Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 823
Filtrar
1.
PLoS One ; 17(5): e0268143, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35522692

RESUMO

BACKGROUND: The China-Myanmar border area is considered a hot spot of active HIV-1 recombination in Southeast Asia. To better understand the characteristics of HIV-1 transmission in this area, a cross-sectional HIV-1 molecular epidemiological survey was conducted in Baoshan Prefecture of Yunnan Province. METHODS: In total, 708 newly reported HIV-1 cases in Baoshan Prefecture from 2019 to 2020 were included in this study. HIV-1 gag, pol and env genes were sequenced, and the spatial and demographic distributions of HIV-1 genotypes were analyzed. The characteristics of HIV-1 transmission were investigated using the HIV-1 molecular network method. RESULTS: In the 497 samples with genotyping results, 19 HIV-1 genotypes were found, with URFs being the predominant strains (30.2%, 150/497). The main circulating HIV-1 strains were mostly distributed in the northern area of Baoshan. URFs were more likely identified in Burmese individuals, intravenous drug users and those younger than 50 years old. CRF08_BC was more likely detected in farmers and those of Han ethnicity, CRF01_AE in the young and those of Han ethnicity, and CRF07_BC in the subpopulation with junior middle school education and higher. Moreover, CRF118_BC and CRF64_BC were more likely found in the subpopulation aged ≥40 years and ≥50 years, respectively. Among 480 individuals with pol sequence detection, 179 (37.3%) were grouped into 78 clusters, with Baoshan natives being more likely to be in the network. The proportion of the linked individuals showed significant differences when stratified by the regional origin, marital status, age and county of case reporting. In the molecular network, recent infections were more likely to occur among nonfarmers and individuals aged below 30 years. CONCLUSIONS: HIV-1 genetics has become complex in Baoshan. HIV-1 molecular network analysis provided transmission characteristics in the local area, and these findings provided information to prioritize transmission-reduction interventions.


Assuntos
Infecções por HIV , Soropositividade para HIV , HIV-1 , China/epidemiologia , Estudos Transversais , Genótipo , Infecções por HIV/epidemiologia , HIV-1/genética , Humanos , Pessoa de Meia-Idade , Mianmar/epidemiologia , Filogenia
2.
PLoS One ; 17(4): e0266185, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35468140

RESUMO

BACKGROUND: Maternal mortality is a persistent public health problem worldwide. The maternal mortality ratio of Myanmar was 250 deaths per 100,000 live births in 2017 which was the second-highest among ASEAN member countries in that year. Myanmar's infant mortality rate was twice the average of ASEAN member countries in 2020. This study examined factors influencing institutional maternity service utilization and identified the need for improved maternal health outcomes. METHODS: A cross-sectional study design was used to examine the experience of 3,642 women from the 2015-16 Myanmar Demographic and Health Survey by adapting Andersen's Behavioral Model. Both descriptive and inferential statistics were applied. Adjusted odds ratios and 95% confidence interval were reported in the logistic regression results. RESULTS: The findings illustrate that the proportion of women who delivered their last child in a health/clinical care facility was 39.7%. Women live in rural areas, states/regions with a high levels of poverty, poor households, experience with financial burden and the husband's occupation in agriculture or unskilled labor were negatively associated with institutional delivery. While a greater number of ANC visits and level of the couple's education had a positive association with institutional delivery. CONCLUSION: The determinants of institutional delivery utilization in this study related to the institutional facilities environment imply an improvement of the institutional availability and accessibility in rural areas, and different states/regions, particularly Chin, Kayah and Kachin States- the poorest states in Myanmar. The poverty reduction strategies are urgently implemented because problems on health care costs and household economic status played important roles in institutional delivery utilization. The ANC visits indicated a significant increase in institutional delivery. The government needs to motivate vulnerable population groups to seek ANC and institutional delivery. Moreover, education is crucial in increasing health knowledge, skills, and capabilities. Thus, improving access to quality, formal, and informal education is necessary.


Assuntos
Utilização de Instalações e Serviços , Serviços de Saúde Materna , Cuidado Pré-Natal , Estudos Transversais , Parto Obstétrico , Feminino , Humanos , Mianmar/epidemiologia , Gravidez
3.
BMC Health Serv Res ; 22(1): 516, 2022 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-35436953

RESUMO

BACKGROUND: Hepatitis B virus birth dose (HepB-BD) vaccination is recommended to reduce mother to infant transmission. We evaluated the HepB-BD status of women who gave birth between 2011 and 2016 (N = 3,583) using the 2015-2016 Myanmar Demographic and Health Survey. METHODS: Frequency distributions of HepB-BD vaccination across maternal and health system factors, concentration indices, and logistic regression models were used to estimate coverage, inequity, and factors associated with vaccination. RESULTS: The majority of participants were younger than 30 years of age, lived in rural areas, and were multiparous. Almost all received antenatal care (ANC), but only 43% received recommended ANC services, and 60% gave birth at home. The overall HepB-BD coverage rate was 26%. Vaccination coverage was higher in urban areas and was inequitably concentrated among children of more educated and wealthier women. HepB-BD coverage was also positively associated with receipt of ANC at non-governmental facilities, and delivery at a facility, skilled provider at birth and Cesarean delivery. After adjusting for sociodemographic and health system factors, receipt of the HepB-BD was positively associated with weekly media exposure, receipt of recommended ANC, and Cesarean delivery, and inversely associated with home delivery. CONCLUSIONS: Both socioeconomic and health systems factors influenced suboptimal and inequitable vaccination coverage. Improved access to quality ANC and delivery services may increase HepB-BD coverage although targeted approaches to reach home births are likely required to achieve national goals.


