Displaying publications 1 - 20 of 94 in total

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  1. Vythilingam I, Phetsouvanh R, Keokenchanh K, Yengmala V, Vanisaveth V, Phompida S, et al.
    Trop Med Int Health, 2003 Jun;8(6):525-35.
    PMID: 12791058
    A longitudinal study was conducted on the prevalence of Anopheles in three malaria endemic villages in Sekong province, in the southern region of Lao PDR, from August 2000 to October 2001. All night, human landing collections took place in August and October 2000 and April and October 2001, and blood smears were taken for malaria parasites during the same period. Mosquitoes were tested for sporozoite antigen using enzyme-linked immunosorbent assay. In August 2000 (wet season) and April 2001 (dry season) the ovaries of the mosquitoes were examined for parity. A total of 16 species of Anopheles were caught in the study sites of which An. dirus A, An. maculatus sl and An. jeyporiensis were positive for sporozoites. The entomological inoculation rate (EIR) ranged from 0.06 to 0.25. There was a good correlation between EIR and vectorial capacity in the wet season, especially in Pai Mai where the prevalence of malaria was also high during the wet seasons (11.8 and 10.53). An. dirus A showed ambivalence in their choice of feeding as approximately 50% attacked man indoors and an equal proportion outdoors. An dirus A was the main vector in Pai Mai. The parous rate did not significantly differ between the wet and dry season, although it was higher in the dry season. In Takaio the parasite prevalence ranged from 8.7% (dry season) to 37.1% (wet season) and An. jeyporiensis was the vector, and the risk of infection was 0.85 in the dry season while 0.99 in the wet season. In Toumgno An. maculatus sl was the vector and infection was found only in August and October 2000. However, malaria prevalence ranged from 9.69 to 20.4% and was equally high in the dry season. Cattle were also present close to the houses in all the villages and this might be a contributory factor in the prevalence of malaria.
    Matched MeSH terms: Life Expectancy
  2. Wang J, Jamison DT, Bos E, Vu MT
    Trop Med Int Health, 1997 Oct;2(10):1001-10.
    PMID: 9357491
    This paper analyses the effect of income and education on life expectancy and mortality rates among the elderly in 33 countries for the period 1960-92 and assesses how that relationship has changed over time as a result of technical progress. Our outcome variables are life expectancy at age 60 and the probability of dying between age 60 and age 80 for both males and females. The data are from vital-registration based life tables published by national statistical offices for several years during this period. We estimate regressions with determinants that include GDP per capita (adjusted for purchasing power), education and time (as a proxy for technical progress). As the available measure of education failed to account for variation in life expectancy or mortality at age 60, our reported analyses focus on a simplified model with only income and time as predictors. The results indicate that, controlling for income, mortality rates among the elderly have declined considerably over the past three decades. We also find that poverty (as measured by low average income levels) explains some of the variation in both life expectancy at age 60 and mortality rates among the elderly across the countries in the sample. The explained amount of variation is more substantial for females than for males. While poverty does adversely affect mortality rates among the elderly (and the strength of this effect is estimated to be increasing over time), technical progress appears far more important in the period following 1960. Predicted female life expectancy (at age 60) in 1960 at the mean income level in 1960 was, for example 18.8 years; income growth to 1992 increased this by an estimated 0.7 years, whereas technical progress increased it by 2.0 years. We then use the estimated regression results to compare country performance on life expectancy of the elderly, controlling for levels of poverty (or income), and to assess how performance has varied over time. High performing countries, on female life expectancy at age 60, for the period around 1990, included Chile (1.0 years longer life expectancy), China (1.7 years longer), France (2.0 years longer), Japan (1.9 years longer), and Switzerland (1.3 years longer). Poorly performing countries included Denmark (1.1 years shorter life expectancy than predicted from income), Hungary (1.4 years shorter), Iceland (1.2 years shorter), Malaysia (1.6 years shorter), and Trinidad and Tobago (3.9 years shorter). Chile and Switzerland registered major improvements in relative performance over this period; Norway, Taiwan and the USA, in contrast showed major declines in performance between 1980 and the early 1990s.
    Matched MeSH terms: Life Expectancy/trends*
  3. Lee VWY, Li A, Li JTS
    Tob Induc Dis, 2021;19:28.
    PMID: 33867905 DOI: 10.18332/tid/133633
    INTRODUCTION: Smoking is a modifiable risk factor for many diseases. The public should recognize the impact of smoking on their health and their wealth. The current study aimed to evaluate the cost burden of smoking to target Asia-Pacific countries.

