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Drug-related problems in a general paediatric ward of a tertiary care hospital in Malaysia

Hon MY, Chua XY, Premakumar CM, Mohamed Shah N

Int J Clin Pharm, 2020 Jun;42(3):948-955.
PMID: 32356248 DOI: 10.1007/s11096-020-01045-w

Background Drug-related problems are relatively common among hospitalised patients and may be detrimental to patients and even increase healthcare costs. Characterising drug-related problems allows remedial actions to be in place to minimise the frequency and ensure higher medication safety for the patients involved. Currently, the incidence of drug-related problems among hospitalised paediatric patients in Malaysia is unknown. Objective To determine the incidence, types and intervention acceptance, as well as the risk factors associated with drug-related problems in a Malaysian general paediatric ward. Setting General paediatric ward in Universiti Kebangsaan Malaysia Medical Centre. Method A cross-sectional observational study was conducted from March to May 2019. Data were collected from patients' medical charts, clinical notes and medical records for problem identification based on the modified Pharmaceutical Care Network Europe (PCNE) classification V 8.02. The incidence, types, causes and intervention acceptance as well as the risk factors were assessed. Main outcome measure Drug-related problems based on the modified PCNE classification V 8.02. Results In total, 225 paediatric patients with a total of 694 prescriptions were included in this study. The incidence of drug-related problems was 52.9% (198 prescriptions with problems in 119 patients). The main types of problems were treatment safety (68 prescriptions, 34.3%), incomplete prescription (56 prescriptions, 28.3%) and un-optimised drug treatment (35 prescriptions, 17.7%). The main causes for the problems were necessary information not provided (n = 63, 30.1%), inappropriate dose selection (n = 47, 22.5%) and medication served without a valid prescription (n = 40, 19.1%). Of the 143 interventions proposed to prescribers by the pharmacist, 117 (81.8%) were accepted. The number of prescriptions was found to be the only risk factor associated with DRPs (odds ratio, 1.91; 95% confidence interval, 1.54-2.38; p

Matched MeSH terms: Pediatrics/statistics & numerical data
Fulltext Impact of infection control training for interns on PICU-acquired bloodstream infections in a middle-income country

Ng YY, Abdel-Latif Mel-A, Gan CS, Siham A, Zainol H, Lum LC

Singapore Med J, 2015 Sep;56(9):506-12.
PMID: 26451053 DOI: 10.11622/smedj.2015135

The present study aimed to determine the impact of an extended infection control training programme, which was conducted for all interns posted to the Department of Paediatrics, on the incidence of paediatric intensive care unit (PICU)-acquired bloodstream infections (BSIs) in University Malaya Medical Centre, Malaysia.

Matched MeSH terms: Pediatrics/education
Fulltext Pattern of antibiotic usage in hospitals in Malaysia

Lim VK, Cheong YM, Suleiman AB

Singapore Med J, 1993 Dec;34(6):525-8.
PMID: 8153716

A prospective survey of antibiotic prescribing patterns in six Ministry of Health general hospitals in Malaysia was undertaken. Information on antibiotic prescriptions including the types of antibiotics used and the purposes for prescription was obtained through the use of questionnaires. A total of 1,918 antibiotic prescriptions were available for analysis. About two-thirds of prescriptions were for therapeutic purposes. The most common infections treated were lower respiratory infection (31%), followed by skin and soft tissue infection (17%), and urinary tract infection (8%). Only 20% of the therapeutic prescriptions were based on microbiological test results. Prophylactic prescriptions were issued for a variety of indications, the most common being toilet and suture of wounds. Only 5% of prophylactic prescriptions were of less than 3 days duration. There was great diversity in antibiotics and antibiotic regimens employed. It was evident that there was a lack of compliance with guidelines on antibiotic use issued by the Ministry of Health.

Matched MeSH terms: Pediatrics/organization & administration
Fulltext Optimal nutrition therapy in paediatric critical care in the Asia-Pacific and Middle East: a consensus

Lee JH, Rogers E, Chor YK, Samransamruajkit R, Koh PL, Miqdady M, et al.

