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Background: In Myanmar, progress towards malaria elimination has stagnated in some areas requiring deployment of new tools and approaches to accelerate malaria elimination. While there is evidence that networks of community-based malaria workers and insecticide-treated nets (ITNs) can reduce malaria transmission in a variety of settings, evidence for the effectiveness of other interventions, such as topical repellents, is limited. Since malaria transmission in Myanmar occurs outdoors, mainly among forest-goers, this study tested the effectiveness of topical repellents in combination with supplemental ITN distribution and strengthened networks of malaria workers. Methods: Thirty-eight villages in the Tanintharyi Region and Rakhine State were initially selected for the study based on malaria incidence in previous years. An additional 31 villages were included as comparison areas. The implementation of interventions began in March 2020 and continued through June 2021. Malaria cases were detected in all villages through surveillance at health facilities and a network of malaria workers. Data were analysed by interrupted time series. A nested case–control study was also conducted where forest-goers who tested positive for malaria by RDT were matched to up to three forest-goers who tested negative. Results: A decrease in mean monthly incidence was observed in the intervention villages from 6.0 (95% CI 4.9–7.1) to 3.7 (95% CI 2.4–4.9) cases per 1000 people at risk before and after the interventions. For the comparison villages, the mean monthly incidence increased from 1.1 (95% CI 0.8–1.5) to 5.7 (95% CI 2.1–9.3) cases per 1000 people at risk. Malaria incidence was significantly lower following the implementation of the interventions (RR = 0.117; 95% CI 0.061–0.223; p < 0.001) in the intervention villages, whereas that of comparison villages was higher after the implementation of the interventions (RR = 3.558; 95% CI 0.311–40.750; p = 0.308). However, a significant trend for increasing malaria incidence after implementation was observed in the intervention villages (RR = 1.113; 95% CI 1.021–1.214, p = 0.015), suggesting a waning effect. The nested case–control analysis showed that the odds of topical repellent use were significantly lower among cases than controls (aOR: 0.063, 95% CI 0.013–0.313, p < 0.001). Conclusion: The tailored intervention package for forest-goers helped reduce malaria incidence in Myanmar. Topical repellents may help to further reduce malaria transmission in elimination settings where high-risk populations such as forest-goers do not have easy access to routine health services or are less likely to use ITNs for malaria prevention. [ABSTRACT FROM AUTHOR]

Background/Objectives: The diagnosis of encephalitis is a challenging problem due to the heterogeneity of clinical presentations. The objective was to determine the etiology, clinical features, laboratory parameters, radiological findings, and in-hospital outcome of acute encephalitis syndrome (AES) cases in Myanmar. Methods: A prospective descriptive study was conducted at the Neuromedical Ward of Yangon General Hospital from March to August 2023. Eighty-one AES cases were enrolled, and cerebrospinal fluid (CSF) samples were collected. A Qiastat ME Panel was used to detect viral, bacterial, and fungal pathogens. Results: Seventeen out of eighty-one (21%) cases were non-encephalitis with alternative definite diagnosis. Among the remaining 64 encephalitis cases, the exact infectious and immune etiologies were identified in 31 of 64 cases (48.4%); 26 of these (83.9%) were due to infectious causes and 5 (16.1%) were immune encephalitis. Among the infectious causes, six Herpes Simplex Virus-1-, one bacteriologically confirmed and seven probable Mycobacterium tuberculosis-, three Haemophilus influenzae-, two Streptococcus pneumoniae-, one Streptococcus pyogenes-, one Varicella-Zoster Virus (Ramsay Hunt Syndrome with meningoencephalitis)-, and two Cryptococcus neoformans-infected patients and rare causes such as Listeria monocytogenes, Burkholdelria cepacia, Sphingomonas paucimobilis, and Aspergillus were identified. One case was a dual infection with Haemophilus influenzae and Cryptococcus neformans. Abnormal protein levels and CSF pleocytosis were significantly higher among bacterial causes (p < 0.05). In total, 6.45% (2/31) of encephalitis patients with identified causes and 12.12% (4/33) of those without an identified organism had poor outcome. Conclusions: Herpes encephalitis and tuberculous meningoencepalitis were the commonest. This study highlighted that molecular testing with a multidisciplinary approach is required to ensure the right treatment on time. [ABSTRACT FROM AUTHOR]

When the book Wild mammals of Myanmar (Tun Yin 1993) was published, a total of 252 mammal species were reported. Since that publication, numerous new species have been described, taxonomic revisions published, and additional distribution records produced that have expanded Myanmar's mammals considerably. Therefore, we aimed to provide an updated checklist of the mammals of Myanmar, which includes the scientific and common names, global and Myanmar distributions, remarks on taxonomy, and conservation information including the IUCN Red List status and legal protection status under The Conservation of Biodiversity and Protected Areas Law 2018 of Myanmar. Our new checklist includes 365 (33 marine and 332 terrestrial) mammal species belonging to 13 orders and 49 families. We also confirmed that Myanmar is home to at least nine endemic mammal species. Our results highlight the areas that require further exploration to gain a more comprehensive understanding of Myanmar's diverse fauna. [ABSTRACT FROM AUTHOR]

Research Aims: The primary aims of this study involve examining the effect of leadership styles on self-efficacy and the effect of self-efficacy on innovative work behaviour. Design/Methodology/Approach: Quantitative research was conducted by collecting data from 242 randomly selected software developers in four software development companies in Yangon using structured questionnaires. Regression analysis was used to attain the research objectives. Research Findings: The results showed that transactional and ambidextrous leadership styles have a significant effect on increasing the self-efficacy of software developers. This study also revealed that self-efficacy is an antecedent of the innovative work behaviour of software developers. Theoretical Contribution/Originality: The study confirmed that transactional leadership significantly impacts self-efficacy and validated the role of ambidextrous leadership in selfefficacy. Moreover, self-efficacy was found to have an impact on innovative work behaviour. Managerial Implication in the South East Asian Context: This study suggests that transactional and ambidextrous leadership styles can create enabling environments by encouraging and empowering team members to increase their self-efficacy and engage in more innovative endeavours. Research Limitation & Implications: Data was collected once using a questionnaire from a sample of four companies. The insights can help leaders maintain a sustainable competitive advantage, leading to more job opportunities and long-term economic growth in Myanmar and other developing countries. [ABSTRACT FROM AUTHOR]

Paw San Hmwe (PSH) is an indigenous rice variety from Myanmar with a good taste, a pleasant fragrance, and excellent elongation ability during cooking. However, its low yield potential and strong photoperiod sensitivity reduce its productivity, and it is vulnerable to climate changes during growth. To improve the photoperiod insensitivity, yield, and plant stature of PSH, the high-yield genes Grain number 1a (Gn1a) and Wealthy Farmer's Panicle (WFP), together with the photoperiod insensitivity trait, were introgressed into PSH via marker-assisted backcross breeding and phenotype selection. For the photoperiod insensitivity trait, phenotypic selection was performed under long-day conditions during the dry season. After foreground selection of Gn1a and WFP via simple sequence repeat genotyping, genotyping-by-sequencing was conducted to validate the introgression of target genes and determine the recurrent parent genome recovery of the selected lines. The improved lines were insensitive to photoperiod, and the Gn1a and WFP introgression lines showed significantly higher numbers of primary panicle branches and spikelets per panicle than the recurrent parent, with comparative similarity in cooking and eating qualities. This study successfully improved PSH by decreasing its photoperiod sensitivity and introducing high-yield genes via marker-assisted selection. The developed lines can be used for crop rotation and double-season cropping of better-quality rice. [ABSTRACT FROM AUTHOR]

Parechovirus‐A (PeV‐A) causes emerging infection in children, and clinical presentation depends on genotype. The virus has been investigated mainly in developed countries; however, data from developing countries, especially in Asia, are sparse. This study investigated whether PeV‐A circulated in children in Myanmar. This retrospective study evaluated PeV‐A in nasopharyngeal samples from children aged 1 month to 12 years who were hospitalized with acute lower respiratory infection at Yankin Children Hospital, Yangon, Myanmar, during the period from May 2017 to April 2019. Real‐time polymerase chain reaction (PCR) was used to detect PeV‐A, and PCR‐positive samples were used for genotyping and phylogenetic analysis. In total, 11/570 (1.9%) of samples were positive for PeV‐A; 7 were successfully genotyped by sequencing the VP3/VP1 region, as follows: PeV‐A1 (n = 4), PeV‐A5 (n = 1), PeV‐A6 (n = 1), and PeV‐A14 (n = 1). Median age was 10.0 months (interquartile range 4.0–12.0 months), and other respiratory viruses were detected in all cases. Phylogenetic analysis showed that all detected PeV‐A1 strains were in clade 1 A, which was a minor clade worldwide. Four PeV‐A genotypes were detected in Myanmar. The clinical impact of PeV‐A in children should be evaluated in future studies. [ABSTRACT FROM AUTHOR]

