Prevalence of adolescent-reported food insecurity and the determinants including coping strategies living in urban slum communities of Bangladesh during the era of COVID-19: a cross-sectional study.

BACKGROUND: As food insecurity (FI) continues to rise worldwide especially in developing countries like Bangladesh, adolescent experience of FI have received minimal attention globally. This study aimed to identify the prevalence of adolescent-reported FI and its association with individual and socio-environmental factors as well as coping strategies amongst a sample of adolescents living in urban slum areas of Bangladesh in the times of the Coronavirus 19 (COVID-19) pandemic. METHODS: A descriptive cross sectional study was conducted amongst 326 adolescents (12-18 years) living in the urban slums of Narayanganj, Dhaka from April to May, 2022. Adolescent-reported FI was assessed using a structured questionnaire adopted from Household Food Insecurity Access Scale (HFIAS). Descriptive statistics, Chi-square tests and ordinal logistic regression were used to draw inference. RESULTS: Prevalence of adolescent-reported FI was high (46.6% moderate and 29.8% severe). The likelihood of experiencing moderate or severe FI versus no/mild FI were 1.7 times (95% Confidence Interval (CI) [1.1, 2.5]) higher in younger adolescents and 5 times (95% CI [2.3, 12.7]) higher in unemployed youth. Socio-environmental factors determining the economic status of a household such as higher number of family members, only one earning family member, unemployed father, no household assets, food aid received by the family during pandemic and positive COVID-19 infection in family were associated with moderate and severe FI. Coping strategies such as a higher number of food seeking strategies (Adjusted Odds Ratio (AOR) 3.4, 95% CI [1.9, 5.9]), substance use (AOR 6.2, 95% CI [1.2, 31.7]) and stopping school (AOR 3.3, 95% CI [1.9, 5.7]) increased odds for moderate and severe FI. Stratified by drop-out of school status, an association between food seeking strategies and FI remained significant among those school-going, while there was no association among those dropping out of school. CONCLUSION: This study showed that adolescents living in urban slum communities in Bangladesh are at very high risk of FI and resort to harmful coping strategies. Our study highlights the importance of further research in adolescent reported FI and coping strategies in low to middle income countries (LMICs) and create appropriate interventions to lower FI among this group and improve their state of health and wellbeing.

Social support for postpartum women and associated factors including online support to reduce stress and depression amidst COVID-19: Results of an online survey in Thailand.

BACKGROUND: Social support for postpartum women helps mothers to recover from childbirth and fosters healthy infant development. However, the impacts of reduced interpersonal interactions inflicted by the COVID-19 outbreak on available social support for postpartum women have received little attention. Therefore, this study aimed to examine the levels of social support provided to postpartum women and associated factors in Thailand during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted from July to October 2021 using an anonymous online questionnaire. The responses of 840 eligible women up to six months postpartum in Thailand were obtained. The maternity social support scale was used to measure social support. Multivariate logistic regression was used to analyse the factors associated with social support among postpartum women. RESULTS: About 57% of women reported to receive high support. Women in the high social support group were more likely to be married (aOR:2.70; 95% CI:1.57-4.66), have a university education or above (1.88; 1.35-2.64), have an intended pregnancy (2.06; 1.34-3.16), good health (2.01; 1.44-2.81), good sleep quality (1.62; 1.14-2.31), receive counsel from peers or family (1.56; 1.13-2.16), and use internet or social media to reduce stress and depression (1.51; 1.08-2.11). Meanwhile, women in the high social support group were significantly less likely to feed complementary foods to infants within 24 hours of completing the survey (0.28; 0.15-0.52). CONCLUSIONS: The results of this study indicated that more than half of the women reported high support and illustrated the important role played by family, peers, and professionals as well as online and remote channels in providing postpartum informational and emotional support during the pandemic. Online platforms and remote support may be considered to provide social support to postpartum women during a pandemic such as COVID-19.

Maternal Depression during Pregnancy and Postpartum Period among the Association of Southeast Asian Nations (ASEAN) Countries: A Scoping Review.

Identification of mothers with depression is important because untreated perinatal depression can have both short- and long-term consequences for the mother, the child, and the family. This review attempts to identify the prevalence of antenatal and postnatal depression (AD and PD, respectively) of mothers among the ASEAN member countries. A literature review was conducted using PubMed, Scopus, and the Asian Citation Index. The reviews covered publications in peer-reviewed journals written in the English language between January 2010 and December 2020. Of the 280 articles identified, a total of 37 peer-reviewed articles conducted in 8 out of 11 ASEAN member countries were included. The Edinburgh Postnatal Depression Scale (EPDS) was the most common instrument used to identify depression. This study showed the number of studies reporting the prevalence of AD was 18 in five countries. For PD, 24 studies in eight countries were included. The prevalence of AD ranged from 4.9% to 46.8%, and that of PD ranged from 4.4% to 57.7%. This first review among ASEAN countries showed very few studies conducted in lower-middle-income and substantial heterogeneity in prevalence among studies reviewed. Further research should be conducted to estimate the prevalence using a large representative sample with a validated assessment tool among the ASEAN countries.

