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Authorship in the East African Medical Journal

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*
Mosquito species and outdoor breeding places in residential areas in Malaysia

Saleeza SN, Norma-Rashid Y, Azirun MS

Southeast Asian J. Trop. Med. Public Health, 2013 Nov;44(6):963-9.
PMID: 24450233

We conducted mosquito surveillance at outdoor breeding habitat in 459 households at 7 urban locations in Putrajaya, Malaysia from January to December 2010 to determine the predominant species and breeding locations. The most common species found at all locations was Aedes albopictus. Gardening utensils were the most common breeding sites. Of the 1,885 mosquito larvae specimens found, 1,774 (94.1%) were Ae. albopictus larvae, 84 (4%) were Ae. aegypti larvae and 27 (1%) were Culex quinquefasciatus larvae. The Aedes index for each of the locations was higher than the goal set by the Ministry of Health for Malaysia. However, the container index at each of the locations was within the goal. The Breateau index was above the goal set by the Ministry of Health at Precinct 9B1 but the other locations were within the goal.

Matched MeSH terms: Residence Characteristics/statistics & numerical data*
Physical Activity Among Adolescents in an East Malaysian Rural Indigenous Community: Exploring the Influence of Neighborhood Environmental Factors

Saimon R, Choo WY, Chang KH, Ng CJ, Bulgiba A

Asia Pac J Public Health, 2015 Nov;27(8 Suppl):33S-40S.
PMID: 25900978 DOI: 10.1177/1010539515582220

This study explores the rural environmental factors that influence adolescents' participation in physical activities (PA). Thirty-six indigenous adolescents, aged 13 to 17 years from rural communities of East Malaysia were involved in the photovoice procedures: photo-taking, selecting, contextualizing, and codifying themes. Despite being endowed with natural resources such as river, forest, hills, and so on, the adolescents and the community did not capitalize on these rich resources to promote and engage in PA. Poor maintenance of natural resources, the lack of pedestrian infrastructures and road safety, the lack of PA facilities, and negative perception of ancestors' agricultural activities were among factors that constrained adolescents' PA. Although basic amenities such as play spaces and pedestrian infrastructures are necessary to increase adolescents' PA, any intervention should make the most of the natural resources, which are cheaper, environment friendly, and sustainable.

Matched MeSH terms: Residence Characteristics/statistics & numerical data*
Fulltext A community based study on the prevalence and factors affecting smoking in Kampong Jenderam Hilir, Sepang, Selangor

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*
Fulltext Association between Availability of Neighborhood Fast Food Outlets and Overweight Among 5⁻18 Year-Old Children in Peninsular Malaysia: A Cross-Sectional Study

Chee Cheong K, Yoon Ling C, Kuang Hock L, Mohd Ghazali S, Chien Huey T, Che Ibrahim MK, et al.

Int J Environ Res Public Health, 2019 02 18;16(4).
PMID: 30781699 DOI: 10.3390/ijerph16040593

A growing number of fast-food outlets in close proximity to residential areas raises a question as to its impact on childhood overweight and obesity. This study aimed at determining the relationship between the availability of fast-food outlets that were in close proximity to residential areas and overweight among Malaysian children aged 5 to 18 years. Measurement data on the weight and height of 5544 children (2797 boys, 2747 girls) were obtained from the National Health and Morbidity Survey 2011. Overweight (including obesity) is defined as BMI-for-age z-score > +1 SD based on the WHO growth reference. Geographic information system geospatial analysis was performed to determine the number of fast-food outlets within 1000 m radius from the children's residential address. Multiple logistic regression was conducted to examine the association between the availability of fast-food outlets (none or more than one outlet) and overweight with adjustment for age, sex, ethnicity, monthly household income, parental educational level, residential area and supermarket density. Our results showed that the prevalence of overweight was 25.0% and there was a statistically significant association between the density of fast-food outlets and overweight (odds ratio: 1.23, 95% confidence interval: 1.03, 1.47). Our study suggested that the availability of fast-food outlets with close proximity in residential areas was significantly associated with being overweight among children. Limiting the number of fast-food outlets in residential areas could have a significant effect in reducing the prevalence of overweight among Malaysian children.