This article is a summary of the available research works of cast‐in‐place deep‐seated bored piles in Myanmar. Instrumented static pile load test results are analyzed, discussed, and updated. The information contained in the article is mainly from the construction projects of private sectors constructed in Yangon and extended study of previous work on current practices of deep foundations and deep excavation Works in Myanmar. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a global health concern that affects individuals and the healthcare system. This study aimed to describe the relationships between personal and environmental factors and self-management behaviors in individuals with type 2 diabetes mellitus (T2DM). Methods: This research included 100 individuals with T2DM who were recruited through convenient sampling from three government hospitals in Myanmar. Data collection was fulfilled using a standardized interviewer-administered questionnaire consisting of demographic information, the Diabetes Management Self-Efficacy Scale, the New Short-Form Health Literacy Instrument, the 24-item version of the Diabetes Knowledge Questionnaire, the Social Support Questionnaire, and the Summary of Diabetes Self-care Activity. Data analysis was conducted using descriptive statistics, Chi-square, Pearson's correlation, and Spearman's rho correlation coefficient. Results: Self-efficacy (r = 0.375, p < 0.01), health literacy (r = 0.43, p < 0.01), diabetes knowledge (r = 0.461, p < 0.01), and social support (r = 0.337, p < 0.01) were significantly related to self-management behavior. Conclusions: This study indicates the importance of enhancing self-management behaviors, self-efficacy, health literacy, diabetes knowledge, and social support for individuals diagnosed with type 2 diabetes. Future studies should focus on the prediction or interventions to explore the relationship between personal and environmental factors and self-management behaviors among T2DM individuals in Myanmar. [ABSTRACT FROM AUTHOR]

Background: Toxoplasmosis, having the significant consequences affecting mortality and quality of life, is still prevalent in various places throughout the world. The major gap in surveillance for Toxoplasma gondii infection among high-risk population, slaughterhouse workers, is an obstacle for the effective policies formulation to reduce the burden of toxoplasmosis in Myanmar. Therefore, this study aimed to assess the seroprevalence of toxoplasmosis and associated factors of seropositivity among slaughterhouse workers in Yangon Region, Myanmar. Methods: A cross-sectional study that was conducted from June to November 2020 included 139 slaughterhouse workers involving at five main slaughterhouses under Yangon City Development Committee, Myanmar. The presence of IgG and IgM anti-T. gondii antibodies in serum was detected using the OnSite Toxo IgG/IgM Combo Rapid Test. A face-to-face interview was also performed using pretested structured questionnaires to obtain the detail histories: sociodemographic characteristics, level of knowledge, occupational factors, and environmental factors related to T. gondii infection. Bivariate logistic regression was used to determine the factors associated with T. gondii infection. Results: Of all participants, the overall seroprevalence of anti-T. gondii was 43.9% (95% CI: 35.5–52.5%), of whom 98.4% (95% CI: 91.2–100.0%) were reactive only for IgG antibody and 1.6% (95% CI: 0.0–8.8%) were reactive for IgG and IgM antibodies. The significant factors associated with the seropositivity of T. gondii antibodies were blood transfusion history (OR: 5.74, 95% CI: 1.17–28.09), low level of knowledge (OR: 2.91, 95% CI: 1.46–5.83), contact with animal organs, muscles or blood (OR: 14.29, 95% CI: 1.83–111.51), and animals most frequently slaughtered (cattle) (OR: 3.22, 95% CI: 1.16–8.93). Conclusions: A high seroprevalence of toxoplasmosis was detected among slaughterhouse workers in Yangon Region and it raises a significant public health concern. Therefore, providing health education regarding toxoplasmosis, enforcement of personal hygiene practices in workplaces, the establishment of training for occupational hygiene, and commencement of the risk assessment and serological screening for toxoplasmosis are crucial to curtail the prevalence of T. gondii infection among slaughterhouse workers. [ABSTRACT FROM AUTHOR]

The presence of potentially toxic metal(loid)s (As, Pb, Cd, Cr, Mn, Fe, Zn, Cu, Ni, Mo and Co) in 120 white (polished) rice grains (Oryza sativa; 2017 or earlier crop) purchased from farmers in the five most agriculturally active townships near Yangon in the eastern edge on Ayeyarwady Delta was determined by triple quadrupole inductively coupled plasma mass spectrometry (ICP-QQQ). Their total-As and Ni concentrations (0.16 mg/kg, 0.39 mg/kg) were around the worldwide average literature values from a heavy metal non-contaminated area of intermediate to acidic (non-mafic) composition. Their Pb, Cd, and Cr mean concentrations (0.010, 0.0056, and 0.056 mg/kg, respectively) were lower than the maximum allowable levels by over one magnitude, reaching the concentration ranges comparable to the lowest level in the literature values. This study's natural background levels were explained by a negligible influence of human, mining and industrial activities in this area, and probably genotype effect, which remains to be examined by the associated paddy soil analysis. Health risks associated with rice consumption (ca. 0.5 kg/day) by the inhabitants were estimated, assuming that inorganic arsenic was 30% of the total. Arsenic was the main contributor (30%) to the total value of the non-cancer risk (HI) of each element, which was 4.5 times the reference value (< 1), followed by Mn, Zn, Cu, Mo, Co and Ni (15–7%) and Pb, Cd, Cr and Fe (below 4%). The total cancer risk (TCR) for each element was around 17 times higher than the upper limit of cancer risk for an environmental carcinogen (< 0.0001): Nickel accounts for two-thirds of the contribution (66%), followed by Cd (16%) and As (13%). This study suggests that consumers of Yangon rice from paddy fields without groundwater irrigation may need to be concerned about the potential risk of Ni intake besides arsenic. [ABSTRACT FROM AUTHOR]

Banded civet Hemigalus derbyanus is a Near Threatened small carnivore species distributed in Indonesia, Malaysia, Brunei Darussalam, peninsular Thailand, and Myanmar. However, the status of banded civet in Myanmar is uncertain, as it has not been recorded there since 1914. Here, we report the first photographic evidence of banded civet in Htaung Pru Reserved Forest of Tanintharyi Region, which is located in the far northwest from the known historical location in Myanmar, and contributes to our knowledge of the current distribution of banded civet in Southeast Asia. Protection and conservation of lowland rainforest by using community-based conservation approaches is critically important for the persistence of this species in this particular area. [ABSTRACT FROM AUTHOR]

Background: Myanmar has a large majority of all malaria in the Greater Mekong Subregion. In the past decade, substantial progress was made in malaria control. The residual burden of malaria is in remote areas where currently recommended malaria elimination approaches are generally not feasible. In such hard-to-reach communities in Mon state, East Myanmar, Medical Action Myanmar introduced community health workers (CHWs) to deliver early diagnosis and treatment for malaria. We conducted a retrospective analysis to assess the impact of this intervention. Methods and findings: This retrospective analysis involved data collected routinely from a CHW programme in Mon state conducted between 2011 and 2018. A network of 172 CHWs serving a population of 236,340 was deployed. These CHWs carried out 260,201 malaria rapid diagnostic tests (RDTs) to investigate patients with acute febrile illness. The median blood examination rate was 1.33%; interquartile range (IQR) (0.38 to 3.48%); 95% CI [1.28%, 1.36%] per month. The changes in malaria incidence and prevalence in patients presenting with fever were assessed using negative binomial regression mixed effects models fitted to the observed data. The incidence of Plasmodium falciparum malaria (including mixed infections) declined by 70%; 95% CI [65%, 75%]; p < 0.001 for each year of CHW operation. The incidence of P. vivax malaria declined by 56%; 95% CI [50%, 62%]; p < 0.001 per year. Malaria RDT positivity rates for P. falciparum and P. vivax declined by 69%; 95% CI [62%, 75%]; p < 0.001 and 53%; 95% CI [47%, 59%]; p < 0.001 per year, respectively. Between 2017 and 2018, only 1 imported P. falciparum case was detected in 54,961 RDTs. The main limitations of the study are use of retrospective data with possible unidentified confounders and uncharacterised population movement. Conclusions: The introduction of CHWs providing community-based malaria diagnosis and treatment and basic health care services in remote communities in Mon state was associated with a substantial reduction in malaria. Within 6 years, P. falciparum was eliminated and the incidence of P. vivax fell markedly. In this retrospective analysis, Aye Sandar Zaw and colleagues report the successful elimination of falciparum malaria following the introduction of community-based health workers in Eastern Myanmar Author summary: Why was this study done?: Malaria is still a major health problem in Myanmar, which has a large majority of all the reported malaria cases in the Greater Mekong Subregion. In Myanmar, malaria is prevalent predominantly in remote and difficult to access communities where currently recommended malaria elimination approaches are generally not feasible. In 2011, Medical Action Myanmar introduced community health workers (CHWs) to deliver early diagnosis and treatment for malaria in hard-to-reach communities in Mon state, East Myanmar. This retrospective study was performed to assess the impact of this intervention on the incidence and prevalence of malaria. What did the researchers do and find?: We conducted an analysis of the uptake of CHW services and the effectiveness of this programme in controlling and eliminating malaria. Overall, 172 CHWs were supported to serve a population of 236,340 people. The CHWs carried out 260,201 malaria rapid diagnostic tests (RDTs) over an 8-year period. There was a rapid and sustained reduction in the incidence of both falciparum and vivax malaria. Falciparum malaria was eliminated within 6 years, and vivax malaria was reduced markedly. What do these findings mean?: Although this is a retrospective observational analysis, it suggests that elimination of falciparum malaria was achieved simply by supporting CHWs to provide effective early detection and treatment of malaria. There was also a substantial reduction in the incidence of vivax malaria, but P. vivax was more difficult to eliminate than P. falciparum. This is a low transmission setting. Additional measures may be required to eliminate malaria where there are foci of higher transmission Continued support and broadening of the remit of CHWs to include basic healthcare support is needed to ensure that malaria elimination is sustained. [ABSTRACT FROM AUTHOR]

