There is a notable lack of vaccine effectiveness studies using test-negative case-controlled appr... more There is a notable lack of vaccine effectiveness studies using test-negative case-controlled approach in low- and middle-income countries which have different logistic, demographic and socio-economic conditions from high-income countries. We aimed to estimate the effectiveness of BNT162b2 vaccine against COVID-19 infection over time, intensive care unit admission, severe or critical disease and death due to COVID-19. This study was conducted in the resident population of Labuan aged ≥18 years who had been tested for SARS-CoV-2 by Reverse-Transcriptase Polymerase Chain Reaction between 1 March 2021 and 31 October 2021. We used a test-negative case-control design where 2644 pairs of cases and controls were matched by age, sex, testing date, nationality and testing reason. Analysis was stratified by age group to estimate age effect (<60 years and ≥60 years). Of 22217 individuals tested by Reverse-Transcriptase Polymerase Chain Reaction, 5100 were positive for SARS-CoV-2 and aged 18 years and above. Overall vaccine effectiveness ≥ 14 days after the second dose was 65.2% (95% CI: 59.8–69.9%) against COVID-19 infection, 92.5% (95% CI: 72.3–98.8%) against intensive care unit admission, and 96.5% (95% CI: 82.3–99.8%) against COVID-19 deaths. Among infected individuals, vaccine effectiveness was 79.2% (95% CI: 42.3–94.1%) in preventing severe or critical disease due to COVID-19. Vaccine effectiveness for ≥60 years was 72.3% (95% CI: 53.4–83.9%) in fully vaccinated individuals, higher than 64.8% (95% CI: 49.3–59.1%) for those <60 years. Two doses of BNT162b2 were highly effective against COVID-19 infection, severe or critical disease, intensive care unit admission and death due to COVID-19. This study addresses a gap in literature on BNT162b2 vaccine effectiveness in low- and middle-income populations and demonstrates the feasibility of such a study design in a resource limited setting while supporting evidence of waning immunity.
The indiscriminate use of cough and cold medicines (CCMs) in children has become a public health ... more The indiscriminate use of cough and cold medicines (CCMs) in children has become a public health concern. The study evaluates the prescription pattern of CCMs in primary care setting. Analysis of CCMs prescription data among children aged 12 years and below who had participated in the National Medical Care Survey (NMCS) 2010. Data was extracted from NMCS 2010, a cross-sectional survey on the primary healthcare service which was carried out from December 2009 to April 2010 in public and private primary care clinics in Malaysia. Of 21,868 encounters for NMCS 2010, 3574 (16.3%) were children 12 years old and below; 597 (17%) were from public clinics and 2977 (83%) were from private clinics. Of these 3574 encounters, 1748 (49%) children were prescribed with CCM with total of 2402 CCMs. On average, CCMs were prescribed at a rate of 1.3 CCMs per encounter in public clinics and 1.4 CCMs per encounter in private clinics. CCMs containing single ingredient constituted 77% of the prescriptions...
Background While patients’ preferences in primary care have been examined in numerous conjoint an... more Background While patients’ preferences in primary care have been examined in numerous conjoint analyses, there has been little systematic effort to synthesise the findings. This review aimed to identify, to organise and to assess the strength of evidence for the attributes and factors associated with preference heterogeneity in conjoint analyses for primary care outpatient visits. Methods We searched five bibliographic databases (PubMed, Embase, PsycINFO, Econlit and Scopus) from inception until 15 December 2021, complemented by hand-searching. We included conjoint analyses for primary care outpatient visits. Two reviewers independently screened papers for inclusion and assessed the quality of all included studies using the checklist by ISPOR Task Force for Conjoint Analysis. We categorized the attributes of primary care based on Primary Care Monitoring System framework and factors based on Andersen’s Behavioural Model of Health Services Use. We then assessed the strength of evidenc...
In response to Coronavirus disease 2019 (COVID-19) global pandemic, various COVID-19 vaccines wer... more In response to Coronavirus disease 2019 (COVID-19) global pandemic, various COVID-19 vaccines were rapidly administered under emergency use authorization. Rare outcomes associated with COVID-19 vaccines might be less likely to be captured in clinical trials, leading to a knowledge gap in real-world vaccine safety. In contrast with high-income countries, many low-to-middle income countries have limited capacity to conduct active surveillance, owing to the absence of large and fully-integrated health information databases. This paper describes the study protocol, which aims to investigate risk of prespecified adverse events of special interests following COVID-19 vaccination in a partially integrated health information system with non-shareable electronic health records. The SAFECOVAC study is a longitudinal, observational retrospective study of active safety surveillance using case-based monitoring approach. This involves linkage of several administrative databases and hospitalizatio...