Matched MeSH terms: Residence Characteristics/statistics & numerical data*
Migration and Unrest in the Deep South Thailand: A Multilevel Analysis of a Longitudinal Study

Jampaklay A, Ford K, Chamratrithirong A

Demography, 2020 04;57(2):727-745.
PMID: 32072505 DOI: 10.1007/s13524-020-00856-w

Although migration of Muslims from the southernmost provinces of Thailand to Malaysia has a long history, research suggests that the intensity of this migration has increased in the past 10 years along with increased unrest in the provinces. This study examines how migration in the three southernmost provinces is affected by the ongoing unrest. Data are drawn from household probability surveys conducted in 2014 and 2016. An individual sample of 3,467 persons who were household residents at the 2014 survey was followed to see who remained in the household of origin or moved out two years later (2016 survey). Data on violent events from the Deep South Watch, an independent organization, were used to measure exposure to violence. Results from a multilevel analysis show that net of other characteristics at the individual, household, and village levels, individuals who live in a village in which a violent event occurred in the previous year are more likely to move out than those who live in a village with no violent event in the previous year. Findings suggest that in addition to the economic reasons that have long motivated migration from this area, violent events accelerate this migration.

Matched MeSH terms: Residence Characteristics/statistics & numerical data
Fulltext Extending Data for Urban Health Decision-Making: a Menu of New and Potential Neighborhood-Level Health Determinants Datasets in LMICs

Thomson DR, Linard C, Vanhuysse S, Steele JE, Shimoni M, Siri J, et al.

J Urban Health, 2019 08;96(4):514-536.
PMID: 31214975 DOI: 10.1007/s11524-019-00363-3

Area-level indicators of the determinants of health are vital to plan and monitor progress toward targets such as the Sustainable Development Goals (SDGs). Tools such as the Urban Health Equity Assessment and Response Tool (Urban HEART) and UN-Habitat Urban Inequities Surveys identify dozens of area-level health determinant indicators that decision-makers can use to track and attempt to address population health burdens and inequalities. However, questions remain as to how such indicators can be measured in a cost-effective way. Area-level health determinants reflect the physical, ecological, and social environments that influence health outcomes at community and societal levels, and include, among others, access to quality health facilities, safe parks, and other urban services, traffic density, level of informality, level of air pollution, degree of social exclusion, and extent of social networks. The identification and disaggregation of indicators is necessarily constrained by which datasets are available. Typically, these include household- and individual-level survey, census, administrative, and health system data. However, continued advancements in earth observation (EO), geographical information system (GIS), and mobile technologies mean that new sources of area-level health determinant indicators derived from satellite imagery, aggregated anonymized mobile phone data, and other sources are also becoming available at granular geographic scale. Not only can these data be used to directly calculate neighborhood- and city-level indicators, they can be combined with survey, census, administrative and health system data to model household- and individual-level outcomes (e.g., population density, household wealth) with tremendous detail and accuracy. WorldPop and the Demographic and Health Surveys (DHS) have already modeled dozens of household survey indicators at country or continental scales at resolutions of 1 × 1 km or even smaller. This paper aims to broaden perceptions about which types of datasets are available for health and development decision-making. For data scientists, we flag area-level indicators at city and sub-city scales identified by health decision-makers in the SDGs, Urban HEART, and other initiatives. For local health decision-makers, we summarize a menu of new datasets that can be feasibly generated from EO, mobile phone, and other spatial data-ideally to be made free and publicly available-and offer lay descriptions of some of the difficulties in generating such data products.