Pyropia is a genus comprising red algae of the Bangiaceae family that is commonly found in intertidal zones worldwide. However, understanding of Pyropia species that are prone to tropical regions remains limited despite recent breakthroughs in genomic research. Within the realm of Pyropia species thriving in tropical regions, P. vietnamensis stands out as a widely recognized species. In this study, we aimed to investigate Pyropia species in the southwest coast of Myanmar using physiological and molecular approaches, culture-based analyses, chloroplast rbcL and nuclear SSU gene sequencing, and whole chloroplast and mitochondrial genome sequencing. Physiological analysis showed that the Myanmar samples were more heat-tolerant than their Japanese counterparts, including those of subtropical origin. Additionally, molecular characterization revealed that the Myanmar samples were closely related to P. vietnamensis from India. This study is the first to sequence the chloroplast and mitochondrial genomes of Pyropia species from tropical regions. A unique deletion event was observed within a ribosomal RNA gene cluster in the chloroplast genome of the studied Pyropia species, which is a deviation from the usual characteristics of most Pyropia species. This study improves current understanding of the physiological and molecular characteristics of this comparatively understudied Pyropia species that grows in tropical regions. [ABSTRACT FROM AUTHOR]

Purpose: Studies show that internet has become a major force propelling growth in tourism sector in many countries. An appropriate diffusion of the information and communication technology (ICT) services can facilitate visibility of hotels and lodges on search sites and third-party booking websites and thus influence demand. It also helps leverage the use of social media for promotion and customer acquisition purposes. Recently, Myanmar, with impressive historical world heritage sites, is witnessing a tourist boom; more hotels are opening up and achieving competitive advantage by offering free internet connectivity to guests and locating their premises in the vicinity of an ICT infrastructure. The purpose of this paper is to investigate ICT readiness to support the lodging industry in Myanmar by focusing on one sub-index of the Network Readiness Index (NRI, a term heavily used by World Economic Forum). The paper focuses on the "Network Use" component of NRI, pertaining to the effect of the "quality of the Internet connection" available to lodges, and its association with the following dimensions: customer service: the availability of ICT services to guests, such as internet connectivity and availability of ATM in the vicinity; digital marketing: the use of social media, keeping records of guests and analyzing aggregate data to extract business insights; and business-to-business online booking: the use of online booking via major third-party intermediary websites like Expedia, Booking.com and Agoda.com. Design/methodology/approach: Surveys were conducted in three major touristic cities in Myanmar: Bagan, Mandalay and the capital city, Nay Pyi Taw. A total of 101 valid questionnaires were used. Survey questions were centered around the following themes: internet connection problems, digital marketing activities, and online booking directly or via third party digital intermediary. The data are presented and interpreted by descriptive statistics and regression analysis. Findings: Though, Myanmar is new to internet and commercial use of ICT, the awareness of the importance of leveraging social media and online booking for business development is surprisingly high in the lodging sector. On average, about 80 percent of surveyed hotels are present on the WWW through a dedicated hotel website. However, most websites lack an online booking capability. As a result, and due to a global trend, online booking through third-party intermediaries has become the dominant option for hotel booking arrangements in Myanmar. Agoda, founded in Bangkok in 2002, was found to be the number one choice for online booking intermediary in Myanmar, followed by Booking.com. Analysis of the logistic regression revealed that it was highly likely that areas around ATMs have better internet connectivity. As expected, it was also found that it is very unlikely that hotels reporting a problem in internet connectivity will be able to provide internet service to their guests. Despite the presence of problems in internet connectivity in Mandalay and Bagan cities, located away from the capital; most hotels in these cities resort to leveraging social media for promotion and customer/guest development. The analysis also revealed that cities located away from the capital are more aggressive in leverage online third-booking intermediaries. Research limitations/implications: While researchers were hoping for a higher participation rate in the survey, especially in the city of Mandalay, data collection was challenging, a number of hotels/lodges denied participation. This may have some implications on the generalization of results. However, over 70 and 45 percent of hotels/lodges in the capital city and the ancient city of Bagan, respectively, had participated in the survey. Practical implications: Tourism has a great potential for growth in Myanmar. This research recommends ways to achieve and sustain competitive advantage for the lodging sector, which is vital for tourism. Originality/value: Though a considerable research exists on tourism and the recent advances of the ICT sector in Myanmar, the country's readiness for the actual usage of the internet for the development of tourism has not been specifically addressed. This paper explores this with compelling research findings useful for policy makers as well as players in the tourism sector. [ABSTRACT FROM AUTHOR]

Urbanization of natural landscapes and increasing human populations have brought people and our companion animals into closer contact with wildlife, even within protected areas. To provide guidance for human–wildlife coexistence, it is therefore critical to understand the effects of anthropogenic disturbances and how well native wildlife species survive in human-dominated landscapes. We investigated the spatio-temporal responses of 10 vertebrate taxa, with an emphasis on the Endangered Eld's deer Rucervus eldii thamin , to anthropogenic disturbances in Shwesettaw Wildlife Sanctuary, Myanmar. We quantified anthropogenic disturbances as distance from human settlements, distance from a highway, and the presence of people and free-ranging dogs Canis familiaris. Anthropogenic disturbances had stronger negative impacts on the detection of native wildlife species than on occupancy. Eld's deer avoided areas close to human settlements and showed low diel activity overlap with both people and dogs, although we found a positive association with human presence at the camera-trap sites. Five species exhibited lower diel activity overlap with people in the rainy season when human activity is the highest in our study area. All studied wildlife species shifted to nocturnal activity or did not show any clear activity pattern during the cool-dry season when the presence of dogs increased. The ecological and conservation impacts of dogs are underestimated in South-east Asia, particularly in Myanmar, and this case study highlights the impacts of dogs on the temporal use of habitat by wildlife and the need for better practices in the management of dogs within protected areas. [ABSTRACT FROM AUTHOR]

The entrepreneurship literature shows inconsistent results in outcome effectiveness, such as entrepreneurial self-efficacy (ESE), entrepreneurial intention (EI), and entrepreneurial behavior. This could be due to the sole focus on the motivational aspects of behavioral change. Action planning, a volitional intervention used to modify health behavior, could resolve the inconsistent results mentioned above. Therefore, this study aims to evaluate the direct impacts of action planning intervention (API) following entrepreneurship education (EE) on ESE, EI, and opportunity recognition and to examine the behavioral change process from motivational and volitional perspectives. In this randomized controlled trial (RCT), we considered action planning to enhance entrepreneurial behavior after EE. The sample included 83 participants from a university in Myanmar. We randomly assigned the students to the API and control groups. We collected data on ESE and EI before and after training. We used objective measures for opportunity recognition through an opportunity evaluation framework. Serial mediation analysis revealed that the volitional impact on opportunity recognition was positively significant. From a motivational standpoint, ESE improved significantly, but we found no significant impact on EI; ESE and EI were serial mediators, with no specific mediation solely by ESE or EI. The findings contribute to the EE literature by presenting a brief and cost-effective API for EE. [ABSTRACT FROM AUTHOR]

Smokers are not the only ones who suffer the effects of tobacco; those around them are also harmed, particularly vulnerable groups such as pregnant women. This study aimed to describe the prevalence of secondhand smoke (SHS) among pregnant women and the factors associated with SHS exposure. This study was a cross-sectional descriptive study conducted at Central Women's Hospital in the Yangon Region in 2022. The prevalence of SHS exposure was described, and multivariate analyses were conducted to determine the associated factors. Out of 407 participants, the prevalence of SHS exposure was 65.4%. Education level, religion, smoking rules at home, visiting public places, and avoidance of SHS during pregnancy were significantly associated with SHS exposure. The findings highlighted the need for community guidance programs, policies, and interventions to establish smoke-free environments. It is also important to conduct behavioral interventions for smokers, especially to avoid SHS for pregnant women. [ABSTRACT FROM AUTHOR]

