Displaying publications 1 - 20 of 319 in total

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  1. Jiamsakul A, Kerr SJ, Kiertiburanakul S, Azwa I, Zhang F, Chaiwarith R, et al.
    AIDS Care, 2018 12;30(12):1560-1566.
    PMID: 30021450 DOI: 10.1080/09540121.2018.1499859
    Missed clinic visits can lead to poorer treatment outcomes in HIV-infected patients. Suboptimal antiretroviral therapy (ART) adherence has been linked to subsequent missed visits. Knowing the determinants of missed visits in Asian patients will allow for appropriate counselling and intervention strategies to ensure continuous engagement in care. A missed visit was defined as having no assessments within six months. Repeated measures logistic regression was used to analyse factors associated with missed visits. A total of 7100 patients were included from 12 countries in Asia with 2676 (37.7%) having at least one missed visit. Patients with early suboptimal self-reported adherence <95% were more likely to have a missed visit compared to those with adherence ≥95% (OR = 2.55, 95% CI(1.81-3.61)). Other factors associated with having a missed visit were homosexual (OR = 1.45, 95%CI(1.27-1.66)) and other modes of HIV exposure (OR = 1.48, 95%CI(1.27-1.74)) compared to heterosexual exposure; using PI-based (OR = 1.33, 95%CI(1.15-1.53) and other ART combinations (OR = 1.79, 95%CI(1.39-2.32)) compared to NRTI+NNRTI combinations; and being hepatitis C co-infected (OR = 1.27, 95%CI(1.06-1.52)). Patients aged >30 years (31-40 years OR = 0.81, 95%CI(0.73-0.89); 41-50 years OR = 0.73, 95%CI(0.64-0.83); and >50 years OR = 0.77, 95%CI(0.64-0.93)); female sex (OR = 0.81, 95%CI(0.72-0.90)); and being from upper middle (OR = 0.78, 95%CI(0.70-0.80)) or high-income countries (OR = 0.42, 95%CI(0.35-0.51)), were less likely to have missed visits. Almost 40% of our patients had a missed clinic visit. Early ART adherence was an indicator of subsequent clinic visits. Intensive counselling and adherence support should be provided at ART initiation in order to optimise long-term clinic attendance and maximise treatment outcomes.
    Matched MeSH terms: Income
  2. Drewnowski A, Poulain JP
    AMA J Ethics, 2018 10 01;20(10):E987-993.
    PMID: 30346927 DOI: 10.1001/amajethics.2018.987
    Dietary changes that occur in response to economic development are collectively known as the nutrition transition. More specifically, diets built around staple cereals and tubers give way to diets with more animal products and more added sugars and fats. Although the proportion of dietary protein stays constant, plant proteins are replaced by animal proteins but in ways that are dependent on regional cultural, religious, and ethical concerns. The protein transition, viewed here as a subset of the broader nutrition transition, illustrates how dietary patterns in low- and middle-income countries are shaped by societal as well as by economic forces. The complexity of food decisions justifies the need to integrate nutrition with the social sciences in the study of evolving food systems.
    Matched MeSH terms: Income
  3. Hua LT, Noland RB, Evans AW
    Accid Anal Prev, 2010 Nov;42(6):1934-42.
    PMID: 20728645 DOI: 10.1016/j.aap.2010.05.015