Matched MeSH terms: Residence Characteristics/statistics & numerical data*
Fulltext Impact of place of residence on place of death in Wales: an observational study

Ziwary SR, Samad D, Johnson CD, Edwards RT

BMC Palliat Care, 2017 Dec 12;16(1):72.
PMID: 29233123 DOI: 10.1186/s12904-017-0261-5

BACKGROUND: Previous research in England showed that deprivation level of a person's place of residence affects the place of death and quality of care received at the end of life. People dying in their preferred place of death has also been shown to act as an indication for high quality of end of life care services and social equality. This study expands on current research to explore the effects of deprivation and place of residence on health related choices and place of death in Wales.
METHODS: We used ten years combined mortality statistics from 2005 to 2014 and Welsh Index of Multiple Deprivation rankings for each lower super output area. After accounting for the population's age, the number of deaths in Hospital, Hospice, Home, Care Home, Psychiatric Units, and Elsewhere were compared across deprivation quintiles.
RESULTS: Distribution of place of death was found to be concentrated in three places - hospital (60%), home (21%) and care home (13%). Results from this study shows a high number of hospital deaths, especially for more deprived areas, despite being the least preferred place of death.
CONCLUSION: This is the first Welsh study investigating place of death in relation to deprivation, which could be of major importance to academics, end of life care providers and policy makers interested in to reduce health care inequality in Wales.

Matched MeSH terms: Residence Characteristics/statistics & numerical data
Malnutrition among 3 to 5 years old children in Baghdad city, Iraq: a cross-sectional study

Ghazi HF, Mustafa J, Aljunid S, Isa Z, Abdalqader MA

J Health Popul Nutr, 2013 Sep;31(3):350-5.
PMID: 24288949

The unstable geopolitical situation in Iraq since 2003 still affects the health of people, especially children. Several factors may indirectly affect a child's nutritional status. The main aim of this study was to identify factors contributing to malnutrition among 3 to 5 years old children in Baghdad city, Iraq. Two hundred twenty children aged 3 to 5 years were chosen randomly from four kindergartens in Baghdad city according to the cross-sectional design. The nutritional status of the children was assessed using a weight-for-age z-score based on the World Health Organization 2007 cutoff points, in which any child with a z-score of

Matched MeSH terms: Residence Characteristics/statistics & numerical data
Fulltext Living arrangement and life satisfaction in older Malaysians: the mediating role of social support function

Kooshiar H, Yahaya N, Hamid TA, Abu Samah A, Sedaghat Jou V

PLoS One, 2012;7(8):e43125.
PMID: 22912806 DOI: 10.1371/journal.pone.0043125

BACKGROUND: This cross-sectional and correlational survey examines the association between different types of living arrangements and life satisfaction in older Malaysians, while taking into account the mediating effects of social support function.
METHODOLOGY AND FINDINGS: A total of 1880 of older adults were selected by multistage stratified sampling. Life satisfaction and social support were measured with the Philadelphia Geriatric Center Morale Scale and Medical Outcomes Study Social Support Survey. The result shows living with children as the commonest type of living arrangement for older adults in peninsular Malaysia. Compared to living alone, living only with a spouse especially and then co-residency with children were both associated with better life satisfaction (p

Matched MeSH terms: Residence Characteristics/statistics & numerical data*
Factors affecting dengue fever knowledge, attitudes and practices among selected urban, semi-urban and rural communities in Malaysia

Al-Dubai SA, Ganasegeran K, Mohanad Rahman A, Alshagga MA, Saif-Ali R

Southeast Asian J. Trop. Med. Public Health, 2013 Jan;44(1):37-49.
PMID: 23682436

Dengue fever is a major public health problem in Malaysia. This study aimed to assess factors affecting knowledge, attitudes, and practices regarding dengue fever among a selected population in Malaysia. A descriptive, community-based, cross sectional study was conducted with 300 participants from three different geographical settings in urban, semi-urban, and rural areas within the states of Selangor and Kuala Lumpur. The questionnaire included questions on demographic data, knowledge, attitudes, and practices regarding dengue fever. Mean age of respondents was 34.4 (+/- 5.7) years, and the age ranged from 18 to 65 years. The majority of respondents were married (54.7%), Malays (72.7%) and heard about dengue fever (89.7%). Television was the common source of information about dengue fever (97.0%). Participants answered 4 out of 15 items of knowledge incorrectly. There was no significant association between knowledge score and socio-demographic factors. About one-fifth of the respondents (24%) believed that immediate treatment is not necessary for dengue fever, and the majority of them were not afraid of the disease (96.0%). Attitudes toward dengue fever were significantly associated with the level of education and employment status (p < 0.05). Practice was associated significantly with age, marital status, and geographic area (p < 0.05) and knowledge on dengue fever (p = 0.030). There is a need to increase health promotion activities through campaigns and social mobilization to increase knowledge regarding dengue fever. This would help to mold positive attitudes and cultivate better preventive practices among the public to eliminate dengue in the country.

