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Various studies have found cultural differences in emotional competence and conflict management styles, yet very few studies to date have addressed the matter from the perspective of relational contexts. This study investigated the influence of emotional competence on conflict management styles toward different relational targets based on intimacy and status, comparing two cultures: Japan and Myanmar. A total of 601 university students participated in a questionnaire survey. Results revealed cultural differences in intrapersonal and interpersonal emotional competence, and conflict management styles. In addition, Myanmar was higher in their preference for integrating and obliging styles across all conditions, while Japanese preferred compromising conflict style more than Myanmar in the high intimacy conditions. Results indicated that participants were apt to change their conflict management styles, depending on relational intimacy and status difference. A causal model testing the influence of culture indicated intrapersonal and interpersonal emotional competence mediated its effect on integrating and compromising styles. Moreover, culture affected obliging style in the high intimacy-high status condition through intrapersonal emotional competence, and likewise through interpersonal emotional competence in the low intimacy-high status condition. Furthermore, interpersonal emotional competence mediated the relationship between culture and dominating style in most conditions, except the high intimacy-equal status condition. [ABSTRACT FROM AUTHOR]

This study investigates the costs incurred by patients diagnosed with uncomplicated malaria at a formal rural health facility in Myanmar. A cross-sectional survey of 410 patients indicated that the majority of patients were male (89.3%), married (84.6%) and the head of their family (80.2%); this spectrum reflected the deliberate selection of persons for whom relatively accurate costing was feasible. The average total costs incurred for an episode of malaria was kyats 173.58 (95% CI = 166.13–181.02), with the highest cost contribution being the loss of earnings due to absence from work (mean = kyats 135.05; 95% CI = 128.14–141.96). Total costs to the patient per episode were, on the average, equivalent to 4.2 days of per capita economic output indicating that malaria imposes a significant financial burden on the patient even though medical services and treatment are provided free of charge. Variables significantly positively associated with patient cost included the duration of illness (P < 0.001), income of the patient (P < 0.001), presence of accompanying person at the health facility (P < 0.001) and being a farmer (P = 0.026). The results of this study highlight the importance of using confirmatory diagnosis in rural settings to minimize the financial burden of malaria to the patient and family. [Copyright &y& Elsevier]

This study investigates the costs incurred by patients diagnosed with uncomplicated malaria at a formal rural health facility in Myanmar. A cross-sectional survey of 410 patients indicated that the majority of patients were male (89.3%), married (84.6%) and the head of their family (80.2%); this spectrum reflected the deliberate selection of persons for whom relatively accurate costing was feasible. The average total costs incurred for an episode of malaria was kyats 173.58 (95% CI = 166.13-181.02). with the highest cost contribution being the loss of earnings due to absence from work (mean = kyats 135.05; 95% CI = 128.14-141.96). Total costs to the patient per episode were, on the average, equivalent to 4.2 days of per capita economic output indicating that malaria imposes a significant financial burden on the patient even though medical services and treatment are provided free of charge. Variables significantly positively associated with patient cost included the duration of illness (P < 0.001), income of the patient (P < 0.001), presence of accompanying person at the health facility (P < 0.001) and being a farmer (P = 0.026). The results of this study highlight the importance of using confirmatory diagnosis in rural settings to minimize the financial burden of malaria to the patient and family.

In an expansion of the first Mekong Malaria monograph published in 1999, this second monograph updates the malaria database in the countries comprising the Mekong region of Southeast Asia. The update adds another 3 years' information to cover cumulative data from the 6 Mekong countries (Cambodia, China/Yunnan, Lao PDR, Myanmar, Thailand, Viet Nam) for the six-year period 1999-2001. The objective is to generate a more comprehensive regional perspective in what is a global epicenter of drug resistant falciparum malaria, in order to improve malaria control on a regional basis in the context of social and economic change. The further application of geographical information systems (GIS) to the analysis has underscored the overall asymmetry of disease patterns in the region, with increased emphasis on population mobility in disease spread. Of great importance is the continuing expansion of resistance of P. falciparum to antimalarial drugs in common use and the increasing employment of differing drug combinations as a result. The variation in drug policy among the 6 countries still represents a major obstacle to the institution of region-wide restrictions on drug misuse. An important step forward has been the establishment of 36 sentinel sites throughout the 6 countries, with the objective of standardizing the drug monitoring process; while not all sentinel sites are fully operational yet, the initial implementation has already given encouraging results in relation to disease monitoring. Some decreases in malaria mortality have been recorded. The disease patterns delineated by GIS are particularly instructive when focused on inter-country distribution, which is where more local collaborative effort can be made to rationalize resource utilization and policy development. Placing disease data in the context of socio-economic trends within and between countries serves to further identify the needs and the potential for placing emphasis on resource rationalization on a regional basis. Despite the difficulties, the 6-year time frame represented in this monograph gives confidence that the now well established collaboration is becoming a major factor in improving malaria control on a regional basis and hopefully redressing to a substantial degree the key problem of spread of drug resistance regionally and eventually globally.

