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PubMed1992

Family change and support of the elderly in Asia: what do we know?

"After outlining variations in traditional family systems in Asia, this article discusses likely impacts of urbanization, industrialization and migration on family structure and care of the elderly. Evidence about changing family support for the elderly in Asia is then reviewed. The article's main conclusion is that future changes in Asian countries and areas seem likely to erode traditional family-based systems of care for the elderly, even if the overall welfare of the elderly improves because of higher incomes. Problems faced by elderly women are likely to be especially acute and may require special policies to deal with them."

Adult↗
PubMed2002

Asia-Pacific mussel watch: monitoring of butyltin contamination in coastal waters of Asian developing countries.

Butyltin compounds (BTs) including mono-, di-, and tributyltin and total tin (sigmaSn), were determined in green mussels (Perna viridis) from various Asian developing countries, such as Cambodia, China (Hong Kong and southern China), Malaysia, India, Indonesia, the Philippines, and Vietnam, to elucidate the contamination status, distribution, and possible sources and to assess the risks on aquatic organisms and humans. Butyltin compounds were detected in green mussels collected from all the sampling location investigated, suggesting widespread contamination of BTs along the coastal waters of Asian developing countries. Among butyltin derivatives, tributyltin (TBT) was the predominant compound, indicating its ongoing usage and recent exposures in Asian coastal waters. Higher concentrations of BTs were found in mussels collected at locations with intensive maritime activities, implying that the usage of TBT as a biocide in antifouling paints was a major source of BTs. In addition, relatively high concentrations of BTs were observed in mussels from aquaculture areas in Hong Kong and Malaysia, as it has been reported in Thailand. With the recent improvement in economic status in Asia, it is probable that an increase in TBT usage will occur in aquaculture. Although contamination levels were generally low in mussel samples from most of the Asian developing countries, some of those from polluted areas in Hong Kong, India, Malaysia, the Philippines, and Thailand revealed levels comparable to those in developed nations. Furthermore, the concentrations of TBT in some mussels from polluted areas exceeded the threshold for toxic effects on organisms and estimated tolerable average residue levels as seafoods for human consumption. A significant correlation was observed between the concentrations of sigmaBTs and sigmaSn in mussels, and sigmaBTs were made up mostly 100% of sigmaSn in mussels taken from locations having intensive maritime/human activities. This suggests that anthropogenic BTs represent the major source of tin accumulation in mussels. To our knowledge, this is a first comprehensive report on butyltin pollution monitoring in developing countries in the Asia-Pacific region.

Animals↗
PubMed2002

Diffusion and utilization of magnetic resonance imaging in Asia.

OBJECTIVES: An assessment of the current status of magnetic resonance imaging (MRI) was undertaken to provide input for future government decisions on the introduction of new technologies in Asia. The objective of the study is to describe and explain the diffusion pattern of this costly technology in several Asian settings. METHODS: Data on the diffusion pattern of MRI for different Asian countries (the Republic of Korea, Malaysia, Indonesia, the Philippines and Thailand) and regions (the cities of Shanghai and Hong Kong in China and the state of Tamil Nadu in India) were obtained from national representatives of professional bodies by using standardized questionnaires for the year 1997-98. In addition, utilization data were collected at the hospital level in three countries before and after the economic crisis in the region. For four countries plus Hong Kong, background information on the legal framework for "big ticket" technologies was collected. RESULTS: Since the introduction of the first MRI in the region in 1987, the number of MRIs has gradually increased both in public and private facilities in Asia. In 1998 the average number of MRI machines installed varied from less than 0.5 machine per million population to more than 5 machines per million population. The maintenance and operating costs, and not the absence of regulation, account for the low number of MRIs in the Philippines and Malaysia. Overall, installed MRIs have low magnetic field strength, vary with respect to brand and type, and are mostly in the private sector and in the urban areas of the region. The diffusion pattern of MRIs in countries of the Asian region appears to follow two types of patterns of diffusion: one set of countries seems to be composed of mostly early adopters and another set of countries appears to be composed mostly of late adopters. CONCLUSIONS: Total number of MRIs per population in this region, though quite small compared to most OECD countries, reflects a higher share of the country's health-resource devoted to expensive high-technology devices. It is difficult to state the appropriate number of MRIs for each country; however, the study shows that there are observable problems in terms of efficiency, equity, and quality of MRI services. The research team proposes a few key recommendations to counteract these problems. Purchasing and regulatory bodies must be empowered with skill and knowledge of health technology assessment. Likewise, the fundamental problems resulting from inefficient and unfair health financing should not be overlooked, so that there is more equitable use of the technology.

