Academic literature on the topic 'Communicable diseases Asia, Southeastern'

Introduction: Singapore is a transition country in Southeast Asia that is both vulnerable and receptive to the introduction and re-introduction of imported communicable diseases. Materials and Methods: For a 10-year period between 1998 and 2007 we studied the trend, epidemiological characteristics, proportion of imported versus local transmission of malaria, viral hepatitis (hepatitis A and E), enteric fevers (typhoid and paratyphoid), cholera, chikungunya and SARS. Results: Of a total of 4617 cases of the above selected diseases notified in Singapore, 3599 (78.0%) were imported. The majority of the imported cases originated from Southeast Asia and the Indian subcontinent. Malaria constituted the largest bulk (of which 95.9% of the 2126 reported cases were imported), followed by hepatitis A (57.1% of 1053 cases imported), typhoid (87.6% of 596 cases imported), paratyphoid (87.6% of 241 cases imported), and hepatitis E (68.8% of 231 cases imported). Furthermore, there were 14 cases of imported cholera, 6 cases of imported severe acute respiratory syndrome (SARS) and 13 cases of imported chikungunya. Conclusion: This study underlines that diseases such as malaria, viral hepatitis and enteric fever occur in Singapore mainly because of importation. The main origin of importation was South and Southeast Asia. The proportion of imported diseases in relation to overall passenger traffic has decreased over the past 10 years. Key words: Chikungunya, Cholera, Hepatitis A and E, Imported diseases, Malaria, Paratyphoid, SARS, Singapore, Typhoid fever

This last decade, regional organizations progressively became unavoidable actors of regional health governance and have been supported by some global health actors to strengthen such a role. Among these actors, the European Union (EU) is the only regional organization that implements health initiatives in cooperation with its regional counterparts. This article focuses on such “health interregionalism” toward Southeast Asia and Africa and in the field of communicable diseases, with the main objective of assessing its nature and identifying its main functions. It concludes that although appreciated and needed, the EU’s health interregionalism should better reflect the EU’s experience in regional health governance in order to represent a unique instrument of development aid and an added value for regional organizations

Aphanomyces invadans is the pathogen that causes epizootic ulcerative syndrome (EUS), an economically devastating fish disease in southern Asia. The present thesis considered possible improvements to current methods of monitoring EUS, and examined the mechanisms of the host immune response to A. invadans in order to establish whether they could be enhanced to reduce the impact of EUS on aquaculture. Monoclonal antibody (MAb) technology was considered as a possible improvement to the histopathological methods currently used in diagnosis of EUS. Five MAbs were raised to day-old A. invadans germlings. Four gave weak reactions to A. invadans and cross-reacted with other Aphanomyces spp, though they may be useful for future studies on A. invadans. The other, designated MAb 3gJC9, only cross-reacted with the crayfish plague pathogen, A. astaci, and was used for the development of an immunohistochemistry protocol that may be of use in diagnosis. Immunohistochemistry with MAb 3gJC9, which recognised an extracellular product (ECP) of A. invadans, was specific to A. invadans in fish tissue, although it also recognised A. astaci in plague-infected crayfish. It also recognised the mycelium in fish infected with ulcerative mycosis, indicating that ulcerative mycosis is synonymous with EUS. Preliminary observations indicated that both ECPs and what appeared to be a hitherto unreported early stage of the mycelium are important in the pathology of EUS. Studies in vitro on the macrophages of EUS-susceptible giant gourami Osphronemus gouramy and silver barb Barbodes gonionotus, and EUS-resistant Nile tilapia Oreochromis niloticus, found that their macrophages were able to inhibit the growth of A. invadans. The macrophages of striped snakehead Channa striata did not inhibit A. invadans, which may account for their high EUS-susceptibility, especially as A. invadans strongly inhibited the respiratory burst of snakehead macrophages. Studies on humoral immune responses revealed that complement inhibited A. invadans in the case of snakeheads, gourami and barbs but not tilapia or swamp eels Monopterus albus. The humoral responses of the latter were very different to the four other species, and not elucidated. Low levels of anti A. invadans antibodies were found in tilapia and gourami from an EUS-endemic region, and high levels in snakehead. Snakehead antibodies appeared to be able to inhibit A. invadans even when complement was removed, but lower levels were produced at the low temperatures typically associated with EUS. A range of potential immunostimulants were screened for the ability to enhance resistance to EUS. The two successful products were administered as feed supplements to snakeheads and barbs that were subsequently injected intramuscularly with A. invadans. One, the algal extract Ergosan, showed some beneficial effects on snakeheads although the challenge was inconclusive. The other, the vitamin supplement Salar-bec, accelerated the cellular immune response and reduced mortality in snakeheads and barbs, and enhanced antibody production in snakeheads. The antibody response of snakeheads was further studied by comparing the anti- A. invadans antibody level, inhibitory activity of sera in vitro and protective capacity of sera from EUS-naïve snakeheads to that of snakeheads recently exposed to EUS and those subject to long term EUS-exposure. Sera of populations recently exposed to EUS showed an increased level of antibodies, but little improvement in inhibitory or protective activity. Sera from snakeheads that had endured long term exposure showed a wide range of antibody levels, but marked increases in inhibitory and protective activity. Antibodies cross-reacted with non-pathogenic Aphanomyces spp. in all cases.

