Food-drug interphase products, referring to nutraceuticals in this study, are a category of health products containing a combination of food ingredients with active substances for oral consumption. Many of these products are marketed as an alternative to prescription medicine to treat various ailments despite the lack of scientific evidence, influencing patients with chronic diseases to consume nutraceutical products. This study aimed to determine the prevalence and factors associated with knowledge, attitude, and practice of nutraceutical use among patients with chronic disease attending to the outpatient clinic. This is a cross-sectional study involving patients with chronic disease at the outpatient specialist clinic. Samples were recruited from the outpatient clinic using convenience sampling. Data was collected using a self-administered questionnaire, which was self-constructed and validated. We found that the use of nutraceuticals was prevalent among 17.9% of respondents. More than half (60.9%) of the respondents have poor knowledge of nutraceutical and 53.1% of respondents have a positive attitude towards nutraceutical. Gender and morbidities were the factors associated with the practice of nutraceutical usage. Female patients are more likely to have increased use of nutraceutical than male patients and patients with multiple morbidities have higher odds of using nutraceutical than patients with single morbidities. There is a high number of patients who consume nutraceutical products and public knowledge of nutraceutical needs to be improved further. The government should develop appropriate regulation and monitoring of nutraceutical products.
Background and Aim: Leptospirosis is a zoonotic disease responsible for high morbidity worldwide. This review is intended to identify other possible animal reservoirs of Leptospira spp. within human surroundings, which may improve the prevention and control of the disease.Methods: A systematic search was performed for the relevant titles, abstracts and keywords in PubMed, Scopus and Google Scholar in March 2018 based on the PICO strategy; which returned 1226 studies. Screening of abstracts had shortlisted 71 studies and data extraction was conducted for 15 studies which had been accepted after review of the full text. Only studies done in South-East Asia were considered. Meta-analysis of the accepted studies was done to compute the composite prevalence of each animal group using random effects model. Results:The articles were analysed from the viewpoint of the study settings and the prevalence of Leptospira spp. in types of animal with the animals being grouped into five major groups, based on taxonomy and likelihood of human contact. It was found that all animal groups have statistically significant value of pooled prevalence, with a range between 8.17% (95% CI: 4.80% -12.39%) for sheep and goats, to as high as 27.28% (95% CI: 1.24% -69.69%) for carnivores. The prevalence for other animal groups are 17.95% (95% CI: 7.77% -31.18%) for rodents, 19.24% (95% CI: 10.65% -29.65%) for pigs, and 24.90% (95% CI: 15.45% -35.71%) for ruminants. Conclusion:Meta-analysis showed that other groups of animals, particularly carnivores, pigs, and large ruminants are just as culpable as rodents in being the reservoir for Leptospira spp. These other groups of animals may also play a vital role in the transmission and overall dynamics of human leptospirosis.
Background: Scrub typhus is an infectious disease with potentially fatal consequences. It is caused by Orientia tsutsugamushi and transmitted to humans via the bites of infected larval mites (chiggers). Scrub typhus is one of the most neglected and severe diseases despite its easy treatment. Delay in diagnosis and treatment is not uncommon, resulting in a 10% fatality rate in cases of inappropriate treatment. The main aim of this study was to determine the prevalence of scrub typhus in Southeast Asia and the risk factors contributing to the disease in order to aid the development of effective control and prevention strategies. Methods: In this meta-analysis, the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were used as a guideline. The systematic literature search was performed for the relevant titles, abstracts, and keywords in the journal databases of PubMed, EBSCOhost, Ovid, and Google Scholar in November 2018. The keywords and terms were derived from population, intervention, comparison, outcome analysis, and a total of 720 studies were retrieved accordingly. Only original research, published articles, and articles written in the English language were selected for this purpose. Screening of abstracts had shortlisted 36 studies and data extraction was conducted accordingly. However, only 9 studies were accepted after a review of the full texts. The other 27 articles were excluded due to ecological studies and different outcome measures. Results: Several factors in this meta-analysis were identified to have significant risk of having scrub typhus (P<0.05), including people who are involved in the agriculture sector (OR: 2.90, 95% CI: 2.33, 3.77), those having direct contact or being exposed to the vector habitat (OR: 2.17, 95% CI: 1.49, 3.16), and house yard conditions (OR: 3.02, 95% CI: 2.1, 4.33). Other factors were indoor house conditions (OR: 1.96, 95% CI: 1.45, 2.67), those having close contact with rodents or domestic animals (OR: 2.51, 95% CI: 1.67, 3.77), those working in paddy fields or vegetable farms (OR: 5.17, 95% CI: 3.15, 8.47), and bad occupational safety practices (OR: 1.71, 95% CI: 1.12, 2.62). Conclusions: The identified risk factors from this meta-analysis highlight the importance of public health intervention strategies for the prevention of scrub typhus among high-risk populations.
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