Nay Pyi Taw Research Articles

Efficacy, Safety of Baricitinib plus Remdesivir versus Standard Therapy (Remdesivir) in Patients with Severe COVID-19 Infection in Third Wave of Epidemics in Myanmar: Case Control Study

Background: Coronavirus disease 2019 (COVID-19) has been a major threat to health around the world as it causes significant morbidity and mortality. SARS-CoV-2 infection induces severe inflammation in lungs and multi-organs; therefore, the Janus kinase (JAK) inhibitor known as baricitinib was proposed as a treatment for COVID-19 because of its anti-inflammatory and potential antiviral effects. It may improve survival in patients with severe Covid-19 infection. The efficacy and safety of Baricitinib therapy in severe COVID-19 infection in Myanmar was not known clearly. Methods: A case control study was conducted in COVID-19 treatment centers in Myanmar- Yangon and Nay Pyi Taw, from June to October 2021. Baricitinib 4 mg daily for 14 days was given to the patients with severe COVID-19 infection as an add on therapy to Standard treatment group (Remdesivir). The primary outcome was survival status; survive or non-survive. The secondary outcome was duration of hospital stay, the requirement for oxygen therapy at Day 7 (improved or not), changes in chest radiograph at Day 14 (improved, same or worse), and changes in inflammatory markers (CPR and LDH). Patient data were stratified by age, sex, body weight, co-morbidities and immune status (immunocompromised or normal immune status). Data were collected by using standardized forms and analysis was done. Results: A total of 64 patients with severe COVID-19 infection were enrolled. Base line characteristics in both groups, Baricitinib group (n =32) and Standard treatment group (n = 32), were comparable. Nearly 53% of patients in Baricitinib group and 59% of patients in Standard treatment group survived; however, mean duration of hospital stay was shorter in Baricitinib group (15.53 ± 6.83 days versus 22.25 ± 11.17 days; p < 0.001). Improvement in oxygen supplementation, radiological changes and changes in inflammatory markers were not different in both groups. Minor side effects like giddiness, appetite loss and insomnia were noted in Baricitinib group. Conclusions: In treating patients with severe COVID-19 infection, the survival rate was not different between Baricitinib group (Baricitinib plus Remdesivir) and Standard treatment group (Remdesivir). In survivors, those in Baricitinib group had shorter duration of hospital stays; quick recovery time and accelerating improvement in clinical status

Efficacy and Safety of Tocilizumab in Severe Covid-19 Infection in Second and Third Wave of Epidemics in Myanmar: Multicenter Randomized Controlled Trial

