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PubMed2026

Reassortment of Highly Pathogenic Avian Influenza as a Driver for Zoonotic Spillover, Asia.

Highly pathogenic avian influenza H5Nx viruses remain a major zoonotic threat, yet global attention has focused largely on clade 2.3.4.4b, potentially overlooking major changes within long-endemic H5N1 lineages in Asia. Recent reports from South and Southeast Asia describe the emergence of reassortant clade 2.3.2.1 viruses alongside renewed human infections after apparent prolonged epidemiologic stability. Collectively, those events suggest a regional pattern rather than isolated anomalies. In this article, we argue that reassortment, rather than point mutation alone, might be an underrecognized driver of zoonotic risk in endemic H5N1 lineages and is reshaping those lineages. We examine why such events might be underrecognized in settings with entrenched poultry influenza, identify limitations of current surveillance systems, and call for integrated, real-time approaches linking genomic detection with phenotypic assessment across animal and human health sectors to enable timely risk assessment and coordinated public health action.

Asia↗

PubMed1975

The distribution and prevalence of group A arbovirus neutralizing antibodies among human populations in Southeast Asia and the Pacific islands.

Plaque reduction neutralization tests, using five group A arboviruses (chikungunya, Ross River, Getah, Bebaru and Sindbis), were done on sera from human populations in 44 Southeast Asia and Pacific island localities. Specificity of the plaque neutralization test was determined by examining convalescent sera from patients with known alphavirus infections. Chikungunya-specific neutralizing antibodies were demonstrated in sera of persons living in South Vietnam, Northern Malaysia, Indonesia (Kalimantan and Sulawesi), as well as Luzon, Marinduque, Cebu and Mindanao islands in the Philippines. Evidence of Ross River virus infection was found among populations living in West New Guinea and Papua New Guinea mainland, the Bismark Archipelago, Rossel Island and the Solomon Islands. There appeared to be no geographic overlap in the distribution of chikungunya and Ross River viruses, with the separation in their distribution corresponding with Weber's line in the Pacific. Sindbis neutralizing antibodies were found in 7 of 21 populations sampled, but in general the prevalence of infection was low. Four sera, from Vietnam, Malaysia and Mindanao gave monospecific reactions with Getah virus. No evidence of specific Bebaru virus infection was detected. The epidemiology of these five alphaviruses in Southeast Asia and the Pacific islands is discussed.

Adolescent↗

PubMed2002

The importance of leptospirosis in Southeast Asia.

The importance of leptospirosis in Southeast Asia was assessed in conjunction with other studies supported by the U.S. Naval Medical Research Unit No. 2 (US NAMRU-2), Jakarta, Republic of Indonesia. These included studies of hospital-based, acute clinical jaundice in Indonesia, Lao PDR, and Socialist Republic of Vietnam; nonmalarial fever in Indonesia; and hemorrhagic fever in Cambodia. Background prevalence estimates of leptospiral infection were obtained by a cross-sectional, community-based study in Lao PDR. Laboratory testing methods involved serology, microscopic agglutination test, and reverse-transcriptase polymerase chain reaction. Suggestive evidence of recent leptospiral infections was detected in 17%, 13%, and 3% of patients selected on the basis of non-hepatitis A through E jaundice, nonmalarial fever, and hemorrhagic fever (in the absence of acute, dengue viral infections). Leptospiral IgG antibody, reflective of prior infections, was detected in 37% of human sera, collected in Lao PDR. The predominant leptospiral serogroups identified from cases with clinical jaundice were Hurstbridge, Bataviae, and Icterohaemorrhagiae tonkini LT 96 69. Among the nonmalarial febrile cases, Bataviae was the most frequently recognized serogroup. Pyrogenes and Hurstbridge were the principal serogroups among the hemorrhagic fever case subjects. These findings further attest to the relative importance of clinical leptospirosis in Southeast Asia. The wide spectrum of clinical signs and symptoms associated with probable, acute, leptospiral infections contributes to the potential of significant underreporting.

Adolescent↗

PubMed1996

Challenge and response: HIV in Asia and the Pacific.

Inexorably, the epicentre of the global HIV pandemic is moving from Africa to Asia. Despite many years of much-publicised analysis of the African epidemic, most countries in Asia and many in the Pacific have not introduced the public health strategies known to minimise the spread of HIV. What must be done now, and how can the developed countries in the region, such as Australia, assist their neighbours?

Asia↗

PubMed2004

Alcohol and road traffic injuries in South Asia: challenges for prevention.