Assuntos
Hepatite B , Criança , Feminino , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Vacinas contra Hepatite B , Vírus da Hepatite B , Humanos , Lactente , Recém-Nascido , Mães , Mianmar/epidemiologia , Gravidez , Vacinação
4.
Infect Dis Poverty ; 11(1): 43, 2022 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-35462549

RESUMO

BACKGROUND: Plasmodium vivax remains the predominant species at the China-Myanmar border, imposing a major challenge to the recent gains in regional malaria elimination. To closely supervise the emerging of drug resistance in this area, we surveyed the variations in genes potentially correlated with drug resistance in P. vivax parasite and the possible drug selection with time. METHODS: A total of 235 P. vivax samples were collected from patients suffering uncomplicated malaria at Yingjiang, Tengchong, and Longling counties, and Nabang port in China, Yunnan province, and Laiza sub-township in Myanmar, from 2008 to 2017. Five potential drug resistance genes were amplified utilizing nested-PCR and analyzed, including pvdhfr, pvdhps, pvmdr1, pvcrt-o, and pvk12. The Pearson's Chi-squared test or Fisher's exact test were applied to determine the statistical frequency differences of mutations between categorical data. RESULTS: The pvdhfr F57I/L, S58R, T61M and S117T/N presented in 40.6%, 56.7%, 40.1%, and 56.0% of the sequenced P. vivax isolates, and these mutations significantly decreased with years. The haplotype formed by these quadruple mutations predominated in Yingjiang, Tengchong, Longling and Nabang. While a mutation H99S/R (56.6%) dominated in Laiza and increased with time. In pvdhps, the A383G prevailed in 69.2% of the samples, which remained the most prevalent haplotype. However, a significant decrease of its occurrence was also noticed over the time. The S382A/C and A553G existed in 8.4% and 30.8% of the isolates, respectively. In pvmdr1, the mutation Y976F occurred at a low frequency in 5/232 (2.2%), while T958M was fixed and F1076L was approaching fixed (72.4%). The K10 insertion was detected at an occurrence of 33.2% in pvcrt-o, whereas there was no significant difference among the sites or over the time. No mutation was identified in pvk12. CONCLUSIONS: Mutations related with resistance to antifolate drugs are prevalent in this area, while their frequencies decrease significantly with time, suggestive of increased susceptibility of P. vivax parasite to antifolate drugs. Resistance to chloroquine (CQ) is possibly emerging. However, since the molecular mechanisms underneath CQ resistance is yet to be better understood, close supervision of clinical drug efficiency and continuous function investigation is urgently needed to alarm drug resistance.


Assuntos
Antimaláricos , Resistência a Medicamentos , Malária Vivax , Plasmodium vivax , Antimaláricos/efeitos adversos , Antimaláricos/farmacologia , Antimaláricos/uso terapêutico , Biomarcadores/análise , Biomarcadores/sangue , China/epidemiologia , Cloroquina/efeitos adversos , Cloroquina/farmacologia , Cloroquina/uso terapêutico , Resistência a Medicamentos/genética , Antagonistas do Ácido Fólico/efeitos adversos , Antagonistas do Ácido Fólico/farmacologia , Antagonistas do Ácido Fólico/uso terapêutico , Humanos , Malária Vivax/tratamento farmacológico , Malária Vivax/genética , Malária Vivax/parasitologia , Mutação , Mianmar/epidemiologia , Plasmodium vivax/genética , Plasmodium vivax/metabolismo , Polimorfismo Genético , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo
5.
BMC Infect Dis ; 22(1): 350, 2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-35395744

RESUMO

BACKGROUND: Acute lower respiratory infection (ALRI) remains the leading cause of death in children worldwide, and viruses have been the major cause of ALRI. In Myanmar, ALRI is associated with high morbidity and mortality in children, and detailed information on ALRI is currently lacking. METHODS: This prospective study investigated the viral aetiologies, clinical manifestations, and outcomes of ALRI in hospitalised children aged 1 month to 12 years at the Yankin Children Hospital, Yangon, Myanmar from May 2017 to April 2019. The sample size was set to 300 patients for each year. Two nasopharyngeal swabs were obtained for the patients with suspected viral ALRI; one for rapid tests for influenza and respiratory syncytial virus (RSV), and the other for real-time PCR for the 16 ALRI-causing viruses. Pneumococcal colonization rates were also investigated using real-time PCR. Clinical information was extracted from the medical records, and enrolled patients were categorised by age and severity for comparison. RESULTS: Among the 5463 patients admitted with a diagnosis of ALRI, 570 (10.4%) were enrolled in this study. The median age of the patients was 8 months (interquartile range, 4-15 months). The most common symptoms were cough (93%) and difficulty in breathing (73%), while the most common signs of ALRI were tachypnoea (78%) and chest indrawing (67%). A total of 16 viruses were detected in 502 of 570 patients' samples (88%), with RSV B (36%) and rhinovirus (28%) being the most commonly detected. Multiple viruses were detected in 221 of 570 samples (37%) collected from 570 patients. Severe ALRI was diagnosed in 107 of 570 patients (19%), and RSV B and human rhinovirus were commonly detected. The mortality rate was 5%; influenza virus A (29%) and RSV B (21%) were commonly detected, and stunting and lack of immunization were frequently observed in such cases. Additionally, 45% (259/570) of the patients had pneumococcal colonization. CONCLUSIONS: Viral ALRI in hospitalised children with a median of 8 months has significant morbidity and mortality rates in Myanmar. RSV and rhinovirus were the most commonly detected from nasopharyngeal swabs, while influenza virus and RSV were the most frequently associated with fatal cases.


