[7] A large community of Indians also reside in Mandalay. Nationally, in 2014, 15,079 snakebite patients sought medical care from government facilities, out of which 13,382 were from the seven high incidence regions (Mandalay, Sagaing, Bago, Magwe, Yangon, Nay Pyi Taw and Ayeryarwady). A secondary aim is to compare these survey data with data from health centre and hospital presentations. This problem is exacerbated by the fact that snakebites mainly affect people in countries where health systems are evolving and the health management information systems are insufficiently robust to capture information even about those presenting to health facilities. The estimated global annual incidence is about 5 million snakebites resulting in between 81,000 and 138,000 deaths [1]. Data from Mandalay General Hospital (MGH) and Mandalay Teaching Hospital (MTH) provide evidence of the relative paucity of snakebite cases in urban areas compared to rural areas. The regional capital is Mandalay. Contents: Subdivision The population in Mandalay as well as related information and services (Wikipedia, Google, images). Project administration, 14% of the villages reported 4 or more bites during the last ten years, whereas 27% villages reported no snakebites. here. Others did not report if their family member fully recovered or had long term consequences. [1] Since almost all of large public hospitals and private hospitals, and doctors are located in Mandalay, these low numbers for a division with 7.7 million are actually even worse in the rest of the division, though these figures are believed to have improved by the advent of Naypyidaw as the nation's capital in 2006 although the level of improvement remains unreported. 44.1% of the victims were women. List of townships in Mandalay Division, Myanmar. In the 12 months from April 2017 till March 2018, MGH admitted a total of 856 patients, and MTH admitted only 153 patients. We are also grateful to the staff at the Regional Division Health Department for their support. https://doi.org/10.1371/journal.pntd.0006643.s001. 59 were Relatively fewer households in Madaya Township had experienced a snakebite (4.7% of households, 95% CI 3.3%–6.7%) during the last 10 years than in Kyaukse Township (7.3%, 95% CI 6.7–9.2%). There is a clear distinction in the Myanmar health system between urban and rural areas. Formal analysis, Other initiatives included auditing of hospital patient data, participatory research with the communities, examination of dead snakes brought by the patients, and discussions with the primary care staff about the snakebite problem in the area. In 2014, the Ministry of Health and Sports data from health facilities indicated an incidence of about 29.5 bites/ 100,000 population/year (a total of 15,079 bites). Methodology, [16], "Mandalay Division marching to new golden land of unity and amity", "Sub-national HDI - Area Database - Global Data Lab", "The Account of Wazo Monks and Nuns in 1377 (2016 year)", "Education statistics by level and by State and Division", "PPI: Almost Half of All World Health Spending is in the United States", 06.28.2007 "Burma junta faulted for rampant diseases", "Hospitals and Dispensaries by State and Division", "Mandalay continues to play vital role as healthcare centre for the upper north", https://en.wikipedia.org/w/index.php?title=Mandalay_Region&oldid=1008724080, Short description is different from Wikidata, Articles containing Burmese-language text, Wikipedia articles with MusicBrainz area identifiers, Creative Commons Attribution-ShareAlike License, General hospitals with specialist services, This page was last edited on 24 February 2021, at 18:59. Mandalay Region (Burmese: မန္တလေးတိုင်းဒေသကြီး, pronounced [máɰ̃dəlé táiɰ̃ dèθa̰ dʑí], formerly Mandalay Division) is an administrative division of Myanmar. Townships of the Mandalay Division There, they should be observed and tested for symptoms and signs of envenoming so that treatment with relevant antivenom can be provided if needed. Mandalay Region is one of Myanmar’s central Regions, sharing borders with Sagaing, Shan,Kayin, Bago, Naypyitaw and Magway. Project administration, The overall survey data could be accessed from the University of Adelaide Research Services Branch (Contact: Simon Brennan, Executive Director Research Services Branch, University of Adelaide simon.brennan@adelaide.edu.au). [9] Minority religious communities include Christians (1.1%), Muslims (3%), and Hindus (0.2%) who collectively comprise the remainder of Mandalay Region’s population. In the Mandalay metropolitan area, however, a large community of Chinese, most of whom are recent immigrants from Yunnan, now nearly rival the Bamar population. One respondent from each of the 4,276 households was interviewed (participation rate of 94%). 