Displaying publications 61 - 80 of 158 in total

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  1. Muir CS, Nectoux J
    Isr. J. Med. Sci., 1971 Dec;7(12):1373-9.
    PMID: 5144585
    Matched MeSH terms: Residence Characteristics
  2. Rampal L, Narasimman S
    Med J Malaysia, 2003 Mar;58(1):54-61.
    PMID: 14556326 MyJurnal
    Objectives: i) To determine the prevalence of smoking among the community aged 15 and above in Kg. Jenderam Hilir in Sepang District, Selangor state. ii) To determine the relationship between smoking and age, sex, household income and education. iii) To determine the parental and peer influence on smoking in Kg Jenderam Hilir.
    Materials and Methods: A study was conducted to Kg Jenderam Hilir, Sepang. All residents aged 15 years and above from all the 381 households of Kg Jenderam Hilir were included in this study. A standardized pre-tested structured questionnaire was used in this study.
    Results: Out of 894 respondents interviewed 69% were males compared to 3.9% of the females (overall 33.6%) reported to have smoked at least once in his/her lifetime. The difference was statistically significant. The mean duration of smoking was 17.7 years. The age at which smoking was first attempted ranged from 4 years to 51 years with a mean of 18.7 years. The mean initiation age for the males was significantly lower as compared to the mean initiation age for the females. The prevalence of current smokers was significantly higher amongst males (52.8%) as compared to the females (1.4%). The prevalence of smoking among current smokers increased with age (p<0.01). there was no significant difference in the prevalence of smoking by household income and educational level. The mean number of cigarettes smoked by current smokers per day was 14.9 cigarettes and ranged from 1 to 60 cigarettes. The mean number of cigarettes smoked by the males was significantly higher than the females (p<0.05). the mean duration of smoking among current smokers was 20 years. There was a significant difference in the level of addiction to smoking and the duration of smoking (p<0.05). sixty five percent of the current smokers reported to have tried to quit smoking while 26% of ever smokers had reported to quit smoking and remained non-smokers. The quit ratio was calculated to be 26.0%. the quit ratio was 52.6% among those with college or university education. There was a significant difference in the quit ratio by education level (p<0.01). There was no significant difference in smokers whose parents were smokers as compared to non-smokers whose parents were smokers. However, there was a significant association between smoking and peer influence (p<0.01).
    Matched MeSH terms: Residence Characteristics/statistics & numerical data*
  3. Selvarajah S, Haniff J, Kaur G, Hiong TG, Cheong KC, Lim CM, et al.
    Eur J Prev Cardiol, 2013 Apr;20(2):368-75.
    PMID: 22345688 DOI: 10.1177/2047487312437327
    BACKGROUND: This study aimed to estimate the prevalence of cardiovascular risk factors and its clustering. The findings are to help shape the Malaysian future healthcare planning for cardiovascular disease prevention and management.
    METHODS: Data from a nationally representative cross-sectional survey was used. The survey was conducted via a face-to-face interview using a standardised questionnaire. A total of 37,906 eligible participants aged 18 years and older was identified, of whom 34,505 (91%) participated. Focus was on hypertension, hyperglycaemia (diabetes and impaired fasting glucose), hypercholesterolaemia and central obesity.
