WHO South-East Asia journal of public health最新文献

{"title":"Public health challenges in Asia: Complex multifaceted challenges require transformative leadership.","authors":"","doi":"10.4103/2224-3151.334414","DOIUrl":"https://doi.org/10.4103/2224-3151.334414","url":null,"abstract":"","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39832800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The trend of emergency department visits among the elderly in Thailand.","authors":"Methasit Lumjeaksuwan,&nbsp;Suparada Patcharasopit,&nbsp;Chanatip Seksanpanit,&nbsp;Natchaya Sritharo,&nbsp;Apichat Aeampuck,&nbsp;Borwon Wittayachamnankul","doi":"10.4103/WHO-SEAJPH.WHO-SEAJPH_67_21","DOIUrl":"https://doi.org/10.4103/WHO-SEAJPH.WHO-SEAJPH_67_21","url":null,"abstract":"<p><p>Emergency department (ED) usage by older adults tends to be a major health issue due to increase in aging population and their health fragility. Currently, there is no study comparing ED data of older adults with those of younger population in Southeast Asia. The aim of this study was to explore the epidemiologic data of elderly who visited the ED from 2016 to 2018 and compare them with data from younger group. Data on ED visits from 2016 to 2018 were extracted from the electronic medical database. Descriptive statistics were used for analyzing the collected data and compared with the data of the age group of 15-59 years. A total of 27,871 elderly patients were found eligible and included. The mean age was 72.69 years (95% confidence interval 72.6-72.8). Patients aged 60-69 years have the highest ED visits rate (45.4%). From the total visits, 58.06% were discharged from ED, while 40.82% were admitted to hospital with 11.22% death rate after the admission. The most diagnosed condition was injury, poisoning, or other consequence from an external cause, with a head injury as the leading cause (20.74%). Compared with patients aged 15-59 years, elderly patients had a higher visit rate per 1000 population (21.99 vs. 30.91; P < 0.001), more admissions (15% vs. 40.8%; P < 0.001), and more re-visits within 7 days (1.81% vs. 4.07%; P < 0.001). These results showed that older adult patients tend to have higher ED visits rate, ED re-visits rate, and admissions rate compared to younger age groups.</p>","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity patterns among rural adults with Type-2 diabetes mellitus: A cross-sectional study in Kerala, India.","authors":"D J Soji,&nbsp;J Lordson,&nbsp;G K Mini","doi":"10.4103/WHO-SEAJPH.WHO-SEAJPH_73_21","DOIUrl":"https://doi.org/10.4103/WHO-SEAJPH.WHO-SEAJPH_73_21","url":null,"abstract":"<p><strong>Objectives: </strong>The study evaluated the prevalence and pattern of multi-morbidity among rural adults with type-2 diabetes mellitus and explored the factors associated with multi-morbidity among 400 adult diabetic patients from rural areas of Thiruvananthapuram district in the Kerala state of India.</p><p><strong>Materials and methods: </strong>The presence of multi-morbidity was assessed using a semi-structured interview schedule based on the physician's confirmation. The reported chronic diseases were classified as concordant (conditions with a similar pathophysiologic risk profile as diabetes) and discordant (conditions whose treatments are not directly related to the pathogenesis for diabetes) co-morbidity. Multivariate analysis was done to find the factors associated with multi-morbidity.</p><p><strong>Results: </strong>Prevalence of multi-morbidity among diabetic patients was 74% (95% Confidence Interval (CI): 69-77), around 66% reported at least one concordant co-morbidity, 30% reported at least one discordant co-morbidity and 21% reported both concordant and discordant co-morbidity with diabetes. Hypertension (59%) was the most frequent co-morbidity. Older adults (above 60 years of age) [Odds Ratio (OR):3.42, 95% CI:1.97-5.94] and women (OR:2.16, CI:1.13-3.51) were more likely to have multi-morbidity compared to their counterparts. Those using insulin and/or oral medication were more likely to have multi-morbidity compared to those using oral medication only (OR: 2.19, CI: 1.07-4.09).</p><p><strong>Conclusion: </strong>Multi-morbidity among diabetic patients needs to be addressed by a comprehensive and integrated approach rather than a diabetes specific approach.