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PubMed2002

Priority nutritional concerns in Asia.

The sustained economic growth and increasing economic stability in the Asian region over the last three decades have been accompanied by changing lifestyles leading to significant changes in the food and nutrition issues facing Asian countries. The chronic diseases associated with excessive consumption of nutrients, especially fat, are becoming increasingly apparent. At the same time, Asia has a disproportionate share of the malnutrition problem. Underweight and stunting remain significant problems in many Asian communities, and micronutrient deficiencies of iron, iodine, and vitamin A continue to afflict large population groups. Effective data collection and analysis are essential to formulate and implement intervention programs to address both sides of the changing nutrition scenario in Asia.

Adolescent↗
PubMed2026

National genomic projects in Asia and Africa: a review.

National genome projects (NGPs) are increasingly shaping precision medicine by improving representation of population-specific genetic diversity. This review compiles findings from NGPs across Asia and Africa, regions that remain underrepresented in global genomic databases despite their extensive demographic and genetic diversity. A total of 53 studies from 24 countries were identified to understand (1) the genomic approach utilized, (2) novel findings that have emerged, and (3) strategies for improving research in these regions. The NGPs implement population-based variome databases (20 NGPs), linear reference genome assemblies (8 NGPs), and graph-based pangenome assemblies (1 NGP). Novel variants ranged between 0.28% (China) and 19.6% (Iran), whereas rare variants accounted for up to 88.9% of the detected variants in the Chinese population. Each NGP documents its country's evolutionary and migration history, which impacts disease frequency and pharmacogenomic variants. Clinically, NGPs revealed strong population stratification in disease-associated and pharmacogenomic variants. For example, the GJB2 rs72474224 hearing-loss variant ranged from 13% in Vietnam and 12% in Hong Kong to 0.0894% in Turkey, while the VKORC1 rs9923231 pharmacogenomic variant reached 89.2% in Taiwan but was 20%-25% in European-related Russian subpopulations. These findings demonstrate that clinically relevant allele frequencies, pathogenicity assessments, and drug-response markers differ substantially across ancestries. This review highlights ongoing efforts and strategies to enhance the representativeness of genomic data through NGPs in Asia and Africa. We also suggest future directions for national projects, including integrating family-based studies, multi-omic data, and standardized pipelines to accelerate discovery and support the equitable implementation of precision medicine.

Humans↗
PubMed2006

History and evolution of HPAI viruses in southeast Asia.

Highly pathogenic avian influenza (HPAI) has been recognized as a serious viral disease of poultry since 1878. The number of outbreaks of this disease globally has increased in the past 10 years culminating in 2004 with the unprecedented outbreak of H5N1 HPAI involving nine countries in East and South East Asia. Apart from the geographical extent of this outbreak and apparent rapid spread, this epidemic has a number of unique features, among which is the carriage of highly pathogenic AI viruses by asymptomatic domestic waterfowl. When this disease first emerged it was recognized almost simultaneously in a number of countries for the first time. This created considerable concern among both veterinary and public health authorities especially as the virus was also shown to cause fatal disease in humans. This article brings together a range of information on H5N1 HPAI viruses in Asia that were collected by FAO during the past year through field projects and explores possible reasons for the emergence of the disease in late 2003 and early 2004. Key epidemiological features of the disease in different Asian countries are described in an attempt to look for, and where possible, explain similarities and differences. This includes assessment of factors that could have contributed to the spread of the disease. Molecular aspects of the viruses are examined to assess relationships between isolates from different locations and times so as to gain insights into the origins of viruses in various countries. It is apparent that the coincidence and grouping of the reports declaring the outbreaks of HPAI did not truly reflect the time course of disease emergence, which was widespread well before the outbreak. The factors that could have led to a change from infection to emergence of widespread disease in 2003-2004 are discussed. There are still some questions that remain unanswered regarding the origins of the 2004 outbreak. This article does not provide answers to all of these, but brings together what is currently known about these outbreaks and the viruses that have caused them.

Agriculture↗
PubMed2000

The training of otorhinolaryngologists in Asia.

Asian nations differ from one another in population, cultural background, ethnic tradition and economic situation. The training of otorhinolaryngologists in Asia is not in any way uniform. A questionnaire survey of 26 leading institutions in 12 countries/regions was carried out. The emphasis of investigation is towards the training programme for specialists in Otorhinolaryngology and continuous medical education (CME). The response rate of the survey was 100 per cent. The duration of training for otorhinolaryngologists ranges from three to seven years and an exit assessment is held in seven countries/regions. The training programmes are modifications of either the British or the American pattern depending on tradition. Documentation of CME is available in eight countries/regions while a defined cycle has been established in only three. Medical/health authorities or professional societies in each country contribute towards its monitoring. Better communication and sharing of experience will improve the training of otorhinolaryngologists in Asia.

