A descriptive study on motivations for entering and remaining, exiting community-based tuberculosis care among volunteers in Yangon, Myanmar / 国際保健医療

Background   Since the Alma Ata Declaration in 1978, Community Health Volunteers (CHVs) have become critical assets to assist tuberculosis (TB) control programs in low and middle-income countries, such as in case finding and treatment support activities. Yet community-based tuberculosis control programs (CBTBC) are faced with numerous challenges, including recruitment and retaining of CHVs. While the possible effect of financial incentives has been extensively discussed, other motivational factors have received less attention. Objective   This study sought to explore on potential motivations for entering, remaining, and exiting volunteer work among CHVs working in a CBTBC project run by an NGO, Japan Anti-Tuberculosis Association (JATA), in urban townships of Yangon, Myanmar.Methods   A semi-structured questionnaire was administered to CHVs who were working for a JATA CBTBC project in Yangon, Myanmar. The questionnaire consisted of closed- and open-ended questions asking about demographic characteristics, their experiences, and their motivations for entering, remaining and exiting volunteer work. Functional theory of motivation was used as a conceptual framework for analysis.Results   A total of 69 volunteers participated in the survey, representing 69% of all CHVs for JATA CBTBC (69/100). From the questionnaire, we found that altruism, self-empowerment, and psychological job satisfaction mainly influenced CHVs’ motivation to enter and remain in volunteer work. Expectations for financial incentives were less important. Being busy with housework and other work priorities could motivate them to temporarily exist volunteer work, while ill-health and old age potentially triggered permanent exit. Conclusions   CHVs working in JATA CBTBC were motivated mainly by altruism, self-empowerment, and psychological job satisfaction - however, their volunteer work must be systematically supported so as to avoid unnecessary burden on CHVs. Further qualitative study would extend the evidences of the potential factors which might contribute to sustaining CHV participation.

Length?weight Relationships of Four Indigenous Freshwater Fishes of Longshen Stream, Indo-Myanmar Borderline of North-East of India

Length-weight relationships (LWR) are reported for four indigenous fish species of longshen stream, Indo-Myanmar boundary line North-Eastern Ghats of Indian region, for the period of June 2020 to September 2022. Specimen species were collected during different exploratory surveys, using through traditional bamboo made fishing gears. The b value for LWRs varied from 2.09(Barilius vagra) to 2.63(Garra lissorhynchus). R2 values varied from 0.85 to 0.95, indicating unique values. The results providing baseline information for the need of sustainable ecological as well as economical management and conservation of indigenous fish species in Indo-Myanmar borderlines

Role of inclusive self-help groups in prevention and management of diabetes and hypertension in Myanmar: a qualitative study

Background: Noncommunicable diseases (NCDs) are a growing public health concern in Myanmar. Community-based self-help groups are essential for participating in health-related activities. However, little is known about the role of inclusive self-help groups (ISHG) in hypertension and diabetes management. This study aimed to assess knowledge and perception of health-related activities of ISHG and explore challenges ISHG group members encountered in performing hypertension and diabetes prevention and management activities. Methods: The study included six townships from three different regions of Myanmar, where ISHG existed. Two focus group discussions (FGDs) were held in each township. A total of twelve FGDs were conducted. All discussions were conducted, audio-recorded and transcribed verbatim in Myanmar language. A thematic analysis was performed using inductive and deductive approaches. Results: The findings revealed that ISHG members provided advice and counselling on behavioural risk factors for hypertension and diabetes prevention and screenings for those diseases. They also offered home care for the elderly and stroke patients who required their assistance. Community members regarded ISHG as a valuable community structure. Members of the ISHG identified a number of challenges, including lack of resources (funding, manpower, and time), lack of confidence, and lack of recognition and acceptance. Support and strengthening activities by local authorities and the government were critical to sustain ISHG's activities and efforts. Conclusions: Hypertension and diabetes management activities of ISHG are appreciative. The public and government should recognize and support ISHG to strengthen their community activities.

