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  1. Hufana-Duran D, Chaikhun-Marcou T, Duran PG, Atabay EP, Nguyen HT, Atabay EC, et al.
    Theriogenology, 2025 Feb;233:123-130.
    PMID: 39613496 DOI: 10.1016/j.theriogenology.2024.11.016
    The future of reproductive biotechnologies in water buffalo in Southeast Asian countries holds significant promise for enhancing genetic quality and productivity. Fixed-time artificial insemination remains the commonly used technology, with advances in assisted reproductive technologies (ART) such as in vitro embryo production (IVEP), embryo transfer (ET), and the use of sex-sorted sperm increasingly adopted to improve breeding efficiency. These technologies overcome traditional breeding limitations, such as low reproductive rates, genetic diversity constraints, and the production of sex-predetermined offspring. The application of multiple ovulation and embryo transfer (MOET) is constrained by poor embryo recovery in this livestock species. Somatic cell nuclear transfer (SCNT) offers great potential for producing sex-predetermined and genetically superior buffalo but requires further research to increase efficiency. Cryopreservation of buffalo genetics is bolstered by the establishment of Gene Banks. Challenges such as high costs, the need for skilled personnel, and infrastructure development remain constraints. Integration of genomic selection, automation, and expansion of ET programs are clear directions. Strengthening research and collaboration among Southeast Asian countries is essential to fully realize the benefits of these biotechnologies and ensure sustainable and profitable buffalo farming.
    Matched MeSH terms: Asia, Southeastern
  2. Dugan PJ, Barlow C, Agostinho AA, Baran E, Cada GF, Chen D, et al.
    Ambio, 2010 Jun;39(4):344-8.
    PMID: 20799685
    The past decade has seen increased international recognition of the importance of the services provided by natural ecosystems. It is unclear however whether such international awareness will lead to improved environmental management in many regions. We explore this issue by examining the specific case of fish migration and dams on the Mekong river. We determine that dams on the Mekong mainstem and major tributaries will have a major impact on the basin's fisheries and the people who depend upon them for food and income. We find no evidence that current moves towards dam construction will stop, and consider two scenarios for the future of the fisheries and other ecosystems of the basin. We conclude that major investment is required in innovative technology to reduce the loss of ecosystem services, and alternative livelihood strategies to cope with the losses that do occur.
    Matched MeSH terms: Asia, Southeastern
  3. Getchell M, Wulandari S, de Alwis R, Agoramurthy S, Khoo YK, Mak TM, et al.
    Nat Microbiol, 2024 Oct;9(10):2738-2747.
    PMID: 39317773 DOI: 10.1038/s41564-024-01809-4
    Asia remains vulnerable to new and emerging infectious diseases. Understanding how to improve next generation sequencing (NGS) use in pathogen surveillance is an urgent priority for regional health security. Here we developed a pathogen genomic surveillance assessment framework to assess capacity in low-resource settings in South and Southeast Asia. Data collected between June 2022 and March 2023 from 42 institutions in 13 countries showed pathogen genomics capacity exists, but use is limited and under-resourced. All countries had NGS capacity and seven countries had strategic plans integrating pathogen genomics into wider surveillance efforts. Several pathogens were prioritized for human surveillance, but NGS application to environmental and human-animal interface surveillance was limited. Barriers to NGS implementation include reliance on external funding, supply chain challenges, trained personnel shortages and limited quality assurance mechanisms. Coordinated efforts are required to support national planning, address capacity gaps, enhance quality assurance and facilitate data sharing for decision making.
    Matched MeSH terms: Asia
  4. Twigg S, Lim S, Yoo SH, Chen L, Bao Y, Kong A, et al.
    J Diabetes Sci Technol, 2024 Nov;18(6):1460-1471.
    PMID: 37232515 DOI: 10.1177/19322968231176533
