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Fulltext The Malaysian health reform in primary health care services

Aniza I, Jamsiah M, Amin SA, Ali M, Munizam AM

Malaysian Journal of Community Health, 2008;14(2):1-10.
MyJurnal

Introduction : Family Health Development Division is one of the earliest divisions in Public Health Department, Ministry of Health Malaysia. The division has progressed each year with the extension and expansion of the scopes of services since the establishment of Maternal and Child Health Unit in 1956. The services currently include school children, adolescent, adult and elderly health and also known as life-course perspective: from womb to tomb.
Objectives : The objective is to elaborate and explain the reformation of primary health care services implemented in the past and present.
Methods : The methodology applied is compilation, data review and comparison from annual report, action plan report, articles, speeches, specialists and stake holder view.
Results : The focus of Primary Health Care Service is covering health promotion, disease prevention, early detection and treatment, acute disease care, disease limitation and rehabilitation, clinical support services and teleprimary care. The reformation is caused by factors such as globalization, modernization, growth of health market, emergence and re-emergence of diseases, and development of medical technology. Three health fields that have underwent and under going reformation are concept and wellness practise in primary healthcare, primary healthcare clinical support services development and primary healthcare informatics development. The outcome of these reformations is the increment of service quality and outstanding services for patients and health staffs.
Conclusion : Health reformation in primary healthcare is greatly needed to give excellent services for primary health care for today and future.

Matched MeSH terms: Public Health
Methicillin-resistant Staphylococcus aureus bacteraemia, 2003-2015: Comparative evaluation of changing trends in molecular epidemiology and clinical outcomes of infections

Niek WK, Teh CSJ, Idris N, Sit PS, Lee YQ, Thong KL, et al.

Infect Genet Evol, 2020 11;85:104567.
PMID: 32980576 DOI: 10.1016/j.meegid.2020.104567

Methicillin-resistant Staphylococcus aureus (MRSA) is a prominent pathogen causing invasive infections such as bacteraemia. The continued excessive use of antibiotics to treat MRSA infections has resulted in the evolution of antimicrobial resistant of S. aureus. This study aims to perform a comparative evaluation of changing trends in molecular epidemiology of MRSA and clinical characteristics of patients. This study shows that ST22-MRSA-IV has gradually replaced ST239-MRSA-III as the predominant MRSA clone in the tertiary teaching hospital studied. Independent predictors of mortality among patients included devices in situ at the time of infection, pre-exposure to macrolides, catheter-related bloodstream infection and mono-microbial infection. Hence, our study affirmed community-associated MRSA, which was previously identified from individuals without any exposure to healthcare settings, has now emerged in healthcare settings, causing healthcare-associated MRSA infections.

Matched MeSH terms: Public Health Surveillance
Fulltext Risk factors of depression, anxiety and stress among adults attending primary health clinics in an urban area in Klang Valley, Malaysia

Abd Rahman R, Idris IB, Husnina Ibrahim

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):240-246.
MyJurnal

Introduction: Mental health problem is an important public health issue which causes deterioration in quality of life, function and financial capabilities. According to the National Health and Morbidity Survey (NHMS) 1996, the prevalence of mental problem among adults in Malaysia was 10.7% and this has increased to 29.2% in NHMS 2015. The aim of this study was to evaluate the burden of depression, anxiety and stress among adults in a city in Klang Valley, Malaysia including its associated factors.
Methods: A cross-sectional study was conducted by analysing secondary data obtained from screening program performed in six primary health clinics in the city throughout 2016. There were 576 adults participated in the screening program which consisted of mental health screening using Depression, Anxiety, Stress 21 (DASS-21) questionnaire and health status screening using Health Status Screening Form.
Results: The prevalence of depression was 20.5%, anxiety was 44.5%, while stress was 10.1%. By using logistic regression, history of being abused was the only significant protective factor associated with depression, anxiety and stress with OR of 0.062 (95% CI 0.007; 0.563, p=0.004), OR of 0.001 (95% CI 0.000; -, p=0.001) and OR of 0.026 (95% CI 0.003; 0.238, p<0.001) respectively. Other independent variables were not statistically significant.
Conclusions: As conclusions, surprisingly the risk of depression, anxiety and stress were not increased among participants who reported history of being abused. This was probably due to good coping mechanism among them. Nevertheless, early intervention needs to be emphasized to prevent mental disorders among this group of people in community.
Keywords: Depression, Anxiety, Stress, Adults, Urban

