1
|
Koly KN, Saba J, Rao M, Rasheed S, Reidpath DD, Armstrong S, Gnani S. Stakeholder perspectives of mental healthcare services in Bangladesh, its challenges and opportunities: a qualitative study. Glob Ment Health (Camb) 2024; 11:e37. [PMID: 38572252 PMCID: PMC10988148 DOI: 10.1017/gmh.2024.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/20/2024] [Accepted: 03/03/2024] [Indexed: 04/05/2024] Open
Abstract
This study explores Bangladesh's mental health services from an individual- and system-level perspective and provides insights and recommendations for strengthening it's mental health system. We conducted 13 in-depth interviews and 2 focus group discussions. Thirty-one participants were recruited using a combination of purposive and snowball sampling methods. All interviews and group discussions were audio-recorded and transcribed, and key findings were translated from Bengali to English. Data were coded manually and analysed using a thematic and narrative analysis approach. Stakeholders perceived scarcity of service availability at the peripheral level, shortage of professionals, weak referral systems, lack of policy implementation and regulatory mechanisms were significant challenges to the mental health system in Bangladesh. At the population level, low levels of mental health literacy, high societal stigma, and treatment costs were barriers to accessing mental healthcare. Key recommendations included increasing the number of mental health workers and capacity building, strengthening regulatory mechanisms to enhance the quality of care within the health systems, and raising awareness about mental health. Introducing measures that relate to tackling stigma, mental health literacy as well as building the capacity of the health workforce and governance systems will help ensure universal mental health coverage.
Collapse
Affiliation(s)
- Kamrun Nahar Koly
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jobaida Saba
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mala Rao
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Sabrina Rasheed
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Daniel D. Reidpath
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Stephanie Armstrong
- School of Health and Social Care, College of Health and Science, University of Lincoln, Lincoln, UK
| | - Shamini Gnani
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| |
Collapse
|
2
|
Razzaque A, Rahman A, Chowdhury R, Mustafa AHMG, Naima S, Begum F, Shafique S, Sarker BK, Islam MZ, Kim M, Jahangir MA, Matin Z, Ferdous J, Vandenent M, Reidpath DD. Preterm birth and neonatal mortality in selected slums in and around Dhaka City of Bangladesh: A cohort study. PLoS One 2024; 19:e0284005. [PMID: 38241263 PMCID: PMC10798464 DOI: 10.1371/journal.pone.0284005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 12/26/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Although under-five mortality has declined appreciably in Bangladesh over the last few decades, neonatal mortality still remains high. The objective of the study is to assess the level and determinants of preterm birth and the contribution of preterm birth to neonatal mortality. METHODS Data for this study came from selected slums in and around Dhaka city, where; since 2015, icddr,b has been maintaining the Health and Demographic Surveillance System (HDSS). The HDSS data were collected by female Field Workers by visiting each household every three months; however, during the visit, data on the Last Menstrual Period (LMP) were also collected by asking each eligible woman to ascertain the date of conception. Gestational age was estimated in complete weeks by subtracting LMP from the date of the pregnancy outcome. In this study, 6,989 livebirths were recorded by HDSS during 2016-2018, and these births were followed for neonatal survival; both bivariate and multivariate analyses were performed. RESULTS Out of total births, 21.7% were born preterm (before 37 weeks of gestation), and sub-categories were: 2.19% for very preterm (28 to 31 weeks), 3.81% for moderate preterm (32 to 33 weeks), and 15.71% for late preterm (34 to 36 weeks). The study revealed that preterm babies contributed to 39.6% of neonatal deaths; however, the probability of death was very high on the 1st day of birth (0.124 for very preterm, 0.048 for moderate preterm, 0.024 for late preterm, and 0.013 for term birth), and continued until the 3rd day. In the regression analysis, compared to the term neonates, the odds of neonatal mortality were 8.66 (CI: 5.63, 13.32, p<0.01), 4.13 (CI: 2.69, 6.34, p<0.01) and 1.48 (CI: 1.05, 2.08, p<0.05) respectively for very, moderate, and late preterm birth categories. The population attributable fraction for neonatal mortality was 23%, and sub-categories were 14% for very preterm, 10% for moderate preterm, and 6% for late preterm. CONCLUSIONS Although urban slums are in proximity to many health facilities, a substantial proportion of preterm births contribute to neonatal deaths. So, pregnant women should be targeted, to ensure timely care during pregnancy, delivery, and post-partum periods to improve the survival of new-borns in general and preterm birth in particular.
Collapse
Affiliation(s)
- Abdur Razzaque
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Anisur Rahman
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Razib Chowdhury
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - A. H. M. Golam Mustafa
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shakera Naima
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Farzana Begum
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sohana Shafique
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Bidhan Krishna Sarker
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Minjoon Kim
- Maternal Newborn Health, UNICEF New York, New York, New York, United States of America
| | | | - Ziaul Matin
- Health Section, UNICEF India, New Delhi, India
| | | | | | - Daniel D. Reidpath
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
3
|
Kamruzzaman M, Rahman A, Reidpath DD, Akhter S. Risk communication and community engagement in the context of COVID-19 response in Bangladesh: a qualitative study. Front Public Health 2024; 11:1267446. [PMID: 38249367 PMCID: PMC10799557 DOI: 10.3389/fpubh.2023.1267446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Background The global COVID-19 pandemic profoundly impacted nations worldwide, and Bangladesh was no exception. In response, the government of Bangladesh implemented community awareness initiatives aimed at containing the spread of the virus, aligned with international guidelines and recommendations. Despite these efforts, a lack of comprehensive community awareness programs played an essential role during the pandemic, not the preventive measures. A qualitative study employing framing theory was conducted to gain a deeper insight into how the social context influenced risk communication and community response throughout the COVID-19 pandemic in Bangladesh. Methods The study was conducted in four selected districts of Bangladesh from February to May 2022 using complementary data collection methods, including key informant interviews, in-depth interviews, and focus group discussions with purposely selected participants. Data were analyzed thematically by following six steps of the thematic analysis process. Codes were developed based on the data and summarized into themes and sub-themes grounded on the codes. Results The findings indicate that the government of Bangladesh, along with development partners and non-government organizations, made a significant effort to raise awareness about COVID-19 in the community. However, there were certain limitations to this effort. These include a lack of social science and public health approaches to understanding the pandemic; inadequate coordination among the authorities for COVID-19 prevention and control; technological and geographical barriers for disseminating messages; the living conditions and lack of facilities; socio-cultural norms in understanding the COVID-19 health messages, and the gendered understanding of the messages. The findings also revealed that the awareness activities remained a one-way approach to inform the people and faced challenges to actively engage and create ownership of the community in the pandemic response. Conclusion The study identified gaps in implementing risk communication and community engagement strategies in Bangladesh during the COVID-19 pandemic. Increasing focus on public health and prioritizing community ownership is essential to designing a more effective community awareness campaign. This approach will help ensure that health messages are communicated effectively and tailored to different communities' needs.
Collapse
Affiliation(s)
| | - Aminur Rahman
- Health Systems and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - Daniel D. Reidpath
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland
| | - Sadika Akhter
- Health Systems and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| |
Collapse
|
4
|
Chan KY, Srivastava N, Wang Z, Xia X, Huang Z, Poon AN, Reidpath DD. A systematic review and meta-analysis of the effectiveness of hypertension interventions in faith-based organisation settings. J Glob Health 2023; 13:04075. [PMID: 37830137 PMCID: PMC10570758 DOI: 10.7189/jogh.13.04075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
Background Hypertension is the global, leading cause of mortality and is the main risk factor for cardiovascular disease. Community-based partnerships can provide cost-saving ways of delivering effective blood pressure (BP) interventions to people in resource-poor settings. Faith-based organisations (FBOs) prove important potential health partners, given their reach and community standing. This potential is especially strong in hard-to-reach, socio-economically marginalised communities. This systematic review explores the state of the evidence of FBO-based interventions on BP management, with a focus on randomised controlled trials (RCTs) and cluster RCTs (C-RCTs). Methods Seven academic databases (English = 5, Chinese = 2) and grey literature were searched for C-/RCTs of community-based interventions in FBO settings. Only studies with pre- and post-intervention BP measures were kept for analysis. Random effects models were developed using restricted maximum likelihood estimation (REML) to estimate the population average mean change and 95% confidence interval (CI) of both systolic and diastolic blood pressure (SBP and DBP). The overall heterogeneity was assessed by successively adding studies and recording changes in heterogeneity. Prediction intervals were generated to capture the spread of the pooled effect across study settings. Results Of the 19 055 titles identified, only 11 studies of fair to good quality were kept for meta-analysis. Non-significant, average mean differences between baseline and follow-up for the intervention and control groups were found for both SBP (0.78 mm of mercury (mmHg) (95% CI = 2.11-0.55)) and DBP (-0.20 mm Hg (95% CI = -1.16 to 0.75)). Subgroup analysis revealed a significant reduction in SBP of -6.23 mm Hg (95% CI = -11.21 to -1.25) for populations with mean baseline SBP of ≥140 mm Hg. Conclusions The results support the potential of FBO-based interventions in lowering SBP in clinically hypertensive populations. However, the limited evidence was concentrated primarily in Christian communities in the US More research is needed to understand the implications of such interventions in producing clinically meaningful long-term effects in a variety of settings. Further research can illuminate factors that affect success and potential expansion to sites outside the US as well as non-Christian FBOs. Current evidence is inadequate to evaluate the potential of FBO-based interventions in preventing hypertension in non-hypertensive populations. Intervention effects in non-hypertensive population might be better reflected through intermediate outcomes.
Collapse
Affiliation(s)
- Kit Yee Chan
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- School of Social Sciences, Monash University, Clayton, Victoria, Australia
| | - Noori Srivastava
- Department of Medicine, School of Medicine & Health Sciences, George Washington University, Washington DC, USA
| | - Zhicheng Wang
- China Development Research Foundation, Beijing, China
| | - Xiaoqian Xia
- London School of Hygiene & Tropical Medicine, London, UK
| | - Zhangziyue Huang
- Milken Institute School of Public Health, George Washington University, Washington DC, USA
| | - Adrienne N Poon
- Department of Medicine, School of Medicine & Health Sciences, George Washington University, Washington DC, USA
| | - Daniel D Reidpath
- School of Social Sciences, Monash University, Clayton, Victoria, Australia
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| |
Collapse
|
5
|
Razzaque A, Chowdhury MR, Mustafa AHMG, Mahmood SS, Iqbal M, Hanifi SMA, Islam MZ, Chin B, Adams AM, Bhuiya A, Reidpath DD. Cohort Profile: Urban Health and Demographic Surveillance System in slums of Dhaka (North and South) and Gazipur City Corporations, Bangladesh. Int J Epidemiol 2023; 52:e283-e291. [PMID: 37301741 DOI: 10.1093/ije/dyad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Affiliation(s)
- Abdur Razzaque
- Health System and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Md Razib Chowdhury
- Health System and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - A H M Golam Mustafa
- Health System and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Shehrin Shaila Mahmood
- Health System and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Mohammad Iqbal
- Health System and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Syed Manzoor Ahmed Hanifi
- Health System and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | | | - Brian Chin
- Social Sector Economist, Asian Development Bank, Manila, Philippines
| | - Alayne M Adams
- Department of Family Medicine, McGill University, Montreal, Canada
| | - Abbas Bhuiya
- Health System and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Daniel D Reidpath
- Health System and Population Studies Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| |
Collapse
|
6
|
Reidpath DD, Gruskin S, Khosla R, Dakessian A, Allotey P. Equity in decline: fair distribution in a worse-off world. Lancet 2023; 402:943-945. [PMID: 37392750 DOI: 10.1016/s0140-6736(23)01304-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 06/21/2023] [Indexed: 07/03/2023]
Affiliation(s)
- Daniel D Reidpath
- Institute for Global Health and Development, Queen Margaret University, Edinburgh EH21 6UU, UK; School of Social Sciences, Monash University, Clayton, VIC, Australia.
| | - Sofia Gruskin
- Institute on Inequalities in Global Health, Program on Global Health and Human Rights, University of Southern California, Los Angeles, CA , USA
| | - Rajat Khosla
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Arek Dakessian
- Institute for Global Health and Development, Queen Margaret University, Edinburgh EH21 6UU, UK
| | - Pascale Allotey
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| |
Collapse
|
7
|
Hasan AMR, Smith G, Selim MA, Khatun F, Mahmood SS, Reidpath DD, Rasheed S. Qualitative exploration of the impact of COVID-19 on the food environment of urban informal settlements of Dhaka, Bangladesh. BMJ Open 2023; 13:e067652. [PMID: 37527892 PMCID: PMC10394537 DOI: 10.1136/bmjopen-2022-067652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVE Our study explored the impact of the COVID-19 pandemic on the food environment from the perspective of the urban poor and food vendors. DESIGN This was a qualitative study conducted during September 2020 and February 2021. SETTING The study was carried out in two purposively selected informal settlements of Dhaka City, Bangladesh. PARTICIPANTS We conducted 21 in-depth interviews with residents of informal settlements and 10 key informant interviews with food vendors and food aid workers. RESULT The availability of staple foods was not disrupted during the pandemic but some perishables foods became more expensive due to supply chain disruptions and increased transportation costs. Limited market hours affected market access and mobility restrictions adversely affected local vendors. Cart vendors selling perishables incurred business losses they could ill afford. Demand for food reduced as employment disruption lead to reduced purchasing power and, therefore, reduction of quantity, quality and desirability of foods purchased. Respondents reported skipping meals and going hungry. The aid received was considered inadequate to meet needs. CONCLUSION The food environment of the urban poor was disrupted from both supply and demand sides and the organisational response (both government and non-government) was severely inadequate. The social safety net needs to be extended and redesigned to ensure food security and health for the urban working poor in the future.
