OBJECTIVES

The increasing prevalence of Kawasaki disease in Southeast Asia (SEA) and its potential relation with Coronavirus Disease 2019 (COVID-19) infection resulted in heightened interest in KD in the region, thus, this paper aimed to determine the trend and the socioeconomic facilitators of scientific productivity of KD research within the region. Specifically, this article determined the number of publication and citations related to KD per country, institution, and journal. We also explored the networks of countries within the region to the rest of the world and the keywords mostly associated with KD research in the region. Lastly, correlation of these bibliometric indices with socioeconomic factors in the region was analyzed.

METHODS

A literature search of KD papers in SEA was performed using Scopus database. We obtained bibliographic data from the available literature and visualized network of existing collaborations and keywords using VOSviewer software.

RESULTS

A total of 196 papers were included in the study. Bibliometric analysis showed a rising trend in publication within the region, most of which were from institutions in Singapore and Thailand. The most common topics on KD studies included clinical features, complications, treatment, and comorbidities. 

Country characteristics such as gross domestic product (GDP) per capita, research and development (R&D) expenditure (% GDP), and number of physician and R&D researchers were positively correlated with bibliometric indices of KD research in SEA. Moreover, number of international linkages was significantly associated with KD research productivity in the region. 

CONCLUSION

In summary, we showed an increasing trend of KD research in SEA. Funding allocation and capacity building are necessary to strengthen research productivity within the region.

Asia ; Asia, Southeastern ; Bibliometrics ; Capacity Building ; Coronavirus ; Covid-19 ; Database ; Disease ; Efficiency ; Gross Domestic Product ; Guanosine Diphosphate ; Infection ; Infections ; Literature ; Mucocutaneous Lymph Node Syndrome ; Paper ; Physicians ; Prevalence ; Publications ; Research ; Research Personnel ; Rest ; Singapore ; Socioeconomic Factors ; Software ; Thailand ; Therapeutics

Human ; Health Occupations ; Education ; Philippines

Rabies remains a persistent public health issue in the Philippines, despite the existence of national and local policies and programs aimed at addressing its eradication. The viral disease, which elicits fatality yet is preventable, disproportionately affects rural areas, especially geographically isolated and disadvantaged area due to the junction of socio-cultural and technical challenges. This commentary article explores the myriad of barriers to rabies prevention and control, including poverty, cultural beliefs, limited health literacy, health delivery, and access inequity. However, the implementation of Rabies Act of 2007, which mandates mass vaccination, education, and the establishment of Animal Bite Treatment Centers (ABTCs), has gaps in the implementation that compromises the program’s sustainability and effectiveness. Deep-rooted cultural practices and beliefs delay or, more so replace evidence-informed medical practices, while geographic isolation and underfunded healthcare facilities hinder optimal provision of care. Moreover, interagency coordination and fragmented reporting surveillance systems further complicate effective rabies control. To address the gaps, this paper advocates for a culturally tailored and community-centered One Health approach that addresses both social and technical aspects of rabies prevention. Important recommendations include decentralizing ABTCs, sustaining vaccination programs with local government support and funding, integrating rabies education into schools and community outreach, and intensifying through multisectoral collaboration both government and nongovernment institutions. Achieving a rabies-free country requires not only biomedical interventions but also a holistic approach – equitable access to healthcare, trust building in communities, and long-term political commitment. In this manner, regardless of location and socioeconomic status, it ensures that this viral disease will be controlled and prevented.

