Prevalence of eggs of liver fluke (Opisthorchis viverrini) and other helminth in Lahanam, Savannakhet, Lao P.D.R

　This study was conducted in Lahanam zone of Songkhone district of Savannakhet province, Lao P.D.R. There are six villages in Lahanam zone, and there are five primary schools in the area. Stool examination and treatment were performed for all school children (total number = 670 children) from grade 1 to grade 5, registered at Lahanam in September 2004. Liver fluke, Opisthorchis viverrini (Ov) was the most common intestinal parasite with prevalence of 49 % , followed by hookworm with 32 % . Ov egg-positives were treated by praziquantel at schools (selective mass-chemotherapy) and all the children were treated for hookworm by albendazol (mass-chemotherapy).　In September 2005, after one year of treatment, stool examination was repeated for the same children in schools. Due to the move to the new academic year, school children of the previous grade 5 had already graduated and we did not include them. Prevalence of Ov and hookworm after one year of treatment were 29% and 12% , respectively.　Children attending Bengkhamlay primary school located about 5 km from Banghiang River had lower prevalence for Ov. And higher prevalence of hookworm than other schools located within 2 km from the river (p<0.001).　In December 2005, community stool examination was carried out in Bengkhamlay The subjects were all the villagers in Bengkhamlay age 5 years old and over. The prevalence of Ov in those over 15 years old (284 people) was 66.2% and the age group showing the highest prevalence (77.5% ) was 30‒39 years old. Prevalence of hookworm was 31.3 % in those over 15 years old. Intensity of Ov. Infection was low to moderate with increasing tendency by age up to middle age, and become low after 60 years old

Initiation of breastfeeding within 120 minutes after birth is associated with breastfeeding at four months among Japanese women: A self-administered questionnaire survey

<p>Abstract</p> <p>Background</p> <p>The proportion of mothers in Japan who breastfeed exclusively has been low since the 1970s. The purpose of this study was to examine the association between the time of first breastfeed after birth and the proportion of mothers fully breastfeeding up to four months postpartum.</p> <p>Methods</p> <p>A survey was conducted using a self-administered questionnaire. The participants were 318 mothers who participated in a physical examination of their four month old infants in Nagasaki City, Japan in 2003.</p> <p>Results</p> <p>The time of first breastfeeding up to 120 minutes was significantly associated with the proportion of mothers fully breastfeeding during their stay in the clinic/hospital (p = 0.006), at one month (p = 0.004) and at four months after birth (p = 0.003). There was no significant difference in the proportion of full breastfeeding in mothers who first breastfed between the period of less 30 minutes after birth and that of between 31 and 120 minutes after birth. Logistic regression analysis indicated that the proportion of mothers who continued full breastfeeding at four months was significantly higher in those who breastfed their baby within 120 minutes compared with more than 120 minutes (OR 2.5, p = 0.01), but was not significantly different in those who breastfed within 30 minutes compared with more than 30 minutes (OR 1.8, p = 0.06). Early breastfeeding was affected by caesarean section, premature delivery and severe bleeding during delivery.</p> <p>Conclusion</p> <p>Commencement of early breastfeeding was associated with the proportion of mothers who fully breastfed their infants up to four months. Early breastfeeding, especially within two hours, is recommended for child and maternal health.</p

Nodding Syndrome in Uganda: Field Observations, Challenges and Research Agenda

This article summarizes observations made in Northern Uganda and a lecture given at the Nodding Syndrome Workshop in Nagasaki September 2013. The objective of the manuscript is to summarize the current knowledge on nodding syndrome and to provide an agenda for investigations into the epidemiology, pathophysiology, diagnosis and care management of nodding syndrome in Uganda

Factors affecting alcohol drinking behaviour among secondary school students in Vientiane Province, Lao People\u27s Democratic Republic: a cross-sectional study

