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Objective: Thalassemia, an inherited hemoglobin synthesis disorder, imposes a significant health burden in Asian regions with high prevalence. Detailed patterns and trends of the disease across countries and territories within these regions remain underexplored. Our study focuses on the disease burden indices of thalassemia within the four GBD-defined Asian regions and the twenty-five included countries and territories. It provides insights into the gender-age distribution, temporal changes, and economic aspects of the thalassemia burden., Methods: Data on thalassemia prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs) were extracted from the Global Burden of Disease (GBD) 2021 study for South, East, Southeast, and high-income Asia regions, encompassing the relevant countries and territories from 1990 to 2021. The Average Annual Percent Change (AAPC) in age-standardized rates of thalassemia was determined to assess temporal trends. Age-gender cohort proportions were considered. The economic aspect of the disease burden and frontier analysis were evaluated using the GBD Socio-Demographic Index and Global Health Expenditure data., Results: Southeast Asia exhibited notably high age-standardized mortality rate (ASMR), age-standardized prevalence rate (ASPR), and age-standardized DALYs rate among the four studied Asian regions in 2021. The East Asia region had recorded the highest age-standardized incidence rate (ASIR). A general decline in disease burden indices across the four regions from 1990 to 2021 was evident, with the exception of ASIR in Southeast Asia. The ASMR was highest among pediatric population under five years old, with a significant male preponderance. An unusual increase in ASMR was detected among females of childbearing age and the elderly within the studied region. Further analysis had identified six high-burden countries and territories, particularly those with low-middle Socio-Demographic Index (SDI) rankings and limited health expenditure., Conclusion: Although the overall burden of thalassemia has decreased substantially, the disease burden was influenced by gender, age, geography, temporal trends, and economic factors in distinct manners. Based on the current SDI, many countries and regions still have greater improvement potential in the disease burden. There is a necessity for enhanced attention and resource allocation, particularly in low-middle and low SDI countries, with an emphasis on policies that promote early diagnosis and comprehensive care., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Antimicrobial resistance is an emerging global threat to public health. The resistant bacteria in food animals can be transferred to humans through the food chain. Limited information on antimicrobial usage and resistance in food animals is available in Southeast Asia due to inadequate monitoring or surveillance systems. A literature review was conducted on antimicrobial use and resistance in food animal production in Southeast Asia for the period 2011-2020, to assess the scope and extent of antibiotic use and resistance. The countries included in the study were Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste. The information was categorised by country, production type and findings regarding antibiotic use and resistance. A total of 108 publications were included in the review. Results showed widespread use of critically and highly important antibiotics in livestock, poultry and aquacultured fish and their products. To curb the growing threat of antibiotic resistance, Southeast Asian countries need to strengthen surveillance and regulatory controls of antimicrobial use in food animal production through "One Health" approach., Competing Interests: Declaration of Competing Interest Authors wish to declare no conflict of interest., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background : Climatic change is an inescapable fact that implies alterations in seasons where weather occurrences have their schedules shift from the regular and magnitudes intensify to more extreme variations over a multi-year period. Southeast Asia is one of the many regions experiencing changes in climate and concurrently still has endemicities of malaria. Given that previous studies have suggested the influence of climate on malaria's vector the Anopheles mosquitoes and parasite the Plasmodium group, this study was conducted to review the evidence of associations made between malaria cases and climatic variables in Southeast Asia throughout a multi-year period. Methods : Our systematic literature review was informed by the PRISMA guidelines and registered in PROSPERO: CRD42022301826 on 5 th February 2022. We searched for original articles in English and Indonesian that focused on the associations between climatic variables and malaria cases. Results : The initial identification stage resulted in 535 records of possible relevance and after abstract screening and eligibility assessment we included 19 research articles for the systematic review. Based on the reviewed articles, changing temperatures, precipitation, humidity and windspeed were considered for statistical association across a multi-year period and are correlated with malaria cases in various regions throughout Southeast Asia. Conclusions : According to the review of evidence, climatic variables that exhibited a statistically significant correlation with malaria cases include temperatures, precipitation, and humidity. The strength of each climatic variable varies across studies. Our systematic review of the limited evidence indicates that further research for the Southeast Asia region remains to be explored., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Rahmani AA et al.)

Background: Influenza poses a major public health challenge in South-East Asia Region (SEAR). To address the challenge, there is a need to generate contextual evidence that could inform policy makers and program managers for response preparedness and impact mitigation. The World Health Organization has identified priority areas across five streams for research evidence generation at a global level (WHO Public Health Research Agenda). Stream 1 focuses on research for reducing the risk of emergence, Stream 2 on limiting the spread, Stream 3 on minimizing the impact, Stream 4 on optimizing the treatment and Stream 5 on promoting public health tools and technologies for Influenza. However, evidence generation from SEAR has been arguably low and needs a relook for alignment with priorities. This study aimed to undertake a bibliometric analysis of medical literature on Influenza over the past 21 years to identify gaps in research evidence and for identifying major areas for focusing with a view to provide recommendations to member states and SEAR office for prioritizing avenues for future research., Methods: We searched Scopus, PubMed, Embase, and Cochrane databases in August 2021. We identified studies on influenza published from the 11 countries in WHO SEAR in the date range of 1 January 2000-31 December 2021. Data was retrieved, tagged and analyzed based on the WHO priority streams for Influenza, member states, study design and type of research. Bibliometric analysis was done on Vosviewer., Findings: We included a total of 1,641 articles (Stream 1: n  = 307; Stream 2: n  = 516; Stream 3: n  = 470; Stream 4: n  = 309; Stream 5: n  = 227). Maximum number of publications were seen in Stream 2, i.e., limiting the spread of pandemic, zoonotic, and seasonal epidemic influenza which majorly included transmission, spread of virus at global and local levels and public health measures to limit the transmission. The highest number of publications was from India ( n  = 524) followed by Thailand ( n  = 407), Indonesia ( n  = 214) and Bangladesh ( n  = 158). Bhutan ( n  = 10), Maldives ( n  = 1), Democratic People's Republic of Korea ( n  = 1), and Timor-Leste ( n  = 3) had the least contribution in Influenza research. The top-most journal was PloS One which had the maximum number of influenza articles ( n  = 94) published from SEAR countries. Research that generated actionable evidence, i.e., implementation and intervention related topics were less common. Similarly, research on pharmaceutical interventions and on innovations was low. SEAR member states had inconsistent output across the five priority research streams, and there was a much higher scope and need for collaborative research. Basic science research showed declining trends and needed reprioritization., Interpretation: While a priority research agenda has been set for influenza at the global level through the WHO Global Influenza Program since 2009, and subsequently revisited in 2011 and again in 2016-2017, a structured contextualized approach to guide actionable evidence generation activities in SEAR has been lacking. In the backset of the Global Influenza Strategy 2019-2030 and the COVID-19 pandemic, attuning research endeavors in SEAR could help in improved pandemic influenza preparedness planning. There is a need to prioritize contextually relevant research themes within priority streams. Member states must inculcate a culture of within and inter-country collaboration to produce evidence that has regional as well as global value., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ranjan Wijesinghe, Sharma, Vaishnav, Mukherjee, Pawar, Mohapatra, Buddha, Ceniza Salvador and Kakkar.)

