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1.
BMC Med ; 22(1): 248, 2024 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-38886762

RESUMEN

BACKGROUND: Most women use medication during pregnancy. Pregnancy-induced changes in physiology may require antenatal dose alterations. Yet, evidence-based doses in pregnancy are missing. Given historically limited data, pharmacokinetic models may inform pregnancy-adjusted doses. However, implementing model-informed doses in clinical practice requires support from relevant stakeholders. PURPOSE: To explore the perceived barriers and facilitators for model-informed antenatal doses among healthcare practitioners (HCPs) and pregnant women. METHODS: Online focus groups and interviews were held among healthcare practitioners (HCPs) and pregnant women from eight countries across Europe, Africa and Asia. Purposive sampling was used to identify pregnant women plus HCPs across various specialties prescribing or providing advice on medication to pregnant women. Perceived barriers and facilitators for implementing model-informed doses in pregnancy were identified and categorised using a hybrid thematic analysis. RESULTS: Fifty HCPs and 11 pregnant women participated in 12 focus groups and 16 interviews between January 2022 and March 2023. HCPs worked in the Netherlands (n = 32), the UK (n = 7), South Africa (n = 5), Uganda (n = 4), Kenya, Cameroon, India and Vietnam (n = 1 each). All pregnant women resided in the Netherlands. Barriers and facilitators identified by HCPs spanned 14 categories across four domains whereas pregnant women described barriers and facilitators spanning nine categories within the same domains. Most participants found current antenatal dosing information inadequate and regarded model-informed doses in pregnancy as a valuable and for some, much-needed addition to antenatal care. Although willingness-to-follow model-informed antenatal doses was high across both groups, several barriers for implementation were identified. HCPs underlined the need for transparent model validation and endorsement of the methodology by recognised institutions. Foetal safety was deemed a critical knowledge gap by both groups. HCPs' information needs and preferred features for model-informed doses in pregnancy varied. Several pregnant women expressed a desire to access information and partake in decisions on antenatal dosing. CONCLUSIONS: Given the perceived limitations of current pharmacotherapy for pregnant women and foetuses, model-informed dosing in pregnancy was seen as a promising means to enhance antenatal care by pregnant women and healthcare practitioners.


Asunto(s)
Grupos Focales , Personal de Salud , Mujeres Embarazadas , Investigación Cualitativa , Humanos , Femenino , Embarazo , Adulto , Atención Prenatal , África , Asia , Europa (Continente) , Uganda
2.
BMC Geriatr ; 24(1): 513, 2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38867148

RESUMEN

BACKGROUND: Pharmaceutical interventions play a key role in the care of older people experiencing polypharmacy. Despite the rapid increase in the aging population in Asia, there is a lack of evidence regarding the effectiveness of pharmacist interventions on older adult's healthcare. This systematic review and meta-analysis assessed the effects of pharmacist interventions in Asian health care environments on hospitalization, mortality, and quality of life (QoL) among older people in Asia. METHODS: A comprehensive search was conducted across 5 databases, encompassing studies published from inception through June 2023. Only studies involving pharmacist interventions for people aged 65 years or older, residing in Asian countries, were considered. Studies without evidence of pharmacist involvement or conducted outside of Asia were excluded. Data extraction was performed by two reviewers, one reviewer (I.K.) performed the initial extraction, and another reviewer (G.R.) verified the extracted data. Forest plots were generated using a random effects model to obtain risk ratios or pooled standardized mean differences (SMDs). RESULTS: A total of 170 articles underwent thorough review, and ultimately, ten studies meeting the inclusion criteria were included in the meta-analyses. These studies encompassed diverse healthcare settings such as outpatient, inpatient, and nursing homes, with sample sizes ranging from 32 to 306 older people. Pharmacist interventions were found to significantly reduce hospitalization rates (n = 5, risk ratio = 0.57, 95% CI = 0.41-0.81) and mortality rates (n = 4, risk ratio = 0.57, 95% CI = 0.37-0.88) among older people. The analysis revealed less significant improvement in QoL in these patients than in those receiving usual care (n = 6, SMD = 0.36, P = 0.057). CONCLUSIONS: These findings highlight the crucial role of pharmacists within healthcare teams in Asian countries. Pharmacist interventions have an impact on reducing hospitalization and mortality rates among the elderly people, underscoring the importance of optimizing patient outcomes in Asia.


