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1.
Zootaxa ; 4890(4): zootaxa.4890.4.1, 2020 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-33311103

RESUMO

A new species of Seira from Koh Rong Sanloem Island, Cambodia, as well as its mitochondrial genome information, are herein described. Seira sanloemensis sp. nov. has a similar colour pattern compared to nine other species of Seira worldwide distributed, but the dorsal chaetotaxy is more similar to S. arunachala Mitra from India, S. camgiangensis Nguyen from Vietnam, and S. gobalezai Christiansen Bellinger from Hawaii. However, the new species differs from these species by dorsal chaetotaxy of head, Th II-III and Abd II, collophore chaetotaxy, and morphology of the empodial complex. This is the third Collembola species described for Cambodia. Its assembled incomplete mitogenome from MGI reads, has a length of 13,953 bp, and contains all protein-coding genes except for tree tRNAs missing; the gene order is the same of the Pancrustacean ancestral gene order. Based on the alignment of the 13 coding genes, a maximum likelihood phylogenetic tree of medium bootstrap values suggested that the Asian Seira species can represent a different lineage from the Neotropical Seirinae, but further biogeographic and divergence estimation analyses plus the inclusion of more Asian taxa are necessary to test such hypothesis.


Assuntos
Artrópodes , Genoma Mitocondrial , Animais , Camboja , Filogenia
2.
Zootaxa ; 4894(3): zootaxa.4894.3.11, 2020 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-33311078

RESUMO

The Limnonectes kuhlii complex is a group of morphologically similar species of fanged frogs distributed across much of mainland and insular Southeast Asia. Many new species in this complex have been described in recent years, primarily on the basis of mitochondrial DNA divergence corroborated by differences in linear measurements and qualitative characters. Males in this species complex develop enlarged heads at sexual maturity, but the degree of head enlargement varies among mature males, even within the same population. We evaluated the utility of body length (snout-vent length minus head length) in descriptive statistics and in size-adjusting measurements for traditional morphometric analysis, as well as a landmark-based geometric morphometric analysis of male head shape, in Indochinese species of the L. kuhlii complex. The analyses supported quantitative and qualitative morphological distinction of a divergent mitochondrial lineage of the L. kuhlii complex in northeastern Cambodia, and the lineage is described as a new species. Limnonectes fastigatus sp. nov. differs from its closest relatives and from geographically proximate members of the complex by having the combination of elongated, slender odontoids; nuptial pads on the first finger; immaculate belly; significantly different body length-adjusted measurements in both sexes; and a significantly different male head shape. The new species is the only member of the L. kuhlii complex known from Cambodia.


Assuntos
Anuros , DNA Mitocondrial , Animais , Anuros/genética , Camboja , Feminino , Masculino , Filogenia
3.
Glob Health Sci Pract ; 8(4): 689-698, 2020 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-33361236

RESUMO

BACKGROUND: Providing professional development opportunities to staff working in clinical laboratories undergoing quality improvement programs can be challenged by limited funding, particularly in resource-limited countries such as Cambodia. Using innovative approaches such as video conferencing can connect mentors with practitioners regardless of location. This study describes and evaluates the methods, outputs, and outcomes of a quality improvement program implemented in 12 public hospital laboratories in Cambodia between January 2018 and April 2019. The program used mixed intervention methods including both in-person and remote-access training and mentorship. METHODS: Training outputs were quantified from the activity reports of program trainers and mentors. Program outcomes were measured by pre- and postimplementation audits of laboratory quality management system conformity to international standards. Variations in improved outcomes were assessed in relation to the time spent by laboratory personnel in video conference training and mentoring activity. An additional cross-sectional comparison described the difference in final audit scores between participating and nonparticipating laboratories. RESULTS: Laboratories significantly improved their audit scores over the project period, showing significant improvement in all sections of the ISO 15189 standard. Pre- and postaudit score differences and laboratory personnel participation time in remote mentoring activities showed a strong monotonic relationship. Average input per laboratory was 6,027±2,454 minutes of participation in video conference activities with mentors. Audit scores of participating laboratories were significantly higher than those of laboratories with no quality improvement program. CONCLUSION: Laboratories improved significantly in ISO 15189 conformity following structured laboratory quality management systems training supported by remote and on-site mentoring. The correlation of laboratory participation in video conference activities highlights the utility of remote video conferencing technology to strengthen laboratories in resource-limited settings and to build communities of practice to address quality improvement issues in health care. These findings are particularly relevant in light of the COVID-19 pandemic.


