Prevalence of HIV and sexually transmitted infections among young women engaged in sex work aboard foreign fishing vessels in Kiribati

Objective: To assess the prevalence of HIV and sexually transmitted infections (STIs) among women who board foreign fishing vessels for sex work in Kiribati. Methods: A cross-sectional study was designed to collect data on behavioural risk factors for STIs and knowledge of and attitudes towards HIV and STIs during 2007. Urine and blood samples were collected to test for HIV and select STIs. Descriptive statistics were performed for sociodemographic and behavioural characteristics, and χ2 tests were used to assess associations between potential key determinants and the presence of genital Chlamydia infection. Results: Women who boarded foreign fishing vessels for transactional sex were younger, had less education, were less likely to live with a partner and were less likely to be otherwise employed. Although no HIV infections were detected, more than half (57.5%) of the women were diagnosed with an STI. One quarter of the women tested positive for chlamydia, and 40% tested positive for mycoplasma. The presence of chlamydia was strongly associated with age at first sexual intercourse (P = 0.02) and number of sexual partners during the prior seven days (P = 0.02). Conclusion: The high rate of STIs in this population of sex workers is concerning given the potential of severe pregnancy-related and chronic health problems and the increased risk of transmission within the general population of Kiribati. We identified a specific sex worker population as a priority group for targeted public health efforts to prevent and control the spread of STIs in Kiribati.

The development of Taiwan Fracture Liaison Service network

Osteoporosis and its associated fragility fractures are becoming a severe burden in the healthcare system globally. In the Asian-Pacific (AP) region, the rapidly increasing in aging population is the main reason accounting for the burden. Moreover, the paucity of quality care for osteoporosis continues to be an ongoing challenge. The Fracture Liaison Service (FLS) is a program promoted by International Osteoporosis Foundation (IOF) with a goal to improve quality of postfracture care and prevention of secondary fractures. In this review article, we would like to introduce the Taiwan FLS network. The first 2 programs were initiated in 2014 at the National Taiwan University Hospital and its affiliated Bei-Hu branch. Since then, the Taiwan FLS program has continued to grow exponentially. Through FLS workshops promoted by the Taiwanese Osteoporosis Association (TOA), program mentors have been able to share their valuable knowledge and clinical experience in order to promote establishments of additional programs. With 22 FLS sites including 11 successfully accredited on the best practice map, Taiwan remains as one of the highest FLS coverage countries in the AP region, and was also granted the IOF Best Secondary Fracture Prevention Promotion award in 2017. Despite challenges faced by the TOA, we strive to promote more FLS sites in Taiwan with a main goal of ameliorating further health burden in managing osteoporotic patients.

The First Meeting of the National Control Laboratories for Vaccines and Biologicals in the Western Pacific in 2016

The first meeting of the National Control Laboratories for Vaccines and Biologicals in the Western Pacific Region was held on September 1–2, 2016 in Seoul, the Republic of Korea. The meeting objectives were to share results of current research and to promote collaboration between the National Control Laboratories. To this end, we first discussed each country’s current status of research on quality control of biologicals. Next, we reviewed quality control of snake venom and antivenom production and the progress of a collaborative study on the Korean reference standard candidate for snake venom. We also discussed the establishment of the second regional reference standard antivenom and the characterization of the Vero cell genome landscape and its application to quality control. Moreover, we also reflected on the importance of collaboration among interested parties participating in this meeting. In conclusion, the meeting initiated networking between the national control laboratories in the Western Pacific region and paved the way to continue collaboration, which will eventually improve the region’s capacity for quality control of biologicals.