Background: Coronavirus disease 2019 (COVID-19), emerged in China at the end of 2019, became a major threat to health around the world as it caused significant morbidity and mortality. SARS-CoV-2 infection induces a cytokine storm due to dose-dependent production of IL-6 from bronchial epithelial cells; therefore, Tocilizumab, a monoclonal antibody against the interleukin-6 receptor, is one of the recommended drugs for treatment of COVID-19 infection. It may result in better outcomes in patients with severe Covid-19 infection. The efficacy and timing of Tocilizumab therapy in severe COVID-19 infection in Myanmar was not known clearly. Methods: A hospital based interventional study design (Randomized controlled trial) was conducted in COVID-19 treatment centers in Myanmar -Yangon and Nay Pyi Taw, from February 2020 to August 2021. Supervised treatment was done; and, both clinical and laboratory data were collected by using standardized forms and analysis was done. We conducted a double-blind, randomized, placebo-controlled trial of intravenous Tocilizumab in adults who were hospitalized with severe COVID-19 infection. Patients were randomly assigned to receive either Tocilizumab or placebo for within 5 days. The primary outcome was the time to recovery, defined by either discharge from the hospital or hospitalization for infection-control purposes only. Results: A total of 105 patients (55 in Tocilizumab group and 50 in Standard treatment group) with severe COVID-19 infection were included. Baseline characteristics in Tocilizumab group and Standard treatment group were as follows: (1) mean age 64.4 ± 11.9 years and 59.9 ± 15.8 years; (2) BMI 24.3 ± 3.0 and 23.9 ± 5.0; (3) mean duration of symptom onset to hospital admission was 9.5 ± 4.4 days and 6.5 ± 3.8; (4) mean duration of symptom onset to treatment was 12.8 ± 3.8 days and 7.1 ± 3.8 days; (6) mean duration of hospital stay was 20.1 ± 16.5 days and 11.4 ± 4.8 days; (7) associated co-morbidities was 88% and 70%; and, (8) mean CXR severity score by Braxia was 12.0 ± 2.0 and 9.6 ± 3.4 respectively. The survival rate in early treatment receiving group was 80% in Tocilizumab group and 65.5% in Standard treatment group; that of median treatment receiving group was 40% and 62.5% respectively. The survival rate in late treatment receiving group reduced to 36% in Tocilizumab group; however, no one survived in Standard treatment group. Inflammatory markers (Ferritin, LDH, D dimer and CRP) dropped significantly at 24 hours and 72 hours after Tocilizumab treatment; the difference was noticeable between survivors and non-survivors. Absolute lymphocyte count, liver enzymes (AST and ALT) and procalcitonin levels became normal by 2 weeks. No significant changes were seen in serum creatinine and blood urea level. Both clinical observation and questioning on experienced side effects from patients on recovery revealed that Tocilizumab therapy was tolerable and safe. Conclusions: Tocilizumab treatment was associated with a lower risk of mortality than Standard treatment group among patients with severe COVID-19 infection. The chance of survival was 36% if Tocilizumab treatment was given late- more than 15 days of symptom onset unlike Standard treatment. The significant inflammatory markers which could predict survival within 24 to 72 hours were serum ferritin, LDH, D dimer and CRP. Tocilizumab treatment in severe COVID-19 infection was safe and effective particularly it was given early.

The strong influence of management factors on coccidian infections in smallholder pig farms and the first molecular identification of Cystoisospora suis in Myanmar.

A cross-sectional study was conducted to investigate coccidian infection and associated factors in smallholder pigs, and to identify Cystoisospora oocysts by PCR. A total of 500 pig faecal samples from 330 smallholder farms were collected in Nay Pyi Taw, Myanmar. The faecal flotation method was used to identify Eimeria and Cystoisospora species, and oocyst counts per gram (OPG) of faeces were recorded. Oocysts were differentiated after sporulation. Oocyst DNA was subjected to ITS1-targeted Cystoisospora-specific PCR. The overall coccidian oocyst detection rate by microscopic was 89.0% (445/500). Among the studied samples, 74.0% (370/500) and 70.6% (353/500), were found to be positive with Eimeria spp. and Cystoisospora suis oocysts, respectively. The sequences of C. suis detected were 100% identical to those of C. suis reported from Japan, and had 99.5% resemblance to sequences from Australia and China. Weaner pigs showed the significantly highest (p < 0.05) OPG when compared to other age groups. The highest intensity of coccidian infection (p < 0.05) was found in pigs fed local feed, pigs raised on earthen floors and pigs under poor hygienic conditions. Factors such as age, breed, feed type, and housing floors were found to be significantly associated with coccidian infection (p < 0.05). Age, as well as management factors including floor type, feed type, and hygiene practices on the farm, had a strong influence on the occurrence of coccidian infection in pigs. This is the first study in Myanmar on coccidian infection in pigs and molecular detection of C. suis.

Cancer Incidence and Mortality in Central Myanmar: Report of Nay Pyi Taw Population-Based Cancer Registry.

