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1.
Eur Rev Med Pharmacol Sci ; 24(24): 13098-13100, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33378063

RESUMO

COVID-19 is rapidly spreading throughout the world since December 2019. It has hit South Asian countries with faded impact, which can be attributed to (a) availability of kits, (b) number of people tested for COVID-19, (c) immunity, (d) environmental conditions and (e) vaccination.


Assuntos
/estatística & dados numéricos , Umidade , Malária/imunologia , Temperatura , Vacinas contra a Tuberculose/uso terapêutico , Tuberculose/prevenção & controle , Ásia Ocidental/epidemiologia , /imunologia , Meio Ambiente , Humanos , Malária/epidemiologia , Prevalência , Kit de Reagentes para Diagnóstico/provisão & distribução , Tuberculose/epidemiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-32867287

RESUMO

Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined. Therefore, an international online survey was launched in April 2020 to elucidate the behavioral and lifestyle consequences of COVID-19 restrictions. This report presents the preliminary results from more than one thousand responders on social participation and life satisfaction. METHODS: Thirty-five research organizations from Europe, North-Africa, Western Asia, and the Americas promoted the survey through their networks to the general society, in 7 languages (English, German, French, Arabic, Spanish, Portuguese, and Slovenian). Questions were presented in a differential format with questions related to responses "before" and "during" confinement conditions. RESULTS: 1047 participations (54% women) from Asia (36%), Africa (40%), Europe (21%), and others (3%) were included in the analysis. Findings revealed psychosocial strain during the enforced COVID-19 home confinement. Large decreases (p < 0.001) in the amount of social activity through family (-58%), friends/neighbors (-44.9%), or entertainment (-46.7%) were triggered by the enforced confinement. These negative effects on social participation were also associated with lower life satisfaction (-30.5%) during the confinement period. Conversely, the social contact score through digital technologies significantly increased (p < 0.001) during the confinement period with more individuals (+24.8%) being socially connected through digital technology. CONCLUSION: These preliminary findings elucidate the risk of psychosocial strain during the early COVID-19 home confinement period in 2020. Therefore, in order to mitigate the negative psychosocial effects of home confinement, implementation of national strategies focused on promoting social inclusion through a technology-based solution is strongly suggested.


Assuntos
Infecções por Coronavirus/psicologia , Satisfação Pessoal , Pneumonia Viral/psicologia , Participação Social , África do Norte , América , Ásia Ocidental , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Europa (Continente) , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
3.
BMJ Glob Health ; 5(8)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32819917

RESUMO

INTRODUCTION: With COVID-19, there is urgency for policymakers to understand and respond to the health needs of slum communities. Lockdowns for pandemic control have health, social and economic consequences. We consider access to healthcare before and during COVID-19 with those working and living in slum communities. METHODS: In seven slums in Bangladesh, Kenya, Nigeria and Pakistan, we explored stakeholder perspectives and experiences of healthcare access for non-COVID-19 conditions in two periods: pre-COVID-19 and during COVID-19 lockdowns. RESULTS: Between March 2018 and May 2020, we engaged with 860 community leaders, residents, health workers and local authority representatives. Perceived common illnesses in all sites included respiratory, gastric, waterborne and mosquitoborne illnesses and hypertension. Pre-COVID, stakeholders described various preventive, diagnostic and treatment services, including well-used antenatal and immunisation programmes and some screening for hypertension, tuberculosis, HIV and vectorborne disease. In all sites, pharmacists and patent medicine vendors were key providers of treatment and advice for minor illnesses. Mental health services and those addressing gender-based violence were perceived to be limited or unavailable. With COVID-19, a reduction in access to healthcare services was reported in all sites, including preventive services. Cost of healthcare increased while household income reduced. Residents had difficulty reaching healthcare facilities. Fear of being diagnosed with COVID-19 discouraged healthcare seeking. Alleviators included provision of healthcare by phone, pharmacists/drug vendors extending credit and residents receiving philanthropic or government support; these were inconsistent and inadequate. CONCLUSION: Slum residents' ability to seek healthcare for non-COVID-19 conditions has been reduced during lockdowns. To encourage healthcare seeking, clear communication is needed about what is available and whether infection control is in place. Policymakers need to ensure that costs do not escalate and unfairly disadvantage slum communities. Remote consulting to reduce face-to-face contact and provision of mental health and gender-based violence services should be considered.


