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  1. Article ; Online: Environmental, Occupational, and Demographic Risk Factors for Clinical Scrub Typhus, Bhutan.

    Zangpo, Tandin / Phuentshok, Yoenten / Dorji, Kezang / Dorjee, Chencho / Dorjee, Sithar / Jolly, Peter / Morris, Roger / Marquetoux, Nelly / McKenzie, Joanna

    Emerging infectious diseases

    2023  Volume 29, Issue 5, Page(s) 909–918

    Abstract: Underdiagnosis and underreporting of scrub typhus has increasingly affected public health in Bhutan since its initial detection in 2008. Identifying scrub typhus risk factors would support early diagnosis and treatment for this nonspecific febrile ... ...

    Abstract Underdiagnosis and underreporting of scrub typhus has increasingly affected public health in Bhutan since its initial detection in 2008. Identifying scrub typhus risk factors would support early diagnosis and treatment for this nonspecific febrile disease, reducing the incidence of potentially fatal complications. We conducted a hospital-based, case‒control study during October‒December 2015 in 11 scrub typhus‒prone districts. We identified harvesting cardamom as the major risk factor (odds ratio 1,519; p<0.001); other factors were traditional housing, largely caused by an outside toilet location, as well as owning a goat and frequently sitting on grass. Harvesting vegetables, herding cattle in the forest, and female sex were protective. Age had a nonlinear effect; children and the elderly were more likely to seek treatment for clinical scrub typhus. This study has informed public health policies and awareness programs for healthcare workers through development of National Guidelines for Prevention, Treatment and Control of Scrub Typhus in Bhutan.
    MeSH term(s) Female ; Animals ; Cattle ; Scrub Typhus/diagnosis ; Scrub Typhus/epidemiology ; Orientia tsutsugamushi ; Case-Control Studies ; Bhutan/epidemiology ; Risk Factors ; Demography
    Language English
    Publishing date 2023-04-20
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1380686-5
    ISSN 1080-6059 ; 1080-6040
    ISSN (online) 1080-6059
    ISSN 1080-6040
    DOI 10.3201/eid2905.221430
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4778: Show issues Location:
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  2. Article ; Online: Social and behavioral factors related to blood pressure measurement: A cross-sectional study in Bhutan.

    Kohori Segawa, Hiromi / Uematsu, Hironori / Dorji, Nidup / Wangdi, Ugyen / Dorjee, Chencho / Yangchen, Pemba / Kunisawa, Susumu / Sakamoto, Ryota / Imanaka, Yuichi

    PloS one

    2022  Volume 17, Issue 8, Page(s) e0271914

    Abstract: Cardiovascular disease is a leading cause of death in the Kingdom of Bhutan, and early detection of hypertension is critical for preventing cardiovascular disease. However, health-seeking behavior, including blood pressure measurement, is infrequently ... ...