Asia Pac J Clin Nutr, 2016 Dec;25(4):676-696.
PMID: 27702711 DOI: 10.6133/apjcn.012016.07

Current practices and available resources for nutrition therapy in paediatric intensive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Existing guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment. Challenges and recommendations unique to the region are described.

Matched MeSH terms: Pediatrics*; Intensive Care Units, Pediatric
Psychometric properties of the self-report Malay version of the Pediatric Quality of Life (PedsQLTM) 4.0 Generic Core Scales among multiethnic Malaysian adolescents

Ainuddin HA, Loh SY, Chinna K, Low WY, Roslani AC

J Child Health Care, 2015 Jun;19(2):229-38.
PMID: 24154841 DOI: 10.1177/1367493513504834

Adolescence is the potential period for growth and optimal functioning, but developmental issues like time of transition from childhood to adulthood will create stress and affect the adolescent's quality of life (QOL). However, there is a lack of research tool for measuring adolescent's QOL in Malaysia. The aim of the study was to determine the validity and reliability of the self-report Malay version of the pediatric QOL (PedsQL™) 4.0 Generic Core Scales in assessing the QOL of Malaysian adolescents. A cross-sectional study design using the 23-item self-report Malay version of the PedsQL 4.0 Generic Core Scales was administered on a convenient cluster sampling (n = 297 adolescent) from a secondary school. The internal consistency reliability had Cronbach's α values ranging from .70 to .89. Factor analysis reported a six-factor structure via principal axis factor analysis. In conclusion, the self-report Malay version of the pediatric QOL 4.0 Generic Core Scales is a reliable and valid tool to measure the QOL of multiethnic Malaysian adolescents.

Matched MeSH terms: Pediatrics
The Proseal laryngeal mask airway in children: a comparison between two insertion techniques

Teoh CY, Lim FS

Paediatr Anaesth, 2008 Feb;18(2):119-24.
PMID: 18184242 DOI: 10.1111/j.1460-9592.2007.02385.x

The Proseal laryngeal mask airway (PLMA) is a relatively new supraglottic airway device with a drain tube to minimize the risk of gastric insufflation and aspiration. We compared introducer tool (IT) and gum elastic bougie (GEB)-guided techniques for insertion of the Proseal LMA in children.

Matched MeSH terms: Pediatrics
Fulltext A case report of unusual para-meningeal rhabdomyosarcoma

Jamilu Abdullahi Faruk, Fahisham Taib

Malaysian Journal of Paediatrics and Child Health, 2019;23(2):60-63.
MyJurnal

A Case Report Of Unusual Para-Meningeal RhabdomyosarcomaMalaysian Journal of Paediatrics and Child Health, Vol. 23 (2), December 2017: 60-63© 2017 MJPCH. All Rights Reserved.60CASE REPORTA CASE REPORT OF UNUSUAL PARA-MENINGEAL RHABDOMYOSARCOMAJamilu Abdullahi Faruk1, Fahisham Taib21.Department of Paediatrics, Ahmadu Bello University Teaching Hospital, PMB -06, Shika-Zaria, Kaduna State,Nigeria.2.Paediatric Department, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia.AbstractRhabdomyosarcomas arise from mesenchymal cells destined to form skeletal muscle, but they are often found at sites where skeletal muscle is typically not found. The parameningeal site has a poor prognostic risk, if it is associated with intra-cranial extensions and skull bone erosions.This is a case report of a five-year-old girl who presented with cranial nerve palsy, and later diagnosed as rhabdomyosarcoma of the mastoid and middle ear, with infiltration of the cerebellopontine angle of the brain. She did not respond to chemotherapyand rapidly deteriorated, succumbed to the disease within a short time following the diagnosis.

