Displaying publications 1 - 20 of 1057 in total

  1. Ray JD, Subandiyah S, Rincon-Florez VA, Prakoso AB, Mudita IW, Carvalhais LC, et al.
    Plant Dis, 2021 Oct;105(10):2792-2800.
    PMID: 33973808 DOI: 10.1094/PDIS-01-21-0149-RE
    Blood disease in bananas caused by Ralstonia syzygii subsp. celebesensis is a bacterial wilt causing significant crop losses in Indonesia and Malaysia. Disease symptoms include wilting of the plant and red-brown vascular staining, internal rot, and discoloration of green banana fruit. There is no known varietal resistance to this disease in the Musa genus, although variation in susceptibility has been observed, with the popular Indonesian cooking banana variety Kepok being highly susceptible. This study established the current geographic distribution of Blood disease in Indonesia and confirmed the pathogenicity of isolates by Koch's postulates. The long-distance distribution of the disease followed an arbitrary pattern indicative of human-assisted movement of infected banana materials. In contrast, local or short-distance spread radiated from a single infection source, indicative of dispersal by insects and possibly contaminated tools, water, or soil. The rapid expansion of its geographical range makes Blood disease an emerging threat to banana production in Southeast Asia and beyond.
    Matched MeSH terms: Asia, Southeastern
  2. Muthiah YD, Ong CE, Sulaiman SA, Ismail R
    Pharmacognosy Res, 2016 Oct-Dec;8(4):292-297.
    PMID: 27695271
    In Southeast Asia and many parts of the world, herbal products are increasingly used in parallel with modern medicine.
    Matched MeSH terms: Asia, Southeastern
  3. Goh LPW, Chong ETJ, Lee PC
    PMID: 33050119 DOI: 10.3390/ijerph17207354
    Alpha(α)-thalassemia is a blood disorder caused by many types of inheritable α-globin gene mutations which causes no-to-severe clinical symptoms, such as Hb Bart's hydrops fetalis that leads to early foetal death. Therefore, the aim of this meta-analysis was to provide an update from year 2010 to 2020 on the prevalence of α-thalassemia in Southeast Asia. A systematic literature search was performed using PubMed and SCOPUS databases for related studies published from 2010 to 2020, based on specified inclusion and exclusion criteria. Heterogeneity of included studies was examined with the I2 index and Q-test. Funnel plots and Egger's tests were performed in order to determine publication bias in this meta-analysis. Twenty-nine studies with 83,674 subjects were included and pooled prevalence rates in this meta-analysis were calculated using random effect models based on high observed heterogeneity (I2 > 99.5, p-value < 0.1). Overall, the prevalence of α-thalassemia is 22.6%. The highest α-thalassemia prevalence was observed in Vietnam (51.5%) followed by Cambodia (39.5%), Laos (26.8%), Thailand (20.1%), and Malaysia (17.3%). No publication bias was detected. Conclusions: This meta-analysis suggested that a high prevalence of α-thalassemia occurred in selected Southeast Asia countries. This meta-analysis data are useful for designing thalassemia screening programs and improve the disease management.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  4. Kazim AR, Houssaini J, Ehlers J, Tappe D, Heo CC
    Acta Trop, 2021 Nov;223:106085.
    PMID: 34389326 DOI: 10.1016/j.actatropica.2021.106085
    Soft ticks (Acari: Argasidae) are the second major family of the blood feeding metastriates and vectors of a number of viral and bacterial pathogens for both humans and animals. Despite the growing effort on tick surveillance and studies worldwide, there is still limited information on the soft tick distribution in the island nations of Southeast Asia, especially species that are medically and veterinarily important. With the aim to provide an overview of the current status of knowledge on soft tick distribution in the island nations of Southeast Asia (Malaysia, Singapore, Brunei, Indonesia, the Philippines and Timor-Leste), this article reviews the species of soft ticks (Acari: Argasidae) and their associated hosts and pathogens, with the addition of a pictorial summary and list of tick species discovered in this region. The most prevalent soft tick genus is Carios, and the host species most associated with findings of soft ticks in this region are bats, particularly of the Pteropodidae and Vespertilionidae families. Furthermore, the only known pathogen originating from soft ticks in the island nations of Southeast Asia was the Keterah virus, which was isolated from Argas pusillus tick in Malaysia.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  5. Rampal S, Rampal L, Jayaraj VJ, Pramanick A, Choolani M, Liew BS, et al.
    Med J Malaysia, 2021 11;76(6):783-791.
    PMID: 34806661
    INTRODUCTION: Periodic benchmarking of the epidemiology of COVID-19 in the Association of Southeast Asian Nations (ASEAN) countries is critical for the continuous understanding of the transmission and control of COVID-19 in the region. The incidence, mortality, testing and vaccination rates within the ASEAN region from 1 January 2020 to 15 October 2021 is analysed in this paper.