Differential of physical activities and its association with hypertension and diabetes in Myanmar

Background: Myanmar has been facing a high and growing burden of NCDs. Since regular physical activity has been recognized as one of the effective strategies in prevention and control of NCDs, promotion of physically active lifestyle might help in combatting a number of NCDs. This study was conducted to assess the sociodemographic differentials of physical activity and to identify the association between the insufficient physical activity and occurrence of hypertension and diabetes using data extracted from Myanmar STEP-2014-data. Methods: This study was further data analysis on 2014 STEP survey and included (5791) 40-64-year-aged participants, a subsample of STEP survey. Binary logistic regression with clustered robust standard error method was applied to estimate the effect of insufficient physical activity on occurrence of hypertension and diabetes. Results: The findings revealed that 17.5% [95%CI: 16.5%, 18.5%] of participants had the insufficient physical activity, 41.9% [95%CI: 40.6%, 43.2%] had raised blood pressure and 16.9% [95%CI: 15.9%, 17.9%] had raised blood glucose. After adjusting other covariates, the significant association between insufficient physical activity and raised blood pressure was not found; whereas insufficient physical activity was significantly contributed to occurrence of raised blood glucose. Conclusions: The present study highlighted the importance of physical activity in occurrence of raised blood glucose. The proportions of insufficient physical activity, raised blood pressure and raised blood glucose were observed as a rising pattern with increasing in age. Community-based health promotion program targeted at promoting physically active lifestyle should be adapted to interventions that are appropriate to different age structures.

Donor’s perspectives on blood donation and challenges of National Blood Center, Yangon, during the COVID-19 pandemic

Background: The ongoing COVID-19 pandemic is causing major disruption at all levels of healthcare services, including blood bank services globally. The donors’ knowledge, attitudes, beliefs, and behaviors regarding blood donation in Myanmar are needed to be considered. Hence, we studied the perspectives of blood donors on their donation and the challenges faced by the National Blood Centre, Yangon (NBC), during the COVID-19 pandemic. Methods: We conducted the cross-sectional descriptive study using mixed methods among blood donors aged 20 years and above for quantitative approach and among three purposively selected blood bank experts for key informant interviews of qualitative portion. Results: Of the 240 donors, the mean age was 36.41±10.83 years, and the male-to-female ratio was 1.24:1. Overall, regarding blood donation, 57.1% had favorable knowledge, 59.2% had favorable attitude, and 31.3% had regular voluntary practice. The higher-income donors had more favorable knowledge (p=0.013). Male donors (p=0.037), donors aged 50 years and above (p<0.001), and who with favorable knowledge (p=0.002) had regular voluntary practice. The more knowledge and positive attitude the donors had, the more times they donated blood. Thematic analysis identified five key themes and during pandemic, NBC encountered reduced blood supply and demand, communication problems with donors, human resources shortage, poor adherence to safety precautions of COVID-19 among donors and staff, and difficulty in arrangement of continuous consumable supply and maintenance as main challenges. Conclusions: Policymakers and medical directors should have proper plans and policies to raise awareness, mobilize regular voluntary donors, especially youth and repeated donors, and recruit potential donors.

Risk factors for stunting of under-five children in Myanmar

Background: This study aimed to identify risk factors and assess their significance concerning childhood stunting in Myanmar. Methods: This study was conducted through the analysis of a secondary dataset based on the 2015-2016 Myanmar Demographic and Health Survey (MDHS 2015-2016), a program funded by the United States Agency for International Development (USAID). Among the 5239 under-five children who participated in the Myanmar DHS 2015-2016 survey, 4172 children with complete anthropometric measurements were included in this study. This was a cross-sectional study, and Chi-squared analysis was applied to determine the association of each risk factor with stunting. In addition, logistic regression was used for multivariate analysis of all risk factors combined. Results: Out of 4172 children who participated in the study, 1146 (27.5%) were stunted. Type of place of residence, household wealth index, and maternal education level have a significant effect on stunting of under-five children with (?2=52.79, df=1, p=0.000), (?2=82.03, df=2, p=0.000) and (?2=72.31, df=3, p=0.000) respectively. When applied to multivariate logistic regression analysis, all three factors remained significant predictors of stunting in under-five children. Conclusions: Individual- and community-level factors determining the stunting of under-five children in Myanmar were explored. Government support programs for the occupation and income of the household heads and household members, as well as education programs targeting women in both the short term and long term, may help improve the condition.

