South Asian Research Articles

Implications for developing global health education in China: evidence from an undergraduate teamwork with role-play

BackgroundSince 2012, China has had one degreed undergraduate programme in global health for domestic students. The International Health Project Management course is a core component of this programme’s curriculum, bridging...

Endogamy and high prevalence of deleterious mutations in India: evidence from strong founder events.

Founder events influence recessive diseases in highly endogamous populations. Several Indian populations have experienced significant founder events due to strict endogamy. However, the clinical implications of it remain underexplored. Therefore, we perform whole-exome sequencing of 281 individuals from four South Indian populations, characterized by high IBD scores. Our study reveals a high inbreeding rate of 59% across the populations. We identify ∼29.2% of the variants that are exclusively present in a single population and uncovered 1284 unreported exonic variants, underscoring the underrepresentation of Indian populations in global databases. Among these, 23 are predicted to be deleterious, all present in heterozygous state may be pathogenic when homozygous, an expected phenomenon in endogamous populations. Approximately 16%-33% of the identified pathogenic variants showed significantly higher occurrence rates compared to the South Asian populations from 1000 Genomes dataset. Pharmacogenomic analysis revealed distinct allele frequencies of variants in CYP450 and non-CYP450 genes, highlighting heterogeneous drug responses and associated risks. We report a high prevalence of ankylosing spondylitis in Reddy population, linked to HLA-B*27:04 allele and strong founder effect. Our findings highlight the need for extensive genomic research in understudied Indian populations for better understanding of disease risk and evolving strategies for precision and preventive medicine.

Oral health disorders among visually impaired children in South Asian countries: a systematic review

Oral health disorders among visually impaired children in South Asian countries: a systematic review

East and South Asian-Specific Blood Pressure Trajectories and Cardiovascular Disease.

Cardiovascular disease (CVD) risk differs across Asian subgroups, possibly due to differences in hypertension burden. We characterized lifetime blood pressure (BP) trajectories for East and South Asian individuals and compared their associations with CVD risk. Among 148 872 UK Biobank participants with primary care utilization data, life course BP trajectories were fitted as a function of age by sex according to self-identified ethnicity. We determined associations of time-averaged young adulthood (18-39 years), middle age (40-64 years), and later life (≥65 years) systolic BP (SBP) and diastolic BP with incident atherosclerotic CVD risk. The predicted SBP/diastolic BP (95% CI) at age 30 years was 108 (103-114)/68 (65-71) mm Hg for East Asian and 114 (110-118)/72 (71-73) mm Hg for South Asian individuals. By age 40, South Asian individuals were projected to reach an SBP of 130.0 mm Hg, whereas East Asian individuals reached the equivalent SBP by age 49 years. Among South Asian individuals, each SD increase in young adulthood SBP was associated with a higher atherosclerotic CVD risk with an odds ratio (95% CI) of 1.41 (1.12-1.75), but not among East Asians (Pinteraction=0.01). Midlife SBP was associated with peripheral artery disease among South Asian individuals (odds ratio, 2.08 [95% CI, 1.51-2.88]) and with ischemic stroke among East Asian individuals (odds ratio, 3.84 [95% CI, 1.08-5.07]). Later-life SBP was associated with myocardial infarction risk by 1.52 (1.15-1.92)-fold among South Asians and ischemic stroke by 2.50 (1.06-3.80)-fold among East Asian individuals. East and South Asian individuals exhibit distinct BP trajectories that age-differentially associate with incident CVD. Disaggregating Asian subgroups may inform tailored hypertension screening and management.

Determinants of Undernutrition and Overweight among Women (19–45 Years): A Cross-sectional Study of Some South Asian Developing Countries

Determinants of Undernutrition and Overweight among Women (19–45 Years): A Cross-sectional Study of Some South Asian Developing Countries

Application to achievement: association between pre-admission factors, admission scores, and medical students’ performance