Human ; Philippines ; Social Class ; Rabies ; Virus Diseases ; Mass Vaccination

INTRODUCTION: Impostor phenomenon (IP) is a set of feelings encountered by individuals of being incompetent, despite experiencing successes. IP affects not only individuals on a personal level, but also organisations where the leadership diversity decreases due to employees' self-doubt. We aim to investigate the prevalence of IP and burnout among employees in the National University Health System (NUHS). METHODS: All permanently employed full-time NUHS employees aged 21 years and above were invited to participate in this self-administered cross-sectional study between April 2021 and August 2021. Mass emails with the embedded study link were sent every 2-3 weeks to the employees' corporate email accounts. RESULTS: In our study, 61% of our study respondents reported having IP experiences and 97% reported having burnout. The associations of IP with ethnicity and age group were significant. Post hoc tests, however, showed that the association was statistically significant only in the 21-29 years age group. CONCLUSION We found that there was no statistical significance between gender and the Maslach Burnout Inventory (MBI) profile types. However, we found that IP was significantly associated with individuals in the 21-29 years age group. This could be because younger individuals who just entered workforce may feel uncomfortable with their newfound independence and responsibility. Workplace support, such as workshops, and emotional support were found to be useful in helping individuals cope with IP. Future studies could be done post coronavirus disease 2019 (COVID-19) pandemic among healthcare workers to have a larger sample size to determine true IP and burnout prevalence.
Humans ; Singapore/epidemiology* ; Adult ; Male ; Female ; Burnout, Professional/psychology* ; Cross-Sectional Studies ; Prevalence ; Middle Aged ; Young Adult ; Surveys and Questionnaires ; COVID-19/epidemiology* ; Workplace/psychology*

INTRODUCTION: Workplace safety and health are interrelated - a worker who is not healthy may cause safety lapses at the workplace; conversely, safety lapses could affect the health of the workers. This study was part of a larger Total Workplace Safety and Health (WSH) programme run by the Workplace Safety and Health Council, Singapore. The objectives were to obtain a baseline health profile of workers across four major industries and identify important health risks for targeted workplace interventions. METHODS: Five service providers (SPs) were appointed to run the Total WSH programme. As part of the programme, SPs conducted an anonymous basic health survey among workers of participating companies. RESULTS: The responses of 6,373 respondents from the cleaning, construction, manufacturing, and transport and storage industries were studied. The overall response rate was 62%. Key health issues identified were high rates of obesity (22%) and smoking (24%) and low prevalence of regular exercise and healthy dietary habits. Chronic disease rates were similar to population self-reported rates (hypertension 15%, high lipid 12% and diabetes mellitus 6%). The workers reported high work stress (13%). CONCLUSION Health issues are prevalent in the workforce and may affect work and employee safety. It is increasingly important for employees' health to be considered in risk assessments and prioritised in workplace safety and health management systems and strategies. Health promotion interventions should be targeted, and multilevel and multicomponent initiatives should be integrated with pre-existing occupational safety programmes.
Humans ; Singapore/epidemiology* ; Occupational Health ; Male ; Female ; Adult ; Middle Aged ; Industry ; Workplace ; Health Surveys ; Surveys and Questionnaires ; Smoking/epidemiology* ; Obesity/epidemiology* ; Health Status ; Occupational Stress/epidemiology* ; Young Adult

BACKGROUND: The American Heart Association recently released a new cardiovascular health (CVH) metric, Life's Essential 8 (LE8), for health promotion. However, the association between LE8 scores and the risk of chronic kidney disease (CKD) remains uncertain. We aimed to explore the association of LE8 scores with new-onset CKD and examine whether socioeconomic deprivation and genetic risk modify this association. METHODS: A total of 286,908 participants from UK Biobank and without prior CKD were included between 2006 and 2010. CVH was categorized using LE8 scores: low (LE8 scores <50), moderate (LE8 scores ≥50 but <80), and high (LE8 scores ≥80). The study outcome was new-onset CKD, ascertained by data linkage with primary care, hospital inpatient, and death data. Cox proportional hazard regression models were used to investigate the association between CVH categories and new-onset CKD. RESULTS: During a median follow-up of 12.5 years, 8857 (3.1%) participants developed new-onset CKD. Compared to the low CVH group, the moderate (adjusted hazards ratio [HR], 0.50; 95% confidence interval [CI]: 0.47-0.53) and high CVH (adjusted HR, 0.31; 95% CI: 0.27-0.34) groups had a significantly lower risk of developing new-onset CKD. The population-attributable risk associated with high vs. intermediate or low CVH scores was 40.3%. Participants who were least deprived ( vs.  most deprived; adjusted HR, 0.75; 95% CI: 0.71-0.79) and with low genetic risk of CKD ( vs.  high genetic risk; adjusted HR, 0.89; 95% CI: 0.85-0.94) had a significantly lower risk of developing new-onset CKD. However, socioeconomic deprivation and genetic risks of CKD did not significantly modify the relationship between LE8 scores and new-onset CKD (both P -interaction >0.05). CONCLUSION Achieving a higher LE8 score was associated with a lower risk of developing new-onset CKD, regardless of socioeconomic deprivation and genetic risks of CKD.
Humans ; Renal Insufficiency, Chronic/epidemiology* ; Male ; Female ; Middle Aged ; Genetic Predisposition to Disease/genetics* ; Aged ; Risk Factors ; Adult ; Proportional Hazards Models ; Socioeconomic Factors