Assuntos
Infecções por Coronavirus , Acesso aos Serviços de Saúde , Pandemias , Pneumonia Viral , Áreas de Pobreza , África ao Sul do Saara , Ásia Ocidental , Betacoronavirus , Humanos , Saúde Pública , Participação dos Interessados
4.
J Pak Med Assoc ; 70(Suppl 3)(5): S158-S161, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32515404

RESUMO

Here, we present an overview of the clinical trials that are currently being conducted or have concluded to date on COVID-19 globally. A comprehensive search was conducted to present 16 trial registries from around the world. Collectively, there are 1,528 trials reported for COVID-19 to date. Out of them, 50 studies included paediatric age group from day 0 to less than or equal to 18 years of age. A few 18 studies involve only females and 20 only males. There are 2 trials currently underway in Bangladesh, 4 in Pakistan and 13 in India. Overall, 940 trials are related to medicines and/or interventions. They include standard of care for any viral illness, antivirals, anti-inflammatory and immune altering medications. Two out of 10 vaccine trials are novel vaccines. It is knowledgeable and resourceful to reach out to the concerned sponsor if a physician thinks his patient can benefit from the trials in the region.


Assuntos
Betacoronavirus , Estudos Clínicos como Assunto , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Ásia Ocidental , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia
5.
PLoS One ; 15(3): e0229906, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163440

RESUMO

BACKGROUND: Caesarean section is considered a relatively preferable and safe method of delivery as compared to normal delivery. Since the last decade, its prevalence has increased in both developed and developing countries. In the context of developing countries viz., South Asia (the highest populated region) and South-East Asia (the third-highest populated region), where a significant proportion of home deliveries were reported,however, the preference for, caesarean delivery and its associated factors are not well understood. OBJECTIVE: To study the caesarean delivery in the South and South-East Asian countries and to determine the factors associated with the preference for caesarean delivery. METHODOLOGY: Demographic and Health Survey Data on from ever-married women of nine developing countries of South and South-East Asia viz., Vietnam, India, Maldives, Timor-Leste, Nepal, Indonesia, Pakistan, Bangladesh, and Cambodia have been considered. Both bivariate and binary logistic regression models were used to estimate the propensity of a woman undergoing for caesarean delivery and to assess the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery. RESULTS: Obtained results have shown an inclination of caesarean delivery among urban than rural women and are quite conspicuous, but is found to be underestimated mostly among rural women. Caesarean delivery in general is mostly predisposed among women whose baby sizes are either very large or smaller than average, have a higher level of education and place of delivery is private medical institutions. The logistic regression also revealed the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery. Based on nine South and South-East Asian countries an overall C-section prevalence of 13%, but based on institutional births its increase to 19%. The forest plot demonstrated that a significant inclination of C-section among urban than rural regions. In Meta-Analysis, very high and significant heterogeneity among countries is observed, but confirms that in terms of prevalence of C-section all of the countries follow independent pattern. CONCLUSION: Study of seven urban and four rural regions of nine South and South- East Asian countries showed, a significant inclination towards the caesarean delivery above the more recent outdated WHO recommended an optimal range of 10-15%and are associated maternal socioeconomic characteristics. In order to control unwanted caesarean delivery, the government needs to develop better healthcare infrastructure and along with more antenatal care related schemes to reduce the risks associated with increased caesarean delivery.