Tobacco use among youth in the South-East Asian region is quite prevalent. This study aims to examine if psychosocial factors (perceived loneliness, peer, and parental relationships) were associated with adolescent smoking, and whether the effects were different according to sex and age. Data came from the Global School-based Student Health Surveys collected between 2012 and 2015 in Brunei, Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand, Timor-Leste, and Vietnam. 64 578 (males = 48.5%) adolescents aged 13-18 completed the survey. Prevalence of past-month cigarette use was 10.6%. Adolescent smoking was associated with loneliness (OR = 1.75), lack of close friends (OR = 1.43), and lack of parental understanding (OR = 1.35). There was significant interactions between sex with loneliness, close friends, and parental understanding ( p < .001). Interactions indicated having no close friends is associated with smoking and is stronger for females than males. Conversely, loneliness was associated with smoking more strongly in males than females. Results indicate that psychosocial factors are linked to adolescent smoking in South-East Asia, suggesting a further need for research on the relation of psychosocial factors with smoking, and their underlying factors.

Although cardiovascular care has improved in the last decade in the low- and middle-income countries (LMICs) in South-East Asia Region; these countries, particularly Indonesia, are still encountering a number of challenges in providing standardized healthcare systems. This article aimed to highlight the current state of cardiology practices in primary and secondary care, including the novel cardiovascular risk factors, recommendations for improving the quality of care, and future directions of cardiovascular research in limited settings in South-East Asia. We also provided the most recent evidence by addressing our latest findings on cardiovascular research in Indonesia, a region where infrastructure, human, and financial resources are largely limited. Improving healthcare policies to reduce a nations' exposure to CVD risk factors, providing affordable and accessible cardiovascular care both at primary and secondary levels, and increasing capacity building for clinical research should be warranted in the LMICs in South-East Asia., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2022 The Author(s).)

This will be the first publication of Type 1 diabetes(T1D) outcomes in five low-middle-income countries (LMICs)-Laos, Malaysia, Vietnam, Cambodia and Myanmar in the Southeast Asia (SEA) region. The information obtained has been possible due to partnership programmes of non-government organisationAction4Diabetes (A4D) with defined local hospitalsthrough a Memorandum of Understandingsigned with the governments in SEAthat guarantees ongoing supplies of free insulin, blood glucose meter supplies, HbA1c tests and hospital emergency funds., Participants: Between 2020 and 2021, 383 children and young people with T1D who were active in the A4D supported programmes were reviewed including information on health coverage, multidisciplinary team management, diabetic ketoacidosis (DKA) on admission and insulin regimen., Results: Mean HbA1c between 2020 and 2021 for patients in these LMICs arereported for the first time. The average glycaemic index in the five SEAcountries reviewed between 2020 and 2021 were high at 83 mmol/mol (9.7%)., Conclusions: Government partnership working with non-government organisationsto support T1D from diagnosis to adulthood are the first steps to closing thegaps in many LMICs. Further epidemiological studies are needed to identify the glycaemic outcomes and DKA rates on admission for many of these countries., (Crown Copyright © 2022. Published by Elsevier B.V. All rights reserved.)

The pandemic has exposed the vulnerability of our civilization and reinforced the importance of living in harmony with nature, not rampaging it in a conquering mode. South and South-East Asia have a vital role to play in achieving the global goal of 'Health for All' as the regions have a significantly large share of global income and multidimensional poor compared to other regions. Clearly, the progress in health and development outcomes of these regions cannot be achieved without addressing social determinants of health and ensuring active public participation. These regions must collectively address the social determinants of health following a realistic health promotion model. It is indeed a favourable time to look beyond the so-called predominantly reductionist biomedical model of health care to a more holistic model of health, that places humans and the environment at the centre, and emphasizes the importance of promoting health and wellbeing.

This study investigated the environmental spatial heterogeneity of novel coronavirus (COVID-19) and spatial and temporal changes among the top-20 metropolitan cities of the Asia-Pacific. Remote sensing-based assessment is performed to analyze before and during the lockdown amid COVID-19 lockdown in the cities. Air pollution and mobility data of each city (Bangkok, Beijing, Busan, Dhaka, Delhi, Ho Chi Minh, Hong Kong, Karachi, Mumbai, Seoul, Shanghai, Singapore, Tokyo, Wuhan, and few others) have been collected and analyzed for 2019 and 2020. Results indicated that almost every city was impacted positively regarding environmental emissions and visible reduction were found in Aerosol Optical Depth (AOD), sulfur dioxide (SO 2 ), carbon monoxide (CO), and nitrogen dioxide (NO 2 ) concentrations before and during lockdown periods of 2020 as compared to those of 2019. The highest NO 2 emission reduction (~ 50%) was recorded in Wuhan city during the lockdown of 2020. AOD was highest in Beijing and lowest in Colombo (< 10%). Overall, 90% movement was reduced till mid-April, 2020. A 98% reduction in mobility was recorded in Delhi, Seoul, and Wuhan. This analysis suggests that smart mobility and partial shutdown policies could be developed to reduce environmental pollutions in the region. Wuhan city is one of the benchmarks and can be replicated for the rest of the Asian cities wherever applicable., (© 2021. The Author(s).)

