Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.153
Filtrar
1.
N Engl J Med ; 381(21): 2009-2019, 2019 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-31693803

RESUMO

BACKGROUND: Dengue, a mosquito-borne viral disease, was designated a World Health Organization top 10 threat to global health in 2019. METHODS: We present primary efficacy data from part 1 of an ongoing phase 3 randomized trial of a tetravalent dengue vaccine candidate (TAK-003) in regions of Asia and Latin America in which the disease is endemic. Healthy children and adolescents 4 to 16 years of age were randomly assigned in a 2:1 ratio (stratified according to age category and region) to receive two doses of vaccine or placebo 3 months apart. Participants presenting with febrile illness were tested for virologically confirmed dengue by serotype-specific reverse-transcriptase polymerase chain reaction. The primary end point was overall vaccine efficacy in preventing virologically confirmed dengue caused by any dengue virus serotype. RESULTS: Of the 20,071 participants who were given at least one dose of vaccine or placebo (safety population), 19,021 (94.8%) received both injections and were included in the per-protocol analysis. The overall vaccine efficacy in the safety population was 80.9% (95% confidence interval [CI], 75.2 to 85.3; 78 cases per 13,380 [0.5 per 100 person-years] in the vaccine group vs. 199 cases per 6687 [2.5 per 100 person-years] in the placebo group). In the per-protocol analyses, vaccine efficacy was 80.2% (95% CI, 73.3 to 85.3; 61 cases of virologically confirmed dengue in the vaccine group vs. 149 cases in the placebo group), with 95.4% efficacy against dengue leading to hospitalization (95% CI, 88.4 to 98.2; 5 hospitalizations in the vaccine group vs. 53 hospitalizations in the placebo group). Planned exploratory analyses involving the 27.7% of the per-protocol population that was seronegative at baseline showed vaccine efficacy of 74.9% (95% CI, 57.0 to 85.4; 20 cases of virologically confirmed dengue in the vaccine group vs. 39 cases in the placebo group). Efficacy trends varied according to serotype. The incidence of serious adverse events was similar in the vaccine group and placebo group (3.1% and 3.8%, respectively). CONCLUSIONS: TAK-003 was efficacious against symptomatic dengue in countries in which the disease is endemic. (Funded by Takeda Vaccines; TIDES ClinicalTrials.gov number, NCT02747927.).


Assuntos
Vacinas contra Dengue/imunologia , Vírus da Dengue/imunologia , Dengue/prevenção & controle , Doenças Endêmicas/prevenção & controle , Adolescente , Américas/epidemiologia , Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Ásia/epidemiologia , Criança , Pré-Escolar , Dengue/epidemiologia , Dengue/imunologia , Vacinas contra Dengue/efeitos adversos , Vírus da Dengue/isolamento & purificação , Método Duplo-Cego , Feminino , Humanos , Incidência , Masculino , Sorogrupo , Resultado do Tratamento
2.
J Dermatol ; 46(10): 825-834, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31436343

RESUMO

Atopic dermatitis is a chronic, inflammatory skin disease characterized by intense pruritus and eczematous lesions. It is considered one of the most common chronic conditions, with an estimated global prevalence of nearly 230 million. As in the rest of the world, prevalence of atopic dermatitis has been increasing in Asian countries over the last few decades. This increased prevalence in Asian countries has been attributed to factors such as rapid urbanization, increasingly Westernized lifestyles, and improved standards of living and education. As a result, it is important to understand the increasing burden of disease in Asian countries and the differences between the countries in terms of epidemiology, diagnostic criteria, management, quality of life and economic burden.


Assuntos
Efeitos Psicossociais da Doença , Dermatite Atópica/epidemiologia , Qualidade de Vida , Ásia/epidemiologia , Dermatite Atópica/complicações , Dermatite Atópica/economia , Humanos , Estilo de Vida/etnologia , Prevalência , Fatores de Risco
4.
BMC Public Health ; 19(1): 934, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31296193

