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Article ; Online: Factors associated with the decline of malaria in Myanmar’s Ayeyarwady Region between 2013 and 2017

Sarah Gallalee / Abigail V. Ward / Moe Moe Aye / Nang Khaing Zar Aung / Julia C. Dunn / Stephen Lavenberg / Christopher Lourenço / Jillian Dunning / Aung Thi / Arnaud Le Menach / Myat Min Tun

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 13

Abstract: ... SD 4.59) to 0.34 (SD 0.79); this decline coincided with the implementation of the government’s multi ...

Abstract	Abstract The burden of malaria in Myanmar has declined rapidly in recent years; cases decreased from 333,871 in 2013 to 85,019 in 2017 (75% decrease). Decline of malaria in the Ayeyarwady Region of Myanmar reflects this trend with an 86% decrease in cases over this period. In this exploratory analysis, quantitative and qualitative information were assessed to explore potential factors responsible for the decline of malaria in Ayeyarwady. Data on malaria incidence, programmatic financing, surveillance, case management, vector control interventions, climate and ecological factors, and policies and guidelines spanning 2013 to 2017 were compiled. Poisson regression models that adjust for correlation were used to analyze the association between annual malaria case numbers with malaria intervention factors at the township level. Between 2013 and 2017, there was a decrease in mean township-level malaria incidence per 1000 from 3.03 (SD 4.59) to 0.34 (SD 0.79); this decline coincided with the implementation of the government’s multi-pronged malaria elimination strategy, an increase of approximately 50.8 million USD in malaria funding nationally, and a period of deforestation in the region. Increased funding in Ayeyarwady was invested in interventions associated with the decline in caseload, and the important roles of surveillance and case management should be maintained while Myanmar works towards malaria elimination.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Trends in admissions, morbidity and outcomes at Red Cross War Memorial Children’s Hospital, Cape Town, 2004 - 2013

Y Isaacs-Long / L Myer / H J Zar

South African Medical Journal, Vol 107, Iss 3, Pp 219-

2017 Volume 226

Abstract: ... at Red Cross War Memorial Children’s Hospital (RCWMCH), a major referral hospital for children in the Western ...

Abstract	Background. Routinely collected patient information has the potential to yield valuable information about health systems and population health, but there have been few comprehensive analyses of paediatric admissions at South African (SA) hospitals. Objectives. To investigate trends in hospitalisation and outcomes at Red Cross War Memorial Children’s Hospital (RCWMCH), a major referral hospital for children in the Western Cape and SA. Methods. Using routinely collected observational health data from the hospital informatics system, we investigated admissions between 2004 and 2013. Clinical classification software was used to group International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) codes to rank causes during 2008 - 2013, when ICD-10 codes were widely available. Analyses examined trends in medical and surgical admissions over time. Results. There were 215 536 admissions over 10 years of 129 733 patients. Admissions increased by 9.3%, with increases in the general medical wards (5%), medical specialty wards (74%), the burns unit (73%), and the intensive care unit (16%). In contrast, admissions decreased in the trauma unit (21%) and short-stay medical wards (1%). In-hospital mortality decreased by 54% (p-trend <0.001) over 10 years. Diarrhoea and lower-respiratory tract illness were the most common causes for medical admissions, although admissions and deaths due to these conditions decreased between 2008 and 2013, which coincided with the national introduction of related vaccines. Similarly, tuberculosis admissions and deaths decreased over this period. These trends could be owing to a concurrent decrease in HIV comorbidity (p-trend <0.001). Trauma was the most common reason for surgical admission. Conclusion. Paediatric in-hospital mortality decreased consistently over a decade, despite an overall increase in admissions. Pneumonia and diarrhoea admissions decreased markedly over a 6-year period, but remain the most important causes of hospitalisation.
Keywords	Database research ; Hospital discharge ; Admission trends ; Child health ; South Africa ; Child mortality ; Child morbidity ; Indicators of child health ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2017-03-01T00:00:00Z
Publisher	South African Medical Association
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Diversity of culturable bacteria recovered from Pico BolÃvarâs glacial and subglacial environments, at 4950 m, in Venezuelan tropical Andes

RondÃ³n, Johnma / Alejandra Melfo / Alirio Balza-Quintero / Delsy DÃ¡vila-Vera / Luis AndrÃ©s YarzÃ¡bal / MarÃa M. Ball / Marcos Rengifo / Rosa Virginia Mendoza-BriceÃ±o / Wileidy GÃ³mez / Wilvis BalcÃ¡zar

Canadian journal of microbiology. 2016 June 8, v. 62, no. 11

2016

Abstract: ... of the culturable fraction of bacteria colonizing Pico BolÃvarâs glacier ice and subglacial meltwaters, at â ...

