Displaying publications 41 - 60 of 265 in total

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  1. Miller V, Yusuf S, Chow CK, Dehghan M, Corsi DJ, Lock K, et al.
    Lancet Glob Health, 2016 10;4(10):e695-703.
    PMID: 27567348 DOI: 10.1016/S2214-109X(16)30186-3
    BACKGROUND: Several international guidelines recommend the consumption of two servings of fruits and three servings of vegetables per day, but their intake is thought to be low worldwide. We aimed to determine the extent to which such low intake is related to availability and affordability.

    METHODS: We assessed fruit and vegetable consumption using data from country-specific, validated semi-quantitative food frequency questionnaires in the Prospective Urban Rural Epidemiology (PURE) study, which enrolled participants from communities in 18 countries between Jan 1, 2003, and Dec 31, 2013. We documented household income data from participants in these communities; we also recorded the diversity and non-sale prices of fruits and vegetables from grocery stores and market places between Jan 1, 2009, and Dec 31, 2013. We determined the cost of fruits and vegetables relative to income per household member. Linear random effects models, adjusting for the clustering of households within communities, were used to assess mean fruit and vegetable intake by their relative cost.

    FINDINGS: Of 143 305 participants who reported plausible energy intake in the food frequency questionnaire, mean fruit and vegetable intake was 3·76 servings (95% CI 3·66-3·86) per day. Mean daily consumption was 2·14 servings (1·93-2·36) in low-income countries (LICs), 3·17 servings (2·99-3·35) in lower-middle-income countries (LMICs), 4·31 servings (4·09-4·53) in upper-middle-income countries (UMICs), and 5·42 servings (5·13-5·71) in high-income countries (HICs). In 130 402 participants who had household income data available, the cost of two servings of fruits and three servings of vegetables per day per individual accounted for 51·97% (95% CI 46·06-57·88) of household income in LICs, 18·10% (14·53-21·68) in LMICs, 15·87% (11·51-20·23) in UMICs, and 1·85% (-3·90 to 7·59) in HICs (ptrend=0·0001). In all regions, a higher percentage of income to meet the guidelines was required in rural areas than in urban areas (p<0·0001 for each pairwise comparison). Fruit and vegetable consumption among individuals decreased as the relative cost increased (ptrend=0·00040).

    INTERPRETATION: The consumption of fruit and vegetables is low worldwide, particularly in LICs, and this is associated with low affordability. Policies worldwide should enhance the availability and affordability of fruits and vegetables.

    FUNDING: Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries.

    Matched MeSH terms: Poverty*
  2. Vijayasingham L, Rhule E, Asgari-Jirhandeh N, Allotey P
    Lancet Glob Health, 2019 07;7(7):e843-e844.
    PMID: 31200884 DOI: 10.1016/S2214-109X(19)30196-2
    Matched MeSH terms: Poverty
  3. Local Burden of Disease Household Air Pollution Collaborators
    Lancet Glob Health, 2022 Oct;10(10):e1395-e1411.
    PMID: 36113526 DOI: 10.1016/S2214-109X(22)00332-1
    BACKGROUND: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels.

    METHODS: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution.

    FINDINGS: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000-257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution.

    INTERPRETATION: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution.

    FUNDING: Bill & Melinda Gates Foundation.

    Matched MeSH terms: Poverty
  4. Arshad AR, Selvapragasam T
    J Craniofac Surg, 2008 Jan;19(1):175-83.
    PMID: 18216685 DOI: 10.1097/scs.0b013e3181534a77
    This is a study on 124 patients who were treated by the authors over a 19-year period. There were 48 male and 76 female patients. The age range of these patients at the time of treatment was between 4 months and 32 years. There was no family history of similar deformity. All of these patients come from a socially low-income group. Fourteen patients had accompanying congenital amputation of fingers, toes, or limbs. Two had oral cleft lip and palate. The surgical treatment was medial orbital wall osteotomy and excision of encephalocele. There were two mortalities and five patients who had complications that needed secondary surgical intervention. Thirty-eight patients are still under follow up without any complaints.
    Matched MeSH terms: Poverty
  5. Malhotra A, Elnakib S
    J Adolesc Health, 2021 05;68(5):847-862.
    PMID: 33446401 DOI: 10.1016/j.jadohealth.2020.11.017
    PURPOSE: This review assesses evaluations published from 2000 to 2019 to shed light on what approaches work, especially at scale and sustainably, to prevent child marriage in low- and middle-income countries.

