<i>Aeromonas</i>spp. Bacteremia in Pregnant Women, Thailand–Myanmar Border, 2011

Turner, Paul; Willemse, C. H.; Phakaudom, Kawalee; Zin, Thet Wai; Nosten, François; McGready, Rose

doi:10.3201/eid1809.111592

Cited by 6 publications

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References 5 publications

(6 reference statements)

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“…Furthermore, SMRU is not equipped to offer long-term clinical care for subjects with transfusion-dependent thalassaemia, and the costs for refugees or migrants would be a limiting factor even when referral to a reference centre in Thailand is possible. Safe termination of pregnancy is not accessible to most migrant and refugee women in this border area and unsafe abortions are a cause of maternal morbidity and mortality in these vulnerable communities ( Turner et al , 2012 ). Despite these challenges and limitations, the current data on the high prevalence of HbE, alpha and beta-thalassaemia warrant a continuation of screening and encourage the implementation of a more extended program of early information and counselling to girls and women of reproductive age among the population.…”

Section: Discussionmentioning

confidence: 99%

Prevalences of inherited red blood cell disorders in pregnant women of different ethnicities living along the Thailand-Myanmar border

Bancone¹,

Gilder²,

Chowwiwat³

et al. 2017

Wellcome Open Res

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Background: Inherited red blood cell disorders are prevalent in populations living in malaria endemic areas; G6PD deficiency is associated with oxidant-induced haemolysis and abnormal haemoglobin variants may cause chronic anaemia. In pregnant women, microcytic anaemia caused by haemoglobinopathies mimics iron deficiency, complicating diagnosis and treatment. Anaemia during pregnancy is associated with morbidity and mortality. The aim of this study was to characterise the prevalence of G6PD deficiency and haemoglobinopathies among the pregnant population living along the Thailand-Myanmar border. Pregnant women attending antenatal clinics in this area belong to several distinct ethnic groups. Methods: Data were available for 13,520 women attending antenatal care between July 2012 and September 2016. Screening for G6PD deficiency was done by fluorescent spot test routinely. G6PD genotyping and quantitative phenotyping by spectrophotometry were analysed in a subsample of women. Haemoglobin variants were diagnosed by HPLC or capillary electrophoresis and molecular methods. The prevalence and distribution of inherited red blood cell disorders was analysed with respect to ethnicity. Results: G6PD deficiency was common, especially in the Sgaw Karen ethnic group, in whom the G6PD Mahidol variant allele frequency was 20.7%. Quantitative G6PD phenotyping showed that 60.5% of heterozygous women had an intermediate enzymatic activity between 30% and 70% of the population median. HbE, beta-thalassaemia trait and Hb Constant Spring were found overall in 15.6% of women. Only 45.2% of women with low percentage of HbA 2 were carriers of mutations on the alpha globin genes. Conclusions: Distribution of G6PD and haemoglobin variants varied among the different ethnic groups, but the prevalence was generally high throughout the cohort. These findings encourage the implementation of an extended program of information and genetic counselling to women of reproductive age and will help inform future studies and current clinical management of anaemia in the pregnant population in this region.

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Section: Discussionmentioning

confidence: 99%

Prevalences of inherited red blood cell disorders in pregnant women of different ethnicities living along the Thailand-Myanmar border

Bancone¹,

Gilder²,

Chowwiwat³

et al. 2017

Wellcome Open Res

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“…In the scenario of the suddenly widowed woman it was suggested that abortion was an option. Legal termination is only available for rape and life-saving medical indications in Thailand and Myanmar, but the answer suggests women will put themselves at risk to solve problems of unwanted pregnancy [ 29 ] and indeed this has been observed in clinical practice in this setting [ 9 ]. Consultations and negotiations with key members of the generally conservative local community [ 30 ] have commenced as a result of this study and as previously recommended from an evaluation of the availability, service delivery, and barriers to access to emergency contraceptive pills (ECPs) along the Thailand–Burma border [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…A parity of four or more amongst refugee and migrant women has been identified as a major risk factor for mortality [ 5 ]. As has induced abortion, a problem recognized in migrant Burmese women in urban centres such as Mae Sot [ 8 ] and more recently for rural refugees and migrants who travel to Mae Sot [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Family planning knowledge, attitudes and practices in refugee and migrant pregnant and post-partum women on the Thailand-Myanmar border – a mixed methods study