Matched MeSH terms: Public Health
Fulltext Examining depressive symptoms and their predictors in Malaysia: stress, locus of control, and occupation

Yeoh SH, Tam CL, Wong CP, Bonn G

Front Psychol, 2017;8:1411.
PMID: 28878710 DOI: 10.3389/fpsyg.2017.01411

The 2015 National Health and Morbidity Survey estimated that over 29% of the adult population of Malaysia suffers from mental distress, a nearly 3-fold increase from the 10.7% estimated by the NHMS in 1996 pointing to the potential beginnings of a public health crisis. This study aimed to better understand this trend by assessing depressive symptoms and their correlates in a cross-section of Malaysians. Specifically, it assesses stress, perceived locus of control, and various socio-demographic variables as possible predictors of depressive symptoms in the Malaysian context. A total of 728 adults from three Malaysian states (Selangor, Penang, Terengganu) completed Beck's depression inventory as well as several other measures: 10% of respondents reported experiencing severe levels of depressive symptoms, 11% reported moderate and 15% reported mild depressive symptoms indicating that Malaysians are experiencing high levels of emotional distress. When controlling for the influence of other variables, depressive symptoms were predictably related to higher levels of stress and lower levels of internal locus of control. Ethnic Chinese Malaysians, housewives and those engaged in professional-type occupations reported less depressive symptoms. Business owners reported more depressive symptoms. Further research should look more into Malaysians' subjective experience of stress and depression as well as explore environmental factors that may be contributing to mental health issues. It is argued that future policies can be designed to better balance individual mental health needs with economic growth.

Matched MeSH terms: Public Health
Fulltext Diagnostics to support elimination of lymphatic filariasis-Development of two target product profiles

Won KY, Gass K, Biamonte M, Dagne DA, Ducker C, Hanna C, et al.

PLoS Negl Trop Dis, 2021 11;15(11):e0009968.
PMID: 34780503 DOI: 10.1371/journal.pntd.0009968

As lymphatic filariasis (LF) programs move closer to established targets for validation elimination of LF as a public health problem, diagnostic tools capable of supporting the needs of the programs are critical for success. Known limitations of existing diagnostic tools make it challenging to have confidence that program endpoints have been achieved. In 2019, the World Health Organization (WHO) established a Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases tasked with prioritizing diagnostic needs including defining use-cases and target product profiles (TPPs) for needed tools. Subsequently, disease-specific DTAG subgroups, including one focused on LF, were established to develop TPPs and use-case analyses to be used by product developers. Here, we describe the development of two priority TPPs for LF diagnostics needed for making decisions for stopping mass drug administration (MDA) of a triple drug regimen and surveillance. Utilizing the WHO core TPP development process as the framework, the LF subgroup convened to discuss and determine attributes required for each use case. TPPs considered the following parameters: product use, design, performance, product configuration and cost, and access and equity. Version 1.0 TPPs for two use cases were published by WHO on 12 March 2021 within the WHO Global Observatory on Health Research and Development. A common TPP characteristic that emerged in both use cases was the need to identify new biomarkers that would allow for greater precision in program delivery. As LF diagnostic tests are rarely used for individual clinical diagnosis, it became apparent that reliance on population-based surveys for decision making requires consideration of test performance in the context of such surveys. In low prevalence settings, the number of false positive test results may lead to unnecessary continuation or resumption of MDA, thus wasting valuable resources and time. Therefore, highly specific diagnostic tools are paramount when used to measure low thresholds. The TPP process brought to the forefront the importance of linking use case, program platform and diagnostic performance characteristics when defining required criteria for diagnostic tools.

Matched MeSH terms: Public Health
Fulltext Maternal obesity and its determinants: A neglected issue?

Nurul-Farehah S, Rohana AJ

Malays Fam Physician, 2020;15(2):34-42.
PMID: 32843943

Maternal obesity is a global public health concern that affects every aspect of maternity care. It affects the short-term and long-term health of the mother and her offspring. Obese pregnant mothers are at an increased risk of developing complications during antenatal, intrapartum, and postnatal periods. Maternal complications include gestational diabetes mellitus, hypertensive disorder in pregnancy, pre-eclampsia and eclampsia, increased rate of cesarean delivery, pulmonary embolism, and maternal mortality; fetal complications include congenital malformation, stillbirth, and macrosomia. Moreover, both mother and infant are at an increased risk of developing subsequent non-communicable diseases and cardiovascular problems later in life. Several factors are associated with the likelihood of maternal obesity, including sociodemographic characteristics, obstetric characteristics, knowledge, and perception of health-promoting behavior. Gaining a sound understanding of these factors is vital to reaching the targets of Sustainable Developmental Goal 3-to reduce global maternal mortality and end preventable deaths of children under 5 years of age-by 2030. It is essential to identify pregnant women who are at risk of maternal obesity in order to plan and implement effective and timely interventions for optimal pregnancy outcomes. Importantly, maternal obesity as a significant pregnancy risk factor is largely modifiable.

