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Fulltext The burden of mental illness: an emerging global disaster

Mohd Razali Salleh

Journal of Clinical and Health Sciences, 2018;3(1):5-12.
MyJurnal

The global burden of disease (GBD) has shifted from communicable to non-communicable diseases, and from premature death to years live with disabilities (YLDs) over the past 30 years. Mental and substance use disorders constitute a major component in the scenario of the global health with a significant impact on the global burden of disease, especially in the developing countries. The 1990 GBD study listed depression as the fourth common cause of global burden of disease; while lower respiratory infections, diarrheal diseases and conditions arising during perinatal period are top in the list. In GBD 2000 study depressive disorders climbed to the third place, however still behind lower respiratory infections and diarrheal diseases. The subsequent 2010 GBD study ranked depression in the second place of the global disability burden, and are also considered as a major contributor to the burden of suicide and ischaemic heart disease. The WHO predicted that depressive disorders will be the leading cause of global burden in 2030.

Matched MeSH terms: Mortality, Premature
Fulltext Prevalence and modifiable risk factors of noncommunicable diseases among Jakun orang asli at Tasik Chini, Pekan, Pahang

Wong, C.M., Faiz D., Diana Safraa S., Raja Mohd Azim R.H., Siti Zubaidah A.R.

International Medical Journal Malaysia, 2018;17(3):3-16.
MyJurnal

Introduction: Non-communicable disease accounted for 73% of premature death in year 2015 Malaysian national survey. The orang asli population may be affected similarly. The prevention of non-communicable diseases should start as early as modifiable risk factors prevention, as proposed by STEPWISE approach of WHO. This study aims to identify the prevalence of hypertension, diabetes mellitus and dyslipidaemia among Jakun orang asli population and examine the association with risk factors. Methods: This is a cross-sectional study analysing 72 case reports of General health screening done in year 2015. The study population was adult Jakun orang asli Tasik Chini using cluster sampling followed by simple random sampling methods. Chi Square test was used for bivariate analysis of relationship each variable has with the diseases, and binary logistic regression was used to analyse association of covariates with each disease. Results: The prevalence was 41.7% for hypertension, 25% for Diabetes mellitus, 6.9% for dyslipidaemia. Education level was significantly related to hypertension, X2 = 11.565 (1), p =0.001; obesity was significantly related to diabetes, X 2 = 8.333 (1), p=0.004. After adjusted for covariates, low education level has 13.379 odds of getting hypertension. Obesity has 7.384 odds of getting diabetes mellitus; female gender has higher odds of getting dyslipidaemia while younger age, physically active and not smoking are protective factors. Conclusion: Higher prevalence of hypertension and diabetes mellitus was found among Tasik Chini orang asli population. Lower sociodemographic characteristics and unhealthy lifestyle factors are associated with the diseases.

Matched MeSH terms: Mortality, Premature
Fulltext Factors associated with uncontrolled hypertension among hypertensive patients in Tuaran, Sabah, Malaysia: a cross-sectional study

Rosfina Ghazali, Khamisah Awang Lukman, Daw Khin Saw Naing, Fairrul Kadir, Mohammad Saffree Jeffree, Fredie Robinson, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):19-19.
MyJurnal

Introduction: Hypertension prevalence is increasing globally and has become a major issue of disease as it is a major cause for cerebrovascular, kidney and cardiovascular diseases. Even among treated patients, there is a dispropor-tional of blood pressure control causing a major public health challenge. This study is aimed to decide on the prev-alence of uncontrolled hypertension and its associated factors among hypertensive patient attending hypertension clinic at primary health clinics in Tuaran district. This study is justified by the fact that uncontrolled hypertension leads to high mortality, morbidity and even premature death. Methods: This study is a cross-sectional study among 460 hypertensive patients attending three primary health clinics in Tuaran district, Sabah. Data were collected using structured modified questionnaires through interviews, physical examinations and patient’s medical records. Types of data collected include socio-demography, lifestyle behavior, physical examination, co-morbidity status and med-ical adherence. Data analysis done using SPSS version 24.0. Results: Prevalence of uncontrolled hypertension was 45.9%. The study found that factors significantly associated with uncontrolled hypertension with p

Matched MeSH terms: Mortality, Premature
Mortality in adult epilepsy patients in Malaysia: a hospital-based study