    Abstract Cardiovascular disease is a leading cause of death in the Kingdom of Bhutan, and early detection of hypertension is critical for preventing cardiovascular disease. However, health-seeking behavior, including blood pressure measurement, is infrequently investigated in Bhutan. Therefore, this study investigated factors related to blood pressure measurement in Bhutan. We performed a secondary data analysis of a target population of 1,962 individuals using data from the "2014 Bhutan STEPS survey data"as a cross-sectional study. Approximately 26% of those with hypertension who were detected during the STEPS survey had never had their blood pressure measured. Previous blood pressure measurement was significantly associated with age and working status in men (self-employed [odds ratio (OR): 0.219, 95% CI: 0.133-0.361], non-working [OR: 0.114, 95% CI: 0.050-0.263], employee [OR: 1.000]). Previous blood pressure measurement was significantly associated with higher income in women (Quartile-2 [OR: 1.984, 95% CI: 1.209-3.255], Quartile-1 [OR: 2.161, 95% CI: 1.415-3.299], Quartile-4 [OR: 1.000]). A family history of hypertension (OR: 2.019, 95% CI: 1.549-2.243) increased the likelihood of having experienced a blood pressure measurement in both men and women. Multivariate logistic regression showed that people with unhealthy lifestyles (high salt intake [adjusted odds ratio (AOR): 0.247, 95% confidence interval (CI): 0.068-0.893], tobacco use [AOR: 0.538, 95% CI: 0.380-0.761]) had a decreased likelihood of previous blood pressure measurement. To promote the early detection of hypertension in Bhutan, we suggest that more attention be paid to low-income women, non-working, self-employed, and low-income men, and a reduction of barriers to blood pressure measurement. Before the STEPS survey, a substantial number of hypertensive people had never had their blood pressure measured or were unconcerned about their health. As a result, we propose that early blood pressure monitoring and treatment for people with hypertension or at higher risk of hypertension be given increased emphasis.
    MeSH term(s) Bhutan/epidemiology ; Blood Pressure ; Cardiovascular Diseases ; Cross-Sectional Studies ; Female ; Humans ; Hypertension/diagnosis ; Hypertension/epidemiology ; Male ; Risk Factors
    Language English
    Publishing date 2022-08-17
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0271914
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Gender with marital status, cultural differences, and vulnerability to hypertension: Findings from the national survey for noncommunicable disease risk factors and mental health using WHO STEPS in Bhutan.

    Segawa, Hiromi Kohori / Uematsu, Hironori / Dorji, Nidup / Wangdi, Ugyen / Dorjee, Chencho / Yangchen, Pemba / Kunisawa, Susumu / Sakamoto, Ryota / Imanaka, Yuichi

    PloS one

    2021  Volume 16, Issue 8, Page(s) e0256811

    Abstract: Cardiovascular disease is the leading cause of death in the Kingdom of Bhutan. Thus, the early detection and prevention of hypertension is critical for reducing cardiovascular disease. However, the influence of sociocultural factors on vulnerability to ... ...

    Abstract Cardiovascular disease is the leading cause of death in the Kingdom of Bhutan. Thus, the early detection and prevention of hypertension is critical for reducing cardiovascular disease. However, the influence of sociocultural factors on vulnerability to hypertension needs further investigation. This study performed secondary data analysis on 1,909 individuals in a cross-sectional study (the National survey for noncommunicable disease risk factors and mental health using World Health Organization (WHO) STEPS approach in Bhutan- 2014). Multivariate logistic regression demonstrated a significant association between gender with marital status and hypertension. Women had a higher odds ratio than men (Ref) when married (AOR: 1.27, 95% confidence intervals (CI): 1.23-1.31), and when separated, divorced, or widowed (AOR: 1.18, 95% CI: 1.12-1.26). People who speak the Tshanglakha language scored the highest odds (AOR: 1.24, 95% CI: 1.20-1.27), followed by Lhotshamkha (AOR: 1.09, 95% CI: 1.06-1.12) and Dzongkha (Ref) after adjusting for various social and biomedical factors. Additionally, tobacco use displayed decreased odds for hypertension. To promote the early detection and prevention of hypertension, these cultural factors should be considered even within small geographic areas, such as Bhutan. It is necessary to strengthen hypertension preventive strategies for people who speak Tshanglakha and Lhotshamkha. Furthermore, careful consideration should be given to preventing hypertension among adults aged 40 years or more, women who are married, separated, divorced, or widowed, and men who never married in Bhutan.
    MeSH term(s) Adolescent ; Adult ; Aged ; Bhutan/epidemiology ; Cross-Sectional Studies ; Culture ; Divorce/statistics & numerical data ; Health Surveys ; Humans ; Hypertension/epidemiology ; Hypertension/ethnology ; Hypertension/etiology ; Male ; Marital Status/statistics & numerical data ; Middle Aged ; Risk Factors ; Sex Factors ; Single Person/statistics & numerical data ; Widowhood/statistics & numerical data ; Young Adult
    Language English
    Publishing date 2021-08-31
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0256811
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Clinical and Epidemiological Patterns of Scrub Typhus, an Emerging Disease in Bhutan.