Assuntos
Laboratórios/organização & administração , Tutoria/organização & administração , Melhoria de Qualidade/organização & administração , Comunicação por Videoconferência/organização & administração , Camboja , Estudos Transversais , Humanos , Laboratórios/normas , Melhoria de Qualidade/normas , Desenvolvimento de Pessoal/organização & administração , Estados Unidos
4.
Oral Health Prev Dent ; 18(1): 973-980, 2020 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-33215488

RESUMO

PURPOSE: To investigate the associations between early childhood caries (ECC) and maternal factors among 18- to 36-month-old children in one rural province of Cambodia. MATERIALS AND METHODS: 121 mother-child pairs (male = 67, female = 54; mean age = 25.18 ± 6.24 months) were recruited at several villages in Stueng Trang district, Kampong Cham province. ECC and maternal caries experience were recorded following WHO guidelines. Maternal factors such as literacy and socioeconomic status, as well as child-rearing behaviours, were assessed through an interview questionnaire of the mothers. RESULTS: ECC and maternal caries prevalence were 54.5% and 84.3%, respectively. Statistically significant associations were found between ECC and: breast-feeding after 18 months; sugary food and beverage intake for the child (p < 0.05); maternal caries experience; illiteracy; night-time breastfeeding, bottle feeding, and late introduction of toothbrushing for the child (p < 0.01). A logistic regression revealed that ECC was more common in children whose mothers had DMFT > 0 (OR = 4.08; 95% CI =1.13-14.75; p = 0.032), children whose mothers were illiterate (OR = 8.21; 95% CI = 1.67-40.85; p = 0.009), children who had night-time breastfeeding after 18 months (OR = 2.76; 95% CI = 1.06-7.19; p = 0.037), and children for whom toothbrushing was introduced after 18 months (OR = 2.87; 95% CI = 1.03-7.97; p = 0.042). CONCLUSION: The findings of this study suggest that maternal caries experience and illiteracy, as well as a range of child-rearing behaviours including prolonged night-time breastfeeding and late introduction of toothbrushing were indicators for ECC in this population.


Assuntos
Cárie Dentária , Alimentação Artificial , Camboja/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Cárie Dentária/epidemiologia , Feminino , Humanos , Lactente , Prevalência , Fatores de Risco , Escovação Dentária
5.
Ann Biol Clin (Paris) ; 78(5): 499-518, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026346

RESUMO

The French society of clinical biology "Biochemical markers of COVID-19" has set up a working group with the primary aim of reviewing, analyzing and monitoring the evolution of biological prescriptions according to the patient's care path and to look for markers of progression and severity of the disease. This study covers all public and private sectors of medical biology located in metropolitan and overseas France and also extends to the French-speaking world. This article presents the testimonies and data obtained for the "Overseas and French-speaking countries" sub-working group made up of 45 volunteer correspondents, located in 20 regions of the world. In view of the delayed spread of the SARS-CoV-2 virus, the overseas regions and the French-speaking regions have benefited from feedback from the first territories confronted with COVID-19. Thus, the entry of the virus or its spread in epidemic form could be avoided, thanks to the rapid closure of borders. The overseas territories depend very strongly on air and/or sea links with the metropolis or with the neighboring continent. The isolation of these countries is responsible for reagent supply difficulties and has necessitated emergency orders and the establishment of stocks lasting several months, in order to avoid shortages and maintain adequate patient care. In addition, in countries located in tropical or intertropical zones, the diagnosis of COVID-19 is complicated by the presence of various zoonoses (dengue, Zika, malaria, leptospirosis, etc.).


Assuntos
Serviços de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Saúde Global/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Medicina de Viagem/organização & administração , Adulto , África/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Bélgica/epidemiologia , Betacoronavirus/fisiologia , Biomarcadores/análise , Biomarcadores/sangue , Camboja/epidemiologia , Criança , Serviços de Laboratório Clínico/organização & administração , Serviços de Laboratório Clínico/estatística & dados numéricos , Busca de Comunicante/métodos , Busca de Comunicante/estatística & dados numéricos , Infecções por Coronavirus/transmissão , Diagnóstico Diferencial , Feminino , França/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Recém-Nascido , Ilhas/epidemiologia , Idioma , Laos/epidemiologia , Louisiana/epidemiologia , Masculino , Pessoal de Laboratório Médico/organização & administração , Pessoal de Laboratório Médico/estatística & dados numéricos , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/transmissão , Estudos Retrospectivos , Inquéritos e Questionários , Análise de Sobrevida , Medicina de Viagem/métodos , Medicina de Viagem/estatística & dados numéricos , Doença Relacionada a Viagens , Clima Tropical , Medicina Tropical/métodos , Medicina Tropical/organização & administração , Medicina Tropical/estatística & dados numéricos , Vietnã/epidemiologia
6.
Zootaxa ; 4830(1): zootaxa.4830.1.3, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-33056252