Khor SB, Lim KS, Fong SL, Ho JH, Koh MY, Tan CT

Seizure, 2021 May;88:56-59.
PMID: 33812309 DOI: 10.1016/j.seizure.2021.03.024

BACKGROUND: The standardized mortality ratio (SMR) of epilepsy in Asia ranges from 2.5 to 5.1. However, there are no such published data in Malaysia to date. Understanding the mortality rate and related factors will allow us to better assess and monitor the health status of PWE, thereby, preventing premature deaths among PWE. Hence, this study aimed to determine the mortality rate of adults with epilepsy (PWE) at the University Malaya Medical Centre (UMMC), a tertiary hospital in Malaysia.
METHOD: A total of 2218 PWE were recruited retrospectively into this study. Deceased cases from 2009-2018 were identified from the National Registry Department of Malaysia. Age-, gender-, and ethnic-specific SMR were calculated.
RESULT: There was a total of 163 deaths, of which 111 (68.1%) were male. The overall case-fatality rate (CFR) was 7.3%. Male PWE had higher CFR (9.2%) compared to females (5.1%, p<0.001). The annual death rate of PWE was 867 per 100, 000 persons. The overall all-cause SMR was 1.6 (CI 95% 1.3-1.8). The SMR for younger age groups (15-19 and 20-29 years) were higher (5.4-5.5) compared to other age groups (0.4-2.5). Overall SMR for male PWE (1.8, 95% CI 1.5-2.1) was higher than females (1.2, 95% CI 0.9-1.6). However, the SMR for female PWE in the younger age groups (15-19, 20-29 and 30-39 years) was higher. SMR among the Indian PWE was the highest (1.6, 95% CI 1.2-2.0) compared to the Chinese (1.5, 95% CI 1.2-1.9) and the Malays (1.4, 95% 1.0-1.9). The CFR was higher in those with focal epilepsy (8.5% vs. 2.5-3.7% in genetic and other generalized epilepsies, p=0.003), epilepsy with structural cause (9.5% vs. 5.9% in others, p=0.005) and uncontrolled seizures (7.9% vs. 5.2% in seizure-free group, p<0.001).
CONCLUSION: The mortality rate of PWE in Malaysia is higher than that of the general population but lower compared to other Asian countries. Specifically, the rates are higher in the younger age group, male gender, and Indian ethnicity. Those with focal epilepsy, structural causes and uncontrolled seizures have higher mortality rates.

Matched MeSH terms: Mortality, Premature
Fulltext Four nucleotide deletions of exon 47 in Dystrophin gene: a case report of a Kelantanese Duchenne Muscular Dystrophy patient

Fatimah Azman, Rose Adzrianee Adnan, Norhafizah Che Abdul Razak, Nazihah Mohd Yunus, Sarina Sulong, Rozita Abdullah, et al.

Journal of Biomedical and Clinical Sciences, 2017;2(202):11-13.
MyJurnal

Muscular dystrophy is a group of diseases that result in progressive muscle weakness and atrophy. Duchenne Muscular Dystrophy (DMD) is classified as dystrophinopathy and is an X-linked recessive disease. It is caused by alterations in the dystrophin gene at Xp21.2 encoding 79 exons [1]. It is characterised by progressive muscle wasting that begins at 3 to 5 years, delay in motor development and eventually wheelchair confinement followed by premature death at about 30 years from cardiac or respiratory complications [2]. Genetic etiology of cases of DMD in Malaysia are still scarcely reported. Here, we report the genetic cause in the case of an 11-year-old Kelantanese Malay boy who has progressive muscle weakness since 5 years old. He has difficulty in getting up from sitting and supine position also in climbing up stairs until 1st floor. He has a strong family history of DMD and musculoskeletal problems. His younger brother was diagnosed with DMD by molecular analysis and his maternal uncle died at the age of 16 with musculoskeletal problems but was never investigated. Physical examination revealed no dysmorphic features, positive Gower sign with absent tounge fasciculation. On neurological examination, tendon reflexes and muscle tone for limbs were normal. Muscle power for bilateral upper limbs were normal, however, bilateral lower limbs showed slight reduction in muscle power with calf hypertrophy.