This study is about age and gender specific HIV morbidity in Nepal. The main objective of the study is to find out the factors that affect the HIV prevalence in Nepali society and the relationships of different existing socio cultural and economic factors that have led females vulnerable to HIV infection especially to housewives. Qualitative and quantitative methods were used for the data collection.

Initially, Nepal’s epidemic was driven by sex workers and drug users .Though HIV prevalence was concentrated in these groups for several years, now it has been proved that  the outbreak is not limited among those groups only, the prevalence among housewives , clients of sex workers, migrants and male homosexuals   are stretching up . Moreover findings have shown that the HIV epidemics is taking a devastating tool in women in Nepal, covering the more HIV prevalence number by low risk group housewives among the HIV affected female population. Lack of fully inclusive knowledge of HIV/AIDS; lack of knowledge of proper use of condom, negligence, and risky sexual behavior have compelled maximum risk for HIV contraction in society.

Socio economic and cultural structures and the consequences of its correlation aggravated the HIV prevalence among people, especially have affected women. Discrimination of women is entrenched in Nepali society. Due to disparity and discrimination women are not able to get formal education that deprives them from any opportunity for the employment that leads poverty on them. Living under poverty often stems them to engage in high risk situations and likely to adopt risky sexual behaviors which in turn render them vulnerable to HIV infection. The masculinity of the society, and women’s less power for the decision making process have made females heavily dependent on males, and this constraint them from entering into negotiating for protective sex which put them in HIV infection .The study further revealed the triggering effect of powerlessness of housewives and risky sexual behavior of men to HIV infection to low risk group housewives.  If the same trends go on, the time is not so far for the Nepali women to take up the higher number of HIV prevalence, and the low risk group housewives will be highly vulnerable. It is already urgent to activate the plans and intervention program for the prevention of HIV prevalence which is stretching towards women especially to low risk group housewives. Based on the findings, conclusions and recommendations are drawn.