Collapse
Affiliation(s)
- A M Rumayan Hasan
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Mohammad Abdus Selim
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Fatema Khatun
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shehrin Shaila Mahmood
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Daniel D Reidpath
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Sabrina Rasheed
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| |
Collapse
|
8
|
Nwameme A, Dako-Gyeke P, Asampong E, Allotey P, Reidpath DD, Certain E, Vahedi M, Ross B, Maher D, Launois P. Improving understanding of disease control implementation research through a mooc with participants from low- and middle-income countries: Evaluating participant reactions and learning. PLoS Negl Trop Dis 2023; 17:e0011139. [PMID: 36961830 PMCID: PMC10075403 DOI: 10.1371/journal.pntd.0011139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/05/2023] [Accepted: 02/05/2023] [Indexed: 03/25/2023] Open
Abstract
The Special Programme for Research and Training in Tropical Diseases developed a massive open online course (MOOC) on implementation research with a focus on infectious diseases of poverty (IDPs) to reinforce the explanation of implementation research concepts through real case studies. The target MOOC participant group included public health officers, researchers and students. By reshaping institutions and building resilience in communities and systems, implementation research will allow progress towards universal health coverage and sustainable development goals. This study evaluates learners' knowledge in implementation research after completing the MOOC using anonymous exit survey responses. Of the almost 4000 enrolled in the two sessions of the MOOC in 2018, about 30% completed all five modules and the assessments, and were awarded certificates. The majority of the participants were early to mid-career professionals, under the age of 40, and from low- and middle-income countries. They were slightly more likely to be men (56%) with a Bachelor or a Master's degree. Participants were public health researchers (45%), public health officers (11%) or students (11%). On completion of the course, an exit survey revealed that 80.9% of respondents indicated significant improvement to strong and very strong implementation research knowledge. This evaluation clearly shows the usefulness of the MOOC on implementation research for reaching out to field researchers and public health practitioners who are facing problems in the implementation of control programmes in low- and middle-income countries.
Collapse
Affiliation(s)
- Adanna Nwameme
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon, Ghana
| | - Phyllis Dako-Gyeke
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon, Ghana
| | - Emmanuel Asampong
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon, Ghana
| | - Pascale Allotey
- United Nations University-International Institute for Global Health (UNU-IGIH), UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Federal Territory of Kuala Lumpur, Malaysia
| | - Daniel D Reidpath
- Health Systems and Population Studies Division, Mohakhali, Dhaka, Bangladesh
| | - Edith Certain
- Consultant, Special Programme for Research and Training in Tropical Diseases (TDR), WHO, Geneva, Switzerland
| | - Mahnaz Vahedi
- Special Programme for Research and Training in Tropical Diseases (TDR), WHO, Geneva, Switzerland
| | - Bella Ross
- Learning Design and Digital Innovation, Monash College, Docklands, Victoria, Australia
| | - Dermot Maher
- Special Programme for Research and Training in Tropical Diseases (TDR), WHO, Geneva, Switzerland
| | - Pascal Launois
- Special Programme for Research and Training in Tropical Diseases (TDR), WHO, Geneva, Switzerland
| |
Collapse
|
9
|
Koly KN, Islam MS, Potenza MN, Mahumud RA, Islam MS, Uddin MS, Sarwar MAH, Begum F, Reidpath DD. Psychosocial health of school-going adolescents during the COVID-19 pandemic: Findings from a nationwide survey in Bangladesh. PLoS One 2023; 18:e0283374. [PMID: 36972260 PMCID: PMC10042372 DOI: 10.1371/journal.pone.0283374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 03/08/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Common psychosocial health problems (PHPs) have become more prevalent among adolescents globally during the COVID-19 pandemic. However, the psychosocial health of school-going adolescents has remained unexplored in Bangladesh due to limited research during the pandemic. The present study aimed to estimate the prevalence of PHPs (i.e., depression and anxiety) and assess associated lifestyle and behavioral factors among school-going adolescents in Bangladesh during the COVID-19 pandemic. METHODS A nationwide cross-sectional survey was conducted among 3,571 school-going adolescents (male: 57.4%, mean age: 14.9±1.8 years; age range: 10-19 years) covering all divisions, including 63 districts in Bangladesh. A semi-structured e-questionnaire, including informed consent and questions related to socio-demographics, lifestyle, academics, pandemic and PHPs, was used to collect data between May and July 2021. RESULTS The prevalence of moderate to severe depression and anxiety were 37.3% and 21.7%, respectively, ranging from 24.7% in the Sylhet Division to 47.5% in the Rajshahi Division for depression, and from 13.4% in the Sylhet Division to 30.3% in the Rajshahi Division for anxiety. Depression and anxiety were associated with older age, reports of poor teacher cooperation in online classes, worries due to academic delays, parental comparison of academic performance with other classmates, difficulties coping with quarantine situations, changes in eating habits, weight gain, physical inactivity and having experienced cyberbullying. Moreover, being female was associated with higher odds of depression. CONCLUSIONS Adolescent psychosocial problems represent a public health problem. The findings suggest a need for generating improved empirically supported school-based psychosocial support programs involving parents and teachers to ensure the well-being of adolescents in Bangladesh. School-based prevention of psychosocial problems that promote environmental and policy changes related to lifestyle practices and active living should be developed, tested, and implemented.
Collapse
Affiliation(s)
- Kamrun Nahar Koly
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh
| | - Md Saiful Islam
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Yale School of Medicine, New Haven, CT, United States of America
- Connecticut Mental Health Center, New Haven, CT, United States of America
- Connecticut Council on Problem Gambling, Wethersfield, CT, United States of America
- Department of Neuroscience and Wu Tsai Institute, Yale University, New Haven, CT, United States of America
| | - Rashidul Alam Mahumud
- Faculty of Medicine and Health, NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Md Shefatul Islam
- Aspire to Innovate (a2i), Information and Communication Technology Division, Agargaon, Dhaka, Bangladesh
| | - Md Salim Uddin
- Aspire to Innovate (a2i), Information and Communication Technology Division, Agargaon, Dhaka, Bangladesh
| | - Md Afzal Hossain Sarwar
- Aspire to Innovate (a2i), Information and Communication Technology Division, Agargaon, Dhaka, Bangladesh
| | - Farzana Begum
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh
| | - Daniel D Reidpath
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland
| |
Collapse
|
10
|
Koly KN, Tasnim Z, Ahmed S, Saba J, Mahmood R, Farin FT, Choudhury S, Ashraf MN, Hasan MT, Oloniniyi I, Modasser RB, Reidpath DD. Mental healthcare-seeking behavior of women in Bangladesh: content analysis of a social media platform. BMC Psychiatry 2022; 22:797. [PMID: 36529761 PMCID: PMC9760542 DOI: 10.1186/s12888-022-04414-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mental health remains a highly stigmatized area of healthcare, and people often conceal their concerns rather than seek assistance or treatment. The Women Support Initiative Forum (WSIF) is a social media platform established in 2018 to provide expert and peer-led psychosocial support services to women of all ages in Bangladesh. The anonymous nature of the forum means that mental health concerns can be aired without fear of identification. METHOD A content analysis was conducted on the anonymous posts retrieved from the WSIF platform between 8th March 2020 and 7th July 2022. Around 1457 posts were initially selected for analysis which was reduced to 1006 after removing duplicates and non-relevant posts, such as queries about the addresses of the doctors and other non-mental health-related issues. A thematic analysis of the data was conducted using an inductive approach. RESULT The 1006 posts generated four themes and nine sub-themes. All the women mentioned mental health symptoms (n = 1006; 100%). Most also mentioned reasons for seeking mental healthcare (n = 818; 81.31%), healthcare-seeking behavior (n = 667; 66.30%), and barriers to seeking mental healthcare (n = 552; 54.87%). The majority of women described symptoms of stress, depression, and anxiety-like symptoms, which were aggregated under common mental health conditions. Mental health symptoms were ascribed to various external influences, including marital relationship, intrafamilial abuse, and insecurities related to the COVID-19 pandemic. A large proportion of posts were related to women seeking information about mental healthcare services and service providers (psychologists or psychiatrists). The analysis found that most women did not obtain mental healthcare services despite their externalized mental health symptoms. The posts identified clear barriers to women accessing mental health services, including low mental health literacy, the stigma associated with mental healthcare-seeking behavior, and the poor availability of mental health care services. CONCLUSION The study revealed that raising mass awareness and designing culturally acceptable evidence-based interventions with multisectoral collaborations are crucial to ensuring better mental healthcare coverage for women in Bangladesh.
Collapse
Affiliation(s)
- Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
| | - Zarin Tasnim
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, 1213 Bangladesh
| | - Sharmin Ahmed
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212 Bangladesh
| | - Jobaida Saba
- grid.414142.60000 0004 0600 7174Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh ,grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Dhaka, 1342 Bangladesh
| | - Rudbar Mahmood
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Faria Tasnim Farin
- grid.254444.70000 0001 1456 7807Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI USA
| | - Sabrina Choudhury
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212 Bangladesh
| | - Mir Nabila Ashraf
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - M. Tasdik Hasan
- grid.1002.30000 0004 1936 7857Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia ,grid.443034.40000 0000 8877 8140Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh ,grid.10025.360000 0004 1936 8470Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - Ibidunni Oloniniyi
- grid.10824.3f0000 0001 2183 9444Departmental of Mental Health, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria ,grid.459853.60000 0000 9364 4761Mental Health Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun Nigeria
| | - Rifath Binta Modasser
- grid.443005.60000 0004 0443 2564School of Public Health, Independent University Bangladesh (IUB), Bashundhara, Dhaka, 1229 Bangladesh
| | - Daniel D. Reidpath
- grid.440425.30000 0004 1798 0746Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia
| |
Collapse
|
11
|
Khatun F, Ahmed NU, Rahman H, Roy SS, Chowdhury SA, Chowdhury R, Sheikh SP, Rasheed S, Reidpath DD. The Promise of Teleconsultation in the Era of Pandemic: A Case from Bangladesh. Telemed J E Health 2022; 29:602-606. [PMID: 35861775 DOI: 10.1089/tmj.2021.0529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: In 2016, the Government of Bangladesh (GoB) established a teleconsultation service called Shastho Batayon to increase access to physicians. During COVID-19 pandemic, health care access became limited due to movement restrictions. In response, GoB made Shastho Batayon toll free, publicized the number through media, increased the number of call center doctors, introduced automated messages on COVID-19 preventive measures, and developed a scoring system to classify risk groups for COVID-19. Objectives and Methods: In this case report, we describe how an existing national teleconsultation service can be utilized in a low- and middle-income country to address primary health care needs during a public health emergency. We conducted secondary analysis of Shastho Batayon service data from January to April 2020. Results: The total calls for doctor's consultation increased during the pandemic. Prepandemic, Shastho Batayon received less than 20,000 calls per month. In March 2020, when the first cases of COVID-19 were confirmed, Shastho Batayon services received 60,811 calls for doctor's consultation, which increased to 125,660 calls in April, 2020. The doctor's consultation for primary care has increased for all conditions. Shastho Batayon services screened 28,944 patients with the influenza-like illness or COVID-19-like symptoms in March and April, 2020, provided preventive measures, advice, and referral to designated hospitals based on a national guideline. Conclusions: In public health emergencies such as COVID-19 pandemic, teleconsultation services can help provide prevention guidelines, debunk misinformation, identify risk categories, and refer people to appropriate service and facilities in a timely manner.