Matched MeSH terms: Pediatrics
Fulltext Meningococcal diseases: post men c vaccination era

Bazlin Ramly

Malaysian Journal of Paediatrics and Child Health, 2019;23(2):36-44.
MyJurnal

Meningococcal Diseases: Post Men C Vaccination EraMalaysian Journal of Paediatrics and Child Health, Vol. 23 (2), December 2017: 36-44© 2017 MJPCH. All Rights Reserved.36ORIGINAL ARTICLEMENINGOCOCCAL DISEASES: POST MEN C VACCINATION ERABazlin RamlyPaediatric Department, Letterkenny University Hospital, Co Donegal, Ireland.AbstractIntroduction: Meningococcal infections are caused by Neisseria Meningitidis and they are manifested in a spectrum of disease in particular meningitis. There are different strains of this bacteria which are A, C, B, W and Y. Mortality rates are from 5-15% with 10-15% suffering permanent disability. After the introduction of Men C vaccination in the year 2000, the incidences of meningitis caused by both Neisseria Meningitidis Serotype C and Serotype B have significantly reduced. Methods: A retrospective study of children whomlumbar puncture was performed with the preliminary diagnosis of meningococcal disease/ meningitis. Total numbers of children were 30 after excluding neonates, those with non-infectious diagnosis and failed lumbar puncture. Symptoms, signs and investigations results were collected in a data collection sheet using the documented data from the patients’ chart. Results: Five children had positive results in either the cultures or the PCR samples sent. None of these children had Serotype C. Three children had Serotype B and 2 others were Serotype W135. Conclusions: There were presence of Nisseria Meningitidis Serotype B and Serotype W135 when blood and cerebrospinal fluid samples were sent. It shows how significant is the value of lumbar puncture to be done to secure a definite diagnosis of meningitis. The preventive strategy to include Men B vaccination in the national vaccination schedule is definite so that death and morbidity can be reduced.

Matched MeSH terms: Pediatrics
Fulltext Peripheral intravenous canula (PIVC) assessment skills among pediatric nurses: audit-based approach study

Deena C T, Li Tsu Chong, Drina Dalie, Rose A Nain, Renie M Joanes, CheristyTumbil

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):4-0.
MyJurnal

Introduction: Peripheral Intravenous Cannula (PIVC) placement can cause undesirable effects, such as phlebitis. Poor PIVC care can irritate tunica intima layers of the superficial vein. The incidence of phlebitis had become a national nursing indicator, with a standard of less than 0.9%. The standard care of the patient with intravenous in- cludes a routine PIVC assessment. However, what the assessment should be based on remained unclear. The objec- tive of this study is to assess nurses’ skill in performing PIVC assessment. Methods: This is a descriptive study using an audit-based approach. It is conducted in a pediatric hospital. Nine pediatric wards were identified via stratified sampling methods. A total of 86 registered nurses consented to participate in this study. A validated research instru- ments (α = 0.83), PIVC Assessment Skill (PIVC-AS) checklist is used to audit nurses in performing PIVC assessment. PIVC-AS consists of nine audit criteria (AC), AC1: communication skill, AC2 until AC7: PIVC assessment skill, AC8: documentation skill and AC9: PIVC management. Results: Nurses communication skills to patient as in AC1 shows compliance rate of seventy six percent. The compliance rate can be explained that this study was done in the pedi- atric setting. Participants may skip this communication due to handling with a pediatric patient. More than eighty eight percent nurses comply with AC2 to AC6 which indicated their excellent skill in performing PIVC assessment every shift. However, in the AC7, only sixty seven percent comply to palpate PIVC area for any evidence of venous cord and warmth. Conclusion: This study concludes that communication between nurses and pediatric patients prior to PIVC assessment often missed out by nurses. The palpation techniques also not been carried out as compared to observation technique in pediatrics setting. Palpation technique is crucial to detect ‘warmth to touch’ because it differentiates between the early and medium stage of phlebitis.

Matched MeSH terms: Pediatrics
Fulltext Acute gastroenteritis among indigenous paediatric patients – a descriptive study in a rural district hospital, Sarawak

Cheah, W. L., Lee, P. Y., Kamarudin, K., Syed Alwi, S. A. R., Albela, H., Lau, E. H., et al.

