Displaying publications 41 - 60 of 91 in total

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  1. Reidpath DD, Jahan NK, Mohan D, Allotey P
    Glob Health Action, 2016;9:31691.
    PMID: 27511810 DOI: 10.3402/gha.v9.31691
    BACKGROUND: The term HbA1c (glycated haemoglobin) is commonly used in relation to diabetes mellitus. The measure gives an indication of the average blood sugar levels over a period of weeks or months prior to testing. For most low- and middle-income countries HbA1c measurement in community surveillance is prohibitively expensive. A question arises about the possibility of using a single blood glucose measure for estimating HbA1c and therefore identifying poor glycaemic control in resource-poor settings.

    DESIGN: Using data from the 2011-2012 US National Health and Nutrition Examination Surveys, we examined the relationship between HbA1c and a single fasting measure of blood glucose in a non-clinical population of people with known diabetes (n=333). A linear equation for estimating HbA1c from blood glucose was developed. Appropriate blood glucose cut-off values were set for poor glycaemic control (HbA1c≥69.4 mmol/mol).

    RESULTS: The HbA1c and blood glucose measures were well correlated (r=0.7). Three blood glucose cut-off values were considered for classifying poor glycaemic control: 8.0, 8.9, and 11.4 mmol/L. A blood glucose of 11.4 had a specificity of 1, but poor sensitivity (0.37); 8.9 had high specificity (0.94) and moderate sensitivity (0.7); 8.0 was associated with good specificity (0.81) and sensitivity (0.75).

    CONCLUSIONS: Where HbA1c measurement is too expensive for community surveillance, a single blood glucose measure may be a reasonable alternative. Generalising the specific results from these US data to low resource settings may not be appropriate, but the general approach is worthy of further investigation.

  2. Partap U, Young EH, Allotey P, Sandhu MS, Reidpath DD
    PMID: 30263138 DOI: 10.1017/gheg.2018.13
    Background: Integration of biomarker data with information on health and lifestyle provides a powerful tool to enhance the scientific value of health research. Existing health and demographic surveillance systems (HDSSs) present an opportunity to create novel biodata resources for this purpose, but data and biological sample collection often presents challenges. We outline some of the challenges in developing these resources and present the outcomes of a biomarker feasibility study embedded within the South East Asia Community Observatory (SEACO) HDSS.

    Methods: We assessed study-related records to determine the pace of data collection, response from potential participants, and feedback following data and sample collection. Overall and stratified measures of data and sample availability were summarised. Crude prevalence of key risk factors was examined.

    Results: Approximately half (49.5%) of invited individuals consented to participate in this study, for a final sample size of 203 (161 adults and 42 children). Women were more likely to consent to participate compared with men, whereas children, young adults and individuals of Malay ethnicity were less likely to consent compared with older individuals or those of any other ethnicity. At least one biological sample (blood from all participants - finger-prick and venous [for serum, plasma and whole blood samples], hair or urine for adults only) was successfully collected from all participants, with blood test data available from over 90% of individuals. Among adults, urine samples were most commonly collected (97.5%), followed by any blood samples (91.9%) and hair samples (83.2%). Cardiometabolic risk factor burden was high (prevalence of elevated HbA1c among adults: 23.8%; of elevated triglycerides among adults: 38.1%; of elevated total cholesterol among children: 19.5%).

    Conclusions: In this study, we show that it is feasible to create biodata resources using existing HDSS frameworks, and identify a potentially high burden of cardiometabolic risk factors that requires further evaluation in this population.