RESUMO

BACKGROUND: Dengue is a major public health problem in the tropics and sub-tropics, but the disease is less known to non-dengue-endemic countries including in Northeast Asia. However, an unexpected dengue outbreak occurred in 2014 in Japan. Given that autochthonous (domestic) dengue cases had not been reported for the past 70 years in Japan, this outbreak was highly unusual and suggests that several environmental factors might have changed in a way that favors vector mosquitoes in the Northeast Asian region. METHODS: A Climate Risk Factor (CRF) index, as validated in previous work, was constructed using climate and non-climate factors. This CRF index was compared to the number of reported dengue cases in Tokyo, Japan where the outbreak was observed in 2014. In order to identify high-risk areas, the CRF index was further estimated at the 5 km by 5 km resolution and mapped for Japan and South Korea. RESULTS: The high-risk areas determined by the CRF index corresponded well to the provinces where a high number of autochthonous cases were reported during the outbreak in Japan. At the provincial-level, high-risk areas for dengue fever were the Eastern part of Tokyo and Kanakawa, the South-Eastern part of Saitama, and the North-Western part of Chiba. While a relatively small number of high-risk areas were identified in South Korea compared with Japan, the high-risk areas in South Korea include popular tourist destinations where international visitors have been increasing. CONCLUSION: The recent dengue outbreak in Japan may signal that the two adjacent non-dengue-endemic countries are also exposed to the risk of temporal and sporadic behavior of dengue fever. It is critical to understand potential high-risk areas for future outbreaks and to set up appropriate prevention activities at the governmental-level.


Assuntos
Mudança Climática , Dengue/epidemiologia , Surtos de Doenças , Ásia/epidemiologia , Conjuntos de Dados como Assunto , Doenças Endêmicas , Humanos , Japão/epidemiologia , República da Coreia/epidemiologia , Fatores de Risco , Tóquio/epidemiologia
6.
Adv Exp Med Biol ; 1154: 71-103, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31297760

RESUMO

Fascioliasis is a major parasitic disease caused by the digenetic trematodes Fasciola hepatica and Fasciola gigantica. The disease is a well-known veterinary problem of worldwide distribution. Fascioliasis is the vector-borne parasitic disease presenting the widest latitudinal, longitudinal, and altitudinal distribution known at present. In the last two decades, many surveys have shown it to be an important public health problem as well, including estimations of 2.4 million, up to 17 million people, or even higher depending on the hitherto unknown situations mainly in several regions of Asia and Africa. In recent years, the increasing number of human case reports in many countries of the five continents and the results of studies on pathogenicity and immunity, mainly regarding the chronic period of the disease, were the reasons why it was decided to no longer consider fascioliasis merely a secondary zoonotic disease but an important human parasitic disease. In this chapter, we review the most relevant features in relation to fascioliasis, including from the most traditional to the most innovative aspects.


Assuntos
Fasciolíase , África/epidemiologia , Animais , Ásia/epidemiologia , Fasciola , Fasciolíase/epidemiologia , Fasciolíase/parasitologia , Fasciolíase/prevenção & controle , Humanos
7.
Adv Exp Med Biol ; 1154: 139-180, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31297762

RESUMO

Clonorchis sinensis, Opisthorchis viverrini, and O. felineus are liver flukes of human and animal pathogens occurring across much of Europe and Asia. Nevertheless, they are often underestimated compared to other, better known neglected diseases in spite of the fact that many millions of people are infected and hundreds of millions are at risk. This is possibly because of the chronic nature of the infection and disease and that it takes several decades prior to a life-threatening pathology to develop. Several studies in the past decade have provided more information on the molecular biology of the liver flukes which clearly lead to better understanding of parasite biology, systematics, and population genetics. Clonorchiasis and opisthorchiasis are characterized by a chronic infection that induces hepatobiliary inflammation, especially periductal fibrosis, which can be detected by ultrasonography. These chronic inflammations eventually lead to cholangiocarcinoma (CCA), a usually fatal bile duct cancer that develops in some infected individuals. In Thailand alone, opisthorchiasis-associated CCA kills up to 20,000 people every year and is therefore of substantial public health importance. Its socioeconomic impacts on impoverished families and communities are considerable. To reduce hepatobiliary morbidity and CCA, the primary intervention measures focus on control and elimination of the liver fluke. Accurate diagnosis of liver fluke infections in both human and other mammalian, snail and fish intermediate hosts, are important for achieving these goals. While the short-term goal of liver fluke control can be achieved by praziquantel chemotherapy, a comprehensive health education package targeting school children is believed to be more beneficial for a long-term goal/solution. It is recommended that a transdisciplinary research or multisectoral control approach including one health and/or eco health intervention strategy should be applied to combat the liver flukes, and hence contribute to reduction of cholangiocarcinoma in endemic areas.


