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PubMed1991

Problems and potential of researching epidemiological transition: examples from Southeast Asia.

The concept of epidemiological transition is now quite widely recognized, if not so widely accepted. The transition appears to progress at varying speeds and to different extents spatially; it seems that there can be considerable international, regional and local variations in its progress. The paper examines this contention in the case of a number of countries in Southeast Asia, principally Hong Kong, Malaysia and Thailand. Drawing on evidence from this region, the paper highlights the importance when researching epidemiological transition of the time period under consideration; socio-cultural variations; the nature and quality of data, and spatial scale. It makes some suggestions as to the potential of the concept of epidemiological transition in health care planning and development studies.

Asia, Southeastern↗
PubMed1992

Racial identification in the context of prehistoric-historic biological continua: examples from South Asia.

The practice of 'racial palaeontology' disappeared 50 years ago with the fall of the biological race concept in systematics and population genetics. However, certain ethnic minorities claim close biological affinities with extinct (sometimes Pleistocene) populations. Forensic anthropologists may be involved in this issue through analyses of prehistoric and modern populations in circumstances where a biological continuum may exist. Skeletal evidence from South Asia is discussed.

Anthropology, Physical↗
PubMed1990

The radiotherapy situation in Thailand and South East Asia.

The situation of radiotherapy in Thailand from its beginning to the present is reported. The situation of radiotherapy in other countries of South East Asia is also analyzed from the data or information requested through the Radiological Society of each country. The situation of radiotherapy in each country will be discussed in terms of equipment, facilities, personnel, teaching and training, research, and clinical practices. In each country, efforts have been made to develop radiotherapy facilities so that services can be given at a modern standard. Some countries has attained that standard and full range of radiotherapy has been available. An effort has been made to help each other and exchange knowledge by organizing the Asian and Oceanian Society of Radiology (AOSR) and the Asian Association of Radiology (AAR) through which Congress of Radiology has been organized every 2 alternate years.

Asia, Southeastern↗
PubMed1980

Sex ratio among opium addicts in Asia: influences of drug availability and sampling method.

The literature on opium addiction in Asia reveals widely different sex ratios. Analysis of these reports indicates that community surveys provide the most reliable and valid ratios. Surveys in psychiatric hospitals appear to overreport women, while case registers and surveys in addiction treatment facilities, vends and dens overreport men. The relative proportion of female addicts is greatest in poppy-producing areas and in communities with high prevalence rates of addiction. Instrumental mechanisms for these observations are explored.

Asia↗
PubMed1995

Characterization of camelpoxvirus isolates from Africa and Asia.

Five orthopoxvirus isolates of camels from different geographic regions of Africa and Asia were analysed with respect to their biological and genomic attributes. The behaviour of the isolates in various cell cultures, the type of pock lesions on the chorioallantoic membrane of embryonated chicken eggs, and the respective ceiling temperatures were determined. Additionally, physical maps for restriction endonucleases HindIII and XhoI were established. The data obtained from biological assays and DNA analyses demonstrated minor differences between the five isolates. However, these findings confirm previous reports suggesting that orthopoxviruses of camels constitute a separate species within the genus Orthopoxvirus.

Africa↗
PubMed1991

Ethnomyocological data from Siberia and North-East Asia on the effect of Amanita muscaria.

The paper includes literary data on the use of Amanita muscaria in Siberia and North-East Asia as well as information collected from ethnographers investigating these areas during the past decades. A survey is given on the cases and rules of Amanita muscaria consumption and the ways of its administration. The peoples having the tradition of Amanita muscaria consumption were aware of its different psychotrophic qualities and were able to use for several purposes. The fungus has been used by them as a psychostimulant having a simultaneous effect on several psychic functions.

Amanita↗
PubMed1993

Drugs and AIDS in Southeast-Asia.