29.1% were 21–40 years of age, 43.8% were 41–60 years of age, and 20.5% were more than 60 years of age. The high snakebite incidence and case fatality rate identified through this survey has important implications. As part of the larger project, this survey was conducted to measure incidence of snakebite in the previous year, snakebite mortality in the previous 10 years, and snakebite-related knowledge and practices among community members. Writing – review & editing, Affiliation As the overall incidence per 100,000 population is relatively low and for that reason despite a relatively larger sample size it was not possible to explore the health services use and outcomes in the community survey. There are seven townships in Mandalay where five are located in urban areas and another two townships (Amarapura and Patheingyi) are located in rural areas which include a farmland The British administration organized seven divisions in Upper Myanmar: Mandalay, Meiktila, Minbu, Sagaing, and the Federated Shan States (North and South). The Pagan dynasty gradually came to dominate the central zone over the next two centuries, and by the late 11th century, all of present-day Myanmar. Based on a previous survey in Myanmar (7), the anticipated snakebite incidence was 100/100,000. Methodology, No, Is the Subject Area "Myanmar" applicable to this article? The completed questionnaires were reviewed daily for completeness by the trained data collector supervisors and were then reviewed by the Project team field supervisors for the survey. With only 24 snakebites in the past year, the point estimate of 116 snakebites per 100,000 population had wide confidence intervals (74/100,000 to 182/100000). After consultations with Myanmar colleagues and visits to numerous candidate townships and hospitals, we determined that the appropriate combination of a high incidence of snakebite, accessibility and local support from senior health care workers could be found in the Kyaukse and Madaya Townships of Mandalay Division. Considering the relatively small number of snakebites as reported by the respondents pointing to an estimated incidence of 116/100,00 with wider confidence intervals, our extrapolations must be interpreted with caution. Mandalay Division included what is now Kachin State. School of Public Health, University of Adelaide, Adelaide, Australia, Roles This page was last edited on 21 January 2017, at 18:53 (UTC). While there was no statistically significant difference between poor outcomes for children and adults, 4 of 38 victims under 18 years of age died compared to 7 of 133 adults 19 to 40 years of age. “Not only Mandalay, but other regions also are quite unsafe for the public, especially those who travel during the night time. The division consists of seven districts, which are subdivided into 30 townships and 2,320 wards and village-tracts. 252 respondents informed us that at least one person in their households had been bitten by a snake during the previous 10 years (5.9% of households, 95% CI 4.8%–7.3%). https://doi.org/10.1371/journal.pntd.0006643, Editor: Abdulrazaq G. Habib, College of Health Sciences, Bayero University Kano, NIGERIA, Received: February 8, 2018; Accepted: June 28, 2018; Published: July 9, 2018. This paper reports the community based incidence based on a community survey. This heterogeneous incidence of bites demands that the trends and situation within an area be carefully assessed when planning targeted health education, antivenom distribution, and in-service training for the health care providers and managers who work in the high incidence areas. The activities most associated with people being bitten were farming and collecting crops (Table 5). Mandalay. Data curation, Formal analysis, Agriculture is the primary economical source of livelihood. Frete GRÁTIS com Prime. 4,276 rural respondents in Kyaukse and Madaya townships in Mandalay Division were recruited using cluster sampling that involved random selection of 150 villages and random sampling of 30 households from each village. PLoS Negl Trop Dis 12(7): Conceptualization, Funding acquisition, This aspect of snakebite sequelae requires further research in the future. We are thankful to Dr Htay Aung for his enthusiastic support and guidance to understand the local primary care and community context, and to Dr Khin Maung Kyaw for his enthusiastic support throughout the Project. Over 30 of the hospitals had less than 100 beds. PLOS Neglected Tropical Diseases is the top Open Access tropical medicine journal, featuring an International Editorial Board and increased support for developing country authors. Snakebite is a major health issue affecting large numbers of people, particularly in tropical developing countries. We are grateful