Assessment of Future Climate Change Projections Using Multiple Global Climate Models

Nowadays, the hydrological cycle which alters river discharge and water availability is affected by climate change. Therefore, the understanding of climate change is curial for the security of hydrologic conditions of river basins. The main purpose of this study is to assess the projections of future climate across the Upper Ayeyarwady river basin for its sustainable development and management of water sector for this area. Global Ten climate Models available from CMIP5 represented by the IPCC for its fifth Assessment Report were bias corrected using linear scaling method to generate the model error. Among the GCMs, a suitable climate model for each station is selected based on the results of performance indicators (R2 and RMSE). Future climate data are projected based on the selected suitable climate models by using future climate scenarios: RCP2.6, RCP4.5, and RCP8.5. According to this study, future projection indicates to increase in precipitation amounts in the rainy and winter season and diminishes in summer season under all future scenarios. Based on the seasonal temperature changes analysis for all stations,  the future temperature are  predicted to steadily increase with higher rates during summer than the other two seasons and it can also be concluded that the monthly minimum temperature rise is a bit larger than the maximum temperature rise in all seasons

Analysis of Streamflow Response to Changing Climate Conditions Using SWAT Model

The understanding of climate change is curial for the security of hydrologic conditions of river basins and it is very important to study the climate change impacts on streamflow by analyzing the different climate scenarios with the help of the hydrological models. The main purpose of this study is to project the future climate impact on streamflow by using the SWAT model. The multi-model projections indicated that Upper Ayeyarwady River Basin is likely to become hotter in dry season under low rainfall intensity with increasing temperature and likely to become wetter but warmer in both rainy and winter season because of high rainfall intensity with increased temperature in future. The impact of climate change scenarios is predicted to decrease the annual streamflow by about 0.30 to 1.92% under RCP2.6, 5.59 to 7.29% under RCP4.5 and 10.43 to 11.92% under RCP8.5. Based on the change in high and low flow percentage with respect to the baseline period, the difference between high and low flow variation range will increase year by year based on future scenarios. Therefore, it can be concluded that it may occur more low flow in the dry season which leads to increase in water scarcity and drought and more high flow in the wet season which can cause flooding, water insecurity, stress, and other water-related disasters

Late prehistoric and early historic chronology of Myanmar: a four-millennia sequence from Halin

Myanmar is located within an important geographic corridor of prehistoric demographic and technological exchange, yet relatively few archaeological sites have been securely dated. Here, the authors present a new radiocarbon chronology for Halin, a UNESCO-listed complex in the north-central Sagaing Division of Myanmar, which contributes to the generation of nuanced regional chronologies and to improving the temporal resolution of Southeast Asia more generally. Discussion of 94 radiocarbon determinates, together with site stratigraphy and pottery traditions, provides a chronological sequence from the early third millennium BC to the early second millennium AD. Corroboration of the beginning of this sequence would place Halin as the oldest currently dated Neolithic site in Mainland Southeast Asia and would provide support for the two-layer model of Neolithic migration

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

The impact of community-delivered models of malaria control and elimination: a systematic review