Assuntos
Clonorquíase , Clonorchis sinensis , Opistorquíase , Opisthorchis , Animais , Ásia/epidemiologia , Clonorquíase/diagnóstico , Clonorquíase/epidemiologia , Clonorquíase/parasitologia , Clonorquíase/prevenção & controle , Clonorchis sinensis/classificação , Clonorchis sinensis/genética , Europa (Continente)/epidemiologia , Humanos , Opistorquíase/diagnóstico , Opistorquíase/epidemiologia , Opistorquíase/parasitologia , Opistorquíase/prevenção & controle , Opisthorchis/classificação , Opisthorchis/genética
8.
Adv Exp Med Biol ; 1154: 279-319, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31297766

RESUMO

This chapter analyses the taxonomic position of Dicrocoeliidae family and several of its genus and species. The biology of the major species causing veterinary diseases such Dicrocoelium dendriticum, Dicrocoelium hospes, Dicrocoelium chinensis, Eurytrema pancreaticum and Platynosomum fastosum, has been reviewed. All these species have an indirect life cycle, involving two intermediate hosts (molluscs as first and ants, grasshoppers and lizards as second). Dicrocoelium dendriticum is a very widespread hepatic trematode in the ruminants of many countries in Europe, Asia, North Africa and North America, even affecting humans. Dicrocoelium hospes is widely distributed in the savanna areas of Africa south of the Sahara, whilst D. chinensis has mainly been found in ruminants in East Asia and some European countries (probably imported from Asia). Eurytrema pancreaticum is a common parasite whose adults live in ruminant bile ducts, gall bladder, pancreatic ducts and intestines in Europe, Madagascar, Asia and South America. Adult P. fastosum live in the liver, gall bladder and pancreas of birds and mammals in Europe, Africa, Asia, North, Central and South America. Information about the epidemiology, pathology, clinical aspect, diagnosis, treatment, control, prevention and economic impact mainly of Dicrocoeliosis produced by D. dendriticum, as well as of Eurytrematodosis and Platynosomiosis, has been included.


Assuntos
Dicrocoeliidae , Infecções por Trematódeos , África/epidemiologia , Animais , Ásia/epidemiologia , Dicrocoeliidae/classificação , Europa (Continente)/epidemiologia , Humanos , América do Norte/epidemiologia , América do Sul/epidemiologia , Infecções por Trematódeos/diagnóstico , Infecções por Trematódeos/epidemiologia , Infecções por Trematódeos/parasitologia , Infecções por Trematódeos/prevenção & controle
9.
Crit Rev Oncol Hematol ; 141: 95-101, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31272046

RESUMO

BACKGROUND: Cancer and heart diseases are the leading causes of morbidity and mortality in many countries worldwide. Recent advancement in chemotherapy and targeted therapies has led to an improvement in cancer survival rates, but at a cost of higher cardiac side effects. However, report on antineoplastic-related cardiotoxicities incidence in Asia is lacking. METHODS: We systematically searched multiple databases to identify studies reporting incidence of antineoplastic-related cardiovascular toxicity in Asia published from inception to November 2018. Pre-specified subgroups were performed to explore heterogeneity and study quality assessed and reported according to PRISMA guidelines. RESULTS: A total of 61 studies across 11 countries in Asia reported 8 types of cardiovascular toxicities were included. These studies mostly reported on adult populations, and usually examined cardiotoxicities related to anthracycline use. The most frequently reported cardiotoxicities were heart failure, electrocardiogram abnormalities and left ventricular dysfunction. The pooled estimated incidence of cardiotoxicity was 4.27% (95% CI: 3.53-5.07). Subgroup analysis showed higher incidence in middle income countries compared to high income countries. CONCLUSIONS: Although robust incidence studies are sparse, cardiovascular complications affects approximately one in twenty cancer patients in Asia. This highlights a unique opportunity of cancer patients caring that need cardiologists and oncologist to become familiar with this emerging sub-specialty.