Opium dependence was indigenous to countries in the Golden Triangle area in south-east Asia (SA). Heroin epidemics developed in most SA countries in the 1960s and early 1970s and remained a significant problem particularly in Myanmar, Thailand and Malaysia until now. In contrast, the island countries in SA seemed quite free from opiate abuse. Intravenous injection (IV) of drugs appeared after the heroin epidemic and currently prevails in countries with a significant opiate abuse problem. IV of opium was particularly common in the highly urbanized cities in Vietnam. Most SA countries started HIV seroscreening in IV drug users (IVDU) around the middle of the 1980s. Rapid epidemic spread of HIV infection was observed in 1988-89 in Thailand and Myanmar. The Highest prevalence of more than 80% was reported from a study of IVDUs in Yangon, Myanmar, followed by Thailand at about 40%. Although HIV infected IVDUs were identified at the same time in Malaysia and later in Singapore and the Philippines, there was no evidence of such a rapid and severe epidemic.

Adult↗
PubMed1992

Venomous snakes of southwest Asia.

This report provides a brief description of the venomous snakes encountered in Southwest Asia, as well as a brief review of the clinical implications of envenomation from each animal. Specific therapy for snake envenomation in the United States is somewhat controversial, and it is no less controversial with animals from this region. The most logical approach probably combines medical management with antivenom when available, and surgical intervention when clearly indicated due to elevated compartment pressure or massive tissue necrosis. Antivenom is available for all species except W aegyptia (in vitro only) and Atractaspis species. Antivenom for V palaestinae may be used for Atractaspis envenomation (Tables 2 and 3).

Animals↗
PubMed2004

Human transportation influences Aedes aegypti gene flow in Southeast Asia.

Estimates of population genetic organization and gene flow of Aedes aegypti, the main vector of dengue viruses, have provided insights into dengue epidemiology. To assess the role of the vector in the changing pattern of dengue in Southeast Asia, extensive studies on the genetic differentiation of Aedes aegypti have been carried out. Among them, vector differentiation has been estimated for Cambodia, Thailand and South Vietnam using microsatellite markers. Analysis showed that there was less genetic differentiation between mosquito populations from Ho Chi Minh City and Phnom Penh than from either of them and Thailand, suggesting that passive migrations through human transportation help to explain this pattern of differentiation.

Aedes↗
PubMed2004

The comparisons of anthropometric characteristics among four peoples in East Asia.

This study presents comparisons of ethnic difference in anthropometric characteristics among four peoples, i.e., Chinese, Japanese, Korean, and Taiwanese, in East Asia. Anthropometric data from the four East Asian countries were compared. The means of 33 body dimensions and 31 bodily proportions are presented. Also, 15 segmental proportions are illustrated. The results of statistical analyses showed that there is a significant morphological difference among these peoples in the same region. The Mainland Chinese body shape has a narrower body with mid-range limbs. The Japanese body shape is wider with shorter limbs. The Korean body shape is mid-range among the four peoples, but the upper limbs are longer. The Taiwanese body shape has wide shoulder and narrow hip with large hands and long legs. The ethnic diversity in bodily proportions should be considered as well as the mean dimensions.

Adult↗
PubMed2005

Geographical determinants and environmental implications of livestock production intensification in Asia.

Under growing and urbanizing demand, livestock production is rapidly evolving in South, East and South-east Asia, with both an increase of production and a shift to intensive production systems. These changes infer impacts on the environment, on public health and on rural development. Environmental impacts are mainly associated with a mismanagement of animal excreta, leading to pollution of surface water, ground water and soils by nutrients, organic matter, and heavy metals. In the framework of the Livestock Environment and Development Initiative, this research aims at assessing, on a regional scale, the impacts of livestock production on nutrient fluxes. Phosphate (P(2)O(5)) mass balances were chosen as an indicator and were calculated on the basis of spatially modelled livestock densities, estimated excretion values and crop uptake. The results show a strong West--East gradient regarding the distribution of monogastrics, with clear concentration in densely populated areas and around urban centres. P(2)O(5) overloads are estimated on 23.6% of the study area's agricultural land, mainly located in eastern China, the Ganges basin and around urban centres such as Bangkok, Ho Chi Minh City and Manila. On average, livestock manure is estimated to account for 39.4% of the agricultural P(2)O(5) supply (the remaining share being supplied by chemical fertilisers). Livestock is the dominant agricultural source of P(2)O(5) around urban centres and in livestock specialised areas (southern and north-eastern China), while chemical fertilisers are dominant in crop (rice) intensive areas.