Asunto(s)
Hospitalización , Farmacéuticos , Calidad de Vida , Humanos , Hospitalización/tendencias , Anciano , Asia/epidemiología , Mortalidad/tendencias
3.
J Glob Health ; 14: 04100, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38867671

RESUMEN

Background: Asia accounts for more than half of the world's population and carries a substantial proportion of the global burden of blindness and vision impairment. Characterising this burden, as well as its causes and determinants, could help with devising targeted interventions for reducing the occurrence of blindness and visual impairment. Methods: Using the Global Burden of Disease Study 2019 database, we retrieved data on the number of disability-adjusted life years (DALYs); crude and age-standardised rates; and the prevalence (with 95% uncertainty intervals (95%UIs)) of blindness and vision loss due to six causes (age-related macular degeneration, cataracts, glaucoma, near-vision impairment, refractive error, and other vision loss) for Asian countries for the period between 1990 and 2019. We defined DALYs as the sum of the years lost due to disability and years of life lost, and calculated age-standardised figures for the number of DALYs and prevalence by adjusting for population size and age structure. We then evaluated the time trend of the disease burden and conducted subgroup analyses by gender, age, geographic locations, and socio-demographic index (SDI). Results: In 2019, the DALYs and prevalence of blindness and vision loss had risen by 90.1% and 116% compared with 1990, reaching 15.84 million DALYs (95% UI = 15.83, 15.85) and 506.71 million cases (95% UI = 506.68, 506.74). Meanwhile, the age-standardised rate of DALYs decreased from 1990 to 2019. Cataracts, refractive error, and near vision impairment were the three most common causes. South Asia had the heaviest regional disease burden (age-standardised rate of DALYs = 517 per 100 000 population; 95% UI = 512, 521). Moreover, the burden due to cataracts ranked high in most Asian populations. Being a woman; being older; and having a lower national SDI were factors associated with a greater vision loss burden. Conclusions: The burden due to vision loss remains high in Asian populations. Cataracts, refractive error, and near vision loss were the primary causes of blindness and vision loss. Greater investment in ocular disease prevention and care by countries with lower socioeconomic status is needed, as well as specific strategies targeting cataract management, women and the elderly.


Asunto(s)
Ceguera , Años de Vida Ajustados por Discapacidad , Carga Global de Enfermedades , Humanos , Ceguera/epidemiología , Ceguera/etiología , Femenino , Masculino , Anciano , Persona de Mediana Edad , Asia/epidemiología , Adulto , Anciano de 80 o más Años , Prevalencia , Adulto Joven , Adolescente , Niño , Preescolar , Lactante , Catarata/epidemiología , Catarata/complicaciones , Baja Visión/epidemiología , Errores de Refracción/epidemiología , Errores de Refracción/complicaciones
5.
PLoS One ; 19(6): e0301597, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38861525

RESUMEN

This research investigates the complex interaction between liquidity and volatility while considering Economic Policy Uncertainty (EPU) as a moderating factor. Using a comprehensive dataset that incorporates various liquidity measures such as market resilience, depth, and breadth, the study examines how changes in liquidity impact volatility in four Asian incipient economies: China, Pakistan, India, and South Korea. By utilizing sophisticated econometric techniques, particularly the System Generalized Method of Moment (GMM), the findings demonstrate a statistically significant inverse relationship between liquidity and volatility. These findings imply that, within the Asian context, lower levels of volatility are correlated with higher market liquidity. By incorporating EPU into the model, the research acknowledges the significant role of economic factors in shaping market dynamics. Stakeholders, decision-makers, and investors can gain valuable insights from this analysis of variables influencing market stability in Asian emerging economies. The study's outcomes can guide policymakers in formulating strategies that promote market stability and improve market microstructure.


Asunto(s)
Modelos Económicos , Incertidumbre , Humanos , India , China , Pakistán , República de Corea , Asia , Comercio/economía , Inversiones en Salud/economía , Modelos Econométricos
6.
Arch Osteoporos ; 19(1): 48, 2024 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-38862849