    RESULTS: Overall, 63% (95% confidence limits 62, 65%) of the participants had at least one cardiovascular risk factor, 33% (32, 35%) had two or more and 14% (12, 15%) had three risk factors or more. The prevalence of hypertension, hyperglycaemia, hypercholesterolaemia and central obesity were 38%, 15%, 24% and 37%, respectively. Women were more likely to have a higher number of cardiovascular risk factors for most age groups; adjusted odds ratios ranging from 1.1 (0.91, 1.32) to 1.26 (1.12, 1.43) for the presence of one risk factor and 1.07 (0.91, 1.32) to 2.00 (1.78, 2.25) for two or more risk factors.
    CONCLUSIONS: Cardiovascular risk-factor clustering provides a clear impression of the true burden of cardiovascular disease risk in the population. Women displayed higher prevalence and a younger age shift in clustering was seen. These findings signal the presence of a cardiovascular epidemic in an upcoming middle-income country and provide evidence that drastic measures have to be taken to safeguard the health of the nation.
    Study name: National Health and Morbidity Survey (NHMS-2006)
    Matched MeSH terms: Residence Characteristics/statistics & numerical data
  4. Noor Zurani, M.H.R., Hussain, H., Rusdi, A.R., Muhammad Muhsin, A.Z.
    MyJurnal
    Substance misuse, in particular heroin addiction contributes to health and social problems. Although effective medical treatment was available, earlier efforts confined the treatment of heroin addicts to in-house rehabilitation which required them to be estranged from the community and their families for 2 years. The in-house rehabilitative programme, implemented for at least three decades has produced low abstinence rates. On the other hand, being ‘away’ meant that many heroin addicts faced employment problems and family relationship difficulties upon completing the in-house rehabilitation. However, recently, the concerted efforts by various government and non-government organisations, and the acknowledgement that heroin addiction is a medical illness has resulted in a revamp to approaching treatment of heroin addiction. At present, methadone substitution programmes have been offered as part of treatment programme for heroin addicts in Malaysia. This new programme has been shown to be effective in treating heroin addiction and would need support and cooperation from all groups involved.
    Matched MeSH terms: Residence Characteristics
  5. Hairi NN, Bulgiba A, Peramalah D, Mudla I
    Prev Med, 2013 Jan;56(1):8-11.
    PMID: 23103916 DOI: 10.1016/j.ypmed.2012.10.016
    Managing stairs is a challenging activity of daily living (ADL) for older people. This study aims to examine the association between visual impairment and difficulty in managing stairs among older people living alone and those living with others.
    Matched MeSH terms: Residence Characteristics*
  6. Villiers-Tuthill A, Doulougeri K, McGee H, Montgomery A, Panagopoulou E, Morgan K
    Patient, 2017 Dec;10(6):753-761.
    PMID: 28523465 DOI: 10.1007/s40271-017-0246-8
    BACKGROUND: Patient perceptions of quality of care (QoC) are directly linked with patient safety and clinical effectiveness. We need patient-designed QoC instruments that work across languages and countries to optimise studies across systems in this area. Few QoC measurement tools exist that assess all aspects of QoC from the patient perspective. This paper describes the development and validation of a comprehensive measure to assess patient perceptions of QoC that incorporates technical and interpersonal aspects of care and is grounded in the established Institute of Medicine (IOM) QoC framework.