BackgroundStudents have long been admitted into medical colleges using standardized tests/interviews. However, limited evidence exists on their association with academic achievement during medical education. Moreover, the relationship between its individual components and subsequent academic achievement remains unexplored. This study aims to determine the association between medical students’ demographics and admission scores with their academic performance during medical college.MethodsThis cross-sectional study was conducted in 2023 at one of the oldest private medical colleges in a South Asian low- and middle-income country, where data for medical students graduating with a Bachelor of Medicine, Bachelor of Surgery (MBBS) degree in 2018–2022 were retrieved electronically. Through an extreme groups approach (EGA) sampling, factors leading to students falling within the top 20% scorers in preclinical, clinical, procedural, and non-procedural clerkships were identified. Binary logistic regression models assessed the association between demographics and admission scores with their academic performance in medical college.ResultsFrom data of 418 students, EGA sampling included a total of 168 and 169 students for comparison between the top and bottom 20% scorers in preclinical and clinical rotations, respectively. Female sex (adjusted OR:4.10, 95% CI:1.94,8.65) and higher biology, physics, and mathematical reasoning scores on the university’s admission test independently predicted preclinical academic achievement. Female sex and higher mathematical reasoning scores significantly predicted academic achievement in clinical, procedural, and non-procedural clerkships. Higher biology scores also independently predicted achievement in non-procedural clerkships (adjusted OR:1.03, CI:1.01,1.06). Prior schooling from the British education system was significantly associated with higher mean percentage for admission scores and clinical clerkships for applicants compared to the local education system.ConclusionHigher scores on medical college admission tests can predict medical students’ academic achievement during undergraduate studies. Understanding the specific test components associated with students’ success can refine the selection process, ultimately fostering efficient healthcare professionals.

Why do some informal settlements fare better than others? A mixed-methods analysis of water and sanitation inequities across informal settlements

Abstract Over a hundred million people in South Asian cities live in informal settlements. The administrative and socio-economic contexts in which these informal settlements emerge exhibit significant heterogeneity, influencing their access to water and sanitation. Using a mixed methods approach, this investigation compares variations in, and determinants of, access to water and sanitation services across informal settlements in Karachi, Pakistan. Quantitative surveys of four hundred households highlight significant inequities in water and sanitation services across informal settlements. These include limited access to piped water, water use that is much lower than the minimum needed to sustain human life, high incidence of waterborne disease, and significant resulting healthcare expenses. Key stakeholder interviews reveal that while legal recognition (i.e., regularization) can help settlements connect to the city’s water and sanitation network, policy and legislative changes have failed to ensure public utility service provision in newly regularized settlements meaning that residents are responsible for developing their own internal infrastructure. Settlements that receive non-governmental support from intermediaries during regularization feature better water and sanitation services as do older informal settlements that have accumulated greater financial and social capital. These findings underscore the importance of addressing service provision as part of the regularization process for Karachi’s informal settlements and emphasize the need for a more granular understanding of differences in water and sanitation service access across South Asian informal settlements.

Rural Migration and Income Inequality in South Asian Countries: An Econometric Descriptive Analysis

The United Nations projects that by 2050, over 64% of Asian regions would be urban. Moreover, during the last few decades, several nations and regions have seen a rise in economic disparity owing to migration. Others find a non-linear link between rural migration and income disparity and dependent on the level of growth. In this way, to find the extent of inequality in the developing countries, South Asian nations continue to be understudied. This article used a balanced panel dataset for eight South Asian nations from 1995 to 2022 to explore the correlation between rural migration and income inequality to determine the amount of inequality. The panel supports Kuznets' inverted-U hypothesis by showing a negative link between growth and income inequality. Additionally, econometric results display a negative relationship between income inequality and rural migration in all three models. Therefore, policy makers should focus on the public policy should prioritize to providing educational opportunities, health care, and other social amenities in rural communities.

Ichthyoarchaeological perspectives on roles of fish and red meat during Indus Civilization in Gujarat, India

The roles of animals during the Indus Civilization (circa 4000 BCE to 1300 BCE), which thrived in South Asia, have been extensively studied by zooarchaeologists. While significant progress has been made in understanding the domestication and hunting of mammals, information on the use of aquatic organisms such as fish, mollusks, and crustaceans has been relatively sparse. Excavations at Indus Civilization sites have uncovered substantial quantities of fish remains, potentially providing valuable insights. In South Asia, the study of fish remains has often been neglected, primarily due to the lack of comprehensive reference collections for comparison. This paper discusses the current state and future possibilities of South Asian ichthyoarchaeology, highlighting the results of ichthyoarchaeological investigations in the Gujarat region of India. Analysis of fishbone assemblages from Indus sites such as Bagasra, Kanmer, Shikarpur, Kotada Bhadli, and Navinal in Gujarat has identified 24 fish species from 14 families. Evidence of anthropogenic activities such as cut marks, charring, and chewing on the bones suggests various aspects of fish consumption. These analyses reveal information about the diversity of fish species used, fishing environments, changes in fish consumption across different cultural phases, spatial distribution of fish remains within the sites, and fish processing patterns. The ichthyoarchaeological data aligns with cultural changes inferred from archaeobotanical and non-fish faunal records from these sites. This paper offers insights into a more nuanced role of fish in the diet, tailored to the tastes and preferences of consumers, rather than being a secondary or incidental food source, alongside mammalian meat during the Harappan Civilization in the Gujarat region.