Background: Community-delivered models have been widely used to reduce the burden of malaria. This review aimed to explore different community-delivered models and their relative effectiveness in terms of coverage and malaria-metric outcomes in order to inform the design and implementation of Community Health Worker (CHW) programmes for malaria control and elimination. Methods: A systematic review of studies investigating the impact of community-delivered models on coverage and malaria-metric (parasitaemia and hyperparasitaemia, malaria case and mortality, anaemia, and fever) outcomes compared to non- community-delivered models was undertaken by searching in five databases of published papers and grey literature databases. Data were extracted from studies meeting inclusion and quality criteria (assessed using relevant tools for the study design) by two independent authors. Meta-analyses were performed where there was sufficient homogeneity in effect and stratified by community-delivered models to assess the impact of each model on coverage and malaria-metric outcomes. Results: 28 studies were included from 7042 records identified. The majority of studies (25/28) were performed in high transmission settings in Africa and there was heterogeneity in the type of, and interventions delivered as part of the community-delivered models. Compared to non- community-delivered models, community-delivered models increased coverage of actual bed net usage (Relative Risk (RR) = 1.64 95% CI 1.39, 1.95), intermittent preventive treatment in pregnancy (RR = 1.36 95% CI 1.29, 1.44) and appropriate and timely treatment of febrile children, and improved malaria-metric outcomes such as malaria mortality (RR = 0.58 95% CI 0.52, 0.65). However, the considerable heterogeneity was found in the impact of community-delivered models in reducing, parasitaemia and hyperparasitaemia prevalence, anaemia incidence, fever prevalence and malaria caseload. Statistical comparisons of different community-delivered models were not undertaken due to the heterogeneity of the included studies in terms of method and interventions provided. Conclusion: Overall, the community-delivered model is effective in improving the coverage of malaria interventions and reducing malaria-associated mortality. The heterogeneity of the community-delivered models and their impact on malaria-metric indices suggests that evidence for context-specific solutions is required. In particular, community-delivered models for malaria elimination, integrated with services for other common primary health problems, are yet to be evaluated

Biology of the Cassava Mite, Tetranychus truncatus Ehara (Acari: Tetranychidae)

The duration of developmental stages of Tetranychus truncatus Ehara was studied at four different temperature regimes (20, 25, 30 and 35˚C) on excised mulberry leaves. Longevity and fecundity of fe-male and sex ratio were also observed at 30˚C. Mites completed their development within this tem-perature range. T. truncatus eggs hatched to larvae in the shortest duration of 2.38 ± 0.06 days at 35˚C and the longest duration of 7.65 ± 0.05 days at 20˚C. Development time for completion of the life cycle de-creased significantly with increasing temperature. The longest (16.93 ± 0.11 days) and the shortest (5.34 ± 0.11 days) life cycle were observed at 20˚C and 35˚C respectively. The highest immature mortality was 13.94% at 35˚C followed by 10.35% at 20˚C. A female mite laid 55.07 eggs during its oviposition period of 10.93± 0.29 days at 30˚C. The oviposition rate was 5.13± 0.24 eggs/female/day at 30˚C. The sex ratio of T. truncatus at 30˚C was 1 : 3.12 (male: female)

Community demand for comprehensive primary health care from malaria volunteers in South-East Myanmar: a qualitative study

Background Malaria volunteers have contributed significantly to malaria control achieving a reduction of annual parasite incidence to pre-elimination levels in several townships across Myanmar. However, the volunteers&rsquo; role is changing as Myanmar transitions from a malaria control to elimination programme and towards the goal of universal health coverage. The aim of the study is to explore the perspectives of community leaders, members and malaria volunteers in South-East Myanmar on community-delivered models to inform an optimal design that targets malaria elimination in the context of primary health care in Myanmar. Methods Qualitative methods including focus group discussions (FGDs) with community members and current or ex-malaria volunteers, and participatory workshops with community leaders were conducted. All data collection tools were pilot tested with similar participants. The FGDs were stratified into male and female participants in consideration of diverse gender roles among the ethnic groups of Myanmar. Data saturation was the key cut-off point to cease recruitment of participants. Inductive thematic analysis was used. Results Community members were willing to be tested for malaria because they were concerned about the consequences of malaria although they were aware that malaria prevalence is low in their villages. Malaria volunteers were the main service providers for malaria and other infectious diseases in the community. Apart from malaria, the community identified common health problems such as the flu (fever, sneezing and coughing), diarrhoea, skin infections and tuberculosis as priority diseases in this order. Incorporating preventive, and whenever possible curative, services for those diseases into the current malaria volunteer model was recommended. Discussion and conclusion There was a gap between the communities&rsquo; expectations of health services and the health services currently being delivered by volunteers in the community that highlights the need for reassessment and reform of the volunteer model in the changing context. An evidence-based, community preferred, pragmatic community-delivered integrated model should be constructed based on the context of malaria elimination and progressing towards universal health coverage in Myanmar

