Background: Mycobacterium tuberculosis complex (MTC) that causes the chronic infectious disease- tuberculosis (TB), often presents with a complicated epidemiological pattern where the transmission chain may include humans, domestic animals and wildlife, including elephants. TB has been reported globally in both captive and wild elephants. The One Health approach might be the most effective way of understanding the shared MTC infection dynamics in captive and wild animals like Asian elephants. This systematic review accumulates evidence on occurrence, transmission pathways, and preventive measures of TB in elephants from a One Health perspective. Results: The prevalence of TB reported in elephant populations ranges from 0 to 23.33% and high prevalence’s are reported for elephants that are in close proximity to infected humans. The risk of elephant to human infection transmission increased significantly with exposure duration and contact with infected elephants. Some studies described the plausible TB transmission to captive elephants from other animals (wild and domestic), suggesting inter- and intra-species transmission. The results of this systematic review based on 27 relevant published works, suggest three overarching interrelated transmission pathways for M. tuberculosis infections in Asian elephants- i) humans and elephants, ii) other animals (wild or domestic) and elephants and iii) unclear sources of infection. Conclusions: The progress made with new TB diagnostic tools provides multiple methods to choose from. However, lack of harmonization of TB testing in elephants and their human contacts remains a challenge to prevent TB in those animals. Routine TB screening among elephants and caretakers by setting up an occupational health program for early diagnosis of infection through combined efforts of public health, veterinary medicine, and occupational health experts is suggested. This implies the need for a One Health approach to elephant TB control. This review reveals the need for more research on Mycobacterium tuberculosis complex transmission pathways at the human-animal interface.

Objective: Japan is seeing a rapid increase in the numbers of migrant workers from Asian countries amidst a rapidly aging population and declining birthrate. The notebook of personal health record (nPHR) system is a Japanese occupational health service that supports those formerly employed in hazardous work, including migrant workers. This review outlines the structure, scale, and importance of the nPHR scheme and explores Japanese medical institutions that conduct health checkups for former workers with nPHR, offering insights into the potential applicability of similar systems in migrant workers’ home countries. Methods: Information on Japanese and international laws and Japanese statistical data was obtained from government websites. Studies of workers with nPHRs were reviewed using the ICHUSHI database. Results: This review outlines the nPHR scheme established under Japanese legislation, summarizing its framework, issuance requirements, and post-retirement health checkups for 15 designated agents/works. In terms of scale, a gradual decline in newly issued nPHRs for major agents/works has been observed in recent years. The system’s importance is highlighted through a review of studies involving former workers with nPHRs and an international comparison of post-retirement health checkup systems. Conclusion: Because of the relatively small number of patients with nPHRs, public hospitals are candidates that could be contracted as medical institutions in migrant workers’ home countries. Over the past 2 decades, three additional agents/works have been included in the system, and the requirements for asbestos-related nPHRs have been expanded, indicating that the system is actively adapting to evolving occupational health needs.

Objectives: Labour migration contributes substantially to the gross domestic product of Nepal, with a large number of the population engaged in overseas employment. This paper describes and critically analyses the policies and the current situation of health services for the labour workforce, and identifies possible solutions to enhance worker safety and health throughout the migration process in Nepal. Methods: We conducted a narrative policy review to describe and analyse policies, practices and evidence regarding occupational safety and health of migrant workers during pre-departure, work and after returning to Nepal. Results: An estimated 2.2 million Nepalis are employed abroad, and around 1,700 individuals depart for destination countries each day. Migrant workers' health remains inadequately prioritised as Occupational Safety and Health (OSH) is not specifically addressed by laws or policies other than the Labour Act 2017. Although pre-departure medical examinations are mandatory, Nepal lacks policies and has no structured mechanism to address the periodic health examination for occupational diseases and their treatment among migrant workers while they are employed overseas and after return. OSH is not integrated into the public health system and has weak institutional frameworks. Furthermore, a comprehensive quality assurance framework for occupational health services has yet to be established in the country. Conclusions: In Nepal, occupational safety and health services are inadequate for the workforce within the country, and services for migrant workers are limited to pre-departure medical examination. Therefore, it is essential to enact policies and develop a system to ensure health services throughout the migration cycle for migrant workers.