The hidden crisis: double burden of malnutrition among refugee children in South Asia – a systematic review and meta-analysis from observational studies

BackgroundChildren living in refugee camps in South Asian countries suffer from undernutrition. However, the emerging prevalence of double burden of malnutrition could potentially cause a crisis in the healthcare of the refugee population. Double burden increases the risk for co-morbidities, poor functional health, and increased risk for premature death among these children. The study aims to assess the prevalence of malnutrition among refugee children in South Asia.MethodsThis systematic review and meta-analysis followed the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines using CoCoPop mnemonic approach. We searched JSTOR, Scopus, PubMed, Web of Science, and MEDLINE databases for studies on the prevalence of malnutrition in refugee children from 1984 to August 2024 with restricted English language. The screening of research articles was undertaken using COVIDENCE 2.0 software. The JBI checklist was used to assess the methodological quality of the included articles. The meta analysis was carried out using MedCalc 22.018 software. The gray literature was manually searched from the reputed organizations focusing on refugee children and was narratively analyzed for malnutrition statistics. Furthermore, the corroboration of primary research articles and gray literature was conducted for comprehensive understanding.ResultsThe review included 10 full-text research articles, all with cross-sectional study design and 11 gray literatures. The 10 studies covered a total of 4,274 participants with 3,536 urban and 738 rural refugee children aged between 0 and 19 years [refugee children (n = 8) and refugee adolescents (n = 2)]. The sample size of the included studies varied between 58 and 1,087 and mostly from Bangladesh. The prevalence of stunting ranged from 3.9–75.4% in the included studies [pooled prevalence: 31.8% (95% CI: 18.6–46.6%)]; wasting between 0.3–24.3% [pooled prevalence:10.1% (95% CI: 4.6–17.3)]; underweight between 4.4–65% [pooled prevalence: 19.1% (95% CI: 10.8–29.2%)]; and overweight between 3 and 24% [pooled prevalence: 6.5% (95% CI: 2.6–12.1%)]. Time trend analysis of the prevalence of malnutrition showed a decreasing trend in underweight, an increasing trend for stunting and wasting, and overweight including a rising prevalence of dual burden of under-and overnutrition.DiscussionThe study indicates a high prevalence of undernutrition and a rising prevalence of overnutrition -the Asian paradox of the double burden of malnutrition in refugee children living in South Asia. The coexisting double burden of malnutrition among refugee children calls for comprehensive programs and policies for the prevention and management of the double burden of malnutrition.

China's Foreign Direct Investment (FDI) in the Development of South Asian Countries

This research paper survey the impact of China’s Foreign Direct Investment (FDI) on the development and growth of South Asian countries with its own government. South Asia, that contains Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka, has noticed a significant rush of China’s Foreign Direct Investment (FDI) in recent years. China’s FDI in the domain has happened generally condensed on framework advancement, energy, and transport projects, proposed at boosting economic growth and territorial integration. The paper resolves the magnitude on which China’s FDI has donated to the economic growth of South Asian countries with its own government, stress particular projects and actions undertaken in each country. China’s FDI in South Asia has happened stable, accompanying investments in distinctions projects such as the China Pakistan Economic Corridor (CPEC), the Bangladesh-China-India-Myanmar (BCIM) Economic Corridor, the Nepal-China Railway Project, and the Sri Lanka-China Hambantota Port Project, with others. In India, China has provided in distinction territories, consisting of technology and renewable energy. In Afghanistan, China has adopted in excavating and energy projects. In Bhutan, China has established in hydropower projects. In Maldives, China has established in touristry and framework advancement. (Asian Development Bank, 2020)The paper decides that China’s FDI has had a certain impact on the economic growth of South Asian countries with its own government, advancing economic growth, generating employment opportunities, and developing territorial integration. However, the paper further highlights the need for South Asian countries with its own government to be guarded and guarantee that China’s FDI is aligned with their national interests and happening preferences.

