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  1. Fulltext Precision Medicine for Sepsis Management in Low- and Middle-Income Countries-Melioidosis as a Model?
    Wen YT, Cheng AC, Podin Y
    Am J Respir Crit Care Med, 2024 Feb 01;209(3):237-238.
    PMID: 38055331 DOI: 10.1164/rccm.202311-2056ED
    Matched MeSH terms: Developing Countries
  2. Fulltext Effect of the Prevalence of HIV/AIDS and the Life Expectancy Rate on Economic Growth in SSA Countries: Difference GMM Approach
    Waziri SI, Mohamed Nor N, Raja Abdullah NM, Adamu P
    Glob J Health Sci, 2016;8(4):212-20.
    PMID: 26573032 DOI: 10.5539/gjhs.v8n4p212
    The productivity of countries around the globe is adversely affected by the health-related problems of their labour force. This study examined the effect of the prevalence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and life expectancy on the economic growth of 33 Sub-Saharan African (SSA) countries over a period of 11 years (2002-2012). The study employed a dynamic panel approach as opposed to the static traditional approach utilised in the literature. The dynamic approach became eminent because of the fact that HIV/AIDS is a dynamic variable as its prevalence today depends on the previous years. The result revealed that HIV/AIDS is negatively correlated with economic growth in the region, with a coefficient of 0.014, and significant at the 1% level. That is, a 10% increase in HIV/AIDS prevalence leads to a 0.14% decrease in the GDP of the region. Tackling HIV/AIDS is therefore imperative to the developing Sub-Saharan African region and all hands must be on deck to end the menace globally.
    Matched MeSH terms: Developing Countries/economics*
  3. Asia Pacific Society of Human Genetics (APSHG) from conception to 2019: 13 years of collaboration to tackle congenital malformation and genetic disorders in Asia
    Wasant P, Padilla C, Lam S, Thong MK, Lai PS
    Am J Med Genet C Semin Med Genet, 2019 06;181(2):155-165.
    PMID: 31050142 DOI: 10.1002/ajmg.c.31701
    Putting together the reports in this issue that come from a representation of the different countries in Asia presents an opportunity to share the unique story of the Asia Pacific Society of Human Genetics (APSHG), which has provided the authors of many of these articles. This paper, authored by the Past Presidents of the Society, shares glimpses of how medical genetics activities were first organized in the Asia Pacific region and provides interesting corollaries on how under-developed and developing countries in this part of the world had developed a unique network for exchange and sharing of expertise and resources. Although APSHG was formally registered as a Society in Singapore in 2006, the Society has its origins as far back as in the 1990s with members from different countries meeting informally, exchanging ideas, and collaborating. This treatise documents the story of the experiences of the Society and hopes it will provide inspiration on how members of a genetics community can foster and build a thriving environment to promote this field.
    Matched MeSH terms: Developing Countries
  4. Fulltext Using Zoo Welfare Assessments to Identify Common Issues in Developing Country Zoos
    Ward SJ, Williams E, Groves G, Marsh S, Morgan D
    Animals (Basel), 2020 Nov 12;10(11).
    PMID: 33198237 DOI: 10.3390/ani10112101
    Zoo animal welfare is a high priority for many institutions worldwide, with modern zoos now ensuring that animals are housed and cared for to the highest standards. However, in countries where this knowledge is not as available or understood, standards may be lower. The aim of this research was to investigate if there were common zoo welfare concerns across developing country zoos. Wild Welfare is a charity working globally to improve welfare for zoo animals and has an independent welfare audit that is carried out before any intervention occurs. The Wild Welfare Audit, consisting of 110 questions, covering nine topics, was completed at 11 zoos in seven developing countries (Brazil, Egypt, Libya, Indonesia, Thailand, Malaysia and Vietnam) following a Likert scale score (1-3). A principal component analysis was also performed to evaluate the audit questions. The results suggest that common areas of concern were animal behaviour, positive animal mental states and human health and safety. These themes were likely due to the lack knowledge and understanding that may be linked to historical and cultural differences. This research has helped to revise the welfare audit as well as inform future intervention strategies for improving developing country zoo animal welfare.
    Matched MeSH terms: Developing Countries
  5. Fulltext Equitable Access to State-of-the-Art Medical Technology-a Malaysian Mini-Public-Private Partnership Case Study
    Waran V, Thillainathan R, Karuppiah R, Pickard JD
    World Neurosurg, 2022 01;157:135-142.
    PMID: 34687934 DOI: 10.1016/j.wneu.2021.10.112
    BACKGROUND: The provision of equitable and affordable health care has become increasingly challenging as advanced technology is introduced, particularly in developing countries. We explored the hypothesis that focused, small-scale mini-public-private partnerships have a potential role in providing equitable and affordable access to advanced technology for the benefit of all patients in developing nations, particularly middle-income countries.