RESUMEN

This pilot audit explored how bone health is assessed patients with diabetes in diverse centres across Asia. Only 343 of 1092 (31%) audited patients had a bone health assessment, 27% of whom were diagnosed with osteoporosis. Quality improvement strategies are needed to address gaps in patient care in this area. PURPOSE: The Asia Pacific Consortium on Osteoporosis (APCO) Framework outlines clinical standards for assessing and managing osteoporosis. A pilot audit evaluated adherence to clinical standard 4, which states that bone health should be assessed in patients with conditions associated with bone loss and/or increased fracture risk; this report summarises the audit findings in patients with diabetes. A secondary aim was to assess the practicality and real-world use of the APCO bone health audit tool kit. METHODS: Eight centres across Asia participated in the pilot audit, selecting diabetes as the target group. Participants reviewed their practice records for at least 20 consecutively treated patients with the target condition. Questions covered routine investigations, bone health assessment, osteoporosis diagnosis, and patient referral pathways. Data were summarised descriptively. RESULTS: The participants represented public hospitals, university medical centres, and private clinics from India, Malaysia, Pakistan, Singapore, Taiwan, and Vietnam that see an estimated total of 95,000 patients with diabetes per year. Overall, only 343 of 1092 audited patients (31%) had a bone health assessment. Osteoporosis was subsequently diagnosed in 92 of 343 (27%) patients. CONCLUSION: Bone health was not assessed in most patients with diabetes. The results provide insight into current practices across diverse Asian centres and demonstrate the practical value of the audit tool kit. Participant feedback has been used to improve the tool kit. Results of this pilot audit are being used in the respective centres to inform quality improvement projects needed to overcome the gap in patient care.


Asunto(s)
Adhesión a Directriz , Osteoporosis , Humanos , Proyectos Piloto , Osteoporosis/epidemiología , Femenino , Masculino , Asia/epidemiología , Adhesión a Directriz/estadística & datos numéricos , Persona de Mediana Edad , Anciano , Auditoría Médica , Diabetes Mellitus/epidemiología , Diabetes Mellitus/terapia , Densidad Ósea
7.
J Med Virol ; 96(6): e29724, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38837426

RESUMEN

Although the burden of the human immunodeficiency virus (HIV) in the Asia-Pacific region is increasingly severe, comprehensive evidence of the burden of HIV is scarce. We aimed to report the burden of HIV in people aged 15-79 years from 1990 to 2019 using data from the Global Burden of Disease Study (GBD) 2019. We analyzed rates of age-standardized disability-adjusted life years (ASDR), age-standardized mortality (ASMR), and age-standardized incidence (ASIR) in our age-period-cohort analysis by sociodemographic index (SDI). According to HIV reports in 2019 from 29 countries in the Asia-Pacific region, the low SDI group in Papua New Guinea had the highest ASDR, ASMR, and ASIR. From 1990 to 2019, the ASDR, ASIR, and ASMR of persons with acquired immune deficiency syndrome (AIDS) increased in 21 (72%) of the 29 countries in the Asia-Pacific region. During the same period, the disability-adjusted life years (DALYs) of AIDS patients in the low SDI group in the region grew the fastest, particularly in Nepal. The incidence of HIV among individuals aged 20-30 years in the low-middle SDI group was higher than that of those in the other age groups. In 2019, unsafe sex was the main cause of HIV-related ASDR in the region's 29 countries, followed by drug use. The severity of the burden of HIV/AIDS in the Asia-Pacific region is increasing, especially among low SDI groups. Specific public health policies should be formulated based on the socioeconomic development level of each country to alleviate the burden of HIV/AIDS.


Asunto(s)
Carga Global de Enfermedades , Infecciones por VIH , Humanos , Adulto , Persona de Mediana Edad , Adolescente , Adulto Joven , Infecciones por VIH/epidemiología , Infecciones por VIH/mortalidad , Masculino , Femenino , Anciano , Carga Global de Enfermedades/tendencias , Asia/epidemiología , Estudios de Cohortes , Incidencia , Años de Vida Ajustados por Discapacidad , Costo de Enfermedad
8.
Sex Health ; 212024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38833542

RESUMEN

Long-acting injectable PrEP, particularly cabotegravir (CAB-LA), has the potential to enhance HIV prevention in Asia, and was the topic of a roundtable held in Singapore in June 2023. Despite proven efficacy, CAB-LA's impact in Asia is hindered by regulatory, manufacturing, and cost barriers. There is an urgent need to address these challenges to expedite CAB-LA's introduction and scale-up, including collaborative research, streamlined regulatory processes, and increased manufacturing capacity. We call for better preparedness in long-acting PrEP in research and implementation science, product licensing and accessibility, and capacity readiness for scale-up, to meet the significant demand among key populations in Asia.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Profilaxis Pre-Exposición , Humanos , Infecciones por VIH/prevención & control , Profilaxis Pre-Exposición/métodos , Asia , Fármacos Anti-VIH/administración & dosificación , Fármacos Anti-VIH/uso terapéutico , Piridonas/administración & dosificación , Dicetopiperazinas
9.
Environ Int ; 189: 108803, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38870578

