Role of inclusive self-help groups in prevention and management of diabetes and hypertension in Myanmar:a qualitative study

Background: Noncommunicable diseases (NCDs) are a growing public health concern in Myanmar. Community-based self-help groups are essential for participating in health-related activities. However, little is known about the role of inclusive self-help groups (ISHG) in hypertension and diabetes management. This study aimed to assess knowledge and perception of health-related activities of ISHG and explore challenges ISHG group members encountered in performing hypertension and diabetes prevention and management activities.Methods: The study included six townships from three different regions of Myanmar, where ISHG existed. Two focus group discussions (FGDs) were held in each township. A total of twelve FGDs were conducted. All discussions were conducted, audio-recorded and transcribed verbatim in Myanmar language. A thematic analysis was performed using inductive and deductive approaches.Results: The findings revealed that ISHG members provided advice and counselling on behavioural risk factors for hypertension and diabetes prevention and screenings for those diseases. They also offered home care for the elderly and stroke patients who required their assistance. Community members regarded ISHG as a valuable community structure. Members of the ISHG identified a number of challenges, including lack of resources (funding, manpower, and time), lack of confidence, and lack of recognition and acceptance. Support and strengthening activities by local authorities and the government were critical to sustain ISHG's activities and efforts.Conclusions: Hypertension and diabetes management activities of ISHG are appreciative. The public and government should recognize and support ISHG to strengthen their community activities

Matching action to need: an analysis of Global Burden of Disease 2017 and population health data to focus adolescent health policy and actions in Myanmar

Background: Myanmar is a country undergoing rapid transitions in health. Its national strategic policy for young people's health is being revised but there is a paucity of population data to inform local priorities and needs. Objective: In this paper we describe a comprehensive profile of adolescent health in Myanmar to focus policy and health actions. Methods: We used available primary data, and modelled estimates from the GBD 2017, to describe health outcomes (mortality and morbidity), health risks and determinants for adolescents in Myanmar between 1990-2017. A governance group of key stakeholders guided the framing of the study, interpretation of findings, and recommendations. Results: Overall health has improved for adolescents in Myanmar since 1990, however adolescent mortality remains high, particularly so for older adolescent males; all-cause mortality rate for 10-24 years was 70 per 100,000 for females and 149 per 100,000 for males (16,095 adolescent deaths in 2017). Overall, the dominant health problems were injuries for males and non-communicable disease for females in a context of ongoing burden of communicable and nutritional diseases for both sexes, and reproductive health needs for females. Health risks relating to undernutrition (thinness and anaemia) remain prevalent, with other health risks (overweight, binge alcohol use, and substance use) relatively low by global and regional standards but increasing. Gains have been made in social determinants such as adolescent fertility and modern contraception use; however, advances have been more limited in secondary education completion and engagement in employment and post education training. Conclusions: These results highlight the need to focus current efforts on addressing disease and mortality experienced by adolescents in Myanmar, with a specific focus on injury, mental health and non-communicable disease.Karly I. Cini, Phone Myint Win, Zay Yar Swe, Kyu Kyu Than, Thin Mar Win ... Peter S. Azzopardi ... et al

DIVERSITY OF TEA ENDOPHYTIC FUNGI: CULTIVAR- AND TISSUE PREFERENCES

Endophytic fungi were isolated from four healthy tissues (new leaf, old leaf, bark, and xylem) of three Japanese tea cultivars (Hokumei, Sayamakaori, and Yabukita) at the Saitama Tea Research Institute, Japan in July 2015. A total of 520 isolates was obtained from 600 segments and were classified into 44 fungal taxa; the majority (93.2%) belonged to the phylum Ascomycota. The lowest infection rate was found in the xylem tissue of all cultivars. The total infection rate did not differ significantly among the cultivars. Colletotrichum gloeosporioides f. sp. camelliae and Pleosporales sp. were the predominant endophytes in all tissue types and cultivars. Most of the dominant endophytes showed obvious cultivar and tissue preferences. Tissue type played a more important role in shaping community structure than did cultivar. Colletotrichum gloeosporioides f. sp. camelliae preferred bark and old leaf tissue while Pleosporales sp. preferred new leaf tissue. The colonization frequency of C. gloeosporioides f. sp. camelliae was significantly lower in the Yabukita cultivar. Stem tissues harbored more diverse endophytes than did leaf tissues

Long-term impact of joint bleeds in von Willebrand disease : A nested case-control study

Patients with severe von Willebrand disease (VWD) may develop arthropathy after joint bleeds. Information on its prevalence and severity is limited. We aimed to assess the occurrence and severity of arthropathy in VWD and its impact on daily life. VWD patients with and without verified joint bleeds were matched for age, sex and Factor VIII level or von Willebrand Factor activity in a nested case-control study within the Willebrand in the Netherlands study. Assessments included the Hemophilia Joint Health Score (0-124), Pettersson score (0-13 per joint X-ray), Hemophilia Activity List score (0-100), joint pain (Visual Analog Scale 0-10), and the Impact on Participation and Autonomy questionnaire (0-20). Arthropathy was defined as a Hemophilia Joint Health Score of 10 or higher, or a Pettersson score over 3 of at least one joint. We included 48 patients with verified joint bleeds (cases) and 48 controls: 60% males, mean age 46 years (range 18-80), median von Willebrand Factor activity 5 versus 8 IU/dL and Factor VIII 24 versus 36 IU/dL. Arthropathy occurred in 40% of the cases versus 10% of the controls (P3: 13 of 19 vs. 3 of 28, P<0.01, and median score on the participation questionnaire 6.1 vs. 0.9, P<0.01). In conclusion, arthropathy occurs in 40% of VWD patients after joint bleeds and is associated with pain, radiological abnormalities, functional limitations, and less social participation (Dutch trial register: NTR4548)