Displaying publications 61 - 80 of 515 in total

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  1. Ullah S, Daud H, Dass SC, Fanaee-T H, Kausarian H, Khalil A
    PMID: 32098247 DOI: 10.3390/ijerph17041413
    The number of tuberculosis (TB) cases in Pakistan ranks fifth in the world. The National TB Control Program (NTP) has recently reported more than 462,920 TB patients in Khyber Pakhtunkhwa province, Pakistan from 2002 to 2017. This study aims to identify spatial and space-time clusters of TB cases in Khyber Pakhtunkhwa province Pakistan during 2015-2019 to design effective interventions. The spatial and space-time cluster analyses were conducted at the district-level based on the reported TB cases from January 2015 to April 2019 using space-time scan statistics (SaTScan). The most likely spatial and space-time clusters were detected in the northern rural part of the province. Additionally, two districts in the west were detected as the secondary space-time clusters. The most likely space-time cluster shows a tendency of spread toward the neighboring districts in the central part, and the most likely spatial cluster shows a tendency of spread toward the neighboring districts in the south. Most of the space-time clusters were detected at the start of the study period 2015-2016. The potential TB clusters in the remote rural part might be associated to the dry-cool climate and lack of access to the healthcare centers in the remote areas.
    Matched MeSH terms: Rural Population
  2. Shyam S, Khor GL, Ambak R, Mahadir B, Hasnan M, Ambu S, et al.
    Public Health Nutr, 2020 Feb;23(2):319-328.
    PMID: 31397262 DOI: 10.1017/S1368980019001861
    OBJECTIVE: To investigate the association between dietary patterns (DP) and overweight risk in the Malaysian Adult Nutrition Surveys (MANS) of 2003 and 2014.

    DESIGN: DP were derived from the MANS FFQ using principal component analysis. The cross-sectional association of the derived DP with prevalence of overweight was analysed.

    SETTING: Malaysia.

    PARTICIPANTS: Nationally representative sample of Malaysian adults from MANS (2003, n 6928; 2014, n 3000).

    RESULTS: Three major DP were identified for both years. These were 'Traditional' (fish, eggs, local cakes), 'Western' (fast foods, meat, carbonated beverages) and 'Mixed' (ready-to-eat cereals, bread, vegetables). A fourth DP was generated in 2003, 'Flatbread & Beverages' (flatbread, creamer, malted beverages), and 2014, 'Noodles & Meat' (noodles, meat, eggs). These DP accounted for 25·6 and 26·6 % of DP variations in 2003 and 2014, respectively. For both years, Traditional DP was significantly associated with rural households, lower income, men and Malay ethnicity, while Western DP was associated with younger age and higher income. Mixed DP was positively associated with women and higher income. None of the DP showed positive association with overweight risk, except for reduced adjusted odds of overweight with adherence to Traditional DP in 2003.

    CONCLUSIONS: Overweight could not be attributed to adherence to a single dietary pattern among Malaysian adults. This may be due to the constantly morphing dietary landscape in Malaysia, especially in urban areas, given the ease of availability and relative affordability of multi-ethnic and international foods. Timely surveys are recommended to monitor implications of these changes.

    Matched MeSH terms: Rural Population
  3. Mohiuddin SG, Aziz S, Iqbal MZ, Naqvi AA, Ahmed R, Mahmoud MA, et al.
    J Pharm Bioallied Sci, 2020 01 29;12(1):57-63.
    PMID: 32801601 DOI: 10.4103/jpbs.JPBS_182_19
    Purpose: The demand of complementary and alternative medicine (CAM) has increased drastically over the past few decades. The perceptions about CAMs among general population are positive. However, the literature highlights that effectiveness and acceptance of alternative therapies among the general population is still a subject of debate.

    Materials and Methods: This is a cross-sectional study and the response along with demographic details was collected through a validated questionnaire; the results were analyzed by using a validated data collection tool. The results were concluded based on good, moderate, and poor responses, which were evaluated through data analysis by using the Statistical Package for the Social Sciences software version 20.0., SPSS Inc., Chicago, III, USA. A value of P < 0.05 was considered statistically significant.

    Results: In total, 182 (44.4%) of male and 228 (55.6%) of female respondents were selected for this study. Studies showed that a greater knowledge level was observed among female respondents (15.55 ± 2.7, P < 0.001). The selected Chinese population had relatively good knowledge (i.e., 15.63, P = 0.006). People practicing Buddhism had also good knowledge. Rural population had lesser family income and showed a good practice pattern and understanding (P = 0.006). The positive attitude was identified among women ( P < 0.001) with a mean score of 15.55 ± 2.7. Postgraduate participants were found to have diverse results with SD ± 6.23, and 77.1% had a good attitude. A statistically significant association was observed between religion and attitude of respondents (P < 0.001).

