Southeast Asian Health Research Articles

Modeling the impacts of open biomass burning on regional O3 and PM2.5 in Southeast Asia considering light absorption and photochemical bleaching of Brown carbon

Open biomass burning in Southeast Asia has significant adverse impacts on air quality in the region and in downwind areas. These biomass burning events emit large amounts of light absorbing brown carbon (BrC). Once in the atmosphere, the light absorbing capacity of BrC is reduced by various oxidation processes. However, few modeling studies have been conducted to explicitly examine light absorption and bleaching on the prediction of ozone (O3) and fine particulate matter (PM2.5). In this study, a modified Community Multiscale Air Quality (CMAQ) model that explicitly tracks the concentrations of light absorbing and non-light absorbing organic aerosol components from different emission sources and the bleaching of BrC due to photooxidation and OH oxidation is applied to widespread open biomass burning events in March 2018 in Southeast Asia. Open biomass burning accounts for as much as 20–40 ppb (30–50%) of the maximum daily average 8-h ozone (MDA8 O3) and 40–120 μg m−3 (60–90%) of the daily average PM2.5 in the emission source regions. Compared to a simulation without BrC light absorption, the predicted MDA8 O3 and PM2.5 are as much as 16 ppb and 16 μg m−3 lower, respectively, than a simulation with light absorption. This confirms that neglecting the UV light absorption of BrC can lead to significant overpredictions of O3 and PM2.5 during the open biomass burning periods, which may lead to an overestimation of the adverse impacts of biomass burning on public health in Southeast Asia. The addition of BrC bleaching results in a 0.5–1% increase in MDA8 O3 and 1–5% increase in PM2.5 compared to the case without BrC bleaching. The results of this study indicate that light absorption by BrC needs to be considered in chemical transport modeling of large open biomass burning events. The BrC bleaching process is relatively slow and neglecting this process does not significantly change the predictions of MDA8 O3 and PM2.5 during open biomass burning.

Prison mental health in South-East Asia: A narrative review.

South-East Asia is a densely populated region with a considerable, however, under-prioritized mental health burden. Little is known about the mental health burden and services status in the prisons of the region. We aimed to investigate the individual country-wise prison mental health status in South-East Asian region. We performed a narrative review based on the evidence available in PubMed, Scopus, PsycINFO, Google, and Google Scholar considering the review objectives. We highlighted country perspectives on total population, prison numbers, prisoner numbers, the prevalence of psychiatric disorders and suicide among prisoners, prison mental health services, current challenges, and ways ahead. We discussed the prison mental health of five countries (Bangladesh, India, Indonesia, Nepal, and Sri Lanka). We found overcrowding (131.4%-215.6%) in the prisons, a high prevalence of psychiatric disorders in the prisons (40%-100%), negligible prison mental health services, and a lack of data on prison suicide with some variations among the five countries. Among the countries, Bangladesh has the highest prevalence (66.4%-100%) of psychiatric morbidity with an absence of a mental health system. Prison mental health in tSouth-East Asia is a neglected domain and warrants attention regarding ensuring adequate mental health services to the prisoners as there are high unmet mental health needs and an absence of poorly supported mental health needs.

Urbanization and Its Influence on Public Health in Southeast Asia

Purpose: The aim of the study was to analyze the urbanization and its influence on public health in Southeast Asia. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Urbanization in Southeast Asia significantly impacts public health through strained healthcare infrastructure, environmental health risks like pollution and inadequate sanitation, and increased prevalence of non-communicable diseases due to urban lifestyles. Infectious disease transmission is amplified in densely populated urban areas, exacerbated by social determinants of health disparities. Effective urban health policies and integrated planning are essential to mitigate these challenges, promoting sustainable development and equitable healthcare access across the region. Unique Contribution to Theory, Practice and Policy: Urbanization theory, social determinants of health theory & ecological systems theory may be used to anchor future studies on urbanization and its influence on public health in Southeast Asia. Initiatives should focus on promoting healthy urban environments through sustainable urban planning and design strategies. Policymakers should prioritize the integration of health considerations into urban planning policies and initiatives.