Abstract	Even though tropical glaciers are retreating rapidly and many will disappear in the next few years, their microbial diversity remains to be studied in depth. In this paper we report on the biodiversity of the culturable fraction of bacteria colonizing Pico BolÃvarâs glacier ice and subglacial meltwaters, at â¼4950 m in the Venezuelan Andean Mountains. Microbial cells of diverse morphologies and exhibiting uncompromised membranes were present at densities ranging from 1.5 Ã 10â´ to 4.7 Ã 10â´ cells/mL in glacier ice and from 4.1 Ã 10âµ to 9.6 Ã 10âµ cells/mL in subglacial meltwater. Of 89 pure isolates recovered from the samples, the majority were eurypsychrophilic or stenopsychrophilic, according to their temperature range of growth. Following analysis of their 16S rDNA nucleotidic sequence, 54 pure isolates were assigned to 23 phylotypes distributed within 4 different phyla or classes: Beta- and Gammaproteobacteria, Actinobacteria, and Bacteroidetes. Actinobacteria dominated the culturable fraction of glacier ice samples, whereas Proteobacteria were dominant in subglacial meltwater samples. Chloramphenicol and ampicillin resistance was exhibited by 73.07% and 65.38%, respectively, of the subglacial isolates, and nearly 35% of them were multiresistant. Considering the fast rate at which tropical glaciers are melting, this study confirms the urgent need to study the microbial communities immured in such environments.
Keywords	Actinobacteria ; ampicillin ; bacteria ; Bacteroidetes ; biodiversity ; chloramphenicol ; gamma-Proteobacteria ; glaciers ; ice ; melting ; microbial communities ; mountains ; phylotype ; ribosomal DNA ; snowmelt ; temperature ; Andes region
Language	English
Dates of publication	2016-0608
Size	p. 904-917.
Publishing place	NRC Research Press
Document type	Article
ZDB-ID	280534-0
ISSN	1480-3275 ; 0008-4166
ISSN (online)	1480-3275
ISSN	0008-4166
DOI	10.1139/cjm-2016-0172
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: New Interventions to Prevent Respiratory Syncytial Virus Disease in Infants-Time for Equitable Global Access.

Cunningham, Steve / Zar, Heather J

American journal of respiratory and critical care medicine

2023 Volume 207, Issue 12, Page(s) 1556–1557

MeSH term(s)	Infant ; Humans ; Respiratory Syncytial Virus Infections/prevention & control ; Respiratory Syncytial Viruses ; Communicable Diseases ; Respiratory Syncytial Virus, Human
Language	English
Publishing date	2023-04-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202303-0568VP
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Article: Genotypic and phenotypic characterization of

Haeberle, Amanda / Greenwood-Quaintance, Kerryl / Zar, Sarah / Johnson, Stephen / Patel, Robin / Willett, Julia L E

bioRxiv : the preprint server for biology

2024

Abstract: Over 2.5 million prosthetic joint implantation surgeries occur annually in the United States. Periprosthetic joint infections (PJIs), though occurring in only 1-2% of patients receiving replacement joints, are challenging to diagnose and treat and are ... ...

Abstract	Over 2.5 million prosthetic joint implantation surgeries occur annually in the United States. Periprosthetic joint infections (PJIs), though occurring in only 1-2% of patients receiving replacement joints, are challenging to diagnose and treat and are associated with significant morbidity. The Gram-positive bacterium
Language	English
Publishing date	2024-02-06
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.02.06.579140
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Article ; Online: Fast magnetic resonance imaging for diagnosing pulmonary tuberculosis in children: the sub-10-min unenhanced scan.

Pillay, Tanyia / Zar, Heather J / Venkatakrishna, Shyam Sunder B / Andronikou, Savvas

Pediatric radiology

2023 Volume 54, Issue 3, Page(s) 425–429

Abstract: Purpose: In this study, we aimed to report the feasibility and quality of fast (unenhanced < 10-min duration) magnetic resonance imaging (MRI) for the detection of lymphadenopathy in non-sedated children with suspected tuberculosis (TB).: Material and ...