RESUMO

An integrative taxonomic analysis based on mitochondrial and morphological data recovered the population of Cyrtodactylus on Koh Rong Island, Preah Sihanouk Province, Cambodiaa as an endemic insular species belonging to the Cyrtodactylus intermedius group. This brings the number of species in the C. intermedius group to at least 10 and the number of species in Cambodia to at least seven. Species of this relatively small group vary widely in habitat preference, occurring in general, terrestrial, karstic, or granitic habitats. Ancestral character state mapping recovered a general habitat preference as the ancestral condition from which all others independently evolved even though this did not covary with morphology. The description of another new species of reptile from Cambodia continues to underscore the potentially significant amount of unrealized biodiversity in Indochina and Southeast Asia and the continued need for field surveys in unexplored or poorly explored areas.


Assuntos
Lagartos , Animais , Camboja , Ecossistema , Filogenia
7.
Zootaxa ; 4834(4): zootaxa.4834.4.4, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-33056105

RESUMO

The species-rich, megophryid frog genus Leptobrachella Smith, 1925 is distributed throughout the uplands of mainland Southeast Asia but is conspicuously absent from the Cardamom Mountains of southwestern Cambodia, where it has been known only by a single, undetermined metamorphic specimen collected nearly two decades ago. We report two adult female specimens of Leptobrachella collected a decade later at a second locality in the Cardamom Mountains and use mitochondrial DNA, nuclear DNA, and morphology to show that it represents a distinct species. Leptobrachella neangi sp. nov., named after its collector, is most closely related in mitochondrial and nuclear DNA to L. fuliginosa (Matsui, 2006) and L. melanoleuca (Matsui, 2006) from western Thailand, but has uncorrected pairwise distances of 8.69-10.99% in a mitochondrial 16S gene fragment from its two sister species. The new species is also readily distinguished from these and other congeners by having the combination of (1) SVL 35.4-36.3 mm in two adult females, (2) distinct dorsolateral glandular line absent, (2) belly transparent, immaculate purplish gray in life, creamy white in preservative, (3) dark inguinal blotch absent, (4) tympanum with black coloration extending from line under supratympanic fold, (5) dorsal skin with small, irregular bumps and ridges, and (6) iris coppery orange around pupil, fading to gold at periphery, not distinctly bicolored. The new species is the first named Leptobrachella from the Cardamom Mountains and the third from Cambodia.


Assuntos
Anuros , Animais , Camboja , Feminino , Filogenia
8.
Zootaxa ; 4859(4): zootaxa.4859.4.7, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33056185

RESUMO

Fibiger (2011) established the genus Sternitta in the Micronoctuidae, with Sternitta gregerseni Fibiger, 2011 from Nepal as the type species. The Micronoctuidae are currently treated as a tribe (Micronoctuini) within the Hypenodinae, and include over 400 described species. To date, the genus Sternitta (Micronoctuini: Micronoctuina) consists of seven species: S. goateri Fibiger, 2011 in Afghanistan; S. hackeri Fibiger, 2011 and S. gabori Fibiger, 2011 in Pakistan; S. parasuffuscalis Fibiger, 2011, S. suffuscalis (Swinhoe, 1886), S. gabori Fibiger, 2011 and S. magna Fibiger, 2011 in India; S. suffuscalis (Swinhoe, 1886) in Sri Lanka and S. gregerseni Fibiger, 2011 only in Nepal (Swinhoe 1886; Fibiger 2011). The genus Sternitta was considered by Fibiger to be among the more primitive micronoctuine genera, and it can be recognized by the sclerotized 8th abdominal sternite with prominent dorsal and ventral processes and, in the male genitalia of most species, by the divided ampulla into dorsal and ventral plates and by the dorsal spinelike processes on the anellus. In the present paper, the new species Sternitta mondulkiriensis sp. n. is described from Cambodia with habitus and male genitalia illustrated and compared with those of S. suffuscalis (Swinhoe, 1886). An updated checklist and a key to all the species are included.