    METHODS: The current study estimated the annual spending and lifetime spending of smokers in the target Asia-Pacific countries (Hong Kong, Malaysia, Thailand, South Korea, Singapore, and Australia) on purchasing cigarettes, as well as predicted the revenue that could be generated if smokers spent the money on investment instead of buying cigarettes. Smokers' spending on cigarettes and the potential revenue generated from investment were estimated based on the selling prices of cigarettes, Standards & Poor's 500 Index, and life expectancies of smokers. Data were extracted from reports released by the World Health Organization or government authorities.

    RESULTS: The annual expenses (in US$) on purchasing one pack of cigarettes, in decreasing order, were: Australia ($5628.30), Singapore ($3777.75), Hong Kong ($2799.55), Malaysia ($1529.35), South Korea ($1467.30), and Thailand ($657.00). The lifetime spending on purchasing one pack of cigarettes each day were: Australia ($308993.67), Singapore ($207398.48), Hong Kong ($151735.61 for male and $166853.18 for female), South Korea ($80261.31), Malaysia ($72338.26), and Thailand ($31207.50).

    CONCLUSIONS: The cost burden of smoking is high from a smoker's perspective. Smokers should recognize the high economic burden and quit smoking to enjoy better health and wealth.

    Matched MeSH terms: Life Expectancy
  4. Bennett CL, Pei GK, Ultmann JE
    West. J. Med., 1996 Jul-Aug;165(1-2):37-42.
    PMID: 8855683
    Hong Kong, Taiwan, Singapore, and Malaysia are initiating health care reform to meet the changing demands of populations with improved socioeconomic status and access to modern technologies and who are living longer than in previous generations. Hong Kong, in particular, is facing a unique set of circumstances as its people prepare for the transition in 1997 from a British colony to a Special Administrative Region of China. While spending only 4% of its gross domestic product on health care, it has a large and regulated public hospital system for most inpatient medical care and a separate, loosely regulated private health care system for most outpatient medical care. In 1993 the Secretary for Health and Welfare of Hong Kong initiated a year-long process to debate the pros and cons of 5 fundamental programs for health care reform. After a year of open consultation, options were chosen. We describe the Hong Kong health care system, the fundamental changes that have been adopted, and lessons for reformers in the United States.
    Matched MeSH terms: Life Expectancy
  5. Hashim NA, Ahmad AH, Rawi CS, Tahir NA, Basari N
    PMID: 18567442
    Life tables were constructed for twelve cohorts of immature stages of the dengue vector Ae. albopictus in a wooded area of Penang, Malaysia. The development time of Ae. albopictus ranged from 6 to 10 days depending on the mean environmental temperature (r = - 0.639, p < 0.05). Total cohort mortality was correlated with total development time (r = 0.713, p < 0.05) but not temperature (r = -0.477, p > 0.05). Rainfall was correlated with neither development time (r = 0.554, p > 0.05) nor mortality (r = 0.322, p > 0.05). There was a significant difference among the total mortality that occurred in the twelve cohorts (H = 119.783, df = 11, p < 0.05). There was also a significant difference in mortality among the different stages (H = 274.00, df = 4, p < 0.05).
    Matched MeSH terms: Life Expectancy
  6. Dobbins JG
    PMID: 483006
    A life table for an aboriginal Malaysian population, the Semelai, living in West Malaysia, was constructed using censuses from 1965, 1969, and 1974; and interview data from 1974. The life expectancy at birth for this population, 54.0 years, was compared to that of other Malaysian populations and selected Asian populations. This comparison indicated that the Semelai were at a disadvantage compared to the Malaysian populations, but in a favorable position when compared with the other Asian populations.
    Matched MeSH terms: Life Expectancy*
  7. Lim TO, Lim YN, Wong HS, Ahmad G, Singam TS, Morad Z, et al.
    Med J Malaysia, 1999 Dec;54(4):459-70.
    PMID: 11072463
    We describe the outcomes on haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) provided by the Ministry of Health (MOH). The assessment was based on data from the Malaysian Dialysis Registry on 2480 HD and 732 CAPD patients who commenced dialysis between 1980 and 1996. Young patients (age < 40) have remarkable long term survival (life expectancies of 16 years on HD, 18 years on CAPD). Adjusting for background mortality, relative survival of older patients was as good as younger ones. Diabetics did poorly. 52% of HD and 26% of CAPD patients were employed in 1996. 71% of HD patients scored 10(normal) on QL index (a measure of quality of life) while 60% of CAPD patients have similar score. Differences in rehabilitation and QL index scores by age, gender and diabetes were also observed. Outcomes of dialysis in the MOH programme are reassuring.
    Matched MeSH terms: Life Expectancy
  8. Chin DM, Kader Maideen SF, Rashid A
    Med J Malaysia, 2019 Oct;74(5):365-371.
    PMID: 31649210
    INTRODUCTION: Thalassemias are the most common human monogenic disorders in the world. Regular blood transfusion and increased intestinal absorption of iron among thalassemia patients will lead to iron overload, which will not only markedly decrease their life expectancy but also pose a heavy burden to the healthcare system. The objective of this study was to evaluate the level of knowledge, attitude and practice towards dietary iron among thalassemia patients and their caregivers.