    Recent empirical research has found that there is an inverted U-shaped or Kuznets relationship between income and motor vehicle crash (MVC) deaths, such that MVC deaths increase as national income increases and decrease after reaching a critical level. Corruption has been identified as one of the underlying factors that could affect this relationship, primarily by undermining institutional development and effective enforcement schemes. The total effect of corruption can be decomposed into two components, a direct and an indirect effect. The direct effect measures the immediate impact of corruption on MVC deaths by undermining effective enforcement and regulations, while the indirect effect captures the impact of corruption on hindering increases in per capita income and the consequent impact of reduced income on MVC deaths. By influencing economic growth, corruption can lead to an increase or decrease in MVC deaths depending on the income level. Using data from 60 countries between 1982 and 2003, these effects are estimated using linear panel and fixed effects negative binomial models. The estimation results suggest that corruption has different direct effects for less developed and highly developed countries. It has a negative (decreasing) effect on MVC deaths for less developed countries and a positive (increasing) effect on MVC deaths for highly developed countries. For highly developed countries, the total effect is positive at lower per capita income levels, but decreases with per capita income and becomes negative at per capita income levels of about US$ 38,248. For less developed countries, the total effect is negative within the sample range and decreases with increased per capita income. In summary, the results of this study suggest that reduction of corruption is likely a necessary condition to effectively tackle road safety problems.
    Matched MeSH terms: Income*
  4. Abdul Rahim FS, Mohamed AM, Marizan Nor M, Saub R
    Acta Odontol Scand, 2014 Nov;72(8):999-1004.
    PMID: 25029211 DOI: 10.3109/00016357.2014.936036
    The purpose of this cross-sectional study was to assess the legal representatives' perceptions on dental care access of individuals with Down syndrome (DS) compared to their non-DS siblings in Peninsular Malaysia.
    Matched MeSH terms: Income
  5. Stubbs B, Koyanagi A, Schuch FB, Firth J, Rosenbaum S, Veronese N, et al.
    Acta Psychiatr Scand, 2016 12;134(6):546-556.
    PMID: 27704532 DOI: 10.1111/acps.12654
    OBJECTIVE: Physical activity (PA) is good for health, yet several small-scale studies have suggested that depression is associated with low PA. A paucity of nationally representative studies investigating this relationship exists, particularly in low- and middle-income countries (LMICs). This study explored the global association of PA with depression and its mediating factors.
    METHOD: Participants from 36 LMICs from the World Health Survey were included. Multivariable logistic regression analyses were undertaken exploring the relationship between PA and depression.
    RESULTS: Across 178 867 people (mean ± SD age = 36.2 ± 13.5 years; 49.9% male), the prevalence of depression and the prevalence of low PA were 6.6% and 16.8% respectively. The prevalence of low PA was significantly higher among those with depression vs. no depression (26.0% vs. 15.8%, P < 0.0001). In the adjusted model, depression was associated with higher odds for low PA (OR = 1.42; 95% CI = 1.24-1.63). Mediation analyses demonstrated that low PA among people with depression was explained by mobility limitations (40.3%), pain and discomfort (35.8%), disruptions in sleep and energy (25.2%), cognition (19.4%) and vision (10.9%).
    CONCLUSION: Individuals with depression engage in lower levels of PA in LMICs. Future longitudinal research is warranted to better understand the relationships observed.
    Study name: World Health Survey (Malaysia is a study site)
    Matched MeSH terms: Income
  6. Borland R, Li L, Driezen P, Wilson N, Hammond D, Thompson ME, et al.