Asia↗
PubMed1992

Thalassemia in SouthEast Asia: problems and strategy for prevention and control.

In Southeast Asia alpha-thalassemia, beta-thalassemia, hemoglobin (Hb) E and Hb Constant Spring are prevalent. The gene frequencies of alpha-thalassemia reach 30-40% in Northern Thailand and Laos. beta-Thalassemia gene frequencies vary between 1 and 9%. Hb E is the hallmark of Southeast Asia attaining a frequency of 50-60% at the junction of Thailand, Laos, and Cambodia. Hb Constant Spring gene frequencies vary between 1 and 8%. These abnormal genes in different combinations lead to over 60 different thalassemia syndromes. The four major thalassemic diseases are Hb Bart's hydrops fetalis (homozygous alpha-thalassemia 1), homozygous beta-thalassemia, beta-thalassemia/Hb E and Hb H diseases. The molecular basis of most of these abnormal genes have been recently described. Therefore, it is possible to set a strategy for prevention and control of thalassemia which includes population screening for heterozygotes, genetic counseling and fetal diagnosis with selective abortion of affected pregnancies.

Asia, Southeastern↗
PubMed1992

Urban planning in metropolitan areas of Asia: the challenge of accomodating the informal sector.

One paradox in the recent pattern of urbanization in Asia is 'metropolisation' and 'informalization'. This is paradoxical since growth and development of a metropolis is expected to reduce its traditional or informal sector. From available evidence, this paper shows that metropolisation in Asia, instead of reducing the size of informal sector, is rather providing new impetus to its growth. After revealing the nature and content of these growth patterns, the paper argues the case for making changes in the urban planning paradigms for accommodation of the informal sector in metropolitan development. The concurrent expansion of a metropolis and the informal sector within it will not appear paradoxical, the author believes, once the traditional urban planning paradigms of land use, zoning, and standards, mostly evolved from the Western experience of urban-industrial development, are modified in light of the socio-economic realities of the Asian metropolises. The huge population base of the respective countries relative to capital and other material resources, and vast qualitative change in the production structure of urban metropolitan economies have made the presence of the informal sector rather functionally relevant in the very heart of their metropolises. The paper provides some directions, citing examples from several cities, as to how to make the necessary accommodation. The paper further contends that mere physical accommodation by legal acceptance and provisions will not be enough. The other major direction of change in urban planning ought to be for integrating the physical, economic, and social dimensions of planning for ensuring better quality of life for all instead of a small proportion of people.

Adolescent↗
PubMed1963

Ticks (Ixodidae) on birds migrating from Europe and Asia to Africa 1959-61.

The need for imaginative thinking and research in the epidemiology of diseases transmitted by arthropods is made manifest by new views of the longevity and host ranges of arthropod-borne viruses, as well as by other biological and medical phenomena. Among these is the intercontinental transport of ticks by migrating birds. During the fall migration periods of 1959, 1960 and 1961, 32 086 birds (comprising 72 forms) were examined for ticks in Egypt while en route from Asia and eastern Europe to tropical Africa. Of these, 40 forms, represented by 31 434 birds, were tick-infested. The bird hosts, numbering 1040 (3.31% of the tick-infested bird forms examined), bore 1761 ticks, or 1.69 ticks per host. Common ticks taken were Hyalomma m. marginatum, Haemaphysalis punctata, and Ixodes ricinus. Ixodes frontalis and Hyalomma aegyptium were less common and Haemaphysalis sulcata, H. otophila, and H. pavlovskyi were rare. The common tick species are known to be reservoirs and vectors of pathogens causing a number of human and animal diseases in Europe and Asia. Several of the bird hosts have also been incriminated as reservoirs in their summer ranges. Over 20 strains of pathogenic viruses were isolated from these birds and their ticks in Egypt in the 1961 fall migration period.THE MOST DIFFICULT PROBLEMS IN INVESTIGATIONS SUCH AS THIS IN MANY PARTS OF THE WORLD ARE TAXONOMIC ONES: the correct identification of bird hosts, of immature stages of ticks and of viruses.