Collapse
Affiliation(s)
- Fatema Khatun
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Habibur Rahman
- MIS, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Sukhendu Shekhor Roy
- MIS, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | | | - Sifat Parveen Sheikh
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Sabrina Rasheed
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Daniel D Reidpath
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| |
Collapse
|
12
|
Raqib R, Sarker P, Akhtar E, Nurul Huda TM, Haq MA, Roy AK, Hosen MB, Haque F, Chowdhury MR, Reidpath DD, Emdadul Hoque DM, Islam Z, Ahmed S, Ahmed T, Tofail F, Razzaque A. Seroprevalence of SARS-CoV-2 infection and associated factors among Bangladeshi slum and non-slum dwellers in pre-COVID-19 vaccination era: October 2020 to February 2021. PLoS One 2022; 17:e0268093. [PMID: 35604947 PMCID: PMC9126397 DOI: 10.1371/journal.pone.0268093] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background Seroprevalence studies have been carried out in many developed and developing countries to evaluate ongoing and past infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Data on this infection in marginalized populations in urban slums are limited, which may offer crucial information to update prevention and mitigation policies and strategies. We aimed to determine the seroprevalence of SARS-CoV-2 infection and factors associated with seropositivity in slum and non-slum communities in two large cities in Bangladesh. Methods A cross-sectional study was carried out among the target population in Dhaka and Chattogram cities between October 2020 and February 2021. Questionnaire-based data, anthropometric and blood pressure measurements and blood were obtained. SARS-CoV-2 serology was assessed by Roche Elecsys® Anti-SARS-CoV-2 immunoassay. Results Among the 3220 participants (2444 adults, ≥18 years; 776 children, 10–17 years), the overall weighted seroprevalence was 67.3% (95% confidence intervals (CI) = 65.2, 69.3) with 71.0% in slum (95% CI = 68.7, 72.2) and 62.2% in non-slum (95% CI = 58.5, 65.8). The weighted seroprevalence was 72.9% in Dhaka and 54.2% in Chattogram. Seroprevalence was positively associated with limited years of formal education (adjusted odds ratio [aOR] = 1.61; 95% CI = 1.43, 1.82), lower income (aOR = 1.23; 95% CI = 1.03, 1.46), overweight (aOR = 1.2835; 95% CI = 1.26, 1.97), diabetes (aOR = 1.67; 95% CI = 1.21, 2.32) and heart disease (aOR = 1.38; 95% CI = 1.03, 1.86). Contrarily, negative associations were found between seropositivity and regular wearing of masks and washing hands, and prior BCG vaccination. About 63% of the population had asymptomatic infection; only 33% slum and 49% non-slum population showed symptomatic infection. Conclusion The estimated seroprevalence of SARS-CoV-2 was more prominent in impoverished informal settlements than in the adjacent middle-income non-slum areas. Additional factors associated with seropositivity included limited education, low income, overweight and pre-existing chronic conditions. Behavioral factors such as regular wearing of masks and washing hands were associated with lower probability of seropositivity.
Collapse
Affiliation(s)
- Rubhana Raqib
- Infectious Diseases Division, icddrb, Dhaka, Bangladesh
- * E-mail:
| | - Protim Sarker
- Infectious Diseases Division, icddrb, Dhaka, Bangladesh
| | - Evana Akhtar
- Infectious Diseases Division, icddrb, Dhaka, Bangladesh
| | | | | | | | | | - Farjana Haque
- Infectious Diseases Division, icddrb, Dhaka, Bangladesh
| | | | - Daniel D. Reidpath
- Health Systems and Population Studies Division, icddrb, Dhaka, Bangladesh
| | | | | | - Shehlina Ahmed
- Foreign, Commonwealth & Development Office (FCDO), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, icddrb, Dhaka, Bangladesh
| | - Fahmida Tofail
- Nutrition and Clinical Services Division, icddrb, Dhaka, Bangladesh
| | - Abdur Razzaque
- Health Systems and Population Studies Division, icddrb, Dhaka, Bangladesh
| |
Collapse
|
13
|
Schliemann D, Hoe WMK, Mohan D, Allotey P, Reidpath DD, Tan MM, Taib NAM, Donnelly M, Su TT. Challenges and opportunities for breast cancer early detection among rural dwelling women in Segamat District, Malaysia: A qualitative study. PLoS One 2022; 17:e0267308. [PMID: 35594267 PMCID: PMC9122189 DOI: 10.1371/journal.pone.0267308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/05/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Breast cancer patients in low- and middle-income countries often present at an advanced stage. This qualitative study elicited views regarding the challenges and opportunities for breast cancer screening and early detection among women in a low-income semi-rural community in Segamat district, Malaysia. METHODS Individual semi-structured interviews with 22 people (health professionals, cancer survivors, community volunteers and member from a non-governmental organization) and four focus group discussions (n = 22 participants) with women from a local community were conducted. All participants were purposively sampled and female residents registered with the South East Asia Community Observatory aged ≥40 years were eligible to participate in the focus group discussions. Data were transcribed verbatim and analyzed using thematic analysis. RESULTS The thematic analysis illuminated barriers, challenges and opportunities across six domains: (i) personal experiences and barriers to help-seeking as well as financial and travel access barriers; (ii) primary care challenges (related to delivering clinical breast examination and teaching breast-self-examination); (iii) secondary care challenges (related to mammogram services); (iv) disconnection between secondary and primary care breast cancer screening pathways; and (v) opportunities to improve breast cancer early detection relating to community civil service society activities (i.e. awareness raising, support groups, addressing stigma/embarrassment and encouraging husbands to support women) and vi) links between public healthcare personnel and community (i.e. improving breast self-examination education, clinical breast examination provision and subsidised mammograms). CONCLUSION The results point to a variety of reasons for low uptake and, therefore, to the complex nature of improving breast cancer screening and early detection. There is a need to adopt a systems approach to address this complexity and to take account of the socio-cultural context of communities in order, in turn, to strengthen cancer control policy and practices in Malaysia.
Collapse
Affiliation(s)
- Désirée Schliemann
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Wilfred Mok Kok Hoe
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Segamat, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Pascale Allotey
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | | | - Min Min Tan
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Segamat, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Nur Aishah Mohd Taib
- Faculty of Medicine, Department of Surgery, Universiti Malaya Cancer Research Institute, University of Malaya, Kuala Lumpur, Malaysia
| | - Michael Donnelly
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Tin Tin Su
- Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Segamat, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| |
Collapse
|
14
|
Affiliation(s)
- Pascale Allotey
- United Nations University International Institute for Global Health
| | | |
Collapse
|
15
|
Reidpath DD, Allotey P, Barker SF, Clasen T, French M, Leder K, Ramirez-Lovering D, Rhule ELM, Siri J. Implementing "from here to there": A case study of conceptual and practical challenges in implementation science. Soc Sci Med 2022; 301:114959. [PMID: 35398672 DOI: 10.1016/j.socscimed.2022.114959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 11/27/2022]
Abstract
There is a significant challenge in global health and development research that pivots on the difficulties of delivering (cost-)effective treatments or interventions that are scalable andtransferable across settings. That is, how does one deliver "true effects", proven treatments, into new settings? This is often addressed in pragmatic trials or implementation research in which one makes adjustments to the delivery of the treatment to ensure that it works here and there. In this critical analytical review, we argue that the approach mis-characterises the cause-effect relationship and fails to recognise the local, highly contextual nature of what it means to say an intervention "works". We use an ongoing randomised controlled trial (RCT)-an informal settlement redevelopment intervention in Indonesia and Fiji to reduce human exposure to pathogenic faecal contamination-as a vehicle for exploring the ideas and implications of identifying interventions that work in global health and development. We describe the highly contextualised features of the research and the challenges these would pose in attempts to generalise the results. In other words, we detail that which is frequently elided from most RCTs. As our critical lens, we us the work of American philosopher, Nancy Cartwright, who argued that research produces dappled regions of causal insights-lacunae against a backdrop of causal ignorance. Rather than learn about a relationship between a treatment and an outcome, we learn that in the right sort of context, a treatment reliably produces a particular outcome. Moving a treatment from here to there becomes, therefore, something of an engineering exercise to ensure the right factors (or "shields") are in place so the cause-effect is manifest. As a consequence, one cannot assume that comparative effectiveness or cost-effectiveness would be maintained.
Collapse
Affiliation(s)
- Daniel D Reidpath
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh; Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Sunway, Malaysia.
| | - Pascale Allotey
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Sunway, Malaysia; International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - S Fiona Barker
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Thomas Clasen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Matthew French
- Monash Sustainable Development Institute, Monash University, Melbourne, Victoria, Australia
| | - Karin Leder
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Diego Ramirez-Lovering
- Faculty of Art, Design and Architecture, Monash University, Caulfield, Victoria, Australia
| | - Emma L M Rhule
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - José Siri
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| |
Collapse
|
16
|
Affiliation(s)
- Pascale Allotey
- United Nations University International Institute for Global Health, UKM Medical Centre, Cheras, 56000 Kuala Lumpur, Malaysia.
| | | |
Collapse
|
17
|
Mattap SM, Mohan D, McGrattan AM, Allotey P, Stephan BC, Reidpath DD, Siervo M, Robinson L, Chaiyakunapruk N. The economic burden of dementia in low- and middle-income countries (LMICs): a systematic review. BMJ Glob Health 2022; 7:bmjgh-2021-007409. [PMID: 35379735 PMCID: PMC8981345 DOI: 10.1136/bmjgh-2021-007409] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/08/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction More than two-thirds of people with dementia live in low- and middle-income countries (LMICs), resulting in a significant economic burden in these settings. In this systematic review, we consolidate the existing evidence on the cost of dementia in LMICs. Methods Six databases were searched for original research reporting on the costs associated with all-cause dementia or its subtypes in LMICs. The national-level dementia costs inflated to 2019 were expressed as percentages of each country’s gross domestic product (GDP) and summarised as the total mean percentage of GDP. The risk of bias of studies was assessed using the Larg and Moss method. Results We identified 14 095 articles, of which 24 studies met the eligibility criteria. Most studies had a low risk of bias. Of the 138 LMICs, data were available from 122 countries. The total annual absolute per capita cost ranged from US$590.78 for mild dementia to US$25 510.66 for severe dementia. Costs increased with the severity of dementia and the number of comorbidities. The estimated annual total national costs of dementia ranged from US$1.04 million in Vanuatu to US$195 billion in China. The average total national expenditure on dementia estimated as a proportion of GDP in LMICs was 0.45%. Indirect costs, on average, accounted for 58% of the total cost of dementia, while direct costs contributed 42%. Lack of nationally representative samples, variation in cost components, and quantification of indirect cost were the major methodological challenges identified in the existing studies. Conclusion The estimated costs of dementia in LMICs are lower than in high-income countries. Indirect costs contribute the most to the LMIC cost. Early detection of dementia and management of comorbidities is essential for reducing costs. The current costs are likely to be an underestimation due to limited dementia costing studies conducted in LMICs, especially in countries defined as low- income. PROSPERO registration number The protocol was registered in the International Prospective Register of Systematic Reviews database with registration number CRD42020191321.
Collapse
Affiliation(s)
- Siti Maisarah Mattap
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Andrea Mary McGrattan
- School of Biomedical, Nutritional and Sports Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Pascale Allotey
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.,United Nations University International Institute for Global Health, Bandar Tun Razak, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Daniel D Reidpath
- International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.,Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Mario Siervo
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, The University of Utah College of Pharmacy, Salt Lake City, Utah, USA.,School of Pharmacy, Monash University Malaysia, Selangor, Malaysia.,IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, USA
| |
Collapse
|
18
|
Tan MM, Reidpath DD, Ting RSK, Allotey P, Su TT. Religiousness and Quality of Life Among Older Adults of Different Ethnic Groups in Malaysia: A Five-Year Follow-up Study. J Relig Health 2022; 61:1548-1563. [PMID: 34324099 DOI: 10.1007/s10943-021-01371-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
Research has shown that religion is associated with a better quality of life (QoL). This study aims to examine ethnic differences in the association between religion and the QoL of older adults in a predominantly Muslim population within a multicultural setting. Two-wave data of 3,810 participants consisting of mostly Muslims and older adults aged ≥ 55 years were collected as part of the community health surveys conducted in 2013 and 2018 in the South East Asia Community Observatory (SEACO). Both cross-sectional analyses of baseline data and prospective analyses of longitudinal data were conducted. The associations between religiosity and quality of life were mainly positive in the cross-sectional analysis. In the two-wave analysis, religious importance was negatively associated with QoL among the Malays (B = - 1.103, SE B = 0.029, p < .001) and the Chinese (B = - 0.160, SE B = 0.043, p < .001), and a belief in a higher power control was associated with better QoL among the Malays (B = 0.051, SE B = 0.022, p < .005) and poorer QoL domains among the Indians (physical health: B = - 5.412, SE B = 1.382, p < .001; psychological: B = - 3.325, SE B = 1.42, p < .001; social relationship: B = - 5.548, SE B = 1.616, p < .001; environment: B = - 2.586, SE B = 1.288; p < .05). Our study's mixed results suggest that religiosity is positively associated with quality of life in cross-sectional analyses. However, in longitudinal analyses, the results are different. Conclusions with regard to causality based on cross-sectional analyses may be misleading. Health promotion programs should continue to examine the effect of religiousness on health outcomes over time among aging populations across different ethnic groups.