    Diabetes is prevalent, and it imposes a substantial public health burden globally and in the Asia-Pacific (APAC) region. The cornerstone for optimizing diabetes management and treatment outcomes is glucose monitoring, the techniques of which have evolved from self-monitoring of blood glucose (SMBG) to glycated hemoglobin (HbA1c), and to continuous glucose monitoring (CGM). Contextual differences with Western populations and limited regionally generated clinical evidence warrant regional standards of diabetes care, including glucose monitoring in APAC. Hence, the APAC Diabetes Care Advisory Board convened to gather insights into clinician-reported CGM utilization for optimized glucose monitoring and diabetes management in the region. We discuss the findings from a pre-meeting survey and an expert panel meeting regarding glucose monitoring patterns and influencing factors, patient profiles for CGM initiation and continuation, CGM benefits, and CGM optimization challenges and potential solutions in APAC. While CGM is becoming the new standard of care and a useful adjunct to HbA1c and SMBG globally, glucose monitoring type, timing, and frequency should be individualized according to local and patient-specific contexts. The results of this APAC survey guide methods for the formulation of future APAC-specific consensus guidelines for the application of CGM in people living with diabetes.
    Matched MeSH terms: Asia
  5. Kalok A, Kamisan Atan I, Sharip S, Safian N, Shah SA
    Front Public Health, 2024;12:1448940.
    PMID: 39877914 DOI: 10.3389/fpubh.2024.1448940
    Fear of childbirth (FOC) or tokophobia adversely affects women during pregnancy, delivery, and postpartum. Childbirth fear may differ across regions and cultures. We aimed to identify factors influencing the fear of childbirth among the Asian population. A systematic literature search was performed using the PubMed, Scopus, and Web of Science databases in November 2023. Original articles in English with research conducted in Asian countries were included. The independent factors associated with childbirth fear, from the relevant studies were identified and discussed. Forty-six papers met the eligibility criteria but only 26 studies were discussed in this review. The significant factors were categorized into (1) demographics, (2) clinical, (3) healthcare service, (4) childbirth education & information, and (5) COVID-19 pandemic. The prevalence of childbirth fear among Asians ranged between 56.6 and 84.8%. Significant demographic factors included age, education, marital status, economic status, and area of residence. Greater levels of tokophobia were linked to nulliparity, unplanned pregnancy, infertility, miscarriage, and pregnancies at risk. Effective doctor-patient communication and more frequent antenatal visits were shown to alleviate maternal childbirth fear. There was consistent evidence of prenatal childbirth education's benefit in reducing FOC. The usage of smartphone apps and prolonged exposure to electronic devices were linked to a higher degree of tokophobia. Nulliparas who received too much pregnancy-related information also reported increased childbirth fear. There was a positive correlation between maternal fear of COVID-19 infection and FOC. Keeping updated with COVID-19 information increased the maternal childbirth fear by two-fold. In conclusion, a stable economy and relationship contribute to lesser childbirth fear among Asian women. Poor maternal health and pregnancy complications were positive predictors of FOC. Health practitioners may reduce maternal childbirth through women's education, clear communication as well as accurate information and guidance to expectant mothers. Further study is required into the content of childbirth fear among Asian women. These research findings hopefully will lead to the development of culturally adapted screening tools and interventions that reduce the burden of FOC among expectant mothers.
    Matched MeSH terms: Asia; Asian Continental Ancestry Group/psychology
  6. Drewnowski A, Tappy L, Forde CG, McCrickerd K, Tee ES, Chan P, et al.
    Asia Pac J Clin Nutr, 2019;28(3):645-663.
    PMID: 31464412 DOI: 10.6133/apjcn.201909_28(3).0025
    BACKGROUND AND OBJECTIVES: Rising obesity in Southeast Asia, one consequence of economic growth, has been linked to a rising consumption of energy from added sugars. This symposium, organized by ILSI Southeast Asia, explored regional issues related to dietary sugars and health and identified ways in which these issues could be addressed by regional regulatory agencies, food producers, and the consumer.