Agriculture↗
PubMed2026

Phylogenomic and Clinical Perspectives of an East Asia-Specific Cluster of Mycobacterium massiliense.

BACKGROUND: Mycobacterium abscessus subspecies massiliense (MAM) can form genetically related clusters through continuous within-host adaptations. RESEARCH QUESTION: What is the epidemiologic and clinical significance of the sequence type 120 (ST120) strain of MAM, an East Asia-specific cluster? STUDY DESIGN AND METHODS: Isolates were obtained from patients with MAM pulmonary disease at Seoul National University Hospital between October 1, 2019, and December 31, 2023. These isolates were analyzed using multilocus sequence typing and colony morphotyping and were evaluated for glycopeptidolipid biosynthesis-related gene deletions. Whole-genome sequencing was performed for phylogenomic and pangenome analyses, incorporating MAM genome data from public databases. Finally, the clinical course and treatment outcomes of patients infected with ST120 were evaluated. RESULTS: Among the isolates obtained from 136 patients, 50 isolates (36.8%) were classified as ST120. All ST120 isolates exhibited a rough colony morphotype and harbored deletions in glycopeptidolipid biosynthesis-related genes. From 796 global strains, ST120 was identified exclusively in the isolates obtained from South Korea (51/137 isolates [37.1%]), Japan (3/53 [5.7%]), and Taiwan (2/52 [3.8%]). Genomic analysis revealed the stepwise genetic evolution of ST120, suggesting transmission from Taiwan to Japan and from Japan to South Korea. The ST120 strains exhibited genetic mutations associated with virulence and structural alterations within the ESX system. Consequently, patients with ST120 strain infections had a higher prevalence of cavitary disease (23/50 [46%]) than those infected with non-ST120 strains (19/86 [22.1%]; P = .004). Among those who initiated treatment, the proportion of microbiological cure was lower in patients with ST120 infection (6/15 [40.0%]) than in those with non-ST120 infection (24/34 [70.6%]; P = .043). INTERPRETATION: Our results show that ST120, a strain predominantly found in South Korea, is characterized by the extensive loss of glycopeptidolipid biosynthesis-related genes and is associated with increased disease severity and worse treatment outcomes.

Humans↗
PubMed2005

Thrombolytic therapy in acute ischemic stroke in Asia: The first prospective evaluation.

OBJECTIVE: Intravenous thrombolytic therapy has been widely recommended as a standard treatment for acute ischemic stroke in most clinical practice guidelines. However, the experience in Asia is still limited. We report the first prospective case series of thrombolytic therapy in a developing Asian country. PATIENTS AND METHODS: Consecutive patients with acute ischemic stroke who presented within 3 h of onset were screened under stroke fast track program. Those who were eligible were treated with intravenous recombinant tissue plasminogen activator (rt-PA). General and neurological examinations together with the National Institute of Health stroke scale (NHISS) and modified Rankin scale (MRS) were recorded prior to and after the treatment at 1 h, 24 h, on discharge and at 3 months. Hemorrhagic brain lesion and death within 3 months were also recorded. RESULTS: Thirty-four patients or 2.1% of patients with acute stroke received intravenous thrombolysis. The mean pretreatment NIHSS was 18.8 and the majority of patients had stroke in the middle cerebral artery territory. The mean door-to-needle time was 72.6 min (ranged 20-150 min). Major neurological improvement, defined as improving of the NIHSS >8 points or NIHSS of 0 points at 24 h, was observed in 17 patients (50%). Intracerebral hemorrhage was detected in four cases (11.8%), two of them were symptomatic (5.9%) and one was fatal. CONCLUSION: Intravenous thrombolysis can be given in patients with acute stroke in our population. Our cases were more severe than other studies. However, half of them experienced major neurological improvement. The risk of hemorrhagic brain lesion is not much higher than previously reported.