Collapse
Affiliation(s)
- Min Min Tan
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia.
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia.
| | - Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh
| | - Rachel Sing-Kiat Ting
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| | - Pascale Allotey
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
- United Nations University International Institute for Global Health (UNU-IIGH), UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
| |
Collapse
|
19
|
McGrattan AM, Pakpahan E, Siervo M, Mohan D, Reidpath DD, Prina M, Allotey P, Zhu Y, Shulin C, Yates J, Paddick SM, Robinson L, Stephan BCM. Risk of conversion from mild cognitive impairment to dementia in low- and middle-income countries: A systematic review and meta-analysis. Alzheimers Dement (N Y) 2022; 8:e12267. [PMID: 35310524 PMCID: PMC8918697 DOI: 10.1002/trc2.12267] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/11/2022] [Indexed: 01/29/2023]
Abstract
Introduction With no treatment for dementia, there is a need to identify high risk cases to focus preventive strategies, particularly in low‐ and middle‐income countries (LMICs) where the burden of dementia is greatest. We evaluated the risk of conversion from mild cognitive ompairment (MCI) to dementia in LMICs. Methods Medline, Embase, PsycINFO, and Scopus were searched from inception until June 30, 2020. The search was restricted to observational studies, conducted in population‐based samples, with at least 1 year follow‐up. There was no restriction on the definition of MCI used as long as it was clearly defined. PROSPERO registration: CRD42019130958. Results Ten thousand six hundred forty‐seven articles were screened; n = 11 retained. Of the 11 studies, most were conducted in China (n = 7 studies), with only two studies from countries classified as low income. A qualitative analysis of n = 11 studies showed that similar to high‐income countries the conversion rate to dementia from MCI was variable (range 6.0%–44.8%; average follow‐up 3.7 years [standard deviation = 1.2]). A meta‐analysis of studies using Petersen criteria (n = 6 studies), found a pooled conversion rate to Alzheimer's disease (AD) of 23.8% (95% confidence interval = 15.4%–33.4%); approximately one in four people with MCI were at risk of AD in LMICs (over 3.0–5.8 years follow‐up). Risk factors for conversion from MCI to dementia included demographic (e.g., age) and health (e.g., cardio‐metabolic disease) variables. Conclusions MCI is associated with high, but variable, conversion to dementia in LMICs and may be influenced by demographic and health factors. There is a notable absence of data from low‐income settings and countries outside of China. This highlights the urgent need for research investment into aging and dementia in LMIC settings. Being able to identify those individuals with cognitive impairment who are at highest risk of dementia in LMICs is necessary for the development of risk reduction strategies that are contextualized to these unique settings.
Collapse
Affiliation(s)
- Andrea M McGrattan
- School of Biomedical, Nutritional and Sports Sciences, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne UK
| | - Eduwin Pakpahan
- Department Mathematics, Physics and Electrical Engineering Northumbria University Newcastle upon Tyne UK
| | - Mario Siervo
- School of Life Sciences The University of Nottingham Medical School Nottingham UK
| | - Devi Mohan
- Global Public Health Jeffrey Cheah School of Medicine and Health Sciences Monash University Malaysia Subang Jaya Malaysia
| | - Daniel D Reidpath
- Global Public Health Jeffrey Cheah School of Medicine and Health Sciences Monash University Malaysia Subang Jaya Malaysia.,International Centre for Diarrhoeal Disease Research, ICDDR,B Dhaka Bangladesh
| | - Matthew Prina
- Department of Health Service and Population Research King's College London London UK
| | - Pascale Allotey
- Global Public Health Jeffrey Cheah School of Medicine and Health Sciences Monash University Malaysia Subang Jaya Malaysia
| | - Yueping Zhu
- Department of Psychology and Behavioural Sciences Zhejiang University Hangzhou China
| | - Chen Shulin
- Department of Psychology and Behavioural Sciences Zhejiang University Hangzhou China
| | - Jennifer Yates
- Institute of Mental Health Nottingham University Nottingham UK
| | - Stella-Maria Paddick
- Translational and Clinical Research Institute Newcastle University Newcastle upon Tyne UK.,Gateshead NHS Community Health Foundation Trust Gateshead UK
| | - Louise Robinson
- Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | | | | |
Collapse
|
20
|
Mahmood SS, Hasan MZ, Hasan AMR, Rabbani MG, Begum F, Yousuf TB, Hanifi SMA, Reidpath DD, Rasheed S. Health system impact of COVID-19 on urban slum population of Bangladesh: a mixed-method rapid assessment study. BMJ Open 2022; 12:e057402. [PMID: 35197355 PMCID: PMC8882639 DOI: 10.1136/bmjopen-2021-057402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE We aimed to rapidly assess the health system impact of COVID-19 in the urban slums of Bangladesh. DESIGN Setting and participantsA cross-sectional survey among 476 households was conducted during October-December 2020 in five selected urban slums of Dhaka North, Dhaka South and Gazipur City Corporation. In-depth interviews with purposively selected 22 slum dwellers and key informant interviews with 16 local healthcare providers and four policymakers and technical experts were also conducted. OUTCOME MEASURES Percentage of people suffering from general illness, percentage of people suffering from chronic illness, percentage of people seeking healthcare, percentage of people seeking maternal care, health system challenges resulting from COVID-19. RESULTS About 12% of members suffered from general illness and 25% reported chronic illness. Over 80% sought healthcare and the majority sought care from informal healthcare providers. 39% of the recently delivered women sought healthcare in 3 months preceding the survey. An overall reduction in healthcare use was reported during the lockdown period compared with prepandemic time. Mismanagement and inefficient use of resources were reported as challenges of health financing during the pandemic. Health information sharing was inadequate at the urban slums, resulting from the lack of community and stakeholder engagement (51% received COVID-19-related information, 49% of respondents knew about the national hotline number for COVID-19 treatment). Shortage of human resources for health was reported to be acute during the pandemic, resulting from the shortage of specialist doctors and uneven distribution of health workforce. COVID-19 test was inadequate due to the lack of adequate test facilities and stigma associated with COVID-19. Lack of strong leadership and stakeholder engagement was seen as the barriers to effective pandemic management. CONCLUSION The findings of the current study are expected to support the government in tailoring interventions and allocating resources more efficiently and timely during a pandemic.
Collapse
Affiliation(s)
| | - Md Zahid Hasan
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - A M Rumayan Hasan
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Md Golam Rabbani
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Farzana Begum
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Tariq Bin Yousuf
- Urban Resilience Project, Dhaka North City Corporation, Dhaka, Bangladesh
| | | | - Daniel D Reidpath
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Sabrina Rasheed
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| |
Collapse
|
21
|
Lee SS, McGrattan A, Soh YC, Alawad M, Su TT, Palanisamy UD, Hussin AM, Kassim ZB, Mohd Ghazali ANB, Christa Maree Stephan B, Allotey P, Reidpath DD, Robinson L, Mohan D, Siervo M. Feasibility and Acceptability of a Dietary Intervention to Reduce Salt Intake and Increase High-Nitrate Vegetable Consumption in Malaysian Middle-Aged and Older Adults with Elevated Blood Pressure: Findings from the DePEC-Nutrition Trial. Nutrients 2022; 14:nu14030430. [PMID: 35276789 PMCID: PMC8839221 DOI: 10.3390/nu14030430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
Abstract
The DePEC-Nutrition trial is a complex dietary and behavioural intervention of salt intake reduction combined with increased high-nitrate vegetable consumption among Malaysian middle-aged and older adults with elevated blood pressure. This study aimed to assess the feasibility and acceptability of the trial. Participants were recruited from the South East Asia Community Observatory (SEACO) database and randomised into one of four groups: (1) low salt; (2) high-nitrate vegetable; (3) combined high-nitrate vegetable and low salt; and (4) control. The intervention included a combination of group counselling sessions, information booklets, reinforcement videos and text messages to modify dietary behaviour. The primary outcomes evaluated were the measures of feasibility and acceptability of (1) recruitment, follow-up attendance and retention; (2) data collection procedures and clinical outcome measures; and (3) individual and combined multi-modal dietary interventions. A total of 74 participants were recruited, and the 10-month retention rate was 73%. Data collection procedures were acceptable with minimal missing data. All intervention strategies were feasible and acceptable, with group counselling being the most acceptable strategy. This study provides important insights into improving the screening process of participants, facilitating their access to the research facilities and refining the measurement protocols and dietary recommendations, which are instrumental in formulating the design of a full-scale definitive DePEC-Nutrition trial.
Collapse
Affiliation(s)
- Siew Siew Lee
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (S.S.L.); (Y.C.S.); (M.A.); (T.T.S.)
| | - Andrea McGrattan
- School of Biomedical, Nutritional and Sports Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
| | - Yee Chang Soh
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (S.S.L.); (Y.C.S.); (M.A.); (T.T.S.)
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 45700, Malaysia;
| | - Mawada Alawad
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (S.S.L.); (Y.C.S.); (M.A.); (T.T.S.)
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 45700, Malaysia;
| | - Tin Tin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (S.S.L.); (Y.C.S.); (M.A.); (T.T.S.)
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 45700, Malaysia;
| | - Uma Devi Palanisamy
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia;
| | - Azizah Mat Hussin
- Institute of Medical Science Technology, Universiti Kuala Lumpur, Kajang 43000, Malaysia;
| | - Zaid bin Kassim
- District Health Office, Pejabat Kesihatan Daerah (PKD) Segamat, Segamat 85000, Malaysia; (Z.b.K.); (A.N.b.M.G.)
| | | | | | - Pascale Allotey
- International Institute for Global Health, United Nations University, Kuala Lumpur 56000, Malaysia;
| | - Daniel D. Reidpath
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 45700, Malaysia;
- International Centre for Diarrhoeal Disease Research, ICDDR, B, Dhaka 1212, Bangladesh
| | - Louise Robinson
- Population Health Science Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK;
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (S.S.L.); (Y.C.S.); (M.A.); (T.T.S.)
- Correspondence: ; Tel.: +60-3-5515-9658
| | - Mario Siervo
- School of Life Sciences, University of Nottingham Medical School, Nottingham NG7 2UH, UK;
| |
Collapse
|
22
|
Hanifi SMA, Jahan N, Sultana N, Hasan SA, Paul A, Reidpath DD. Millions of Bangladeshi Children Missed Their Scheduled Vaccination Amidst COVID-19 Pandemic. Front Public Health 2022; 9:738623. [PMID: 35111708 PMCID: PMC8801521 DOI: 10.3389/fpubh.2021.738623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/16/2021] [Indexed: 12/04/2022] Open
Abstract
The Government of Bangladesh imposed a movement control order as a mass quarantine strategy to control the outbreak of coronavirus disease 2019 (COVID-19). Adherence to the home quarantine may put children at risk by missing routine vaccination. In this study, we investigated the impact of COVID-19 on child routine immunization in a rural area of Bangladesh and consider the broader implications. Data for this study comes from the Chakaria Health and Demographic Surveillance System (HDSS) of icddr,b with a population of 90,000 people residing in 16,000 households in 49 villages in a rural, coastal area of Southeast Bangladesh. We used an explanatory sequential mixed methods design which involved two phases between March 1, 2020, and May 31, 2020: first, we observed 258 outreach sessions of 86 EPI centers. We calculated the number of Expanded Program on Immunization (EPI) outreach sessions suspended and the number of children who missed their routine vaccination due to the COVID-19. We extrapolated the number of Bangladeshi children who missed their routine vaccination using Chakaria HDSS observations. Secondly, we conducted in-depth interviews to explain the quantitative results. The EPI outreach session (EOS) declined to 74.42% (95% CI 63.97–83.22), 10.45% (95% CI 5.00–18.94), and 3.45% (95% CI 1.00–9.75) from 2019 levels in March, April, and May 2020, respectively. By extrapolation, in Bangladesh, between March and May 2020, 3.2 million children missed their scheduled vaccination compared to 2019. Results from in-depth interviews showed that the unwillingness of villagers to hold EOS and the absenteeism of the vaccinators due to social distancing recommendations and lack of personal safety measures were the main reasons for the discontinuation of the EOS. Resuming EPI outreach sessions and introducing a special catch-up program is essential to prevent future outbreaks and deaths due to vaccine-preventable diseases in Bangladesh and the countries where children missed their routine vaccination due to COVID-19. This health system failure should be considered a factor in all future pandemic preparedness plans.