to the Myanmar and Australian health services specialists, CSIRO Australia, and Seqirus Australia for their voluntary support of this Project. For each selected household, an adult member was interviewed. However, Mandarin Chinese is increasingly spoken in Mandalay and the northern gem mining town of Mogok. *FREE* shipping on eligible orders. Funding acquisition, 9 Mandalay Basic Education High School No. The original Mandalay Region consists of 8 districts.Later the Pyinmana district was formed as Union Territory under the direct administration of president.So Mandalay Region remains 28 townships organized into seven districts. [12][13] Although health care is nominally free, in reality patients have to pay for medicine and treatment even in public clinics and hospitals. The incidence identified through our survey suggests that the number of snakebites in the rural areas of seven regions of Myanmar, where 90% of snakebites occur and where about 23 million people live, may be significantly higher than the number of snakebites reported in the national health facilities data. Supervision, Supervision, Industry, including alcoholic breweries, textile factories, sugar mills, and gem mines also exists. This survey was one of the many aspects of the health system development project. According to the 2014 Myanmar Census, Buddhists make up 95.7% of Mandalay Region’s population, forming the largest religious community there. This collaborative project aims to improve outcomes of snakebite patients, with a focus on improving the quantity and quality of nationally produced antivenom, its distribution in quantities sufficient for the needs of the various regions of the country, health services development through in-service training and resource improvement, and community education targeting training for prevention, first aid and appropriate use of health services. District in Myanmar. Myanmar Australia Snakebite Project, Mandalay, Myanmar, Roles Our findings suggest a higher incidence of snakebite than recorded in health services data. The respondents informed us that most snakebites occur in and around fields and in the forests (Table 3). A minority, 11.5%, sought care from traditional healers before visiting a formal health care facility, while 87.7% sought care from the formal health system as their first point of contact. In Myanmar, a ‘township’ comprises not just an urban centre, but also the surrounding rural hinterland that may cover a significant area with many rural villages. The project was in collaboration with the Myanmar MOHS and had approval for these two townships only. History of snakebites and snakebite-related deaths among all household residents covering a period of 10 years prior to the survey was collected. Contacts and Details of Soe Kabar Real Estate, Myanmar Property and Real Estate Services. However, as it would have been difficult for the community members to remember the symptoms correctly, this survey, which focussed on incidence, did not include questions about signs and symptoms affecting those who were reported bitten in the last ten years. Yes It is located in the center of the country, bordering Sagaing Region and Magway Region to the west, Shan State to the east, and Bago Region and Kayin State to the south. Photos were not shown for the respondents to identify the type of snakes sighted in the area as this method has proved misleading and unreliable. Research that involves reviewing the data of patients admitted to the township, district and referral hospitals will help capture such clinical information which when used in conjunction with the information about incidence would help refine and strengthen in-service trainings and better define which anti venoms are necessary. Other aspects of the project, particularly examining of dead snakes brought by the patients to Mandalay General Hosital, confirmed that most of the snakebites in this area are by Russell’s Viper, Rat Snake, Cobra, Checkered Keelback and Green Snakes. Writing – review & editing, Roles The region has some of the best institutions of higher education in Myanmar. To the south of the region lies the national capital of Nay Pyi Taw. One respondent from each of 4,276 households represented 19,877 residents from 144 villages. No, Is the Subject Area "Snakes" applicable to this article? School of Public Health, University of Sydney, Sydney, Australia, Roles The military government spends between 0.5% to 3% of the country's GDP on health care, consistently ranking among the lowest in the world. Language; Watch; Edit Last edited on 21 January 2017, at 18:53. Methodology, The lack of detailed information about symptoms, treatment and outcomes including long term consequences is another limitation. Hardwoods such as teak and