    Conclusion: Although a better practice was noticed in Malaysian population, more awareness is required and knowledge should be disseminated among the population to improve the overall health and quality of life in Malaysia.

    Matched MeSH terms: Rural Population
  4. Naing Oo Tha, Wendy Diana Shoesmith, Chrystalle B. Y. Tan, Mohd Yusof Ibrahim, Syed Shajee Hussein
    Borneo Epidemiology Journal, 2020;1(1):45-54.
    MyJurnal
    Introduction: One of the aims outlined in Malaysia’s Health Vision 2020 is to be a nation of healthy individuals, families, and communities through an equitable, affordable, efficient, environmentally adaptable, and consumer friendly healthcare system. Sabah faces tremendous challenges to provide the best care for patients. For example, Sabah's unique geographical location and landscape, such as steep hills and rivers, is one of the challenges that health staff faces. Objectives of this study aimed to examine the prevalence of geographical accessibility, types of healthcare services, and the types of health seeking behaviour in 2 northern rural areas of Sabah to assess the geographic accessibility and availability of healthcare services.
    Materials and Methods: A community-based cross-sectional study was conducted in two rural areas in Sabah—Kudat and Pitas. Data collection was done by using questionnaire and face–to-face interviews
    Results: It was found that 48% of the study population sought healthcare and they mainly chose healthcare services from hospitals and health clinics.
    Conclusion: Half of the population in the areas studied used healthcare in the last year. The choice of using a public hospital or community health clinics was determined by distance from residence
    Matched MeSH terms: Rural Population
  5. Law, Leh Shii, Stephen, Jeffery
    MyJurnal
    Oral health gained attention worldwide as it exerted unfavourable and undesired influences on an individual’s daily lives and wellbeing, especially among the rural population. In order to increase the understanding on the oral health among the rural community, this study aimed to determine the oral health knowledge and practice and its association with sociodemographic characteristics among the longhouse residents in Julau, Sarawak. In this cross-sectional study, a total of 105 residents were recruited from five longhouses, namely Rumah Panjang Mengga, Rumah Panjang Ikeh, Rumah Panjang Michael, Rumah Panjang Budit, and Rumah Panjang Manju. Information related to sociodemographic characteristics, as well as oral health knowledge and practice was gathered through face-to-face interview by using a structured questionnaire. Spearman rho correlation test, Mann-Whitney U-test, and Krukal-Wallis H-test were applied during data analysis. Median (interquartile) age of the children and adults was 10.0 (5.0) and 50.0 (22.0) years old, respectively. Findings revealed that oral health knowledge and practices among participants, both children and adults were inadequate as a high proportion of the participants were unable to provide answers for oral health related questions (functions of fluoride and correlation between gum disease with heart disease) and several oral health practices (regular oral check-up, change of toothbrush, and consumption of sweetened food) were also not being engaged in the daily life among the children and adult participants. A significant correlation was found between age and knowledge score among adult participants (rs = -0.389, p < 0.001). Besides, significant higher oral health knowledge score were found among adult participants with higher education level (H = 27.466; p < 0.001) and significant higher in oral health practice score was found among unemployed adult participants when compared to self-employed and employed workers for government and private (H = 9.631, p = 0.008). In conclusion, younger and educated participants are more knowledgeable regarding oral health. Engagement of oral health practices were related to occupation of the adult participants. Provision of health education and education aid for longhouse community should be continued taking into consideration age, level of education level, and even occupation in order to improve their oral health knowledge and practice.
    Matched MeSH terms: Rural Population
  6. Rahim FF, Abdulrahman SA, Kader Maideen SF, Rashid A
    PLoS One, 2020;15(2):e0228570.
    PMID: 32040497 DOI: 10.1371/journal.pone.0228570
    BACKGROUND: Diabetes is a metabolic disorder, characterized by hyperglycemic state of the body. A silent killer, which can take the lives of victims if undiagnosed at the earliest stage. Prediabetes has become an important health concern across countries due to its huge potential for the development of diabetes and other complications. The objectives of this study were to determine the prevalence of prediabetes and diabetes and its associated factors among rural fishing communities in Penang, Malaysia.