Matched MeSH terms: Public Health
Fulltext Helminthiasis among Indian preschoolers from urban areas in Penang

Vikneswaran Sabramani, Halim Ismail, Asrul Abdul Wahab

Int J Public Health Res, 2015;5(2):584-591.
MyJurnal

Introduction Helminthiasis is a common parasitic condition particularly among children in
rural areas in developing countries where poor hygiene standard is practiced.
The study aimed to determine the prevalence of helminthiasis among Indian
preschoolers in urban areas in Penang and its associated factors.

Methods A total of 194 urban Indian preschoolers aged 4 to 6 years old were selected
randomly from 11 kindergartens in the state of Penang for this cross sectional
study. Data collection was carried out in 2 phases. First, microscopic stool
examinations were done to examine the presence of helminths. Second, self
administered questionnaires which inquired about human, environment and
socioeconomic factors were completed by the parents/guardians.

Results The overall prevalence of helminthiasis was 7.2% and the most frequently
encountered infective agent was Ascaris lumbricoides (57.1%) and followed
by the tapeworms (42.86%). The logistic regression indicated that habitual
thumb sucking (AOR= 5.6. 95%CI: 1.73-18.39) and families owning
domestic pets (AOR= 3.2; 95%CI: 1.03-10.14) were the significant
contributing factors to helminthiasis among the Indian pre-schoolers in urban
Penang. Although the prevalence of helminth infection among the urban
Indian preschoolers is lower than rural area, it is still a public health concern.
Children habitual thumb sucking and rearing domestic pets at home were the
significant contributing factors in helminthiasis.

Conclusion Prevention strategy should focus on health education and promotion among
adults and children, awareness on domestic animal hygiene and maintaining
good environmental sanitation. Multi agency collaboration is clearly
essential, especially between state health, education and veterinary
departments in curbing this disease.

Matched MeSH terms: Public Health
Current Technology in the Discovery and Development of Novel Antibacterials

Chung PY

Curr Drug Targets, 2018;19(7):832-840.
PMID: 28891454 DOI: 10.2174/1389450118666170911114604

BACKGROUND: Bacterial resistance to antibiotics is one of the most serious challenge to global public health. The introduction of new antibiotics in clinical settings, i.e. agents that belong to a new class of antibacterials, act on new targets or has a novel mechanisms of action, may not be sufficient to cope with the emergence of multidrug-resistant pathogens such as Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii and Escherichia coli, which are increasingly prevalent in healthcare settings in Europe, the USA and Asia. Hence, coordinated efforts in minimizing the risk of spread of resistant bacteria and renewing research efforts in the search for novel antibacterial agents are urgently needed to manage this global crisis.
OBJECTIVE: This review highlights the challenges and potential in using current technologies in the discovery and development of novel antibacterial agents to keep up with the constantly evolving resistance in bacteria.
CONCLUSION: With the explosion of bacterial genomic data and rapid development of new sequencing technologies, the understanding of bacterial pathogenesis and identification of novel antibiotic targets have significantly improved.

Matched MeSH terms: Public Health
Impact of human Campylobacter infections in Southeast Asia: The contribution of the poultry sector

Premarathne JMKJK, Satharasinghe DA, Huat JTY, Basri DF, Rukayadi Y, Nakaguchi Y, et al.

Crit Rev Food Sci Nutr, 2017 Dec 12;57(18):3971-3986.
PMID: 28001082 DOI: 10.1080/10408398.2016.1266297

Campylobacter is globally recognized as a major cause of foodborne infection in humans, whilst the development of antimicrobial resistance and the possibility of repelling therapy increase the threat to public health. Poultry is the most frequent source of Campylobacter infection in humans, and southeast Asia is a global leader in poultry production, consumption, and exports. Though three of the world's top 20 most populated countries are located in southeast Asia, the true burden of Campylobacter infection in the region has not been fully elucidated. Based on published data, Campylobacter has been reported in humans, animals, and food commodities in the region. To our knowledge, this study is the first to review the status of human Campylobacter infection in southeast Asia and to discuss future perspectives. Gaining insight into the true burden of the infection and prevalence levels of Campylobacter spp. in the southeast Asian region is essential to ensuring global and regional food safety through facilitating improvements in surveillance systems, food safety regulations, and mitigation strategies.