Background:Cancer is a major public health problem in Myanmar, and cancer registration activities are currently underway through both hospital-based and population-based approaches. So far, there are no population-based cancer incidence and mortality estimates in the country. Methods:According to the 2014 census, the total population of Nay Pyi Taw Union Territory was 1,160,242 within the area of 70,571 km2. Nay Pyi Taw Cancer Registry team collected data of new cancer cases both actively and passively from all data sources in the region. The data were registered, updated, cross-checked, quality-assured, and analyzed in CanReg5. The results were presented as the number of cases by site, sex, and age, cumulative risk (CR), crude rate, age-specific, and age-standardized incidence rates (ASRs) per 100,000. Results:Total 5,952 new cancer cases and 1874 cancer deaths were recorded among the population of the Nay Pyi Taw Union Territory between 2013 and 2017. The age-standardized incidence rate for all cancer sites excluding non-melanoma skin cancers in males was 125.9 and 107.3 for females. For both sexes combined, the most common cancers were lung (14%), breast (11.4%), liver (10.2%), mouth and pharynx (8.5%), and stomach cancers (7.8%). In males, the most common were lung (18.1%), liver (14.8%), mouth and pharynx (13%), stomach (8.9%) and colon, rectum, and anus (7.4%) cancers. In females, these were breast (21.2%), cervix (13.0%), lung (10.3%), stomach (6.9%) and colon, rectum, and anus (6.3%) cancers. The most common cancer deaths were caused by liver (20.8%), lung (15.7%), mouth and pharynx (9.3%), stomach (7.5%), and Colon, rectum, and anus (6.8%) cancers. Conclusion:The findings in this study are salient and have potential to serve as important information for the National Cancer Control Program to formulate prevention and control strategies.

Occurrence of gastrointestinal helminths and the first molecular detection of Ancylostoma ceylanicum, Trichuris trichiura, and Trichuris vulpis in dogs in Myanmar.

Dogs may serve as hosts for a variety of zoonotic or potentially zoonotic helminths, including Ancylostoma ceylanicum and Trichuris species. Cross-sectional study design was used to collect 210 faecal samples of dogs from Nay Pyi Taw area, Myanmar. According to microscopic examination, 180 samples (85.7%) were positive for eight species of gastrointestinal helminths. Among them, positive rates of Ancylostoma species and Trichuris species eggs were observed as 79.0% (166/210) and 11.9% (15/210), respectively. Molecular identification of A. ceylanicum and Trichuris species was confirmed by COX1 gene- and SSU rRNA gene-targeted PCR. Partial sequences of COX1 and SSU rRNA showed 100% identity with A. ceylanicum, Trichuris trichiura, and Trichuris vulpis deposited in GenBank.

Inventory Studies on the Subfamily Pselaphinae (Coleoptera, Staphylinidae) of Myanmar Part 5: A List of Collected Species in Yezin, Nay Pyi Taw in February 2020

Inventory Studies on the Subfamily Pselaphinae (Coleoptera, Staphylinidae) of Myanmar Part 5: A List of Collected Species in Yezin, Nay Pyi Taw in February 2020

Information and communication technology literacy, knowledge and readiness for electronic medical record system adoption among health professionals in a tertiary hospital, Myanmar: A cross-sectional study.

Some developing countries are currently introducing and implementing an electronic medical record system (EMRs) for improvement in healthcare delivery services. Availability of information and communication technology (ICT), technical skillful staff, and strong resistance to change by the health professionals impacted the successful adoption of EMRs. This study aimed to assess the ICT literacy, knowledge, and readiness for EMRs adoption among health professionals in a tertiary hospital, Myanmar. A cross-sectional study was conducted among 118 health professionals involving in a tertiary hospital at Nay Pyi Taw, Myanmar from February to April 2020 using a stratified sampling method. The data were collected through face-to-face interviews using a pretested structured questionnaire after getting informed consent. Data were analyzed by using SPSS version 23.0. Chi-square test, Fisher’s exact test, and logistic regression analysis were performed to assess the associated factors of ICT literacy, knowledge, and overall readiness for EMRs adoption. The prevalence of high ICT literacy and knowledge on EMRs among health professionals were 20.3% and 24.6% respectively. The factors associated with ICT literacy were professional, education, duration of service, and reported English language skills. Duration of service was associated with knowledge on EMRs. The overall readiness was 54.2% (core readiness 59.3% and engagement readiness 61.9%), and postgraduate [Adjusted Odds Ratio (AOR): 7.32, 95% Confidence Interval (CI): 2.26–23.68] and knowledge on EMRs (AOR: 1.27, 95% CI: 1.13–1.43) were the factors associated with overall readiness for EMRs adoption. Expanding infrastructure and provision of ICT development training are crucial for the improvement of ICT literacy. EMRs training program enabling hands-on experience should be implemented for improvement of knowledge on EMRs. In general, the overall readiness for EMRs adoption was found to be moderate. Enhancing the establishment of comprehensive on-the-job training and contextualization of curriculum in EMRs training program are recommended to improve the health professionals’ readiness for EMRs adoption.