    DESIGN: We conducted a multi-country cross-sectional study.

    METHODS: Following a literature review and patient focus groups, an expert panel generated questionnaire items. Following a pilot study, item numbers were reduced. The final questionnaire consisted of three sections: demographics, perceived QoC and one open-ended question. Data was collected from patients (n = 531) discharged from hospitals across seven countries in South East Europe (languages: Turkish, Greek, Portuguese, Romanian, Croatian, Macedonian and Bulgarian). Reliability and validity of the measure were assessed.

    RESULTS: Confirmatory factor analysis was used to compare various factor models of patient-perceived QoC. Good model fit was demonstrated for a two-factor model: communication and interpersonal care, and hospital facilities.

    CONCLUSIONS: The ORCAB (Improving quality and safety in the hospital: The link between organisational culture, burnout and quality of care) Patient QoC questionnaire has been collaboratively and exhaustively developed between healthcare professionals and patients. It enables patient QoC data to be assessed in the context of the IOM pillars of quality, considering both technical and interpersonal dimensions of care. It represents an important first step in including the patient perspective.

    Matched MeSH terms: Residence Characteristics
  7. Lim TO, Goh A, Lim YN, Morad Z
    Nephrology (Carlton), 2008 Dec;13(8):745-52.
    PMID: 19154324 DOI: 10.1111/j.1440-1797.2008.01044.x
    We review renal registry data from the Asia-Pacific region with an emphasis on their uses in health care and in dialysis care in particular. The review aims to demonstrate the information value of registry data. While renal registry provides a useful data resource for epidemiological research, there are severe methodological limitations in its application for analytical or therapeutic research. However, it is the use of renal registry data for public health and health-care management purposes that registry really comes into its own, and it is primarily for these that governments have invested in national patient and disease registries. We apply data from several renal registries in the Asia-Pacific region to illustrate its wide application for planning dialysis services, for evaluating dialysis practices and health outcomes, with a view to improving the quality of dialysis care. In the course of preparing the review, we have found that the quality and accessibility of renal registry data were highly variable across the region. Given the value of renal registry, every country in the Asia-Pacific region should establish one or should ensure that their current registries are better resourced and developed. Greater data sharing and collaboration among registries in the region could help advance the nephrology to serve our patients better.
    Matched MeSH terms: Residence Characteristics
  8. Sherina, M.S., Rampal, L., Hejar, A.R., Rozali, A., Mohd Yunusn, A.
    MyJurnal
    The objectives of this study were to determine the prevalence of the urban poor and its health related factors in Selangor. This cross-sectional study was conducted in the community of Selangor. Data was collected from January 2006 to June 2006. Three out of nine districts were selected to be involved in the study, which were Klang, Kuala Langat and Petaling. A Multistage Stratified Proportionate Systematic Random Sampling was used for this study. The sampling was carried out by the Statistics Department of Malaysia. The survey frame was based on the information gathered from the Population and Housing Census in year 2000. The respondents were interviewed by trained research assistants using a structured pre-tested standardized questionnaire prepared in Malay and English languages. A monthly income of RM706 and less was used to define urban poor based on the guidelines given by the Economy Planning Unit of Malaysia (2004). SPSS 16.0 version was used to analyze the data. Out of 2535 respondents interviewed in this study, 2491 respondents answered the questionnaire completely (response rate 98.3%). Out of 2491 respondents, 202 (8.1%) had a monthly income of RM706 and less. Analysis of the urban poor respondents found that majority were aged between 18 to 40 years old (55.9%), and 29.7% had diagnosed medical illnesses, where hypertension, diabetes and asthma were the most common illnesses at 12.4%, 10.9% and 5.0% respectively. About 10% of the urban poor respondents had physical disabilities such as blurring of vision (7.9%), hearing problems (1.0%) and other disabilities (1.0%).

    Matched MeSH terms: Residence Characteristics
  9. Tung SE, Ng XH, Chin YS, Mohd Taib MN
    Child Care Health Dev, 2016 Jul;42(4):478-85.
    PMID: 27272607 DOI: 10.1111/cch.12355
    BACKGROUND: This study aimed to evaluate parental perception of neighbourhood environments and safety in association with children's physical activity among primary school children in Klang, Selangor, Malaysia.

    METHODS: A total of 250 children (9-12 years of age) and their parents participated in this cross-sectional study. Physical Activity Questionnaire for Older Children and Neighbourhood Environmental Walkability Scale as well as questions on constrained behaviours (avoidance and defensive behaviours) were used to assess the children's physical activity and parental perception of neighbourhood environment and safety, respectively.

    RESULTS: More than one-third (36.0%) of the children were physically inactive compared with only a small percentage (4.8%) who were physically active, with boys achieving higher physical activity levels than girls (t = 2.564, P = 0.011). For the environmental scale, parents' perception of land-use mix (access) (r = 0.173, P = 0.006), traffic hazards (r = -0.152, P = 0.016) and defensive behaviour (r = -0.024, P = 0.143) correlated significantly with children's physical activity. In multiple linear regression analysis, child's gender (β = -0.226; P = 0.003), parent's education (β = 0.140; P = 0.001), household income (β = 0.151; P = 0.024), land-use mix (access) (β = 0.134; P = 0.011) and defensive behaviour (β = -0.017; P = 0.038) were significantly associated with physical activity in children (R = 0.349, F = 6.760; P 

    Matched MeSH terms: Residence Characteristics
  10. Amar HS, Ho JJ, Mohan AJ
    J Paediatr Child Health, 1999 Feb;35(1):63-6.
    PMID: 10234638
    OBJECTIVE: To determine the community prevalence of human immunodeficiency virus (HIV) in women at the time of delivery in a Malaysian setting.