    METHODS: A cross-sectional study was conducted among fishing communities in Southwest District of Penang, Malaysia from August to November 2017. Blood sample (finger prick test) and physical examination were performed on sample of 168 participants consented in this study. Pre-validated Malay versions of International Physical Activity 7 (IPAQ-7) and Perceived Stress Scale (PSS) questionnaires were used to assess the level of physical activity and stress levels of the participants. Multinomial logistic regression models were fitted to identify factors associated with prediabetes and diabetes.

    RESULTS: The prevalence of diabetes and prediabetes were 19.6% (95% CI: 14.3, 26.4) and 10.12% (95% CI: 6.4, 15.7) respectively. The median physical activity (interquartile range) in MET-minutes per week for those with diabetes (1071.0 (2120.0)) and prediabetes (1314.0 (1710.0)) was generally lower as compared to non-diabetes. Majority reported moderate stress (57.3%) from PSS system. Abdominal obesity, family history of diabetes and being hypertensive were significant factors associated with diabetes; while older age, bigger waist circumference and self-perceived poor routine diet were factors associated with prediabetes.

    CONCLUSIONS: The screening for prediabetes in this population gives the opportunity to implement lifestyle interventions at the earliest possible, which could prevent the development of diabetes. The identification of diabetic individuals provides an opportunity to conduct health promotion and education to ensure good metabolic control and hence reduce the risks of complications.
    Matched MeSH terms: Rural Population
  7. Lim-Leroy A, Chua TH
    PLoS One, 2020;15(9):e0239680.
    PMID: 32986746 DOI: 10.1371/journal.pone.0239680
    Geohelminthiasis is a worldwide problem, especially in low-income countries. Children from rural areas and those living in poverty, lacking basic health amenities and having poor environmental sanitation are likely to be affected. Adverse effects such as anemia, protein malnutrition, colitis are common which can affect both the children's physical and mental growing development. A cross-sectional study on geohelminthiasis was conducted among children from 238 households in 13 villages in Kota Marudu of northern Sabah, East Malaysia. The study involved interviewing villagers using questionnaires to collect demographic and socio-economic data, getting faecal samples from the children, collecting soil samples and identifying parasite eggs with microscopy and molecular methods. A total of 407 children (6 months-17 years old) enrolled in the study. Geohelminthiasis was detected in the faecal samples of children from 54% (7/13) of the villages with mean prevalence of infection per village of 9.0% (0%-34.9%). On a household basis, 18% (43/238) of the households sampled had infected children, with mean prevalence rate per household of 11% (0%-43%). The prevalence was for Ascaris lumbricoides: 9.6% (39/407), Trichuris trichiura: 2.7% (11/407) and hookworms (Necator americanus and Ancylostoma sp.): 2.7% (11/407). The overall mean infection rate of the children examined was 14.3%. Significantly higher prevalence was recorded for the children of mothers who did not have any formal education (p = 0.003); household income of less than USD119 (RM500) (p<0.001); children from homes without proper sanitation facilities (p<0.001); children who usually go about barefoot (p<0.001) and not washing feet before entering the house (p = 0.017). Soil samples were found to have geohelminth eggs or larvae which could be due to unhygienic sanitation practices. This study shows the geohelminthiasis is prevalent in the villages, and the risk factors are lack of maternal education, low income, poor sanitation facilities and irregular deworming practice. Expanding deworming coverage in the study region may help reduce the worm infections in these communities, so that the mental and physical development of the children would not be affected by geohelminthiasis. The data on the prevalence of geohelminthiasis in this study would contribute to better public health monitoring and operation to reduce the infection in rural areas.
    Matched MeSH terms: Rural Population
  8. Mohd-Ali B, Tan XL
    PMID: 31861174 DOI: 10.3390/ijerph16245161
    BACKGROUND: Contact lenses (CLs) are more popular than spectacles for vision correction amongst the youth. Knowledge about the risks of wearing CLs is critical especially for those with poor access to public health education. This study investigates the patterns of use and level of knowledge about CL wear amongst teenagers living in rural areas in Selangor, Malaysia using a set of validated questionnaires.

    METHODS: A total of 8500 self-administered questionnaires were distributed in eight selected secondary schools. The results were analysed using descriptive statistics.

