Are there any changes in burden and management of communicable diseases in areas affected by Cyclone Nargis?

<p>Abstract</p> <p>Background</p> <p>This study aims to assess the situation of communicable diseases under national surveillance in the Cyclone Nargis-affected areas in Myanmar (Burma) before and after the incident.</p> <p>Methods</p> <p>Monthly data during 2007, 2008 and 2009 from the routine reporting system for disease surveillance of the Myanmar Ministry of Health (MMOH) were reviewed and compared with weekly reporting from the Early Warning and Rapid Response (EWAR) system. Data from some UN agencies, NGOs and Tri-Partite Core Group (TCG) periodic reviews were also extracted for comparisons with indicators from Sphere and the Inter-Agency Standing Committee.</p> <p>Results</p> <p>Compared to 2007 and 2009, large and atypical increases in diarrheal disease and especially dysentery cases occurred in 2008 following Cyclone Nargis. A seasonal increase in ARI reached levels higher than usual in the months of 2008 post-Nargis. The number of malaria cases post-Nargis also increased, but it was less clear if this reflected normal seasonal patterns or was specifically associated with the disaster event. There was no significant change in the occurrence of other communicable diseases in Nargis-affected areas. Except for a small decrease in mortality for diarrheal diseases and ARI in 2008 in Nargis-affected areas, population-based mortality rates for all other communicable diseases showed no significant change in 2008 in these areas, compared to 2007 and 2009. Tuberculosis control programs reached their targets of 70% case detection and 85% treatment success rates in 2007 and 2008. Vaccination coverage rates for DPT 3^rddose and measles remained at high though measles coverage still did not reach the Sphere target of 95% even by 2009. Sanitary latrine coverage in the Nargis-affected area dropped sharply to 50% in the months of 2008 following the incident but then rose to 72% in 2009.</p> <p>Conclusion</p> <p>While the incidence of diarrhea, dysentery and ARI increased post-Nargis in areas affected by the incident, the incidence rate for other diseases and mortality rates did not increase, and normal disease patterns resumed by 2009. This suggests that health services as well as prevention and control measures provided to the Nargis-affected population mitigated what could have been a far more severe health impact.</p

Poverty among households living in slum area of Hlaing Tharyar Township, Yangon City, Myanmar

Background: Slums can be regarded as physical manifestations of urban poverty. Although the world has made dramatic improvement in reducing poverty since 1990, poverty still persists at an unacceptable level. Although current situations highlights the importance of slum areas to be given priority in poverty alleviation, there are limited data on poverty level among people living in urban slums of Myanmar.Methods: A cross-sectional study was conducted among households living in slum areas of Hlaing Tharyar Township, Yangon City, Myanmar during 2016. Multi-staged systematic random sampling and face-to-face interview were applied in selecting the samples and collecting the data, respectively. The new global poverty line (1.9 USD per person per day) was used as a threshold in determining the poverty. Chi-squared test and multivariate logistic regression analysis were utilized in data analysis.Results: Altogether 254 participants were recruited after getting informed consent. The occurrence of poverty among households was 54.3% (95% CI: 48.2%, 60.5%). Head counts of poverty among study population was 58.8%. The education status of household’s head, size of household and the presence of less than 15 years old children in the household were detected as significant determinants of being poor household.Conclusions: Poverty among households living in slum area of Hlaing Tharyar Township, Yangon City was high. Measures to alleviate poverty in urban slums should be intensified. Education level of household’s heads should be improved. Family planning or birth spacing programme should also be strengthened, especially in urban slums.

Development of High-Speed Fluorescent X-Ray Micro-Computed Tomography

A high-speed fluorescent x-ray CT (FXCT) system using monochromatic synchrotron x rays was developed to detect very low concentration of medium-Z elements for biomedical use. The system is equipped two types of high purity germanium detectors, and fast electronics and software. Preliminary images of a 10mm diameter plastic phantom containing channels field with iodine solutions of different concentrations showed a minimum detection level of 0.002 mg I/ml at an in-plane spatial resolution of 100µm. Furthermore, the acquisition time was reduced about 1/2 comparing to previous system. The results indicate that FXCT is a highly sensitive imaging modality capable of detecting very low concentration of iodine, and that the method has potential in biomedical applications

Evaluation on dry forage yields and nutritional characteristics of introduced herbaceous legumes in Myanmar