Objective: This study aimed to assess effectiveness and safety outcomes of antiplatelet therapy f... more Objective: This study aimed to assess effectiveness and safety outcomes of antiplatelet therapy for secondary prevention among patients with ischaemic stroke or transient ischaemic attack (TIA) in Malaysia. Method: Patients with a first ischaemic stroke/TIA between 2014 and 2017 were identified from stroke registry and data was linked with other data sources for information on antiplatelet exposure and outcome events. Exposure was defined as antiplatelet therapy at discharge from the index stroke hospitalisation and categorised into single antiplatelet therapy (SAPT) and dual antiplatelet therapy (DAPT) groups. Primary outcome was composite events of stroke, myocardial infarction, and all-cause death at up to one year after the index stroke in an intention-to-treat analysis. Results: Of 4434 patients included in the analysis, 6.7% were treated with DAPT and 93.3% were in SAPT group. During the 1-year follow-up, composite events occurred in 5.7% of patients in DAPT group and in 12.3%...
Background and objectives: Data on population-level outcomes after heart failure (HF) hospitalisa... more Background and objectives: Data on population-level outcomes after heart failure (HF) hospitalisation in Asia is sparse. This study aimed to estimate readmission and mortality after hospitalisation among HF patients and examine temporal variation by sex and ethnicity. Methods: Data for 105,399 patients who had incident HF hospitalisations from 2007 to 2016 were identified from a national discharge database and linked to death registration records. The outcomes assessed here were 30-day readmission, in-hospital, 30-day and one-year all-cause mortality. Results: Eighteen percent of patients (n = 16786) were readmitted within 30 days. Mortality rates were 5.3% (95% confidence interval (CI) 5.1–5.4%), 11.2% (11.0–11.4%) and 33.1% (32.9–33.4%) for in-hospital, 30-day and 1-year mortality after the index admission. Age, sex and ethnicity-adjusted 30-day readmissions increased by 2% per calendar year while in-hospital and 30-day mortality declined by 7% and 4% per year respectively. One-year mortality rates remained constant during the study period. Men were at higher risk of 30-day readmission (adjusted rate ratio (RR) 1.16, 1.13–1.20) and one-year mortality (RR 1.17, 1.15–1.19) than women. Ethnic differences in outcomes were evident. Readmission rates were equally high in Chinese and Indians relative to Malays whereas Others, which mainly comprised Indigenous groups, fared worst for in-hospital and 30-day mortality with RR 1.84 (1.64–2.07) and 1.3 (1.21–1.41) relative to Malays. Conclusions: Short-term survival was improving across sex and ethnic groups but prognosis at one year after incident HF hospitalisation remained poor. The steady increase in 30-day readmission rates deserves further investigation.
Factors related to the prescription of secondary preventive drugs among ischemic stroke patients ... more Factors related to the prescription of secondary preventive drugs among ischemic stroke patients by types of drugs (multivariable analysis). This table is similar to Fig. 3aâ d but the estimates are provided in a table format. (DOCX 21 kb)
Background and Objectives: Stroke is life-threatening neurological disorder and a leading cause o... more Background and Objectives: Stroke is life-threatening neurological disorder and a leading cause of adult disability. Several clinical trials have been performed using potential neuroprotective agents, none of them has proven to be useful for providing functional recovery from ischemic stroke. Therefore, present invivo and in-silico study were designed to investigate the plasma pharmacokinetics, brain penetration and neuroprotective potential of chlorogenic acid (CGA) in rats. Methods: The molecular docking simulation was performed to evaluate the inhibition potential of chlorogenic acid for MMP2, MMP-9, NMDA, nNOS, and iNOS. The plasma pharmacokinetics and brain penetration study is also performed. To evaluate neuroprotective activity, brain infarction, % brain water content, blood-brain barrier (BBB) disruption along with the level of nitrate, glutamate, and calcium were observed in the sham, ischemic and treated rats. Results: The CGA was docked with mediators of neuronal dysfunct...