External quality assessment of dengue and chikungunya diagnostics in Asia Pacific region, 2015

OBJECTIVE: To conduct an external quality assessment (EQA) of dengue and chikungunya diagnostics among national-level public health laboratories in the Asia Pacific region following the first round of EQA for dengue diagnostics in 2013. METHODS: Twenty-four national-level public health laboratories performed routine diagnostic assays on a proficiency testing panel consisting of two modules. Module A contained serum samples spiked with cultured dengue virus (DENV) or chikungunya virus (CHIKV) for the detection of nucleic acid and DENV non-structural protein 1 (NS1) antigen. Module B contained human serum samples for the detection of anti-DENV antibodies. RESULTS: Among 20 laboratories testing Module A, 17 (85%) correctly detected DENV RNA by reverse transcription polymerase chain reaction (RT-PCR), 18 (90%) correctly determined serotype and 19 (95%) correctly identified CHIKV by RT-PCR. Ten of 15 (66.7%) laboratories performing NS1 antigen assays obtained the correct results. In Module B, 18/23 (78.3%) and 20/20 (100%) of laboratories correctly detected anti-DENV IgM and IgG, respectively. Detection of acute/recent DENV infection by both molecular (RT-PCR) and serological methods (IgM) was available in 19/24 (79.2%) participating laboratories. DISCUSSION: Accurate laboratory testing is a critical component of dengue and chikungunya surveillance and control. This second round of EQA reveals good proficiency in molecular and serological diagnostics of these diseases in the Asia Pacific region. Further comprehensive diagnostic testing, including testing for Zika virus, should comprise future iterations of the EQA.

Aproximación a la racionalidad ambiental del extractivismo en una comunidad afrodescendiente del pacífico Colombiano / Approachingthe eenvironmental rationale of xtractivism in an afro-descendaant community from the Colombian pacific region

Dado que el uso y transformación del territorio en el Pacífico colombiano se ha realizado a través de una serie de prácticas y lógicas ancestrales que empiezan a transformarse desde finales del siglo XX, a través del empleo de la observación participante, este artículo describe las prácticas extractivas en el Consejo Comunitario de San Marcos (Buenaventura, Colombia) a inicios del siglo XXI, buscando presentar una aproximación a la racionalidad ambiental asociada, que orienta las acciones. Se concluye que la orientación hacia el mercado o el autoabastecimiento de las actividades extractivas en San Marcos y la escala de la intervención asociada, permiten dilucidar dos racionalidades ambientales en conflicto: la depredadora asociada a la presión de la modernidad capitalista y la alterna asociada a la cosmovisión y concepción afrocolombiana de la naturaleza.

Since the use and transformation of the territory in the Colombian Pacific Region was conducted through a series of ancestral practices and rationales that have started changing since the late 20th century.by the use of participant observation, this article describes the extractive practices in the Community Council of San Marcos (Buenaventura, Colombia) at the beginning of the 21st century in order to present an approach to the associated environmental rationale that supports the actions. It is concluded that the market-oriented and the self-sufficiency orientation of extractive activities in San Marcos and the associated scale of intervention elucidate two environmental rationales in conflict: the predatory associated with the pressure of modern capitalism and the alternative associated to the Colombian Afro-descendent worldview and conception of nature.

Measles Elimination Activities in the Western Pacific Region: Experience from the Republic of Korea

We describe the global status of measles control and elimination, including surveillance and vaccination coverage data provided by the World Health Organization (WHO). Since 2000, two doses of measles vaccine (MCV2) became recommended globally and the achievement of high vaccination coverage has led to dramatic decrease in the measles incidence. Our finding indicates that, in the Western Pacific Region (WPR), substantial progress has been made to control measles transmission in some countries; however, the measles virus continues to circulate, causing outbreaks. The Republic of Korea (ROK) experienced a series of resurgence of measles due to the importation and healthcare-associated transmission in infants, however overall incidence and surveillance indicators met the WHO criteria for measles elimination. The ROK was verified to be measles-free along with Australia, Mongolia, and Macau, China in 2014. One of the effective elimination activities was the establishment of solid keep-up vaccination system in school settings. The lessons learnt from the measles elimination activities in Korea may contribute to enhancing the surveillance schemes and strengthening of vaccination programs in member countries and areas of WPR.

