Displaying publications 141 - 160 of 2413 in total

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  1. Balakrishnan V, Ng KS, Kaur W, Govaichelvan K, Lee ZL
    J Affect Disord, 2022 Feb 01;298(Pt B):47-56.
    PMID: 34801606 DOI: 10.1016/j.jad.2021.11.048
    BACKGROUND: This systematic review and meta-analysis aim to synthesize the extant literature reporting the effects of COVID-19 pandemic based on the pooled prevalence of depression among affected populations in Asia Pacific, as well as its risk factors.

    METHOD: A systematic review and meta-analysis approach was adopted as per the PRISMA guidelines, targeting articles published in PubMed, Google Scholar and Scopus from January 2021 to March 30, 2021. The screening resulted in 82 papers.

    RESULTS: The overall pooled depression prevalence among 201,953 respondents was 34% (95%CI, 29-38, 99.7%), with no significant differences observed between the cohorts, timelines, and regions (p > 0.05). Dominant risk factors found were fear of COVID-19 infection (13%), gender (i.e., females; 12%) and deterioration of underlying medical conditions (8.3%), regardless of the sub-groups. Specifically, fear of COVID-19 infection was the most reported risk factor among general population (k = 14) and healthcare workers (k = 8). Gender (k = 7) and increased workload (k = 7) were reported among healthcare workers whereas education disruption among students (k = 7).

    LIMITATION: The review is limited to articles published in three electronic databases. Conclusion The pandemic has caused depression among the populations across Asia Pacific, specifically among the general population, healthcare workers and students. Immediate attention and interventions from the concerned authorities are needed in addressing this issue.

    Matched MeSH terms: Asia/epidemiology
  2. Yamada M, Lee WJ, Akishita M, Yang M, Kang L, Kim S, et al.
    Arch Gerontol Geriatr, 2023 Dec;115:105132.
    PMID: 37490804 DOI: 10.1016/j.archger.2023.105132
    OBJECTIVE: This study aimed to (1) investigate the clinical practice for the management of sarcopenia among healthcare professionals in Asia, (2) determine the characteristics of clinical care provided by geriatricians versus by other healthcare professionals, and (3) clarify the awareness of sarcopenia.

    METHODS: From December 1 to 31, 2022, an online survey was completed by 1990 healthcare professionals in Asia. The survey comprises demographics and institutional characteristics, basic sarcopenia-related details, and sarcopenia-related assessment and treatment details.

    RESULTS: The mean respondent age was 44.2 ± 10.7 years, 36.4% of the respondents were women, and the mean years of experience in clinical practice were 19.0 ± 10.6 years. The percentages of respondents who were aware of the term "sarcopenia", its definition and the importance of its management were high, at 99.3%, 91.9%, and 97.2%, respectively. The percentages of respondents who had screened patients for, diagnosed patients with, and treated patients for sarcopenia were 42.4%, 42.9%, and 58.8%, respectively. Medical doctors had higher performance rates compared to allied health professionals (45.5% vs. 40.5% for screening, 56.8% vs. 34.5% for diagnosis, and 65.0% vs. 55.0% for treatment) (P 