Malaysian Journal of Medicine and Health Sciences, 2011;7(2):3-7.
MyJurnal

Introduction: Acute gastroenteritis (AGE) is one of the frequent causes of hospitalization in children under the age of five, particularly in a rural setting. This study was conducted to determine the epidemiology of acute gastroenteritis in indigenous children admitted to a rural district hospital in Sarawak. Methods: A retrospective review of indigenous paediatrics cases of acute gastroenteritis
admitted to the ward of Serian District Hospital, a rural district hospital in Sarawak, between the years
2006-2007. The data was collected from the patients’ case notes, obtained with permission from the
hospital management. Data was entered and analyzed using SPSS version 16. Results: During the study period, 234 indigenous children with acute gastroenteritis were admitted with the highest prevalence in 2006 (53.4%). The findings showed higher prevalence was found in children aged 3 years and below (76.5%) and male (56.4%) The minimum duration of hospital stay is 1 day, and the maximum stay is 5 days. The clinical findings showed that the majority of the cases presented with vomiting, diarrhea, dry mouth and tongue, sunken eye, with the majority (76%) reported having mild dehydration. The most common treatment used is oral rehydration solutions (85.4%), followed by intravenous bolus or drip (82.3%), paracetamol (79%) and antibiotic (36.2%). Peak incidence of admissions was between November to January. About 38.5% of the AGE cases admitted were found to be underweight (weight for- age below -2SD). Conclusion: The findings indicated children aged 3 years and below are the most vulnerable to AGE and malnutrition could be one of the predisposing factors. The peak incidence during the raining season at the end of the year indicated a possible relationship between AGE and seasonal type of virus infection. Prevention in the form of proper hygiene at the household level probably will prove to be useful.

Matched MeSH terms: Pediatrics
Fulltext Prescription patterns and appropriateness of antibiotics in the management of cough/cold and diarrhea in a rural tertiary care teaching hospital

Ahmad A, Khan MU, Malik S, Mohanta GP, Parimalakrishnan S, Patel I, et al.

J Pharm Bioallied Sci, 2016 Oct-Dec;8(4):335-340.
PMID: 28216959 DOI: 10.4103/0975-7406.199340

BACKGROUND: Acute gastroenteritis and respiratory illnesses are the major causes of morbidity and mortality in children under 5 years of age. The objective of this study was to evaluate the prescription pattern of antibiotic utilization during the treatment of cough/cold and/or diarrhea in pediatric patients.

METHODS: A descriptive, cross-sectional study was conducted for 6 months in pediatric units of a tertiary care hospital in South India. Children under 5 years of age presenting with illness related to diarrhea and/or cough/cold were included in this study. Data were collected by reviewing patient files and then assessed for its appropriateness against the criteria developed in view of the Medication Appropriateness Index and Guidelines of the Indian Academy of Pediatrics. The results were expressed in frequencies and percentages. Chi-square test was used to analyze the data. A P < 0.05 was considered statistically significant.

RESULTS: A total of 303 patients were studied during the study period. The mean age of the patients was 3.5 ± 0.6 years. The majority of children were admitted mainly due to chief complaint of fever (63%) and cough and cold (56.4%). The appropriateness of antibiotic prescriptions was higher in bloody and watery diarrhea (83.3% and 82.6%; P < 0.05). Cephalosporins (46.2%) and penicillins (39.9%) were the most commonly prescribed antibiotics, though the generic prescriptions of these drugs were the lowest (13.5% and 10%, respectively). The seniority of prescriber was significantly associated with the appropriateness of prescriptions (P < 0.05). Antibiotics prescription was higher in cold/cough and diarrhea (93.5%) in comparison to cough/cold (85%) or diarrhea (75%) alone.

CONCLUSIONS: The study observed high rates of antibiotic utilization in Chidambaram during the treatment of cough/cold and/or diarrhea in pediatric patients. The findings highlight the need for combined interventions using education and expert counseling, targeted to the clinical conditions and classes of antibiotic for which inappropriate usage is most common.