    Addiction, 2012 Jan;107(1):197-205.
    PMID: 21883605 DOI: 10.1111/j.1360-0443.2011.03636.x
    To describe some of the variability across the world in levels of quit smoking attempts and use of various forms of cessation support.
    Matched MeSH terms: Income
  7. Tosanguan J, Chaiyakunapruk N
    Addiction, 2016 Feb;111(2):340-50.
    PMID: 26360507 DOI: 10.1111/add.13166
    AIMS: Clinical smoking cessation interventions have been found typically to be highly cost-effective in many high-income countries. There is a need to extend this to low- and middle-income countries and undertake comparative analyses. This study aimed to estimate the incremental cost-effectiveness ratio of a range of clinical smoking cessation interventions available in Thailand.
    METHODS: Using a Markov model, cost-effectiveness, in terms of cost per quality-adjusted life years (QALY) gained, from a range of interventions was estimated from a societal perspective for males and females aged 40 years who smoke at least 10 cigarettes per day. Interventions considered were: counselling in hospital, phone counselling (Quitline) and counselling plus nicotine gum, nicotine patch, bupropion, nortriptyline or varenicline. An annual discounting rate of 3% was used. Probabilistic sensitivity analyses were conducted and a cost-effectiveness acceptability curve (CEAC) plotted. Comparisons between interventions were conducted involving application of a 'decision rule' process.
    RESULTS: Counselling with varenicline and counselling with nortriptyline were found to be cost-effective. Hospital counselling only, nicotine patch and bupropion were dominated by Quitline, nortriptyline and varenicline, respectively, according to the decision rule. When compared with unassisted cessation, probabilistic sensitivity analysis revealed that all interventions have very high probabilities (95%) of being cost-saving except for nicotine replacement therapy (NRT) patch (74%).
    CONCLUSION: In middle-income countries such as Thailand, nortriptyline and varenicline appear to provide cost-effective clinical options for supporting smokers to quit.
    Matched MeSH terms: Income
  8. Tilley A, Burgos A, Duarte A, Dos Reis Lopes J, Eriksson H, Mills D
    Ambio, 2021 Jan;50(1):113-124.
    PMID: 32385810 DOI: 10.1007/s13280-020-01335-7
    A greater understanding of gendered roles in fisheries is necessary to value the often-hidden roles that women play in fisheries and households. We examine women's contributions to household food and income using focus group discussions, market surveys, and landings data in six communities in Timor-Leste. Women were actively fishing more days per month than men. Gleaning was the most frequent activity and 100% of trips returned with catch for food and/or income. Mollusc and crab catches were common and exploitation appeared targeted on a dynamic reappraisal of changing food values and changing estimates of group needs. With as many as 80% of households in coastal areas involved in fishing, and at least 50% of women fishing, this highlights the current lack of women's engagement as a critical gap in fisheries management approaches. The current androcentric dialogue limits social-ecological understanding of these systems and the potential for their effective stewardship.
    Matched MeSH terms: Income
  9. Aizuddin AN, Aljunid SM
    Ann Glob Health, 2017 11 21;83(3-4):654-660.
    PMID: 29221542 DOI: 10.1016/j.aogh.2017.10.002
    BACKGROUND: Malaysia is no exception to the challenging health care financing phenomenon of globalization.

