Are Husbands Involving in Birth Preparedness and Complication Readiness for their Wives’ Pregnancies?: A Cross-Sectional Study in Nay Pyi Taw, Myanmar

INTRODUCTION: Husbands’ involvement in birth preparedness and complication readiness (BP/CR) has been encouraged as a new approach to improve maternal health for safe motherhood since 2000. However, Myanmar is a patriarchy society and despite the strong domination of husbands on the health of their families, their role and involvement in maternal health are still limited. OBJECTIVE: This study aimed to assess husbands’ involvement in BP/CR for their pregnant wives in Nay Pyi Taw, Myanmar. MATERIAL AND METHODS: The research was a cross sectional study which was carried out through a structured questionnaire among 198 husbands of pregnant women aged 18 years and above in Nay Pyi Taw. RESULTS: The results showed that 42.4% of husbands included in the study had poor involvement in BP/CR for safe motherhood. Approximately 38% of husbands failed to plan health facility for delivery, 45% did not plan for a skilled birth attendant, 20% did not save money for the delivery, 43% neglected transportation arrangement and 66% did not identify a blood donor in case of emergency. Husbands having good knowledge and positive attitude were significantly (p-value <0.001) involved in BP/CR as compared to those who did not. In addition, husbands who planned the pregnancy along with wives were involved in BP/CR more than those who did not and association was significant at p<0.001. Conclusion: Level of husbands’ involvement in BP/CR is slightly low for their wives’ pregnancies. It was, therefore, recommended that effective husband involvement intervention programmes should be promoted at all levels of healthcare for safe motherhood

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Effectiveness of men in maternity health (MiM) intervention on male involvement in maternal health care to improve maternal health outcomes in Naypyitaw, Myanmar

Myanmar recorded 1,700 maternal fatalities in 2020, indicating one of the highest maternal mortality ratios (MMR). The provision of adequate maternal health care (MHC) is crucial to reducing maternal mortality in Myanmar, but the prevalence of low institutional delivery (ID) contributes to avoidable deaths. While Myanmar has made recent efforts to enhance the utilization of MH services, there are still existing gaps that need attention. The concept of male involvement (MI) in maternal health (MH) has emerged as a strategy to improve MHC outcomes in Myanmar. To assess the efficacy of male involvement in maternal health in Myanmar, a research study will be conducted. This study aims to investigate the impact of Men in Maternity Health (MiM) education specifically designed for husbands and male partners of pregnant women in Myanmar. Thus, the research aims to determine the effectiveness of Men in Maternity Health (MiM) education intervention to improve husband involvement in birth preparedness and complication readiness for safe motherhood in Nay Pyi Taw, Myanmar.</p

Performance and feasibility of reactive surveillance and response strategies for malaria elimination in Vietnam: a mixed-methods study

Abstract Background To enhance malaria elimination, Vietnam adopted a Reactive Surveillance and Response (RASR) Strategy in which malaria case notification and investigation must be completed within 2 days followed by a focus investigation within 7 days. The nationwide performance of Vietnam’s RASR strategy has yet to be evaluated. This study aims to evaluate the performance and feasibility of RASR in Vietnam, thereby providing recommendations for improved RASR. Methods To assess malaria RASR in Vietnam, a mixed-methods study of (1) secondary data analysis of nationwide malaria case-based dataset from 2017 to 2021; (2) a quantitative survey, and (3) qualitative in-depth interviews and focus group discussions administered to central, provincial and district level stakeholders/staff and to the commune and community level front line health services providers was conducted. Results In Vietnam, there are guidelines and procedures for implementation of each step of RASR. The completeness of case notification on the reported monthly aggregated data was very high in both the paper-based (12,463/12,498, 99.7% in 2017–2020) and electronic reporting systems (467/467, 100% in 2021 when electronic reporting was introduced); however, there were delays in notification while using the paper-based system (timely notification—7,978/12,498, 63.8%). In 2021, the completeness (453/467, 97.0%) and timeliness (371/467, 79.4%) of case investigation were found to be high. Reactive case detection was the major focus investigation response, with fever screening achievement of 88.6% (11,481 / 12,965) and 88.5% (11,471 / 12,965) among index case and neighbouring household members, respectively. Conclusions Overall, there was policy commitment for implementation of RASR in Vietnam. The completeness and timeliness of case notification and case investigation were high and improved after the introduction of the electronic reporting system. More evidence is required for reactive case detection in defining the screening area or population

Exploring COVID-19 circuit breaker (CB) restrictions at a migrant worker dormitory in Singapore: a case study and nested mixed-method analysis of stress management and mental health