The first seroepidemiological study on Toxoplasma gondii in backyard pigs in Myanmar

A cross-sectional study of Toxoplasma gondii infection in pigs was carried out in backyard farms in three townships, within Nay Pyi Taw area from June 2014 to August 2014. Blood samples were randomly collected from 256 pigs in 129 farms. Using commercial Latex Agglutination Test kits, specific antibodies to T. gondii were analyzed. Based on LAT results, among 256 serum samples examined, 47 samples (18.4%) were found positive to T. gondii. The numbers of samples showing specific antibody titres from 47 positive pig sera were 20 at 1:64, 2 samples at 1:128, 9 samples at 1:256, 3 samples at 1:512 and 13 samples at 1:1024. Among the hypothesized risk factors, roaming of cats around the farm was found associated to T. gondii seropositivity in pigs (OR = 3.13; 95% CI = 1.33–7.34). This study provides information on seroepidemiology study of T. gondii in backyard pigs for the first time in Myanmar. This information will be useful in developing strategies for the control of T. gondii infection in pigs.

Prevalence and risk factors of anxiety and depression among the community-dwelling elderly in Nay Pyi Taw Union Territory, Myanmar

Providing elderly mental healthcare in Myanmar is challenging due to the growing elderly population and limited health resources. To understand common mental health problems among Myanmar elderly, this study explored the prevalence and risk factors of anxiety and depression among the elderly in the Nay Pyi Taw Union Territory, Myanmar. A cross-sectional study was conducted among 655 elderly by face-to-face interviews with a pretested questionnaire. Descriptive analysis and multiple logistic regression analyses were performed. The prevalence of anxiety and depression were 39.4% (33.5% for males and 42.4% for females) and 35.6% (33.0% for males and 36.9% for females), respectively. The adjusted odds ratio of having anxiety was significant for having low education level, having comorbidity, having BMI < 21.3, poor dental health, no social participation, and having no one to consult regarding personal problems, while that of having depression was significant for having comorbidity, having BMI < 21.3, poor vision, and having no one to consult regarding personal problems. The reported prevalence of anxiety and depression indicate the demand for mental healthcare services among Myanmar elderly. Myanmar needs to improve its elderly care, mental healthcare, and social security system to reflect the actual needs of its increasing elderly population. Screening for anxiety and depression among elderly with comorbidities should be promoted. Raising community awareness of mental health, encouraging social participation, and supportive counselling are also essential in combating anxiety and depression among Myanmar elderly.

Molecular Prevalence and Identification of Ehrlichia canis and Anaplasma platys from Dogs in Nay Pyi Taw Area, Myanmar.

Ticks are vectors of different types of viruses, protozoans, and other microorganisms, which include Gram-negative prokaryotes of the genera Rickettsiales, Ehrlichia, Anaplasma, and Borrelia. Canine monocytic ehrlichiosis caused by Ehrlichia canis and canine cyclic thrombocytopenia caused by Anaplasma platys are of veterinary importance worldwide. In Myanmar, there is limited information concerning tick-borne pathogens, Ehrlichia and Anaplasma spp., as well as genetic characterization of these species. We performed nested PCR for the gltA gene of the genus Ehrlichia spp. and the 16S rRNA gene of the genus Anaplasma spp. with blood samples from 400 apparently healthy dogs in Nay Pyi Taw area. These amplicon sequences were compared with other sequences from GenBank. Among the 400 blood samples from dogs, 3 (0.75%) were positive for E. canis and 1 (0.25%) was positive for A. platys. The partial sequences of the E. canis gltA and A. platys 16SrRNA genes obtained were highly similar to E. canis and A. platys isolated from different other countries.