Prevalence of Staphylococcus aureus, its antimicrobial resistance and relation to food hygiene practices of food handlers: analysis of food and non-food items from market food shops in Yangon, Myanmar

Background: Staphylococcus aureus is the common cause of food poisoning and its rising antibiotic resistance poses a severe threat to public health. In Myanmar, S aureus isolation and AMR pattern in food and non-food objects studied at the markets are still limited. This research filled the information gaps regarding the prevalence of S aureus in food and non-food items from market food shops relation to hygienic practices of the food handlers and assessed its antimicrobial resistance. Methods: Cross-sectional study was conducted at sixteen markets in Yangon during 2022. The study included 75 food handlers to assess their hygiene practices. From each shop, one food and one non-food samples were taken to reach the total 150 samples. Chi-square test was used for analysis. Results: S aureus was found in 4% of food samples and 5.3% of non-food samples. Bacterial contamination in food was satisfactory, 17.3% to unsatifactory, 60% while non-food samples were 4%, clean to 73.3%, very contaminted. Drug resistance to benzyl penicillin, azithromycin, erythromycin, clindamycin, lincomycin in food samples and tetracycline in both samples were found. Hygiene practices was good among 57.3% of food handlers and there was no association between practices and S aureus prevalence although positivity was higher among the samples taken from the shops of handlers with poor hygiene practices. Conclusions: The prevalence of S aureus was not different between food and non-food samples and not associated with the hygiene practices of food handlers.

Polymorphisms of pvcrt-o and pvmdr1 genes of 48 Plasmodium vivax isolates from the China-Myanmar border / 中国热带医学

@#Abstract: Objective To detect the polymorphisms of drug resistance-related genes pvcrt-o and pvmdr1 of Plasmodium vivax in lazan city in the China-Myanmar border, in order to guide the treatment plan of Plasmodium vivax. Methods A total of 48 Plasmodium vivax samples were collected from Lazan in the China-Myanmar border in 2007, and fragments of pvcrt-o and pvmdr1 genes were amplified by PCR and sequenced. The sequences were aligned with the Salvador I (Sal-I) strain reference genome sequences to determine the presence of SNPs. Results The target fragments of pvcrt-o gene were amplified from 39 Plasmodium vivax samples, while pvmdr1 genes were amplified from 40 samples. Amongst them, 25 samples had AAG insertion before the 10th amino acid (K10 insertion) of pvcrt-o gene, accounting for 64.1%. Non-synonymous mutations were detected at three loci of pvmdr1 gene (T958M, Y976F, and F1076L), the mutation rates were 100%, 22.5%, and 55.0%, respectively. There were three haplotypes of pvmdr1 gene, of which the triple mutant 958M/976F/1076L accounted for 22.5% (9/40), the double mutant 958M/Y976/1076L accounted for 32.5% (13/40), and the single mutant 958M/Y976/F1076 accounted for 45.0% (18/40). The proportion of strains with pvcrt-o and pvmdr1 gene mutation is 63.16%, which is significantly different from those only with pvmdr1 mutation. Conclusions The proportion of pvcrt-o and pvmdr1 gene mutation of 48 Plasmodium vivax isolates is high in the China-Myanmar border, and there is a certain degree of correlation between the two gene mutations. To assess changes in Plasmodium vivax drug resistance in this region, it is required to improve the surveillance of these two molecular markers.

Malaria control knowledge and behaviors and their influencing factors among residents in Banlao Township, Cangyuan County, Yunnan Province / 中国血吸虫病防治杂志