    RESULTS: A total of 2474 (29%) completed questionnaires were collected. The mean age of the respondents was 14.8 ± 1.5 years, and approximately 7.2% were CL wearers. The majority of the wearers were females (76.0%) and wore soft CLs (92.2%). Cosmetic purposes (58.1%) and comfort (24.6%) were the main reasons for wearing CLs. Many of the respondents purchased their lenses from optical shops (50.1%) and beauty accessory shops (15.6%), and approximately 10% did not disinfect their lenses properly. Regarding knowledge about CL care, approximately 56% of the respondents responded correctly.

    CONCLUSION: Half of the respondents do not have sufficient knowledge about the risks of wearing CLs. Thus, aggressive public health education aimed at teenagers is needed to prevent improper CL usage.

    Matched MeSH terms: Rural Population*
  9. Yap KH, Warren N, Reidpath DD, Allotey P
    Int J Qual Stud Health Well-being, 2019 Dec;14(1):1613875.
    PMID: 31120385 DOI: 10.1080/17482631.2019.1613875
    Purpose: Stroke survivors report poorer self-rated health (SRH) compared to the general population but there is limited understanding on what contributes to SRH. This ethnographic study examined the individual and contextual factors that shape stroke survivors' SRH in a rural middle income country situated in South East Asia. Methods: Ethnographic methods which encompasses various data collection methods from different data sources were used in this study to describe the socio-cultural context of 16 stroke survivors living in a rural village. Within this context, the experiences of these participants were then interpreted in terms of what contributed to their perception of health and recovery, juxtaposed with objectively measure physical and cognitive states. Results: SRH reflected the post stroke adjustment of stroke survivors. Better SRH was influenced by good post-stroke adjustment that was achieved by a combination of physical functioning, cognitive functioning, emotional well-being and family support. Poorer SRH appear to reflect poor post-stroke adjustment regardless of the objective physical and cognitive states of the stroke survivors. It was also observed that cognitive deficits, though its presence was acknowledged by participants, were usually not taken into account when rating SRH. However, while physical functioning was perceived by participants to directly impact SRH, the presence of cognitive deficits (often in tandem with depressive symptoms) indirectly complicated the recovery of physical functions treasured by participants. Conclusion: Stroke survivors reporting poorer SRH warrant further attention and intervention from health practitioners supporting the longer-term needs of stroke survivors in similar settings.
    Matched MeSH terms: Rural Population*
  10. Ali MH, Alrasheedy AA, Kibuule D, Godman B, Hassali MA, Ali HMH
    Expert Rev Anti Infect Ther, 2019 11;17(11):927-937.
    PMID: 31689134 DOI: 10.1080/14787210.2019.1689818
    Background: Multidrug-resistant tuberculosis (MDR-TB) has a socioeconomic impact and threatens global public health. We assessed treatment outcomes of MDR-TB and predictors of poor treatment outcomes in Sudan given current high prevalence rates.Methods: Combined retrospective and prospective cohort study at Abu-Anga hospital (TB specialized hospital in Sudan). All patients with MDR-TB between 2013 and 2017 were targeted.Results: A total of 156 patients were recruited as having good records, 117 (75%) were male, and 152 (97.4%) had pulmonary TB. Patients were followed for a median of 18 months and a total of 2108 person-months. The overall success rate was 63.5% and the mortality rate was 14.1%. Rural residency (P < 0.05) and relapsing on previous treatments (P < 0.05) were determinants of time to poor MDR-TB treatment outcomes.Conclusion: Overall, more attention needs to be given to special MDR-TB groups that are highly susceptible to poor outcomes, i.e. rural patients. As a result, it is highly recommended to maintain total coverage of medicines for all MDR-TB patients for the entire period of treatment in Sudan. It is also recommended to instigate more treatment centers in rural areas in Sudan together with programs to enhance adherence to treatments including patient counseling to improve future outcomes.
    Matched MeSH terms: Rural Population/statistics & numerical data*
  11. Wong YA, Mukari SZS, Harithasan D, Mazlan R
    Int J Pediatr Otorhinolaryngol, 2019 Sep;124:79-84.
    PMID: 31174022 DOI: 10.1016/j.ijporl.2019.05.040
    OBJECTIVES: Maternal knowledge and attitude towards childhood hearing loss play an important role in determining the success of early diagnosis and intervention of hearing loss programs in children. This study aimed to 1) assess the knowledge and attitude of childhood hearing loss among mothers, 2) compare knowledge and attitude of childhood hearing loss in urban and rural mothers, 3) investigate the relationship between knowledge and attitude on childhood hearing loss, and 4) identify socio-demographic factors that influence mothers' knowledge and attitude on childhood hearing loss.