Assuntos
Antraciclinas/efeitos adversos , Antibióticos Antineoplásicos/efeitos adversos , Cardiopatias/induzido quimicamente , Neoplasias/tratamento farmacológico , Adulto , Antraciclinas/classificação , Antraciclinas/uso terapêutico , Antibióticos Antineoplásicos/classificação , Antibióticos Antineoplásicos/uso terapêutico , Ásia/epidemiologia , Cardiotoxicidade/epidemiologia , Cardiopatias/epidemiologia , Humanos , Incidência , Neoplasias/epidemiologia
10.
Lancet ; 394(10192): 64-80, 2019 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-31178151

RESUMO

Nasopharyngeal carcinoma is characterised by distinct geographical distribution and is particularly prevalent in east and southeast Asia. Epidemiological trends in the past decade have shown that its incidence has declined gradually but progressively, and mortality has been reduced substantially. These findings probably reflect lifestyle and environmental changes, enhanced understanding of the pathogenesis and risk factors, population screening, advancements in imaging techniques, and individualised comprehensive chemoradiotherapy strategies. In particular, plasma Epstein-Barr virus (EBV) DNA has been used for population screening, prognostication, predicting treatment response for therapeutic adaptation, and disease surveillance. Moreover, the widespread application of intensity-modulated radiotherapy and optimisation of chemotherapy strategies (induction, concurrent, adjuvant) have contributed to improved survival with reduced toxicities. Among the existing developments in novel therapeutics, immune checkpoint therapies have achieved breakthroughs for treating recurrent or metastatic disease and represent a promising future direction in nasopharyngeal carcinoma.


Assuntos
Infecções por Vírus Epstein-Barr/epidemiologia , Carcinoma Nasofaríngeo/virologia , Neoplasias Nasofaríngeas/virologia , Ásia/epidemiologia , Quimiorradioterapia , Gerenciamento Clínico , Detecção Precoce de Câncer , Infecções por Vírus Epstein-Barr/diagnóstico , Infecções por Vírus Epstein-Barr/terapia , Humanos , Carcinoma Nasofaríngeo/epidemiologia , Carcinoma Nasofaríngeo/terapia , Neoplasias Nasofaríngeas/epidemiologia , Neoplasias Nasofaríngeas/terapia , Medicina de Precisão , Fatores de Risco , Análise de Sobrevida
11.
Ecotoxicol Environ Saf ; 182: 109362, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31254856

RESUMO

In low concentration, fluoride is considered a necessary compound for human health. Exposure to high concentrations of fluoride is the reason for a serious disease called fluorosis. Fluorosis is categorized as Skeletal and Dental fluorosis. Several Asian countries, such as India, face contamination of water resources with fluoride. In this study, a comprehensive overview on fluoride contamination in Asian water resources has been presented. Since water contamination with fluoride in India is higher than other Asian countries, a separate section was dedicated to review published articles on fluoride contamination in this country. The status of health effects in Asian countries was another topic that was reviewed in this study. The effects of fluoride on human organs/systems such as urinary, renal, endocrine, gastrointestinal, cardiovascular, brain, and reproductive systems were another topic that was reviewed in this study. Different methods to remove fluoride from water such as reverse osmosis, electrocoagulation, nanofiltration, adsorption, ion-exchange and precipitation/coagulation were introduced in this study. Although several studies have been carried out on contamination of water resources with fluoride, the situation of water contamination with fluoride and newly developed technology to remove fluoride from water in Asian countries has not been reviewed. Therefore, this review is focused on these issues: 1) The status of fluoride contamination in Asian countries, 2) health effects of fluoride contamination in drinking water in Asia, and 3) the existing current technologies for defluoridation in Asia.


Assuntos
Fluoretos/análise , Água Subterrânea/química , Poluentes Químicos da Água/análise , Adsorção , Ásia/epidemiologia , Água Potável , Recuperação e Remediação Ambiental , Filtração , Fluorose Dentária/epidemiologia , Trato Gastrointestinal/química , Humanos , Índia , Desenvolvimento Industrial , Rim/química , Poluição da Água , Recursos Hídricos
12.
Nord J Psychiatry ; 73(6): 323-330, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31240984