</p>","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on the global supply chain of antiretroviral drugs: a rapid survey of Indian manufacturers.","authors":"Bharat Bhushan Rewari,&nbsp;Nabeel Mangadan-Konath,&nbsp;Mukta Sharma","doi":"10.4103/2224-3151.294306","DOIUrl":"https://doi.org/10.4103/2224-3151.294306","url":null,"abstract":"<p><p>Most people living with HIV in low- and middle-income countries are treated with generic antiretroviral (ARV) drugs produced by manufacturers in India - the \"pharmacy of the developing world\". India's nationwide lockdown in March 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic therefore prompted concerns about disruption to this essential supply. A preliminary assessment of ARV drug manufacturers in India in March 2020 indicated a range of concerns. This prompted a rapid questionnaire-based survey in May 2020 of eight manufacturers that account for most of India's ARV drug exports. The greatest challenges reported were in international shipping, including delays, increased lead times and rising costs. Contrary to expectations, lack of access to the active pharmaceutical ingredients (APIs) required for ARV drug manufacture was not a major hindrance, as manufacturers reported that their reliance on China for API supplies had reduced in recent years. However, their reliance on overseas markets for the raw materials required for local API synthesis was a major challenge. The findings from this survey have implications for addressing some of the immediate and medium-term concerns about the production and supply of generic ARV drugs. Long-term orders to support multi-month dispensing and buffer stocks need to be in place, together with computerized inventory management systems with real-time information from the lowest-level dispensation unit. Manufacturers and industry associations should have regular, formal interaction with the key ministries of the Government of India regarding these issues. Measures to improve the resilience of the generic ARV drug supply system are essential to minimize ongoing supply shocks resulting from the COVID-19 pandemic and to prepare for future emergencies.</p>","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38518063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating the impact of the COVID-19 pandemic on progress towards ending tuberculosis in the WHO South-East Asia Region.","authors":"Vineet Bhatia,&nbsp;Partha Pratim Mandal,&nbsp;Srinath Satyanarayana,&nbsp;Tjandra Yoga Aditama,&nbsp;Mukta Sharma","doi":"10.4103/2224-3151.294300","DOIUrl":"https://doi.org/10.4103/2224-3151.294300","url":null,"abstract":"<p><p>Almost half of the deaths worldwide caused by tuberculosis in 2018 occurred in the World Health Organization (WHO) South-East Asia Region, home to around a quarter of the global population. Maintaining robust progress in this region is therefore essential if the global goal of ending the tuberculosis epidemic is to be realized. Substantial gains have been made in the region, but the threat to health worldwide posed by the coronavirus disease 2019 (COVID-19) pandemic includes not only the direct effects of the pandemic but also the potential eclipsing of the global tuberculosis emergency. The results of modelling studies present stark warnings of a reversal of years of progress and a significant resurgence in deaths from tuberculosis. The COVID-19 pandemic has had variable impacts in the WHO South-East Asia Region to date, but in the countries most affected there has been targeted diversion and repurposing of tuberculosis services, health-care workers and diagnostic equipment. The combined effects of COVID-19, containment measures and fragmentation of tuberculosis services have resulted in delays in diagnosis or non-diagnosis and disruption in treatment resulting in increased morbidity, mortality, transmission and drug resistance. Countries of the region have made attempts to ensure continuity of services and civil society and nongovernmental organizations have instituted a range of innovative mechanisms to support national programmes. However, a comprehensive approach - including scaling up successful initiatives, empowering community leadership, harnessing digital tools, and implementing easily accessible cash transfers and nutrition support - will be critical to success. As COVID-19 recedes, countries will need \"catch-up plans\" to deploy supplementary measures to address the increased tuberculosis burden. Urgent, targeted and agile responses have the potential to mitigate and reverse the impact of the COVID-19 pandemic on tuberculosis in South-East Asia.