    OBJECTIVES: The objective of the present study was to assess the ability to pay among Malaysian households as preparation for a future national health financing scheme.

    METHODS: This was a cross-sectional study involving representative samples of 774 households in Peninsular Malaysia.

    FINDINGS: A majority of households were found to have the ability to pay for their health care. Household expenditure on health care per month was between MYR1 and MYR2000 with a mean (standard deviation [SD]) of 73.54 (142.66), or in a percentage of per-month income between 0.05% and 50% with mean (SD) 2.74 (5.20). The final analysis indicated that ability to pay was significantly higher among younger and higher-income households.

    CONCLUSIONS: Sociodemographic and socioeconomic statuses are important eligibility factors to be considered in planning the proposed national health care financing scheme to shield the needed group from catastrophic health expenditures.

    Matched MeSH terms: Income*
  10. Chan YY, Sooryanarayana R, Mohamad Kasim N, Lim KK, Cheong SM, Kee CC, et al.
    Arch Gerontol Geriatr, 2018 11 26;81:74-83.
    PMID: 30521992 DOI: 10.1016/j.archger.2018.11.012
    Malaysia has an increasingly aging population. Despite the substantial benefits of physical activity for healthy aging, older adults are considered the most physically inactive segment of the Malaysian population. The purpose of this study was to determine the prevalence of physical inactivity among older adults in Malaysia and its correlates. We analysed data on adults aged ≥60 years (n = 3790) from the National Health and Morbidity Survey (NHMS) 2015, a cross-sectional, nationwide population-based survey covering information on socio-demographic characteristics, physical activity and other lifestyle-related variables, health conditions, and functional limitations. Individuals included in this study were classified as physically active or physically inactive. Logistic regression was used to determine factors associated with physical inactivity. The overall prevalence of physical inactivity among older adults aged ≥60 years old was 48.8%. Physical inactivity was significantly more prevalent among females, older age groups, Indians, those being single/widowed/divorced, those with no formal education, those who reported high sedentary time (≥7 h/day), those with diabetes, anaemia, and functional limitations (p 
    Matched MeSH terms: Income
  11. Wan Puteh SE, Ahmad SNA, Aizuddin AN, Zainal R, Ismail R
    Asia Pac Fam Med, 2017;16:5.
    PMID: 28392749 DOI: 10.1186/s12930-017-0035-5
    BACKGROUND: Malaysia is an upper middle income country that provides subsidized healthcare to ensure universal coverage to its citizens. The challenge of escalating health care cost occurs in most countries, including Malaysia due to increase in disease prevalence, which induced an escalation in drug expenditure. In 2009, the Ministry of Health has allocated up to Malaysian Ringgit (MYR) 1.402 billion (approximately USD 390 million) on subsidised drugs. This study was conducted to measure patients' willingness to pay (WTP) for treatment of chronic condition or acute illnesses, in an urbanized population.
    METHODS: A cross-sectional study, through face-to-face interview was conducted in an urban state in 2012-2013. Systematic random sampling of 324 patients was selected from a list of patients attending ten public primary cares with Family Medicine Specialist service. Patients were asked using a bidding technique of maximum amount (in MYR) if they are WTP for chronic or acute illnesses.
    RESULTS: Patients are mostly young, female, of lower education and lower income. A total of 234 respondents (72.2%) were not willing to pay for drug charges. WTP for drugs either for chronic or acute illness were at low at median of MYR10 per visit (USD 3.8). Bivariate analysis showed that lower numbers of dependent children (≤3), higher personal and household income are associated with WTP. Multivariate analysis showed only number of dependent children (≤3) as significant (p = 0.009; 95% CI 1.27-5.44) predictor to drugs' WTP.
    CONCLUSION: The result indicates that primary care patients have low WTP for drugs, either for chronic condition or acute illness. Citizens are comfortable in the comfort zone whereby health services are highly subsidized through universal coverage. Hence, there is a resistance to pay for drugs.
    Matched MeSH terms: Income
  12. Sidik SM, Rampal L
    Asia Pac Fam Med, 2009 Apr 09;8(1):2.
    PMID: 19358728 DOI: 10.1186/1447-056X-8-2
    INTRODUCTION: The prevalence of obesity in developing countries especially among women is on the rise. This matter should be taken seriously because it can burden the health care systems and lower the quality of life.

    AIM: The purpose of this study was to determine the prevalence of obesity among adult women in Selangor and to determine factors associated with obesity among these women.

    METHODS: This community based cross sectional study was conducted in Selangor in January 2004. Multi stage stratified proportionate to size sampling method was used. Women aged 20-59 years old were included in this study. Data was collected using a questionnaire-guided interview method. The questionnaire consisted of questions on socio-demographic (age, ethnicity, religion, education level, occupation, monthly income, marital status), Obstetric & Gynaecology history, body mass index (BMI), and the Patient Health Questionnaire (PHQ-9).

    RESULTS: Out of 1032 women, 972 agreed to participate in this study, giving a response rate of 94.2%. The mean age was 37.91 +/- 10.91. The prevalence of obesity among the respondents was 16.7% (mean = 1.83 +/- 0.373). Obesity was found to be significantly associated with age (p = 0.013), ethnicity (p = 0.001), religion (p = 0.002), schooling (p = 0.020), educational level (p = 0.016), marital status (p = 0.001) and the history of suffering a miscarriage within the past 6 months (p = 0.023).