Asia↗
PubMed2003

Environmental threats to children's health in Southeast Asia and the Western Pacific.

The Southeast Asia and Western Pacific regions contain half of the world's children and are among the most rapidly industrializing regions of the globe. Environmental threats to children's health are widespread and are multiplying as nations in the area undergo industrial development and pass through the epidemiologic transition. These environmental hazards range from traditional threats such as bacterial contamination of drinking water and wood smoke in poorly ventilated dwellings to more recently introduced chemical threats such as asbestos construction materials; arsenic in groundwater; methyl isocyanate in Bhopal, India; untreated manufacturing wastes released to landfills; chlorinated hydrocarbon and organophosphorous pesticides; and atmospheric lead emissions from the combustion of leaded gasoline. To address these problems, pediatricians, environmental health scientists, and public health workers throughout Southeast Asia and the Western Pacific have begun to build local and national research and prevention programs in children's environmental health. Successes have been achieved as a result of these efforts: A cost-effective system for producing safe drinking water at the village level has been devised in India; many nations have launched aggressive antismoking campaigns; and Thailand, the Philippines, India, and Pakistan have all begun to reduce their use of lead in gasoline, with resultant declines in children's blood lead levels. The International Conference on Environmental Threats to the Health of Children, held in Bangkok, Thailand, in March 2002, brought together more than 300 representatives from 35 countries and organizations to increase awareness on environmental health hazards affecting children in these regions and throughout the world. The conference, a direct result of the Environmental Threats to the Health of Children meeting held in Manila in April 2000, provided participants with the latest scientific data on children's vulnerability to environmental hazards and models for future policy and public health discussions on ways to improve children's health. The Bangkok Statement, a pledge resulting from the conference proceedings, is an important first step in creating a global alliance committed to developing active and innovative national and international networks to promote and protect children's environmental health.

Asia, Southeastern↗
PubMed2002

Social security in Asia and the Pacific: a brief overview.

In terms of numbers of people, the global challenges facing social security systems are largely Asian. Because of rapid population aging in Asia, while it accounted for 28% of the world's population aged 60 and older in 1985, that percentage will more than double to 58% in 2050. Provident funds are a prominent feature of retirement income systems in the region-Asia and the Pacific contain the majority of the world's countries with provident funds. These programs typically provide lump-sum benefits, and thus, do not provide annuity protection against outliving one's resources. Because of the influence of Confucian philosophy with its emphasis on family responsibility for elders, countries in the region have been relatively slow in developing social security programs. China does not have a social security program for workers who do not work for the government or in government-owned enterprises.

Aged↗
PubMed2003

Forest cover of insular Southeast Asia mapped from recent satellite images of coarse spatial resolution.

The study provides an example of mapping tropical forest cover from SPOT-Vegetation satellite images of coarse spatial resolution (1 km) for the subregion of insular Southeast Asia. A satellite image mosaic has been generated from satellite images acquired for the period 1998 to 2000. Forest cover has been mapped by unsupervised digital classification. The mapping result has then been compared to selected forest maps from the subregion, demonstrating the potential to provide basic information on forest area extent and distribution, but also on massive forest cover change in the subregional context. Forest area estimates derived from the map for the subregion have been found comparable to those compiled by FAO. The results indicate that many of the remaining tropical forests in Southeast Asia, rich in timber resources and biodiversity, may be lost in the near future if deforestation continues at present or previous rates.

Asia, Southeastern↗
PubMed2004

Eco-ethological heterogeneity of the members of the Anopheles minimus complex (Diptera: Culicidae) in Southeast Asia and its consequences for vector control.

