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AIM: To update data previously published on the health profile of the refugees resettling in New Zealand, and to draw attention to the change in health profile over time, with a decline of infectious disease/deficiencies, and a rise of non-communicable diseases, a worldwide phenomenon. METHOD: Comparative data was extracted from (1) written annual reports prepared by medical officers at the Mangere Refugee Resettlement Centre (1978-1991), (2) a Microsoft ACCESS patient management system between 1995 and 1999 and (3) a MEDTECH patient management system between 2010 and 2014. RESULTS: Over the period 1979-2014, the rate of infectious diseases has declined markedly in resettling refugees, and the rate of non-communicable diseases has increased. For example, the incidence of tuberculosis has decreased from 4% to 0.2%, gut parasites from more than 40% to, in some intakes, 15% and iron deficiency from 22% to 10%, while the diabetes rate has gone from 0.1% to 2.7%. CONCLUSION: While management of unfamiliar infectious diseases and deficiencies (especially vitamin D) still remains an important part of the management of refugee health, their management usually involves limited time and expense, and their burden is much less than before. However, refugees now resettling in New Zealand and the rest of the world often present with familiar non-communicable diseases that require long-term management.

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BACKGROUND: Cardiovascular diseases (CVD) are the leading causes of death for men and women in low-and-middle income countries (LMIC). The nutrition transition to diets high in salt, fat and sugar and low in fruit and vegetables, in parallel with increasing prevalence of diet-related CVD risk factors in LMICs, identifies the need for urgent action to reverse this trend. To aid identification of the most effective interventions it is crucial to understand whether there are sex differences in dietary behaviours related to CVD risk. METHODS: From a dataset of 46 nationally representative surveys, we included data from seven countries that had recorded the same dietary behaviour measurements in adults; Bhutan, Eswatini, Georgia, Guyana, Kenya, Nepal and St Vincent and the Grenadines (2013-2017). Three dietary behaviours were investigated: positive salt use behaviour (SUB), meeting fruit and vegetable (F&V) recommendations and use of vegetable oil rather than animal fats in cooking. Generalized linear models were used to investigate the association between dietary behaviours and waist circumference (WC) and undiagnosed and diagnosed hypertension and diabetes. Interaction terms between sex and dietary behaviour were added to test for sex differences. RESULTS: Twenty-four thousand three hundred thirty-two participants were included. More females than males reported positive SUB (31.3 vs. 27.2% p-value < 0.001), yet less met F&V recommendations (13.2 vs. 14.8%, p-value< 0.05). The prevalence of reporting all three dietary behaviours in a positive manner was 2.7%, varying by country, but not sex. Poor SUB was associated with a higher prevalence of undiagnosed hypertension for females (13.1% vs. 9.9%, p-value = 0.04), and a higher prevalence of undiagnosed diabetes for males (2.4% vs. 1.5%, p-value = 0.02). Meeting F&V recommendations was associated with a higher prevalence of high WC (24.4% vs 22.6%, p-value = 0.01), but was not associated with undiagnosed or diagnosed hypertension or diabetes. CONCLUSION: Interventions to increase F&V intake and positive SUBs in the included countries are urgently needed. Dietary behaviours were not notably different between sexes. However, our findings were limited by the small proportion of the population reporting positive dietary behaviours, and further research is required to understand whether associations with CVD risk factors and interactions by sex would change as the prevalence of positive behaviours increases.

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In 2018, Bhutan reported 54 cases of malaria, of which six were indigenous, 14 introduced and 34 imported. Considering the continuous reduction in the number of indigenous cases, Bhutan plans to eliminate malaria by 2025 under the Bhutan Malaria Elimination Strategy. The study was conducted to assess the presence of asymptomatic plasmodial infection in both, Bhutanese population living in malaria-risk areas and in migrant workers to guide the elimination strategies. A cross-sectional study was conducted from April to May 2016 in 750 Bhutanese people and 473 migrant workers. Plasmodium falciparum and Plasmodium vivax infections were investigated by using a rapid diagnostic test (RDT) and the polymerase chain reaction (PCR). Prevalence of asymptomatic plasmodial infection based on PCR was 0.27% (95% CI: 0.05-1.07%) among Bhutanese people with a mean age of 43 years old. The proportions of males and females were 45% and 55%, respectively. Among migrant workers, the prevalence of asymptomatic plasmodial infection was 0.42% (95% CI: 0.07-1.69%) with a mean age of 30 years old. The majority of migrant workers were from the neighboring Indian State of West Bengal (57.51%), followed by Assam (12.26%). RDT in both study groups did not detect any plasmodial infection. The presence of a low prevalence of asymptomatic plasmodial infection indicates that the current elimination strategies and interventions are effective.

