Epidemiology of diseases in Malaysia

  • 7,419 views
Uploaded on

Epidemiology of diseases in Malaysia

Epidemiology of diseases in Malaysia

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
  • thanks doc. this slide is very helpful for me :)
    Are you sure you want to
    Your message goes here
No Downloads

Views

Total Views
7,419
On Slideshare
0
From Embeds
0
Number of Embeds
4

Actions

Shares
Downloads
0
Comments
1
Likes
3

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide
  • Hipertensi Prevalens hipertensi semakin meningkat di Malaysia. Menurut penemuan awal, prevalens hipertensi dianggarkan 14.7% pada 1980. Kajian dikalangan Orang Melayu di Kuala Selangor, dari 359 sampel yang diperiksa tekanan darahnya 92 atau 25.6% penduduk yang berumur 15 tahun dan keatas mengalami hipertensi (Osman Ali et al. 1984a, Osman ali 1990d). Prevalensnya meningkat menurut umur dan tinggi dikalangan perokok.(jadual 6).
  • Hipertensi Prevalens hipertensi semakin meningkat di Malaysia. Menurut penemuan awal, prevalens hipertensi dianggarkan 14.7% pada 1980. Kajian dikalangan Orang Melayu di Kuala Selangor, dari 359 sampel yang diperiksa tekanan darahnya 92 atau 25.6% penduduk yang berumur 15 tahun dan keatas mengalami hipertensi (Osman Ali et al. 1984a, Osman ali 1990d). Prevalensnya meningkat menurut umur dan tinggi dikalangan perokok.(jadual 6).
  • CABARAN MENDATANG AKIBAT PERALIHAN KESIHATAN Corak penyakit yang akan terjadi di negara yang mengalami permodenan pesat seperti Malaysia tidak akan jauh berbeza dengan corak yang telah berlaku di negara maju pada masa kini. Dijangkakan akan terdapat peningkatan berterusan penyakit kardiovaskular, kanser dan injuri dalam tempuh 30 tahun akan datang disebabkan oleh permodenan dan perubahan gaya hidup (first fruit of affluence), kemudian kadar penyakit-penyakit tersebut akan stabil seterusnya menurun akibat meningkatnya pendidikan dan kesedaran tentang kesihatan seperti yang sedang dialami oleh negara-negara maju masa kini (second fruit of affluence)(jadual 14). Selain dari peningkatan sosioekonomi, corak penyakit masa akan datang dipengaruhi oleh umur penduduk memandangkan kadar kematian yang berkurangan dan jangkaan hidup yang bertambah. Lebih ramai penduduk yang akan mencapai umur tua dan sebahagian besar akan mengalami masalah penyakit kronik dan degeneratif seperti kanser, strok, athritis, katarak, dementia dsb (Osman Ali 1995f, Khatijah & Osman Ali 1997).