Assuntos
Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Viroses , Vírus , Criança , Criança Hospitalizada , Humanos , Lactente , Mianmar/epidemiologia , Estudos Prospectivos , Vírus Sincicial Respiratório Humano/genética , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Rhinovirus , Viroses/diagnóstico
6.
Parasitology ; 149(4): 529-533, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35331348

RESUMO

Although parasitic nematodes in the genera Murshidia and Quilonia (family Strongylidae) are recognized as major gastrointestinal parasites in Asian elephants, they have been poorly studied. Recently, light micrographs of these parasites in Myanmar have been presented, almost 100 years after the original drawings. However, the number of coronal leaflets, a key taxonomic feature of Quilonia species, has not been precisely determined based on light microscopy. The current study aimed to determine the exact number of coronal leaflets in Quilonia renniei specimens from Asian elephants in Myanmar. On the basis of scanning electron micrographs, leaflet number in females (19­20, average 19.7, n = 9) was significantly higher (P < 0.005) than that in males (16­19, average 18.1, n = 8). This compares with 18 coronal leaflets indicated in the original species description. Specimens bearing 19 coronal leaflets were most numerous, followed by those with 20 leaflets. Median-joining network analysis of mitochondrial cytochrome c oxidase subunit I gene sequences with 16 haplotypes from 19 individuals revealed no clear association between parasite populations and the number of coronal leaflets. These results highlight the importance of determining the number of coronal leaflets in the taxonomy of Q. renniei and other related Quilonia species infecting Asian elephants.


Assuntos
Elefantes , Enteropatias Parasitárias , Animais , Elefantes/parasitologia , Feminino , Masculino , Microscopia Eletrônica de Varredura , Mianmar/epidemiologia , Strongyloidea
7.
PLoS One ; 17(3): e0265262, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35271668

RESUMO

BACKGROUND: Due to the effectiveness of insecticide-treated nets (ITNs), most malaria-endemic countries resort to free distributions in the population with particular attention to pregnant women, a more vulnerable group. However, the mere issuance of ITNs does not usually translate to proper utilization. This study aimed to examine the utilization of ITNs and its associated factors among pregnant women in Myanmar. METHODS: The data analyzed in this cross-sectional study were extracted from available survey datasets of the 2015-16 Myanmar Demographic Health Survey. The secondary data were presented using a chart, descriptive statistics and inferential statistics including simple and multiple logistic regression models. All analyses were performed using STATA, Version 15. A p-value <0.05 was considered statistically significant. RESULTS: Of 466 currently pregnant women, the majority (96%) possessed bed nets for sleeping. Among them, 15.9% slept without a bed net the night before the survey, while 65.7% slept with untreated nets. Only about 1 in 5 (18.4%) slept under ITNs. In the multivariate logistic regression analysis, pregnant women residing in delta and lowland regions [adjusted odds ratio (aOR) = 7.70, 95% confidence interval (CI): 3.62, 16.38], plains (aOR = 7.09, 95%CI: 3.09, 16.25) or hilly areas (aOR = 4.26, 95%CI: 1.91, 9.52) were more likely to report non-utilization of ITNs than those residing in coastal regions. CONCLUSION: Relatively poor ITN utilization was observed among pregnant women in Myanmar. Health promotion activities for ITN utilization should be implemented especially for pregnant women residing in the delta, lowland, plain and hilly regions. Other social-behavioral factors including perceived susceptibility to malaria, knowledge of ITNs, and attitude towards ITN that might favor the non-utilization of ITNs need to be further explored.


Assuntos
Mosquiteiros Tratados com Inseticida , Inseticidas , Malária , Estudos Transversais , Demografia , Feminino , Humanos , Malária/epidemiologia , Malária/prevenção & controle , Mianmar/epidemiologia , Gravidez , Gestantes
8.
Artigo em Inglês | MEDLINE | ID: mdl-35329196