Hidradenitis suppurativa (HS) in South-East Asia and East Asia shows distinct clinical, environmental, physiological and likely genetic differences compared with the West. A male predominance is present, which may be due to differences in smoking habits. Involvement of the buttocks is common in East Asian patients, while the axillae are most commonly affected in South-East Asian patients. Metabolic comorbidities are prevalent in South-East Asian and East Asian HS patients. A family history of HS is less common than noted in Western populations. Asian ethnic subgroups deserve further study., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The genus Bandavirus consists of seven tick-borne bunyaviruses, among which four are known to infect humans. Dabie bandavirus , severe fever with thrombocytopenia syndrome virus (SFTSV), poses serious threats to public health worldwide. SFTSV is a tick-borne virus mainly reported in China, South Korea, and Japan with a mortality rate of up to 30%. To date, most immunology-related studies focused on the antagonistic role of SFTSV non-structural protein (NSs) in sequestering RIG-I-like-receptors (RLRs)-mediated type I interferon (IFN) induction and type I IFN mediated signaling pathway. It is still elusive whether the interaction of SFTSV and other conserved innate immune responses exists. As of now, no specific vaccines or therapeutics are approved for SFTSV prevention or treatments respectively, in part due to a lack of comprehensive understanding of the molecular interactions occurring between SFTSV and hosts. Hence, it is necessary to fully understand the host-virus interactions including antiviral responses and viral evasion mechanisms. In this review, we highlight the recent progress in understanding the pathogenesis of SFTS and speculate underlying novel mechanisms in response to SFTSV infection., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Zhou and Yu.)

In September 2018, all countries made a commitment at the first ever United Nations High-Level Meeting (UNHLM) on TB, to provide TB preventive treatment (TPT) to at least 30 million people at high-risk of TB disease between 2018 and 2022. In the WHO South-East Asia Region (SEA Region), which accounts for 44% of the global TB burden, only 1.2 million high-risk individuals (household contacts and people living with HIV) were provided TPT (11% of the 10.8 million regional UNHLM TPT target) in 2018 and 2019. By 2020, almost all 11 countries of the SEA Region had revised their policies on TPT target groups and criteria to assess TPT eligibility, and had adopted at least one shorter TPT regimen recommended in the latest WHO TPT guidelines. The major challenges for TPT scale-up in the SEA Region are resource shortages, knowledge and service delivery/uptake gaps among providers and service recipients, and the lack of adequate quantities of rifapentine for use in shorter TPT regimens. There are several regional opportunities to address these gaps and countries of the SEA Region must make use of these opportunities to scale up TPT services rapidly to reduce the TB burden in the SEA Region.

Background: The COVID-19 pandemic has had a profound global impact on governments, health care systems, economies, and populations around the world. Within the East Asia and Pacific region, some countries have mitigated the spread of the novel coronavirus effectively and largely avoided severe negative consequences, while others still struggle with containment. As the second wave reaches East Asia and the Pacific, it becomes more evident that additional SARS-CoV-2 surveillance is needed to track recent shifts, rates of increase, and persistence associated with the pandemic., Objective: The goal of this study is to provide advanced surveillance metrics for COVID-19 transmission that account for speed, acceleration, jerk, persistence, and weekly shifts, to better understand country risk for explosive growth and those countries who are managing the pandemic successfully. Existing surveillance coupled with our dynamic metrics of transmission will inform health policy to control the COVID-19 pandemic until an effective vaccine is developed. We provide novel indicators to measure disease transmission., Methods: Using a longitudinal trend analysis study design, we extracted 330 days of COVID-19 data from public health registries. We used an empirical difference equation to measure the daily number of cases in East Asia and the Pacific as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R., Results: The standard surveillance metrics for Indonesia, the Philippines, and Myanmar were concerning as they had the largest new caseloads at 4301, 2588, and 1387, respectively. When looking at the acceleration of new COVID-19 infections, we found that French Polynesia, Malaysia, and the Philippines had rates at 3.17, 0.22, and 0.06 per 100,000. These three countries also ranked highest in terms of jerk at 15.45, 0.10, and 0.04, respectively., Conclusions: Two of the most populous countries in East Asia and the Pacific, Indonesia and the Philippines, have alarming surveillance metrics. These two countries rank highest in new infections in the region. The highest rates of speed, acceleration, and positive upwards jerk belong to French Polynesia, Malaysia, and the Philippines, and may result in explosive growth. While all countries in East Asia and the Pacific need to be cautious about reopening their countries since outbreaks are likely to occur in the second wave of COVID-19, the country of greatest concern is the Philippines. Based on standard and enhanced surveillance, the Philippines has not gained control of the COVID-19 epidemic, which is particularly troubling because the country ranks 4th in population in the region. Without extreme and rigid social distancing, quarantines, hygiene, and masking to reverse trends, the Philippines will remain on the global top 5 list of worst COVID-19 outbreaks resulting in high morbidity and mortality. The second wave will only exacerbate existing conditions and increase COVID-19 transmissions., (©Lori Ann Post, Jasmine S Lin, Charles B Moss, Robert Leo Murphy, Michael G Ison, Chad J Achenbach, Danielle Resnick, Lauren Nadya Singh, Janine White, Michael J Boctor, Sarah B Welch, James Francis Oehmke. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.02.2021.)

Objectives: To clarify the pandemic status in Western Pacific countries or territories., Methods: The WHO's daily situation reports of COVID-19 were reviewed from January 20, 2020, to March 24, 2020. Changes in the infections, deaths, and the case fatality rate (CFR) in Western Pacific countries or territories were counted., Results: As of March 24, a total of 17 countries or territories had reported the presence of COVID-19 in the Western Pacific Region, 96,580 people have been infected and a total of 3502 deaths. Fifty-three percent (9/17) of these countries or territories had their first case within 2 wk since the WHO's first report, most are China's neighbors with a large and dense population. No other country or territory in this region reported a new infection from January 30 to February 28. However, 8 (47.0%) countries or territories have reported the first cases in 3 wk since February 28, almost all are islands. Many countries maintained a small number of infections for a long time after the first report, but a rapid increase occurred later. Deaths occurred in 8 countries with a total CFR of 3.63%, and the CFR varies widely, from 0.39% (Singapore) to 7.14% (Philippines)., Conclusions: The regional spread of COVID-19 urgently requires an aggressive preparedness for the Western Pacific Islands.

South Asia's rich ecological, geographic and cultural diversity make the region unique but also explains why it is volatile and vulnerable in social, economic and environmental terms. It is a high-priority region for many public health concerns. Rising population, increase in number of urban poverty, low government spending (in terms of % of GDP) on health, dwindling health indicators are some of the immediate concerns. Apart from this, the region is facing a dual burden of diseases, where the communicable diseases are still responsible for substantial portion of deaths, burden of non-communicable diseases is steadily increasing. These changes are explained by four main stages of epidemiological transition. Movement through these stages has resulted in a dramatic shift in the cause of death from infectious diseases and malnutrition in the first stage to cardio-vascular diseases (CVDs) and cancers in most high-income countries over the last two centuries. Policy makers, public health specialists and primary care physicians are expected to keep these changes in mind, while draft policies and dealing with patients on a day to day level.