RESUMEN

BACKGROUND: Exposure to ambient air pollution is associated with a significant number of deaths. Much of the evidence associating air pollution with adverse effects is from North American and Europe, partially due to incomplete data in other regions limiting location specific examinations. The aim of the current paper is to leverage satellite derived air quality data to examine the relationship between ambient particulate matter and all-cause and cause-specific mortality in Asia. METHODS: Six cohorts from the Asia Cohort Consortium provided residential information for participants, recruited between 1991 and 2008, across six countries (Bangladesh, India, Iran, Japan, South Korea, and Taiwan). Ambient particulate material (PM2·5) levels for the year of enrolment (or 1998 if enrolled earlier) were assigned utilizing satellite and sensor-based maps. Cox proportional models were used to examine the association between ambient air pollution and all-cause and cause-specific mortality (all cancer, lung cancer, cardiovascular and lung disease). Models were additionally adjusted for urbanicity (representing urban and built characteristics) and stratified by smoking status in secondary analyses. Country-specific findings were pooled via random-effects meta-analysis. FINDINGS: More than 300,000 participants across six cohorts were included, representing more than 4-million-person years. A positive relationship was observed between a 5 µg/m (Dockery et al., 1993) increase in PM2·5 and cardiovascular mortality (HR: 1·06, 95 % CI: 0.99, 1·13). The additional adjustment for urbanicity resulted in increased associations between PM2.5 and mortality outcomes, including all-cause mortality (1·04, 95 % CI: 0·97, 1·11). Results were generally similar regardless of whether one was a current, never, or ex-smoker. INTERPRETATION: Using satellite and remote sensing technology we showed that associations between PM2.5 and all-cause and cause-specific Hazard Ratios estimated are similar to those reported for U.S. and European cohorts. FUNDING: This project was supported by the Health Effects Institute. Grant number #4963-RFA/18-5. Specific funding support for individual cohorts is described in the Acknowledgements.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Exposición a Riesgos Ambientales , Material Particulado , Humanos , Material Particulado/análisis , Asia , Exposición a Riesgos Ambientales/estadística & datos numéricos , Exposición a Riesgos Ambientales/efectos adversos , Masculino , Estudios de Cohortes , Femenino , Contaminación del Aire/estadística & datos numéricos , Contaminación del Aire/efectos adversos , Contaminantes Atmosféricos/análisis , Persona de Mediana Edad , Adulto , Enfermedades Cardiovasculares/mortalidad , Anciano , Neoplasias/mortalidad , Neoplasias Pulmonares/mortalidad , Enfermedades Pulmonares/mortalidad , Modelos de Riesgos Proporcionales , Causas de Muerte
10.
Sci Rep ; 14(1): 13871, 2024 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-38879558

RESUMEN

Enteric viral pathogens are associated with a significant burden of childhood morbidity and mortality. We investigated the relationship between viral pathogens and child growth among under-5 children. We analyzed data from 5572/22,567 children enrolled in the Global Enteric Multicenter Study across seven study sites (2007-2011). Multiple linear regression was used to examine the association between the viral pathogens and changes of length/height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length/height (WHZ) z-scores, stratified by diarrheal symptoms and adjusted for potential covariates. Rotavirus (18.51%) and norovirus (7.33%) were the most prevalent enteric viral pathogens among symptomatic and asymptomatic under-5 children, respectively. Infection with individual enteric viral pathogens hurts child growth in asymptomatic children. However, the relationship with HAZ was less clear and statistically non-significant. On the other hand, the combined viral pathogens demonstrated a strong negative influence on child growth [WAZ: ß coef.: - 0.10 (95%, CI - 0.15, - 0.05); P < 0.001 and WHZ: ß: - 0.12 (95% CI - 0.17, - 0.07); P < 0.001] among asymptomatic children. Infection with any viral pathogen was associated with growth shortfalls [HAZ: ß: - 0.05 (95% CI - 0.09, 0.00); P = 0.03 and WAZ: ß: - 0.11 (95% CI - 0.16, - 0.07); P < 0.001 and WHZ: ß: - 0.13 (95% CI - 0.18, - 0.09); P < 0.001], though the relationship with HAZ was less evident and became statistically non-significant in older children. Notably, among symptomatic children with moderate-to-severe diarrhea, individual enteric viral pathogens, as well as the combined effects of these pathogens [WHZ: ß: 0.07; (95% CI 0.01, 0.14); P = 0.03] and the presence of any virus [HAZ: ß: 0.09 (95% CI 0.05, 0.13) & WAZ: ß: 0.08 (95% CI 0.03, 0.12); P < 0.001], exhibited positive effects on child growth. While previous studies hypothesized that several viral pathogens had a conflicting controversial role in child growth, we find clear indications that enteric viral pathogens are associated with growth shortfalls, specifically among asymptomatic children. These findings highlight the need for preventive strategies targeting children with enteric viral pathogens, which could address the consequences of growth faltering.


