OBJECTIVES: To determine the prevalence and descriptive epidemiology of atopic dermatitis among school children in the general community in Singapore.
METHODS: This is a questionnaire study of 12 323 students done over a 1-year period, comprising 7 year olds (4605), 12 year olds (3940) and 16 year olds (3778) from 19 primary and 17 secondary schools randomly selected in Singapore. All children had a complete cutaneous examination. The diagnosis of atopic dermatitis was based on the U.K. Working Party diagnostic criteria. The questionnaire was translated into Chinese and both the English and Chinese versions were issued simultaneously to the students.
RESULTS: The 1-year period prevalence of atopic dermatitis was 20.8%. Atopic dermatitis was present in 22.7% of 7 year olds, 17.9% of 12 year olds and 21.5% of 16 year olds. The overall sex ratio was equal. There were slightly more boys with atopic dermatitis among the younger children (6 and 12 year olds, 1.18 : 1 and 1.19 : 1, respectively) but more girls were affected (1.57 : 1) among the 16 year olds. Atopic dermatitis was more common among the Chinese (21.6%) and Malays (19.8%) compared with the Indians (16%) and other races (14%). The onset of the disease occurred before the age of 10 years in 49.5% of the 16 year olds. "Pure" atopic dermatitis without concomitant respiratory allergies was noted in 788 respondents (30.7%); 1775 (69.3%) suffered from a "mixed" type, with 34.3% having allergic rhinitis, 9.5% having asthma and 25.5% having both asthma and allergic rhinitis. More boys had atopic dermatitis and concomitant respiratory allergies whereas more girls were affected with "pure" atopic dermatitis alone (1.4 : 1). At least one first-degree family member with atopy was noted in 1435 children (56%): atopic dermatitis (70%), asthma (62%) and allergic rhinitis (68%). Among siblings with one parent with atopic dermatitis, 37% had either a father or a mother with atopic dermatitis. Common aggravating factors reported included exercise, heat and sweating, grass intolerance, thick clothing and stress. Pityriasis alba was noted in 25% of the study population, keratosis pilaris in 13% and ichthyosis vulgaris in 8%. Most respondents had mild to moderate atopic dermatitis that could be controlled with a fairly simple regimen of moisturizers, topical steroids, antihistamines and antibiotics.
CONCLUSIONS: The high prevalence of atopic dermatitis in Singapore is similar to that observed in developed countries, suggesting that environmental factors may be important in determining the expression of the disease.
Objective: To estimate changes in the prevalence of current tobacco use and socioeconomic inequalities among male and female participants from 22 sub-Saharan African countries from 2003 to 2019.
Design, Setting, and Participants: Secondary data analyses were conducted of sequential Demographic and Health Surveys in 22 sub-Saharan African countries including male and female participants aged 15 to 49 years. The baseline surveys (2003-2011) and the most recent surveys (2011-2019) were pooled.
Exposures: Household wealth index and highest educational level were the markers of inequality.
Main Outcomes and Measures: Sex-specific absolute and relative changes in age-standardized prevalence of current tobacco use in each country and absolute and relative measures of inequality using pooled data.
Results: The survey samples included 428 197 individuals (303 232 female participants [70.8%]; mean [SD] age, 28.6 [9.8] years) in the baseline surveys and 493 032 participants (348 490 female participants [70.7%]; mean [SD] age, 28.5 [9.4] years) in the most recent surveys. Both sexes were educated up to primary (35.7%) or secondary school (40.0%). The prevalence of current tobacco use among male participants ranged from 6.1% (95% CI, 5.2%-6.9%) in Ghana to 38.3% (95% CI, 35.8%-40.8%) in Lesotho in the baseline surveys and from 4.5% (95% CI, 3.7%-5.3%) in Ghana to 46.0% (95% CI, 43.2%-48.9%) in Lesotho during the most recent surveys. The decrease in prevalence ranged from 1.5% (Ghana) to 9.6% (Sierra Leone). The World Health Organization target of a 30% decrease in smoking was achieved among male participants in 8 countries: Rwanda, Nigeria, Ethiopia, Benin, Liberia, Tanzania, Burundi, and Cameroon. For female participants, the number of countries having a prevalence of smoking less than 1% increased from 9 in baseline surveys to 16 in the most recent surveys. The World Health Organization target of a 30% decrease in smoking was achieved among female participants in 15 countries: Cameroon, Namibia, Mozambique, Mali, Liberia, Nigeria, Burundi, Tanzania, Malawi, Kenya, Rwanda, Zimbabwe, Ethiopia, Burkina Faso, and Zambia. For both sexes, the prevalence of tobacco use and the decrease in prevalence of tobacco use were higher among less-educated individuals and individuals with low income. In both groups, the magnitude of inequalities consistently decreased, and its direction remained the same. Absolute inequalities were 3-fold higher among male participants, while relative inequalities were nearly 2-fold higher among female participants.