Abstract	Purpose: In this study, we aimed to report the feasibility and quality of fast (unenhanced < 10-min duration) magnetic resonance imaging (MRI) for the detection of lymphadenopathy in non-sedated children with suspected tuberculosis (TB). Material and methods: This was a prospective study that involved children (< 13 years of age) hospitalised at Red Cross Children's Hospital with suspected pulmonary TB who were referred for a fast MRI of the chest. The limited short-duration MRI protocol included coronal short tau inversion recovery (STIR) and axial diffusion-weighted imaging (DWI) sequences with additional axial STIR and axial and coronal T2 sequences if the patient was compliant. The scan time was capped at 10 min and a study was considered successfully completed when DWI and STIR images were obtained in axial planes. MRI quality was recorded as 'acceptable quality'; 'poor quality, but readable'; and 'non-diagnostic'. Results: Of the 192 fast MRI protocol scans, 166 (86%) were successfully completed within the 10-min allotted scan period. There was no age or sex difference between successful and unsuccessful studies. The mean duration of successful scans was 6.5 min (standard deviation = 1.5 min, range = 4-10 min). Conclusion: Fast (sub-10-min scan) MRI is feasible for diagnosis of lymphadenopathy in non-sedated children in the setting of suspected TB, including those below 6 years of age.
MeSH term(s)	Child ; Humans ; Male ; Female ; Prospective Studies ; Magnetic Resonance Imaging/methods ; Diffusion Magnetic Resonance Imaging/methods ; Tuberculosis, Pulmonary/diagnostic imaging ; Lymphadenopathy
Language	English
Publishing date	2023-05-22
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	124459-0
ISSN	1432-1998 ; 0301-0449
ISSN (online)	1432-1998
ISSN	0301-0449
DOI	10.1007/s00247-023-05683-w
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Article ; Online: A Child Psychiatry Perspective on Encopresis.

Baroud, Evelyne / Zar-Kessler, Claire / Bender, Suzanne

Journal of the American Academy of Child and Adolescent Psychiatry

2022 Volume 61, Issue 7, Page(s) 851–853

Abstract: Fecal incontinence, known as encopresis, is the repetitive, intentional or unintentional passage of stool in inappropriate places in children who are developmentally four years old or older. Incontinence can have a chronic course and is associated with ... ...

Abstract	Fecal incontinence, known as encopresis, is the repetitive, intentional or unintentional passage of stool in inappropriate places in children who are developmentally four years old or older. Incontinence can have a chronic course and is associated with emotional distress and a substantial negative impact on quality of life. We review how a medical and behavioral health multidisciplinary approach provides the optimal clinical care for this condition, and we discuss how the unique skill set of the child psychiatrist may address the complex family dynamics and psychiatric comorbidities which may be preventing remission from this condition. Identifying and understanding these factors is essential in developing a comprehensive and effective treatment plan.
MeSH term(s)	Child ; Child Psychiatry ; Child, Preschool ; Encopresis/psychology ; Encopresis/therapy ; Fecal Incontinence/therapy ; Humans ; Quality of Life ; Treatment Outcome
Language	English
Publishing date	2022-01-03
Publishing country	United States
Document type	Editorial ; Review
ZDB-ID	392535-3
ISSN	1527-5418 ; 0890-8567
ISSN (online)	1527-5418
ISSN	0890-8567
DOI	10.1016/j.jaac.2021.12.011
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Article: Lung Function in Preschool Children in Low and Middle Income Countries: An Under-Represented Potential Tool to Strengthen Child Health.

Chaya, Shaakira / Zar, Heather J / Gray, Diane M

Frontiers in pediatrics

2022 Volume 10, Page(s) 908607

Abstract: Background: The burden of respiratory disease is high in low-middle income countries (LMIC). Pulmonary function tests are useful as an objective measure of lung health and to track progression. Spirometry is the commonest test, but its use is limited in ...

Abstract	Background: The burden of respiratory disease is high in low-middle income countries (LMIC). Pulmonary function tests are useful as an objective measure of lung health and to track progression. Spirometry is the commonest test, but its use is limited in preschool children. Other lung function methods have been developed but their use in LMIC has not been well described. Aim: To review the use of preschool lung function testing in children in LMIC, with particular reference to feasibility and clinical applications. Methods: Electronic databases "PubMed", "Scopus"," Web of Science", and "EBSCO host" were searched for publications in low and middle income countries on preschool lung function testing, including spirometry, fractional exhaled nitric oxide (FeNO), oscillometry, interrupter technique, tidal breathing and multiple breath washout (MBW), from 1 January 2011 to 31 January 2022. Papers in English were included and those including only children ≥6 years were excluded. Result: A total of 61 papers from LMIC in Asia, South America, Africa, Eurasia or the Middle East were included. Of these, 40 included spirometry, 7 FeNO, 15 oscillometry, 2 interrupter technique, and 2 tidal breathing. The papers covered test feasibility (19/61), clinical application (46/61) or epidemiological studies (13/61). Lung function testing was successful in preschool children from LMIC. Spirometry was the most technically demanding and success gradually increased with age. Conclusion: Preschool lung function testing is under-represented in LMIC for the burden of respiratory disease. These tests have the potential to strengthen respiratory care in LMIC, however access needs to be improved.
Language	English
Publishing date	2022-06-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2022.908607
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Article ; Online: Determinants of institutional maternity services utilization in Myanmar

