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1.
Acta Trop ; 199: 105131, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31401192

RESUMO

Chikungunya is a viral disease caused by chikungunya virus (CHIKV) belonging to the Alphavirus genus and transmitted to humans by mosquitoes of Aedes spp. Nearly 40 countries in Asia, Africa, Europe, and the Americas have documented chikungunya cases. Most recent severe outbreaks have occurred in Indian Ocean islands of Réunion and Mauritius and India. There is no specific drug treatment for the disease, neither is there a standardized vaccine available for prevention of the disease. The present review gives a global perspective on patents filed pertaining to chikungunya. The United States has been the top patent filing jurisdiction followed by China, Europe, and India. The patents have been classified into categories of therapeutics, diagnostics, and vaccines. Maximum patent documents fall under the therapeutics category, in which patent applications are predominantly related to chemically derived drugs. They include nucleic acid analogues, various other host and virus enzyme/protein inhibitors. Patents on biological or plant derived drugs are being filed relatively recently. In the category of diagnostics, immunoassay based tests seemed to be of choice until the year 2005, whereas, patent filings for molecular diagnostics have now surpassed those with immunoassay techniques. In the vaccines category, vaccines based on viral vectors appear to be emerging as the preferred vaccine platform with the majority of patents filed in the years 2014-2017. Corporate sector has the most patent filings to its credit, followed closely by academic institutions. Pasteur Institut along with Chinese Agency for Science, Technology and Research is the top patent filing entity in chikungunya related technology space. Presently, nine vaccine products, three antiviral drugs and one mRNA based gene therapy are under development. Three vaccine products have been given fast track designation by US Food and Drug Administration (FDA) to expedite review and facilitate the development of a vaccine to prevent a serious or life-threatening condition and fill an unmet medical need. Similarly, one vaccine has been given PRIME (Priority Medicines) status by the European Medicines Agency (EMA).


Assuntos
Febre de Chikungunya/diagnóstico , Vírus Chikungunya/imunologia , Surtos de Doenças , Patentes como Assunto/estatística & dados numéricos , Vacinas Virais , Aedes/virologia , África/epidemiologia , Américas/epidemiologia , Animais , Ásia/epidemiologia , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/prevenção & controle , Vírus Chikungunya/genética , China , Surtos de Doenças/prevenção & controle , Europa (Continente)/epidemiologia , Humanos , Índia , Mosquitos Vetores/virologia , Ilhas do Pacífico/epidemiologia , Estados Unidos
2.
Bull World Health Organ ; 97(7): 486-501B, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31258218

RESUMO

Objective: To make a systematic review of risk factors, outcomes and prevalence of extended-spectrum ß-lactamase-associated infection in children and young adults in South-East Asia and the Western Pacific. Methods: Up to June 2018 we searched online databases for published studies of infection with extended-spectrum ß-lactamase-producing Enterobacteriaceae in individuals aged 0-21 years. We included case-control, cohort, cross-sectional and observational studies reporting patients positive and negative for these organisms. For the meta-analysis we used random-effects modelling of risk factors and outcomes for infection, and meta-regression for analysis of subgroups. We mapped the prevalence of these infections in 20 countries and areas using available surveillance data. Findings: Of 6665 articles scanned, we included 40 studies from 11 countries and areas in the meta-analysis. The pooled studies included 2411 samples testing positive and 2874 negative. A higher risk of infection with extended-spectrum ß-lactamase-producing bacteria was associated with previous hospital care, notably intensive care unit stays (pooled odds ratio, OR: 6.5; 95% confidence interval, CI: 3.04 to 13.73); antibiotic exposure (OR: 4.8; 95% CI: 2.25 to 10.27); and certain co-existing conditions. Empirical antibiotic therapy was protective against infection (OR: 0.29; 95% CI: 0.11 to 0.79). Infected patients had longer hospital stays (26 days; 95% CI: 12.81 to 38.89) and higher risk of death (OR: 3.2; 95% CI: 1.82 to 5.80). The population prevalence of infection was high in these regions and surveillance data for children were scarce. Conclusion: Antibiotic stewardship policies to prevent infection and encourage appropriate treatment are needed in South-East Asia and the Western Pacific.


