Search

Age gap between spouses has important implications for a range of outcomes—from fertility and longevity, to gender relationships, marital quality, and stability. This paper examines the age gap between spouses in 12 countries in South and Southeast Asia. The average age difference (husband's minus wife's age) is positive in all countries and ranges from 2.7 in Myanmar to 8.4 in Bangladesh. Age homogamous marriages accounted for 5% of all marriages in Bangladesh to close to half of all marriages in Thailand. The proportion of age hypogamous marriages was uniformly low in all the countries except for Myanmar where it reaches close to 10%. Men's marriage age has a stronger effect in determining the age gap. In general, the age gap for women with lower education was larger than for those with higher education. However, much of this effect was explained by the difference in marriage timing across educational groups. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is twofold: to explore the interrelationships between FDI with growth and sustainability dimension; and to empirically analyze the four dimensions, namely, environmental, economic, social and governance of sustainable FDI for South Asia and West Asia. Design/methodology/approach: The data utilized in the paper is sourced from the World Development Indicators and the Worldwide Governance Indicators, covering South and West Asian region over the period 2011–2017. The paper employed both static and dynamic panel (two-step difference generalized methods of moments) estimation methods. Findings: The results established a significant and robust relationship of past year FDI inflows with the current year's value of FDI inflows for both the regions. Further, some variances in the relationships such as control of corruption, long-run carbon emissions, research and development, number of trademark applications as per the contextual factors have been detected. Research limitations/implications: The conclusions related to gender and governance found in this paper will be of interest to both researchers and policy makers for substantially reorienting the sustainability attributes to the foreign investment. Originality/value: The authors' main contributions are: to encapsulate the conceptual framework into an empirical model by combining all the four dimensions, namely, environmental, economic, social and governance; to have analyzed the possible differences and similarities in the study based on South and West Asia; to have explored the relationship between gender and FDI. [ABSTRACT FROM AUTHOR]

A 'majoritarian turn' identified by scholars of Asian democracy in the 1990s saw the rise of mixed-member majoritarian electoral systems and more centripetal party competition across both Northeast and Southeast Asia. In this paper, we argue that since the 2000s, the institutional pendulum has shifted, with more consensual approaches to democracy appearing to better represent key identity cleavages of gender, ethnicity, and territory—a trend evident not just in East Asia but South Asia as well. This new 'Asian model' typically involves increasing the proportional components of existing electoral formulas and grafting gender quotas, multiethnic party lists, and quasi-federal elements onto ostensibly majoritarian state structures. We show that these reforms have, as intended, mostly increased female and ethnic minority representation and decentralized governance structures. At the same time, however, these de jure changes are not associated with de facto political development in terms of greater democratic quality, counter to theoretical expectations. Indeed, democracy has declined across most of Asia at the same time as its democratic institutions have become more consensual. [ABSTRACT FROM AUTHOR]

This research uses the case study of world heritage sites from South Asia and the Asian Pacific region. It aims to explore how macro cultural psychology, social identity, and community engagement influence the conservation of world heritage sites. The data for this paper was collected from three Asian countries namely Indonesia, Pakistan, and Malaysia. FGDs and In-depth interviews from all the stakeholders were conducted, also, data analysis were made. The paper found that in all three countries heritage site remnants are used to create social identity, making macro psychology and engaging communities. [ABSTRACT FROM AUTHOR]

Background: Bangladesh is one of the most anemia prone countries in South Asia. Children of age under five years and women of reproductive age are particularly vulnerable in this region. Although several studies have investigated the risk factors of anemia, only few have explored its association with malnutrition, despite its high prevalence in the same group. The objective of this paper is to investigate the association of malnutrition with anemia by conducting separate analyses for under-five children and women of reproductive age using data from the nationally representative 2011 Bangladesh Demographic and Health Survey. Methods: Two binary outcome variables are considered separately: presence of anemia in children under five years of age (Hb<11.0 g/dl) and presence of anemia in women of childbearing age (Hb<12.0 g/dl). The exposures of interest corresponding to these two outcomes are stunting (low height-for-age) and low BMI (<18.5 kg/m2), respectively. Preliminary analysis involves estimating the association between exposure and outcome while controlling for a single confounder by computing adjusted odds ratios (adjOR) using the Cochran-Mantel-Haenszel approach in stratified analysis. Later, associations between the exposures and outcomes are estimated separately for under-five children and women of reproductive age by fitting multivariable regression models that adjust simultaneously for several confounders. Results: The prevalence of anemia is found to be higher among both the stunted children and women with low BMI compared to their healthy counterparts (Children: 56% vs 48%; women: 50% vs 43%). Furthermore, stunted children and women with low BMI have significantly increased odds of developing anemia, as reflected by the adjusted ORs of 1.76 (95% CI:1.10–2.83) and 1.81 (95% CI: 1.11–3.48), respectively. The association of stunting with anemia in children was modified by their age and socio-economic condition, where risk of being anemic decreases with increasing age but with a lower rate for stunted children from richest family. In addition, stunted children of anemic mothers are at greater risk of being anemic compared to non-stunted children of anemic or non-anemic mothers. Again the association between BMI and anemia in women is modified by the level of education, with risk of anemia being lowest among women with low BMI and higher education. Conclusion: Evidence–based policies targeting the vulnerable groups are required to combat anemia and nutritional deficiencies simultaneously under the same program. [ABSTRACT FROM AUTHOR]