Conclusions and Relevance: Contrary to a projected increase, tobacco use decreased in most sub-Saharan African countries. Persisting socioeconomic inequalities warrant the stricter implementation of tobacco control measures to reach less-educated individuals and individuals with low income.
DESIGN: Cross-sectional study, analysing baseline findings of a cohort of older adults.
SETTING: Kuala Pilah district, Negeri Sembilan state, Malaysia.
OBJECTIVES: To determine the prevalence of elder abuse among community dwelling older adults and its associated factors.
PARTICIPANTS: A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census.
PRIMARY AND SECONDARY OUTCOME MEASURES: Elder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined.
RESULTS: The prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse.
CONCLUSION: Elder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse.
SETTING: A formal questionnaire was anonymously completed by physicians from different countries/regions in the Asia-Pacific. The survey sought responses relating to general familiarity, awareness of management guidelines, identification (clinical characteristics and lipid profile), prevalence and inheritance, extent of elevation in risk of cardiovascular disease (CVD) and practice on screening and treatment.
PARTICIPANTS: Practising community physicians from Australia, Japan, Malaysia, South Korea, Philippines, Hong Kong, China, Vietnam and Taiwan were recruited to complete the questionnaire, with the UK as the international benchmark.
PRIMARY OUTCOME: An assessment and comparison of the knowledge, awareness and preferences of FH among physicians in 10 different countries/regions.
RESULTS: 1078 physicians completed the questionnaire from the Asia-Pacific region; only 34% considered themselves to be familiar with FH. 72% correctly described FH and 65% identified the typical lipid profile, with a higher proportion of physicians from Japan and China selecting the correct FH definition and lipid profile compared with those from Vietnam and Philippines. However, less than half of the physician were aware of national or international management guidelines; this was significantly worse than physicians from the UK (35% vs 61%, p<0.001). Knowledge of prevalence (24%), inheritability (41%) and CVD risk (9%) of FH were also suboptimal. The majority of the physicians considered laboratory interpretative commenting as being useful (81%) and statin therapy as an appropriate cholesterol-lowering therapy (89%) for FH management.
CONCLUSIONS: The study identified important gaps, which are readily addressable, in the awareness and knowledge of FH among physicians in the region. Implementation of country-specific guidelines and extensive work in FH education and awareness programmes are imperative to improve the care of FH in the region.
Method:: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013.
Results:: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD.
Conclusion:: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.
STUDY DESIGN: A non-randomized prospectively collected patients over a three year period, with complaints of nose congestion, rhinorrhea and/or nasal discharge.
RESULTS: There were 435 patients enrolled, 213 children and 222 adults. The children group had a high prevalence of allergen specific IgE to Dermatophagoides pteryonysinus (70%), Dermatophagoides farina (69%), and Blomia tropicalis (55%); followed by dogs (32%), cats (19%) and cockroaches (19%). In the children food allergy category, the top three allergens were egg white (54%), milk (31%) and soya bean (13%). The adult group had results of Dermatophagoides pteryonysinus (71%), Dermatophagoides farina (72%), and Blomia tropicalis (59%); the adult food allergy category, the top 3 allergens were egg white (13%), milk (6%) and soya bean (5%). There was a statistically significant difference in the child and adult group for Dust, D. pteryonysinus, D. farina, B.tropicalis, egg white, wheat, gluten and soya bean. In the age specific child groups, there was an increased in egg food allergy levels, with a peak at the age of five-nine years old and decreasing thereafter (p=0.04). In the children group, the mean Total Nasal Symptom Score (TNSS) was 10.3 (range of 7 to 13); the adult group was similar, with a mean TNSS of 9.8 (range 5 to 12).
CONCLUSION: The prevalence of food allergy in paediatric patients with allergic rhinitis is fairly high and should be considered when treating these children.
DESIGN AND SETTING: A cross-sectional survey was carried out in rural and urban areas in a state in Malaysia. Secondary schools were randomly selected and used as sampling units.