Objective To investigate the awareness of malaria-related knowledge, the use of mosquito nets and their influencing factors among residents in Banlao Township, Cangyuan County, Yunnan Province.. Methods In August 2020, 19 settlement sites in Banlao Township, Cangyuan County, Lincang City, Yunnan Province were selected as study areas, and permanent residents at ages of 10 years and older were enrolled for a questionnaire survey, including residents’ demographics, family economic status, malaria control knowledge and use of mosquito nets. In addition, the factors affecting the use of mosquito nets in the night prior to the survey were identified using multivariate logistic regression analysis. Results A total of 320 questionnaires were allocated, and all were recovered (a 100% recovery rate). There were 316 valid questionnaires, with an effective recovery rate of 98.75%. The 316 respondents included 152 men and 164 women and 250 Chinese respondents and 66 foreign respondents. The awareness of clinical syndromes of malaria was significantly higher among Chinese residents (71.60%) than among foreign residents (50.00%) (χ2 = 11.03, P < 0.01), and the proportions of Chinese and foreign residents sleeping under mosquito nets were 46.00% and 69.70% on the night prior to the survey, respectively (χ2 = 11.73, P < 0.01). Multivariate logistic regression analysis identified ethnicity group and type of residence as factors affecting the use of mosquito nets in the night prior to the survey. Conclusions The awareness of malaria control knowledge, the coverage and the use of mosquito nets were low among residents in Banlao Township, Cangyuan County, Yunnan Province. Targeted health education is recommended to improve the awareness of malaria control knowledge and self-protection ability. In addition, improving the allocation of long-lasting mosquito nets and health education pertaining to their uses and increasing the proportion of using mosquito nets correctly is needed to prevent re-establishment of imported malaria.

Screening for malaria infection in residents on the China-Myanmar border: RDT, microscopy and PCR / 中国热带医学

@#Abstract: Objective To compare the screening effects of RDT, microscopy and PCR for malaria among residents in low malaria areas and elimination areas, and to investigate the presence of malaria in residents of border Villages in Cangyuan Va County and asymptomatic infections in surrounding areas, providing a basis for preventing re-introduction of malaria after elimination. Methods From August 2020 to March 2021, the fingertip blood of the investigated subjects was collected from three survey sites in the border area between China and Myanmar, namely Banlao Township in Cangyuan Va Autonomous County of Lincang City, Banwai District, Mengmao County, the Second Special Zone of Shan State, Myanmar, Yongmo and Dayan Township, Nandeng Special Zone, the Second Special Zone of Shan State, Myanmar. The malaria parasite antigen detection test kit, malaria parasite microscopic examination, fluorescent quantitative PCR and nested PCR were used to detect the asymptomatic infection of malaria parasites. Results A total of 1 040 blood samples were collected, including 606 from China and 434 from Myanmar, with 506 males and 534 females. Among them, , there were 51 individuals aged 0 to <5 years, 283 aged 5 to < years, 187 aged 15 to < years, 232 aged 30 to <45 years, 205 aged 45 to < years, and 82 aged ≥60 years. All 1 040 people tested negative for plasmodium antigen detection kit. One case of Plasmodium vivax detected by plasmodium microscopic etiology, with a detection rate of 0.10%. One case of P. vivax was also detected by fluorescent quantitative PCR and nested PCR, with a detection rate of 0.10%. Among them, one case of P. vivax was detected in Banwai District, Mengmao County, the Second Special Zone of Shan State, Myanmar, with a detection rate of 0.35%. The detection rates of malaria parasites in Banlao Township in Cangyuan Va Autonomous County of Lincang City, Yunnan Province and Yongmo Township and Dayan Township, Nandeng Special District, the Second Special Zone of Shan State, Myanmar were both 0. The difference in the detection rate of malaria parasites among the three survey sites was not statistically significant (χ2 =2.682, P>0.05). The asymptomatic P. vivax infection was detected in a 6-year-old girl from Banwai District, Mengmao County, the Second Special Zone of Shan State, Myanmar. Conclusions RDT is not suitable for malaria screening in low malaria area and elimination area. Microscopic examination and PCR can be used for malaria screening, but PCR operation is complex and costly. In surrounding areas outside of China, malaria is still prevalent, while there is no source of malaria infection in border villages of Cangyuan Va County. However, there is a risk of importation, and timely and effective measures should be taken to prevent reintroduction and transmission.

Detection and factors associated with tuberculosis and rifampicin resistance among presumptive patients at the Thailand-Myanmar border