Assuntos
Mariposas , Animais , Camboja , Masculino
9.
Zootaxa ; 4853(1): zootaxa.4853.1.9, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-33056390

RESUMO

Males of four new species of caddisflies from Kampong Speu and Siem Reap provinces, Cambodia [Psychomyia kimcheangi n. sp. (Psychomyiidae), Macrostemum siemreapensis n. sp. (Hydropsychidae), Leptocerus angkorwatensis n. sp. (Leptoceridae), and Trichosetodes kampongspeuensis n. sp. (Leptoceridae)] are described and illustrated. Psychomyia kimcheangi n. sp. can be distinguished from other species by characters of the inferior appendages. The main body of each inferior appendage has two branches that are separated near its base but are parallel and close together until the end. In Macrostemum siemreapensis n. sp. the dorsal tip of the phallus has no curved hooklet but instead a knot-like protruding structure in ventral view and looped-like structure in dorsal view. Leptocerus angkorwatensis n. sp. can be distinguished from others by the characters of long needled-like preanal appendages. Trichosetodes kampongspeuensis is distinguished from others by the characters of segment IX in ventral view, which is asymmetrical, and inferior appendages that are not divided and asymmetrical.


Assuntos
Holometábolos , Insetos , Animais , Camboja , Extremidades , Masculino
10.
Korean J Parasitol ; 58(4): 431-443, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32871637

RESUMO

Echinostoma mekongi n. sp. (Digenea: Echinostomatidae) is described based on adult flukes collected from humans residing along the Mekong River in Cambodia. Total 256 flukes were collected from the diarrheic stool of 6 echinostome egg positive villagers in Kratie and Takeo Province after praziquantel treatment and purging. Adults of the new species were 9.0-13.1 (av. 11.3) mm in length and 1.3-2.5 (1.9) mm in maximum width and characterized by having a head collar armed with 37 collar spines (dorsal spines arranged in 2 alternative rows), including 5 end group spines. The eggs in feces and worm uterus were 98-132 (117) µm long and 62-90 (75) µm wide. These morphological features closely resembled those of Echinostoma revolutum, E. miyagawai, and several other 37-collar-spined Echinostoma species. However, sequencing of the nuclear ITS (ITS1-5.8S rRNA-ITS2) and 2 mitochondrial genes, cox1 and </>nad1, revealed unique features distinct from E. revolutum and also from other 37-collar-spined Echinostoma group available in GenBank (E. bolschewense, E. caproni, E. cinetorchis, E. deserticum, E. miyagawai, E. nasincovae, E. novaezealandense, E. paraensei, E. paraulum, E. robustum, E. trivolvis, and Echinostoma sp. IG). Thus, we assigned our flukes as a new species, E. mekongi. The new species revealed marked variation in the morphology of testes (globular or lobulated), and smaller head collar, collar spines, oral and ventral suckers, and cirrus sac compared to E. revolutum and E. miyagawai. Epidemiological studies regarding the geographical distribution and its life history, including the source of human infections, remain to be performed.


Assuntos
Echinostoma/anatomia & histologia , Echinostoma/isolamento & purificação , Helmintíase/epidemiologia , Helmintíase/parasitologia , Adolescente , Adulto , Animais , Camboja/epidemiologia , Criança , Feminino , Humanos , Masculino , Contagem de Ovos de Parasitas , Adulto Jovem
11.
Am J Trop Med Hyg ; 103(5): 2026-2028, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32901600

RESUMO

Ocular complications are rare in patients with dengue fever, but may cause permanent loss of vision. We present the case of a 29-year-old German woman who developed severe acute vision loss because of dengue-associated maculopathy after traveling to Vietnam and Cambodia. Initially, the optical coherence tomography showed detachment of the retinal pigment epithelium, a central shift in the retinal pigmentation and intraretinal cysts. The patient was hospitalized and treated with a short course of intravenous prednisolone. Vision improved, and the patient showed full recovery at 9 months after the onset. This case highlights the importance of awareness and adequate management for ocular involvement in patients with dengue fever, including travelers.