Ebola preparedness in the Western Pacific Region, 2014

West Africa is currently experiencing the largest outbreak of Ebola virus disease (EVD) in history with intense transmission in several affected countries. For non-affected countries, the best protective measures are adequate levels of preparedness including vigilant surveillance to detect cases early and well-prepared health systems to ensure rapid containment of the virus and to avoid further spread. The World Health Organization Regional Office for the Western Pacific recently conducted two activities: a web-based EVD preparedness survey and an EVD simulation exercise to determine the overall level of EVD preparedness in the Region. The survey and exercise together demonstrate there is a good overall level of preparedness for a potential imported case of EVD in the Western Pacific Region. However, a number of areas still require further strengthening before the Region can efficiently and effectively respond to potential EVD events, including laboratory testing arrangements; clinical management and infection prevention and control; and public health intervention measures, particularly at points of entry. Importantly, the survey and exercise also highlight the unique situation in Pacific island countries and emphasize that special considerations are needed to better support these countries in EVD preparedness.

Advances and problems in Western Pacific Region Index Medicus / 中华医学图书情报杂志

The history of Western Pacific Region Index Medicus (WPRIM), and advances in its journal selection, retrieval service platform construction and data acquisition were described.The daily record of users showed that WPRIM is of certain international influencing power, but is not a matured regional international index medicus. Suggestions were put forward for its popularization, project development funds, journal review and data acquisition.

Progress of traditional medicine in the WHO/western pacific region / 国际中医中药杂志

This article briefs the progress of traditional medicine (TM) in the WHO Western Pacific Region during the last decades, including the government support of member states on TM, the implementation of standards for good manufacturing practices of herbal medicine products, and university education and training programs of TM. It also gives an introduction on the main contents of Regional Strategy for Traditional Medicine in the Western Pacific (2011-2020), the situation of WHO collaborating centers for traditional medicine, and put forward the suggestions for improving the work of WHO collaborating centers for traditional medicine. It can provide references for understanding the general progress of TM in the member states of WHO Western Pacific Region and strengthening the work of WHO collaborating centers for traditional medicine in China.

Antibiotic prescribing for upper respiratory tract infections in the Asia-Pacific region: A brief review

This review highlights the high prevalence of antibiotic use for upper respiratory tract infections(URTIs) in a larger part of the Asia-Pacific region. Since URTIs are one of the common reasons for primary care consultations in this region, inappropriate use of antibiotic in both quantity and drug choice has greatly influenced the development of antibiotic resistance. Notwithstanding the paucity of Asia-Pacific data on the above issues, the available information suggests urgent actions needed to be taken to promote judicious antibiotic use at the point-of-care through a multipronged approach targeting the patients/consumers (or parents), healthcare providers and health care systems.

Diabetes epidemic in the Asia Pacific region: has hemoglobin A1C finally earned its place as a diagnostic tool?

Two-third of the world's population lives in the Asia Pacific region where prevalence of diabetes has reached epidemic proportion. With China and India being the most populous nations on the globe, it is believed that over 150 million diabetes reside in the region with more than 95% being of type 2 diabetes mellitus (T2DM). Furthermore, other Pacific islands in the region have high rates of T2DM including Tonga, Fiji, French Polynesia, and Nauru. The latter has the highest prevalence of T2DM per population in the world. Over the past two decades, in Australia and New Zealand, the prevalence of T2DM has more than doubled, mainly amongst the Aboriginal and Torres Strait Islander and Maori peoples respectively. With the increasing prevalence of diabetes in the Asia Pacific region coupled with the limited number of resources, use of a reliable and effective mode of diagnosis for T2DM is warranted. Yet to date, only New Zealand has adopted the American Diabetes Association recommendation of using hemoglobin A1C in the diagnosis of the disease. The aim of this review is to discuss the clinical usefulness of hemoglobin A1C and highlight its diagnostic role in the Asia Pacific region where T2DM is increasingly encountered.