Aged↗
PubMed2005

Comparisons of the outcomes on control, type of management and complications status in early onset and late onset type 2 diabetes in Asia.

OBJECTIVE: To describe the clinical characteristics and chronic diabetic complications in early (EOD) and late onset type 2 diabetes mellitus (LOD) in Asia. RESEARCH DESIGN AND METHODS: Retrospective collection of information (basic patient data, treatment received for diabetes, hypertension, dyslipidaemia, clinical measurements, complications, life-style management, etc.) on paper form and prospective collection of blood samples for HbA(1c) assessment were performed. Means, proportions and associated factors were analyzed using non-parametric and logistic regression. RESULTS: The frequency of EOD (<30 years) varies in different Asian countries (0.4-5.3%). Overweight (BMI>or=23 kg/m2) was common in both EOD (60%) and LOD (66%). EOD was characterized by significantly higher levels of HbA(1c) (median 8.9% versus 7.9%) and FPG (median 9.8 mmol/L versus 8.3 mmol/L) but hypertension was less common (43% versus 59%). Lipid profiles (cholesterol and triglycerides) were similar between both groups of patients. Cataract was more common in LOD and was associated with onset age and diabetes duration whereas an increase in frequency of advanced eye disease, retinopathy and history of photocoagulation was found in EOD cohort. CONCLUSIONS: In addition to diabetic control and duration of the disease, the onset age conferred risk to certain subsets of chronic complications in type 2 diabetes population.

Adult↗
PubMed2006

Clinical isolates of Streptococcus iniae from Asia are more mucoid and beta-hemolytic than those from North America.

Streptococcus iniae, a widely distributed fish pathogen, is known to cause rare cases of human infection. We describe 2 cases of invasive S. iniae infection, one with septic arthritis complicating chronic gout and the other with bacteremic cellulitis. Both patients were Chinese and have been regularly handling fresh fish for cooking. Both isolates were unidentified or misidentified by 3 commercially available identification system and were only identified by 16S rRNA gene sequencing. When compared with a clinical isolate of S. iniae from Canada, their colonies were larger, more beta-hemolytic, and microcoid. Although bacteremic cellulitis has been described as the most common infection associated with S. iniae, the bacterium has not been reported to cause exacerbations of gouty arthritis previously. Clinical laboratories should be aware of the possibility of different colony morphology of S. iniae from Asia. More accurate identification of nongroupable beta-hemolytic streptococci, especially from patients with epidemiologic linkage to fresh fish, may uncover more cases of S. iniae infection. The Asian population and handlers of fresh fish should be informed of the risk of acquiring S. iniae infection.

Aged↗
PubMed2005

Changing demography of prostate cancer in Asia.