Assuntos
Dengue/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Adulto , Camboja , Dengue/complicações , Dengue/parasitologia , Dengue/patologia , Feminino , Alemanha , Humanos , Degeneração Macular , Retina/diagnóstico por imagem , Retina/parasitologia , Retina/patologia , Doenças Retinianas/complicações , Doenças Retinianas/parasitologia , Doenças Retinianas/patologia , Tomografia de Coerência Óptica , Viagem , Vietnã
12.
PLoS Negl Trop Dis ; 14(9): e0008603, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32925941

RESUMO

BACKGROUND: The World Health Organization (WHO) proposed guidelines on dengue clinical classification in 1997 and more recently in 2009 for the clinical management of patients. The WHO 1997 classification defines three categories of dengue infection according to severity: dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). Alternative WHO 2009 guidelines provide a cross-sectional classification aiming to discriminate dengue fever from dengue with warning signs (DWWS) and severe dengue (SD). The primary objective of this study was to perform a comparison of two dengue classifications. The secondary objective was to describe the changes of hematological and biochemical parameters occurring in patients presenting with different degrees of severity during the course of the disease, since progression to more severe clinical forms is unpredictable. METHODOLOGY/PRINCIPAL FINDINGS: We performed a prospective, monocentric, cross-sectional study of hospitalized children in Cambodia, aged from 2 to 15 years old with severe and non-severe dengue. We enrolled 243 patients with acute dengue-like illness: 71.2% were dengue infections confirmed using quantitative reverse transcription PCR or NS1 antigen capture ELISA, of which 87.2% and 9.0% of DF cases were respectively classified DWWS and SD, and 35.9% of DHF were designated SD using an adapted WHO 2009 classification for SD case definition. Systematic use of ultrasound at patient admission was crucial for detecting plasma leakage. No difference was observed in the concentration of secreted NS1 protein between different dengue severity groups. Lipid profiles were different between DWWS and SD at admission, characterized by a decrease in total cholesterol, HDL cholesterol, and LDL cholesterol, in SD. CONCLUSIONS/SIGNIFICANCE: Our results show discrepancies between the two classifications, including misclassification of severe dengue cases as mild cases by the WHO 1997 classification. Using an adapted WHO 2009 classification, SD more precisely defines the group of patients requiring careful clinical care at a given time during hospitalization.


Assuntos
Dengue Grave/classificação , Dengue Grave/patologia , Índice de Gravidade de Doença , Adolescente , Camboja , Criança , Criança Hospitalizada , Pré-Escolar , Colesterol/sangue , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Masculino , Estudos Prospectivos , Dengue Grave/diagnóstico , Triglicerídeos/sangue , Proteínas não Estruturais Virais/metabolismo , Organização Mundial da Saúde
14.
J Environ Manage ; 275: 111300, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32871522

RESUMO

A growing concern on the deleterious effects of chemical inputs to the environment has been on the rise from the excessive use of chemical inputs leading to soil and water pollution, destruction to fauna and microbial communities, reduced soil fertility and increased crop disease susceptibility. In the Great Mekong Region (GMR), a large majority of the population relies on agriculture and faces severe challenges including decline in soil fertility, increased pests and diseases, leading to lower ecosystem productivity. In this region, over-dependence on chemical fertilizers also continues to impact negatively on soil health and the wider ecosystem. Agroecological practices, and beneficial microorganisms in particular, offer an affordable and sustainable alternative to mineral inputs for improved plant nutrition and soil health for optimal crop performance and sustainable production. Biofertilizers are a key component in integrated nutrient management as well as for increased economic benefits from reduced expenditure on chemical fertilizers, holistically leading to sustainable agriculture. To cope with the need for biofertilizer adoption for sustainable agricultural production, the countries in the GMR are putting efforts in promoting development and use of biofertilizers and making them available to farmers at affordable costs. Despite these efforts, farmers continue to use chemical fertilizers at high rates with the hope of increased yields instead of taking advantage of microbial products capable of providing plant nutrients while restoring or improving soil health. This study explored the current agricultural practices in the six countries in the GMR (China, Vietnam, Myanmar, Thailand, Cambodia and Lao PDR), the critical need for sustainable agroecological practices with a special emphasis on biofertilizers. We highlighted the current status, distribution, adoption and gaps of biofertilizer production in the GMR, in order to obtain an insight on the nature of biofertilizers, efficacy and production standards, adoption or lack of biofertilizers in the GMR.