    METHODS: We conducted a search of electronic databases and gray literature and evaluated the methodological quality and risk of bias of included studies.

    RESULTS: A total of 30 studies met the inclusion criteria. Interventions that support girls' schooling through cash or in-kind transfers show the clearest pattern of success in preventing child marriage, with 8 of 10 medium-high quality studies showing positive results. Although limited in number, five studies on favorable job markets and targeted life skills and livelihoods training show consistent positive results. Comparatively, asset or cash transfers conditional on delaying marriage show success only among two of four evaluations, and the three studies on unconditional cash transfers for poverty mitigation show no effect. Findings also show a low success rate for multicomponent interventions with positive results in only one of eight medium-high quality studies. Further, single component interventions were much more likely to be at scale and sustainable than multicomponent interventions.

    CONCLUSIONS: These results indicate that enhancement of girls' own human capital and opportunities is the most compelling pathway to delaying marriage. In contrast, low rates of success, scale-up, and sustainability of multicomponent programs requires reconsideration of this approach.

    Matched MeSH terms: Poverty*
  6. Townend J, Minelli C, Mortimer K, Obaseki DO, Al Ghobain M, Cherkaski H, et al.
    Eur Respir J, 2017 06;49(6).
    PMID: 28572124 DOI: 10.1183/13993003.01880-2016
    Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction.In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0-10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV1/FVC
    Matched MeSH terms: Poverty*
  7. Ngui R, Aziz S, Chua KH, Aidil RM, Lee SC, Tan TK, et al.
    Am J Trop Med Hyg, 2015 Aug;93(2):361-70.
    PMID: 26055746 DOI: 10.4269/ajtmh.13-0677
    A cross-sectional study was conducted to provide comprehensive data on the patterns and associated risk factors of soil-transmitted helminth (STH) infections among five Orang Asli subgroups in Peninsular Malaysia. The overall prevalence of STH infections was 59.9% (95% confidence interval [CI] = 56.1-63.7%). Trichuris trichiura (54.3%; 95% CI = 50.4-58.2%) was the predominant species followed by Ascaris lumbricoides (26.7%; 95% CI = 23.3-30.1%) and hookworm (9.1%; 95% CI = 6.9-11.3%). This study showed diversity for STH infections by subgroup with poverty and personal sanitary behavior as important risk factors for infection. Risk profile analyses indicating that Orang Kuala subgroup who has a generally well-developed infrastructure and better quality of life had a low rate of infection. There is a need for poverty reduction and promotion of deworming programs along with mass scale campaigns to create awareness about health and hygiene to reduce STH infections.
    Matched MeSH terms: Poverty
  8. Sahimin N, Sharif SA, Mohd Hanapi IR, Nai Chuan S, Lewis JW, Douadi B, et al.
    Am J Trop Med Hyg, 2019 12;101(6):1265-1271.
    PMID: 31628737 DOI: 10.4269/ajtmh.19-0003
    Leptospirosis is a zoonotic bacterial disease caused by pathogenic species of the genus Leptospira. Disease incidence is known to be attributed to environmental and social conditions which promote the spread of reservoir hosts, primarily rodents. A well-being program was conducted to determine the seroprevalence and risk factors associated with leptospirosis in urban poor communities occupying low-cost flat accommodation and squatter settlements in the vicinity of Wilayah Persekutuan, Kuala Lumpur. Blood samples from a total of 532 volunteers were screened for the detection of IgG and IgM antibodies against leptospirosis using ELISA. Demographic data were collected for each participant through a questionnaire survey before blood collection. The overall seroprevalence was low (12.6%, n = 67/532; 95% CI: 9.9-15.7%), with 8.1% (n = 43/532) being seropositive for anti-Leptospira IgG, indicating previous infection, and 4.9% (n = 26/532) for anti-Leptospira IgM, indicating current infection. Two significant factors such as host age (P ≤ 0.01) and knowledge of disease transmission (P = 0.017) significantly influenced the presence of anti-Leptospira IgM, whereas the detection of anti-IgG indicated the presence of clean drinking water sources (P = 0.043). Despite the low prevalence, the transmission of leptospirosis does occur among urban poor communities, suggesting the need for undertaking public awareness programs.
    Matched MeSH terms: Poverty/statistics & numerical data
  9. Azzani M, Roslani AC, Su TT
    Support Care Cancer, 2015 Mar;23(3):889-98.
    PMID: 25337681 DOI: 10.1007/s00520-014-2474-y
    PURPOSE: The escalating health-care spending for cancer management has caused cancer patients to struggle further as a result of financial burden. This systematic review was carried out to investigate the prevalence of perceived financial hardship and associated factors among cancer patients and their families.