Background: Although Remdesivir has been evaluated for the treatment of coronavirus disease 2019 (COVID-19), few study has yet shown effective mortality reduction. It might be because, in almost all those studies, remdesivir therapy was started beyond 7th days from the onset of symptoms when the active viral replications have already gone. Methods: This study reviewed the effectiveness of early remdesivir therapy during viral phase of COVID-19 and safety of its administration at home or community care during the outbreak of COVID-19 from July to September 2021 in Myanmar. We retrospectively reviewed clinical records of 204 high risk COVID-19 patients who had received remdesivir therapy within 7 days from the onset of illness and before oxygen desaturation. Findings: All patients received remdesivir therapy according to standard five days course of 200 mg loading dose on day 1, followed by 100 mg daily for up to 4 additional days. Out of 204 patients, 60.75% (124/204) were aged 60 years and above with comorbidity; 21.1% (43/204) aged under 60 years with comorbidity and 18.1% (37/204) were aged more than 60 years old without comorbidity. The patients who received RDSV therapy within 1-4 days and within 5-7 days were 50.5% (103/204) and 49.5% (101/204) respectively. All patients survived to 21 days without ICU admission or mechanical ventilation. Eighty six percent of patients had no hypoxia and only five percent had moderate to severe hypoxia, requiring oxygen. Those who received RDSV therapy within 1 to 4 days from the onset of symptoms had significantly lower rate of hypoxia compared to those who received remdesivir therapy on 5 to 7 days. After RDSV therapy, increased lymphocyte count and decreased CPR were observed in 74.5% (152/204) and 52.9% (108/204) of the patients respectively. There was no report of major adverse events. Conclusion: Remdesivir, if given within first 4 days from the onset of symptoms, is the most effective strategy for prevention of oxygen desaturation, further progression of COVID-19 and death although it is still beneficial if given later, days 5 to 7. It is a safe drug to be prescribed in hospital at home care. It may be cost-benefit if high-risk group of patients with COVID-19 were selected for early remdesivir therapy in the community. [ABSTRACT FROM AUTHOR]

Background: In Myanmar, 1.3 million people have been exposed to hepatitis C (HCV). However, public sector access to viral load (VL) testing for HCV diagnosis remains limited; ten near-point-of-care (POC) devices are available nationally. Myanmar's National Health Laboratory (NHL) has surplus capacity on centralized molecular testing platforms used for HIV diagnostics, presenting an opportunity for integrating HCV testing to expand overall testing capacity. This pilot assessed the operational feasibility and acceptability of HCV/HIV integrated testing implemented with a comprehensive package of supportive interventions. Methods: HCV VL samples were collected prospectively from consenting participants at five treatment clinics and tested at Myanmar's NHL (October 2019-February 2020) on the Abbott m2000. To optimize integration, laboratory human resources were bolstered, staff trainings were offered, and existing laboratory equipment was serviced/repaired as needed. Diagnostics data during the intervention period were compared against HIV diagnostics data in the seven months prior. We conducted three time and motion analyses at the laboratory and semi-structured interviews with laboratory staff to assess time needs and program acceptability. Results: 715 HCV samples were processed during the intervention period with an average test processing time of 18 days (IQR: 8–28). Despite adding HCV testing, average monthly test volumes were 2,331 for HIV VL and 232 for early infant diagnosis (EID), comparable to the pre-intervention period. Processing times were 7 days for HIV VL and 17 days for EID, also comparable to the pre-intervention period. HCV test error rate was 4.3%. Platforms utilization increased from 18.4% to 24.6%. All staff interviewed were supportive of HCV and HIV diagnostics integration; suggestions were made for broader implementation and expansion. Conclusions: With a package of supportive interventions, integration of HCV and HIV diagnostics on a centralized platform was operationally feasible, did not adversely impact HIV testing, and was acceptable to laboratory staff. In Myanmar, integrated HCV VL diagnostic testing on centralized platforms may be an important addition to existing near-POC testing in expanding national testing capacity for HCV elimination. [ABSTRACT FROM AUTHOR]

Cash‐based interventions are increasingly used in humanitarian response, including in the water, sanitation, and hygiene (WASH) sector. To strengthen evidence, we conducted a qualitative study on cash‐based interventions programs for WASH operations and maintenance in Kachin, Myanmar. We collected field data for one programme and completed a desk review for two programs. We found camp‐based committees were responsible for spending decisions and cash use was aligned with community needs/priorities. Programme strengths included community empowerment, time effectiveness; programme weaknesses included funding insecurity, limited training and monitoring and vulnerable groups inclusion. Recommendations for cash‐based WASH operation and maintenance programs in Kachin and similar contexts are presented. [ABSTRACT FROM AUTHOR]

The NGO Fauna & Flora started working in the Myeik Archipelago, southern Myanmar in 2013, and in 2017 three locally managed marine areas were established to aid sustainable fisheries management and support biodiversity conservation. These sites are the first protected areas specifically established for co-management of marine fisheries in Myanmar, in which long-term management rights have been formally granted to local fishing communities. The establishment of a further four locally managed marine areas is now in progress, with ambitions for a network to be established throughout the archipelago. To track changes in these habitats over time, assess effectiveness and inform adaptive fisheries management, annual coral reef monitoring will be conducted at these community-managed sites. We provide an overview of the locally managed marine areas recently established in Myanmar and of proposed new sites, and detail the establishment of the first permanent coral reef monitoring transects. In sharing the initial evidence gathered on the impact of new, local management measures, we aim to highlight the importance and benefit of developing marine resource management systems to strengthen fisheries management while simultaneously establishing a monitoring framework to fill a national and global coral reef data gap. [ABSTRACT FROM AUTHOR]

Objective: Prospective studies of encephalitis are rare in regions where encephalitis is prevalent, such as low middle‐income Southeast Asian countries. We compared the diagnostic yield of local and advanced tests in cases of pediatric encephalitis in Myanmar. Methods: Children with suspected subacute or acute encephalitis at Yangon Children's Hospital, Yangon, Myanmar, were prospectively recruited from 2016–2018. Cohort 1 (n = 65) had locally available diagnostic testing, whereas cohort 2 (n = 38) had advanced tests for autoantibodies (ie, cell‐based assays, tissue immunostaining, studies with cultured neurons) and infections (ie, BioFire FilmArray multiplex Meningitis/Encephalitis multiplex PCR panel, metagenomic sequencing, and pan‐viral serologic testing [VirScan] of cerebrospinal fluid). Results: A total of 20 cases (13 in cohort 1 and 7 in cohort 2) were found to have illnesses other than encephalitis. Of the 52 remaining cases in cohort 1, 43 (83%) had presumed infectious encephalitis, of which 2 cases (4%) had a confirmed infectious etiology. Nine cases (17%) had presumed autoimmune encephalitis. Of the 31 cases in cohort 2, 23 (74%) had presumed infectious encephalitis, of which one (3%) had confirmed infectious etiology using local tests only, whereas 8 (26%) had presumed autoimmune encephalitis. Advanced tests confirmed an additional 10 (32%) infections, 4 (13%) possible infections, and 5 (16%) cases of N‐methyl‐D‐aspartate receptor antibody encephalitis. Interpretation: Pediatric encephalitis is prevalent in Myanmar, and advanced technologies increase identification of treatable infectious and autoimmune causes. Developing affordable advanced tests to use globally represents a high clinical and research priority to improve the diagnosis and prognosis of encephalitis. ANN NEUROL 2023;93:615–628 [ABSTRACT FROM AUTHOR]

Objectives: Since 2007, anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis has been increasingly reported worldwide. Although the diagnostic testing of anti-NMDAR encephalitis was available in Myanmar since 2016, there have been no studies reported so far. This is a report of anti- NMDAR encephalitis admitted to one of the tertiary care hospitals in Myanmar. Methods: It is an observational study of anti-NMDAR encephalitis admitted at North Okkalapa General and Teaching Hospital (NOGTH) for three consecutive years. Results: In this study, ten patients diagnosed as anti- NMDAR encephalitis were included. Median age of onset was 21 years, ranged from 16 to 85 years. Nine out of ten patients were female (90%). Seven patients (70%) showed four of the six major groups of symptoms. Only one patient (10%) was found to have ovarian teratoma. EEG abnormalities were observed in all patients (100%). Out of six MRIs done, four (66.6%) were normal. Conclusion: This study showed that demographic profile, clinical characteristics, and ancillary test results were in similarity with other previous studies but mortality rate of 40% was relatively high as compared to previous studies. [ABSTRACT FROM AUTHOR]

An influenza circulation was observed in Myanmar between October and November in 2021. Patients with symptoms of influenza-like illness were screened using rapid diagnostic test (RDT) kits, and 147/414 (35.5%) upper respiratory tract specimens presented positive results. All RDT-positive samples were screened by a commercial multiplex real-time polymerase chain reaction (RT-PCR) assay, and 30 samples positive for influenza A(H3N2) or B underwent further typing/subtyping for cycle threshold (Ct) value determination based on cycling probe RT-PCR. The majority of subtyped samples (n = 13) were influenza A(H3N2), while only three were B/Victoria. Clinical samples with low Ct values obtained by RT-PCR were used for whole-genome sequencing via next-generation sequencing technology. All collected viruses were distinct from the Southern Hemisphere vaccine strains of the corresponding season but matched with vaccines of the following season. Influenza A(H3N2) strains from Myanmar belonged to clade 2a.3 and shared the highest genetic proximity with Bahraini strains. B/Victoria viruses belonged to clade V1A.3a.2 and were genetically similar to Bangladeshi strains. This study highlights the importance of performing influenza virus surveillance with genetic characterization of the influenza virus in Myanmar, to contribute to global influenza surveillance during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This study aims to increase knowledge and understanding of Government-to-Business (G2B) Services in Myanmar and will also discover the critical challenges for G2B e-Service provision in Myanmar. The government officials from the agencies providing G2B services are surveyed to explore the current status of G2B services in Myanmar. Questionnaires were analyzed quantitatively and qualitatively, with the respondents identifying themselves as they currently work at government agencies. The study revealed that among the total 30 Ministries, it is 24 % of public services are available online. The current study found that ICT infrastructure barriers, legal and policy issues, and financial barriers are significant challenges that delay the progress of G2B e-Service implementation in Myanmar. The ICT infrastructure, particularly regarding data center, are still considered inadequate, and financial and technical assistance is in demand for implementing the G2B e-Service. Social and cultural barriers are the fewer obstacles found in the analysis, with an overall rate of 87.3% positive opinion on the digital transformation of G2B services. This study will support several contributions to implementing eGovernment services in Myanmar and provide awareness about G2B e-Service in Myanmar. [ABSTRACT FROM AUTHOR]