Assuntos
Agricultura , Fertilizantes , Camboja , China , Tailândia , Vietnã
15.
PLoS One ; 15(9): e0238314, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886693

RESUMO

BACKGROUND: Globally, the prevalence of HIV among transgender women remains much higher than that of the general population, and a large proportion of them are unaware of their HIV status. Transgender women are exposed to gender-based violence and social stigma and discrimination in different settings that may create significant barriers to receiving HIV prevention and care services. This study aimed to identify factors associated with recent HIV testing among transgender women in Cambodia. METHODS: We conducted a cross-sectional survey in 2016 among 1375 transgender women recruited from 13 provinces using a peer-based social network recruitment method. We used a structured questionnaire for face-to-face interviews and performed rapid HIV/syphilis testing onsite. We used a multiple logistic regression analysis to identify factors associated with recent HIV testing. RESULTS: Of the total, 49.2% of the participants reported having an HIV test in the past six months. After controlling for other covariates, the odds of having an HIV test in the past six months was significantly lower among students (AOR 0.36, 95% CI 0.20-0.65), participants who perceived that they were unlikely to be HIV infected (AOR 0.50, 95% CI 0.32-0.78), and participants who reported always using condoms with male non-commercial partners in the past three months (AOR 0.65, 95% CI 0.49-0.85) relative to their respective reference group. The odds of having an HIV test in the past six months was significantly higher among participants who had been reached by community-based HIV services (AOR 5.01, 95% CI 3.29-7.65) and received HIV education (AOR 1.65, 95% CI 1.06-2.58) in the past six months relative to their respective reference group. CONCLUSIONS: Despite the widely available free HIV testing services, more than half of transgender women in this study had not received an HIV test in the past six months. Our findings suggest that a tailored and comprehensive combination prevention program, in which HIV testing is linked to care continuum and beyond, maybe an essential next step. Social media may have the potential to be promoted and utilized among transgender women populations in order to improve HIV testing and other prevention measures.


Assuntos
Infecções por HIV/diagnóstico , HIV/isolamento & purificação , Programas de Rastreamento/estatística & dados numéricos , Comportamento Sexual , Parceiros Sexuais/psicologia , Inquéritos e Questionários , Pessoas Transgênero/psicologia , Adolescente , Adulto , Camboja/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Prevalência , Fatores de Risco , Estigma Social , Pessoas Transgênero/estatística & dados numéricos , Adulto Jovem
16.
J Pregnancy ; 2020: 2097285, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32908703

RESUMO

Introduction: Practicing exclusive breastfeeding (EBF) in an infant's first six months of life is recommended by the World Health Organization because of its proven effectiveness as a method to support the infant's short- and long-term physical and cognitive development. However, many countries, including Cambodia, face contextually driven challenges in meeting this optimum standard of breastfeeding. The recent declining EBF rate in Cambodia is a concerning indicator of the impact of these challenges. Methods: We used existing data from the 2014 Cambodian Demographic and Health Survey (CDHS) to analyze 717 Cambodian mother-infant pairs. CDHS 2014 used a two-stage stratified cluster sampling approach to select samples. A multivariable logistic regression analysis was used to assess determinants of EBF, taking into account the sampling weight in the analysis. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and significance level was considered at p value < 0.05. Results: Our findings indicate that among mothers with infants under six months, EBF was more likely if they resided rurally (AOR = 2.28; 95% CI 1.23-4.23) and if they delivered at a public hospital (AOR = 2.64; 95% CI 1.28-5.47). On the other hand, mothers of middle wealth index practiced EBF less than mothers of low wealth index (AOR = 0.58; 95% CI 0.34-0.99). And as expected, our analysis confirmed that the older the infants grew, the less likely they were to be exclusively breastfed than those younger than one month old (2-3 months: AOR = 0.49; 95% CI 0.26-0.92; 4-5 months: AOR = 0.25; 95% CI 0.15-0.43). Conclusion: The findings emphasize the need to address these determinants adequately by appropriate interventions to halt the declining trend of EBF practice. We recommend a multifaceted approach to improve EBF rates in Cambodia. Advocacy around EBF at public hospitals should continue, and private hospital staff should receive training to provide EBF counselling and support to mothers.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Aleitamento Materno/tendências , Mães/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Camboja/epidemiologia , Aconselhamento , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , População Rural , Classe Social , Apoio Social , Adulto Jovem
18.
PLoS Negl Trop Dis ; 14(8): e0008381, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32804954