Among the one million people killed on the roads during 2000, nearly 75% died in developing countries of the world, about half of them in Asia. A selective examination of RTIs in the region indicate that they constitute the second or third leading cause of death in the 5-44 years age group. The increase in direct and indirect health risk associated with alcohol usage has been well-documented in recent years. Alcohol is a major risk factor for RTIs as it impairs judgment and increases the possibility of involvement in other high risk behaviours (e.g., speeding, violating traffic rules, etc.). Precise information on the involvement of alcohol in RTIs and deaths is clearly not available from South Asian countries. With the recognition that road safety needs to focus on reducing drinking and driving, many high-income countries have formulated and implemented a number of coordinated, integrated and sustainable programmes based on scientific research. Considering the gravity of the situation, ongoing efforts to reduce the problem and lessons learnt from high-income countries, it is important to change strategies and mechanisms to reduce drink driving in South Asia.

Accidents, Traffic↗

PubMed2004

Emergency care in South Asia: challenges and opportunities.

One of the striking deficiencies in the current health delivery structure is lack of focus on emergency care in primary health systems, which are ill-equipped to offer appropriate care in emergency situations resulting in a high burden of preventable deaths and disability. Emergency medical systems (EMS) encompass a much wider spectrum from recognition of the emergency, access to the system, provision of pre-hospital care, through definitive hospital care. The burden of death and disability resulting from lack of appropriate emergency care is very high in low- and middle-income countries. In South Asia, health services in general, and emergency care in particular, have failed to attract priority, investments and efforts for a variety of reasons. It has to be emphasized that integrating EMS with other health system components improves health care for the entire community, including children, the elderly, and other vulnerable groups with special needs. Out-of-facility care is an integral component of the health care system in South Asia. EMS focuses on out-of-facility care and also supports efforts to implement cost-effective community health care. There is a possibility of integration of other health services and programmes with an innovative, cost-effective EMS in the region.

Asia↗

PubMed2004

Road crashes: a modern plague on South Asia's poor.

South Asian nations are at the crossroads of economic and political progress but still face severe problems of under-development. Available data illustrates that while some macroeconomic indicators have improved over the years, disparities between rich and poor have increased manifold. Although infectious diseases remain a formidable enemy, noncommunicable diseases and injuries are increasing the health challenges facing the countries of the region. While it is widely recognized and accepted that infectious diseases predominantly affect the poor, there is insufficient evidence documenting the burden of RTI on the lower socioeconomic groups in developing countries. Low educational level, poorly paid occupations and poverty have all been found to be risk factors for road traffic injuries. This paper reviews available data from South Asia to show that RTI disproportionately affect the poor in terms of mortality, morbidity and disability, and presents a persuasive argument to policy makers about the importance of road crashes as a public health problem in South Asia. It is hoped that this will provide further visibility to the increasing burden of RTI in South Asian countries and will attract more political and financial support from the national governments and the donor community to further scale up prevention and control.

Accidents, Traffic↗

PubMed1987

The design and construction of hospitals in Asia.

This paper presents the design approach and solutions for two major teaching hospital projects in South East Asia. It outlines the projects and highlights special aspects. Emphasis is made on the need to design in the context of environment in Asia.

Asia, Southeastern↗

PubMed1999

[Geography of genetic processes in the population: genetic migration in Northern Eurasia (Central Asia region)].

Based on the data of the census of 1970, a map of the rates of gene migrations in the rural population of Central Asia and Kazakhstan was drawn. The corrected average value for 35 populations of oblasts (administrative regions) and autonomous republics was m = 0.0606 +/- 0.0102. The estimate obtained from the mapped data was 0.0799 +/- 0.0014, which is 1.2-fold higher than similar values for Europe. The relationship between the rate of gene migration m, the genetically effective population size Ne, and the density of elementary populations in the studied area Pp was analyzed by means of correlation and regression analyses. The following relationship was obtained: m = A/Ne + BPp, where A > 0 and B < 0. This was accounted for by the fact that the migration flow is mainly directed to the less densely populated rural areas. Given that the region was chosen somewhat artificially, studying gene migrations in Central Asia and Kazakhstan as separate historical, geographic, and genetic subregions of northern Eurasia might be a better approach.

Asia↗

PubMed1999

[Probable ways for spreading domestic chicken genes from Asia to Russia: analysis of the genogeographic studies of A.S. Serebrovskii].