Improving LGBTQ+ mental health in Southeast Asia through social work: Insights from the Philippines

This article explores the roles of social workers in advancing LGBTQ+ inclusive mental healthcare in Southeast Asia. This role aligns with the global nature of the social work profession and several regional and national ethical frameworks and principles for social workers in Southeast Asia, emphasizing core values such as dignity, human rights, and social justice. Highlighting mental health disparities and social adversities faced by LGBTQ+ in the region, social workers can adopt a framework encompassing cultural competency, community support, advocacy, and research to improve the mental health outcomes of this marginalized population.

Southeast Asia's environmental challenges: emergence of new contaminants and advancements in testing methods.

Emerging contaminants, including pharmaceuticals, personal care products, microplastics, and per- and poly-fluoroalkyl substances, pose a major threat to both ecosystems and human health in Southeast Asia. As this region undergoes rapid industrialization and urbanization, the increasing presence of unconventional pollutants in water bodies, soil, and various organisms has become an alarming concern. This review comprehensively examines the environmental challenges posed by emerging contaminants in Southeast Asia and recent progress in toxicity testing methods. We discuss the diverse range of emerging contaminants found in Southeast Asia, shedding light on their causes and effects on ecosystems, and emphasize the need for robust toxicological testing methods. This review is a valuable resource for researchers, policymakers, and environmental practitioners working to mitigate the impacts of emerging contaminants and secure a sustainable future for Southeast Asia.

Digital rights and mobile health in Southeast Asia: A scoping review.

Digital technology has the potential to support or infringe upon human rights. The ubiquity of mobile technology in low- and middle-income countries (LMICs) presents an opportunity to leverage mobile health (mHealth) interventions to reach remote populations and enable them to exercise human rights. Yet, simultaneously, the proliferation of mHealth results in expanding sensitive datasets and data processing, which risks endangering rights. The promotion of digital health often centers on its role in enhancing rights and health equity, particularly in LMICs. However, the interplay between mHealth in LMICs and digital rights is underexplored. The objective of this scoping review is to bridge this gap and identify digital rights topics in the 2022 literature on mHealth in Southeast Asian LMICs. Furthermore, it aims to highlight the importance of patient empowerment and data protection in mHealth and related policies in LMICs. This review follows Arksey and O'Malley's framework for scoping reviews. Search results are reported using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. Frequency and content analyses were applied to summarize and interpret the data. Three key findings emerge from this review. First, the digital rights topics covered in the literature are sparse, sporadic, and unsystematic. Second, despite significant concerns surrounding data privacy in Southeast Asian LMICs, no article in this review explores challenges to data privacy. Third, all included articles state or allude to the role of mHealth in advancing the right to health. Engagement in digital rights topics in the literature on mHealth in Southeast Asian mHealth is limited and irregular. Researchers and practitioners lack guidance, collective understanding, and shared language to proactively examine and communicate digital rights topics in mHealth in LMIC research. A systematic method for engaging with digital rights in this context is required going forward.

Two linked clinical cases of avian influenza in Cambodia: what threat to public health in southeast Asia does this pose?

Two linked clinical cases of avian influenza in Cambodia: what threat to public health in southeast Asia does this pose?

Common assumptions in tobacco control that may not hold true for South-East Asia.

Tobacco is a threat to public health in South-East Asia and its control should be a priority. However, many common assumptions about tobacco control may not hold true for the region and can misdirect policy. The substantial health risks associated with smokeless tobacco have been largely misunderstood and neglected. The syndemic association between tuberculosis and tobacco has also been overlooked. Similarly, less attention has been paid to address second-hand smoke exposure of pregnant women to indoor smoking (caused predominantly by men). On the other hand, our poor understanding of the diverse tobacco supply chain has been blocking progress in tobacco control. Finally, the rising popularity of electronic cigarettes has thrown new challenges; many governments, concerned for its youth, have banned such products. We argue for a nuanced approach to tobacco control in South-East Asia. We also encourage a wider debate in public health, where other established assumptions may be hampering progress.

