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- Item“We face the same risk as the other health workers”: Perceptions and experiences of community pharmacists in Indonesia during the COVID-19 pandemic(2022-07-01) Wulandari L.P.L.; Khan M.; Probandari A.; Batura N.; Ferdiana A.; Mashuri Y.A.; Wibawa T.; Daraninggar D.; Dewi B.K.; Day R.; Jan S.; Schierhout G.; Yeung S.; Wiseman V.; Liverani M.; Wulandari L.P.L.; Mahidol UniversityIn many countries, community pharmacies have played an important role during the COVID-19 pandemic, providing essential medicines and personal protective equipment (PPE), disseminating information on disease prevention and management, and referring clients to health facilities. In recognition of this, there are increasing calls for an improved understanding of the challenges and experiences faced by these providers during the COVID-19 pandemic, with a view to providing them with better support and guidance now and during future emergencies. Between January and February 2021 we conducted 21 qualitative interviews to explore the experiences, safety concerns, and attitudes of pharmacists and pharmacy technicians during the COVID-19 crisis in Indonesia, a country that has recorded more than four million cases since the start of the pandemic. Interview transcripts were analysed using thematic content analysis. Findings indicate that COVID-19 has had a significant impact on pharmacy practices in Indonesia. Most participants implemented preventive measures and adapted their business models to the changing circumstances. The shift to remote sales and home delivery allowed many pharmacies to maintain, and even increase their profit margins due to greater demand for medicines and PPE. However, many participants were concerned about the increased risk of infection due to limited social distancing and prolonged interactions with clients, many of whom displayed COVID-19 symptoms. Importantly, there was a general perception that the government did not sufficiently recognize these risks. In conclusion, the government should consider developing additional operational guidelines and regulatory frameworks to improve the safety, operation, and involvement of community pharmacies in the current pandemic response efforts and any future public health emergencies.
- ItemRESOLVING PHYLOGENETIC AND TAXONOMIC CONFLICT IN BEGONIA(2022-08-18) Ardi W.H.; Campos-Domínguez L.; Chung K.F.; Dong W.K.; Drinkwater E.; Fuller D.; Gagul J.; Garnett G.J.L.; Girmansyah D.; Goodall-Copestake W.P.; Hughes M.; Jacques E.L.; Jara-Muñoz O.A.; Julia S.; Kidner C.A.; Kiew R.; Krishna N.; Li R.; Marasinghe L.D.K.; Maw M.B.; Lin C.W.; Moonlight P.W.; Nguyen H.T.; Nguyen H.Q.; Phutthai T.; Pradeep A.K.; Rajbhandary S.; Rubite R.R.; Scherberich D.; Souvannakhoummane K.; Sreenath M.; Tebbitt M.C.; Thomas D.C.; Tian D.; Tseng Y.H.; Wilson H.P.; Ardi W.H.; Mahidol UniversityBegonia is the world’s fastest-growing genus and a focus of intense taxonomic research. To support this, a stable and useful sectional classification is needed. This paper reviews the feasibility and challenges of creating an infrageneric classification for Begonia based on phylogenetic data, and how to overcome phylogenetic and taxonomic conflict. In particular, it (i) tests genus-wide patterns of incongruence between phylogenies based on the nuclear, chloroplast and mitochondrial genomes; (ii) explains organelle inheritance and its contribution to phylogenetic incongruence, and (iii) presents a manifesto for a workable and stable subgeneric classification in light of the above and lays the foundation for a collaborative Begonia Phylogeny Group.