Assuntos
Resistência Microbiana a Medicamentos , Infecções por Enterobacteriaceae/tratamento farmacológico , Enterobacteriaceae/efeitos dos fármacos , beta-Lactamases/metabolismo , Ásia Sudeste/epidemiologia , Criança , Enterobacteriaceae/enzimologia , Infecções por Enterobacteriaceae/microbiologia , Humanos , Ilhas do Pacífico/epidemiologia , Fatores de Risco
3.
Nutrients ; 11(6)2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31200513

RESUMO

BACKGROUND: The role of processed foods in nutrition transition in the Pacific is receiving some attention in the context of a significant obesity and diet-related noncommunicable disease health burden. However, trends, patterns and underlying drivers of processed food markets in the Pacific are not well understood. The aim of this study was to investigate recent trends and patterns of processed food markets in the region and interpret the findings by engaging key literature on relevant food systems drivers. METHODS: We conducted a mixed-methods approach involving two steps; (1) We analysed Euromonitor market sales data for processed food and beverage products sold from 2004-2018 for 16 countries differentiated by income level, and (2) guided by a food systems conceptual framework, we drew upon key literature to understand the likely drivers of our observations. RESULTS: We observed plateaus and declines in processed food sales in some high-income countries but increases in upper-middle and lower-middle income countries, and most rapidly in the latter. Beverage markets appear to be stagnating across all income groups. Carbonated soft drinks, baked goods, vegetable oils, processed meats, noodles and sweet biscuits made up the majority of sales in transitioning countries. These observations are likely a result of income growth, urbanising populations, trade and globalisation, and various policies implemented by Pacific governments. CONCLUSIONS: A processed foods nutrition transition is well underway in the Pacific region and accelerating most prominently in lower-middle income countries.


Assuntos
Bebidas/provisão & distribução , Comércio/tendências , Fast Foods/provisão & distribução , Manipulação de Alimentos , Abastecimento de Alimentos/estatística & dados numéricos , Dieta/efeitos adversos , Dieta/estatística & dados numéricos , Humanos , Obesidade/epidemiologia , Obesidade/etiologia , Ilhas do Pacífico/epidemiologia
4.
Heart Lung Circ ; 28(10): 1490-1500, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31128985

RESUMO

OBJECTIVE: Despite the advances in wire technology and development of algorithm-driven methodology for chronic total occlusion (CTO) intervention, there is a void in the literature about the technical aspects of CTO wiring. The Asia Pacific CTO Club, a group of 10 experienced operators in the Asia Pacific region, has tried to fill this void with this state-of-the-art review on CTO wiring. METHODS: This review explains, for proximal cap puncture: choices of wires, shaping of the wire, use of dual lumen catheter, and method of step-down of wire penetration force for successful wiring. In wiring the CTO body, the techniques of loose tissue tracking, intentional intimal plaque tracking, and intentional subintimal wiring are described in detail. For distal lumen wiring, a blunt distal cap, presence of a distal cap side branch, calcium, and sharp tapered distal stump predict cap toughness, and wire penetration force should be stepped-up in these cases. The importance of choosing between redirection, parallel wiring, and Stingray (Boston Scientific, Marlborough, MA, USA) for angiographic guidance is discussed along with which will be more successful. On the retrograde side, the problems encountered with distal cap puncture and methods to overcome these problems are explained. The method of wiring the CTO body through a retrograde approach depending on the morphology of the CTO is described. Different reverse controlled antegrade and retrograde tracking (CART) wiring methods - including end balloon wiring, side balloon entry, and conventional reverse CART - are explained in detail. CONCLUSION: This is a systematic CTO wiring review, which is believed to be beneficial for CTO operators worldwide.


