R4D Burma

Protifolon Issue 3. Disaster Risk Management and Climate Change Adaptation in South Asia

Wed, 04 Apr 2012 07:29 GMT

Document Type: Briefing
Creator: Atiq Rahman, A.; Fatema Rajabali; Mafruha Alam; Md. Masum Billah; Shah Md. Ashraful Amin (Editors)

Production Year: 2010

Citation: Atiq Rahman, A.; Fatema Rajabali; Mafruha Alam; Md. Masum Billah; Shah Md. Ashraful Amin (Editors). Protifolon Issue 3. Disaster Risk Management and Climate Change Adaptation in South Asia. D.Net, Dhaka, Bangladesh (2010) 8 pp.

Summary: This issue focuses on how local communities in six countries in south-east Asia are managing risk; how they are coping with and preparing for possible disaster in their villages; how people living on the flood plains of the Brahmaputra-Jamuna river in Bangladesh are coping with annual flooding; and how rice farmers in Hambantota district, Sri Lanka are dealing with increasing soil salinity.

Effectiveness of five artemisinin combination regimens with or without primaquine in uncomplicated falciparum malaria: an open-label randomised trial.

Fri, 11 Mar 2011 08:01 GMT

Document Type: Miscellaneous
Creator: Smithuis, F.; Kyaw Kyaw, M.; Phe, O.; Win, T.; Phyo Aung, P.; Pyay Phyo Oo, A.; Naing, A.L.; Yee Nyo, M.; Htun Myint, N.Z.; Imwong, M.; Ashley, E.; Lee, S.J.; White, N.J.

Production Year: 2010

Citation: The Lancet Infectious Diseases (2010) 10 (10) 673-681 [doi:10.1016/S1473-3099(10)70187-0].

Summary: Background: Artemisinin-combination therapy (ACT) is recommended as first-line treatment for falciparum malaria throughout the world, and fixed-dose combinations are preferred by WHO; whether a single gametocytocidal dose of primaquine should be added is unknown. We aimed to compare effectiveness of four fixed-dose ACTs and a loose tablet combination of artesunate and mefloquine, and assess the addition of a single gametocytocidal dose of primaquine. Methods: In an open-label randomised trial in clinics in Rakhine state, Kachin state, and Shan state in Myanmar (Burma) between Dec 30, 2008, and March 20, 2009, we compared the effectiveness of all four WHO-recommended fixed-dose ACTs (artesunate-mefloquine, artesunate-amodiaquine, dihydroartemisinin-piperaquine, artemether-lumefantrine) and loose artesunate-mefloquine in Burmese adults and children. Eligible patients were those who presented to the clinics with acute uncomplicated Plasmodium falciparum malaria or mixed infection, who were older than 6 months, and who weighed more than 5 kg. Treatments were randomised in equal numbers within blocks of 50 and allocation was in sealed envelopes. All patients were also randomly assigned to receive either a single dose of primaquine 0·75 mg base/kg, or no primaquine. Patients were followed up for 63 days. Treatment groups were compared by analysis of variance and multiple logistic regression. The primary outcome was the 63 day recrudescence rate. This study is registered with clinicaltrials.gov, number NCT00902811. Findings: 155 patients received artesunate-amodiaquine, 162 artemether-lumefantrine, 169 artesunate-mefloquine, 161 loose artesunate-mefloquine, and 161 dihydroartemisinin-piperaquine. By day 63 of follow-up, 14 patients (9·4%; 95% CI 5·7-15·3%) on artesunate-amodiaquine had recrudescent P falciparum infections, a rate significantly higher than for artemether-lumefantrine (two patients; 1·4%; 0·3-5·3; p=0·0013), fixed-dose artesunate-mefloquine (0 patients; 0-2·3; p<0·0001), loose artesunate-mefloquine (two patients; 1·3%; 0·3-5·3; p=0·0018), and dihydroartemisinin-piperaquine (two patients 1·3%; 0·3-5·2%; p=0·0012). Hazard ratios for re-infection (95% CI) after artesunate-amodiaquine were 3·2 (1·3-8·0) compared with the two artesunate-mefloquine groups (p=0·01), 2·6 (1·0-6.0) compared with artemether-lumefantrine (p=0·04), and 2·3 (0·9-6·0) compared with dihydroartemisinin-piperaquine (p=0·08). Mixed P. falciparum and P. vivax infections were common: 129 patients (16%) had a mixed infection at presentation and 330 (41%) had one or more episodes of P. vivax infection during follow-up. The addition of a single dose of primaquine (0·75 mg/kg) reduced P. falciparum gametocyte carriage substantially: rate ratio 11·9 (95% CI 7·4-20·5). All regimens were well tolerated. Adverse events were reported by 599 patients, most commonly vomiting and dizziness. Other side-effects were less common and were not related to a specific treatment. Interpretation: Artesunate-amodiaquine should not be used in Myanmar, because the other ACTs are substantially more effective. Artesunate-mefloquine provided the greatest post-treatment suppression of malaria. Adding a single dose of primaquine would substantially reduce transmission potential. P. vivax malaria, not recurrent P. falciparum malaria, is the main complication after treatment of P. falciparum infections in this region.