Matched MeSH terms: Residence Characteristics/statistics & numerical data*
Physical activity pattern of Malaysian preschoolers: Environment, barriers, and motivators for active play

Lee ST, Wong JE, Ong WW, Ismail MN, Deurenberg P, Poh BK

Asia Pac J Public Health, 2016 07;28(5 Suppl):21S-34S.
PMID: 27026634 DOI: 10.1177/1010539516638155

Children's physical activity has been correlated with child characteristics and social or physical environment. This study aimed to compare preschoolers' physical activity among various sociodemographic characteristics and to determine barriers, motivators, and environmental factors for active play. A total of 835 preschoolers were included in this analysis. Time spent on active play, quiet play, and screen time was reported by parents. Boys spent significantly more time on active play and screen time than girls. Time spent on quiet play was highest in East Coast Peninsular Malaysia and lowest in Sarawak. Some 40% of children achieved active play recommendation while 27% exceeded daily screen time recommendation. Most parents reported that their child played actively in the house area; and that the main barrier and motivator to active play were safety and child's enjoyment, respectively. These findings demonstrate that sociodemographic characteristics and environment should be considered in designing physical activity intervention programs.
MESH: screen time

Matched MeSH terms: Residence Characteristics/statistics & numerical data
Country variations in depressive symptoms profile in Asian countries: Findings of the Research on Asia Psychotropic Prescription (REAP) studies

Chee KY, Tripathi A, Avasthi A, Chong MY, Xiang YT, Sim K, et al.

Asia Pac Psychiatry, 2015 Sep;7(3):276-85.
PMID: 25641910 DOI: 10.1111/appy.12170

This study was to assess differences in the symptom profile of depressive illness across various countries/territories in Asia. The study was a part of the Research on Asia Psychotropic Prescription project. The participating countries/territories include China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Singapore, Taiwan, and Thailand.

Matched MeSH terms: Residence Characteristics/statistics & numerical data
Fulltext The relationship of dental caries and dental fear in Malaysian adolescents: a latent variable approach

Esa R, Ong AL, Humphris G, Freeman R

BMC Oral Health, 2014;14:19.
PMID: 24621226 DOI: 10.1186/1472-6831-14-19

To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia.

Matched MeSH terms: Residence Characteristics/statistics & numerical data
Fulltext Perceived physical activity barriers related to body weight status and sociodemographic factors among Malaysian men in Klang Valley

Ibrahim S, Karim NA, Oon NL, Ngah WZ

BMC Public Health, 2013;13:275.
PMID: 23530696 DOI: 10.1186/1471-2458-13-275

Physical inactivity has been acknowledged as a public health issue and has received increasing attention in recent years. This cross-sectional study was conducted to determine the barriers to physical activity among Malaysian men. These barriers were analyzed with regards to sociodemographic factors, physical activity level, BMI and waist circumference.