Matched MeSH terms: Mortality, Premature
Fulltext Hepatocellular Carcinoma in Malaysia and Its Changing Trend

Raihan R, Azzeri A, H Shabaruddin F, Mohamed R

Euroasian J Hepatogastroenterol, 2018 05 01;8(1):54-56.
PMID: 29963463 DOI: 10.5005/jp-journals-10018-1259

Hepatocellular carcinoma (HCC) is one of the leading causes of death globally. In Malaysia liver cancer is the eighth most common cause of cancer for both gender and fifth most common cause of cancer for males. Liver cancer is a cause of premature death in Malaysia: The trend from 1990 to 2010 was observed upward. Since 1990, the annual years of life lost (YLLs) from liver cancer have increased by 31.5%. Older persons are at higher risk and there is male predominance observed. Curative surgical resection, liver transplantation, and supportive symptomatic care, including percutaneous ethanol injection and radiofrequency ablation (RFA), and noncurative transarterial chemoembolization (TACE) are among available treatment facilities. Yet the survival rate is very poor as majority of patients present at very advanced stage. Hepatitis B virus (HBV) remained the leading cause of HCC in Malaysia. Several studies showed cryptogenic causes, which are mainly nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) among the predominant causes of HCC in Malaysia than hepatitis C virus (HCV), alcohol, or any other reason. This mainly correlates with the increasing incidence of diabetes and obesity in Malaysia. How to cite this article: Raihan R, Azzeri A, Shabaruddin FH, Mohamed R. Hepatocellular Carcinoma in Malaysia and Its Changing Trend. Euroasian J Hepato-Gastroenterol 2018;8(1):54-56.

Matched MeSH terms: Mortality, Premature
Achieving the targets of sustainable development goals (2030 agenda) for congenital disorders in Asia: Bottlenecks and interventions

Thong MK

Am J Med Genet C Semin Med Genet, 2019 06;181(2):254-261.
PMID: 30801969 DOI: 10.1002/ajmg.c.31690

The United Nations General Assembly adopted the 2030 Agenda for Sustainable Development in November 2015 which included a set of 17 measurable "sustainable development goals" (SDGs). The SDGs included targets to end preventable deaths of newborns and children under 5 years of age by 2030, universal health care coverage, reduction of premature mortality from noncommunicable diseases (NCDs) by 33% as well as support the development and research for medicines for both communicable and NCDs. Although some successes were achieved in combating communicable diseases and improved childhood mortality rates, health systems in Asia are generally characterized by lack of accurate epidemiological information on congenital disorders, lack of human and financial resources, and inadequate focus on public health strategies to ensure targeted interventions, low level knowledge on congenital disorders amongst the community and healthcare providers and the ethical dilemma of managing rare congenital disorders in an environment of low national health expenditures. These bottlenecks must be addressed systematically and interventions such as the use of innovative epidemiological tools to overcome lack of data, increased efforts to standardize rare disease nomenclature and classification and renewed interest in birth defects registries by countries in the region must be considered. Targeted curative and public health approaches currently used in thalassaemia and neural tube defects may be used for other congenital disorders in Asian countries. The implementation of congenital disorders-related research, prevention, care, and treatment delivery services must be integrated into existing health systems in order to be effective to achieve the targets of SDG2030.

Matched MeSH terms: Mortality, Premature
Fulltext Strengthening Primary Health-Care Services to Help Prevent and Control Long-Term (Chronic) Non-Communicable Diseases in Low- and Middle-Income Countries

Haque M, Islam T, Rahman NAA, McKimm J, Abdullah A, Dhingra S

Risk Manag Healthc Policy, 2020;13:409-426.
PMID: 32547272 DOI: 10.2147/RMHP.S239074

The prevalence of long-term (chronic) non-communicable diseases (NCDs) is increasing globally due to an ageing global population, urbanization, changes in lifestyles, and inequitable access to healthcare. Although previously more common in high- and upper-middle-income countries, lower-middle-income countries (LMICs) are more affected, with NCDs in LMICs currently accounting for 85-90% of premature deaths among 30-69 years old. NCDs have both high morbidity and mortality and high treatment costs, not only for the diseases themselves but also for their complications. Primary health care (PHC) services are a vital component in the prevention and control of long-term NCDs, particularly in LMICs, where the health infrastructure and hospital services may be under strain. Drawing from published studies, this review analyses how PHC services can be utilized and strengthened to help prevent and control long-term NCDs in LMICs. The review finds that a PHC service approach, which deals with health in a comprehensive way, including the promotion, prevention, and control of diseases, can be useful in both high and low resource settings. Further, a PHC based approach also provides opportunities for communities to better access appropriate healthcare, which ensures more significant equity, efficiency, effectiveness, safety, and timeliness, empowers service users, and helps healthcare providers to achieve better health outcomes at lower costs.

