RESUMO
Background: Dental caries is a common chronic oral disease, posing a serious public health issue. By analyzing large datasets, machine learning shows potential in addressing this problem. This study employs bibliometric analysis to explore emerging topics, collaborations, key authors, and research trends in Southeast Asia related to the application of machine learning in dental caries management. Methods: A comprehensive selection using the Scopus database to obtain relevant research, covering publications from inception to July 2024 was done. We employed the Bibliometric approaches, including co-authorship networks, yearly publishing trends, institutional and national partnerships, keyword co-occurrence analysis, and citation analysis, for the collected data. To explore the visualization and network analysis, we employed the tools such as VOSviewer and Bibliometrix in R package. Results: The final bibliometric analysis included 246 papers. We found that Malaysia became the top contributor with 59 publications, followed by Indonesia (37) and Thailand (29). Malaysia had the highest Multiple Country Publications (MCP) ratio at 0.407. Top institutions including the Universiti Sains Malaysia led with 39 articles, followed by Chiang Mai University (36) and the National University of Singapore (30) became the leader. Co-authorship analysis using VOSviewer revealed six distinct clusters. A total of 1220 scholars contributed to these publications. The top 10 keywords, including 'human' and 'dental caries,' indicated research hotspots. Conclusion: We found growing evidence of machine learning applications to address dental caries in Southeast Asia. The bibliometric analysis highlights key authors, collaborative networks, and emerging topics, revealing research trends since 2014. This study underscores the importance of bibliometric analysis in tackling this public health issue.
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Bibliometria , Cárie Dentária , Aprendizado de Máquina , Cárie Dentária/epidemiologia , Humanos , Sudeste Asiático/epidemiologiaRESUMO
INTRODUCTION: The South and Southeast Asia region has the second-highest number of people living with HIV globally. Despite progress in reducing HIV incidence and AIDS-related deaths, the region still has a long way to go in achieving the Joint United Nations Programme on HIV and AIDS (UNAIDS) 95-95-95 HIV testing, treatment and viral suppression targets. HIV self-testing (HIVST) is recommended by the World Health Organization as an additional approach to HIV testing. This paper provides a commentary on the implementation status, benefits, barriers and recommendations for HIVST implementation in South and Southeast Asia. Additionally, it presents perspectives from HIV testing service experts from 11 countries in the region to put forth recommendations to accelerate the implementation of HIVST in South and Southeast Asia. DISCUSSION: There is uneven progress in national HIVST policy development and implementation across the region. HIVST, as an additional testing approach, can help to enhance testing coverage, frequency and demand for follow-up HIV services among key populations. Key factors influencing the implementation and scale-up of HIVST include the degree of awareness of HIVST among general and key populations, the development and implementation of supportive national HIVST policies and the availability of public funding for HIVST. To address barriers and leverage enablers to HIVST implementation, generating evidence on cost-effectiveness and budget impact, developing multisectoral partnerships for market shaping, promoting differentiated and decentralized delivery models, and optimizing linkage to further testing and care are recommended. CONCLUSIONS: It is crucial to accelerate the implementation and scale-up of HIVST to differentiate and decentralize the delivery of HIV testing services in South and Southeast Asian countries. Sharing experiences among country experts is vital to foster the adoption of best practices and facilitate the trial-and-error process of HIVST implementation. Such collaborative approaches can help South and Southeast Asian countries attain the UNAIDS 95-95-95 targets, especially the first 95 on HIV diagnosis, and play a significant role in ending the global AIDS epidemic.
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Infecções por HIV , Autoteste , Humanos , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Sudeste Asiático/epidemiologia , Nações Unidas , Teste de HIV/métodosRESUMO
We reviewed and analyzed the existing data on vibriosis in Southeast Asia to better understand its burden and prevalent causal agents. We searched PubMed, Web of Science, and EMBASE for studies published between January 2000 and April 2024. A random-effects meta-analysis was used to estimate the pooled isolation rate of non-cholera Vibrio species. Among the 1385 retrieved studies, 22 met the inclusion criteria for the systematic review and 11 were included in the meta-analysis. The pooled isolation rate of non-cholera Vibrio species among diarrheal patients was 5.0 %. Most species that caused vibriosis included V. parahaemolyticus, V. mimicus, V. vulnificus, non-O1/non-O139 V. cholerae, V. fluvialis, and V. alginolyticus. Pooled isolation rate of V. parahaemolyticus and non-O1 V. cholerae were 7.0, and 4.0, respectively. The prevalence of vibriosis in Southeast Asia is non-negligible. Public health strategies should prioritize enhanced surveillance, and clinicians should consider vibriosis in diarrheal patients with seafood consumption history.