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Vespa velutina nigrithorax is an invasive alien organism that has raised concerns in all beekeeping communities of invaded countries including the Republic of Korea, European countries and Japan. Known also as the yellow-legged hornet (or the 'Asian hornet'), it is native to northern India, eastern Nepal, Bhutan and the People's Republic of China. Given its climatic and biological characteristics and the effects of climate change, some coastal areas of North America, Argentina, South Africa, Australia and New Zealand are also susceptible to invasion. Vespa velutina nigrithorax notably affects managed honey-bee colonies by predation on foragers and causing a reduction in the collection of food resources. Being a generalist predator, the yellow-legged hornet also preys on other managed and wild pollinators, and therefore its impacts are not limited to the beekeeping sector but also represent a biodiversity concern. The purpose of this paper is to provide an assessment of V. v. nigrithorax against the four criteria established in Chapter 1.2. of the World Organisation for Animal Health (OIE) Terrestrial Animal Health Code for the inclusion of a disease, infection or infestation in the OIE list. The work was requested by the OIE Scientific Commission for Animal Diseases and presented to this Commission and to the OIE Terrestrial Animal Health Standards Commission in September 2017. Owing to the lack of effective measures to prevent its spread, the fact that its legal situation in some countries is under the mandate of environmental authorities rather than Veterinary Services, and because it is not considered a disease or parasite, V. v. nigrithorax is not currently being proposed for inclusion in the OIE list. At the end of the text, the statements from the two commissions are included and discussed.

Vespa velutina nigrithorax est une espèce allochtone envahissante qui inquiète l'ensemble du secteur apicole dans les pays qu'elle a colonisés, dont la République de Corée, les pays européens et le Japon. Désignée communément sous le nom de frelon asiatique ou de frelon à pattes jaunes, V. v. nigrithorax est originaire du Nord de l'Inde, du Népal oriental, du Bhoutan et de la République populaire de Chine. Certaines zones littorales d'Amérique du Nord, d'Argentine, d'Afrique du Sud, d'Australie et de Nouvelle-Zélande sont également susceptibles d'être colonisées compte tenu de leurs caractéristiques climatiques et biologiques et des effets induits par le changement climatique. Vespa velutina nigrithorax affecte surtout les colonies d'abeilles mellifères en s'attaquant aux butineuses ce qui se traduit par une baisse des ressources alimentaires collectées dans les ruches. Étant un prédateur généraliste, cette espèce de frelon s'attaque également à d'autres pollinisateurs d'élevage ou sauvages de sorte que son impact ne se limite pas au secteur apicole mais représente également une menace pour la biodiversité. Dans cet article, les auteurs évaluent V. v. nigrithorax au regard des quatre critères définis dans le chapitre 1.2. du Code sanitaire pour les animaux terrestres de l'Organisation mondiale de la santé animale (OIE) pour qu'une maladie, une infection ou une infestation soit ajoutée à celles listées par l'OIE. Les résultats de cette étude, réalisée à la demande de la Commission scientifique pour les maladies animales de l'OIE, ont été présentés en septembre 2017 à cette commission ainsi qu'à la Commission des normes sanitaires pour les animaux terrestres de l'OIE. L'inclusion de V. v. nigrithorax dans la liste de l'OIE n'est pas proposée actuellement pour trois raisons : 1) l'absence de méthodes efficaces pour prévenir la propagation de cette espèce ; 2) le fait que sa gestion relève dans certains pays de la compétence des autorités chargées de l'environnement et non des Services vétérinaires ; 3) le fait que le frelon asiatique n'est ni un vecteur de maladie ni un parasite. En conclusion de leur article les auteurs citent et commentent les avis rendus par les deux Commissions spécialisées de l'OIE suite à cette étude.

Vespa velutina nigrithorax es un organismo alóctono (exótico) invasor que ha generado preocupación en todas las comunidades apícolas de los países que ha invadido, entre ellos la República de Corea, diferentes países europeos y Japón. Conocido también cómo avispón asiático, es originario del norte de India, el Nepal oriental, Bután y la República Popular de China. Zonas costeras de Norteamérica, Argentina, Sudáfrica, Australia y Nueva Zelanda también corren peligro de ser invadidas debido a sus condiciones climáticas y biológicas y a los efectos del cambio climático. Vespa velutina nigrithorax afecta significativamente a las colonias de manejo apícola, ya que ataca a las pecoreadoras y reduce la capacidad de recolectar recursos alimenticios de la colmena. Además, como depredador generalista que es, el avispón asiático también ataca a otros polinizadores salvajes o manejados por el hombre, por lo que sus impactos no se limitan al sector apícola sino que suponen también un problema de biodiversidad. El objetivo del presente artículo es evaluar en qué medida V. v. nigrithorax cumple los cuatro criterios establecidos en el capítulo 1.2 del Código Sanitario para los Animales Terrestres de la Organización Mundial de Sanidad Animal (OIE) para incluir una enfermedad, infección o infestación en la lista de la OIE. Este trabajo fue realizado a petición de la Comisión Científica para las Enfermedades de los Animales de la OIE y presentado a esta comisión y a la Comisión de Normas Sanitarias para los Animales Terrestres de la OIE en septiembre de 2017. Puesto que no existen medidas eficaces para contener su diseminación, que en algunos países está legalmente bajo competencia de las autoridades ambientales, y no de los Servicios Veterinarios, y que no está considerada ni una enfermedad ni un parásito, actualmente no se recomienda incluir V. v. nigrithorax en la lista de la OIE. Al final del artículo se incluyen y discuten las declaraciones de ambas comisiones.