Background: Residual malaria is probably an important source for the re-emergence of malaria infection in the elimination era. Assessment to identify the factors influencing residual malaria in high-risk groups is needed to develop evidence-based decisions by stakeholders and policymakers.Methods: This study was conducted to explore the factors influencing the residual malaria infection among migrant workers in two sentinel sites (endemic vs. pre-elimination areas) in Myanmar using the mixed-model method.Results: A total of 102 migrant respondents (65 in Bamauk and 37 in Shwegyin) were included for the quantitative assessment using pretested questionnaires during household visits. Although 87.3% of them had insecticidal bed nets (ITNs/LLINs), only 68.3% of the migrants in Bamauk and 57.9% in Shwegyin used it regularly. The use of any bed net was high (79.9% in Bamauk vs. 91.0% in Shwegyin). The mean LLINs in their families were 1.64 (95%CI: 1.48-1.81) in Bamauk and 2.89 (95%CI: 2.67-3.11) in Shwegyin. Most of them received no health information for malaria prevention within the last year and their knowledge about malaria was low. Their working nature was a challenge for control measures against malaria in migrants.Conclusion: The strategy for distributing LLINs and health promotion activities for mobile/migrant populations should be reviewed, and an appropriate action plan should be developed for the specific migrant group. Moreover, health promotion activities for behavior change communication should be strengthened in the migrant population in Myanmar. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to compare the efficacy of limited plasma exchange against supportive and standard treatments in treatment of Guillain-Barré syndrome (GBS). Method: A total of 90 GBS patients admitted to Yangon General Hospital, Yangon, Myanmar were recruited over 1.5-year-period from January 2017 to June 2018 and they were divided into 3 groups according to the treatment they received (convenience sampling method): supportive (n=36), limited plasma exchange (LPE) (n=35) and standard (therapeutic plasma exchange - TPE or IVIg) (n=19)). Their clinical features, electrophysiological subtypes and severity were compared at baseline, and outcome (change in GBS disability score (GDS) at 30 days after entry) was assessed and compared. Results: Baseline characteristics such as gender, GBS subtypes and respiratory involvement were comparable, but standard treatment group had older patients, and LPE group had shorter latency to nadir and more cases with antecedent diarrhea, which are poor outcome predictors. At 30 days from entry, mean GDS improvement was 0.9 + 0.6 in supportive, 1.4 + 0.6 in LPE and 1.2 + 0.8 in standard treatment groups respectively. The difference between LPE and supportive treatment was statistically significant (p 0.002) but there was no difference between LPE and standard treatment (p = 0.512). Regarding untoward effects, apart from one transient hypotension and 2 anemic cases, no other serious adverse effects were noted from LPE therapy. Conclusion: LPE may be superior to supportive treatment and may not be inferior to standard treatment. Therefore, LPE may be an alternative effective treatment for GBS patients who are not accessible to standard treatments especially in low income countries with limited resources. [ABSTRACT FROM AUTHOR]

Different shoot/root micro-environments were investigated for growth performances and nutraceutical compounds in leaves of mulberry (Morus alba L.) transplants. Single-node segments were taken from seedling-grown pots of three cultivars: Myanmar large leaf (MLL), Myanmar medium leaf (MML), and C14. Transplant production was compared in soil, vermiculite (V), or the dynamic root floating technique (DRFT). The highest survival percentage of the transplants was obtained from V-system, and MLL showed a higher shoot/root formation over two tested cultivars. The MLL transplants grown in V-system under white LED light (445 and 554 nm) at 200 μmol·m−2·s−1 gave a fresh weight with superior qualified transplants compared to other treatments. The bioactive compounds in leaves of MLL, MML, and C14 were analyzed using GC–MS after incubation with different LED spectra. Ethanol extracts of the leaves revealed that more than 50% of the bioactive compounds were fatty acids and conjugates and varied according to spectra and cultivar. Blue LED light (445 nm) induced the production of total phenolics, whereas white LED light favored the production of total proteins, soluble sugar, and biomass. The modified environments at the root and aerial zones significantly influenced the growth and biochemical parameters of transplants, and this applied technique can elevate useful functional ingredients of mulberry leaves. [ABSTRACT FROM AUTHOR]

This study describes sex trafficking and associations with violence and health among female migrants in the sex industry in Mae Sot, Thailand. The mixed-methods study included a qualitative interview phase (n = 10), followed by a cross-sectional survey phase (n = 128). Entry via trafficking (force, fraud, or coercion [FFC], or as minors) was prevalent (76.6%), primarily FFC (73.4%). FFC was associated with inconsistent condom use, inability to refuse clients, poor health, and anxiety. Past-year violence was normative including client sexual violence (66.4%), client coercion for condom nonuse (> 95%), and police extortion (56%). Working conditions enabled violence irrespective of mode of entry. Profound unmet needs exist for safety and access to justice irrespective of trafficking history. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a major health concern globally. Genomic epidemiology is an important tool to assess the pandemic of coronavirus disease 2019 (COVID-19). Several mutations have been reported by genome analysis of the SARS-CoV-2. In the present study, we investigated the mutational and phylogenetic analysis of 30 whole-genome sequences for the virus's genomic characteristics in the specimens collected in the early phase of the pandemic (March–June, 2020) and the sudden surge of local transmission (August–September, 2020). The four samples in the early phase of infection were B.6 lineage and located within a clade of the samples collected at the same time in Singapore and Malaysia, while five returnees by rescue flights showed the lineage B. 1.36.1 (three from India), B.1.1 (one from India) and B.1.80 (one from China). However, there was no evidence of local spread from these returnees. Further, all 19 whole-genome sequences collected in the sudden surge of local transmission showed lineage B.1.36. The surge of the second wave on SARS-CoV-2 infection was linked to the single-introduction of a variant (B.1.36) that may result from the strict restriction of international travel and containment efforts. These genomic data provides the useful information to disease control and prevention strategy. [ABSTRACT FROM AUTHOR]

The Silond catfish Silonia silondia, locally known as Nga Myin Yinn, is a commercially important fish in Myanmar; however, fundamental knowledge of its population structure is insufficient. Specimens caught in different regions of the Ayeyarwady River, the basin of which is the country's largest, from 2017 to 2019 were used to sequence two mitochondrial (mt)DNA genes, cytochrome b and ATPase 6/8, for investigating population differentiation. Phylogenetic trees and pairwise fixation index values revealed that the populations of S. silondia differed between Myanmar and Bangladesh/India, whereas the populations and mtDNA haplotypes were not significantly different among four regions of the Ayeyarwady River (Ayeyarwady, Yangon, Magway, and Mandalay). In addition, no unique haplotype was observed, given the lack of nucleotide diversity. Thus, S. silondia in the Ayeyarwady River can be considered a single population, which is different from those of Bangladesh/India. Our study provides the first content for understanding the genetic diversity of S. silondia in the Ayeyarwady River in Myanmar according to molecular analyses. These genetic data will be useful for understanding the genetic diversity of this species in South and Southeast Asia. [ABSTRACT FROM AUTHOR]

Mangrove ecosystems sequester and store large amounts of carbon in both biomass and soil. In this study, species diversity, the above and below-ground biomass as well as carbon stock by the mangroves in Kanhlyashay natural mangrove forest were estimated. Six true mangrove species from four families were recorded in the sample plots of the study area. Among them, Avicennia officinalis L. from the Acanthaceae family was the abundance of species with an importance value of 218.69%. Shannon–Wiener's diversity index value (H′ = 0.71) of the mangrove community was very low compared to other natural mangrove forests since the mangrove stands in the study site possessed a low number of mangrove species and were dominated by a few species. Estimated mean biomass was 335.55 ± 181.41 Mg ha−1 (AGB = 241.37 ± 132.73 Mg ha−1, BGB = 94.17 ± 48.73 Mg ha−1). The mean overall C-stock of the mangrove stand was 150.25 ± 81.35 Mg C ha−1 and is equivalent to 551.10 ± 298.64 Mg CO2 eq. The role of forests in climate change is two-fold as a cause and a solution for greenhouse gas emissions. The result of the study demonstrated that the mangroves in Letkhutkon village have high carbon storage potential, therefore it is necessary to be sustainably managed to maintain and increase carbon storage. Climate change mitigation may be achieved not only by reducing the carbon emission levels but also by maintaining the mangrove ecosystem services as carbon sinks and sequestration. [ABSTRACT FROM AUTHOR]

