Plasma galectin-9 relates to cognitive performance and inflammation among adolescents with vertically acquired HIV.

Objective: Adolescents with perinatally acquired HIV (AWH) are at an increased risk of poor cognitive development yet the underlying mechanisms remain unclear. Circulating galectin-9 (Gal-9) has been associated with increased inflammation and multimorbidity in adults with HIV despite antiretroviral therapy (ART); however, the relationship between Gal-9 in AWH and cognition remain unexplored.

Design: A cross-sectional study of two independent age-matched cohorts from India [AWH on ART ( n  = 15), ART-naive ( n  = 15), and adolescents without HIV (AWOH; n  = 10)] and Myanmar [AWH on ART ( n  = 54) and AWOH ( n  = 22)] were studied.

A guide to outcome evaluation of simulation-based education programmes in low and middle-income countries.

Evaluation is a vital part of any learning activity and is essential to optimize and improve educational programmes. It should be considered and prioritized prior to the implementation of any learning activity. However, comprehensive programme evaluation is rarely conducted, and there are numerous barriers to high-quality evaluation.

Intussusception risk following oral monovalent rotavirus vaccination in 3 Asian countries: A self-control case series evaluation.

Rotavirus vaccines have substantially decreased rotavirus hospitalizations in countries where they have been implemented. In some high- and middle-income countries, a low-level of increased risk of intussusception, a type of acute bowel obstruction, has been detected following rotavirus vaccination. However, no increased risk of intussusception was found in India, South Africa, or a network of 7 other African countries.

Molecular Epidemiological Characterization of and Clinical Isolates from a National Tertiary Care Hospital in Myanmar: Co-Isolation of Multiple Clones and Identification of Novel Staphylocoagulase Genotype.

Spread of antimicrobial resistance and virulence factors among / poses a potential public health concern in Myanmar. In this study, a total of 226 clinical isolates of ( = 211) and ( = 15) collected in Yangon General Hospital during a two-year period were analyzed for their antimicrobial susceptibility and genetic features. Methicillin-resistant (MRSA) accounted for 19% of isolates, associated with mostly staphylococcal cassette chromosome (SCC) type IV, or V.

Pathogen and Antibody Identification in Children with Encephalitis in Myanmar.

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.

Childhood encephalitis in the Greater Mekong region (the SouthEast Asia Encephalitis Project): a multicentre prospective study.

Background: Encephalitis is a worldwide public health issue, with a substantially high burden among children in southeast Asia. We aimed to determine the causes of encephalitis in children admitted to hospitals across the Greater Mekong region by implementing a comprehensive state-of-the-art diagnostic procedure harmonised across all centres, and identifying clinical characteristics related to patients' conditions.

Methods: In this multicentre, observational, prospective study of childhood encephalitis, four referral hospitals in Cambodia, Vietnam, Laos, and Myanmar recruited children (aged 28 days to 16 years) who presented with altered mental status lasting more than 24 h and two of the following minor criteria: fever (within the 72 h before or after presentation), one or more generalised or partial seizures (excluding febrile seizures), a new-onset focal neurological deficit, cerebrospinal fluid (CSF) white blood cell count of 5 per mL or higher, or brain imaging (CT or MRI) suggestive of lesions of encephalitis.

Bacterial Species and Antimicrobial Resistance of Clinical Isolates from Pediatric Patients in Yangon, Myanmar, 2020.

Antimicrobial resistance (AMR) is a concern in medical care for children who have high burden of infectious diseases. We investigated the prevalence of bacterial species and their susceptibility to antimicrobials of 1019 clinical isolates from pediatric patients in a tertiary-care hospital in Yangon, Myanmar for one-year period (2020). The most frequently recovered species was , followed by and , all of which accounted for 43% of clinical isolates, while 25% of isolates comprised non-fermenter, including sp.

Point-prevalence surveys of antimicrobial consumption and resistance at a paediatric and an adult tertiary referral hospital in Yangon, Myanmar.

Background: Antimicrobial resistance is increasingly prevalent worldwide. The inappropriate use of antimicrobials, including in the hospital setting, is considered a major driver of antimicrobial resistance.

Aim: To inform improvements in antimicrobial stewardship, we undertook point prevalence surveys of antimicrobial prescribing at Yangon Children's Hospital and Yangon General Hospital in Yangon, Myanmar.

Rotavirus infection among children under five years of age hospitalized with acute gastroenteritis in Myanmar during 2018-2020 - Multicentre surveillance before rotavirus vaccine introduction.

Background: Rotavirus gastroenteritis (RVGE) is a leading cause of severe diarrhea in children under-five worldwide, with the majority of mortality in lower -income countries. This study aimed to provide baseline information on epidemiology of rotavirus and circulating strains before rotavirus vaccine introduction in Myanmar.

Methods: Hospital-based, prospective surveillance was conducted from May 2018 to January 2020 at four sentinel sites; two hospitals in Lower Myanmar, one hospital each in Middle Myanmar and East Myanmar.

Long-Term Impact of a Low-Cost Paediatric Intussusception Air Enema Reduction Simulation-Based Education Programme in a Low-Middle Income Country.

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.

Clonal Diversity and Molecular Characteristics of Methicillin-Susceptible and -Resistant from Pediatric Patients in Myanmar.

The spread of multidrug-resistant and virulent among children is a public health concern, but the actual conditions in Myanmar have not been characterized. In this study, a total of 244 clinical isolates of collected from pediatric patients in Yangon Children's Hospital during a 1-year period were analyzed for their drug resistance and genetic features. Methicillin-resistant (MRSA) accounted for 19.

