INTRODUCTION: In Europe and North America, the majority of children with high-risk neuroblastoma survive the disease. Elsewhere, the treatment outcomes are poor. METHODS: A retrospective review of children treated for high-risk neuroblastoma in a single institution in Singapore from 2007 to 2019 was carried out. Treatment consisted of intensive chemotherapy, surgery aimed at gross total resection of residual disease after chemotherapy, consolidation with high-dose therapy followed by autologous stem cell rescue, and radiotherapy to the primary and metastatic sites followed by maintenance treatment with either cis-retinoic acid or anti-disialoganglioside monoclonal antibody therapy. Survival data were examined on certain clinical and laboratory factors. RESULTS: There were 57 children (32 male) treated for high-risk neuroblastoma. Their mean age was 3.9 (range 0.7-14.9) years. The median follow-up time was 5.5 (range 1.8-13.0) years for the surviving patients. There were 31 survivors, with 27 patients surviving in first remission, and the five-year overall survival and event-free survival rates were 52.5% and 47.4%, respectively. On log-rank testing, only the group of 17 patients who were exclusively treated at our centre had a survival advantage. Their five-year overall survival rate compared to patients whose initial chemotherapy was done elsewhere was 81.6% versus 41.1% (P = 0.011), and that of event-free survival was 69.7% versus 36.1% (P = 0.032). Published treatment results were obtained from four countries in Southeast Asia with five-year overall survival rates from 13.5% to 28.2%. CONCLUSION Intensified medical and surgical treatment for high-risk neuroblastoma proved to be effective, with superior survival rates compared to previous data from Southeast Asia.
Child ; Humans ; Male ; Infant ; Child, Preschool ; Adolescent ; Disease-Free Survival ; Neuroblastoma/pathology* ; Hematopoietic Stem Cell Transplantation/methods* ; Treatment Outcome ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Asia, Southeastern/epidemiology* ; Combined Modality Therapy

INTRODUCTION: Haze is a recurrent problem in Southeast Asia. Exposure to haze is linked to ophthalmic, respiratory and cardiovascular diseases, and mortality. In this study, we investigated the role of demographic factors, knowledge and perceived risk in influencing protective behaviours during the 2013 haze in Singapore. METHODS: We evaluated 696 adults in a cross-sectional study. Participants were sampled via a 2-stage simple random sampling without replacement from a large residential district in Singapore in 2015. The questionnaire measured the participant's knowledge, perceived risk and behaviours during the Southeast Asian haze crisis in 2013. Reliability and validity of the questionnaire were assessed using comparative fit index (≥0.96) and root mean square error of approximation (≤0.05). We performed structural equation modelling to examine the relationship between the hypothesised factors and protective behaviours. RESULTS: More than 95% of the individuals engaged in at least 1 form of protective behaviour. Knowledge was strongly associated with protective behaviours via direct effect (β=0.45, 95% CI 0.19-0.69, CONCLUSION Knowledge was associated with protective behaviours, suggesting the importance of public education. Efforts should target those of lower education level and smokers. The wearing of N95 masks correlates with uptake of other protective behaviours.
Adult ; Asia, Southeastern ; Cross-Sectional Studies ; Ethnic Groups ; Humans ; Minority Groups ; Reproducibility of Results ; Singapore/epidemiology*

African Swine Fever (ASF) is a highly contagious and deadly viral disease affecting both domestic pig and wild boar populations. Once introduced, it is a terrible disease that can devastate the swine industry in many countries. ASF has spread most recently beyond China to Southeast Asia, and parts of the Korean Peninsula. The majority of Asian countries consume pork as the primary source of meat compared to all other meat products. Particular emphasis is on the spread of ASF within North Korea and on future perspectives including protective guidelines. Thus far, the Korean peninsula has endured an extensive history of diseases, most notably from foot and mouth disease. For this reason, the Korean swine industries are familiar with the detrimental impacts of such a disease. On the other hand, exposure to a disease like ASF will decimate the swine industry even further. Therefore, it is crucial to bring urgent awareness to the spread of ASF.
African Swine Fever ; Animals ; Asia, Southeastern ; Asian Continental Ancestry Group ; China ; Democratic People's Republic of Korea ; Epidemiology ; Foot-and-Mouth Disease ; Hand ; Humans ; Meat ; Meat Products ; Red Meat ; Sus scrofa ; Swine ; Virus Diseases

Asia, Southeastern ; epidemiology ; Climate Change ; Communicable Disease Control ; organization & administration ; Communicable Diseases ; diagnosis ; epidemiology ; Disease Outbreaks ; Female ; Forecasting ; Humans ; Male ; Time Factors