    Matched MeSH terms: Asia/epidemiology
  3. Bhidayasiri R, Sringean J, Van Le T, Lim TT, Navuth C, Phoumindr A, et al.
    J Neural Transm (Vienna), 2023 Jul;130(7):875-889.
    PMID: 37306791 DOI: 10.1007/s00702-023-02662-1
    Movement disorders are a major cause of disability worldwide and their increasing prevalence predicts a substantial future burden of care. Impactful patient care requires availability of, and accessibility to, effective medications, knowledge, and disease awareness among both medical professionals and patients, driven by skilled personnel to harness and manage resources. The highest burden of movement disorders is in low-to-middle income countries where resources are often limited and infrastructure is insufficient to meet growing demands. This article focuses on the specific challenges faced in the management and delivery of care for movement disorders in Indochina, the mainland region of Southeast Asia comprising the neighboring countries of Cambodia, Laos, Malaysia, Myanmar, Thailand, and Vietnam. The first Indochina Movement Disorders Conference was held in August 2022 in Ho Chi Minh City, Vietnam, to provide a platform to better understand the situation in the region. Future management of movement disorders in Indochina will require progressive adaptation of existing practices to reflect modern approaches to care delivery. Digital technologies offer an opportunity to strengthen these processes and address the challenges identified in the region. Ultimately, a long-term collaborative approach by regional healthcare providers is key.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  4. Rampal L, Liew BS, Choolani M, Shorey S
    Med J Malaysia, 2023 Nov;78(6):689-695.
    PMID: 38031208
    This paper provides a comprehensive analysis of Southeast Asian countries' responses to the COVID-19 pandemic, particularly focusing on Malaysia, Singapore, Thailand, the Philippines, Indonesia, and Myanmar. The primary objective is to explore how the pandemic has evolved in these nations, how the respective healthcare delivery systems responded, and the current COVID-19 status within each country. It presents epidemiological trends and governmental strategies adopted in combating the pandemic. The paper also outlines lessons learned and future challenges, highlighting key areas like global health diplomacy, the need for collaboration, clear government agency communication, and a stance against social discrimination. It culminates in an assessment of the postpandemic landscape, discussing the transformation of public health policies and the socio-economic implications of pandemic management.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  5. Chan CM, Abdul Latiff AH, Noh LM, Ismail IH, Abd Hamid IJ, Liew WK, et al.
    Front Immunol, 2023;14:1209315.
    PMID: 37529038 DOI: 10.3389/fimmu.2023.1209315
    INTRODUCTION: With increased diagnostic capabilities and treatment modalities in the field of primary immunodeficiencies (PID), many pediatric patients survive beyond childhood and experience a change of care to the adult-oriented healthcare system. Unfortunately, the transition pathways for PID are less clearly defined, resulting in deterioration of quality of care in adulthood. Hence, this is the first regional study to address PID clinicians' opinions on practices and challenges of transition care in 7 Southeast Asia (SEA) countries.

    METHODS: We adopted a cross-sectional study design through an online survey platform to enquire opinions of transition practices from expert representatives in 7 SEA countries.

    RESULTS: Regionally, 3 out 7 countries reported having no practice of transition care. Among cited challenges were reluctant adaptation by patients and caregivers to unfamiliarized adult healthcare systems, inadequate ratio of adult immunologists to patients and lack of facilities for transfer.

    DISCUSSION AND CONCLUSION: Our study provides evidence to advocate policy makers on the importance of standardized integration of transition practice towards betterment of transiting PID patients into adulthood.

    Matched MeSH terms: Asia, Southeastern/epidemiology
  6. Centers for Disease Control and Prevention (CDC)
    MMWR Morb Mortal Wkly Rep, 1997 Nov 28;46(47):1113-7.
    PMID: 9393657
    In 1988, the World Health Assembly adopted the goal of global poliomyelitis eradication by 2000, which was endorsed in each of the six regions of the World Health Organization (WHO). In the Western Pacific Region (WPR), where the last known case of polio associated with isolation of wild poliovirus occurred in March 1997, the reported number of cases decreased from 5963 in 1990 to 197 in 1996. This report documents progress toward polio eradication in WPR from January 1, 1996, through September 27, 1997, in countries where polio is endemic (Cambodia, China, Laos, Papua New Guinea, Philippines, and Vietnam) or recently was endemic (Malaysia and Mongolia) and describes the routine and supplemental vaccination activities necessary to interrupt wild poliovirus transmission in the region.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  7. He Z, Chin Y, Yu S, Huang J, Zhang CJP, Zhu K, et al.
    JMIR Public Health Surveill, 2021 Jan 25;7(1):e20495.
    PMID: 33232262 DOI: 10.2196/20495
    BACKGROUND: The influence of meteorological factors on the transmission and spread of COVID-19 is of interest and has not been investigated.

    OBJECTIVE: This study aimed to investigate the associations between meteorological factors and the daily number of new cases of COVID-19 in 9 Asian cities.

    METHODS: Pearson correlation and generalized additive modeling (GAM) were performed to assess the relationships between daily new COVID-19 cases and meteorological factors (daily average temperature and relative humidity) with the most updated data currently available.

