AIMS AND METHODS: We analyzed Global Adult Tobacco Survey data in Bangladesh, China, Costa Rica, Ethiopia, India, Kazakhstan, Mexico, Philippines, Romania, Russia, Senegal, Ukraine, Turkey, Uruguay, and Viet Nam during 2014-2018. The weighted prevalence of "awareness" (heard about), "ever" (even once), and "current" (daily/nondaily) EC use among never, current, and former cigarette smokers and quit ratios (past smokers/ever smokers) was estimated. Association of EC use with sociodemographic, and CS, was explored by multilevel regression.
RESULTS: Overall, prevalence of "awareness," "ever," and "current" ECs use was 19.3% (95% confidence interval [CI] 27.4, 31.1), 2.6% (95% CI 2.4, 2.8), and 0.7% (95% CI 0.6, 0.8), respectively. In most countries, "ever use" <10%, and "current use" was about 1% except Romania (4.4%) and Russia (3.5%). "Current use" was 0.1%, 2.9%, and 3.1% among never, current, and former smokers, respectively. "Current" and "ever" EC use was higher among current and former than never smokers (2.8% and 3.1% vs. 0.1%; 9.9% and 10.9% vs. 0.7%), respectively. Current EC use was associated with male sex, urban residence and younger age, higher education, and wealth. "Quit attempts" (aOR 1.3, 95% CI 1.2, 1.5) and cigarettes smoked per day (aOR 1.6, 95% CI 1.4, 1.9) were associated with "ever use."
CONCLUSIONS: EC use was low in most countries. "Dual use" was common among current smokers and the quit ratio was higher among ECs users.
IMPLICATIONS: EC use is increasing in high-income countries (HICs) where regulations on ECs are usually permissive. Evidence on the individual- or population-level impact of ECs on CS cessation is inconclusive. Little is known about the prevalence of EC use in LMICs where regulations are nonexistent or less restrictive. Studying the distribution of EC use rates by population subgroups, CS status, and quit ratios for CS among EC users will assist the formulation of EC regulatory policies. We provide comparable nationally representative prevalence estimates of "awareness" about and, use of ECs to serve as a benchmark for future monitoring. EC use was associated with the attempt to quit CS and smoking >10 cigarettes per day. However, "dual use" was common, and the quit ratio for CS was higher among EC users. EC use was very low relative to HICs. Nevertheless, comprehensive EC regulatory policies should be implemented to prevent the escalation of EC use by targeting population subgroups such as young adults, educated and wealthier individuals.
METHODS: We analyzed school-based Global Youth Tobacco Survey (2014-2019) microdata from 18 WPR countries and estimated weighted prevalence rates of ST consumption, cigarette smoking, and dual use. We used multilevel binary logistic regression to examine the associations of ST consumption and dual use with demographic variables, exposure to pro-tobacco and anti-tobacco factors, national income, and MPOWER indicators.
RESULTS: Data from 58,263 school-going youth were analyzed. The prevalence of past 30-day ST consumption was highest in Kiribati (42.1%), the Marshall Islands (26.1%), Micronesia (21.3%), Palau (16.0%), and Papua New Guinea (15.2%). In adjusted multilevel models, ST consumption and dual use were significantly associated with sex, age, parental smoking, pro-tobacco factors, national income, and MPOWER score. For each unit increase in score for cessation programs, we observed approximately 1.4-fold increases in the odds of youth ST consumption (adjusted odds ratio [aOR], 1.38; 95% confidence interval [CI], 1.15 to 1.66) and dual use (aOR, 1.47; 95% CI, 1.16 to 1.86). Similarly, for each unit increase in score for health-related warnings, the odds of both ST consumption (aOR, 0.47; 95% CI, 0.42 to 0.53) and dual use (aOR, 0.35; 95% CI, 0.30 to 0.42) decreased by approximately 60%.
CONCLUSIONS: The prevalence of youth ST consumption was substantial in the Pacific Islands, exceeding that of cigarette smoking in some countries. Implementing MPOWER measures for ST products could help reduce ST consumption.
METHOD: In-depth interviews were conducted face-to-face or via telephone among patients with a clinical diagnosis of LTBI using a semi-structured topic guide developed based on the common-sense model of self-regulation and literature review. Audio recordings of interviews were transcribed verbatim and analysed thematically.
RESULTS: We conducted 26 In-depth interviews; Good knowledge of active tuberculosis (TB) and its associated complications, including the perceived seriousness and transmissibility of active TB, facilitates treatment. LTBI is viewed as a concern when immune status is compromised, thus fostering TPT. However, optimal health is a barrier for TPT. Owing to the lack of knowledge, patients rely on healthcare practitioners (HCPs) to determine their treatment paths. HCPs possessing comprehensive knowledge play a role in facilitating TPT whereas barriers to TPT encompass misinterpretation of tuberculin skin test (TST), inadequate explanation of TST, and apprehensions about potential medication side effects.
CONCLUSIONS: Knowledge of LTBI can influence TPT uptake and patients often entrust their HCPs for treatment decisions. Improving knowledge of LTBI both among patients and HCPs can lead to more effective doctor-patient consultation and consequently boost the acceptance of TPT. Quality assurance should be enhanced to ensure the effective usage of TST as a screening tool.
