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PubMed2002

A spatial aspect on mitochondrial DNA genealogy in Apodemus peninsulae from East Asia.

Apodemus peninsulae is a field mouse that inhabits the broad-leafed forests of temperate Eurasia. We examined the mitochondrial cytochrome b gene in 57 in dividuals of A. peninsulae from northeastern Asia, including Siberia, Primorye, Magadan region, Sakhalin, Hokkaido, and the Korean Peninsula. The genealogy of the mitochondrial DNA (mtDNA) in A. peninsulae was shown to have substantial geographic affinity, suggesting geographic architecture of northeastern Asia, including the islands of Sakhalin and Hokkaido, played important roles on the cladogenesis. Taking into account the presence of region-specific anciently divergent mtDNA types, three parts of the regions of Primorye, Siberia, and the Korean Peninsula can be denoted as refugia for A. peninsulae during the substantial period of the Quaternary glacial ages. Among the geographic regions examined, Primorye is likely to be the most influential one, from which the mtDNA is thought to have migrated to the neighboring regions of Sakhalin, Hokkaido, the Magadan region, and Siberia during the evolution of this species.

Animals↗
PubMed2003

Psychological assessment in Asia: introduction to the special section.

Psychological assessment with Asians is an important topic not only for psychologists from Asian countries but also for psychologists in multicultural societies with large populations of ethnic Asians. There is a dearth of information in the English language literature on psychological assessment for Asians. This special section is organized to review various forms of psychological assessment in Asia. The objectives of the special section are to inform test users and researchers of the issues related to cross-cultural validity of psychological assessment in Asia and to introduce examples of adapted and indigenously developed instruments that are culturally appropriate.

Asia↗
PubMed2006

Epidemiological comparisons of codon usage patterns among HIV-1 isolates from Asia, Europe, Africa and the Americas.

To investigate the genomic properties of HIV-1, we collected 3,081 sequences from the HIV Sequence Database. The sequences were categorized according to sampling region, country, year, subtype, gene name, and sequence and were saved in a database constructed for this study. The relative synonymous codon usage (RSCU) values of matrix, capsid, and gp120 and gp41 genes were calculated using correspondence analysis. The synonymous codon usage patterns based on the geographical regions of African countries showed broad distributions; when all the other regions, including Asia, Europe, and the Americas, were taken into account, the Asian countries tended to be divided into two groups. The sequences were clustered into nine non-CRF subtypes. Among these, subtype C showed the most distinct codon usage pattern. To determine why the codon usage patterns in Asian countries were divided into two groups for four target genes, the sequences of the isolates from the Asian countries were analyzed. As a result, the synonymous codon usage patterns among Asian countries were divided into two groups, the southern Asian countries and the other Asian countries, with subtype 01_AE being the most dominant subtype in southern Asia. In summary, the synonymous codon usage patterns among the individual HIV-1 subtypes reflect genetic variations, and this bioinformatics technique may be useful in conjunction with phylogenetic methods for predicting the evolutionary patterns of pandemic viruses.

Africa↗
PubMed2005

Strategies for containing an emerging influenza pandemic in Southeast Asia.

Highly pathogenic H5N1 influenza A viruses are now endemic in avian populations in Southeast Asia, and human cases continue to accumulate. Although currently incapable of sustained human-to-human transmission, H5N1 represents a serious pandemic threat owing to the risk of a mutation or reassortment generating a virus with increased transmissibility. Identifying public health interventions that might be able to halt a pandemic in its earliest stages is therefore a priority. Here we use a simulation model of influenza transmission in Southeast Asia to evaluate the potential effectiveness of targeted mass prophylactic use of antiviral drugs as a containment strategy. Other interventions aimed at reducing population contact rates are also examined as reinforcements to an antiviral-based containment policy. We show that elimination of a nascent pandemic may be feasible using a combination of geographically targeted prophylaxis and social distancing measures, if the basic reproduction number of the new virus is below 1.8. We predict that a stockpile of 3 million courses of antiviral drugs should be sufficient for elimination. Policy effectiveness depends critically on how quickly clinical cases are diagnosed and the speed with which antiviral drugs can be distributed.