Access to primaquine in the last mile: challenges at the service delivery points in pre-elimination era, Myanmar

Abstract Background Alongside monitoring of the disease burden, the successful move towards malaria elimination relies on the readiness of the health care delivery system. However, there is a lack of evidence in the gap of existing National Guidelines and access to low dose primaquine in real practice under varying degrees of antimalarial resistance in the pre-elimination phase in Myanmar. Therefore, this study addressed the essential information from the service delivery points (SDPs) of public and private sectors on the availability and the use of primaquine in both supply and demand side. Concomitantly, the study aimed to underscore challenges in health system infrastructure to promote the sustained flow in rolling out primaquine in line with National Guidelines for malaria elimination. Methods A cross-sectional study conducted from September 2017 to February 2018 included six townships of three states/regions. The team used an observation checklist for documenting primaquine supplies at SDPs. Semi-structured interviews, key informant, and in-depth interviews focused both public and private sectors including staff from the Vector-Borne Diseases Control (VBDC) teams in each state/region and rural health centers (n = 25), those from the non-governmental organizations (NGOs), general practitioners and drug sellers (n = 11), and recently infected malaria patients (n = 11). Triangulation of quantitative and qualitative data provided meaningful interpretations. Results Public sector staff reported an adequate stock of primaquine, but it was unavailable at the general practitioners’ clinics without any connection to NGOs and also at the unlicensed drug shops. Health care providers of the public sector experienced challenges in poor compliance of malaria patients to primaquine treatment in conjunction with an artemisinin-based combination therapy, loss-to-follow-ups especially in conflict areas, and delays in timely substitution of new batches of primaquine. Respondents from the private sector demanded for the refresher training course on updated antimalarial treatment guidelines. Conclusion Monitoring compliance and safety of primaquine treatment was found as a barrier especially among mobile migrant workers and those who were in conflict areas. An alternative strategy by the NMCP could enable to prevent the underutilization of primaquine in vivax malaria to reach the malaria elimination targets

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

Study of fault zone and basin structure of 2019 Mw5.5 Ye-U earthquake sequence beneath Central Myanmar Basin

Accurate and precise location of earthquake sequence is critical to better understand seismotectonics, such as better delineation fault geometry and understanding of the rupture of the earthquakes. However, nearfield seismic observations are usually rare for such study. Here we study a unique dense nodal array data acquired by the deployment after the 31/08/2019 Mw5.5 crustal earthquake that is located ~50km to the west of Sagaing fault near Mandalay beneath ShweBo Central Myanmar Basin (CMB). The network, composed of 20 nodal stations with station spacing of ~5km, was deployed ~ 2 weeks after the mainshock and continuously recording for ~ 40 days. High quality waveforms containing clear P and S phase arrivals, and an interesting P-to-S phase converted at the basement of CMB were recorded for aftershocks. We applied a machine learning based automatic phase detection software (Earthquake-Transformer) to the dataset and detected 1143 events that were recorded by at least 3 stations. Double difference relocation of these aftershocks reveals a near E-W trending fault with a dimension of ~10km along strike and located between 7 to 12 km in depth. The strike of aftershock lineation is highly consistent with the focal mechanism derived from regional waveform inversion, indicating a left lateral strike-slip fault beneath CMB. Mainshock epicenter refined by a path calibration technique is located to the western edge of the seismicity, suggesting an eastward rupture directivity of the mainshock. Taking advantage of the P-basin-S converted phase at the basement of CMB, we constrained the thickness of the basin to be 5 ± 0.7 km. Strong strength of the P-basin-S phase requires sharp velocity change between the basin and bedrock. It is possible that the earthquake sequence is a result of small block rotation that has been taking place beneath the CMB due to the convergence of India plate. Another possible explanation is a conjugate fault system associated with 2012 Mw 6.8 Thabeikkyin earthquake sequence which ruptured close to Sagaing fault