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Diarreia , Vibrioses , Vibrio , Humanos , Vibrioses/epidemiologia , Vibrioses/microbiologia , Sudeste Asiático/epidemiologia , Prevalência , Vibrio/isolamento & purificação , Diarreia/epidemiologia , Diarreia/microbiologia , Vibrio parahaemolyticus/isolamento & purificação , Alimentos Marinhos/microbiologia , Cólera/epidemiologia , Cólera/microbiologiaRESUMO
INTRODUCTION: Stunting or growth failure is a health problem faced by the world today, especially in developing countries, including Southeast Asia. The Southeast Asian region accounts for more than a quarter of the number of children experiencing stunting worldwide. In addition to impacting children's growth and development, mortality and morbidity rates will also affect the economies and productivity of countries in the future. RESEARCH OBJECTIVES: This scoping review aimed to systematically map the research that has been conducted in this area and identify existing gaps in knowledge related to risk factors for stunting in the Southeast Asian region. METHODE: A scoping review was conducted using three databases: Scopus, PubMed, Embase, and one academic publisher, Taylor & Francis. The keywords used were "Children," "Risk Factors," "Stunting.". The inclusion criteria were as follows: (1) studies with a population of children under five years of age, (2) studies addressing risk factors for stunting, (3) studies conducted in countries in the Southeast Asian region, (4) studies of all research types, and (5) articles published in English. Of the 2252 articles, 54 met the inclusion criteria. RESULT: In this review, the risk factors associated with stunting in children under five years of age in Southeast Asia were categorized into direct, underlying, and basic factors. Direct factors include parental and child characteristics, food intake, and health. Underlying factors include the practice of providing food and access to health services and care. The basic factors causing stunting are environmental, household health, and socioeconomic factors. CONCLUSIONS: This scoping review determined the risk factors for childhood stunting in Southeast Asia, such as attributes of the child, traits of the parent, the amount of food the child consumes, the health of the child, feeding habits, access to health services, household and environmental health, and socioeconomic status. These factors are interrelated and affect each other. Therefore, it is necessary to pay attention to these factors to reduce the risk of stunting among underfives in Southeast Asia.
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Transtornos do Crescimento , Humanos , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Sudeste Asiático/epidemiologia , Fatores de Risco , Pré-Escolar , Lactente , Incidência , Fatores Socioeconômicos , Feminino , MasculinoRESUMO
This narrative review describes pneumococcal serotype prevalence for invasive disease and carriage and antibiotic resistance among specimens collected from children in countries across South and Southeast Asia from 2012 to 2024. Literature search retrieved 326 articles; 96 were included. The prevalence of pneumococcal serotypes varied geographically and over time after introduction of pneumococcal conjugate vaccine. Serotypes common in both pneumococcal carriage and disease were 6A, 6B, 14, 15B/15C, 19F, and 23F; serotypes 1, 3, 5, 19A, 15A, 10A, and 35B were also common in disease. Most of these serotypes are included in the 13-valent and 10-valent PCV. Carriage and disease isolates remained generally highly susceptible to vancomycin (mostly 100%) and levofloxacin (mostly >97%). These findings indicate that vaccine-preventable serotypes contribute significantly to pneumococcal disease burden in children in South and Southeast Asia. Consistency of national immunization programs with World Health Organization recommendations may reduce rates of pneumococcal disease in this region.