Assuntos
Cesárea/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Determinantes Sociais da Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Adolescente , Adulto , Ásia Sudeste , Ásia Ocidental , Cesárea/tendências , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Modelos Logísticos , Idade Materna , Gravidez , Prevalência , População Rural/estatística & dados numéricos , População Rural/tendências , População Urbana/estatística & dados numéricos , População Urbana/tendências , Adulto Jovem
6.
Curr Diab Rep ; 20(1): 4, 2020 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-32002674

RESUMO

PURPOSE OF REVIEW: The purpose of this review is to summarize our current knowledge of factors that influence clinical decision making and management of type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD) among South Asians (SA). RECENT FINDINGS: ASCVD and T2DM in SAs have been examined in recent times. Pathophysiologic and genetic factors including the role of adiponectin, visceral adiposity, lower beta cell function, and psycho-social factors like sedentary lifestyle, poor adherence to medications, and carbohydrate dense meals play a role in early development and the high-risk presentation of both ASCVD and T2DM in SA. Recently, large population-based cohort studies have attempted to compare outcomes and interventions that can be translated to timely detection and targeted interventions in this high-risk group. SAs in the USA are more likely to be diagnosed with T2DM and ASCVD when compared to non-Hispanic whites, non-Hispanic Blacks, and Hispanic populations. The development of personalized ethnic risk assessment tools and better representation of SAs in prospective studies are essential to increasing our understanding and management of cardio-metabolic disease in SA living in the USA.


Assuntos
Americanos Asiáticos , Aterosclerose/etnologia , Diabetes Mellitus Tipo 2/etnologia , Ásia Ocidental/etnologia , Aterosclerose/epidemiologia , Aterosclerose/etiologia , Aterosclerose/terapia , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/terapia , Tomada de Decisão Clínica , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Humanos , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Estados Unidos/epidemiologia
7.
N Engl J Med ; 382(8): 717-726, 2020 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-32074419

RESUMO

BACKGROUND: The burden of hypertension is escalating, and control rates are poor in low- and middle-income countries. Cardiovascular mortality is high in rural areas. METHODS: We conducted a cluster-randomized, controlled trial in rural districts in Bangladesh, Pakistan, and Sri Lanka. A total of 30 communities were randomly assigned to either a multicomponent intervention (intervention group) or usual care (control group). The intervention involved home visits by trained government community health workers for blood-pressure monitoring and counseling, training of physicians, and care coordination in the public sector. A total of 2645 adults with hypertension were enrolled. The primary outcome was reduction in systolic blood pressure at 24 months. Follow-up at 24 months was completed for more than 90% of the participants. RESULTS: At baseline, the mean systolic blood pressure was 146.7 mm Hg in the intervention group and 144.7 mm Hg in the control group. At 24 months, the mean systolic blood pressure fell by 9.0 mm Hg in the intervention group and by 3.9 mm Hg in the control group; the mean reduction was 5.2 mm Hg greater with the intervention (95% confidence interval [CI], 3.2 to 7.1; P<0.001). The mean reduction in diastolic blood pressure was 2.8 mm Hg greater in the intervention group than in the control group (95% CI, 1.7 to 3.9). Blood-pressure control (<140/90 mm Hg) was achieved in 53.2% of the participants in the intervention group, as compared with 43.7% of those in the control group (relative risk, 1.22; 95% CI, 1.10 to 1.35). All-cause mortality was 2.9% in the intervention group and 4.3% in the control group. CONCLUSIONS: In rural communities in Bangladesh, Pakistan, and Sri Lanka, a multicomponent intervention that was centered on proactive home visits by trained government community health workers who were linked with existing public health care infrastructure led to a greater reduction in blood pressure than usual care among adults with hypertension. (Funded by the Joint Global Health Trials scheme; COBRA-BPS ClinicalTrials.gov number, NCT02657746.).


Assuntos
Anti-Hipertensivos/uso terapêutico , Agentes Comunitários de Saúde , Visita Domiciliar , Hipertensão/terapia , Educação de Pacientes como Assunto , Idoso , Ásia Ocidental , Pressão Sanguínea , Determinação da Pressão Arterial , Lista de Checagem , Países em Desenvolvimento , Educação Médica Continuada , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prática de Saúde Pública , População Rural
8.
J Nerv Ment Dis ; 208(2): 165-168, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31977829

