Snake Bite in South Asia: A Review

Snake bite is one of the most neglected public health issues in poor rural communities living in the tropics. Because of serious misreporting, the true worldwide burden of snake bite is not known. South Asia is the world''s most heavily affected region, due to its high population density, widespread agricultural activities, numerous venomous snake species and lack of functional snake bite control programs. Despite increasing knowledge of snake venoms'' composition and mode of action, good understanding of clinical features of envenoming and sufficient production of antivenom by Indian manufacturers, snake bite management remains unsatisfactory in this region. Field diagnostic tests for snake species identification do not exist and treatment mainly relies on the administration of antivenoms that do not cover all of the important venomous snakes of the region. Care-givers need better training and supervision, and national guidelines should be fed by evidence-based data generated by well-designed research studies. Poorly informed rural populations often apply inappropriate first-aid measures and vital time is lost before the victim is transported to a treatment centre, where cost of treatment can constitute an additional hurdle. The deficiency of snake bite management in South Asia is multi-causal and requires joint collaborative efforts from researchers, antivenom manufacturers, policy makers, public health authorities and international funders.     

God-Apes and Fossil Men: Paleoanthropology in South Asia

God-Apes and Fossil Men: Paleoanthropology in South Asia. Kenneth A. R. Kennedy. Ann Arbor: University of Michigan Press, 2000.480 pp.     

A collaborative epidemiological investigation into the criminal fake artesunate trade in South East Asia

Background

Since 1998 the serious public health problem in South East Asia of counterfeit artesunate, containing no or subtherapeutic amounts of the active antimalarial ingredient, has led to deaths from untreated malaria, reduced confidence in this vital drug, large economic losses for the legitimate manufacturers, and concerns that artemisinin resistance might be engendered.

Methods and Findings

With evidence of a deteriorating situation, a group of police, criminal analysts, chemists, palynologists, and health workers collaborated to determine the source of these counterfeits under the auspices of the International Criminal Police Organization (INTERPOL) and the Western Pacific World Health Organization Regional Office. A total of 391 samples of genuine and counterfeit artesunate collected in Vietnam (75), Cambodia (48), Lao PDR (115), Myanmar (Burma) (137) and the Thai/Myanmar border (16), were available for analysis. Sixteen different fake hologram types were identified. High-performance liquid chromatography and/or mass spectrometry confirmed that all specimens thought to be counterfeit (195/391, 49.9%) on the basis of packaging contained no or small quantities of artesunate (up to 12 mg per tablet as opposed to ∼ 50 mg per genuine tablet). Chemical analysis demonstrated a wide diversity of wrong active ingredients, including banned pharmaceuticals, such as metamizole, and safrole, a carcinogen, and raw material for manufacture of methylenedioxymethamphetamine (‘ecstasy''). Evidence from chemical, mineralogical, biological, and packaging analysis suggested that at least some of the counterfeits were manufactured in southeast People''s Republic of China. This evidence prompted the Chinese Government to act quickly against the criminal traders with arrests and seizures.

Conclusions

An international multi-disciplinary group obtained evidence that some of the counterfeit artesunate was manufactured in China, and this prompted a criminal investigation. International cross-disciplinary collaborations may be appropriate in the investigation of other serious counterfeit medicine public health problems elsewhere, but strengthening of international collaborations and forensic and drug regulatory authority capacity will be required.     

南亚药用植物概述

简介了南亚药用植物的总体情况,30种重要种类的产地、药用部位、活性成分、功效,以及常用种类的简要情况。     

Materialising Oceania: New ethnographies of things in Melanesia and Polynesia

Oceania occupies an intriguing place within anthropology’s genealogy. In the introduction to this collection of essays, we examine the role of the ethnography of Oceania in the development of our anthropological perspectives on materialisation, the dynamic process by which persons and things are inter‐related. Building upon the recent resurgence of theoretical interests in things we use the term materialisation (rather than material culture or materiality) to capture the vitality of the lived processes by which ideas of objectivity and subjectivity, persons and things, minds and bodies are entangled. Taking a processual view, we advocate for an Oceanic anthropology that continues to engage with things on the ground; that asks what strategies communities use to materialise their social relations, desires and values; and that recognises how these processes remain important tools for understanding historical and contemporary Oceanic societies. Examining these locally articulated processes and forms contributes to a material (re)turn for anthropology that clarifies how we, as scholars, think about things more widely.     

Defining women's health: a dozen messages from more than 150 ethnographies

Although the women's health research agenda has been largely defined by Western biomedicine and public health, anthropology has much to offer in terms of defining and understanding women's health from the perspective of women themselves. Through the in-depth qualitative tradition of ethnography, anthropologists have documented women's health concerns around the globe, producing a large and constantly expanding literature that is rich and provocative. This article summarizes a dozen major messages about women's health that emerge from the ethnographic literature, now consisting of more than 150 volumes. These volumes are listed in the article, and some primary examples are described as representative of anthropology's contribution to knowledge production in women's health.     

Early initiation of breastfeeding: a systematic literature review of factors and barriers in South Asia

Background

Early or timely initiation of breastfeeding is crucial in preventing newborn deaths and influences childhood nutrition however remains low in South Asia and the factors and barriers warrant greater consideration for improved action. This review synthesises the evidence on factors and barriers to initiation of breastfeeding within 1 h of birth in South Asia encompassing Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka.

Methods

Studies published between 1990 and 2013 were systematically reviewed through identification in Academic Search Complete, CINAHL, Global Health, MEDLINE and Scopus databases. Twenty-five studies meeting inclusion criteria were included for review. Structured thematic analysis based on leading frameworks was undertaken to understand factors and barriers.

Results

Factors at geographical, socioeconomic, individual, and health-specific levels, such as residence, education, occupation, income, mother’s age and newborn’s gender, and ill health of mother and newborn at delivery, affect early or timely breastfeeding initiation in South Asia. Reported barriers impact through influence on acceptability by traditional feeding practices, priests’ advice, prelacteal feeding and discarding colostrum, mother-in-law’s opinion; availability and accessibility through lack of information, low access to media and health services, and misperception, support and milk insufficiency, involvement of mothers in decision making.

Conclusions

Whilst some barriers manifest similarly across the region some factors are context-specific thus tailored interventions are imperative. Initiatives halting factors and directed towards contextual barriers are required for greater impact on newborn survival and improved nutrition in the South Asia region.