Age Distribution↗
PubMed2002

Incidence and risk factors of probable dengue virus infection among Dutch travellers to Asia.

We studied the incidence of dengue virus (DEN) infections in a cohort of Dutch short-term travellers to endemic areas in Asia during 1991-92. Sera were collected before and after travel. All post-travel sera were tested for DEN immunoglobulin M (IgM) [IgM capture (MAC)-enzyme-linked immunosorbent assay (ELISA)] and IgG (indirect ELISA). Probable DEN infection was defined as IgM seroconversion or a fourfold rise in IgG ratio in the absence of cross-reaction with antibody to Japanese encephalitis virus (JEV). Infections were considered clinically apparent in case of febrile illness (> 24 H) with headache, myalgia, arthralgia or rash. Probable DEN infection was found in 13 of 447 travellers (incidence rate 30/1000 person-months, 95% CI 17.4-51.6). One infection was considered secondary; no haemorrhagic fever occurred. The clinical-to-subclinical infection rate was 1 : 3.3. The risk of infection showed marked seasonal variation. DEN infections are frequent in travellers to endemic areas in Asia; most remain subclinical.

Adult↗
PubMed2000

Public health measures to control hepatitis B virus infection in the developing countries of the Asia-Pacific region.

Hepatitis B virus (HBV) infection is prevalent in the Asia-Pacific region and the disease burden caused by chronic HBV infection has been enormous. Although vaccination programmes have been implemented in the past decade, and there are extremely successful countries in the region, many countries still cannot afford a control program. These countries are often populous and highly endemic for HBV infection. To overcome this, aid from developed countries or private foundations should be actively sought. In the developing countries of this region, HBV infection in early childhood is the main cause of chronic HBV status, and thus universal vaccination of all infants is the best way to control HBV infection. Because of the expense and extra costs of screening pregnant women, the use of hepatitis B immune globulin may not be essential. To achieve the goal of universal infant vaccination, public education should be done in parallel with education of health professionals and control measures. The Asia Pacific region has more people with chronic hepatitis B than any other part of the world, and control of HBV infection in this region will no doubt be the most important and challenging task to be taken in the beginning of the new millennium.

Asia↗
PubMed2000

Survey of gastrointestinal endoscope disinfection and accessory reprocessing practices in the Asia-Pacific region.

Concern has been raised about the possibility of transmission of infection by gastrointestinal endoscope. This vexation may be related to reliability of the disinfecting techniques or to the compliance with the guidelines laid down for disinfection. There have been very few recent surveys examining the disinfection practices for gastrointestinal endoscopes and their accessories. This survey was undertaken to understand such practices in the Asia-Pacific region. A questionnaire was sent by post or electronic mail to 356 randomly selected endoscopy centres in the Asia-Pacific region. Responses were received from 38.7% of the centres. The survey showed that there were significant aberrations in the application of disinfection procedures. One-third of the respondents did not practise disinfection at the start of the day's session, 2.9% of the centres were not using a high-level disinfectant and 34.7% of the centres used a soak time in 2% glutaraldehyde of less than 10 min. At 40% of the centres, at the end of the day's session, forced air or alcohol was not used to dry the endoscopes. Reuse of accessories meant for single use was widely practised.

Asia↗
PubMed2003

COPD prevalence in 12 Asia-Pacific countries and regions: projections based on the COPD prevalence estimation model.

OBJECTIVE: COPD is a leading cause of mortality and morbidity worldwide. Despite the high rates of cigarette smoking, and the wide use of biomass fuels, there is very little objective data on the prevalence of COPD in Asia. METHODOLOGY: We used a COPD prevalence model to estimate the prevalence of COPD in 12 Asian countries. This model is a validated, computerized tool that uses epidemiological relationships and risk factor prevalence to project the prevalence of COPD within a given population aged 30 years and older. RESULTS: The total number of moderate to severe COPD cases in the 12 countries of this region, as projected by the model, is 56.6 million with an overall prevalence rate of 6.3%. The COPD prevalence rates for the individual countries range from 3.5% (Hong Kong and Singapore) to 6.7% (Vietnam). CONCLUSIONS: The COPD prevalence rates projected by the model reflect the high prevalence of the risk factors for the disease in Asia. The combined prevalence of 6.3% for these countries is considerably higher than the overall rate of 3.8% as extrapolated from WHO data for this region. These estimates highlight the need for further epidemiological studies to support appropriate allocation of resources for the prevention and management of COPD.

