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PubMed2003

Integration of post-abortion care: the role of township medical officers and midwives in Myanmar.

Complications of unsafe abortion are a significant cause of maternal morbidity and mortality in Myanmar, and are recognised by the Ministry of Health as a priority. The Department of Health developed a strategy to address the problem of abortion complications by integrating post-abortion care and contraceptive services into the existing township health system. The quality of post-abortion care was assessed by the Department of Health in 2000, using a baseline survey of health providers and post-abortion women in Bago Division. The integration of post-abortion care was led by the Township Medical Officers, who provided monthly in-service training and supervision of health care workers in each township. Hospital-based doctors and nurses, clinic midwives, village midwives and other volunteer health providers, including traditional birth attendants, were all trained. The role of the local clinic midwife was extended to make follow-up home visits to the women with post-abortion complications and provide them with contraception when requested. Preliminary results show positive outcomes. However, donor-funded projects may have a destabilizing effect on township services by diverting attention and resources; donors need to work with government to support its priorities for health care. The future nationwide integration of post-abortion care services into township services should be planned in consultation with Township Medical Officers and midwives, the key providers of these services.

Abortion, Induced↗
PubMed2004

Cassane- and norcassane-type diterpenes of Caesalpinia crista from Myanmar.

From the CH(2)Cl(2) extract of seed kernels of Caesalpinia crista from Myanmar, five new cassane-type diterpenes, caesalpinins MA-ME (1-5), and three new norcassane-type diterpenes, norcaesalpinins MA-MC (6-8), have been isolated, together with 12 known cassane-type diterpenes, 14(17)-dehydrocaesalmin F, caesaldekarin e, caesalmin B, caesalmin C, caesalmin E, 2-acetoxy-3-deacetoxycaesaldekarin e, 2-acetoxycaesaldekarin e, caesalpinin C, 7-acetoxybonducellpin C, caesalpinin E, norcaesalpinin B, and 6-acetoxy-3-deacetoxycaesaldekarin e. The structures of the isolated compounds were elucidated by analysis of their spectroscopic data.

Caesalpinia↗
PubMed2001

Small intestinal mucosal pattern of Myanmar children.

BACKGROUND: Little is known about the small intestinal mucosal pattern of Myanmar children. METHODS: Duodenal, jejunal and ileal mucosal specimens obtained from children within 6 h of death were examined under a dissecting microscope with the objective of determining villus pattern in relation to site within the small intestine and then correlated with age. RESULTS: Abnormalities in the small intestinal mucosa were detected at a very young age. In children under 1 year of age, the changes are more marked proximally and become less marked distally, perhaps reflecting exposure to the causative agent(s) in early life. Presumably these agents are ingested orally and inactivated progressively. The pattern in older children reflects more severe changes in the ileum. CONCLUSIONS: It is postulated that frequent intestinal infections or small bowel bacterial contamination could lead to damage of the intestinal mucosa.

Aging↗
PubMed1991

Control of Culex quinquefasciatus in Myanmar (Burma) and India: 1960-1990.

During the past 30 years three major programmes of research have been carried out in Myanmar (Burma) and India on the ecology and control of Culex quinquefasciatus. To differing degrees the programmes have employed environmental, chemical, biological and genetic control strategies, but none has been an unqualified success. Results have been good when well-trained staff with substantial resources were employed, but much poorer when less-well-equipped general health workers took over the programmes. Overall, it would seem most cost-effective for health workers to concentrate their efforts on the elimination of the limited number of larval habitat categories which commonly contribute a large fraction of the adult population. Insecticides and biological control agents should serve as supplements, not as alternatives, to environmental management. Genetic control strategies have currently no place in C. quinquefasciatus programmes.

Animals↗
PubMed2005

Drug-resistant tuberculosis in Yangon, Myanmar.