Male Sex Is Associated With Worse Microbiological and Clinical Outcomes Following Tuberculosis Treatment: A Retrospective Cohort Study, a Systematic Review of the Literature, and Meta-analysis.

Background: Although the incidence of tuberculosis is higher in men than in women, the relationship of sex with tuberculosis treatment outcomes has not been adequately studied.

Methods: We performed a retrospective cohort study and a systematic review and meta-analysis of observational studies during the last 10 years to assess sex differences in clinical and microbiological outcomes in tuberculosis.

Results: In our cohort of 2894 Taiwanese patients with drug-susceptible pulmonary tuberculosis (1975 male and 919 female), male patients had higher adjusted hazards of 9-month mortality due to all causes (hazard ratio, 1.

High burden of infections caused by ESBL-producing MDR in paediatric patients, Yangon, Myanmar.

Background: There is mounting evidence of a high burden of antimicrobial-resistant infections in children in low- and middle-income countries (LMICs).

Objectives: To detect the frequency of ESBL-producing in clinical specimens from paediatric patients attending Yangon Children's Hospital in Myanmar.

Methods: All children attending Yangon Children's Hospital who had clinical specimens submitted to the hospital diagnostic microbiology laboratory from June 2019 to December 2019 were included in the study.

Analysis of Financial Risk Protection Indicators in Myanmar for Paediatric Surgery.

Purpose: To estimate proportion of Myanmar paediatric population at risk of impoverishment and catastrophic expenditure due to emergency surgical intervention.

Methods: Prospective data were collected at two tertiary surgical centres including income, household expenses, expenses related to surgery. Data analysis was performed to estimate out-of-pocket (OOP) direct medical costs and OOP total costs.

Overview of a novel paediatric surgical simulation-based medical education programme in Myanmar.

Background: Simulation-based medical education (SBME) is an integral part of undergraduate and postgraduate training in high-income countries (HICs). Despite potential benefits to low- and middle-income countries (LMICs), it has not been widely applied. Our aim was to use SBME to address some essential paediatric surgery learning needs in a LMIC.

Meningococcal disease surveillance in the Asia-Pacific region (2020): The global meningococcal initiative.

The degree of surveillance data and control strategies for invasive meningococcal disease (IMD) varies across the Asia-Pacific region. IMD cases are often reported throughout the region, but the disease is not notifiable in some countries, including Myanmar, Bangladesh and Malaysia. Although there remains a paucity of data from many countries, specific nations have introduced additional surveillance measures.

The application of simulation-based medical education in low- and middle-income countries; the Myanmar experience.

Simulation-based medical education (SBME) has become a routine part of practice in many disciplines including paediatric surgery. There is an evolving evidence base of its benefits both for surgical education, training and also patient education in high-income countries (HICs) but not in the low- and middle-income country (LMIC) setting. The advantages are hypothesised to be the same in both of these settings, although our experience is that they may be increased.

ASVAC2019: 7th Asian Vaccine Conference.

The 7th Asian Vaccine Conference (ASVAC 2019) was held in Yangon, Myanmar from 13 to 15, September 2019. It brought together stakeholders in the field of vaccination to address challenges and issues relevant to clinical practice and immunization programs in the region. The conference themed "", included pre-conference workshops, a Vaccinology Masterclass, plenary lectures, symposia, and poster presentations.

Clinical Impact of the Introduction of Pediatric Intussusception Air Enema Reduction Technology in a Low- to Middle-Income Country Using Low-Cost Simulation-Based Medical Education.

Introduction: Pediatric intussusception is a common cause of bowel obstruction in infants. Air enema (AE) reduction is routine first-line management in many countries; however, there is a high rate of operative intervention in low- and middle-income countries. The aims of the study were to use simulation-based medical education with an intussusception simulator to introduce AE reduction to Myanmar and to assess its effect on provider behaviors and the resulting clinical care.

Genetic Diversity of CMY Beta-Lactamase Genes in Clinical Isolates of in Myanmar: Identification of Three Novel Types and Updated Phylogenetic Classification of .

The dissemination of CMY-type enzymes, one of the plasmid-mediated AmpC beta-lactamases, among Enterobacteriaceae has become an important public health concern. In this study, genetic diversity of CMY beta-lactamase genes was investigated for 50 -positive isolates detected from 426 clinical isolates of in Yangon, Myanmar. CMY genes were differentiated into 9 types, with being predominant (22 isolates, 44%), followed by , , , and included three novel types (CMY-156, CMY-158, CMY-159).

Molecular Characterization of Methicillin-Susceptible and -Resistant Harboring Panton-Valentine Leukocidin-Encoding Bacteriophages in a Tertiary Care Hospital in Myanmar.

Panton-Valentine leukocidin (PVL) is a pore-forming toxin encoded by genes on bacteriophages distributed to , associated with its increased virulence to humans. In this study, molecular epidemiological characteristics were investigated for 239 clinical isolates of collected in a tertiary care hospital in Yangon, Myanmar, particularly with regard to methicillin resistance and PVL genes. Methicillin-resistant (MRSA) accounted for 13.

First detection of the colistin resistance gene in from a patient with urinary tract infection in Myanmar.

Colistin-resistance gene was detected in an sample among 442 clinical isolates collected in a tertiary-care hospital in Yangon, Myanmar, in 2018. This isolate was classified into phylogroup A-ST23 complex and harboured and , associated with multiple mutations in quinolone-resistance-determining regions in and