RESUMO

Almost no research exists on the relationship between religiosity/spirituality (R/S) and health in the US South Asian population. Using data from the joint Study on Stress, Spirituality, and Health and Mediators of Atherosclerosis Among South Asians Living in America Study (MASALA), this article examined associations between self-rated R/S and self-rated health, emotional functioning, trait anxiety, and trait anger in a community-based sample (n = 933) from the Chicago and San Francisco Bay areas. Ordinary least squares regression was used to analyze categorical differences in levels of R/S and ordinal trends for R/S, adjusting for potential confounders. Being slightly or moderately religious/spiritual was associated with lower levels of self-rated health compared with being very religious/spiritual, and being slightly or moderately religious/spiritual was associated with higher levels of anxiety. In both cases, there was no significant difference between very religious/spiritual individuals and non-religious/spiritual individuals, suggesting a curvilinear relationship. Self-rated R/S was not significantly associated with emotional functioning or anger. In sum, high-R/S and low-R/S individuals had salutary associations with self-rated health and anxiety compared with individuals with slight/moderate levels of R/S. It is important for clinicians and policy makers to recognize the role R/S can play in the health status of South Asians living in the United States.


Assuntos
Nível de Saúde , Espiritualidade , Estresse Psicológico/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia Ocidental/etnologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Estados Unidos
9.
Trials ; 21(1): 71, 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31931848

RESUMO

BACKGROUND: Acute diarrhoea is a common cause of illness and death among children in low- to middle-income settings. World Health Organization guidelines for the clinical management of acute watery diarrhoea in children focus on oral rehydration, supplemental zinc and feeding advice. Routine use of antibiotics is not recommended except when diarrhoea is bloody or cholera is suspected. Young children who are undernourished or have a dehydrating diarrhoea are more susceptible to death at 90 days after onset of diarrhoea. Given the mortality risk associated with diarrhoea in children with malnutrition or dehydrating diarrhoea, expanding the use of antibiotics for this subset of children could be an important intervention to reduce diarrhoea-associated mortality and morbidity. We designed the Antibiotics for Childhood Diarrhoea (ABCD) trial to test this intervention. METHODS: ABCD is a double-blind, randomised trial recruiting 11,500 children aged 2-23 months presenting with acute non-bloody diarrhoea who are dehydrated and/or undernourished (i.e. have a high risk for mortality). Enrolled children in Bangladesh, India, Kenya, Malawi, Mali, Pakistan and Tanzania are randomised (1:1) to oral azithromycin 10 mg/kg or placebo once daily for 3 days and followed-up for 180 days. Primary efficacy endpoints are all-cause mortality during the 180 days post-enrolment and change in linear growth 90 days post-enrolment. DISCUSSION: Expanding the treatment of acute watery diarrhoea in high-risk children to include an antibiotic may offer an opportunity to reduce deaths. These benefits may result from direct antimicrobial effects on pathogens or other incompletely understood mechanisms including improved nutrition, alterations in immune responsiveness or improved enteric function. The expansion of indications for antibiotic use raises concerns about the emergence of antimicrobial resistance both within treated children and the communities in which they live. ABCD will monitor antimicrobial resistance. The ABCD trial has important policy implications. If the trial shows significant benefits of azithromycin use, this may provide evidence to support reconsideration of antibiotic indications in the present World Health Organization diarrhoea management guidelines. Conversely, if there is no evidence of benefit, these results will support the current avoidance of antibiotics except in dysentery or cholera, thereby avoiding inappropriate use of antibiotics and reaffirming the current guidelines. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03130114. Registered on April 26 2017.


Assuntos
Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Desenvolvimento Infantil , Desidratação/fisiopatologia , Países em Desenvolvimento , Diarreia/tratamento farmacológico , Transtornos da Nutrição do Lactente/fisiopatologia , Desnutrição/fisiopatologia , África ao Sul do Saara , Fatores Etários , Antibacterianos/efeitos adversos , Ásia Ocidental , Azitromicina/efeitos adversos , Desidratação/diagnóstico , Desidratação/mortalidade , Diarreia/diagnóstico , Diarreia/mortalidade , Diarreia/fisiopatologia , Método Duplo-Cego , Feminino , Humanos , Lactente , Mortalidade Infantil , Transtornos da Nutrição do Lactente/diagnóstico , Transtornos da Nutrição do Lactente/mortalidade , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Desnutrição/diagnóstico , Desnutrição/mortalidade , Estudos Multicêntricos como Assunto , Estado Nutricional , Estado de Hidratação do Organismo , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Equilíbrio Hidroeletrolítico
10.
Mol Phylogenet Evol ; 144: 106706, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31830551

