6 research outputs found
Effectiveness of men in maternity health (MiM) intervention on male involvement in maternal health care to improve maternal health outcomes in Naypyitaw, Myanmar
No full textMyanmar recorded 1,700 maternal fatalities in 2020, indicating one of the highest maternal mortality ratios (MMR). The provision of adequate maternal health care (MHC) is crucial to reducing maternal mortality in Myanmar, but the prevalence of low institutional delivery (ID) contributes to avoidable deaths. While Myanmar has made recent efforts to enhance the utilization of MH services, there are still existing gaps that need attention. The concept of male involvement (MI) in maternal health (MH) has emerged as a strategy to improve MHC outcomes in Myanmar. To assess the efficacy of male involvement in maternal health in Myanmar, a research study will be conducted. This study aims to investigate the impact of Men in Maternity Health (MiM) education specifically designed for husbands and male partners of pregnant women in Myanmar. Thus, the research aims to determine the effectiveness of Men in Maternity Health (MiM) education intervention to improve husband involvement in birth preparedness and complication readiness for safe motherhood in Nay Pyi Taw, Myanmar.</p
Effectiveness of men in maternity health (MiM) intervention on male involvement in maternal health care to improve maternal health outcomes in Naypyitaw, Myanmar [version 1; peer review: 2 approved]
No full textBackground Maternal health care (MHC) is critical for safe motherhood and preventing maternal deaths in Myanmar, but the institutional delivery rates are not yet optimal, increasing preventable maternal deaths. To address this issue, involving men in supporting MHC has been recognized as a strategy to improve MHC outcomes. This study aimed to assess the effectiveness, acceptability, and feasibility of men in maternity health (MiM) intervention on male involvement in MHC and its influence on knowledge, attitudes, and practices related to maternal health and institutional delivery rates in Naypyitaw, Myanmar. Methods This study employed a mixed-methods approach with quantitative surveying of the male partners and qualitative interviewing of both male and female partners and health stakeholders. A 6-month MiM education program on pregnancy complications, antenatal care, delivery care, and birth preparedness was provided to the intervention group. Before and after the intervention, comparisons between intervention and control groups were made. Results The socio-demographic characteristics of male partners were comparable between the intervention and control groups during the pre-intervention assessment. Before MiM intervention, notable differences in male partners’ knowledge, attitudes, birth preparedness and complication readiness practices regarding MHC were not evident between these two groups. After completing the MiM, significant score improvement, including higher ID rates compared to the control group (p<0.001), was observed. The acceptability and feasibility of the MiM program were contributed by positive responses from qualitative findings, highlighting remarkable changes in the perspectives of male partners in supporting MHC. However, challenges, including financial limitations, cultural influences and a shortage of trained personnel, were encountered. Conclusion The MiM program effectively promotes male involvement in MHC, leading to improved MHC outcomes. The MiM intervention offers a promising, evidence-based model to enhance ID rates in Myanmar, requiring tailored approaches to address cultural and financial factors
Delayed care-seeking and its underlying factors among patients with tuberculosis in Yangon, Myanmar
No full textIntroduction: Tuberculosis (TB) remains a major public health problem in Myanmar. Early care-seeking behaviors play a significant role in reducing TB transmission and speeding recovery. This study was conducted to estimate the proportion of patients with TB who delayed care-seeking and to identify underlying factors.
Methodology: The study population included patients with TB treated in a TB diagnostic center in April 2015. A total of 346 patients were chosen as eligible respondents. The data were collected using structured questionnaires and face-to-face interviews. In addition to descriptive statistics, chi-squared test and multiple logistic regression were performed to show any associations.
Results: The study revealed that 66.8% of patients delayed care-seeking, and the average duration of delay was 21 days. Using the chi-squared test, factors such as education, occupation, family income, knowledge of TB, possessing information about TB, having a family member or close friend contract TB, travel distance, and cost causing a burden were significantly associated with delayed care-seeking (p < 0.05). Multiple logistic regression analysis found that 4 variables exhibited significant associations: low levels of education, occupation as government staff member, possessing information about TB, and having a family member or close friend contract TB (p < 0.05).
Conclusion: The results from this study provide useful comprehensive information addressing underlying factors associated with delayed care-seeking behaviors. These can be used to advance health education interventions regarding TB and strengthen early diagnosis of TB within community settings
Adverse Drug Reactions in Selected Wards of the Yangon General Hospital and Yangon Specialty Hospital During the First Quarter of 2019 : An Active Pharmacovigilance Study in Myanmar
No full textPrevious 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. Our objective was to study ADRs in patients admitted to selected wards of Yangon General Hospital (YGH) and Yangon Specialty Hospital (YSH), Myanmar. 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). 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. 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. The online version of this article (10.1007/s40801-020-00180-0) contains supplementary material, which is available to authorized users
Molecular epidemiology of resistance to antimalarial drugs in the Greater Mekong subregion: an observational study
No full textBackground
The Greater Mekong subregion is a recurrent source of antimalarial drug resistance in Plasmodium falciparum malaria. This study aimed to characterise the extent and spread of resistance across this entire region between 2007 and 2018.
Methods
P falciparum isolates from Myanmar, Thailand, Laos, and Cambodia were obtained from clinical trials and epidemiological studies done between Jan 1, 2007, and Dec 31, 2018, and were genotyped for molecular markers (pfkelch, pfcrt, pfplasmepsin2, and pfmdr1) of antimalarial drug resistance. Genetic relatedness was assessed using microsatellite and single nucleotide polymorphism typing of flanking sequences around target genes.
Findings
10 632 isolates were genotyped. A single long pfkelch Cys580Tyr haplotype (from −50 kb to +31·5 kb) conferring artemisinin resistance (PfPailin) now dominates across the eastern Greater Mekong subregion. Piperaquine resistance associated with pfplasmepsin2 gene amplification and mutations in pfcrt downstream of the Lys76Thr chloroquine resistance locus has also developed. On the Thailand–Myanmar border a different pfkelch Cys580Tyr lineage rose to high frequencies before it was eliminated. Elsewhere in Myanmar the Cys580Tyr allele remains widespread at low allele frequencies. Meanwhile a single artemisinin-resistant pfkelch Phe446Ile haplotype has spread across Myanmar. Despite intense use of dihydroartemisinin–piperaquine in Kayin state, eastern Myanmar, both in treatment and mass drug administrations, no selection of piperaquine resistance markers was observed. pfmdr1 amplification, a marker of resistance to mefloquine, remains at low prevalence across the entire region.
Interpretation
Artemisinin resistance in P falciparum is now prevalent across the Greater Mekong subregion. In the eastern Greater Mekong subregion a multidrug resistant P falciparum lineage (PfPailin) dominates. In Myanmar a long pfkelch Phe446Ile haplotype has spread widely but, by contrast with the eastern Greater Mekong subregion, there is no indication of artemisinin combination therapy (ACT) partner drug resistance from genotyping known markers, and no evidence of spread of ACT resistant P falciparum from the east to the west. There is still a window of opportunity to prevent global spread of ACT resistance
