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4.
Viruses ; 13(7)2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34372606

RESUMO

As demonstrated with the novel coronavirus pandemic, rapid and accurate diagnosis is key to determine the clinical characteristic of a disease and to improve vaccine development. Once the infected person is identified, hematological findings may be used to predict disease outcome and offer the correct treatment. Rapid and accurate diagnosis and clinical parameters are pivotal to track infections during clinical trials and set protection status. This is also applicable for re-emerging diseases like dengue fever, which causes outbreaks in Asia and Latin America every 4 to 5 years. Some areas in the US are also endemic for the transmission of dengue virus (DENV), the causal agent of dengue fever. However, significant number of DENV infections in rural areas are diagnosed solely by clinical and hematological findings because of the lack of availability of ELISA or PCR-based tests or the infrastructure to implement them in the near future. Rapid diagnostic tests (RDT) are a less sensitive, yet they represent a timely way of detecting DENV infections. The purpose of this study was to determine whether there is an association between hematological findings and the probability for an NS1-based DENV RDT to detect the DENV NS1 antigen. We also aimed to describe the hematological parameters that are associated with the diagnosis through each test.


Assuntos
COVID-19/diagnóstico , COVID-19/epidemiologia , Dengue/diagnóstico , Adolescente , Adulto , Ásia/epidemiologia , Criança , Pré-Escolar , Colômbia/epidemiologia , Dengue/virologia , Vírus da Dengue/isolamento & purificação , Testes Diagnósticos de Rotina/métodos , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Masculino , Pandemias , Reação em Cadeia da Polimerase , Kit de Reagentes para Diagnóstico , SARS-CoV-2/isolamento & purificação , Adulto Jovem
5.
Int J Rheum Dis ; 24(9): 1106-1111, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34375036

RESUMO

Rheumatoid arthritis (RA) is a major health burden in Asia Pacific affecting the quality of life of patients and consuming healthcare resources. According to recent estimates from the World Health Organization-International League Against Rheumatism-Community Oriented Program for Control of Rheumatic Diseases, prevalence is around 0.3%-0.5%. Management guidelines have helped to improve treatment across this diverse region. To gain better insight into current real-world management applications in view of these guidelines, virtual meetings were conducted in mid-2020 to explore perspectives of rheumatologists and patients, as well as discuss the impact of coronavirus disease 2019 on RA management. Patients and rheumatologists from Hong Kong, Malaysia, Singapore, the Philippines, Thailand, India, Pakistan, and Taiwan were included, representing a diverse mix of healthcare systems, wealth, ethnicity and culture. Despite many countries having prospered in recent years, similar challenges in RA diagnosis and treatment were identified. The daily impact and patient experience of RA were also similar across countries, marked by "silent" pain and disability, and universal misunderstanding of the disease. Late diagnosis and treatment, and barriers to access to appropriate treatment, remain problematic. The experience shared by Taiwan offers a glimmer of hope, however, wherein patient advocacy groups have succeeded in being included in policy-making decisions and securing access to advanced treatment. Real-world solutions that pay heed to the unique local needs and diversity of Asia Pacific are required to improve RA management, which will take time. In the interim, help can be sought from the trained, non-rheumatologist community to reduce some of the disease burden.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , COVID-19 , Manejo da Dor/tendências , Padrões de Prática Médica/tendências , Antirreumáticos/efeitos adversos , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/epidemiologia , Ásia/epidemiologia , Humanos , Resultado do Tratamento
6.
Artigo em Inglês | MEDLINE | ID: mdl-34204659

RESUMO

Air pollution in Asian countries represents one of the biggest health threats given the varied levels of economic and population growth in the recent past. The quantification of air pollution (PM2.5) vis à vis health problems has important policy implications in tackling its health effects. This paper investigates the relationship between air pollution (PM2.5) and child mortality in sixteen Asian countries using panel data from 2000 to 2017. We adopt a two-stage least squares approach that exploits variations in PM2.5 attributable to economic growth in estimating the effect on child mortality. We find that a one-unit annual increase in PM2.5 leads to a nearly 14.5% increase in the number of children dying before the age of five, suggesting the severity of the effects of particulate matter (PM2.5) on health outcomes in sixteen Asian countries considered in this study. The results of this study suggest the need for strict policy interventions by governments in Asian countries to reduce PM2.5 concentration alongside environment-friendly policies for economic growth.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Ásia/epidemiologia , Criança , Mortalidade da Criança , Humanos , Material Particulado/análise
8.
BMJ Open ; 11(7): e049282, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34312207