Collapse
|
23
|
Mahmood N, Kamruzzaman M, Rahman A, Reidpath DD, Akhter S. Impact of the COVID-19 lockdown on intimate partner violence: Issues of non-reporting in Bangladesh. Womens Health (Lond Engl) 2022; 18:17455057221087888. [PMID: 35323066 PMCID: PMC8958668 DOI: 10.1177/17455057221087888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: COVID-19 pandemic induced lockdown as prevention and control measure, forced people globally to limit their movements and to stay at home for extended period of time. The objective of this study was to analyze the impact of lockdown on intimate partner violence in Bangladesh. Methods: We conducted a secondary research by employing a Poisson regression model to estimate the effect of pandemic-led lockdown policy on the change in the number of intimate partner violence-related calls during pandemic using national emergency helpline 999 call logs. Data from January 2019 to May 2020 for 64 districts produced 1088 district-month-year observations which had been used for the main analysis. Results: We found a 46% decrease in the incidence rate of intimate partner violence-related calls during the pandemic after adjusting for year, month, district fixed-effects—suggesting, non-reporting of the violence might have exacerbated during lockdown. Conclusion: While increasing rate of intimate partner violence is one side of issue, non-reporting of it has received less attention and during the lockdown non-reporting might grow large and have severe health impacts for women.
Collapse
Affiliation(s)
- Nabila Mahmood
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammed Kamruzzaman
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Aminur Rahman
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Daniel D Reidpath
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sadika Akhter
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
24
|
Koly KN, Khanam MI, Islam MS, Mahmood SS, Hanifi SMA, Reidpath DD, Khatun F, Rasheed S. Anxiety and Insomnia Among Urban Slum Dwellers in Bangladesh: The Role of COVID-19 and Its Associated Factors. Front Psychiatry 2021; 12:769048. [PMID: 34925097 PMCID: PMC8678050 DOI: 10.3389/fpsyt.2021.769048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Although mental health is an important part of health and wellbeing, very little is known about the impact of the COVID-19 pandemic on the mental health of marginalized communities like urban slum dwellers. Our study estimated the prevalence of generalized anxiety disorder and insomnia among the residents of the informal settlements of Dhaka, Bangladesh, during the COVID-19 pandemic. Methods: A cross-sectional phone-based survey was conducted from October to November 2020 among adult residents of five informal settlements of Dhaka city randomly chosen from an existing Urban Health and Demographic Surveillance Systems (UHDSS) run by icddr,b. Data on Generalized Anxiety Disorder-7 (GAD-7) and Insomnia Severity Index (ISI) were collected. A multinomial logistic regression was performed to assess the associated factors of anxiety and insomnia. Results: Of the total 586 participants, the prevalence of mild to severe anxiety and insomnia were 53% and 43%, respectively. As per the multinomial regression analysis, participants with mild anxiety were significantly more likely to be older (>50 years) and afraid of COVID-19 infection. Likewise, participants with moderate/severe anxiety were significantly more likely to share less household facilities (e.g., toilet, kitchen, water) (OR: 2.23; 95% CI: 1.31-3.79), to have difficulties in food availability (OR: 2.76; 95% CI: 1.10-6.93), to be afraid of self (OR: 5.27; 95% CI: 2.82-9.88), and to worry about the family members (OR: 2.26; 95% CI: 1.23-4.17) getting infected. Participants with mild insomnia were significantly more likely to share fewer household facilities and be afraid of being infected with COVID-19 infection. Moreover, participants with moderate/severe insomnia were significantly more likely to be female (OR: 1.90; 95% CI: 1.02-3.56), to receive food aid (OR: 0.50; 95% CI: 0.29-0.88), to be afraid of self (OR: 3.85; 95% CI: 1.81-8.19), and to worry about someone like friends or neighbors (OR: 2.45; 95% CI: 1.07-5.58) getting infected with COVID-19. Conclusions: We found elevated prevalence of both anxiety and insomnia among the urban poor of Bangladesh in the context of COVID-19. This indicates the importance of integrating mental health in the mitigation and recovery efforts related to similar crises for the urban poor in the future.
Collapse
Affiliation(s)
- Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Hanifi SMA, Alam SS, Shuma SS, Reidpath DD. Insights Into Excess Mortality During the First Months of the COVID-19 Pandemic From a Rural, Demographic Surveillance Site in Bangladesh. Front Public Health 2021; 9:622379. [PMID: 34395351 PMCID: PMC8358064 DOI: 10.3389/fpubh.2021.622379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/24/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) has spread globally, and the government of each affected country is publishing the number of deaths every day. This official figure is an underestimate as it excludes anybody who did not die in a hospital, who did not test positive, who had a false result, or those who recovered on their own without a test. Objective: This study aimed to measure the community level excess mortality using health and demographic surveillance in a rural area of Bangladesh. Method: The study was conducted in Matlab, in a rural area of Bangladesh, with a Health and Demographic Surveillance System (HDSS) covering a population of 239,030 individuals living in 54,823 households in 142 villages. We examined the mortality in January-April from 2015 to 2020 and compared the mortality in 2020 with the historical trend of 2015–2019. Between 2015 and 2020, we followed 276,868 people until migration or death, whichever occurred first. We analyzed mortality using crude mortality rate ratio (MRR) and adjusted MRR (aMRR) from a Cox proportional hazard model. Mortality was analyzed according to age, sex, and period. Results: During follow-up, 3,197 people died. The mortality rate per 1,000 person-years increased from 10 in 2019 to 12 in 2020. Excess mortality was observed among the elderly population (aged 65 years and above). The elderly mortality rate per 1,000 person-years increased from 80 in 2019 to 110 in 2020, and the aMRR was 1.40 (95% CI: 1.19–1.64). Although an increasing tendency in mortality was observed between 2015 and 2019, it was statistically insignificant. Conclusions: The study reported a 28% increase in excess deaths among the elderly population during the first months of the pandemic. This all-cause mortality estimation at the community level will urge policymakers, public health professionals, and researchers to further investigate the causes of death and the underlying reasons for excess deaths in the older age-group.
Collapse
Affiliation(s)
| | - Sayed Saidul Alam
- Health Systems and Population Studies Division, icddr, b, Dhaka, Bangladesh
| | | | - Daniel D Reidpath
- Health Systems and Population Studies Division, icddr, b, Dhaka, Bangladesh
| |
Collapse
|
26
|
Affiliation(s)
- Pascale Allotey
- International Institute for Global Health, United Nations University, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia.
| | - Daniel D Reidpath
- International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| |
Collapse
|
27
|
Hasan SM, Das S, Hanifi SMA, Shafique S, Rasheed S, Reidpath DD. A place-based analysis of COVID-19 risk factors in Bangladesh urban slums: a secondary analysis of World Bank microdata. BMC Public Health 2021; 21:502. [PMID: 33722207 PMCID: PMC7957470 DOI: 10.1186/s12889-021-10230-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/12/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There is a lack of research investigating the confluence of risk factors in urban slums that may make them accelerators for respiratory, droplet infections like COVID-19. Our working hypothesis was that, even within slums, an inverse relationship existed between living density and access to shared or private WASH facilities. METHODS In an exploratory, secondary analysis of World Bank, cross-sectional microdata from slums in Bangladesh we investigated the relationship between intra-household population density (crowding) and access to private or shared water sources and toilet facilities. RESULTS The analysis showed that most households were single-room dwellings (80.4%). Median crowding ranged from 0.55 m2 per person up to 67.7 m2 per person. The majority of the dwellings (83.3%), shared both toilet facilities and the source of water, and there was a significant positive relationship between crowding and the use of shared facilities. CONCLUSION The findings highlight the practical constraints on implementing, in slums, the conventional COVID19 management approaches of social distancing, regular hand washing, and not sharing spaces. It has implications for the management of future respiratory epidemics.
Collapse
Affiliation(s)
- Shaikh Mehdi Hasan
- International Centre for Diarrhoeal Disease Research, Bangladesh, Health System and Population Studies Division, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Susmita Das
- International Centre for Diarrhoeal Disease Research, Bangladesh, Health System and Population Studies Division, Mohakhali, Dhaka, 1212, Bangladesh
| | - Syed Manzoor Ahmed Hanifi
- International Centre for Diarrhoeal Disease Research, Bangladesh, Health System and Population Studies Division, Mohakhali, Dhaka, 1212, Bangladesh
| | - Sohana Shafique
- International Centre for Diarrhoeal Disease Research, Bangladesh, Health System and Population Studies Division, Mohakhali, Dhaka, 1212, Bangladesh
| | - Sabrina Rasheed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Health System and Population Studies Division, Mohakhali, Dhaka, 1212, Bangladesh
| | - Daniel D Reidpath
- International Centre for Diarrhoeal Disease Research, Bangladesh, Health System and Population Studies Division, Mohakhali, Dhaka, 1212, Bangladesh
| |
Collapse
|
28
|
Leder K, Openshaw JJ, Allotey P, Ansariadi A, Barker SF, Burge K, Clasen TF, Chown SL, Duffy GA, Faber PA, Fleming G, Forbes AB, French M, Greening C, Henry R, Higginson E, Johnston DW, Lappan R, Lin A, Luby SP, McCarthy D, O'Toole JE, Ramirez-Lovering D, Reidpath DD, Simpson JA, Sinharoy SS, Sweeney R, Taruc RR, Tela A, Turagabeci AR, Wardani J, Wong T, Brown R. Study design, rationale and methods of the Revitalising Informal Settlements and their Environments (RISE) study: a cluster randomised controlled trial to evaluate environmental and human health impacts of a water-sensitive intervention in informal settlements in Indonesia and Fiji. BMJ Open 2021; 11:e042850. [PMID: 33419917 PMCID: PMC7798802 DOI: 10.1136/bmjopen-2020-042850] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Increasing urban populations have led to the growth of informal settlements, with contaminated environments linked to poor human health through a range of interlinked pathways. Here, we describe the design and methods for the Revitalising Informal Settlements and their Environments (RISE) study, a transdisciplinary randomised trial evaluating impacts of an intervention to upgrade urban informal settlements in two Asia-Pacific countries. METHODS AND ANALYSIS RISE is a cluster randomised controlled trial among 12 settlements in Makassar, Indonesia, and 12 in Suva, Fiji. Six settlements in each country have been randomised to receive the intervention at the outset; the remainder will serve as controls and be offered intervention delivery after trial completion. The intervention involves a water-sensitive approach, delivering site-specific, modular, decentralised infrastructure primarily aimed at improving health by decreasing exposure to environmental faecal contamination. Consenting households within each informal settlement site have been enrolled, with longitudinal assessment to involve health and well-being surveys, and human and environmental sampling. Primary outcomes will be evaluated in children under 5 years of age and include prevalence and diversity of gastrointestinal pathogens, abundance and diversity of antimicrobial resistance (AMR) genes in gastrointestinal microorganisms and markers of gastrointestinal inflammation. Diverse secondary outcomes include changes in microbial contamination; abundance and diversity of pathogens and AMR genes in environmental samples; impacts on ecological biodiversity and microclimates; mosquito vector abundance; anthropometric assessments, nutrition markers and systemic inflammation in children; caregiver-reported and self-reported health symptoms and healthcare utilisation; and measures of individual and community psychological, emotional and economic well-being. The study aims to provide proof-of-concept evidence to inform policies on upgrading of informal settlements to improve environments and human health and well-being. ETHICS Study protocols have been approved by ethics boards at Monash University, Fiji National University and Hasanuddin University. TRIAL REGISTRATION NUMBER ACTRN12618000633280; Pre-results.