    RESULTS: The Pearson correlation showed that daily new confirmed cases of COVID-19 were more correlated with the average temperature than with relative humidity. Daily new confirmed cases were negatively correlated with the average temperature in Beijing (r=-0.565, P

    Matched MeSH terms: Asia/epidemiology
  8. Srisawat N, Gubler DJ, Pangestu T, Limothai U, Thisyakorn U, Ismail Z, et al.
    PLoS Negl Trop Dis, 2024 Mar;18(3):e0012060.
    PMID: 38551892 DOI: 10.1371/journal.pntd.0012060
    The 6th Asia Dengue Summit (ADS) themed "Road Map to Zero Dengue Death" was held in Thailand from 15th-16th June 2023. The summit was hosted by Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand in conjunction with Queen Saovabha Memorial Institute, The Thai Red Cross Society; Faculty of Tropical Medicine, Mahidol University; and the Ministry of Public Health. The 6th ADS was convened by Asia Dengue Voice and Action (ADVA); Global Dengue and Aedes Transmitted Diseases Consortium (GDAC); Southeast Asian Ministers of Education Tropical Medicine and Public Health Network (SEAMEO TROPMED); Fondation Mérieux (FMx) and the International Society for Neglected Tropical Diseases (ISNTD). Dengue experts from academia and research, and representatives from the Ministries of Health, Regional and Global World Health Organization (WHO) and International Vaccine Institute (IVI) participated in the three-day summit. With more than 51 speakers and 451 delegates from over 24 countries, 10 symposiums, and 2 full days, the 6th ADS highlighted the growing threat of dengue and its antigenic evolution, flagged the urgent need to overcome vaccine hesitancy and misinformation crisis, and focused on dengue control policies, newer diagnostics, therapeutics and vaccines, travel-associated dengue, and strategies to improve community involvement.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  9. Hamid TA, Salih SA, Zillah Abdullah SF, Ibrahim R, Mahmud A
    PeerJ, 2024;12:e17058.
    PMID: 38500524 DOI: 10.7717/peerj.17058
    BACKGROUND: Frailty is a significant healthcare challenge worldwide, increasing interest in developing more assessment tools covering for frailty. Recently, there has been a growing awareness of a correlation between social variables and frailty in older people. However, there is a lack of understanding of the social domains of frailty and the related adverse outcomes, particularly in the Asia-Pacific settings. This study aimed to characterize the social frailty domains and their health outcomes by overviewing the frailty screening tools in older people living in the Asia-Pacific region.

    METHODOLOGY: A systematic review, using the PRISMA guideline, was conducted on articles published between 2002 and 2023 from three electronic databases: PubMed, Scopus, and ScienceDirect. A manual search was conducted for the references of the included articles using Google Scholar. Included articles must be in English and were based on empirical evidence published in peer-reviewed journals and focus on the assessment of domains of social frailty in older people aged 60 or over in the Asia-Pacific (East Asia, Southeast Asia, and Oceania).

    RESULT: A total of 31 studies were included in the thematic analysis, from which 16 screening tools measuring six social domains were reviewed. The six domains were: social networks, followed by social activities, social support, financial difficulties, social roles, and socioeconomic, arranged in four categories: social resources, social needs, social behaviors (or social activities), and general resources. The six social domains predicted mortality, physical difficulties, and disability incidence. Other adverse health outcomes were also associated with these social domains, including cognitive disorders, mental illness, and nutritional disorders (n = 5 domains each), dementia (n = 4 domains), and oral frailty, hearing loss, obesity, and chronic pain (n = 3 domains each).

    CONCLUSION: Overall, social frailty is a complex construct with multiple dimensions, including the frailty of social and general resources, social behaviors, and social needs, leading to several health disorders. The findings contribute to understanding the conceptual framework of social frailty in older people and its related health outcomes. Therefore, it could facilitate professionals and researchers to monitor and reduce the risks of adverse health outcomes related to each domain of social frailty, contributing to a better aging process.

    Matched MeSH terms: Asia/epidemiology
  10. Peters R, Li B, Swinburn B, Allender S, He Z, Lim SY, et al.
    Bull World Health Organ, 2023 Nov 01;101(11):690-706F.
    PMID: 37961057 DOI: 10.2471/BLT.23.289973
    OBJECTIVE: To identify and analyse ongoing nutrition-related surveillance programmes led and/or funded by national authorities in countries in South-East Asian and Western Pacific Regions.

    METHODS: We systematically searched for publications in PubMed® and Scopus, manually searched the grey literature and consulted with national health and nutrition officials, with no restrictions on publication type or language. We included low- and middle-income countries in the World Health Organization South-East Asia Region, and the Association of Southeast Asian Nations and China. We analysed the included programmes by adapting the United States Centers for Disease Control and Prevention's public health surveillance evaluation framework.