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Antibacterianos , Infecções Pneumocócicas , Vacinas Pneumocócicas , Sorogrupo , Streptococcus pneumoniae , Humanos , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/imunologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Infecções Pneumocócicas/microbiologia , Sudeste Asiático/epidemiologia , Prevalência , Vacinas Pneumocócicas/imunologia , Vacinas Pneumocócicas/administração & dosagem , Criança , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Pré-Escolar , Lactente , Vacinas Conjugadas/imunologia , Ásia/epidemiologiaRESUMO
PURPOSE: Breast cancer progression varies across molecular subtypes, and treatment options for human epidermal growth factor receptor 2 (HER2)-low expression tumors are limited compared with those of HER2 overexpression tumors. Comprehensive information regarding the epidemiology and clinical outcomes of metastatic HER2-low expression breast cancer in a Southeast Asian population is lacking. METHODS: This retrospective cohort study was performed to analyze data from patients with de novo advanced breast cancer, including HER2 expression, tumor stage, and metastatic pattern. Statistical analyses, including chi-square tests and survival analyses, were used to compare HER2-low expression and HER2-negative groups. RESULTS: Of the 491 patients, 21.2% had HER2-low expression, 30% had HER2 overexpression, and 50% had HER2-negative expression. Among the hormone receptor (HR)-positive patients, 34% had HER2-low expression; in the triple-negative patients, the HER2-low incidence was 20.6%. No significant differences in clinical characteristics between HER2-low and HER2-negative groups were observed, except for more HR-positive patients in the HER2-low group. HER2-low patients had a longer overall survival (OS) than HER2-negative patients (43 v 23 months; hazard ratio, 0.7; P < .001), especially in HR-positive patients. After adjusting for HR status, HER2-low patients maintained improved outcomes. HR-positive HER2-low patients showed nonsignificant OS gains compared with HR-positive HER2-negative patients, regardless of first-line chemotherapy or endocrine therapy. CONCLUSION: This study revealed the incidence and clinical outcomes of HER2-low expression in de novo advanced breast cancer, suggesting favorable outcomes, particularly in HR-positive breast cancer. These findings may inform personalized treatment strategies. Further research into the mechanisms and implications of HER2-low expression in breast cancer is required.
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Neoplasias da Mama , Receptor ErbB-2 , Humanos , Receptor ErbB-2/metabolismo , Feminino , Estudos Retrospectivos , Neoplasias da Mama/patologia , Neoplasias da Mama/mortalidade , Pessoa de Meia-Idade , Prognóstico , Incidência , Adulto , Idoso , Sudeste Asiático/epidemiologia , Metástase Neoplásica , Biomarcadores Tumorais/metabolismo , População do Sudeste AsiáticoRESUMO
BACKGROUND: Cardiovascular disease (CVD) risk factors tend to cluster and interact multiplicatively and have been incorporated into risk equations such as the Framingham risk score, which can reasonably predict CVD over short- and long-term periods. Beyond risk factor levels at a single time point, recent evidence demonstrated that risk trajectories are differentially related to CVD risk. However, factors associated with suboptimal control or unstable CVD risk trajectories are not yet established. OBJECTIVE: This study aims to examine factors associated with CVD risk trajectories in a semirural, multiethnic community-dwelling population. METHODS: Data on demographic, socioeconomic, lifestyle, mental health, and cardiovascular factors were measured at baseline (2013) and during follow-up (2018) of the South East Asia Community Observatory cohort. The 10-year CVD risk change transition was computed. The trajectory patterns identified were improved; remained unchanged in low, moderate, or high CVD risk clusters; and worsened CVD risk trajectories. Multivariable regression analyses were used to examine the association between risk factors and changes in Framingham risk score and predicted CVD risk trajectory patterns with adjustments for concurrent risk factors. RESULTS: Of the 6599 multiethnic community-dwelling individuals (n=3954, 59.92% female participants and n=2645, 40.08% male participants; mean age 55.3, SD 10.6 years), CVD risk increased over time in 33.37% (n=2202) of the sample population, while 24.38% (n=1609 remained in the high-risk trajectory pattern, which was reflected by the increased prevalence of all major CVD risk factors over the 5-year follow-up. Meanwhile, sex-specific prevalence data indicate that 21.44% (n=567) of male and 41.35% (n=1635) of female participants experienced an increase in CVD risk. However, a stark sex difference was observed in those remaining in the high CVD risk cluster, with 45.1% (n=1193) male participants and 10.52% (n=416) female participants. Regarding specific CVD risk factors, male participants exhibited a higher percentage increase in the prevalence of hypertension, antihypertensive medication use, smoking, and obesity, while female participants showed a higher prevalence of diabetes. Further regression analyses identified that Malay compared to Chinese (P<.001) and Indian (P=.04) ethnicity, nonmarried status (P<.001), full-time employment (P<.001), and depressive symptoms (P=.04) were all significantly associated with increased CVD risk scores. In addition, lower educational levels and frequently having meals from outside were significantly associated to higher odds of both worsening and remaining in high CVD risk trajectories. CONCLUSIONS: Sociodemographics and mental health were found to be differently associated with CVD risk trajectories, warranting future research to disentangle the role of psychosocial disparities in CVD. Our findings carry public health implications, suggesting that the rise in major risk factors along with psychosocial disparities could potentially elevate CVD risk among individuals in underserved settings. More prevention efforts that continuously monitor CVD risk and consider changes in risk factors among vulnerable populations should be emphasized.