thanaka are also harvested. e0006643. The last population-based study in Myanmar was conducted more than a decade ago. Tourism now forms a substantial part of Mandalay Region's economy, as it contains many historical sites including Mandalay, Amarapura, Bagan, Pyin U Lwin, Mount Popa, and Ava. In 1990, there were 56 constituencies. Writing – review & editing, Roles This page draws together available Township profiles from the General Administration Department (GAD), Ministry of Home Affairs (2017 data), and the Department of Population (DoP), Ministry of Labour, Immigration and Population (2014 Census data).These resources are also available on the respective department’s websites. Data were collected using an interviewer-administered questionnaire that took about 20 minutes to complete. We excluded residents who lived in urban areas of Kyaukse and Madaya Townships (16% and 9% respectively). 111 of 252 (44%) snakebites were reported from 21 villages (14% of the villages) were there had been 4 or more snakebites during the last 10 years. In India alone, a well-designed community-based study documented more than 45,000 deaths in 2005 [4]. We excluded residents who lived in urban areas of Kyaukse and Madaya Townships (16% and 9% respectively). 9 Mandalay မန္တလေး ; formerly, St. Peters High School) is a public high school in downtown Mandalay… The township is bounded by Aungmyethazan Township and Chanayethazan Township in the west. Many snakebite victims do not seek or receive care in the formal health care sector. A survey in Bangladesh reported an incidence of 623/100,000 [8] and a survey in Laos reported an incidence of 355/100,000 in one area and 1162/100000 in another [9]. This difference was not statistically significant. [5], Under the Mandalay Region High Court there are 8 district courts,Mandalay,Pyin Oo Lwin, Kyaukse, Meithtila,Myingyan, Nyaung Oo, Yamethin and Dakina (for Union Territory).There are 35 township courts including the townships of Union Territory and 5 special courts.[6]. State/Division & Township P-codes Shan State (South) (MMR014) Map Index Township Pcode 250 Hopong MMR014003 251 Hsihseng MMR014004 Ayeyarwady Division (MMR017) Kachin State (MMR001) Mandalay Division (MMR010) Sagaing Division (MMR005) 252 Kalaw MMR014005 Map Index Township Pcode Map Index Township Pcode Map Index Township Pcode Map Index Township Pcode … In 2014, Ministry of Health and Sports (MOHS) data from health facilities indicated about 29.5 bites / 100,000 population / year (a total of 15,079 bites). Contributed equally to this work with: The division consists of seven districts, which are subdivided into 28 townships and 2,320 wards and village-tracts. A dwindling community of Anglo-Burmese still exists in both Pyinoolwin and Mandalay. This higher incidence points to the need for a nation-wide population-based survey, community education about gaining access to care where antivenom is available, and to the potential need for a larger supply of antivenom and expansion of medical care in rural areas. With demographic changes, changes to agricultural practices, education, economic development and associated changes in prevention and access to health care, it is important periodically to re-assess the incidence, morbidity, mortality, community knowledge and practices in relation to prevention and service utilisation. ShweProperty.com, Myanmar's #1 Real Estate Portal Likely reasons, that require further exploration, include the type of crops grown, proximity to rivers and marshy areas, sanitation in and around houses, and use of personal protective equipment such as long boots. The design effect for snakebite incidence in Myanmar is unknown. Yes There is a clear distinction in the Myanmar health system between urban and rural areas. Konbaung Dynasty ruled the region until December 1885 when it lost all of Upper Myanmar in the Third Anglo-Burmese War. Out of 144 villages, respondents from 40 villages reported no snakebite during the previous ten years. In order to improve the health outcomes of snakebite patients in Myanmar, access to accurate snakebite incidence data is crucial. Considering the likely better recall about symptoms and treatment for those 24 snakebite victims who were bitten during the one year preceding the survey, the household members were asked questions about symptoms and treatment received. Category:Townships of Mandalay Region. Actually, Myanmar is special in its own way. This incidence reported by the community members points to substantially more snakebites than the number of snakebite patients attending health facilities. The regional health management authority had separate lists for rural and urban areas and that was the basis of distinction.
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