The extent of drug resistant tuberculosis (TB) in the capital city of Myanmar, Yangon has not yet been reported. This study aimed to determine the proportion and pattern of drug resistance to first-line anti-TB drugs, among Mycobacterium tuberculosis complex isolates from sputum smear positive TB patients who attended National TB Programme Yangon centres in April-August and October-December 2002. Drug susceptibility was determined by the Mycobacteria Growth Indicator Tube manual system (Becton Dickinson, MD, USA). Of the 567 patients, sputum specimens from 447 (79%) had a positive culture. Of these, 357 isolates (80%) had a susceptibility test result. Isolates from 76 of 259 (29.3%) new patients and from 45 of 98 (45.9%) previously treated patients were resistant to at least 1 of the anti-TB drugs. Resistance to isoniazid (INH) (22.0% vs 40.8%: new vs previously treated patients) and to > or =2 drugs (17.8% vs 29.6%: new vs previously treated patients) was common. Multidrug- resistant TB (MDR-TB) among new and previously treated patients was 4.2% and 18.4%, respectively. INH-resistant (adjusted OR: 2.0, 95% CI 1.1-3.6) and MDR-TB (adjusted OR: 3.4, 95% CI 1.4-8.3) cases were more likely to have taken anti-TB drugs > or =1 month previously. Collectively, prevalence of MDR-TB and TB resistance to > or =2 drugs are not rare in Yangon.

Adult↗
PubMed1998

The Center for Epidemiological Studies Depression Scale in older community samples in Indonesia, North Korea, Myanmar, Sri Lanka, and Thailand.

Cultural differences in the reporting of depressive symptoms among older people were examined using the Center for Epidemiological Studies Depression (CES-D) scale in five Southeast Asian countries: Indonesia, Korea, Myanmar, Sri Lanka, and Thailand. Previous work in Asian samples--principally North American immigrants--suggested differential functioning of the CES-D. The four-factor solution established in the original studies of the CES-D was replicated for all countries using a confirmatory factor analytic approach. It was, however, demonstrated that little information was lost in considering full-scale scores rather than the four subscales separately. The behavior of the CES-D in older Asian populations was found to be comparable to results obtained in North American and European cultures. Significant somatization of depression in these Asian samples was not found. There appears to be a general factor measuring depressed mood across older populations. The results support the validity of comparing responses on the CES-D across cultures.

Affect↗
PubMed2004

Soil-transmitted helminthiasis in Myanmar and approximate costs for countrywide control.

Previous surveys in Myanmar indicate that soil-transmitted helminths (STH) are a significant public health problem. However the majority of these surveys are small scale or hospital based. To date there has been no countrywide assessment of the prevalence and intensity of STH infection. We conducted a survey (June 2002-June 2003) to assess the magnitude of STH infection in school age children in each of the different ecological areas of the country. In each area, five schools were selected and from each one, 50 children were randomly chosen. Parasitological and nutritional data were collected from each child. We found an overall prevalence of infection of 69%: 18% had a moderate-heavy intensity of infection, 22% were anaemic. A pilot exercise to treat 25,000 school age children in the 200 schools of Nyangdone Township tested the strategy before scaling up and to generate some rough costings. A crude calculation of the expenditure to buy and deliver the drugs, including the costs incurred in the teacher training, concluded that the cost per child was approximately 0.05 USD.

Adolescent↗
PubMed1993

An epidemic outbreak of hepatitis E in Yangon of Myanmar: antibody assay and animal transmission of the virus.

An epidemic outbreak of hepatitis E occurred in an army recruit camp of Yangon, Myanmar, in October 1989. One hundred and eleven patients among 600 residents were hospitalized. As high as 83.7% of these patients were positive for the acute phase antibody against hepatitis E virus by an enzyme-linked immunosorbent assay developed in our laboratory. Also, 30.6% of 49 symptom-free residents examined were positive for the antibody. We prepared a stool extract from six patients and inoculated it into 10 rhesus monkeys for a series of three sub-passages. All of them developed acute biochemical hepatitis along with an elevation of antibody levels. A rechallenge with viruses of the present outbreak failed to provoke hepatitis in two monkeys that had previously recovered from acute hepatitis caused by an isolate of sporadic hepatitis E of the same area. Similarly, the rechallenge of the sporadic strain did not induce hepatitis in two monkeys that had been previously infected with the epidemic virus. These data suggested that the subjects would obtain neutralizing antibodies against the hepatitis E virus once infected, and many adult inhabitants of the endemic area had no protective antibodies and were still susceptible to hepatitis E infection.