EFFECT OF DIFFERENT GROWING SEASONS ON CORRELATION AND PATH COEFFICIENTS OFYIELD AND YIELD COMPONENTS IN MAIZE (ZEAMAYS L.)

Path analysis depicted the strength of association of all independent variables under study on the grain yield. Thus, the study aimed at examining changes in associations and path analysis of yield related traits to yield in post-monsoon and monsoon season. A total of 14 maizegenotypes were evaluated in two growing seasons at the Maize and other Cereal Crops Research Section, Department of Agricultural Research (DAR), Yezin, Nay Pyi Taw, Myanmar. Genotypic correlation and path coefficient analyses were carried out to examine the relationship among the traits under both environments. Yield was positively correlated with ear length, row length, ear diameter, rows per ear, kernels per row, shelling percent and 1000 seed weight but had a negative correlation with days to tasseling and days to silking in both growing seasons with different magnitudes. These traits can be used as the main criteria for grain yield improvement of maize yield in the respective growing seasons. Some traits showed similar direct effects in both growing seasons, however,the link between direct and indirect effects on grain yield depends on respective growing season.

Source-sink Relationship and Their Influence on Yield Performance of YAU Promising Rice Lines

Fifty YAU promising rice genotypes were used to evaluate source-sink relationship and yield performance in 2017 dry season. The experiment was conducted in the experimental field of Yezin Agricultural University, Nay Pyi Taw, Myanmar. The spacing was 20 cm between row and 20 cm between plants in a randomized complete block design with three replications. The data on physiological traits, yield and yield component traits were collected and analyzed by using STAR and R program. Growth duration1 is positively and significantly correlated with the number of grains panicle-1, filled grains percentage, grain yield, panicle weight, dry weight at heading and harvesting, straw weight and LAI at harvesting, and increase of dry weight from heading to harvesting. Significant positive correlation was found between growth duration2 and decrease of LAI from heading to harvesting indicating that these traits are strongly influenced by source before heading. Significant correlations between yield and physiological and yield component traits were observed except LAI at harvesting and 1000-grain weight. Therefore, yield variation among YAU promising rice lines is more related with source size than with sink size. Decrease of LAI from heading to harvesting and dry weight at maturity exhibited positive direct effect on 1000-grain weight, filled grains percentage and grain number m-2 meaning the relative contribution of source components to the sink. The contribution of the decrease of LAI from heading to harvesting to the grain yield was much higher than that of number of grains, panicle weight and 1000-grain weight. This research finding will be useful for the plant breeder to consider the improvement of yield supporting traits in the breeding program.

Estimation of the Recyclable Waste amount Collected by Informal Recycling Shops: Case Study in Nay Pyi Taw, Myanmar

The study investigates and estimates the type and amount of recyclable waste collected by informal recycling shops in Nay Pyi Taw by using face to face interview for 23 informal recycling shops in Nay Pyi Taw in May 2020. The descriptive statistics (frequency and percentage) and inferential statistics (two-sample paired t-test and Pearson’s correlation) were applied. According to the results, the average estimated waste amount collected by each recycling shop per day before and during the novel coronavirus (COVID-19) pandemic was 1,798 kg (Min. 0 to Max. 1,401 kg) and 856 kg (Min. 0 to Max. 892 kg), respectively. As a result of this study, it can be seen that the amount of daily collected waste has a positive relationship with the daily income of recycling shops, and COVID-19 has impacted the income of informal recycling shops. According to the results, getting an official license, financial problems, and limited land for managing buying recyclable waste, unstable market conditions, no factory in Nay Pyi Taw and no definitive legislation or laws, seasonal changes are the main challenges for informal recycling shops. This study indicates the ways to mainstream the informal sectors in waste management schemes. In addition, the results of this study can be useful in developing national and regional waste management plans and programs.