Background: Ticks and fleas are considered amongst the most important arthropod vectors of medical and veterinary concern due to their ability to transmit pathogens to a range of animal species including dogs, cats and humans. By sharing a common environment with humans, companion animal-associated parasitic arthropods may potentially transmit zoonotic vector-borne pathogens (VBPs). This study aimed to molecularly detect pathogens from ticks and fleas from companion dogs and cats in East and Southeast Asia., Methods: A total of 392 ticks and 248 fleas were collected from 401 infested animals (i.e. 271 dogs and 130 cats) from China, Taiwan, Indonesia, Malaysia, Singapore, Thailand, the Philippines and Vietnam, and molecularly screened for the presence of pathogens. Ticks were tested for Rickettsia spp., Anaplasma spp., Ehrlichia spp., Babesia spp. and Hepatozoon spp. while fleas were screened for the presence of Rickettsia spp. and Bartonella spp., Result: Of the 392 ticks tested, 37 (9.4%) scored positive for at least one pathogen with Hepatozoon canis being the most prevalent (5.4%), followed by Ehrlichia canis (1.8%), Babesia vogeli (1%), Anaplasma platys (0.8%) and Rickettsia spp. (1%) [including Rickettsia sp. (0.5%), Rickettsia asembonensis (0.3%) and Rickettsia felis (0.3%)]. Out of 248 fleas tested, 106 (42.7%) were harboring at least one pathogen with R. felis being the most common (19.4%), followed by Bartonella spp. (16.5%), Rickettsia asembonensis (10.9%) and "Candidatus Rickettsia senegalensis" (0.4%). Furthermore, 35 Rhipicephalus sanguineus ticks were subjected to phylogenetic analysis, of which 34 ticks belonged to the tropical and only one belonged to the temperate lineage (Rh. sanguineus (sensu stricto))., Conclusion: Our data reveals the circulation of different VBPs in ticks and fleas of dogs and cats from Asia, including zoonotic agents, which may represent a potential risk to animal and human health.

Background: The World Report on Vision suggests that universal eye health coverage (UEHC) can be achieved through an integrated people-centered eye care (IPCEC) delivery. This study provides an estimation of capacity building of facilities and workforce to attain UEHC through IPCEC in South East Asia (SEA) beyond 2020., Methods: The data sources on the magnitude of blindness and visual impairment in the SEA region included reports of the Vision Loss Expert Group, most recent population-based studies from the member states and unpublished data from the study teams. The model is based on the estimated or projected population of the member states in 2020 and 2030., Results: Data from the ten member states of the World Health Organization (WHO) SEA show that the magnitude of blindness and moderate to severe visual impairment (MSVI) has decreased between 1990 and 2015, but still higher than global average. Cataract and uncorrected refractive errors were the common causes of blindness and MSVI, respectively. The estimated WHO SEA region share of world population is likely to increase from 38.39% in 2020 to 44.32% in 2030, and so also will be the visually impaired people. By adopting the IPCEC the WHO SEA countries would require at least 429,802 community workers, 164,784 allied ophthalmic personnel and 10,744 ophthalmologists in the public facilities in 2030., Conclusion: In order to attain UEHC and use the IPCEC model, each country in the region should invest substantially more in structured eye care delivery and workforce.

Background: Taenia saginata is an important zoonotic parasite, causing taeniosis in humans and cysticercosis in bovines, the latter being a significant concern for the global beef industry. Many countries in East, Southeast and South Asia are experiencing rapid economic growth, and an increasing number of people in these countries are dependent on the livestock industry. Currently, however, an overview of the prevalence of T. saginata in this region is lacking. In this review, we analysed the available literature on T. saginata taeniosis and bovine cysticercosis for East, Southeast and South Asia., Methods: A systematic review was conducted, based on both published and grey literature. Articles published between 1990 and 2017 were mined for information on the occurrence, prevalence, and geographical distribution of T. saginata taeniosis and bovine cysticercosis in East, Southeast and South Asia., Results: The presence of T. saginata was described in 15 of 27 countries of the region, including Afghanistan, Cambodia, China, India, Indonesia, Japan, Lao PDR, Malaysia, Mongolia, Nepal, Pakistan, Philippines, South Korea, Thailand and Vietnam. The only country that reported an absence of T. saginata is Japan, although sporadic reports of imported cases and unconfirmed reports of autochthonous infections were identified. Nationwide surveys of taeniosis with systematic sample collection and high sample numbers were available for Cambodia, China, Lao PDR, and South Korea, although speciation of Taenia was not always performed. Regional prevalence of taeniosis and bovine cysticercosis in endemic regions ranged between 0.02-42.6%, and 0.76-46.7%, respectively. However, data for bovine cysticercosis were only available for five countries (Japan, Lao PDR, Mongolia, Pakistan and Vietnam)., Conclusions: The data indicate a widespread occurrence of T. saginata throughout East, Southeast and South Asia. Identification of Taenia spp. in human infections was frequently not performed, leading to gaps in knowledge about the distribution of human tapeworm infections, mainly in regions where different human Taenia species co-occur. A high prevalence of T. saginata taeniosis and bovine cysticercosis may reflect insufficiencies in sanitation, limited health education standards, and insufficient food safety measures. Therefore, there is a need to improve local surveillance, notification, and overall control systems.

Enterovirus A71 (EV-A71) is one of the common causative pathogens for hand foot and mouth disease (HFMD) affecting young children. HFMD outbreak can result in a substantial pediatric hospitalization and burden the healthcare services, especially in less-developed countries. Since the initial epidemic of predominantly EV-A71 in California in 1969, the high prevalence of HFMD in the Asia-pacific region and elsewhere around the world represents a significant morbidity in this age group. With the advent of rapid and accurate diagnostic tools, there has been a dramatic increase in the number of laboratory-confirmed EV-A71 infection over the past two decades. The population, cultural, and socioeconomic diversity among countries in the Asia-Pacific region all influence the transmission and morbidity associated with HFMD. This review summarizes the current state of epidemiology of EV-A71 in Asia-Pacific countries based on the most recent epidemiological data and available information on the prevalence and disease burden. This knowledge is important in guiding the prevention, control and future research on vaccine development of this highly contagious disease of significant socioeconomic implications in public health.