    METHODS: COVID-19 data on cases, deaths, testing, and vaccinations were extracted from the Our World in Data (OWID) COVID-19 data repository for all the ten ASEAN countries. Comparative time-trends of the epidemiology of COVID-19 using the incidence rate, cumulative case fatality rate (CFR), delay-adjusted case fatality rate, cumulative mortality rate (MR), test positivity rate (TPR), cumulative testing rate (TR) and vaccination rate was carried out.

    RESULTS: Over the study period, a total of 12,720,661 cases and 271,475 deaths was reported within the ASEAN region. Trends of daily per capita cases were observed to peak between July and September 2021 for the ASEAN region. The cumulative case fatality rate (CFR) in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, was of 0.9% (N=68), 2.2% (N=2,610), 3.5% (N=142,889), 0.1% (N=36), 1.2% (N=27,700), 4.0% (N=18,297), 1.6% (N=40,424), 0.1% (N=215), 1.7% (N=18,123), and 2.6% (N=21,043), respectively. CFR was consistently highest between January-June 2020. The cumulative mortality rate (MR) was 9.5, 13.7, 51.4, 0.2, 80.3, 32.4, 34.5, 1.6, 23.9 and 19.7 per 100,000 population, respectively. The cumulative test positivity rate (TPR) was 8.4%, 16.9%, 4.6%, 7.5%, 11.1%, 12.9%, 0.5%, 11.7%, and 3.6%, with the cumulative testing rate (TR) at 25.0, 90.1, 27.4, 917.7, 75.8, 177.8, 3303.3, 195.2, and 224.9 tests per 1,000 population in Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, respectively. The percentage of population that completed vaccinations (VR) was 44.5%, 65.3%, 18.5%, 28.2%, 61.8%, 6.8%, 19.2%, 76.8%, 22.7%, and 10% in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, respectively.

    CONCLUSION: In 2020, most countries in ASEAN had higher case fatality rates but lower mortalities per population when compared to the third quarter of 2021 where higher mortalities per population were observed. Low testing rates have been one of the factors leading to high test positivity rates. Slow initiation of vaccination programs was found to be the key factor leading to high incidence and case fatality rate in most countries in ASEAN. Effective public health measures were able to interrupt the transmission of this novel virus to some extent. Increasing preparedness capacity within the ASEAN region is critical to ensure that any future similar outbreaks can be dealt with collectively.