Collapse
Affiliation(s)
- Karin Leder
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - John J Openshaw
- Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford, California, USA
| | - Pascale Allotey
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Ansariadi Ansariadi
- Public Health Faculty, Hasanuddin University, Makassar, Sulawesi Selatan, Indonesia
| | - S Fiona Barker
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Kerrie Burge
- CRC for Water Sensitive Cities, Monash University, Melbourne, Victoria, Australia
| | - Thomas F Clasen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Steven L Chown
- School of Biological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Grant A Duffy
- School of Biological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Peter A Faber
- School of Biological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Genie Fleming
- School of Biological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Andrew B Forbes
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Matthew French
- Monash Sustainable Development Institute, Monash University, Melbourne, Victoria, Australia
| | - Chris Greening
- Department of Microbiology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Rebekah Henry
- Civil Engineering, Monash University, Melbourne, Victoria, Australia
| | - Ellen Higginson
- Cambridge Institute for Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - David W Johnston
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, Australia
| | - Rachael Lappan
- Department of Microbiology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Audrie Lin
- Division of Epidemiology and Biostatistics, School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Stephen P Luby
- Infectious Diseases and Geographic Medicine Division, Stanford University, Stanford, California, USA
| | - David McCarthy
- Civil Engineering, Monash University, Melbourne, Victoria, Australia
| | - Joanne E O'Toole
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | | | - Daniel D Reidpath
- Monash University - Malaysia Campus, Bandar Sunway, Selangor, Malaysia
| | - Julie A Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sheela S Sinharoy
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Rohan Sweeney
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, Australia
| | - Ruzka R Taruc
- Public Health Faculty, Hasanuddin University, Makassar, Sulawesi Selatan, Indonesia
| | - Autiko Tela
- School of Public Health and Primary Care, Fiji National University, College of Medicine, Nursing and Health Sciences, Tamavua Campus, Suva, Rewa, Fiji
| | - Amelia R Turagabeci
- School of Public Health and Primary Care, Fiji National University, College of Medicine, Nursing and Health Sciences, Tamavua Campus, Suva, Rewa, Fiji
| | - Jane Wardani
- Monash Sustainable Development Institute, Monash University, Melbourne, Victoria, Australia
| | - Tony Wong
- CRC for Water Sensitive Cities, Monash University, Melbourne, Victoria, Australia
| | - Rebekah Brown
- Monash Sustainable Development Institute, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
29
|
McGrattan A, Mohan D, Chua PW, Mat Hussin A, Soh YC, Alawad M, Bin Kassim Z, Bin Mohd Ghazali AN, Stephan B, Allotey P, Reidpath DD, Robinson L, Siervo M. Feasibility and acceptability of a dietary intervention study to reduce salt intake and increase high-nitrate vegetable consumption among middle-aged and older Malaysian adults with elevated blood pressure: a study protocol. BMJ Open 2020; 10:e035453. [PMID: 32859661 PMCID: PMC7454174 DOI: 10.1136/bmjopen-2019-035453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Global population ageing is one of the key factors linked to the projected rise of dementia incidence. Hence, there is a clear need to identify strategies to overcome this expected health burden and have a meaningful impact on populations' health worldwide. Current evidence supports the role of modifiable dietary and lifestyle risk factors in reducing the risk of dementia. In South-East Asia, changes in eating and lifestyle patterns under the influence of westernised habits have resulted in significant increases in the prevalence of metabolic, cardiovascular and neurodegenerative non-communicable diseases (NCDs). Low vegetable consumption and high sodium intake have been identified as key contributors to the increased prevalence of NCDs in these countries. Therefore, nutritional and lifestyle strategies targeting these dietary risk factors are warranted. The overall objective of this randomised feasibility trial is to demonstrate the acceptability of a dietary intervention to increase the consumption of high-nitrate green leafy vegetables and reduce salt intake over 6 months among Malaysian adults with raised blood pressure. METHODS AND ANALYSIS Primary outcomes focus on feasibility measures of recruitment, retention, implementation and acceptability of the intervention. Secondary outcomes will include blood pressure, cognitive function, body composition and physical function (including muscle strength and gait speed). Adherence to the dietary intervention will be assessed through collection of biological samples, 24-hour recall and Food Frequency Questionnaire. A subgroup of participants will also complete postintervention focus groups to further explore the feasibility considerations of executing a larger trial, the ability of these individuals to make dietary changes and the barriers and facilitators associated with implementing these changes. ETHICS AND DISSEMINATION Ethical approval has been obtained from Monash University Human Research Ethics Committee and Medical Research and Ethics Committee of Malaysia. Results of the study will be disseminated via peer-reviewed publications and presentations at national and international conferences.ISRCTN47562685; Pre-results.
Collapse
Affiliation(s)
- Andrea McGrattan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Devi Mohan
- Global Public Health. Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Segamat, Johor, Malaysia
| | - Pei Wei Chua
- Global Public Health. Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Segamat, Johor, Malaysia
| | - Azizah Mat Hussin
- Kampus Cawangan Institute of Medical Science Technology, Universiti Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Yee Chang Soh
- Global Public Health. Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Segamat, Johor, Malaysia
| | - Mawada Alawad
- Global Public Health. Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Segamat, Johor, Malaysia
| | - Zaid Bin Kassim
- District Health Office, Pejabat Kesihatan Daerah (PKD) Segamat, Segamat, Johor, Malaysia
| | | | - Blossom Stephan
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Pascale Allotey
- Global Public Health. Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia
| | - Daniel D Reidpath
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Segamat, Johor, Malaysia
- International Centre for Diarrhoeal Disease Research, ICDDR,B, Dhaka, Bangladesh
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Mario Siervo
- School of Life Sciences, University of Nottingham, Nottingham, UK
| |
Collapse
|
30
|
Affiliation(s)
| | - Pascale Allotey
- United Nations University – International Institute for Global Health, Cheras, Kuala Lumpur, Malaysia
| | - Daniel D. Reidpath
- International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| |
Collapse
|
31
|
Yap KH, Warren N, Reidpath DD, Allotey P. Understanding Cognitive Impairment after Stroke: Stories from a Middle-Income Country. Population Ageing 2020. [DOI: 10.1007/s12062-020-09289-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
32
|
Yap KH, Warren N, Allotey P, Reidpath DD. Chronic disease profiles of subjective memory complaints: a latent class analysis of older people in a rural Malaysian community. Aging Ment Health 2020; 24:709-716. [PMID: 30588848 DOI: 10.1080/13607863.2018.1550632] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: Subjective memory complaints (SMC) are common in the elderly and have been suggested as the first subtle sign of decline which can predict dementia. Cognitive decline is thought to be related to inflammatory processes similarly found in other chronic diseases and conditions such as stroke, heart disease and arthritis. This study aimed to examine the association of SMC with chronic diseases and the profile of these health conditions reported by a group of older adults.Methods: Data from a cross-sectional survey conducted from August 2013 and March 2014 was drawn from 6179 individuals aged 56 years and above. Multivariable logistic regression analyses were used to examine SMC's relationship with individual chronic diseases (asthma, kidney disease, heart disease, stroke, arthritis, hypertension and diabetes) and multimorbidity. Latent class analysis (LCA) was used to identify the profile of health conditions. The effect of SMC was estimated in a multinomial logistic regression as part of the latent class model.Results: SMC was statistically significant in its association with asthma, stroke, heart disease, arthritis and multimorbidity in the fully controlled multivariable logistic regression models. Three health profiles were identified: low comorbidity (n = 4136, low rates in all health conditions), arthritis group (n = 860) and diabetes and hypertension group (n = 1183). SMC was associated with arthritis group (OR = 2.04, 95% CI = 1.51-2.75) and diabetes and hypertension group (OR = 1.22, 95% CI = 1.03-1.46).Conclusion: Adapting a combination of analytical approaches allows a better understanding in the assessment of SMC's relationship with chronic diseases and the patterns of distribution of these health conditions.
Collapse
Affiliation(s)
- Kwong Hsia Yap
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
| | - Narelle Warren
- School of Social Sciences, Clayton Campus, Monash University, VIC, Australia
| | - Pascale Allotey
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia.,International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia.,South East Asia Community Observatory (SEACO), Monash University, Segamat, Malaysia
| |
Collapse
|
33
|
Karalasingam SD, Jeganathan R, Jegasothy R, Reidpath DD. Caesarean section rates from Malaysian tertiary hospitals using Robson's 10-group classification. BMC Pregnancy Childbirth 2020; 20:64. [PMID: 32005188 PMCID: PMC6995123 DOI: 10.1186/s12884-020-2760-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 01/22/2020] [Indexed: 11/17/2022] Open
Abstract
Background Rising caesarean section rates is a concern worldwide. This study aimed to use Robson’s ten group classification to identify which groups of women were contributing most to the rising caesarean section rates in Malaysian tertiary hospitals and to compare between hospitals, using a common standard set of variables. Methods A 5-year (2011–2015) cross-sectional study was conducted using data from the Malaysian National Obstetrics Registry (NOR). A total of 608,747 deliveries were recorded from 11 tertiary state hospitals and 1 tertiary hospital from the Federal territory. Results During the study period, there were 141,257 Caesarean sections (23.2%). Caesarean sections in Group 1 (nulliparous term pregnancy in spontaneous labour) and Group 3 (multiparous term pregnancy in spontaneous labour) had an increasing trend from 2011 to 2015. The group that contributed most to the overall caesarean section rates was Group 5 (multiparous, singleton, cephalic≥37 weeks with previous caesarean section) and the rates remained high during the 5-year study period. Groups 6, 7 and 9 had the highest caesarean section rates but they made the smallest contribution to the overall rates. Conclusions Like many countries, the rate of caesarean section has risen over time, and the rise is driven by caesarean section in low-risk groups. There was an important hospital to hospital variation. The rise in caesarean section rates reflects a globally disturbing trend, and changes in policy and training that creates a uniform standard across hospitals should be considered.
Collapse
Affiliation(s)
- Shamala Devi Karalasingam
- National Obstetrics Registry, Institute Clinical Research, National Institute of Health, No 1 Jalan Setia Murni U13/52, Seksyen U13, Setai Alam, Shah Alam, 40170, Selangor, Malaysia.
| | | | - Ravindran Jegasothy
- Faculty of Medicine, MAHSA University, Jalan SP2, Bandar Saujana Putra, 42610, Jenjarom, Selangor, Malaysia
| | - Daniel D Reidpath
- South East Asia Community Observatory (SEACO), 125, Jalan Sia Her Yam, Kampung Abdullah, 85000, Segamat, Johor, Malaysia.,Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500, Subang Jaya, Malaysia
| |
Collapse
|
34
|
Abstract
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.
Collapse
Affiliation(s)
- Kwong Hsia Yap
- a Jeffrey Cheah School of Medicine and Health Sciences , Monash University Malaysia , Bandar Sunway , Malaysia
| | - Narelle Warren
- b School of Social Sciences, Clayton Campus , Monash University , Melbourne , Australia
| | - Daniel D Reidpath
- a Jeffrey Cheah School of Medicine and Health Sciences , Monash University Malaysia , Bandar Sunway , Malaysia.,c South East Asia Community Observatory (SEACO) , Monash University , Segamat , Malaysia
| | - Pascale Allotey
- a Jeffrey Cheah School of Medicine and Health Sciences , Monash University Malaysia , Bandar Sunway , Malaysia.,d International Institute for Global Health , United Nations University , Kuala Lumpur , Malaysia
| |
Collapse
|
35
|
Mohan D, Stephan BCM, Allotey P, Reidpath DD. 34 Gender Difference in the Association between Handgrip Strength and Cognitive Performance of Older Adults in Rural Malaysia. Age Ageing 2019. [DOI: 10.1093/ageing/afz164.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Handgrip strength is an easy and safe measurement to evaluate the physical functioning of older adults. Lower hand grip strength is associated with cognitive decline, and can be used as an effective method for early detection of cognitive impairment.
Objective
This study aimed to evaluate the gender differences in association between hand grip strength and cognitive performance among older adults in rural Malaysia
Methods
This was a cross-sectional study done among 200 community dwelling older adults (100 men and 100 women) aged ≥ 50 years. The study was embedded in the ongoing longitudinal study of South East Asia Community Observatory (SEACO) in Segamat district of Johor, Malaysia. Data was collected by trained data collectors during home visits. Cognitive performance was assessed using Mini Mental State Examination (MMSE). Hand grip strength was measured using digital grip dynamometer.
Results
The mean age of study participants was 61.5 years (SD= 8.4). Women had lower mean hand grip strength (19.8, SD=5.6) compared to men (33.4, SD= 8.2). The mean MMSE score for women and men were 23 (SD= 4.5) and 25.1(SD=3) respectively. Cognitive impairment was detected in 26% of men and 21% of women. Hand grip strength showed positive association with MMSE score, among women (ß coefficient= 0.302, p<0.001), but not among men (p= 0.077). Hand grip strength was significantly association with MMSE score among women (ß coefficient=0.162, 95% CI = 0.026- 0.298; p=0.02) after controlling for age, level of education and body mass index.
Conclusion
The study shows that lower hand grip strength is associated with poor cognitive performance among women, while hand grip strength is not associated with cognitive performance among men.