BackgroundCOVID-19 vaccines have been highly effective in reducing morbidity and mortality during... more BackgroundCOVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. While primary series vaccination rates are generally high in Southeast Asian (SEA) countries, various factors have limited the rollout and impact of booster doses.MethodsTo objectively review the evidence for vaccine effectiveness (VE), we extracted data from 79 studies identified in the publicly-available International Vaccine Access Center (IVAC) VIEW-hub platform reporting VE after a primary immunisation with two-dose schedules for three important clinical outcomes. We evaluated VE after primary immunisation against SARS-CoV-2 infection, and COVID-19-related hospitalisations and deaths for the most widely reported vaccines, stratified across variants of concern (VOC), age, study design and prior SARS-CoV-2 infection. The majority of studies evaluated mRNA vaccines (58 BNT162b2 studies, 34 mRNA-1273 studies and 14 combinations of both) and vector vaccines [25 COVID-19 Va...
SUMMARYBackgroundEvaluation of vaccine effectiveness over time against severe acute respiratory s... more SUMMARYBackgroundEvaluation of vaccine effectiveness over time against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (COVID-19) is important. Evidence on effectiveness over time for the CoronaVac vaccine is lacking despite its widespread use globally. In Malaysia, a diverse set-up of COVID-19 vaccines was rolled out nationwide, and the waning of vaccine protection is a concern. We aimed to investigate and compare waning vaccine effectiveness against COVID-19 infections, COVID-19 related ICU admission and COVID-19 related deaths for BNT162b2 and CoronaVac vaccines.MethodsIn this observational study, we consolidated nationally representative data on COVID-19 vaccination and patients’ outcomes. Data on all confirmed COVID-19 cases from 1 to 30 September 2021 were used to compare vaccine effectiveness between the ‘early’ group (fully vaccinated in April to June 2021) and the ‘late’ group (fully vaccinated in Jul to Aug 2021). We used ...
IntroductionCOVID-19 vaccines have been highly effective in reducing morbidity and mortality duri... more IntroductionCOVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. While primary series vaccination rates are generally high in Southeast Asian (SEA) countries, various factors have limited the rollout and impact of booster doses.Areas coveredWe reviewed 79 studies in the publicly available International Vaccine Access Center (IVAC) VIEW-hub platform on vaccine effectiveness (VE) after primary immunizations with two-dose schedules. VE data were reported for SARS-CoV-2 infection, COVID-19-related hospitalizations and deaths, and stratified across variants of concern (VOC), age, study design and prior SARS-CoV-2 infection for mRNA vaccines (BNT162b2, mRNA-1273 and combinations of both), vector vaccines (AstraZeneca, AZD1222 “Vaxzevria”) and inactivated virus vaccines (CoronaVac).Expert opinionThe most-studied COVID-19 vaccines provide consistently high (>90%) protection against serious clinical outcomes like hospitalizations and deaths...
<strong>Introduction </strong>Almost no country-specific incidence trends data of de ... more <strong>Introduction </strong>Almost no country-specific incidence trends data of de novo heart failure (HF) hospitalisations are available for Southeast Asia. This study aimed to determine the trends in incidence of HF hospitalisations and how these differ by age, sex and ethnicity in Malaysia. <strong>Methodology </strong>Using a national hospital discharge database, we estimated the rates of incident HF hospitalisations between 2007 and 2016. <strong>Results </strong>Of 105 399 patients who had incident hospitalisations for HF, 58 866 (55·9%) were men and 67 374 (63.9%) were 60 years and older. By ethnicity, 64 146 (60·9%) were Malay, 18·2% were Chinese, 10·9% were Indian and a remaining 9·7% were other ethnic groups combined. The absolute number of new hospitalisations increased by 52·3%. Meanwhile, standardised incident HF hospitalisations decreased at a similar rate for both men and women, by an average of 1% per calendar year. Overall, women had lower incidence than men after adjusting for age, ethnicity and calendar year (incidence rate ratio 0·77; 95% confidence interval 0·74-0·80). Although age-standardised incidence was highest in the Indian ethnic group, this subgroup has also exhibited the highest annual rate of decline compared to other ethnic groups. Of note, Indian women had elevated risk of incident HF hospitalisation compared to women of other ethnic groups. <strong>Conclusion</strong> Incidence of HF hospitalisations has decreased in the past ten years, irrespective of sex. However, differences in absolute risks of HF hospitalisations remain across sex and ethnic groups, representing opportunity for public health initiatives to target high-risk subgroups to reduce HF hospitalisations. [<strong>Disclaimer:</strong> Abstract text might vary slightly from what is displayed in the e-poster]
Additional file 3: Table S1. Changes in job satisfaction among cohort group following EnPHC Inter... more Additional file 3: Table S1. Changes in job satisfaction among cohort group following EnPHC Interventions.