RESUMO

Background: Although cannabis use has been linked with schizophrenia in a dose-response pattern, to our knowledge, the relationship between cannabis and schizophrenia has rarely been reported in Asian population. Aim: We compared the clinical characteristics and psychotropic prescription patterns between cannabis users and non-users among Asian patients with schizophrenia. Moreover, we aimed to identify the independent correlates of cannabis use in these subjects. Methods: We performed the analysis of the data from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP), a collaborative consortium survey used to collate the prescription patterns for antipsychotic and other psychotropic medications in patients with schizophrenia in Asia. We included 132 schizophrenia patients in the group of lifetime cannabis use and 1756 in the group that had never used cannabis. A binary logistic model was fitted to detect the clinical correlates of lifetime cannabis use. Results: Adjusting for the effects of age, sex, geographical region, income group, duration of untreated psychosis, and Charlson comordity index level, a binary logistic regression model revealed that lifetime cannabis use was independently associated with aggressive behavior [adjusted odds ratio (aOR) = 1.582, 95% confidence interval (CI) = 1.006-2.490, p = .047] and with long-acting injectable antipsychotic treatment (aOR = 1.796, 95% CI = 1.444-2.820, p = .001). Conclusion: Our findings indicate a close link between lifetime cannabis use and aggressive behavior. The use of long-acting, injectable antipsychotics preferentially treats the aggressive behavior cannabis users among patients with schizophrenia in Asia, especially, the South or Southeast Asia.


Assuntos
Agressão , Antipsicóticos/administração & dosagem , Antipsicóticos/uso terapêutico , Cannabis/efeitos adversos , Fumar Maconha/efeitos adversos , Esquizofrenia/tratamento farmacológico , Adulto , Ásia/epidemiologia , Grupo com Ancestrais do Continente Asiático/psicologia , Feminino , Humanos , Modelos Logísticos , Masculino , Fumar Maconha/epidemiologia , Fumar Maconha/psicologia , Razão de Chances , Psicotrópicos/administração & dosagem , Psicotrópicos/uso terapêutico , Esquizofrenia/epidemiologia , Inquéritos e Questionários
13.
PLoS Genet ; 15(6): e1008204, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31181058

RESUMO

We learn about population history and underlying evolutionary biology through patterns of genetic polymorphism. Many approaches to reconstruct evolutionary histories focus on a limited number of informative statistics describing distributions of allele frequencies or patterns of linkage disequilibrium. We show that many commonly used statistics are part of a broad family of two-locus moments whose expectation can be computed jointly and rapidly under a wide range of scenarios, including complex multi-population demographies with continuous migration and admixture events. A full inspection of these statistics reveals that widely used models of human history fail to predict simple patterns of linkage disequilibrium. To jointly capture the information contained in classical and novel statistics, we implemented a tractable likelihood-based inference framework for demographic history. Using this approach, we show that human evolutionary models that include archaic admixture in Africa, Asia, and Europe provide a much better description of patterns of genetic diversity across the human genome. We estimate that an unidentified, deeply diverged population admixed with modern humans within Africa both before and after the split of African and Eurasian populations, contributing 4 - 8% genetic ancestry to individuals in world-wide populations.


Assuntos
Evolução Molecular , Genética Populacional , Genoma Humano/genética , Hominidae/genética , África/epidemiologia , Grupo com Ancestrais do Continente Africano/genética , Animais , Ásia/epidemiologia , Europa (Continente)/epidemiologia , Fluxo Gênico/genética , Frequência do Gene , Humanos , Funções Verossimilhança , Desequilíbrio de Ligação , Modelos Genéticos , Polimorfismo Genético/genética
14.
Int J Public Health ; 64(6): 909-920, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31240333

RESUMO

OBJECTIVES: We compared pregnancy identification methods and outcome capture across 31 Health Demographic Surveillance System (HDSS) sites in 14 countries in sub-Saharan Africa and Asia. METHODS: From 2009 to 2014, details on the sites and surveillance systems including frequency of update rounds, characteristics of enumerators and interviewers, acceptable respondents were collected and compared across sites. RESULTS: The 31 HDSS had a combined population of over 2,905,602 with 165,820 births for the period. Stillbirth rate ranged from 1.9 to 42.6 deaths per 1000 total births and the neonatal mortality rate from 2.6 to 41.6 per 1000 live births. Three quarters (75.3%) of recorded neonatal deaths occurred in the first week of life. The proportion of infant deaths that occurred in the neonatal period ranged from 8 to 83%, with a median of 53%. Sites that registered pregnancies upon locating a live baby in the routine household surveillance round had lower recorded mortality rates. CONCLUSIONS: Increased attention and standardization of pregnancy surveillance and the time of birth will improve data collection and provide platforms for evaluations and availability of data for decision-making with implications for national planning.