Aims: Nearly 60% of the world's population lives in Asia but little is known about the characteristics and outcomes of Asian patients with heart failure with reduced ejection fraction (HFrEF) compared to other areas of the world., Methods and Results: We pooled two, large, global trials, with similar design, in 13 174 patients with HFrEF (patient distribution: China 833, India 1390, Japan 209, Korea 223, Philippines 223, Taiwan 199 and Thailand 95, Western Europe 3521, Eastern Europe 4758, North America 613, and Latin America 1110). Asian patients were younger (55.0-63.9 years) than in Western Europe (67.9 years) and North America (66.6 years). Diuretics and devices were used less, and digoxin used more, in Asia. Mineralocorticoid receptor antagonist use was higher in China (66.3%), the Philippines (64.1%) and Latin America (62.8%) compared to Europe and North America (range 32.8% to 49.6%). The rate of cardiovascular death/heart failure hospitalization was higher in Asia (e.g. Taiwan 17.2, China 14.9 per 100 patient-years) than in Western Europe (10.4) and North America (12.8). However, the adjusted risk of cardiovascular death was higher in many Asian countries than in Western Europe (except Japan) and the risk of heart failure hospitalization was lower in India and in the Philippines than in Western Europe, but significantly higher in China, Japan, and Taiwan., Conclusion: Patient characteristics and outcomes vary between Asia and other regions and between Asian countries. These variations may reflect several factors, including geography, climate and environment, diet and lifestyle, health care systems, genetics and socioeconomic influences., (© 2018 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Trypanosoma lewisi (Kinetoplastea: Trypanosomatida: Trypanosomatidae) with a cosmopolitan distribution is the type species of the subgenus Herpetosoma, which includes ca. 50 nominal species isolated mainly from rodents. Since members of Herpetosoma in different host species have an almost identical morphology of bloodstream forms, these trypanosomes are referred to as 'T. lewisi-like', and the molecular genetic characterization of each species is necessary to verify their taxonomy. In the present study, we collected blood samples from 89 murid rodents of 15 species and 11 soricids of four species in Indonesia, Philippines, Vietnam, Taiwan, and mainland China for the detection of hemoprotozoan infection. T. lewisi and T. lewisi-like trypanosomes were found in the blood smears of 10 murid animals, which included Bandicota indica (two rats), Rattus argentiventer (one rat), and Rattus tiomanicus (two rats) in Indonesia; Rattus rattus (one rat) in the Philippines; and Niviventer confucianus (four rats) in mainland China. Furthermore, large- or medium-sized non-T. lewisi-like trypanosomes were detected in two soricids, Crocidura dracula in Vietnam and Anourosorex yamashinai in Taiwan, respectively. Molecular genetic characterization of the small subunit (SSU) ribosomal RNA gene (rDNA) and glycosomal glyceraldehyde-3-phosphate dehydrogenase (gGAPDH) gene indicated that the trypanosomes from all the murid hosts had identical SSU rDNA or gGAPDH gene nucleotide sequences except for those in N. confucianus in mainland China. These N. confucianus-infecting trypanosomes also showed several unique morphological features such as smaller bodies, anteriorly positioned nuclei, and larger rod-shaped kinetoplasts when compared with T. lewisi trypomastigotes. Trypanosoma (Herpetosoma) niviventerae n. sp. is erected for this new species. Similarly, based on morphological and molecular genetic characterization, Trypanosoma sapaensis n. sp. and Trypanosoma anourosoricis n. sp. are proposed for the trypanosomes in C. dracula in Vietnam and A. yamashinai in Taiwan, respectively. More effort directed toward the morphological and molecular genetic characterization of the trypanosomes of rodents and soricids is required to fully understand the real biodiversity of their hemoflagellates.

Background and Aims: People who have recently injected drugs are a priority population in efforts to achieve hepatitis C virus (HCV) elimination. This study estimated the prevalence and number of people with recent injecting drug use living with HCV, and the proportion of people with recent injecting drug use among all people living with HCV infection at global, regional and country-levels., Methods: Data from a global systematic review of injecting drug use and HCV antibody prevalence among people with recent (previous year) injecting drug use were used to estimate the prevalence and number of people with recent injecting drug use living with HCV. These data were combined with a systematic review of global HCV prevalence to estimate the proportion of people with recent injecting drug use among all people living with HCV., Results: There are an estimated 6.1 million [95% uncertainty interval (UI) = 3.4-9.2] people with recent injecting drug use aged 15-64 years living with HCV globally (39.2% viraemic prevalence; UI = 31.6-47.0), with the greatest numbers in East and Southeast Asia (1.5 million, UI = 1.0-2.1), eastern Europe (1.5 million, UI = 0.7-2.4) and North America (1.0 million, UI = 0.4-1.7). People with recent injecting drug use comprise an estimated 8.5% (UI = 4.6-13.1) of all HCV infections globally, with the greatest proportions in North America (30.5%, UI = 11.7-56.7), Latin America (22.0%, UI = 15.3-30.4) and eastern Europe (17.9%, UI = 8.2-30.9)., Conclusions: Although, globally, 39.2% of people with recent injecting drug use are living with hepatitis C virus (HCV) and 8.5% of all HCV infections occur globally among people with recent injecting drug use, there is wide variation among countries and regions., (© 2018 Society for the Study of Addiction.)

Objective: To describe the prevalence of food allergy in Asian patients with allergic rhinitis., Study Design: A non-randomized prospectively collected patients over a three year period, with complaints of nose congestion, rhinorrhea and/or nasal discharge., Results: There were 435 patients enrolled, 213 children and 222 adults. The children group had a high prevalence of allergen specific IgE to Dermatophagoides pteryonysinus (70%), Dermatophagoides farina (69%), and Blomia tropicalis (55%); followed by dogs (32%), cats (19%) and cockroaches (19%). In the children food allergy category, the top three allergens were egg white (54%), milk (31%) and soya bean (13%). The adult group had results of Dermatophagoides pteryonysinus (71%), Dermatophagoides farina (72%), and Blomia tropicalis (59%); the adult food allergy category, the top 3 allergens were egg white (13%), milk (6%) and soya bean (5%). There was a statistically significant difference in the child and adult group for Dust, D. pteryonysinus, D. farina, B.tropicalis, egg white, wheat, gluten and soya bean. In the age specific child groups, there was an increased in egg food allergy levels, with a peak at the age of five-nine years old and decreasing thereafter (p=0.04). In the children group, the mean Total Nasal Symptom Score (TNSS) was 10.3 (range of 7 to 13); the adult group was similar, with a mean TNSS of 9.8 (range 5 to 12)., Conclusion: The prevalence of food allergy in paediatric patients with allergic rhinitis is fairly high and should be considered when treating these children.

