A mixed methods study investigating factors affecting adherence to Plasmodium vivax malaria primaquine radical cure regimens among migrants along the Myanmar-Thailand border.

Background: The countries within the Greater Mekong Region of Southeast Asia have pledged to eliminate malaria by 2030. Elimination of Plasmodium vivax malaria is challenging as it requires radical cure to prevent relapse. Understanding and facilitating adherence to primaquine radical cure regimens is necessary for malaria elimination.

In hypertension, with or without orthostatic hypotension, more- vs. less-intensive BP therapy improves clinical outcomes.

Juraschek SP, Hu JR, Cluett JL, et al. JAMA. 2023;330:1459-1471.

The Association between Betel Quid Chewing and Metabolic Syndrome Among Urban Adults in Mandalay District of Myanmar.

Background: As the prevalence of metabolic syndrome, obesity and diabetes increase worldwide, the need to identify modifiable lifestyle risk factors also increases, especially those that may be relatively unique to a specific population. To explore a possible association between betel quid chewing and metabolic syndrome, a community-based cross-sectional study was conducted.

Methodology: Three hundred ninety-one (391) adults were interviewed and the following parameters were measured: triglycerides, HDL-cholesterol, glucose, waist circumference, body mass index and blood pressure.

In low-risk penicillin allergies, direct oral challenge was noninferior to skin testing followed by oral challenge.

Copaescu AM, Vogrin S, James F, et al. JAMA Intern Med. 2023;183:944-952.

Sodium Homeostasis and Hypertension.

Purpose Of Review: This review aims to summarize and discuss the relationship between sodium homeostasis and hypertension, including emerging concepts of factors outside cardiovascular and renal systems influencing sodium homeostasis and hypertension.

Recent Findings: Recent studies support the dose-response association between higher sodium and lower potassium intakes and a higher cardiovascular risk in addition to the dose-response relationship between sodium restriction and blood pressure lowering. The growing body of evidence suggests the role of genetic determinants, immune system, and gut microbiota in sodium homeostasis and hypertension.

In adults with hypertension, effects of BP-lowering drug monotherapy varied by patient.

Sundström J, Lind L, Nowrouzi S, et al. JAMA. 2023;329:1160-1169.

Born too soon in a resource-limited setting: A 10-year mixed methods review of a special care baby unit for refugees and migrants on the Myanmar-Thailand border.

Background: Preterm birth is a major public health concern with the largest burden of morbidity and mortality falling within low- and middle-income countries (LMIC).

Materials And Methods: This sequential explanatory mixed methods study was conducted in special care baby units (SCBUs) serving migrants and refugees along the Myanmar-Thailand border. It included a retrospective medical records review, qualitative interviews with mothers receiving care within SCBUs, and focus group discussions with health workers.

In BPPV, canalith repositioning maneuver increased symptom resolution vs. vestibular suppressants.

Sharif S, Khoujah D, Greer A, et al. Acad Emerg Med. 2022.

In hypertension, evening vs. morning dosing of antihypertensive drugs did not differ for major CV outcomes at 5.2 y.

Mackenzie IS, Rogers A, Poulter NR, et al. Lancet. 2022;400:1417-25.

Who is protected? Determinants of hepatitis B infant vaccination completion among a prospective cohort of migrant workers in Thailand during the COVID-19 pandemic.

Background: Hepatitis B causes significant disease and death globally, despite the availability of effective vaccination. Migration likewise affects hundreds of millions of people annually, many of whom are women and children, and increases risks for poor vaccine completion and mother to child transmission of hepatitis B. In the neighbouring countries of Thailand and Myanmar, vaccine campaigns have made progress but little is known about the reach of these programs into migrant worker communities from Myanmar living in Thailand.

Technical evaluation and usability of a quantitative G6PD POC test in cord blood: a mixed-methods study in a low-resource setting.

Objectives: New point-of-care (POC) quantitative G6PD testing devices developed to provide safe radical cure for malaria may be used to diagnose G6PD deficiency in newborns at risk of severe neonatal hyperbilirubinaemia, improving clinical care, and preventing related morbidity and mortality.

Methods: We conducted a mixed-methods study analysing technical performance and usability of the 'STANDARD G6PD' Biosensor when used by trained midwives on cord blood samples at two rural clinics on the Thailand-Myanmar border.

Results: In 307 cord blood samples, the Biosensor had a sensitivity of 1.

Under the Mask: A Film on Tuberculosis at the Thai-Myanmar Border.

In this paper, we describe the development of the film, "Under the Mask," which follows the lives of three fictional characters who live on the Thai-Myanmar border as they journey from diagnosis of tuberculosis (TB) to completion of treatment. Under the Mask was filmed on location on the Thai-Myanmar border by local filmmakers and former refugee populations. Cast members were chosen from communities living along the border.

Cross-sectional study of nutritional intake among patients undergoing tuberculosis treatment along the Myanmar-Thailand border.

Objective: This study summarises nutritional intake among patients with tuberculosis (TB) along the Myanmar-Thailand border according to the local diet.

Setting: TB clinic along the Myanmar-Thailand border.

Participants: Cross-sectional surveys of 24-hour food recall were conducted with participants receiving anti-TB treatment.

USPSTF found insufficient evidence on benefits and harms of screening for vitamin D deficiency in asymptomatic adults.

Krist AH, Davidson KW, Mangione CM, et al. JAMA. 2021;325:1436-42.

Insufficient evidence for benefits/harms of cognitive impairment screening in asymptomatic older adults.

US Preventive Services Task Force, Owens DK, Davidson KW, et al. JAMA. 2020;323:757-63.

Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes.

Purpose Of Review: The aims of this review are to summarize recent data on mortality and cardiovascular disease (CVD) in type 1 and type 2 diabetes and to determine the interventions that could have contributed to a reduction in mortality.

Recent Findings: Recent studies found a downward trend in mortality and CVD among both diabetics and non-diabetics worldwide over the last few decades. The decline among diabetics is steeper than that among non-diabetics.

Relationship Between Outpatient Clinic and Ambulatory Blood Pressure Measurements and Mortality.

Purpose Of Review: This review aims to summarize and discuss the relationship between outpatient clinic and ambulatory blood pressure (BP) measurements and cardiovascular morbidity and mortality.

Recent Findings: Contemporary clinical practice guidelines worldwide recommend ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension. Recent epidemiological studies and systematic reviews showed ABPM predicts cardiovascular events and mortality independent of clinic BP.