Asia-Pacific Journal of Public Health最新文献

There are limited data on pulmonary tuberculosis (PTB) requiring intensive care unit (ICU) admission despite its high mortality rate. The objectives of our study were to determine the prevalence of culture-confirmed PTB requiring ICU admission and the trend in prevalence before and during the COVID-19 pandemic. A retrospective cohort study was conducted on all patients aged ≥18 years with culture-confirmed PTB requiring ICU admission in a Malaysian tertiary academic medical center from 2015 to 2021. The linear-by-linear association test was performed to determine if the trend in prevalence was significant. The overall prevalence of culture-confirmed PTB requiring ICU admission was 8.0% (139/1736). Between 2015 and 2021, the prevalence increased by 5.8% from 1.6% (5/312) to 7.4% (16/215). This study demonstrated an overall low but increasing trend in the prevalence of culture-confirmed PTB requiring ICU admission. Disruption in TB services during the COVID-19 pandemic may have impacted the prevalence trend.

Antidepressant use is common in women. However, characteristics associated with duration of use remain unclear. We conducted a descriptive study using data from the 1973-1978 and 1946-1951 birth cohorts of the Australian Longitudinal Study on Women's Health linked to antidepressant dispensing records from the Pharmaceutical Benefits Scheme, July 2012 to December 2019 to examine use patterns and their associated characteristics. Early discontinuation and prolonged antidepressant use were common, a significant deviation from current guideline recommendations. There were 5553 episodes of antidepressant use in 4416 women, with a mean estimated duration of first-time use of 664 days. One in four women had only one prescription filled, while 32% continued treatment beyond two years, with 14% continuing use at five years. Age and previous antidepressant use impacted duration of use, with a shorter average duration of use and a higher proportion of discontinuation for each subsequent episode after the first prescription.

Gestational diabetes mellitus (GDM) is a major global health concern, affecting maternal and child health. Although genetic predispositions and individual medical histories are well-recognized risk factors, emerging research suggests a significant impact of external factors like neighborhood socioeconomic characteristics. This study systematically reviews and meta-analyzes the association between neighborhood deprivation and GDM incidence. We searched multiple databases up to January 10, 2024, for studies linking neighborhood deprivation with GDM. Eligible studies were selected based on predefined criteria, with the Nested Knowledge software assisting in screening and data extraction. Quality assessment utilized the Newcastle-Ottawa Scale, and a random-effects model computed the pooled relative risk (RR) using R software, version 4.3. The review included six studies varying significantly in design, sample sizes, and deprivation assessment methods. The meta-analysis combined data from five studies totaling 15 827 participants from the least deprived and 18 147 from the most deprived neighborhoods, yielding an RR of 0.909, indicating a non-significant lower risk of GDM in more deprived groups. A substantial heterogeneity (I² = 70%) was observed, and sensitivity analysis confirmed the robustness of these findings. This analysis suggests that living in a deprived neighborhood does not significantly alter GDM risk, underscoring the necessity for further research to refine public health strategies and interventions. The variability in neighborhood deprivation definitions and potential unaccounted confounding factors highlight the need for comprehensive studies, especially from low-income and middle-income countries, to elucidate the intricate links between socioeconomic factors and GDM.

Nutritional quality of food for infants and young children (FIYC) is key to optimum development and health. To evaluate commercial FIYC products, the World Health Organization Regional Office for Europe (WHO-EURO) has defined a Nutrient and Promotion Profile Model (NPPM). Although FIYC is commonly used in Malaysia, its quality is largely unknown. We evaluated the nutrient profiles and on-pack promotions of FIYC available in Kuala Lumpur, Malaysia, using the NPPM. Among the 285 products sampled from a range of retail outlets, none met all NPPM promotional recommendations; only 24% satisfied all relevant nutrition criteria. Several products failed on sugar (29%) and sodium (26%) criteria, with around half having added sugar. In addition, 3%, 6%, and 9% of FIYC failed relevant fat, protein, and energy requirements, respectively. Although 98% had inappropriate health claims, 36% missed appropriate breastfeeding statements. There is an urgent need to improve the quality of FIYC in Malaysia.