Asunto(s)
Rotavirus , Humanos , Lactante , Preescolar , Femenino , Masculino , África del Sur del Sahara/epidemiología , Asia/epidemiología , Diarrea/virología , Diarrea/epidemiología , Desarrollo Infantil , Norovirus , Infecciones por Rotavirus/epidemiología , Recién Nacido , Sur de Asia
11.
Environ Monit Assess ; 196(7): 597, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38842642

RESUMEN

Photosynthesis in vegetation is one of the key processes in maintaining regional ecological balance and climate stability, and it is of significant importance for understanding the health of regional ecosystems and addressing climate change. Based on 2001-2021 Global OCO-2 Solar-Induced Fluorescence (GOSIF) dataset, this study analyzed spatiotemporal variations in Asian vegetation photosynthesis and its response to climate and human activities. Results show the following: (1) From 2001 to 2021, the overall photosynthetic activity of vegetation in the Asian region has shown an upward trend, exhibiting a stable distribution pattern with higher values in the eastern and southern regions and lower values in the central, western, and northern regions. In specific regions such as the Turgen Plateau in northwestern Kazakhstan, Cambodia, Laos, and northeastern Syria, photosynthesis significantly declined. (2) Meteorological factors influencing photosynthesis exhibit differences based on latitude and vertical zones. In low-latitude regions, temperature is the primary driver, while in mid-latitude areas, solar radiation and precipitation are crucial. High-latitude regions are primarily influenced by temperature, and high-altitude areas depend on precipitation and solar radiation. (3) Human activities (56.44%) have a slightly greater impact on the dynamics of Asian vegetation photosynthesis compared to climate change (43.56%). This research deepens our comprehension of the mechanisms behind the fluctuations in Asian vegetation photosynthesis, offering valuable perspectives for initiatives in environmental conservation, sustainability, and climate research.


Asunto(s)
Cambio Climático , Monitoreo del Ambiente , Fotosíntesis , Imágenes Satelitales , Monitoreo del Ambiente/métodos , Asia , Ecosistema , Plantas
12.
Genes (Basel) ; 15(5)2024 05 19.
Artículo en Inglés | MEDLINE | ID: mdl-38790273

RESUMEN

Crassostrea ariakensis (Fujita, 1913) is one of the most important economic and ecological oysters that is naturally distributed along the coast of Asia, separated by the Yangtze River estuary. They are usually compared as different populations, while there is no consensus on whether C. ariakensis in northern and southern areas should be considered as two species or subspecies. Here, we analyzed morphological characteristics, COI, 16s rRNA, mitogenome sequences, and species delimitation analysis (ASAP and PTP) to resolve the intraspecific taxonomic status of the C. ariakensis. Phylogenetic and ASAP analysis highlight that C. ariakensis was divided into N-type and S-type. PTP was unable to differentiate between the two types of C. ariakensis. The divergence time of N-type and S-type C. ariakinsis is estimated to be 1.6 Mya, using the relaxed uncorrelated lognormal clock method. Additionally, significant morphological differences exist between the two groups in terms of the adductor muscle scar color. Despite these differences, the COI (0.6%) and 16S rRNA (0.6%) genetic distance differences between N-type and S-type C. ariakensis has not yet reached the interspecific level. These results suggest that N-type and S-type C. ariakensis should be treated as different subspecies and renamed as C. ariakensis ariakensis subsp. nov and C. ariakensis meridioyangtzensis subsp. nov.