@#Tuberculosis (TB) continues to be a major public health problem in Thailand and many countries. Endemic TB and outbreaks of TB drug resistance in the borderlands are particularly important. The Thailand-Myanmar border has extensive cross-border travel that may accelerate TB’s spread. This cross-sectional study aimed to determine the frequency and factors associated with TB, and rifampicinresistant TB (RR-TB) among presumptive tuberculosis patients in Mae Sot Hospital. Sputum was processed by microscopic examination and Xpert MTB/RIF assay. Laboratory results and socio-demographic characteristics were collected and analyzed. Univariate and multivariate analyses were performed to assess the association of the risk factors with TB and RR-TB. The significant variables at p-values < 0.05 in univariate analysis were selected for multivariate analysis. Of 365 presumptive patients enrolled, 244 (66.85%) were males and 199 (54.52%) were Burmese. Of these, 314 (86.03%) were registered as new cases and 183 (50.14%) worked as laborers. Sputum microscopy was positive in 132 (36.16%) cases. Based on Xpert MTB/RIF, the frequency of TB was 136 (37.26%) and RR-TB was 15 (11.03%). TB was more common in males than females. The majority of the cases belonged to the 26-50-year-old age group and migrant workers. In RR-TB detection, the rpoB mutations covered by probe E were the most frequently observed. Sequencing showed that the most highly mutated codon was codon 531 and Ser531Thr was the most common mutation. For risk factor analysis, working as laborers was significantly (p-value < 0.05) associated with TB (aOR 2.83; 95% CI 1.43-5.63) and previously treated cases were significantly associated with RR-TB (aOR 12.33; 95% CI 2.29-66.49). The high frequency of TB and RR-TB in migrants highlights the problem and factors associated with TB at the border and the need for efforts in TB control programs in this setting.

Accuracy and cost-effectiveness of the Diabetic Foot Screen Proforma in detection of Diabetic Peripheral Neuropathy in Myanmar / Journal of the ASEAN Federation of Endocrine Societies

Objective@#Proper foot assessment is important for early detection and treatment of diabetic peripheral neuropathy (DPN), the main cause of diabetic foot ulcers (DFUs). This study aimed to determine the accuracy and cost-effectiveness of the locally developed Diabetic Foot Screen (DFS) proforma in detecting DPN among diabetic patients at 10 selected clinics in Yangon, Myanmar@*Methodology@#The study included 625 type 2 diabetics from 10 primary care clinics who participated in the diagnostic accuracy and cost-effectiveness analysis. They were assessed with DFS proforma and biothesiometry by two examiners independently. The cost-effectiveness analysis was conducted based on available data in the local primary care setting.@*Results@#The overall accuracy of the DFS proforma assessment was 74.76% (95% CI: 70.46%- 79.06%). The optimal cut-off DFS score was ≥1.5 (sensitivity 62%; specificity 76%) in detecting DPN. Compared to biothesiometry, the cost-effectiveness of DFS proforma assessment in DPN detection was 41.79 USD per DPN case detected.@*Conclusion@#This study supported the use of DFS proforma for DPN detection in primary care clinics. It also provided new information on the estimated costs per patient with DPN detected in Myanmar.

Challenges of maintaining malaria elimination in China: Cross-border malaria / 中国血吸虫病防治杂志

China was certificated malaria-free by WHO in 2021 and has continued to maintain malaria elimination. However, there are still huge challenges in malaria control in the border regions between Yunnan Province, China and Myanmar due to lack of geographic barriers and frequent cross-border travel. Hereby, we review the direction contributions of the Global Fund Malaria Program implemented by Health Poverty Action (HPA), an international non-governmental organization (NGO), to malaria elimination in China, and analyze the challenges of malaria control caused by external environmental factors, such as COVID-19, in regions where the Global Fund Malaria Program is implemented. In addition, some suggestions are proposed for cross-border collaboration on malaria control.

Association of Self-reported Figural Scales With Body Mass Index Among Adults With Hypertension in a Resource-limited Setting

@#Introduction: This study examined the performance of perceived body size in predicting measured body mass index (BMI) among adults with hypertension in Myanmar and to determine the perceived body size cutoffs for obesity. Methods: This cross-sectional study was conducted among 410 hypertensive patients attending public health centers in Myitkyina Township, Kachin State, Myanmar. Perceived body size was measured using the Stunkard’s silhouettes and was compared to a measured BMI. The performance of perceived body size was analyzed by sex-specific receiver operating characteristic curves (ROC) and the optimal perceived body size cutoffs for overweight/obesity (BMI ≥25) were determined. Results: With good correlation coefficients between perceived body size and BMI (0.78 and 0.70 in men and women respectively), perceived body size had the high area under curve (AUC) for overweight/ obesity (0.896 (95%CI=0.835-0.956) for men and 0.828 (0.761-0.895) for women). The optimal figural scales for identifying overweight/obese individuals with a correct detection rate were sixth in men and women. Linear regression analyses supported the fact that the self-reported silhouette rankings in detecting the social patterning of body size was similar with measured BMI. Conclusion: This study supports the idea that figural drawing scales are a potentially useful indicator to assess the overweight/obesity of adults in resource limit settings when self-reported and measured BMI are not available. Further studies are required to re-examine our findings and its effectiveness using a larger population.