Worldwide, pneumonia is the leading cause of death in infants and young children (aged <5 years). We provide an overview of the global pneumonia disease burden, as well as the aetiology and management practices in different parts of the world, with a specific focus on the WHO Western Pacific Region. In 2011, the Western Pacific region had an estimated 0.11 pneumonia episodes per child-year with 61,900 pneumonia-related deaths in children less than 5 years of age. The majority (>75%) of pneumonia deaths occurred in six countries; Cambodia, China, Laos, Papua New Guinea, the Philippines and Viet Nam. Historically Streptococcus pneumoniae and Haemophilus influenzae were the commonest causes of severe pneumonia and pneumonia-related deaths in young children, but this is changing with the introduction of highly effective conjugate vaccines and socio-economic development. The relative contribution of viruses and atypical bacteria appear to be increasing and traditional case management approaches may require revision to accommodate increased uptake of conjugated vaccines in the Western Pacific region. Careful consideration should be given to risk reduction strategies, enhanced vaccination coverage, improved management of hypoxaemia and antibiotic stewardship., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

In the coastal countries of East Asia and Southeast Asia, ciguatera should be common because of the extensive tropical and subtropical coral reefs along the coasts and in the neighboring seas with ciguatoxic fishes. An extensive search of journal databases, the Internet and the government websites was performed to identify all reports of ciguatera from the regions. Based on the official data and large published case series, the incidence of ciguatera was higher in the coastal cities (Hong Kong, Foshan, Zhongshan) of southern China than in Japan (Okinawa Prefecture). In Singapore, ciguatera appeared to be almost unknown. In other countries, only isolated cases or small case series were reported, but under-reporting was assumed to be common. Ciguatera may cause severe acute illness and prolonged neurological symptoms. Ciguatera represents an important public health issue for endemic regions, with significant socio-economic impact. Coordinated strategies to improve risk assessment, risk management and risk communication are required. The systematic collection of accurate data on the incidence and epidemiology of ciguatera should enable better assessment and management of its risk. Much more work needs to be done to define the size threshold for important coral reef fish species from different regions, above which the risk of ciguatera significantly increases.

Five outbreaks of foot-and-mouth disease have occurred in South Korea during 2000-2011. Macro-analysis of these outbreaks showed a correlation with outbreaks in countries in eastern Asia. Genetic analyses of food-and-mouth disease viruses in South Korea showed a correlation with viruses that are prevalent in neighboring countries.

Background: Suicides by carbon monoxide poisoning resulting from burning barbecue charcoal reached epidemic levels in Hong Kong and Taiwan within 5 y of the first reported cases in the early 2000s. The objectives of this analysis were to investigate (i) time trends and regional patterns of charcoal-burning suicide throughout East/Southeast Asia during the time period 1995-2011 and (ii) whether any rises in use of this method were associated with increases in overall suicide rates. Sex- and age-specific trends over time were also examined to identify the demographic groups showing the greatest increases in charcoal-burning suicide rates across different countries., Methods and Findings: We used data on suicides by gases other than domestic gas for Hong Kong, Japan, the Republic of Korea, Taiwan, and Singapore in the years 1995/1996-2011. Similar data for Malaysia, the Philippines, and Thailand were also extracted but were incomplete. Graphical and joinpoint regression analyses were used to examine time trends in suicide, and negative binomial regression analysis to study sex- and age-specific patterns. In 1995/1996, charcoal-burning suicides accounted for <1% of all suicides in all study countries, except in Japan (5%), but they increased to account for 13%, 24%, 10%, 7%, and 5% of all suicides in Hong Kong, Taiwan, Japan, the Republic of Korea, and Singapore, respectively, in 2011. Rises were first seen in Hong Kong after 1998 (95% CI 1997-1999), followed by Singapore in 1999 (95% CI 1998-2001), Taiwan in 2000 (95% CI 1999-2001), Japan in 2002 (95% CI 1999-2003), and the Republic of Korea in 2007 (95% CI 2006-2008). No marked increases were seen in Malaysia, the Philippines, or Thailand. There was some evidence that charcoal-burning suicides were associated with an increase in overall suicide rates in Hong Kong, Taiwan, and Japan (for females), but not in Japan (for males), the Republic of Korea, and Singapore. Rates of change in charcoal-burning suicide rate did not differ by sex/age group in Taiwan and Hong Kong but appeared to be greatest in people aged 15-24 y in Japan and people aged 25-64 y in the Republic of Korea. The lack of specific codes for charcoal-burning suicide in the International Classification of Diseases and variations in coding practice in different countries are potential limitations of this study., Conclusions: Charcoal-burning suicides increased markedly in some East/Southeast Asian countries (Hong Kong, Taiwan, Japan, the Republic of Korea, and Singapore) in the first decade of the 21st century, but such rises were not experienced by all countries in the region. In countries with a rise in charcoal-burning suicide rates, the timing, scale, and sex/age pattern of increases varied by country. Factors underlying these variations require further investigation, but may include differences in culture or in media portrayals of the method. Please see later in the article for the Editors' Summary.

In 2005, the World Health Organization (WHO) Regional Committee for the Western Pacific Region (WPR) resolved that WPR should aim to eliminate measles by 2012. The recommended measles elimination strategies in WPR include 1) achieving and maintaining high (≥95%) coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services and by implementing supplementary immunization activities (SIAs), when required; 2) conducting high-quality, case-based measles surveillance; 3) ensuring high-quality laboratory surveillance, with timely and accurate testing of specimens to confirm or discard suspected cases and detect measles virus for genotyping and molecular analysis; and 4) establishing and maintaining measles outbreak preparedness for rapid response and ensuring appropriate case management. This report updates the previous report and describes progress toward eliminating measles in WPR during 2009-2012. During this period, measles incidence reached a historic low, decreasing by 83%, from 34.0 to 5.9 cases per million population. However, to achieve measles elimination in WPR, additional efforts are needed to strengthen routine immunization services in countries and areas with <95% coverage with the routine first (MCV1) or second dose of MCV (MCV2), to introduce a MCV2 dose in the four remaining countries and areas that do not yet have a routine 2-dose MCV schedule, and to use SIAs to close immunity gaps among measles-susceptible populations in countries and areas that have ongoing measles virus transmission.

Hilar cholangiocarcinoma (HCCA) is one of the most common types of hepatobiliary cancers reported in the world including Asia-Pacific region. Early HCCA may be completely asymptomatic. When significant hilar obstruction develops, the patient presents with jaundice, pale stools, dark urine, pruritus, abdominal pain, and sometimes fever. Because no single test can establish the definite diagnosis then, a combination of many investigations such as tumor markers, tissue acquisition, computed tomography scan, magnetic resonance imaging/magnetic resonance cholangiopancreatography, endoscopic ultrasonography/intraductal ultrasonography, and advanced cholangioscopy is required. Surgery is the only curative treatment. Unfortunately, the majority of HCCA has a poor prognosis due to their advanced stage on presentation. Although there is no survival advantage, inoperable HCCA managed by palliative drainage may benefit from symptomatic improvement. Currently, there are three techniques of biliary drainage which include endoscopic, percutaneous, and surgical approaches. For nonsurgical approaches, stent is the most preferred device and there are two types of stents i.e. plastic and metal. Type of stent and number of stent for HCCA biliary drainage are subjected to debate because the decision is made under many grounds i.e. volume of liver drainage, life expectancy, expertise of the facility, etc. Recently, radio-frequency ablation and photodynamic therapy are promising techniques that may extend drainage patency. Through a review in the literature and regional data, the Asia-Pacific Working Group for hepatobiliary cancers has developed statements to assist clinicians in diagnosing and managing of HCCA. After voting anonymously using modified Delphi method, all final statements were determined for the level of evidence quality and strength of recommendation., (© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.)