Genetic diversity of Mycobacterium tuberculosis using 24-locus MIRU-VNTR typing and Spoligotyping in Upper Myanmar

MIRU-VNTR typing and Spoligotyping are the useful molecular tools for TB epidemiology study. Information regarding genetic diversity and tuberculosis (TB) transmission in Upper Myanmar only is scares. We determined the genetic diversity of Mycobacterium tuberculosis (Mtb) and TB transmission from Upper Myanmar TB Reference Laboratory, Mandalay Region, including Mandalay (72), Shan (22), Magway (15), Sagaing (13), Nay Pyi Taw (8), Kachin (7), Chin (2) and Kayah (1). One hundred and forty Mtb isolates were genotyped using 24-locus MIRU-VNTR typing and spoligotyping. Lineage classification and TB transmission analysis were performed. 24-locus MIRU-VNTR typing identified 135 unique profiles and two clusters compared to 35 spoligotyping profiles which contained 12 clusters and 23 unique isolates, Beijing (n=100, 71.4%) was found to be prominent lineage by combine two methods. The expected proportion attributable to recent transmission based on clustering rate was 2.1%. One cluster case was more likely to be in MDR patient. Our findings showed Beijing genotypes were dominant in Upper Myanmar. The usage and analysis of 24-locus MIRU-VNTR typing might prove useful for our broader understanding of TB outbreaks and epidemiology than spoligotyping. The genotypic pattern of this combined method suggests that the lower transmission rate may be due to a higher possibility of reactivation cases in Upper Myanmar.

Farmers’ attitude to the effectiveness of ICTs Use in their Farming, Nay Pyi Taw, Myanmar

This study focused on farmers’ attitudes to the effectiveness of ICTs in their farming and farmers’ challenges in accessing it. Extension workers of the respective Townships identified the 144 sample farmers, and the data was collected through interviews using questionnaires during 2019. There were frequency means and a dichotomous scale used to analyze the ICT attitude pattern among farmers and a 5-point Likert scale with the options.&#x0D; This study explored the personal factors of ICT accessed farmers who are significantly getting young and middle age, high school, and graduate-level education and a moderate working experience compared with ICTs non- access farmers. 110 out of 144 farmers frequently used and accessed ICTs such as Radio, FM radio, TV, Facebook, Phone, and Agricultural Journals to obtain the agricultural information, but 34 farmers could not access ICTs due to the high cost, other social factors, and low ICT exposure. Most of the farmers received agricultural information from related Departments and Organizations traditionally, such as training, meeting, demonstration, trials, and conferences. More than half of the farmers were positively consistent agricultural information with their needs, but the rest did not meet their needs. Most farmers believed highly positive to agricultural information. However, some farmers responded negatively to agricultural details because they seem commonly knowledgeable information. Farmers mentioned in this study that more than half of farmers positively showed that attitude on high true and true regarding agricultural information.&#x0D; Moreover, farmers encountered insufficient electricity, challenging ICT exposure, low trust, and social problems. And also, farmers commonly faced challenges as high cost for ICT usage, high price for ICTs tools, and poor ICT service. Besides, farmers’ other challenges were poor connectivity, inadequate support for the mother service provider, failure to attend the training, complexity to operate, and badly wanted news. Finally, this study recommended that farmers use effective utilization of ICTs in their farming in Nay Pyi Taw area that has the potential to make the rural communities prosperous as it enables the dissemination of required information in user-friendly patterns, easy to access, cost-effective ways at the right time with relevant information and training to be a skill.