The presence of cryptic species within Anopheles minimus s.l. Theobald, one of the most widespread malaria vectors in Southeast Asia, was suggested on the basis of behavioral heterogeneities observed within this taxon. Subsequently, two species, A and C, were recognized. However, the existence of these cryptic species did not explain all observed behavioral heterogeneities within this complex. Besides, data on the behavior of vectors are essential to understand the dynamics of disease transmission and thus evaluate the appropriateness of vector control measures. Different collection methods were used to collect Anopheles species from several localities in Southeast Asia to assess the inter- and intraspecific behavioral divergences of An. minimus A and C. Collection results were subjected to a correspondence analysis. The members of the An. minimus complex were identified by use of the octanol dehydrogenase allozyme profiles or the polymerase chain reaction-restriction fragment length polymorphism assay. Large intraspecific behavioral differences were observed among populations of An. minimus A. These populations belong to the same species on the basis of the applied genetic markers. In northern Vietnam, species A tended to be more zoophilic, whereas in the study sites of south central Vietnam, Cambodia, and Laos it showed marked antropophilic behavior when cattle were scarce. In the most northern study site, An. minimus A showed noteworthy endophilic behavior. An. minimus C was primarily zoophilic and based on this behavior, its role in malaria transmission is questionable. However, it was only found in one locality, so that intraspecific behavioral variation could not be assessed. An. minimus A is able to change its host preference in function of local situations in host availability. Hence, its role in malaria transmission can differ from region to region. Similarly, the impact of vector control on this species may differ between localities. In conclusion, intraspecific behavioral differences in Anopheles species can occur and these behavioral heterogeneities, albeit important for disease transmission and control, are not a priori indicative for the presence of cryptic species.

Animals↗
PubMed1996

Special challenges of maintaining wildlife in captivity in Europe and Asia.

In the second half of the 20th century, populations of many wild animal species have been established in captivity for various purposes (e.g. education, conservation, research, farming) and many are kept as companion animals. With continuing human pressure on the environment, captive or semi-captive management is likely to become a component in the conservation of an increasing range of species throughout Europe and Asia. The management of small and divided populations (some of which may be in zoos while some are free-ranging) requires careful control to minimise loss of genetic diversity. This, in turn, may require movements of animals or germplasm between sub-populations. A potentially serious hazard associated with these translocations is the accidental introduction of infectious agents into populations which have hitherto been geographically or ecologically isolated from these agents. When planning translocations, the state veterinary authorities of both importing and exporting countries should be contacted at an early stage for details of legal requirements in relation to animal health, welfare and conservation. Animal health legislation is mostly aimed at preventing disease in man and domestic animals, and further disease control measures may be required when translocating wild animals. In addition to the need for efforts in ensuring genetic diversity and disease control, good husbandry and welfare can often be challenging in species about which relatively little is known. A variety of organisations are involved in coordinating captive breeding programmes in Europe and Asia, and some of these organisations and the routes through which they can be identified are mentioned here.

Animal Husbandry↗
PubMed1990

The opium wars revisited as US forces tobacco exports in Asia.

The tobacco industry has lobbied successfully to obtain the support of the United States government for opening Asian Markets to American tobacco products. This paper comments on two issues arising from these efforts: the development of an atmosphere of invasion and resistance to invasion in Asia; and the change in the image of the United States in Asian nations from that of a leader in health to that of an exporter of death. The threat of sanctions and the effects of the open market and United States tobacco company advertising in Japan, Taiwan, and South Korea are noted. Parallels are drawn between the opium wars a century and a half ago in China and the current threat of trade sanctions. Reacting to American policy, an Asia-Pacific Association for Control of Tobacco has been formed and linked with the US Coalition Against Smoking.

Asia, Southeastern↗
PubMed2001

A new paradigm for international disease control: lessons learned from polio eradication in Southeast Asia.

OBJECTIVES: This study evaluated the impact of international coordination on polio eradication in Southeast Asia. METHODS: Active surveillance systems for acute flaccid paralysis were assessed. Analyses focused on surveillance proficiency and polio incidence. RESULTS: Ten countries coordinated activities. Importations occurred and were rapidly contained in China and Myanmar. Countries that have been free of indigenous polio transmission for at least 3 years include Sri Lanka, Indonesia, Myanmar, and Thailand. In the remaining endemic countries--India, Nepal, and Bangladesh--poliovirus transmission has been substantially reduced; however, these countries still harbor the world's largest polio reservoir. CONCLUSIONS: Unprecedented international coordination in Southeast Asia resulted in dramatic progress in polio eradication and serves as a paradigm for control of other infectious diseases such as malaria and tuberculosis.

Adolescent↗
PubMed2005

Anthropoecological investigations in Central Asia.

The results of anthropoecological investigations in Central Asia are described. From 1976 to 1991 about 6,000 individuals of both sexes were examined. 2,500 of them were children from 7 to 17 years. The program included the study of body build, metabolic rates, genetic markers and demographic structures. Different groups of Tuvins, Khakass, Mountain and Abakan Shortsys, Altai-kijis, Telengits, Teleuts, Kazakhs, and several groups of Mongols and Khotons were studied. It was shown that some patterns of body build and physiological traits of native populations of Central Asia partly reflect the influence of the geographical environment. The differences observed between various populations of the region may be explained by ecological reasons and not only by ethnic differentiation.

Adult↗
PubMed2005

Probiotic research in Australia, New Zealand and the Asia-Pacific region.