Assuntos
Coeficiente de Natalidade/tendências , Mortalidade Infantil/tendências , Vigilância da População/métodos , Resultado da Gravidez/epidemiologia , Natimorto/epidemiologia , Adulto , África ao Sul do Saara/epidemiologia , Ásia/epidemiologia , Feminino , Previsões , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez
15.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(2. Vyp. 2): 12-17, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31156235

RESUMO

AIM: To study clinical-epidemiological characteristics of multiple sclerosis (MS) and neuroopticomyelitis spectrum diseases (NOMSD) in Semej town (Kazakhstan) taking into account ethnic identity. MATERIAL AND METHODS: Epidemiological indicators and clinical characteristics of MS and NOMSD in Semej (the Central Asia region) were studied. RESULTS AND DISCUSSION: General MS prevalence was 10.1 per 100 000 population, 16.8 in Caucasians, 4.9 in Asians (OR=2.64; 95% CI 1.31-5.36). General female to male (F/M) ratio was 1:2.5, 1:1.2 in Asians; 1:5 in Caucasians. Mean age of patients and EDSS index at the time of observation were equal in both ethnic groups. Ten cases of NOMSD were found, all of them were recorded in the Asian population (prevalence 4.9 per 100 000 population). F/M was 1:9. Mean age (p=0.02) and age at disease onset (p=0.01), as well as EDSS indexes at time of onset and observation (p<0.001 and p<0.001) were higher in NOMSD patients compared to MS. No NOMSD cases were identified in Caucasians, while in Asians the equal prevalence of MS and NOMSD was shown. This finding may be explained by the presence of both Asian and Caucasian haplogroups in the Kazakh population.


Assuntos
Esclerose Múltipla , Ásia/epidemiologia , Grupo com Ancestrais do Continente Asiático , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Cazaquistão/epidemiologia , Masculino , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/etnologia
16.
Emerg Microbes Infect ; 8(1): 823-826, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31164049

RESUMO

The spread of highly pathogenic avian influenza (HPAI) H5N1 virus is associated with wild fowl migration in East Asian-Australasian (EA) and Central Asian (CA) flyways. However, the spread of H5N1 virus between the two flyways is still unclear. Here, the movements of wild waterfowl were obtained from satellite tracking data covering seven bar-headed geese and three great black-headed gulls breeding in the Qinghai Lake area (along the EA flyway), and 20 whooper swans wintering in the Sanmenxia Reservoir area (at the CA flyway). From the 2688 samples that were screened from wild birds at Qinghai Lake after an outbreak of H5N1 in July 2015, four genomes of H5N1 virus were obtained from bar-headed geese. The results of phylogenetic analysis indicated that these H5N1 viruses belonged to clade 2.3.2.1c and their gene fragments were highly homologous with A/whooper swan/Henan/SMX1/2015 (H5N1) virus (ranging from 99.76% to 100.00%) isolated from a dead whooper swan from the Sanmenxia Reservoir area along the EA flyway in January 2015. Furthermore, the coincidental timing of the H5N1 outbreak with spring migration, together with phylogenetic evidence, provided new evidence of the east-to-west spread of HPAI H5N1 between the EA and CA migratory flyways of China.


Assuntos
Anseriformes/fisiologia , Virus da Influenza A Subtipo H5N1/fisiologia , Influenza Aviária/epidemiologia , Migração Animal , Animais , Animais Selvagens/fisiologia , Animais Selvagens/virologia , Anseriformes/virologia , Ásia/epidemiologia , Austrália/epidemiologia , China/epidemiologia , Virus da Influenza A Subtipo H5N1/classificação , Virus da Influenza A Subtipo H5N1/genética , Virus da Influenza A Subtipo H5N1/isolamento & purificação , Influenza Aviária/transmissão , Influenza Aviária/virologia , Filogenia , Estações do Ano
17.
High Blood Press Cardiovasc Prev ; 26(3): 227-237, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31228169