Distribution of Pigeon Pea Cyst Nematode and Root-Knot Nematodes in Major Sesame Growing Areas in Myanmar

The pigeon pea cyst nematode, Heterodera cajani, is an economically important plant-parasitic nematode in sesame production. The objective of the study was to investigate distribution of H. cajani in the major sesame producing areas in Myanmar. Before cultivation, soil samples were collected in 96 local farmer’s fields: (19 fields in Magway, 20 fields in Mandalay, 14 fields in Sagaing and 43 in Nay Pyi Taw), and nematode density was quantified by real-time PCR. The cyst nematode was detected in 63.2% of the fields in Magway and the mean density was 22.6 eggs equivalent (20 g soil)−1. In Mandalay and Nay Pyi Taw, the cyst nematode was detected in 40.0% and 18.6% of the fields with the mean densities of 9.9 and 21.0 eggs equivalent (20 g soil)−1, respectively. By contrast, the cyst nematode was not detected in Sagaing fields, in which sesame is rotated with paddy rice. Infestation of root-knot nematodes (RKN, Meloidogyne spp.) was also evaluated, because sesame is generally rotated with rice and pulses, which are attacked by RKN. The results showed 25.6% infestation of RKN with a mean density of 34.3 eggs equivalent (20 g soil)−1 only in Nay Pyi Taw, while there was no infestation in Magway, Mandalay, and Sagaing. The relationships between the nematode infestation level and the cropping patterns in each sesame growing area in Myanmar were discussed.

Distribution of hepatitis B virus genotypes in the general population of Myanmar via nationwide study

BackgroundHepatitis B virus (HBV) infections are a severe health concern worldwide. HBV is a DNA virus with a rapid rate of mutation. Based on heterogeneity of the nucleotide sequence, the HBV strains are divided into nine genotypes, each with a characteristic geographical distribution. Identifying and tracking alterations of HBV genotypes is important in epidemiological and transmission studies, and contributes to predicting the risk for development of severe liver disease and response to antiviral treatment. The present study was undertaken to detect HBV genotypes and sub-genotypes in the general population of different states and regions in Myanmar.MethodsIn 2015, a total of 5547 adults of the general population, residing in seven states, seven regions and the Nay Pyi Taw Union Territory, were screened for Hepatitis B Surface antigen (HBsAg) by the immunochromatographic test (ICT). Of the 353 HBsAg positive samples, the HBVDNA was identified using polymerase chain reactions (PCR) targeting the DNA sequences encoding the Pre-S region. A total of 153 PCR positive samples were subsequently subjected to genotyping by partial genome sequencing in both directions. The resulting sequences were then edited, aligned, and compared with reference sequences using the National Centre for Biotechnology Information (NCBI) web-based genotyping tool.ResultsThree HBV genotypes (HBV genotype B, genotype C and genotype D) were detected in Myanmar, of which genotype HBV genotype C (66.7%) was the most prevalent, followed by HBV genotype D (32%) and HBV genotype B (1.3%). Sub-genotyping revealed a total of 7 variants within the B, C and D genotypes: 2 (B4 and B5) in HBV genotype B, 3 (C1, C5 and C7) in HBV genotype C, and 2 (D3 and D6) in HBV genotype D.ConclusionHBV genotype C, sub-genotype C1 was predominantly distributed in all states and regions of Myanmar. This study is the first report on the nationwide distribution of HBV genotypes and sub-genotypes in Myanmar. We believe our findings will enable huge support for the hepatitis disease surveillance program, since HBV infection is one of the National Priority Diseases in Myanmar.

Cooking fuels use and carotid intima-media thickness during early pregnancy of women in Myanmar

BackgroundFuels burned in households for cooking cause indoor air pollution, exposing those who are cooking. Despite the mounting evidence of the effects of fuels use on health, few studies focus on the effect of cooking fuels have on carotid intima-media thickness (CIMT), a surrogate atherosclerosis biomarker in the early stages of pregnancy. This study aimed to examine the association between the use of cooking fuels and CIMT during early trimester of pregnancy among cooking women in Myanmar.MethodologyIn this cross-sectional study, a part of an ongoing birth cohort analysis, a total of 192 cooking pregnant women over 18 years with gestational weeks less than 18 were recruited from 15 rural health centers in Nay Pyi Taw from September to November 2019. Sociodemographic data, residential data, and fuels use data were collected with semi-structured questionnaires in face-to-face interviews. Anthropometric, hemodynamic, blood lipids, and ultrasound CIMT measurements were performed under standard protocols. Multiple linear regression was modeled to explore associations.ResultsThe study included 70 firewood fuel users, 26 charcoal fuel users, and 96 electricity fuel users. Following adjustments for potential confounding factors, firewood use was significantly associated with the increase of all CIMT analyzed. Importantly, a greater increase of mean CIMT of the right common carotid artery (RCCA; β = 0.033 mm; 95%CI: 0.006, 0.058; P<0.05) had significant association with charcoal use compared to firewood use (β = 0.029 mm; 95%CI: 0.010, 0.049; P<0.05).ConclusionsOur findings demonstrate that the indoor use of cooking fuels that cause indoor air pollution, such as firewood and charcoal, is a considerable risk factor for human health and is associated with increased CIMT, wherein charcoal use contributes to more increase of mean CIMT of the RCCA. Measures to prevent health risks related to the use of such fuels should be instituted early on during pregnancy.