    METHODS: A systematic search for studies concerning the perception of financial burden among cancer patients and their families was conducted. Several electronic resources such as Medline, Elsevier (Science Direct), Web of Science, Embase, PubMed, CINAHL and Scopus (SciVerse) were searched. Additionally, manual search through indices citation was also thoroughly utilized. The main outcome of interest was the prevalence of perceived financial hardship among cancer patients and their families. Studies reported only the cost of cancer treatment and qualitative studies were excluded. Our search was limited to articles that were published from 2003 to 2013.

    RESULT: Ten studies were included in this review and with a majority originating from high-income countries. The prevalence of the financial burden perception was reported between 14.8 and 78.8 %. The most frequent and significant risk factor reported associated with the perception of financial difficulty was the households with low income. Discontinuation of treatment and poverty were conversely the important consequences of financial burden in cancer patients and their families.

    CONCLUSION: Evidently, cancer is a long-term illness that requires a high financial cost, and a significant number of cancer patients and families struggle with financial difficulty. Identifying such groups with a high risk of facing financial difficulty is a crucial measure to ensure safety nets are readily available for these targeted population.

    Matched MeSH terms: Poverty
  10. Ting CY, Teh GC, Yu KL, Alias H, Tan HM, Wong LP
    Support Care Cancer, 2020 Apr;28(4):1703-1715.
    PMID: 31292755 DOI: 10.1007/s00520-019-04975-y
    PURPOSE: This study examined the prevalence of financial toxicity (FT) and associated factors among urologic cancer patients. The association between FT and health-related quality of life (HRQoL) was also investigated.

    METHODS: A total of 429 respondents diagnosed with urologic cancers (prostate cancer, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed using a structured questionnaire. Objective and subjective FT were measured by catastrophic health expenditure (healthcare-cost-to-income ratio greater than 40%) and the Personal Financial Well-being Scale, respectively. HRQoL was measured with the Functional Assessment of Cancer Therapy - General 7 Items scale.

    RESULTS: Objective and subjective FT were experienced by 16.1 and 47.3% of the respondents, respectively. Respondents who sought treatment at a private hospital and had out-of-pocket health expenditures were more likely to experience objective FT, after adjustment for covariates. Respondents who were female and had a monthly household income less than MYR 5000 were more likely to experience average to high subjective FT. Greater objective FT (OR = 2.75, 95% CI 1.09-6.95) and subjective FT (OR = 4.68, 95% CI 2.63-8.30) were associated with poor HRQoL.

    CONCLUSIONS: The significant association between both objective and subjective FT and HRQoL highlights the importance of reducing FT among urologic cancer patients. Subjective FT was found to have a greater negative impact on HRQoL.