Background: This study investigated alcohol consumption prevalence among adolescents in school settings in Lao People’s Democratic Republic and identified factors associated with alcohol consumption to establish better school-based interventions.Methods: Self-administered questionnaires containing items assessing alcohol drinking behaviour and underlying factors were administered to 393 secondary school students ages 10–19 y. Multivariate logistic regression was used to predict factors associated with drinking behaviour.Results: Fifty-eight percent of respondents reported ever drinking alcohol. Among the drinkers, 52.6% were light drinkers, 16.8% were moderate drinkers, 27.0% were heavy drinkers and 3.5% were very heavy drinkers. Older age group (adjusted odds ratio [AOR] 5.2 [95% confidence interval {CI} 2.6 to 10.1]); peer pressure, particularly when more than two-thirds of friends drank alcohol (AOR 8.0 [95% CI 2.2 to 29.5]); and siblings’ drinking behaviour (AOR 2.8 [95% CI 1.4 to 5.5]) were positively associated with alcohol use, while no permission to drink at home (AOR 0.2 [95% CI 0.1 to 0.6]), uncertain of permission to drink at home (AOR 0.06 [95% CI 0.02 to 0.1]) and never attempting to buy alcohol (AOR 0.2 [95% CI 0.1 to 0.4]) were negatively associated with respondents’ alcohol use.Conclusions: By the age of 19 y, most participating students had started drinking alcohol. One-third of them were permitted to drink by family members and drinking was strongly accelerated by peer pressure. Educational programmes are needed for adolescents attending school and their families that employ peer learning to raise awareness of the ill effects of alcohol use

Anemia and Related Factors in Preschool Children in the Southern Rural Lao People’s Democratic Republic

Anemia is a severe public health problem in the Lao People’s Democratic Republic (PDR). Consequently, a new control strategy to reduce the burden of anemia has been introduced for preschool children (aged 6–52 months). The objective of this study was to assess the current prevalence of anemia and related factors in preschool children in southern rural Lao PDR. A population-based cross-sectional study was carried out in six communities in Songkhone district, Savannakheth province, in February 2009. As a result, the prevalence of anemia was found to be 48.9% (95% confidence interval (CI), 43.5–54.3), although most cases were mild. A multiple logistic regression analysis indicated that there was no protective effect of breastfeeding against anemia. The anemia prevalence was higher in 1) children aged 6–23 months (Odds Ratio (OR) = 1.73, 95% CI, 1.02–2.90) than in older children, 2) children in large families (6 or more members) (OR = 1.96, 95% CI, 1.17–3.29), and 3) children in three remote villages with relatively difficult access to markets (OR = 3.01, 95% CI, 1.25–7.47)

Appendicular bone mass and knee and hand osteoarthritis in Japanese women: a cross-sectional study

BACKGROUND: It has been reported that there is an inverse association between osteoarthritis (OA) and osteoporosis. However, the relationship of bone mass to OA in a Japanese population whose rates of OA are different from Caucasians remains uncertain. METHODS: We studied the association of appendicular bone mineral density (second metacarpal; mBMD) and quantitative bone ultrasound (calcaneus; stiffness index) with knee and hand OA among 567 Japanese community-dwelling women. Knee and hand radiographs were scored for OA using Kellgren-Lawrence (K/L) scales. In addition, we evaluated the presence of osteophytes and of joint space narrowing. The hand joints were examined at the distal and proximal interphalangeal (DIP, PIP) and first metacarpophalangeal/carpometacarpal (MCP/CMC) joints. RESULTS: After adjusting for age and body mass index (BMI), stiffness index was significantly higher in women with K/L scale, grade 3 at CMC/MCP joint compared with those with no OA. Adjusted means of stiffness index and mBMD were significantly higher in women with definite osteophytes at the CMC/MCP joint compared to those without osteophytes, whereas there were no significant differences for knee, DIP and PIP joints. Stiffness index, but not mBMD, was higher in women with definite joint space narrowing at the CMC/MCP joint compared with those with no joint space narrowing. CONCLUSIONS: Appendicular bone mass was increased with OA at the CMC/MCP joint, especially among women with osteophytes. Our findings suggest that the association of peripheral bone mass with OA for knee, DIP or PIP may be less clearcut in Japanese women than in other populations

A SIMULATION SHEDS A LIGHT ON THE PRESENT HIV EPIDEMIC

A hypothetical community of one million people where birth rate and death rate are equal was applied to the modified deferential equations Lipsitch and Nowak published in 1995 in order to examine the impact of partner acquisition change on the HIV epidemic over a relatively short term. The results showed that if the partner exchange rate increases from two to three per year in the population, the epidemic caused by a more virulent strain would overweigh that caused by a less virulent strain within a century. This result reveals that an increase in the rate of partner acquisition gives the more virulent strain an advantage in terms of propagating the virus in a given population, at least over a relatively short term of several decades. The partner acquisition rate also exerts an influence on the magnitude of the HIV epidemic and the time it needs to reach a peak in the hypothetical community.These results indicate that increased sexual contact may be even more important than expected and thus shed a new light on the present HIV epidemic

The ecosystem approach to health is a promising strategy in international development: lessons from Japan and Laos