RESUMO

OBJECTIVES: To test associations between men's past year alcohol use and patterns of drinking, and their perpetration of intimate partner violence (IPV) and non-partner sexual violence (NPSV). To test the associations between women's reports of partner alcohol use and their experience of IPV, in three countries in Africa. DESIGN: Pooled analysis of cross-sectional baseline data from men and women participating in four IPV prevention studies across Africa and Asia. SETTING: Data from five data sets generated by four violence against women and girls prevention studies in three countries in sub-Saharan Africa, South Africa, Ghana and Rwanda. PARTICIPANTS: 8104 men 18+ years old and 5613 women 18+ years old from a mix of volunteer and randomly selected samples. MAIN OUTCOME MEASURES: Studies employed comparable measures of past year alcohol use, harmful alcohol use (Alcohol Use Disorder Identification Test scale) and items from modified WHO Women's Health and Domestic Violence to measure physical IPV and NPSV perpetration among men and IPV experience among women. FINDINGS: Overall harmful alcohol use among men was associated with a substantially increased odds of perpetrating physical IPV (adjusted OR (aOR)=3.45 (95% CI 2.56 to 4.64)) and NPSV (aOR=2.64 (95% CI 1.85 to 3.76)) compared with non-drinkers. Women who had seen their partner occasionally drunk (aOR=2.68 (95% CI 2.13 to 3.36)) or frequently drunk (aOR=5.94 (95% CI 4.19 to 8.41)) in the past 12 months had an increased odds of experiencing physical IPV. CONCLUSIONS: Alcohol use is associated with increased IPV and NPSV perpetration for men and (physical) IPV experience for women. Reported frequency of IPV and NPSV increase with increasing levels and frequency of alcohol use. Interventions aimed at reducing alcohol may also lead to reductions in IPV and NPSV perpetration and experience.


Assuntos
Violência por Parceiro Íntimo , Adolescente , Ásia/epidemiologia , Estudos Transversais , Feminino , Gana , Humanos , Violência por Parceiro Íntimo/prevenção & controle , Masculino , Fatores de Risco , Ruanda , Parceiros Sexuais , África do Sul
9.
Int J Equity Health ; 20(1): 161, 2021 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-34253198

RESUMO

BACKGROUND: The COVID-19 pandemic is expected to have profound mental health impact, including in the Asia Pacific Economic Cooperation (APEC) region. Some populations might be at higher risk of experiencing negative mental health impacts and may encounter increased barriers to accessing mental health care. The pandemic and related restrictions have led to changes in care delivery, including a rapid shift to the use of e-mental health and digital technologies. It is therefore essential to consider needs and opportunities for equitable mental health care delivery to the most at-risk populations. This rapid scoping review: 1) identifies populations in the APEC region that are at higher risk of the negative mental health impacts of COVID-19, 2) identifies needs and gaps in access to standard and e-mental health care among these populations, and 3) explores the potential of e-mental health to address these needs. METHODS: We conducted a rapid scoping review following the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched Medline, Embase and PsychInfo databases and Google Scholar using a search strategy developed in consultation with a biomedical librarian. We included records related to mental health or psychosocial risk factors and COVID-19 among at-risk groups; that referred to one or more APEC member economies or had a global, thus generalizable, scope; English language papers, and papers with full text available. RESULTS: A total of 132 records published between December 2019 and August 2020 were included in the final analysis. Several priority at-risk populations, risk factors, challenges and recommendations for standard and e-mental health care were identified. Results demonstrate that e-mental health care can be a viable option for care delivery but that specific accessibility and acceptability considerations must be considered. Options for in-person, hybrid or "low-tech" care must also remain available. CONCLUSIONS: The COVID-19 pandemic has highlighted the urgent need for equitable standard and e-mental health care. It has also highlighted the persistent social and structural inequities that contribute to poor mental health. The APEC region is vast and diverse; findings from the region can guide policy and practice in the delivery of equitable mental health care in the region and beyond.