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Doenças Cardiovasculares , Humanos , Masculino , Feminino , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto , Fatores de Risco , Sudeste Asiático/epidemiologia , Sudeste Asiático/etnologia , Idoso , Etnicidade/estatística & dados numéricos , Medição de Risco/métodos , Fatores de Risco de Doenças CardíacasRESUMO
INTRODUCTION: Respiratory syncytial virus (RSV) is a common, highly contagious pathogen and a leading cause of serious illness among infants and older adults. While existing scientific evidence has predominantly focused on the epidemiology and disease burden of RSV in infants, data in older adults remain limited in some countries, including those in Southeast Asia (SEA) and the Middle East and North Africa (MENA) region. Here, we outline the key challenges for understanding the burden of RSV in older adults in SEA and the MENA region and we propose opportunities for improving understanding and eventually reducing the impact of RSV. MAIN FINDINGS AND CONCLUSIONS: A key challenge identified by the expert group, particularly in older adults, is a lack of awareness (among healthcare professionals, policy makers, and the public) of RSV burden and the associated risks for severe outcomes. This is often confounded by the complexities of underdiagnosis, surveillance limitations, and comorbidities. To address these issues, we suggest medical education initiatives for physicians in SEA and the MENA region to better understand the need to protect older adults from RSV, and encourage more widespread routine testing to better understand the burden of RSV. We also recommend surveillance studies in these regions to provide comprehensive and accurate epidemiological data on RSV in older adults. Finally, in the absence of current surveillance data in these regions, we propose extrapolating existing global data and local pediatric data to inform the likely burden of RSV in older adults. A graphical abstract is available with this article.
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Infecções por Vírus Respiratório Sincicial , Humanos , Infecções por Vírus Respiratório Sincicial/epidemiologia , África do Norte/epidemiologia , Oriente Médio/epidemiologia , Sudeste Asiático/epidemiologia , Idoso , Efeitos Psicossociais da DoençaRESUMO
BACKGROUND: The number of tuberculosis (TB)-related morbidities and mortalities is still high in the South-east Asian region. This study was performed to characterize and visualize the post-coronavirus disease 2019 (COVID-19) TB research in South Asian Association for Regional Cooperation (SAARC). METHODS: The Web of Science Core Collection database was utilized. A total of 4822 documents were included in the final analysis according to the predefined eligibility criteria. The data were exported to the R package and VOSviewer software for factorial analysis and network visualization, respectively. RESULTS: The included documents were published in English between 2020 and 2024 in 1255 journals. These documents were authored by 17005 authors (3.53 authors/document). The authors collaboration index was noticed 3.61. In total, 74.16% documents were published as the article. The highest number of documents were published in 2022 (n = 1089). The documents published in 2020 received the highest number of mean total citations per article (n = 8.64). The most published journal was Cureus Journal of Medical Science (n = 228). The most prolific author was Gupta A (n = 115). The most active institution was the All India Institute of Medical Sciences (n = 587). The top most trending topics were Mycobacterium tuberculosis, TB elimination, molecular docking, extrapulmonary TB, Cartridge Based Nucleic Acid Amplification Test, and multidrug resistance. India was the most productive country and had the strongest research collaboration with the United States of America (USA), the United Kingdom (UK), and South Africa. Pakistan was mainly collaborating with the USA, the UK, Saudi Arabia, and China. The India and Pakistan collaboration was observed only in 66 documents. CONCLUSION: There is a poor output of scientific publication on TB in most SAARC countries. However, it is recognized that India has produced the highest number of scientific publications. The detection of undiagnosed post-COVID-19 pandemic TB cases is crucial to control further cases in the region. An effective regional cooperation should be established among institutions, universities, and countries to achieve the World Health Organization End TB goals.