Matched MeSH terms: Pediatrics
Global Emergencies in Child Health: Challenges and Solutions-Viewpoint and Recommendations from the European Paediatric Association and the International Pediatric Association

Thacker N, Hasanoglu E, Dipesalema J, Namazova-Baranova L, Pulungan A, Alden E, et al.

J Pediatr, 2022 Feb;241:266-266.e3.
PMID: 34756940 DOI: 10.1016/j.jpeds.2021.10.052
Matched MeSH terms: Pediatrics
Fulltext Preserving Optimal Cardiovascular Health in Children

Perak AM, Benuck I

Pediatr Ann, 2018 Dec 01;47(12):e479-e486.
PMID: 30543376 DOI: 10.3928/19382359-20181115-01

The origins of cardiovascular disease are at the beginning of life, and national guidelines recommend evaluation for cardiovascular risk factors such as obesity and hypertension as part of general pediatric care. In this review, a simple plan is proposed for clear and consistent monitoring and messaging throughout childhood, based on the American Heart Association's "cardiovascular health" construct. A framework is provided for age-appropriate scoring of the cardiovascular health components, including diet, physical activity and screen time, sleep, smoking exposure, body mass index, blood pressure, cholesterol, and glucose. Guidance is provided for evidence-based, efficient intervention by pediatric clinicians to preserve or restore cardiovascular health. Finally, anticipated near-term advances in pediatric cardiovascular health promotion are previewed. [Pediatr Ann. 2018;47(12):e479-e486.].

Matched MeSH terms: Pediatrics
Susceptibility pattern of Streptococcus pneumoniae among pre-school children in Kota Bharu, Malaysia

Malik AS, Ismail A, Pennie RA, Naidu JV

J Trop Pediatr, 1998 02;44(1):10-4.
PMID: 9538599 DOI: 10.1093/tropej/44.1.10

Streptococcus pneumoniae (S. pneumoniae) is the most common bacterial cause of pneumonia, meningitis, and otitis media, with the highest incidence among young children and the elderly. S. pneumoniae was once routinely susceptible to penicillin, but since the mid-1980s the incidence of resistance to penicillin and other antimicrobial agents has been increasing all over the world. To optimize empirical regimens and initial therapy for S. pneumoniae infections, clinical healthcare providers must be informed about the prevalence and pattern of drug resistance among the isolates in their communities. No such data are available for the Malaysian population. Therefore, this study was designed to determine the antibiotic susceptibility pattern of S. pneumoniae among colonized pre-school children in Kota Bharu, Malaysia. Pharyngeal swabs were collected from children 1 month to 6 years of age. S. pneumoniae isolates were identified according to the standard and tested for penicillin resistance with a 1-microgram oxacillin disk by the Kirby-Bauer disk diffusion methods. Of 355 nasopharyngeal specimens obtained from kindergarten students, in-patients and pediatric clinics over a period of 1 year, S. pneumoniae was isolated from 36 (10 per cent). All isolates, except one, were susceptible to penicillin. The resistant isolates was susceptible to erythromycin, chloramphenicol and cephalosporins.
Study site: kindergarten, schools, pediatric outpatients clinics, and in-patient wards of Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia.

Matched MeSH terms: Pediatrics
Validation of Paediatric Nutrition Screening Tool (PNST) among Hospitalized Malaysian Children

Ong SH, Chen ST

J Trop Pediatr, 2020 10 01;66(5):461-469.
PMID: 31943107 DOI: 10.1093/tropej/fmz085