RESUMO

Hycleus is a hyper-diverse genus of blister beetles including ~500 species widely distributed in the Old World, currently divided into three "sections" and into 45 "phenetic" species groups according to morphological characters. Recently the monophyly of Hycleus was questioned pointing out its paraphyly with respect to the genera Ceroctis and Paractenodia. In this study, we built a time-calibrated phylogenetic tree based on DNA sequence data from mitochondrial and nuclear genes obtained from 125 species, to understand the phylogenetic relationships among the species of this genus, to infer the biogeographic processes behind their diversification, and to assess their taxonomy and classification. Our results identified four main lineages one of which included the species belonging to Ceroctis and Paractenodia; therefore, both taxa are now referred to Hycleus as new synonyms. The three described sections of Hycleus resulted polyphyletic and are rejected, whereas several species groups represented well supported clades. Hycleus likely originated in Africa during the Early Miocene (~20 Mya), and subsequently spread in Europe and western Asia. Later, in the Late Miocene (~6 Mya) a Saharo-Sindian group branched off from the Palaearctic lineage, whereas the Oriental Region was colonized following a dispersal event through the Arabian Peninsula from the Afrotropical Region (~5 Mya).


Assuntos
Besouros/classificação , Besouros/genética , Variação Genética , África , Animais , Arábia , Ásia Ocidental , Europa (Continente) , Filogenia , Filogeografia , Análise de Sequência de DNA
11.
Can J Diabetes ; 43(8): 573-579, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31787243

RESUMO

OBJECTIVES: Gestational diabetes mellitus (GDM) increases the risk of pregnancy complications. South Asian immigrant women have among the highest rates of GDM in Canada and they also have the highest lifelong risk of developing type 2 diabetes after a GDM pregnancy. Diabetes Canada has been developing diabetes education material that accounts for the cultural preferences of South Asians. However, there is uncertainty to whether South Asian immigrants are aware of these resources or trust them, or if other factors influence their uptake of advice. METHODS: In this study, we conducted qualitative interviews to explore, among South Asian immigrant women with GDM: 1) their awareness of diabetes education resources, 2) their attitudes toward information from different resources and varying health-care providers and 3) their barriers and facilitators for GDM management recommendations. Gender theory is embedded in this study, as culturally specific gender roles regarding motherhood have been shown to be important to South Asian immigrant women and their perceptions of health. RESULTS: There was an emergence of 3 main themes. First, awareness of culturally tailored educational resources is low. Second, there is an overabundance of GDM management information, which leads to variability among participants of how they rank accuracy of informational sources. Finally, there is a gender role reversal present, where women are being taken care of by their families instead of being the providers of care. CONCLUSIONS: These results indicate that better dissemination strategies for GDM educational material are needed for health-care providers and patients, and may require additional consideration of family involvement during GDM education sessions.


Assuntos
Diabetes Gestacional , Gerenciamento Clínico , Emigrantes e Imigrantes , Educação em Saúde , Adulto , Ásia Ocidental/etnologia , Feminino , Humanos , Ontário , Gravidez , Pesquisa Qualitativa
12.
Prog Community Health Partnersh ; 13(3): 303-319, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31564671