Matched MeSH terms: Residence Characteristics/statistics & numerical data
Fulltext A four year review of acute viral hepatitis cases in the east coast of peninsular Malaysia (1994-1997)

Saat Z, Sinniah M, Kin TL, Baharuddin R, Krishnasamy M

Southeast Asian J. Trop. Med. Public Health, 1999 Mar;30(1):106-9.
PMID: 10695797

A total of 1,157 sera from jaundiced patients with clinical and biochemical evidence of liver disease received from government hospital in Kelantan and Terengganu, during the period from 1994 to 1997, were investigated to determine the cause. Hepatitis A virus was found to be the main cause in 26.1% (24/92) of symptomatic clinical hepatitis cases in 1994, 47.8% (63/132) in 1995, 66.4% (613/923) in 1996 and 20% (2/10) in 1997. Sera received in 1996 were also tested for hepatitis B, hepatitis C, hepatitis D and hepatitis E. 1.4% (13/923) anti-bodies were found to be positive for HBc IgM indicating recent HBV infection, 5.4% (50/923) for total HCV Ab, 0.9% (8/923) for total HDV Ab and 0.4% (4/923) for anti-HEV IgM. This study shows that HAV is still a major problem in Kelantan and Terengganu, and there is a need to identify effective strategies for prevention and control in these two states.

Matched MeSH terms: Residence Characteristics/statistics & numerical data
Fulltext Pilot study to investigate the feasibility of the Home Falls and Accidents Screening Tool (HOME FAST) to identify older Malaysian people at risk of falls

Romli MH, Mackenzie L, Lovarini M, Tan MP

BMJ Open, 2016 08 16;6(8):e012048.
PMID: 27531736 DOI: 10.1136/bmjopen-2016-012048

OBJECTIVE: The relationship between home hazards and falls in older Malaysian people is not yet fully understood. No tools to evaluate the Malaysian home environment currently exist. Therefore, this study aimed to pilot the Home Falls and Accidents Screening Tool (HOME FAST) to identify hazards in Malaysian homes, to evaluate the feasibility of using the HOME FAST in the Malaysian Elders Longitudinal Research (MELoR) study and to gather preliminary data about the experience of falls among a small sample of Malaysian older people.
DESIGN: A cross-sectional pilot study was conducted.
SETTING: An urban setting in Kuala Lumpur.
PARTICIPANTS: 26 older people aged 60 and over were recruited from the control group of a related research project in Malaysia, in addition to older people known to the researchers.
PRIMARY OUTCOME MEASURE: The HOME FAST was applied with the baseline survey for the MELoR study via a face-to-face interview and observation of the home by research staff.
RESULTS: The majority of the participants were female, of Malay or Chinese ethnicity and living with others in a double-storeyed house. Falls were reported in the previous year by 19% and 80% of falls occurred at home. Gender and fear of falling had the strongest associations with home hazards. Most hazards were detected in the bathroom area. A small number of errors were detected in the HOME FAST ratings by researchers.
CONCLUSIONS: The HOME FAST is feasible as a research and clinical tool for the Malaysian context and is appropriate for use in the MELoR study. Home hazards were prevalent in the homes of older people and further research with the larger MELoR sample is needed to confirm the validity of using the HOME FAST in Malaysia. Training in the use of the HOME FAST is needed to ensure accurate use by researchers.

Matched MeSH terms: Residence Characteristics/statistics & numerical data*
Clustering of cardiovascular risk factors in a middle-income country: a call for urgency

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
Fulltext Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Global Burden of Disease Study 2013 Collaborators

Lancet, 2015 Aug 22;386(9995):743-800.
PMID: 26063472 DOI: 10.1016/S0140-6736(15)60692-4

BACKGROUND: Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013.
METHODS: Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries.
FINDINGS: Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013.
INTERPRETATION: Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.
FUNDING: Bill & Melinda Gates Foundation.
Malaysian collaborators: Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lampur, Malaysia (Prof N Mohamed Ibrahim MBBch); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Selangor, Malaysia (R Sahathevan PhD); Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Selangor, Malaysia (C T Sreeramareddy MD); WorldFish, Penang, Malaysia (A L Thorne-Lyman ScD); TCM Medical TK SDN BHD TCM, Nusajaya, Johor Bahru, Malaysia (K Yun Kin PhD)

Matched MeSH terms: Residence Characteristics/statistics & numerical data
Fulltext Cohort Profile: The Malaysian Cohort (TMC) project: a prospective study of non-communicable diseases in a multi-ethnic population

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

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