Background Japanese encephalitis (JE) is one of the major mosquito-borne infectious diseases in the Western Pacific region, accounting for 20-30% of mortality cases. The JE virus (JEV) seroprevalence fluctuations indicate that continuous research is important for prevention and control activities. By mapping JEV seroprevalence by age stratification, the population profile for immunity and susceptibility can be identified to aid in vaccination programme planning. Thus, the aim of this study is to determine the trend of age-specific JEV seroprevalence. Method Systematic search was conducted on all studies conducted on JEV seroprevalence between the years 2010 until 2019. The two search engines used were PubMed and Web of Science. Eligible criteria were set and articles were screened according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Three investigators cross-checked all articles assigned. Data were extracted into Excel sheet and results were tabulated in tables and graphs accordingly. Result Four studies from four countries (Taiwan, Sri Lanka, South Korea, India) met the eligibility criteria. The papers show an increasing trend of JEV seropositivity in all countries as their populations reach older age cohorts. Nonetheless, there were slight downtrend notches seen among young adults in Taiwan and India before increasing again after reaching more mature ages. South Korea has the highest seroprevalence rate (97.8% to 98.3%) among the compared countries; this is most likely because it was the earliest to introduce the JEV vaccine in 1967 which was later made mandatory in early 1980s, while India has the lowest seroprevalence rate (12.9% to 18.1%). Among the old-vaccination-naïve population, seropositivity is commonly derived from natural infection. Conclusion Decreases in reported JE cases are mainly due to immunisation. As JEV is expected to remain in nature and the zoonotic chains, the risk of infection will persist. Hence, it is important to apply JEV vaccination protocols in national immunisation programmes with priority given to those at the young childhood stages.
Setting a suitable age limit of e-cigarette user should be established. This requirement considers the need for youth protection against e-cigarette misuse as such childproofing and age limits. Appropriate advertising without aiming for children to curb underage users. Advertisements could be done within sellers’ or distributors’ compound to keep vigilant control of appropriate or come of age users. Another reason for promoting e-cigarette use are to encourage smoking cessation and give information and incentives to smokers who are unable to stop to transition to less dangerous nicotine delivery methods. Addictive behaviors toward nicotine and complications from smoking e-cigarette should be warned and exposed to the public and users especially on newcomers as health warnings. Safety threshold of constituents should be complied and limit the strength of nicotine in the fluid could be done to reduce harm on users. An e-cigarette aerosol contains a variety of chemicals such as glycols, volatile organic compounds, and metals. The chemicals used have to be monitored for its safety threshold, where potential harm can be demoted. Harm causing effects of public vaping are considered for public vaping ban enforcement. While, many are opposed to the idea of vaping as medicinal treatment.
Tobacco and nicotine derivatives uses are multiple in nature. These include conventional cigarettes (CCs), heated tobacco products (HTPs), and electronic cigarettes (ECs). This study aims to determine the practices, nicotine dependency profile, association with exhaled carbon monoxide (eCO) level, and pulmonary function (PF) among adult product users and non-smokers. This cross-sectional study involved smokers, nicotine users, and non-smokers from two public health facilities in Kuala Lumpur from December 2021 to April 2022. Data on socio-demography, smoking profile, nicotine dependency level, anthropometry, eCO monitor, and spirometer measurements were recorded. Out of 657 respondents, 52.1% were non-smokers, 48.3% were CC only smokers, poly-users (PUs) (27.3%), EC-only users (20.9%), and HTP-only users (3.5%). EC use was prevalent among the younger aged, tertiary educated, and females; HTP use was prevalent among those of an older age and CC users was common among lower educated males. The highest median eCO (in ppm) seen were as follows: in CC users only (13.00), PUs (7.00), EC users (2.00), HTP users (2.00), and the least was observed among non-smokers (1.00). Comparison of practice between the CC-only users and PUs showed a significant difference in sticks per day (p = 0.006, CC users had the highest), duration of smoking (p = 0.005, CC users had the longest), and attempts to quit smoking (p < 0.001, PUs had the highest attempt to quit). Among EC users, 68.2% successfully switched from smoking CCs to ECs. The findings suggest that EC and HTP users are exhaling less CO. The use of these products in a targeted approach may manage nicotine addiction. Switching practice was higher among current EC users (from using CCs), hence emphasizing the need of switching encouragement and total nicotine abstinence later on. Lower eCO levels in the PU group, (as compared to CC-only users) may indicate attempt of PUs in reducing CC use through alternative modalities such as ECs and HTPs.
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