RESUMO

BACKGROUND: Non-communicable diseases (NCDs) are showing an increasing trend worldwide, and the COVID-19 pandemic may interrupt or delay NCD care, the leading cause of mortality in Thailand, which is hosting 2-3 million migrant workers. The transition of epidemiological risk factors, limited access to health-promoting activities, and pandemic containment measures may adversely impact NCD risks. Therefore, hypertension and associated risk factors were determined among registered Myanmar migrant workers in Thailand. METHODS: A cross-sectional survey with structured questionnaires was conducted in Thailand in 2017. Having hypertension was analyzed as a dependent variable, and the associated risk factors were explored by binary logistic regression analysis. RESULTS: A total of 414 participants with a mean age of 29.45 ± 9.03 years were included, and 27.8 percent of the study participants were hypertensive, which was a rate higher than that in their host country (24.7%) and country of origin (26.4%). An older age, being male, current alcohol drinking, and being overweight and obese with reference to the body mass index (BMI) were significantly associated with hypertension. CONCLUSIONS: Our findings reaffirmed the idea that NCDs are important public health concerns, and a simple BMI measurement would be a valuable tool with which to determine hypertension risks. Targeted surveillance and an appropriate health policy are necessary for such a vulnerable population in Thailand.


Assuntos
COVID-19 , Hipertensão , Migrantes , Adulto , COVID-19/epidemiologia , Estudos Transversais , Humanos , Hipertensão/epidemiologia , Masculino , Mianmar/epidemiologia , Pandemias , Prevalência , Fatores de Risco , Tailândia/epidemiologia , Adulto Jovem
9.
Malar J ; 21(1): 86, 2022 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-35292042

RESUMO

BACKGROUND: Ayeyarwady Region in Myanmar has made significant progress towards malaria elimination, with cases decreasing from 12,312 in 2015 to 122 in 2019. As transmission declines, malaria becomes increasingly focalized both in geographic hotspots and among population groups sharing certain risk factors. Developing a thorough profile of high-risk activities associated with malaria infections is critical to ensure intervention approaches are evidence-based. METHODS: A test-negative study was conducted from September 2017 to May 2018 in Ngaputaw, Pathein and Thabaung townships in Ayeyarwady Region. Patients that presented to selected public facilities or community health volunteers with fever answered survey questions on demographic and behavioural risk factors, including exposure to malaria interventions, and were assigned to case and control groups based on the result of a malaria rapid diagnostic test. A random-effects logistic regression model adjusted for clustering at the facility level, as well as any variables along the causal pathway described by a directed acyclic graph, was used to determine odds ratios and association with malaria infections. RESULTS: A total of 119 cases and 1744 controls were recruited from 41 public facilities, with a mean age of 31.3 and 63.7% male. Higher risk groups were identified as males (aOR 1.8, 95% CI 1.2-2.9) and those with a worksite located within the forest (aOR 2.8, 95% CI 1.4-5.3), specifically working in the logging (aOR 2.7, 95% CI 1.5-4.6) and rubber plantation (aOR 3.0, 95% CI 1.4-6.8) industries. Additionally, links between forest travel and malaria were observed, with risk factors identified to be sleeping in the forest within the past month (aOR 2.6, 95% CI 1.1-6.3), and extended forest travel with durations from 3 to 14 days (aOR 8.6, 95% CI 3.5-21.4) or longer periods (aOR 8.4, 95% CI 3.2-21.6). CONCLUSION: Malaria transmission is highly focalized in Ayeyarwady, and results illustrate the need to target interventions to the most at-risk populations of working males and forest goers. It will become increasingly necessary to ensure full intervention coverage of at-risk populations active in forested areas as Myanmar moves closer to malaria elimination goals.


Assuntos
Malária , Setor Público , Adulto , Estudos Transversais , Feminino , Febre , Humanos , Malária/epidemiologia , Malária/prevenção & controle , Masculino , Pessoa de Meia-Idade , Mianmar/epidemiologia
10.
Malar J ; 21(1): 69, 2022 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-35241079

RESUMO

BACKGROUND: To understand the Plasmodium vivax malaria transmission intensity and to assess the effectiveness of prevention and control measures taken along the China-Myanmar border, a catalytic model was used to calculate the seroconversion rate, an important indicator of malaria transmission intensity with high sensitivity, which is particularly useful in areas of low transmission. METHODS: Five counties in Yunnan Province bordering Myanmar were selected as survey sites, and subjects were obtained in each county by stratified random sampling in 2013-2014. Fingerstick blood was collected from each subject and tested for antibodies to P. vivax Merozoite Surface Protein 1-19 (PvMSP1-19) using indirect ELISA. A catalytic conversion model was used to assess the transmission intensity of P. vivax malaria based on the maximum likelihood of generating a community seroconversion rate. RESULTS: A total of 3064 valid blood samples were collected. Antibody levels were positively correlated with age. The seroconversion rate (SCR) values for each village were Luoping (0.0054), Jingqiao (0.0061), Longpen (0.0087), Eluo (0.0079), Banwang (0.0042) and Banbie (0.0046), respectively. CONCLUSION: Overall, the intensity of P. vivax malaria transmission in the border areas of Yunnan Province is low and not entirely consistent across counties. Consecutive serological surveys are needed to provide a sensitive evaluation of transmission dynamics and can help to confirm areas where infection is no longer present.