Cognitive impairment and its risk factors among Myanmar elderly using the Revised Hasegawa's Dementia Scale: A cross-sectional study in Nay Pyi Taw, Myanmar.

Globally, elderly population with impaired cognitive function, such as dementia, has been accelerating, and Myanmar is no exception. However, cognitive function among elderly in Myanmar has rarely been assessed. This study aimed to identify the rate of cognitive impairment and its risk factors among the elderly in Myanmar. This cross-sectional study was conducted at rural health centers in Nay Pyi Taw Union Territory, Myanmar, from December 2018 to January 2019. In total, 757 elderly individuals aged 60 years or over (males: 246 [32.5%], females: 511 [67.5%]) were interviewed using a face-to-face method with a pre-tested questionnaire. Descriptive statistics and multivariable logistic regression analyses were performed. The rate of impaired cognitive function among participants was 29.9% (males: 23.6%; females: 32.9%). The following participants were more likely to present cognitive impairment: those aged 70-79 years (adjusted odds ratio [AOR] = 1.8; 95% confidence interval [CI]: 1.19-2.70) and 80 years or older (AOR = 3.9; 95% CI: 2.25-6.76); those who were illiterate (AOR = 9.1; 95% CI: 3.82-21.51); and those dependent on family members (AOR = 1.6; 95% CI: 1.04-2.44). The elderly livening with their families and those who reported having good health (AOR = 0.7; 95% CI: 0.44-0.99) were less likely to have cognitive impairment. Using the HDS-R Myanmar version, this study reported that there out of five elderly participants had cognitive impairment, and its risk factors, altering policy makers that Myanmar needs to prepare for adequate healthcare services and social support for elderly with cognitive impairment. Future research should be performed not only to detect general cognitive impairment but also to differentiate specific cognitive domains impairments among Myanmar elderly. Longitudinal studies are needed to observe the causal and protective factors associated with cognitive impairments in Myanmar.

Comparison of Latent Tuberculosis Infections among General versus Tuberculosis Health Care Workers in Myanmar

Health care workers (HCWs) in high tuberculosis (TB) prevalence countries have to care for many cases, thus increasing their risk of infection. The objective of the study was to compare the prevalence of latent TB infection (LTBI) between general HCWs and TB HCWs, and also to explore the associated factors. A cross-sectional study was conducted in Nay Pyi Taw, Myanmar from September 2019 to January 2020. Staff working at two general hospitals were recruited. Those allocated for TB care were classified as TB HCWs, while the remaining were classified as general HCWs. Participants were interviewed using a structured questionnaire, and screened for LTBI using a tuberculin skin test (TST). Individuals who had an induration of 10 mm or more with normal chest radiograph were regarded as having LTBI. The prevalence of LTBI among general HCWs was 2.04 times higher than that of TB HCWs (31.2% vs. 15.3%, p < 0.001). The associated factors for LTBI included low education level, duration of work experience ≥ 10 years, a low knowledge of regular TB screening, and teaching cough etiquette to TB patients. The higher prevalence of LTBI in the general HCWs in this study was due to confounding by education and experience. After adjustment for these, we have no evidence to support that either group of HCWs had higher LTBI risk.