Impact of EU’s carbon border tax on South Asian trade partners

Impact of EU’s carbon border tax on South Asian trade partners

South Asian Climate Transnationalism: Beyond Diasporic Humanitarianism

South Asia is currently on the front line of the global climate emergency, with the region experiencing increasing, devastating crises resulting from climate change and ‘climate coloniality’ (Sultana, 2022). This article, drawing upon original qualitative research, explores the relationship between the South Asian diaspora and climate action within South Asia. We introduce and chart the nature and dynamics of contemporary South Asian climate transnationalism and suggest that this significant contemporary phenomenon has been hitherto unrecognised within South Asian migration, diaspora and transnational studies. It is further argued that concepts utilised within the existing literature on the diaspora-climate action nexus, such as ‘diaspora humanitarianism’ and ‘intensive transnationalism’, do not adequately capture the nature, significance, diversity, scale and ever-presence of contemporary South Asian transnational diasporic climate action in the face of the unending plethora of crises precipitated by climate change. We also contend that while South Asian religions do play a significant role in motivating some of the ever-present diasporic climate action studied, much of this activity is also guided by environmental rationalities, and articulations of climate coloniality and climate justice, which both cut across and exist independently of South Asian religious beliefs and attachments.

The social cost of student food insecurity at an Atlantic Canadian university: exploring the relationship between social support and psychological distress

ABSTRACT With escalating living expenses and tuition fees, food insescurity continues to moderate university student well-being and academic success. In the postsecondary food security literature, studies assessing distinctions among social support subtypes and how they might interact with mental health are absent. Therefore, the primary objectives of the current study were to characterise students classified as food insecure at an Atlantic Canadian university, compare their social support subtype and psychological distress levels with students classified as food secure, and determine whether/how these subtypes predict psychological distress. Using data from the 2023 National College Health Assessment (NCHA-III) survey (n = 1694), 46.6% were deemed food insecure based on the USDA ERS Food Security scale. A series of two-factor chi-square tests revealed that students classified as food insecure were more likely to be male, undergraduate, international, identify as Black or South Asian, and report lower family incomes and poorer grade point averages (GPAs). These students were also less likely to report campus belongingness, reciprocity, and wellness advocacy. Subsequent t-tests revealed that students classified as food insecure scored lower on each Social Provisions Scale subtype (‘attachment’, ‘guidance’, ‘reliable alliance’, ‘social integration’, and ‘reassurance of worth’), and higher in psychological distress. A hierarchical regression analysis revealed ‘reassurance of worth’ to be the lone, significant support subtype predicting lower psychological distress for students classified as food insecure, a finding which suggests that having one’s self-worth validated, affirmed, and fostered by others may help moderate psychological distress, perhaps by counteracting stigma and shame. The implications of this finding are considered.

Hybrid Machine Learning and Deep Learning Approaches for Insult Detection in Roman Urdu Text

Thisstudy introduces a new model for detecting insults in Roman Urdu, filling an important gap in natural language processing (NLP) for low-resource languages. The transliterated nature of Roman Urdu also poses specific challenges from a computational linguistics perspective, including non-standardized grammar, variation in spellings for the same word, and high levels of code-mixing with English, which together make automated insult detection for Roman Urdu a highly complex problem. To address these problems, we created a large-scale dataset with 46,045 labeled comments from social media websites such as Twitter, Facebook, and YouTube. This is the first dataset for insult detection for Roman Urdu that was created and annotated with insulting and non-insulting content. Advanced preprocessing methods such as text cleaning, text normalization, and tokenization are used in the study, as well as feature extraction using TF–IDF through unigram (Uni), bigram (Bi), trigram (Tri), and their unions: Uni+Bi+Trigram. We compared ten machine learning algorithms (logistic regression, support vector machines, random forest, gradient boosting, AdaBoost, and XGBoost) and three deep learning topologies (CNN, LSTM, and Bi-LSTM). Different models were compared, and ensemble ones were proven to give the highest F1-scores, reaching 97.79%, 97.78%, and 95.25%, respectively, for AdaBoost, decision tree, TF–IDF, and Uni+Bi+Trigram configurations. Deeper learning models also performed on par, with CNN achieving an F1-score of 97.01%. Overall, the results highlight the utility of n-gram features and the combination of robust classifiers in detecting insults. This study makes strides in improving NLP for Roman Urdu, yet further research has established the foundation of pre-trained transformers and hybrid approaches; this could overcome existing systems and platform limitations. This study has conscious implications, mainly on the construction of automated moderation tools to achieve safer online spaces, especially for South Asian social media websites.