PARTICIPANTS: Adults aged ≥18 years old were invited to answer a self-administered questionnaire on pain experienced over the previous 6 months. Out of 9300 questionnaires distributed, 5206 were returned and 150 participants who did not fall into the 3 ethnic groups were excluded, yielding a total of 5056 questionnaires for analysis. 58.2% (n=2926) were women. 50% (n=2512) were Malays, 41.4% (n=2079) were Chinese and 8.6% (n=434) were Indians.
RESULTS: 21.1% (n=1069) had knee pain during the previous 6 months. More Indians (31.8%) experienced knee pain compared with Malays (24.3%) and Chinese (15%) (p<0.001). The odds of Indian women reporting knee pain was twofold higher compared with Malay women. There was a rising trend in the prevalence of knee pain with increasing age (p<0.001). The association between age and knee pain appeared to be stronger in women than men. 68.1% of Indians used analgesia for knee pain while 75.4% of Malays and 52.1% of Chinese did so (p<0.001). The most common analgesic used for knee pain across all groups was topical medicated oil (43.7%).
CONCLUSIONS: The prevalence of knee pain in adults was more common in Indian women and older women age groups and Chinese men had the lowest prevalence of knee pain. Further studies should investigate the reasons for these differences.
METHODS: We analysed Demographic and Health Survey data on tobacco use collected from large nationally representative samples of men and women in 54 LMICs. We estimated the weighted prevalence of any current tobacco use (including smokeless tobacco) in each country for 4 educational groups and 4 wealth groups. We calculated absolute and relative measures of inequality, that is, the slope index of inequality (SII) and relative index of inequality (RII), which take into account the distribution of prevalence across all education and wealth groups and account for population size. We also calculated the aggregate SII and RII for low-income (LIC), lower-middle-income (lMIC) and upper-middle-income (uMIC) countries as per World Bank classification.
FINDINGS: Male tobacco use was highest in Bangladesh (70.3%) and lowest in Sao Tome (7.4%), whereas female tobacco use was highest in Madagascar (21%) and lowest in Tajikistan (0.22%). Among men, educational inequalities varied widely between countries, but aggregate RII and SII showed an inverse trend by country wealth groups. RII was 3.61 (95% CI 2.83 to 4.61) in LICs, 1.99 (95% CI 1.66 to 2.38) in lMIC and 1.82 (95% CI 1.24 to 2.67) in uMIC. Wealth inequalities among men varied less between countries, but RII and SII showed an inverse pattern where RII was 2.43 (95% CI 2.05 to 2.88) in LICs, 1.84 (95% CI 1.54 to 2.21) in lMICs and 1.67 (95% CI 1.15 to 2.42) in uMICs. For educational inequalities among women, the RII varied much more than SII varied between the countries, and the aggregate RII was 14.49 (95% CI 8.87 to 23.68) in LICs, 3.05 (95% CI 1.44 to 6.47) in lMIC and 1.58 (95% CI 0.33 to 7.56) in uMIC. Wealth inequalities among women showed a pattern similar to that of men: the RII was 5.88 (95% CI 3.91 to 8.85) in LICs, 1.76 (95% CI 0.80 to 3.85) in lMIC and 0.39 (95% CI 0.09 to 1.64) in uMIC. In contrast to men, among women, the SII was pro-rich (higher smoking among the more advantaged) in 13 of the 52 countries (7 of 23 lMIC and 5 of 7 uMIC).
INTERPRETATION: Our results confirm that socioeconomic inequalities tobacco use exist in LMIC, varied widely between the countries and were much wider in the lowest income countries. These findings are important for better understanding and tackling of socioeconomic inequalities in health in LMIC.
METHODS: An analytical cross sectional study design was used and a self-administered proforma was distributed for data collection. 1239 Malay secondary school children in Putrajaya were tested for absence of Palmaris Longus using Schaffer's test. 4 additional tests namely Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's 'two-finger sign' method were used to confirm its absence in respondents with negative Schaffer's test. Function of Flexor Digitorum Superficialis tendon to little finger was determined by flexing PIP of little finger while hyperextend the other fingers.
RESULTS: The prevalence of absence of Palmaris Longus was 11.7%. Left side absence of Palmaris Longus was much common. There was a significant association between absence of Palmaris Longus with gender in which female had higher prevalence of absence of Palmaris Longus than male.
CONCLUSIONS: In conclusion, the prevalence of absence of Palmaris Longus in Malay population was lower than Indian but higher than Chinese population. Females had higher prevalence of absence of Palmaris Longus and no association can be found with hand dominance and absence of Flexor Digitorum Superficialis tendon to little finger.