Collapse
Affiliation(s)
- Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia
| | - Blossom C M Stephan
- Newcastle University Institute for Ageing & Institute of Health and Society, Newcastle University, United Kingdom
| | - Pascale Allotey
- International Institute for Global Health, United Nations University, Malaysia
| | - Daniel D Reidpath
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia
- South East Asia Community Observatory, Monash University Malaysia, Malaysia
| |
Collapse
|
36
|
Chan KY, Adeloye D, Asante KP, Calia C, Campbell H, Danso SO, Juvekar S, Luz S, Mohan D, Muniz-Terrera G, Nitrini R, Noroozian M, Nulkar A, Nyame S, Paralikar V, Parra Rodriguez MA, Poon AN, Reidpath DD, Rudan I, Stephan BCM, Su T, Wang H, Watermeyer T, Wilkinson H, Yassuda MS, Yu X, Ritchie C. Tackling dementia globally: the Global Dementia Prevention Program (GloDePP) collaboration. J Glob Health 2019; 9:020103. [PMID: 31893025 PMCID: PMC6925964 DOI: 10.7189/jogh.09.020103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Kit Yee Chan
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Davies Adeloye
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
- RcDavies Evidence-based Medicine, Lagos, Nigeria
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Clara Calia
- Department of Clinical Psychology, School of Health in Social Science, Medical School, The University of Edinburgh, United Kingdom
| | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
| | - Samuel O Danso
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
| | - Sanjay Juvekar
- King Edward Memorial Hospital Research Centre (KEMHRC), Pune, India
| | - Saturnino Luz
- Usher Institute, University of Edinburgh, United Kingdom
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia
- South East Asia Community Observatory, Monash University Malaysia, Malaysia
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
| | - Ricardo Nitrini
- Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil
| | | | - Amit Nulkar
- King Edward Memorial Hospital Research Centre (KEMHRC), Pune, India
| | - Solomon Nyame
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | | | - Mario A Parra Rodriguez
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
- Autonomous University of the Caribbean, Barranquilla, Colombia
| | - Adrienne N. Poon
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
- Department of Medicine, George Washington School of Medicine & Health Sciences, Washington, DC, United States
| | | | - Igor Rudan
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
| | - Blossom CM Stephan
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, Nottingham University, United Kingdom
| | - TinTin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia
- South East Asia Community Observatory, Monash University Malaysia, Malaysia
| | - Huali Wang
- Dementia Care & Research Centre, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Centre for Mental Disorders, Key Laboratory for Mental Health, Beijing, China
| | - Tam Watermeyer
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Heather Wilkinson
- Edinburgh – Centre for Research on the Experience of Dementia, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Monica Sanches Yassuda
- Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Xin Yu
- Dementia Care & Research Centre, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Centre for Mental Disorders, Key Laboratory for Mental Health, Beijing, China
| | - Craig Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
| | - on behalf of the Global Dementia Prevention Program (GloDePP)
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
- RcDavies Evidence-based Medicine, Lagos, Nigeria
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
- Department of Clinical Psychology, School of Health in Social Science, Medical School, The University of Edinburgh, United Kingdom
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
- King Edward Memorial Hospital Research Centre (KEMHRC), Pune, India
- Usher Institute, University of Edinburgh, United Kingdom
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia
- South East Asia Community Observatory, Monash University Malaysia, Malaysia
- Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil
- Tehran University of Medical Sciences (TUMS), Tehran, Iran
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
- Alzheimer’s Scotland Dementia Research Centre, Edinburgh University, United Kingdom
- Autonomous University of the Caribbean, Barranquilla, Colombia
- Department of Medicine, George Washington School of Medicine & Health Sciences, Washington, DC, United States
- Health System and Population Studies Division, icddr,b Bangladesh
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, Nottingham University, United Kingdom
- Dementia Care & Research Centre, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- Beijing Dementia Key Lab, Beijing, China
- National Clinical Research Centre for Mental Disorders, Key Laboratory for Mental Health, Beijing, China
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- Edinburgh – Centre for Research on the Experience of Dementia, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| |
Collapse
|
37
|
Cheong WL, Mohan D, Warren N, Reidpath DD. Living with a neglected neurological disease: a qualitative study of patients with multiple sclerosis in Malaysia. Disabil Rehabil 2019; 43:2184-2190. [PMID: 31769306 DOI: 10.1080/09638288.2019.1695000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The needs of patients with multiple sclerosis have been well-studied in high-income, high-prevalence countries but few studies have been based in low- and middle-income countries where resources are relatively scarce. As such, little is known about the needs of patients living in these countries. OBJECTIVE The study seeks to develop an understanding of the needs of patients with multiple sclerosis living in Malaysia in order to generate insights and contribute to a global database of patients' experience. METHOD 12 patients with multiple sclerosis participated in this qualitative study and took part in a semi-structured interview. The interviews were transcribed and analysed using an iterative thematic analysis approach. RESULTS The experiences, challenges and needs of the patients were reported. Five themes were developed (Daily living, Financial, Emotional and psychological, Healthcare, and Family). These predominantly revolved around the struggles of coping and adapting to the symptoms and disabilities imposed by multiple sclerosis, their heavy reliance on personal finances to cope with the increased costs of living for themselves and their families, as well as the limited healthcare services and treatments available to help them to manage the physical and emotional symptoms of multiple sclerosis. CONCLUSION Patients with multiple sclerosis in Malaysia have complex needs that are neglected due perceived lack of importance of the disease and the poor understanding of multiple sclerosis in general. Patients rely heavily on their finances to improve their quality of life. This perpetuates health inequities and reform of the national health financing system is needed to provide patients with the healthcare and support they need.Implications for rehabilitationPatients with multiple sclerosis in Malaysia prioritize being able to cope and adapt to their disabilities in order to continue performing their activities of daily living.There is a need to increase the availability and accessibility of healthcare professionals that are experienced with the management of multiple sclerosis.Healthcare professionals need to improve their understanding of the patients' needs and what they consider to be important in order to provide therapy that is effective and relevant.Patients also require financial support to help them with the increased costs of living associated with MS as well as the costs of healthcare services such as physiotherapy and rehabilitation.
Collapse
Affiliation(s)
- Wing Loong Cheong
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Devi Mohan
- Jeffrey Cheah School of Medicine and Health Sciences (JCSMHS), Monash University Malaysia, Bandar Sunway, Malaysia
| | - Narelle Warren
- School of Social Sciences, Monash University, Clayton, Australia
| | - Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences (JCSMHS), Monash University Malaysia, Bandar Sunway, Malaysia
| |
Collapse
|
38
|
Cheong WL, Mohan D, Warren N, Reidpath DD. Response to de Groot ‘There is an urgent need for palliative care specialists in MS – Commentary’. Mult Scler 2019; 25:1821-1822. [DOI: 10.1177/1352458519876697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Wing Loong Cheong
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Devi Mohan
- Jeffrey Cheah School of Medicine and Health Sciences (JCSMHS), Monash University Malaysia, Bandar Sunway, Malaysia
| | - Narelle Warren
- School of Social Sciences, Monash University, Clayton, VIC, Australia
| | - Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences (JCSMHS), Monash University Malaysia, Bandar Sunway, Malaysia
| |
Collapse
|
39
|
Masood M, Aggarwal A, Reidpath DD. Effect of national culture on BMI: a multilevel analysis of 53 countries. BMC Public Health 2019; 19:1212. [PMID: 31481044 PMCID: PMC6719355 DOI: 10.1186/s12889-019-7536-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 08/22/2019] [Indexed: 11/18/2022] Open
Abstract
Background To investigate the association between national culture and national BMI in 53 low-middle- and high-income countries. Methods Data from World Health Survey conducted in 2002–2004 in low-middle- and high-income countries were used. Participants aged 18 years and over were selected using multistage, stratified cluster sampling. BMI was used as an outcome variable. Culture of the countries was measured using Hofstede’s cultural dimensions: Uncertainty avoidance, individualism, Power Distance and masculinity. The potential determinants of individual-level BMI were participants’ sex, age, marital status, education, occupation as well as household-wealth and location (rural/urban) at the individual-level. The country-level factors used were average national income (GNI-PPP), income inequality (Gini-index) and Hofstede’s cultural dimensions. A two-level random-intercepts and fixed-slopes model structure with individuals nested within countries were fitted, treating BMI as a continuous outcome variable. Results A sample of 156,192 people from 53 countries was included in this analysis. The design-based (weighted) mean BMI (SE) in these 53 countries was 23.95(0.08). Uncertainty avoidance (UAI) and individualism (IDV) were significantly associated with BMI, showing that people in more individualistic or high uncertainty avoidance countries had higher BMI than collectivist or low uncertainty avoidance ones. This model explained that one unit increase in UAI or IDV was associated with 0.03 unit increase in BMI. Power distance and masculinity were not associated with BMI of the people. National level Income was also significantly associated with individual-level BMI. Conclusion National culture has a substantial association with BMI of the individuals in the country. This association is important for understanding the pattern of obesity or overweight across different cultures and countries. It is also important to recognise the importance of the association of culture and BMI in developing public health interventions to reduce obesity or overweight.
Collapse
Affiliation(s)
- Mohd Masood
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Australia. .,Division of Population and Patient Health, Dental Institute, King's College London, London, UK. .,Department of Global Public Health, Jeffery Cheah School of Medicine and Health Science, Monash University, Bandar Sunway, Malaysia.
| | - Akash Aggarwal
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Daniel D Reidpath
- Department of Global Public Health, Jeffery Cheah School of Medicine and Health Science, Monash University, Bandar Sunway, Malaysia
| |
Collapse
|
40
|
Reidpath DD, Allotey P. The problem of 'trickle-down science' from the Global North to the Global South. BMJ Glob Health 2019; 4:e001719. [PMID: 31406597 PMCID: PMC6666820 DOI: 10.1136/bmjgh-2019-001719] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/02/2019] [Accepted: 07/05/2019] [Indexed: 11/03/2022] Open
Affiliation(s)
- Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.,South-East Asia Community Observatory (SEACO), Monash University Malaysia, Bandar Sunway, Malaysia
| | - Pascale Allotey
- International Institute for Global Health (UNU-IIGH), United Nations University, Cheras, Malaysia
| |
Collapse
|
41
|
Abstract
BACKGROUND Stroke is a public health concern in Malaysia but local beliefs and lay understandings of stroke have not been examined before. Explanatory models provide a way for people to make sense of their illness and influence health seeking behaviors, in a locally relevant way. METHODS Drawing on ethnographic research from rural Malaysia, this descriptive article explores ethnic Malaysian-Chinese stroke survivors' lay understandings of stroke. Eighteen community-dwelling stroke survivors aged 50-83 took part in the study. RESULTS Causation of stroke was derived from cultural, biomedical and social sources. Participants also drew simultaneously from both biomedical and traditional explanations of stroke to develop their own understanding of etiology. Similarities with biomedical causation and other studies from different cultures were found. Participants' typically focused on the more immediate effects of stroke and often do not attribute causation and association with their comorbid conditions which are also risk factors of stroke. CONCLUSION Lack of knowledge about stroke and its symptoms was evident in participants' account. Findings emphasize the importance of knowledge based health interventions, especially in health education strategies for stroke survivors to reduce delays to diagnosis and potentially improve health outcomes post-stroke. Implications for rehabilitation Stroke survivors often form explanatory models of stroke that draw from both biomedical and traditional explanations of stroke. Understanding how people derive lay understandings of stroke can contribute towards developing the goals and activities that facilitate recovery and rehabilitation in similar settings. Health practitioners in the community should strengthen communication regarding the identification, etiology and risk factors of stroke with stroke survivors and their carers to improve compliance to medication, exercise and diet for better recovery. Sustained health education which is culturally relevant is recommended. Communication should also include non-physical impact of stroke (such as cognitive deficits and emotional difficulties) as the stroke survivors were unlikely to relate such symptoms to stroke.
Collapse
Affiliation(s)
- Kwong Hsia Yap
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
| | - Narelle Warren
- School of Social Sciences, Clayton Campus, Monash University, VIC, Australia
| | - Pascale Allotey
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia.,International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia.,South East Asia Community Observatory (SEACO), Monash University, Segamat, Malaysia
| |
Collapse
|
42
|
Cheong WL, Mohan D, Warren N, Reidpath DD. Palliative Care Research in the Asia Pacific Region: A Systematic Review and Bibliometric Analysis of Peer-Reviewed Publications. J Palliat Med 2019; 22:545-552. [DOI: 10.1089/jpm.2018.0447] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Wing Loong Cheong
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Devi Mohan
- Jeffrey Cheah School of Medicine and Health Sciences (JCSMHS), Monash University Malaysia, Bandar Sunway, Malaysia
| | - Narelle Warren
- School of Social Sciences, Monash University, Clayton, Australia
| | - Daniel D. Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences (JCSMHS), Monash University Malaysia, Bandar Sunway, Malaysia
| |
Collapse
|
43
|
Abstract
Purpose: A stroke is a sudden event which may leave individuals and their families ill-prepared to deal with the resultant disability. Several contextual factors can influence the recovery process. These factors, internal and external, exist interactively in the lived experiences of the survivors. The limited availability of rehabilitation centres that are located in urban centres meant that recovery predominately occurred outside of the biomedical health and instead relied upon the resources available to individuals and their families.Methods: A qualitative approach with data from in-depth interviews and observations were used to identify contextual factors that shaped recovery following stroke in a community. Twenty-seven individuals with stroke were drawn from a health and demographic surveillance system in Malaysia.Results: Hope and optimism, coping strategies, motivation and support from family and friends, and the use of alternative and complementary medicine shaped the process of recovery within a context where infrastructure is extremely limited.Conclusion: The identification of factors that facilitate the recovery process provides a background in which health care providers can utilise to improve their understanding of the stroke experience. Such understanding could be instrumental in aiding health professionals to offer the most effective help to their clients.Implications for rehabilitationIdentification of contextual factors provides a background for the understanding of the stroke experience.Incorporation of religion into rehabilitation could support and maintain hope in recovery for the survivors and aid acceptance.A collaboration of healthcare professionals with traditional medicine therapists may prove beneficial for the rehabilitation of stroke survivors in Malaysia.