    METHODS: An analytical cross-sectional study using purposive sampling method was conducted at eight thalassemia societies in Peninsular Malaysia. 260 respondents comprised of patients and caregivers were assessed with two separate sets of questionnaires.

    RESULTS: Knowledge on dietary iron among the respondents was unsatisfactory, despite them having good knowledge on thalassemia disorder. Female patients were found to have better dietary knowledge, attitude and practice compared to males. The percentage of caregivers with good attitude and good practice were significantly higher compared to adult patients. Caregivers with children on iron chelators were noted to have better dietary attitude and practice. Thalassemia knowledge and children on vitamins were found to be the predictors of dietary knowledge among the patients and caregivers respectively.

    CONCLUSION: The level of knowledge on dietary iron among the patients and caregivers was unsatisfactory in spite of their attitude and practice towards dietary iron were good. Effective delivery of dietary information to the patients and caregivers is essential to enable them to choose a healthy diet for their condition.

    Matched MeSH terms: Life Expectancy
  9. Sandosham AA
    Med J Malaya, 1969 Sep;24(1):1-2.
    PMID: 4243837
    According to the statistical information recently released, the expectation of life of the average Malaysian had increased by 1966 to about 67 years and there was every prospect of the trend being continued. No doubt the sound economy leading to higher living standards and better nutrition and the improved health services in the rural areas account for present day Malaysians being healthier and living longer. The health of children in particular has shown great improvement, the infant deaths having dropped from 75.5 per 1,000 children below the age of one in 1957 to 48 in 1966, and the crude toddler mortality rate from 10.7 to 5.1. Further improvement may be expected, especially in the rural areas with the current malaria eradication programme and the proposal to get the rural health clinic personnel to visit homes in the kampongs to disseminate knowledge on health, nutrition and home economics. It is to be hoped that at the same time, the family planning campaign in the rural areas will begin to produce results so that the economic and other benefits are not spread too thin over a large population. However, almost simultaneously with the release of the information that the life span had increased and that the average Malaysian of 55 may now expect to live for about another 20 years, came the shocking announcement by the government that the compulsory retiring age has been reduced from 60 to 55. Why is the Malaysian considered too old for government service when he reaches the magic age of 55 while there has been new thinking on retirement policies in Western countries? In view of the longer active life expectancy, there has been a fuller recognition in many countries of the contribution that older people can make to the life of the community. In the case of the professional man, this enforced premature retirement from government service may actually prove a blessing in disguise. The doctor, dentist, engineer, etc., may, in fact, welcome the opportunity of being released early so that he can set himself up in private practice or join in partnership with his fellows in the private sector. What happens to the vast majority of government servants who are not so luckily placed? What is he to do when he is thrown out without any training or preparation into a ruthless competitive world of commerce and industry at the age of 55 when he could be usefully employed in the public services for a few more years?
    It has been estimated that there are in West Malaysia alone about 800,000 people in the age group of 55 and above. This latter figure will keep increasing with the rising span of life and a population growing steadily at the rate of over three percent per annum. With the better control of infectious and communicable diseases, problems of degenerative diseases are becoming more common. The picture of medical practice in the country has begun to change with more and more people presenting themselves with condition resulting from cardiovascular derangement, neoplasm and mental and senile changes. Traditionally, the old folks in Asia have been housed and cared for by the children but modernization in outlook and urbanization are steadily changing that state of affairs. The old folks are finding themselves more and more dependant on themselves and the poorer ones tend to finish up in overcrowded homes run by charitable organizations with little or no geriatric care. These people, however, should not be penalized because they are too old and cannot earn any more. Most modern countries accept their responsibility to support the aged in dignity and comfort by providing adequate old age pensions and properly run old folks’ homes and do not leave them to the charity of a few benevolent members of society. We would like to see more done for them in this country.
    Matched MeSH terms: Life Expectancy*
  10. Azmin S, Osman SS, Mukari S, Sahathevan R
    Malays J Med Sci, 2015 Jan-Feb;22(1):74-8.
    PMID: 25892953
    Cerebral amyloid angiopathy (CAA) accounts for approximately 10-20% of spontaneous intracerebral haemorrhage (ICH). This figure is thought to be higher in the elderly population. With the increasing life expectancy of our population, we anticipate that the prevalence of CAA- related ICH will increase in tandem. Although CAA-related ICH and hypertension-related ICH are distinct entities based on histopathology and imaging, the clinical presentation of the two conditions is similar. The use of brain computed tomography (CT) scans remain the ICH imaging modality of choice in Malaysia due to its availability, cost, and sensitivity in detecting acute bleeds. On the other hand, the use of brain magnetic resonance imaging (MRI) with susceptibility-weighted imaging (SWI) sequencing enables the clinician to determine the presence of chronic blood products in the brain, especially clinically silent microbleeds associated with CAA. However, the use of brain MRI scans in our country is limited and leads to a blurring of lines when differentiating between hypertension-related ICH and CAA-related ICH. How this misrepresentation affects the management of these conditions is unclear. In this study, we present two cases of ICH to illustrate this point and to serve as a springboard to question current practice and promote discussion.
    Matched MeSH terms: Life Expectancy
  11. GBD 2019 Adolescent Young Adult Cancer Collaborators
    Lancet Oncol, 2022 Jan;23(1):27-52.
    PMID: 34871551 DOI: 10.1016/S1470-2045(21)00581-7
    BACKGROUND: In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults.

    METHODS: Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults.

    FINDINGS: There were 1·19 million (95% UI 1·11-1·28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5-65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8-57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9-15·6] per 100 000 person-years) and middle SDI (13·6 [12·6-14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9-25·2) DALYs to the global burden of disease, of which 2·7% (1·9-3·6) came from YLDs and 97·3% (96·4-98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally.

    INTERPRETATION: Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts.

    FUNDING: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute.