Adult↗
PubMed2003

Identification of Rickettsia spp. and Bartonella spp. in ffrom the Thai-Myanmar border.

During a survey for possible rickettsial vectors in villages of the central part of the Thai-Myanmar border from September 2001 to February 2002, four species of fleas were collected from common peridomestic animals. All fleas were tested by PCR to detect DNA of bacteria of the genera Rickettsia (gltA and ompB genes) and Bartonella (ITS and ftsZ genes). Sequencing of PCR-amplified products was done using gltA fragments for Rickettsia and ftsZ fragments for BARTONELLA: Two genotypes related to Rickettsia felis were identified in three Ctenocephalides canis and one C. felis specimen. Further, the following Bartonella spp. were detected: Bartonella henselae in two C. felis specimens; Bartonella clarridgeiae in three C. felis specimens; and a new Bartonella genotype in one Nosopsylla fasciatus specimen. Rickettsia and Bartonella may be frequently detected in fleas infesting peridomestic animals from the western border of Thailand.

Animals↗
PubMed1993

[Incidence and prevalence of serotypes of enteroaggregative Escherichia coli from diarrheal patients in Brazil, Myanmar and Japan].

By using HeLa cells, we tried to detect enteroaggregative Escherichia coli from stock strains derived from infants with or without diarrhea in Brazil and Myanmer, and from diarrheal patients in Osaka, Japan. Enteroaggregative E. coli was detected from 7.9% in diarrheal cases, 5.6% in control cases in Brazil and from 5.4% in diarrheal cases, 3.4% in control cases in Myanmar. A total of 38 strains that showed aggregative adherence to HeLa cells was examined for colony hybridization with the 32P-labeled EAggEC probe. Thirty-four strains hybridized with the EAggEC probe, while 4 strains did not hybridize with the probe, suggesting an existence of another aggregative factor. Seventeen of the 38 strains were O-antigen serotypeable. Eight strains belonged to serogroups O44, O86, O111, O125 and O126, which have been considered to be enteropathogenic E. coli serogroups. Most of the 38 strains were H-antigen serotypeable.

Bacterial Adhesion↗
PubMed1999

A new primate from the Middle Eocene of Myanmar and the Asian early origin of anthropoids.

A new genus and species of anthropoid primate, Bahinia pondaungensis gen. et sp. nov., is described from the Yashe Kyitchaung locality in the Late Middle Eocene Pondaung Formation (Myanmar). It is related to Eosimias, but it is represented by more complete remains, including upper dentition with associated lower jaw fragment. It is interpreted as a new representative of the family Eosimiidae, which corresponds to the sister group of the Amphipithecidae and of all other anthropoids. Eosimiidae are now recorded from three distinct Middle Eocene localities in Asia, giving support to the hypothesis of an Asian origin of anthropoids.

Animals↗
PubMed2003

Detection of Ehrlichia spp., Anaplasma spp., Rickettsia spp., and other eubacteria in ticks from the Thai-Myanmar border and Vietnam.