Africa↗
PubMed2004

Update: Cutaneous leishmaniasis in U.S. military personnel--Southwest/Central Asia, 2002-2004.

Cutaneous leishmaniasis (CL) is a sand fly-borne parasitic infection. Preliminary data about cases of CL in military personnel deployed to three countries (Afghanistan, Iraq, and Kuwait) in Southwest/Central Asia have been published previously. During August 2002-February 2004, Department of Defense (DoD) staff identified 522 parasitologically confirmed cases of CL in military personnel. Leishmania major was the etiologic agent for all 176 cases for which species data, obtained by isoenzyme electrophoresis of cultured parasites, are available. This update focuses on the 361 cases (69% of 522) in patients whose demographic data were collected systematically under treatment protocols for therapy with the pentavalent antimonial compound sodium stibogluconate (Pentostam(R); GlaxoSmithKline, United Kingdom) at Walter Reed Army Medical Center, District of Columbia. U.S. health-care providers should consider CL in persons with persistent skin lesions who were deployed to Southwest/Central Asia or who were in other areas where leishmaniasis is endemic.

Adult↗
PubMed2004

[Genetic structure of people from the Volga-Ural region and Central Asia from data of Alu-polymorphism].

Nine Alu loci (Ya5NBC5, Ya5NBC27, Ya5NBC148, Ya5NBC182, YA5NBC361, ACE, ApoA1, PV92, TPA25) were analyzed in six ethnic populations (Trans-Ural Bashkirs, Tatars-Mishars, Mordovians-Moksha, Mountain Maris, Udmurts, and Komi-Permyaks) of the Volga-Ural region and in three Central Asian populations (Uzbeks, Kazakhs, and Uigurs). All Alu insertions analyzed appeared to be polymorphic in all populations examined. The frequency of insertion varied from 0.110 in Mountain Maris at the Ya5NBC5 locus to 0.914 in Tatars at the ApoA1 locus. The data on the allele frequency distribution at nine loci point to the existence of substantial genetic diversity in the populations examined. The value of the observed heterozygosity averaged over nine Alu insertions varied from 0.326 in Mountain Maris to 0.445 in Kazakhs and Uigurs. The level of the interpopulation genetic differences for the Volga-Ural population (Fst = 0.061) was higher than for the populations of Central Asia (Fst = 0.024), Europe (Fst = 0.02), and Southeastern Asia (Fst = 0.018). The populations examined were highly differentiated both in respect of linguistic characteristics and the geographical position. The data obtained confirmed the effectiveness of the marker system used for the assessment of genetic differentiation and the relationships between the ethnic groups.

Alu Elements↗
PubMed2004

Lung cancer epidemiology and risk factors in Asia and Africa.

In industrialised countries, lung cancer is the most common form of cancer among males and it is growing among females. For both sexes, rates reflect smoking behaviours. The pattern appears to be different in Asia, particularly in China, where lung cancer rates in men reflect high smoking rates but high rates among non-smoking women appear to be related to other factors. The incidence of lung cancer is low in most African countries, but it is increasing. In addition to tobacco smoking, a number of etiological factors have been identified for lung cancer: indoor exposure to environmental tobacco smoke, cooking oil vapour, coal burning, or radon, outdoor air pollution and occupational exposure to asbestos and other carcinogens. Recent studies have shown that dietary factors may be important, with high consumption of vegetables and fruits being protective while preserved food and fatty food are harmful, and certain infections such as Mycobacterium tuberculosis, human papilloma virus and Microsporum canis are associated with a high risk of lung cancer. Among non-smokers, the probable role of genetic predisposition in lung cancer by increasing the individual's susceptibility to environmental carcinogens is currently being studied actively. As the single most important cause for lung cancer is tobacco smoke and, with increased sales, a major epidemic is predicted for both Asia and Africa, all health care professionals, government health authorities and national and international health organisations must join in a concerted effort against tobacco.