    METHODS: A clinician-led financial plan was developed at the University of Malaya to create the Centre for Image Guidance and Minimally Invasive Therapy (CIGMIT) to provide an integrated platform for high-end care for Malaysian patients of all ages, both public and private, requiring complex neurosurgical and spinal procedures and stereotactic and intensity-modulated radiotherapy. The challenges faced during development of the plan were documented together with an audit of patient throughput and analyses of financial risk and return.

    RESULTS: CIGMIT opened in 2015. Patient throughput, both public and private, progressively increased in all facilities. In 2015-2019, 37,724 patients used the Centre's facilities. CIGMIT has become progressively more profitable for the University of Malaya, the public and private hospitals, and the investor. CIGMIT has weathered the challenges posed by coronavirus disease 19.

    CONCLUSIONS: Focused, small-scale mini-public-private partnerships have a potential role in providing advanced technology for the benefit of patients in developing nations, particularly middle-income countries, subject to an approach that balances equity of access between public and private health care systems with fair reward.

    Matched MeSH terms: Developing Countries
  6. Fulltext Underweight, overweight, and tobacco use among adolescents aged 12-15 years: Evidence from 23 low-income and middle-income countries
    Wang Q
    Tob Induc Dis, 2021;19:37.
    PMID: 34017231 DOI: 10.18332/tid/133932
    INTRODUCTION: Compared with the number of studies in adults, body weight in relation to tobacco use has been understudied in the adolescent population. This study aimed to examine the association between underweight, overweight and tobacco use in low- and middle-income countries.

    METHODS: Data were derived from the Global School-Based Student Health Survey (GSHS). Data from 71176 adolescents aged 12-15 years residing in 23 countries were analyzed. The Centers for Disease Control and Prevention (CDC) 2000 growth charts were used to identify underweight, normal weight, and overweight/ obesity. Weighted age- and gender-adjusted prevalence of weight categories and tobacco use was calculated. Multivariate logistic regression analysis was performed to estimate the association between weight categories and tobacco use for each country, controlling for covariates. Pooled odds ratios and confidence intervals were computed using random- or fixed-effects meta-analyses.

    RESULTS: A significant association between weight categories and tobacco use was evident in only a few countries. Adolescents reporting tobacco use in French Polynesia, Suriname, and Indonesia, had 72% (95% CI: 0.15-0.56), 55% (95% CI: 0.24-0.84), and 24% (95% CI: 0.61-0.94) lower odds of being underweight, respectively. Adolescents reporting tobacco use in Uganda, Algeria, and Namibia, had 2.30 (95% CI: 1.04-5.09), 1.71 (95% CI: 1.25-2.34), and 1.45 (95% CI: 1.00-2.12) times greater odds of being overweight/obese, but those in Indonesia and Malaysia had 33% (95% CI: 0.50-0.91) and 16% (95% CI: 0.73-0.98) lower odds of being overweight/obese.

    CONCLUSIONS: The association between tobacco use and BMI categories is likely to be different among adolescents versus adults. Associating tobacco use with being thin may be more myth than fact and should be emphasized in tobacco prevention programs targeting adolescents.