    Matched MeSH terms: Asia, Southeastern/epidemiology
  6. Winterton SL, Wang Y
    Zookeys, 2016.
    PMID: 27667953 DOI: 10.3897/zookeys.617.10165
    The charismatic lance lacewing genus Gryposmylus Krüger, 1913 (Osmylidae: Protosmylinae) from South East Asia is revised with a new species (Gryposmylus pennyi sp. n.) described from Malaysia. The genus is diagnosed and both species in the genus redescribed and figured. An extraordinary example of morphological convergence is presented, with disruptive camouflaging wing markings in Gryposmylus pennyi sp. n. being remarkably similar to the South American green lacewing Vieira leschenaulti Navás (Chrysopidae).
    Matched MeSH terms: Asia, Southeastern
  7. Polunin I, Sneah PHA
    Matched MeSH terms: Asia, Southeastern
  8. Baticulon RE, Nga VDW, Sobana M, Bahuri NFA, Wittayanakorn N
    World Neurosurg, 2021 Feb;146:427.
    PMID: 33607747 DOI: 10.1016/j.wneu.2020.11.056
    Matched MeSH terms: Asia, Southeastern
  9. Praveena SM, Aris AZ
    Environ Sci Pollut Res Int, 2021 Dec;28(45):63829-63836.
    PMID: 33410033 DOI: 10.1007/s11356-020-11774-0
    This study examined the impacts of the Coronavirus disease 2019 (COVID-19) on the environment in the Southeast Asia region using qualitative content analysis to analyze the textual data of published studies and other online references such as the organizational reports. Besides, the materiality assessment particularly the Global Reporting Initiative was conducted by analyzing short- and long-term impacts from the stakeholders' (local and regional policymakers) perspective. The positive effects of COVID-19 lockdown and movement restriction on the regional environment identified in this study included a reduction in air pollution, improvement of air and water quality, lower noise levels, and reduced land surface temperature. In contrast, the negative effects encompassed a rise in the use of plastics and the generation of medical waste in Indonesia, Malaysia, Thailand, the Philippines, and Vietnam. Materiality assessment findings have offered insights on the need of stakeholders' importance for further to deal with huge amount of waste, inadequate waste management facilities and system, explore the effectiveness of such sustainable work and lifestyle changes, utilize real-time monitoring air quality data and future prediction responses for climate change mitigation and adaptation policies as well as consideration towards new green technologies for clean energy in each Southeast Asian country and at regional level. It is anticipated that this study will contribute towards a better understanding of the impacts of COVID-19 on environmental sustainability in the Southeast Asia region, particularly from the perspective of the stakeholders.
    Matched MeSH terms: Asia, Southeastern
  10. Selvam K, Ganapathy T, Najib MA, Khalid MF, Abdullah NA, Harun A, et al.
    Int J Environ Res Public Health, 2022 Nov 22;19(23).
    PMID: 36497549 DOI: 10.3390/ijerph192315475
    This scoping review aims to provide a comprehensive overview of human melioidosis in Southeast Asia as well as to highlight knowledge gaps in the prevalence and risk factors of this life-threatening disease using available evidence-based data for better diagnosis and treatment. Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was used as the guideline for this review. The literature search was conducted on 23 March 2022 through two electronic databases (PubMed and Scopus) using lists of keywords referring to the Medical Subject Headings (MeSH) thesaurus. A total of 38 articles related to human melioidosis were included from 645 screened articles. These studies were carried out between 1986 and 2019 in six Southeast Asian countries: Thailand, Cambodia, Malaysia, Myanmar, Singapore, and Vietnam. Melioidosis has been reported with a high disease prevalence among high-risk populations. Studies in Thailand (48.0%) and Cambodia (74.4%) revealed disease prevalence in patients with septic arthritis and children with suppurative parotitis, respectively. Other studies in Thailand (63.5%) and Malaysia (54.4% and 65.7%) showed a high seroprevalence of melioidosis among Tsunami survivors and military personnel, respectively. Additionally, this review documented soil and water exposure, diabetes mellitus, chronic renal failure, thalassemia, and children under the age of 15 as the main risk factors for melioidosis. Human melioidosis is currently under-reported in Southeast Asia and its true prevalence is unknown.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  11. Jane Ling MY, Abdul Halim AFN, Ahmad D, Ahmad N, Safian N, Mohammed Nawi A
    PMID: 36900893 DOI: 10.3390/ijerph20053883
    The use of e-cigarettes in adolescents remains a major public health concern. Like other tobacco products, e-cigarettes pose health risks to adolescents. Understanding the magnitude of this problem and identification of its associated factors will serve as a guide for development of preventive interventions. This systematic review aims to identify and discuss current epidemiological data on the prevalence and associated factors of e-cigarette use among adolescents in Southeast Asia. The reporting of this systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. We carried out a literature search through three databases (Scopus, PubMed, Web of Science) and targeted original English-language articles published between 2012 and 2021. A total of 10 studies were included in this review. The prevalence of current e-cigarette uses ranges from 3.3% to 11.8%. Several associated factors of e-cigarette use were identified, including sociodemographic factors, traumatic childhood experience, peer and parental influence, knowledge and perception, substance use, and accessibility of e-cigarettes. These factors should be addressed though multifaceted interventions which simultaneously target multiple factors. Laws, policies, programs, and interventions must be strengthened and tailored to the needs of adolescents at risk of using e-cigarettes.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  12. Chan CM, Mahlaoui N, Sánchez Ramón S, Pergent M, Solis L, Prevot J, et al.
    Front Immunol, 2023;14:1151335.
    PMID: 37063889 DOI: 10.3389/fimmu.2023.1151335
    OBJECTIVE: To analyze the implementation of the Principles of Care (PoC) in primary immunodeficiencies (PID) in Southeast Asia (SEA) countries - six years after its call of action.

    METHODOLOGY: Using the newly developed PID Life Index software, the index of implementation of principles of care in the management of PIDs patients involving the six participating SEA countries (Cambodia, Indonesia, Malaysia, Vietnam, Thailand, and Philippines) were extracted. For each of the six separate principles, the index from the six countries will be compared and presented based on the calculated index.

    RESULTS: Comparative analysis of the six principles of care of PID in the SEA countries showed low diagnostic rate with minimal availability of diagnostic tests options. Generally, almost all SEA countries provide curative treatments, vaccines, and anti-infectious therapies although the reimbursement scheme varied in relieving patients' financial burden. We also highlighted the active involvement of patient organizations in SEA, with main areas of work focused on advocacy and increasing awareness among public and healthcare professionals.