Asia↗
PubMed2000

Training and delivery of pediatric surgery services in Asia.

PURPOSE: The purpose of this report is to obtain an overview of pediatric surgery training in Asia and to have a glimpse of its delivery. METHODS: A questionnaire survey was conducted, and the returns from 41 (67%) pediatric surgeons from 14 (88%) Asian countries were reviewed. RESULTS: The number of pediatric surgeons per million population is lowest in Indonesia (0.1) and highest in Japan (25). Two cities in China have 100 or more pediatric surgeons. The number of staff surgeons per center ranges from 1 to 36. Centers with 5 or fewer neonatal surgical operations per staff surgeon per year are located in Cambodia, China, and Japan, and centers with more than 40 neonatal surgical operations per staff surgeon per year are found in India, South Korea, Myanmar, and Thailand. There are centers in which more than 400 postneonatal pediatric surgical operations are performed per staff surgeon each year in Cambodia, India, Indonesia, South Korea, and Myanmar. After general surgery training, pediatric surgery training commonly lasts 2 to 3 years (71%). The shortest training period is 1 year in a center in 1 country to 5 or more years in a few countries. At the end of the training, a variety of exit examinations or assessments (clinicals, orals, written) are conducted in most countries. CONCLUSIONS: Pediatric surgery training programs in Asia are diverse. Clinical cases per trainee surgeon vary greatly. Although some countries have an adequate number of pediatric surgeons to deliver a high quality service, others are severely short staffed, and have huge caseloads, delivering pediatric surgical services under extremely difficult conditions. Governments subsidize the cost of surgical care in most countries (93%): self-payment is common (86%) and insurance is least practiced (64%).

Asia↗
PubMed2006

Establishment of multiple sublineages of H5N1 influenza virus in Asia: implications for pandemic control.

Preparedness for a possible influenza pandemic caused by highly pathogenic avian influenza A subtype H5N1 has become a global priority. The spread of the virus to Europe and continued human infection in Southeast Asia have heightened pandemic concern. It remains unknown from where the pandemic strain may emerge; current attention is directed at Vietnam, Thailand, and, more recently, Indonesia and China. Here, we report that genetically and antigenically distinct sublineages of H5N1 virus have become established in poultry in different geographical regions of Southeast Asia, indicating the long-term endemicity of the virus, and the isolation of H5N1 virus from apparently healthy migratory birds in southern China. Our data show that H5N1 influenza virus, has continued to spread from its established source in southern China to other regions through transport of poultry and bird migration. The identification of regionally distinct sublineages contributes to the understanding of the mechanism for the perpetuation and spread of H5N1, providing information that is directly relevant to control of the source of infection in poultry. It points to the necessity of surveillance that is geographically broader than previously supposed and that includes H5N1 viruses of greater genetic and antigenic diversity.

Animals↗
PubMed1995

Vector control in some countries of Southeast Asia: comparing the vectors and the strategies.