Background: The collection and utilization of surveillance data is essential in monitoring progress towards achieving malaria elimination, in the timely response to increases in malaria case numbers and in the assessment of programme functioning. This paper describes the surveillance activities used by the malaria elimination task force (METF) programme which operates in eastern Myanmar, and provides an analysis of data collected from weekly surveillance, case investigations, and monitoring and evaluation of programme performance. Methods: This retrospective analysis was conducted using data collected from a network of 1250 malaria posts operational between 2014 and 2021. To investigate changes in data completeness, malaria post performance, malaria case numbers, and the demographic details of malaria cases, summary statistics were used to compare data collected over space and time. Results: In the first 3 years of the METF programme, improvements in data transmission routes resulted in a 18.9% reduction in late reporting, allowing for near real-time analysis of data collected at the malaria posts. In 2020, travel restrictions were in place across Karen State in response to COVID-19, and from February 2021 the military coup in Myanmar resulted in widescale population displacement. However, over that period there has been no decline in malaria post attendance, and the majority of consultations continue to occur within 48 h of fever onset. Case investigations found that 43.8% of cases travelled away from their resident village in the 3 weeks prior to diagnosis and 36.3% reported never using a bed net whilst sleeping in their resident village, which increased to 72.2% when sleeping away from their resident village. Malaria post assessments performed in 82.3% of the METF malaria posts found malaria posts generally performed to a high standard. Conclusions: Surveillance data collected by the METF programme demonstrate that despite significant changes in the context in which the programme operates, malaria posts have remained accessible and continue to provide early diagnosis and treatment contributing to an 89.3% decrease in Plasmodium falciparum incidence between 2014 and 2021. [ABSTRACT FROM AUTHOR]

Molecular marker has been used for variety identification, genetic diversity of genotypes and additional using intellectual property protection in DUS testing. DNA fingerprinting of fourteen maize genotypes had been studied at Plant Biotechnology Laboratory, DAR, Myanmar during 2020-2021. Nine hybrids and five inbreds were analyzed using 24 polymorphic SSR markers, resulted a total number of 101 alleles with a range from 2 to 9 alleles per locus. Polymorphism has been sufficiently detected with the average of 0.66 per SSR locus. Cluster analysis separated all the maize genotypes as five major groups and indicated the existence of genetic variation among the observed inbreds and hybrids. Six SSR primer pairs (dupssr12, bnlg1940, umc1248, umc1586, bnlg1518 and bnlg1028) were selected as final marker set for variety identification with the selection criteria such as detection rate of the SSR fragment, the presence of rare allele, PIC value, and reproducibility and PCR band pattern of SSR fragments. In this study, all tested genotypes have been fingerprinted with unique profile identity (ID) to support the DNA fingerprint catalogues of Myanmar Maize Molecular DUS test guidelines. [ABSTRACT FROM AUTHOR]

Background: In Myanmar, the use of a mobile app for tuberculosis (TB) screening and its operational effect on seeking TB health care have not been evaluated yet. Objective: This study aims to report the usability of a simple mobile app to screen TB and comply with chest X-ray (CXR) examination of presumptive cases detected by the app. Methods: A new "TB-screen" app was developed from a Google Sheet based on a previously published algorithm. The app calculates a TB risk propensity score from an individual's sociodemographic characteristics and TB clinical history and suggests whether the individual should undergo a CXR. The screening program was launched in urban slum areas soon after the COVID-19 outbreak subsided. A standard questionnaire was used to assess the app's usability rated by presumptive cases. Compliance to undergo CXR was confirmed by scanning the referral quick response (QR) code via the app. Results: Raters were 453 presumptive cases detected by the app. The mean usability rating score was 4.1 out of 5. Compliance to undergo CXR examination was 71.1% (n=322). Active TB case detection among CXR compliances was 7.5% (n=24). One standard deviation (SD) increase in the app usability score was significantly associated with a 59% increase in the odds to comply with CXR (ß=.464) after adjusting for other variables (P<.001). Conclusions: This simple mobile app got a high usability score rated by 453 users. The mobile app usability score successfully predicted compliance to undergo CXR examination. Eventually, 24 (7.5%) of 322 users who were suspected of having TB by the mobile app were detected as active TB cases by CXR. The system should be upscaled for a large trial. [ABSTRACT FROM AUTHOR]

Myanmar has experienced considerable economic and social changes since its political transition in the early 2010s. Its agriculture sector has demonstrated rapid intensification and modernization. Agricultural best management practices (BMPs), e.g., drum seeders and laser land levelling, were introduced to rice farmers in Bago Region in 2012 to increase sustainable production and counter negative environmental impacts. The objective of this study was to determine the socioeconomic and agronomic changes due to the adoption of BMPs between adopters and non-adopters. Using a digital survey questionnaire application to collect household data, 200 farmers in eight villages were interviewed in 2012 and 2017. Data were analysed using uni- and multivariate statistics. Mediation analysis was utilized to evaluate the effect of the farmer group on rice yields. Overall, all farmers in this study experienced substantial positive changes over the course of five years in line with the national development efforts. Differences among adopters and non-adopters were not significant, but notable distinctions existed between cropping patterns. Rice-pulse farmers had higher yields (+ 0.4 t/ha), yet rice-rice farmers had larger cultivation areas, received higher agricultural credits, and had superior income levels. Nevertheless, rice yields remained low (<4 t/ha). Education was found to be an important predictor of yield. Hence, this factor is crucial for accelerating agricultural development in Myanmar. Improving extension services and knowledge transfer are necessary to expand the dissemination of sustainable BMPs and make farmers more resilient against the negative implications of climate change. [ABSTRACT FROM AUTHOR]

Background Although betel quid chewing with tobacco use is one of the major behavioral risk factors for chronic diseases, the prevalence is rather on the increase in Myanmar. This study determined prevalence of betel quid chewing at the national and subnational levels and its associations with tobacco and sociodemographic factors. Methods This study is a secondary data analysis of Myanmar demographic health survey 2015–2016 with a total of 11 773 women and 4251 men aged 18–49 years. Chi-square tests and multivariable logistic regression tests were performed. Results Prevalence of betel quid chewing was 61.8% in men and 19.5% in women and by regions it ranged from 34 to 82.2% and from 5–8 to 52.9%, respectively. The prevalence of the concurrent use with tobacco was 25.8 and 2.3%, respectively. Women with older age, low education and low wealth and occupation and living with spouse were associated with betel quid chewing, while low education, living with spouse and Myanmar speaker were associated with men. Tobacco use was inversely and positively associated with betel quid chewing in men and women, respectively (P -interaction <0.0001). Conclusion Implementation of culturally sensitive intervention and policies including effective community awareness campaigns for anti-betel quid chewing is strongly recommended in Myanmar. [ABSTRACT FROM AUTHOR]

Rice is the major food crop in Myanmar and bacterial blight is one of the devastating diseases affecting production. In this study, 37 local rice varieties and 41 rice lines were tested at Yezin Agricultural University, Myanmar, to three different isolates of Xanthomonas oryzae pv. oryzae to evaluate the resistance levels of these different rice varieties. The three bacterial isolates used in this experiment were collected from Zeyathiri, Zabuthiri and Pyinmana townships in Nay Pyi Taw Union Territory. At maximum tillering stage, the uppermost fully expanded leaves were inoculated by the clipping method. Three weeks after the inoculation, the percent leaf area of the inoculated leaves was visually estimated and the disease reaction of the rice varieties determined. The thirty-seven local rice varieties were classified into seven groups, with this grouping based on the reaction patterns to the three isolates. Group VII, which contained two varieties, Nga Sar Kay and Sinthukha, was moderately resistant to Pyinmana isolate and moderately susceptible to the Zeyathiri and Zabuthiri isolates. The rice varieties included in Group I to Group VI showed susceptible reactions to testing with all three isolates. Among YAU rice lines tested, YAU-1211-71-1-1 exhibited moderate resistance to the Pyinmana isolate only. Apart from the line mentioned above, all the other YAU rice lines, did not exhibit resistance reactions to the test isolates. Nga Sar Kay, a local rice variety, has the potential to be used in the future rice breeding programs and YAU-1211-71-1-1 is the promising one to be used in areas where rice bacterial blight disease is prevalent. [ABSTRACT FROM AUTHOR]