BACKGROUND: The incidence and mortality rates of lung cancer remain on the rise, creating an urgent need for screening among high-risk populations and early prevention. This study aims to explore the association and interaction between multidimensional lifestyle, socioeconomic status, and the incidence of lung cancer, and to provide scientific evidence for screening high-risk populations and preventing lung cancer. METHODS: Healthy lifestyle score was constructed using information on smoking, alcohol consumption, exercise, diet and sleep obtained through a questionnaire survey. Socioeconomic status was evaluated based on information on education, employment, and family income, and genetic testing data were used to assess the risk of genetic variation. A proportional hazards assumption test was conducted, and the Cox proportional hazards model was applied to analyze the associations between healthy lifestyle scores, socioeconomic status, and lung cancer, as well as the interactions among various factors, after adjusting for the risk of genetic variation, age, gender, diabetes, hypertension and the living environment score. RESULTS: A total of 245,538 samples that entered the cohort from March, 2006 to October, 2010 were included and followed up until December 31, 2022. The participants were divided into the case group (n=1472) and the control group (n=244,066). The analysis results showed that after adjusting for covariates, there was still an association between the healthy lifestyle score, socioeconomic status, and the incidence of lung cancer: compared with participants with a high healthy lifestyle score, the risk of lung cancer in participants with medium and low healthy lifestyle scores was significantly increased, with hazard ratios (HR) of 2.12 (95%CI: 1.86-2.41) and 3.36 (95%CI: 2.82-3.99) respectively; compared with participants with high socioeconomic status, the risk of lung cancer in participants with medium and low socioeconomic status was significantly increased, with HR of 1.29 (95%CI: 1.13-1.48) and 1.67 (95%CI: 1.46-1.90) respectively. Moreover, there were interactions between smoking status and socioeconomic status (Pfor interaction=0.05), as well as the other four lifestyle factors (Pfor interaction=0.02). CONCLUSIONS This study identified the association between multidimensional lifestyle factors and socioeconomic status with the incidence of lung cancer, as well as interactions between smoking and socioeconomic status and four other lifestyle factors, providing a scientific basis for screening and prevention in high-risk populations for lung cancer.
Humans ; Lung Neoplasms/epidemiology* ; Male ; Female ; Middle Aged ; Incidence ; Life Style ; Social Class ; Aged ; Adult ; Risk Factors

BACKGROUND: Medical Aid (MA) beneficiaries, belonging to low-income and vulnerable groups, tend to utilize more healthcare services than patients covered by general health insurance. This study aimed to investigate shifts in medical expenses among South Korean MA beneficiaries from 2010 to 2020 in response to changes in health coverage. METHODS: This study was a retrospective cohort study that involved analyzing data from 354,289 MA beneficiaries aged 20 years and older as of 2010 whose healthcare utilization data could be tracked up to 2020. The impact of changes in health coverage of MA beneficiaries on the increase in medical expenses was analyzed with multiple logistic regression analysis. RESULTS: The findings revealed that the group maintaining their MA eligibility had a higher rate of increase in medical expenses compared to those transitioning from MA to National Health Insurance (NHI). Even after adjusting for covariates, the likelihood of an increase in total annual medical expenses was more than 1.4 times higher for the MA maintenance group. However, the group that maintained MA also had higher initial healthcare expenses, indicating poorer health status, compared to the group that transitioned to NHI. CONCLUSION In the public healthcare domain, such as MA, it is crucial to enhance access to necessary healthcare services while preventing unnecessary medical treatments. There is a need for systemic improvements to ensure that low-income, medically vulnerable groups can appropriately use the healthcare services they require to achieve high-value health outcomes.
Republic of Korea ; Humans ; Retrospective Studies ; Middle Aged ; Adult ; Female ; Poverty/statistics & numerical data* ; Male ; Vulnerable Populations/statistics & numerical data* ; Aged ; Health Expenditures/statistics & numerical data* ; Young Adult ; Medical Assistance/statistics & numerical data* ; Insurance Coverage/statistics & numerical data*