Assuntos
Algoritmos , Angioplastia Coronária com Balão/métodos , Cardiologia , Oclusão Coronária/cirurgia , Intervenção Coronária Percutânea/métodos , Sociedades Médicas , Ásia/epidemiologia , Doença Crônica , Angiografia Coronária , Oclusão Coronária/diagnóstico , Oclusão Coronária/epidemiologia , Humanos , Incidência , Ilhas do Pacífico/epidemiologia
5.
MMWR Morb Mortal Wkly Rep ; 68(8): 195-200, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30817746

RESUMO

Hepatitis B vaccine (HepB), which has been available since 1982, provides lifelong protection against hepatitis B virus (HBV) infection and the associated 20%-30% increased lifetime risk for developing cirrhosis or hepatocellular carcinoma among >95% of vaccine recipients (1). Before HepB introduction into national childhood immunization schedules, the estimated hepatitis B surface antigen (HBsAg) prevalence in the World Health Organization (WHO) Western Pacific Region (WPR)* was >8% in 1990 (2). In 2005, the WPR was the first WHO region to establish a hepatitis B control goal, with an initial target of reducing HBsAg prevalence to <2% among children aged 5 years by 2012. In 2013, the WPR set more stringent control targets to achieve by 2017, including reducing HBsAg prevalence to <1% in children aged 5 years and increasing national coverage with both timely HepB birth dose (HepB-BD) (defined as administration within 24 hours of birth) and the third HepB dose (HepB3) to ≥95% (3). All WPR countries/areas endorsed the Regional Action Plan for Viral Hepatitis in the Western Pacific Region 2016-2020 in 2015 (4) and the Regional Framework for the Triple Elimination of Mother-to-Child Transmission of human immunodeficiency virus (HIV), Hepatitis B and Syphilis in Asia and the Pacific 2018-2030 (triple elimination framework) in 2017 (5). These regional targets and strategies are aligned with program targets established by the WHO Global Health Sector Strategy on Viral Hepatitis 2016-2021 that aim to reduce HBsAg prevalence among children aged 5 years to ≤1% by 2020 and to ≤0.1% by 2030 (6). This report describes progress made to achieve hepatitis B control in the WPR and the steps taken to eliminate mother-to-child transmission (MTCT) of HBV during 2005-2017. During this period, regional timely HepB-BD and HepB3 coverage increased from 63% to 85% and from 76% to 93%, respectively. As of December 2017, 15 (42%) countries/areas achieved ≥95% timely HepB-BD coverage; 18 (50%) reached ≥95% HepB3 coverage; and 19 (53%) countries/areas as well as the region as a whole were verified to have achieved the regional and global target of <1% HBsAg prevalence among children aged 5 years. Continued implementation of proven vaccination strategies will be needed to make further progress toward WPR hepatitis B control targets. In addition to high HepB-BD and HepB3 coverage, enhanced implementation of complementary hepatitis B prevention services through the triple elimination framework, including routine HBsAg testing of pregnant women, timely administration of hepatitis B immunoglobulin to exposed newborns, and antiviral treatment of mothers with high viral loads, will be needed to achieve the global hepatitis B elimination target by 2030.


Assuntos
Erradicação de Doenças , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Pré-Escolar , Feminino , Hepatite B/transmissão , Antígenos de Superfície da Hepatite B , Vacinas contra Hepatite B/administração & dosagem , Humanos , Esquemas de Imunização , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Ilhas do Pacífico/epidemiologia , Gravidez , Estudos Soroepidemiológicos , Inquéritos e Questionários , Cobertura Vacinal/estatística & dados numéricos
6.
BMC Public Health ; 19(1): 331, 2019 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-30898100

RESUMO

BACKGROUND: Description of the epidemiology of influenza is needed to inform influenza vaccination policy. Here we examined influenza virus circulation in countries in the Asia-Pacific region and compared the timing of seasonal epidemics with the timing of influenza vaccination. METHODS: Data were obtained from the World Health Organization (WHO) FluNet database for 2010-2017 for countries in the WHO Asia-Pacific region. Data from countries covering ≥5 consecutive seasons and ≥ 100 influenza positive cases per year were included. Median proportions of cases for each influenza virus type were calculated by country and season. The timing and amplitude of the epidemic peaks were determined by Fourier decomposition. Vaccination timing was considered appropriate for each country if it was recommended ≤4 months before the primary peak of influenza circulation. RESULTS: Seven hundred eleven thousand seven hundred thirty-four influenza cases were included from 19 countries. Peak circulation coincided with the winter seasons in most countries, although patterns were less clear in some countries in the inter-tropical area due to substantial secondary peaks. Influenza A/H3N2 dominated overall, but proportions of A and B strains varied by year and by country. Influenza B represented 31.4% of all cases. The WHO-recommended timing for influenza vaccination was appropriate in 12 countries. Vaccination timing recommendations were considered inappropriate in Laos, Cambodia, and Thailand, and were inconclusive for India, Sri Lanka, Singapore, and Vietnam due to unclear seasonality of influenza virus circulation. CONCLUSIONS: Influenza virus circulation varied considerably across the Asia-Pacific region with an unusually high burden of influenza B. The recommended timing for vaccination was appropriate in most countries, except for several countries with unclear seasonality, mainly located in the inter-tropical area.


