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Nyunt MH, Aye KM, Naing ST, Mon AS, Htwe MM, Win SM, Thwe WM, Zaw NN, Kyaw MP, Thi A. Residual malaria among migrant workers in Myanmar: why still persistent and how to eliminate it? BMC Infect Dis 2021; 21:1146. [PMID: 34758727 PMCID: PMC8579646 DOI: 10.1186/s12879-021-06839-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Residual malaria is probably an important source for the re-emergence of malaria infection in the elimination era. Assessment to identify the factors influencing residual malaria in high-risk groups is needed to develop evidence-based decisions by stakeholders and policymakers. METHODS This study was conducted to explore the factors influencing the residual malaria infection among migrant workers in two sentinel sites (endemic vs. pre-elimination areas) in Myanmar using the mixed-model method. RESULTS A total of 102 migrant respondents (65 in Bamauk and 37 in Shwegyin) were included for the quantitative assessment using pretested questionnaires during household visits. Although 87.3% of them had insecticidal bed nets (ITNs/LLINs), only 68.3% of the migrants in Bamauk and 57.9% in Shwegyin used it regularly. The use of any bed net was high (79.9% in Bamauk vs. 91.0% in Shwegyin). The mean LLINs in their families were 1.64 (95%CI: 1.48-1.81) in Bamauk and 2.89 (95%CI: 2.67-3.11) in Shwegyin. Most of them received no health information for malaria prevention within the last year and their knowledge about malaria was low. Their working nature was a challenge for control measures against malaria in migrants. CONCLUSION The strategy for distributing LLINs and health promotion activities for mobile/migrant populations should be reviewed, and an appropriate action plan should be developed for the specific migrant group. Moreover, health promotion activities for behavior change communication should be strengthened in the migrant population in Myanmar.
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Affiliation(s)
- Myat Htut Nyunt
- Department of Medical Research, Ministry of Health and Sports, Yangon, Republic of the Union of Myanmar.
| | - Khin Myo Aye
- Department of Medical Research, Ministry of Health and Sports, Yangon, Republic of the Union of Myanmar
| | - Shine Thura Naing
- Department of Medical Research, Ministry of Health and Sports, Yangon, Republic of the Union of Myanmar
| | - Aye Su Mon
- Department of Medical Research, Ministry of Health and Sports, Yangon, Republic of the Union of Myanmar
| | - Mi Mi Htwe
- Department of Medical Research, Ministry of Health and Sports, Yangon, Republic of the Union of Myanmar
| | - Su Mon Win
- Department of Medical Research, Ministry of Health and Sports, Yangon, Republic of the Union of Myanmar
| | - Wai Myat Thwe
- Department of Medical Research, Ministry of Health and Sports, Yangon, Republic of the Union of Myanmar
| | - Ni Ni Zaw
- Department of Medical Research, Ministry of Health and Sports, Yangon, Republic of the Union of Myanmar
| | - Myat Phone Kyaw
- Department of Medical Research, Ministry of Health and Sports, Yangon, Republic of the Union of Myanmar
| | - Aung Thi
- Department of Public Health, National Malaria Control Programme, Ministry of Health and Sports, Nay Pyi Taw, Republic of the Union of Myanmar
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Ei PW, Mon AS, Htwe MM, Win SM, Aye KT, San LL, Zaw NN, Nyunt WW, Myint Z, Lee JS, Aung WW. Pyrazinamide resistance and pncA mutations in drug resistant Mycobacterium tuberculosis clinical isolates from Myanmar. Tuberculosis (Edinb) 2020; 125:102013. [PMID: 33142220 DOI: 10.1016/j.tube.2020.102013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 10/12/2020] [Accepted: 10/18/2020] [Indexed: 10/23/2022]
Abstract
Pyrazinamide (PZA) is an important anti-tuberculosis drug, which is active against semi-dormant bacilli and used as a component of first-line drugs and drug-resistant tuberculosis regimens. Mutations in pncA and its promoter region are main cause of PZA resistance. There are limited PZA susceptibility data as there is no routine drug susceptibility testing (DST) for PZA. This study was aimed to determine the proportion of PZA resistance among rifampicin-resistant tuberculosis patients and to identify mutations which are responsible for PZA resistance in pncA and its promoter region. Liquid-based DST was performed to detect PZA susceptibility on 192 culture positive rifampicin-resistant isolates collected from National Tuberculosis Reference Laboratory. Sequencing on pncA including its promoter region was performed and analysis was done on 157 isolates. Phenotypic PZA resistance was detected in 58.9% of isolates. Sixty-five different mutations were distributed in pncA or promoter region of 82 isolates. Sensitivity and specificity of pncA sequencing in detection of PZA resistance showed 89.8% and 95.6% respectively. High proportion of PZA resistance among rifampicin-resistant cases highlighted the need for effective treatment regimen development for PZA-resistant MDR-TB. It is also suggested that routine PZA susceptibility test should be incorporated to treatment monitoring regimen and National Drug Resistance surveys.