Africa↗
PubMed2004

Trends in medical education: challenges and directions for need-based reforms of medical training in South-East Asia.

Most medical schools, especially in South-East Asia, currently are experiencing difficulties in providing the right quality and quantity of educational experiences as the curricula have failed to respond to the needs of the community and country. The pedagogic shift from traditional approach to a need-based approach requires a fundamental change of the roles and commitments of educators, planners and policymakers. Teachers of health professional education in the region are to be well-informed of the trends and innovations and utilize these to increase relevance and quality of education to produce competent human resources for the region. The purpose of this paper is twofold: (i) to discuss innovative strategies and emerging trends, which have been successfully adopted by educators around the world for the reorientation of medical education to overcome existing traditions of educational planning, review and development and (ii) to highlight their implications and importance to initiate need-based reforms of medical training in South-East Asia.

Asia, Southeastern↗
PubMed2004

[Emergence of new viruses in Asia: is climate change involved?].

Tropical Africa is not the only area where deadly viruses have recently emerged. In South-East Asia severe epidemics of dengue hemorrhagic fever started in 1954 and flu pandemics have originated from China such as the Asian flu (H2N2) in 1957, the Hong-Kong flu (H3N2) in 1968, and the Russian flu (H1N1) in 1977. However, it is especially during the last ten years that very dangerous viruses for mankind have repeatedly developed in Asia, with the occurrence of Alkhurma hemorrhagic fever in Saudi Arabia (1995), avian flu (H5N1) in Hong-Kong (1997), Nipah virus encephalitis in Malaysia (1998,) and, above all, the SARS pandemic fever from Southern China (2002). The evolution of these viral diseases was probably not directly affected by climate change. In fact, their emergential success may be better explained by the development of large industry poultry flocks increasing the risks of epizootics, dietary habits, economic and demographic constraints, and negligence in the surveillance and reporting of the first cases.

Africa↗
PubMedDate not supplied

[Evolution of avian influenza viruses H5N1 (1997-2004) in southern and south-eastern Asia].

Highly pathogenic avian influenza viruses of the H5N1 subtype are widespread and have become endemic in poultry in southern and southeastern Asia. An unprecedented epizootic was caused by these viruses in 8 countries in the winter of 2003 to 2004. This fact along with more frequent human cases of the infection with unusually high mortality rates in Vietnam and Thailand raises concern that these H5N1 events may lead to a new influenza A virus pandemic. This review summarizes the results of studies dealing with the ecology and evolution of avian influenza H5N1 viruses in southern and southeastern Asia since 1997. The pathogenesis of the infection in human beings and laboratory animals and possible determinants of the high pathogenicity of H5N1 viruses in mammals are considered. A scheme for designing modified H5N1 vaccines using the latest advances in reverse genetics of influenza viruses is given.

Animals↗
PubMed2006

[Current trends of NASH/NAFLD in Asia-Pacific region].

In Japan, much attention has been paid to NASH and NAFLD for the past several years and the prevalence of this disease entity has been estimated, and NASH is thought to be present in 10% of those who have fatty liver diseases. Other points out the prevalence of NASH in Japan as 6 to 8 hundred thousand patients. The last two or three decades have seen the evolution of Western-style life of near complete inactivity, energy-dense food choices and liberal fiscal resources to obtain them and other means to avoid physical activity. Moreover, what is increasingly apparent is that NASH and NAFLD is not a Western disease and many population groups in the Asia-Pacific region are particularly prone to type 2 diabetes. Thus, it is not surprising that NASH has increasingly been diagnosed in several regions in Asia including Indonesia, Malaysia, Philippines, Thailand and India.

Asia↗
PubMedDate not supplied

Prostate cancer control--aims of the UICC Asia Regional Office Consortium.