    Matched MeSH terms: Poverty/psychology
  11. Parra-Mujica F, Roope LS, Abdul-Aziz A, Mustapha F, Ng CW, Rampal S, et al.
    Soc Sci Med, 2024 Jan;340:116426.
    PMID: 38016309 DOI: 10.1016/j.socscimed.2023.116426
    In the context of the escalating burden of diabetes in low and middle-income countries (LMICs), there is a pressing concern about the widening disparities in care and outcomes across socioeconomic groups. This paper estimates health poverty measures among individuals with type 2 diabetes mellitus (T2DM) in Malaysia. Using data from the National Diabetes Registry between 2009 and 2018, the study linked 932,855 people with T2DM aged 40-75 to death records. Cox proportional hazards models were used to estimate the 5-year survival probabilities for each patient, stratified by age and sex, while controlling for comorbidities and area-based indicators of socio-economic status (SES), such as district-level asset-based indices and night-time luminosity. Measures of health poverty, based on the Foster-Greer-Thorbecke (FGT) measures, were employed to capture excessive risk of premature mortality. Two poverty line thresholds were used, namely a 5% and 10% reduction in survival probability compared to age and sex-adjusted survival probability of the general population. Counterfactual simulations estimated the extent to which comorbidities contribute to health poverty. 43.5% of the sample experienced health poverty using the 5% threshold, and 8.9% were health poor using the 10% threshold. Comorbidities contribute 2.9% for males and 5.4% for females, at the 5% threshold. At the 10% threshold, they contribute 7.4% for males and 3.4% for females. If all patients lived in areas of highest night-light intensity, poverty would fall by 5.8% for males and 4.6% for females at the 5% threshold, and 4.1% for males and 0.8% for females at the 10% threshold. In Malaysia, there is a high incidence of health poverty among people with diabetes, and it is strongly associated with comorbidities and area-based measures of SES. Expanding the application of health poverty measurement, through a combination of clinical registries and open spatial data, can facilitate simulations for health poverty alleviation.
    Matched MeSH terms: Poverty
  12. Kimenyu P, Oyaro N, Chacha J, Tsanuo M
    Population in urban centers in Kenya is increasing rapidly due to rural urban migration in search of better paying jobs. This migration has resulted in unauthorized settlements in the various urban centers. The income per capital of these people is less than a dollar a day. The amount of money is inadequate for survival and this has resulted into cultivating on open grounds for food crops. Unfortunately, these slums have come up along rivers, which carry, wastewater from household and industries. This wastewater is rich in heavy metals and the inhabitants of these areas use this contaminated water for irrigating their crops. The food crops from such areas have very high levels of heavy metals. The present study has screened Zea mays, Commelina bengalensis and Amaranthus hybridus for their ability to bioaccumulate these metals from contaminated soils using atomic absorption spectrophotometer (AAS). The results obtained showed that the C. bengalensis has high potential for removal of Cu, Pb and Cd metals as compared to the Zea mays and Amaranthus hybridus even though, results showed that C. bengalensis has a low potential for the removal of Zn as compared to Zea mays and Amaranthus hybridus.
    Matched MeSH terms: Poverty Areas
  13. Maniam T, L. F. Chan
    Sains Malaysiana, 2013;42:399-402.
    Suicide studies in Malaysia tend to be repetitive. Data from hospital studies, small scale community surveys and national epidemiological studies over nearly 50 years have consistently shown that there are real ethnic differences in terms of suicides and attempted suicides in this country, though some of these differences appear to be narrowing somewhat. Malays have shown significantly lower rates of suicidal ideas, attempts and completed suicides. Indians, on the other hand, figure prominently at the other end with high rates in all the above parameters. The reasons for these are also necessarily complex. Experience elsewhere from studies of the Indian diaspora have elucidated a number of explanations, which include the effects of poverty, acculturation, alcoholism, the lack of a strong religious protective factor as well as increased rates of mental ill-health. Efforts to contain this public health problem have been somewhat patchy. This has largely depended on efforts by non-government organizations such as the Befrienders whereas the public response
    lags behind in providing the financial and other resources necessary for a comprehensive national program. This paper reviews the relevant literature and suggest new areas for research as well as steps to provide a fresh impetus to suicide prevention in Malaysia.
    Matched MeSH terms: Poverty
  14. Mostak Ahmed, Noorlidah Abdullah, Nuruddin MM
    Sains Malaysiana, 2016;45:1609-1615.
    In recent decades, minimizing the frequency of nutrient deficiency and malnutrition in rural areas of developing
    countries becomes an alarming issue. Oyster mushrooms are rich source of both macro and micro nutrients. The
    objective of this paper was to evaluate the yield of newly introduced oyster mushroom strains viz. Pleurotus sajorcaju
    (PSC), Pleurotus flabellatus (FLB), Pleurotus florida (FLO), Pleurotus ostreatus (PO2
    and PO3
    ), Pleurotus ostreatus
    (HK-51) and Pleurotus geesteranus (PG1
    and PG3
    ) and to justify their nutritional values when grown in the climatic
    condition of Bangladesh. Strain HK-51 produced the highest amount of fresh sporophore (197.80 g). In contrast, the
    highest number of fruiting body was obtained from the strain FLO (82 g) followed by strain PSC (69 g). Strain PG1 has
    recorded the highest biological yield (278 g), productivity (55%) and biological efficiency (96%). Nutrient and mineral
    analysis of sporophore of strain PG1 showed protein (31.80%), lipid (3.6%), potassium (1.3 mg/100 g), phosphorus
    (0.8 mg/100 g), calcium (32 mg/100 g), iron (43 mg/100 g), magnesium (12 mg/100 g), copper (3.5 mcg/100 g), zinc
    (12.5 mcg/100 g) and manganese (2.3 mcg/100 g). This study showed that the strain PG1
    performed well with regard to
    quality and productivity as compared to other strains. Hence, oyster mushroom strain PG1
    is a potential cheap source
    of nutrients and minerals to combat socioeconomic problems including malnutrition, diseases linked to malnutrition,
    poverty reduction and agricultural diversity.
    Matched MeSH terms: Poverty
  15. Cheah WL, Wan Muda WAM, Zamh ZH
    Rural Remote Health, 2010;10(1):1248.
    PMID: 20184392
    Many studies had shown that poor growth in children is associated with malnutrition. The underlying factors are diverse, multisectoral and interrelated, ranging from biological to social, cultural and economically related. Because the highest levels of under-nutrition worldwide are found in South Asia, it is essential that policymakers in the region understand the underlying determinants, in order to design effective public health intervention programs. This is especially so if public resources are limited. The purpose of this cross-sectional study was to examine causal relationships among the biological, behavioural and environmental factors related to malnutrition in children aged 5 years and under.
    Matched MeSH terms: Poverty
  16. 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: Poverty
  17. Sreeramareddy CT, Ramakrishnareddy N, Subramaniam M
    Public Health Nutr, 2015 Nov;18(16):2906-14.
    PMID: 25435296 DOI: 10.1017/S1368980014002729
    OBJECTIVE: To examine the association between household food insecurity score and Z-scores of childhood nutritional status indicators.