    METHODS AND STUDY DESIGN: Papers on the following topics were presented: 1) current scientific evidence on the effects of sugars and non-caloric sweeteners on body weight, health, and eating behaviors; 2) innovations by food producers to reduce sugar consumption in the region; 3) regional dietary surveillance of sugar consumption and suggestions for consumer guidance. A panel discussion explored effective approaches to promote healthy eating in the region.

    RESULTS: Excessive consumption of energy in the form of added sugars can have adverse consequences on diet quality, lipid profiles, and health. There is a need for better surveillance of total and added sugars intakes in selected Southeast Asian countries. Among feasible alternatives to corn sweeteners (high fructose corn syrup) and cane sugar are indigenous sweeteners with low glycemic index (e.g., coconut sap sugar). Their health benefits should be examined and regional sugar consumption tracked in detail. Product reformulation to develop palatable lower calorie alternatives that are accepted by consumers continues to be a challenge for industry and regulatory agencies.

    CONCLUSIONS: Public-private collaborations to develop healthy products and effective communication strategies can facilitate consumer acceptance and adoption of healthier foods.

    Matched MeSH terms: Asia
  7. Sasmito SD, Taillardat P, Adinugroho WC, Krisnawati H, Novita N, Fatoyinbo L, et al.
    Nat Commun, 2025 Jan 28;16(1):740.
    PMID: 39875368 DOI: 10.1038/s41467-025-55892-0
    Southeast Asia (SEA) contributes approximately one-third of global land-use change carbon emissions, a substantial yet highly uncertain part of which is from anthropogenically-modified peat swamp forests (PSFs) and mangroves. Here, we report that between 2001-2022 land-use change impacting PSFs and mangroves in SEA generate approximately 691.8±97.2 teragrams of CO2 equivalent emissions annually (TgCO2eyr-1) or 48% of region's land-use change emissions, and carbon removal through secondary regrowth of -16.3 ± 2.0 TgCO2eyr-1. Indonesia (73%), Malaysia (14%), Myanmar (7%), and Vietnam (2%) combined accounted for over 90% of regional emissions from these sources. Consequently, great potential exists for emissions reduction through PSFs and mangroves conservation. Moreover, restoring degraded PSFs and mangroves could provide an additional annual mitigation potential of 94.4 ± 7.4 TgCO2eyr-1. Although peatlands and mangroves occupy only 5.4% of SEA land area, restoring and protecting these carbon-dense ecosystems can contribute substantially to climate change mitigation, while maintaining valuable ecosystem services, livelihoods and biodiversity.
    Matched MeSH terms: Asia, Southeastern
  8. van der Eijk Y, Tan Ping Ping G, Ong SE, Tan Li Xin G, Li D, Zhang D, et al.
    Int J Health Policy Manag, 2022 Sep 01;11(9):1616-1624.
    PMID: 33906338 DOI: 10.34172/ijhpm.2021.25
    BACKGROUND: The global e-cigarette market has proliferated and is increasingly dominated by transnational tobacco companies. While Southeast Asian countries have received relatively little attention in e-cigarette research, the region represents an area of potentially untapped growth for the industry. We review the e-cigarette situation in Southeast Asia in terms of the e-cigarette markets, advertising and promotion of e-cigarettes, reported health impacts of e-cigarette use, and policy responses in the region.

    METHODS: We examined e-cigarette market data from the Euromonitor Global Market Information Database (GMID) Passport database, searched in the academic literature, grey literature and news archives for any reports or studies of e-cigarette related diseases or injuries, e-cigarette marketing, and e-cigarette policy responses in Southeast Asian countries, and browsed the websites of online e-cigarette retailers catering to the region's active e-cigarette markets.

    RESULTS: In 2019, e-cigarettes were sold in six Southeast Asian markets with a total market value of $595 million, projected to grow to $766 million by 2023. E-commerce is a significant and growing sales channel in the region, with most of the popular or featured brands in online shops originating from China. Southeast Asian youth are targeted with a wide variety of flavours, trendy designs and point of sale promotions, and several e-cigarette related injuries and diseases have been reported in the region. Policy responses vary considerably between countries, ranging from strict bans to no or partial regulations.

    CONCLUSION: Although Southeast Asia's e-cigarette market is relatively nascent, this is likely to change if transnationals invest more heavily in the region. Populous countries with weak e-cigarette regulations, notably Indonesia, Malaysia, Vietnam and the Philippines, are desirable targets for the transnationals. Regulatory action is needed to prevent e-cigarette use from becoming entrenched into these societies, especially among young people.

    Matched MeSH terms: Asia, Southeastern
  9. Mohd Noor MN, Leow ML, Lai WH, Hon YK, Tiong LL, Chern PM
    BMJ Open, 2022 Dec 13;12(12):e065546.
    PMID: 36523224 DOI: 10.1136/bmjopen-2022-065546
    INTRODUCTION: Three-dimensional (3D) printing plays a significant role as a promising technological advancement in modern healthcare settings. 3D printing has been incorporated by many sectors worldwide including in Southeast Asian countries. However, there is a paucity of research, especially in the healthcare pertaining to 3D printing activity in the Southeast Asian region. Thus, a scoping review is conducted to gain insight into 3D printing healthcare research landscape in the Southeast Asian region.

