OBJECTIVES: To estimate the number and risk of imported infections resulting from people visiting Asian and Latin American countries.METHODS: The dataset of visitors to 5 Asian countries with dengue were analyzed for 2016 and 2017, and in the Philippines, Thailand and Vietnam, imported cases of zika virus infection were also reported. For zika virus, a single imported case was reported from Brazil in 2016, and 2 imported cases reported from the Maldives in 2017. To understand the transmissibility in 5 Southeast Asian countries, the estimate of the force of infection, i.e., the hazard of infection per year and the average duration of travel has been extracted. Outbound travel numbers were retrieved from the World Tourism Organization, including business travelers.RESULTS: The incidence of imported dengue in 2016 was estimated at 7.46, 15.00, 2.14, 4.73 and 2.40 per 100,000 travelers visiting Philippines, Indonesia, Thailand, Malaysia and Vietnam, respectively. Similarly, 2.55, 1.65, 1.53, 1.86 and 1.70 per 100,000 travelers in 2017, respectively. It was estimated that there were 60.1 infections (range: from 16.8 to 150.7 infections) with zika virus in Brazil, 2016, and 345.6 infections (range: from 85.4 to 425.5 infections) with zika virus in the Maldives, 2017.CONCLUSION: This study emphasizes that dengue and zika virus infections are mild in their nature, and a substantial number of infections may go undetected. An appropriate risk assessment of zika virus infection must use the estimated total size of infections.
Asia, Southeastern ; Asian Continental Ancestry Group ; Brazil ; Commerce ; Dataset ; Dengue ; Humans ; Incidence ; Indian Ocean Islands ; Indonesia ; Korea ; Latin America ; Malaysia ; Philippines ; Risk Assessment ; Thailand ; Vietnam ; Zika Virus ; Zika Virus Infection

P. marneffei is a fungus that causes life-threatening disseminated infection in a geographically distinct areas of the world. Following the first case of human infection in 1959, the incidence of this infection has risen markedly during the past 5 years. However, even in the midst of such rapid increase, the infection has always occurred only in a limited geographic distributions or in persons who have visited this limited geographic areas. These areas include Myanmar, Hong Kong, Indonesia, Laos, Malaysia, Singapore, Taiwan, Thailand, Vietnam, and the Guangxi province of southern China. P. marneffei infection occurs mostly in immunocompromised patients, particularly AIDS patients. P. marneffei infection commonly presents with skin and subcutanous tissue infection, fungemia, diarrhea, bone marrow infection, and generalized lymphadenopathy with hepatosplenomegaly. We report the case of continuous ambulatory peritoneal dialysis-associated peritonitis caused by P. marneffei. The case occurred in Korea, a non-endemic area of P. marneffei, in a non-AIDS patient who has not been exposed to any of the endemic areas. This warrants further consideration in determining the yet unknown transmission route of this fungal organism. P. marneffei was diagnosed without delay by 18sRNA PCR and sequencing, and was later confirmed by culture. PCR and sequencing may contribute to the early diagnosis of the P. marneffei infection, which is important given this infection's ability to progress to a systemic infection with high mortality rate when diagnosis and management are delayed.
Bone Marrow ; China ; Diagnosis ; Diarrhea ; Early Diagnosis ; Fungemia ; Fungi ; Hong Kong ; Humans ; Immunocompromised Host ; Incidence ; Indonesia ; Korea ; Laos ; Lymphatic Diseases ; Malaysia ; Mortality ; Myanmar ; Penicillium* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Polymerase Chain Reaction ; Singapore ; Skin ; Taiwan ; Thailand ; Vietnam

PURPOSE: Lactose intolerance (LI) is perceived to be frequent in Asia and has been reported to have considerable impact on dietary intake, nutritional status and the quality of life. We aimed to gather information from healthcare professionals on the perceived incidence, diagnosis and management of LI in 1 to 5 year old children in Southeast Asia. METHODS: An anonymous electronic survey was sent randomly among healthcare professionals registered in the database of the pediatric societies in Thailand, Indonesia, and Singapore between June and October 2016. RESULTS: In total, 259 health care professionals responded of which 45.5% (n=118) were from Thailand, 37.4% (n=97) from Indonesia and 16.9% (n=44) from Singapore. Of the participants who responded (n=248), primary LI prevalence among children 1 to 3 years of age was estimated to be less than 5% by 56.8%. However, about 18.9% (n=47) answered they did not know/unsure. Regarding secondary LI, 61.6% of respondents (n=153) estimated the prevalence to be less than 15%. But again, 10.8% (n=27) answered they did not know or unsure. Rotavirus gastroenteritis was ranked as the top cause for secondary LI. There was considerable heterogeneity in the diagnostic methods used. The majority of respondents (75%) recommended lactose-free milk to manage primary and secondary LI. CONCLUSION: More education/training of pediatricians on this topic and further epidemiological studies using a more systematic approach are required.
Anonyms and Pseudonyms ; Asia ; Asia, Southeastern ; Child* ; Delivery of Health Care ; Diagnosis ; Epidemiologic Studies ; Far East* ; Gastroenteritis ; Health Personnel ; Humans ; Incidence ; Indonesia ; Lactose Intolerance* ; Lactose* ; Milk ; Nutritional Status ; Population Characteristics ; Prevalence* ; Quality of Life ; Rotavirus ; Singapore ; Surveys and Questionnaires ; Thailand