Assuntos
Malária Vivax , Plasmodium vivax , China/epidemiologia , Humanos , Malária Vivax/epidemiologia , Proteína 1 de Superfície de Merozoito , Mianmar/epidemiologia , Plasmodium falciparum
11.
Infect Dis Poverty ; 11(1): 28, 2022 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-35272701

RESUMO

BACKGROUND: Achieving the elimination of soil-transmitted helminth (STH) infections requires a sufficient understanding of the current epidemiological status of STH endemicity. We aimed to examine the status of STH in Myanmar - a country with the eighth highest STH prevalence in the world, 10 years after instigation of the national deworming programme. METHODS: In August 2016 we screened for STH infections using Kato Katz (KK) microscopy and real-time PCR (qPCR) in schoolchildren from the Bago Region township of Phyu, a STH sentinel site in Myanmar. Ten schools were randomly selected, and one stool sample each from a total of 264 students was examined. Prevalence and intensity of infection were calculated for each STH. RESULTS: High prevalence of STH was identified in the study area with 78.8% of the schoolchildren infected with at least one STH by qPCR, and 33.3% by KK. The most prevalent STH was Trichuris trichiura, diagnosed by both KK (26.1%) and qPCR (67.1%), followed by Ascaris lumbricoides (15.5% KK; 54.9% qPCR). No hookworm infections were identified by KK; however, the qPCR analysis showed a high prevalence of Ancylostoma sp. infection (29.6%) with few Necator americanus (1.1%) infections. CONCLUSIONS: Despite bi-annual deworming of schoolchildren in the fourth-grade and below, STH prevalence remains stubbornly high. These results informed the expansion of the Myanmar National STH control programme to include all school-aged children by the Ministry of Health and Sports in 2017, however further expansion to the whole community should be considered along with improving sanitation and hygiene measures. This would be augmented by rigorous monitoring and evaluation, including national prevalence surveys.


Assuntos
Ascaris lumbricoides , Solo , Animais , Criança , Estudos Transversais , Humanos , Mianmar/epidemiologia , Prevalência
12.
BMJ Open ; 12(1): e052571, 2022 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-35105627

RESUMO

OBJECTIVES: Over 2.4 million people have been displaced within the Thailand-Myanmar border region since 1988. The efficacy of community-driven health models within displaced populations is largely unstudied. Here, we examined the relationship between maternal healthcare access and delivery outcomes to evaluate the impact of community-provided health services for marginalised populations. SETTING: Study setting was the Thailand-Myanmar border region's single largest provider of reproductive health services to displaced mothers. PARTICIPANTS: All women who had a delivery (n=34 240) between 2008 and 2019 at the study clinic were included in the performed retrospective analyses. PRIMARY AND SECONDARY OUTCOME MEASURES: Low birth weight was measured as the study outcome to understand the relationship between antenatal care access, family planning service utilisation, demographics and healthy deliveries. RESULTS: First trimester (OR=0.86; 95% CI=0.81 to 0.91) and second trimester (OR=0.86; 95% CI=0.83 to 0.90) antenatal care visits emerged as independent protective factors against low birthweight delivery, as did prior utilisation of family planning services (OR=0.82; 95% CI=0.73 to 0.92). Additionally, advanced maternal age (OR=1.36; 95% CI=1.21 to 1.52) and teenage pregnancy (OR=1.27, 95% CI=1.13 to 1.42) were notable risk factors, while maternal gravidity (OR=0.914; 95% CI=0.89 to 0.94) displayed a protective effect against low birth weight. CONCLUSION: Access to community-delivered maternal health services is strongly associated with positive delivery outcomes among displaced mothers. This study calls for further inquiry into how to best engage migrant and refugee populations in their own reproductive healthcare, in order to develop resilient models of care for a growing displaced population globally.


Assuntos
Serviços de Saúde Materna , Refugiados , Adolescente , Peso ao Nascer , Serviços de Saúde Comunitária , Feminino , Humanos , Incidência , Recém-Nascido de Baixo Peso , Recém-Nascido , Mães , Mianmar/epidemiologia , Gravidez , Estudos Retrospectivos , Tailândia/epidemiologia
13.
Viruses ; 14(2)2022 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-35215852

RESUMO

We aimed to analyze the situation of the first two epidemic waves in Myanmar using the publicly available daily situation of COVID-19 and whole-genome sequencing data of SARS-CoV-2. From March 23 to December 31, 2020, there were 33,917 confirmed cases and 741 deaths in Myanmar (case fatality rate of 2.18%). The first wave in Myanmar from March to July was linked to overseas travel, and then a second wave started from Rakhine State, a western border state, leading to the second wave spreading countrywide in Myanmar from August to December 2020. The estimated effective reproductive number (Rt) nationwide reached 6-8 at the beginning of each wave and gradually decreased as the epidemic spread to the community. The whole-genome analysis of 10 Myanmar SARS-CoV-2 strains together with 31 previously registered strains showed that the first wave was caused by GISAID clade O or PANGOLIN lineage B.6 and the second wave was changed to clade GH or lineage B.1.36.16 with a close genetic relationship with other South Asian strains. Constant monitoring of epidemiological situations combined with SARS-CoV-2 genome analysis is important for adjusting public health measures to mitigate the community transmissions of COVID-19.


