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1.
JCO Glob Oncol ; 9: e2200297, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36724416

ABSTRACT

PURPOSE: Although cervical cancer is a disease of inequity, it can be eliminated as a public health problem through vaccination, screening, and treatment. Human papillomavirus vaginal self-collection cervical screening is a high-performance test that can increase reach of screening. This review describes the different contexts and models of care used to pilot or implement self-collection within the Asia-Pacific, measures the extent that implementation outcome measures are reported and, where available, summarizes key implementation findings. METHODS: A scoping review was conducted by searching five databases of the peer-reviewed literature on June 20, 2022. Two researchers assessed eligibility and extracted data independently to the model of care used and the Conceptual Framework for Implementation Outcomes. A mixed-method consolidation of findings (quantitative: count and frequencies; qualitative: content analysis) was undertaken to narratively report findings. RESULTS: Fifty-seven articles, comprising 50 unique studies from 11 countries and two special autonomous regions, were included; 82% were conducted in trials. The implementation of self-collection was conducted in low- (2%), lower-middle- (32%), upper-middle- (32%), and high-income (35%) settings, with 10 different delivery models used; 80% delivered through practitioner-supported models with diversity in how samples were processed, and treatment was offered. Acceptability (73%) and appropriateness (64%) measures were most reported, followed by adoption (57%), feasibility (48%), and fidelity (38%). Only 7% of articles reported implementation cost or penetration measures. No articles reported sustainability measures. CONCLUSION: The literature confirms that self-collection cervical screening has been implemented within the Asia-Pacific region, with evidence demonstrating that it is acceptable and appropriate from the user's perspective. Well-designed, high-quality implementation trials and real-world evaluations of self-collection that report the breadth of implementation outcomes can support the progression toward the elimination of cervical cancer.


Subject(s)
Uterine Cervical Neoplasms , Female , Humans , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Early Detection of Cancer , Asia/epidemiology , Income
2.
Viruses ; 15(1)2022 Dec 24.
Article in English | MEDLINE | ID: mdl-36680101

ABSTRACT

African swine fever (ASF) in Asia and the Pacific is currently dominated by ASF virus transmission within and between domestic pig populations. The contribution made by wild suids is currently not well understood; their distribution, density and susceptibility to the virus has raised concerns that their role in the epidemiology of ASF in the region might be underestimated. Whilst in the Republic of Korea wild suids are considered important in the spread and maintenance of ASF virus, there is an apparent underreporting to official sources of the disease in wild suids from other countires and regions. A review of the current literature, an analysis of the official reporting resources and a survey of the World Organisation of Animal Health Member delegates in Asia and the Pacific were used to assess the potential role of wild suids in ASF outbreaks, and also to gain insight into what ASF management or control strategies are currently implemented for wild suids. Applying appropriate population control and management strategies can be increased in some areas, especially to assist in the conservation of endangered endemic wild suids in this region.


Subject(s)
African Swine Fever Virus , African Swine Fever , Swine , Animals , Sus scrofa , Disease Outbreaks , Asia/epidemiology
3.
BMJ Glob Health ; 8(1)2023 Jan.
Article in English | MEDLINE | ID: mdl-36650014

ABSTRACT

INTRODUCTION: Tuberculosis (TB) treatment interruption remains a critical challenge leading to poor treatment outcomes. Two-thirds of global new TB cases are mostly contributed by Asian countries, prompting systematic analysis of predictors for treatment interruption due to the variable findings. METHODS: Articles published from 2012 to 2021 were searched through seven databases. Studies that established the relationship for risk factors of TB treatment interruption among adult Asian were included. Relevant articles were screened, extracted and appraised using Joanna Briggs Institute's checklists for cohort, case-control and cross-sectional study designs by three reviewers. Meta-analysis was performed using the random effect model in Review Manager software. The pooled prevalence and predictors of treatment interruption were expressed in ORs with 95% CIs; heterogeneity was assessed using the I2 statistic. The publication bias was visually inspected using the funnel plot. RESULTS: Fifty eligible studies (658 304 participants) from 17 Asian countries were included. The overall pooled prevalence of treatment interruption was 17% (95% CI 16% to 18%), the highest in Southern Asia (22% (95% CI 16% to 29%)), followed by Eastern Asia (18% (95% CI 16% to 20%)) and South East Asia (16% (95% CI 4% to 28%)). Seven predictors were identified to increase the risk of treatment interruption, namely, male gender (OR 1.38 (95% CI 1.26 to 1.51)), employment (OR 1.43 (95% CI 1.11 to 1.84)), alcohol intake (OR 2.24 (95% CI 1.58 to 3.18)), smoking (OR 2.74 (95% CI 1.98 to 3.78)), HIV-positive (OR 1.50 (95% CI 1.15 to 1.96)), adverse drug reactions (OR 2.01 (95% CI 1.20 to 3.34)) and previously treated cases (OR 1.77 (95% CI 1.39 to 2.26)). All predictors demonstrated substantial heterogeneity except employment and HIV status with no publication bias. CONCLUSION: The identification of predictors for TB treatment interruption enables strategised planning and collective intervention to be targeted at the high-risk groups to strengthen TB care and control in the Asia region.