    DISCUSSION AND CONCLUSION: It is applaudable that the SEA continent is gradually strengthening its work in management of PID, especially in Thailand and Vietnam. However, more emphasis must be placed among stakeholders in SEA countries towards successful implementation of the PoC for a holistic management of PID patients.

    Matched MeSH terms: Asia, Southeastern/epidemiology
  13. 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
  14. Lim VK
    Med J Malaysia, 1991 Dec;46(4):298-300.
    PMID: 1840435
    Matched MeSH terms: Asia, Southeastern/epidemiology
  15. Rampal L, Liew BS, Choolani M, Ganasegeran K, Pramanick A, Vallibhakara SA, et al.
    Med J Malaysia, 2020 11;75(6):613-625.
    PMID: 33219168
    INTRODUCTION: COVID-19 has caused unprecedented public health concerns, triggering an escalated burden to health systems worldwide. The pandemic has altered people's living norms, yet coherently escalating countries' socioeconomic instability. This real-time consensus review aims to describe the epidemiological trends of COVID-19 pandemic across six South-East Asian nations, and countryspecific experiences on pandemic preparedness, responses and interventions.

    METHODS: Consensus-driven approach between authors from the six selected countries was applied. Country specific policy documents, official government media statements, mainstream news portals, global statistics databases and latest published literature available between January-October 2020 were utilised for information retrieval. Situational and epidemiological trend analyses were conducted. Country-specific interventions and challenges were described. Based on evidence appraised, a descriptive framework was considered through a consensus. The authors subsequently outlined the lessons learned, challenges ahead and interventions that needs to be in place to control the pandemic.

    RESULTS: The total number of people infected with COVID-19 between 1 January and 16 November 2020 had reached 48,520 in Malaysia, 58,124 in Singapore, 3,875 in Thailand, 470,648 in Indonesia, 409,574 in Philippines and 70,161 in Myanmar. The total number of people infected with COVID- 19 in the six countries from January to 31 October 2020 were 936,866 cases and the mortality rate was 2.42%. Indonesia had 410,088 cases with a mortality rate of 3.38%, Philippines had 380,729 cases with a mortality rate of 1.90%, Myanmar had 52,706 cases with a mortality rate of 2.34%, Thailand had 3,780 cases with a mortality rate of 1.56%, Malaysia had 31,548 cases with a mortality rate of 0.79%, and Singapore had 58,015 cases with a mortality rate of 0.05% over the 10- month period. Each country response varied depending on its real-time situations based on the number of active cases and economic situation of the country.

    CONCLUSION: The number of COVID-19 cases in these countries waxed and waned over the 10-month period, the number of cases may be coming down in one country, and vice versa in another. Each country, if acting alone, will not be able to control this pandemic. Sharing of information and resources across nations is the key to successful control of the pandemic. There is a need to reflect on how the pandemic affects individuals, families and the community as a whole. There are many people who cannot afford to be isolated from their families and daily wage workers who cannot afford to miss work. Are we as a medical community, only empathising with our patients or are we doing our utmost to uphold them during this time of crisis? Are there any other avenues which can curb the epidemic while reducing its impact on the health and socio-economic condition of the individual, community and the nation?