The use of information on malaria vector behaviour in vector control is discussed in relation to the area of Southeast Asia comprising Cambodia, Laos, Myanmar, Thailand and Vietnam. The major vectors in the region are Anopheles dirus, An. minimus, An. maculatus and An. sundaicus, of which An. dirus is the most important. Options for vector control and the biological features of mosquitoes, which would make them amenable to control by these measures, are listed. The methods with the greatest potential for controlling each of the four vector species are described. Experiences of vector control by residual spraying, insecticide-treated nets and larva control and of personal protection against the four vectors are outlined, and it is noted that choice of control strategy is often determined by epidemiological, economic and political considerations, whilst entomological observations may help to explain failures of control and to indicate alternative strategies. Future research needs include basic entomological field studies using the most appropriate indicators to detect changes related to rapidly changing environmental conditions, such as loss of forest and climate change. Further studies of the efficacy of insecticide-treated mosquito nets, with greater attention to study design, are needed before it can be assumed that they will work in Southeast Asia. At the same time, research to improve sustainable utilization of nets is important, bearing in mind that nets are not the only means to control malaria and should not drain resources from supervision and training, which improve access to diagnosis and treatment of malaria and other diseases. Research is needed to make decisions on whether vector control is appropriate in different environments, and, if so, how to carry it out in different health systems. Researchers need to play a greater role in making operational research (entomological, epidemiological, social, economic and health systems research) of good quality an integral component of implementation programmes.

Animals↗
PubMed1999

Pattern of social interaction in societies of the Asia-Pacific region.

The authors developed an 18-item Social Interaction Inventory that yielded a factorial structure based on the 3 domains of social interaction: interpersonal, personal, and extrapersonal. They administered the inventory to samples from 15 countries of the Asia-Pacific region (N = 146). The participants in the different cultural groups preferred to interact more within the interpersonal (in-group) domain as compared with the personal (individual) and extrapersonal (out-group) domains. The findings reflect a collective pattern, rather than an individualistic pattern, of social interaction in the societies of the Asia-Pacific region.

Adult↗
PubMed2005

AIDS-related discrimination in Asia.

The Asia Pacific Network of People Living with HIV/AIDS (APN+) conducted the first regional documentation of AIDS-related discrimination in Asia. This project was an action-based, peer-implemented study that aimed to develop an understanding of the nature, pattern and extent of AIDS-related discrimination in several Asian countries. Trained HIV-positive people interviewed 764 positive people in four countries (India 302; Indonesia 42; Thailand 338; the Philippines 82) using a structured questionnaire. Findings indicate that the major area of discrimination in each country is within the health sector, where over half of those surveyed experienced some form of discrimination. In all countries, the majority of people did not receive pre-test counselling before being tested for HIV. People who reported coerced testing were significantly more likely than other respondents to face subsequent AIDS-related discrimination. A considerable number of respondents were refused treatment after being diagnosed with HIV and many experienced delayed provision of treatment or health services. Breaches of confidentiality by health workers were common. Within the family and the community, women were significantly more likely to experience discrimination than men, including ridicule and harassment, physical assault and being forced to change their place of residence because of their HIV status. These findings have serious implications, particularly in light of the increasing trend in many countries to test all pregnant women in order to prevent transmission of HIV to their unborn children.

Acquired Immunodeficiency Syndrome↗
PubMed1993

HIV infection among injecting drug users in Asia: an evolving public health crisis.

Injecting drug use is being reported from an increasing number of Asian and other Third World countries. HIV continues to spread globally among and from populations of injecting drug users (IDUs), although the rate of spread appears to have slowed down recently in some industrialized countries. Asia produces two-thirds of the world's supply of opium. In recent years the rapid development of new illicit drug trade routes in efforts to evade detection by law enforcement authorities has exposed new populations in Asia to drug injecting and, thus, the risk of HIV infection. Epidemic spread of HIV has recently commenced in some Asian countries among injecting drug users, and others are at substantial risk of an HIV epidemic among their IDU populations. The speed of spread and the consequences of HIV infection among IDUs in Asian and other Third World countries are even more profound than in western countries. Asian countries attempting to control this component of the epidemic often have greater difficulty than industrialized countries because of their proximity to drug producing areas, scarcity of resources and a greater likelihood of pragmatic policies conflicting with traditional values. Vigorous efforts are urgently required at both a national and international level to raise awareness of the consequences of an uncontrolled epidemic of HIV among IDUs in Asian and other countries, and to support the implementation of policies which are likely to reduce the spread of HIV.

Asia↗
PubMed2006

Disaster preparedness in the South East Asia region.