Cohort prevalence of young-onset type 2 diabetes in South Asia: A systematic review.

The prevalence of young onset (≤30years) type 2 diabetes (T2D) is increasing in South Asians, reflecting rise in childhood obesity. This systematic review analyses current data on thecohort prevalence of young onset T2D in South Asians. PubMed, Scopus,Science Direct,and Ebscohost were searched for articles published between 1990 and 2024, anda manual search identified additional articles. This study included case series, cross-sectional, retrospective cohort, or case reports. Out of 5073 studies, 26 eligible studies were found including three case reports. Seventeen studies were from India, five werefrom other South Asian countries (Pakistan, Bangladesh, Nepal, Maldives), and nine were on migrant South Asians residing in different countries (UK,USA,Qatar, Canada). The cohort prevalence of young onset T2D in South Asians ranged from 0.1% to 28.3% (India 0.4 to 26.8%, other SA countries 0.1 to 28.3%, and migrant South Asians 4.1 to 18.1%). The burden of T2D among native South Asian children and young adults is higher than among migrant South Asians. This contrasts with traditional perceptions that T2D primarily affects older individuals and the South Asian diaspora i.e., those who have migrated from South Asia.

The association between implicit culture beliefs and intercultural sensitivity: anticipated intergroup exclusion and stigma as underlying processes

South Asians and Chinese mainlanders are two distinct cultural minority groups in the Hong Kong context. Grounded in theories and findings on implicit beliefs, this study examined the mediating roles of anticipated intergroup exclusion and stigma toward these cultural minority groups in the link between implicit culture beliefs and intercultural sensitivity. A total of 192 university students aged between 18 and 26 years old (M = 21.18; SD = 1.82) residing in Hong Kong participated in this study. Participants completed self-report questionnaires that assessed fixed versus malleable beliefs about cultural attributes, anticipated intergroup exclusion towards South Asians and Chinese mainlanders, stigma towards South Asians and Chinese mainlanders, and intercultural sensitivity. Path analysis and bootstrapping were applied to test the mediation model. Results showed that fixed implicit beliefs about cultural attributes were related to anticipated intergroup exclusion, greater stigma towards cultural minority groups, and lower intercultural sensitivity. However, only greater stigma towards South Asians, but not towards Chinese mainlanders, was then significantly associated with lower intercultural sensitivity. Taken together, the present study revealed the partial mediating roles of anticipated intergroup exclusion and stigma towards cultural minorities (i.e., South Asians and Chinese mainlanders) between implicit culture beliefs and intercultural sensitivity in the context of Hong Kong. In addition, the strengths of associations among anticipated intergroup exclusion, stigma, and intercultural sensitivity differed as a function of cultural groups.

Urbanization Drives Carbon Dioxide Supersaturation in South Asian River Networks: Insights from the Krishna River Basin, India

Urbanization Drives Carbon Dioxide Supersaturation in South Asian River Networks: Insights from the Krishna River Basin, India

Government Stability and Inflation Dynamics: Evidence from South Asian Nations

Government Stability and Inflation Dynamics: Evidence from South Asian Nations

Public sector corruption in South Asia: focusing on institutional factors with a two-step fsQCA

While the influence of institutions on public sector corruption is widely recognised, empirical exploration of their specific effects remains limited. Using a two-step fuzzy-set qualitative comparative analysis (fsQCA), this paper identifies several causal combinations of political and economic institutions that contribute to higher levels of public sector corruption in South Asia. Based on these findings, we recommend strengthening e-governance to streamline administrative processes, thereby reinforcing the corruption-reducing effects of parliamentarism, which may otherwise be distorted by factors such as excessive bureaucracy in the region. Additionally, we emphasise the need for South Asian policymakers to enhance external audits and integrity assessments by independent agencies while prioritising the improvement of democratic governance as a key strategy for effectively addressing corruption in the public sector.