    Matched MeSH terms: Asia, Southeastern/epidemiology
  16. Lee HM, Okuda KS, González FE, Patel V
    Adv Exp Med Biol, 2019;1164:11-34.
    PMID: 31576537 DOI: 10.1007/978-3-030-22254-3_2
    Of the ~129,079 new cases of nasopharyngeal carcinoma (NPC) and 72,987 associated deaths estimated for 2018, the majority will be geographically localized to South East Asia, and likely to show an upward trend annually. It is thought that disparities in dietary habits, lifestyle, and exposures to harmful environmental factors are likely the root cause of NPC incidence rates to differ geographically. Genetic differences due to ethnicity and the Epstein Barr virus (EBV) are likely contributing factors. Pertinently, NPC is associated with poor prognosis which is largely attributed to lack of awareness of the salient symptoms of NPC. These include nose hemorrhage and headaches and coupled with detection and the limited therapeutic options. Treatment options include radiotherapy or chemotherapy or combination of both. Surgical excision is generally the last option considered for advanced and metastatic disease, given the close proximity of nasopharynx to brain stem cell area, major blood vessels, and nerves. To improve outcome of NPC patients, novel cellular and in vivo systems are needed to allow an understanding of the underling molecular events causal for NPC pathogenesis and for identifying novel therapeutic targets and effective therapies. While challenges and gaps in current NPC research are noted, some advances in targeted therapies and immunotherapies targeting EBV NPCs are discussed in this chapter, which may offer improvements in outcome of NPC patients.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  17. Kunasegaran T, Balasubramaniam VRMT, Arasoo VJT, Palanisamy UD, Ramadas A
    PMID: 33572656 DOI: 10.3390/ijerph18031272
    A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute's methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  18. Zhu M, Shen J, Zeng Q, Tan JW, Kleepbua J, Chew I, et al.
    Front Public Health, 2021 07 30;9:685315.
    PMID: 34395364 DOI: 10.3389/fpubh.2021.685315
    Background: The ongoing coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to public health in Southeast Asia, a tropical region with limited resources. This study aimed to investigate the evolutionary dynamics and spatiotemporal patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the region. Materials and Methods: A total of 1491 complete SARS-CoV-2 genome sequences from 10 Southeast Asian countries were downloaded from the Global Initiative on Sharing Avian Influenza Data (GISAID) database on November 17, 2020. The evolutionary relationships were assessed using maximum likelihood (ML) and time-scaled Bayesian phylogenetic analyses, and the phylogenetic clustering was tested using principal component analysis (PCA). The spatial patterns of SARS-CoV-2 spread within Southeast Asia were inferred using the Bayesian stochastic search variable selection (BSSVS) model. The effective population size (Ne) trajectory was inferred using the Bayesian Skygrid model. Results: Four major clades (including one potentially endemic) were identified based on the maximum clade credibility (MCC) tree. Similar clustering was yielded by PCA; the first three PCs explained 46.9% of the total genomic variations among the samples. The time to the most recent common ancestor (tMRCA) and the evolutionary rate of SARS-CoV-2 circulating in Southeast Asia were estimated to be November 28, 2019 (September 7, 2019 to January 4, 2020) and 1.446 × 10-3 (1.292 × 10-3 to 1.613 × 10-3) substitutions per site per year, respectively. Singapore and Thailand were the two most probable root positions, with posterior probabilities of 0.549 and 0.413, respectively. There were high-support transmission links (Bayes factors exceeding 1,000) in Singapore, Malaysia, and Indonesia; Malaysia involved the highest number (7) of inferred transmission links within the region. A twice-accelerated viral population expansion, followed by a temporary setback, was inferred during the early stages of the pandemic in Southeast Asia. Conclusions: With available genomic data, we illustrate the phylogeography and phylodynamics of SARS-CoV-2 circulating in Southeast Asia. Continuous genomic surveillance and enhanced strategic collaboration should be listed as priorities to curb the pandemic, especially for regional communities dominated by developing countries.
    Matched MeSH terms: Asia, Southeastern/epidemiology
  19. Wu J, Wang HL, Liu X, Ding C, Zhou Y, Fu X, et al.
    Liver Int, 2020 02;40(2):298-307.
    PMID: 31674705 DOI: 10.1111/liv.14289
    BACKGROUND & AIMS: Trends in long-term mortality rates for viral hepatitis in East and Southeast Asia have been rarely reported. The aim of our study was to explore the long-term trends in viral hepatitis mortality rates in East and Southeast Asian countries between 1987 and 2015 and provide predictions of mortality to 2030.

    METHODS: We obtained viral hepatitis mortality data from the WHO Mortality Database for six East and Southeast Asian countries between 1987 and 2015. We produced choropleth maps of viral hepatitis mortality rates in 1987 and 2015 in East and Southeast Asia to illustrate geographic variations. We made predictions of mortality rates for each included country until the year 2030 using a series of joinpoint models.

    RESULTS: Viral hepatitis mortality rates declined in China (the average annual percent change (AAPC) = -5.1%, 95% CI: -7.5, -2.6), Singapore (AAPC = -5.4%, 95% CI: -7.5, -3.2), and the Philippines (AAPC = -3.4%, 95% CI: -4.9, -1.8). In contrast, Japan, the Republic of Korea, and Malaysia have experienced increasing trends in mortality rates, followed by decreasing trends. Our predictions indicate that all countries will experience slight to moderate downward trends until 2030.

    CONCLUSION: Favourable decreasing trends have been noted in East and Southeast Asian countries, which may not only inform the control and management of viral hepatitis in this region but also guide the prevention of viral hepatitis deaths in another region with a similar viral hepatitis epidemic.

    Matched MeSH terms: Asia, Southeastern/epidemiology
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