Matched MeSH terms: Public Health
Fulltext Undiagnosed type 2 diabetes mellitus and its risk factors among Malaysians: findings of a nationwide study

Hasimah Ismail, Mohd Azahadi Omar, Tahir Aris, Rashidah Ambak, Mohammad Fadhli Mohd Yusoff, Lim, Kuang Kuay, et al.

Int J Public Health Res, 2016;6(1):677-684.
MyJurnal

Introduction The prevalence of Type 2 diabetes mellitus (T2DM) is increasing worldwide
and many of these affected individuals remain unidentified. Undiagnosed
T2DM may impose substantial public health implications because these
individuals remain untreated and at risk for complications. The objective of
this study was to determine the national prevalence of undiagnosed T2DM
and to identify the associated risk factors.

Methods A nationwide cross-sectional study was conducted involving 17,783
respondents. Two-stage stratified sampling design was used to select a
representative sample of the Malaysian adult population. Structured
validated questionnaires with face to face interviews were used to obtain
data. Respondents, who claimed that they were not having diabetes, were
then asked to perform a fasting blood glucose finger-prick test by Accutrend
GC machine.

Results The prevalence of undiagnosed T2DM was 8.9% (n=1587). The highest
percentage of undiagnosed T2DM was found among males (10.2%), 55-59
years old (13.4%), highest education attainers of primary school (11.1%),
Indians (10.3%), married (10.3%), working (8.9%) and living in the urban
areas (9.2%). Multivariate analyses showed that factors associated with
undiagnosed T2DM were gender, age group, ethnicity, marital status, obesity
and hypertension.

Conclusion This study found an increasing trend of undiagnosed T2DM in Malaysia
compared to 2006. This finding is alarming as risk factors associated with
undiagnosed diabetes were related to most of the socio-demographic factors
studied. Therefore, early diabetic screening is crucial especially among adults
aged 30 and above to prevent more serious complications of this disease.

Matched MeSH terms: Public Health
Fulltext Knowledge on Alzheimer's Disease among Public Hospitals and Health Clinics Pharmacists in the State of Selangor, Malaysia

Mat Nuri TH, Hong YH, Ming LC, Mohd Joffry S, Othman MF, Neoh CF

Front Pharmacol, 2017;8:739.
PMID: 29123479 DOI: 10.3389/fphar.2017.00739

The prevalence of Alzheimer's disease (AD) has increased with the fast growing of aging population, thereby posing great challenges to provision of care for AD patients. Pharmacists play a vital role in the management of AD; this includes recognizing early symptoms of AD, providing medication counseling to AD patients and their caretakers, and identifying potential adverse drug reactions. A comprehensive understanding of the disease progression, as well as the pharmacological therapy, is essential to provide effective care to AD patients. The level of knowledge about AD among the pharmacists, however, remains unknown. Hence, this study aimed to assess the knowledge on AD among the pharmacists in public hospitals and health clinics and its correlates. A clear picture of the characteristics associated with different levels of knowledge could facilitate the targeted re-training of pharmacists. The 30-item validated Alzheimer disease knowledge scale (ADKS) tool was pilot-tested and used in this cross-sectional study. All pharmacists, from nine public hospitals and seven public health clinics in the State of Selangor, Malaysia, were invited to participate in this cross-sectional survey. The ADKS score was computed and compared across demographics characteristics. A total of 445 pharmacists responded to the survey. These pharmacists had a moderate overall score in ADKS; nevertheless, high scores were recorded in the domains of treatment management and care giving. No difference in AD knowledge was found among pharmacists worked in public hospitals and health clinics, except for the domain of care giving (p = 0.033). Ethnicity and age group were independent predictors of ADKS score in the current study. The pharmacists in the current study had moderate AD knowledge. On-going education and training programme on AD, in particular the domains other than treatment management and care giving, should be provided to the pharmacists to ensure delivery of quality care to AD patients.
Study site: Klinik Kesihatan, Hospitals, Selangor, Malaysia

