METHODS: The self-administered online survey utilized in this cross-sectional study was derived from the Global Health Professions Students Survey (GHPSS), which involved medical, dental, and pharmacy students. A total of 328 participants completed a questionnaire from June to August 2022, with a response rate of 91.1%.
RESULTS: The overall smoking prevalence was 4.6% among the medical, dental, and pharmacy students who participated in this study; 46.7% of current smokers were exposed to secondhand smoke at home compared to 17.6% of non-smokers (p=0.011); and 66.7% of smokers were exposed to secondhand smoke in public compared to 40.3% of non-smokers (p=0.043). In all, 99.1% of respondents supported the smoking ban and 46.7% of current smokers supported the smoking ban in discos/bars/pubs, compared to 82.0% of non-smokers (p=0.002). Of the participants, 96.6% received lessons on the danger of tobacco, and 65.5% received smoking cessation training. Among factors associated with current smoking was gender; male students had a 19-fold higher likelihood of smoking than female students (adjusted odds ratio, AOR=19.25; 95% CI: 4.25-87.19, p<0.001). In addition, home exposure to secondhand smoke was four times more common for current smokers (OR=4.11; 95% CI: 1.43-11.79, p=0.009).
CONCLUSIONS: Although smoking prevalence was low among the students in this study, there was a higher percentage of them exposed to secondhand smoke at home and in public.
METHODOLOGY: This study involved 194 older adults with probable sarcopenia and sarcopenia aged 60 years and above. Sarcopenia was assessed using the Asian Working Group of Sarcopenia (AWGS) 2019. Among the parameters investigated in this study were sociodemographic, medical history, anthropometry, body composition, physical fitness, subjective cognitive decline, depressive symptoms, cognitive function and functional status. Dementia risk was assessed using the Montreal Cognitive Assessment (MoCA) tool. Adjusted binary logistic regression was employed to identify the factors associated with dementia among probable sarcopenia and sarcopenia older adults.
RESULTS: Probable sarcopenia subjects with dementia were older (68.5(7.8) years old) as compared to those without dementia (66.0(6.0) years old). Among the probable sarcopenia, 66.1% of the subjects with dementia had hypertension, while 64.3% of the sarcopenia subjects had hypertension. Fat mass was significantly higher among dementia subjects with probable sarcopenia (33.0(6.5) %) as compared to non-dementia subjects (30.4(6.8) %). Multivariate analysis revealed that hypertension (OR: 4.049; 95% CI: 1.510; 10.855, p = 0.005) was the only factor associated with dementia risk among older adults with probable sarcopenia and sarcopenia.
CONCLUSION: Hypertension is the only factors associated with risk of dementia after adjusting for potential confounders among older adults with probable sarcopenia and sarcopenia. Good control of blood pressure is essential among sarcopenia patients for lowering risk of dementia. Well-designed clinical trials are essential to investigate optimizing blood pressure level to reduce risk of dementia among patients with sarcopenia and probable sarcopenia.
OBJECTIVE: To assist with achieving these goals and to inform the development of a national strategic plan for Malaysia, we estimated the long-term burden incurred by the care and management of patients with chronic hepatitis C virus (HCV) infection. We compared cumulative healthcare costs and disease burden under different treatment cascade scenarios.
METHODS: We attached direct costs for the management/care of chronically HCV-infected patients to a previously developed clinical disease progression model. Under assumptions regarding disease stage-specific proportions of model-predicted HCV patients within care, annual numbers of patients initiated on antiviral treatment and distribution of treatments over stage, we projected the healthcare costs and disease burden [in disability-adjusted life-years (DALY)] in 2018-2040 under four treatment scenarios: (A) no treatment/baseline; (B) pre-2018 standard of care (pegylated interferon/ribavirin); (C) gradual scale-up in direct-acting antiviral (DAA) treatment uptake that does not meet the WHO 2030 treatment uptake target; (D) scale-up in DAA treatment uptake that meets the WHO 2030 target.
RESULTS: Scenario D, while achieving the WHO 2030 target and averting 253,500 DALYs compared with the pre-2018 standard of care B, incurred the highest direct patient costs over the period 2018-2030: US$890 million (95% uncertainty interval 653-1271). When including screening programme costs, the total cost was estimated at US$952 million, which was 12% higher than the estimated total cost of scenario C.
CONCLUSIONS: The scale-up to meet the WHO 2030 target may be achievable with appropriately high governmental commitment to the expansion of HCV screening to bring sufficient undiagnosed chronically infected patients into the treatment pathway.