    METHOD: A cross-sectional survey was conducted on 362 mothers and mothers-to-be (mean age: 31.9 ± 4.9 years, range: 20-48 years old) recruited from Hospital Universiti Kebangsaan Malaysia in Cheras, Kuala Lumpur and two health clinics in Lenggeng, Negeri Sembilan and Beranang, Selangor representing the urban and rural areas respectively. All participants were interviewed in person using a newly developed and reliable questionnaire that tested their knowledge and attitude on childhood hearing loss.

    RESULTS: Generally, the majority of mothers had a moderate level of knowledge and positive attitude towards childhood hearing loss. Urban mothers had a significantly higher knowledge than those of the rural area (p rural mothers. In addition, there was no significant relationship found between knowledge and attitude on childhood hearing loss among mothers. Age, race, occupation and education level contributed to the knowledge score significantly (p 

    Matched MeSH terms: Rural Population*
  12. Yusuf A, Mamun ASMA, Kamruzzaman M, Saw A, Abo El-Fetoh NM, Lestrel PE, et al.
    BMC Pediatr, 2019 06 29;19(1):213.
    PMID: 31255172 DOI: 10.1186/s12887-019-1581-9
    BACKGROUND: Anemia is not only a major public health problem among children in developing countries, it is also an important predictor for their future growth and development. The objective of this study was to identify possible factors associated with anemia among pre-school children in Bangladesh after removing a cluster effect of the population, and to determine the prevalence of this condition.

    METHODS: Data for this study was extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS-2011). In this survey, data was collected using a two-stage stratified cluster sampling approach. The chi-square test and a two-level logistic regression model were used for further analysis.

    RESULTS: Data from 2231 children aged 6-59 months were included for analysis. The prevalence of child anemia was noted to be 52.10%. Among these anemic children, 48.40% where from urban environment and 53.90% were from rural areas. The prevalence of mild, moderate and severe anemia among children was 57.10, 41.40 and 1.50% respectively. The two-level logistic regression model revealed that the following factors were associated with childhood anemia: children of anemic mothers (p 

    Matched MeSH terms: Rural Population/statistics & numerical data
  13. Murukesu RR, Singh DKA, Shahar S
    BMC Public Health, 2019 Jun 13;19(Suppl 4):529.
    PMID: 31196015 DOI: 10.1186/s12889-019-6870-6
    BACKGROUND: Urinary incontinence (UI) is known to be more prevalent among women and is associated with decline in quality of life. The aim of our study was to investigate the prevalence, risk factors of urinary incontinence and its impact on quality of life among community dwelling older women living in urban and rural populations.

    METHODS: This study was conducted based on secondary data analysed from the third phase of the longitudinal study "Neuroprotective Model for Health Longevity among Malaysian Elderly" (LRGS TUA). Stratification of urban and rural study areas were in accordance to that determined by the Department of Statistics. A total of 814 community dwelling older women (53% urban, 47% rural), aged 60 years and above, across four states within Peninsular Malaysia were included in this analysis. Interview-based questionnaires were used to obtain respondents' sociodemographic details and clinical characteristics. The Timed Up and Go test and Handgrip Strength tests were used to assess physical function. Urinary incontinence was self-reported, and quality of life of those with incontinence was assessed using the King's Health Questionnaire (KHQ).

    RESULTS: Prevalence of urinary incontinence was 16% and 23% among older women living in urban and rural areas, respectively. Ethnicity was significantly associated with incontinence among older women in both urban and rural population (p rural setting (p rural population, respondents with chronic constipation [OR: 3.384, 95% C.I: 1.556-7.360, p = 0.002] were found to be at a higher risk of UI. In terms of quality of life, respondents in rural areas experienced more role, physical, social, emotional limitations and sleep disturbance as compared to their urban counterparts (p rural setting. The risk factors of UI were ethnicity and chronic constipation among urban and rural older women respectively. It is important to provide holistic strategies in the prevention and management of UI among older women especially within the rural population.