Assuntos
COVID-19/epidemiologia , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/virologia , Epidemias/estatística & dados numéricos , Saúde Pública/estatística & dados numéricos , SARS-CoV-2/genética , Adulto , Idoso , COVID-19/transmissão , Criança , Infecções Comunitárias Adquiridas/transmissão , Feminino , Genoma Viral , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Mianmar/epidemiologia , Filogenia , SARS-CoV-2/classificação , Sequenciamento Completo do Genoma , Adulto Jovem
14.
Parasite ; 29: 1, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35089127

RESUMO

A cross-sectional study was conducted to investigate coccidian infection and associated factors in smallholder pigs, and to identify Cystoisospora oocysts by PCR. A total of 500 pig faecal samples from 330 smallholder farms were collected in Nay Pyi Taw, Myanmar. The faecal flotation method was used to identify Eimeria and Cystoisospora species, and oocyst counts per gram (OPG) of faeces were recorded. Oocysts were differentiated after sporulation. Oocyst DNA was subjected to ITS1-targeted Cystoisospora-specific PCR. The overall coccidian oocyst detection rate by microscopic was 89.0% (445/500). Among the studied samples, 74.0% (370/500) and 70.6% (353/500), were found to be positive with Eimeria spp. and Cystoisospora suis oocysts, respectively. The sequences of C. suis detected were 100% identical to those of C. suis reported from Japan, and had 99.5% resemblance to sequences from Australia and China. Weaner pigs showed the significantly highest (p < 0.05) OPG when compared to other age groups. The highest intensity of coccidian infection (p < 0.05) was found in pigs fed local feed, pigs raised on earthen floors and pigs under poor hygienic conditions. Factors such as age, breed, feed type, and housing floors were found to be significantly associated with coccidian infection (p < 0.05). Age, as well as management factors including floor type, feed type, and hygiene practices on the farm, had a strong influence on the occurrence of coccidian infection in pigs. This is the first study in Myanmar on coccidian infection in pigs and molecular detection of C. suis.


TITLE: Forte influence des facteurs de gestion sur les infections à coccidies dans les petites exploitations porcines et première identification moléculaire de Cystoisospora suis au Myanmar. ABSTRACT: Une étude transversale a été menée pour étudier l'infection coccidienne et les facteurs associés chez les porcs dans des petites exploitations, et pour identifier les oocystes de Cystoisospora par PCR. Au total, 500 échantillons de matières fécales de porcs provenant de 330 petites exploitations agricoles ont été collectés dans la région de Nay Pyi Taw, au Myanmar. La méthode de flottation fécale a été utilisée pour identifier les espèces d'Eimeria et de Cystoisospora, et le nombre d'oocystes par gramme (OPG) de matières fécales a été déterminé. Les oocystes ont été différenciés après sporulation. L'ADN des oocystes a été soumis à une PCR spécifique à Cystoisospora, ciblée sur ITS1. Le taux global de détection d'oocystes de coccidies au microscope était de 89,0 % (445/500). Parmi les échantillons étudiés, respectivement 74,0 % (370/500) et 70,6 % (353/500) ont été trouvés positifs pour Eimeria spp. et les oocystes de Cystoisospora suis. Les séquences de C. suis détectées étaient identiques à 100 % à celles de C. suis signalées au Japon, et avaient 99,5 % de ressemblance avec des séquences d'Australie et de Chine. Les porcs sevrés ont montré un OPG significativement plus élevé (p < 0,05) par rapport aux autres groupes d'âge. L'intensité la plus élevée de l'infection coccidienne (p < 0,05) a été observée chez les porcs nourris avec des aliments locaux, les porcs élevés sur des sols en terre battue et les porcs dans de mauvaises conditions d'hygiène. Des facteurs tels que l'âge, la race, le type d'alimentation et les étages se sont avérés être significativement (p < 0,05) associés à l'infection coccidienne. L'âge, ainsi que les facteurs de gestion, notamment le type de sol, le type d'alimentation et les pratiques d'hygiène dans la ferme, ont eu une forte influence sur la survenue d'une infection coccidienne chez les porcs. Il s'agit de la première étude au Myanmar sur l'infection coccidienne chez le porc et la détection moléculaire de C. suis.


Assuntos
Coccidiose , Doenças dos Suínos , Animais , Coccidiose/epidemiologia , Coccidiose/veterinária , Estudos Transversais , Fazendas , Fezes , Mianmar/epidemiologia , Suínos , Doenças dos Suínos/epidemiologia
15.
J Water Health ; 20(1): 149-156, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35100162

RESUMO

Myanmar is an agriculture-based country with 70% of the total population residing in rural areas. Around half of the total population in Myanmar has to consume water from unimproved sources. The prevalence of diarrhea due to contaminated drinking water is high even in urban areas. The urban community may expect the provision of municipal water supply in the near future if the current revolution against military dictatorship succeeds. However, the rural areas have less or no chance to get quality water because of a lot of other prioritized tasks. Household water treatment is encouraged to be implemented as one of the national water safety plans for rural water supply in Myanmar. This study explored the diarrhea prevention awareness of the rural community using a questionnaire survey. The microbial quality parameters of drinking water sources were also examined. Fecal coliform contamination was detected in all examined drinking water sources. A significant association was found between drinking untreated water and the occurrence of diarrhea. The percentage of people who applied the diarrhea preventive measures was low. Even if they knew how to prevent the disease, very few people applied the measures in reality. Therefore, measures to cause behavioral change should be initiated, together with awareness raising, to promote diarrhea prevention in the community.