Never before have network airlines been so exposed and vulnerable to low-cost carriers (LCCs). While LCCs had 26.3% of all world seats in 2013, Southeast Asia had 57.7% and South Asia 58.4% – and these figures will only increase. There are many consequences of LCCs on network airlines, including inadequately meeting the expectations of customers, so increasing dissatisfaction, and not offering sufficient value-for-money. Clearly, it is fundamentally important for Asian network airlines to respond appropriately to LCCs. This paper looks at the strategic capability of 22 of the top Asian network airlines in competing with LCCs, which is achieved by analysing questionnaire data from these airlines in terms of 37 competitive responses across six distinct response categories. It is crucial to note that this paper only concerns their capability in competing with LCCs, and it does not consider their overall strength. This paper also investigates how strategic capability varies by Asian sub-region and by airline performance, with performance examined in two respects: by perceived performance and actual performance. The results show that strategic capability varies widely, with Vietnam Airlines possessing the strongest strategic capability to compete with LCCs and SilkAir the weakest. Of others that compete heavily with LCCs, Malaysia Airlines and Garuda Indonesia have strong capabilities, while Philippine Airlines does not. However, all three need to more forcefully respond to LCCs. As a whole, network airlines within Southeast Asia have the greatest strategic capability, and Northeast Asia the weakest. There is a reasonably strong correlation between strategic capability and both actual and perceived performance, which suggests that those airlines with strong strategic capabilities should achieve strong overall performance. [ABSTRACT FROM AUTHOR]

Background: This meta-analysis study summarized the available information on the prevalence of thermotolerant Campylobacter jejuni and Campylobacter coli among poultry products in Asia; Methods: Exhaustive literature search was conducted and 30 studies were included. A number of multilevel random-effect meta-analysis models were used to calculate their pooled prevalence and compare each Asian regions; Results: The pooled prevalence for C.jejuni was 34%. On a separate meta-analysis for East Asia (EA), Middle East (ME) and South Asia (SA) and Southeast Asia (SEA), the pooled prevalences for C. jejuni were 33%, 37% and 33%, respectively. Moreover, results showed that there was significant heterogeneity and no significant publication bias. Conversely, the pooled prevalence for C. coli was 13%. On separate analysis by region, the pooled prevalences for EA, ME, and SEA were 10%, 18% and 12.08%, respectively. Significant heterogeneity was observed and there was no publication bias detected in the EA and the SEA; Conclusions: Overall, the high incidence of both C. jejuni and C. coli infections across Asia highlight the public health importance of these pathogens. Moreover, the meta-analysis of C. jejuni and C. coli prevalence across Asia gives crucial insights into the public health concerns connected with these pathogens. [ABSTRACT FROM AUTHOR]