A total of 650 ticks, including 13 species from five genera, were collected from animals, from people, or by flagging of the vegetation at sites on the Thai-Myanmar border and in Vietnam. They were tested by PCR to detect DNA of bacteria of the order RICKETTSIALES: Three Anaplasma spp. were detected in ticks collected in Thailand, including (i) Anaplasma sp. strain AnDa465, which was considered a genotype of Anaplasma platys (formerly Ehrlichia platys) and which was obtained from Dermacentor auratus ticks collected from dogs; (ii) Anaplasma sp. strain AnAj360, which was obtained from Amblyomma javanense ticks collected on a pangolin; and (iii) Anaplasma sp. strain AnHl446, which was closely related to Anaplasma bovis and which was detected in Haemaphysalis lagrangei ticks collected from a bear. Three Ehrlichia spp. were identified, including (i) Ehrlichia sp. strain EBm52, which was obtained from Boophilus microplus ticks collected from cattle from Thailand; (ii) Ehrlichia sp. strain EHh324, which was closely related to Ehrlichia chaffeensis and which was detected in Haemaphysalis hystricis ticks collected from wild pigs in Vietnam; and (iii) Ehrlichia sp. strain EHh317, which was closely related to Ehrlichia sp. strain EBm52 and which was also detected in H. hystricis ticks collected from wild pigs in Vietnam. Two Rickettsia spp. were detected in Thailand, including (i) Rickettsia sp. strain RDla420, which was detected in Dermacentor auratus ticks collected from a bear, and (ii) Rickettsia sp. strain RDla440, which was identified from two pools of Dermacentor larvae collected from a wild pig nest. Finally, two bacteria named Eubacterium sp. strain Hw124 and Eubacterium sp. strain Hw191 were identified in Haemaphysalis wellingtoni ticks collected from chicken in Thailand; these strains could belong to a new group of bacteria.

Anaplasma↗
PubMed1999

Cost analysis of malaria patients in Taikkyi Township Myanmar.

A hospital and clinic-based study was conducted in one malaria endemic area, Taikkyi Township, Yangon Division, Myanmar, for analysis of cost incurred by different types of malaria cases and the factors influencing the cost of illness from July to October 1995. A total of 100 patients admitted to hospital and 100 patients receiving ambulatory care from malaria clinics were interviewed using a structured questionnaire. Total cost of one episode of malaria was estimated to be kyats 559 for ambulatory care, kyats 2582 for an uncomplicated admitted case, kyats 4056 for one episode of cerebral malaria, kyats 4568 for one episode of other severe and complicated malaria and kyats 4758 for one episode of malaria with other disease. This study showed that the cost of illness for patients attending outpatient malaria clinics who received early diagnosis and prompt treatment was four to seven times cheaper than the cost of illness for hospitalized malaria cases. Multivariate analysis revealed the factors that contributed to high cost of care. Duration of illness before getting any type of treatment was the key factor that contributed to high or low cost of care. Long duration of illness before getting any type of treatment can lead to high malaria parasite density, long duration of actual illness and high total attendance cost. Therefore, it is recommended that people from malaria endemic areas should be informed to seek early treatment from health staff, and primary health care services should be made accessible to people who live in malaria endemic areas. The information obtained from this study will be useful in planning future malaria control programs and influencing policy makers to focus on timely and effective treatment of non-severe cases, which can save a large amount of economic loss due to treatment of severe malaria.

Adult↗
PubMed2004

In vitro screening of leishmanicidal activity in myanmar timber extracts.

Seventy-five Myanmar timber extracts belonging to 27 families were examined for their leishmanicidal activities. Some timber extracts had significant leishmanicidal activity, especially extracts of Millettia pendula, which exhibited the most potent activity (MLC 3.1 microg/ml, MIC 1.6 microg/ml). Other timber extracts showing potent activity included those from Cedrela serrata, Cedrela toona, Cordia fragrantissima, Calophyllum kunstleri, Dalbergia cultrate, Grevillea robusta, Haplophragma adenophyllum, Michelia champaca, and Tectona grandis. From a literature search for reports on the chemical constituents of these plants, most constituents were found to be quinone derivatives or other compounds with unsaturated carbonyl groups.

Animals↗
PubMed2005

Methyl migrated cassane-type furanoditerpenes of Caesalpinia crista from Myanmar.

