scholarly journals The Relative Risk Estimation of Pneumonia in Malaysia using Standardized Morbidity Ratio (SMR)

2021 ◽  
Vol 16 ◽  
pp. 1-5
Author(s):  
IJLAL MOHD DIAH

Pneumonia is the most serious inflammatory disease of the respiratory system which cause millions of deaths worldwide especially for children under age five and older adults. The numbers of pneumonia cases reported keep on increasing from year to year in Malaysia. Moreover, this type of disease can become outbreak if it is not controlled. Besides using as prevention strategies for a disease risk, statistical modelling of disease mapping can also be used in monitoring as it clearly shows risk areas. The objective of this paper is to estimate the value of relative risk for pneumonia transmission by using Standardized Morbidity Ratio (SMR) method which is the conventional statistic method used in disease mapping and subsequently propose a disease risk map to show the pneumonia risk areas. Pneumonia data in Malaysia is used in estimating the relative risk. The results show that, Terengganu has the highest risk of contracting pneumonia while Pulau Pinang shows the lowest risk.

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaoxiao Song ◽  
Yan Li ◽  
Le Cai ◽  
Wei Liu ◽  
Wenlong Cui

ObjectiveThe purpose is to propose a serial of approach for estimation for disease risk for ILI in "small area" and present the risk values by spatio-temporal disease mapping or an interactive visualization with HTML format.IntroductionDisease mapping is a method used to descript the geographical variation in risk (heterogeneity of risk) and to provide the potential reason (factors or confounders) to explain the distribution. Possibly the most famous uses of disease mapping in epidemiology were the studies by John Snow of the cholera epidemics in London. Accurate estimation relative risk of small areas such as mortality and morbidity, by different age, ethnic group, interval and regions, is important for government agencies to identify hazards and mitigate disease burden. Recently, as the innovative algorithms and the available software, more and more disease risk index has been pouring out. This abstract will provide several estimation risk index, from raw incidence to model-based relative risks, and use visual approach to display them.MethodsAll the data are from a syndromic surveillance and real-time early warning system in the Yunnan province in the China. For brief introduction aim, we are using the ILI (Influenza-like illness) data in December 2017 in one county. The relative risks of disease in small area are including: raw incidence, a standardized morbidity ratio (SMR), Empirical Bayes smoothing estimation relative risk (EB-RR) and the Besag-York-Mollio model (BYM). The incidence in each small area is common used for descriptive the risk but fail to comparable directly since the different population at risk in each area. SMR is a good way to deal with this incomparability. But SMR can give rise to imprecisely estimate in areas with small populations. Empirical Bayes estimation approach has been used for smoothing purpose and can be seen as a compromise between relative risks and P-values. However, all above approaches are inept to have spatial or spatio-temporal structure in mind. BYM based the Bayesian inference can handle both the area-specific spatial structured component (such as intrinsic conditional autoregressive component) and the exchangeable random effect (unstructured component). All the analyses are implemented in the R software with INLA package (http://www.r-inla.org). The outcome of relative risk estimation with visual way and interactive maps showing are using ggplot2 and leaflet packages.Results1, the spatio-temporal raw cases of ILI from 2017/12/01 to 2017/12/31 is Fig.12. the SMR and EB-RR estimation RR of ILI are in Fig.2 and Fig.33. the most excited is the interactive visualization with HTML format for all the risk indexes is visited http://rpubs.com/ynsxx/424814 in detail. And the screenshot is Fig.4ConclusionsSmall area disease risk estimation is important for disease prevention and control. The faster function of computer with power R software can lead to advance in disease mapping, allowing for complex spatio-temporal models and communicate the results with visualization way. 


2021 ◽  
Vol 29 (2) ◽  
Author(s):  
Sufi Hafawati Ideris ◽  
Muhammad Rozi Malim ◽  
Norshahida Shaadan

The disease leptospirosis is known to be endemic in Malaysia, and it significantly impacts human wellbeing and the national economy. Current surveillance systems are based on morbidity and mortality leptospirosis national data from the Ministry of Health and remain inadequate due to the number of unreported and misdiagnosed cases. A robust surveillance system is needed to monitor temporal and spatial changes which yield improvements in terms of identifying high-risk areas and disease behaviour. The objective of this study is to identify high-risk areas by estimating relative risk using existing models which are the Standardized Morbidity Ratio (SMR), Poisson-gamma, log-normal, Besag, York and Mollié (BYM) and mixture models. An alternative model is also proposed which involves transmission systems and stochastic elements, namely the stochastic Susceptible-Infected-Removed (SIR) transmission model. This estimation of risk is expected to assist in the early detection of high-risk areas which can be applied as a strategy for preventive and control measures. The methodology in this paper applies relative risk estimates to determine the infection risk for all states in Malaysia based on monthly data from 2011 to 2018 using WinBUGS 1.4 software. The results of relative risks are discussed and presented in tables and graphs for each model to disclose high-risk areas across the country. Based on the risk estimates, different models used have different risk interpretations and drawbacks which make each model different in its use depending on the objectives of the study. As a result, the deviance information criteria (DIC) values obtained do not differ greatly from each expected risk which was estimated


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 417-418
Author(s):  
Hyo Jung Lee ◽  
Giyeon Kim