Asunto(s)
Crassostrea , Filogenia , ARN Ribosómico 16S , Animales , Crassostrea/genética , Crassostrea/clasificación , ARN Ribosómico 16S/genética , Asia , Genoma Mitocondrial , Complejo IV de Transporte de Electrones/genética
13.
PeerJ ; 12: e17339, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38756443

RESUMEN

Background: Alzheimer's disease (AD) is one of the multifaceted neurodegenerative diseases influenced by many genetic and epigenetic factors. Genetic factors are merely not responsible for developing AD in the whole population. The studies of genetic variants can provide significant insights into the molecular basis of Alzheimer's disease. Our research aimed to show how genetic variants interact with environmental influences in different parts of the world. Methodology: We searched PubMed and Google Scholar for articles exploring the relationship between genetic variations and global regions such as America, Europe, and Asia. We aimed to identify common genetic variations susceptible to AD and have no significant heterogeneity. To achieve this, we analyzed 35 single-nucleotide polymorphisms (SNPs) from 17 genes (ABCA7, APOE, BIN1, CD2AP, CD33, CLU, CR1, EPHA1, TOMM40, MS4A6A, ARID5B, SORL1, APOC1, MTHFD1L, BDNF, TFAM, and PICALM) from different regions based on previous genomic studies of AD. It has been reported that rs3865444, CD33, is the most common polymorphism in the American and European populations. From TOMM40 and APOE rs2075650, rs429358, and rs6656401, CR1 is the common investigational polymorphism in the Asian population. Conclusion: The results of all the research conducted on AD have consistently shown a correlation between genetic variations and the incidence of AD in the populations of each region. This review is expected to be of immense value in future genetic research and precision medicine on AD, as it provides a comprehensive understanding of the genetic factors contributing to the development of this debilitating disease.


Asunto(s)
Enfermedad de Alzheimer , Predisposición Genética a la Enfermedad , Polimorfismo de Nucleótido Simple , Enfermedad de Alzheimer/genética , Enfermedad de Alzheimer/epidemiología , Humanos , Europa (Continente)/epidemiología , Asia/epidemiología , Estados Unidos/epidemiología , Variación Genética/genética
14.
PLoS One ; 19(5): e0298154, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38809901

RESUMEN

BACKGROUND: Ovarian cancer is a challenging disease to diagnose and treat effectively with five-year survival rates below 50%. Previous patient experience research in high-income countries highlighted common challenges and opportunities to improve survival and quality of life for women affected by ovarian cancer. However, no comparable data exist for low-and middle-income countries, where 70% of women with the disease live. This study aims to address this evidence gap. METHODS: This is an observational multi-country study set in low- and middle-income countries. We aim to recruit over 2000 women diagnosed with ovarian cancer across multiple hospitals in 24 countries in Asia, Africa and South America. Country sample sizes have been calculated (n = 70-96 participants /country), taking account of varying national five-year disease prevalence rates. Women within five years of their diagnosis, who are in contact with participating hospitals, are invited to take part in the study. A questionnaire has been adapted from a tool previously used in high-income countries. It comprises 57 multiple choice and two open-ended questions designed to collect information on demographics, women's knowledge of ovarian cancer, route to diagnosis, access to treatments, surgery and genetic testing, support needs, the impact of the disease on women and their families, and their priorities for action. The questionnaire has been designed in English, translated into local languages and tested according to local ethics requirements. Questionnaires will be administered by a trained member of the clinical team. CONCLUSION: This study will inform further research, advocacy, and action in low- and middle-income countries based on tailored approaches to the national, regional and global challenges and opportunities. In addition, participating countries can choose to repeat the study to track progress and the protocol can be adapted for other countries and other diseases.


Asunto(s)
Países en Desarrollo , Neoplasias Ováricas , Calidad de Vida , Humanos , Femenino , Neoplasias Ováricas/terapia , Neoplasias Ováricas/mortalidad , Neoplasias Ováricas/diagnóstico , Encuestas y Cuestionarios , Asia/epidemiología , África/epidemiología , América del Sur/epidemiología , Tasa de Supervivencia , Adulto , Persona de Mediana Edad
15.
PLoS Negl Trop Dis ; 18(5): e0012221, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38814987