There is a notable lack of vaccine effectiveness studies using test-negative case-controlled appr... more There is a notable lack of vaccine effectiveness studies using test-negative case-controlled approach in low- and middle-income countries which have different logistic, demographic and socio-economic conditions from high-income countries. We aimed to estimate the effectiveness of BNT162b2 vaccine against COVID-19 infection over time, intensive care unit admission, severe or critical disease and death due to COVID-19. This study was conducted in the resident population of Labuan aged ≥18 years who had been tested for SARS-CoV-2 by Reverse-Transcriptase Polymerase Chain Reaction between 1 March 2021 and 31 October 2021. We used a test-negative case-control design where 2644 pairs of cases and controls were matched by age, sex, testing date, nationality and testing reason. Analysis was stratified by age group to estimate age effect (<60 years and ≥60 years). Of 22217 individuals tested by Reverse-Transcriptase Polymerase Chain Reaction, 5100 were positive for SARS-CoV-2 and aged 18 years and above. Overall vaccine effectiveness ≥ 14 days after the second dose was 65.2% (95% CI: 59.8–69.9%) against COVID-19 infection, 92.5% (95% CI: 72.3–98.8%) against intensive care unit admission, and 96.5% (95% CI: 82.3–99.8%) against COVID-19 deaths. Among infected individuals, vaccine effectiveness was 79.2% (95% CI: 42.3–94.1%) in preventing severe or critical disease due to COVID-19. Vaccine effectiveness for ≥60 years was 72.3% (95% CI: 53.4–83.9%) in fully vaccinated individuals, higher than 64.8% (95% CI: 49.3–59.1%) for those <60 years. Two doses of BNT162b2 were highly effective against COVID-19 infection, severe or critical disease, intensive care unit admission and death due to COVID-19. This study addresses a gap in literature on BNT162b2 vaccine effectiveness in low- and middle-income populations and demonstrates the feasibility of such a study design in a resource limited setting while supporting evidence of waning immunity.
The indiscriminate use of cough and cold medicines (CCMs) in children has become a public health ... more The indiscriminate use of cough and cold medicines (CCMs) in children has become a public health concern. The study evaluates the prescription pattern of CCMs in primary care setting. Analysis of CCMs prescription data among children aged 12 years and below who had participated in the National Medical Care Survey (NMCS) 2010. Data was extracted from NMCS 2010, a cross-sectional survey on the primary healthcare service which was carried out from December 2009 to April 2010 in public and private primary care clinics in Malaysia. Of 21,868 encounters for NMCS 2010, 3574 (16.3%) were children 12 years old and below; 597 (17%) were from public clinics and 2977 (83%) were from private clinics. Of these 3574 encounters, 1748 (49%) children were prescribed with CCM with total of 2402 CCMs. On average, CCMs were prescribed at a rate of 1.3 CCMs per encounter in public clinics and 1.4 CCMs per encounter in private clinics. CCMs containing single ingredient constituted 77% of the prescriptions...
Background While patients’ preferences in primary care have been examined in numerous conjoint an... more Background While patients’ preferences in primary care have been examined in numerous conjoint analyses, there has been little systematic effort to synthesise the findings. This review aimed to identify, to organise and to assess the strength of evidence for the attributes and factors associated with preference heterogeneity in conjoint analyses for primary care outpatient visits. Methods We searched five bibliographic databases (PubMed, Embase, PsycINFO, Econlit and Scopus) from inception until 15 December 2021, complemented by hand-searching. We included conjoint analyses for primary care outpatient visits. Two reviewers independently screened papers for inclusion and assessed the quality of all included studies using the checklist by ISPOR Task Force for Conjoint Analysis. We categorized the attributes of primary care based on Primary Care Monitoring System framework and factors based on Andersen’s Behavioural Model of Health Services Use. We then assessed the strength of evidenc...
In response to Coronavirus disease 2019 (COVID-19) global pandemic, various COVID-19 vaccines wer... more In response to Coronavirus disease 2019 (COVID-19) global pandemic, various COVID-19 vaccines were rapidly administered under emergency use authorization. Rare outcomes associated with COVID-19 vaccines might be less likely to be captured in clinical trials, leading to a knowledge gap in real-world vaccine safety. In contrast with high-income countries, many low-to-middle income countries have limited capacity to conduct active surveillance, owing to the absence of large and fully-integrated health information databases. This paper describes the study protocol, which aims to investigate risk of prespecified adverse events of special interests following COVID-19 vaccination in a partially integrated health information system with non-shareable electronic health records. The SAFECOVAC study is a longitudinal, observational retrospective study of active safety surveillance using case-based monitoring approach. This involves linkage of several administrative databases and hospitalizatio...