This article presents an overview of risks and hazards in the South East Asia Region, as well as disaster preparedness and response in countries in South East Asia (SEA) before and after the Tsunami of 26 December 2004. This event has become a reference point and turning point for most countries and organizations in improving and reforming disaster risk management. Changes have been put in place as to how emergencies are managed and these were largely brought about by taking forward lessons that were drawn from the Tsunami experience. Benchmarking for preparedness and response has been a critical step in the standardization of systems for emergency preparedness and response.

Asia, Southeastern↗
PubMed2006

A comparison of the postdeployment hospitalization experience of U.S. military personnel following service in the 1991 Gulf War, Southwest Asia after the Gulf War, and Bosnia.

Much attention has been given to the impact of deployment on the health of veterans from the 1991 Gulf War. Whereas increases in self-reported symptoms have been common, no specific exposures have been implicated. Some have suggested that stress from deployment is the chief cause for multisymptom conditions among Gulf War veterans, but comparisons with the health of other recent deployers have not been made. We sought to examine the impact of several large military deployments on hospitalization experience. Hospitalization records were examined for all active duty personnel deployed exclusively to the Gulf War, Southwest Asia after the Gulf War, or Bosnia. Cox's hazard modeling was used to assess time until first post-deployment hospitalization, separation from active duty, or December 31, 2000, whichever occurred first, while controlling for influential covariates and temporal changes. Personnel deployed to Southwest Asia after the 1991 Gulf War were at a slight increased risk for any-cause hospitalization and for 3 of the 14 major diagnostic categories when compared with veterans of the 1991 Gulf War. Personnel deployed to Bosnia were at a decreased risk for any-cause hospitalization and 12 of the 14 major diagnostic categories when compared with Gulf War veterans. These findings do not fully explain the complexity of postdeployment health experiences. Although the risk for hospitalization may be associated with regional deployment, it is unlikely that Gulf War veterans are at greater risk of hospitalization due to a specific exposure-related disease.

Adolescent↗
PubMed2002

Current status of rehabilitation medicine in Asia: a report from New Millennium Asian Symposium on Rehabilitation Medicine.

With the aim of promoting rehabilitation medicine in Asian countries, where the number of persons with disability occupies a significant proportion in the world, New Millennium Asian Symposium on Rehabilitation Medicine was held in February 2001 in Tokyo, under the sponsorship of the Japanese Association of Rehabilitation Medicine. Twenty-three guest speakers from 14 Asian countries and regions participated in the 2-day meeting. With a structured questionnaire that was sent to the participants beforehand, demographic data related to rehabilitation practice and information on training and certification in rehabilitation medicine in the participating countries were collected, and presented at the meeting. Based on these data, the current status of rehabilitation medicine in Asia was summarized. The symposium marked an important step forward for the promotion of rehabilitation medicine in Asia.

Asia↗
PubMed2004

Treatment guidelines for depression in the Asia Pacific region: a review of current developments.

OBJECTIVE: This paper examines the development of treatment guidelines, medication algorithms and clinical pathway guides for depression in countries participating in the SEBoD Initiative. METHODS: A systematic review of the extent of development of treatment guidelines, medication algorithms or clinical pathway guides for depression in participating countries. RESULTS: Most countries in the Asia Pacific region have commenced the development of treatment guidelines, medication algorithms or clinical pathway guides. The promoters of such efforts have included a range of professional and government bodies. Most efforts have borrowed heavily on existing international guidelines. There is a significant emphasis on medication practices in most countries, with less emphasis on the role of psychological or other non-pharmacological approaches. There has been insufficient emphasis on integrating local classification, assessment and cultural practices into the provision of high quality care. Important additional measures, including practice surveys and consensus judgements, have been undertaken in some countries. CONCLUSIONS: The development of a genuine quality improvement movement for depression treatments is in its infancy in the Asia Pacific region. However, there is now the capacity to bring together such efforts at a regional level and, in doing so, promote standards for best care, more community and professional involvement and the uptake of a wider variety of treatment approaches.

Antidepressive Agents↗