    Matched MeSH terms: Rural Population/statistics & numerical data*
  14. Harris H, Ooi YBH, Lee JS, Matanjun P
    BMC Public Health, 2019 Jun 13;19(Suppl 4):554.
    PMID: 31196012 DOI: 10.1186/s12889-019-6854-6
    BACKGROUND: Rural coastal communities in Sabah are still overly represented in the hardcore poor economic status. The aim of this study was to determine the prevalence of hypertension, diabetes mellitus and hypercholesterolemia among adults, in relation to economic status.
    METHODS: A cross-sectional study using stratified random sampling was conducted in seven coastal villages in Semporna, Sabah: Kabogan Laut, Salimbangun, Pekalangan, Pokas, Tampi-Tampi Timbayan, Sum Sum and Selinggit. Socio-demographic data were obtained via interviewer administered questionnaires in Sabah Malay creole. Anthropometric measurements, blood pressure, fasting blood glucose and blood lipids were obtained.
    RESULTS: A total of 330 adults (133 males, 197 females) completed the study. Mean age was 43.7 ± 15.8 years. Most participants (87%) were living below the Poverty Line Income. Median per capita household income was RM83.33/month (≈ USD20/month). The number of newly diagnosed cases of hypercholesterolemia was 40.6%, diabetes mellitus was 5.8%, and hypertension was 24.5%. Adults from the hardcore poor economic status (household income ≤RM760/month (≈USD183/month) were the most represented in those who did not have a blood pressure, blood sugar and blood lipids check in the 12 months preceding the study (Χ2, p rural coastal community were unaware that they had high cholesterol level (40.6%) and elevated blood pressure (24.5%). Routine health check is not common among low income adults in rural coastal communities in Semporna. The findings suggest public health initiatives should emphasize access to and the necessity of routine health checks for those aged 40 years.
    Study site: seven coastal villages, Semporna, Sabah, Malaysia
    Matched MeSH terms: Rural Population/statistics & numerical data*
  15. Shahar S, Vanoh D, Mat Ludin AF, Singh DKA, Hamid TA
    BMC Public Health, 2019 Jun 13;19(Suppl 4):549.
    PMID: 31196023 DOI: 10.1186/s12889-019-6866-2
    BACKGROUND: Poverty at old age is associated with poor dietary habit, nutritional status and higher rates of chronic diseases and psychosocial problems. However, there is limited information about this matter according to urban and rural settings. The aim of this study was to identify dietary, nutritional, physical and cognitive factors associated with poor socioeconomic status (SES) among older adults according to urban and rural settings in Malaysia.

    METHODS: An analysis was conducted among 2237 older adults who participated in a longitudinal study on aging (LRGS TUA). This study involved four states in Malaysia, with 49.4% from urban areas. Respondents were divided into three categories of SES based on percentile, stratified according to urban and rural settings. SES was measured using household income.

    RESULTS: The prevalence of low SES was higher among older adults in the rural area (50.6%) as compared to the urban area (49.4%). Factors associated with low SES among older adults in an urban setting were low dietary fibre intake (Adj OR:0.91),longer time for the Timed up and Go Test (Adj OR:1.09), greater disability (Adj OR:1.02), less frequent practice of caloric restriction (Adj OR:1.65), lower cognitive processing speed score (Adj OR:0.94) and lower protein intake (Adj OR:0.94). Whilst, among respondents from rural area, the factors associated with low SES were lack of dietary fibre intake (Adj OR:0.79), lower calf circumference (Adj OR: 0.91), lesser fresh fruits intake (Adj OR:0.91), greater disability (Adj OR:1.02) and having lower score in instrumental activities of daily living (Adj OR: 0.92).

    CONCLUSION: Lower SES ismore prevalent in rural areas. Poor dietary intake, lower fitness and disability were common factors associated with low in SES, regardless of settings. Factors associated with low SES identifiedin both the urban and rural areas in our study may be useful inplanning strategies to combat low SES and its related problems among older adults.

    Matched MeSH terms: Rural Population/statistics & numerical data*
  16. Kaur S, Ng CM, Badon SE, Jalil RA, Maykanathan D, Yim HS, et al.
    BMC Public Health, 2019 Jun 13;19(Suppl 4):539.
    PMID: 31196034 DOI: 10.1186/s12889-019-6864-4
    BACKGROUND: Low birth weight prevalence in Malaysia remains high. Socioeconomic background may lead to differences in physical activity and maternal nutritional status, which may play an important role in birth outcomes.

    METHODS: This prospective cross-sectional study aimed to identify rural-urban differences in risk factors for low birth weight among women in Malaysia. Pregnant women at ≥20 weeks of gestation in urban and rural Malaysia (n = 437) completed questionnaires on sociodemographic characteristics and physical activity. Weight and middle-upper arm circumference were measured. Infant birth outcomes were extracted from medical records.