Background: Previous studies in Europe and the USA have reported a high prevalence of adverse drug reactions (ADRs), but data on local ADRs in Myanmar are sparse. Objective: Our objective was to study ADRs in patients admitted to selected wards of Yangon General Hospital (YGH) and Yangon Specialty Hospital (YSH), Myanmar. Methods: This was a prospective observational study in three hospital wards during the first quarter of 2019. Suspected ADRs were carefully investigated in a face-to-face interview with each patient and via review of clinical records. Patients transferred to other wards or discharged were followed-up by the researchers until day 28 after admission. ADRs were divided into those that (1) led to the admission and (2) occurred during the hospital stay or after discharge (up to day 28 after admission). Results: A total of 65 ADRs were identified, with 47 (29.4%) of 160 patients experiencing at least one ADR. Among these, 16 (24.6%) had led to hospital admission and 49 (75.4%) occurred in 31 patients during their hospital stay. Of 160 patients, 21 had taken at least one herbal remedy and six of these developed an ADR. Five ADR–drug associations (hypokalaemia with methylprednisolone, increased transaminase levels with standard antituberculosis drugs, upper gastrointestinal bleeding with nonsteroidal anti-inflammatory drugs, constipation with tramadol, and increased transaminase levels with herbal remedies) represented 18 (27.7%) of the 65 ADRs in this study. According to the Schumock and Thornton preventability scale, more than half of these ADRs (35 [53.9%]) were preventable. Conclusion: The present study highlights the existence of ADRs among patients attending these hospitals. The implementation of active pharmacovigilance in hospitals could be a helpful first step to improving the awareness of unwanted effects of medicines and patient safety, as well as a way to strengthen the national pharmacovigilance system in countries such as Myanmar. [ABSTRACT FROM AUTHOR]

Background: Ayeyarwady Region in Myanmar has made significant progress towards malaria elimination, with cases decreasing from 12,312 in 2015 to 122 in 2019. As transmission declines, malaria becomes increasingly focalized both in geographic hotspots and among population groups sharing certain risk factors. Developing a thorough profile of high-risk activities associated with malaria infections is critical to ensure intervention approaches are evidence-based. Methods: A test-negative study was conducted from September 2017 to May 2018 in Ngaputaw, Pathein and Thabaung townships in Ayeyarwady Region. Patients that presented to selected public facilities or community health volunteers with fever answered survey questions on demographic and behavioural risk factors, including exposure to malaria interventions, and were assigned to case and control groups based on the result of a malaria rapid diagnostic test. A random-effects logistic regression model adjusted for clustering at the facility level, as well as any variables along the causal pathway described by a directed acyclic graph, was used to determine odds ratios and association with malaria infections. Results: A total of 119 cases and 1744 controls were recruited from 41 public facilities, with a mean age of 31.3 and 63.7% male. Higher risk groups were identified as males (aOR 1.8, 95% CI 1.2–2.9) and those with a worksite located within the forest (aOR 2.8, 95% CI 1.4–5.3), specifically working in the logging (aOR 2.7, 95% CI 1.5–4.6) and rubber plantation (aOR 3.0, 95% CI 1.4–6.8) industries. Additionally, links between forest travel and malaria were observed, with risk factors identified to be sleeping in the forest within the past month (aOR 2.6, 95% CI 1.1–6.3), and extended forest travel with durations from 3 to 14 days (aOR 8.6, 95% CI 3.5–21.4) or longer periods (aOR 8.4, 95% CI 3.2–21.6). Conclusion: Malaria transmission is highly focalized in Ayeyarwady, and results illustrate the need to target interventions to the most at-risk populations of working males and forest goers. It will become increasingly necessary to ensure full intervention coverage of at-risk populations active in forested areas as Myanmar moves closer to malaria elimination goals. [ABSTRACT FROM AUTHOR]

Background: Achieving the elimination of soil-transmitted helminth (STH) infections requires a sufficient understanding of the current epidemiological status of STH endemicity. We aimed to examine the status of STH in Myanmar – a country with the eighth highest STH prevalence in the world, 10 years after instigation of the national deworming programme. Methods: In August 2016 we screened for STH infections using Kato Katz (KK) microscopy and real-time PCR (qPCR) in schoolchildren from the Bago Region township of Phyu, a STH sentinel site in Myanmar. Ten schools were randomly selected, and one stool sample each from a total of 264 students was examined. Prevalence and intensity of infection were calculated for each STH. Results: High prevalence of STH was identified in the study area with 78.8% of the schoolchildren infected with at least one STH by qPCR, and 33.3% by KK. The most prevalent STH was Trichuris trichiura, diagnosed by both KK (26.1%) and qPCR (67.1%), followed by Ascaris lumbricoides (15.5% KK; 54.9% qPCR). No hookworm infections were identified by KK; however, the qPCR analysis showed a high prevalence of Ancylostoma sp. infection (29.6%) with few Necator americanus (1.1%) infections. Conclusions: Despite bi-annual deworming of schoolchildren in the fourth-grade and below, STH prevalence remains stubbornly high. These results informed the expansion of the Myanmar National STH control programme to include all school-aged children by the Ministry of Health and Sports in 2017, however further expansion to the whole community should be considered along with improving sanitation and hygiene measures. This would be augmented by rigorous monitoring and evaluation, including national prevalence surveys. [ABSTRACT FROM AUTHOR]

Taxonomy, species diversity, and geographical distribution of the marine brown algal genus Padina (Dictyotales, Phaeophyceae) from tropical South-East Asian waters were investigated through a combination of morphological and molecular analyses. The study presents a new schematic diagram showing a suite of morphological characters including thallus hairline structures that are useful for species delineation in the genus. This study also revealed two new species from Myanmar, P. gracilis sp. nov. and P. lata sp. nov. based on molecular and morphological data. P. gracilis is characterised by a 2-layered thallus, thin hairlines on both surfaces of the thallus at equal distances, non-indusiate reproductive sori distally very close to the hairlines on the inferior surface, and the presence of Vaughaniella stage. P. lata is characterized by a 2–4-layered tiny thallus, broad hairlines located only on the inferior thallus surface, non-indusiate reproductive sori abutting the hairlines on the inferior surface and irregularly spreading on the superior surface, and the presence of Vaughaniella stage. This study also revealed new distributional records for four Padina species: P. okinawaensis from Myanmar and P. fasciata, P. ryukyuana and P. terricolor from the Philippines. These findings point to elevated species diversity in central Indo-Pacific waters. This study confirmed that most of the Padina species in the Pacific regions are showing overlapping distribution across the regions, in contrast to species from the Indian Ocean, which tend to be confined to specific localities. [ABSTRACT FROM AUTHOR]

Introduction: Intussusception is one of the commonest causes of bowel obstruction in infants. Most infants in Low- and Middle-Income Countries (LMICs) undergo an invasive operative intervention. Supported by simulation-based education (SBE), the Air Enema (AE) non-operative technique was introduced in 2016 in Myanmar. This study assesses the long-term outcomes. Methods: Mixed methods study design over 4 years including clinical outcomes and surgeon's attitudes towards the AE technique and SBE. Prospectively collected clinical outcomes and semi-structured interview with reflexive thematic analysis (RTA). Primary outcome measure was a long-term shift to non-operative intervention. Secondary outcomes: Length of Stay (LoS), recurrence rates, intestinal resection rates, compared to the operative group. The data was analysed according to intention to treat. Quantitative data analysis with Mann–Whitney U test, Fisher's exact test, Student's T-Test or Wilcoxon Signed-Rank Test utilised. A p-value of <.05 was considered significant. Results: A total of 311 infants with intussusception were included. A sustained shift to AE was revealed with high success rates (86.1–91.2%). AE had a reduced LoS (4 vs. 7 days p ≤ 0.0001), Duration of Symptoms (DoS) was lower with AE (1.9/7 vs. 2.5/7, p = 0.002). Low recurrence rates (0–5.8%) and intestinal resection rates stabilised at 30.5–31.8% vs.15.3% pre-intervention. Four RTA themes were identified: Expanding conceptions of healthcare professional education and training; realising far reaching advantages; promoting critical analysis and reflective practice of clinicians; and adapting clinical practice to local context. RTA revealed an overall positive paradigm shift in attitudes and application of SBE. Conclusions: A sustained change in clinical outcomes and appreciation of the value of SBE was demonstrated following the intervention. [ABSTRACT FROM AUTHOR]

β-Thalassemia (β-thal) is highly prevalent in Myanmar, but limited data are available on the molecular basis and the clinical manifestations in Myanmar patients. In this study, we investigated the clinical features and β-globin gene abnormalities in 15 homozygous β-thal and 60 Hb E (HBB: c.79G>A)/β-thal pediatric patients who attended Yangon Children Hospital, the biggest thalassemia day care unit center in Myanmar. Eight different β0-thal mutations were identified, with four accounting for 88.9% of alleles studied (excluding the Hb E variant). A genotype-phenotype correlation was found; all homozygous β0-thalassemias had severe clinical courses, whereas the highly variable disease severity was demonstrated among Hb E/β0-thal patients. Interactions of IVS-I-1 (G>T) (HBB: c0.92+1G>T) β0-thal with Hb E are associated with milder clinical symptoms. The number of mildly affected Hb E/β-thal patients was lower than expected, suggesting that there may be a considerable number of patients in the population who have either not been admitted to hospital or diagnosed with carrying the disease. Although the clinical severity in the Myanmar β-thal patients seems to be similar to that in other populations, the levels of hemoglobin (Hb) appears to be very low. These findings indicate the need for the improvement of patient management and the development of prevention and control programs for β-thal in Myanmar. [ABSTRACT FROM AUTHOR]