Assuntos
Higiene , Saneamento , Diarreia/epidemiologia , Diarreia/prevenção & controle , Humanos , Mianmar/epidemiologia , Prevalência
16.
Asian Pac J Cancer Prev ; 23(1): 311-318, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35092400

RESUMO

BACKGROUND: Cancer is a major public health problem in Myanmar, and cancer registration activities are currently underway through both hospital-based and population-based approaches. So far, there are no population-based cancer incidence and mortality estimates in the country. METHODS: According to the 2014 census, the total population of Nay Pyi Taw Union Territory was 1,160,242 within the area of 70,571 km2. Nay Pyi Taw Cancer Registry team collected data of new cancer cases both actively and passively from all data sources in the region. The data were registered, updated, cross-checked, quality-assured, and analyzed in CanReg5. The results were presented as the number of cases by site, sex, and age, cumulative risk (CR), crude rate, age-specific, and age-standardized incidence rates (ASRs) per 100,000. RESULTS: Total 5,952 new cancer cases and 1874 cancer deaths were recorded among the population of the Nay Pyi Taw Union Territory between 2013 and 2017. The age-standardized incidence rate for all cancer sites excluding non-melanoma skin cancers in males was 125.9 and 107.3 for females. For both sexes combined, the most common cancers were lung (14%), breast (11.4%), liver (10.2%), mouth and pharynx (8.5%), and stomach cancers (7.8%). In males, the most common were lung (18.1%), liver (14.8%), mouth and pharynx (13%), stomach (8.9%) and colon, rectum, and anus (7.4%) cancers. In females, these were breast (21.2%), cervix (13.0%), lung (10.3%), stomach (6.9%) and colon, rectum, and anus (6.3%) cancers. The most common cancer deaths were caused by liver (20.8%), lung (15.7%), mouth and pharynx (9.3%), stomach (7.5%), and Colon, rectum, and anus (6.8%) cancers. CONCLUSION: The findings in this study are salient and have potential to serve as important information for the National Cancer Control Program to formulate prevention and control strategies.


Assuntos
Neoplasias/epidemiologia , Distribuição por Idade , Feminino , Humanos , Incidência , Masculino , Mianmar/epidemiologia , Sistema de Registros , Distribuição por Sexo
17.
J Acquir Immune Defic Syndr ; 89(1): 19-26, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34542090

RESUMO

INTRODUCTION: Understanding social and structural barriers that determine antiretroviral therapy (ART) adherence can improve care. Assessment of such factors is limited in Myanmar, a country with high HIV prevalence and increasing number of people living with HIV initiating ART. METHODS: Questionnaires were administered to adults with HIV across 4 Myanmar cities to estimate adherence and its potential determinants, including HIV knowledge, social support, barriers to care, enacted and internalized stigma, and engagement in peer-to-peer HIV counseling (PC). Associations were determined using logistic mixed-effects modeling. RESULTS: Among 956 participants, the mean age was 39 years, 52% were female, 36% had CD4 <350 cells/mm3, and 50% received pre-ART PC. Good adherence was reported by 74% of participants who had better HIV knowledge than those reporting nonadherence. Among nonadherent, 44% were forgetful and 81% were careless about taking ART. Among all participants, most (53%) were very satisfied with their social support and 79% reported lack of financial resources as barriers to care. Participants most frequently reported being viewed differently by others (30%) and feeling as if they were paying for past karma or sins because of their HIV diagnosis (66%). Enacted stigma (odds ratio 0.86; 95% confidence interval 0.79 to 0.92, P < 0.01) and internalized stigma (odds ratio 0.73; 95% confidence interval: 0.56 to 0.95, P = 0.023) were associated with worse adherence. CONCLUSIONS: Increased self-reported ART adherence in Myanmar is associated with less enacted and internalized stigma. These findings suggest the benefit of developing and promoting adherence interventions, which are focused on mitigating HIV-related stigma in the county.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Adulto , Fármacos Anti-HIV/uso terapêutico , Antirretrovirais/uso terapêutico , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Adesão à Medicação , Mianmar/epidemiologia , Estigma Social
18.
AIDS Educ Prev ; 33(6): 551-566, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34874755

RESUMO

This study aimed to investigate HIV risks among female sex workers (FSWs) who were from the Shan ethnic group, and how they relate to complex relationships with inconsistent condom use. The study was conducted using in-depth interviews with 17 Shan FSWs (aged 18-45 years old) in Chiang Mai. Intimate relationships between participants and regular clients/steady partners were found to facilitate inconsistent condom use. Participating Shan FSWs sustained intimacy with regular clients not only for economic ends but also for emotional support. Gender norms and male power dominated condom use decision making. Some participants lacked proper HIV preventive knowledge regarding condom breakage and HIV risks. Effective intervention and proper HIV preventive practices should address these intimate contexts. Capacity building among women would assist FSWs to make choices that protect them from HIV/STDs infections. Couples-based HIV interventions addressing emotional intimacy is an urgent need for HIV communication and service delivery in Thailand.