et al. 2016

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BackgroundLack of data in marginalized populations on knowledge, attitudes and practices (KAP) hampers efforts to improve modern contraceptive practice. A mixed methods study to better understand family planning KAP amongst refugee and migrant women on the Thailand-Myanmar border was conducted as part of an ongoing effort to improve reproductive health, particularly maternal mortality, through Shoklo Malaria Research Unit (SMRU) antenatal and birthing services.MethodsCross-sectional surveys and focus group discussions (FGDs) in currently pregnant women; and in-depth interviews (IDIs) in selected post-partum women with three children or more; were conducted. Quantitative data were described with medians and proportions and compared using standard statistical tests. Risk factors associated with high parity (>3) were identified using logistic regression analysis. Qualitative data were coded and grouped and discussed using identified themes.ResultsIn January-March 2015, 978 women participated in cross-sectional studies, 120 in FGD and 21 in IDI. Major positive findings were: > 90 % of women knew about contraceptives for birth spacing, >60 % of women in the FGD and IDI reported use of family planning (FP) in the past and nearly all women knew where they could obtain FP supplies. Major gaps identified included: low uptake of long acting contraception (LAC), lack of awareness of emergency contraception (>90 % of women), unreliable estimates of when child bearing years end, and misconceptions surrounding female sterilization. Three was identified as the ideal number of children in the cross-sectional survey but less than half of the women with this parity or higher in the IDI actually adopted LAC leaving them at risk for unintended pregnancy. Discussing basic female anatomy using a simple diagram was well received in FGD and IDIs. LAC uptake has increased particularly the IUD from 2013–2015.ConclusionDefinitive contextual issues were identified during this study and a significant range of action points have been implemented in FP services at SMRU as a result, particularly in regard to the IUD. The importance of the role and attitudes of husbands were acknowledged by women and studies to investigate male perspectives in future may enhance FP practice in this area.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-016-0212-2) contains supplementary material, which is available to authorized users.

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“…In Thailand, Aeromonas spp. have been clinically isolated from human cases of bacteremia and peritonitis [ 11 , 12 , 13 ].…”

Section: Resultsmentioning

confidence: 99%

Genomic Analysis of Aeromonas veronii C198, a Novel Mcr-3.41-Harboring Isolate from a Patient with Septicemia in Thailand

et al. 2020

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The resistance of Gram-negative bacteria to colistin, mediated by plasmid-borne mcr genes, is an emerging public health concern. The complete genome sequence (4.55 Mb) of a clinical isolate of Aeromonas veronii biovar veronii obtained from a patient with septicemia was determined using short-read and long-read platforms. This isolate (C198) was found to harbor a novel mcr-3 gene, designated mcr-3.41. Isolate C198 revealed adjacent mcr-3.41 and mcr-3-like genes. It contained one chromosome and two plasmids, both of which encoded a RepB replication protein. Other antimicrobial resistance genes, including blacphA3, blaOXA-12, tetA, rsmA, and adeF, were also present. Isolate C198 was resistant to amoxicillin–clavulanate, ampicillin–sulbactam and tetracycline, and showed intermediate resistance to trimethoprim–sulfamethoxazole. The isolate was susceptible to piperacillin–tazobactam, carbapenem, third-generation cephalosporins, fluoroquinolones, chloramphenicol, and aminoglycosides. Putative virulence genes in the C198 genome encoded type II, III, and VI secretion systems; type IV Aeromonas pili; and type I fimbria, flagella, hemagglutinin, aerolysin, and hemolysins. Multilocus sequence typing revealed a novel sequence type (ST), ST720 for C198. Phylogenetic analysis of the single nucleotide polymorphisms in C198 demonstrated that the strain was closely related to A. veronii 17ISAe. The present study provides insights into the genomic characteristics of human A. veronii isolates.

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Aeromonasspp. Bacteremia in Pregnant Women, Thailand–Myanmar Border, 2011

Cited by 6 publications

References 5 publications

Prevalences of inherited red blood cell disorders in pregnant women of different ethnicities living along the Thailand-Myanmar border

Prevalences of inherited red blood cell disorders in pregnant women of different ethnicities living along the Thailand-Myanmar border

Family planning knowledge, attitudes and practices in refugee and migrant pregnant and post-partum women on the Thailand-Myanmar border – a mixed methods study

Genomic Analysis of Aeromonas veronii C198, a Novel Mcr-3.41-Harboring Isolate from a Patient with Septicemia in Thailand

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