Transcript

  • 1. EPIDEMIOLOGYOF DISEASES INMALAYSIA
  • 2. VPDS (VACCINEPREVENTABLE DISEASES )• All infectious diseases which can be prevented by vaccines are on a downward trend, in line with the national and WHO target.• No cases of polio, neonatal tetanus and diphtheria.• No large epidemics• Measles and hepatitis B under control and on a downward trend.
  • 3. Childhood Immunisation Coverage, Malaysia 2003BCG 99.00%Triple & Double Antigen (3rd Dose) 85.40%Polio Immunisation (3rd Dose) 94.90%Measles Immunisation 75.50%Hep B Immunisation (3rd Dose) 93.10%
  • 4. WATER & FOOD BORNEDISEASES• A drop in the incidence rate of food and water borne diseases such as typhoid, cholera, para typhoid, hepatitis A and dysentry since 10 years ago (1988-1997)• Related to improvement of safe water supply and better sanitation.• However there is an increase of food poisoning incidence.
  • 5. CHOLERA• Still a public health problem especially in Sabah and the northern peninsular.• Related to the use of contaminated water during drought or water shortage.• Sabah - GREG storm 1997• Sarawak – use of contaminated rain water
  • 6. TYPHOID• Occurs in some states especially Kelantan, Sabah and Terengganu.• Big outbreak in Tawau 1997 due to the use of contaminated river water (180 cases)• Outbreak in Kota Baru, Kelantan believed to be related to “sirap ais”.
  • 7. HEPATITIS A• Endemic in some states such as Terengganu, Kelantan and Sabah.DYSENTRY• Most cases occurs at border areas in Sabah, Sarawak, Kedah, Perlis, Perak and Johor.
  • 8. FOOD POISONING• A big problem in institutions, schools and factories.• Related to unhygienic food preparation.• Mostly due to E. coli, Salmonella spp and Staphyllococcus aureus.
  • 9. AIDS/HIV
  • 10. AIDS• Abbreviation for Acquired Immune Deficiency Syndrome.• Infected persons will lose their natural immune defence system and minor infections will become life threatening diseases.• This person will usually die from serious opportunistic infection or due to rare cancers.
  • 11. The Virus• Identified in 1983/84.• In 1986, given the name Human Immuno- deficiency Virus (HIV) by ICTV.• It is a retrovirus that belongs to a large family of RNA lentiviruses.• 2 types identified – HIV-1, – HIV-2.
  • 12. Epidemiology of HIV/AIDS• Currently more than 34.3 million people with HIV worldwide.• Malaysia – – No cases before 1986 – end of 2003, 58012 accumulated cases.• Malaysia majority are IDU’s, male & Malays.
  • 13. HIV/ AIDS• Infected newborns - increasing• Infected prostitutes - increasing• Heterosexual transmission more nowadays• Infection rate amongst blood donors ( 0.03- 0.06%)• Sentinel surveillance sentinel – no obvious trend
  • 14. HIV and AIDS Estimates for the Western Pacific Region, 1999 Estimated HIV Estimated HIV Estimated Country/area prevalence prevalence rate AIDS Status of epidemic (age 15-49) (age 15-49) incidenceCambodia 170 000 3.3% 10 000 Stabilizing; heterosexual Expanding in selected areas;Papua New Guinea 14 000 0.6% 150 heterosexual transmissionMalaysia 50 000 0.4% 900 Stable; mostly IDU Expanding; IDU, heterosexualViet Nam 100 000 0.2% 3 700 transmission increasing rapidlySingapore 3 000 0.1% >120 StableAustralia 14 000 0.1% +/- 200 Declining; mostly homosexual Expanding; mostly IDU;China 500 000 <0.1% n/a heterosexual increasingHong Kong 3 700 <0.1% +/- 60 StableJapan 8 100 <0.1% +/- 200 StableLao, PDR 1 400 <0.1% >50 StableNew Zealand 1 200 <0.1% +/- 30 Declining; mostly homosexualPhilippines +/- 10 000 <0.1% >50 Slowly expanding; heterosexualKorea, Republic 3 800 <0.1% +/- 30 stableTotal >876 200 <0.1% >>15 490
  • 15. Trends in HIV/AIDS Reported Selected countries 1989-1998 HIV/AIDS cases reported New Zealand 9 000 Australia Hong Kong 8 000 Japan 7 000 S. Korea Singapore 6 000 Malaysia Cambodia 5 000 Vietnam 4 000 3 000 2 000 1 000 0110418 89 90 91 92 93 94 95 96 97 98
  • 16. Trends in AIDS Reported Cases Selected countries 1989-1998 AIDS cases reported New Zealand Australia1 600 Hong Kong Japan1 400 S. Korea Singapore1 200 Malaysia Cambodia1 000 Vietnam 800 600 400 200 0110507 89 90 91 92 93 94 95 96 97 98
  • 17. VECTOR BORNE DISEASESDENGUE/DHF• Increasing number of cases and deaths due to rapid urbanisation and industrialisation.• Especially in Kuala Lumpur, Selangor, Johor, Perak and Negeri Sembilan (urban areas)• Ratio of DF:DHF are 7-25 : 1• Fatality rate DHF 0.2-0.4%
  • 18. MALARIA• Still a major problem in Sabah, Pahang, Sarawak, Perak, Kelantan and Johor.• Main Agent - Plasmodium falciparum• Especially amongst Orang Asli, land settlers, soldiers and immigrants.