    METHODS AND ANALYSIS: The methodology draws on Arksey and O'Malley's seminal framework for the scoping review. The literature search will be conducted by using keywords to find suitable published literature. The existing literature will be searched using selected electronic databases such as PubMed/MEDLINE, CINAHL, Scopus, ProQuest and Web of Science from the years 2011 and 2021. The selected publications will focus on 10 Southeast Asian countries: Malaysia, Indonesia, Singapore, Thailand, Brunei, Philippines, Laos, Vietnam, Cambodia and Myanmar. Two reviewers will be performing title and abstract screening for the criteria of each publication, in which they will be working independently of each other. The included publication will undergo a full-text review and references cited will be examined for relevance using the same inclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram will guide throughout the process. Data will be extracted, analysed and charted within each category from the selected publications for each Southeast Asian country.

    ETHICS AND DISSEMINATION: The results of this scoping review will illustrate an overview of the 3D printing healthcare research in the Southeast Asian context, which can be a guide for the advancement of 3D printing that can be accentuated in future research. The results will undergo dissemination which will be submitted for publication in a scientific journal.

    Matched MeSH terms: Asia, Southeastern
  10. Tumian NR, Wong M, Wong CL
    J Obstet Gynaecol Res, 2015 Jun;41(6):967-70.
    PMID: 25510540 DOI: 10.1111/jog.12648
    α°-thalassemia is a well-known cause of hydrops fetalis in South-East Asia and can be detected in utero. We report a very rare case of thyrotoxic cardiomyopathy associated with hyperplacentosis secondary to α°-thalassemia-associated hydrops fetalis. A 22-year-old primigravida with microcytic anemia presented at 27 weeks' gestation with pre-eclampsia, hyperthyroidism and cardiac failure. Serum β-human chorionic gonadotrophin was markedly elevated and abdominal ultrasound revealed severe hydropic features and enlarged placenta. Serum β-human chorionic gonadotrophin, cardiac function and thyroid function tests normalized after she delivered a macerated stillbirth. Histopathology of the placenta showed hyperplacentosis. Blood DNA analysis revealed that both patient and husband have the α°-thalassemia trait. This case illustrates a very atypical presentation of α°-thalassemia-associated hydrops fetalis and the importance of early prenatal diagnosis of α-thalassemia in women of relevant ethnic origin with microcytic anemia so that appropriate genetic counseling can be provided to reduce maternal morbidity and the incidence of hydrops fetalis.
    Matched MeSH terms: Asia; Asia, Southeastern
  11. Kwan Z, Pailoor J, Tan LL, Robinson S, Wong SM, Ismail R
    Lepr Rev, 2014 Sep;85(3):170-6.
    PMID: 25509717
    OBJECTIVES: Leprosy remains a public health concern in Malaysia and globally. We aim to review the characteristics of leprosy patients in a tertiary institution in urban Malaysia.
    DESIGN: This is a case series of 27 leprosy patients who presented between 2008 and 2013.
    RESULTS: The majority of our patients consisted of male (74.1%), Malaysian (63.0%), blue collar workers (51.9%) and married (59.3%) patients; 48.1% had lepromatous leprosy. All except one of the patients presented with skin lesions, 25.9% had nerve involvement and 33.3% developed lepra reactions. Forty-four point four percent (44.4%) of the cases seen initially in the primary care setup were misdiagnosed.
    CONCLUSIONS: Doctors need to have a high index of suspicion for leprosy when patients present with suggestive skin, nerve or musculoskeletal lesions. Immigrants accounted for 37% of cases and these patients may become a reservoir of infection, thus accounting for the rise in incidence. An increasing trend in multibacillary cases may be attributed to the spread from migrants from countries with a high burden of leprosy.
    Matched MeSH terms: Asia/epidemiology
  12. Asia-Pacific ACS Medical Management Working Group, Huo Y, Thompson P, Buddhari W, Ge J, Harding S, et al.
    Int J Cardiol, 2015 Mar 15;183:63-75.
    PMID: 25662044 DOI: 10.1016/j.ijcard.2014.11.195