Cancer of the prostate remains at relatively low incidence in Asia but rates are increasing rapidly in some countries and specific populations so that measures for control need our attention. Little is known about risk factors, although vegetables and phytoestrogens may be protective and fat, meat and dairy products may increase the risk. Physical exercise may have preventive effects, while tobacco and alcohol appear to have no consistent relationship. The lack of clear lifestyle targets means that emphasis needs to be placed on screening for various prostate specific antigen parameters and clinical treatment, whether hormonal, radio or surgical, alone or in combination. While there is a massive literature for the Western world, the limited literature available for Asia means that cooperation to obtain a standardized data base is a high priority if the most effective measures for the specific populations of Asian countries are to be identified and put into practice.

Asia↗
PubMed1991

Intestinal fluke infections in Southeast Asia.

Twenty-three species of intestinal flukes reported in man in Southeast Asia are assigned to seven families: Echinostomatidae, Fasciolidae, Heterophyidae, Lecithodriidae, Microphallidae, Paramphistomatidae and Plagiorchiidae. The majority of species belongs to the Heterophyidae and Echinostomatidae families. Common species are Fasciolopsis buski, Echinostoma ilocanum, E. malayanum, E. revolutum and Haplorchis yokogawai. The countries where large number of species were reported are Thailand (14 species), Philippines (12 species), Indonesia (8 species) and Malaysia (4 species). Only one species was recognized in Laos, and Vietnam. Several species reported in man in the other regions, were reported in animals in Southeast Asia. It is possible that these are present in humans but have not yet been reported.

Animals↗
PubMed1991

[William Moorcroft (1767-1825). Veterinarian, explorer in Asia--and spy?].

From 1790 to 1791 the surgeon William MOORCROFT studied veterinary medicine in Alford. He was the first Englishman with a complete formal veterinary education. In 1808 he gave up his horse practice and went into service of the East India Company as superintendent of the Company's Indian stud. Search for appropriate stud-horses and his efforts for opening up trading-routes from India to inner Asia induced him to exploring expeditions into the regions of the southwest Himalayas, the Hindu kush, Samarkand and Afghanistan. There he made also a lot of geographical and biological observations. He was not only one of the European pioneer Himalaya explorers but became also an early participant of the later so called "Great Game", the struggle between England and Russia for supremacy in Central Asia.

Asia↗
PubMed1989

[The treatment of multiresistant falciparum malaria in Southeast Asia].

The spread of chloroquine resistant strains of P. falciparum requires new approaches to treatment especially in tropical Africa. A single dose of 3 tablets of sulfadoxine-pyrimethamine (Fansidar) is a suitable and relatively inexpensive alternative. But under drug pressure resistance to this compound has developed in some South-East Asian countries and in Brazil, giving rise to multiple resistant strains of P. falciparum. A similar pattern has arisen with quinine to which almost 50% of P. falciparum strains have become resistant in Thailand. However the combination treatment of quinine with tetracycline given for 7 days is still successful in most cases. Unfortunately compliance to this regimen is rather poor in out-patients. Mefloquine (Lariam), recently marketed, and if used as 750 mg dose in semi-immune adult patients weighing less than 60 kg, has made possible a single-dose treatment schedule for falciparum malaria. In controlled studies conducted in South-East Asia the success rate of mefloquine was 97% in 445 patients. Since there is some fear of the appearance of resistance of P. falciparum to mefloquine, a combination of this compound with sulfadoxine and pyrimethamine was developed (MSP or Fansimef). Various controlled studies in South-East Asia have shown a success rate of this compound of 97% in 278 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

The spectrum of beta-thalassemia genes in China and Southeast Asia.

To make possible prenatal diagnosis of beta-thalassemia in China and Southeast Asia by direct detection of mutant beta-globin genes, we have determined the spectrum of mutations producing the disorder in this region of the world. Seventy-eight beta-thalassemia genes from Chinese and Southeast Asians were randomly obtained, and the relevant mutation was characterized in 76 (98%) of them. Seven different point mutations were found among the 78 genes studied. Of these seven beta-thalassemia alleles, two constitute 62%, and two others account for 29% of the total. Since only four alleles make up 91% of the mutant genes, prenatal diagnosis of beta-thalassemia in China and Southeast Asia should be feasible by simplified techniques for direct detection of point mutations.

Asia, Southeastern↗