    CONCLUSION: The prevalence of obesity among adult women in this study was high. This problem needs to be emphasized as the prevalence of obesity keeps increasing, and will continue to worsen unless appropriate preventive measures are taken.

    Matched MeSH terms: Income
  13. Chee HL, Kandiah M, Khalid M, Shamsuddin K, Jamaluddin J, Nordin NA, et al.
    Asia Pac J Clin Nutr, 2004;13(3):248-54.
    PMID: 15331336
    Factors related to overweight were examined in a cross-sectional survey that included 1612 women workers from 10 large electronics assembly factories in Peninsular Malaysia. Respondents were Malaysian citizens, direct production workers below the supervisory level, and had worked at least a year in the factory where they were presently employed. Heights and weights were taken to calculate the body mass index (BMI). Weights and BMI increased with increasing age. After adjusting for age, odds ratios for overweight were significantly raised for married women in relation to not married women (OR 1.5, 95% CI=1.15-2.02), lower secondary education in relation to higher than upper secondary education (OR 1.8, 95% CI=1.06-3.14), monthly income RM800-999 (OR 1.7, 95% CI=1.21-2.45) and >/=RM1,000 (OR 1.8, 95% CI=1.23-2.72) in relation to
    Matched MeSH terms: Income
  14. Marjan ZM, Kandiah M, Lin KG, Siong TE
    Asia Pac J Clin Nutr, 2002;11(2):133-41.
    PMID: 12074180
    This paper will present the socioeconomic profile and nutritional status of children aged 1-6 years in the rubber smallholdings of Peninsula Malaysia. A total of 323 households were involved in this study. The sociodemographic data were obtained through interviews with heads of households using a set of questionnaires. Anthropometric measurements were taken from 506 children aged 1-6 years from these households. The weight and height of the children were compared with the reference values of the National Center for Health Statistics (NCHS) and the nutritional status was classified based on the recommendations of WHO. The average age of the fathers was 39.9+/-8.6 years and 34.4+/-7.0 years for the mothers. The mean household size was 6.67+/-2.27. The majority (49.7%) of the heads of households received 4-6 years of formal education and 7.9% received no formal education. Based on the monthly per capita income, 24.0% were found to be in the hardcore poor category, 38.3% fall into the poor category and 37.7% in the above poverty income group. The prevalence of stunting and underweight among children between the ages of 1-6 years were highest among children from the hardcore poor, followed by the poor category and above the poverty line income group. Wasting was present in all income groups, with a prevalence of 4.2% found among the hardcore poor, 9.4% among the poor group and 8.4% in the above poverty income group. The Pearson Product Moment Correlation showed significant relationships between household total income and height-for-age (r = 0.131, P = 0.05) and weight-for-age (r = 0.127, P = 0.05). There were also significant correlations between monthly per capita income with height-for-age (r = 0.16, P < 0.01) and weight-for-age (r = 0.13, P < 0.05). The acreage of land utilised was correlated with height-for-age (r = 0.11, P < 0.05), weight-for-age (r = 0.17, P < 0.05) and weight-for-height (r = 0.16, P < 0.05). However, stepwise multiple regression analysis indicated that the predictor of height-for-age was monthly per capita income (R2 = 0.03, P < 0.01) and acreage of land utilised was a predictor for weight-for-age (R2 = 0.03, P < 0.01) and weight-for-height (R2 = 0.01, P < 0.01). Because income and acreage of land utilised have been shown to be associated with nutritional status, it is recommended that intervention programs that focus on generation of income and diversification of land utilisation should be undertaken. A multidiscipline approach involving the family, community and government agencies should be applied to any type of intervention program.
    Matched MeSH terms: Income/statistics & numerical data
  15. Marjan ZM, Taib MN, Lin KG, Siong TE
    Asia Pac J Clin Nutr, 1998 Dec;7(3/4):307-10.
    PMID: 24393689
