Asymptomatic and sub-microscopic malaria infection in Kayah State, eastern Myanmar.

BACKGROUND: Myanmar has the heaviest burden of malaria in the Greater Mekong Sub-region. Asymptomatic Plasmodium spp. infections are common in this region and may represent an important reservoir of transmission that must be targeted for malaria elimination. METHODS: A mass blood survey was conducted among 485 individuals from six villages in Kayah State, an area of endemic but low transmission malaria in eastern Myanmar. Malaria infection was screened by rapid diagnostic test (RDT), light microscopy and real-time polymerase chain reaction (PCR), and its association with demographic factors was explored. RESULTS: The prevalence of asymptomatic Plasmodium spp. infection was 2.3% (11/485) by real-time PCR. Plasmodium vivax accounted for 72.7% (8/11) and Plasmodium falciparum for 27.3% (3/11) of infections. Men were at greater risk of infection by Plasmodium spp. than women. Individuals who worked as farmers or wood and bamboo cutters had an increased risk of infection. CONCLUSION: A combination of RDT, light microscopy and PCR diagnostics were used to identify asymptomatic malaria infection, providing additional information on asymptomatic cases in addition to the routine statistics on symptomatic cases, so as to determine the true burden of disease in the area. Such information and risk factors can improve malaria risk stratification and guide decision-makers towards better design and delivery of targeted interventions in small villages, representative of Kayah State.

Driving factors of community pharmacist weight management service: A structural equation modeling approach.

BACKGROUND: Even though the effectiveness of community pharmacists in helping customers to reduce weight has been evident, few pharmacists provided weight management services (WMS). To drive community pharmacist WMS provision, factors affecting their intention and WMS provision were important to be investigated. OBJECTIVE: The present study aimed to explore relationships among pharmacist authority, perceived customer obstruction, WMS performance support, obstacles, and facilitators with intention to provide WMS and WMS rovision using structural equation modeling (WMS. METHOD: Self-administered questionnaires were utilized to collect data from 302 Thai community pharmacists from December 2022 to March 2023. Structural equation modeling (SEM) was used to explore the influencing factors on pharmacist WMS intention and WMS provision. RESULTS: Pharmacist authority (r = 0.35), WMS performance support (r = 0.24), and facilitators (r = 0.22) were significantly correlated with community pharmacist WMS provision. Pharmacist authority (r = 0.50), facilitators (r = 0.46), and WMS performance support (r = 0.42) were significantly correlated with community pharmacist intention to provide WMS e structural equation model (SEM), pharmacist authority (ß = 0.34) and intention (ß = 0.16) significantly influenced WMS provision (R2 = 0.20). Authority (ß = 0.49) and WMS performance support (ß = 0.28) significantly influenced pharmacist intention to WMS (R2 = 0.42). The model from empirical data indicated a good fit with the hypothetical model (p-value = 0.000, Comparatively Fit Index = 0.9, and Tucker-Lewis Index = 0.878). CONCLUSION: Pharmacist authority had direct effects with both their intention to provide WMS and WMS provision. WMS performance support had a direct effect on intention to provide WMS and an indirect effect on WMS provision. Facilitators also had significant correlations with intention to provide WMS and WMS provision.

Genomic Tracking of SARS-CoV-2 Variants in Myanmar.

In December 2019, the COVID-19 disease started in Wuhan, China. The WHO declared a pandemic on 12 March 2020, and the disease started in Myanmar on 23 March 2020. In December 2020, different variants were brought worldwide, threatening global health. To counter those threats, Myanmar started the COVID-19 variant surveillance program in late 2020. Whole genome sequencing was done six times between January 2021 and March 2022. Among them, 83 samples with a PCR threshold cycle of less than 25 were chosen. Then, we used MiSeq FGx for sequencing and Illumina DRAGEN COVIDSeq pipeline, command line interface, GISAID, and MEGA version 7 for data analysis. In January 2021, no variant was detected. The second run, during the rise of cases in June 2021, showed Alpha, Delta, and Kappa variants. The third and the fourth runs in August and December showed only a Delta variant. Omicron and Delta variants were detected during the fifth run in January 2022. The sixth run in March 2022 showed only Omicron BA.2. Amino acid mutation at the receptor binding domain of Spike glycoprotein started since the second run coupling with high transmission, recurrence, and vaccine escape. We also found the mutation at the primer targets used in current RT-PCR platforms, but there was no mutation at the existing antiviral drug targets. The occurrence of multiple variants and mutations claimed vigilance at ports of entry and preparedness for effective control measures. Genomic surveillance with the observation of evolutionary data is required to predict imminent threats of the current disease and diagnose emerging infectious diseases.