Subject(s)
Tuberculosis , Adult , Humans , Male , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Prevalence , Cross-Sectional Studies , Risk Factors , Asia/epidemiology
4.
Drug Alcohol Depend ; 243: 109741, 2023 Feb 01.
Article in English | MEDLINE | ID: mdl-36630807

ABSTRACT

BACKGROUND: The prevalence of chemsex has been reported by multiple systematic reviews among men who have sex with men (MSM) focussing predominantly on the Global North. An Asian perspective with meta-analytical evidence is missing. This meta-analysis summarised the prevalence of substance use associated with chemsex, and chemsex activity among MSM and MSM sub-populations in Asia, as well as the likelihood for chemsex among MSM living with or without HIV. METHODS: We utilized PubMed, Web of Science and medRxiv to search for literature describing chemsex and its associated substance use among MSM and MSM sub-populations in Asia from January 1, 2010 to November 1, 2021 to conduct three meta-analyses with both frequentist and Bayesian approaches. RESULTS: We identified 219 studies and included 23 in the meta-analysis. Based on the frequentist models, methamphetamine was the default substance associated with chemsex among MSM in Asia (prevalence = 0.16, 95 %CI:0.09-0.22), followed by GHB/GBL (prevalence = 0.15, 95 %CI:0.03-0.27) and ketamine (prevalence = 0.08, 95 %CI:0.04-0.12), but hardly any cocaine (prevalence = 0.01, 95 %CI:0.00-0.03). Compared to a general MSM population (prevalence = 0.19, 95 %CI:0.15-0.23), MSM engaging in transactional sex showed a higher prevalence of chemsex (MSM sex work clients [prevalence = 0.28, 95 %CI:0.11-0.45]; MSM sex worker [prevalence = 0.28, 95 %CI:0.17-0.26]). MSM living with HIV also showed higher odds of chemsex activity (OR = 3.35, 95 %CI:1.57-7.10), compared to MSM living without HIV. Both meta-analytic models converged, indicating robust evidence. CONCLUSIONS: Our meta-analyses showed that chemsex is not uncommon among MSM, and MSM engaging in transactional sex in Asia. We confirmed that MSM living with HIV have a higher likelihood of engaging in chemsex, too. Chemsex prevention and management strategies in Asia should be adjusted accordingly.


Subject(s)
HIV Infections , Illicit Drugs , Sexual and Gender Minorities , Substance-Related Disorders , Male , Humans , Homosexuality, Male , Unsafe Sex , Bayes Theorem , Cross-Sectional Studies , Substance-Related Disorders/epidemiology , Substance-Related Disorders/complications , Asia/epidemiology , HIV Infections/epidemiology , HIV Infections/complications , Sexual Behavior
5.
Int J Environ Res Public Health ; 20(1)2022 Dec 23.
Article in English | MEDLINE | ID: mdl-36612567

ABSTRACT

The COVID-19 pandemic has been the largest infectious disease epidemic to affect the human race since the great influenza pandemic of 1918-19 and is close to approaching the number of deaths from the earlier epidemic. A review of available data and the numerous currently available studies on COVID-19 shows that the rate of clinical cases is about 10% greater in females than males in Asia. However, the number of deaths is greater in males than in females. Women are more likely to experience the psychological effects of COVID-19 during and after acute infections. A significant proportion of acute COVID-19 infections continue and their prolonged symptoms have been reported. Further studies are needed, including detailed serology, to measure and monitor the incidence of COVID-19. The pandemic has had a widespread impact on broader societies including shortages of food, lockdowns and isolation. The number of orphans in developing countries has increased. Women have had to bear the major impacts of these community effects. More research is required to develop better vaccines acting against new strains of the virus and to develop systems to distribute vaccines to all people.