AIMS AND METHODS: Global Youth Tobacco Survey (GYTS)s from Georgia, Iraq, Italy, Latvia, Montenegro, Paraguay, Peru, Qatar, Romania, and San Marino were analyzed. Changes in prevalence of "awareness of e-cigarettes," "ever use" (even tried a few puffs) and "current use" (during last 30 days) of e-cigarettes and cigarette smoking, and "dual use" (both e-cigarette and cigarette smoking) between baseline (2013 and 2014) and most recent (2017-2019) surveys were estimated.
RESULTS: "Awareness of e-cigarettes" and "ever e-cigarette use" significantly increased (p 50% in most countries. During the most recent surveys, "current e-cigarette" use was > 10% in five countries Italy (18.3%) and Latvia (18.5%) being the highest. Cigarette smoking significantly declined in Italy, Latvia, Peru, and San Marino (p
METHODS: This qualitative study used a phenomenological research design and was conducted from July 2019 to January 2021. A semi-structured topic guide was developed based on literature and the Common-Sense Model of Self-Regulation. We conducted one focus group discussion and 15 in-depth interviews with primary care HCWs. Interviewees were 7 physicians and 11 allied HCWs who tested positive for LTBI by Tuberculin Skin Test or Interferon Gamma Release Assay. Audio recordings were transcribed verbatim and thematic analysis was used to analyse the data.
RESULTS: We found four factors that serve as barriers to HCWs' LTBI treatment uptake. Uncertainties about the need for LTBI treatment, alongside several other factors including the attitude of the treating physician towards treatment, time constraints during clinical consultations, and concerns about the treatment itself. On the other hand, facilitators for LTBI treatment uptake can be grouped into two themes: diagnostic modalities and improving knowledge of LTBI treatment.
CONCLUSIONS: Improving HCWs' knowledge and informative clinical consultation on LTBI and its treatment benefit, aided with a definitive diagnostic test can facilitate treatment uptake. Additionally, there is a need to improve infection control measures at the workplace to protect HCWs. Utilizing behavioural insights can help modify risk perception among HCWs and promote treatment uptake.
METHOD: We described the steps taken in developing assessment tools and guidelines for assisting healthcare providers in safely monitoring patients with COVID-19 undergoing home isolation.
RESULTS: A total of 26,826 patients were clinically assessed from 1 to 28 February 2021 in various CACs in the state. The majority of the cases seen in the CACs were under category (CAT) 1 and 2. Only 0.2% (n=53) of the cases were categorised as severe COVID-19 (CAT 3 and above).
CONCLUSION: CACs coordinated by primary care providers play an important role in triaging, assessing and monitoring patients with COVID-19 undergoing home isolation in the community. There needs to be a better partnership between various stakeholders and the private healthcare sector to improve the services. The usage of a pulse oximeter in home monitoring of all patients with COVID-19 in Selangor needs to be seriously considered.
METHODS: Using a self-administered Menopause Quick-6 in the Malay language (MQ6[M]) questionnaire, we surveyed 349 women aged 40-60 years attending primary healthcare clinics in four states in Malaysia for their menopause symptoms. Health-seeking behaviors for menopause symptoms were assessed using questions regarding HCPs consulted and treatments prescribed. Binary logistic regression was employed on factors associated with seeking consultation for menopause symptoms.
RESULTS: Using MQ6(M), we observed that 125 (31.3%) women reported at least one menopause symptom, with joint pains (42.8%), menstrual changes (39.5%), and hot flashes (29.3%) being the most frequent symptoms. Furthermore, 60% of the women were prescribed vitamins, and only 13% were administered Hormone Replacement Therapy (HRT). Medical comorbidities, the presence of at least one gynecological condition, menopause status, and MQ6(M) score were associated with seeking consultation with an HCP. For women with medical conditions, the odds of seeking consultation increased by a factor of 1.34 (adjusted odds ratio [AOR], 1.34; 95% confidence interval [CI], 1.11-1.76) for every additional comorbidity. The odds of seeking consultation from an HCP increased by a factor of 1.26 (AOR, 1.26; 95% CI, 1.04-1.47) with a unit increase in MQ6(M) score.
CONCLUSIONS: Most women had menopause symptoms but favored the use of complementary and alternative medicine over HRT. Screening and awareness of menopause treatments need to be improved at primary healthcare clinics.
METHODS: The Menopause Quick 6 (MQ6) questionnaire was translated into the Malay language with an addition of an item, henceforth termed MQ6 (M). Forward and backward translation was performed. Face and content validity were conducted. MQ6 (M) was self-administered to 400 women aged between 40 and 60 attending six primary healthcare clinics in Malaysia. To ascertain the reliability for MQ6 (M), corrected Item-Total Correlation, Squared Multiple Correlation, Cronbach's Alpha if the Item is Deleted, and Kuder-Richardson Reliability Coefficients (KR20). Exploratory factor analysis was done to determine its' construct validity.
RESULTS: The outcome of the validation was satisfactory. By the Lawshe method, the content validity ratios ranged from 0.6 to 1.0 and the content validity index was 0.914. The Internal consistency for MQ6(M) Cronbach's alpha was 0.711 while Kuder-Richardson Reliability Coefficients KR20 was 0.676. Factor loading of all four items is above 0.70, indicating a well-defined structure. Whereas factor loading for three items fell within the range of 0.50-0.69 indicating a practically significant threshold for a new questionnaire.
CONCLUSION: MQ6 (M) has acceptable reliability and construct validity to be considered as a self-administered screening tool in primary care clinics in Malaysia.