Developing a New Region-Specific Preference-Based Measure in East and Southeast Asia

ObjectivesAlmost all preference-based measures (PBMs) have been developed in Western countries, with none having been formulated in Asian countries. In this study, we construct a new generic PBM based on concept elicitation using interview surveys in East and Southeast Asian countries and qualitative analysis. MethodsThis cross-sectional study included 225 adults recruited from 9 East and Southeast Asian countries or regions (Indonesia, Japan, Korea, mainland China, Malaysia, the Philippines, Singapore, Taiwan, and Thailand). Trained interviewers conducted semistructured interviews with 25 participants from the general population of each country/region. Qualitative data were analyzed using a content analysis approach. The selection of items was determined based on interview surveys and team member discussions. The description of items was considered based on a detailed qualitative analysis of the interview survey. ResultsA new region-specific PBM—the Asia PBM 7 dimensions instrument—was designed. It reflects East and Southeast Asian values and comprises 7 items: pain, mental health, energy, mobility, work/school, interpersonal interactions, and burden to others. ConclusionsThe new region-specific instrument is one of the first PBMs developed in the context of non-Western countries. The Asia PBM 7 dimensions contains 7 items that address the core concepts of health-related quality of life that are deemed important based on East and Southeast Asian health concepts.

Climate change and health in Southeast Asia - defining research priorities and the role of the Wellcome Trust Africa Asia Programmes.

This article summarises a recent virtual meeting organised by the Oxford University Clinical Research Unit in Vietnam on the topic of climate change and health, bringing local partners, faculty and external collaborators together from across the Wellcome and Oxford networks. Attendees included invited local and global climate scientists, clinicians, modelers, epidemiologists and community engagement practitioners, with a view to setting priorities, identifying synergies and fostering collaborations to help define the regional climate and health research agenda. In this summary paper, we outline the major themes and topics that were identified and what will be needed to take forward this research for the next decade. We aim to take a broad, collaborative approach to including climate science in our current portfolio where it touches on infectious diseases now, and more broadly in our future research directions. We will focus on strengthening our research portfolio on climate-sensitive diseases, and supplement this with high quality data obtained from internal studies and external collaborations, obtained by multiple methods, ranging from traditional epidemiology to innovative technology and artificial intelligence and community-led research. Through timely agenda setting and involvement of local stakeholders, we aim to help support and shape research into global heating and health in the region.

Climate change and health in Southeast Asia – defining research priorities and the role of the Wellcome Trust Africa Asia Programmes

This article summarises a recent virtual meeting organised by the Oxford University Clinical Research Unit in Vietnam on the topic of climate change and health, bringing local partners, faculty and external collaborators together from across the Wellcome and Oxford networks. Attendees included invited local and global climate scientists, clinicians, modelers, epidemiologists and community engagement practitioners, with a view to setting priorities, identifying synergies and fostering collaborations to help define the regional climate and health research agenda. In this summary paper, we outline the major themes and topics that were identified and what will be needed to take forward this research for the next decade. We aim to take a broad, collaborative approach to including climate science in our current portfolio where it touches on infectious diseases now, and more broadly in our future research directions. We will focus on strengthening our research portfolio on climate-sensitive diseases, and supplement this with high quality data obtained from internal studies and external collaborations, obtained by multiple methods, ranging from traditional epidemiology to innovative technology and artificial intelligence and community-led research. Through timely agenda setting and involvement of local stakeholders, we aim to help support and shape research into global heating and health in the region.

Climate change and health in Southeast Asia – defining research priorities and the role of the Wellcome Trust Africa Asia Programmes

This article summarises a recent virtual meeting organised by the Oxford University Clinical Research Unit in Vietnam on the topic of climate change and health, bringing local partners, faculty and external collaborators together from across the Wellcome and Oxford networks. Attendees included invited local and global climate scientists, clinicians, modelers, epidemiologists and community engagement practitioners, with a view to setting priorities, identifying synergies and fostering collaborations to help define the regional climate and health research agenda. In this summary paper, we outline the major themes and topics that were identified and what will be needed to take forward this research for the next decade. We aim to take a broad, collaborative approach to including climate science in our current portfolio where it touches on infectious diseases now, and more broadly in our future research directions. We will focus on strengthening our research portfolio on climate-sensitive diseases, and supplement this with high quality data obtained from internal studies and external collaborations, obtained by multiple methods, ranging from traditional epidemiology to innovative technology and artificial intelligence and community-led research. Through timely agenda setting and involvement of local stakeholders, we aim to help support and shape research into global heating and health in the region.

Air Pollution From Forest and Vegetation Fires in Southeast Asia Disproportionately Impacts the Poor.