From the CH2Cl2 extract of seed kernels of Caesalpinia crista from Myanmar, two rare and biogenetically interesting methyl migrated cassane-type furanoditerpenes [caesalpinins MM (1) and MN (2)] and two normal cassane-type furanoditerpenes [caesalpinins MO (3) and MP (4)] have been isolated, together with eight known cassane-type diterpenes, 1-deacetoxy-1-oxocaesalmin C (5), 1-deacetylcaesalmin C (6), caesalmin C (7), bonducellpin C (8), caesaldekarin e (9), 2-acetoxycaesaldekarin e (10), 2-acetoxy-3-deacetoxycaesaldekarin e (11), and norcaesalpinin E (12). Among the known compounds, compounds 5 and 6 were for the first time isolated from a natural source. The structures of these compounds were elucidated by the use of spectroscopic techniques.

Caesalpinia↗
PubMed2005

New cassane-type diterpenes of Caesalpinia crista from Myanmar.

Seven new cassane-type diterpenes, caesalpinin MF-ML (1-7), and a new norcassane-type diterpene, norcaesalpinin MD (8), have been isolated from the CH2Cl2 extract of seed kernels of Caesalpinia crista from Myanmar, together with sixteen known cassane-type diterpenes, 7-acetoxybonducellpin C, caesaldekarin e, caesalmin C, caesalmin G, 2-acetoxycaesaldekarin e, zeta-caesalpin, caesalpinin D, caesalpinin E, caesalpinin F, caesalpinin H, caesalpinin I, caesalpinin J, caesalpinin K, caesalpinin M, caesalpinin N, and caesalpinin O. The structures of the isolated compounds were elucidated by the use of spectroscopic techniques.

Caesalpinia↗
PubMed2006

Three type 6 hepatitis C virus subgroups among blood donors in the Yangon area of Myanmar are identified as subtypes 6m and 6n, and a novel subtype by sequence analysis of the core region.

Previously, using phylogenetic analysis of NS5b sequences, we found that three type 6 variant subgroups (M6-1, M6-2 and M6-3) exist in Myanmar. According to the new nomenclature of hepatitis C, M6-1 and M6-2 belong to subtypes 6m and 6n, respectively, but M6-3 is unassigned. In this study, we sequenced and phylogenetically analyzed the core region of these type 6 variant subgroups. Serum samples assigned as 6m or 6n by NS5b sequence were also identified as 6 m or 6n by core region analysis. The M6-3 (sample name MYAN-3E-3) remained unassigned to a subgroup based on its core region analysis. The findings of this study suggest that either the core region or the NS5b region can be analyzed for HCV subtype classification.

Base Sequence↗
PubMed2002

Feasibility and limitations of acridine orange fluorescence technique using a Malaria Diagnosis Microscope in Myanmar.

We studied parasite detectability in thick films by an acridine orange fluorescence technique (AO) to test its applicability and the use of a Malaria Diagnosis Microscope (MDM)-ESL in the detection of parasites, compared to the conventional Giemsa staining method. This study was conducted on 1,390 clinically suspected malaria cases of Thaton township, Myanmar. We found sensitivities of 82.8% for Plasmodium falciparum (P. falciparum) and 100% for Plasmodium vivax (P. vivax) and specificities of 97.1% for P. falciparum and 98.6% for P. vivax. AO had a higher sensitivity than Giemsa-stained films at low levels of parasitemia (< 1,000/microl). AO showed lower sensitivity and higher specificity than the Giemsa method at parasite levels of more than 1,000/microl. The results of using the AO method, achieved by both novice and experienced observers, showed no significant difference and required less practice to perform the test as well as to identify the parasite. The acridine orange fluorescence technique using a malaria diagnosis microscope MDM-ESL series is simple, rapid and cost effective. The microscope is conveniently operable using standard AC power or a 12-V DC car battery, and it is easily convertible to a conventional biological microscope. With the exception of species differentiation, which is not possible with this method, this method would be appropriate for both clinical and epidemiological studies.

Acridine Orange↗