Public health status of Myanmar refugees in South East Asia: A Malaysian case study

@#The United Nations High Commissioner for Refugees (UNHCR) reports over 80 million people are displaced worldwide with approximately 26.3 million categorized as refugees and over a million residing temporarily in South East Asia. Despite the lack of national legislative framework in place for refugees and asylum seekers (RAS), Malaysia hosts approximately 178,140 as registered with UNHCR and the majority originate from Myanmar. In this review, we examine refugees from South East Asia, particularly from Myanmar that have contributed to the largest influx of refugees to this region with a focus on their health status. The present study traces barriers to the health care of refugees in the country of asylum and also the challenges faced by these communities in accessing health services.

Factors Associated With Food Safety Knowledge And Practice Among Street Food Vendors In Taunggyi Township, Myanmar: A Cross-Sectional Study

@#Food safety is a growing public health concern worldwide. Street foods are an integral part of many cultures and offer at affordable prices. However, it is associated with food safety issues, especially in developing countries. Therefore, it is essential that street food vendors understand and implement food safety practices to prevent outbreaks of food-borne illnesses. This cross-sectional study investigated the food safety knowledge and practices as well as their associated factors among street food vendors in Taunggyi Township, Myanmar. Validated structured questionnaires were used to interview 158 street food vendors, and a set of observational checklists was used to inspect the sanitary conditions of vending sites and vendors’ food hygiene practices. The association between food safety knowledge and practices was assessed using a chi-squared test. Our results revealed that most vendors had a high level of food safety knowledge and that 58.9% scored equal to or lower than the median value in food safety practices, whereas 41.1% scored higher than the median value (median=15). Sex and education level were significantly associated with participants’ food safety knowledge (p < 0.001). Similarly, education, race and monthly income were significantly associated with their food safety practices (p < 0.001), whereas food safety training attendance had no association. Additionally, participants with better knowledge scores were more likely to have better practice scores. Food safety training given to vendors should be more detailed and comply with standard guidelines, especially with regard to street food safety practices.

Seroprevalence And Associated Factors Of Helicobacter Pylori Among Myanmar Children From The Peri-Urban Community Of Yangon

@#Helicobacter pylori infects 50% of children aged 5 years in developing countries. The infection is associated with socio-economic background and family composition. The aim of this study was to determine the seroprevalence and associated factors of Helicobacter pylori infection among Myanmar children in Insein Township, which is a peri-urban community situated in the northern region of Yangon. A cross-sectional study was carried out in Insein Township on 193 children, aged 2 to 13 years, who were tested for H. pylori antibody by enzyme-linked immunosorbent assay (ELISA) test. Parents were interviewed using a questionnaire. Statistical analyses were done using chi-square test and two-sample t-test. The prevalence of H. pylori infections was 67.36%. The mean age of the participants was 7.6 +/- 3.85 years. Those positive for H. pylori antibody were significantly older (8.18+/-3.8) than those with negative results (6.41+/-3.7). There is no gender preponderance. The sero- positive rate was higher among low socio-economic group. The children who tested positive for H. pylori antibody had a mean family member of 5.97+/-2.22 and those who tested negative had 6.06+/-2.17. Thus, there was no association between H. pylori infection and number of family members. There was no association between H. pylori infection and overcrowding, type of drinking water, type of latrine used and type of housing.Our findings suggest that the prevalence of H. pylori infection among Myanmar children is common, as it is in other developing countries, and also highlight its association with socioeconomic status. Over time, the prevalence of H. pylori infections in children is expected to decline worldwide in parallel with the improvement in socioeconomic status of the nations. There is a need to intensify efforts of improving sanitation and living conditions in order to protect children against H. pylori infection.