In May 2021, the Myanmar junta announced that it planned to re-open public schools, which have been closed for almost a year since the pandemic hit the country. Drawing on a thematic analysis of selected English-medium news sources on the re-opening of schools in Myanmar in 2020 and 2021, we examine how the re-opening of schools has become entangled in the junta's quest for legitimacy and citizens' everyday acts of dissent. We argue that, after the February 1 coup, which saw the junta overthrowing the democratically elected government, the mundane acts of attending schools are increasingly read by supporters of the civil disobedience movement as acts of consent and endorsement of a brutal military regime rather than citizens simply exercising their right to education. We highlight the importance of an expanded understanding of politics, one that moves beyond the Big 'P' world of politicians to the small 'p' in the everyday life of citizens. [ABSTRACT FROM AUTHOR]

Myanmar is the second most vulnerable country in the world to the effects of climate change, with agriculture highly vulnerable. This study was conducted to determine farmers' knowledge on how to respond to the impacts of climate change, to identify climateresilient adaptation technologies in rice farming, to also identify the desired characteristics of chosen rice varieties, and to estimate the cost and benefits for different rice production systems for the chosen varieties. The study was carried out in Myittha Township, a major rice-growing area in the middle of Myanmar. Most of the rice areas are irrigated. Primary data were collected by conducting a socio-economic survey. Descriptive analysis and cost benefit analysis were applied. More than 95 percent of the farmers adopted an adaptation strategy of using quality seeds. A change to the time of sowing, was favored by only 27% of respondents. About 41% of farmers grew Manaw Thukha rice variety, followed in popularity by Ayeyar Min (33.62%), and Shwe Manaw (20.49%) varieties. The traits of rice variety most desired were high yield and high marketability. The farmers practiced two different methods of rice establishment: direct seeding and transplanting, and grew in both monsoon and summer seasons. In monsoon, direct-seeded Ayeyarmin achieved the highest BCR (1.75) whereas the Manaw Thukha variety yielded the highest BCR in summer (1.70). The study area is an irrigated rice-growing area and has not yet suffered much from climate change impacts on rice production. This is despite a trend to scarcity of rainfall, which implies that improved irrigation facilities will comprise an essential adaptation strategy. [ABSTRACT FROM AUTHOR]

Background: Myanmar is one of the countries in Southeast Asia where serious dengue outbreaks occur and Yangon is among the regions with the highest number of cases in the country. Many infections including dengue are common in Yangon during the rainy season, and co-infections may also occur. Adults are more likely than children to experience co-infections of dengue and other diseases. Although pediatric dengue has been studied in Yangon for decades, research on adult dengue is scant. Therefore, this study compared the clinical and virological characteristics of pediatric and adult dengue cases in Yangon. Methods: This cross-sectional study was conducted at Insein General Hospital in Yangon, Myanmar, from June to September 2022. We recruited 221 suspected dengue patients (134 children and 87 adults), with or without other diseases, and tested their dengue serological markers using a serological method and their dengue virus (DENV) serotypes using conventional RT-PCR. Chi-squared and Fisher's exact tests were conducted to assess significance. Results: The dengue non-structural protein-1 antigen (NS1Ag) positivity was 37% in children and 32% in adults. DENV serotypes were identified in 80% of NS1Ag-positive patients. Among NS1Ag-positive cases, the DENV-1 serotype predominated (67%), followed by DENV-2 (17%), DENV-3 (9%), DENV-4 (5%), and mixed DENV-1 and DENV-2 (2%) serotypes. Shock was observed in 14% of children and 3% of adults. Anti-dengue IgG antibody positivity was positively correlated with dengue shock. Three pediatric dengue cases (6%) also had other infections including bronchiolitis, ear infection, and diarrhea. Seven adult dengue cases (25%) also had other diseases including advanced HIV infection, severe pneumonia, tonsillitis, thyroid disease, cholecystitis, drug poisoning, and thalassemia. Conclusion: The serotype distribution and clinical presentations of pediatric and adult dengue cases were not significantly different, but adults were more likely to have dengue together with other diseases than children. This study provides information for the better management of febrile children and adults in hospital settings and provides a foundation for nationwide epidemiological studies on dengue serotypes and modifications of the national guidelines for dengue management in Myanmar. [ABSTRACT FROM AUTHOR]

Successful plant recruitment is crucial for maintaining forest ecosystems, but knowledge of the responses of early life stages of tropical montane tree species to complex environmental factors is still limited across the Himalayas. Vegetation was surveyed along an altitudinal gradient (2450–3070 m) in six altitudinal bands in a tropical montane forest of Myanmar. We examined the effects of microclimate, soil, and microsite conditions on seedling and sapling recruitment in three dominant tree species (Quercus semecarpifolia, Rhododendron arboreum, and Symplocos lucida). We found that densities of R. arboreum and Q. semecarpifolia were higher in high and mid-altitudinal bands (2800–3000 m), whereas density of S. lucida was higher in lower altitudinal bands (2600–2700 m). Seedlings showed better recruitment in humid conditions and more sensitive to soil properties than saplings. R. arboreum and S. lucida preferred debris microsites, followed by shrub and grass microsites, whereas Q. semecarpifolia showed no significant microsite preference. Seedling recruitment mainly depended on soils and microsites, whereas sapling recruitment depended on microclimate and altitude. The study provides information on species-specific preferences and responses of montane tree species to complex environmental factors, which may contribute to restoration and sustainable forest conservation. [ABSTRACT FROM AUTHOR]

Background: Myanmar commenced a lymphatic filariasis (LF) elimination programme in 2000. Whilst the country has made considerable progress since then, a number of districts have demonstrated persistent transmission after many rounds of mass drug administration (MDA). The causes of unsuccessful MDA have been examined elsewhere; however, there remains little information on the factors that contribute in Myanmar. Methods: We conducted an analysis of factors associated with persistent infection, LF-related hydrocoele and MDA participation in an area with ongoing transmission in 2015. A cross-sectional household survey was undertaken in 24 villages across four townships of Mandalay Region. Participants were screened for circulating filarial antigen (CFA) using immunochromatographic tests and, if positive, for microfilaria by night-time thick blood slide. Individuals 15 year and older were assessed for filariasis morbidity (lymphoedema and, if male, hydrocoele) by ultrasound-assisted clinical examination. A pre-coded questionnaire was used to assess risk factors for LF and for non-participation (never taking MDA). Significant variables identified in univariate analyses were included in separate step-wise multivariate logistic regressions for each outcome. Results: After adjustment for covariates and survey design, being CFA positive was significantly associated with age [odds ratio (OR) 1.03, 95% CI 1.01–1.06), per year], male gender (OR 3.14, 1.27–7.76), elevation (OR 0.96, 0.94–0.99, per metre) and the density of people per household room (OR 1.59, 1.31–1.92). LF-related hydrocoele was associated with age (OR 1.06, 1.03–1.09, per year) and residing in Amarapura Township (OR 8.93, 1.37–58.32). Never taking MDA was associated with male gender [OR 6.89 (2.13–22.28)] and age, particularly in females, with a significant interaction term. Overall, compared to those aged 30–44 years, the proportion never taking MDA was higher in all age groups (OR highest in those < 5 years and > 60 years, ranging from 3.37 to 12.82). Never taking MDA was also associated with residing in Amarapura township (OR 2.48, 1.15–5.31), moving to one's current village from another (OR 2.62, 1.12–6.11) and ever having declined medication (OR 11.82, 4.25–32.91). Decreased likelihood of never taking MDA was associated with a higher proportion of household members being present during the last MDA round (OR 0.16, 0.03–0.74) and the number visits by the MDA programme (OR 0.69, 0.48–1.00). Conclusions: These results contribute to the understanding of LF and MDA participation-related risk factors and will assist Myanmar to improve its elimination and morbidity management programmes. [ABSTRACT FROM AUTHOR]

The burden of malaria in Myanmar has declined rapidly in recent years; cases decreased from 333,871 in 2013 to 85,019 in 2017 (75% decrease). Decline of malaria in the Ayeyarwady Region of Myanmar reflects this trend with an 86% decrease in cases over this period. In this exploratory analysis, quantitative and qualitative information were assessed to explore potential factors responsible for the decline of malaria in Ayeyarwady. Data on malaria incidence, programmatic financing, surveillance, case management, vector control interventions, climate and ecological factors, and policies and guidelines spanning 2013 to 2017 were compiled. Poisson regression models that adjust for correlation were used to analyze the association between annual malaria case numbers with malaria intervention factors at the township level. Between 2013 and 2017, there was a decrease in mean township-level malaria incidence per 1000 from 3.03 (SD 4.59) to 0.34 (SD 0.79); this decline coincided with the implementation of the government's multi-pronged malaria elimination strategy, an increase of approximately 50.8 million USD in malaria funding nationally, and a period of deforestation in the region. Increased funding in Ayeyarwady was invested in interventions associated with the decline in caseload, and the important roles of surveillance and case management should be maintained while Myanmar works towards malaria elimination. [ABSTRACT FROM AUTHOR]