The Tibetan Plateau (TP), known as the "Third Pole," profoundly affects weather and climate at regional and global scales. In this study, we investigate the characteristics of heat waves in China and their association with the TP heat source. The results show that during the summertime from 1980 to 2020, the frequency of heat wave days that hit eastern China and northwest China increased at rates of 0.09 and 0.24 days yr−1, respectively, accompanied by an increase in the atmospheric heat source (AHS) over the TP by over 2 W m−2 yr−1 under the background of global warming. The enhanced TP heat source induces an anomalous upper-tropospheric anticyclone, which caused the western Pacific subtropical high and South Asia high to be stronger and closer to each other, causing descending motions over eastern China and consequently more heat waves. At the same time, the enhanced TP heat source weakened the westerlies, thereby favoring the occurrence and maintenance of the anticyclone centered in northwest China and creating more heat waves due to strong descending motions. Therefore, the association between the TP heat source and heat waves in China provides relevant information for studying the mechanism and future changes of heat waves. Significance Statement: The Tibetan Plateau significantly affects the surrounding weather and climate. We find that there are some linkages between the Tibetan heat source and heat waves in China. The stronger the Tibetan heat source is, the more heat waves hit China. The enhancement of the Tibetan heat source could induce an anomalous upper-tropospheric anticyclone by affecting the western Pacific subtropical high and South Asia high, consequently causing descending motions over eastern China and the resulting heat waves. The weaker westerly due to the enhanced Tibetan heat source favors the occurrence of the anticyclone centered in northwest China, leading to more heat waves by descending motions. This study reveals a potential contributor to heat waves in China, providing some clues for better prediction in the future. [ABSTRACT FROM AUTHOR]

• 18 new Ancestry informative markers (AIMs) were screened from the 1000 Genomes Project. • A novel panel of 18 AIMs can improve ancestry distinctions among Asian populations. • Our panel could distinguish the GIH (Gujarati Indian in Houston, TX) from other South Asian groups. At present, several mature ancestry informative SNP (AISNP) panels are used to distinguish between continental regions of the world, but a more accurate division within the continent requires a secondary panel to complete. However, many AISNPs for the subgroup ancestry inference are selected from the Kidd Lab panel of 55 AISNPs or other published papers. These panels inevitably lack valuable markers for subgroup ancestry inference. Therefore, instead of choosing from the published panels, we used the 1000 Genomes Project to screen potentially informational markers in Asian populations, including single nucleotide polymorphisms (SNPs) and insertion/deletion polymorphisms (InDels). The allele frequencies of all autosomal SNPs and InDels of the 1000 Genomes Project were compared between 10 populations in Asia to identify markers with the largest pairwise allele frequency differences. Finally, we established a second-tier panel of 18 AIMs in this study, which not only divided the 26 populations of the 1000 Genomes Project into six clusters, but also divided the Asia subgroup into four clusters: Gujarati, East Asia, Southeast Asia and South Asia. [ABSTRACT FROM AUTHOR]

The relative impacts of the Tibetan Plateau–Himalaya (TPH) and the adjacent narrow mountains on the South Asian summer monsoon (SASM) are still unclear. We used a general circulation model to evaluate the relative effects of the TPH, the Hindu Kush Mountains (HKM), and the Iranian Plateau on the SASM from the perspective of the asymmetrical onset of the Bay of Bengal (BOB) summer monsoon (BOBSM) and the Indian summer monsoon (ISM). The results show that the abrupt onset of the BOBSM in May is affected by the TPH and HKM, which significantly strengthen precipitation over the BOB. By contrast, precipitation over the Indian subcontinent is suppressed by the TPH. In June, the TPH and the HKM contribute to strengthening and expanding precipitation over the Indian subcontinent and the ISM is significantly intensified. The strengthening of the SASM onset induced by the HKM is comparable with, or even larger than, that induced by the TPH. The effect of the Iranian Plateau on the SASM is much weaker and localized. The distinct role of the HKM is caused by the appearance of an anomalous low-level cyclone around the HKM and an anticyclone to the south, strengthening the India–Burma trough and the Somali jet. The topographic control of the HKM depends on the pre-existence of the TPH. We show that the sensible heat from the HKM accounts for 78.6% and 31.6% of the HKM-induced increase in precipitation during the onset of the BOBSM and ISM, respectively. Significance Statement: The South Asian summer monsoon shows a prominent asynchronous feature in that it starts earlier over the Bay of the Bengal (BOB) during May and appears over the Indian subcontinent in June. However, how the adjacent mountain ranges modulate this monsoon advance is still unclear. Our climate model experiments show that both the Hindu Kush Mountains (HKM) and the Tibet Plateau–Himalaya (TPH) contribute to the strengthening of the asymmetrical onset of the monsoon. During May, the monsoon over the BOB is significantly intensified while the precipitation over the Indian subcontinent is largely suppressed. The HKM–TPH strengthens the precipitation over the Indian subcontinent in June. The HKM-induced strengthening is comparable with, or even larger than, that induced by the TPH. [ABSTRACT FROM AUTHOR]