Matched MeSH terms: Public Health
Fulltext Epidemiology, Diagnosis, and Risk Factors of Helicobacter pylori Infection in Children

Ozbey G, Hanafiah A

Euroasian J Hepatogastroenterol, 2017 Jan-Jun;7(1):34-39.
PMID: 29201769 DOI: 10.5005/jp-journals-10018-1208

H. pylori infection is a global public health problem associated with some gastrointestinal diseases in children, especially in developing countries, since prevalence of H. pylori is low in the developed world. Both noninvasive (stool antigen test, urea breath test, and blood test) and invasive (histology, rapid urease test, and microbiological culture) tests have been utilized to detect H. pylori infection. However, a single test is not reliable enough and does not provide accurate enough data to determine H. pylori infection among children. Risk factors of H. pylori infection in children were related to ethnicities, household properties, geographic location, living conditions, water sources, type of housing, presence/absence of sewage systems, and garbage collection within the living environment. These risk factors were usually associated with the socioeconomic status of the family. This review article aims to determine the gaps in the knowledge of the epidemiology, risk factors, and diagnostic tests of H. pylori infection among children. How to cite this article: Ozbey G, Hanafiah A. Epidemiology, Diagnosis, and Risk Factors of Helicobacter pylori Infection in Children. Euroasian J Hepato-Gastroenterol 2017;7(1):34-39.

Matched MeSH terms: Public Health
Fulltext Utilization and Impact of Electronic and Print Media on the Patients' Health Status: Physicians' Perspectives

Shakeel S, Nesar S, Rahim N, Iffat W, Ahmed HF, Rizvi M, et al.

J Pharm Bioallied Sci, 2017 Oct-Dec;9(4):266-271.
PMID: 29456378 DOI: 10.4103/jpbs.JPBS_327_16

Aims: Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors' opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients.
Setting and Design: The current research is a cross-sectional study conducted from January 2015 to July 2015. The study population comprised physicians rendering their services in different hospitals of Karachi, Pakistan, selected by the nonprobability convenience sampling technique. In this study, 500 questionnaires were distributed through email or direct correspondence.
Methods and Materials: Physicians' perception toward the impact of electronic and print media on the health status of patients was assessed with a 20-item questionnaire. Different demographic characteristics, such as age, gender, institution, position, and experience of respondents, were recorded. Quantitative data were analyzed with the use of Statistical Package for Social Sciences, version 20.0 (SPSS, Chicago, IL). The association of the demographic characteristics of the responses of physicians was determined by one-way ANOVA using 0.05 level of significance.
Results: In this study, 254 physicians provided consent to show their responses for research purposes. A response rate of 50.8% was obtained. Nearly one-third of the respondents negated that patients get health benefit using electronic and print media. The majority did not consider electronic and print media as lifestyle-modifying factors. Physicians thought that patients particularly do not rely on mass media for acquiring health information and consider healthcare professionals as unswerving information resource.
Conclusions: Mass media can be productive resources to augment awareness among patients, although physicians seem unconvinced about the extended usage of print/electronic media.

Matched MeSH terms: Public Health
Fulltext Needs of exploring the burden of recent onset seizures due to neurocysticercosis and challenges in southeast Asia focusing on scenario in Malaysia

Sahu PS, Lim YAL, Mahmud R, Somanath SD, Tan CT, Ramachandran CP

Asian Pac J Trop Med, 2017 Apr;10(4):332-340.
PMID: 28552103 DOI: 10.1016/j.apjtm.2017.03.024

Seizures due to neurocysticercosis (NCC) is a neglected human-to-human transmitted disorder and an emerging problem worldwide. A substantial portion of recent onset seizures is known to be attributed to NCC in Taenia solium (T. solium) endemic areas where populations which neither raise pigs nor eat pig meat are also at risk. High prevalence of NCC causing epilepsy has been reported in the underdeveloped areas of Southeast Asia (SEA) however, only fragmentary information on its incidence is available in countries like Malaysia. In Malaysia T. solium infection was previously thought to be infrequent due to Muslim population majority and the religious prohibition of consuming pork, but it is not totally absent. There is an evident lack of knowledge and awareness of the actual burden, routes of transmission, and the impact of NCC in this region. The problem is assumed to be more prevalent particularly in cities because of the frequent inflow of possibly T. solium infected individuals or carriers among those who migrate from neighboring endemic countries to Malaysia. The issue of imported cases that are likely to be emerging in Malaysia is highlighted here. An accurate quantification of regional burdens of epilepsy due to NCC in Malaysia is warranted considering the disease emergence in its neighboring countries. It is suggested that the importance of NCC be recognized through quantification of its burden, and also to collect epidemiological data for its subsequent elimination in line of World Health Organization's mission for control of cysticercosis as a neglected tropical disease. In this review the need as well as a strategy for neuro-care center screening of epilepsy cases, and various issues with possible explanations are discussed. It is also proposed that NCC be declared as a reportable disease which is one of the eradicable public health problems in SEA.