</p>","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38421121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protecting sex workers in Thailand during the COVID-19 pandemic: opportunities to build back better.","authors":"Surang Janyam,&nbsp;Dusita Phuengsamran,&nbsp;Jamrong Pangnongyang,&nbsp;Wutikan Saripra,&nbsp;Ladda Jitwattanapataya,&nbsp;Chalidaporn Songsamphan,&nbsp;Patchara Benjarattanaporn,&nbsp;Deyer Gopinath","doi":"10.4103/2224-3151.294301","DOIUrl":"https://doi.org/10.4103/2224-3151.294301","url":null,"abstract":"<p><p>The Government of Thailand was prompt to launch social and economic measures to mitigate the effects on the general population following lockdown measures to counter coronavirus disease 2019 (COVID-19). However, sex workers were one of the vulnerable groups who were unable to access state support. A rapid survey of sex workers in Thailand showed that almost all had become unemployed and lost their income as a consequence of the lockdown, restrictions on international flights into the country and the closure of entertainment venues. Most were unable to cover the costs of food and shelter for themselves and their dependents. COVID-19 had also disrupted testing and treatment for sexually transmitted infections and HIV services for sex workers. As in other countries, community-based organizations were essential to providing an immediate, short-term COVID-19 response for sex workers. Also as in other countries, the pandemic has demonstrated that many people's health and well-being depends on very fragile foundations. This presents a clear opportunity to build back better by committing to a longer-term vision for the overall societal inclusion of sex workers. Thailand should advocate for decriminalization of sex work and ensure sex workers are entitled to equal labour rights and inclusion in the government social protection programme. Progress in innovative government initiatives aimed at ending HIV stigma and discrimination show how structural change can come about through harnessing community-based organizations. In turn, HIV services for sex workers need to expand and incorporate targeted interventions to reduce sex workers' occupational susceptibility to COVID-19.</p>","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38421122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community action for people with HIV and sex workers during the COVID-19 pandemic in India.","authors":"Sushena Reza-Paul,&nbsp;Lisa Lazarus,&nbsp;Partha Haldar,&nbsp;Manisha Reza Paul,&nbsp;Bhagya Lakshmi,&nbsp;Manjula Ramaiah,&nbsp;Akram Pasha,&nbsp;Syed Hafeez Ur Rahman,&nbsp;K T Venukumar,&nbsp;M S Venugopa,&nbsp;Bharat Bhushan Rewari,&nbsp;Robert Lorway","doi":"10.4103/2224-3151.294302","DOIUrl":"https://doi.org/10.4103/2224-3151.294302","url":null,"abstract":"<p><p>Sex workers have been one of the marginalized groups that have been particularly affected by India's stringent lockdown in response to the coronavirus disease 2019 (COVID-19) pandemic. The sudden loss of livelihood and lack of access to health care and social protection intensified the vulnerabilities of sex workers, especially those living with HIV. In response, Ashodaya Samithi, an organization of more than 6000 sex workers, launched an innovative programme of assistance in four districts in Karnataka. Since access to antiretroviral therapy (ART) was immediately disrupted, Ashodaya adapted its HIV outreach programme to form an alternative, community-led system of distributing ART at discreet, private sites. WhatsApp messaging was used to distribute information on accessing government social benefits made available in response to the COVID-19 pandemic. Other assistance included advisory messages posted in WhatsApp groups to raise awareness, dispel myths and mitigate violence, and regular, discreet phone check-ins to follow up on the well-being of members. The lessons learnt from these activities represent an important opportunity to consider more sustainable approaches to the health of marginalized populations that can enable community organizations to be better prepared to respond to other public health crises as they emerge.