Background InVietnam, the proportion of people aged 60 and above has increased rapidly in recent decades. The majority live in rural areas where socioeconomic status is more disadvantaged than in urban areas.Vietnam’s economic status is improving but disparities in income and living conditions are widening between groups and regions. A consistent and emerging danger of communicable diseases and an increase of non-communicable diseases exist concurrently. The emigration of young people and the impact of other socioeconomic changes leave more elderly on their own and with less family support. Introduction of user fees and development of a private sector improve the coverage and quality of health care but increase household health expenditures and inequalities in health care. Life expectancy at birth has increased, but not much is known about changes during old age. There is a lack of evidence, particularly in rural settings, about health-related quality of life (HRQoL) among older people within the context of socioeconomic changes and health-sector reform. Knowledge of long-term elderly care needs in the community and the relevant models are still limited. To provide evidence for developing new policies and models of care, this thesis aimed to assess general health status, health care needs, and perspectives on future health care options for community-dwelling older people. Methods An abridged life table was used to estimate cohort life expectancies at old age from longitudinal data collected by FilaBavi DSS during 1999-2006. This covered 7,668 people aged 60 and above with 43,272 person-years. A 2007 cross-sectional survey was conducted among people aged 60 and over living in 2,240 households that were randomly selected from the FilaBavi DSS. Interviews used a structured questionnaire to assess HRQoL, daily care needs, and willingness to use and to pay for models of care. Participant and household socioeconomic characteristics were extracted from the 2007 DSS re-census. Differences in life expectancy are examined by socioeconomic factors. The EQ-5D index is calculated based on the time trade-off tariff. Distributions of study subjects by study variables are described with 95% confidence intervals. Multivariate analyses are performed to identify socioeconomic determinants of HRQoL, need of support, ADL index, and willingness to use and pay for models of care. In addition, four focus group discussions with the elderly, their household members, and community association representatives were conducted to explore perspectives on the use of services by applying content analysis. Results Life expectancy at age 60 increased by approximately one year from 1999-2002 to 2003-2006, but tended to decrease in the most vulnerable groups. There is a wide gap in life expectancy by poverty status and living arrangement. The sex gap in life expectancy is consistent across all socioeconomic groups and is wider among the more disadvantaged populations.  The EQ-5D index at old age is 0.876. Younger age groups, position as household head, working, literacy, and belonging to better wealth quintiles are determinants of higher HRQoL. Ageing has a primary influence on HRQoL that is mainly due to reduction in physical (rather than mental) functions. Being a household head and working at old age are advantageous for attaining better HRQoL in physical rather than psychological terms. Economic conditions affect HRQoL through sensory rather than physical functions. Long-term living conditions are more likely to affect HRQoL than short-term economic conditions. Dependence in instrumental or intellectual activities of daily living (ADLs) is more common than in basic ADLs. People who need complete help are fewer than those who need some help in almost all ADLs. Over two-fifths of people who needed help received enough support in all ADL dimensions. Children and grand-children are confirmed to be the main caregivers. Presence of chronic illness, age groups, sex, educational level, marital status, household membership, working status, household size, living arrangement, residential area, household wealth, and poverty status are determinants of the need for care. Use of mobile teams is the most requested service; the fewest respondents intend to use a nursing centre. Households expect to use services for their elderly to a greater extent than did the elderly themselves. Willingness to use services decreases when potential fees increase. The proportion of respondents who require free services is 2 to 3 times higher than those willing to pay full cost. Households are willing to pay more for day care and nursing centres than are the elderly. The elderly are more willing to pay for mobile teams than are their households. ADL index, age group, sex, literacy, marital status, living arrangement, head of household status, living area, working status, poverty and household wealth are factors related to willingness to use services.   Conclusions                                                                                         There is a trend of increasing life expectancy at older ages in ruralVietnam. Inequalities in life expectancy exist between socioeconomic groups. HRQoL at old age is at a high level, but varies substantially according to socioeconomic factors. An unmet need of daily care for older people remains. Family is the main source of support for care. Need for care is in more demand among disadvantaged groups.  Development of a social network for community-based long-term elderly care is needed. The network should focus on instrumental and intellectual ADLs rather than basic ADLs. Home-based care is more essential than institutionalized care. Community-based elderly care will be used and partly paid for if it is provided by the government or associations. The determinants of elderly health and care needs should be addressed by appropriate social and health policies with greater targeting of the poorest and most disadvantaged groups. Building capacity for health professionals and informal caregivers, as well as support for the most vulnerable elderly groups, is essential for providing and assessing the services.
Aging and Living Conditions Program
Vietnam-Sweden Collaborative Program in Health, SIDA/Sarec

AbstractThe Sultanate of Oman is located on the Arabian Peninsula and is part of Western Asia. Oman has a relatively young population. The economy is based on oil, agriculture, fishing, and overseas trading. Oman spends around 3% of its GDP on health care. Omani nationals have free access to public healthcare. Due to increased incomes and changing lifestyles, the rate of Non-Communicable Diseases (NCD) including cancer is rising. This is slowly saturating the system and increasing health care costs. Cancer is now the third leading cause of mortality. The age-adjusted annual incidence of cancer ranges from 70 to 110 per 100,000 population. Oman has an operational national NCD action plan. This multi-sectoral plan was launched in 2018 and focuses on the government approach in addressing NCDs including cancer, highlighting the prevention and control strategies. There is an integrated cancer care service, cancer registry, and cancer control program; under the auspices of the Directorate general of Non-communicable diseases—Ministry of Health. Oman has envisioned an ambitious long-term health care plan called “Health care Vision 2050”, which includes the development and progression of cancer care services as well. This plan has an emphasis on development, patient empowerment, public awareness, health education, integration and accessibility of services, screening, and early detection, public–private partnership, indulgence for NGOs, research, and capacity building.

Global health issues are a global burden and are relatively common in industrialized societies. The World Health Organization and researchers have developed and rebuilt tools to report the burden of disease affecting mortality and health of the people. Apart from America and Europe, which are at an average of global burden for mental health disease, in some regions it is a major priority to be addressed globally. In South East Asia, one of the affected regions is Kashmir, Northern Indian. Disasters have manifested in various forms encompassing the natural calamities of earthquake, flood, landslides and manmade calamities of violence. Trauma due to manmade calamities has taken over as a leading cause of morbidity and mortality among the most productive working age group of 12-35 years. The chapter aims to understand the patterns of resilience in people surviving war and conflict in Kashmir over last 60 years. The focus is on the young population of society. Generations in Kashmir have faced the psychosocial impact of ongoing political conflict since the 1980's.