Subject(s)
COVID-19 , Male , Female , Humans , COVID-19/epidemiology , SARS-CoV-2 , Pandemics/prevention & control , Communicable Disease Control , Asia/epidemiology
9.
Int J Immunopathol Pharmacol ; 36: 3946320221145520, 2022.
Article in English | MEDLINE | ID: mdl-36565299

ABSTRACT

OBJECTIVE: The haematopoietic cytopenia (HC) of the cyclin-dependent kinase (CDK)4/6 inhibitors was evaluated using the Food and Drug Administration Adverse Event Reporting System (FAERS). METHOD: Data from 1 January 2015 to 31 December 2021 has been retrieved from the FAERS database. Disproportionality analysis and Bayesian analysis were utilized in the data mining. The reporting odds ratio (ROR) with 95% confidence interval (CI) for HC was calculated for each CDK 4/6 inhibitor agent. Clinical features of the patients were collected and compared between death outcome and non-death outcome groups. Time to onset (TTO), proportion of deaths, life-threatening and hospitalizations of CDK 4/6 inhibitors-associated HC were also studied. RESULTS: A total of 17,235 cases of HC associated with CDK 4/6 inhibitors were identified with a median age of 65 years (interquartile range [IQR] 57-73). Palbociclib appeared the strongest signal, with the highest (ROR 9.64, 95% CI 9.46-9.83), followed by ribociclib (ROR 6.38, 95% CI 6.04-6.73) and then abemaciclib (ROR 2.72, 95% CI 2.49-2.97). Patients aged 18-64 had a higher proportion of deaths than those aged 65-84 (12.21% vs. 9.91%, p = 0.001). In Africa and Asia, the proportions of deaths were higher (31.65% and 26.13%, respectively). The median TTO was 26 days (IQR 14-65) for abemaciclib, 33 days (IQR 15-134) for palbociclib and 23 days (IQR 14-69) for ribociclib, respectively. The highest proportion of deaths, life-threatening and hospitalizations all occurred in abemaciclib (13.00%, 5.42% and 44.04%, respectively). CONCLUSIONS: Greater proportions of deaths occurred in Africa and Asia. HC may occur early in any CDK 4/6 inhibitor regimen. Abemaciclib had the highest proportion of deaths, life-threatening and hospitalizations. Health care workers should be more concerned about CDK 4/6 inhibitors. The higher proportions of serious events, including deaths, from Africa and Asia, as well as for abemaciclib, deserve further investigations through additional pharmacoepidemiological approaches.


Subject(s)
Antineoplastic Agents , Cyclin-Dependent Kinase 4 , Cyclin-Dependent Kinase 6 , Hematologic Diseases , Hematopoiesis , Protein Kinase Inhibitors , Aged , Humans , Bayes Theorem , Cyclin-Dependent Kinase 4/antagonists & inhibitors , United States/epidemiology , United States Food and Drug Administration , Hematologic Diseases/chemically induced , Hematologic Diseases/epidemiology , Hematologic Diseases/mortality , Cyclin-Dependent Kinase 6/antagonists & inhibitors , Protein Kinase Inhibitors/adverse effects , Protein Kinase Inhibitors/therapeutic use , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Hematopoiesis/drug effects , Africa/epidemiology , Asia/epidemiology , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged, 80 and over
10.
Viruses ; 14(12)2022 11 26.
Article in English | MEDLINE | ID: mdl-36560644

ABSTRACT

Japanese encephalitis is a serious disease transmitted by mosquitoes. With its recent spread beyond the traditional territory of endemicity in Asia, the magnitude of global threat has increased sharply. While much of the current research are largely focused on changing epidemiology, molecular genetics of virus, and vaccination, little attention has been paid to the early history of virus isolation and phenotypic characterization of this virus. In this review, using this piece of history as an example, I review the transition of the concept and practice of virus isolation and characterization from the early period of history to modern times. The spectacular development of molecular techniques in modern times has brought many changes in practices as well as enormous amount of new knowledge. However, many aspects of virus characterization, in particular, transmission mechanism and host relationship, remain unsolved. As molecular techniques are not perfect in all respects, beneficial accommodation of molecular and biologic data is critically important in many branches of research. Accordingly, I emphasize exercising caution in applying only these modern techniques, point out unrecognized communication problems, and stress that JE research history is a rich source of interesting works still valuable even today and waiting to be discovered.