    Matched MeSH terms: Developing Countries
  7. Poverty and mortality among the elderly: measurement of performance in 33 countries 1960-92
    Wang J, Jamison DT, Bos E, Vu MT
    Trop Med Int Health, 1997 Oct;2(10):1001-10.
    PMID: 9357491
    This paper analyses the effect of income and education on life expectancy and mortality rates among the elderly in 33 countries for the period 1960-92 and assesses how that relationship has changed over time as a result of technical progress. Our outcome variables are life expectancy at age 60 and the probability of dying between age 60 and age 80 for both males and females. The data are from vital-registration based life tables published by national statistical offices for several years during this period. We estimate regressions with determinants that include GDP per capita (adjusted for purchasing power), education and time (as a proxy for technical progress). As the available measure of education failed to account for variation in life expectancy or mortality at age 60, our reported analyses focus on a simplified model with only income and time as predictors. The results indicate that, controlling for income, mortality rates among the elderly have declined considerably over the past three decades. We also find that poverty (as measured by low average income levels) explains some of the variation in both life expectancy at age 60 and mortality rates among the elderly across the countries in the sample. The explained amount of variation is more substantial for females than for males. While poverty does adversely affect mortality rates among the elderly (and the strength of this effect is estimated to be increasing over time), technical progress appears far more important in the period following 1960. Predicted female life expectancy (at age 60) in 1960 at the mean income level in 1960 was, for example 18.8 years; income growth to 1992 increased this by an estimated 0.7 years, whereas technical progress increased it by 2.0 years. We then use the estimated regression results to compare country performance on life expectancy of the elderly, controlling for levels of poverty (or income), and to assess how performance has varied over time. High performing countries, on female life expectancy at age 60, for the period around 1990, included Chile (1.0 years longer life expectancy), China (1.7 years longer), France (2.0 years longer), Japan (1.9 years longer), and Switzerland (1.3 years longer). Poorly performing countries included Denmark (1.1 years shorter life expectancy than predicted from income), Hungary (1.4 years shorter), Iceland (1.2 years shorter), Malaysia (1.6 years shorter), and Trinidad and Tobago (3.9 years shorter). Chile and Switzerland registered major improvements in relative performance over this period; Norway, Taiwan and the USA, in contrast showed major declines in performance between 1980 and the early 1990s.
    Matched MeSH terms: Developing Countries/statistics & numerical data*
  8. Fulltext Catastrophic Health Expenditure (CHE) among Cancer Population in a Middle Income Country with Universal Healthcare Financing
    Wan Puteh SE, Abdullah YR, Aizuddin AN
    Asian Pac J Cancer Prev, 2023 Jun 01;24(6):1897-1904.
    PMID: 37378917 DOI: 10.31557/APJCP.2023.24.6.1897
    BACKGROUND: The study investigated healthcare expenditure from the perspective of cancer patients, to determine the level of Catastrophic Health Expenditure (CHE) and its associated factors.

    METHODS: This cross-sectional study was conducted in three Malaysian public hospitals namely Hospital Kuala Lumpur, Hospital Canselor Tuanku Muhriz and the National Cancer Institute using a multi-level sampling technique to recruit 630 respondents from February 2020 to February 2021. CHE was defined as incurring a monthly health expenditure of more than 10% of the total monthly household expenditure. A validated questionnaire was used to collect the relevant data.

    RESULTS: The CHE level was 54.4%. CHE was higher among patients of Indian ethnicity (P = 0.015), lower level education (P = 0.001), those unemployed (P < 0.001), lower income (P < 0.001), those in poverty (P < 0.001), those staying far from the hospital (P < 0.001), living in rural areas (P = 0.003), small household size (P = 0.029), moderate cancer duration (P = 0.030), received radiotherapy  treatment (P < 0.001), had very frequent treatment (P < 0.001), and without a Guarantee Letter (GL) (P < 0.001). The regression analysis identified significant predictors of CHE as lower income aOR 18.63 (CI 5.71-60.78), middle income aOR 4.67 (CI 1.52-14.41), poverty income aOR 4.66 (CI 2.60-8.33), staying far from hospital aOR 2.62 (CI 1.58-4.34), chemotherapy aOR 3.70 (CI 2.01-6.82), radiotherapy aOR 2.99 (CI 1.37-6.57), combination chemo-radiotherapy aOR 4.99 (CI 1.48-16.87), health insurance aOR 3.99 (CI 2.31-6.90), without GL aOR 3.38 (CI 2.06-5.40), and without health financial aids aOR 2.94 (CI 1.24-6.96).