    Dorji, Kezang / Phuentshok, Yoenten / Zangpo, Tandin / Dorjee, Sithar / Dorjee, Chencho / Jolly, Peter / Morris, Roger / Marquetoux, Nelly / McKenzie, Joanna

    Tropical medicine and infectious disease

    2019  Volume 4, Issue 2

    Abstract: Scrub typhus (ST) is a vector-borne rickettsial infection causing acute febrile illness. The re-emergence of ST in the Asia-Pacific region represents a serious public health threat. ST was first detected in Bhutan in 2008. However, the disease is likely ... ...

    Abstract Scrub typhus (ST) is a vector-borne rickettsial infection causing acute febrile illness. The re-emergence of ST in the Asia-Pacific region represents a serious public health threat. ST was first detected in Bhutan in 2008. However, the disease is likely to be under-diagnosed and under-reported, and the true impact is difficult to estimate. At the end of 2014, the SD Bioline Tsutsugamushi Test
    Language English
    Publishing date 2019-03-29
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2414-6366
    ISSN (online) 2414-6366
    DOI 10.3390/tropicalmed4020056
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Evaluation of post-exposure prophylaxis practices to improve the cost-effectiveness of rabies control in human cases potentially exposed to rabies in southern Bhutan.

    Penjor, Kinley / Marquetoux, Nelly / Dorji, Chendu / Dorjee, Sithar / Dorjee, Chencho / Jolly, P D / Morris, R S / McKenzie, J S

    BMC infectious diseases

    2020  Volume 20, Issue 1, Page(s) 203

    Abstract: Background: Rabies is endemic in southern Bhutan, associated with 1-2 human deaths and high post exposure prophylaxis (PEP) costs annually. Evaluation of clinicians' management of human cases potentially exposed to rabies could contribute to improving ... ...

    Abstract Background: Rabies is endemic in southern Bhutan, associated with 1-2 human deaths and high post exposure prophylaxis (PEP) costs annually. Evaluation of clinicians' management of human cases potentially exposed to rabies could contribute to improving PEP prescribing practices to both reduce unnecessary costs associated with PEP and reach the target of zero human deaths due to rabies by 2023.
    Methods: A cross-sectional survey of 50 clinicians' management of human cases potentially exposed to rabies was conducted in 13 health centers in high-rabies-risk areas of Bhutan during February-March 2016.
    Results: Data were collected on clinicians' management of 273 human cases potentially exposed to rabies. The 50 clinicians comprised health assistants or clinical officers (55%) and medical doctors (45%) with a respective median of 19, 21 and 2 years' experience. There was poor agreement between clinicians' rabies risk assessment compared with an independent assessment for each case based on criteria in the National Rabies Management Guidelines (NRMG). Of the 194 cases for which clinicians recorded a rabies risk category, only 53% were correctly classified when compared with the NRMG. Clinicians were more likely to underestimate the risk of exposure to rabies and appeared to prescribe PEP independently of their risk classification.. Male health assistants performed the most accurate risk assessments while female health assistants performed the least accurate. Clinicians in Basic Health Units performed less accurate risk assessments compared with those in hospitals.
    Conclusions: This study highlights important discrepancies between clinicians' management of human cases potentially exposed to rabies and recommendations in the NRMG. In particular, clinicians were not accurately assessing rabies risk in potentially exposed cases and were not basing their PEP treatment on the basis of their risk assessment. This has significant implications for achieving the national goal of eliminating dog-mediated human rabies by 2030 and may result in unnecessary costs associated with PEP. Recommendations to improve clinician's management of human cases potentially exposed to rabies include: reviewing and updating the NRMG, providing clinicians with regular and appropriately targeted training about rabies risk assessment and PEP prescription, and regularly reviewing clinicians' practices.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Bhutan/epidemiology ; Bites and Stings ; Child ; Child, Preschool ; Cost-Benefit Analysis ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Physicians/psychology ; Post-Exposure Prophylaxis ; Prescriptions ; Rabies/diagnosis ; Rabies/economics ; Rabies/epidemiology ; Rabies/prevention & control ; Rabies Vaccines/immunology ; Referral and Consultation ; Risk Assessment ; Young Adult
    Chemical Substances Rabies Vaccines
    Language English
    Publishing date 2020-03-06
    Publishing country England
    Document type Journal Article
    ISSN 1471-2334
    ISSN (online) 1471-2334
    DOI 10.1186/s12879-020-4926-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Survey and Phylogenetic Analysis of Rodents and Important Rodent-Borne Zoonotic Pathogens in Gedu, Bhutan.