    FINDINGS: We identified 82 surveillance programmes in 18 countries that repeatedly collect, analyse and disseminate data on nutrition and/or related indicators. Seventeen countries implemented a national periodic survey that exclusively collects nutrition-outcome indicators, often alongside internationally linked survey programmes. Coverage of different subpopulations and monitoring frequency vary substantially across countries. We found limited integration of food environment and wider food system indicators in these programmes, and no programmes specifically monitor nutrition-sensitive data across the food system. There is also limited nutrition-related surveillance of people living in urban deprived areas. Most surveillance programmes are digitized, use measures to ensure high data quality and report evidence of flexibility; however, many are inconsistently implemented and rely on external agencies' financial support.

    CONCLUSION: Efforts to improve the time efficiency, scope and stability of national nutrition surveillance, and integration with other sectoral data, should be encouraged and supported to allow systemic monitoring and evaluation of malnutrition interventions in these countries.

    Matched MeSH terms: Asia, Southeastern/epidemiology
  11. Gilcharan Singh HK, Sinnasamy P, Wan Yi T, Chiao Wei C, Chee Siew Swee W, Shyam S
    Asia Pac J Public Health, 2024 Mar;36(2-3):172-183.
    PMID: 38483070 DOI: 10.1177/10105395241237635
    Food environment (FE), an interface where people interact with a broader food system, is critical to health. Understanding the Asian FE may help to tackle the "triple burden of malnutrition" through informed research and policy. This review identifies FE domains assessed in the Asian context and collates the tools/measures used in these evaluations. We further synthesized the reported associations of FE with diet and health outcomes and identified knowledge gaps. Forty-two articles were reviewed (East Asia, n = 25, 60%; South Asia, n = 8, 19%; and Southeast Asia, n = 9, 21%). The results showed that FE was frequently examined in children, adolescents, or adults, but data were scarce in older adults. Food availability (n = 30) and accessibility (n = 19) were popularly studied domains. Furthermore, FE was measured using geographic information systems (n = 18), market (n = 7), or stakeholder (n = 21) surveys. Twenty-eight (67%) articles assessed associations of FE exposures with diet (n = 12) and health (n = 21). Increased food availability and accessibility were associated with poorer dietary and health outcomes despite nonexisting validity and reliability reporting in 62% of articles. Limited high-quality studies emphasize the need for harmonized definitions, better study designs, and validated FE measures/tools in Asia. Improving the quality of FE research is critical to designing effective interventions to improve public health nutrition in Asia.
    Matched MeSH terms: Asia; Asia, Southeastern
  12. Li ZZ, Liu G, Tao R, Lobont OR
    Front Public Health, 2021;9:699821.
    PMID: 34568255 DOI: 10.3389/fpubh.2021.699821
    This paper aims to determine the existence of convergence in health expenditures among Association for South East Asian Nations (ASEAN) countries. Based on the SPSM procedure and panel KSS unit root test results, the public health expenditures (PUHE) in Indonesia, Lao PDR, Cambodia, the Philippines, and Myanmar are converging, while that of Brunei Darussalam, Malaysia, Vietnam, Singapore, and Thailand are diverging. In addition, the sequences of private health expenditures (PRHE) in ASEAN member states are stationary, which implies convergence. This finding is in accordance with Wagner's law, that is, as nations develop, they are forced to expand public expenditure. Specifically, countries with low levels of PUHE tend to catch up with the high health spending countries. This research has policy implications with regard to the convergence of health expenditure across countries. The government in low- and lower-middle income countries should raise PUHE to provide access to health services for those who are unaffordable individuals.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  13. van Panhuis WG, Choisy M, Xiong X, Chok NS, Akarasewi P, Iamsirithaworn S, et al.
    Proc Natl Acad Sci U S A, 2015 Oct 20;112(42):13069-74.
    PMID: 26438851 DOI: 10.1073/pnas.1501375112
    Dengue is a mosquito-transmitted virus infection that causes epidemics of febrile illness and hemorrhagic fever across the tropics and subtropics worldwide. Annual epidemics are commonly observed, but there is substantial spatiotemporal heterogeneity in intensity. A better understanding of this heterogeneity in dengue transmission could lead to improved epidemic prediction and disease control. Time series decomposition methods enable the isolation and study of temporal epidemic dynamics with a specific periodicity (e.g., annual cycles related to climatic drivers and multiannual cycles caused by dynamics in population immunity). We collected and analyzed up to 18 y of monthly dengue surveillance reports on a total of 3.5 million reported dengue cases from 273 provinces in eight countries in Southeast Asia, covering ∼ 10(7) km(2). We detected strong patterns of synchronous dengue transmission across the entire region, most markedly during a period of high incidence in 1997-1998, which was followed by a period of extremely low incidence in 2001-2002. This synchrony in dengue incidence coincided with elevated temperatures throughout the region in 1997-1998 and the strongest El Niño episode of the century. Multiannual dengue cycles (2-5 y) were highly coherent with the Oceanic Niño Index, and synchrony of these cycles increased with temperature. We also detected localized traveling waves of multiannual dengue epidemic cycles in Thailand, Laos, and the Philippines that were dependent on temperature. This study reveals forcing mechanisms that drive synchronization of dengue epidemics on a continental scale across Southeast Asia.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  14. Angchaisuksiri P, Amurao-Abiera M, Chou SC, Chewcharat P, Chozie NA, Gomez R, et al.
    Haemophilia, 2024 May;30(3):609-616.
    PMID: 38523289 DOI: 10.1111/hae.14998
    BACKGROUND: The healthcare systems in Asia vary greatly due to the socio-economic and cultural diversities which impact haemophilia management.