Predictors of modern contraceptive use and fertility preferences among men in Myanmar: further analysis of the 2015-16 demographic and health survey

Background: Men’s opposition to contraception and men’s fertility preferences can affect women’s unmet need for family planning. In Myanmar, there is limited research on men's reproductive health while women’s fertility, fertility preferences, and use of reproductive health services were well understood. A better understanding of men’s perceptions and preferences can support evidence-based male sexual and reproductive health programs and improve their effectiveness. This study focused on predictors of modern contraceptive use and fertility preferences among men age 15-49 years in Myanmar.Methods: A secondary data analysis was conducted using the 2015-16 Myanmar Demographic and Health Survey. Among 4,737 men age 15-49 years in the selected households, 3,248 men who ever had sex and 2,831 currently married men were selected as the sample for contraceptive use and fertility preferences respectively. Multiple logistic regression analysis was used with two separate models.Results: Among men who ever had sex, 39% were currently using modern contraception and 60% married men said they would like to have more than two children. Men from the coastal, and plain regions were more likely to use modern contraception and had higher fertility preferences compared with men living in the hilly region. The working men had higher levels of modern contraceptive use than jobless men and men from middle wealth index were significant current contraceptive users.Conclusions: The geographic region was a predictor of both current contraceptive use and fertility preferences, while occupation showed a significant correlation with contraceptive use.

Bio-efficacy of Long Lasting Insecticidal Mosquito Nets (LLINs) on Malaria Vector Anopheles Mosquitoes in Malaria-Endemic Areas of Myanmar

Sixty used Long Lasting Insecticidal Nets (LLINs) from six malaria endemicareas of States and Regions of Myanmar were assessed for their bio-efficacy againstAnopheles mosquitoes. Total ten nets were collected from the randomly selectedhousehold of each area. Insecticide susceptibility and bio-efficacy test were doneaccording to WHO testing method. Results revealed that a total of 4470 mosquitoes of 12Anopheles species including main vector and secondary vectors were collected in highdensity in Beelin, Taungoo, Pyin Oo Lwin, Kamamaung and Hpa-an. All collectedmosquitoes were found susceptible to insecticides as recommended by the WHO. Bioefficacy of PermaNet 2.0, DAWA TANA, Yorkool, BASF, Net protect and Yahe LLINs netswere 12(100%), 11/12(91.67%), 4(100%), 8(100%), 5(100%) and 19(100%)respectively. The DAWA TANA net had 20% sensitivity after repetitive washing. Thesensitivity of LLINs nets was higher for all selected areas of States and Regions inMyanmar. The study suggested that there is need to distribute a large number of effectiveLLINs nets in malaria endemic areas as well as the replacement of expired, less effectiveand very old LLINs nets with a new one is also necessary. LLINs nets are very effectiveAnopheles mosquitoes control tools and it can reduce the human-vector contact effectively.Moreover, research on bio-efficacy evaluations of the LLINs nets is required regularly tomaintain and control the transmission of malaria through Anopheles mosquitoes.

Seroprevalence of Toxoplasma gondii among School Children in Pyin Oo Lwin and Naung Cho, Upper Myanmar

Toxoplasma gondii is an apicomplexan parasite that can cause toxoplasmosis in a wide range of warm-blooded animals including humans. In this study, we analyzed seroprevalence of T. gondii among 467 school children living in the rural areas of Pyin Oo Lwin and Naung Cho, Myanmar. The overall seroprevalence of T. gondii among school children was 23.5%; 22.5% of children were positive for T. gondii IgG, 0.4% of children were positive for T. gondii IgM, and 0.6% of children were positive for both T. gondii IgG and IgM. Geographical factors did not significantly affect the seroprevalence frequency between Pyin Oo Lwin and Naung Cho, Myanmar. No significant difference was found between males (22.2%) and females (25.0%). The overall seroprevalence among school children differed by ages (10 years old [13.6%], 11–12 years old [19.8%], 13–14 years old [24.6%], and 15–16 years old [28.0%]), however, the result was not significant. Polymerase chain reaction analysis for T. gondii B1 gene for IgG-positive and IgM-positive blood samples were negative, indicating no direct evidence of active infection. These results collectively suggest that T. gondii infection among school children in Myanmar was relatively high. Integrated and improved strategies including reinforced education on toxoplasmosis should be implemented to prevent and control T. gondii infection among school children in Myanmar.