    Acute coronary syndromes (ACS) remain a leading cause of mortality and morbidity in the Asia-Pacific (APAC) region. International guidelines advocate invasive procedures in all but low-risk ACS patients; however, a high proportion of ACS patients in the APAC region receive solely medical management due to a combination of unique geographical, socioeconomic, and population-specific barriers. The APAC ACS Medical Management Working Group recently convened to discuss the ACS medical management landscape in the APAC region. Local and international ACS guidelines and the global and APAC clinical evidence-base for medical management of ACS were reviewed. Challenges in the provision of optimal care for these patients were identified and broadly categorized into issues related to (1) accessibility/systems of care, (2) risk stratification, (3) education, (4) optimization of pharmacotherapy, and (5) cost/affordability. While ACS guidelines clearly represent a valuable standard of care, the group concluded that these challenges can be best met by establishing cardiac networks and individual hospital models/clinical pathways taking into account local risk factors (including socioeconomic status), affordability and availability of pharmacotherapies/invasive facilities, and the nature of local healthcare systems. Potential solutions central to the optimization of ACS medical management in the APAC region are outlined with specific recommendations.
    Matched MeSH terms: Asia/epidemiology
  13. Rougeron V, Sam IC, Caron M, Nkoghe D, Leroy E, Roques P
    J Clin Virol, 2015 Mar;64:144-52.
    PMID: 25453326 DOI: 10.1016/j.jcv.2014.08.032
    Chikungunya virus (CHIKV) is an alphavirus of the Togaviridae family that causes chronic and incapacitating arthralgia in human populations. Since its discovery in 1952, CHIKV was responsible for sporadic and infrequent outbreaks. However, since 2005, global Chikungunya outbreaks have occurred, inducing some fatalities and associated with severe and chronic morbidity. Chikungunya is thus considered as an important re-emerging public health problem in both tropical and temperate countries, where the distribution of the Aedes mosquito vectors continues to expand. This review highlights the most recent advances in our knowledge and understanding of the epidemiology, biology, treatment and vaccination strategies of CHIKV.
    Matched MeSH terms: Asia/epidemiology
  14. Tan CT
    Neurology, 2015 Feb 10;84(6):623-5.
    PMID: 25666629 DOI: 10.1212/WNL.0000000000001224
    Asia is important as it accounts for more than half of the world population. The majority of Asian countries fall into the middle income category. As for cultural traditions, Asia is highly varied, with many languages spoken. The pattern of neurologic diseases in Asia is largely similar to the West, with some disease features being specific to Asia. Whereas Asia constitutes 60% of the world's population, it contains only 20% of the world's neurologists. This disparity is particularly evident in South and South East Asia. As for neurologic care, it is highly variable depending on whether it is an urban or rural setting, the level of economic development, and the system of health care financing. To help remedy the shortage of neurologists, most counties with larger populations have established training programs in neurology. These programs are diverse, with many areas of concern. There are regional organizations serving as a vehicle for networking in neurology and various subspecialties, as well as an official journal (Neurology Asia). The Asian Epilepsy Academy, with its emphasis on workshops in various locations, EEG certification examination, and fellowships, may provide a template of effective regional networking for improving neurology care in the region.
    Matched MeSH terms: Asia; Asia, Southeastern
  15. Wong AH, Umapathi T, Shahrizaila N, Chan YC, Kokubun N, Fong MK, et al.
    J Neurol Sci, 2014 Sep 15;344(1-2):60-2.
    PMID: 24993467 DOI: 10.1016/j.jns.2014.06.021
    To study the clinical profile of Guillain-Barré syndrome (GBS) patients who died in 4 Asian countries in order to understand factors underlying any variation in mortality.
    Matched MeSH terms: Asia/epidemiology
  16. Ng SC, Tang W, Leong RW, Chen M, Ko Y, Studd C, et al.
    Gut, 2015 Jul;64(7):1063-71.
    PMID: 25217388 DOI: 10.1136/gutjnl-2014-307410
    The rising incidence of inflammatory bowel disease in Asia supports the importance of environmental risk factors in disease aetiology. This prospective population-based case-control study in Asia-Pacific examined risk factors prior to patients developing IBD.
    Matched MeSH terms: Asia/epidemiology
  17. Moyes CL, Henry AJ, Golding N, Huang Z, Singh B, Baird JK, et al.
    PLoS Negl Trop Dis, 2014 Mar;8(3):e2780.
    PMID: 24676231 DOI: 10.1371/journal.pntd.0002780
    BACKGROUND: The simian malaria parasite, Plasmodium knowlesi, can cause severe and fatal disease in humans yet it is rarely included in routine public health reporting systems for malaria and its geographical range is largely unknown. Because malaria caused by P. knowlesi is a truly neglected tropical disease, there are substantial obstacles to defining the geographical extent and risk of this disease. Information is required on the occurrence of human cases in different locations, on which non-human primates host this parasite and on which vectors are able to transmit it to humans. We undertook a systematic review and ranked the existing evidence, at a subnational spatial scale, to investigate the potential geographical range of the parasite reservoir capable of infecting humans.