RESUMEN

BACKGROUND: Following the COVID-19 pandemic declaration, the World Health Organization recommended suspending neglected tropical diseases (NTD) control activities as part of sweeping strategies to minimise COVID-19 transmission. Understanding how NTD programs were impacted and resumed operations will inform contingency planning for future emergencies. This is the first study that documents how South-East Asian and Pacific NTD programs addressed challenges experienced during the COVID-19 pandemic. METHODOLOGY/PRINCIPAL FINDINGS: Data was collected through semi-structured interviews with 11 NTD Program Coordinators and related personnel from Fiji, Papua New Guinea, The Philippines, Timor-Leste, and Vanuatu. Constructivist grounded theory methods were drawn on to generate an explanation of factors that enabled or hindered NTD program operations during the COVID-19 pandemic. The COVID-19 pandemic disrupted NTD programs in all countries. Some programs implemented novel strategies by partnering with services deemed essential or used new communications technology to continue (albeit scaled-back) NTD activities. Strong relationships to initiate cross-program integration, sufficient resources to implement adapted activities, and dedicated administrative systems were key enabling factors for recommencement. As the COVID-19 pandemic continued, exacerbating health resources scarcity, programs faced funding shortages and participants needed to find efficiencies through greater integration and activity prioritisation within their NTD units. Emphasising community-led approaches to restore trust and engagement was critical after widespread social anxiety and disconnection. CONCLUSIONS/SIGNIFICANCE: Sustaining effective NTD programs during a global emergency goes beyond managing immediate activity disruptions and requires attention to how NTD programs can be better ensconced within wider health programs, administrative, and social systems. This study underscores the importance of pre-emergency planning that reinforces NTD control programs as a critical service at all health systems levels, accompanied by governance arrangements that increase NTD staff control over their operations and strategies to maintain strong community relationships. Ensuring NTD units are supported via appropriate funding, personnel, and bureaucratic resources is also required.


Asunto(s)
COVID-19 , Enfermedades Desatendidas , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Enfermedades Desatendidas/prevención & control , Enfermedades Desatendidas/epidemiología , Medicina Tropical , Asia/epidemiología , SARS-CoV-2 , Investigación Cualitativa , Pandemias/prevención & control
17.
J Glob Health ; 14: 04072, 2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38700432

RESUMEN

Background: Short birth interval is associated with an increased risk of adverse health outcomes for mothers and children. Despite this, there is a lack of comprehensive evidence on short birth interval in the Asia-Pacific region. Thus, this study aimed to synthesise evidence related to the definition, classification, prevalence, and predictors of short birth interval in the Asia-Pacific region. Methods: Five databases (MEDLINE, Scopus, Cumulative Index to Nursing and Allied Health Literature, Maternity and Infant Care, and Web of Science) were searched for studies published between September 2000 and May 2023 (the last search was conducted for all databases in May 2023). We included original studies published in English that reported on short birth interval in the Asia-Pacific region. Studies that combined birth interval with birth order, used multi-country data and were published as conference abstracts and commentaries were excluded. Three independent reviewers screened the articles for relevancy, and two reviewers performed the data extraction and quality assessment. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. The findings were both qualitatively and quantitatively synthesised and presented. Results: A total of 140 studies met the inclusion criteria for this review. About 58% (n = 82) of the studies defined short birth interval, while 42% (n = 58) did not. Out of 82 studies, nearly half (n = 39) measured a birth-to-birth interval, 37 studies measured a birth-to-pregnancy, four measured a pregnancy-to-pregnancy, and two studies measured a pregnancy loss-to-conception. Approximately 39% (n = 55) and 6% (n = 8) of studies classified short birth intervals as <24 months and <33 months, respectively. Most of the included studies were cross-sectional, and about two-thirds had either medium or high risk of bias. The pooled prevalence of short birth interval was 33.8% (95% confidence interval (CI) = 23.0-44.6, I2 = 99.9%, P < 0.01) among the studies that used the World Health Organization definition. Conclusions: This review's findings highlighted significant variations in the definition, measurement, classification, and reported prevalence of short birth interval across the included studies. Future research is needed to harmonise the definition and classification of short birth interval to ensure consistency and comparability across studies and facilitate the development of targeted interventions and policies. Registration: PROSPERO CRD42023426975.