- ItemDiversity and lipolytic activity of lactic acid bacteria isolated from fermented foods and plant materials in Thailand(2022-01-01) Techo S.; Kuncharoen N.; Tanasupawat S.; Techo S.; Mahidol UniversityLactic acid bacteria (LAB) originated from fermented foods, are generally known to possess the lipolytic activity which provides the desirable flavor of the products. However, the researches on their lipolytic activity are limited. Therefore, LAB with lipolytic activity derived from traditional fermented foods and plants in Thailand were isolated and identified based on the phenotypic characteristics and 16S rRNA gene sequences. The isolates were identified as Lactiplantibacillus pentosus (four isolates), Lactiplantibacillus plantarum (three isolates), Limosilactobacillus fermentum (four isolates), Enterococcus hirae (two isolates), and each isolate of Lactiplantibacillus paraplantarum, Companilactobacillus tucceti, Companilactobacillus farciminis, Lacticaseibacillus porcinae, Lactobacillus amylovorus, Pediococcus pentosaceus, and Enterococcus faecalis. Lipolytic activity of isolates was in the range of 0.16 ± 0.01–1.07 ± 0.02 U/mL. Enterococcus faecalis MP1-3 from mum displayed the highest lipolytic activity (1.07 ± 0.02 U/mL). Various inducers including tributyrin, Tween 20, Tween 40, Tween 60, Tween 80, and palm oil were used for lipolytic activity assay of isolate MP1-3 which cultivated in production medium at 30°C for 72 h. The greatest lipolytic activity (3.28 ± 0.22 U/mL) was found when supplemented the medium with Tween 20. The results suggest that Enterococcus faecalis MP1-3 could be chosen for further lipase purification and characterization.
- ItemSIX NEW SPECIES OF WURFBAINIA (ZINGIBERACEAE) FROM THAILAND(2022-05-03) Kaewsri W.; Sangvirotjanapat S.; Kaewsri W.; Mahidol UniversitySix new species are described from Thailand: Wurfbainia ellipticarpa, W. geostachyoides, W. globosa, W. longiflora, W. parviflora and W. yingyongii. A line drawing and photographs, information on phenology, distribution, ecology and etymology, and a proposed IUCN conservation category are provided for each species. A key to the species of Wurfbainia in Thailand is also provided.
- ItemContribution of genetic factors to high rates of neonatal hyperbilirubinaemia on the Thailand-Myanmar border(2022-06-01) Bancone G.; Gornsawun G.; Peerawaranun P.; Penpitchaporn P.; Paw M.K.; Poe D.D.; Win D.; Cicelia N.; Mukaka M.; Archasuksan L.; Thielemans L.; Nosten F.; White N.J.; McGready R.; Carrara V.I.; Bancone G.; Mahidol UniversityVery high unconjugated bilirubin plasma concentrations in neonates (neonatal hyperbilirubinaemia; NH) may cause neurologic damage (kernicterus). Both increased red blood cell turn-over and immaturity of hepatic glucuronidation contribute to neonatal hyperbilirubinaemia. The incidence of NH requiring phototherapy during the first week of life on the Thailand-Myanmar border is high (approximately 25%). On the Thailand-Myanmar border we investigated the contribution of genetic risk factors to high bilirubin levels in the first month of life in 1596 neonates enrolled in a prospective observational birth cohort study. Lower gestational age (<38 weeks), mutations in the genes encoding glucose-6-phosphate dehydrogenase (G6PD) and uridine 50-diphospho-glucuronosyltransferase (UGT) 1A1 were identified as the main independent risk factors for NH in the first week, and for prolonged jaundice in the first month of life. Population attributable risks (PAR%) were 61.7% for lower gestational age, 22.9% for hemi or homozygous and 9.9% for heterozygous G6PD deficiency respectively, and 6.3% for UGT1A1*6 homozygosity. In neonates with an estimated gestational age ≥ 38 weeks, G6PD mutations contributed PARs of 38.1% and 23.6% for “early” (≤ 48 hours) and “late” (49–168 hours) NH respectively. For late NH, the PAR for UGT1A1*6 homozygosity was 7.7%. Maternal excess weight was also a significant risk factor for “early” NH while maternal mutations on the beta-globin gene, prolonged rupture of membranes, large haematomas and neonatal sepsis were risk factors for “late” NH. For prolonged jaundice during the first month of life, G6PD mutations and UGT1A1*6 mutation, together with lower gestational age at birth and presence of haematoma were significant risk factors. In this population, genetic factors contribute considerably to the high risk of NH. Diagnostic tools to identify G6PD deficiency at birth would facilitate early recognition of high risk cases.