    METHODOLOGY: Cord blood samples from a pilot screening programme for congenital hypothyroidism in 1995 at Ipoh city and surrounding district hospitals were screened anonymously for HIV 1 and 2. HIV status was determined using chemiluminescent technology. Positive samples were retested using the Genelavia Mixt assay.

    RESULTS: A total of 4927 samples were tested. The ethnic breakdown included 51.7% Malays, 18.9% Chinese, 14.3% Indian, 2.3% Others and 12.9% unknown. The geographical distribution of samples was 73.9% urban, 24.2% rural and 1.9% unknown. The seroprevalence of HIV positivity was 3.25 per 1000 deliveries (95% CI: 1.92-5.16). Seroprevalence was higher for samples from rural and Malay mothers.

    CONCLUSION: The high seroprevalence in this study suggests that the spread of HIV is far wider than that anticipated by mandatory national reporting. It also supports antenatal screening and the use of antiretroviral therapy as an important strategy to reduce perinatal transmission.

    Matched MeSH terms: Residence Characteristics
  11. Rahimi R, Zulkifli ZF, Omar E, Ismail H, Md Noor S
    Malays J Pathol, 2017 Apr;39(1):83-87.
    PMID: 28413210 MyJurnal
    Child abuse is a worldwide problem. The four major types of abuse include physical abuse, child neglect, psychological maltreatment and sexual violence. We describe a fatal case of child abuse which presented with numerous old and recent soft tissue injuries all over the body. The injuries on the legs have immobilized the victim for quite some time, giving rise to deep vein thrombosis, leading to death as a result of acute pulmonary thromboembolism. This case demonstrates presence of both elements of abuse and neglect in one victim. As this category of crime involves a helpless child, we would also like to reiterate that the community has an obligation to prevent such tragedies and educating the public to recognize the signs and symptoms of abuse would be of utmost important. Ultimately, the community must also be responsible for reporting such offences and the act of silence is akin to condoning a crime witnessed.
    Matched MeSH terms: Residence Characteristics
  12. Ketchoo C, Sangthong R, Chongsuvivatwong V, Geater A, McNeil E
    Tob Control, 2013 Jul;22(4):255-60.
    PMID: 22174006 DOI: 10.1136/tobaccocontrol-2011-050008
    BACKGROUND:
    Illicit cigarette consumption has increased worldwide. It is important to understand this problem thoroughly.

    OBJECTIVES:
    To investigate behaviours and factors associated with illicit cigarette consumption in southern Thailand.

    DESIGN:
    A survey and qualitative study were conducted in a border province in southern Thailand next to Malaysia. A modified snowballing technique was used to recruit 300 illicit and 150 non-illicit cigarette smokers. A questionnaire was used to interview subjects. Illicit cigarette packs were obtained in order to identify their characteristics. Bivariate and multivariate logistic regression was used for data analysis.

    RESULTS:
    Smoking of illicit cigarettes has become accepted in the communities. They were available in supermarkets and vendor shops. Friends and other illicit smokers known by illicit cigarette smokers were an important source of information for access to illicit cigarette products. The main factors associated with smoking illicit cigarettes, compared with smoking non-illicit cigarettes, were younger age, higher education and higher average monthly expenditure on cigarettes (most illicit smokers smoked illicit cigarettes (average price per packet = 33 THB (US$1.1), while most non-illicit smokers smoked hand-rolled cigarettes (average price per packet = 7 THB (US$0.2)) and knowledge of other illicit cigarette smokers. The low price of illicit cigarettes was the main reason for their use. Selling strategies included sale of singles, sale in shops and direct sale through social networking.

    CONCLUSIONS:
    Illicit cigarette consumption has become more acceptable especially among young adult smokers. Age and extent of social networks are important factors associated with smoking illicit cigarettes.