    Matched MeSH terms: Life Expectancy
  12. Ekker MS, Boot EM, Singhal AB, Tan KS, Debette S, Tuladhar AM, et al.
    Lancet Neurol, 2018 09;17(9):790-801.
    PMID: 30129475 DOI: 10.1016/S1474-4422(18)30233-3
    Epidemiological evidence suggests that the incidence of ischaemic stroke in young adults (18-50 years) has increased substantially. These patients have a long life expectancy after stroke, and the costs of long-term care pose huge challenges to health-care systems. Although the current recommendations for treatment of young and old (>50 years) patients with stroke are similar, the optimal management of young adult patients with stroke is unknown. They are usually not included in trials, and specific subanalyses limited to young adult patients with stroke are usually not done, owing to lower incidence of stroke and lower prevalence of vascular risk factors in young adults. Progress has been made in identifying patients with a considerable risk of stroke occurrence, such as those with patent foramen ovale. Future prevention studies might result in a decrease in the incidence of stroke and its sequelae in young adults. The development of guidelines specifically devoted to the management of stroke in young adults will be an important step in achieving this aim.
    Matched MeSH terms: Life Expectancy
  13. Malhotra R, Bautista MAC, Müller AM, Aw S, Koh GCH, Theng YL, et al.
    Gerontologist, 2019 05 17;59(3):401-410.
    PMID: 30517628 DOI: 10.1093/geront/gny160
    The juxtaposition of a young city-state showing relative maturity as a rapidly aging society suffuses the population aging narrative in Singapore and places the "little red dot" on the spotlight of international aging. We first describe population aging in Singapore, including the characteristic events that shaped this demographic transition. We then detail the health care and socioeconomic ramifications of the rapid and significant shift to an aging society, followed by an overview of the main aging research areas in Singapore, including selected population-based data sets and the main thrust of leading aging research centers/institutes. After presenting established aging policies and programs, we also discuss current and emerging policy issues surrounding population aging in Singapore. We aim to contribute to the international aging literature by describing Singapore's position and extensive experience in managing the challenges and maximizing the potential of an aging population. We hope that similar graying populations in the region will find the material as a rich source of information and learning opportunities. Ultimately, we aspire to encourage transformative collaborations-locally, regionally, and internationally-and provide valuable insights for policy and practice.
    Matched MeSH terms: Life Expectancy
  14. Normaz Wana Ismail, Siti Wardah Abd Rahman, Tengku Aizan Tengku Abdul Hamid, Rusmawati Said
    Sains Malaysiana, 2016;45:1345-1350.
    The purpose of this study was to examine the impact of aging on economic growth. The study used dynamic growth model and employed Autoregressive Distributed Lag (ARDL) approach for the period of 1980 to 2011. Three proxies for aging are used namely fertility rate, life expectancy and old dependency ratio. However, only fertility rate is detected to have a long run cointegration. The major finding of this study showed that a reduction of fertility rate lead to higher economic growth. This implied that even though Malaysia will face aging society by 2020, the economic growth is still stable and can increase by investing more on human capital.