BACKGROUND: It is recommended to screen hospitalized children to identify those at risk of malnutrition. Constricted schedule in tertiary care settings calls for the needs of a less burdensome yet effective nutrition screening tool. This study aimed to validate the use of Paediatric Nutrition Screening Tool (PNST) among hospitalized children in a Malaysian tertiary hospital.
METHODS: This cross-sectional study recruited children below 18 years old admitting into general paediatric ward in a public hospital. The PNST and Subjective Global Nutritional Assessment (SGNA) were performed on 100 children (64 boys and 36 girls). The objective measurements include anthropometry (z-scores for weight, height and body mass index), dietary history and biochemical markers were measured. These were used to classify malnutrition as per Academy of Nutrition and Dietetics/American Society of Parental and Enteral Nutrition (AND/ASPEN) Consensus Statement for identification of paediatric malnutrition and WHO growth standards for children. Cohen's kappa was computed to report the level of agreement.
RESULTS: The PNST identified 57% of hospitalized children as being at risk of malnutrition. In this study, there was a stronger agreement between PNST with AND/ASPEN malnutrition classification (k = 0.602) as when PNST was compared with WHO (k = 0.225) and SGNA (k = 0.431). The PNST shows higher specificity (85.29%) and sensitivity (78.79%) when compared with AND/ASPEN than with WHO malnutrition criteria (55.81% specificity and 66.67% sensitivity).
CONCLUSION: This study showed the usefulness of routine use of PNST for screening the malnutrition risk of hospitalized children in Malaysian tertiary hospital settings.

Matched MeSH terms: Pediatrics
Fulltext Spectrum of hematological disorders in children diagnosed by bone marrow aspiration/biopsy: a retrospective study in a tertiary care center

Khan, Humayun Iqbal, Amir Rashid, Shabbir, A.S., Warriach, Israr B., Tariq, Rabia, Sarfraz, A., et al.

Malaysian Journal of Paediatrics and Child Health, 2011;17(1):0-0.
MyJurnal

Objective: This study assessed the pattern of clinical course of hematological disorders in children diagnosed by bone marrow aspiration/biopsy in a tertiary care centre. Setting: The study was conducted at the Department of Pediatrics, Lahore General Hospital, Pakistan. Design: A retrospective descriptive study. Duration of study: Jan 2006 to Dec 2010. Methods: The clinical and laboratory data of 250 patients including complete history, physical examination, investigations and bone marrow examination reports were collected and then analyzed retrospectively. On the basis of these data, relative frequency of different hematological disorders was determined. Results: A total of 250 patients were selected during this study period where their bone marrow was sent for the investigations. Out of these cases, double deficiency anemia was the commonest diagnosis (22%) followed by aplastic anemia (13.6%), megaloblastic anemia (13.2%) and iron deficiency anemia (5.6%). For hematological malignancies, acute lymphoblastic leukemia (ALL) was observed in 27 cases (10.8%) followed by acute myeloid leukemia (AML) in 12 cases (4.8%), lymphoma in 8 cases (3.2%) and chronic myeloid leukemia (CML) in only two cases. Idiopathic thrombocytopenic purpura (ITP) was reported as frequent as 13.2% (33 cases). Conclusion: The pattern of non malignant hematological disorders in children diagnosed by bone marrow aspiration/biopsy was more common than malignant conditions. Double deficiency anemia was the commonest non malignant condition followed by aplastic anemia, idiopathic thrombocytopenic purpura and megaloblastic anemia. ALL was the most common presentation of the hematological malignancy.

Matched MeSH terms: Pediatrics
Challenges in pediatric drug use: A pharmacist point of view

Balan S, Hassali MA, Mak VSL

Res Social Adm Pharm, 2017 May-Jun;13(3):653-655.
PMID: 27493130 DOI: 10.1016/j.sapharm.2016.06.014

The pediatric population is an enormously diverse segment of population varying both in size and age. The diversity caused pharmacists face various challenges primarily related to procuring, provision as well as use of drugs in this group of patients. Pediatric dose calculation is particularly a concern for pharmacists. Another challenge faced by pharmacists is unavailability of suitable formulations for pediatric use. This has also led many pharmacists to prepare extemporaneous liquid preparations, even though stability data on such preparations are scarce. Some extemporaneous preparations contain excipients which are potentially harmful in children. Besides that, inadequate labeling and drug information for pediatric drug use had not only challenged pharmacists in recommending and optimizing drug use in children, but also inadvertently caused many drugs used outside the approved terms of the product license (off-label use). Pharmacists are striving to stay connected to overcome the common and comparable challenges faced in their day to day duties and strive to maximize the safe and effective use of medicines for children.

