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Fulltext Factors influencing dyspepsia-related consultation: differences between a rural and an urban population

Mahadeva S, Yadav H, Everett SM, Goh KL

Neurogastroenterol Motil, 2011 Sep;23(9):846-53.
PMID: 21740483 DOI: 10.1111/j.1365-2982.2011.01746.x

BACKGROUND:
Dyspepsia is a common, chronic condition but medical consultation rates for symptoms remain variable. We aimed to examine two populations with varied health-care provision to determine predictive factors for dyspepsia-related consultation.

METHODS:
A cross-sectional, population-based study in both an urban and a rural community within a single Asian country was conducted. Details on dyspepsia-related consultation rates over a fixed period and independent factors influencing them were identified.

KEY RESULTS:
A total of 4039/5370 (75.2%) adults from representative rural and urban areas in this country agreed to participate in the study. Although mean ages of respondents were similar (40.4years), the demographics of both populations varied in terms of gender (62.7% female, rural vs 55.7% female, urban, P<0.0001), marital status (75.4% rural vs 70.5% urban, P=0.002), ethnicity, (79% Malay rural vs 45.3% Malays urban, P<0.0001) and socio-economic status (professional occupation 7.1% rural vs 47.3% urban, P<0.0001). Dyspepsia-related consultation rates were found to be higher among rural compared to urban adults (41.4%vs 28.7%, P<0.0001). Over-the-counter medication consumption was higher among urban compared to rural dyspepsia sufferers (n=157 vs n=35, P<0.0001). Following logistic regression, rural population (OR 3.14, 95% CI=1.65-6.0), low quality of life (OR 1.90, 95% CI=1.17-3.10), and self-medication (OR 0.40, 95% CI=0.25-0.62) were found to independently predict dyspepsia-related consultation.

CONCLUSIONS & INFERENCES:
Dyspepsia-related consultation varied significantly between urban and rural communities. Factors within the rural population, self-medication practices, and a low quality of life independently influenced dyspepsia-related consultation.
Fulltext Ethnic variation, epidemiological factors and quality of life impairment associated with dyspepsia in urban Malaysia

Mahadeva S, Yadav H, Rampal S, Everett SM, Goh KL

Aliment Pharmacol Ther, 2010 May;31(10):1141-51.
PMID: 20175766 DOI: 10.1111/j.1365-2036.2010.04270.x

The role of ethnicity in the development of dyspepsia remains uncertain.
Fulltext Economic impact of dyspepsia in rural and urban malaysia: a population-based study

Mahadeva S, Yadav H, Everett SM, Goh KL

J Neurogastroenterol Motil, 2012 Jan;18(1):43-57.
PMID: 22323987 DOI: 10.5056/jnm.2012.18.1.43

BACKGROUND/AIMS: The economic impact of dyspepsia in regions with a diverse healthcare system remains uncertain. This study aimed to estimate the costs of dyspepsia in a rural and urban population in Malaysia.
METHODS: Economic evaluation was performed based on the cost-of-illness method. Resource utilization and quality of life data over a specific time frame, were collected to determine direct, indirect and intangible costs related to dyspepsia.
RESULTS: The prevalences of dyspepsia in the rural (n = 2,000) and urban (n = 2,039) populations were 14.6% and 24.3% respectively. Differences in socioeconomic status and healthcare utilisation between both populations were considerable. The cost of dyspepsia per 1,000 population per year was estimated at USD14,816.10 and USD59,282.20 in the rural and urban populations respectively. The cost per quality adjusted life year for dyspepsia in rural and urban adults was USD16.30 and USD69.75, respectively.
CONCLUSIONS: The economic impact of dyspepsia is greater in an urban compared to a rural setting. Differences in socioeconomic status and healthcare utilisation between populations are thought to contribute to this difference.

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