental health services in primary healthcare settings. Mental health training for healthcare workers, particularly primary-level nurses, should be prioritized and strengthened. Further clinical study on EPDS validation should be carried out to justify the appropriate cut-off EPDS score for Cambodian women. The EPDS should be integrated into routine PNC services to identify women with suspected-PPD. Education on PPD should be provided not only to the nurses and midwives, but also to the women and their families to support the mental health of pregnant and postpartum women.


Asunto(s)
Depresión Posparto , Humanos , Femenino , Adulto , Cambodia/epidemiología , Estudios Transversales , Depresión Posparto/epidemiología , Depresión Posparto/psicología , Prevalencia , Encuestas y Cuestionarios , Embarazo , Escalas de Valoración Psiquiátrica , Factores de Riesgo
19.
PLoS One ; 19(5): e0300388, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38701061

RESUMEN

BACKGROUND: Women migrant workers are vulnerable to discrimination and violence, which are significant public health problems. These situations may have been intensified during the COVID-19 pandemic. This study aimed to investigate discrimination against women migrant workers in Thailand during the COVID-19 pandemic and its intersection with their experiences of violence and associated factors. METHODS: A mixed-methods study design was employed to collect data from 572 women migrant workers from Myanmar, Lao People's Democratic Republic, and Cambodia. Face-to-face interviews were conducted with 494 participants using a structured questionnaire for quantitative data, whereas qualitative data was collected through 24 in-depth interviews and focus group discussions with 54 migrant women. Simple and multiple logistic regression and content analysis were employed. RESULTS: This study found that about one in five women migrant workers experienced discrimination during the COVID-19 pandemic. Among those who experienced discrimination, 63.2% had experienced intimate partner violence and 76.4% had experienced non-intimate partner violence in their lifetime. The multivariable analysis revealed that women migrant workers who had experienced any violence (AOR = 2.76, 95% CI = 1.49, 5.12), lost their jobs or income during the pandemic (AOR = 3.99, 95% CI = 2.09, 7.62), and were from Myanmar (AOR = 4.68, 95% CI = 1.79, 12.21) were more likely to have experienced discrimination. CONCLUSION: The results suggest that the intersection of discrimination and violence against women migrant workers in Thailand demands special interest to understand and address the problem. It is recommended that policymakers provide interventions and programs that are inclusive and responsive to the unique needs of women migrants depending on their country of origin and job profile.


Asunto(s)
COVID-19 , Migrantes , Humanos , Femenino , Tailandia/epidemiología , Migrantes/estadística & datos numéricos , Migrantes/psicología , Adulto , COVID-19/epidemiología , Pandemias , Adulto Joven , Encuestas y Cuestionarios , Persona de Mediana Edad , Mianmar/epidemiología , Violencia de Pareja/estadística & datos numéricos , SARS-CoV-2 , Laos/epidemiología , Cambodia/epidemiología
20.
PLoS One ; 19(5): e0293197, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38758946

RESUMEN

BACKGROUND: A maternal mortality ratio is a sensitive indicator when comparing the overall maternal health between countries and its very high figure indicates the failure of maternal healthcare efforts. Cambodia, Laos, Myanmar, and Vietnam-CLMV countries are the low-income countries of the South-East Asia region where their maternal mortality ratios are disproportionately high. This systematic review aimed to summarize all possible factors influencing maternal mortality in CLMV countries. METHODS: This systematic review applied "The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist (2020)", Three key phrases: "Maternal Mortality and Health Outcome", "Maternal Healthcare Interventions" and "CLMV Countries" were used for the literature search. 75 full-text papers were systematically selected from three databases (PubMed, Google Scholar and Hinari). Two stages of data analysis were descriptive analysis of the general information of the included papers and qualitative analysis of key findings. RESULTS: Poor family income, illiteracy, low education levels, living in poor households, and agricultural and unskilled manual job types of mothers contributed to insufficient antenatal care. Maternal factors like non-marital status and sex-associated work were highly associated with induced abortions while being rural women, ethnic minorities, poor maternal knowledge and attitudes, certain social and cultural beliefs and husbands' influences directly contributed to the limitations of maternal healthcare services. Maternal factors that made more contributions to poor maternal healthcare outcomes included lower quintiles of wealth index, maternal smoking and drinking behaviours, early and elderly age at marriage, over 35 years pregnancies, unfavourable birth history, gender-based violence experiences, multigravida and higher parity. Higher unmet needs and lower demands for maternal healthcare services occurred among women living far from healthcare facilities. Regarding the maternal healthcare workforce, the quality and number of healthcare providers, the development of healthcare infrastructures and human resource management policy appeared to be arguable. Concerning maternal healthcare service use, the provisions of mobile and outreach maternal healthcare services were inconvenient and limited. CONCLUSION: Low utilization rates were due to several supply-side constraints. The results will advance knowledge about maternal healthcare and mortality and provide a valuable summary to policymakers for developing policies and strategies promoting high-quality maternal healthcare.


Asunto(s)
Muerte Materna , Mortalidad Materna , Humanos , Femenino , Mianmar/epidemiología , Cambodia/epidemiología , Laos/epidemiología , Embarazo , Vietnam/epidemiología , Muerte Materna/estadística & datos numéricos , Atención Prenatal/estadística & datos numéricos , Servicios de Salud Materna/estadística & datos numéricos
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