    RESULTS: The overall prevalence of low birth weight infants was 6.38%. Rural women had more low birth weight infants than urban women (9.8% vs 2.0%, p = 0.03). Findings showed rural women were less sedentary (p = 0.003) and participated in more household/caregiving activities (p = 0.036), sports activities (p = 0.01) and less occupational activity (p rural, but not in urban women.

    CONCLUSIONS: We observed differences in risk factors for low birth weight between urban and rural pregnant women. Age, malnutrition and low parity were risk factors for low birth weight among rural pregnant women. Our findings suggest that rural pregnant women with low nutritional status should be encouraged to monitor their middle-upper arm circumference consistently throughout pregnancy. Improving nutritional status in rural pregnant women may reduce the risk of low birth weight infants in this population.

    Matched MeSH terms: Rural Population/statistics & numerical data*
  17. Wan Puteh SE, Siwar C, Zaidi MAS, Abdul Kadir H
    BMC Public Health, 2019 Jun 13;19(Suppl 4):551.
    PMID: 31196024 DOI: 10.1186/s12889-019-6853-7
    BACKGROUND: The rapid growth of economy and increasing cost of living in Malaysia have given significant impact especially to the lowest household income population. The main objective of this study was to determine risk factors for low quality of life (QOL) and poor health status of this population.

    METHODS: This was a cross sectional study design. A total of 347 respondents from low household income groups, including persons with disability and Orang Asli were recruited from E-kasih. A semi-guided self-administered questionnaire was used. QOL measured by EQ. 5D utility value and health status measured by visual analogue score (VAS). Descriptive statistic, bivariate Chi-square analysis and binary logistic regression were conducted to determine factors influencing low QOL and poor health status.

    RESULTS: Majority of the respondents were Malay, female (61%), 63% were married, 60% were employed and 46% with total household income of less than 1 thousand Ringgit Malaysia. 70% of them were not having any chronic medical problems. Factors that associated with low QOL were male, single, low household income, and present chronic medical illness, while poor health status associated with female, lower education level and present chronic medical illness. Logistic regression analysis has showed that determinants of low QOL was present chronic illness [AOR 4.15 95%CI (2.42, 7.13)], while determinants for poor health status were; female [AOR 1.94 95%CI (1.09,3.44)], lower education [AOR 3.07 95%CI (1.28,7.34)] and present chronic illness [AOR 2.53 95%CI (1.39,4.61)].

    CONCLUSION: Low socioeconomic population defined as low total household income in this study. Low QOL of this population determined by present chronic illness, while poor health status determined by gender, education level and chronic medical illness.

    Matched MeSH terms: Rural Population/statistics & numerical data
  18. Shahar S, Lau H, Puteh SEW, Amara S, Razak NA
    BMC Public Health, 2019 Jun 13;19(Suppl 4):552.
    PMID: 31196021 DOI: 10.1186/s12889-019-6852-8
    The current issue of BMC Public Health presents work by the Consortium of Low Income Population Research (CB40R), highlighting a comprehensive aspect of health, i.e., physical health, mental health, health behaviour and health financing; and also nutrition involving all stages of lifespan of the socioeconomic deprived group in Malaysia.Consortium of B40 Research (CB40R) reposited and harmonised shared, non-identifiable data from epidemiological studies involving low income population (B40) in Malaysia. CB40R also performed joint or mega-analyses using combined, harmonised data sets that yield collated results with enhanced statistical power, more variabilities (study population, geographical regions, ethnicities and sociocultural groups) to better understand the needs, characteristics and issues of B40 groups in Malaysia. It also aimed to develope a system/framework of minimum/standard variables to be collected in research involving B40 in future. For this special issues, members of the consortium have been invited to contribute an original article involving analysis of the health aspects, access to health and nutritional issues of the B40 samples.All the papers in this special issue have successfully highlighted the health and nutritional issues (i.e., non-communicable disease (NCD), inflammatory bowel disease (IBD), knowledge towards sexually transmitted disease (STD), low birth weight, Motoric Cognitive Risk (MCR) syndrome, urinary incontinence), mental health, oral health and inequalities among the low-income group in Malaysia, including the rural population and also the urban poor. The low-income population in Malaysia is also at risk of both under- and over nutrition, of which specific cost effective strategies are indeed needed to improve their quality of life.The low income population in Malaysia is facing various health challenges, particularly related to NCD and poor mental health, nutritional and physical function. There is a need for a sustainable intervention model to tackle the issues. It is also important to highlight that reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health.
    Matched MeSH terms: Rural Population/trends
  19. Rosengren A, Smyth A, Rangarajan S, Ramasundarahettige C, Bangdiwala SI, AlHabib KF, et al.
    Lancet Glob Health, 2019 06;7(6):e748-e760.
    PMID: 31028013 DOI: 10.1016/S2214-109X(19)30045-2
    BACKGROUND: Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status-wealth and education-differ among high-income, middle-income, and low-income countries, and, if so, why these differences exist. We explored the association between education and household wealth and cardiovascular disease and mortality to assess which marker is the stronger predictor of outcomes, and examined whether any differences in cardiovascular disease by socioeconomic status parallel differences in risk factor levels or differences in management.