Assuntos
Epidemias/estatística & dados numéricos , Influenza Humana/epidemiologia , Ásia/epidemiologia , Bases de Dados Factuais , Humanos , Programas de Imunização , Vacinas contra Influenza/administração & dosagem , Ilhas do Pacífico/epidemiologia , Estações do Ano , Fatores de Tempo , Organização Mundial da Saúde
7.
Pediatr Obes ; 14(5): e12497, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30653850

RESUMO

BACKGROUND: The relationships between the trajectories of weight gain from early childhood to adolescence and risk for metabolic disease are not well understood. OBJECTIVE: The objective of the study is to examine the relationships between weight gain from 2 to 14 years and metabolic risk factors at age 14 years in Pacific Island children. METHODS: z scores for weight were calculated at each of the ages 2.5, 4, 6, 9, 11, and 13.5 years in 1053 children. Growth trajectories were determined by estimating the linear trend of z scores with age for each child. In a subgroup of 204 children, biomarkers of metabolic risk were measured and related to linear trend intercepts and slopes. RESULTS: More rapid growth (greater slope of z score trajectory) was associated with higher concentrations of insulin, leptin (boys), urate, and markers of liver function, insulin resistance and inflammation. Children with higher weights in early life (greater intercept) showed fewer associations with metabolic markers, but considered together, intercept and slope were independently associated with a range of metabolic risk factors. CONCLUSIONS: Both rapid weight gain and a higher body weight in early childhood were associated with higher risk for metabolic disease. Monitoring growth trajectories may help target interventions to optimize nutrition, physical activity, and growth.


Assuntos
Biomarcadores/sangue , Desenvolvimento Infantil/fisiologia , Doenças Metabólicas/etiologia , Ganho de Peso/fisiologia , Adolescente , Índice de Massa Corporal , Peso Corporal/fisiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Doenças Metabólicas/epidemiologia , Ilhas do Pacífico/epidemiologia , Obesidade Pediátrica/complicações , Obesidade Pediátrica/epidemiologia , Fatores de Risco
8.
Eur J Emerg Med ; 26(5): 345-349, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30169464

RESUMO

OBJECTIVE: The primary objective of this study was to describe the epidemiology and management of dyspneic patients presenting to emergency departments (EDs) in an international patient population. Our secondary objective was to compare the EURODEM and AANZDEM patient populations. PATIENTS AND METHODS: An observational prospective cohort study was carried out in Europe and the Asia-Pacific region. The study included consecutive patients presenting to EDs with dyspnea as the main complaint. Data were collected on demographics, comorbidities, chronic treatment, clinical signs and investigations, treatment in the ED, diagnosis, and disposition from ED. RESULTS: A total of 5569 patients were included in the study. The most common ED diagnoses were lower respiratory tract infection (LRTI) (24.9%), heart failure (HF) (17.3%), chronic obstructive pulmonary disease (COPD) exacerbation (15.8%), and asthma (10.5%) in the overall population. There were more LRTI, HF, and COPD exacerbations in the EURODEM population, whereas asthma was more frequent in the AANZDEM population. ICU admission rates were 5.5%. ED mortality was 0.6%. The overall in-hospital mortality was 5.0%. In-hospital mortality rates were 8.7% for LRTI, 7.6% for HF, and 5.6% for COPD patients. CONCLUSION: Dyspnea as a symptom in the ED has high ward and ICU admission rates. A variety of causes of dyspnea were observed in this study, with chronic diseases accounting for a major proportion.