    CONCLUSIONS: CHE is related to various sociodemographic, economic, disease, treatment and presence of health insurance, GL and health financial aids variables in Malaysia.

    Matched MeSH terms: Developing Countries
  9. Fulltext Cost of type 2 diabetes mellitus in selected developing countries
    Wan Norlida Ibrahim, Syed Aljunid, Aniza Ismail
    Malaysian Journal of Public Health Medicine, 2010;10(2):68-71.
    MyJurnal
    Increasing prevalence of chronic diseases is a major contributor for rapid rise in healthcare cost in developing countries since the last decade. It was estimated that around 54% of deaths in developing countries are due to chronic non-communicable diseases which is predicted to rise by 65% by 2030. Diabetes mellitus is among the most prevalent chronic diseases suffered by more than 180 million people worldwide. By 2030 it is estimated that around 400 million people in the world will be afflicted with diabetes. Annual deaths attributable to diabetes are probably as high as 3 million with more than 80% occur in developing countries. India, China and Indonesia are three countries in the Asian region with most number of people with diabetes. The total number of cases in these three countries is expected to increase more than double from 61 million in 2000 to 163 million in 2030. China and India will suffer cumulative GDP loss of 13.8% and 16.7% respectively, over the next ten year period. Assessing economic burden of diabetes is a challenging task for researchers because identification of direct and indirect cost of the disease is often complex since patients with diabetes also suffers from other complications and co-morbidities. In conclusion, the heavy economic burden of diabetes pose major challenges to health policy makers in developing countries to assess the current approach in managing this chronic disease. Serious efforts should be made on focusing and up-scaling activities on health promotion and prevention of diabetes so that to provide a more cost-effective solution to this condition with huge and increasing economic loss.
    Matched MeSH terms: Developing Countries
  10. Fulltext Clinical inertia in type 2 diabetes management in a middle-income country: A retrospective cohort study
    Wan KS, Moy FM, Mohd Yusof K, Mustapha FI, Mohd Ali Z, Hairi NN
    PLoS One, 2020;15(10):e0240531.
    PMID: 33035261 DOI: 10.1371/journal.pone.0240531
    BACKGROUND: Clinical inertia can lead to poor glycemic control among type 2 diabetes patients. However, there is paucity of information on clinical inertia in low- and middle-income countries including Malaysia. This study aimed to determine the time to treatment intensification among T2D patients with HbA1c of ≥7% (≥53 mmol/mol) in Malaysian public health clinics. The proportion of patients with treatment intensification and its associated factors were also determined.

    MATERIAL AND METHODS: This was a five-year retrospective open cohort study using secondary data from the National Diabetes Registry. The study setting was all public health clinics (n = 47) in the state of Negeri Sembilan, Malaysia. Time to treatment intensification was defined as the number of years from the index year until the addition of another oral antidiabetic drug or initiation of insulin. Life table survival analysis based on best-worst case scenarios was used to determine the time to treatment intensification. Discrete-time proportional hazards model was fitted for the factors associated with treatment intensification.

    RESULTS: The mean follow-up duration was 2.6 (SD 1.1) years. Of 7,646 patients, the median time to treatment intensification was 1.29 years (15.5 months), 1.58 years (19.0 months) and 2.32 years (27.8 months) under the best-, average- and worst-case scenarios respectively. The proportion of patients with treatment intensification was 45.4% (95% CI: 44.2-46.5), of which 34.6% occurred only after one year. Younger adults, overweight, obesity, use of antiplatelet medications and poorer HbA1c were positively associated with treatment intensification. Patients treated with more oral antidiabetics were less likely to have treatment intensification.

    CONCLUSION: Clinical inertia is present in the management of T2D patients in Malaysian public health clinics. We recommend further studies in lower- and middle-income countries to explore its causes so that targeted strategies can be developed to address this issue.