RESUMO

BACKGROUND: Building the collective capacity of racialized women to meaningfully lead and engage in research is critical to health equity. To address the silence and stigma related to HIV/sexually transmitted infections (STIs) among South Asian women in Canada, peer leadership and engagement were identified as important strategies to promote open discussion about sexual health. OBJECTIVES: Underpinned by the principle of 'nothing about us without us', the objectives of the Story Sharing for Sexual Health (SSSH) research study included engaging and training South Asian women peer leaders to become an integral part of the study and build community research capacity. To achieve these objectives, it was critical to support the peer leaders in gaining a thorough understanding of the research ethics, protocols and teamwork principles, and to consolidate skills in group facilitation and community engagement. METHODS: The peer leaders attended four full-day training sessions on the social determinants of health and gender equity for racialized populations, HIV/STI and sexual health in the context of South Asian communities, community-based participatory research (CBPR) principles, skills in focus group facilitation, community partnerships building, and storytelling epistemologies. A training manual was developed. Evaluation of the training program included 1) evaluation forms, 2) process evaluations through journal writing and feedback sessions, and 3) implementation outcomes. CONCLUSIONS: The SSSH peer research training program was effective. Peer leaders demonstrated effectiveness in liaising with partner agencies, engaging South Asian women in sexual health discussion, completing CBPR activities and team building. Knowledge generated can be applied in CBPR with other racialized women populations.


Assuntos
Pesquisa Participativa Baseada na Comunidade/organização & administração , Saúde Sexual , Adulto , Ásia Ocidental/etnologia , Canadá , Participação da Comunidade/métodos , Pesquisa Participativa Baseada na Comunidade/métodos , Currículo , Feminino , Grupos Focais , Humanos , Liderança , Grupo Associado , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Saúde Sexual/educação , Saúde Sexual/etnologia
13.
Nat Commun ; 10(1): 4828, 2019 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-31645551

RESUMO

Shigella sonnei increasingly dominates the international epidemiological landscape of shigellosis. Treatment options for S. sonnei are dwindling due to resistance to several key antimicrobials, including the fluoroquinolones. Here we analyse nearly 400 S. sonnei whole genome sequences from both endemic and non-endemic regions to delineate the evolutionary history of the recently emergent fluoroquinolone-resistant S. sonnei. We reaffirm that extant resistant organisms belong to a single clonal expansion event. Our results indicate that sequential accumulation of defining mutations (gyrA-S83L, parC-S80I, and gyrA-D87G) led to the emergence of the fluoroquinolone-resistant S. sonnei population around 2007 in South Asia. This clone was then transmitted globally, resulting in establishments in Southeast Asia and Europe. Mutation analysis suggests that the clone became dominant through enhanced adaptation to oxidative stress. Experimental evolution reveals that under fluoroquinolone exposure in vitro, resistant S. sonnei develops further intolerance to the antimicrobial while the susceptible counterpart fails to attain complete resistance.


Assuntos
Farmacorresistência Bacteriana/genética , Disenteria Bacilar/microbiologia , Fluoroquinolonas , Genoma Bacteriano/genética , Shigella sonnei/genética , Antibacterianos/uso terapêutico , Ásia Sudeste/epidemiologia , Ásia Ocidental/epidemiologia , Teorema de Bayes , Ciprofloxacino/uso terapêutico , DNA Girase/genética , DNA Topoisomerase IV/genética , Evolução Molecular Direcionada , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Europa (Continente)/epidemiologia , Evolução Molecular , Humanos , Epidemiologia Molecular , Mutação , Filogenia , Polimorfismo de Nucleotídeo Único , Shigella sonnei/fisiologia
14.
J Pak Med Assoc ; 69(9): 1349-1354, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31511723

RESUMO

High costs associated with traditional print-based publishing have made open access publishing a popular way to improve research dissemination. Now several options and initiatives are enabling developing-world authors to attain equitable access to the scientific literature. However, little is known about the role of journals and initiatives from low- and middle-income countries in Asia regarding open access and their publication standards. Therefore, this article presents some exemplar y initiatives to promote research dissemination in South Asia through open access and publishing standards of the regional journals. Such initiatives deserve wider recognition, especially when u nder taken by resource -limited cou ntr ies, an d international collaboration schemes hold the potential to build further on current achievements.