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COVID-19 , Aprendizado de Máquina , Tuberculose , Humanos , Tuberculose/epidemiologia , Tuberculose/diagnóstico , COVID-19/epidemiologia , Bibliometria , SARS-CoV-2/genética , Pesquisa Biomédica/tendências , Ásia/epidemiologia , Sudeste Asiático/epidemiologiaRESUMO
Lumpy skin disease (LSD) poses a significant threat to animal welfare and leads to economic losses in affected countries. LSD outbreaks may also impact trade and regional relationships. South and Southeast Asia, with its dense livestock population and intricate trade networks, are susceptible to LSD outbreaks. Indonesia confirmed its first LSD cases in March 2022, leading to substantial livestock losses by August 2023. Australia, an important player in the global beef industry, faced trade disruptions due to LSD concerns raised by Indonesia and Malaysia, claims that were refuted by Australian authorities. The dispute highlights the need for good surveillance. EPIWATCH®, employing artificial intelligence, provides real-time outbreak signals, and spatial analysis can identify LSD hotspots, leading to timely interventions. This study uses data collected by the EPIWATCH® open-source disease surveillance system at the University of New South Wales in 2022 and 2023 and compares it for timeliness and completeness with data available on the World Animal Health Information System (WAHIS). We found more timely reports of LSD outbreaks in EPIWATCH® compared to WAHIS. In conclusion, open-source surveillance tools like EPIWATCH® can provide timely alerts of disease emergence, such as LSD outbreaks in South and Southeast Asia, which can supplement formal reporting systems.
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Surtos de Doenças , Doença Nodular Cutânea , Doença Nodular Cutânea/epidemiologia , Animais , Surtos de Doenças/veterinária , Bovinos , Sudeste Asiático/epidemiologia , Vigilância da População/métodos , Vírus da Doença Nodular CutâneaRESUMO
Accurate diagnosis of strongyloidiasis is crucial for effective treatment and prevention of complications. We reviewed the current landscape of diagnostic assays used in detecting Strongyloides infection in Southeast Asia. A literature search was performed using Scopus, PubMed, and Web of Science databases spanning the last three decades. Based on the exclusion and inclusion criteria, 52 papers were included in this review. We outlined the diagnostic methods used and their advantages and drawbacks. Insensitive parasitological methods were commonly used, thus underscoring the underestimation of Strongyloides infection rates in Southeast Asia. A combination of diagnostic methods (i.e., microscopy, molecular techniques, and serology) is preferred because it leads to more effective detection and higher prevalence rates. New approaches have been developed, including urine ELISAs and rapid lateral flow tests. Improving and standardizing diagnostics and making them more accessible can improve Strongyloides prevalence estimates and facilitate control efforts.
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Strongyloides stercoralis , Estrongiloidíase , Estrongiloidíase/diagnóstico , Estrongiloidíase/epidemiologia , Strongyloides stercoralis/imunologia , Strongyloides stercoralis/isolamento & purificação , Animais , Humanos , Sudeste Asiático/epidemiologia , Prevalência , Testes Sorológicos/métodosRESUMO
PURPOSE: Visceral leishmaniasis (VL) is caused by an intracellular parasite that is transmitted to humans by sandfly bites. It is prevalent throughout Asia, Africa, the Americas, and the Mediterranean area, where 147 million people are at risk of contracting the illness. The manifestation of heterotrophic illness relies on both Leishmania implicated and the host's immunological response, ranging from asymptomatic to severe leishmaniasis with potentially lethal effects. METHOD: We reviewed the literature (published till 31st December 2023) on the worldwide situation of leishmaniasis, standard and novel detection techniques, and traditional and modern treatment strategies and endeavors to eliminate VL. Moreover, epidemiological data was collected from the World Health Organization's publicly available databases. GraphPad Prism Version 8 was used to analyze and produce figures based on the epidemiological data. RESULTS: Diagnosis of parasites in tissues or serology is commonly employed. Diagnosis by identifying parasite DNA using molecular techniques is becoming more popular. Despite recent findings of L. donovani resistance to pentavalent antimoniate medications, it continues to be the cornerstone in the medical management of VL. Amphotericin B and its lipid formulations, injectable paromomycin, and oral miltefosine are among the new therapy options being researched. The number of reported VL cases has reduced remarkably over the last decade due to human interventions made to eliminate VL. Particularly countries from the South East Asian region have experienced momentous progress in reducing VL cases and eliminating this disease from this region. Owing to the robust elimination programs, countries such as Bangladesh has eliminated VL as a public health concern. India and Nepal are on the verge of its elimination. CONCLUSION: Rapid diagnosis, effective and inexpensive treatment, simple access to newly discovered medications, appropriate vector control, and a well-designed vaccine are all required for the elimination of this disease burden in impoverished areas of the globe.