RESUMO

INTRODUCTION: Contribution of risk factors for cardiovascular-related deaths in the Eastern Mediterranean Region Organization (EMRO) is not estimated quantitatively. AIM: To determine the avoidable burden of cardiovascular diseases (CVDs) due to hypertension, diabetes, smoking, overweight, and obesity in countries of EMRO of the WHO. METHODS: The comparative risk assessment methodology was used to calculate the potential impact fraction (PIF) and percentage of the avoidable burden of CVD-related death due to associated risk factors. Population exposure levels for CVDs and corresponding measures of association were extracted from published studies. The attributable burden was calculated by multiplying the Disability-Adjusted Life-Years (DALYs) for CVDs by the estimated impact fraction of risk factors. DALYs of the CVDs in all countries of the EMRO were extracted from the GBD official website in 2016. RESULTS: Following reduction of the current prevalence of smoking, obesity, hypertension, diabetes, and overweight to a feasible minimum risk exposure level in Lebanon, about 12.4%, 4.2%, 10.2%, 3.8%, and 5.7% of the burden of CVD-related mortality could be avoidable, respectively. The corresponding values of avoidable burden in selected EMRO countries were 5.1%, 3.5%, 9.4%, 5.9% and 5.3% in Iran and 9.5%, 4.1%, 11%, 8.2% and 5.4% in Egypt. CONCLUSIONS: Findings suggest that health policy makers of all EMRO countries should take into account the attributable burden of CVD-related mortality due to associated risk factors to effectively develop preventive interventions.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Fumar/epidemiologia , África do Norte/epidemiologia , Ásia/epidemiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/mortalidade , Diabetes Mellitus/terapia , Estilo de Vida Saudável , Humanos , Hipertensão/diagnóstico , Hipertensão/mortalidade , Hipertensão/terapia , Obesidade/diagnóstico , Obesidade/mortalidade , Obesidade/terapia , Prevalência , Serviços Preventivos de Saúde , Prognóstico , Fatores de Proteção , Medição de Risco , Fatores de Risco , Comportamento de Redução do Risco , Fumar/efeitos adversos , Fumar/mortalidade , Abandono do Hábito de Fumar
18.
MBio ; 10(2)2019 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-31040246

RESUMO

The global spread of Plasmodium falciparum chloroquine resistance transporter (PfCRT) variant haplotypes earlier caused the widespread loss of chloroquine (CQ) efficacy. In Asia, novel PfCRT mutations that emerged on the Dd2 allelic background have recently been implicated in high-level resistance to piperaquine, and N326S and I356T have been associated with genetic backgrounds in which resistance emerged to artemisinin derivatives. By analyzing large-scale genome sequencing data, we report that the predominant Asian CQ-resistant Dd2 haplotype is undetectable in Africa. Instead, the GB4 and previously unexplored Cam783 haplotypes predominate, along with wild-type, drug-sensitive PfCRT that has reemerged as the major haplotype. To interrogate how these alleles impact drug susceptibility, we generated pfcrt-modified isogenic parasite lines spanning the mutational interval between GB4 and Dd2, which includes Cam783 and involves amino acid substitutions at residues 326 and 356. Relative to Dd2, the GB4 and Cam783 alleles were observed to mediate lower degrees of resistance to CQ and the first-line drug amodiaquine, while resulting in higher growth rates. These findings suggest that differences in growth rates, a surrogate of parasite fitness, influence selection in the context of African infections that are frequently characterized by high transmission rates, mixed infections, increased immunity, and less recourse to treatment. We also observe that the Asian Dd2 allele affords partial protection against piperaquine yet does not directly impact artemisinin efficacy. Our results can help inform the regional recommendations of antimalarials, whose activity is influenced by and, in certain cases, enhanced against select PfCRT variant haplotypes.IMPORTANCE Our study defines the allelic distribution of pfcrt, an important mediator of multidrug resistance in Plasmodium falciparum, in Africa and Asia. We leveraged whole-genome sequence analysis and gene editing to demonstrate how current drug combinations can select different allelic variants of this gene and shape region-specific parasite population structures. We document the ability of PfCRT mutations to modulate parasite susceptibility to current antimalarials in dissimilar, pfcrt allele-specific ways. This study underscores the importance of actively monitoring pfcrt genotypes to identify emerging patterns of multidrug resistance and help guide region-specific treatment options.