Background: An ecological perspective was prominently present in the health promotion movement in the 1980s, but this seems to have faded. The burden of disease the developing world is facing cannot be addressed solely by reductionist approaches. Holistic approaches are called for that recognize the fundamentally interdependent nature of health and other societal, developmental, and ecosystem related factors in human communities. An ecosystem approach to human health (ecohealth) provides a good starting point to explore these interdependencies. Discussion: Development assistance is often based on the assumption that developed countries can serve as models for developing ones. Japan has provided lavish assistance to Laos for example, much of it going to the development of transport networks. However, there is little sign that there is an awareness of the potentially negative environmental and health impacts of this assistance. We argue that the health consequences of environmental degradation are not always understood, and that developing countries need to consider these issues. The ecohealth approach is useful when exploring this issue. Summary: This article presents a brief case study of Japan\u27s development assistance to Laos, and its environmental and health implications, as an illustration of the ecohealth approach. We highlight three implications of the ecohealth perspective

A descriptive study of stroke types, risk factors, clinical features, and outcomes in a tertiary hospital in Myanmar

BACKGROUND: Stroke is a leading cause of death in the world, and the burden of stroke is higher in low- and middle-income countries. Understanding the risk factors, complications, and outcomes of stroke are useful for healthcare planning and resource allocation. Little information on stroke is available for many low- and middle-income Asian countries; including Myanmar, which is the focus of this study. METHODS: A review was conducted of medical records for stroke admissions during 2017 in a tertiary hospital in Myanmar. The final diagnoses, risk factors, clinical features, complications, and outcomes were systematically collected from computer- and paper-based medical records. RESULTS: Of 908 cases analysed, haemorrhagic stroke was the most common type (49%), followed by ischaemic stroke (43%). Unimproved cases were 32%. Identified risk factors of unimproved cases were 'haemorrhagic stroke' [adjusted odds ratio (aOR): 1.73], 'having fever during hospitalization' [aOR: 2.49], 'Glasgow Coma Scale (GCS) at the admission between 9 and 14' [aOR: 4.33], and GCS less than 9 [aOR: 42.86]. CONCLUSION: This study is based on hospital medical records to assess stroke types, risk factors, clinical features, and outcomes in a tertiary hospital, in Nay Pyi Daw, Myanmar. The findings indicated that early case admission, improved hospital care management, and increased awareness of the modifiable risk factors within populations are crucial for preventing stroke incidents

Effect of daily versus weekly home fortification with multiple micronutrient powder on haemoglobin concentration of young children in a rural area, Lao People's Democratic Republic: a randomised trial

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Background Multiple micronutrient deficiencies, in particular iron deficiency anaemia (IDA) is a severe public health problem in Lao People's Democratic Republic (Lao PDR). Because of the practical difficulties encountered in improving the nutritional adequacy of traditional complementary foods and the limitations associated with the use of liquid iron supplementation for the treatment and prevention of IDA in infants and young children, recently, home-fortification with multivitamins and minerals sprinkles was recommended. This study aims to compare the effect of twice weekly versus daily supplementation with multivitamins and minerals powder (MMP) on anaemia prevalence, haemoglobin concentration, and growth in infants and young children in a rural community in Lao PDR. Methods A randomized trial was conducted in six rural communities. Children aged 6 to 52 months (n = 336) were randomly assigned to a control group (n = 110) or to one of two intervention groups receiving either two sachets per week (n = 115) or a daily sachet (n = 111) of MMP for 24 weeks; 331 children completed the study. A finger prick of blood was taken at baseline, at week 12, and again at week 24 to determine haemoglobin concentration. Anthropometric measurements were taken every 4 weeks. The McNemar test was used to assess within group differences at three time points in the study subjects with anaemia and one-way ANOVA was used to assess changes in mean haemoglobin concentration in the treatment groups. Results MMP supplementation resulted in significant improvements in haemoglobin concentration and in the reduction of anaemia prevalence in the two treatment groups compared with the control group (p <0.001). The severely to moderately anaemic children (Hb <100 g/L) on daily supplementation recovered faster than those on twice weekly supplementation. MMP was well accepted and compliance was high in both treatment groups. Overall, the improvement in the weight for age Z-score was very small and not statistically significant across the three study groups. Conclusions MMP supplementation had positive effects in reduction of anaemia prevalence and in improving haemoglobin concentration. For severely to moderately anaemic children, daily MMP supplementation was more effective in improving haemoglobin concentration and reducing anaemia prevalence. A longer intervention period is probably needed to have a positive effect on growth.Peer Reviewe