Assuntos
COVID-19/psicologia , Necessidades e Demandas de Serviços de Saúde , Transtornos Mentais/terapia , Pandemias , Telemedicina , Ásia/epidemiologia , COVID-19/epidemiologia , Humanos , Transtornos Mentais/epidemiologia , Ilhas do Pacífico/epidemiologia , Fatores de Risco
10.
Clin Nutr ESPEN ; 44: 372-378, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34330492

RESUMO

BACKGROUND & AIMS: COVID-19 has emerged as a global pandemic affecting millions of people. Vitamin D deficiency is one of the risk factors for increased susceptibility to COVID-19. This study aimed to examine the correlation between the prevalence of vitamin D deficiency and COVID-19 infection and mortality rates among the adult population in European and Asian continents. METHODS: Prevalence of vitamin D deficiency in each country was retrieved through literature searching on PubMed® database for the last ten years. As of December, 31st 2020, COVID-19 infections and mortalities per million population were extracted from the 'real time' statistics of the Worldometer website. The association between both vitamin D deficiency and COVID-19 infections and mortalities were explored. RESULTS: Forty seven countries were included in the analysis. The prevalence of vitamin D deficiency ranged from 6.9 to 81.8% in European countries and 2.0-87.5% in Asian countries. Significantly positive correlations were observed for both COVID-19 infection (r = 0.76; p < 0.001) and mortality rates (r = 0.75; p < 0.001) in the Asian continent. The correlation values for the infections and mortality rates in the European continent were (r = 0.37; p = 0.08) and (r = 0.43; p = 0.04) respectively. When both the continents were combined, the correlation results for both infection (r = 0.42; p = 0.003) and mortality (r = 0.35; p = 0.016) rates with vitamin D deficiency values remained significant. CONCLUSION: Prevalence of vitamin D deficiency was significantly associated with the mortality rate of COVID-19 in Europe and Asia. The association between the infection rate and prevalence of vitamin D deficiency was significant for Asia only. Both the associations were significant when the two continents were combined in the analysis. Therefore we suggest that vitamin D supplementation could play a key role in the prevention and/or treatment of the COVID-19 patients.


Assuntos
COVID-19/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , Comorbidade , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , SARS-CoV-2 , Adulto Jovem
11.
Int J Hematol ; 114(3): 355-362, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34302593

RESUMO

Cutaneous T-cell lymphomas (CTCLs) are a group of T-cell lymphomas with low incidence. Due to their indolent characteristics, treatment strategies have not yet been established for advanced CTCLs. In this study, relative incidence of CTCLs in Asia was estimated and the therapeutic outcomes presented based on various treatments currently used in clinics for advanced CTCLs. As part of a prospective registry study of peripheral T-cell lymphoma (PTCL) conducted across Asia, including Korea, China, Taiwan, Singapore, Malaysia, and Indonesia, subgroup analysis was performed for patients with CTCLs. Among 486 patients with PTCL, 37 with CTCL (7.6%) were identified between April 2016 and February 2019. Primary cutaneous ALK-negative anaplastic large cell lymphoma (ALCL, 35.1%) was the most common subtype. With a median follow-up period of 32.1 months, median progression-free survival (PFS) was 53.5 months (95% CI 0.0-122.5), and overall survival was not reached. 14 patients (48.2%) underwent subsequent treatment after the first relapse, but the response rate was 20% with a PFS of 2.2 months (95% CI 0.3-4.0). Six patients received autologous stem cell transplantation (auto-SCT). However, auto-SCT did not result in better outcomes. Additional studies are needed on standard care treatment of advanced or refractory and relapsed CTCLs.


Assuntos
Linfoma Cutâneo de Células T/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , Terapia Combinada , Diagnóstico Diferencial , Gerenciamento Clínico , Feminino , Humanos , Incidência , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/etiologia , Linfoma Cutâneo de Células T/terapia , Linfoma de Células T Periférico/diagnóstico , Linfoma de Células T Periférico/epidemiologia , Linfoma de Células T Periférico/etiologia , Linfoma de Células T Periférico/terapia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Vigilância em Saúde Pública , Sistema de Registros , Adulto Jovem
14.
Eur J Epidemiol ; 36(6): 629-640, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34114189