Subject(s)
Culicidae , Encephalitis Virus, Japanese , Encephalitis, Japanese , Animals , Humans , Encephalitis Virus, Japanese/genetics , Asia/epidemiology , Vaccination
11.
Rev Fac Cien Med Univ Nac Cordoba ; 79(4): 374-378, 2022 12 21.
Article in Spanish | MEDLINE | ID: mdl-36542591

ABSTRACT

Introducción: La disfunción sexual femenina (DSF) se define como un trastorno en el deseo, excitación, orgasmo y/o dolor durante la relación sexual, que genera estrés personal y tiene impacto en la calidad de vida, en la presente revisión sistemática, se describen los factores que mayormente influyen en la disfunción sexual femenina durante la etapa gestacional. El objetivo de este trabajo fue analizar los artículos publicados sobre los factores que influyen en la disfunción sexual femenina durante la etapa gestacional en Sudamérica y Asia en la última década. Métodos: Se realizó una revisión sistemática utilizando las siguientes las siguientes bases de datos:  Doaj, Nure, Pubmed, Scopus, Scielo, Medigraphic, Revista de salud materno fetal y por último el Artículo ciencias, docencia y tecnología.  Resultados: Existen diversos factores que influyen en la disfunción sexual femenina en gestantes y los más frecuentes son por el avance de los trimestres de gestación, por el mismo embarazo, por miedos a complicaciones o creencias, estado emocional, y el estilo de vida que lleva gestante. Conclusión: Existen diversos factores por lo cual se produce este cambio en el comportamiento sexual, para evitar la disfunción sexual femenina en la etapa gestacional se recomienda que la gestante reciba una orientación adecuada sobre los cambios y dificultades en la sexualidad que se darán en este periodo.


Subject(s)
Retrospective Studies , Pregnancy , Humans , Female , South America/epidemiology , Asia/epidemiology
12.
J Infect Chemother ; 29(3): 316-321, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36528275

ABSTRACT

BACKGROUND: Enteroviruses have been in massive, cyclical epidemics worldwide. An in-depth understanding of the international epidemiological characteristics of Enterovirus A (EVA) is critical to determining its clinical significance and total disease burden. Although much research has been conducted on EVA epidemiology, there is still a lack of a comprehensive overview of EVA epidemiological characteristics and trends. OBJECTIVE: EVA nucleic acid sequences from the NCBI virus database were used to summarize the epidemic time (based on the time of specimen collection), spatial and serotype distribution of EVA, and to analyze EVA isolated from cerebrospinal fluid specimens. METHODS: EVA sequences were searched in NCBI Virus by keyword ("Enterovirus A″ or "EVA") to screen sequences released before December 2021 and sort them to analyze EVA by year, geographic region and serotype prevalence. RESULTS: The results found 23,041 retrieved nucleic acid sequences with precise collection dates and geographical regions as of December 2021, with Asia accounting for 87%, Europe for 11% and Africa and the Americas for only 2%. Overall, EV-A71, CVA6 and CVA16 are a few of the main prevalent serotypes; and the prevalence characteristics of the different serotypes change over time from place to place. CONCLUSION: The prevalence of different serotypes of EVA varies considerably over time and space, and we focused on analysing the epidemiological characteristics of EVAs in Asia and Europe and EVAs that invade the nervous system. This study will likely provide important clues for prevention, control and future research in virological surveillance, disease management and vaccine development.


Subject(s)
Enterovirus A, Human , Enterovirus Infections , Epidemics , Humans , Enterovirus A, Human/genetics , Enterovirus Infections/epidemiology , Enterovirus Infections/virology , Europe/epidemiology , Nucleic Acids/genetics , Phylogeny , Asia/epidemiology
13.
Alcohol Clin Exp Res ; 46(12): 2137-2148, 2022 12.
Article in English | MEDLINE | ID: mdl-36524922