    The data presented is part of the findings from a four-year collaborative research project between Universiti Putra Malaysia, the Institute for Medical Research and the Ministry of Health Malaysia. The project assessed the nutritional status of the major functional groups in Peninsular Malaysia. Mukim Sayong and Pulau Kemiri in the District of Kuala Kangsar, Perak were two of the subdistricts selected to represent small rubber holdings in Peninsular Malaysia. This paper attempts to analyse the socio-economic profile of the households and the nutritional status of children below 9 years of age. A total of 307 households were studied. Approximately 63% of the households were involved in rubber activities and the majority of them were hired tappers. The average monthly income of the households was RM467 and the income ranged between RM30 to RM2120. Based on the per capita poverty line income of RM84.38, it was found that 14.1% of the households earned less than RM42.19, which can be considered as hard-core poor, while 32.7% were poor (monthly per capita income between RM42.19 and RM84.38). Slightly more than half (52.7%) earned income above the poverty line. The average family size was 4.5, ranging from 1 through to 16. The majority of the heads of households (56.6%) had between 3 and 6 years of education, and 14.5% did not receive any formal education. The prevalence of stunting among children 0-5 years of age was 26%, while 31.5% were underweight and 3.8% wasted. Among children aged between 5 and 9 years, almost the same pattern of nutritional status was noted. The overall percentages of stunting, underweight and wasting among these children were 29.2%, 26.1% and 0.62%, respectively. Analysis on nutritional status according to income level showed a noticeable difference in the prevalence of malnutrition in children above and below the poverty line income. The Student's t-test indicated significant differences in weight-for-age and weight-for-height between the two poverty line income for children below 5 years of age. Pearson's correlation coefficient showed a significant correlation between height-for-age with household size (r = -0.26, p<0.05), and monthly per capita income with weight-for-height (r = 0.25, p<0.05). There was a highly significant correlation between acreage of land cultivated and weight-for-height (r = 0.42, p<0.01), and weight-for-age (r = 0.25, p<0.05). The findings indicated the influence of socio-economic factors on the nutritional status of children.
    Matched MeSH terms: Income
  16. Lum KY, Oppong R, Kigozi J
    Asia Pac J Public Health, 2022 Nov;34(8):752-760.
    PMID: 36039503 DOI: 10.1177/10105395221122643
    The primary aim of this study is to assess the evidence on the cost-effectiveness of type 2 diabetes mellitus (T2DM) interventions with a focus on diabetes education, lifestyle modifications, surgical intervention, and pharmacological therapy in low- and middle-income countries (LMICs). A systematic review was conducted to identify economic evaluations of T2DM interventions published in LMICs for the period 2009-2019. A total of 25 studies were identified, with more than half of the studies being decision analytic models. Critical appraisal of the identified studies showed they were of good quality. Overall, the reported interventions in this review were very heterogeneous, which made them difficult to compare. However, there was strong evidence suggesting that diabetes education was a very cost-effective strategy in LMICs. Further evidence on affordability and budget impact of bariatric surgery is required before adopting the intervention. Metformin-based therapy showed promising evidence on cost-effectiveness and thus should be offered to T2DM patients in LMICs. On the contrary, the cost-effectiveness of lifestyle modifications remains understudied in LMICs. The findings in this review can inform policy guidance toward the inclusion of T2DM interventions in the benefit packages for Universal Health Coverage in LMICs.
    Matched MeSH terms: Income
  17. Ainuddin HA, Loh SY, Low WY, Sapihis M, Roslani AC
    Asian Pac J Cancer Prev, 2012;13(12):6289-94.
    PMID: 23464447
    BACKGROUND: Research evidence suggests a debilitating impact of the diagnosis of cancer on the quality of life of the afflicted individuals, their spouses and their families. However, relatively few studies have been carried out on the impact on the QOL of adolescents living with parents diagnosed with cancer. This paper presents a sub- analysis on the impact of parental cancer (colorectal, breast and lung) on adolescents.