    METHODOLOGY/PRINCIPAL FINDINGS: After reviewing the published literature we identified potential host and vector species and ranked these based on how informative they are for the presence of an infectious parasite reservoir, based on current evidence. We collated spatial data on parasite occurrence and the ranges of the identified host and vector species. The ranked spatial data allowed us to assign an evidence score to 475 subnational areas in 19 countries and we present the results on a map of the Southeast and South Asia region.

    CONCLUSIONS/SIGNIFICANCE: We have ranked subnational areas within the potential disease range according to evidence for presence of a disease risk to humans, providing geographical evidence to support decisions on prevention, management and prophylaxis. This work also highlights the unknown risk status of large parts of the region. Within this unknown category, our map identifies which areas have most evidence for the potential to support an infectious reservoir and are therefore a priority for further investigation. Furthermore we identify geographical areas where further investigation of putative host and vector species would be highly informative for the region-wide assessment.

    Matched MeSH terms: Asia/epidemiology
  18. Lee CH, Chiang SL, Ko AM, Hua CH, Tsai MH, Warnakulasuriya S, et al.
    Addiction, 2014 Jul;109(7):1194-204.
    PMID: 24650227 DOI: 10.1111/add.12530
    Betel-quid (BQ) contains biologically psychoactive ingredients; however, data are limited concerning the symptoms and syndrome of BQ dependence among chewers. The aims of this study were to evaluate the ingredients-associated BQ dependence syndrome and country-specific chewing features and behaviour for BQ dependence among chewers from six Asian communities.
    Matched MeSH terms: Asia/epidemiology
  19. Capeding MR, Chua MN, Hadinegoro SR, Hussain II, Nallusamy R, Pitisuttithum P, et al.
    PLoS Negl Trop Dis, 2013;7(7):e2331.
    PMID: 23936565 DOI: 10.1371/journal.pntd.0002331
    Common causes of acute febrile illness in tropical countries have similar symptoms, which often mimic those of dengue. Accurate clinical diagnosis can be difficult without laboratory confirmation and disease burden is generally under-reported. Accurate, population-based, laboratory-confirmed incidence data on dengue and other causes of acute fever in dengue-endemic Asian countries are needed.
    Matched MeSH terms: Asia/epidemiology
  20. Badurdeen S, Valladares DB, Farrar J, Gozzer E, Kroeger A, Kuswara N, et al.
    BMC Public Health, 2013 Jun 24;13:607.
    PMID: 23800243 DOI: 10.1186/1471-2458-13-607
    BACKGROUND: The increasing frequency and intensity of dengue outbreaks in endemic and non-endemic countries requires a rational, evidence based response. To this end, we aimed to collate the experiences of a number of affected countries, identify strengths and limitations in dengue surveillance, outbreak preparedness, detection and response and contribute towards the development of a model contingency plan adaptable to country needs.

    METHODS: The study was undertaken in five Latin American (Brazil, Colombia, Dominican Republic, Mexico, Peru) and five in Asian countries (Indonesia, Malaysia, Maldives, Sri Lanka, Vietnam). A mixed-methods approach was used which included document analysis, key informant interviews, focus-group discussions, secondary data analysis and consensus building by an international dengue expert meeting organised by the World Health Organization, Special Program for Research and Training in Tropical Diseases (WHO-TDR).

    RESULTS: Country information on dengue is based on compulsory notification and reporting ("passive surveillance"), with laboratory confirmation (in all participating Latin American countries and some Asian countries) or by using a clinical syndromic definition. Seven countries additionally had sentinel sites with active dengue reporting, some also had virological surveillance. Six had agreed a formal definition of a dengue outbreak separate to seasonal variation in case numbers. Countries collected data on a range of warning signs that may identify outbreaks early, but none had developed a systematic approach to identifying and responding to the early stages of an outbreak. Outbreak response plans varied in quality, particularly regarding the early response. The surge capacity of hospitals with recent dengue outbreaks varied; those that could mobilise additional staff, beds, laboratory support and resources coped best in comparison to those improvising a coping strategy during the outbreak. Hospital outbreak management plans were present in 9/22 participating hospitals in Latin-America and 8/20 participating hospitals in Asia.

    CONCLUSIONS: Considerable variation between countries was observed with regard to surveillance, outbreak detection, and response. Through discussion at the expert meeting, suggestions were made for the development of a more standardised approach in the form of a model contingency plan, with agreed outbreak definitions and country-specific risk assessment schemes to initiate early response activities according to the outbreak phase. This would also allow greater cross-country sharing of ideas.

    Matched MeSH terms: Asia/epidemiology
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