Objective: This study aimed to assess effectiveness and safety outcomes of antiplatelet therapy f... more Objective: This study aimed to assess effectiveness and safety outcomes of antiplatelet therapy for secondary prevention among patients with ischaemic stroke or transient ischaemic attack (TIA) in Malaysia. Method: Patients with a first ischaemic stroke/TIA between 2014 and 2017 were identified from stroke registry and data was linked with other data sources for information on antiplatelet exposure and outcome events. Exposure was defined as antiplatelet therapy at discharge from the index stroke hospitalisation and categorised into single antiplatelet therapy (SAPT) and dual antiplatelet therapy (DAPT) groups. Primary outcome was composite events of stroke, myocardial infarction, and all-cause death at up to one year after the index stroke in an intention-to-treat analysis. Results: Of 4434 patients included in the analysis, 6.7% were treated with DAPT and 93.3% were in SAPT group. During the 1-year follow-up, composite events occurred in 5.7% of patients in DAPT group and in 12.3%...
Background and objectives: Data on population-level outcomes after heart failure (HF) hospitalisa... more Background and objectives: Data on population-level outcomes after heart failure (HF) hospitalisation in Asia is sparse. This study aimed to estimate readmission and mortality after hospitalisation among HF patients and examine temporal variation by sex and ethnicity. Methods: Data for 105,399 patients who had incident HF hospitalisations from 2007 to 2016 were identified from a national discharge database and linked to death registration records. The outcomes assessed here were 30-day readmission, in-hospital, 30-day and one-year all-cause mortality. Results: Eighteen percent of patients (n = 16786) were readmitted within 30 days. Mortality rates were 5.3% (95% confidence interval (CI) 5.1–5.4%), 11.2% (11.0–11.4%) and 33.1% (32.9–33.4%) for in-hospital, 30-day and 1-year mortality after the index admission. Age, sex and ethnicity-adjusted 30-day readmissions increased by 2% per calendar year while in-hospital and 30-day mortality declined by 7% and 4% per year respectively. One-year mortality rates remained constant during the study period. Men were at higher risk of 30-day readmission (adjusted rate ratio (RR) 1.16, 1.13–1.20) and one-year mortality (RR 1.17, 1.15–1.19) than women. Ethnic differences in outcomes were evident. Readmission rates were equally high in Chinese and Indians relative to Malays whereas Others, which mainly comprised Indigenous groups, fared worst for in-hospital and 30-day mortality with RR 1.84 (1.64–2.07) and 1.3 (1.21–1.41) relative to Malays. Conclusions: Short-term survival was improving across sex and ethnic groups but prognosis at one year after incident HF hospitalisation remained poor. The steady increase in 30-day readmission rates deserves further investigation.
Factors related to the prescription of secondary preventive drugs among ischemic stroke patients ... more Factors related to the prescription of secondary preventive drugs among ischemic stroke patients by types of drugs (multivariable analysis). This table is similar to Fig. 3aâ d but the estimates are provided in a table format. (DOCX 21 kb)
Background and Objectives: Stroke is life-threatening neurological disorder and a leading cause o... more Background and Objectives: Stroke is life-threatening neurological disorder and a leading cause of adult disability. Several clinical trials have been performed using potential neuroprotective agents, none of them has proven to be useful for providing functional recovery from ischemic stroke. Therefore, present invivo and in-silico study were designed to investigate the plasma pharmacokinetics, brain penetration and neuroprotective potential of chlorogenic acid (CGA) in rats. Methods: The molecular docking simulation was performed to evaluate the inhibition potential of chlorogenic acid for MMP2, MMP-9, NMDA, nNOS, and iNOS. The plasma pharmacokinetics and brain penetration study is also performed. To evaluate neuroprotective activity, brain infarction, % brain water content, blood-brain barrier (BBB) disruption along with the level of nitrate, glutamate, and calcium were observed in the sham, ischemic and treated rats. Results: The CGA was docked with mediators of neuronal dysfunct...