The unique material of A.S. Serebrovsky's gene-geographic studies, most of which is kept at the Archives of the Russian Academy of Sciences, was analyzed and summarized. A comparison of 58 populations of the domestic chicken was conducted. These populations were described by Serebrovsky and his coworkers in 23 regions of the former USSR from 1926 to 1933. On the dendrogram constructed on the basis of a comparison between the frequencies of 14 genes of the domestic chicken, three major clusters can be detected. Russian populations formed a separate cluster. Ukrainian populations clustered with some North-Caucasian populations. The Bashkir chicken populations were shown to be unique. A parallel change in frequencies of some gene pairs (termed by Serebrovsky "gene parallelism") was studied. As a result, three pathways for spreading domestic chickens from Asia to Russia were suggested: through Europe, the Caucasus, and Central Asia.

Animals↗

PubMed1999

Icsh activities and Asia.

The International Council for Standardization in Haematology (ICSH), an international organization promoting international agreement on hematological testing, is now restructuring to strengthen its activities. In Asia, a diversity of testing methods exists and the resulting testing levels make it difficult to compare test results internationally among Asian countries. Fortunately, the ICSH is considering regionalizing its organization to 5 sub-societies to increase its activity, and we have been able to establish a new society, ICSH-Asia, under the ICSH umbrella.

Asia↗

PubMed2000

The malaria cauldron of Southeast Asia: conflicting strategies of contiguous nation states.

The past half-century or so has witnessed dramatic failures but also some successes in control of malaria in the world at large. South and Southeast Asia have had their share of both outcomes, a scenario that reflects many variables in control programs: technology, management strategy, human and financial resources. However, at least equally culpable have been major wars and minor conflicts, economic growth and stagnation, inequity of opportunity, urbanisation, deforestation, changing transport and communications. The history of malaria is thus an integral part of the broader political and economic evolution of the region, as well as the story of the wisdom and unwisdom of malaria specialists. In positive reflection on the latter, systematic organisational effort using standard tools of trade has seen the gradual elimination of major malaria foci from central plain regions of a number of nations in this large region, with residual foci at forested border areas. In many cases there is good evidence of sustainability of elimination in defined areas but the differing success stories reflect in part conflicting strategies in neighboring nation states. On the other hand, physical conflicts, population migration, inequitable economic change, border instability and many other socio-economic variables can be clearly seen to undermine the most ingenuous strategies. Undoubtedly the single most important negative ingredient is the rise and spread of multi-drug resistant falciparum malaria that has its epicenter in Southeast Asia, from which it threatens the world in insidious fashion. Containment of this phenomenon has been the focus of attention for 30 years, more particularly the past decade, and represents the greatest challenge at this time in predicting the continuing impact of malaria globally on human history. So too does the compelling necessity to link malaria control with macro and micro economic planning. This challenge impinges on the sovereignty of individual nations in this region, for they exist in contiguity, so that successful applications of technology require collaborative political determination.

Animals↗

PubMedDate not supplied

Molecular epidemiology of infectious bronchitis virus isolates from China and Southeast Asia.

In order to trace the origin and evolution of avian infectious bronchitis virus (IBV) isolates in China and Southeast Asia, genomic sequencing was used for molecular characterization of 24 IBV isolates and two reference strains in comparison with the published sequences. The 5' region of the S1 genes, containing hypervariable regions I and II, and 3' region of the nucleocapsid genes, containing cytotoxic T lymphocyte epitopes, were used to construct phylogenetic trees for analysis. The results showed that the 24 isolates could be divided into three distinct groups, that is, American, Asian, and European. Some isolates formed a distinct Asian phylogenetic group, suggesting that IBV has existed for some time in Asia. Our results also showed that in vivo recombination of IBV may have occurred at a rather high frequency, contributing to the diversity of these IBV isolates. Importantly, recombination events have probably occurred between vaccine strains and field strains in the natural condition.

Animals↗

PubMed2001

[Clinical PET activities in European and Asia-Oceanian countries].

Clinical diagnosis using positron emission tomography (PET) requires high costs. Therefore, sociomedical evaluation is very important for spread of clinical PET. In this report, sociomedical situation in European and Asia-Oceanian countries, especially concerning transportation of 18F-FDG and reimbursement of medical costs for clinical PET indications, is reported. It seems that UK, Germany and Belgium are the most advanced in clinical PET in Europe. In these countries, many PET investigations are reimbursed though systems are different among the countries. In UK, both public and private insurance gives authorization for clinical PET to some extent. In Germany, private health insurance companies give authorization but public insurance has not. In Belgium, private health insurance does not exist and public insurance gives authorization for clinical PET. Other European countries seem to be in transitional stages. Transportation of 18F-FDG has been already started in almost every country in Europe and Asia-Oceania. In Japan, neither transportation of FDG nor full reimbursement of clinical PET has not started yet and this situation seems to be exceptional. To promote clinical PET in Japan, there is the need of at least establishing a list of clinical indications for PET investigations and establishing commercial-based 18F-FDG supplying system. They could be regarded as a kind of infrastructure for spread of clinical PET.