    KEYWORDS:
    Smoking behaviour; border province; cessation; cigarette consumption; global health; hand-rolled/RYO tobacco; health services; illegal tobacco products; illicit cigarette
    Matched MeSH terms: Residence Characteristics
  13. Rizawati, M., Mas Ayu, S.
    JUMMEC, 2008;11(2):72-82.
    MyJurnal
    The aim of this study was to determine whether the home environment was a risk factor for falls occurring at home among the elderly in the Masjid Tanah community, Malaysia. An analytical cross-sectional study conducted from early June 2006 until May 2007 in six randomly selected villages in Masjid Tanah Province. A total of 516 participants were included in this study. Overall prevalence of falls among the study participants was 27.3%. Home falls accounted for 66.7% of the total falls. In conclusion, there was no association between home environment and home fall in this study. Logistic regression analysis showed that having a depressive mood was the main determinant for home falls among the elderly in this study.
    Matched MeSH terms: Residence Characteristics
  14. Mani, Shani Ann
    MyJurnal
    The use of fluoride as a preventive measure for dental caries has been established more than 50 years ago. The recommendations for fluoride use has been modified over the years due to factors like decreased prevalence of caries, increased prevalence of dental fluorosis and the widespread availability of fluoride in various forms to the community. In recent years, the role of evidence-based recommendations has come to the forefront, in an attempt to ensure the most favorable treatment for the individual. This review has attempted to appraise the most recent evidence- based recommendations for different fluoride modalities put forth by various organizations worldwide, in order to appreciate the current status of fluoride in the early 21st century.
    Matched MeSH terms: Residence Characteristics
  15. Jamal R, Syed Zakaria SZ, Kamaruddin MA, Abd Jalal N, Ismail N, Mohd Kamil N, et al.
    Int J Epidemiol, 2015 Apr;44(2):423-31.
    PMID: 24729425 DOI: 10.1093/ije/dyu089
    The Malaysian Cohort study was initiated in 2005 by the Malaysian government. The top-down approach to this population-based cohort study ensured the allocation of sufficient funding for the project which aimed to recruit 100,000 individuals aged 35-70 years. Participants were recruited from rural and urban areas as well as from various socioeconomic groups. The main objectives of the study were to identify risk factors, to study gene-environment interaction and to discover biomarkers for the early detection of cancers and other diseases. At recruitment, a questionnaire-based interview was conducted, biophysical measurements were performed and biospecimens were collected, processed and stored. Baseline investigations included fasting blood sugar, fasting lipid profile, renal profile and full blood count. From April 2006 to the end of September 2012 we recruited a total of 106,527 participants. The baseline prevalence data showed 16.6% participants with diabetes, 46.5% with hypertension, 44.9% with hypercholesterolaemia and 17.7% with obesity. The follow-up phase commenced in June 2013. This is the most comprehensive and biggest cohort study in Malaysia, and has become a valuable resource for epidemiological and biological research. For information on collaboration and also data access, investigators can contact the project leader at (rahmanj@ppukm.ukm.edu.my).
    Study name: The Malaysian Cohort (TMC) project
    Matched MeSH terms: Residence Characteristics/statistics & numerical data