  3. Yap KH, Warren N, Reidpath DD, Allotey P
    Int J Qual Stud Health Well-being, 2019 Dec;14(1):1613875.
    PMID: 31120385 DOI: 10.1080/17482631.2019.1613875
    Purpose: Stroke survivors report poorer self-rated health (SRH) compared to the general population but there is limited understanding on what contributes to SRH. This ethnographic study examined the individual and contextual factors that shape stroke survivors' SRH in a rural middle income country situated in South East Asia. Methods: Ethnographic methods which encompasses various data collection methods from different data sources were used in this study to describe the socio-cultural context of 16 stroke survivors living in a rural village. Within this context, the experiences of these participants were then interpreted in terms of what contributed to their perception of health and recovery, juxtaposed with objectively measure physical and cognitive states. Results: SRH reflected the post stroke adjustment of stroke survivors. Better SRH was influenced by good post-stroke adjustment that was achieved by a combination of physical functioning, cognitive functioning, emotional well-being and family support. Poorer SRH appear to reflect poor post-stroke adjustment regardless of the objective physical and cognitive states of the stroke survivors. It was also observed that cognitive deficits, though its presence was acknowledged by participants, were usually not taken into account when rating SRH. However, while physical functioning was perceived by participants to directly impact SRH, the presence of cognitive deficits (often in tandem with depressive symptoms) indirectly complicated the recovery of physical functions treasured by participants. Conclusion: Stroke survivors reporting poorer SRH warrant further attention and intervention from health practitioners supporting the longer-term needs of stroke survivors in similar settings.
  4. Allotey P, Tan DT, Kirby T, Tan LH
    Health Syst Reform, 2019;5(1):66-77.
    PMID: 30924744 DOI: 10.1080/23288604.2018.1541497
    Community engagement describes a complex political process with dynamic negotiation and renegotiation of power and authority between providers and recipients of health care in order to achieve a shared goal of universal health care coverage. Though examples exist of community engagement projects, there is very little guidance on how to implement and embed community engagement as a concerted, integrated, strategic, and sustained component of health systems. Through a series of case studies, this article explores the factors that enable community engagement particularly with a direct impact on health systems.
  5. Aborigo RA, Reidpath DD, Oduro AR, Allotey P
    BMC Pregnancy Childbirth, 2018 01 02;18(1):3.
    PMID: 29291711 DOI: 10.1186/s12884-017-1641-9
    BACKGROUND: Twenty years after acknowledging the importance of joint responsibilities and male participation in maternal health programs, most health care systems in low income countries continue to face challenges in involving men. We explored the reasons for men's resistance to the adoption of a more proactive role in pregnancy care and their enduring influence in the decision making process during emergencies.

    METHODS: Ten focus group discussions were held with opinion leaders (chiefs, elders, assemblymen, leaders of women groups) and 16 in-depth interviews were conducted with healthcare workers (District Directors of Health, Medical Assistants in-charge of health centres, and district Public Health Nurses and Midwives). The interviews and discussions were audio recorded, transcribed into English and imported into NVivo 10 for content analysis.

    RESULTS: As heads of the family, men control resources, consult soothsayers to determine the health seeking or treatment for pregnant women, and serve as the final authority on where and when pregnant women should seek medical care. Beyond that, they have no expectation of any further role during antenatal care and therefore find it unnecessary to attend clinics with their partners. There were conflicting views about whether men needed to provide any extra support to their pregnant partners within the home. Health workers generally agreed that men provided little or no support to their partners. Although health workers had facilitated the formation of father support groups, there was little evidence of any impact on antenatal support.

    CONCLUSIONS: In patriarchal settings, the role of men can be complex and social and cultural traditions may conflict with public health recommendations. Initiatives to promote male involvement should focus on young men and use chiefs and opinion leaders as advocates to re-orient men towards more proactive involvement in ensuring the health of their partners.

  6. Reidpath D, Khosla R, Gruskin S, Dakessian A, Allotey P
    BMJ Glob Health, 2023 Oct;8(10).
    PMID: 37903566 DOI: 10.1136/bmjgh-2023-013274
  7. Reidpath DD, Gruskin S, Khosla R, Dakessian A, Allotey P
    Lancet, 2023 Sep 16;402(10406):943-945.
    PMID: 37392750 DOI: 10.1016/S0140-6736(23)01304-1
  8. Ahmadi K, Reidpath DD, Allotey P, Hassali MA
    BMJ Open, 2013 May 28;3(5).
    PMID: 23793653 DOI: 10.1136/bmjopen-2013-002755
    INTRODUCTION: HIV/AIDS-related stigma affects the access and utilisation of health services. Although HIV/AIDS-related stigma in the health services has been studied, little work has attended to the relationship between professional development and stigmatising attitudes. Hence, in this study, we will extend earlier research by examining the relationship between the stage of professional development and the kinds of stigmatising attitudes held about people living with HIV/AIDS.

    METHODS AND ANALYSIS: A serial cross-sectional design will be combined with a two-point in time longitudinal design to measure the levels of stigma among healthcare students from each year of undergraduate and graduate courses in Malaysia and Australia. In the absence of suitable measures, we will carry out a sequential mixed methods design to develop such a tool. The questionnaire data will be analysed using mixed effects linear models to manage the repeated measures.

    ETHICS AND DISSEMINATION: We have received ethical approval from the Monash MBBS executive committee as well as the Monash University Human Research Ethics Committee. We will keep the data in a locked filing cabinet in the Monash University (Sunway campus) premises for 5 years, after which the information will be shredded and disposed of in secure bins, and digital recordings will be erased in accordance with Monash University's regulations. Only the principal investigator and the researcher will have access to the filing cabinet. We aim to present and publish the results of this study in national and international conferences and peer-reviewed journals, respectively.