Joining WHO of Republic of Korea and the Projects in the 1950s / 의사학

The Republic of Korea(ROK) and the World Health Organization(WHO) have done many projects successfully from 1949, in which the government of First Republic joined the WHO. However the relation between the ROK and the WHO have not been studied very much so far. The main purpose of this research, which could be done by the support of WHO, is connected with three questions. First research point would be "how could the ROK joined WHO in 1949 and what's the meaning of it? And the what's the difference in the process for the WHO between the ROK of 1949 and the DPRK(Democratic People's Republic of Korea) of 1973?" The first president of the ROK, Rhee Syngman, who had received his Ph. D.(about international politics) from Princeton University in 1910, was strongly interested in joining international institutes like UN, WHO. The ROK that could join WHO on 17 August 1949, with the approval of Assembly on 25 May 1949, was one of the founder members of the Western Pacific Region. By joining WHO, the ROK could get chance to increase the level of public health and its administration in 1950's. But the DPRK manage to became a member of WHO on 19 May 1973 and joined the South-East Asia Region. The joining of DPRK was influenced by the easing of the cold war after the Nixon Doctrine and the joining of the China(People's Republic of China). Second research point would be "What kind of roll did the WHO take in the First Republic?" Yet the public health administration of the First Republic that had been made in the period of US army military government was been strongly influenced by USA, the roll of WHO was also important in the 1950's. Last research point would be "What kind of the projects did the ROK and the WHO take part in during the period of he First Republic? How could evaluate the results?" The ROK and the WHO handled the projects including health services, communicable disease prevention and control, control of noncommunicable diseases, and protection of health. Specially for the efforts to prevent communicable disease, the WHO focused on leprosy, malaria, measles, smallpox, tuberculosis in 1950's. The First Republic could overcome the bad health condition after the Korea War successfully, supported by WHO.

Inflammatory Bowel Disease-related Colorectal Cancer in the Asia-Pacific Region: Past, Present, and Future

Patients with inflammatory bowel disease (IBD) are at an increased risk of developing colorectal cancer (CRC), and key contributing factors include chronic colonic inflammation and the extent and duration of disease. This increase in risk is more likely to result from chronic inflammation of the colonic mucosa than from any clearly defined genetic predisposition. However, globally, the true magnitude of this risk is debatable, since results from different studies are heterogeneous in terms of geographical and methodological variables. The prevalence of IBD-related CRC in the Asia-Pacific region ranges from 0.3% to 1.8% and a recent study found that the cumulative incidence of IBD-related CRC is comparable to that in Western countries. However, the CRC mortality rate in the Asia-Pacific region is on the rise compared with that in Western countries, and a few Asian countries show particularly rapid upward trends in CRC incidence. Although our understanding of the molecular and clinical basis for IBD-related CRC has improved substantially, our means of prevention, endoscopic surveillance, chemoprevention, and prophylactic surgery remain modest at best. Furthermore, published data on IBD-related CRC in the Asia-Pacific region is lacking, and this review addresses many aspects including epidemiology, natural history, etiopathogenesis, morphology, and biological behaviors of IBD-related CRC and sporadic CRC in the Asia-Pacific region. In this review, we will also discuss the risk factors for CRC in IBD patients, endoscopic technology screening, and surveillance programs and management strategies for IBD-related CRC.

Outbreak investigations in the Western Pacific Region

In this issue we introduce a new article type – the outbreak investigation report – with our theme Outbreak investigations in the Western Pacific Region. This new article type allows for concise reports on outbreak investigations and expands the role of the Western Pacific Surveillance and Response Journal (WPSAR) as a regional information-sharing platform, as per the Asia Pacific Strategy for Emerging Diseases (APSED 2010) in line with the International Health Regulation (2005). Timely sharing of outbreak investigations may be useful in informing public health action across the Region.

Strengthening collaboration on chemical hazards in food among food safety authorities and the World Health Organization in the Western Pacific Region

The objectives of this paper are to highlight the benefits of sharing information to Western Pacific Region Member States and to identify similarities at the regional level in terms of food safety issues and public health protection. In addition, it aims to propose an improved partnership among regional food safety authorities and WHO on targeted objectives.