    Matched MeSH terms: Developing Countries*
  11. Variations between women and men in risk factors, treatments, cardiovascular disease incidence, and death in 27 high-income, middle-income, and low-income countries (PURE): a prospective cohort study
    Walli-Attaei M, Joseph P, Rosengren A, Chow CK, Rangarajan S, Lear SA, et al.
    Lancet, 2020 07 11;396(10244):97-109.
    PMID: 32445693 DOI: 10.1016/S0140-6736(20)30543-2
    BACKGROUND: Some studies, mainly from high-income countries (HICs), report that women receive less care (investigations and treatments) for cardiovascular disease than do men and might have a higher risk of death. However, very few studies systematically report risk factors, use of primary or secondary prevention medications, incidence of cardiovascular disease, or death in populations drawn from the community. Given that most cardiovascular disease occurs in low-income and middle-income countries (LMICs), there is a need for comprehensive information comparing treatments and outcomes between women and men in HICs, middle-income countries, and low-income countries from community-based population studies.

    METHODS: In the Prospective Urban Rural Epidemiological study (PURE), individuals aged 35-70 years from urban and rural communities in 27 countries were considered for inclusion. We recorded information on participants' sociodemographic characteristics, risk factors, medication use, cardiac investigations, and interventions. 168 490 participants who enrolled in the first two of the three phases of PURE were followed up prospectively for incident cardiovascular disease and death.

    FINDINGS: From Jan 6, 2005 to May 6, 2019, 202 072 individuals were recruited to the study. The mean age of women included in the study was 50·8 (SD 9·9) years compared with 51·7 (10) years for men. Participants were followed up for a median of 9·5 (IQR 8·5-10·9) years. Women had a lower cardiovascular disease risk factor burden using two different risk scores (INTERHEART and Framingham). Primary prevention strategies, such as adoption of several healthy lifestyle behaviours and use of proven medicines, were more frequent in women than men. Incidence of cardiovascular disease (4·1 [95% CI 4·0-4·2] for women vs 6·4 [6·2-6·6] for men per 1000 person-years; adjusted hazard ratio [aHR] 0·75 [95% CI 0·72-0·79]) and all-cause death (4·5 [95% CI 4·4-4·7] for women vs 7·4 [7·2-7·7] for men per 1000 person-years; aHR 0·62 [95% CI 0·60-0·65]) were also lower in women. By contrast, secondary prevention treatments, cardiac investigations, and coronary revascularisation were less frequent in women than men with coronary artery disease in all groups of countries. Despite this, women had lower risk of recurrent cardiovascular disease events (20·0 [95% CI 18·2-21·7] versus 27·7 [95% CI 25·6-29·8] per 1000 person-years in men, adjusted hazard ratio 0·73 [95% CI 0·64-0·83]) and women had lower 30-day mortality after a new cardiovascular disease event compared with men (22% in women versus 28% in men; p<0·0001). Differences between women and men in treatments and outcomes were more marked in LMICs with little differences in HICs in those with or without previous cardiovascular disease.

    INTERPRETATION: Treatments for cardiovascular disease are more common in women than men in primary prevention, but the reverse is seen in secondary prevention. However, consistently better outcomes are observed in women than in men, both in those with and without previous cardiovascular disease. Improving cardiovascular disease prevention and treatment, especially in LMICs, should be vigorously pursued in both women and men.