Artemisinin Combination Therapy (ACTs) in Myanmar: Status update and outlook. Symposium held by DNDi, Cipla and Vimal, Yangon, Myanmar (Rangoon, Burma), 24 January 2011.

Wed, 16 Feb 2011 10:48 GMT

Document Type: Miscellaneous
Creator: Drugs For Neglected Diseases Initiative (DNDi)

Production Year: 2011

Citation: Artemisinin Combination Therapy (ACTs) in Myanmar: Status update and outlook. Symposium held by DNDi, Cipla and Vimal, Yangon, Myanmar (Rangoon, Burma), 24 January 2011.

Summary: The subjects of the presentations from this symposium included the malaria situation in East Asia, that in Myanmar in particular, the development of DNDi's fixed dose antimalarial combinbation ASMQ (artesunate + mefloquine), trials of its use in Myanmar, the tolerability of artemisinin combination therapies in malaria patients, and an overview of the work of DNDi.

The ASMQ Fixed-Dose Combination to treat Malaria: From Blueprint to Use in the Field.

Thu, 13 Jan 2011 11:17 GMT

Document Type: Miscellaneous
Creator: Drugs For Neglected Diseases Initiative (DNDi)

Production Year: 2009

Citation: Symposium from American Society of Tropical Medicine and Hygiene 58th Annual Meeting, Washington, DC, USA, 19 November 2009.

Summary: This symposium consisted of 3 presentations: one giving a general description of the new fixed-dose antimalarial formulation ASMQ (artesunate + mefloquine), with a mention of its use in Africa; one about its use in the Amazon basin (Acre state, Brazil); and one about the treatment of malaria in Myanmar with different artemisinin combinations.

Other Planned Studies: AS-MQ in India [and] Asia.

Wed, 08 Dec 2010 09:30 GMT

Document Type: Miscellaneous
Creator: Ribeiro, I.

Production Year: 2008

Citation: Presentatation from: Scientific Symposium "Implementation of Artemisinin Combination Therapies (ACTs): Role of ASMQ". Rio de Janeiro, Brazil, 17 April 2008.

Summary: This presentation describes two proposed studies of artemisinin-based combination therapies against uncomplicated Plasmodium falciparum malaria: one in India, to assess the efficacy, safety and population pharmacokinetics of ASMQ (fixed dose artesunate + mefloquine), and one in Myanmar (Burma), to compare the effectiveness of the current first-line treatment (artesunate and mefloquine as separate loose tablets) with 4 alternatives: ASMQ, artemether-lumefantrine, dihydroartemisinine-piperaquine, and ASAQ (fixed dose artesunate + amodiaquine).

Improving Health Services and Strengthening Health Systems: Adopting and Implementing Innovative Strategies

Tue, 23 Nov 2010 10:15 GMT

Document Type: Miscellaneous
Creator: K. Janovsky and D. H. Peters

Production Year: 2006

Citation: Working Paper No. 5. Department of Health Policy, Development and Services, Evidence and Information for Policy. Geneva: World Health Organization, 29 pp.

Summary: In recent years, a number of specific strategies for improving health services and strengthening health systems have been consistently advocated. This exploratory study examines the track record of these strategies in twelve low-income countries.

Working Paper No. 73. 'A Pariah in Our Midst': regional organisations and the problematic of Western-designated pariah regimes - the cases of SADC/Zimbabwe and ASEAN/Myanmar

Wed, 26 May 2010 07:26 GMT

Document Type: Miscellaneous
Creator: C. Alden

Production Year: 2010

Citation: Working Paper No. 73 (series 2), London, UK; Crisis States Research Centre, 26 pp.