  9. Jeganathan R, Karalasingam SD, Hussein J, Allotey P, Reidpath DD
    BMC Pregnancy Childbirth, 2017 Apr 08;17(1):110.
    PMID: 28390414 DOI: 10.1186/s12884-017-1293-9
    BACKGROUND: The neonatal Apgar score at 5 min has been found to be a better predictor of outcomes than the Apgar score at 1 min. A baby, however, must pass through the first minute of life to reach the fifth. There has been no research looking at predictors of recovery (Apgar scores ≥7) by 5 min in neonates with 1 min Apgar scores <4.

    METHODS: An analysis of observational data was conducted using live, singleton, term births recorded in the Malaysian National Obstetrics Registry between 2010 and 2012. A total of 272,472 live, singleton, term births without congential anomalies were recorded, of which 1,580 (0.59%) had 1 min Apgar scores <4. Descriptive methods and bi- and multi-variable logistic regression were used to identify risk factors associated with recovery (5 min Apgar score ≥7) from 1 min Apgar scores <4.

    RESULTS: Less than 1% of births have a 1 min Apgar scores <4. Only 29.4% of neonates with 1 min Apgar scores <4 recover to a 5 min Apgar score ≥7. Among uncomplicated vaginal deliveries, after controlling for other factors, deliveries by a doctor of neonates with a 1 min Apgar score <4 had odds of recovery 2.4 times greater than deliveries of neonates with a 1 min Apgar score <4 by a nurse-midwife. Among deliveries of neonates with a 1 min Apgar score <4 by doctors, after controlling for other factors, planned and unplanned CS was associated with better odds of recovery than uncomplicated vaginal deliveries. Recovery was also associated with maternal obesity, and there was some ethnic variation - in the adjusted analysis indigenous (Orang Asal) Malaysians had lower odds of recovery.

    CONCLUSIONS: A 1 min Apgar score <4 is relatively rare, and less than a third recover by five minutes. In those newborns the qualification of the person performing the delivery and the type of delivery are independent predictors of recovery as is maternal BMI and ethnicity. These are associations only, not necessarily causes, and they point to potential areas of research into health systems factors in the labour room, as well as possible biological and cultural factors.