Although the epicentres of probiotic research in the past decade have been Japan and Europe, researchers in the Asia-Pacific region have actively contributed to the growing understanding of the intestinal microbial ecosystem, and interactions between gut bacteria, diet and health of the human host. A number of new probiotic strains have been developed in the region that have been demonstrated to have beneficial impacts on health in animal and human trials, including improved protection against intestinal pathogens and modulation of the immune system. Probiotics targeted to animals, including aquaculture, feature heavily in many Asian countries. Developments in probiotic technologies have included microencapsulation techniques, antimicrobial production in fermented meats, and synbiotic combinations. In particular, the impact of resistant starch on the intestinal environment and fermentation by intestinal bacteria has been intensively studied and new probiotic strains selected specifically for synbiotic combinations with resistant starch. This paper provides an overview of probiotic research within Australia, New Zealand and a number of Asian countries, and lists scientists in the Asia-Pacific region involved in various aspects of probiotic research and development.

Academies and Institutes↗
PubMedDate not supplied

Malaria chemoprophylaxis in UK general practitioners traveling to South Asia.

BACKGROUND: Imported malaria continues to be a significant cause of morbidity and mortality in the United Kingdom. Low uptake and poor compliance of chemoprophylaxis are thought to be contributory factors. Little information is available on how well health care physicians comply with malaria chemoprophylaxis when they travel to malarial areas. The aim of this study was to determine the usage and compliance of malarial chemoprophylaxis by general practitioners who have traveled to South Asia. METHOD: A telephone survey of 172 general practitioners practicing in the West Yorkshire area of the UK who have traveled to South Asia. RESULTS: Of the 145 (84%) responding to the survey, 50 (35%) took no chemoprophylaxis, 28 (19%) did not complete the chemoprophylaxis course, and 67 (46%) were fully compliant. The reasons for noncompliance were; the belief the area visited was free from malaria (34%), no wish to take prophylaxis (18%), previous side-effects (10%), the belief of possessing long-term immunity (10%), no time to obtain prophylaxis (4%), malaria is easier to treat than to prevent (2%), costs of purchasing prophylaxis (2%), went for a short period of time and took the risk (2%), and no specific reason (18%). CONCLUSIONS: This study has shown that a large proportion of general practitioners questioned did not take the recommended antimalarial prophylaxis. If they themselves do not keep to the guidelines, it is of concern that they may not reinforce the taking of chemoprophylaxis by their patients. Training in travel medicine may improve chemoprophylaxis uptake by general practitioners, but until then, such physicians should not be regarded as the main provider of pretravel advice. All travelers including health care physicians should be aware, and should comply with malarial prophylaxis guidelines, with emphasis on chemoprophylaxis compliance and mosquito avoidance.

Antimalarials↗
PubMedDate not supplied

Dengue Fever in travelers returning from southeast Asia.

BACKGROUND: Dengue fever is an important illness facing travelers from nonendemic to endemic countries. METHODS: We reviewed 696 consecutive returned travelers managed at an Australian tertiary-care hospital for an illness acquired overseas. Patients with dengue fever were compared to those with a dengue-like illness, malaria, typhoid fever and rickettsial infections. RESULTS: In total, 19 cases of dengue fever and 20 cases of dengue-like illness were diagnosed, with 85% of cases acquired in Asia. The most common presenting features of dengue were fever (100%), myalgia (79%), rash (74%), headache (68%), nausea (37%), and diarrhea (37%). Compared to those with malaria, typhoid fever and rickettsial infections, patients with dengue were significantly more likely to have myalgia and a temperature <39 degrees C. Compared to all other illnesses in our returned travelers, dengue fever was 18 times more likely if fever and leukopenia were present, 71 times if fever and rash were present, and 230 times if fever, rash and leukopenia were present. All patients with dengue recovered completely. CONCLUSIONS: Dengue fever is an important health problem for travelers not only to Southeast Asia but to all endemic countries. The prevalence appears to be increasing in travelers, and health care professionals need to be familiar with its presentation in travelers. The clinical presenting features provide important guides to establishing the diagnosis.

Adolescent↗
PubMed1999

Ergonomic strategies for improving working conditions in some developing countries in Asia.