    METHODS: An advisory board meeting was conducted with experts in haemophilia care from Asia to understand the heterogeneity in clinical practices and care provision in the region.

    FINDINGS: The overall prevalence of haemophilia in Asia ranges between 3 and 8.58/100,000 patients. Haemophilia A was more prevalent as compared to haemophilia B with a ratio of around 5:1. There is under-diagnosis in the region due to lack of diagnosis, registries and/or lack of appropriate facilities in suburban areas. Most patients are referred to the haematologists by their families or primary care physicians, while some are identified during bleeding episodes. Genetic testing faces obstacles like resource constraints, services available at limited centres and unwillingness of patients to participate. Prophylaxis is offered for people with haemophilia (PWH) with a severe bleeding phenotype. Recombinant factors are approved in most countries across the region and are the preferred therapy. The challenges highlighted for not receiving a high standard of care include patients' reluctance to use an intravenous treatment, poor patient compliance due to frequency of infusions, budget constraints and lack of funding, insurance, availability and accessibility of factor concentrates. Prevalence of neutralizing antibodies ranged from 5% to 20% in the region. Use of immune tolerance induction and bypassing agents to treat inhibitors depends on their cost and availability.

    CONCLUSION: Haemophilia care in Asia has evolved to a great extent. However, some challenges remain for which a strategic approach along with multi-stakeholder involvement are needed.

    Matched MeSH terms: Asia/epidemiology
  15. Saad S, Hisham S, Amir Hamzah SPA
    Malays J Pathol, 2024 Apr;46(1):21-40.
    PMID: 38682842
    INTRODUCTION: Sex estimation is crucial in forensic anthropology. In situations such as mass disasters, and forensic anthropology cases, sex estimation is a very important initial step in the disaster victim identification process. Literature has acknowledged that sex estimation is population-specific. However, sex estimation standards in South-East Asian populations are limited, leading to the usage of most Thais discriminant function equations on sex estimation by other South-East Asian countries including Malaysia. This systematic review was conducted to summarise the findings of sex estimation studies in South-East Asian countries.

    MATERIALS AND METHODS: A systematic literature search was performed through the SCOPUS database and Web of Science (WOS) database for relevant studies between 2014 and 2022. All published articles that are related to sex estimation from different types of bone, methods, landmarks, and sample sources (i.e., photographs, dry bones, and CT images) were included in this review. The main inclusion criteria were studies on (i) sex estimation; (ii) in South-East Asian populations; (iii) between the years 2014 and 2022; and (iv) in English.

    RESULTS: The literature search identified 30 potentially relevant studies, of which 15 publications met all the inclusion criteria. From those research, 13 studies were related to the Thai population and two to the Malaysian population. Only one study was based on morphological traits, while the rest were based on a morphometric approach.