Background: The New Zealand (NZ) Ministry of Health ethnicity data protocols recommend that people of South Asian (SAsian) ethnicity, other than Indian, are combined with people of Japanese and Korean ethnicity at the most commonly used level of aggregation in health research (level two). This may not work well for perinatal studies, as it has long been observed that women of Indian ethnicity have higher rates of adverse pregnancy outcomes, such as perinatal death. It is possible that women of other SAsian ethnicities share this risk. Aims: This study was performed to identify appropriate groupings of women of SAsian ethnicity for perinatal research. Materials and Methods: National maternity and neonatal data, and singleton birth records between 2008 and 2017 were linked using the Statistics NZ Integrated Data Infrastructure. Socio‐demographic risk profiles and pregnancy outcomes were compared between 15 ethnic groups. Recommendations were made based on statistical analyses and cultural evaluation with members of the SAsian research community. Results: Similarities were observed between women of Indian, Fijian Indian, South African Indian, Sri Lankan, Bangladeshi and Pakistani ethnicities. A lower‐risk profile was seen among Japanese and Korean mothers. Risk profiles of women of combined Indian‐Māori, Indian‐Pacific and Indian‐New Zealand European ethnicity more closely represented their corresponding non‐Indian ethnicities. Conclusions: Based on these findings, we suggest a review of current NZ Ministry of Health ethnicity data protocols. We recommend that researchers understand the risk profiles of participants prior to aggregation of groups in research, to mitigate risks associated with masking differences. [ABSTRACT FROM AUTHOR]

Both South Asia and East Asia are the most polluted regions of the world. Unlike East Asia, the aerosol optical depth (AOD) over South Asia keeps increasing for all recent years, which calls for more attention. This study investigates the impacts of anthropogenic emissions over South Asia on the downstream regional climate during spring with the Community Earth System Model 2 (CESM2). The model results suggest that South Asian pollutants have significant impacts on East Asian spring climate, and the impacts could be even larger than locally emitted aerosols. Two possible dynamical pathways (i.e., the northern and the southern pathways) bridging South Asian aerosol forcing and East Asian climate are proposed, and both ways are associated with the black carbon (BC)-induced climate feedbacks surrounding the Tibetan Plateau (TP). The northern pathway is mainly due to the TP warming induced by the BC snow darkening effect (SDE), which significantly reduces the surface air temperature (SAT) over northern East Asia. BC-induced TP warming increases the meridional thermal gradient and accelerates the midlatitude jet stream, which favors the cold-air advection over northern East Asia. The southern pathway is associated with the BC "elevated heat pump" hypothesis, which mainly affects the precipitation in southern East Asia. BC from South Asia accumulates near the south slope of TP, inducing an abnormal ascending motion near the Bay of Bengal. A compensating anomalous sinking motion is then forced in South China, which suppresses the precipitation there. A primary observational analysis is also performed to verify both dynamical pathways. [ABSTRACT FROM AUTHOR]

Significant anomalies in frequency of summer extreme hot days (SEHDs) are broadly observed in the Asian monsoon region (AMR) in the post-ENSO summers. The delayed ENSO impacts are mainly conveyed by provoking the Indo-western Pacific Ocean capacitor (IPOC) effect that maintains the anomalous anticyclone in the western North Pacific. The related diabatic heating anomaly can trigger the westward-propagating Rossby wave to the Indian subcontinent, which increases the geopotential heights, reduces the cloud cover, and thus increases the seasonal surface temperature and SEHD frequency in the southern AMR. Besides, the reduced atmospheric moisture in the western North Pacific hinders the northward propagation of intraseasonal oscillation (ISO) and modulates the occurrence frequency of individual ISO phases, contributing to the significantly increased/decreased SEHDs in eastern China/Hokkaido, Japan, in the post-El Niño summers. The 25-model-ensemble mean of CMIP6 historical runs can reproduce well the observed SEHD anomalies in the southern AMR in the post-ENSO summers mainly due to the realistic simulation of ENSO impacts on the seasonal surface temperature, although a large intermodel spread exists due to different strengths of IPOC effect in each model owing to model biases in the mean state of the eastern tropical Pacific, the ENSO variance, and teleconnection to the Indian Ocean. Furthermore, future projections under the SSP5-8.5 scenario show that the delayed ENSO impacts on the southern AMR remain stable under global warming via a similar mechanism as in the observations and historical runs. [ABSTRACT FROM AUTHOR]