Asunto(s)
Intervalo entre Nacimientos , Humanos , Asia/epidemiología , Femenino , Intervalo entre Nacimientos/estadística & datos numéricos , Embarazo , Recién Nacido , Islas del Pacífico/epidemiología
18.
J Environ Manage ; 360: 121125, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38772231

RESUMEN

Environmental degradation poses a significant challenge in many developing countries, as they heavily rely on fossil fuels to drive economic activities. The transition towards renewable energy is crucial to mitigate ecological depletion, yet numerous Asian developing countries may struggle to achieve the desired levels of renewable energy adoption due to financial constraints. Foreign aid in the energy sector can expedite this transition process. This study aims to examine the impact of foreign aid on the energy decarbonization transition in 22 Asian developing countries from 2003 to 2022 to analyze its contributions and challenges to promote renewable energy adoption. This paper incorporates the two types of foreign aid in the energy sector (nonrenewable and renewable energy aid) provided by the OECD to developing economies. Utilizing the System-Generalized Method of Moments (Sys-GMM), the findings reveal that energy aid significantly contributes to the transition towards energy decarbonization by providing financial support for embracing renewable energy technologies. Specifically, the analysis indicates that a 1% increase in energy aid leads to approximately 3% enhancement in the decarbonization transition process. Moreover, this study adds to the existing body of knowledge by examining the mediating impact of human capital and financial development as well as the moderating effect of institutional quality and demand for clean fuel. These factors play a pivotal role in energy decarbonization transition by fostering financial development and enhancing human capital through capacity-building initiatives and facilitating the adoption of renewable energy technologies.


Asunto(s)
Países en Desarrollo , Energía Renovable , Asia , Combustibles Fósiles
19.
PLoS One ; 19(5): e0300581, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38820339

RESUMEN

BACKGROUND: Despite improvements, the prevalence of HIV, syphilis, and hepatitis B remains high in Asia. These sexually transmitted infections (STIs) can be transmitted from infected mothers to their children. Antenatal screening and treatment are effective interventions to prevent mother-to-child transmission (MTCT), but coverage of antenatal screening remains low. Understanding factors influencing antenatal screening is essential to increase its uptake and design effective interventions. This systematic literature review aims to investigate barriers and facilitators to antenatal screening for HIV, syphilis, and hepatitis B in Asia. METHODS: We conducted a systematic review by searching Ovid (MEDLINE, Embase, PsycINFO), Scopus, Global Index Medicus and Web of Science for published articles between January 2000 and June 2023, and screening abstracts and full articles. Eligible studies include peer-reviewed journal articles of quantitative, qualitative and mixed-method studies that explored factors influencing the use of antenatal screening for HIV, syphilis or hepatitis B in Asia. We extracted key information including study characteristics, sample, aim, identified barriers and facilitators to screening. We conducted a narrative synthesis to summarise the findings and presented barriers and facilitators following Andersen's conceptual model. RESULTS: The literature search revealed 23 articles suitable for inclusion, 19 used quantitative methods, 3 qualitative and one mixed method. We found only three studies on syphilis screening and one on hepatitis B. The analysis demonstrates that antenatal screening for HIV in Asia is influenced by many barriers and facilitators including (1) predisposing characteristics of pregnant women (age, education level, knowledge) (2) enabling factors (wealth, place of residence, husband support, health facilities characteristics, health workers support and training) (3) need factors of pregnant women (risk perception, perceived benefits of screening). CONCLUSION: Knowledge of identified barriers to antenatal screening may support implementation of appropriate interventions to prevent MTCT and help countries achieve Sustainable Development Goals' targets for HIV and STIs.


Asunto(s)
Infecciones por VIH , Hepatitis B , Complicaciones Infecciosas del Embarazo , Diagnóstico Prenatal , Sífilis , Humanos , Femenino , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Embarazo , Sífilis/diagnóstico , Sífilis/epidemiología , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Diagnóstico Prenatal/métodos , Asia/epidemiología , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Personal de Salud/psicología , Mujeres Embarazadas/psicología , Tamizaje Masivo/métodos , Familia
20.
Nat Commun ; 15(1): 3678, 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38744815

RESUMEN

The global population is aging at the same time as heat exposures are increasing due to climate change. Age structure, and its biological and socio-economic drivers, determine populations' vulnerability to high temperatures. Here we combine age-stratified demographic projections with downscaled temperature projections to mid-century and find that chronic exposure to heat doubles across all warming scenarios. Moreover, >23% of the global population aged 69+ will inhabit climates whose 95th percentile of daily maximum temperature exceeds the critical threshold of 37.5 °C, compared with 14% today, exposing an additional 177-246 million older adults to dangerous acute heat. Effects are most severe in Asia and Africa, which also have the lowest adaptive capacity. Our results facilitate regional heat risk assessments and inform public health decision-making.


Asunto(s)
Cambio Climático , Calor , Humanos , Anciano , Calor/efectos adversos , Masculino , Anciano de 80 o más Años , Femenino , Medición de Riesgo , Exposición a Riesgos Ambientales , Asia/epidemiología
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