Logistic, economic and technical factors limit rapid access to microscopic confirmation of symptomatic diagnosis of malaria in many rural areas in endemic countries such as Myanmar. A study was conducted to evaluate a rapid on-site immunochromatographic test (ICT Malaria Pf/Pv) for detection of Plasmodium falciparum and P. vivax in two villages in the Taikkyi region of Myanmar. The ICT Malaria tests were performed by a volunteer health worker (VHW) in Yae-Aye-San village and by a professionally trained midwife (MW) in Kankone village. A total of 1000 symptomatic patients participated in the study by providing blood samples for an ICT test and for microscopy. The ICT performance indices, relative to microscopy, were better for the trained MW compared with the less experienced VHW. For P. falciparum and/or P. vivax infections, the sensitivities were 82.7% for the VHW compared with 93.7% for the MW. For P. falciparum infections, the sensitivities were 82.2% for the VHW and 91.3% for the MW, while the corresponding values for P. vivax infections were 66.7 and 79%, respectively. Although the test kit appeared to perform better in more experienced hands, this study questions whether this difference is related to the use of the ICT Malaria Pf/Pv test kit, or related to other factors such as differences in the quality of blood slides prepared by the VHW and MW for microscopic examination. Overall, the results suggest that a rapid diagnostic assay such as the ICT Malaria Pf/Pv test kit can be used in rural settings by relatively inexperienced persons, such as VHWs, with a reasonable degree of sensitivity, thus providing on-site confirmation of symptomatic diagnosis of malaria.

This study assesses the burden of dengue hemorrhagic fever (DHF) and effectiveness of an intervention package in Myanmar. Disability adjusted life years (DALYs) lost for fatal and non-fatal DHF cases and DALYs averted due to intervention for DHF from 1970-1997 were estimated. The data are based on reported cases and deaths from DHF extracted from annual reports of the Myanmar vector borne disease control program. Sensitivity analyses were performed for robustness of conclusions. DALYs lost from both fatal and non-fatal DHF cases in Myanmar were estimated as 83.83 DALYs per year per million population (range = 83.33-86.32) for the period 1970-1997. DALYs averted from DHF due to intervention were estimated as 134 DALYs per year per million population (range = 47-159). The burden of DHF in Myanmar for the selected year 1990 was 91.3 DALYs per year per million population (range = 90.1-96.5). A comparison was made with China, India and other Asian countries based on information provided by a World Bank study.

This is a documentary study to determine factors influencing malaria incidence in Myanmar. The period of study covered was from 1989 to 1998 using time series data. Multiple regression analysis was performed on the dependent variable, yearly incidence of malaria in Myanmar, with hypothesized independent variables including variables related to epidemiology, demography, service and socioeconomic status. Malaria incidence was inversely associated with the government budget for malaria control at the 5% level and with the case fatality rate of malaria at the 10% level. Other variables: yearly gross domestic product, yearly proportion of Plasmodium falciparum cases and yearly DDT use of spraying displayed expected signs but were not statistically significant.

This study was undertaken to compare cost-effectiveness of three drug regimes for treatment of uncomplicated falciparum malaria in Myanmar. The alternative regimens in this study were chloroquine (CQ), sulphadoxine-pyrimethamine (SP) and mefloquine (MFQ) along with their therapeutic efficacy in Myanmar. The study was performed by modeling a clinical decision tree based on a hypothetical 1,000 adult uncomplicated falciparum malaria cases. Key variables were (i) three drug regimes: CQ, SP and MFQ, (ii) three categories of therapeutic efficacy of each drug: adequate clinical response (ACR), early treatment failure (ETF) and late treatment failure (LTF) according to the 1996 WHO protocol, and (iii) compliance with each drug. In structuring the model, necessary assumptions were made. The cost effectiveness was measured as cost per case cured and cost per case prevented death related to the provided drug, from the provider's perspective. According to the present price and therapeutic efficacy, SP is the most cost effective drug for a case cured in all three categories of efficacy (US$ 0.12 per case cured in ACR, US$ 0.38 per case cured in ETF and US$ 0.54 per case cured in LTF). For a case prevented death, CQ is most cost effective in all three categories (US$ 0.58 per case prevented death in the ACR, US$ 2.14 per case prevented death in the ETF and US$ 2.51 per case prevented death in the LTF). The lowest cost effective regimen is MFQ for both indicators of effectiveness at the present price and therapeutic efficacy. A sensitivity analysis was performed for sensitive values.

Willingness to pay (WTP) for the ICT Malaria Pf/Pv test kit was assessed by the contingent valuation method using a bidding game approach in two villages in Myanmar. Kankone (KK) village has a rural health center (RHC) and Yae-Aye-Sann (YAS) is serviced by community health worker (CHW). The objectives were to assess WTP for the ICT Malaria Pf/Pv test kit and to determine factors affecting the WTP. In both villages WTP was assessed in two different conditions, ex post and ex ante. The ex post WTP was assessed at an RHC in the KK village and at the residence of a CHW in the YAS village on patients immediately following diagnosis of malaria. The ex ante WTP was assessed by household interviews in both villages on people with a prior history of malaria. Ordinary least squares (OLS) multiple regression analysis was used to analyze factors affecting WTP. The WTP was higher in ex post conditions than ex ante in both villages. WTP was significantly positively associated with the average monthly income of the respondents and severity of illness in both ex post and ex ante conditions (p < 0.001). Distance between the residence of the respondents and the health center was significantly positively associated (p < 0.05) in the ex ante condition in a household survey of YAS village. Traveling time to RHC had a negative relationship with WTP (p < 0.05) in the ex post condition in the RHC survey in KK village.