Assuntos
Asma/epidemiologia , Dispneia/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Insuficiência Cardíaca/epidemiologia , Pneumonia/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , Asma/diagnóstico , Estudos de Coortes , Comorbidade , Dispneia/diagnóstico , Europa (Continente)/epidemiologia , Feminino , Insuficiência Cardíaca/diagnóstico , Mortalidade Hospitalar/tendências , Humanos , Internacionalidade , Masculino , Pessoa de Meia-Idade , Ilhas do Pacífico/epidemiologia , Pneumonia/diagnóstico , Prevalência , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Índice de Gravidade de Doença , Distribuição por Sexo
9.
Am J Gastroenterol ; 114(1): 107-115, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30177785

RESUMO

INTRODUCTION: Living in an urban environment may increase the risk of developing inflammatory bowel disease (IBD). It is unclear if this observation is seen globally. We conducted a population-based study to assess the relationship between urbanization and incidence of IBD in the Asia-Pacific region. METHODS: Newly diagnosed IBD cases between 2011 and 2013 from 13 countries or regions in Asia-Pacific were included. Incidence was calculated with 95% confidence interval (CI) and pooled using random-effects model. Meta-regression analysis was used to assess incidence rates and their association with population density, latitude, and longitude. RESULTS: We identified 1175 ulcerative colitis (UC), 656 Crohn's disease (CD), and 37 IBD undetermined (IBD-U). Mean annual IBD incidence per 100 000 was 1.50 (95% CI: 1.43-1.57). India (9.31; 95% CI: 8.38-10.31) and China (3.64; 95% CI, 2.97-4.42) had the highest IBD incidence in Asia. Incidence of overall IBD (incidence rate ratio [IRR]: 2.19; 95% CI: 1.01-4.76]) and CD (IRR: 3.28; 95% CI: 1.83-9.12) was higher across 19 areas of Asia with a higher population density. In China, incidence of IBD (IRR: 2.37; 95% CI: 1.10-5.16) and UC (IRR: 2.63; 95% CI: 1.2-5.8) was positively associated with gross domestic product. A south-to-north disease gradient (IRR: 0.94; 95% CI: 0.91-0.98) was observed for IBD incidence and a west-to-east gradient (IRR: 1.14; 95% CI: 1.05-1.24) was observed for CD incidence in China. This study received IRB approval. CONCLUSIONS: Regions in Asia with a high population density had a higher CD and UC incidence. Coastal areas within China had higher IBD incidence. With increasing urbanization and a shift from rural areas to cities, disease incidence may continue to climb in Asia.


Assuntos
Doenças Inflamatórias Intestinais/epidemiologia , Adulto , Ásia/epidemiologia , Austrália/epidemiologia , Demografia , Feminino , Humanos , Incidência , Doenças Inflamatórias Intestinais/etiologia , Masculino , Pessoa de Meia-Idade , Ilhas do Pacífico/epidemiologia , Vigilância da População , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
10.
Eye (Lond) ; 33(1): 66-77, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30323327

RESUMO

Uveitis is a sight-threatening disease. Up to 35% of patients may have impaired vision. Inflammation of the uvea tissue has more than 60 etiologies. Previous reports have shown that 20-40% of uveitis cases were noninfectious. Some of them may be associated with systemic rheumatological and autoimmune diseases but some may affect the eyes only. The epidemiology and clinical situations of some specific uveitis entities vary worldwide because they are influenced by genetic, ethnic, environmental, and socioeconomic factors. The Asia-Pacific region comprises more than 30 countries. Epidemiology and patterns of uveitis vary greatly in this region. However, some uveitis entities, such as Behcet's disease, sarcoidosis, and Vogt-Koyanagi-Harada disease, are more common in this region. Many studies on the epidemiology, risk factors, and immune pathogenesis of this disease have been conducted. In this article, we review the epidemiology of noninfectious uveitis and special situations of these three uveitis entities in the Asia-Pacific region.