- ItemRapid review of the front-of-pack labelling schemes in Thailand(2022-11-01) Suya I.; Lorenzetti L.; Lebrun V.; Poowanasatien A.; Jones A.; Pettigrew S.; Bhatia T.; Kantachuvesiri S.; Hanbunjerd K.; Vijitsoonthornkul K.; Yuan M.; Saenyakul P.; Kowal P.; Suya I.; Mahidol UniversityThailand has used front-of-pack labelling (FoPL) policies to support its public health objectives of improving consumer nutrition to reduce the risk of noncommunicable disease. A rapid literature review explored the current types of FoPL systems in Thailand and how they are understood by consumers. Twelve studies were included, most of which examined the mandatory Guideline Daily Amount (GDA) label. Evidence showed gaps in consumer comprehension of the GDA—consistent with international literature demonstrating the GDA is not as effective at improving identification and choice of healthier foods as interpretive labels. Thai consumers reported somewhat better comprehension when colors or text were added to the GDA. Thai stakeholders should consider supplementing or replacing the GDA with one of the newer FoPL systems shown to be more effective in other countries. More rigorous research is necessary to ensure potential FoPL schemes have intended effects among Thai consumers to inform policy action.
- ItemDevelopment of nine microsatellite loci for Trypanosoma lewisi, a potential human pathogen in Western Africa and South-East Asia, and preliminary population genetics analyses(2022-01-01) Ségard A.; Romero A.; Ravel S.; Truc P.; Dobigny G.; Gauthier P.; Etougbetche J.; Dossou H.J.; Badou S.; Houéménou G.; Morand S.; Chaisiri K.; Noûs C.; de Meeûs T.; Ségard A.; Mahidol UniversityTrypanosoma lewisi belongs to the so-called atypical trypanosomes that occasionally affect humans. It shares the same hosts and flea vector of other medically relevant pathogenic agents as Yersinia pestis, the agent of plague. Increasing knowledge on the population structure (reproductive mode, population size, dispersal) of this parasite thus represents a challenging but important issue. The use of polymorphic genetic markers, together with suitable population genetics tools, is a convenient way to achieve such objectives. To date, the population biology of T. lewisi is poorly known and, to our knowledge, no population genetics studies have ever been conducted. Here, we present the development of nine microsatellite markers of this species. We investigated their polymorphism in different countries from Africa and South-East Asia from DNAs extracted from the spleen of their rodent reservoirs (essentially rat species). Several amplification problems arose, especially with SouthEast Asian individuals. This led to retain only those individuals with complete genotypes (most of them originating from West Africa, notably Cotonou, Benin) to ensure an optimal estimate of het-erozygosity. Our results pointed towards a mainly (at least 95-99%) clonal mode of propagation, a strong subdivision at the smallest scale available (i.e., urban neighborhoods, i.e. 0.250 km²), and a generation time most probably shorter than 4 months. In future studies, more extensive sampling at smaller geographic scales (i.e., households), within a one-or two-months window and with improved amplification conditions, should lead to a more precise picture of the fine population structure of this parasite.
- ItemThe challenges of the low birth rate in China(2022-06-01) Lucero-Prisno D.E.; Kouwenhoven M.B.N.; Vicerra P.M.M.; Ma Z.F.; Méndez M.J.G.; Gacutno-Evardone A.J.A.; Manirambona E.; Gyeltshen D.; Musa S.S.; Lucero-Prisno D.E.; Mahidol UniversityIntroduction: The population growth rate of China has been steadily declining owing to the low birth rate of the country. The Chinese census also indicates that the population is also rapidly ageing because of increasing life expectancy in conjunction with the low birth rate. Method: We performed a commentary to point out the challenges of the low birth rate in China. A comprehensive data search was performed in data bases such as Google Scholar and PubMed using predetermined search term. Results: The decline in birth rate is due to societal changes including increasing standard of living. Although the Chinese government has recently allowed couples to have up to three children in a major policy shift, many couples remain unwilling to have more than one child due to the high cost. An increasing fraction of Chinese women, particularly among the highly-educated urban dwellers, no longer regard marriage and parenthood as essential aspects of life. Conclusion: If not addressed urgently, the declining young population will impact China's future socio-economic situation, as there will be a smaller workforce relative to an increasing dependent older population. The repercussions may cascade to other spheres of China's status, including socioeconomic, security and global influence, if not addressed decisively. It is imperative that the country develops policies, strategies, and approaches to tackle this issue, including human capital development and the use of technology and innovations.