This study examines the causal relationship between the Internet and economic factors in Asian economies between 1997 and 2017. The economic factors consist of gross domestic product (GDP), foreign direct investment (FDI), imports, and exports. A comparative analysis of East, South, and Western Asia was conducted using a panel vector autoregressive model. The findings show bidirectional causality between FDI and Internet use in South Asia, unidirectional causality from Internet use to FDI in East Asia, and unidirectional causality from FDI to Internet use in Western Asia. Moreover, the findings indicate unidirectional causality from exports to Internet use in East Asia and unidirectional causality from Internet use to exports in South Asia, but no impact in Western Asia. Finally, the results show unidirectional causality from Internet use to GDP in Western Asia. As these results suggest that Internet use has boosted economic performance in Asia, policy makers in the region should improve Internet use with a focus on economic growth, improving transaction efficiency, and facilitating foreign investment. [ABSTRACT FROM AUTHOR]

Copyright of Politics & Policy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Our confidence in future climate projection depends on the ability of climate models to simulate the current climate, and model performance in simulating atmospheric circulation affects its ability of simulating extreme events. In this study, the self-organizing map (SOM) method is used to evaluate the frequency, persistence, and transition characteristics of models in the Coupled Model Intercomparison Project Phase 6 (CMIP6) for different ensembles of daily 500 hPa geopotential height (Z500) in Asia, and then all ensembles are ranked according to a comprehensive ranking metric (MR). Our results show that the SOM method is a powerful tool for assessing the daily-scale circulation simulation skills in Asia, and the results will not be significantly affected by different map sizes. Positive associations between each two of the performance in frequency, persistence and transition were found, indicating that a good ensemble of simulation for one metric is good for the others. The r10i1p1f1 ensemble of CanESM5 best simulates Z500 in Asia comprehensively, and it is also the best of simulating frequency characteristics. The MR simulation of the highest 10 ensembles for the Western North Pacific Subtropical High (WNPSH) and the South Asia High (SAH) are far better than those of the lowest 10. Such differences may lead to errors in the simulation of extreme events. This study will help future studies in the choice of ensembles with better circulation simulation skills to improve the credibility of their conclusions. [ABSTRACT FROM AUTHOR]

This study examines processes fundamental to the development of South Asian monsoon depressions using an array of integrations of an idealized convection-permitting numerical model. In each integration, a wave of initially small amplitude is subjected to a different amount of vertical and meridional wind shear, with temperature and moisture fields constructed according to realistic constraints. Based on the evolution of this disturbance into monsoon depression–like vortices, two features of the background environment emerge as important: the low-level gradient of moist static energy (MSE) and the low-level meridional shear. As the low-level MSE gradient steepens, the disturbance becomes stronger and produces more rain. This strengthening results from the interaction of the vortex with latent heat release by convection that is in turn organized by positive MSE advection in the northerly flow west of the vortex. In this region of advection, moister air from the north ascends along upward-sloping isentropes, driving moist convection. The disturbance also becomes stronger with increasing meridional shear, which makes the environment more barotropically unstable. The absence of either of these two features of the background environment prevents substantial growth of the disturbance. Our results suggest that monsoon depression growth in South Asia is fostered by the coexistence of a strong low-level MSE gradient with strong meridional wind shear associated with the monsoon trough. [ABSTRACT FROM AUTHOR]

A large number of studies evidenced the role of energy on growth and renewable energy as a cleaner input, which is the need of the hour as because of population and growth, the energy demand is on the rise in South Asia region. This study scrutinizes the quadratic effect of the non-renewable and renewable energy consumption mix and its impact on sustainable development while controlling for trade openness, development expenditures and industrialization. This study resorts to feasible generalized least squared model for the estimation of quadratic function for five SAARC countries between 1990 and 2017. The results show that the non-renewable-to-renewable energy mix ratio follows an inverted U-shaped relationship with HDI. Further renewable energy must be significantly higher than non-renewable energy in order to ensure that it is development promoting. [ABSTRACT FROM AUTHOR]

Copyright of Research in Ornithology / Rivista Italiana di Ornitologia is the property of PAGEPress and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rice is the most residue-producing crop in Asia (826 million tons) contributing 84% of total production of the world. Traditionally, rice straw is removed from fields for use as cattle feed and other purposes in South Asia. On average, rice crop residues contain 0.7% N, 0.23% P and 1.75% K. Therefore, the amount of NPK contained in rice crop residues produced is about 22.13 × 106 and 26.26 × 106 t year−1 in Asia and the world, respectively. Recently, with the advent of mechanized harvesting, farmers have been burning in situ large quantities of crop residues left in the field which interfere with tillage and succeeding operations for the subsequent crop, causing loss of nutrients and soil organic matter (SOM). On-field residue retention benefits soil health, soil water conservation, soil productivity and environment but there are several challenges in residue incorporation – physical problem of soil incorporation, labor intensive, fallow period and N immobilization. There are several off-field options for managing rice crop residues – palatable livestock feed, economic roof thatch for rural poor, rural residue composting, edible mushroom cultivation, biogas production and packaging of non-consumable items for transport. [ABSTRACT FROM AUTHOR]