    DESIGN: Population-based, cross-sectional survey, Nepal Demographic and Health Survey 2011.

    SETTING: A nationally representative sample of 11 085 households selected by a two-stage, stratified cluster sampling design to interview eligible men and women.

    SUBJECTS: Children (n 2591) aged 0-60 months in a sub-sample of households selected for men's interview.

    RESULTS: Prevalence of moderate and severe household food insecurity was 23·2% and 19·0%, respectively, for children aged 0-60 months. Weighted prevalence rates for stunting (height-for-age Z-score (HAZ)

    Matched MeSH terms: Poverty*
  18. Foong HF, Haron SA, Koris R, Hamid TA, Ibrahim R
    Psychogeriatrics, 2021 Jul;21(4):586-595.
    PMID: 33969594 DOI: 10.1111/psyg.12709
    BACKGROUND: Low financial well-being is a common predicament among older adults living in poverty. The existing literature suggests a correlation between financial well-being and mental health in old age. Therefore, this study aimed to identify the relationships among financial well-being, life satisfaction, and cognitive function among low-income older adults and to examine the moderating effect of sex on these relationships.

    METHODS: This study involved 2004 nationally representative community-dwelling older Malaysians from the bottom 40% household income group. Financial well-being was assessed by the four-item financial satisfaction scale, while life satisfaction was measured by the Satisfaction with Life Scale. Cognitive function was measured by using the Malay version of the Mini-Mental State Examination. Hierarchical multiple regression was used as the prime method for statistical analysis.

    RESULTS: Financial well-being was positively associated with life satisfaction and cognitive function. Sex moderated the relationship between financial well-being and life satisfaction but not between financial well-being and cognitive function.