  16. Lore W
    East Afr Med J, 1994 Dec;71(12):762-7.
    PMID: 7705242
    Between 1978 and 1987, Kenyan authors contributed an average of 47% of papers published in the East African Medical Journal (EAMJ), in comparison to 24% originating from Nigeria and 29% from other countries, mainly those in the eastern and central African region. From January 1988 to December 1993, 44.1% of the papers published in EAMJ originated from Kenyan authors as compared to 26.7% from Nigerian authors and 29.2% from authors in other countries. During this six year period, there has been a steady increase in authorship from Saudi Arabia, Sudan, Zimbabwe, Ethiopia and Tanzania, whereas authorship from Uganda and Zambia has declined. Many authors from Saudi Arabia are individuals originally from Nigeria now working in Saudi Arabia. These data indicate that Kenyan authorship has dropped by 3% over the last six years compared to the 1978-1987 period, while that of Nigeria has increased by at least 3% over the same period. During the period under review, EAMJ has attracted papers from as far as China, Turkey, Malaysia, Canada, USA, France, Sweden and Hungary. Similarly, papers have been received from other African countries not previously contributing to the journal; these include: Gabon, Mozambique, RSA, Burkina Faso, Botswana, Burundi, Namibia, Liberia, Egypt, Somalia and Zaire. Possible factors influencing authorship in the EAMJ are discussed.
    Matched MeSH terms: Residence Characteristics/statistics & numerical data*
  17. Konchom S, Singhasivanon P, Kaewkungwal J, Chupraphawan S, Thimasarn K, Kidson C, et al.
    PMID: 15115117
    The intercountry border areas of Thailand have high malaria receptivity and vulnerability that present numerous problems in the control of malaria transmission. This study focused on the 30 provinces of Thailand situated next to neighboring countries, which can be divided into 4 groups: the Thai-Myanmar border (10 provinces), the Thai-Cambodia border (6 provinces), the Thai-Lao border (10 provinces) and the Thai-Malaysia border (4 provinces). The purpose of the present study was to describe the pattern and trend of malaria incidence in the highly endemic provinces along the Thai borders for the 11 years from 1991 to 2001. Analysis of trends showed the distribution of malaria parasites to have shifted from a preponderance of Plasmodium falciparum to Plasmodium vivax along the western border with Myanmar, the northern border with Lao PDR and along the eastern border with Cambodia whereas the southern border with Malaysia the pattern changed from a preponderance of P. vivax to P. falciparum, since 1997. There was a significant difference in annual parasite incidence between borders and non-border districts, especially along the Thai-Myanmar and Thai-Cambodia borders. It is thus evident that all border districts should pay more attention to control of malaria transmission and the activities of the malaria surveillance system, and that monitoring and evaluation of the Thai Malaria Control Program needs to be performed consistently, including some areas where a few malaria cases were found as well as in malaria free areas.
    Matched MeSH terms: Residence Characteristics
  18. Wong LP, Alias H, Farid NDN, Yusop SM, Musa Z, Hu Z, et al.
    Front Public Health, 2023;11:1158698.
    PMID: 37213607 DOI: 10.3389/fpubh.2023.1158698
    INTRODUCTION: This study aims to shed light on parent-child relationships and the psychological health of parents from low-income families after the easing of the COVID-19 pandemic restrictions.