  • 19. TUBERCULOSISIncreasing trend, >50% new cases areinfectiousNew cases - age 21-40 yrs.-13% are imigrants (50% in Sabah, 15% inWP,KL)-cure rate 86% (1997)Mortality increasing due to late treatmentand HIV/AIDS.
  • 20. Survival Functions 1.2 1.0 .8 Ujian ELISA .6 Tidak reaktif .4Cum Survival Tidak reaktif -censored .2 Reaktif 0.0 Reaktif-censored -200 200 600 1000 1400 0 400 800 1200 1600 INTERVAL
  • 21. Non-Communicable Disease
  • 22. Common Risk Factors of Lifestyle Diseases Share Predisposing Conditions: – Hypertension – Obesity (especially central obesity) – Diabetes Mellitus – Cancer And Common Risk Factors: – Tobacco – Physical Inactivity – Irrational Diet (especially high fat intake) – Alcohol over-consumption
  • 23. Adult Smoking (NHMS 3)• 27.0% ever smokers• 21.5% current smokers• Higher amongst Malay (24.0%), rural (32.3%), males (57.6%, females only 2.5%).• Higher in Kelantan (31.7%), Pahang (29.8%) and Sabah (29.3%). Lowest in Penang (20.7%) - NHMS 2
  • 24. Physical Inactivity• NHMS 2 (20 minutes/day, 3x a week) – 11.6% exercised adequately, – 31.7% ever exercised – Nearly 70% of Malaysians do not exercise• NHMS 3 (WHO-stepwise questionnaire, <150 minutes/week of moderate physical activities & 60 minute/week of vigorous physical activities) – 43.7% physically inactive – higher in woman, older age, urban residence, unemployed and housewife.
  • 25. Irrational Diet (NHMS 3)• Underweight (BMI <18.5kg/m2) - 8.5%• Normal (BMI 18.5-24.9kg/m2) - 48.3%• Overweight (BMI 25.0-29.9 kg/m2)-29.1%• Obese (BMI 30kg/m2 & >) - 14.1%• Overweight in 1996 16.6%, now 29.1%• Obese in 1996 4.4%, 2002/2003 12.7% and now 14.1%.
  • 26. Alcohol (NHMS 3)• 16.2% ever drank – age group between 70 – 74 years old (10.4%),• 7.4% current drinkers – Christians (25.6%),• For current drinker the – senior officer / prevalence was higher manager (24.8%), and in; – married (7.9%). – Sarawak state (15.0%), – tertiary level of – in urban area (8.9%), education (13.7%). – among males (11.8%), – earned RM 5000 and – Chinese (23.8%), above per month (16.3%)
  • 27. Major NCD Diseases• Hypertension - 29.9% 1996, 32.2% in 2006• Cancer - 31,700 cases a year• Diabetes Mellitus - 8.3% 1996, 11.6% in 2006.• Injury
  • 28. HYPERTENSIONIncrease of cases due to;•aging•Smoking habit•?life stressors•? Excessive dietary salt intake
  • 29. HYPERTENSION• According to NHMS ’2006; – Prevalence of 32.2% • Self-reported 11.5% • Previously undiagnosed 20.7%• Higher in rural (36.9% vs 29.3%), Malays (33.9% vs 32.4% vs 29.4%) >30 yrs, obese/overweight• Amongst the hypertensive, 35.8% were previously diagnosed. Among those who were previously diagnosed, 87.7% were on treatment. Of those on treatment, only 26.3% of their BP were under control.
  • 30. CANCEROne of 5 main cause of death since 20years ago.Incidence -150 per 100,000 pop. (31,700cases a year), the cases and deaths due tocancer are on the rise.Related to lifestyle and the environment.
  • 31. Burden of Cancer• Incidence -150 per 100,000 pop. (30,000 case a year)• Prevalence – 90,000• Incidence expected to rise with an increase of aging population. – >60 yrs • 1957 4.6% • 1990 5.7% • 2020 9.8%GCC Lim, 2002. Overview of Cancer in Malaysia. Jpn J Clin Oncology
  • 32. Incidence by Gender• No nationwide population-based cancer registry. Data based on extrapolation.• Survey between 1988-1990; – Males 56.3 per 100,000 – Females 56.9 per 100,000• Penang registry 1994; – Males 115.9 per 100,000 – Females 119.7 per 100,000GCC Lim, 2002. Overview of Cancer in Malaysia. Jpn J Clin Oncology
  • 33. Racial Differences• Noted in NPC & oral cavity cancer• NPC amongst males by race; – Malay 0.79 per 100,000 – Chinese 15.9 per 100,000 – Indian 1.1 per 100,000• NPC amongst females by race; – Malay 0.8 per 100,000 – Chinese 4.1 per 100,000 – Indian 0 per 100,000
  • 34. Incidence by Type
  • 35. Diabetes Mellitus – (NHMS3)• Overall prevalence was 11.6%. Known diabetes was 7.0%. Newly diagnosed diabetes was 4.5%.• Higher in the urban at 12.1% compared to the rural areas at 10.5%.• Between ethnicity, Indians have the highest prevalence of 19.9% , followed by Malays 11.9% and Chinese 11.4%.
  • 36. INJURYMain cause of death and hospitaladmission - MVA & fall.Upward trend.
  • 37. Diseases Due To Migration
  • 38. Conclusion• Malaysia is a country undergoing a health transition• Improving socioeconomic status and aging population leads to chronic & degenerative diseases. Problems such as;  Occupational diseases  Chemical poisoning from industry and agriculture  Diseases due to air pollution  Work injury and MVA  Disease related to urbanisation• Trend of disease approaching those of developed countries and yet unable to shake off the diseases of developing countries. A double burden…………
  • 39. TERIMA KASIH