Gnathostomiasis is caused by the nematode parasite Gnathostoma spinigerum. Humans are usually infected by ingestion of inadequately cooked fish, containing larva. Gnathostomiasis is endemic in much of southeast Asia including Thailand, Japan, China and Philippines. It causes migratory cutaneous erythematous indurated plaque and serious visceral sequellae. Treatment with all kinds of antiparasitic drugs has been disappointing. The disease has not been reported in Korea. We report the first case of gnathostomiasis in a 41-year-old Korean man travelling in an endemic area.
Adult ; Antiparasitic Agents ; Asia, Southeastern ; China ; Eating ; Gnathostoma ; Gnathostomiasis* ; Humans ; Japan ; Korea ; Larva ; Parasites ; Philippines ; Thailand

The REAP-AP study recruited 3,746 patients with schizophrenia, in March and April 2016, from 71 centers in 15 Asian countries/territories namely Bangladesh, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, Thailand and Vietnam. Our findings reveal a trend according to which high dose antipsychotic prescription is more prevalent in Eastern Asia (especially, Japan and Korea) than in other regions of Asia. This historical factor may be associated with our finding of an Eastern Asian preponderance of high dose antipsychotic prescription.
Asia ; Asian Continental Ancestry Group* ; Bangladesh ; China ; Far East ; Hong Kong ; Humans ; India ; Indonesia ; Japan ; Korea ; Malaysia ; Myanmar ; Pakistan ; Prescriptions* ; Schizophrenia* ; Singapore ; Sri Lanka ; Taiwan ; Thailand ; Vietnam

The COVID-19 pandemic has had pervasive effects on society at large, specifically disrupting routine and established processes at the household, organizational, and community levels. The Philippine Psychiatric Association organized the Fourth Southeast Asia Mental Health Forum to discuss issues and share experiences on how this community can respond to the challenges brought about by the COVID-19 pandemic. Three common challenges for the mental health community were identified – (a) ensuring the continuity of services for persons with psychiatric disorders in different settings; (b) preventing spread of COVID-19 infection in in-patient or residential mental health facilities; and (c) addressing the emergent demand for mental health services from health workers and the general population experiencing psychological symptoms because of the pandemic situation. In the face of these challenges, two broad groups of good practices and innovations were conceptualized and implemented by professionals and institutions: (a) development of alternative arrangements for the delivery of mental health services; and (b) mobilization of stakeholders and resources to ensure whole-of-government and whole-of-society approaches. The lessons and ideas that emerged from the forum may find applicability not only in the next few months during which COVID-19 may persist in our midst (i.e., the “new normal”), but also in other future events that may cause the same level of societal impact and disruption.
Mental Health ; COVID-19 ; Asia, Southeastern ; Mental Health Services ; Philippines

PURPOSE: The Korean society has moved rapidly toward becoming a multicultural society. This study aimed to estimate the seroprevalence of hepatitis viruses and investigate hepatitis B virus (HBV) genotypic diversity in female marriage immigrants. MATERIALS AND METHODS: Screening program was conducted at support centers for multicultural families in 21 administrative districts in Korea between July 2011 and January 2017. A total of 963 female marriage immigrants were included in this study. Blood samples were tested for hepatitis viral markers and HBV genotype. RESULTS: Subjects' median age was 33 years (20–40 years), and they originated from nine countries including Vietnam (n=422, 43.8%), China (n=311, 32.3%), the Philippines (n=85, 8.8%), Cambodia (n=58, 6.0%), and Japan (n=39, 4.0%). About 30% (n=288) of subjects required hepatitis A vaccination. HBsAg positive rate was 5.4% (n=52). Positive HBsAg results were the highest in subjects from Southeast Asia (6.6%, n=38). Anti-HBs positive rate was 60.4% (n=582). About 34% (n=329) of subjects who were negative for anti-HBs and HBsAg required HBV vaccinations. Genotypes B and C were found in 54.6% (n=12) and 45.4% (n=10) of the 22 subjects with HBV, in whom genotypes were tested. Eight (0.8%) subjects were positive for anti-HCV. Positive anti-HCV results were the highest in subjects from Central Asia (7.9%, n=3). CONCLUSION: Testing for hepatitis viral marker (hepatitis A virus IgG and HBsAg/anti-HBs) is needed for female marriage immigrants. Especially, HBV genotype B is different from genotype C of Koreans. Therefore, interest and attention to vaccination programs for female marriage immigrants are necessary for both clinicians and public health institutes.
Academies and Institutes ; Asia ; Asia, Southeastern ; Biomarkers ; Cambodia ; China ; Emigrants and Immigrants* ; Female* ; Genotype* ; Hepatitis A ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis Viruses* ; Hepatitis* ; Humans ; Immunoglobulin G ; Japan ; Korea* ; Marriage* ; Mass Screening ; Philippines ; Prevalence ; Public Health ; Seroepidemiologic Studies ; Vaccination ; Vietnam