Asia↗

PubMed2000

[Fujian oversea Chinese and Chinese traditional pharmacist in Southeast Asia].

Hakka from Yongding and southern part of Fujian, engaged in Chinese traditional medicine enterprise in south - east Asia, make up the majority of overseas from Fujian. They played an important part in the development of traditional Chinese medicine and insurance of people's health, in planting Chinese herbs, opening pharmaceutical factory, organizing pharmaceutical company and associations of medicine etc. They made great contributions to the communication and cooperation of medicine between PR China and other countries, especially Fujian and south - east Asia.

Asia, Southeastern↗

PubMed2001

Measles immunization acceptance in Southeast Asia: past patterns and future challenges.

Despite substantial increases in immunization rates, measles remains a major health problem in developing countries of Southeast Asia. The authors of this paper undertook separate investigations which examined factors influencing measles immunization acceptance in the rural Philippines, Central Java, Indonesia, and an impoverished neighborhood in Bangkok, Thailand. We briefly summarize the findings of our three field investigations before presenting a synthesizing analysis of the psychosocial and demographic factors which affect measles immunization. We then review trends influencing measles acceptance in industrialized countries to anticipate possible future challenges to measles immunization acceptance in Southeast Asia in an era of increasing globalization and information transfer. We suggest that parental perceptions of the risks and benefits of immunization, philosophical and religious convictions and state and social regulatory policies will profoundly influence measles immunization in the new millennium.

Asia, Southeastern↗

PubMed2001

Taxonomy of Trichinella and the epidemiology of infection in the Southeast Asia and Australian regions.

Seven species belonging to the Trichinella genus (five with encapsulated larvae and two with non-encapsulated larvae in host muscles) and three additional genotypes have been described to date: T. spiralis (genotype T1), a cosmopolitan species with a high infectivity to swine and rats; T. nativa (T2), etiological agent of sylvatic trichinellosis in arctic and subarctic areas of the Holarctic region, and its related genotype (Trichinella T6), detected in Alaska, Idaho, Montana, Pennsylvania, Wyoming, and Ontario; T. britovi (T3), etiological agent of sylvatic trichinellosis in temperate areas of Europe and Asia, and its related genotypes Trichinella T9 in Japan and Trichinella T8 in South Africa and Namibia; T. murrelli (T5), etiological agent of sylvatic trichinellosis in temperate areas of the USA; T. nelsoni (T7), etiological agent of sylvatic trichinellosis in Africa south of the Sahara; T. pseudospiralis (T4), a non-encapsulated cosmopolitan species infecting both mammals and birds; and T. papuae (T10), a recently discovered non-encapsulated species in sylvatic swine of Papua New Guinea. In the Southeast Asia and Australian regions, T. spiralis, T. pseudospiralis and T. papuae have been detected in sylvatic and domestic animals and in humans. A focus of human trichinellosis due to T. papuae was recently discovered in Papua New Guinea, with a prevalence of 28.9%. Trichinellosis has also been documented in domestic animals and/or humans in Cambodia, Indonesia (Bali and Sumatra), Lao PDR, Malaysia, Myanmar, Thailand, and New Zealand, and in wildlife of Tasmania.

Animals↗

PubMed2002

Reducing abortion-related mortality in South Asia: a review of constraints and a road map for change.

South Asia (Bangladesh, India, Nepal, Pakistan, and Sri Lanka) is home to 28% of the world's people and accounts for about a third (30%) of the world's maternal deaths. Thirteen percent of all maternal deaths in South Asia are attributed to complications of unsafe abortion and are almost entirely preventable. This article reviews the legal, health system, and sociocultural barriers to safe abortion and suggests strategies to reduce abortion-related morbidity and mortality. Restrictive laws hamper safe abortion in most of the region, but even where laws are more liberal, limited awareness of the law has been a barrier to access. Such health system barriers as an insufficient number of trained providers, inequitable distribution of services, and excessive costs have contributed to death from unsafe abortion. Sociocultural attitudes, including the right of male relatives to make reproductive decisions, the emphasis on male heirs, and the strong social stigma against extramarital pregnancy also put women at risk. Government and other institutions must strive to prevent abortion-related death and disability by making safe abortion services accessible to the fullest extent of the law. Health systems need to provide emergency care for complications and postabortion contraceptive counseling, use appropriate technology, and allow nonphysician providers to deliver care. Safe abortion care programs need to address the needs of the local community, particularly the needs of socially and economically vulnerable subgroups, such as the unmarried and adolescents.

Abortion, Induced↗