Khaing Zar Lwin / Sureeporn Punpuing

PLoS ONE, Vol 17, Iss

2022 Volume 4

Abstract: ... among ASEAN member countries in that year. Myanmar’s infant mortality rate was twice the average of ASEAN ... Demographic and Health Survey by adapting Andersen’s Behavioral Model. Both descriptive and inferential statistics were applied ... poor households, experience with financial burden and the husband’s occupation in agriculture or unskilled labor ...

Abstract	Background Maternal mortality is a persistent public health problem worldwide. The maternal mortality ratio of Myanmar was 250 deaths per 100,000 live births in 2017 which was the second-highest among ASEAN member countries in that year. Myanmar’s infant mortality rate was twice the average of ASEAN member countries in 2020. This study examined factors influencing institutional maternity service utilization and identified the need for improved maternal health outcomes. Methods A cross-sectional study design was used to examine the experience of 3,642 women from the 2015–16 Myanmar Demographic and Health Survey by adapting Andersen’s Behavioral Model. Both descriptive and inferential statistics were applied. Adjusted odds ratios and 95% confidence interval were reported in the logistic regression results. Results The findings illustrate that the proportion of women who delivered their last child in a health/clinical care facility was 39.7%. Women live in rural areas, states/regions with a high levels of poverty, poor households, experience with financial burden and the husband’s occupation in agriculture or unskilled labor were negatively associated with institutional delivery. While a greater number of ANC visits and level of the couple’s education had a positive association with institutional delivery. Conclusion The determinants of institutional delivery utilization in this study related to the institutional facilities environment imply an improvement of the institutional availability and accessibility in rural areas, and different states/regions, particularly Chin, Kayah and Kachin States- the poorest states in Myanmar. The poverty reduction strategies are urgently implemented because problems on health care costs and household economic status played important roles in institutional delivery utilization. The ANC visits indicated a significant increase in institutional delivery. The government needs to motivate vulnerable population groups to seek ANC and institutional delivery. Moreover, education is crucial ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Acute effect of two exercise intensity programs on interleukin-6, interleukin-1 beta and tumour necrosis factor-α in female futsalists

Zar, A. / Ahmadi, E. / Amani, D. / Ramsbottom, R.

Comparative exercise physiology. 2022 Jan. 1, v. 18, no. 1

2022

Abstract: ... each exercise session from an antecubital vein by venous puncture in a seated position. A Student’s t-test (P<0 ...

Abstract	Duration, intensity, and type of exercise can affect serum cytokine levels and change inflammatory indices. The present study aimed to examine the acute effect of two different exercise intensity programs on levels of circulating interleukin (IL)-6, IL-1β and tumour necrosis factor-α (TNF-α) in athletes. Eleven female futsal players aged 20.6±1.2 years completed this cross-over study. Participants performed, either a MI (moderate intensity: 60-65%) or a HI (high intensity: 75-80% heart rate reserve) exercise program. The study was performed on different days separated by a 1-week washout period. Each session consisted of 30 min running, either MI or HI. Blood samples were taken before (Pre) and immediately after (Post) each exercise session from an antecubital vein by venous puncture in a seated position. A Student’s t-test (P<0.05) was used to examine any difference between Pre and Post values. The results showed that IL-6 (P=0.22), IL-1β (P=0.90) and TNF-α (P=0.63) serum concentrations were not significantly different after moderate-intensity exercise. Similarly, high-intensity exercise did not significantly change serum concentrations of TNF-α (P=0.63), and IL-1β (P=0.18). However, HI caused a significant increase in IL-6 (P=0.04). A significant correlation was observed only between IL-1β and IL-6 (r=-0.761, P=0.01) after MI exercise. Based on the findings of the present study, the intensity of exercise can affect some cytokines, such as IL-6 in female futsal players.
Keywords	acute effects ; blood serum ; cross-over studies ; exercise ; females ; heart rate ; interleukin-1beta ; interleukin-6 ; necrosis ; neoplasms ; t-test
Language	English
Dates of publication	2022-0101
Size	p. 57-63.
Publishing place	Wageningen Academic Publishers
Document type	Article
ZDB-ID	2433254-9
ISSN	1755-2559 ; 1755-2540
ISSN (online)	1755-2559
ISSN	1755-2540
DOI	10.3920/CEP210007
Database	NAL-Catalogue (AGRICOLA)

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