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

    Matched MeSH terms: Developing Countries/economics*; Developing Countries/statistics & numerical data
  12. Science, politics, and radiation
    Wagner HN
    JAMA, 1988 Aug 5;260(5):697-8.
    PMID: 3392799
    Matched MeSH terms: Developing Countries
  13. Tropical medicine and industrial development
    Waddy BB
    J Trop Med Hyg, 1974 Apr;77(4):s:19-21.
    PMID: 4841357
    Matched MeSH terms: Developing Countries
  14. Fulltext Plasmodium knowlesi and Wuchereria bancrofti: Their Vectors and Challenges for the Future
    Vythilingam I
    Front Physiol, 2012;3:115.
    PMID: 22557977 DOI: 10.3389/fphys.2012.00115
    Malaria and filariasis still continue to pose public health problems in developing countries of the tropics. Although plans are in progress for the elimination of both these parasitic vector borne diseases, we are now faced with a daunting challenge as we have a fifth species, Plasmodium knowlesi a simian malaria parasite affecting humans. Similarly in peninsular Malaysia, filariasis was mainly due to Brugia malayi. However, we now see cases of Wuchereria bancrofti in immigrant workers coming into the country. In order to successfully eliminate both these diseases we need to know the vectors involved and introduce appropriate control measures to prevent the diseases occurring in the future. As for knowlesi malaria it is still uncertain if human to human transmission through mosquito bites is occurring. However, P. knowlesi in human is not a rare occurrence anymore and has all the characteristics of a pathogen spreading due to changes in the ecosystem, international travel, and cross border migration. This has created a more complex situation. In order to overcome these challenges we need to revamp our control measures. This paper reviews the vectors of malaria and filariasis in Southeast Asia with special emphasis on P. knowlesi and W. bancrofti in Malaysia and their control strategies.
    Matched MeSH terms: Developing Countries
  15. Fulltext Cockroaches from urban human dwellings: isolation of bacterial pathogens and control
    Vythilingam I, Jeffery J, Oothuman P, Abdul Razak AR, Sulaiman A
    Southeast Asian J. Trop. Med. Public Health, 1997 Mar;28(1):218-22.
    PMID: 9322309
    A study was carried out to determine the distribution of cockroaches in two different housing areas with central sewerage or individual septic tanks in an urban area in Kuala Lumpur, Malaysia. Six species of cockroaches were present and of these Periplaneta americana and Periplaneta brunnea were found in greater abundance. Seventeen species of bacteria were isolated and of these Escherichia coli and Klebsiella p. pneumoniae were isolated in greatest numbers. Control measures carried out using lambda cyhalothrin showed that there was no significant difference between treated and control sites.
    Matched MeSH terms: Developing Countries*
  16. Early phase oncology clinical trials in Malaysia: current status and future perspectives
    Voon PJ, Lai WH, Bustaman RS, Siu LL, Razak ARA, Yusof A, et al.
    Asia Pac J Clin Oncol, 2023 Jun;19(3):296-304.
    PMID: 36305522 DOI: 10.1111/ajco.13886
    Historically, the majority of oncology clinical trials are conducted in Western Europe and North America. Globalization of drug development has resulted in sponsors shifting their focus to the Asia-Pacific region. In Malaysia, implementation of various government policies to promote clinical trials has been initiated over a decade ago and includes the establishment of Clinical Research Malaysia, which functions as a facilitator and enabler of industry-sponsored clinical trials on a nationwide basis. Although oncology clinical trials in Malaysia have seen promising growth, there are still only a limited number of early phase oncology studies being conducted. Hence, the Phase 1 Realization Project was initiated to develop Malaysia's early phase clinical trial capabilities. In addition, the adaptation of good practices from other countries contribute to the effective implementation of existing initiatives to drive progress in the development of early phase drug development set up in Malaysia. Furthermore, holistic approaches with emphasis in training and education, infrastructure capacities, strategic alliances, reinforcement of upstream activities in the value chain of drug development, enhanced patient advocacy, coupled with continued commitment from policy makers are imperative in nurturing a resilient clinical research ecosystem in Malaysia.
    Matched MeSH terms: Developing Countries
  17. The pill in figures and facts
    Von Keep PA
    Adv Fertil Control, 1967;2:1-5.
    PMID: 12275322
    Matched MeSH terms: Developing Countries
  18. WHO's role and activities in the promotion of diagnostic ultrasound in developing countries
    Volodin V
    Family Physician, 1990;2:47-50.
    Matched MeSH terms: Developing Countries
  19. Presidential address
    Vohra U
    IIPS Newsl, 1993 Jul;34(3):4-6.
    PMID: 12287408
    Matched MeSH terms: Developing Countries
  20. 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: Developing Countries
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