Ergonomic action is growing in Asia in response to increasing local needs. Recent studies in some developing countries in Asia commonly developed and applied widely-applicable measures for assessing local needs in field conditions including small enterprises and agriculture. For this purpose, carefully examining the actual workplace conditions of the local people was essential. Consequently, a number of field studies could contributed to improving the working conditions of the local people in materials handling, workstation design, work organization and work environment by using available local resources. Building on local capacity and practice, action-oriented ergonomics training has also been developing and spreading into many workplaces. Various non-expert human resources including local government units, trade unions, industrial associations and the agricultural sectors have been mobilized to act as participatory trainers in the action-oriented ergonomic training programmes. Training tools such as action checklists, good local examples and group work dynamics have been developed and applied to such training activities. Learning from local achievements and focusing on locally available resources, ergonomists have facilitated these local action processes by developing action-oriented training tools and training local trainers. It was confirmed that a number of ergonomic improvements could be formulated by the self-help initiative of the local people when participatory action tools and training were provided. Developing flexible and dynamic ergonomic research and training methods to meet the diversifying needs of the local people will continuously be important. Ergonomists' efforts to cover the wider population and workplaces need to be strengthened and accelerated.

Asia↗
PubMed1999

Clinical spectrum of food allergy in children in Australia and South-East Asia: identification and targets for treatment.

The prevalence of atopic diseases is increasing worldwide for reasons that are not clear. Food allergies are the earliest manifestations of atopy. This review defines the foods most commonly involved in allergic reactions and identifies an emerging group of syndromes in which food allergy is involved. A study of the frequency of food allergies in Australia and South-East Asia has recently shown that egg, cow's milk and peanut are the most common food allergens in Australia, but there were divergent results from different regions of South-East Asia. It is not clear whether the differences in reactivity to foods are due to genetic or cultural factors, but the findings raise the possibility that genetic susceptibility to food allergy may operate at the T-cell level modulated by the major histocompatibility complex. The Melbourne Milk Allergy Study defined a wide range of clinical symptoms and syndromes that could be reproduced by dietary challenge. A subsequent analysis of the infants with hypersensitivity to cow's milk and other multiple food proteins identified a new syndrome, multiple food protein intolerance of infancy. Food challenges demonstrated reactions developing slowly days after commencement of low-allergen soy formula or extensively hydrolysed formula. Follow-up at the age of 3 years showed that most children with this disorder tolerated most foods apart from cow's milk, egg and peanut. Atopic dermatitis affects about 18% of infants in the first 2 years of life. In a community-based study we have shown a very strong association (RR 3.5) between atopic dermatitis and infants with immunoglobulin E allergy to cow's milk, egg or peanut. Family studies on these infants have shown a link between atopic dermatitis and the genomic region 5q31 adjacent to the interleukin-4 gene cluster. Infantile colic (distress) affects 15-40% of infants in the first 4 months of life. Many theories of causation have been proposed, but a study from our centre showed that dietary modification, particularly that of breastfeeding mothers whose infants present with colic before the age of 6 weeks, alleviated symptoms. Colic associated with vomiting has been attributed to gastro-oesophageal reflux (GOR). This has been considered primarily a motility disorder, but a secondary form resulting from food protein intolerance has been described recently. We have also recently identified a group of infants with distressed behaviour attributed to GOR who have failed to respond to H2-receptor antagonists, prokinetic agents and multiple formula changes. Symptoms resolved on commencement of an elemental amino acid-based formula. In two-thirds of the patients, symptoms relapsed when challenged with low-allergen soy formula or extensively hydrolysed formula. We propose that a period of food protein intolerance is a part of the normal development of the immune system as it encounters common dietary proteins in infancy and early childhood. Future targets for research are development of appropriate dietary and management strategies for these entities and identification of genetic markers for these disorders.

Allergens↗
PubMed2003

Molecular epidemiology of human enterovirus 71 strains and recent outbreaks in the Asia-Pacific region: comparative analysis of the VP1 and VP4 genes.

This study provides a comprehensive overview of the molecular epidemiology of human enterovirus 71 (HEV71) in the Asia-Pacific region from 1997 through 2002. Phylogenetic analysis of the VP4 and VP1 genes of recent HEV71 strains indicates that several genogroups of the virus have been circulating in the Asia-Pacific region since 1997. The first of these recent outbreaks, described in Sarawak (Malaysian Borneo) in 1997, was caused by genogroup B3. This outbreak was followed by large outbreaks in Taiwan in 1998, caused by genogroup C2, and in Perth (Western Australia) in 1999, where viruses belonging to genogroups B3 and C2 cocirculated. Singapore, Taiwan, and Sarawak had HEV71 epidemics in 2000, caused predominantly by viruses belonging to genogroup B4; however, large numbers of fatalities were observed only in Taiwan. HEV71 was identified during an epidemic of hand, foot and mouth disease in Korea; that epidemic was found to be due to viruses constituting a new genogroup, C3.

Asia, Southeastern↗