There has been a recent trend in Asia towards increasing incidence of prostate cancer, with some low-risk regions, such as Japan and Singapore, reporting a more rapid increase than high-risk countries. In this study, age-specific and age-standardised (world) incidence rates and mortality rates for prostate cancer in Asian countries for 1978-1997 were retrieved and compared. The results confirm that the incidence of prostate cancer has risen by 5-118% in the indexed Asian countries. Incidence at centres in Japan rose as much as 102% (Miyagi 6.3-12.7 per 100,000 person-years) whilst the incidence in Singaporean Chinese increased 118% from 6.6 to 14.4 per 100,000 person-years. The lowest incidence rate recorded was in Shanghai, China and the highest rates were in Rizal Province in the Philippines, although still much lower than those in the United States of America (USA) and many European countries. Whilst the absolute value of the increase is not comparable to North American and European populations, the incidence ratio in many Asian centres is similar to that of the high-risk countries. The mortality data for prostate cancer showed a similar rising trend. The increases in age-adjusted mortality rates per 100,000 person-years, adjusted to the world standard, ranged from 50% in Thailand to 260% in Korea. The difference may be partly due to genetic polymorphism in the androgen receptor and androgen metabolism pathway enzymes as well as to dietary or environmental factors. In particular, phytochemicals, such as isoflavonoids and tea polyphenols, which are common in Asian diets showed promising anti-mitotic activity in animal and clinical studies. In conclusion, with gradual Westernisation, many Asian countries may be losing their cultural protective factors and acquiring high-risk ones. A better understanding of how these factors interact to cause prostate cancer through further studies with a multi-ethnic perspective will facilitate appropriate public health strategies to minimise high-risk factors and maintain protective factors and keep prostate cancer at bay.

Adult↗
PubMed2006

Distribution and transportability of hexabromocyclododecane (HBCD) in the Asia-Pacific region using skipjack tuna as a bioindicator.

The geographical distribution of hexabromocyclododecane (HBCD) was investigated through analysis of muscle tissue of skipjack tuna (Katsuwonus pelamis) collected from offshore waters of Asia-Pacific region (Japan, Taiwan, Philippines, Indonesia, Seychelles, Brazil, Japan Sea, East China Sea, South China Sea, Indian Ocean and North Pacific Ocean). HBCD was detected in almost all samples analyzed (<0.1 to 45 ng/g lipid weight basis), indicating widespread presence of this compound in the marine environment. Elevated concentrations of HBCD were found in skipjack tuna from areas around Japan, which have the larger modern industrial/urban societies, and implicated these areas as primary regional sources. All three individual HBCD isomers (alpha-, gamma- and beta-HBCD) were detected in almost all samples; the percentage contribution of the alpha-isomer to total HBCD increased with increasing latitude. The estimated empirical 1/2 distance for alpha-HBCD was 8500 km, which is one of the highest atmospheric transportability among various halogenated persistent organic pollutants (POPs).

Animals↗
PubMed2004

Global public health mandates in a diverse world: the polio eradication initiative and the expanded programme on immunization in sub-Saharan Africa and South Asia.

BACKGROUND: The circulation of wild poliovirus is expected to cease soon due to the success of the global polio eradication initiative. Thereafter, intensified polio eradication efforts such as National Immunisation Days (NIDs) will most likely be discontinued. As a consequence, the expanded programme on immunization (EPI) will no longer enjoy extra inputs from the polio eradication initiative. We investigated whether today's EPIs are ensuring universal and equitable vaccine coverage; and whether the removal of extra inputs associated with the implementation of NIDs is likely to affect EPI coverage and equity. METHODS: Using data from Demographic and Health Surveys conducted in 15 countries of South Asia and Africa during 1990-2001, we examined absolute levels of EPI coverage; changes in EPI coverage after the introduction of NIDs; and relative coverage according to urban versus rural residence, higher versus lower education of mothers, and wealthiest vs. poorest population segment. RESULTS: Polio and non-polio antigen coverage increased in seven countries during the study period. Substantial inequalities in coverage of non-polio antigens persist, however, translating into inequities in the risk of contracting vaccine preventable diseases. In some African countries, routine EPI coverage and/or equity declined during the study period. In these countries, any positive effect of NIDs on the EPI coverage must have been small, relative to the negative effects of declining economies or deteriorating health systems. In Nigeria, Zimbabwe, Kenya and Malawi, even polio coverage declined, in spite of the introduction of NIDs. CONCLUSION: As additional inputs associated with polio eradication will cease, routine EPI services need to be strengthened substantially in order to maintain levels of population immunity against polio and to improve social equity in the coverage of non-polio EPI antigens. Our findings imply that this aim will require additional inputs, particularly in African countries.

Africa South of the Sahara↗