Anniversaries and Special Events ; Asia, Southeastern ; Biomedical Research ; Dengue ; Humans ; Singapore

Natural infections with influenza A viruses have been reported in a variety of animal species including humans, pigs, horses, sea mammals, and birds. Although viruses of relatively few haemagglutinin(HA) and neuraminidase(NA) subtype combinations have been isolated from mammalian species, all subtypes, in most combinations, have been isolated from birds. During the past few years, several subtypes of avian influenza A have been shown to cross the species barrier and infect humans. During an outbreak of a highly pathogenic influenza A(H5N1) virus among poultry in Hong Kong in 1997, 6 of 18 people with confirmed infection died. And a total of 89 human infections with influenza A(H7N7), including 1 resulting in the death of a Dutch veterinarian, occurred during the extensive outbreak in 2003. During late 2003 and early 2004, there were reports of large outbreaks of H5N1 among poultry throughout Asia (including Korea, Japan, Indonesia, Vietnam, Thailand, Laos, Cambodia, and China). In Korea, we had also highly pathogenic avian influenza(HPAI) outbreak in 2003~2004 with a first suspected case reported on 10 December 2003. The case was reported at a parent stock farm for broilers, which was located in Chungbuk province, and the farm was immediately placed under movement restrictions. Laboratory tests confirmed the outbreak of HPAI on 12 December 2003. Up to 20 March 2004, a total of 19 farms were confirmed as having been infected with HPAI virus. No further outbreaks occurred after that date. Fortunately there were no human cases founded in this epidemic in Korea. In January 2004, there was confirmation that influenza A(H5N1) virus had been isolated from patients who had died of a respiratory illness in Vietnam. Total 107 human confirmed cases were reported until June 2005 to WHO, threatening new pandemic outbreak. We reviewed our prevention and control strategies of avian influenza and preparedness to the pandemic outbreak.
Animals ; Asia ; Birds ; Cambodia ; Chungcheongbuk-do ; Communicable Diseases, Emerging ; Disease Outbreaks ; Epidemiology* ; Hong Kong ; Horses ; Humans ; Indonesia ; Influenza A virus ; Influenza in Birds* ; Influenza, Human ; Japan ; Korea ; Laos ; Mammals ; Pandemics ; Parents ; Poultry ; Swine ; Thailand ; Veterinarians ; Vietnam

Artemisinin-based combination therapy (ACT) resistance is widespread throughout the Greater Mekong Subregion. This raises concern over the antimalarial treatment in Thailand since it shares borders with Cambodia, Laos, and Myanmar where high ACT failure rates were reported. It is crucial to have information about the spread of ACT resistance for efficient planning and treatment. This study was to identify the molecular markers for antimalarial drug resistance: Pfkelch13 and Pfmdr1 mutations from 5 provinces of southern Thailand, from 2012 to 2017, of which 2 provinces on the Thai- Myanmar border (Chumphon and Ranong), one on Thai-Malaysia border (Yala) and 2 from non-border provinces (Phang Nga and Surat Thani). The results showed that C580Y mutation of Pfkelch13 was found mainly in the province on the Thai-Myanmar border. No mutations in the PfKelch13 gene were found in Surat Thani and Yala. The Pfmdr1 gene isolated from the Thai-Malaysia border was a different pattern from those found in other areas (100% N86Y) whereas wild type strain was present in Phang Nga. Our study indicated that the molecular markers of artemisinin resistance were spread in the provinces bordering along the Thai-Myanmar, and the pattern of Pfmdr1 mutations from the areas along the international border of Thailand differed from those of the non-border provinces. The information of the molecular markers from this study highlighted the recent spread of artemisinin resistant parasites from the endemic area, and the data will be useful for optimizing antimalarial treatment based on regional differences.
Cambodia ; Drug Resistance ; Laos ; Myanmar ; Parasites ; Plasmodium falciparum ; Plasmodium ; Thailand