Male-female differences in the number of reported incident dengue fever cases in six Asian countries

INTRODUCTION: Demographic factors, such as age and sex, are associated with the likelihood of exposure to Aedes aegypti, the vector for dengue. However, dengue data disaggregated by both sex and age are not routinely reported or analyzed by national surveillance systems. This study analysed the reported number of incident dengue cases by age and sex for six countries in Asia. METHODS: Data for the Lao People’s Democratic Republic, the Philippines, Singapore and Sri Lanka were obtained from DengueNet; the number of male and female dengue cases was available for four age groups ( 15 years) over a cumulative period of six to 10 years. Data for Cambodia (2010) and Malaysia (1997–2008) were obtained from their respective ministries of health. Results: An excess of males was found among reported dengue cases > 15 years of age. This pattern was observed consistently over several years across six culturally and economically diverse countries. DISCUSSION: These data indicated the importance of reporting data stratified by both sex and age since collapsing the data over all ages would have masked some of the male-female differences. In order to target preventive measures appropriately, assessment of gender by age is important for dengue because biological or gender-related factors can change over the human lifespan and gender-related factors may differ across countries.

Challenges and future perspective for dengue vector control in the Western Pacific Region

Dengue remains a significant public health issue in the Western Pacific Region. In the absence of a vaccine, vector control is the mainstay for dengue prevention and control. In this paper we describe vector surveillance and vector control in the Western Pacific countries and areas. Vector surveillance and control strategies used by countries and areas of the Western Pacific Region vary. Vector control strategies include chemical, biological and environmental management that mainly target larval breeding sites. The use of insecticides targeting larvae and adult mosquitoes remains the mainstay of vector control programmes. Existing vector control tools have several limitations in terms of cost, delivery and long-term sustainability. However, there are several new innovative tools in the pipeline. These include Release of Insects Carrying a Dominant Lethal system and Wolbachia, an endosymbiotic bacterium, to inhibit dengue virus in the vector. In addition, the use of biological control such as larvivorous fish in combination with community participation has potential to be scaled up. Any vector control strategy should be selected based on evidence and appropriateness for the entomological and epidemiological setting and carried out in both inter-epidemic and epidemic periods. Community participation and interagency collaboration are required for effective and sustainable dengue prevention and control. Countries and areas are now moving towards integrated vector management.

Epidemiologic update on the dengue situation in the Western Pacific Region, 2010

Dengue is an emerging vectorborne infectious disease that is a major public health concern in the Asia Pacific region. Official dengue surveillance data for 2010 provided by the ministries of health were summarized as part of routine activities of the World Health Organization Regional Office for the Western Pacific. Based on reported data, dengue has continued to show an increasing trend in the Western Pacific Region. In 2010, countries and areas reported a total of 353 907 dengue cases, of which 1073 died, for a case fatality ratio of 0.30%. More than 1000 cases were reported each from Australia (North Queensland), Cambodia, the Lao People's Democratic Republic, Malaysia, the Philippines, Singapore and Viet Nam. All of these countries, except for Australia where the dengue virus is not endemic, reported an increase in the number of reported cases in 2010 compared to 2009. The elevated number of cases reported in 2010 in some countries, such as the Philippines, is likely due to several factors, such as enhanced reporting and continued epidemic activity. However, increases in reported number of cases in other areas, such as Singapore and Malaysia, appear to indicate sustained epidemic activity in those countries. The continued epidemic dengue activity in the Region highlights the need for timely and routine regional sharing of information.

The possibility of eradicating malaria in the Western Pacific Region

Malaria is endemic, to a greater or lesser extent, in the Western Pacific region apart from New Zealand and some islands in the South Pacific. It has practically disappeared from Australia except in its northern part; in Japan, the incidence of the disease has been reduced to such a level that it no longer constitutes a serious public health problem. The greater part of the region, however, is still burdened by this disease.In discussing the possibility of eradicating malaria in the Western Pacific region, one naturally has to consider certain elements which play an essential part in the overall scheme; these are briefly discussed below. (Author)

Development and Practice of Pharmacoeconomics in Aisa - Pacific Region / 中国药房

OBJECTIVE: To provide reference information for formulating drug policies in China.METHODS: To introduce the development and application of pharmacoeconomics in drug pricing and reimbursement process in Asia - Pacific region. RESULTS & CONCLUSION:Pharmacoeconomics can aid for drug policy decision.