ABSTRACT

BACKGROUND: This study aims to increase understanding of the relationship between heavy episodic drinking (HED) and fathers' involvement in parenting in five countries. The potential moderating effect of fathers' experiences of childhood trauma is also studied, controlling for the possible confounding of the effect of HED by father's attitudes toward gender equality, father's age and father's education. METHOD: United Nations Multi-Country Study on Men and Violence (UNMCS) survey data from 4562 fathers aged 18-49 years from Cambodia, China, Indonesia and Papua New Guinea (PNG) and Sri Lanka were used to assess the relationship between fathering involvement (e.g., helping children with their homework) and self-reported HED of 6+ drinks in one occasion vs. non-HED and abstaining. Moderating effects of a 13-item fathers' childhood trauma (FCT) scale were tested and analyses were adjusted for gender-inequitable attitudes using the Gender-Equitable Men scale score. Bivariate and adjusted individual participant meta-analyses were used to determine effect estimates for each site and across all sites. RESULTS: Fathers' HED was associated with less positive parental involvement after adjusting for gender-equitable attitudes, FCT, age and education. No overall interaction between HED and FCT was identified. Gender equitable attitudes were associated with fathering involvement in some countries but not overall (p = 0.07). CONCLUSIONS: Heavy episodic drinking was associated with reduced positive fathering involvement. These findings suggest that interventions to increase fathers' involvement in parenting should include targeting reductions in fathers' HED. Structural barriers to fathers' involvement should be considered alongside HED in future studies of fathers' engagement with their children.


Subject(s)
Fathers , Parenting , Male , Child , Humans , Parents , Asia/epidemiology , Attitude , Father-Child Relations
14.
Int J Clin Oncol ; 28(2): 255-267, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36520255

ABSTRACT

BACKGROUND: Asia accounts for the largest burden of colorectal cancer (CRC) worldwide. This study examines the temporal patterns of CRC in Asia in the last three decades. METHODS: The data pertaining to CRC burden measured by incidence, mortality, and disability-adjusted-life-years (DALYs) and its risk factors for 49 countries in the Asian continent were drawn from the Global Burden of Disease 2019 study between 1990 and 2019. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates. RESULTS: In Asia, incident cases more than tripled from 270,851 to 1.1 million, deaths tripled from 183,252 to 560,426, and DALYs more than doubled from 5 million to 13.4 million between 1990 and 2019. The age-standardized incidence rate (ASIR) increased from 14.0/100,000 to 23.9/100,000, age-standardized mortality rate (ASMR) increased from 10.1/100,000 to 12.5/100,000, and MIR decreased from 0.68 to 0.50 between 1990 and 2019. ASIR varied 10-folds across countries from 5.6/100,000 in Bangladesh to 62.0/100,000 in Taiwan in 2019 and ASMR from 4.9/1000 in Bangladesh to 30.3/100,000 in Brunei. In 2019, diet low in milk (18.7%) and whole grains (15.2%) and calcium (16.6%) were the major contributory risk factors in CRC DALYs in 2019. CONCLUSION: CRC is a fast-rising neoplasm in Asia and its burden can be curtailed by focusing on primary prevention (e.g., diet and physical activity) and secondary prevention through screening. The policy focus and resources must be directed towards capacity building, including cancer infrastructure and quality data availability from cancer registries.


Subject(s)
Colorectal Neoplasms , Humans , Quality-Adjusted Life Years , Risk Factors , Asia/epidemiology , Incidence , Colorectal Neoplasms/epidemiology , Global Health
15.
Int J Infect Dis ; 127: 48-55, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36516915

ABSTRACT

OBJECTIVES: This study aimed to investigate the geographic distribution of carbapenem-resistant Acinetobacter baumannii (CR-AB) isolates in the Asia-Pacific region. METHODS: We collected A. baumannii isolates using the Antimicrobial Testing Leadership and Surveillance program from 2012 to 2019. The minimum inhibitory concentrations (MICs) of the isolates were determined using the broth microdilution method. The major carbapenemase genes were identified using multiplex polymerase chain reaction assays for the isolates collected between 2012 and 2014. CR-AB was defined as isolates with meropenem MICs ≥8 mg/l. RESULTS: In total, 2674 A. baumannii isolates were collected from 13 countries, of which 1918 (71.7%) were CR-AB. The carbapenem resistance rates among A. baumannii isolates were as low as 2.8% and 6.5% in Japan and Australia, respectively, but as high as 88% and 87.2% in South Korea and India, respectively. Of the 232 CR-AB isolates that underwent carbapenemase gene screening, 224 (96.6%) harbored at least one carbapenemase gene. A total of 226 carbapenemase genes were detected, with blaOXA-23 (94.7%, 214/226) being the most dominant, followed by blaOXA-72 (2.7%, 6/226), blaOXA-58 (2.2%, 5/226), and blaNDM-1 (0.4%, 1/226). CR-AB isolates had >80% resistance to amikacin, ampicillin/sulbactam, cefepime, ceftazidime, ciprofloxacin, levofloxacin, and piperacillin/tazobactam. The rates of CR-AB resistance to minocycline and colistin were 7.2% (31/429) and 1.7% (23/1368). For cefoperazone/sulbactam and tigecycline, 50.2% (527/1049) and 93.3% (1789/1918) of CR-AB isolates had an MIC ≤16 mg/l and ≤2 mg/l, respectively. CONCLUSION: The prevalence of carbapenem resistance in A. baumannii showed significant differences among countries in the Asia-Pacific region, and the treatment options were limited.