Zika is a re-emerging, mosquito-borne viral infection, which has been recently shown to cause microcephaly and Guillain-Barré syndrome. Since 2015 the number of infected patients has increased significantly in South America. The purpose of this study was to identify the epidemiologic and clinical characteristics of patients with Zika virus (ZIKV) infections in Korea. Patients who had visited areas of risk and tested positive in the ZIKV reverse transcriptase polymerase chain reaction (RT-PCR) in blood, urine, or saliva specimens were included. The first Korean case of ZIKV infection was reported in March 2016, and 14 cases had been reported by October 2016. The median age of the patients was 34 years (19–64 years). Ten patients had been exposed in Southeast Asia and 4 in Latin America. Rash was the most common symptom (92.9%; 13/14), followed by myalgia (50.0%; 7/14), and arthralgia (28.6%, 4/14). There were no neurologic abnormalities and none of the patients was pregnant. Results of biochemical tests were normal. Positivity rates of RT-PCR for ZIKV in serum, urine, and saliva were 53.8%, 100.0%, and 83.3%, respectively in the first week of symptoms. In conclusion, 14 patients with ZIKV infections were reported in Korea by October 2016 and all of them had mild clinical symptoms.
Arthralgia ; Asia, Southeastern ; Epidemiology* ; Exanthema ; Guillain-Barre Syndrome ; Humans ; Korea* ; Latin America ; Microcephaly ; Myalgia ; Reverse Transcriptase Polymerase Chain Reaction ; Saliva ; South America ; Virus Shedding ; Zika Virus*

Africa ; epidemiology ; Asia, Southeastern ; epidemiology ; Carcinoma ; Epstein-Barr Virus Infections ; complications ; epidemiology ; virology ; Herpesvirus 4, Human ; pathogenicity ; Humans ; Middle East ; epidemiology ; Nasopharyngeal Neoplasms ; epidemiology ; etiology ; virology

Asia, Southeastern ; Cardiology ; methods ; trends ; Cardiovascular Diseases ; diagnosis ; epidemiology ; therapy ; Heart Failure ; therapy ; Humans ; Myocardial Infarction ; therapy ; Percutaneous Coronary Intervention ; Risk Factors ; Singapore ; Stents

Malaria is a tropical disease caused by protozoans of the Plasmodium genus. Delayed diagnosis and misdiagnosis are strongly associated with higher mortality. In recent years, a greater importance is attributed to Plasmodium knowlesi, a species found mainly in Southeast Asia. Routine parasitological diagnostics are associated with certain limitations and difficulties in unambiguous determination of the parasite species based only on microscopic image. Recently, molecular techniques have been increasingly used for predictive diagnosis. The aim of the study is to draw attention to the risk of travelling to knowlesi malaria endemic areas and to raise awareness among personnel involved in the therapeutic process.
Asia, Southeastern ; Global Health ; Humans ; Malaria/diagnosis/*epidemiology/*parasitology ; Microscopy/methods ; Molecular Diagnostic Techniques/methods ; Plasmodium knowlesi/*isolation & purification ; Public Health

Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East.
Asia, Southeastern ; Databases, Factual ; Far East ; Humans ; Incidence ; Neoplasms/diagnosis/epidemiology/*prevention & control ; Periodicals as Topic ; Public Policy ; Registries ; Risk Factors ; Smoke-Free Policy

Growing Up in Singapore Towards healthy Outcomes (GUSTO) is Singapore's largest birth cohort study to date. The main aim of GUSTO is to evaluate the role of developmental factors in the early pathways to metabolic compromise. Detailed data is collected for a range of environmental exposures in the parents and offspring, and allergic disorders are among a number of outcomes assessed in infancy and childhood. Under the Allergy domain of GUSTO, this integrated study will describe the epidemiology of allergic manifestations and different phenotypes in the Asian context and help shed light on the association of metabolic disease to allergy. Epigenetic mechanisms and associations with other childhood disorders will also be explored. The aim of this report is to focus on methodology of GUSTO, and to suggest similar approaches (i.e., integrated cohort studies on pediatric allergy) worldwide. Recruitment commenced in 2009 with a cohort of 1,163 pregnant mothers in their first trimester. The mothers and children were followed throughout pregnancy and follow-up will continue until the child reaches 3 years of age. Preliminary results showed that 39.8% of the mothers had a personal history of having at least one allergic disease, which included asthma, eczema and allergic rhinitis. Further data collection and analyses are still ongoing. Allergy is a complex spectrum of disorders with numerous poorly-understood aspects. The ongoing GUSTO cohort study, with its longitudinal design and multi-disciplinary nature, may provide new insights into developmental influences on allergy. As a Singapore-based study, it will be the first integrated allergy cohort in Southeast Asia, of which recruitment started during pregnancy.
Asia, Southeastern ; Asian Continental Ancestry Group ; Asthma ; Child ; Cohort Studies ; Data Collection ; Eczema ; Environmental Exposure ; Epidemiology ; Epigenomics ; Female ; Follow-Up Studies ; Humans ; Hypersensitivity ; Metabolic Diseases ; Mothers ; Parents ; Parturition ; Phenotype ; Pregnancy ; Pregnancy Trimester, First ; Rhinitis, Allergic ; Singapore