The extreme concentration of population over South Asia makes it critical to accurately understand the global warming impact on the South Asian monsoon (SAM), but the complex orography of the region makes future projections of monsoon intensity technically challenging. Here we describe a series of climate projections constructed using the Weather Research and Forecasting (WRF) Model for South Asia to dynamically downscale a global warming simulation constructed using the Community Earth System Model under the representative concentration pathway 8.5 (RCP8.5) scenario. A physics-based miniensemble is employed to investigate the sensitivity of the projected change of the SAM to the implementation of different parameterization schemes in WRF. We analyze not only the changes in mean seasonal precipitation but also the impact of the warming process on precipitation extremes. All projections are characterized by a consistent increase in average monsoon precipitation and a fattening of the tail of the daily rainfall distribution (more than a 50% decrease in the return periods of 50-yr extreme rainfall events by the end of the twenty-first century). Further analysis based on one of the WRF physics ensemble members shows that both the average rainfall intensity changes and the extreme precipitation increases are projected to be slightly larger than expectations based upon the Clausius–Clapeyron thermodynamic reference of 7% °C−1 of surface warming in most parts of India. This further increase can be primarily explained by the fact that the surface warming is projected to be smaller than the warming in the midtroposphere, where a significant portion of rain originates, and dynamical effects play only a secondary role. [ABSTRACT FROM AUTHOR]

Hepatitis A, an acute inflammatory liver disease caused by hepatitis A virus (HAV) infection from close contact with infected people, is highly endemic in the Indian subcontinent. Due to poor sanitary conditions, most of the population is exposed to the virus in childhood. At this age, the disease is asymptomatic and provides life-long protection against the disease. Due to rapid socioeconomic development in some areas, however, pockets of the population are reaching adolescence/adulthood without prior exposure to the virus and are thus susceptible to infection. At these ages, infection carries a higher risk of symptomatic disease and complications including mortality. This review of epidemiology and burden of disease studies in the Indian subcontinent, published since 2005, shows increasing evidence of a shift from high to intermediate endemicity in high-income—typically urban—populations. The prevalence of anti-HAV antibodies (previously reported at > 90%) is lower now in adolescents and young adults (e.g., around 80% in Bangladesh and 55% in 5–15 years in India). As a result, HAV is responsible for more acute viral hepatitis predominantly in this age group (e.g., > 15 years: 3.4% in 1999 to 12.3% in 2003 or high socioeconomic status 13–20 years: 27% in 1999 to 62% in 2003), with a greater clinical and economic burden. Numerous outbreaks due to HAV have been reported [e.g., Sri Lanka (2009–2010): > 13,000 affected; Kashmir (2015–2017): 12 outbreaks; Kerala (2012–2016): 84 outbreaks] from water or food contamination. Due to current shifts in endemicity, a growing proportion of the population is no longer exposed in childhood. As the disease remains highly endemic, it also provides a source for more severe disease in susceptible people at an older age and for outbreaks. Well-tolerated and effective vaccines are available and help prevent disease burden and provide long-term protection. These should now be used more widely to protect more patients from the growing disease burden of hepatitis A. Funding: GlaxoSmithKline Biologicals SA. Plain Language Summary: Plain language summary available for this article—please see Fig. 1 and the following link: 10.6084/m9.figshare.9963044. [ABSTRACT FROM AUTHOR]