RESUMO

We estimated the impact of a comprehensive set of non-pharmeceutical interventions on the COVID-19 epidemic growth rate across the 37 member states of the Organisation for Economic Co-operation and Development during the early phase of the COVID-19 pandemic and between October and December 2020. For this task, we conducted a data-driven, longitudinal analysis using a multilevel modelling approach with both maximum likelihood and Bayesian estimation. We found that during the early phase of the epidemic: implementing restrictions on gatherings of more than 100 people, between 11 and 100 people, and 10 people or less was associated with a respective average reduction of 2.58%, 2.78% and 2.81% in the daily growth rate in weekly confirmed cases; requiring closing for some sectors or for all but essential workplaces with an average reduction of 1.51% and 1.78%; requiring closing of some school levels or all school levels with an average reduction of 1.12% or 1.65%; recommending mask wearing with an average reduction of 0.45%, requiring mask wearing country-wide in specific public spaces or in specific geographical areas within the country with an average reduction of 0.44%, requiring mask-wearing country-wide in all public places or all public places where social distancing is not possible with an average reduction of 0.96%; and number of tests per thousand population with an average reduction of 0.02% per unit increase. Between October and December 2020 work closing requirements and testing policy were significant predictors of the epidemic growth rate. These findings provide evidence to support policy decision-making regarding which NPIs to implement to control the spread of the COVID-19 pandemic.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Máscaras/estatística & dados numéricos , Organização para a Cooperação e Desenvolvimento Econômico , Distanciamento Físico , Quarentena/estatística & dados numéricos , Ásia/epidemiologia , Australásia/epidemiologia , Europa (Continente)/epidemiologia , Humanos , Estudos Longitudinais , América do Norte/epidemiologia , Pandemias , Quarentena/métodos , SARS-CoV-2
16.
J Glob Health ; 11: 04031, 2021 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-34131486

RESUMO

Background: This review assessed the case definitions, diagnostic criteria, antimicrobial resistance, and methods used for enteric fever outbreaks and utilization of any unified outbreak score or checklist for early identification and response in Asia and Africa from 1965-2019. Methods: We searched enteric fever outbreaks using PubMed, Google Scholar, and the Cochrane library. Studies describing a single outbreak event of enteric fever in Asia and Africa from 1965-2019 were reviewed. We excluded case reports, letter to editors, studies reporting typhoid in conjunction with other diseases, the Centers for Disease Control and Prevention (CDC) trip reports, the World Health Organization (WHO) bulletins report, data from mathematical modeling and simulation studies, reviews and ProMed alert. Also, non-typhoidal salmonella outbreaks were excluded. Results: A total of 5063 articles were identified using the key terms and 68 studies were selected for data extraction. Most (48, 71%) outbreaks were from Asian countries, 20 (29%) were reported from Africa. Only 15 studies reported the case definition used for case identification during an outbreak and 8 of those were from Asia. A third (20, 29%) of the studies described antibiotic resistance pattern. 43 (63%) studies contained information regarding the source of the outbreak. Outcomes (hospitalization and deaths) were reported in a quarter of studies. Only 23 (29%) of the studies reported outbreak control strategies while none reported any unified outbreak score or a checklist to identify the outbreak. Conclusion: This review highlights the variability in detection and reporting methods for enteric fever outbreaks in Asia and Africa. No standardized case definitions or laboratory methods were reported. Only a few studies reported strategies for outbreak control. There is a need for the development of a unified outbreak score or a checklist to identify and report enteric fever outbreaks globally.


Assuntos
Surtos de Doenças , Febre Tifoide/diagnóstico , Febre Tifoide/epidemiologia , África/epidemiologia , Ásia/epidemiologia , Humanos
18.
JMIR Public Health Surveill ; 7(6): e24251, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-34081593

RESUMO

BACKGROUND: COVID-19 transmission rates in South Asia initially were under control when governments implemented health policies aimed at controlling the pandemic such as quarantines, travel bans, and border, business, and school closures. Governments have since relaxed public health restrictions, which resulted in significant outbreaks, shifting the global epicenter of COVID-19 to India. Ongoing systematic public health surveillance of the COVID-19 pandemic is needed to inform disease prevention policy to re-establish control over the pandemic within South Asia. OBJECTIVE: This study aimed to inform public health leaders about the state of the COVID-19 pandemic, how South Asia displays differences within and among countries and other global regions, and where immediate action is needed to control the outbreaks. METHODS: We extracted COVID-19 data spanning 62 days from public health registries and calculated traditional and enhanced surveillance metrics. We use an empirical difference equation to measure the daily number of cases in South Asia as a function of the prior number of cases, the level of testing, and weekly shifts in variables with a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS: Traditional surveillance metrics indicate that South Asian countries have an alarming outbreak, with India leading the region with 310,310 new daily cases in accordance with the 7-day moving average. Enhanced surveillance indicates that while Pakistan and Bangladesh still have a high daily number of new COVID-19 cases (n=4819 and n=3878, respectively), their speed of new infections declined from April 12-25, 2021, from 2.28 to 2.18 and 3.15 to 2.35 daily new infections per 100,000 population, respectively, which suggests that their outbreaks are decreasing and that these countries are headed in the right direction. In contrast, India's speed of new infections per 100,000 population increased by 52% during the same period from 14.79 to 22.49 new cases per day per 100,000 population, which constitutes an increased outbreak. CONCLUSIONS: Relaxation of public health restrictions and the spread of novel variants fueled the second wave of the COVID-19 pandemic in South Asia. Public health surveillance indicates that shifts in policy and the spread of new variants correlate with a drastic expansion in the pandemic, requiring immediate action to mitigate the spread of COVID-19. Surveillance is needed to inform leaders whether policies help control the pandemic.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/estatística & dados numéricos , Surtos de Doenças/estatística & dados numéricos , Política de Saúde , Saúde Pública/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/legislação & jurisprudência , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Vigilância em Saúde Pública , SARS-CoV-2
19.
BMJ Glob Health ; 6(6)2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34130991

