Island health review, progress and the way forward in the Western Pacific Region

Island health differs from other health care systems, particularly in that there are limited resources and referral faculties available. With globalisation and climate change, island populations have become increasingly vulnerable to natural disasters and global pandemics. This study will identify, explore, compare and report on island health issues facing in the western Pacific, before making appropriate recommendations. A review of selected health indicators in Pacific islands was collected from the World Health Organization (WHO) and other publicly available resources. In the Pacific region, 15 islands saw lower health expenditure (<US $500), one physician and two to six nurses per 1,000 people (fall below WHO recommendation), lower life expectancy (60-70 years), higher fertility rates (2.5 to 6.4 children per women, excepting Palau), and higher adolescent fertility rates (23 to 88 children per 1,000 girls, excepting Tonga). Island populations also suffer a higher disease burden per 100,000 people, with TB, malaria, and non-communicable diseases contributing to elevated mortality rates throughout much of the region. This article highlights four areas: the sustainable development of the health workforce, improved maternal and antenatal health care provisioning, and selective communicable and non-communicable disease control. However, there are some limitations especially under reporting of maternal health data and generalization effect of reported data

Effectiveness of the SA 14-14-2 Live-Attenuated Japanese Encephalitis Vaccine in Myanmar

Myanmar is an endemic country for the Japanese encephalitis virus (JEV), and the SA-14-14-2 live-attenuated JEV vaccine was first introduced as a catch-up vaccination campaign in 2017. To determine the effectiveness of vaccination by means of neutralizing antibody titers against JEV, a cross-sectional descriptive study was conducted among five to 15-year-old monastic school children in Mandalay, Myanmar. A total of 198 students who had received vaccines were recruited, and single-time investigation of anti-JEV IgG and neutralizing antibodies against wild-type JEV were determined using anti-JEV IgG ELISA and plaque reduction neutralization tests (PRNT50). All students 100% (198/198) showed positive results on the anti-JEV IgG ELISA, and 87% (172/198) of the students had neutralizing antibodies against JEV six months after immunization. The geometric mean titers of both IgG antibodies and neutralizing antibodies increased with the participants’ age groups, and statistically significant differences in anti-JEV IgG titers were noted across age groups. In this study, we could not investigate the persistence of neutralizing antibodies as only single-time blood collection was done. This study, which is the first report of JEV vaccination among children in Myanmar, showed similar neutralizing antibody production rates among vaccinated individuals as did studies in other countries

Statistical Machine Translation between Myanmar Sign Language and Myanmar Written Text

This paper contributes the first evaluation of the quality of automatic translation between Myanmar sign language (MSL) and Myanmar written text, in both directions. Our developing MSL-Myanmar parallel corpus was used for translations and the experiments were carried out using three different statistical machine translation (SMT) approaches: phrase-based, hierarchical phrase-based, and the operation sequence model. In addition, three different segmentation schemes were studies, these were syllable segmentation, word segmentation and sign unit based word segmentation. The results show that the highest quality machine translation was attained with syllable segmentations for both MSL and Myanmar written text

Investigation of Japanese Encephalitis Virus Infection in Bogalay Township, Myanmar in 1999

An investigation was in Nyi-naung-wa village, Bogalay township for Japanese encephalitis (JE) virus infection and the possibility of a JE outbreak. JE virus antibody was determined among the pigs and the people living near the pig farms in that village and at an adjacent village as a control. The known JE virus vector Culex mosquito species were also identified in both villages. Haemagglutination inhibition (HAI) methods were used for the detectioon of JE and dengue antibodies. Homotypic or monotypic JE antibodies were detected in 33% of the pigs tested. No homotypic nor monotypic JE antibodis was detected among the villagers. Although there was no JE virus infection among the people, because of the presence of JE virus infection among the pigs and the presence of Culex mosquito vector in that area, the possibility of a JE outbreak in humans in that area, if the number of pig breeding per household increase and the mosquito density become higher is discussed

Development of Natural Language Processing based Communication and Educational Assisted Systems for the People with Hearing Disability in Myanmar

Information and communication technologies (ICTs) provide people with disabilities to better integrate socially and economically into their communities by supporting access to information and knowledge, learning and teaching situations, personal communication and interaction. Our research purpose is to develop systems that will provide communication and educational assistance to persons with hearing disability using Natural Language Processing (NLP). In this paper, we present corpus building for Myanmar sign language (MSL), Machine Translation (MT) between MSL, Myanmar written text (MWT) and Myanmar SignWriting (MSW) and two Fingerspelling keyboard layouts for Myanmar SignWriting. We believe that the outcome of this research is useful for educational contents and communication between hearing disability and general people

Determination of Oncogenic Human Papillomavirus (HPV) Genotypes in Anogenital Cancers in Myanmar

Molecular and epidemiologic investigations suggest a causal role for human papillomavirus (HPV) in anogenital cancers. This study identified oncogenic HPV genotypes in anogenital cancers among men and women in a 2013 cross-sectional descriptive study in Myanmar. In total, 100 biopsy tissues of histologically confirmed anogenital cancers collected in 2008-2012 were studied, including 30 penile and 9 anal cancers from Yangon General Hospital and 61 vulvar cancers from Central Women's Hospital, Yangon. HPV-DNA testing and genotyping were performed by polymerase chain reaction-restriction fragment length polymorphism. Overall, 34% of anogenital cancers were HPV-positive. HPV was found in 44.4% of anal (4/9), 36.1% of vulvar (22/61), and 26.7% of penile (8/30) cancers. The most frequent genotypes in anal cancers were HPV 16 (75%) and 18 (25%). In vulvar cancers, HPV 33 was most common (40.9%), followed by 16 (31.8%), 31 (22.7%), and 18 (4.6%). In penile cancers, HPV 16 (62.5%) was most common, followed by 33 (25%) and 18 (12.5%). This is the first report of evidencebased oncogenic HPV genotypes in anogenital cancers among men and women in Myanmar. This research provides valuable information for understanding the burden of HPV-associated cancers of the anus, penis, and vulva and considering the effectiveness of prophylactic HPV vaccination

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 evidence of drug resistance in asymptomatic malaria Infections, Myanmar, 2015

Artennisinin resistance containment in Myanmar was initiated in 2011 after artemisinin-resistant Plasmodium falciparum malaria was reported. Molecular evidence suggests that asymptomatic malaria infections harboring drug resistance genes are present among residents of the Myanmar artemisinin resistance containment zone. This evidence supports efforts to eliminate these hidden infections.Publisher PDFPeer reviewe