Objective: To conduct a secondary data analysis detailing the associations between sociodemographic and behavioral factors and nutrition-related chronic disease. Methods: These analyses utilized 2014 data from the Indonesian Family Life Survey, a home-based survey that collected socioeconomic, dietary intake, physical activity, and biological data among adults. We explored four outcomes in relation to sociodemographic and behavioral determinants: 1) hypertension, 2) elevated high-sensitivity c-reactive protein (hs-CRP), and 3) central obesity, as these are critical metabolic determinants in the progression to cardiovascular disease, and 4) type 2 diabetes. Hypertension was defined as systolic blood pressure ≥140 mm or diastolic blood pressure ≥ 90mm or current use of antihypertensive medication. Elevated hs-CRP was defined as hs-CRP >3 mg/dL. Central obesity was defined as waist circumference ≥ 90 cm if male and waist circumference ≥ 80 cm if female, which are specific to South Asia. Type 2 diabetes was defined as glycated hemoglobin ≥ 6.5%. We employed separate gender-stratified multivariate logistic regression models to test the associations between sociodemographic and behavioral determinants and each nutrition-related chronic disease outcome. All analyses employed sampling weights, which account for the survey design. Results: In 2014, about 30% of adults were hypertensive and one-fifth had elevated hs-CRP. Approximately 70% of women had central obesity and 11.6% of women and 8.9% of men had diabetes. Older-age was consistently associated with nutrition-related chronic disease and being overweight was associated with hypertension, elevated hs-CRP, and type 2 diabetes. Regularly consuming instant noodles (women) and soda (men) were associated with elevated hs-CRP and soda consumption was associated with central obesity among men. Conclusions: Large segments of the adult population in Indonesia now have or are at risk for non-communicable disease. Our analyses provide preliminary empirical evidence that interventions that target healthful food intake (e.g. reduce the intake of ultra-processed foods) should be considered and that the reduction of overweight is critical for preventing chronic diseases in Indonesia. [ABSTRACT FROM AUTHOR]

Background: In South Asia, hundreds of millions of people are infected with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura). However, high-resolution risk profiles and the estimated number of people infected have yet to be determined. In turn, such information will assist control programs to identify priority areas for allocation of scarce resource for the control of soil-transmitted helminth infection. Methodology: We pursued a systematic review to identify prevalence surveys pertaining to soil-transmitted helminth infections in four mainland countries (i.e., Bangladesh, India, Nepal, and Pakistan) of South Asia. PubMed and ISI Web of Science were searched from inception to April 25, 2019, without restriction of language, study design, and survey date. We utilized Bayesian geostatistical models to identify environmental and socioeconomic predictors, and to estimate infection risk at high spatial resolution across the study region. Principal findings: A total of 536, 490, and 410 georeferenced surveys were identified for A. lumbricoides, hookworm, and T. trichiura, respectively. We estimate that 361 million people (95% Bayesian credible interval (BCI) 331–395 million), approximately one-quarter of the South Asia population, was infected with at least one soil-transmitted helminth species in 2015. A. lumbricoides was the predominant species. Moderate to high prevalence (>20%) of any soil-transmitted helminth infection was predicted in the northeastern part and some northern areas of the study region, as well as the southern coastal areas of India. The annual treatment needs for the school-age population requiring preventive chemotherapy was estimated at 165 million doses (95% BCI: 146–185 million). Conclusions/significance: Our risk maps provide an overview of the geographic distribution of soil-transmitted helminth infection in four mainland countries of South Asia and highlight the need for up-to-date surveys to accurately evaluate the disease burden in the region. [ABSTRACT FROM AUTHOR]

South Asia continues to carry the greatest share and number of wasted children worldwide. Understanding the determinants of wasting is important as policymakers renew efforts to tackle this persistent public health and development problem. Using data from national surveys in Bangladesh, India, the Maldives, Nepal, Pakistan and Afghanistan, this analysis explores factors associated with wasting among children aged 0 to 59 months (n = 252,797). We conducted multivariate mixed logistic regression and backwards stepwise methods to identify parsimonious models for each country separately (all p values <0.05). Younger children (0 to 5 months), and those whose mothers had a low body mass index (<18.5 kg/m2) had greater odds of being wasted in all countries. Later birth order, being male, maternal illiteracy, short maternal stature, lack of improved water source, and household poverty were also associated with wasting in various countries, but not systematically in all. Seasonality was also not consistently associated with wasting in the final models. These findings suggest that pre-conception (adolescence), pregnancy and early postpartum, represent windows of opportunity for tackling child wasting, not only stunting. Our analysis suggests that the underlying determinants of wasting and stunting in South Asia are similar, but not universal across geographies. Cost-effective interventions to prevent both stunting and wasting, and to treat severe wasting, need to be scaled up urgently. Separating these two manifestations of child undernutrition in conceptual and programmatic terms may unnecessarily impair progress to reach the Sustainable Development Goals targets aimed at addressing both child stunting and wasting. [ABSTRACT FROM AUTHOR]