Matched MeSH terms: Public Health
Fulltext Influencing factors for household water quality improvement in reducing diarrhoea in resource-limited areas

Zin T, Mudin KD, Myint T, Naing DKS, Sein T, Shamsul BS

WHO South East Asia J Public Health, 2013 Jan-Mar;2(1):6-11.
PMID: 28612817 DOI: 10.4103/2224-3151.115828

BACKGROUND AND OBJECTIVES: Water and sanitation are major public health issues exacerbated by rapid population growth, limited resources, disasters and environmental depletion. This study was undertaken to study the influencing factors for household water quality improvement for reducing diarrhoea in resource-limited areas.

MATERIALS AND METHODS: Data were collected from articles and reviews from relevant randomized controlled trials, new articles, systematic reviews and meta-analyses from PubMed, World Health Organization (WHO), United Nations Children's Fund (UNICEF) and WELL Resource Centre For Water, Sanitation And Environmental Health.

DISCUSSION: Water quality on diarrhoea prevention could be affected by contamination during storage, collection and even at point-of-use. Point-of-use water treatment (household-based) is the most cost-effective method for prevention of diarrhoea. Chemical disinfection, filtration, thermal disinfection, solar disinfection and flocculation and disinfection are five most promising household water treatment methodologies for resource-limited areas.

CONCLUSION: Promoting household water treatment is most essential for preventing diarrhoeal disease. In addition, the water should be of acceptable taste, appropriate for emergency and non-emergency use.

Matched MeSH terms: Public Health
Prevalence and predictors of poor sleep quality among secondary school students in Gombak District, Selangor

Kesintha A, Rampal L, Sherina MS, Kalaiselvam T

Med J Malaysia, 2018 02;73(1):31-40.
PMID: 29531200 MyJurnal

INTRODUCTION: Poor sleep quality among adolescents is becoming a major worldwide concern and is widely recognized as a significant public health issue.
OBJECTIVES: To determine the prevalence and predictors of poor sleep quality among secondary school students in Gombak District, Selangor.
METHODS: A cross-sectional study was conducted in Gombak District. The sample size was 1,092 based on two group comparison formula. Students were selected using sampling with probability to proportionate to size. Selfadministered pretested questionnaires were used to collect the data. The data were analysed using the Statistical Package for Social Sciences (SPSS) version 22. Chi-square or Fisher's exact test was performed to determine the association between individual categorical variables and sleep quality. Variables with p-value <0.25 were selected to be subjected into multivariate logistic regression to determine the predictors.
RESULTS: The response rate was 93.0%. The prevalence of poor sleep quality was 24.0% (95% CI = 21.5, 26.6). Based on the analysis of simple logistic regression seven variables that were significantly associated with poor sleep quality were age, gender, marital status of parents, depression, anxiety, stress and academic performance found fit in the model. Multivariate logistic analysis showed that the significant predictors of poor sleep quality were age, marital status of parents, depression, anxiety, stress and academic performance. Factors that were not statistically significant were gender, religion, ethnicity, parent's educational level and family income.
CONCLUSIONS: Prevalence of poor sleep quality among adolescents is high. The predictors of poor sleep quality are age, marital status of parents, depression, anxiety, stress and academic performance.

Matched MeSH terms: Public Health
Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions

Sayed S, Cherniak W, Lawler M, Tan SY, El Sadr W, Wolf N, et al.