    Phuentshok, Yoenten / Dorji, Kezang / Zangpo, Tandin / Davidson, Silas A / Takhampunya, Ratree / Tenzinla, Tenzinla / Dorjee, Chencho / Morris, Roger S / Jolly, Peter D / Dorjee, Sithar / McKenzie, Joanna S

    The Korean journal of parasitology

    2018  Volume 56, Issue 5, Page(s) 521–525

    Abstract: Rodents are well-known reservoirs and vectors of many emerging and re-emerging infectious diseases, but little is known about their role in zoonotic disease transmission in Bhutan. In this study, a cross-sectional investigation of zoonotic disease ... ...

    Abstract Rodents are well-known reservoirs and vectors of many emerging and re-emerging infectious diseases, but little is known about their role in zoonotic disease transmission in Bhutan. In this study, a cross-sectional investigation of zoonotic disease pathogens in rodents was performed in Chukha district, Bhutan, where a high incidence of scrub typhus and cases of acute undifferentiated febrile illness had been reported in people during the preceding 4-6 months. Twelve rodents were trapped alive using wire-mesh traps. Following euthanasia, liver and kidney tissues were removed and tested using PCR for Orientia tsutsugamushi and other bacterial and rickettsial pathogens causing bartonellosis, borreliosis, human monocytic ehrlichiosis, human granulocytic anaplasmosis, leptospirosis, and rickettsiosis. A phylogenetic analysis was performed on all rodent species captured and pathogens detected. Four out of the 12 rodents (33.3%) tested positive by PCR for zoonotic pathogens. Anaplasma phagocytophilum, Bartonella grahamii, and B. queenslandensis were identified for the first time in Bhutan. Leptospira interrogans was also detected for the first time from rodents in Bhutan. The findings demonstrate the presence of these zoonotic pathogens in rodents in Bhutan, which may pose a risk of disease transmission to humans.
    MeSH term(s) Anaplasma phagocytophilum/genetics ; Anaplasma phagocytophilum/isolation & purification ; Anaplasma phagocytophilum/pathogenicity ; Animals ; Bartonella/genetics ; Bartonella/isolation & purification ; Bartonella/pathogenicity ; Bhutan/epidemiology ; Cross-Sectional Studies ; Disease Reservoirs/microbiology ; Disease Vectors ; Gram-Negative Bacterial Infections/epidemiology ; Gram-Negative Bacterial Infections/microbiology ; Gram-Negative Bacterial Infections/transmission ; Humans ; Incidence ; Leptospira interrogans/genetics ; Leptospira interrogans/isolation & purification ; Leptospira interrogans/pathogenicity ; Orientia tsutsugamushi/genetics ; Orientia tsutsugamushi/isolation & purification ; Orientia tsutsugamushi/pathogenicity ; Phylogeny ; Rickettsia/genetics ; Rickettsia/isolation & purification ; Rickettsia/pathogenicity ; Rodentia/genetics ; Rodentia/microbiology ; Time Factors ; Zoonoses/epidemiology ; Zoonoses/microbiology ; Zoonoses/transmission
    Language English
    Publishing date 2018-10-31
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 286875-1
    ISSN 1738-0006 ; 0023-4001
    ISSN (online) 1738-0006
    ISSN 0023-4001
    DOI 10.3347/kjp.2018.56.5.521
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3476: Show issues Location:
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