Collapse
Affiliation(s)
- Fatima Fanna Mairami
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Narelle Warren
- School of Social Sciences, Monash University, Clayton Campus, Melbourne, Australia
| | - Pascale A Allotey
- UN University International Institute for Global Health (UNU-IIGH), Kuala Lumpur, Malaysia
| | - Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.,South East Asia Community Observatory (SEACO), Monash University, Segamat, Malaysia
| |
Collapse
|
44
|
Hwong WY, Bots ML, Selvarajah S, Sivasampu S, Reidpath DD, Law WC, Musa KI, Vaartjes I. Sex differences in stroke metrics among Southeast Asian countries: Results from the Global Burden of Disease Study 2015. Int J Stroke 2019; 14:826-834. [PMID: 30843480 DOI: 10.1177/1747493019832995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Sex differences in cardiovascular diseases generally disadvantage women, particularly within developing regions. AIMS This study aims to examine sex-related differences in stroke metrics across Southeast Asia in 2015. Furthermore, relative changes between sexes are compared from 1990 to 2015. METHODS Data were sourced from the Global Burden of Disease Study. Incidence and mortality from ischemic and hemorrhagic strokes were explored with the following statistics derived: (1) women-to-men incidence/mortality ratio and (2) relative percentage change in rate. RESULTS Women had lower incidence and mortality from stroke compared to men. Notable findings include higher ischemic stroke incidence for women at 30-34 years in high-income countries (women-to-men ratio: 1.3, 95% CI: 0.1, 16.2 in Brunei and 1.3, 95% CI: 0.5, 3.2 in Singapore) and the largest difference between sexes for ischemic stroke mortality in Vietnam and Myanmar across most ages. Within the last 25 years, greater reductions for ischemic stroke metrics were observed among women compared to men. Nevertheless, women below 40 years in some countries showed an increase in ischemic stroke incidence between 0.5% and 11.4%, whereas in men, a decline from -4.2% to -44.2%. Indonesia reported the largest difference between sexes for ischemic stroke mortality; a reduction for women whereas an increase in men. For hemorrhagic stroke, findings were similar: higher incidence among young women in high-income countries and greater reductions for stroke metrics in women than men over the last 25 years. CONCLUSIONS Distinct sex-specific differences observed across Southeast Asia should be accounted in future stroke preventive guidelines.
Collapse
Affiliation(s)
- Wen Yea Hwong
- National Clinical Research Centre, Ministry of Health Malaysia, Selangor, Malaysia.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sharmini Selvarajah
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.,Sharmini Selvarajah Consulting, Selangor, Malaysia
| | - Sheamini Sivasampu
- National Clinical Research Centre, Ministry of Health Malaysia, Selangor, Malaysia
| | - Daniel D Reidpath
- Jeffery Cheah School of Medicine and Health Sciences, Monash University, Selangor, Malaysia
| | - Wan Chung Law
- Neurology Unit, Sarawak General Hospital, Kuching, Sarawak, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| |
Collapse
|
45
|
Warren N, Allotey P, Reidpath DD. Having Impact: Doing Applied Medical Anthropology in Australia and Malaysia. American Anthropologist 2018. [DOI: 10.1111/aman.13142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Pascale Allotey
- United Nations University-International Institute for Global Health; Malaysia
| | | |
Collapse
|
46
|
Abstract
Purpose: Stroke is an abrupt event that often leaves survivors with long term disabilities, causing role changes, and financial strains on households. The profound impact of stroke on survivors may lead to a decline in quality of life due to the physical, psychological, and social difficulties they experience. Taking Malaysia as an example, this study aimed to explore the impact of stroke on survivors and how health services influence their recovery in low and middle-income countries (LMIC).Method: An ethnographic approach with data obtained primarily through in-depth interviews was used. Twenty-seven participants identified as having suffered a stroke were drawn from a health and demographic surveillance system in Malaysia.Results: The physical and social disruption of the lives of stroke survivors was intensified by the resultant financial constraints placed upon individuals, families and households, compounded by inadequate support from the health, and welfare systems. Despite the disruption to their lives, most participants were, at least in part, able to reestablish their lives through various factors that include a strong family support and active coping strategies.Conclusion: In LMIC, recovery can be shaped by the family unit and through active coping strategies especially those in relation to spirituality.Implications for rehabilitationThe impact of stroke on survivors and lack of specialized stroke care compromise the recovery process and quality of life for stroke survivors in low and middle-income countries.Support from the family and reinforcement of religious coping were judged to successfully aid recovery.Physical and emotional impairments as well as psychosocial wellbeing of survivors in the context of environmental factors need to be addressed.
Collapse
Affiliation(s)
- Fatima Fanna Mairami
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Narelle Warren
- School of Social Sciences, Clayton Campus, Monash University, Melbourne, Australia
| | - Pascale A Allotey
- UN University International Institute for Global Health (UNU-IIGH), Kuala Lumpur, Malaysia
| | - Jun Shin Mak
- School of Social Sciences, Clayton Campus, Monash University, Melbourne, Australia
| | - Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.,South East Asia Community Observatory (SEACO), Monash University, Segamat, Johor, Malaysia
| |
Collapse
|
47
|
Cheong WL, Mohan D, Warren N, Reidpath DD. Multiple Sclerosis in the Asia Pacific Region: A Systematic Review of a Neglected Neurological Disease. Front Neurol 2018; 9:432. [PMID: 29937752 PMCID: PMC6002494 DOI: 10.3389/fneur.2018.00432] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 05/23/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Multiple sclerosis is thought to be relatively uncommon in the Asia Pacific region with prevalence estimated between 0 and 20 per 100,000. There is reason to doubt these estimates due to the lack of data from many countries and the growing evidence of variability in prevalence across small geographic areas. This study was conducted to systematically review the population prevalence, incidence, mortality and disability progression estimates of MS within the Asia Pacific region. Methods: The systematic review was conducted on articles from 1985 till 31st July 2017 within the PubMed/MEDLINE, EMBASE, SCOPUS, and The Cochrane Library databases. The review included articles that were population-based studies conducted on patients with MS in the Asia Pacific region that reported either incidence, prevalence, mortality, or disease progression. Hospital-based studies and non-research articles were excluded to ensure that only information representative of the population was included for analysis. Data appraisal and extraction was done by independent reviewers. This review was registered with PROSPERO (ID: CRD42017082760). Findings: Of the 2,757 articles found, 16 studies were included. Information on 6 (18.75%) of 32 Asia Pacific countries was found, with data representing 8% of the total population. Prevalence estimates were available for 6 countries while estimates for incidence (3 countries), mortality (4 countries), and disease progression (2 countries) were limited. Interpretation: The lack of epidemiological data available in the Asia Pacific region creates a blind spot in the surveillance of MS which obscures the true burden of MS, causing patients to struggle to receive the resources and funding that they need.
Collapse
Affiliation(s)
- Wing L. Cheong
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Devi Mohan
- Jeffrey Cheah School of Medicine and Health Sciences (JCSMHS), Monash University Malaysia, Bandar Sunway, Malaysia
| | - Narelle Warren
- School of Social Sciences, Monash University, Clayton, Australia
| | - Daniel D. Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences (JCSMHS), Monash University Malaysia, Bandar Sunway, Malaysia
| |
Collapse
|
48
|
Abstract
Recent globally compiled evidence suggests that one-quarter of pregnancies end in abortions. However, abortions remain illegal in many countries, resulting in unsafe practices. Debates have largely stalled with the pro-life, pro-choice epithets. To provide further arguments in support of legalising abortion services, we argue that the state cannot demand of a woman that she maintains an unwanted pregnancy because that demand places her in a state of involuntary servitude. Involuntary servitude would put states in breach of international human rights law (Article 8 of International Covenant on Civil and Political Rights). Furthermore, we argue that the fact that a life may be forfeit when a woman withdraws her service is no basis for enforcing the servitude. We draw on the 13th Amendment of the US Constitution as an example to extend the argument and highlight the need to test involuntary servitude in international human rights law through mechanisms offered in the international periodic review of member states. This could provide a robust approach to support and strengthen access to safe abortion services.
Collapse
Affiliation(s)
| | - Pascale Allotey
- b Director , United Nations University (UNU), International Institute for Global Health (IIGH), UNU-IIGH Building, UKM Medical Centre , Federal Territory of Kuala Lumpur , Malaysia
| | - Daniel D Reidpath
- c Professor of Population Health , Jeffrey Cheah School of Medicine and Health Sciences & SEACO, Monash University Malaysia, Jalan Lagoon Selatan , Bandar Sunway , Selangor , Malaysia
| |
Collapse
|
49
|
Wong YS, Allotey P, Reidpath DD. Why we run when the doctor comes: Orang Asli responses to health systems in transition in Malaysia. Critical Public Health 2018. [DOI: 10.1080/09581596.2018.1438588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Young Soon Wong
- Global Public Health, School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Pascale Allotey
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Daniel D Reidpath
- Global Public Health, School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
- South East Asia Community Observatory (SEACO), Monash University, Subang Jaya, Malaysia
| |
Collapse
|
50
|
Foo CY, Bonsu KO, Nallamothu BK, Reid CM, Dhippayom T, Reidpath DD, Chaiyakunapruk N. Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: a meta-analysis. Heart 2018; 104:1362-1369. [PMID: 29437704 DOI: 10.1136/heartjnl-2017-312517] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 12/27/2017] [Accepted: 01/05/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers. METHODS We conducted a systematic review and meta-analysis of prospective observational studies that have investigated the relationship of door-to-balloon delay and clinical outcomes. The main outcomes include mortality and heart failure. RESULTS 32 studies involving 299 320 patients contained adequate data for quantitative reporting. Patients with ST-elevation MI who experienced longer (>90 min) door-to-balloon delay had a higher risk of short-term mortality (pooled OR 1.52, 95% CI 1.40 to 1.65) and medium-term to long-term mortality (pooled OR 1.53, 95% CI 1.13 to 2.06). A non-linear time-risk relation was observed (P=0.004 for non-linearity). The association between longer door-to-balloon delay and short-term mortality differed between those presented early and late after symptom onset (Cochran's Q 3.88, P value 0.049) with a stronger relationship among those with shorter prehospital delays. CONCLUSION Longer door-to-balloon delay in primary percutaneous coronary intervention for ST-elevation MI is related to higher risk of adverse outcomes. Prehospital delays modified this effect. The non-linearity of the time-risk relation might explain the lack of population effect despite an improved door-to-balloon time in the USA. CLINICAL TRIAL REGISTRATION PROSPERO (CRD42015026069).
Collapse
Affiliation(s)
- Chee Yoong Foo
- National Clinical Research Centre, Kuala Lumpur, Malaysia.,School of Pharmacy, Monash University Malaysia, Bandar Sunway, Subang Jaya, Selangor, Malaysia.,Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Subang Jaya, Selangor, Malaysia
| | - Kwadwo Osei Bonsu
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Subang Jaya, Selangor, Malaysia.,Pharmacy Department, Accident and Emergency Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana.,Department of Pharmacy Practice Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Brahmajee K Nallamothu
- VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Internal Medicine, Michigan Integrated Center for Health Analytics and Medical Prediction (MiCHAMP), University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Christopher M Reid
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Teerapon Dhippayom
- Faculty of Pharmaceutical Sciences, Naresuan University, Tha Pho, Muang Phitsanulok, Thailand
| | - Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Subang Jaya, Selangor, Malaysia.,School of Population Health, Curtin University, Perth, Western Australia, Australia.,Molecular, Genetic & Population Health Sciences, University of Edinburgh, Edinburgh, UK.,Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Subang Jaya, Selangor, Malaysia.,Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.,School of Pharmacy, University of Wisconsin, Madison, Wisconsin, USA.,Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| |
Collapse
|