RESUMO

The world's most consequential pathogens occur in regions with the fewest diagnostic resources, leaving the true burden of these diseases largely under-represented. During a prospective observational study of sepsis in Takeo Province Cambodia, we enrolled 200 patients over an 18-month period. By coupling traditional diagnostic methods such as culture, serology, and PCR to Next Generation Sequencing (NGS) and advanced statistical analyses, we successfully identified a pathogenic cause in 46.5% of our cohort. In all, we detected 25 infectious agents in 93 patients, including severe threat pathogens such as Burkholderia pseudomallei and viral pathogens such as Dengue virus. Approximately half of our cohort remained undiagnosed; however, an independent panel of clinical adjudicators determined that 81% of those patients had infectious causes of their hospitalization, further underscoring the difficulty of diagnosing severe infections in resource-limited settings. We garnered greater insight as to the clinical features of severe infection in Cambodia through analysis of a robust set of clinical data.


Assuntos
Sepse/epidemiologia , Sepse/etiologia , Sepse/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bactérias/classificação , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/epidemiologia , Camboja/epidemiologia , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Estudos Prospectivos , Sepse/virologia , Análise de Sequência de RNA , Testes Sorológicos , Viroses/diagnóstico , Viroses/epidemiologia , Vírus/classificação
19.
Artigo em Inglês | MEDLINE | ID: mdl-32679855

RESUMO

Thailand has become a popular destination for international migrant workers, particularly from Cambodia, Lao PDR, and Myanmar. However, only a fraction of these migrant workers were insured by public health insurance. The objective of this study was to apply systems thinking to explore contextual factors affecting access to public health insurance among cross-border migrants in Thailand. A group model building approach was applied. Participants (n = 20) were encouraged to share ideas about underlying drivers and barriers of migrants' access to health insurance. The causal loop diagram and stock and flow diagram were synthesised to identify the dynamics of access to migrant health insurance. Results showed that nationality verification is an important mechanism to deal with the precarious citizenship status of undocumented migrants. However, some migrants are still left uninsured. The likely explanations are the semi-voluntary nature of the Health Insurance Card Scheme, administrative delay of the enrollment process, and resistance of some employers to hiring migrants. As a result, findings suggest that effective communication is required to raise acceptance towards insurance among migrants and their employers. A participatory public policy process is needed to create a good balance of migrant policies among diverse authorities.


Assuntos
Acesso aos Serviços de Saúde , Migrantes , Camboja , Humanos , Seguro Saúde , Mianmar , Análise de Sistemas , Tailândia
20.
BMC Public Health ; 20(1): 1051, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32616007

RESUMO

BACKGROUND: Violence against children is a pervasive public health issue, with limited data available across multiple contexts. This study explores the rarely studied prevalence and dynamics around disclosure, reporting and help-seeking behaviours of children who ever experienced physical and/or sexual violence. METHODS: Using nationally-representative Violence Against Children Surveys in six countries: Cambodia, Haiti, Kenya, Malawi, Nigeria and Tanzania, we present descriptive statistics for prevalence of four outcomes among children aged 13-17 years: informal disclosure, knowledge of where to seek formal help, formal disclosure/help seeking and receipt of formal help. We ran country-specific multivariate logistic regressions predicting outcomes on factors at the individual, household and community levels. RESULTS: The prevalence of help-seeking behaviours ranged from 23 to 54% for informal disclosure, 16 to 28% for knowledge of where to seek formal help, under 1 to 25% for formal disclosure or help seeking, and 1 to 11% for receipt of formal help. Factors consistently correlated with promoting help-seeking behaviours included household number of adult females and absence of biological father, while those correlated with reduced help-seeking behaviours included being male and living in a female-headed household. Primary reasons for not seeking help varied by country, including self-blame, apathy and not needing or wanting services. CONCLUSIONS: Across countries examined, help-seeking and receipt of formal services is low for children experiencing physical and/or sexual violence, with few consistent factors identified which facilitated help-seeking. Further understanding of help seeking, alongside improved data quality and availability will aid prevention responses, including the ability to assist child survivors in a timely manner.


Assuntos
Saúde da Criança/estatística & dados numéricos , Revelação/estatística & dados numéricos , Sobreviventes/psicologia , Violência/psicologia , Adolescente , Camboja/epidemiologia , Criança , Feminino , Haiti/epidemiologia , Humanos , Quênia/epidemiologia , Modelos Logísticos , Malaui , Masculino , Prevalência , Delitos Sexuais/psicologia , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricos , Tanzânia/epidemiologia , Violência/prevenção & controle
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