Subject(s)
Acinetobacter Infections , Acinetobacter baumannii , Anti-Infective Agents , Humans , Anti-Bacterial Agents/pharmacology , Sulbactam , Carbapenems/pharmacology , Leadership , Acinetobacter Infections/drug therapy , Acinetobacter Infections/epidemiology , beta-Lactamases/genetics , Asia/epidemiology , Microbial Sensitivity Tests
16.
Trials ; 23(1): 986, 2022 Dec 07.
Article in English | MEDLINE | ID: mdl-36476401

ABSTRACT

BACKGROUND: More than half of the world's population lives in Asia. With current life expectancies in Asian countries, the burden of cardiovascular disease is increasing exponentially. Overcrowding in the emergency departments (ED) has become a public health problem. Since 2015, the European Society of Cardiology recommends the use of a 0/1-h algorithm based on high-sensitivity cardiac troponin (hs-cTn) for rapid triage of patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). However, these algorithms are currently not recommended by Asian guidelines due to the lack of suitable data. METHODS: The DROP-Asian ACS is a prospective, stepped wedge, cluster-randomized trial enrolling 4260 participants presenting with chest pain to the ED of 12 acute care hospitals in five Asian countries (UMIN; 000042461). Consecutive patients presenting with suspected acute coronary syndrome between July 2022 and Apr 2024 were included. Initially, all clusters will apply "usual care" according to local standard operating procedures including hs-cTnT but not the 0/1-h algorithm. The primary outcome is the incidence of major adverse cardiac events (MACE), the composite of all-cause death, myocardial infarction, unstable angina, or unplanned revascularization within 30 days. The difference in MACE (with one-sided 95% CI) was estimated to evaluate non-inferiority. The non-inferiority margin was prespecified at 1.5%. Secondary efficacy outcomes include costs for healthcare resources and duration of stay in ED. CONCLUSIONS: This study provides important evidence concerning the safety and efficacy of the 0/1-h algorithm in Asian countries and may help to reduce congestion of the ED as well as medical costs.


Subject(s)
Acute Coronary Syndrome , Humans , Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/therapy , Prospective Studies , Asia/epidemiology
17.
United European Gastroenterol J ; 10(10): 1063-1076, 2022 12.
Article in English | MEDLINE | ID: mdl-36479863

ABSTRACT

Inflammatory bowel disease (IBD), which comprises Crohn's disease and ulcerative colitis, is an idiopathic inflammatory condition of the gastrointestinal tract. The incidence and prevalence of IBD are rapidly increasing worldwide, particularly in newly industrialized regions such as Asia. Although a large medical armamentarium is available for treating this chronic disease, IBD imposes a marked global disease burden. To understand the complex etiopathogenesis of this condition, it is important to consider the rapidly changing trends in its epidemiology in Asia. During the past few decades, the incidence and prevalence of IBD have significantly increased in both Asian countries and Asian immigrants in Western countries. In this review, we aimed to study and update the epidemiology of IBD in diverse Asian regions and among Asian immigrants in North America and Europe. Moreover, we highlighted that this population exhibits a unique disease phenotype, such as male predominance and high frequency of perianal fistula in Crohn's disease. Also, a different disease phenotype including more complicated disease such as perianal complications was noted in Asian Americans and Asian Europeans.