Assuntos
Técnicas de Diagnóstico Oftalmológico , Uveíte/epidemiologia , Ásia/epidemiologia , Humanos , Incidência , Ilhas do Pacífico/epidemiologia , Uveíte/diagnóstico
11.
J Glob Health ; 9(2): 020431, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31893034

RESUMO

Background: Respiratory syncytial virus (RSV) is the leading cause of viral pneumonia and bronchiolitis, especially in younger children. The burden of RSV infection in adults, particularly in the older age group, is increasingly recognised. However, RSV disease burden and molecular epidemiology in the World Health Organization (WHO) Western Pacific Region (WPR) has not been reviewed systematically. The aim of this systematic review is to investigate the epidemiological aspects of RSV (incidence, prevalence, seasonality and hospitalisation status) and the associated molecular data in the WPRO countries. Methods: A systematic search was conducted in international literature databases (MEDLINE, EMBASE, Scopus and Web of Science) to identify RSV-related publications from January 2000 to October 2017 in the WPR countries. Results: A total of 196 studies from 15 WPR countries were included. The positivity rate for RSV among respiratory tract infection patients was 16.73% (95% confidence interval (CI) = 15.12%-18.4%). The RSV-positive cases were mostly found in hospitalised compared with outpatients (18.28% vs 11.54%, P < 0.001), and children compared with adults (20.72% vs 1.87%, P < 0.001). The seasonality of RSV in the WPR countries follows the latitude, with the peak of RSV season occurring in the winter in temperate countries, and during the rainy season in tropical countries. The molecular epidemiology pattern of RSV in WPR countries was similar to the global pattern, with NA1 (RSV A) and BA (RSV B) being the predominant genotypes. Conclusions: The available data on RSV are limited in several countries within the WPR, with most data focusing on children and hospitalised patients. Further studies and surveillance, incorporating laboratory testing, are needed to determine the burden of RSV infection in the WPR countries.


Assuntos
Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/terapia , Vírus Sincicial Respiratório Humano/genética , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Ilhas do Pacífico/epidemiologia , Prevalência , Estações do Ano
12.
Nat Commun ; 9(1): 5444, 2018 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-30575720

RESUMO

Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. Here, we analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low-transmission and post-elimination settings. Analyses with sero-catalytic and antibody acquisition models provide insights into transmission history within each population. To accurately estimate sero-conversion rates (SCR) for trachoma in populations with high-seroprevalence in adults, the model accounts for secondary exposure to Chlamydia trachomatis due to urogenital infection. We estimate the population half-life of sero-reversion for anti-Pgp3 antibodies to be 26 (95% credible interval (CrI): 21-34) years. We show SCRs below 0.015 (95% confidence interval (CI): 0.0-0.049) per year correspond to a prevalence of trachomatous inflammation-follicular below 5%, the current threshold for elimination of active trachoma as a public health problem. As global trachoma prevalence declines, we may need cross-sectional serological survey data to inform programmatic decisions.


Assuntos
Chlamydia trachomatis/imunologia , Modelos Estatísticos , Tracoma/imunologia , Adolescente , Adulto , África ao Sul do Saara/epidemiologia , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Nepal/epidemiologia , Ilhas do Pacífico/epidemiologia , Vigilância em Saúde Pública , Estudos Soroepidemiológicos , Tracoma/epidemiologia , Tracoma/transmissão , Adulto Jovem
13.
Indian J Dent Res ; 29(6): 820-829, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30589014

RESUMO

Background: At a population level, there are no systematic data to correlate the pattern of prevalence of noncommunicable diseases (NCD) with oral disease burden in South Asian countries. The influence of the age, gender, and geographical distribution on these diseases is not reported. We attempt to provide a population level correlation of occurrence using the Global Burden of Disease approach. Materials and Methods: Using the data from the Global Burden of Diseases, 2016, the occurrence of oral diseases (dental caries of permanent teeth, edentulism (including severe tooth loss), and periodontal diseases) and various NCDs, based on geographical region, gender and age groups were collected and subjected to correlation statistics. Statistical Package for Social Services (Version 23) was used to analyze the results. P ≤ 0.05 was considered as statistically significant. Results: Geographical location and age had a significant role in the occurrence of dental diseases. There was a considerable difference in rates of dental diseases and NCD prevalence in the various regions of Asia-Pacific. It was observed that for most of the NCDs, there was a linear significant relationship for edentulism as well as periodontal diseases with high statistical significance. Discussion: The factors that contribute to the discrepancies, phenomenon, and relationship between the oral diseases and NCDs are discussed. The current state of the importance of oral health, in maintaining overall health is discussed. Methods by which policymakers could bring about a change by utilizing the principles of "Overton window" for mobilizing the support of people are presented.