In 2020, the coronavirus disease 2019 (COVID-19) pandemic altered lifestyles dramatically. We previously reported that the physical function of walk-in rehabilitation users in Japan worsened after the state of emergency declaration and continued to worsen until the end of 2020. However, whether physical function continued to worsen during the prolonged pandemic period remains unclear. This study aimed to characterize the impact of the COVID-19 pandemic on community-dwelling people with disabilities. Data measured every 3 to 6 months from January 2018 to December 2022 were examined retrospectively for patients who started using day care services by July 2018 and continued until July 2022. Every 6 months was considered one period. Mixed-effects model repeated measures (MMRMs) were performed, including missing measurements for 10 periods from the first half of 2018 to the second half of 2022, and each period was tested for multiple comparisons. The MMRM showed that both walking speed (P < .001) and Timed Up and Go (TUG) scores (P < .001) changed from period to period. Walking speed and TUG scores worsened after 2020 and continued to worsen thereafter. Thus, the impact of lifestyle changes associated with the pandemic on community-dwelling people with disabilities was not transitory.

This study investigated the association between insurance status and postoperative mortality using South Korean national data. The data included 540 422 patients aged 20 to 64 treated at 958 facilities. To calculate odds ratios (ORs) for in-hospital and 30-day mortality post-admission, generalized estimating equation (GEE) logistic regression was used. Significantly lower ORs for in-hospital mortality (0.55) and 30-day mortality post-admission (0.59) were found among subscribers with "employee insured" status than among those who were self-employed or Medical Aid beneficiaries. Significantly higher ORs for in-hospital mortality (1.45) and 30-day mortality post-admission (1.46) were observed among those with a <25% premium than in those with a ≥75% premium. The risk of both in-hospital and 30-day post-admission mortality consistently increased with declining socioeconomic status, confirming the presence of inequality.

In the Philippines, the co-occurrence of two or more types of malnutrition in an individual, also known as intra-individual double burden of malnutrition (DBM), has rarely been investigated. This study aimed to determine the prevalence and the factors associated with DBM at the individual level among Filipino women of reproductive age (WRA) using the data collected from the 2018 Philippine Expanded National Nutrition Survey. For this study, intra-individual DBM was defined as the co-existence of overweight or obesity and anemia in an individual. Analysis showed that a significantly high prevalence of intra-individual DBM was found among WRA aged 40 to 49 years old, widowed, and those with a waist circumference of ≥80 cm. Furthermore, a waist circumference of ≥80 cm was highly associated with the likelihood of having intra-individual DBM among this age group. On the contrary, being single had a significantly lower risk of having this condition.

Our study explored the link between body mass index (BMI) and symptoms of depression, anxiety, and suicidality among university students in China. We conducted a cross-sectional study involving 11 251 undergraduates from seven provinces. Body mass index, physical health status, economic status, depression and anxiety symptoms, and suicidality were self-reported using validated questionnaires. Multiple logistic regression models were fitted for males and females. Results showed that of 11 251 participants (mean age = 20.7 ± 1.3), 22.6% were with underweight, 6.1% with overweight, and 2.7% with obesity. Females with class III obesity had higher suicide risk (adjusted odds ratio [aOR] = 2.05) and suicide attempt history (aOR = 3.55). Males with overweight and class I obesity had lower odds of depressive symptoms. Suicide attempt history was associated with higher odds of overweight for males (aOR = 2.58). Clinicians and public health authorities should take into consideration the implications of overweight and obesity levels on suicidality.

Cancer is a global public health concern with increasing incidence and mortality rates, particularly in low- and middle-income countries (LMICs) like the Pacific Island Countries and Territories (PICTs). Among the PICTs, Fiji faces a growing burden of cancer. This study aimed to analyze cancer incidence and mortality data in Fiji from 2010 to 2018 to identify trends and provide an update on the current cancer-related statistics in the Fiji Islands. The top three cancer incidence rates among women were breast, cervical, and endometrial cancer, whereas prostate, liver, and lung cancer were the most prevalent among men. Notably, the central division had higher cancer incidence rates, whereas the northern division had a disproportionately higher mortality rate. Factors contributing to these trends may include lifestyle behaviors, limited access to health care in certain regions, and low awareness. Although this study has limitations due to data quality, it emphasizes the need for targeted interventions, accurate data reporting, and improved cancer treatment delivery to reduce the burden of cancer in Fiji.