Abstract Although there has been growing evidence that Advance care planning (ACP) benefits people with cognitive impairment nearing death, our understanding about this issue is still limited. This study examines whether cognitive impairment is associated with ACP engagement and end-of-life care preferences among older adults in the U.S. Using data from the 2012 National Health and Trends Study (n=1798, aged 65 to 101), we identified four levels of ACP engagement: None (28%), Informal ACP conversation only (12%), Formal ACP only (14%), and Both informal and formal ACP (46%). Older adults with None showed the highest prevalence of having cognitive impairment (17%), followed by those with Formal ACP only (15%) and the other two (6%, 6%). The results of Multinomial Logistic Regression showed that, compared to those without, respondents with cognitive impairment had 143% increased relative risk of having None (RR = 2.43, CI: 1.58-3.73) and 81% increased relative risk of completing Formal ACP only (RR = 1.81, CI: 1.11-2.95) relative to completing Both informal and formal ACP. In addition, respondents with None were more likely to prefer to receive all treatments available nearing death than those with any ACP engagement. Achieving high quality care at the end of life can be more challenging for older adults with cognitive impairment and their family caregivers due to the limited capacity. Although encouraged, informal ACP conversation with loved ones does not necessarily occur before the formal ACP, especially, for those with cognitive impairment. Therefore, they may merit more attention such as early ACP engagement.


2021 ◽  
pp. 016402752110172
Author(s):  
Desirée C. Bygrave ◽  
Constance S. Gerassimakis ◽  
Denée T. Mwendwa ◽  
Guray Erus ◽  
Christos Davatzikos ◽  
...  

Evidence suggests social support may buffer brain pathology. However, neither its association with hippocampal volume, a marker of Alzheimer’s disease risk, nor the role of race in this association has been fully investigated. Multiple regression analyses examined relations of total social support to magnetic resonance imaging-assessed gray matter (GM) hippocampal volumes in the total sample ( n = 165; mean age = 68.48 year), and in race-stratified models of African American and White older adults, adjusting for select covariates. Results showed greater social support was associated with greater GM hippocampal volumes among African American older adults only ( p < .01). Our findings suggest greater total social support may play a role in supporting the hippocampus, particularly among African American older adults, who had lower hippocampal volumes than their White counterparts. Further research is needed to test these questions longitudinally and examine which aspects of social support may promote hippocampal integrity, specifically.


2021 ◽  
pp. 089826432110147
Author(s):  
Tessa Clemens ◽  
Amy E. Peden ◽  
Richard C. Franklin

Objectives: To explore trends in unintentional fatal drowning among older adults (65 years and older). Methods: Total population retrospective analysis of unintentional fatal drowning among people aged 65 years and older in Australia, Canada and New Zealand (2005–2014) was conducted. Results: 1459 older adults died. Rates ranged from 1.69 (Canada) to 2.20 (New Zealand) per 100,000. Trends in crude drowning rates were variable from year to year. A downward trend was observed in New Zealand (y = −.507ln(x) + 2.9918), with upward trends in Australia (y = .1056ln(x) + 1.5948) and Canada (y = .1489ln(x) + 1.4571). Population projections suggest high annual drowning deaths by 2050 in Australia (range: 120–190; 1.69–2.76/100,000) and Canada (range: 209–430; 1.78–3.66/100,000). Significant locations and activities associated with older adult drowning differed by country and age band. Conclusions: Drowning among older adults is a hidden epidemic claiming increasing lives as the population ages. Targeted drowning prevention strategies are urgently needed in Australia, Canada, New Zealand and other similar countries.


2017 ◽  
Vol 30 (8) ◽  
pp. 799-806 ◽  
Author(s):  
François Gaillard ◽  
Stéphanie Baron ◽  
Marc-Olivier Timsit ◽  
Dominique Eladari ◽  
Catherine Fournier ◽  
...  

2021 ◽  
Author(s):  
Wang Haoran ◽  
Xiao Jianhua ◽  
Ouyang Maolin ◽  
Gao Hongyan ◽  
Bie Jia ◽  
...  

Abstract Background Foot-and-mouth disease (FMD) is a highly contagious viral disease of cloven-hoofed animals. As a transboundary animal disease, the prevention and control of FMD are important. This study was based on spatial multi-criteria decision analysis (MCDA) to assess FMD risk areas in mainland China. Ten risk factors were identified for constructing risk maps by scoring, and the analytic hierarchy process (AHP) was used to calculate the criteria weights of all factors. Different risk factors had different units and attributes, and fuzzy membership was used to standardize the risk factors. The weighted linear combination (WLC) and one-at-a-time (OAT) were used to obtain risk and uncertainty maps as well as to perform sensitivity analysis. Results Four major risk areas were identified in mainland China, including western (Xinjiang and Tibet), southern (Yunnan, Guizhou, Guangxi and Guangdong), northern (Gansu, Ningxia and Inner Mongolia), and eastern (Hebei, Henan, Anhui, Jiangsu and Shandong). We found spring as the main season for FMD outbreaks. Risk areas were associated with the distance to previous outbreak points, grazing areas and cattle density. Receiver operating characteristic (ROC) analysis indicated that the risk map had good predictive power (AUC = 0.8532). Conclusions These results can be used to delineate FMD risk areas in mainland China, and provinces can adopt the targeted preventive measures and control strategies.


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