Subject(s)
Crohn Disease , Emigrants and Immigrants , Inflammatory Bowel Diseases , Humans , Male , Female , Crohn Disease/epidemiology , Crohn Disease/complications , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/etiology , Asia/epidemiology
18.
Hypertens Res ; 45(12): 1847-1849, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36464746
19.
J Nutr Sci Vitaminol (Tokyo) ; 68(Supplement): S92-S94, 2022.
Article in English | MEDLINE | ID: mdl-36437032

ABSTRACT

Many studies in Western countries have reported that people with low socioeconomic status (SES) have a greater risk of obesity and non-communicable diseases. However, the relationship between SES and nutrition is considered to differ from country to country among Asian countries. Based on studies since 2010, the nutritional status of populations with low SES can be summarized as follows. In India, undernutrition among children and women has been reported. In China, low energy and nutrient intakes and undernutrition are common among children and the elderly, while both obesity and undernutrition are common in adults. In Japan and Korea, weight faltering in preschool children, low dietary quality among groups from school children to adults, and high obesity among adolescents and adult women have been reported. There are two types of policies aimed at reducing nutrition disparities: approaches for population and those for households with low SES. Nutrition disparities due to SES disparities in Asia need to be monitored. In Asia, studies on nutrition policy have focused on cash subsidies and food assistance for low SES households with the aim of improving undernutrition, but food environment measures for the population as a whole also need to be studied in order to reduce under- and over-nutrition, the double burden of malnutrition.


Subject(s)
Malnutrition , Nutritional Status , Adolescent , Adult , Aged , Child, Preschool , Female , Humans , Child , Asia/epidemiology , Nutrition Policy , Social Class , Malnutrition/epidemiology , Obesity
20.
J Headache Pain ; 23(1): 146, 2022 Nov 21.
Article in English | MEDLINE | ID: mdl-36404301

ABSTRACT

ABSTACT: BACKGROUND: DRAGON was a phase 3, randomised, double-blind, placebo-controlled study which evaluated the efficacy and safety of erenumab in patients with chronic migraine (CM) from Asia not adequately represented in the global pivotal CM study. METHODS: DRAGON study was conducted across 9 Asian countries or regions including mainland China, India, the Republic of Korea, Malaysia, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. Patients (N = 557) with CM (aged 18-65 years) were randomised (1:1) to receive once-monthly subcutaneous erenumab 70 mg or matching placebo for 12 weeks. The primary endpoint was the change in monthly migraine days (MMD) from baseline to the last 4 weeks of the 12-week double-blind treatment phase (DBTP). Secondary endpoints included achievement of ≥ 50% reduction in MMD, change in monthly acute headache medication days, modified migraine disability assessment (mMIDAS), and safety. Study was powered for the primary endpoint of change from baseline in MMD. RESULTS: At baseline, the mean (SD) age was 41.7 (± 10.9) years, and 81.5% (n = 454) patients were women. The mean migraine duration was 18.0 (± 11.6) years, and the mean MMD was 19.2 (± 5.4). 97.8% (n = 545) randomised patients completed the DBTP. Overall, demographics and baseline characteristics were balanced between the erenumab and placebo groups except for a slightly higher proportion of women in the placebo group. At Week 12, the adjusted mean change from baseline in MMD was - 8.2 days for erenumab and - 6.6 days for placebo, with a statistically significant difference for erenumab versus placebo (adjusted mean difference vs placebo: - 1.57 [95%CI: - 2.83, - 0.30]; P = 0.015). A greater proportion of patients treated with erenumab achieved ≥ 50% reduction in MMD versus placebo (47.0% vs 36.7%, P = 0.014). At Week 12, greater reductions in monthly acute headache medication days (- 5.34 vs - 4.66) and mMIDAS scores (- 14.67 vs - 12.93) were observed in patients treated with erenumab versus placebo. Safety and tolerability profile of erenumab was comparable to placebo, except the incidence of constipation (8.6% for erenumab vs 3.2% for placebo). CONCLUSION: DRAGON study demonstrated the efficacy and safety of erenumab 70 mg in patients with CM from Asia. No new safety signals were observed during the DBTP compared with the previous trials. TRIAL REGISTRATION: NCT03867201.


Subject(s)
Acute Pain , Migraine Disorders , Humans , Female , Male , Migraine Disorders/drug therapy , Migraine Disorders/prevention & control , Migraine Disorders/epidemiology , Antibodies, Monoclonal, Humanized/adverse effects , Asia/epidemiology , Camphor/therapeutic use , Headache/drug therapy , Menthol/therapeutic use , Acute Pain/drug therapy
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