The study was carried out to evaluate the forage yields, nutritive values and in vitro fermentation parameters of herbaceous legumes. Five varieties of introduced herbaceous legumes; Stylosanthes guianensis cv. Ubon stylo, Macrotyloma axillare cv. Archer, Centrosema brasilianum cv. Ooloo, Stylosanthes guianensis cv. Stylo 184 and Macroptilum bracteatum cv. Cadarga were evaluated at the research farm, University of Veterinary Science, Yezin, Myanmar. No fertilizer and no irrigation were applied for cultivation to test drought resistance. Dry forage yield, nutritive values and gas production at four harvesting times were measured with 4×5 factorial arrangement (5 legumes and 4 harvesting time) in randomized complete block design. There was no interaction between legumes and harvesting time on forage yield, nutritive values and fermentation parameters but they were affected by the main effects of legume types and harvesting time. Among the legume forages, the highest dry forage yields were found in Ooloo, Ubon stylo, and Stylo 184, and followed by the DM yield of Archer and Cadarga. The DM yield of the second harvest was significantly higher (p&lt;0.05) than those of the first, third and fourth harvest which were not significantly different from each other. As a chemical composition, the DM content of Archer was lower (p&lt;0.05) than those of other varieties. Among the legumes forages, the lower CP content was found in Cadarga. The higher NDF was observed in Ooloo. Ooloo, Ubon stylo and Cadarga showed higher ADF in comparison with the other two varieties. Among the harvesting time, the lowest DM content was found at the first harvest. The highest CP content was found at third harvest. The NDF content was not significantly different. The lowest ADF content was found in fourth harvest. According to the dry forage yield, Ubon stylo and Ooloo had the highest dry forage yield and in term of nutritive values, Stylo 184 and Archer had higher nutritive values. As the main effect of forages, Stylo 184 and Archer had higher gas production in comparison with the other varieties. As the main effect of harvesting time, the fourth harvest had the highest gas production in comparison with other harvesting time. It could be better for cultivation by application of fertilizer and irrigation to get more forage yield and quality. &nbsp

Socio-economic and agricultural factors associated with stunting of under 5-year children: findings from surveys in mountains, dry zone and delta regions of rural Myanmar (2016–2017)

Abstract Objective: The study’s objective was to investigate multiple underlying social, economic and agricultural determinants of stunting among under-five children in three distinct ecological areas in rural Myanmar. Design: Repeated cross-sectional surveys in three states of Myanmar. Setting: Rural households in Chin (mountainous), Magway (plains) and Ayeyarwady (delta). Participants: From two purposively selected adjacent townships in each state, we randomly selected twenty villages and, in each village, thirty households with under-five children. Households in the first survey in 2016 were revisited in late 2017 to capture seasonal variations. Results: Stunting increased from 40·4 % to 42·0 %, with the highest stunting prevalence in Chin state (62·4%). Univariate Poisson regression showed factors contributing to child stunting varied across the regions. Adjusted Poisson regression models showed that child’s age and short maternal stature (aRR = 1·14 for Chin, aRR = 1·89 for Magway and aRR = 1·86 for Ayeyarwady) were consistently associated with child stunting across three areas. For Chin, village-level indicators such as crop consumption (aRR = 1·18), crop diversity (aRR = 0·82) and land ownership (aRR = 0·89) were significantly associated with stunting. In Magway, the number of household members (aRR = 1·92), wealth status (aRR = 0·46), food security status (aRR = 1·14), land ownership (aRR = 0·85) and in Ayeyarwady, women’s decision-making (aRR = 0·67) and indicators related to hygiene (aRR = 1·13) and sanitation (aRR = 1·45) were associated with stunting. Conclusions: Area-specific factors were associated with stunting. Maternal short stature and child age were consistent determinants of stunting. A multi-sectoral local approach, including improvements in transport, is needed to address the intergenerational malnutrition problem

Molecular Epidemiology of Dengue Viruses Co-circulating in Upper Myanmar in 2006

To understand the molecular epidemiology of circulating dengue viruses (DENV) in Upper Myanmar, DENV isolation was attempted by inoculating the sera of a panel of 110 serum samples onto a C6/36 mosquito cell line. The samples were collected from dengue (DEN) patients admitted at Mandalay Children’s Hospital in 2006. Infected culture fluids were subjected to a RT-PCR to detect the DENV genome. Three DENV strains were isolated. This was the first DENV isolation performed either in Mandalay or in Upper Myanmar. One strain belonged to DENV serotype-3 (DENV-3), and two other strains belonged to DENV serotype-4 (DEN-4). The sequence data for the envelope gene of these strains were used in a phylogenetic comparison of DENV-3 and DENV-4 from various countries. Phylogenetic analyses revealed that this DENV-3 strain was clustered within genotype II, and the two DENV-4 strains were clustered within genotype I in each serotype. The Myanmar strains were closely related to strains from the neighboring countries of Thailand and Bangladesh. These results are important for elucidating the trends of recent and future DEN outbreaks in Myanmar