There is limited data regarding the epidemiology, pathology, and management of distal radius fractures from centers in Asia. The advanced economies in Asia include Hong Kong, Japan, Korea, Singapore, and Taiwan, whereas the prominent emerging economies are China, India, Malaysia, Philippines, and Thailand. This article examines the available epidemiological data from Asia, compares the management of distal radius fractures in the advanced and emerging Asian economies and how they compare with the current management in the west. It concludes by offering solutions for improving outcomes of distal radius fractures in Asia., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Foot-and-mouth disease (FMD) outbreaks recently affected 2 countries (Japan and South Korea) in eastern Asia that were free of FMD without vaccination. Analysis of viral protein 1 nucleotide sequences indicated that FMD serotype A and O viruses that caused these outbreaks originated in mainland Southeast Asia to which these viruses are endemic.

Background: Influenza causes yearly seasonal epidemics and periodic pandemics. Global systems have been established to monitor the evolution and impact of influenza viruses, yet regional analysis of surveillance findings has been limited. This study describes epidemiological and virological characteristics of influenza during 2006-2010 in the World Health Organization's Western Pacific Region., Methodology/principal Findings: Influenza-like illness (ILI) and influenza virus data were obtained from the 14 countries with National Influenza Centres. Data were obtained directly from countries and from FluNet, the web-based tool of the Global Influenza Surveillance and Response System. National influenza surveillance and participation in the global system increased over the five years. Peaks in ILI reporting appeared to be coincident with the proportion of influenza positive specimens. Temporal patterns of ILI activity and the proportion of influenza positive specimens were clearly observed in temperate countries: Mongolia, Japan and the Republic of Korea in the northern hemisphere, and Australia, New Zealand, Fiji and New Caledonia (France) in the southern hemisphere. Two annual peaks in activity were observed in China from 2006 through the first quarter of 2009. A temporal pattern was less evident in tropical countries, where influenza activity was observed year-round. Influenza A viruses accounted for the majority of viruses reported between 2006 and 2009, but an equal proportion of influenza A and influenza B viruses was detected in 2010., Conclusions/significance: Despite differences in surveillance methods and intensity, commonalities in ILI and influenza virus circulation patterns were identified. Patterns suggest that influenza circulation may be dependent on a multitude of factors including seasonality and population movement. Dominant strains in Southeast Asian countries were later detected in other countries. Thus, timely reporting and regional sharing of information about influenza may serve as an early warning, and may assist countries to anticipate the potential severity and burden associated with incoming strains.

Moyamoya disease is an idiopathic vascular disorder of the intracranial arteries. Ring finger 213 (RNF213) was previously identified as the strongest susceptibility gene for moyamoya disease in East Asian people by a genome-wide linkage analysis and exome analysis. The coding variant p.R4810K in RNF213 was strongly associated with moyamoya disease in the Japanese (odds ratio: 338.94, p = 1.05 × 10(-100)) and Korean (odds ratio: 135.63, p = 7.59 × 10(-27)) populations, and much less strongly associated in the Chinese population (odds ratio: 14.70, p = 2.63 × 10(-5)). The present study investigated the distribution of variant p.R4810K in RNF213 in 2,508 participants from East and Southeast Asian countries using a TaqMan probe. p.R4810K was detected at an allele frequency of about 1.00% in 4 of 11 investigated locations in China. In contrast, p.R4810K was detected homogeneously at relatively high frequencies of 1.00-1.72% in all investigated locations in Korea and Japan, including Okinawa. p.R4810K was not detected in Southeast Asian populations. The population susceptible to moyamoya disease was estimated to be 16.16 million people in East Asian countries, including 11.41 million Chinese, 1.36 million Korean, and 3.39 million Japanese people. The number of patients with moyamoya disease, which was estimated at approximately one per 300 carriers of p.R4810K, was considered to be 53,800 in East Asian populations.

This paper analyses the publicly available data on the distribution and evolution of highly pathogenic avian influenza virus (HPAIV) H5N1 clades, whilst acknowledging the biases resulting from the non-random selection of isolates for gene sequencing. The data indicate molecular heterogeneity in the global distribution of HPAIV H5N1, in particular in different parts of East and Southeast Asia. Analysis of the temporal pattern of haemagglutinin clade data shows a progression from clade 0 (the 'dominant' clade between 1996 and 2002) to clade 1 (2003-2005) and then to clade 2.3.4 (2005 onwards). This process continuously produces variants, depending on the frequency of virus multiplication in the host population, which is influenced by geographical variation in poultry density, poultry production systems and also HPAI risk management measures such as vaccination. Increased multilateral collaboration needs to focus on developing enhanced disease surveillance and control targeted at evolutionary 'hotspots'., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Background: The 37 countries and areas of the World Health Organization (WHO) Western Pacific Region have targeted measles for elimination by 2012., Methods: We reviewed routine and supplementary immunization coverage based on 2010 WHO/United Nation's Children's Fund (UNICEF) estimates and Joint Reporting Forms and epidemiologic and laboratory data submitted by the countries and areas., Results: In 2009, 21 of 37 countries and areas had ≥90% coverage with a first dose of measles vaccine; 32 countries and areas provided 2 routine doses of measles vaccine with 94% weighted average coverage among those reporting. From 1996 to 2009, 235 million persons received measles vaccine during 94 immunization campaigns in 30 countries and areas. As of 2009, 2.8 suspected cases per 100,000 population were discarded as nonmeasles; however, only 43% of second level administrative units reported at least 1 discarded case per 100,000. Adequate specimen collection rate was 71%. Measles incidence was 34 per million population in 2009, a 58% decrease compared with 2008 and the lowest ever reported. As many as 25 countries and areas already may have eliminated measles., Conclusions: Achieving the 2012 measles elimination goal is feasible provided political and financial commitments are increased at every level to further improve routine and supplementary immunization activity (SIA) coverage and surveillance in every district., (Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2011.)