RESUMO

BACKGROUND: The caesarean section (CS) rate continues to increase across high-income, middle-income and low-income countries. We present current global and regional CS rates, trends since 1990 and projections for 2030. METHODS: We obtained nationally representative data on the CS rate from countries worldwide from 1990 to 2018. We used routine health information systems reports and population-based household surveys. Using the latest available data, we calculated current regional and subregional weighted averages. We estimated trends by a piecewise analysis of CS rates at the national, regional and global levels from 1990 to 2018. We projected the CS rate and the number of CS expected in 2030 using autoregressive integrated moving-average models. RESULTS: Latest available data (2010-2018) from 154 countries covering 94.5% of world live births shows that 21.1% of women gave birth by caesarean worldwide, averages ranging from 5% in sub-Saharan Africa to 42.8% in Latin America and the Caribbean. CS has risen in all regions since 1990. Subregions with the greatest increases were Eastern Asia, Western Asia and Northern Africa (44.9, 34.7 and 31.5 percentage point increase, respectively) while sub-Saharan Africa and Northern America (3.6 and 9.5 percentage point increase, respectively) had the lowest rise. Projections showed that by 2030, 28.5% of women worldwide will give birth by CS (38 million caesareans of which 33.5 million in LMIC annually) ranging from 7.1% in sub-Saharan Africa to 63.4% in Eastern Asia . CONCLUSION: The use of CS has steadily increased worldwide and will continue increasing over the current decade where both unmet need and overuse are expected to coexist. In the absence of global effective interventions to revert the trend, Southern Asia and sub-Saharan Africa will face a complex scenario with morbidity and mortality associated with the unmet need, the unsafe provision of CS and with the concomitant overuse of the surgical procedure which drains resources and adds avoidable morbidity and mortality. If the Sustainable Development Goals are to be achieved, comprehensively addressing the CS issue is a global priority.


Assuntos
Cesárea , Pobreza , África ao Sul do Saara/epidemiologia , Ásia/epidemiologia , Ásia Ocidental , Feminino , Humanos , Gravidez
20.
J Pak Med Assoc ; 71(4): 1200-1205, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34125772

RESUMO

OBJECTIVE: To determine the prevalence rate of diabetes mellitus among active tuberculosis patients, and to assess the impact of age in this regard. METHODS: The meta-analysis comprised studies conducted in Asian and African countries from 2012 to 2018. Data was extracted from the selected studies and was analyzed using the Meta extension of Excel. Comprised studies conducted in Asian and African countries from 2012 to 2018. Data was extracted from the selected studies and was analyzed using the Meta extension of Excel. RESULTS: Of the 200 studies reviewed, 15(7.5%) were selected for further analyses. The selected studies involved a total of 28,055 patients. Of the selected studies, 8(53%) were from Asia and 7(47%) were from Africa. The overall pooled prevalence of diabetes among tuberculosis patients was 26% (95% confidence interval: 14.62 to 35.34). Age had a significant negative effect on the prevalence rate (95% confidence interval: -0.634 to 4.179). CONCLUSIONS: Diabetes was found to be widely spreading among Asian and African people, and age was found to be a significant negative factor.


Assuntos
Diabetes Mellitus , Tuberculose , África/epidemiologia , Ásia/epidemiologia , Diabetes Mellitus/epidemiologia , Humanos , Prevalência , Tuberculose/epidemiologia
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