Assuntos
Resistência a Múltiplos Medicamentos , Aptidão Genética , Genótipo , Malária Falciparum/parasitologia , Proteínas de Membrana Transportadoras/genética , Plasmodium falciparum/crescimento & desenvolvimento , Proteínas de Protozoários/genética , África/epidemiologia , Ásia/epidemiologia , Frequência do Gene , Genética Populacional , Malária Falciparum/epidemiologia , Proteínas Mutantes/genética , Plasmodium falciparum/classificação , Plasmodium falciparum/genética , Plasmodium falciparum/isolamento & purificação
19.
Sci Total Environ ; 683: 489-497, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31141750

RESUMO

BACKGROUND: The growing concern with environmental related impacts on mortality and morbidity means that the conceptual framework of environment-health-economic policy nexus is salient in the global debate on air pollution. OBJECTIVES: With time series data spanning 2000-2016, this study explored the proximate determinants of ambient air pollution, mortality, and life expectancy in North America, Europe & Central Asia, and East Asia & Pacific regions. METHODS: The study applied historical data on urban population, total pollution, energy consumption, GDP per capita, life expectancy, mortality rate and industrial PM2.5 emissions to develop six parsimonious models using the generalized least squares (GLS) random-effects model estimation with first-order autoregressive [AR(1)] disturbance across 54 countries. RESULTS: An increase in income level by 1% declined mortality rate by 0.01% and increased longevity by ~0.02% (95% Confidence Interval [CI]) in the long-run. An increase in industrial PM2.5 emissions per capita by 1% decreased life expectancy by 0.004% and mortality rate by 0.02% (95% CI). Intensification of energy consumption and its related services by 1% were found to increase industrial PM2.5 emissions by 0.42-0.45% (95% CI). An inversed-U shaped curve between PM2.5 emissions per capita and income levels was found at a turning point of US$ 48,061. The validity of an environmental Kuznets curve hypothesis between ambient air pollution and urbanization was confirmed, while a rapid increase in population had a significant positive impact on ambient air pollution. CONCLUSION: Ambient air pollution contributes significantly in reducing life expectancy and increasing mortality. However, sustained economic development, along with energy efficiency, and sustainable urban settlement planning and management are potential options for reducing ambient air pollution while improving quality of life and environmental sustainability.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Mortalidade/tendências , Material Particulado/análise , Ásia/epidemiologia , Austrália/epidemiologia , Europa (Continente)/epidemiologia , Extremo Oriente/epidemiologia , Expectativa de Vida , América do Norte/epidemiologia , Qualidade de Vida
20.
Vet Parasitol ; 269: 42-52, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31079827

RESUMO

Toxoplasmosis, caused by the protozoan parasite Toxoplasma gondii, is an important disease with worldwide distribution. Infection can occur from ingesting raw or undercooked infected meat, and among food animal species, pork is known to be one of the main sources of meat-borne infection. Here, we present results of the first systematic review and meta-analysis on the global T. gondii seroprevalence in pigs. PubMed/MEDLINE, Scopus, and EMBASE databases were comprehensively searched for relevant studies published between January 1, 1990 and October 25, 2018. We used a random effects model to calculate pooled seroprevalence estimates with 95% confidence intervals (CI) and analyzed data from five continents. We also conducted subgroup and meta-regression analyses to evaluate the effects of geographical and climate variables on pooled seroprevalence rates. Among 1542 publications identified, 148 studies containing 150 datasets were included in the meta-analysis, and comprised 148,092 pigs from 47 countries. The pooled global T. gondii seroprevalence in pigs was estimated to be 19% (95%CI, 17-22%; 23,696/148,092), with the lowest seroprevalence in Europe (13%; 10-15%) and highest seroprevalence in Africa (25%; 17-34%) and North America (25%; 19-33%). The seropositivity rates in Asia and South America regions were (21%, 16-26%) and (23%; 17-30%), respectively. A significantly higher T. gondii seroprevalence was associated with higher mean annual temperature and lower geographical latitude. The presence of cats on farms was identified as a potential risk factor for T. gondii seropositivity (OR, 1.41; 95%CI, 1.00-2.02). Our findings highlight the importance of pigs as a possible source of human T. gondii infections.


Assuntos
Anticorpos Antiprotozoários/sangue , Carne Vermelha/parasitologia , Doenças dos Suínos/epidemiologia , Toxoplasma/imunologia , Toxoplasmose Animal/epidemiologia , Toxoplasmose/epidemiologia , África/epidemiologia , Animais , Ásia/epidemiologia , Europa (Continente)/epidemiologia , Saúde Global , Humanos , América do Norte/epidemiologia , Fatores de Risco , Estudos Soroepidemiológicos , América do Sul/epidemiologia , Suínos , Doenças dos Suínos/parasitologia , Temperatura Ambiente , Toxoplasmose/parasitologia , Toxoplasmose Animal/parasitologia , Zoonoses
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA