Asia-Pacific Journal of Public Health最新文献

The Council of Indigenous Peoples in Taiwan has established tribal-based Cultural Health Stations offering basic health services and social activities for Indigenous communities. However, little is known about the factors influencing participation. This pilot study examined the reasons for attendance among older adults from five Paiwan communities in eastern Taiwan. A structured questionnaire, informed by Andersen's Behavioral Model of Health Services Use and shaped through community consensus, was administered to 211 elders, 77 of whom were attending Cultural Health Stations. Participants who attended were generally older, female, living alone, not engaged in paid work or farming, and reported positive perceptions of the activities. Common reasons for non-attendance included time constraints, preference for alternative social settings, and dissatisfaction with the programs. Multivariable logistic regression analysis revealed that being aged 75 or older, living alone, and reporting a higher self-rated ability to manage health issues were positively associated with attendance. In contrast, having paid employment was negatively associated. Findings from the open-ended questions suggested attendees appreciated services and activities but requested more cultural content. Non-attendees expressed that activities should be inclusive of different age groups and ability levels, culturally connected to local communities, and mindful that many elders still need to work. These findings highlight the importance of incorporating elders' perspectives in the planning and evaluation of community-based services and may inform policy improvements for Indigenous elder care in Taiwan. However, it is also necessary to consider the economic circumstances of elders, design culturally centered activities, and respond to their interest in courses related to cultural transmission to ensure services are both accessible and meaningful.

Informal carers are essential to post-stroke recovery in Malaysia but often encounter significant challenges with minimal support. This qualitative study examined the lived experiences of 10 carers of stroke survivors with moderate to severe dependency in Klang Valley. Guided by Schlossberg's transition theory, in-depth interviews were analyzed using inductive thematic analysis. Five main themes emerged: (1) focus shifted toward the stroke survivors, (2) caregiving repercussions, (3) lack of resources, (4) ways of surviving hardships, and (5) beauty emerging from hardships. Findings highlight the public health importance of integrating carer support into post-stroke services, particularly in aging societies. Policy measures should include structured carer training, expanded community rehabilitation, workplace flexibility, and stronger linkages between health care, social services, and non-governmental organizations. Addressing these needs can enhance carer wellbeing, improve survivor outcomes and reduce long-term health system burdens.

Evidence on modern contraceptive use among Orang Asli women is limited. This study aimed to assess the prevalence and factors influencing modern contraceptive use among married or cohabiting Orang Asli women of reproductive age (15-49 years). Data from 3249 Orang Asli women in the 2022 Orang Asli Health Survey (OAHS), a cross-sectional study employing a two-stage stratified random sampling design, were analyzed. Complex sample analysis with logistic regression was applied. The study found that 53.3% of Orang Asli women used modern contraceptives. Key factors significantly associated with contraceptive use included residence in remote areas (aOR=1.88; 95% CI = 1.08, 3.27), age 20-34 years (aOR = 2.43; 95% CI = 1.91, 3.09), and having three or more children (aOR = 2.17; 95% CI = 1.75, 2.70). The prevalence of modern contraceptive use among Orang Asli women exceeded Malaysia's national average and Indigenous populations globally. Improving accessibility and affordability remains critical, particularly for Orang Asli women in urban areas, to reduce disparities.

The Orang Asli, the indigenous community of Peninsular Malaysia, experience significant health disparities. This study assesses the prevalence and factors associated with poor self-rated health (SRH) among adults aged 18 and above using data from the Orang Asli Health Survey 2022. The prevalence of poor SRH was 12.8% (95% CI: [9.74, 16.68]). Factors associated with poor SRH are health-related factors (acute illness [adjusted odds ratio, aOR = 4.61, 95% CI: [3.54, 5.99]], recent hospitalization [aOR = 2.58, 95% CI: [1.78, 3.74]]), sociodemographic (unemployment [aOR = 1.51, 95% CI: [1.30, 1.76]], older age [aOR = 0.43, 95% CI: [0.30, 0.64]], and the Negrito tribes [aOR = 0.61, 95% CI: [0.37, 0.99]]) as well as lifestyle (tobacco use [aOR = 1.26, 95% CI: [1.03, 1.53]]). These findings underscore the importance of integrated health and social interventions sensitive to Orang Asli beliefs to improve health equity.

Dengue is a significant public health concern in tropical countries. This study explored the short-term associations between monthly climatic variables and dengue incidence. Dengue cases and weather parameters from 2001 to 2023 were collected in Can Tho City, a central province of the Mekong Delta, Vietnam. A quasi-Poisson regression with a distributed lag linear model was employed to determine the associations. A total of 32 265 dengue cases were collected. Of these cases, 53.7% were male, and 64.1% were under 15. Each 5% increase in relative humidity was associated with a 19.3% increase in dengue cases. Each 1°C increase in average temperature was associated with a 13.8% increase in dengue cases. Rainfall showed a negative effect, with each 5 mm increase in rainfall decreasing cases by 1.3%. Wind velocity showed no significant impact. The study demonstrated that relative humidity and temperature are key predictors for dengue forecasting and prevention.

Malaysia's aging population faces a growing burden of noncommunicable diseases (NCDs), with obesity as a key modifiable risk factor. While body mass index (BMI) is commonly used to assess obesity, the waist-hip ratio (WHR) may better capture central adiposity, which increases with age-related changes in body composition. This study examined the associations between BMI and WHR with hypertension, diabetes, hypercholesterolemia, and multimorbidity among 2,137 older Malaysians from the 2022 Malaysia Aging and Retirement Survey. Multivariable logistic and ordinal regressions showed that both BMI and WHR were significantly associated with all NCD outcomes after adjusting for sociodemographic and lifestyle factors. The findings highlight the critical need to routinely include both BMI and WHR in health screenings, emphasizing central adiposity as a key focus in public health strategies.

Typhoid fever is a major cause of morbidity and mortality in developing countries. This review assessed the efficacy, safety, and immunogenicity of the tetanus toxoid conjugate typhoid vaccine (Vi-TT) in children and adolescents. Randomized controlled trials involving Vi-TT in individuals under 18 were included. Eligible studies were screened, and quality was assessed using the Cochrane Risk of Bias-2 tool. Meta-analysis was conducted with RevMan Web. Four trials with 111 481 children found the risk of blood culture-confirmed typhoid fever after Vi-TT to be 0.18 compared with nontyphoid vaccines. Adverse event rates were similar, with a serious adverse event risk of 0.82 within six months. Seroconversion was 58.04 times higher at 28 days and 21.80 times higher after 18 months postvaccination, respectively). One trial had a high risk of bias, so sensitivity analysis was performed with and without it. GRADE assessment showed strong evidence that Vi-TT reduces typhoid risk without significant safety concerns. Seroconversion declined over time but remained significantly higher after 18 months. This concludes that Vi-TT is safe and effective for children and adolescents, and is recommended for vaccination in endemic areas.

This study investigated the impact of economic growth and unemployment on obesity within the Obesity Kuznets Curve (OKC) framework across 15 post-Soviet countries using annual data from 1991 to 2016. Employing the Augmented ARDL (A-ARDL) cointegration test for the first time in this context, the study reveals cointegration in nine countries, with the OKC hypothesis validated for Armenia, Azerbaijan, Belarus, Kazakhstan, Russia, and Turkmenistan. Initial economic growth increases obesity rates, but beyond specific GDP thresholds, healthier lifestyles emerge. The FADF-SB unit root test confirms variable stationarity at varying levels. Findings also highlight unemployment's diverse regional effects: a negative impact in Kazakhstan and Uzbekistan but a positive one elsewhere. The Fourier Toda-Yamamoto test identifies bidirectional causality between GDP and obesity in Kyrgyzstan and varying causal relationships in other countries. These results emphasize the complex interplay between economic and health factors, informing policies to address obesity trends in transitioning economies.

The objective of this systematic review was to evaluate the prevalence of periodontal disease in South Pacific Island countries. A literature search was conducted using Scopus, Medline (via PubMed and Ovid), databases, and Google Scholar. The inclusion criteria for the review were the studies that reported on periodontal disease in the 1- to 85-year age group, excluding data from Australia, New Zealand, and protectorates of the United States and France. The findings from the studies were synthesized, noting the demographics, periodontal disease assessment methods, and main outcomes. The initial search yielded 475 relevant articles. After further screening for eligibility, a total of nine articles were included in this systematic review. In the studies included, the population ranged from 185 to 7966 participants with the age range of 1 to 64 years. The studies were heterogeneous, with each study utilizing different criteria to assess periodontal disease. Notably, the latest study eligible for inclusion was published in 2012. The prevalence of periodontitis ranged from 20% to 100%, with greater prevalence in the age group of 40 years or older. The findings from this review highlighted the need for regular prevalence studies to inform public health policy makers and develop strategies to manage periodontal disease proactively.