    Matched MeSH terms: Life Expectancy
  15. Eshkoor SA, Tengku Aizan Hamid, Chan YM
    Sains Malaysiana, 2016;45:1357-1361.
    The improvement of health care support has greatly extended the average life expectancy over the last 50 years, which
    has increased the rate of cognitive decline consequently. The avoidance of risk factors such as toxins, stress and somatic
    diseases can be protective against the reduction of cognitive function in the elderly. This study aimed to determine the
    effects of socio-demographic factors, constipation and renal failure on cognitive status among 2322 samples who were
    the non-institutionalized Malaysian elderly. The multiple logistic regression analysis was applied to estimate the risk of
    such factors on cognitive decline in subjects. Approximately, 77.54% of samples experienced cognitive impairment. The
    results showed that advanced age (odds ratio (OR) = 1.03), Malay ethnic (OR = 2.15), constipation (OR = 3.31) and renal
    failure (OR= 4.42), significantly increased the risk of cognitive impairment in subjects (p<0.05). In addition, education
    (OR = 0.38) significantly reduced the risk. However, we concluded that age, Malay ethnic, constipation and renal failure
    increased the risk of cognitive impairment in subjects but education reduced the risk.
    Matched MeSH terms: Life Expectancy
  16. Arifah Bahar, Siti Rohani Mohd Nor, Fadhilah Yusof
    Sains Malaysiana, 2018;47:1337-1347.
    The growing number of multi-population mortality models in the recent years signifies the mortality improvement in
    developed countries. In this case, there exists a narrowing gap of sex-differential in life expectancy between populations;
    hence multi-population mortality models are designed to assimilate the correlation between populations. The present
    study considers two extensions of the single-population Lee-Carter model, namely the independent model and augmented
    common factor model. The independent model incorporates the information between male and female separately
    whereas the augmented common factor model incorporates the information between male and female simultaneously.
    The methods are demonstrated in two perspectives: First is by applying them to Malaysian mortality data and second
    is by comparing the significance of the methods to the annuity pricing. The performances of the two methods are then
    compared in which has been found that the augmented common factor model is more superior in terms of historical fit,
    forecast performance, and annuity pricing.
    Matched MeSH terms: Life Expectancy
  17. Jakovljevic M, Sugahara T, Timofeyev Y, Rancic N
    Risk Manag Healthc Policy, 2020;13:2261-2280.
    PMID: 33117004 DOI: 10.2147/RMHP.S266386
    Purpose: The goal of this study was to assess the effectiveness of healthcare spending among the leading Asian economies.

    Methods: We have selected a total of nine Asian nations, based on the strength of their economic output and long-term real GDP growth rates. The OECD members included Japan and the Republic of Korea, while the seven non-OECD nations were China, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand. Healthcare systems efficiency was analyzed over the period 1996-2017. To assess the effectiveness of healthcare expenditure of each group of countries, the two-way fixed effects model (country- and year effects) was used.