Summary: How do regional organisations handle the problem of Western-designated 'pariah' states? It is often assumed that regional organisations are best placed to intervene due to their proximity, local knowledge and interlocking interests with the 'pariah' state. This paper examines the role they can play in interpreting liberal norms as sources of regime legitimacy and in mediating with multilateral institutions.

BFP02. Water-use accounts in CPWF basins: Simple water-use accounting of the Mekong Basin.

Wed, 21 Apr 2010 04:49 GMT

Document Type: Miscellaneous
Creator: M. Kirby, M. Mainuddin and J. Eastham

Production Year: 2010

Citation: CPWF Working Paper: Basin Focal Project series, BFP02. Colombo, Sri Lanka: The CGIAR Challenge Program on Water and Food. 27 pp.

Summary: This paper applies the principles of water-use accounts, developed in the first of the series, to the Mekong River basin in Southeast Asia. The Mekong Basin covers six countries: the River rises in China, but there are substantial downstream tributaries from Thailand, Laos, Cambodia, and Vietnam, and from a small area in Myanmar. A unique feature is the reverse flow from the Mekong to the Tonle Sap via the Tonle Sap River at the height of the wet season flow and its ebb as the river levels fall.

Net runoff is about 37% of total precipitation. Forest and woodland cover 43% of the basin and use about 33% of the precipitation. Grassland covers much of the upper part of the Basin, consuming about 6% of the precipitation. Irrigated agriculture covers just 6% of the Basin and uses about 6% of the water (excluding runoff).

Climate change, using an assumed change in rainfall distribution, shows that with the expected shorter and more intense rainy season, and longer and more intense dry season, both floods and seasonal water shortages may be exacerbated.

Poultry, HPAI and Livelihoods in Myanmar – A Review.

Wed, 29 Apr 2009 08:23 GMT

Document Type: Miscellaneous
Creator: S. Burgos, J. Otte, and D. Roland-Holst

Production Year: 2009

Citation: Mekong Team Working Paper No. 8. 35 pp.

Summary: This document aims to provide a brief country economic overview of Myanmar; a review of the poultry sector that examines production, trade, markets and consumption; information on household income, food expenditures and poultry contribution to nutrition. Finally, it describes the course of HPAI and applied control measures, with their concomitant impacts on livelihoods, the poultry sector and the economy at large. This information should provide background information to be used as additional evidence for policymaking processes at national and international levels.

CABI Asia-Pacific Member Country consultation synthesis report, 29-30 November 2007 Beijing, China

Tue, 26 Feb 2008 05:58 GMT

Document Type: Miscellaneous
Creator: CABI

Production Year: 2007

Citation: CABI, Wallingford, UK, 19 pp.

Summary:

CABI's programmes are driven by the needs of its Member Countries. To reinforce this connection, CABI is establishing a series of direct dialogues in each region of operation. These aim to strengthen understanding of CABI's activities and capabilities in support of international development and to build close engagement with the regional priorities of Member Countries. These priorities will help to shape CABI's strategic programmes and to help establish the particular forms of mutual commitment and financial resourcing required to deliver its mission. The Asia-Pacific Member Country Consultation was the second of three such dialogues.

Liaison Officers or Member Country representatives from 12 Asia-Pacific Member Countries attended the meeting, together with one representative from Indonesia (a former Member) and one from Canada. The meeting itself was a closed business session for Member Countries. However, in the final session, the outcomes were presented to a wider audience of partners, donors, and stakeholders.

This document outlines the member country objectives; national priorities and key sub-regional issues amongst CABI's Members; and action plans and responsibilities. The countries in the 3 subregional groups were:
1. Australia, China, Papua New Guinea, Vietnam
2. Brunei, Indonesia, Malaysia, Myanmar, Philippines
3. Bangladesh, India, Pakistan, Sri Lanka.

Six key themes were identified:

Trade development and markets
Institutional capacity strengthening and knowledge management
Biofuels and Climate Change
Microbial collection - use and management
ICT and Enterprise development including animal and aquaculture sectors
Integrated Pest Management/Invasive Species in relation to high value crops

The details of the findings for each theme, are summarized in tables in the Appendices