- ItemThe monkeypox virus: A public health challenge threatening Africa(2022-12-01) Manirambona E.; Musa S.S.; Shomuyiwa D.O.; Salam F.A.; John O.O.; Dinyo D.G.A.; Haruna U.A.; Sow A.U.; Lucero-Prisno D.E.; Ezie K.N.; Samai M.; Aziato L.; Manirambona E.; Mahidol UniversityOn 23 July 2022, the World Health Organization reported monkeypox cases in over 75 countries and, as a result, declared the virus a Public Health Emergency of International Concern (PHEIC). Despite Africa being the centre of the zoonotic disease evolution, its healthcare systems have not provided optimum attention to the problem. The African healthcare system is under the threat of a repeat of the situation that transpired during the COVID-19 pandemonium if stringent measures are not implemented immediately. Lessons learned from the COVID-19 pandemic should inform emergency preparedness and response from African countries. Concerted and sustainable efforts can be achieved by reviewing and redesigning strategic preparedness plans for testing and vaccination as in previous pandemics. Africa needs to drive this response with collaboration and a united response, and with the use of strategic communication and a sense of urgency. Africa should prioritise access to available vaccines and invest in systems development for local vaccine production. In this article, we argue that monkeypox virus has serious public health implications in Africa and the region.
- Item‘The broker also told me that I will not have problems after selling because we have two and we can survive on one kidney’: Findings from an ethnographic study of a village with one kidney in Central Nepal(2022-10-01) Shrestha B.; Adhikari B.; Shrestha M.; Poudel A.; Shrestha B.; Sunuwar D.R.; Mishra S.R.; Sringernyuang L.; Shrestha B.; Mahidol UniversityKidney selling is a global phenomenon engraved by poverty and governance in low-income countries with the higher-income countries functioning as recipients and the lower-income countries as donors. Over the years, an increasing number of residents in a village near the capital city of Nepal have sold their kidneys. This study aims to explore the drivers of kidney selling and its consequences using ethnographic methods and multi-stakeholder consultations. An ethnographic approach was used in which the researcher lived and observed the residents’ life and carried out formal and informal interactions including in-depth interviews with key informants, community members and kidney sellers in Hokse village, Kavrepalanchok district. Participants in the village were interacted by researchers who resided in the village. In addition, remote interviews were conducted with multiple relevant stakeholders at various levels that included legal workers, government officers, non-government organization (NGO) workers, medical professionals, and policymaker. All formal interviews were audio-recorded for transcription in addition to field notes and underwent thematic analysis. The study identified processes, mechanisms, and drivers of kidney selling. Historically, diversion of a major highway from the village to another village was found to impact the livelihood, economy and access to the urban centres, ultimately increasing poverty and vulnerability for kidney selling. Existing and augmented deprivation of employment opportunities were shown to foster emigration of villagers to India, where they ultimately succumbed to brokers associated with kidney selling. Population in the village also maintained social cohesion through commune living, social conformity (that had a high impact on decision making), including behaviours that deepened their poverty. Behaviours such as alcoholism, trusting and following brokers based on the persuasion and decision of their peers, relatives, and neighbours who became the new member of the kidney brokerage also contributed to kidney selling. The other reasons that may have influenced high kidney selling were perceived to be a poor level of education, high demands of kidneys in the market and an easy source of cash through selling. In Hokse village, kidney selling stemmed from the interaction between the brokers and community members’ vulnerability (poverty and ignorance), mainly as the brokers raised false hopes of palliating the vulnerability. The decision-making of the villagers was influenced heavily by fellow kidney sellers, some of whom later joined the network of kidney brokers. Although sustained support in livelihood, development, and education are essential, an expanding network and influence of kidney brokers require urgent restrictive actions by the legal authority.