Assuntos
Países em Desenvolvimento , Disseminação de Informação , Comunicação Acadêmica , Ásia Ocidental , Bangladesh , Humanos , Índia , Nepal , Publicação de Acesso Aberto , Paquistão , Sri Lanka
16.
Eur Respir J ; 54(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31413161

RESUMO

In countries of the European Union, tuberculosis (TB) mainly affects marginalised people, including asylum seekers. Migratory flows from high-incidence countries to Italy have increased up to 2017, posing challenges to the national health system. This study sought to assess TB and latent TB infection (LTBI) prevalence among asylum seekers in Milan during the biennium 2016-2017 and to evaluate interventions in place.A two-level active surveillance and screening system was developed for both TB and LTBI. Asylum seekers underwent an initial screening with a tuberculin skin test (TST) and a questionnaire at the receiving sites. At the Regional TB Reference Centre, those with a positive result underwent chest radiography. People aged <35 years with negative chest radiography results underwent further testing by interferon-γ release assay. If results of the assay were positive, LTBI treatment was offered. TB and LTBI prevalence were compared with literature data.A total of 5324 asylum seekers, mostly young (10-39 years; 98%), male (84%) and from sub-Saharan Africa (69%), were enrolled in the study. 69 active TB cases were diagnosed and 863 LTBI-positive individuals were detected. TB prevalence was high (1236 per 100 000 population) and LTBI prevalence was 28%. Despite losses (41%) during the transition from initial screening sites and the diagnostic centre, a good TB cure rate (84%) and optimal LTBI treatment completion (94%) were achieved.Our study shows that TB incidence is high among asylum seekers in Milan and that well-coordinated screening measures are critical for early diagnosis and treatment. It also proves that rolling out successful at-scale interventions for both prophylaxis and disease management is feasible.


Assuntos
Tuberculose Latente/epidemiologia , Refugiados/estatística & dados numéricos , Tuberculose dos Linfonodos/epidemiologia , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , África Oriental/etnologia , África do Norte/etnologia , África Ocidental/etnologia , Antituberculosos/uso terapêutico , Ásia Ocidental/etnologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Testes de Liberação de Interferon-gama , Itália/epidemiologia , Tuberculose Latente/diagnóstico , Tuberculose Latente/tratamento farmacológico , Masculino , Programas de Rastreamento , Prevalência , Radiografia Torácica , Resultado do Tratamento , Teste Tuberculínico , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Tuberculose dos Linfonodos/diagnóstico , Tuberculose dos Linfonodos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Adulto Jovem
17.
Mol Genet Genomics ; 294(6): 1547-1559, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31372716

RESUMO

Distinctive peculiarities of Armenians such as their millennia-long genetic isolation and strong national identity attract a keen interest while studying the demographic history of the West Asia. Here, to examine their fine-scale matrilineal genetic structure, ancestry and relationships with neighboring populations, we analyzed 536 complete mitogenomes (141 of which are novel) from 8 geographically different Armenian populations, covering the whole stretch of historical Armenia. The observed patterns highlight a remarkable degree of matrilineal genetic heterogeneity and weak population structuring of Armenians. Moreover, our phylogeographic analysis reveals common ancestries for some mtDNA lineages shared by West Asians, Transcaucasians, Europeans, Central Asians and Armenians. About third of the mtDNA subhaplogroups found in Armenian gene pool might be considered as Armenian-specific, as these are virtually absent elsewhere in Europe, West Asia and Transcaucasia. Coalescence ages of most of these lineages do not exceed 3.1 kya and coincide well with the population size growth started around 1.8-2.8 kya detectable only in the Bayesian Skyline Plots based on the Armenian-specific mtDNA haplotypes.