</p>","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38421124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safeguarding essential health services during emergencies: lessons learnt from the COVID-19 pandemic.","authors":"Poonam Khetrapal Singh,&nbsp;Manoj Jhalani","doi":"10.4103/2224-3151.293433","DOIUrl":"https://doi.org/10.4103/2224-3151.293433","url":null,"abstract":"","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38421120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the COVID-19 diagnostic laboratory capacity in Indonesia in the early phase of the pandemic.","authors":"Harimat Hendarwan,&nbsp;Syachroni Syachroni,&nbsp;Ni Ketut Aryastami,&nbsp;Amir Su'udi,&nbsp;Made Dewi Susilawati,&nbsp;Mieska Despitasari,&nbsp;Ully Adhie Mulyani,&nbsp;Mimi Sumiarsih,&nbsp;Nelly Puspandari,&nbsp;Agnes Rengga Indrati,&nbsp;Dewi Amila Solikha,&nbsp;Dyah Armi Riana,&nbsp;Indira Rezky Wahyuni","doi":"10.4103/2224-3151.294307","DOIUrl":"https://doi.org/10.4103/2224-3151.294307","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic has put a great burden on countries as a result of the demand for laboratory diagnostic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This paper reports our experiences in rapidly assessing Indonesia's COVID-19 laboratory testing capacity in the early phase of the pandemic response. Through a questionnaire-based survey carried out between 23 March and 2 April, we estimated the daily tests that could be done by the 44 facilities, excluding the national referral laboratory, first assigned to be COVID-19 diagnostic laboratories. The capacity constraints were lack of reagents and equipment, and limited human resources; because of these constraints, most of the laboratories were not yet operational. A major hindrance was reliance on imported supplies and the associated procurement time. Expanding real-time polymerase chain reaction testing capacity, through increased numbers of laboratories and optimization of existing facilities, was clearly the main priority. We also assessed the potential yield from using rapid molecular testing machines in the country's referral hospitals. Even assuming this potential could be tapped, several provinces would still be poorly served by diagnostic services in the event of a surge in cases. Since this rapid assessment, the number of designated COVID-19 laboratories has increased and, by 1 July 2020, was 163. On 29 July 2020, for the first time, the number of specimens examined in a day reached more than 30 000, achieving the WHO testing capacity target of 1 in 1000 inhabitants per week.</p>","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38518064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring COVID-19 where capacity for testing is limited: use of a three-step analysis based on test positivity ratio.","authors":"Sirenda Vong,&nbsp;Manish Kakkar","doi":"10.4103/2224-3151.294308","DOIUrl":"https://doi.org/10.4103/2224-3151.294308","url":null,"abstract":"<p><p>In an effort to monitor coronavirus disease 2019 (COVID-19), many countries have been calculating the ratio of cases confirmed to tests performed (test positivity ratio - TPR). While inferior to sentinel surveillance, TPR has the benefit of being easily calculated using readily available data; however, interpreting TPR and its trends can be complex because both the numerator and the denominator are constantly changing. We describe a three-step process where the ratio of relative increase in cases to relative increase in tests is accounted for in an adjusted TPR. This adjusted value more appropriately reflects the case number and factors out the effect of changes in the number of tests done. Unadjusted and adjusted TPRs are then assessed step-wise with reference to the epidemic curve and the cumulative numbers of cases and tests. Use of this three-step analysis and its potential use in guiding public health interventions are demonstrated for selected countries and subnational areas of the World Health Organization South-East Asia Region, together with the Republic of Korea as a reference. To date, application of the three-step analysis to data from countries of the region has signalled potential inadequacies of testing strategies. Further work is needed on approaches to support countries where testing capacity is likely to remain constrained. One example would be enumeration of the average number of tests needed to detect one COVID-19 case, which could be stratified by factors such as location and population. Such data would allow evidence-informed strategies that best balance the highest detection rate with the prevailing testing capacity.</p>","PeriodicalId":37393,"journal":{"name":"WHO South-East Asia journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38518065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}