BackgroundCOVID-19 vaccines have been highly effective in reducing morbidity and mortality during... more BackgroundCOVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. While primary series vaccination rates are generally high in Southeast Asian (SEA) countries, various factors have limited the rollout and impact of booster doses.MethodsTo objectively review the evidence for vaccine effectiveness (VE), we extracted data from 79 studies identified in the publicly-available International Vaccine Access Center (IVAC) VIEW-hub platform reporting VE after a primary immunisation with two-dose schedules for three important clinical outcomes. We evaluated VE after primary immunisation against SARS-CoV-2 infection, and COVID-19-related hospitalisations and deaths for the most widely reported vaccines, stratified across variants of concern (VOC), age, study design and prior SARS-CoV-2 infection. The majority of studies evaluated mRNA vaccines (58 BNT162b2 studies, 34 mRNA-1273 studies and 14 combinations of both) and vector vaccines [25 COVID-19 Va...
SUMMARYBackgroundEvaluation of vaccine effectiveness over time against severe acute respiratory s... more SUMMARYBackgroundEvaluation of vaccine effectiveness over time against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (COVID-19) is important. Evidence on effectiveness over time for the CoronaVac vaccine is lacking despite its widespread use globally. In Malaysia, a diverse set-up of COVID-19 vaccines was rolled out nationwide, and the waning of vaccine protection is a concern. We aimed to investigate and compare waning vaccine effectiveness against COVID-19 infections, COVID-19 related ICU admission and COVID-19 related deaths for BNT162b2 and CoronaVac vaccines.MethodsIn this observational study, we consolidated nationally representative data on COVID-19 vaccination and patients’ outcomes. Data on all confirmed COVID-19 cases from 1 to 30 September 2021 were used to compare vaccine effectiveness between the ‘early’ group (fully vaccinated in April to June 2021) and the ‘late’ group (fully vaccinated in Jul to Aug 2021). We used ...
IntroductionCOVID-19 vaccines have been highly effective in reducing morbidity and mortality duri... more IntroductionCOVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. While primary series vaccination rates are generally high in Southeast Asian (SEA) countries, various factors have limited the rollout and impact of booster doses.Areas coveredWe reviewed 79 studies in the publicly available International Vaccine Access Center (IVAC) VIEW-hub platform on vaccine effectiveness (VE) after primary immunizations with two-dose schedules. VE data were reported for SARS-CoV-2 infection, COVID-19-related hospitalizations and deaths, and stratified across variants of concern (VOC), age, study design and prior SARS-CoV-2 infection for mRNA vaccines (BNT162b2, mRNA-1273 and combinations of both), vector vaccines (AstraZeneca, AZD1222 “Vaxzevria”) and inactivated virus vaccines (CoronaVac).Expert opinionThe most-studied COVID-19 vaccines provide consistently high (>90%) protection against serious clinical outcomes like hospitalizations and deaths...
<strong>Introduction </strong>Almost no country-specific incidence trends data of de ... more <strong>Introduction </strong>Almost no country-specific incidence trends data of de novo heart failure (HF) hospitalisations are available for Southeast Asia. This study aimed to determine the trends in incidence of HF hospitalisations and how these differ by age, sex and ethnicity in Malaysia. <strong>Methodology </strong>Using a national hospital discharge database, we estimated the rates of incident HF hospitalisations between 2007 and 2016. <strong>Results </strong>Of 105 399 patients who had incident hospitalisations for HF, 58 866 (55·9%) were men and 67 374 (63.9%) were 60 years and older. By ethnicity, 64 146 (60·9%) were Malay, 18·2% were Chinese, 10·9% were Indian and a remaining 9·7% were other ethnic groups combined. The absolute number of new hospitalisations increased by 52·3%. Meanwhile, standardised incident HF hospitalisations decreased at a similar rate for both men and women, by an average of 1% per calendar year. Overall, women had lower incidence than men after adjusting for age, ethnicity and calendar year (incidence rate ratio 0·77; 95% confidence interval 0·74-0·80). Although age-standardised incidence was highest in the Indian ethnic group, this subgroup has also exhibited the highest annual rate of decline compared to other ethnic groups. Of note, Indian women had elevated risk of incident HF hospitalisation compared to women of other ethnic groups. <strong>Conclusion</strong> Incidence of HF hospitalisations has decreased in the past ten years, irrespective of sex. However, differences in absolute risks of HF hospitalisations remain across sex and ethnic groups, representing opportunity for public health initiatives to target high-risk subgroups to reduce HF hospitalisations. [<strong>Disclaimer:</strong> Abstract text might vary slightly from what is displayed in the e-poster]
Additional file 3: Table S1. Changes in job satisfaction among cohort group following EnPHC Inter... more Additional file 3: Table S1. Changes in job satisfaction among cohort group following EnPHC Interventions.
Uploads
Papers by sheamini sivasampu