Forest and vegetation fires, used as tools for agriculture and deforestation, are a major source of air pollutants and can cause serious air quality issues in many parts of Asia. Actions to reduce fire may offer considerable, yet largely unrecognized, options for rapid improvements in air quality. In this study, we used a combination of regional and global air quality models and observations to examine the impact of forest and vegetation fires on air quality degradation and public health in Southeast Asia (including Mainland Southeast Asia and south‐eastern China). We found that eliminating fire could substantially improve regional air quality across Southeast Asia by reducing the population exposure to fine particulate matter (PM2.5) concentrations by 7% and surface ozone concentrations by 5%. These reductions in PM2.5 exposures would yield a considerable public health benefit across the region; averting 59,000 (95% uncertainty interval (95UI): 55,200–62,900) premature deaths annually. Analysis of subnational infant mortality rate data and PM2.5 exposure suggested that PM2.5 from fires disproportionately impacts poorer populations across Southeast Asia. We identified two key regions in northern Laos and western Myanmar where particularly high levels of poverty coincide with exposure to relatively high levels of PM2.5 from fires. Our results show that reducing forest and vegetation fires should be a public health priority for the Southeast Asia region.

Molecular Phylogenesis and Spatiotemporal Spread of SARS-CoV-2 in Southeast Asia.

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.

Trust or do not trust: evaluation strategies used by online health information consumers in South East Asia

Introduction. Health information searching is a popular activity conducted on the Internet. However, the focus of past research studies has been on health consumers from the western world. Thus, there is a gap of information pertaining to online health information searching behaviour from the South East Asian region. In this study, trust evaluation strategies used by South East Asian health consumers are described. Method. A grounded theory approach was used. A total of eighty participants were interviewed. Analysis. Interviews were analysed using qualitative analysis methods. Open coding and thematic analysis methods were employed. Results. Results indicate most participants evaluate information for trustworthiness. The most popular technique used is evaluating the quality of the source. In addition, South East Asian health consumers place high trust value on information based on personal experiences. Conclusions. This research study extends current understanding of trustworthiness evaluations and points to the need for education and training mechanisms to be in place.

THE IMPLICATIONS OF SECURITISING HEALTH CRISES: THE CASE OF SOUTHEAST ASIA

This article examined the consequences of linking health as a regional security issue. Securitisation Theory (hereinafter ST) is an innovative approach to understand how Non-Traditional Security (from now on NTS) is deemed as a posing threat to a referent object. Prioritising NTS issue as a security threat enables the issue to receive a higher degree of importance from policymakers, thereby gathering the resources needed in dealing with the threat. However, addressing NTS issues also bring negative implications; it can divert attention from more concerning issues. This article, therefore, investigated the consequences of securitising health issues at the Southeast Asian level. This was done through triangulating academic materials, ASEAN’s official statements, and semi-structured elite interviews on Southeast Asian health policy discourses between 1967 and 2010. This study argues that while there are some disadvantages to regional efforts in constructing pandemic disease as a regional security threat, the advantages of such a move outweighs the drawbacks, particularly in terms of establishing regional health mechanisms.

Southeast Asian health system challenges and responses to the 'Andaman Sea refugee crisis': A qualitative study of health-sector perspectives from Indonesia, Malaysia, Myanmar, and Thailand.

BackgroundSoutheast Asian countries host signficant numbers of forcibly displaced people. This study was conducted to examine how health systems in Southeast Asia have responded to the health system challenges of forced migration and refugee-related health including the health needs of populations affected by forced displacement; the health systems–level barriers and facilitators in addressing these needs; and the implications of existing health policies relating to forcibly displaced and refugee populations. This study aims to fill in the gap in knowledge by analysing how health systems are organised in Southeast Asia to address the health needs of forcibly displaced people.Methods and findingsWe conducted 30 semistructured interviews with health policy-makers, health service providers, and other experts working in the United Nations (n = 6), ministries and public health (n = 5), international (n = 9) and national civil society (n = 7), and academia (n = 3) based in Indonesia (n = 6), Malaysia (n = 10), Myanmar (n = 6), and Thailand (n = 8). Data were analysed thematically using deductive and inductive coding. Interviewees described the cumulative nature of health risks at each migratory phase. Perceived barriers to addressing migrants’ cumulative health needs were primarily financial, juridico-political, and sociocultural, whereas key facilitators were many health workers’ humanitarian stance and positive national commitment to pursuing universal health coverage (UHC). Across all countries, financial constraints were identified as the main challenges in addressing the comprehensive health needs of refugees and asylum seekers. Participants recommended regional and multisectoral approaches led by national governments, recognising refugee and asylum-seeker contributions, and promoting inclusion and livelihoods. Main study limitations included that we were not able to include migrant voices or those professionals not already interested in migrants.ConclusionsTo our knowledge, this is one of the first qualitative studies to investigate the health concerns and barriers to access among migrants experiencing forced displacement, particularly refugees and asylum seekers, in Southeast Asia. Findings provide practical new insights with implications for informing policy and practice. Overall, sociopolitical inclusion of forcibly displaced populations remains difficult in these four countries despite their significant contributions to host-country economies.