Assuntos
Infecções por HIV , Profissionais do Sexo , Adolescente , Adulto , Preservativos , Feminino , Infecções por HIV/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Mianmar/epidemiologia , Parceiros Sexuais , Tailândia , Adulto Jovem
19.
PLoS Negl Trop Dis ; 15(12): e0009961, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34851949

RESUMO

INTRODUCTION: Chikungunya virus (CHIKV) is a mosquito-borne virus known to cause acute febrile illness associated with debilitating polyarthritis. In 2019, several institutions in Myanmar reported a CHIKV outbreak. There are no official reports of CHIKV cases between 2011 and 2018. Therefore, this study sought to determine the seroprevalence of CHIKV infection before the 2019 outbreak. METHODS: A total of 1,544 serum samples were collected from healthy volunteers and patients with febrile illnesses in Yangon, Mandalay, and the Myeik district in 2013, 2015, and 2018. Participants ranged from one month to 65 years of age. Antibody screening was performed with in-house anti-CHIKV IgG and IgM ELISA. A neutralization assay was used as a confirmatory test. RESULTS: The seroprevalence of anti-CHIKV IgM and anti-CHIKV IgG was 8.9% and 28.6%, respectively, with an overall seropositivity rate of 34.5%. A focus reduction neutralization assay confirmed 32.5% seroprevalence of CHIKV in the study population. Age, health status, and region were significantly associated with neutralizing antibodies (NAbs) and CHIKV seropositivity (p < 0.05), while gender was not (p = 0.9). Seroprevalence in 2013, 2015, and 2018 was 32.1%, 28.8%, and 37.3%, respectively. Of the clinical symptoms observed in participants with fevers, arthralgia was mainly noted in CHIKV-seropositive patients. CONCLUSION: The findings in this study reveal the circulation of CHIKV in Myanmar's Mandalay, Yangon, and Myeik regions before the 2019 CHIKV outbreak. As no treatment or vaccine for CHIKV exists, the virus must be monitored through systematic surveillance in Myanmar.


Assuntos
Anticorpos Antivirais/sangue , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/imunologia , Vírus Chikungunya/imunologia , Dengue/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Dengue/diagnóstico , Feminino , Voluntários Saudáveis , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Lactente , Masculino , Pessoa de Meia-Idade , Mianmar/epidemiologia , Estudos Retrospectivos , Estudos Soroepidemiológicos , Adulto Jovem
20.
BMC Infect Dis ; 21(1): 1246, 2021 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-34906092

RESUMO

BACKGROUND: Cross-border malaria in Laiza City of Myanmar seriously affected Yingjiang County of China and compromised reaching the goal of malaria elimination by 2020. Since 2017, a pilot project on 3 + 1 strategy of joint cross-border malaria prevention and control was carried out for building a malaria buffer in these border areas. Here, 3 were the three preventive lines in China where different focalized approaches of malaria elimination were applied and + 1 was a defined border area in Myanmar where the integrated measures of malaria control were adopted. METHODS: A 5-year retrospective analysis (2015 to 2019) was conducted that included case detection, parasite prevalence and vector surveillance. Descriptive statistics was used and the incidence or rates were compared. The annual parasite incidence and the parasite prevalence rate in + 1 area of Myanmar, the annual importation rate in Yingjiang County of China and the density of An. minimus were statistically significant indictors to assess the effectiveness of the 3 + 1 strategy. RESULTS: In + 1 area of Myanmar from 2015 to 2019, the averaged annual parasite incidence was (59.11 ± 40.73)/1000 and Plasmodium vivax accounted for 96.27% of the total confirmed cases. After the pilot project, the annual parasite incidence dropped 89% from 104.77/1000 in 2016 to 12.18/1000 in 2019, the microscopic parasite prevalence rate dropped 100% from 0.34% in 2017 to zero in 2019 and the averaged density of An. Minimus per trap-night dropped 93% from 1.92 in June to 0.13 in September. The submicroscopic parasite prevalence rate increased from 1.15% in 2017 to 1.66% in 2019 without significant difference between the two surveys (P = 0.084). In Yingjiang County of China, neither indigenous nor introduced case was reported and 100% cases were imported from Myanmar since 2017. The averaged annual importation rate from 2015 to 2019 was (0.47 ± 0.15)/1000. After the pilot project, the annual importation rate dropped from 0.59/1000 in 2016 to 0.28/1000 in 2019 with an overall reduction of 53% in the whole county. The reduction was 67% (57.63/1000 to 18.01/1000) in the first preventive line, 52% (0.20/1000 to 0.10/1000) in the second preventive line and 36% (0.32/1000 to 0.22/1000) in the third preventive line. The averaged density of An. Minimus per trap-night in the first preventive line dropped 94% from 2.55 in June to 0.14 in September, without significant difference from that of + 1 area of Myanmar (Z value = - 1.18, P value = 0.24). CONCLUSION: The pilot project on 3 + 1 strategy has been significantly effective in the study areas and a buffer zone of border malaria was successfully established between Laiza City of Myanmar and Yingjiang County of China.


Assuntos
Malária , China/epidemiologia , Humanos , Malária/epidemiologia , Malária/prevenção & controle , Mianmar/epidemiologia , Projetos Piloto , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...