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Leishmaniose Visceral , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/tratamento farmacológico , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/prevenção & controle , Humanos , Sudeste Asiático/epidemiologia , Antiprotozoários/uso terapêutico , Erradicação de Doenças , Leishmania donovani/imunologia , Leishmania donovani/efeitos dos fármacos , Animais , Anfotericina B/uso terapêuticoRESUMO
Livestock is a strategic part of the small-farm economy in Southeast Asia's society, providing food income, clothing, fertilizer, and draught power. However, incidences or outbreaks of transboundary animal diseases (TADs) are due to converging factors such as the natural hazards' aftermath, climate change, deforestation, urban growth, changing production conditions, and market chains. Therefore, this affects productivity and impacts farmers' livelihoods with small holdings. The literature review was carried out to understand the current situation of TADs in Southeast Asia, identifying knowledge gaps to provide actions for disease control and prevention in the region. We have attempted to summarise the scientific literature in English on the prevalence data of TADs in Southeast Asia between 2011 and March 2022. Relatively few studies evaluated the distribution of TAD, where most of the studies focused on diseases that are important for international trade, such as avian influenza (AI), African swine fever (ASF), classical swine fever (CSF), foot-and-mouth disease (FMD) and Newcastle disease (ND). Traditional production systems have received little attention in such studies as they belonged to mainly smallholders. The outbreaks of ASF and lumpy skin disease (LSD) in 2019 resulted in increased research activity between 2019-2022, while the other TADs were ignored in this period. For new emerging TADs diseases such as ASF and LSD, there is only information about the first detection without prevalence information. Therefore, further epidemiological investigations are necessary to reduce the gaps in disease surveillance reporting systems and support the prevention and reduction of further outbreaks.
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Doenças das Aves Domésticas , Aves Domésticas , Doenças dos Suínos , Animais , Sudeste Asiático/epidemiologia , Suínos , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/virologia , Doenças das Aves Domésticas/epidemiologia , Doenças das Aves Domésticas/virologia , Viroses/veterinária , Viroses/epidemiologia , Ruminantes/virologia , Surtos de Doenças/veterinária , PrevalênciaRESUMO
The Monocled Cobra (Naja kaouthia), a category one medically significant snake from the Elapidae family, inflicts severe envenomation in South and Southeast Asian countries. N. kaouthia is distributed throughout the eastern and northeastern parts of India, Nepal, Bangladesh, Myanmar, Thailand, Vietnam, Malaysia, and southwestern China. Envenomation by N. kaouthia is a medical emergency, and the primary clinical symptoms are neurotoxicity and localized tissue destruction. Unfortunately, data on the actual magnitude of N. kaouthia envenomation is scarce due to poor record keeping, lack of diagnostic kits, and region-wise well-coordinated epidemiological surveys. The present review highlights the diversity in the composition of N. Kaouthia venom (NKV) across various geographical regions, as revealed through biochemical and proteomic analyses. The qualitative and quantitative differences in the toxin isoforms result in differences in lethality and pathophysiological manifestation that may limit the effectiveness of antivenom therapy. Studies on commercial polyvalent antivenom (PAV) effectiveness against distinct NKV samples have revealed varying toxicity and enzymatic activity neutralization. Additionally, the identification of snake venom's poorly immunogenic toxins by mass spectrometry, quantification of venom-specific antibodies, and implications for antivenom therapy against snakebites are highlighted. Future directions involve clinical studies on NK envenomation where the snake is frequently encountered and the correlation of this data with NKV composition in that region. For more efficient and superior hospital management of NK envenomation, research should enhance the current immunization procedure to boost the development of antibodies against less immunogenic venom components of this snake.