Assuntos
Efeitos Psicossociais da Doença , Doenças não Transmissíveis/epidemiologia , Doenças Estomatognáticas/epidemiologia , Ásia Sudeste/epidemiologia , Saúde Global , Política de Saúde , Humanos , Boca Edêntula/epidemiologia , Saúde Bucal , Ilhas do Pacífico/epidemiologia , Doenças Periodontais/epidemiologia , Prevalência
14.
Viruses ; 11(1)2018 12 25.
Artigo em Inglês | MEDLINE | ID: mdl-30585228

RESUMO

During the past ten years, an increasing number of arbovirus outbreaks have affected tropical islands worldwide. We examined the available literature in peer-reviewed journals, from the second half of the 20th century until 2018, with the aim of gathering an overall picture of the emergence of arboviruses in these islands. In addition, we included information on environmental and social drivers specific to island setting that can facilitate the emergence of outbreaks. Within the context of the One Health approach, our review highlights how the emergence of arboviruses in tropical islands is linked to the complex interplay between their unique ecological settings and to the recent changes in local and global sociodemographic patterns. We also advocate for greater coordination between stakeholders in developing novel prevention and mitigation approaches for an intractable problem.


Assuntos
Arbovirus/fisiologia , Doenças Transmissíveis Emergentes/virologia , Ilhas/epidemiologia , Mosquitos Vetores/virologia , Saúde Única , Aedes/virologia , Animais , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/transmissão , Doenças Transmissíveis Emergentes/epidemiologia , Dengue/epidemiologia , Dengue/transmissão , Surtos de Doenças/prevenção & controle , Humanos , Ilhas do Oceano Índico/epidemiologia , Ilhas do Pacífico/epidemiologia , Clima Tropical , Índias Ocidentais/epidemiologia
16.
PLoS One ; 13(11): e0207393, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30440006

RESUMO

INTRODUCTION: Trachoma is endemic in several Pacific Island countries. The aims of this study were to (a) identify future trachoma mapping needs in the Pacific and (b) to examine whether any temporal trends in trachoma prevalence could be ascertained from the historical literature on trachoma in the Pacific Islands. METHODS: Human studies of trachoma and eye care in the Pacific Islands were identified from a systematic search of PubMed, EMbase, Scopus and Web of Science databases. A published quality assessment system for disease prevalence studies was modified to assess studies for quality and transparency. RESULTS: Few general ophthalmic studies in the Pacific mention trachoma. In targeted studies of trachoma, cases have consistently been identified throughout the Pacific since the early twentieth century. The largest number of studies come from Papua New Guinea and Fiji, whereas some countries have no published data on trachoma. The majority of studies identified were published before the Alliance for the Global Elimination of Trachoma 2020 was convened, so lack the standardisation of population-based mapping which has been implemented in the past decade. CONCLUSIONS: Population-based trachoma prevalence estimates have been recently generated in Papua New Guinea, Solomon Islands, Vanuatu, Kiribati and Fiji. There is insufficient evidence to assess whether there has been temporal change in trachoma prevalence in these countries over the past century. Cases of trachoma have been identified in some countries (for example, Nauru and Samoa) which have no recent population-based mapping data, but may be at risk of trachoma endemcitiy. Deployment of appropriate mapping strategies is warranted to identify whether interventions are required.


Assuntos
Tracoma/epidemiologia , Feminino , Humanos , Masculino , Ilhas do Pacífico/epidemiologia , Prevalência
17.
Emerg Infect Dis ; 24(11): 2119-2121, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30334729

RESUMO

The role of Easter Island in the dissemination of Zika virus from the Pacific islands into the Americas remains unclear. We analyzed new Zika virus sequences from Eastern Island and found that Zika virus was independently disseminated from French Polynesia into the Americas and Easter Island at around the same time.