Long-term surveillance of antimicrobial resistance in Neisseria gonorrhoeae has been conducted in the World Health Organization (WHO) Western Pacific Region (WPR) to optimise antibiotic treatment of gonococcal disease since 1992. From 2007, the Gonococcal Antimicrobial Surveillance Programme (GASP) has been enhanced by the inclusion of data from the South East Asian Region (SEAR) and recruitment of additional centres in the WPR. Approximately 8,704 isolates of N. gonorrhoeae were examined for their susceptibility to one or more antibiotics used for the treatment of gonorrhoea, incorporating External Quality Assurance controlled methods, from reporting centres in 21 countries and/or jurisdictions. A high proportion of penicillin and/or quinolone resistance was again detected amongst isolates tested in North Asia and the WHO SEAR. In contrast, from the Pacific Island states Fiji reported low penicillin and quinolone resistance, New Caledonia again reported no penicillin resistance and little quinolone resistance, Tonga reported no penicillin resistance and there was a continued absence of quinolone resistance reported in Papua New Guinea in 2009. The proportion of gonococci reported as 'decreased susceptibility' and 'resistant' to the third-generation cephalosporin antibiotic ceftriaxone varied widely but no major changes were evident in cephalosporin minimum inhibitory concentrations (MIC) patterns in 2009. Altered cephalosporin susceptibility has been associated with treatment failures following therapy with oral third-generation cephalosporins. There is a need for revision and clarification of some of the in vitro criteria that are currently used to categorise the clinical importance of gonococci with different ceftriaxone and oral cephalosporin MIC levels. The number of instances of spectinomycin resistance remained low. A high proportion of strains tested continued to exhibit high-level plasmid mediated resistance to tetracyclines. The continuing emergence and spread of antibiotic resistant gonococci in and from the WHO WPR and SEAR suggests that surveillance programs such as GASP be maintained and expanded.

Background: The term "cholangiocarcinoma" was originally used only for intrahepatic bile duct (adeno)carcinomas, but is now regarded as inclusive of intrahepatic, perihilar, and distal extrahepatic tumors of the bile ducts. A rise in incidence of intrahepatic cholangiocarcinoma has been recently reported in Western countries but comparatively little is known about recent cholangiocarcinoma incidence trends in East and South-Eastern Asia., Methods: We compared age-adjusted incidence rates of both intrahepatic and extrahepatic cholangiocarcinomas, as well as coding practices, using data from 18 cancer registries in Asia and 4 selected registries in Western countries. Intrahepatic cholangiocarcinoma incidence rates were calculated after reallocation of cases with unknown or unspecified histology among liver cancer cases., Results: Age-adjusted incidence rates of intrahepatic cholangiocarcinoma varied by more than 60-fold by region. The highest rates were found in Khon Kaen, Thailand, where 90% of liver tumors were cholangiocarcinomas. The next highest rates were found in the People's Republic of China, followed by the Republic of Korea. The highest age-adjusted incidence rate for extrahepatic cholangiocarcinoma was found in Korea. Coding practices for perihilar (Klatskin tumor) or unspecified sites of cholangiocarcinoma differed from one cancer registry to the other. The proportion of Klatskin tumors among cholangiocarcinomas was less than the one reported in clinical settings., Conclusion: Developing a consistent and uniform topographical classification for acceptable coding practice to all health professionals is necessary. In addition, epidemiological research on risk factors according to anatomical location (intrahepatic versus extrahepatic) and the macroscopic appearance and/or new histological classification of cholangiocarcinoma is also needed.

Helminths are the cause of some of the major infectious diseases of humanity in what is still a "wormy" world. There is, in East and Southeast Asia, a high prevalence of several helminthiases which occur primarily in rural, impoverished areas of low-income and developing countries throughout the tropics and subtropics. Subsequent to various parasite genome projects that commenced in the early 1990s, under the aegis of the World Health Organization (WHO), the draft genomes of three major helminth species (Schistosoma japonicum, S. mansoni and Brugia malayi) have been sequenced, and many other helminth parasites have now been targeted for intensive genomics investigation. The continuing release of genome sequences has catalyzed the emergence of transcriptomics, proteomics and related "-omics" analyses of helminth parasites, which provide unprecedented approaches to understanding their biology that will result in new clues for the development of novel control interventions. In this review, we present a summary of current approaches employed in helminth "-omics" studies and review recent advances in helminth genomics and post-genomics in the Southeast Asian setting., (Copyright 2010 Elsevier Ltd. All rights reserved.)

In 1997-1998 a widespread economic crisis hit the economies of many East/Southeast Asian countries; its impact on suicide rates across the region has not been systematically documented. We investigated the impact of the Asian economic crisis (1997-1998) on suicide in Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Suicide and population data for the period 1985-2006 were extracted from the World Health Organisation's mortality database and Taiwanese mortality statistics. Sex-specific age-standardised suicide rates for people aged 15years or above were analysed using joinpoint regression. Trends in divorce, marriage, unemployment, gross domestic product (GDP) per capita and alcohol consumption were compared with trends in suicide rates graphically and using time-series analysis. Suicide mortality decreased in the late 1980s and early 1990s but subsequently increased markedly in all countries except Singapore, which had steadily declining suicide rates throughout the study period. Compared to 1997, male rates in 1998 rose by 39% in Japan, 44% in Hong Kong and 45% in Korea; rises in female rates were less marked. Male rates also rose in Thailand, but accurate data were incomplete. The economic crisis was associated with 10,400 more suicides in 1998 compared to 1997 in Japan, Hong Kong and Korea. Similar increases in suicide rates were not seen in Taiwan and Singapore, the two countries where the economic crisis had a smaller impact on GDP and unemployment. Time-series analyses indicated that some of the crisis's impact on male suicides was attributable to increases in unemployment. These findings suggest an association of the Asian economic crisis with a sharp increase in suicide mortality in some, but not all, East/Southeast Asian countries, and that these increases were most closely associated with rises in unemployment.

The Japanese encephalitis virus (JEV) circulating in Japan consists of viruses with multiple phylogenetic origins. Phylogenetic analysis revealed that some JEV strains have recently migrated from south-east and continental east Asian countries. One phylogenetic subcluster of the JEV strains circulating in Japan was closely related to viruses isolated in Vietnam and China's inland region while other JEV subclusters were related to viruses isolated in Shanghai, China. One virus subcluster, however, was isolated solely in Japan and was not found in any other Asian country. Therefore, our data suggests that the JEVs that have remained or are circulating in Japan include a mixture of viruses that have previously migrated from south-east and continental east Asian countries.