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Antivenenos , Venenos Elapídicos , Mordeduras de Serpentes , Animais , Antivenenos/uso terapêutico , Sudeste Asiático/epidemiologia , Mordeduras de Serpentes/tratamento farmacológico , Humanos , Serpentes PeçonhentasRESUMO
Introduction: Tuberculosis (TB) remains a leading cause of mortality worldwide. We conducted this systematic review to understand the distribution of bovine and zoonotic tuberculosis in the World Health Organization (WHO)'s Southeast Asia Region (SEAR) and Western Pacific Region (WPR) to inform our understanding of the risk posed by this disease. Methods: A two-pronged strategy was used by evaluating data from peer-reviewed literature and official reports. A systematic search was conducted using a structured query in four databases (Web of Science, Scopus, Medline, and PubMed) to identify any reports of the occurrence of zoonotic TB. No language and time constraints were used during the search, but non-English language articles were later excluded. The official data were sourced from the World Organization for Animal Health's (WOAH) World Animal Health Information System (WAHIS) and WHO's global TB database. Results: The retrieved records from SEAR and WPR (n = 113) were screened for eligibility, and data about disease occurrence were extracted and tabulated. In SEAR, all of the five studies that conducted Mycobacterium speciation (5/6) in humans were from India, and the reported Mycobacterium species included M. tuberculosis, M. bovis, M. scrofulacium, M. kansasii, M. phlei, M. smegmatis and M. orygis. In WPR, Mycobacterium speciation investigations in humans were conducted in Australia (8), China (2), Japan (2), NewZealand (2) and Malaysia (1), and the reported Mycobacterium species included M. bovis, M. africanum and M. tuberculosis. Seven countries in WHO's SEAR have officially reported the occurrence of Mycobacterium bovis in their animals: Bangladesh, India, Indonesia, Myanmar, Nepal, Sri Lanka and Thailand. In WPR, the WAHIS information system includes reports of the identification of M. bovis from 11 countries - China, Fiji, Japan, Malaysia, Mongolia, New Zealand, the Philippines, the Republic of Korea, Singapore, Tonga and Viet Nam. In contrast, human zoonotic TB cases in the WHO database were only listed from Australia, Brunei Darussalam and Palau countries. Discussion: The available data suggests under-reporting of zoonotic TB in the regions. Efforts are required to strengthen zoonotic TB surveillance systems from both animal and human health sides to better understand the impact of zoonotic TB in order to take appropriate action to achieve the goal of ending the TB epidemic.
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Tuberculose Bovina , Tuberculose , Organização Mundial da Saúde , Zoonoses , Animais , Bovinos , Sudeste Asiático/epidemiologia , Humanos , Zoonoses/epidemiologia , Tuberculose/epidemiologia , Tuberculose Bovina/epidemiologiaRESUMO
INTRODUCTION: Tuberculosis (TB) is a global public health issue. The Southeast Asian region grapples with numerous challenges in TB management, with loss to follow-up (LTFU) emerging as a critical barrier to effective control of the disease. This review synthesised published articles to identify socioeconomic factors contributing to the burden of TB losses for follow-up in Southeast Asia. MATERIALS AND METHODS: This scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework developed by the Joanna Briggs Institute (JBI). A total of 10 studies were identified as eligible from the title and abstract review. The mixed method quality appraisal tool (MMAT) version 2018 was used to assess the quality of the included quantitative studies. RESULTS: The results showed that poverty, unemployment, low education levels, migrant status, community support, male gender, substance abuse, and regional disparities significantly impact the occurrence of TB LTFU in Southeast Asia. CONCLUSION: The findings have significant implications for public health in Southeast Asia. Addressing these socioeconomic barriers through community-based strategies, educational initiatives, and policy reforms is vital for improving treatment outcomes and overall public health.