BACKGROUND: Changes in socioeconomic inequalities in health behaviours following the COVID-19 pandemic remain unknown, particularly among Japanese school-aged adolescents. Therefore, in this study, we examined changes in socioeconomic inequalities in school-aged adolescents' health behaviours, including physical activity (PA), screen time (ST), sleep duration, breakfast consumption, and bowel movement frequency, before and after the pandemic. METHODS: This three-wave repeated cross-sectional study utilised data from the 2019, 2021, and 2023 National Sports-Life Survey of Children and Young People in Japan, analysing data from 766, 725, and 604 participants aged 12-18 years, respectively. Favourable health behaviours were defined as moderate-to-vigorous PA of ≥60 min/day, ST <2 h/day, sleep duration of 8-10 h, daily breakfast consumption, and bowel movements at least every 3 days. Absolute and relative socioeconomic inequalities were quantified using the slope index of inequality (SII) and the relative index of inequality (RII). Temporal changes were analysed using quadratic trend analyses, employing interaction terms between socioeconomic status and survey year. RESULTS: Significant quadratic trends indicated that socioeconomic inequalities in breakfast consumption decreased substantially from 2019 (SII: 20.7%, RII: 5.09) to 2021 (SII: -0.1%, RII: 0.95) but resurged in 2023 (SII: 16.2%, RII: 3.70). This resurgence may have been primarily driven by changes among those in the moderately low-income (poverty level II) and higher-income groups, which had a breakfast consumption rate of 81.0, 87.0, and 76.4% in 2019, 2021, and 2023, and 88.7, 82.1, and 87.5%, respectively. Among low-income households, adherence to PA recommendations significantly declined from 18.6% to 5.3%, and ST adherence worsened over the study period. No significant inequalities or trends were observed for sleep duration or bowel movement frequency across survey years. CONCLUSIONS Socioeconomic disparities in breakfast consumption among Japanese school-aged adolescents resurfaced after initially narrowing during the pandemic, likely driven by changes in moderately low-income and higher-income groups. Among low-income households, adherence to PA and ST guidelines declined over time. However, at the population level, socioeconomic inequalities in PA did not exhibit a consistent trend of widening or narrowing. This study highlights the need for sustained public health initiatives to address these socioeconomic disparities.
Adolescent ; Child ; Female ; Humans ; Male ; Breakfast ; COVID-19/psychology* ; Cross-Sectional Studies ; Exercise ; Health Behavior ; Japan/epidemiology* ; Screen Time ; Sleep ; Socioeconomic Factors ; East Asian People

Congenital musculoskeletal and limb deformities (CMLD) seriously affect the physical and mental health of patients, and pose great challenges to healthcare systems worldwide. We explored the specific situation and changes of incidence, prevalence, disability-adjusted life years rates, and mortality of CMLD in under-5 children from 1990 to 2021 in different groups, including different regions, periods, genders and socio-demographic indices (SDI), through corresponding analytical models. Overall, the global disease burden of CMLD in under-5 children has decreased from 1990 to 2021. The disease burden of CMLD in under-5 children varied significantly among different regions and countries, and there was a strong correlation between the corresponding burden of disease and the level of SDI. In addition, cross-country inequality analysis showed that while absolute inequalities in the disease burden of CMLD in under-5 children have improved, relative inequalities have worsened. It is essential to reduce the global health impact of CMLD by implementing targeted interventions to improve health care in underdeveloped areas.
Humans ; Global Burden of Disease/trends* ; Child, Preschool ; Global Health/statistics & numerical data* ; Infant ; Male ; Prevalence ; Limb Deformities, Congenital/mortality* ; Musculoskeletal Abnormalities/mortality* ; Female ; Disability-Adjusted Life Years ; Incidence ; Infant, Newborn ; Cost of Illness ; Socioeconomic Factors