Matched MeSH terms: Mortality, Premature
The global estimate of premature cardiovascular mortality: a systematic review and meta-analysis of age-standardized mortality rate

Hasani WSR, Muhamad NA, Hanis TM, Maamor NH, Chen XW, Omar MA, et al.

BMC Public Health, 2023 Aug 16;23(1):1561.
PMID: 37587427 DOI: 10.1186/s12889-023-16466-1

BACKGROUND: Cardiovascular disease (CVD) is a significant cause of premature mortality worldwide, with a growing burden in recent years. Despite this, there is a lack of comprehensive meta-analyses that quantify the extent of premature CVD mortality. Study addressed this gap by estimating the pooled age-standardized mortality rate (ASMR) of premature CVD mortality.
METHODS: We conducted a systematic review of published CVD mortality studies that reported ASMR as an indicator for premature mortality measurement. All English articles published as of October 2022 were searched in four electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). We computed pooled estimates of ASMR using random-effects meta-analysis. We assessed heterogeneity from the selected studies using the I2 statistic. Subgroup analyses and meta regression analysis was performed based on sex, main CVD types, income country level, study time and age group. The analysis was performed using R software with the "meta" and "metafor" packages.
RESULTS: A total of 15 studies met the inclusion criteria. The estimated global ASMR for premature mortality from total CVD was 96.04 per 100,000 people (95% CI: 67.18, 137.31). Subgroup analysis by specific CVD types revealed a higher ASMR for ischemic heart disease (ASMR = 15.57, 95% CI: 11.27, 21.5) compared to stroke (ASMR = 12.36, 95% CI: 8.09, 18.91). Sex-specific differences were also observed, with higher ASMRs for males (37.50, 95% CI: 23.69, 59.37) than females (15.75, 95% CI: 9.61, 25.81). Middle-income countries had a significantly higher ASMR (90.58, 95% CI: 56.40, 145.48) compared to high-income countries (21.42, 95% CI: 15.63, 29.37). Stratifying by age group indicated that the age groups of 20-64 years and 30-74 years had a higher ASMR than the age group of 0-74 years. Our multivariable meta-regression model suggested significant differences in the adjusted ASMR estimates for all covariates except study time.
CONCLUSIONS: This meta-analysis synthesized a comprehensive estimate of the worldwide burden of premature CVD mortality. Our findings underscore the continued burden of premature CVD mortality, particularly in middle-income countries. Addressing this issue requires targeted interventions to mitigate the high risk of premature CVD mortality in these vulnerable populations.

Matched MeSH terms: Mortality, Premature
Fulltext The importance of exercise as a therapeutic agent

Singh R

Malays J Med Sci, 2002 Jul;9(2):7-16.
PMID: 22844219 MyJurnal

Adaptations in the structural and/or functional properties of cells, tissues and organ systems in the human body occurs when exposed to various stimuli. While there is unanimous agreement that regular physical activity is essential for optimal function of the human body, it is evident that extrinsic factors, such as diet, smoking, exercise habits, are reflected in the morbidity and mortality statistics of the population. Ageing is obligatorily associated with reduced maximal aerobic power and reduced muscle strength, i.e. with reduced physical fitness. As a consequence of diminished exercise tolerance, a large and increasing number of the aged population will be living below, at or just above 'threshold' of physical ability, needing only a minor illness to render them completely dependent. Physical training can readily produce a profound improvement of functions essential for physical fitness in old age. Adaptation to regular physical activity causes less disruption of the cells' internal environment and minimises fatigue which enhances performances and the economy of energy output during daily physical activity. Regular physical exercise reduces the risk of premature mortality in general, and of coronary heart disease, hypertension and diabetes mellitus. Physical activity also improves mental health and is important for health and optimal function of muscles, bones and joints. The most recent recommendations advice the people of all ages to include a minimum of 30 minutes of physical activity of moderate intensity, such as brisk walking, on most, if not all, days of the week.

Matched MeSH terms: Mortality, Premature

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