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Fatores Socioeconômicos , Tuberculose , Humanos , Sudeste Asiático/epidemiologia , Tuberculose/epidemiologia , Perda de Seguimento , MasculinoRESUMO
Objective: The COVID-19 pandemic challenged the Global Outbreak Alert and Response Network's (GOARN) mechanism used to rapidly deploy technical support for international responses and highlighted areas that require strengthened capacity within the Network. GOARN's partners in the World Health Organization's (WHO) South-East Asia and Western Pacific regions were engaged to explore their levels of preparedness, readiness and ability to respond to international public health emergencies. Methods: Consultative discussions were held and a survey was conducted with GOARN's partners from the two WHO regions. Discussion topics included partners' capacity to support and participate in a GOARN deployment, training, research and collaboration. Descriptive and content analyses were conducted. Results: Barriers to engaging in GOARN's international outbreak response efforts included limited numbers of personnel trained to respond to outbreaks; institutional, financial and administrative hurdles; and limited collaboration opportunities. Partners identified innovative solutions that could strengthen their engagement with deployment, such as financial subsidies, mentorship for less experienced staff, and the ability to provide remote support. Discussion: GOARN plays an important role in enabling WHO to fulfil its international alert and response duties during disease outbreaks and humanitarian crises that have the potential to spark disease outbreaks. Yet without systematic improvement to strengthen national outbreak capacity and regional connectedness, support for international outbreak responses may remain limited. Thus, it is necessary to integrate novel approaches to support international deployments, as identified in this study.
Assuntos
COVID-19 , Surtos de Doenças , Organização Mundial da Saúde , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Surtos de Doenças/prevenção & controle , Organização Mundial da Saúde/organização & administração , Sudeste Asiático/epidemiologia , SARS-CoV-2 , Cooperação Internacional , Saúde Global , Fortalecimento Institucional/organização & administração , Pandemias/prevenção & controle , Ilhas do Pacífico/epidemiologiaRESUMO
BACKGROUND: South-East Asia is a densely populated region with a considerable, however, under-prioritized mental health burden. Little is known about the mental health burden and services status in the prisons of the region. OBJECTIVES: We aimed to investigate the individual country-wise prison mental health status in South-East Asian region. METHODS: We performed a narrative review based on the evidence available in PubMed, Scopus, PsycINFO, Google, and Google Scholar considering the review objectives. We highlighted country perspectives on total population, prison numbers, prisoner numbers, the prevalence of psychiatric disorders and suicide among prisoners, prison mental health services, current challenges, and ways ahead. RESULTS: We discussed the prison mental health of five countries (Bangladesh, India, Indonesia, Nepal, and Sri Lanka). We found overcrowding (131.4%-215.6%) in the prisons, a high prevalence of psychiatric disorders in the prisons (40%-100%), negligible prison mental health services, and a lack of data on prison suicide with some variations among the five countries. Among the countries, Bangladesh has the highest prevalence (66.4%-100%) of psychiatric morbidity with an absence of a mental health system. CONCLUSIONS: Prison mental health in tSouth-East Asia is a neglected domain and warrants attention regarding ensuring adequate mental health services to the prisoners as there are high unmet mental health needs and an absence of poorly supported mental health needs.
Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Prisioneiros , Prisões , Humanos , Prisioneiros/estatística & dados numéricos , Prisioneiros/psicologia , Sudeste Asiático/epidemiologia , Transtornos Mentais/epidemiologia , Prisões/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Nepal/epidemiologia , PrevalênciaRESUMO
BACKGROUND: In 2021, the World Health Organization (WHO) launched the Global Breast Cancer Initiative (GBCI) with the aim of strategically guiding and coordinating efforts to reduce breast cancer mortality in low- and middle-income countries (LMICs). At the country level, GBCI requires adaptation to local contexts based on a systematic assessment of barriers faced by breast cancer patients and the health system's capacity. This requires engaging stakeholders with civil society organizations being key. METHOD: During the 7th Southeast Asia Breast Cancer Symposium (SEABCS) held in Hue, Vietnam, breast cancer clinicians, policy makers, patients, advocates, and caregivers were invited to participate in a workshop to discuss the role civil society organizations will play in the implementation of GBCI. The workshop objective was to identify the needs of CSOs to effectively support the domestic implementation of GBCI principles and strategies. RESULT: Twenty-two people registered for the workshop, with eight civil society organizations represented by one or more members. Participants were assigned to three groups and were asked to describe; (a) the ways in which civil society could use the GBCI framework document, advocate for its implementation at the country level, and support the implementation of recommended interventions; and (b) what would be needed for civil society to use, advocate for, or implement GBCI. CONCLUSION: This report outlines the main discussion points, the roles that civil society can play in countries' implementation efforts, and the resources needed so they can efficiently support their governments in their implementation strategy. By including civil society as a key element of breast cancer control, countries in the region and beyond can accelerate the domestic implementation of the GBCI principles and strategies, making significant progress in breast cancer control and improving the lives of those affected by the disease.