  10. Allotey P, Verghis S, Alvarez-Castillo F, Reidpath DD
    BMC Public Health, 2012;12 Suppl 1(Suppl 1):S2.
    PMID: 22992314 DOI: 10.1186/1471-2458-12-S1-S2
  11. Jahan N, Allotey P, Arunachalam D, Yasin S, Soyiri IN, Davey TM, et al.
    BMC Public Health, 2014;14 Suppl 2:S8.
    PMID: 25081203 DOI: 10.1186/1471-2458-14-S2-S8
    Health services can only be responsive if they are designed to service the needs of the population at hand. In many low and middle income countries, the rate of urbanisation can leave the profile of the rural population quite different from the urban population. As a consequence, the kinds of services required for an urban population may be quite different from that required for a rural population. This is examined using data from the South East Asia Community Observatory in rural Malaysia and contrasting it with the national Malaysia population profile.
  12. Reidpath DD, Davey TM, Kadirvelu A, Soyiri IN, Allotey P
    Prev Med, 2014 Feb;59:37-41.
    PMID: 24270054 DOI: 10.1016/j.ypmed.2013.11.011
    OBJECTIVES: Evidence that age of smoking initiation represents a risk factor for regular smoking in adolescence is complicated by inconsistencies in the operational definition of smoking initiation and simultaneous inclusion of age as an explanatory variable. The aim of this study was to examine the relationship between age, age of smoking initiation and subsequent regular smoking.
    METHODS: A secondary analysis was conducted of the U.S. Youth Risk Behavior Survey 2011. A sex stratified multivariable logistic regression analysis was used to model the likelihood of regular smoking with age and age of smoking initiation as explanatory variables and race/ethnicity as a covariate.
    RESULTS: After controlling for race/ethnicity, age and age of smoking initiation were independently associated with regular smoking in males and females. Independent of age, a one year's decrease in the age of smoking initiation was associated with a 1.27 times increase in odds of regular smoking in females (95% CI: 1.192-1.348); and similar associations for males (OR: 1.28; 95% CI: 1.216-1.341).
    CONCLUSION: While the majority of high school students do not become regular smokers after initiating smoking, earlier initiation of smoking is associated with subsequent regular smoking irrespective of sex or race/ethnicity. These findings have potentially important implications for intervention targeting.
    KEYWORDS: Adolescent; Epidemiology; Smoking
  13. Reidpath DD, Cheah JC, Lam FC, Yasin S, Soyiri I, Allotey P
    Nutr J, 2013;12:135.
    PMID: 24093886 DOI: 10.1186/1475-2891-12-135
    BACKGROUND: Measures of central adiposity are better predictors of adverse health events than BMI. Nonetheless, BMI is more widely used in health research. One reason for this may be the limited research supporting the self-measurement of waist and hip circumference. The lack of validity studies is particularly acute in Asia. The main objective was to establish the validity of self-measurement of waist and hip circumference in a community setting and the correlation of those measures with BMI, blood pressure, and blood glucose levels.
    METHODS: A community based, cross-sectional survey. A "healthy living expo" at a shopping mall in a rural town on peninsular Malaysia One hundred and thirty six (136) individuals volunteered to participate in the study, 125 of whom met the inclusion criteria. The ethnic distribution of the participants was 80% Chinese, 17% Malay and 3% Indian. Most participants were female (60%), with participants' ages ranging from 18 to 78 years (mean, 47.2). Self and assisted measurements of waist and hip were taken. Blood pressure, non-fasting blood glucose, height, and weight were also measured. Bland Altman plots and Lin's concordance coefficient were used to measure agreement between self and assisted measures. Pearson's correlation was used to examine the association of self and assisted measures with blood pressure, blood glucose, and BMI.
    RESULTS: There was a downwards bias in self measured waist (-0.81 cm) and hip (-1 cm) circumferences compared with assisted measures. The concordance for the self and assisted measures of waist, hip and the ratio of the two were, respectively, .96, .93 , and .84. The correlation between measures of central adiposity and BMI, blood pressure and blood glucose were similar for self and assisted measures.
    CONCLUSION: The results provide additional support for the use of self-measurement of waist and hip circumference studies of central adiposity, but is limited by the specificity of the setting.
  14. Allotey P, Yasin S, Tang S, Chong SL, Cheah JC, Reidpath DD
    BMC Public Health, 2012;12 Suppl 1:S1.
    PMID: 22992275
  15. Allotey P, Reidpath DD, Yasin S, Chan CK, de-Graft Aikins A
    Lancet, 2011 Feb 5;377(9764):450-1.
    PMID: 21074257 DOI: 10.1016/S0140-6736(10)61856-9
  16. Tan MM, Reidpath DD, Ting RS, Allotey P, Su TT
    J Relig Health, 2021 Jul 29.
    PMID: 34324099 DOI: 10.1007/s10943-021-01371-x
    Research has shown that religion is associated with a better quality of life (QoL). This study aims to examine ethnic differences in the association between religion and the QoL of older adults in a predominantly Muslim population within a multicultural setting. Two-wave data of 3,810 participants consisting of mostly Muslims and older adults aged ≥ 55 years were collected as part of the community health surveys conducted in 2013 and 2018 in the South East Asia Community Observatory (SEACO). Both cross-sectional analyses of baseline data and prospective analyses of longitudinal data were conducted. The associations between religiosity and quality of life were mainly positive in the cross-sectional analysis. In the two-wave analysis, religious importance was negatively associated with QoL among the Malays (B = - 1.103, SE B = 0.029, p p p p p p p 
  17. Mohan D, Stephan BC, Allotey P, Jagger C, Pearce M, Siervo M, et al.
    BMJ Open, 2017 01 19;7(1):e013635.
    PMID: 28104710 DOI: 10.1136/bmjopen-2016-013635
    INTRODUCTION: There is a growing proportion of population aged 65 years and older in low-income and middle-income countries. In Malaysia, this proportion is predicted to increase from 5.1% in 2010 to more than 15.4% by 2050. Cognitive ageing and dementia are global health priorities. However, risk factors and disease associations in a multiethnic, middle-income country like Malaysia may not be consistent with those reported in other world regions. Knowing the burden of cognitive impairment and its risk factors in Malaysia is necessary for the development of management strategies and would provide valuable information for other transitional economies.

    METHODS AND ANALYSIS: This is a community-based feasibility study focused on the assessment of cognition, embedded in the longitudinal study of health and demographic surveillance site of the South East Asia Community Observatory (SEACO), in Malaysia. In total, 200 adults aged ≥50 years are selected for an in-depth health and cognitive assessment including the Mini Mental State Examination, the Montreal Cognitive Assessment, blood pressure, anthropometry, gait speed, hand grip strength, Depression Anxiety Stress Score and dried blood spots.

    DISCUSSION AND CONCLUSIONS: The results will inform the feasibility, response rates and operational challenges for establishing an ageing study focused on cognitive function in similar middle-income country settings. Knowing the burden of cognitive impairment and dementia and risk factors for disease will inform local health priorities and management, and place these within the context of increasing life expectancy.

    ETHICS AND DISSEMINATION: The study protocol is approved by the Monash University Human Research Ethics Committee. Informed consent is obtained from all the participants. The project's analysed data and findings will be made available through publications and conference presentations and a data sharing archive. Reports on key findings will be made available as community briefs on the SEACO website.

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