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Affiliation(s)
- Phyu Win Ei
- Advanced Molecular Research Centre, Department of Medical Research, 5, Ziwaka Road, Dagon Township, 11191, Yangon, Myanmar.
| | - Aye Su Mon
- Advanced Molecular Research Centre, Department of Medical Research, 5, Ziwaka Road, Dagon Township, 11191, Yangon, Myanmar.
| | - Mi Mi Htwe
- Advanced Molecular Research Centre, Department of Medical Research, 5, Ziwaka Road, Dagon Township, 11191, Yangon, Myanmar.
| | - Su Mon Win
- Advanced Molecular Research Centre, Department of Medical Research, 5, Ziwaka Road, Dagon Township, 11191, Yangon, Myanmar.
| | - Kay Thi Aye
- Advanced Molecular Research Centre, Department of Medical Research, 5, Ziwaka Road, Dagon Township, 11191, Yangon, Myanmar
| | - Lai Lai San
- Advanced Molecular Research Centre, Department of Medical Research, 5, Ziwaka Road, Dagon Township, 11191, Yangon, Myanmar.
| | - Ni Ni Zaw
- Advanced Molecular Research Centre, Department of Medical Research, 5, Ziwaka Road, Dagon Township, 11191, Yangon, Myanmar.
| | - Wint Wint Nyunt
- National Tuberculosis Program, Department of Public Health, 15011, Naypyitaw, Myanmar.
| | - Zaw Myint
- National Tuberculosis Program, Department of Public Health, 15011, Naypyitaw, Myanmar.
| | - Jong Seok Lee
- International Tuberculosis Research Center, 234 Gaposunhwan-ro, Masanhappo-gu, Changwon-si, Gyeongsangnamdo, 51755, Republic of Korea.
| | - Wah Wah Aung
- Advanced Molecular Research Centre, Department of Medical Research, 5, Ziwaka Road, Dagon Township, 11191, Yangon, Myanmar.
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Mon AS, Pulle C, Bell J. Development of an 'Enteral tube feeding decision support tool' for hip fracture patients: A modified Delphi approach. Australas J Ageing 2018; 37:217-223. [PMID: 30175544 DOI: 10.1111/ajag.12575] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Malnutrition after hip fracture is recognised as the co-morbidity most likely to impact hospital length of stay and cost. Despite this, the role of enteral tube feeding in hip fracture patients remains unclear. METHODS A modified Delphi process was used to establish consensus for an enteral tube feeding decision support tool. Three rounds of the Delphi survey were administered to a purposeful sample of twenty multidisciplinary clinicians from the Australian and New Zealand Hip Fracture Registry. RESULTS Consensus markedly improved across the three rounds (33, 44 and 87%, respectively). More than 80% of participants positively supported implementing the tool in clinical practice. CONCLUSIONS This study describes experienced, multidisciplinary clinician consensus and support for an 'Enteral tube feeding decision support tool' to be applied in acute hip fracture settings. Further studies are being undertaken to identify the impact of the checklist tool on informed consent decision processes in this population.
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Affiliation(s)
- Aye Su Mon
- Department of Geriatric Medicine, Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Chrys Pulle
- Internal Medical Services, Prince Charles Hospital, Queensland, Australia
| | - Jack Bell
- School of Human Movement and Nutrition Sciences, University of Queensland; and Prince Charles Hospital, Queensland, Australia
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