    MATERIALS AND METHODS: This is a cross-sectional study on adolescents aged 13-18 years old. Upon ethical clearance obtained from UMMC Medical Ethics Committee, patients with colorectal, breast or lung cancer and their adolescent children were recruited from the Clinical Oncology Unit of University of Malaya Medical Centre. Respondents who gave consent completed a demographic questionnaire and the Pediatric Quality of Life Inventory, via the post, email, home visit or meetings at the clinics.

    RESULTS: 95 adolescents from 50 families responded, giving a response rate of 88 percent. The adolescent's mean age was 16 years (ranging between 13-18 years). Adolescents with parental cancer had the lowest mean score in emotional functioning (p<0.05). Male adolescents had significantly higher quality of life overall and in physical functioning compared to female adolescents. Adolescents with a father with cancer had better school functioning compared to adolescents whose mothers had cancer. Families with household income of RM 5000 and above have significantly better quality of life compared to families with lower household income.

    CONCLUSIONS: Adolescent sons and daughters of parents with a cancer diagnosis show lowered QOL, particularly with reference to emotional functioning and school performance. Addressing the needs of this young group has been slow and warrants special attention. Revisiting the risk and resilience factors of adolescents might also inform tailored programs to address the needs of this neglected adolescent population.

    Matched MeSH terms: Income
  18. Tee GH, Aris T, Rarick J, Irimie S
    Asian Pac J Cancer Prev, 2016;17(3):1269-76.
    PMID: 27039759
    BACKGROUND: Tobacco consumption continues to be the leading cause of preventable deaths globally. The objective of this study was to examine the associaton of selected socio-demographic variables with current tobacco use in five countries that participated in the Phase II Global Adult Tobacco Survey in 2011 - 2012.

    MATERIALS AND METHODS: We analysed internationally comparable representative household survey data from 33,482 respondents aged ≥ 15 years in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally.

    RESULTS: The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina.

    CONCLUSIONS: Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.

    Matched MeSH terms: Income
  19. Yap SL, Wong SS, Chew KS, Kueh JS, Siew KL
    Asian Pac J Cancer Prev, 2020 Oct 01;21(10):3077-3083.
    PMID: 33112570 DOI: 10.31557/APJCP.2020.21.10.3077
    BACKGROUND: Patient's financial ability is always the most critical imputes to treatment choice and adherence; as it translates into health outcomes such as survival rate and quality of life. Cancer care is likely to affect the patient's financial well-being, putting huge financial pressure to the families. Therefore, it is imperative to understand the confounding factors of financial toxicity among cancer survivors along the course of survivorship.

    METHODS: This study was designed in the form of cross-sectional analysis, in which, cancer survivors were recruited from the Sarawak General Hospital, the largest tertiary and referral public hospital in Sarawak. To capture the financial toxicity of the cancer survivors, the Comprehensive Score for Financial Toxicity (COST) instrument in its validated form was adopted. Multivariable logistic regression analysis was applied to determine the relationship between financial toxicity (FT) and its predictors.

    RESULTS: The median age of the 461 cancer survivors was 56 while the median score of COST was 22.0. Besides, finding from multivariable logistic regression revealed that low income households (OR: 6.893, 95% CI, 3.109-15.281) were susceptible to higher risk of financial toxicity, while elderly survivors above 50 years old reported a lower risk in financial toxicity. Also, survivors with secondary schooling (OR:0.240; 95%CI, 0.110-0.519) and above [College or university (OR: 0.242; 95% CI, 0.090-0.646)] suffer a lower risk of FT.

    CONCLUSION: Financial toxicity was found to be associated with survivors age, household income and educational level. In the context of cancer treatment within public health facility, younger survivors, households from B40 group and individual with educational attainment below the first level schooling in the Malaysian system of education are prone to greater financial toxicity. Therefore, it is crucial for healthcare policymakers and clinicians to deliberate the plausible risk of financial toxicity borne by the patient amidst the treatment process.

    Matched MeSH terms: Income
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