New biotic stresses have emerged around the globe over the last decades threatening food safety and security. In 2016, scientists confirmed the presence of the devastating wheat-blast disease in Bangladesh, South Asia–its first occurrence outside South America. Severely blast-affected wheat fields had their grain yield wiped out. This poses a severe threat to food security in a densely-populated region with millions of poor inhabitants where wheat is a major staple crop and per capita wheat consumption has been increasing. As an ex ante impact assessment, this study examined potential wheat-blast scenarios in Bangladesh, India, and Pakistan. Based on the agro-climatic conditions in the epicenter, where the disease was first identified in Bangladesh in 2016, this study identified the correspondingly vulnerable areas in India, Pakistan and Bangladesh amounting to 7 million ha. Assuming a conservative scenario of 5–10% for blast-induced wheat production loss, this study estimated the annual potential wheat loss across the sampled countries to be 0.89–1.77 million tons, equivalent to USD 132–264 million. Such losses further threaten an already-precarious national food security, putting pressure on wheat imports and wheat prices. The study is a call for action to tackle the real wheat-blast threat in South Asia. [ABSTRACT FROM AUTHOR]

Globally, road traffic injuries accounted for about 1.36 million deaths in 2015 and are projected to become the fourth leading cause of disability-adjusted life years (DALYs) lost by 2030. One-fifth of these deaths occurred in South Asia where road traffic injuries are projected to increase by 144% by 2020. Despite this rapidly increasing disease burden there is limited evidence on the economic burden of road traffic injuries on households in South Asia. We applied a novel coarsened exact matching method to assess the household economic burden of road traffic injuries using nationally representative World Health Survey data from five South Asian countries- Bangladesh, India, Nepal, Pakistan and Sri Lanka collected during 2002–2003. We examined the impact of road traffic injuries on household out-of-pocket (OOP) health spending, household non-medical consumption expenditure and the employment status of the traffic injury-affected respondent. We exactly matched a household (after ‘coarsening’) where a respondent reported being involved in a road traffic injury to households where the respondent did not report a road traffic injury on each of multiple observed household characteristics. Our analysis found that road traffic injury-affected households had significantly higher levels of OOP health spending per member (I$0.75, p<0.01), higher OOP spending on drugs per member (I$0.30, p = 0.03), and higher OOP hospital spending per member (I$0.29, p<0.01) in the four weeks preceding the survey. Indicators of “catastrophic spending” were also significantly higher in road traffic injury-affected households: 6.45% (p<0.01) for a threshold of OOP health spending to total household spending ratio of 20%, and 7.40% (p<0.01) for a threshold of OOP health spending to household ‘capacity to pay’ ratio of 40%. However, no statistically significant effects were observed for household non-medical consumption expenditure, and employment status of the road traffic injury-affected individual. Our analysis points to the need for financial risk protection against the road traffic injury-related OOP health expenditure and a focus on prevention. [ABSTRACT FROM AUTHOR]

Background: Acute undifferentiated febrile illness (AUFI) is caused by a multitude of diverse pathogens, with significant morbidity and mortality in the developing world. The objective of this review was to characterise the diversity and relative importance of common infectious aetiologies of AUFI in South and Southeast Asia.Methods: We conducted a comprehensive literature review to identify common aetiologies of AUFI in Asian countries. Four medical and life sciences databases including PubMed, Medline, Embase and Cochrane Central, and Google Scholar were searched for articles published from January 1998 to March 2019.Results: Forty-three studies met the inclusion criteria. Among AUFI cases, viral aetiologies at 18.5% (14888) were more common than bacterial aetiologies (12.9% [10384]). From 80,554 cases, dengue fever was the most common aetiology (11.8%, 9511), followed by leptospirosis (4.4%, 3549), typhoid (4.0%, 3258), scrub typhus (4.0%, 3243) and influenza other than H1N1 (3.1%, 2514). In both adults and children: dengue fever was the leading cause of AUFI with 16.6% (1928) and 18.7% (1281) of the total cases. In admitted patients, dengue fever was the main cause of AUFI at 16.4% (2377), however leptospirosis at 13.9% (2090) was the main cause of AUFI for outpatients. In South Asia, dengue fever was the main cause of AUFI, causing 12.0% (6821) of cases, whereas in Southeast Asia, leptospirosis was the main diagnosis, causing 12.1% (2861) of cases.Conclusions: In this study the most common causes of AUFI were viral, followed by bacterial and protozoal (malaria) infections. Dengue was the commonest virus that caused AUFI while leptospirosis and typhoid were important bacterial infectious causes. Therefore, it is imperative to maintain a sound epidemiological knowledge of AUFI so that evidence-based diagnostic criteria and treatment guidelines can be developed. [ABSTRACT FROM AUTHOR]