Lancet, 2018 05 12;391(10133):1939-1952.
PMID: 29550027 DOI: 10.1016/S0140-6736(18)30459-8

Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Increasing and retaining a quality PALM workforce requires access to mentorship and continuing professional development, task sharing, and the development of short-term visitor programmes. Opportunities to enhance the training of pathologists and allied PALM personnel by increasing and improving education provision must be explored and implemented. PALM infrastructure must be strengthened by addressing supply chain barriers, and ensuring laboratory information systems are in place. New technologies, including telepathology and point-of-care testing, can have a substantial role in PALM service delivery, if used appropriately. We emphasise the crucial importance of maintaining PALM quality and posit that all laboratories in LMICs should participate in quality assurance and accreditation programmes. A potential role for public-private partnerships in filling PALM services gaps should also be investigated. Finally, to deliver these solutions and ensure equitable access to essential services in LMICs, we propose a PALM package focused on these countries, integrated within a nationally tiered laboratory system, as part of an overarching national laboratory strategic plan.

Matched MeSH terms: Public Health
Fulltext The Nipah virus outbreak--a reminder

Tambyah PA

Singapore Med J, 1999 May;40(5):329-30.
PMID: 10489488
Matched MeSH terms: Public Health
Fulltext Interdisciplinary approaches to understanding disease emergence: the past, present, and future drivers of Nipah virus emergence

Daszak P, Zambrana-Torrelio C, Bogich TL, Fernandez M, Epstein JH, Murray KA, et al.

Proc Natl Acad Sci U S A, 2013 Feb 26;110 Suppl 1:3681-8.
PMID: 22936052 DOI: 10.1073/pnas.1201243109

Emerging infectious diseases (EIDs) pose a significant threat to human health, economic stability, and biodiversity. Despite this, the mechanisms underlying disease emergence are still not fully understood, and control measures rely heavily on mitigating the impact of EIDs after they have emerged. Here, we highlight the emergence of a zoonotic Henipavirus, Nipah virus, to demonstrate the interdisciplinary and macroecological approaches necessary to understand EID emergence. Previous work suggests that Nipah virus emerged due to the interaction of the wildlife reservoir (Pteropus spp. fruit bats) with intensively managed livestock. The emergence of this and other henipaviruses involves interactions among a suite of anthropogenic environmental changes, socioeconomic factors, and changes in demography that overlay and interact with the distribution of these pathogens in their wildlife reservoirs. Here, we demonstrate how ecological niche modeling may be used to investigate the potential role of a changing climate on the future risk for Henipavirus emergence. We show that the distribution of Henipavirus reservoirs, and therefore henipaviruses, will likely change under climate change scenarios, a fundamental precondition for disease emergence in humans. We assess the variation among climate models to estimate where Henipavirus host distribution is most likely to expand, contract, or remain stable, presenting new risks for human health. We conclude that there is substantial potential to use this modeling framework to explore the distribution of wildlife hosts under a changing climate. These approaches may directly inform current and future management and surveillance strategies aiming to improve pathogen detection and, ultimately, reduce emergence risk.

Matched MeSH terms: Public Health
Fulltext Prevalence of goiter in rural area of Belgaum district, Karnataka

Kamath R, Bhat V, Rao R, Das A, Ks G, Kamath A

Indian J Community Med, 2009 Jan;34(1):48-51.
PMID: 19876455 DOI: 10.4103/0970-0218.45373

BACKGROUND: To determine the prevalence of goiter and to study the factors influencing goiter among people of the rural community in Karnataka state, a community based study. Setting and Study Design: A cross sectional study was carried out to find out the prevalence of goiter in a rural community of Belgaum district. The study was conducted by house-to-house survey for a period of one month.
MATERIALS AND METHODS: Two villages (Handiganur and Gundwad) were selected randomly from Belgaum and Raibag taluks of Belgaum district. All the family members in each household were examined for the presence of goiter using WHO criteria. Iodine content of the salt sample obtained from each household was estimated by using spot testing kits. Information regarding the determinants of goiter was collected and recorded in a pre tested proforma. Data collected was analyzed using SPSS statistical packages.
RESULTS: The prevalence of goiter among rural population was found to be 16.6%. Goiter of grade 1 was 15.7% and that of grade 2 was 0.9%. Prevalence among males and females were 7.2% and 21.8%, respectively. The prevalence of goiter was highest among adolescents. Estimation of iodine content in the salt sample revealed that 50% of samples had adequate iodine content (>/=15 ppm). Multiple Logistic Regression Analysis revealed that females of the age group 10-49 years were independently associated with goiter.
CONCLUSION: Prevalence of goiter was relatively high and therefore constituted a public health problem in this region.
KEYWORDS: Determinants; goiter; multiple logistic regression analysis; prevalence

Matched MeSH terms: Public Health

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