    CONCLUSION: All studies found that sex estimation is populationspecific. Therefore, further research is recommended to explore more on population-specific sex estimation using different parts of bone.

    Matched MeSH terms: Asia, Southeastern/ethnology
  16. Sun YQ, Zhang YY, Liu MC, Chen JJ, Li TT, Liu YN, et al.
    Lancet Planet Health, 2024 Jul;8(7):e463-e475.
    PMID: 38969474 DOI: 10.1016/S2542-5196(24)00119-0
    BACKGROUND: Nipah virus is a zoonotic paramyxovirus responsible for disease outbreaks with high fatality rates in south and southeast Asia. However, knowledge of the potential geographical extent and risk patterns of the virus is poor. We aimed to establish an integrated spatiotemporal and phylogenetic database of Nipah virus infections in humans and animals across south and southeast Asia.

    METHODS: In this geospatial modelling analysis, we developed an integrated database containing information on the distribution of Nipah virus infections in humans and animals from 1998 to 2021. We conducted phylodynamic analysis to examine the evolution and migration pathways of the virus and meta-analyses to estimate the adjusted case-fatality rate. We used two boosted regression tree models to identify the potential ecological drivers of Nipah virus occurrences in spillover events and endemic areas, and mapped potential risk areas for Nipah virus endemicity.

    FINDINGS: 749 people and eight bat species across nine countries were documented as being infected with Nipah virus. On the basis of 66 complete genomes of the virus, we identified two clades-the Bangladesh clade and the Malaysia clade-with the time of the most recent common ancestor estimated to be 1863. Adjusted case-fatality rates varied widely between countries and were higher for the Bangladesh clade than for the Malaysia clade. Multivariable meta-regression analysis revealed significant relationships between case-fatality rate estimates and viral clade (p=0·0021), source country (p=0·016), proportion of male patients (p=0·036), and travel time to health-care facilities (p=0·036). Temperature-related bioclimate variables and the probability of occurrence of Pteropus medius were important contributors to both the spillover and the endemic infection models.

    INTERPRETATION: The suitable niches for Nipah virus are more extensive than previously reported. Future surveillance efforts should focus on high-risk areas informed by updated projections. Specifically, intensifying zoonotic surveillance efforts, enhancing laboratory testing capacity, and implementing public health education in projected high-risk areas where no human cases have been reported to date will be crucial. Additionally, strengthening wildlife surveillance and investigating potential modes of transmission in regions with documented human cases is needed.

    FUNDING: The Key Research and Development Program of China.

    Matched MeSH terms: Asia, Southeastern/epidemiology
  17. Jasuja S, Gallieni M, Jha V, Vachharajani T, Bhalla AK, Tan J, et al.
    Nephrology (Carlton), 2023 Dec;28(12):672-681.
    PMID: 37697492 DOI: 10.1111/nep.14236
    AIM: This cross-sectional survey aimed to determine the prevalence of Interventional Nephrology (IN) practice amongst nephrologists in the Asia-Pacific Region (APR), specifically related to dialysis access (DA).

    METHODS: The Association of VA and intervenTionAl Renal physicians (AVATAR) Foundation from India conducted a multinational online survey amongst nephrologists from the Asia-Pacific to determine the practice of IN in the planning, creation, and management of dialysis access. The treatment modalities, manpower and equipment availability, monthly cost of treatment, specifics of dialysis access interventions, and challenges in the training and practice of IN by nephrologists were included in the survey.

    RESULTS: Twenty-one countries from the APR participated in the survey. Nephrologists from 18 (85.7%) countries reported performing at least one of the basic dialysis access-related IN procedures, primarily the placement of non-tunnelled central catheters (n-TCC; 71.5%). Only 10 countries (47.6%) reported having an average of <4% of nephrologists performing any of the advanced IN access procedures, the most common being the placement of a peritoneal dialysis (PD) catheter (20%). Lack of formal training (57.14%), time (42.8%), incentive (38%), institutional support (38%), medico-legal protection (28.6%), and prohibitive cost (23.8%) were the main challenges to practice IN. The primary obstacles to implementing the IN training were a lack of funding and skilled personnel.

    CONCLUSION: The practice of dialysis access-related IN in APR is inadequate, mostly due to a lack of training, backup support, and economic constraints, whereas training in access-related IN is constrained by a lack of a skilled workforce and finances.