Assuntos
Genoma Mitocondrial , Armênia , Ásia Central , Ásia Ocidental , DNA Mitocondrial/química , Europa (Continente) , Variação Genética , Haplótipos , Humanos , Filogenia , Filogeografia
18.
BMJ Open ; 9(8): e025928, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31375603

RESUMO

INTRODUCTION: The South Asian population is the UK's largest and fastest growing minority ethnic group. There is evidence to suggest the lay understanding of postnatal psychiatric illnesses of this group may fall outside the purview of Western biomedical perspectives. Alternative explanations include psychosocial, cultural and spiritual factors. Approaching psychiatric illnesses through a social perspective includes gaining insight to the patient's subjective experiences and understandings via qualitative inquiry. The objectives of this qualitative study are to explore South Asian women's narrative of living with a severe postnatal psychiatric illness and experiences of Perinatal Mental Health Services, care and support. METHODS AND ANALYSIS: Data collection is ongoing and will continue until 31 December 2018. Participants will be identified and recruited from Perinatal Mental Health Services in Birmingham and London. Eligible participants will be English speaking South Asian females aged 18 years or above with the capacity to give written informed consent. Participants are clinically diagnosed with a severe postnatal psychiatric illness. This qualitative study uses individual in-depth face-to-face interviews that aim to last 1 hour. Interviews will be audio recorded with participants' permission. Interview audio recordings will be transcribed verbatim and analysed using interpretative phenomenological analysis (IPA). The primary goal of IPA is for the researcher to closely study and interpret how individuals make sense of their life experiences in a particular context by drawing on the fundamental principles of phenomenology, hermeneutics and idiography. ETHICS AND DISSEMINATION: The University of Birmingham, the South Birmingham Research Ethics Committee and the Health Research Authority have approved this study (approvals date: 18-12-2017 ref: 17/WM/0350). Local capability and capacity have been confirmed from Trust Research and Development departments. The researchers plan to publish the results from this study in journals and present findings at academic conferences.


Assuntos
Transtornos Mentais/etnologia , Transtornos Puerperais/psicologia , Adulto , Ásia Ocidental/etnologia , Depressão Pós-Parto/etnologia , Depressão Pós-Parto/etiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Serviços de Saúde Mental , Transtornos Puerperais/etnologia , Pesquisa Qualitativa , Reino Unido
20.
BMJ Open ; 9(8): e025071, 2019 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-31427310

RESUMO

OBJECTIVES: To investigate factors associated with movement behaviours among White British (WB) and South Asian (SA) children aged 6-8 years during school terms and holidays. DESIGN: Cross-sectional. SETTING: Three primary schools from the Bradford area, UK. PARTICIPANTS: One hundred and sixty WB and SA children aged 6-8 years. PRIMARY AND SECONDARY OUTCOMES: Sedentary behaviour (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) measured by accelerometry during summer, winter and spring and during school terms and school holidays. Data were analysed using multivariate mixed-effects multilevel modelling with robust SEs. Factors of interest were ethnicity, holiday/term, sex, socioeconomic status (SES), weight status, weekend/weekday and season. RESULTS: One hundred and eight children (67.5%) provided 1157 valid days of data. Fifty-nine per cent of children were WB (n=64) and 41% (n=44) were SA. Boys spent more time in MVPA (11 min/day, p=0.013) compared with girls and SA children spent more time in SB (39 min, p=0.017) compared with WB children in adjusted models. Children living in higher SES areas were more sedentary (43 min, p=0.006) than children living in low SES areas. Children were more active during summer (15 min MVPA, p<0.001; 27 LPA, p<0.001) and spring (15 min MVPA, p=0.005; 38 min LPA, p<0.001) and less sedentary (-42 min and -53 min, p<0.001) compared with winter. Less time (8 min, p=0.012) was spent in LPA during school terms compared with school holidays. Children spent more time in MVPA (5 min, p=0.036) during weekend compared with weekdays. Overweight and obese children spent more time in LPA (21 min, p=0.021) than normal-weight children. CONCLUSION: The results of our study suggest that significant child level factors associated with movement behaviours are ethnicity, sex, weight-status and area SES. Significant temporal factors are weekends, school holidays and seasonality. Interventions to support health enhancing movement behaviours may need to be tailored around these factors.


Assuntos
Acelerometria , Grupo com Ancestrais do Continente Europeu/psicologia , Atividade Motora , Ásia Ocidental/etnologia , Criança , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Férias e Feriados/psicologia , Férias e Feriados/estatística & dados numéricos , Humanos , Masculino , Instituições Acadêmicas/estatística & dados numéricos , Comportamento Sedentário/etnologia , Reino Unido
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