Introduction Measures to mitigate the COVID-19 outbreak in the migrant worker dormitories in Singapore included lockdown and isolation of residents for prolonged periods. In this paper, we explore efforts to ease tensions and support mental health under these conditions. Methods Case study of dormitory residents under lockdown from April to August 2020 comprises a nested mixed-method approach using an online questionnaire (n=175) and semistructured interviews (n=23) of migrant workers sampled from the survey (August to September 2020). Logistic regression models were used to analyse survey data. Semistructured interviews were analysed using applied thematic analysis. Results Survey and interview data showed that mental health was largely protected despite initial rising tensions over restrictions during lockdown. Sources of tension negatively affecting low stress responses included job related worries, OR=0.07 (95% CI 0.03 to 0.18, p<0.001), poor communication with employers, OR=0.12 (95% CI 0.03 to 0.44, p<0.001) and loneliness, OR=0.24 (95% CI 0.10 to 0.55, p<0.001). Interview narratives concurrently revealed themes around job insecurity and the effects of the lockdown 'not being good for mind and body', the imposition of new rules and regulations compounded by the most emphasised concern - worry about family back home. Interviewees shared how their adaptive capability played a pivotal protective role alongside social support and solidarity; aided by regular use of messaging applications, which supported mental health, OR=4.81 (95% CI 1.54 to 15.21, p<0.01). Employers were described as central to alleviating tensions, providing feedback loops to improve dorm conditions. Employees feeling their employers cared about their health and well-being was especially protective to mental health, OR=17.24 (95% CI 4.00 to 85.74, p<0.001). Gratitude and trust in government and healthcare provision was widely acknowledged. Concurrently, related attitudes such as believing in the timeliness and appropriateness of the lockdown also protected mental health, OR 2.85 (95% CI 1.08 to 7.39, p=0.03). Conclusion Tensions are mapped to protective solutions informing guidelines for future outbreak stress management response.Ministry of Health (MOH)Published versionThis work was supported by the National Centre for Infectious Diseases, Ministry of Health, Singapore, Research Grant Ref: COVID19COVID-19 CG0001

Anopheles diversity, biting behaviour and transmission potential in forest and farm environments of Gia Lai province, Vietnam

Abstract Background Despite recent reductions in Vietnam, malaria transmission persists in some areas in forests and farmlands where a high density of Anopheles mosquitoes relative to other environments occurs. To inform effective malaria control measures, it is important to understand vector bionomics and the malaria transmission role of Anopheles spp. in the highland regions of Vietnam. This study was conducted to quantify the abundance, composition and biting behaviour of the Anopheles mosquito population, and the proportion of Plasmodium spp. infected mosquitoes collected from forest and agricultural farm sites in Gia Lai province, Vietnam. Methods Forest and agricultural farm sites in Gia Lai province were selected for mosquito collections (total eight sites). Mosquito collection was performed by Human-baited Double Net Trap (HDNT), animal-baited traps (ABT) using cattle, and CDC light traps. Captured mosquitoes were identified morphologically, and salivary glands of Anopheles mosquitoes were examined for sporozoites using microscopy. Plasmodium infection was determined by Polymerase Chain Reaction (PCR), and identification of blood meal type was determined by PCR and diffuse serum agglutination assay. Results A total of 1815 Anopheles mosquitoes belonging to 19 species were collected by ABT (n = 1169), HDNT (n = 471) and CDC light trap (n = 175). Anopheles abundance and diversity varied by district and environment. Capture by HDNT of Anopheles of vectorial concern was observed between early evening and early morning. Plasmodium vivax infection was determined by PCR in two Anopheles dirus specimens captured by HDNT in forest sites. Blood from a range of hosts could, including human blood, could be detected in species considered primary and secondary vectors An. dirus, and Anopheles aconitus, and Anopheles maculatus, respectively. Conclusions A low number of Anopheles spp. considered primary vectors of concern and very low numbers of Plasmodium spp. infected Anopheles mosquitoes were captured at the end of the rainy season in the Central Highlands of Vietnam. However, capture species of vectorial concern by HDNT throughout the early to late evening demonstrates that use of additional personal protective measures could supplement current preventative measures, such as bed nets to prevent exposure to vectors of concern in this region

Genome-wide association study identifies five new susceptibility loci for primary angle closure glaucoma.

Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study (GWAS) followed by replication in a combined total of 10,503 PACG cases and 29,567 controls drawn from 24 countries across Asia, Australia, Europe, North America, and South America. We observed significant evidence of disease association at five new genetic loci upon meta-analysis of all patient collections. These loci are at EPDR1 rs3816415 (odds ratio (OR) = 1.24, P = 5.94 × 10(-15)), CHAT rs1258267 (OR = 1.22, P = 2.85 × 10(-16)), GLIS3 rs736893 (OR = 1.18, P = 1.43 × 10(-14)), FERMT2 rs7494379 (OR = 1.14, P = 3.43 × 10(-11)), and DPM2-FAM102A rs3739821 (OR = 1.15, P = 8.32 × 10(-12)). We also confirmed significant association at three previously described loci (P < 5 × 10(-8) for each sentinel SNP at PLEKHA7, COL11A1, and PCMTD1-ST18), providing new insights into the biology of PACG