    CONCLUSIONS: Financial well-being and life satisfaction were strongly correlated among older women, although no gender difference was found for the relationship between financial well-being and cognitive function. It appears financial well-being strongly predicts mental health. As such, poverty eradication initiatives targeting low-income older adults should be implemented to sustain life satisfaction and cognitive function.

    Matched MeSH terms: Poverty
  19. Subramaniam S, Kong YC, Chinna K, Kimman M, Ho YZ, Saat N, et al.
    Psychooncology, 2018 09;27(9):2172-2179.
    PMID: 29856903 DOI: 10.1002/pon.4787
    OBJECTIVES: Quality of life and psychological well-being are important patient-centered outcomes, which are useful in evaluation of cancer care delivery. However, evidence from low-income and middle-income countries remains scarce. We assessed health-related quality of life (HRQoL) and prevalence of psychological distress (anxiety or depression), as well as their predictors, among cancer survivors in a middle-income setting.

    METHODS: Through the Association of Southeast Asian Nations Costs in Oncology study, 1490 newly diagnosed cancer patients were followed-up in Malaysia for 1 year. Health-related quality of life was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EuroQol-5 (EQ-5D) dimension questionnaires at baseline, 3 and 12 months. Psychological distress was assessed by using Hospital Anxiety and Depression Scale. Data were modeled by using general linear and logistic regressions analyses.

    RESULTS: One year after diagnosis, the mean EORTC QLQ-C30 Global Health score of the cancer survivors remained low at 53.0 over 100 (SD 21.4). Fifty-four percent of survivors reported at least moderate levels of anxiety, while 27% had at least moderate levels of depression. Late stage at diagnosis was the strongest predictor of low HRQoL. Increasing age, being married, high-income status, hospital type, presence of comorbidities, and chemotherapy administration were also associated with worse HRQoL. The significant predictors of psychological distress were cancer stage and hospital type.

    CONCLUSION: Cancer survivors in this middle-income setting have persistently impaired HRQoL and high levels of psychological distress. Development of a holistic cancer survivorship program addressing wider aspects of well-being is urgently needed in our settings.

    Matched MeSH terms: Poverty/psychology*; Poverty/statistics & numerical data
  20. Sreeramareddy CT, Pradhan PM, Mir IA, Sin S
    Popul Health Metr, 2014;12:22.
    PMID: 25183954 DOI: 10.1186/s12963-014-0022-0
    BACKGROUND: In South and Southeast Asian countries, tobacco is consumed in diverse forms, and smoking among women is very low. We aimed to provide national estimates of prevalence and social determinants of smoking and smokeless tobacco use among men and women separately.
    METHODS: Data from Demographic and Health Surveys completed in nine countries (India, Pakistan, Nepal, Bangladesh, Maldives, Philippines, Cambodia, Indonesia, and Timor Leste) were analyzed. Current smoking or smokeless tobacco use was assessed as response "yes" to one or more of three questions, such as "Do you currently smoke cigarettes?" Weighted country-level prevalence rates for socio-economic subgroups were calculated for smoking and smokeless tobacco use. Binary logistic regression analyses were done on STATA/IC (version 10) by 'svy' command.
    RESULTS: Prevalence and type of tobacco use among men and women varied across the countries and among socio-economic sub groups. Smoking prevalence was much lower in women than men in all countries. Smoking among men was very high in Indonesia, Maldives, and Bangladesh. Smokeless tobacco (mainly chewable) was used in diverse forms, particularly in India, among both men and women. Chewing tobacco was common in Nepal, Bangladesh, Maldives, and Cambodia. Both smoking and smokeless tobacco use were associated with higher age, lower education, and poverty, but their association with place of residence and marital status was not uniform between men and women across the countries.
    CONCLUSION: Policymakers should consider type of tobacco consumption and their differentials among various population subgroups to implement country-specific tobacco control policies and target the vulnerable groups. Smokeless tobacco use should also be prioritized in tobacco control efforts.
    KEYWORDS: Prevalence; Smokeless tobacco use; Smoking; Social determinants; South and Southeast Asia
    Matched MeSH terms: Poverty
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