    Results: Quality of governance and current health expenditure determine healthcare system performance. Population density and urbanization are positively associated with a healthy life expectancy in the non-OECD Asian countries. In this group, unsafe water drinking has a statistically negative effect on healthy life expectancy. Interestingly, only per capita consumption of carbohydrates is significantly linked with healthy life expectancy. In these non-OECD Asian countries, unsafe water drinking and per capita carbon dioxide emissions increase infant mortality. There is a strong negative association between GDP per capita and infant mortality in both sub-samples, although its impact is far larger in the OECD group. In Japan and South Korea, unemployment is negatively associated with infant mortality.

    Conclusion: Japan outperforms other countries from the sample in major healthcare performance indicators, while South Korea is ranked second. The only exception is per capita carbon dioxide emissions, which have maximal values in the Republic of Korea and Japan. Non-OECD nations' outcomes were led by China, as the largest economy. This group was characterized with substantial improvement in efficiency of health spending since the middle of the 1990s. Yet, progress was noted with remarkable heterogeneity within the group.

    Matched MeSH terms: Life Expectancy
  18. Concepcion M
    Rev Bras Estud Popul, 1987 Jan-Jul;4(1):61-76.
    PMID: 12280935
    Matched MeSH terms: Life Expectancy*
  19. Jiwa M, Othman S, Hanafi NS, Ng CJ, Khoo EM, Chia YC
    Qual Prim Care, 2012;20(5):317-20.
    PMID: 23113999
    Malaysia has achieved reasonable health outcomes even though the country spends a modest amount of Gross Domestic Product on healthcare. However, the country is now experiencing a rising incidence of both infectious diseases and chronic lifestyle conditions that reflect growing wealth in a vibrant and successful economy. With an eye on an ageing population, reform of the health sector is a government priority. As in other many parts of the world, general practitioners are the first healthcare professional consulted by patients. The Malaysian health system is served by public and private care providers. The integration of the two sectors is a key target for reform. However, the future health of the nation will depend on leadership in the primary care sector. This leadership will need to be informed by research to integrate care providers, empower patients, bridge cultural gaps and ensure equitable access to scarce health resources.
    Matched MeSH terms: Life Expectancy/trends
  20. Chong BTW, Wahab S, Muthukrishnan A, Tan KL, Ch'ng ML, Yoong MT
    Psychol Res Behav Manag, 2020;13:949-962.
    PMID: 33204188 DOI: 10.2147/PRBM.S266976
    Purpose: The shorter life expectancy and increased risk of suicide in patients with schizophrenia have been well documented. However, study outcomes on suicidality in this special population have been few to date. This study investigated the prevalence and factors associated with suicidal ideation in a population of institutionalized patients with schizophrenia.

    Methods: Two hundred fifty-six patients with schizophrenia between the age of 18 and 65 years were randomly recruited. This cross-sectional study utilised the Calgary Depression Scale for Schizophrenia (CDSS), the Positive and Negative Syndrome Scale (PANSS) and the Psychotic Symptom Rating Scale (PSYRATS-AH). Univariate analysis was performed using an independent t-test or chi-square test, followed by binary logistic regression to determine the factors associated with increased suicidal risks.

    Results: The socio-demographic factors associated with suicidal ideation included level of education (p=0.039); secondary-level education (OR=5.76, 95% CI:1.49, 22.34, p=0.011) and tertiary-level education (OR=9.30, 95% CI: 1.80, 48.12, p=0.008) posed a greater risk. A history of attempted suicide (OR=2.09, 95% CI: 1.01, 4.36, p=0.049) and the presence of co-morbid physical illnesses (OR=2.07, 95% CI: 1.02, 4.21, p=0.044) were also found to be associated with a suicidal ideation. Other significant factors associated with suicidal thoughts were concurrent depression (OR=9.68, 95% CI: 3.74, 25.05, p<0.001) and a higher PSYRATS score in emotional characteristics of auditory hallucinations (OR=1.13, 95% CI: 1.06, 1.21, p<0.001).

    Conclusion: Suicide in schizophrenia appears to be more closely associated with certain socio-demographic factors and affective symptoms. Appropriate screening and treatment addressing these challenges must be emphasized if suicidal thoughts and actions are to be reduced.

    Matched MeSH terms: Life Expectancy
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