    METHODS: This cross-sectional study recruited 553 parents of children aged 13-24 years in low-income community settings. The Parent-Child Conflict scale of the Parental Environment Questionnaire (PEQ) was used to measure parent-child conflict. Psychological distress was assessed using the Depression, Anxiety, and Stress Scale short form (DASS-21).

    RESULTS: The study revealed a low level of parent-child conflict in the overall study population, with a median PEQ of 48.0 (interquartile range [IQR] 36 to 48). Concerning demographics, married parents reported a likelihood of having a higher level of parent-child conflict over 3 times higher than single parents (OR = 3.18 95%, CI 1.30-7.75). More parent-child conflicts were also found in parents aged 60-72 years old who were unemployed, retired, or housewives and from lower-income groups. In regard to lifestyle factors, a higher level of physical activity and having enough sleep were associated with lower levels of parent-child conflict. Only approximately 1% of the participants reported symptoms of depression, anxiety, or stress.

    DISCUSSION: Low risk exists for parent-child conflict and psychological sequelae following the easing of the COVID-19 pandemic restrictions, which could be due to various support measures implemented by the government. Vulnerable parents identified as being at risk of parent-child conflict warrant attention in future advocacy efforts.

    Matched MeSH terms: Residence Characteristics
  19. Yong HS, Song SL, Eamsobhana P, Pasartvit A, Lim PE
    Mol Biol Rep, 2019 Aug;46(4):3765-3776.
    PMID: 31012029 DOI: 10.1007/s11033-019-04818-3
    Zeugodacus cucurbitae (Coquillet) is one of the most significant and widespread tephritid pest species of agricultural crops. This study reports the bacterial communities associated with Z. cucurbitae from three geographical regions in Southeast Asia (Thailand, Peninsular Malaysia, and Sarawak). The bacterial microbiota were investigated by targeted 16S rRNA gene (V3-V4 region) sequencing using the Illumina Mi-Seq platform. At 97% similarity and filtering at 0.001%, there were seven bacterial phyla and unassigned bacteria, comprising 11 classes, 23 orders, 39 families and 67 genera. The bacterial diversity and richness varied within and among the samples from the three geographical regions. Five phyla were detected for the Sarawak sample, and six each for the Thailand and Peninsular Malaysia samples. Four phyla-Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria-were represented in all the fruit fly specimens, forming the core members of the bacterial community. Proteobacteria was the predominant phylum, followed by Bacteroidetes, Firmicutes, and Actinobacteria. Fifty-three genera were represented in the Thailand sample, 56 in the Peninsular Malaysia sample, and 55 in the Sarawak sample. Forty-two genera were present in all the three geographical regions. The predominant core members were order Enterobacteriales (Proeteobacteria), and family Enterobacteriaceae (Enterobacteriales). Klebsiella (Enterobacteriaceae) was the predominant genus and K. oxytoca the predominant species with all specimens having > 10% relative abundance. The results indicate the presence of a great diversity as well as core members of the bacterial community associated with different populations of Z. cucurbitae.
    Matched MeSH terms: Residence Characteristics
  20. Pan DS, Huang JH, Lee MH, Yu Y, Chen MI, Goh EH, et al.
    BMC Fam Pract, 2016 11 03;17(1):148.
    PMID: 27809770 DOI: 10.1186/s12875-016-0547-3
    BACKGROUND: Patients' expectations can influence antibiotic prescription by primary healthcare physicians. We assessed knowledge, attitude and practices towards antibiotic use for upper respiratory tract infections (URTIs), and whether knowledge is associated with increased expectations for antibiotics among patients visiting primary healthcare services in Singapore.

    METHODS: Data was collected through a cross-sectional interviewer-assisted survey of patients aged ≥21 years waiting to see primary healthcare practitioners for one or more symptoms suggestive of URTI (cough, sore throat, runny nose or blocked nose) for 7 days or less, covering the demographics, presenting symptoms, knowledge, attitudes, beliefs and practices of URTI and associated antibiotic use. Univariate and multivariate logistic regression was used to assess independent factors associated with patients' expectations for antibiotics.

    RESULTS: Nine hundred fourteen out of 987 eligible patients consulting 35 doctors were recruited from 24 private sector primary care clinics in Singapore. A third (307/907) expected antibiotics, of which a substantial proportion would ask the doctor for antibiotics (121/304, 40 %) and/or see another doctor (31/304, 10 %) if antibiotics were not prescribed. The majority agreed "antibiotics are effective against viruses" (715/914, 78 %) and that "antibiotics cure URTI faster" (594/912, 65 %). Inappropriate antibiotic practices include "keeping antibiotics stock at home" (125/913, 12 %), "taking leftover antibiotics" (114/913, 14 %) and giving antibiotics to family members (62/913, 7 %). On multivariate regression, the following factors were independently associated with wanting antibiotics (odds ratio; 95 % confidence interval): Malay ethnicity (1.67; 1.00-2.79), living in private housing (1.69; 1.13-2.51), presence of sore throat (1.50; 1.07-2.10) or fever (1.46; 1.01-2.12), perception that illness is serious (1.70; 1.27-2.27), belief that antibiotics cure URTI faster (5.35; 3.76-7.62) and not knowing URTI resolves on its own (2.18; 1.08-2.06), while post-secondary education (0.67; 0.48-0.94) was inversely associated. Those with lower educational levels were significantly more likely to have multiple misconceptions about antibiotics.

    CONCLUSION: Majority of patients seeking primary health care in Singapore are misinformed about the role of antibiotics in URTI. Agreeing with the statement that antibiotics cure URTI faster was most strongly associated with wanting antibiotics. Those with higher educational levels were less likely to want antibiotics, while those with lower educational levels more likely to have incorrect knowledge.
    Matched MeSH terms: Residence Characteristics
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