    Matched MeSH terms: Asia/epidemiology
  18. Hoshide S, Kario K, Chia YC, Siddique S, Buranakitjaroen P, Tsoi K, et al.
    J Clin Hypertens (Greenwich), 2021 03;23(3):489-495.
    PMID: 33705599 DOI: 10.1111/jch.14184
    Obstructive sleep apnea (OSA) is a risk of hypertension and is associated with cardiovascular disease (CVD) incidence. In Asian countries, the prevalence of OSA is high, as in Western countries. When blood pressure (BP) is evaluated in OSA individuals using ambulatory BP monitoring (ABPM), the BP phenotype often indicates abnormal BP variability, such as increased nighttime BP or abnormal diurnal BP variation, that is, non-dipper pattern, riser pattern, and morning BP surge, and all these conditions have been associated with increased CVD events. Asians have a higher prevalence of increased nighttime BP or morning BP surge than Westerners. Therefore, this review paper focused on OSA and hypertension from an Asian perspective to investigate the importance of the association between OSA and hypertension in the Asian population. Such abnormal BP variability has been shown to be associated with progression of arterial stiffness, and this association could provoke a vicious cycle between abnormal BP phenotypes and arterial stiffness, a phenomenon recognized as systemic hemodynamic atherothrombotic syndrome (SHATS). OSA may be one of the background factors that augment SHATS. An oxygen-triggered nocturnal oscillometric BP measurement device combined with a pulse oximeter for continuous SpO2 monitoring could detect BP variability caused by OSA. In addition to treating the OSA, accurate and reliable detection and treatment of any residual BP elevation and BP variability caused by OSA would be necessary to prevent CVD events. However, more detailed detection of BP variability, such as beat-by-beat BP monitoring, would further help to reduce CV events.
    Matched MeSH terms: Asia/epidemiology; Asian Continental Ancestry Group
  19. Turana Y, Shen R, Nathaniel M, Chia YC, Li Y, Kario K
    J Clin Hypertens (Greenwich), 2022 Sep;24(9):1204-1217.
    PMID: 36196471 DOI: 10.1111/jch.14559
    Asia has an enormous number of older people and is the primary contributor to the rise in neurodegenerative diseases such as Alzheimer's and Parkinson's disease. The therapy of many neurodegenerative diseases has not yet progressed to the point where it is possible to alter the course of the disease. Mid-life hypertension is an important predictor of later-life cognitive impairment and brain neurodegenerative conditions. These findings highlight the pivotal role of preventing and managing hypertension as a risk factor for neurodegenerative disease. Autonomic dysfunction, neuropsychiatric and sleep disturbances can arise in neurodegenerative diseases, resulting in blood pressure variability (BPV). The BPV itself can worsen the progression of the disease. In older people with neurodegenerative disease and hypertension, it is critical to consider 24-h blood pressure monitoring and personalized blood pressure therapy.
    Matched MeSH terms: Asia/epidemiology
  20. Kario K, Park S, Chia YC, Sukonthasarn A, Turana Y, Shin J, et al.
    J Clin Hypertens (Greenwich), 2020 03;22(3):351-362.
    PMID: 31816164 DOI: 10.1111/jch.13751
    Hypertension professionals from Asia have been meeting together for the last decade to discuss how to improve the management of hypertension. Based on these education and research activities, the Hypertension, brain, cardiovascular and renal Outcome Prevention and Evidence in Asia (HOPE Asia) Network was officially established in June 2018 and includes experts from 12 countries/regions across Asia. Among the numerous research and review papers published by members of the HOPE Asia Network since 2017, publications in three key areas provide important guidance on the management of hypertension in Asia. This article highlights key consensus documents, which relate to the Asian characteristics of hypertension, home blood pressure monitoring (HBPM), and ambulatory blood pressure monitoring (ABPM). Hypertension and hypertension-related diseases are common in Asia, and their characteristics differ from those in other populations. It is essential that these are taken into consideration to provide the best opportunity for achieving "perfect 24-hour blood pressure control", guided by out-of-office (home and ambulatory) blood pressure monitoring. These region-specific consensus documents should contribute to optimizing individual and population-based hypertension management strategies in Asian country. In addition, the HOPE Asia Network model provides a good example of the local interpretation, modification, and dissemination of international best practice to benefit specific populations.
    Matched MeSH terms: Asia/epidemiology
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