Matched MeSH terms: Pediatrics
Influence of health providers on pediatrics' immunization rate

Al-lela OQ, Baidi Bahari M, Al-abbassi MG, Salih MR, Basher AY

J Trop Pediatr, 2012 Dec;58(6):441-5.
PMID: 22538210 DOI: 10.1093/tropej/fms014

To identify the immunization providers' characteristics associated with immunization rate in children younger than 2 years. A cohort and a cluster sampling design were implemented; 528 children between 18 and 70 months of age were sampled in five public health clinics in Mosul-Iraq. Providers' characterizations were obtained. Immunization rate for the children was assessed. Risk factors for partial immunization were explored using both bivariate analyses and multi-level logistic regression models. Less than half of the children had one or more than one missed dose, considered as partial immunization cases. The study found significant association of immunization rate with provider's type. Two factors were found that strongly impacted on immunization rate in the presence of other factors: birthplace and immunization providers' type.

Matched MeSH terms: Pediatrics
Fulltext Survey of knowledge and perception on the access to evidence-based practice and clinical practice change among maternal and infant health practitioners in South East Asia

Martis R, Ho JJ, Crowther CA, SEA-ORCHID Study Group

BMC Pregnancy Childbirth, 2008;8:34.
PMID: 18680603 DOI: 10.1186/1471-2393-8-34

Evidence-based practice (EBP) can provide appropriate care for women and their babies; however implementation of EBP requires health professionals to have access to knowledge, the ability to interpret health care information and then strategies to apply care. The aim of this survey was to assess current knowledge of evidence-based practice, information seeking practices, perceptions and potential enablers and barriers to clinical practice change among maternal and infant health practitioners in South East Asia.

Matched MeSH terms: Pediatrics
Paediatric rheumatology clinic population in Southeast Asia: are we different?

Arkachaisri T, Tang SP, Daengsuwan T, Phongsamart G, Vilaiyuk S, Charuvanij S, et al.

Rheumatology (Oxford), 2017 03 01;56(3):390-398.
PMID: 27994096 DOI: 10.1093/rheumatology/kew446

Objectives: To examine the descriptive epidemiology of the patient population referred to paediatric rheumatology centres (PRCs) in Southeast Asia (SEA) and to compare the frequency of conditions encountered with other PRC populations.

Methods: A web-based Registry for Childhood Onset Paediatric Rheumatic Diseases was established in 2009 and seven PRCs in four SEA countries, where paediatric rheumatologists are available, participated in a prospective 24 month data collection (43 months for Singapore).

Results: The number of patients analysed was 4038 (788 from Malaysia, 711 from the Philippines, 1943 from Singapore and 596 from Thailand). Over 70% of patients evaluated in PRCs in Malaysia, the Philippines and Thailand had rheumatic diseases (RDs), as compared with one-half of the proportion seen in Singaporean PRCs, which was similar to the Western PRC experience. Among RDs diagnosed (n = 2602), JIA was the most common disease encountered in Malaysia (41%) and Thailand (61%) as compared with systemic vasculitides in the Philippines (37%) and Singapore (35%) among which Henoch-Schönlein purpura was the most prevalent. SLE and related diseases were more common, but idiopathic pain syndrome and abnormal immunological laboratory tests were rarer than those seen in the West. JIA subtype distributions were different among countries. Among non-RDs (n = 1436), orthopaedic and related conditions predominated (21.7-59.4%).

Conclusion: The frequencies of RDs seen by SEA PRCs were different from those in the West. Systemic vasculitides and SLE were common in addition to JIA. Paediatric rheumatologist availability and healthcare accessibility partially explain these observed discrepancies.

Study site: multination + Selayang Hospital, Malaysia

Matched MeSH terms: Pediatrics

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