Mitigating Global Oral Health Inequalities: Research Training Programs in Low- and Middle-Income Countries.

Although oral diseases are largely preventable, they are among the most non-communicable diseases globally, and they disproportionately burden disadvantaged communities, specially within low- and middle-income nations. The COVID-19 pandemic has highlighted the social, economic, and health inequalities in our society, including the existing global oral health inequalities. There is a shortage of dentist-scientist all around the world, especially in developing countries, such as Thailand. The National Institute of Dental and Craniofacial Research (NIDCR) and Fogarty International Center (FIC), joined efforts on creating research capacity in oral health in South East Asia through the Fogarty International Center Training Program in Clinical, Public Health and Behavioral Oral Health Research for Thailand (2006–2016). The University of Washington (USA), Thammasat University (Thailand) and Khon Kaen University (Thailand) partnered to conduct short-, medium- and long-term training programs to build regional oral health research capabilities. Investing in research has not only impacted trainees’ career development but enhanced advancement of oral health research of South East Asia. The success of partnership calls for expanding oral health research training in other low-income countries.

Health and security nexus in Southeast Asia: Collective securitisation

This article examines how the Association of Southeast Asian Nations (ASEAN) collectively securitised a non-traditional security issue. Securitisation theory provides a way for government policymakers to devote more attention and resources to issues that might otherwise be overlooked. Securitisation theory, however, is not without significant shortcoming. The framework only emphasises nation-state as the referent object and unit of analysis. By contrast, the characteristics of non-traditional security issue threats require a multilevel relationship, as national solutions are often inadequate. This study, therefore, highlights the process of securitising infectious diseases at the ASEAN level and identifying the types of health challenges that have been collectively securitised. This was done through triangulation of academic materials, ASEAN’s official statements and semi-structured elite interviews of the discourse on Southeast Asian health policy between 1967 and 2010. This study argues that only diseases with the potential of becoming a pandemic and threaten the stability of a region have been successfully securitised at the regional level. Additionally, collective securitisation has increase multilateral cooperation among the ASEAN member states. Keywords: ASEAN, collective securitisation, health security, infectious disease, regional.

Education background and monthly household income are factors affecting the knowledge, awareness and practice on haze pollution among Malaysians.

Transboundary haze pollution caused by periodic forest fires has initiated a serious negative implication to the economy, tourism sectors and public health in Southeast Asia. Due to the raising concerns of health effects of haze towards the Malaysian population, the present study was conducted to investigate the degree of awareness towards haze and the number of safety measures adopted by the Malaysian population during the haze crisis based on demographic characteristics. A cross-sectional questionnaire-based study was conducted from 4 to 29 January 2016 on 387 subjects in Klang Valley, Malaysia. The results showed that more than 90% of the respondents were aware of the hazards of haze pollution. Respondents with higher education background with diploma, undergraduate and postgraduate degree possessed greater awareness on the hazards of haze (p < 0.001) and practiced safety measures (p = 0.025) compared with those with lower education background with no proper schooling, primary schooling and secondary schooling. Among the subjects with higher household income (>RM 10,000/month) had higher awareness level on haze (p < 0.05) and adopted more safety measures (p < 0.05) compared with respondents with lower household income (<RM 3000/month). Despite controversies regarding the association of demographic factors with awareness level on haze reported, our present study confirmed that demographic factors such as the education background and monthly household income are affecting the awareness score and the number of safety measure taken during haze episode in Malaysia. Hence, more awareness on haze pollution to engage more safety measures during haze episodes should address to the lower education level and socioeconomic group to improve their health and quality of life.