    METHODS: In this large-scale prospective cohort study, we recruited adults aged between 35 years and 70 years from 367 urban and 302 rural communities in 20 countries. We collected data on families and households in two questionnaires, and data on cardiovascular risk factors in a third questionnaire, which was supplemented with physical examination. We assessed socioeconomic status using education and a household wealth index. Education was categorised as no or primary school education only, secondary school education, or higher education, defined as completion of trade school, college, or university. Household wealth, calculated at the household level and with household data, was defined by an index on the basis of ownership of assets and housing characteristics. Primary outcomes were major cardiovascular disease (a composite of cardiovascular deaths, strokes, myocardial infarction, and heart failure), cardiovascular mortality, and all-cause mortality. Information on specific events was obtained from participants or their family.

    FINDINGS: Recruitment to the study began on Jan 12, 2001, with most participants enrolled between Jan 6, 2005, and Dec 4, 2014. 160 299 (87·9%) of 182 375 participants with baseline data had available follow-up event data and were eligible for inclusion. After exclusion of 6130 (3·8%) participants without complete baseline or follow-up data, 154 169 individuals remained for analysis, from five low-income, 11 middle-income, and four high-income countries. Participants were followed-up for a mean of 7·5 years. Major cardiovascular events were more common among those with low levels of education in all types of country studied, but much more so in low-income countries. After adjustment for wealth and other factors, the HR (low level of education vs high level of education) was 1·23 (95% CI 0·96-1·58) for high-income countries, 1·59 (1·42-1·78) in middle-income countries, and 2·23 (1·79-2·77) in low-income countries (pinteraction<0·0001). We observed similar results for all-cause mortality, with HRs of 1·50 (1·14-1·98) for high-income countries, 1·80 (1·58-2·06) in middle-income countries, and 2·76 (2·29-3·31) in low-income countries (pinteraction<0·0001). By contrast, we found no or weak associations between wealth and these two outcomes. Differences in outcomes between educational groups were not explained by differences in risk factors, which decreased as the level of education increased in high-income countries, but increased as the level of education increased in low-income countries (pinteraction<0·0001). Medical care (eg, management of hypertension, diabetes, and secondary prevention) seemed to play an important part in adverse cardiovascular disease outcomes because such care is likely to be poorer in people with the lowest levels of education compared to those with higher levels of education in low-income countries; however, we observed less marked differences in care based on level of education in middle-income countries and no or minor differences in high-income countries.

    INTERPRETATION: Although people with a lower level of education in low-income and middle-income countries have higher incidence of and mortality from cardiovascular disease, they have better overall risk factor profiles. However, these individuals have markedly poorer health care. Policies to reduce health inequities globally must include strategies to overcome barriers to care, especially for those with lower levels of education.

    FUNDING: Full funding sources are listed at the end of the paper (see Acknowledgments).

    Matched MeSH terms: Rural Population/statistics & numerical data
  20. Tamang MK, Yadav UN, Hosseinzadeh H, Kafle B, Paudel G, Khatiwada S, et al.
    BMC Res Notes, 2019 Apr 30;12(1):246.
    PMID: 31039794 DOI: 10.1186/s13104-019-4282-4
    OBJECTIVES: This study aimed at assessing the nutritional status among the elderly population and factors associated with malnutrition in the community setting in rural Nepal.

    RESULTS: Out of 339 participants, 24.8% (95% CI 20.21-29.30) fell into the normal nutritional status range; 49.6% (95% CI 44.29-54.91) were at risk for malnutrition while 24.8% (95% CI 20.21-29.30) were in the malnourished range, based on Mini Nutritional Assessment scores. Our findings revealed that belonging to a Dalit community, being unemployed, having experience of any form of mistreatment, lack of physical exercise, experiencing problems with concentration in past 30 days and taking medication for more than one co-morbidity was significantly associated with the malnutrition status of the elderly.

    Matched MeSH terms: Rural Population
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