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A highly disproportionate burden of cancer is manifested in the world's poorest societies. Since 2016, I have volunteered with the Washington, DC-based organization Health Volunteers Overseas and have provided oncology and palliative nursing education and consultation in Vietnam, Honduras, and Bhutan. In addition, I have volunteered with Living Room International in Kenya, focusing on hospice nursing resource enhancement. I have traveled more than 50,000 miles to those four resource-impoverished nations and witnessed hardships beyond description.

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The interleukin-17 (IL-17) family of cytokines (IL-17A to IL-17F) is involved in many inflammatory diseases. Although IL-17A is recognized as being involved in the pathophysiology of Helicobacter pylori-associated diseases, the role of other IL-17 cytokine family members remains unclear. Microarray analysis of IL-17 family cytokines was performed in H. pylori-infected and uninfected gastric biopsy specimens. IL-17C mRNA was upregulated approximately 4.5-fold in H. pylori-infected gastric biopsy specimens. This was confirmed by quantitative reverse transcriptase PCR in infected and uninfected gastric mucosa obtained from Bhutan and from the Dominican Republic. Immunohistochemical analysis showed that IL-17C expression in H. pylori-infected gastric biopsy specimens was predominantly localized to epithelial and chromogranin A-positive endocrine cells. IL-17C mRNA levels were also significantly greater among cagA-positive than cagA-negative H. pylori infections (P = 0.012). In vitro studies confirmed an increase in IL-17C mRNA and protein levels in cells infected with cagA-positive infections compared to cells infected with either cagA-negative or cag pathogenicity island (PAI) mutant. Chemical inhibition of IκB kinase (IKK), mitogen-activated protein extracellular signal-regulated kinase (MEK), and Jun N-terminal kinase (JNK) inhibited induction of IL-17C proteins in infected cells, whereas p38 inhibition had no effect on IL-17C protein secretion. In conclusion, H. pylori infection was associated with a significant increase in IL-17C expression in human gastric mucosa. The role of IL-17C in the pathogenesis of H. pylori-induced diseases remains to be determined.

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The outcomes of Helicobacter pylori infection vary geographically. H pylori strains, disease presentation, and environments differ markedly in Bhutan and Dominican Republic. The aims were to compare the strains, histology, and expression of interleukin (IL) 8 and IL-10 from gastric mucosa from the 2 countries. H pylori status was assessed by the combination of rapid urease test, culture, and histology. Histology was evaluated using the updated Sydney System, and cytokines in gastric biopsies were measured using real-time polymerase chain reaction (PCR). There were 138 subjects from Bhutan and 155 from Dominican Republic. The prevalence of H pylori infection was 65% and 59%, respectively. The genotype of cagA was predominantly East Asian type in Bhutan versus Western type in Dominican Republic. Gastritis severity was significantly higher in H pylori-infected subjects from Bhutan than those from Dominican Republic. IL-8 expression by H pylori infection was 5.5-fold increased in Bhutan versus 3-fold in Dominican Republic (P < .001); IL-10 expression was similar. IL-8 expression levels among H pylori-infected cases tended to be positively correlated with polymorphonuclear leucocyte and monocyte infiltration scores in both countries. IL-8 expression among those with grade 2 and 3 polymorphonuclear leucocyte and monocyte infiltration was significantly higher in Bhutan than in Dominican Republic. The difference in IL-8 expression in the 2 countries is reflected in the different disease pattern between them. Whether the dominant factor is differences in H pylori virulence, in host-H pylori-environmental interactions, genetic factors or all remains unclear. However, severity of inflammation appears to be a critical factor in disease pathogenesis. We compared IL-8 messenger RNA levels between the high gastric cancer risk country, Bhutan (mainly East Asian-type H pylori), and the lower gastric cancer risk country, Dominican Republic (mainly Western-type H pylori).

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Since the identification of the new human virus, GB virus C (GBV-C)/hepatitis G-virus (HGV), in 1995/1996, reverse transcription polymerase chain reaction remained the sole available diagnostic tool for GBV-C/HGV infection. Recently, a serologic test based on the detection of antibodies to the putative envelope protein 2 (anti-E2) has been introduced. We used this assay for a seroepidemiological survey including 3,314 healthy individuals from different parts of the world, 123 patients from Germany who were suspected to have an increased risk of acquiring GBV-C/HGV infection, 128 multiple organ donors, and 90 GBV-C/HGV RNA positive persons. In European countries, anti-E2 seropositivity ranged from 10.9% (Germany) to 15.3% (Austria). In South Africa (20.3%) and Brazil (19.5%), even higher anti-E2 prevalence rates were recorded. In Asian countries like Bhutan (3.9%), Malaysia (6.3%), and the Philippines (2.7%), anti-E2 positivity was significantly lower. GBV-C/HGV anti-E2 prevalence in potential "risk groups," i.e., patients on hemodialysis and renal transplant recipients, did not vary significantly from anti-E2 seroprevalence in German blood donors. Anti-E2 and GBV-C/HGV RNA were found to be mutually exclusive, confirming the notion that anti-E2 has to be considered as a marker of past infection.