Assuntos
Surtos de Doenças , Infecção por Zika virus/epidemiologia , Zika virus/isolamento & purificação , Américas/epidemiologia , Humanos , Ilhas do Pacífico/epidemiologia , Polinésia/epidemiologia , Zika virus/genética , Infecção por Zika virus/transmissão , Infecção por Zika virus/virologia
18.
BMC Public Health ; 18(1): 1187, 2018 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-30340557

RESUMO

BACKGROUND: According to the World Health Organization (WHO), 80% of the world's smokers live in low- and middle-income countries. Moreover, more than half of the world's smoking-addicted population resides in the Asia-Pacific region. The reduction of tobacco consumption has thus become one of the major social policies in the region. This study investigates the effects of price increases on cigarette consumption, tobacco tax revenues and reduction in smoking-caused mortality in 22 low-income as well as middle-income countries in the Asia-Pacific region. METHODS: Using panel data from the 1999-2015 Euromonitor International, the World Bank and the World Health Organization, we applied fixed effects regression models of panel data to estimate the elasticity of cigarette prices and to simulate the effect of price fluctuations. RESULTS: Cigarette price elasticity was the highest for countries with a per capita Gross National Income (GNI) above US$6000 (China and Malaysia), and considerably higher for other economies in the region. The administered simulation shows that with an average annual cigarette price increase of 9.51%, the average annual cigarette consumption would decrease by 3.56%, and the average annual tobacco tax revenue would increase by 16.20%. The number of averted smoking-attributable deaths (SADs) would be the highest in China, followed by Indonesia and India. In total, over 17.96 million lives could be saved by tax increases. CONCLUSION: Excise tax increases have a significant effect on the reduction of smoking prevalence and the number of averted smoking-attributable deaths. Middle- and upper-middle income countries would be most affected by high-taxation policies.


Assuntos
Prevenção do Hábito de Fumar/métodos , Fumar/economia , Fumar/epidemiologia , Impostos/economia , Produtos do Tabaco/economia , Ásia/epidemiologia , Comércio/estatística & dados numéricos , Países em Desenvolvimento , Humanos , Ilhas do Pacífico/epidemiologia , Prevalência , Política Pública , Fumar/mortalidade
20.
Rev Med Virol ; 28(6): e2005, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30109914

RESUMO

We systematically searched and meta-analyzed the epidemiological characteristics, frequency of clinical signs, and outcomes of dengue-associated hemophagocytic lymphohistiocytosis. Ten electronic databases were searched systematically plus manual search of reference lists to identify relevant articles published until May 2017. The highest number of reported cases were from South-East Asia region (62 cases), followed by Western Pacific region (20 cases), and America (31 cases). The term "dengue hemorrhagic fever" predominated in studies that used the World Health Organization 1997 definition (59.7%), whereas "severe dengue" predominated in studies using the World Health Organization 2009 definition (76.8%). Among 122 cases, fever, splenomegaly, hepatomegaly, anemia, thrombocytopenia, and serum ferritin ≥500 µg/L were likely to report by articles representing by large sample size. The pooled proportion of these findings were as follows: fever 97.2%, hepatomegaly 70.2%, splenomegaly 78.4%, thrombocytopenia 90.1%, anemia 76.0%, and serum ferritin ≥500 µg/L 97.1%. This study highlighted a high case fatality rate (14.6%) and co-infection among dengue hemophagocytic lymphohistiocytosis patients. We suggest that long fever duration, persistent thrombocytopenia, elevated serum ferritin, and lactate dehydrogenase levels could be good diagnostic indicators for dengue-associated hemophagocytic syndrome. Bone marrow aspiration could be used as one criterion for diagnosis but is not obligatory. Further research is needed to examine the possible risk difference for development of hemophagocytic syndrome and to explore potential relationships between specific dengue classifications and dengue-associated hemophagocytic syndrome.


Assuntos
Dengue/complicações , Linfo-Histiocitose Hemofagocítica/epidemiologia , Linfo-Histiocitose Hemofagocítica/patologia , Américas/epidemiologia , Ásia Sudeste/epidemiologia , Humanos , Linfo-Histiocitose Hemofagocítica/mortalidade , Ilhas do Pacífico/epidemiologia , Fatores de Risco , Análise de Sobrevida , Resultado do Tratamento
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