Factors associated with postpartum depression symptoms among postpartum women in five countries during the COVID-19 pandemic: an online cross-sectional study.

BACKGROUND: This study aimed to examine factors associated with postpartum depression (PPD) symptoms during the COVID-19 pandemic among postpartum women in five countries, a subject that has not been investigated thus far. METHODS: A multi-country, cross-sectional, online survey was conducted with a convenience sample of 3,523 postpartum women in Brazil, South Korea, Taiwan, Thailand, and the United Kingdom, from July to November 2021. Sociodemographic and obstetric data, food insecurity, COVID-19 positive status, COVID-19 vaccination, infant feeding, breastfeeding belief score, and social support were investigated. PPD and social support were measured using the Edinburgh Postnatal Depression Scale and Maternal Social Support Scale, respectively. Descriptive statistics, chi-squared tests, and t-tests were used to identify associations with PPD symptoms. A binary logistic regression model was used to identify explanatory factors associated with PPD and adjusted odds ratios (OR) and 95% confidence intervals (CIs) were calculated. RESULTS: Women in Taiwan (AOR = 0.5; 95%CI 0.34, 0.73) and Thailand (AOR = 0.68; 95%CI 0.46, 0.99) had a lower risk of PPD symptoms than those in Brazil. In addition, women with planned pregnancies had a lower risk of PPD (AOR = 0.74; 95%CI 0.60, 0.91). Younger women (AOR = 1.62; 95%CI 1.05, 2.51), health problems during pregnancy, delivery, or postpartum (AOR = 1.71; 95%CI 1.42, 2.06), and no change or worse food insecurity during COVID-19 (AOR = 1.66; 95%CI 1.21, 1.27 for no change and AOR = 1.68; 95%CI 1.27, 1.23, respectively) presented a higher likelihood of having PPD. Feeding babies with expressed human milk (AOR = 1.25; 95%CI 1.03, 1.50) and/or complementary food (AOR = 1.51; 95%CI 1.17, 1.94) were associated with PPD symptoms. Women who received low (AOR = 7.74; 95%CI 5.43, 11.03) or medium support (AOR = 3.25; 95%CI 2.71, 3.88) had higher likelihoods of PPD. CONCLUSION: PPD symptoms during the pandemic were high in young women, particularly Brazilian women, with health problems in the puerperal pregnancy cycle who fed their babies expressed breast milk and/or complementary food. Low social support also impacted PPD symptoms. This study highlights the need for the professional screening for PPD and provision of virtual or personal support.

Prevalence and factors associated with treatment and control of hypertension among adults with hypertension in Myanmar.

BACKGROUND: Due to a dearth in the number of studies conducted in low- and middle-income countries, this study aimed to identify the prevalence and determinants of the treatment and control of hypertension among patients with hypertension in Myanmar. METHODS: This community-based cross-sectional study was conducted among 410 adults who were registered for hypertensive treatment in health centers in Myitkyina Township, Kachin State, Myanmar. Multiple logistic regression was used to identify the associated factors. RESULTS: The prevalence of treatment and control of hypertension was 48.1% and 20.5%, respectively. The factors associated with treatment were age (OR=2.60 for 46-60 y and OR=2.29 for 61-70 y compared with 30-45 y), ethnicity (OR=1.87), monthly family income (OR=1.90), comorbidity (OR=2.33), knowledge (OR=2.63) and adherence to physical activity (OR=1.86). Controlled hypertension was associated with age (OR=3.03 for 46-60 y and OR=2.27 for 61-70 y compared with 30-45 y), education (OR=1.81), comorbidity (OR=1.67) and adherence to medication (OR=3.45). CONCLUSIONS: The prevalence of treated and controlled hypertension was relatively low in this study. To improve the prevalence of hypertension treatment and control in this study population, effective and culturally sensitive intervention programs under universal health coverage should be established with an emphasis on individuals with lower educational attainment and younger ages.

Impact of COVID-19 on breastfeeding intention and behaviour among postpartum women in five countries.

BACKGROUND: Studies regarding the impact of COVID-19 on breastfeeding have mostly used single- country samples or a qualitative design. AIM: The objective of this study was to examine breastfeeding intention during pregnancy and breastfeeding behaviour among postpartum women in five countries during the COVID-19 pandemic and the associated factors. METHODS: An online questionnaire survey was conducted in Thailand, the United Kingdom, South Korea, Taiwan, and Brazil from July through November 2021. The study participants included 3253 mothers within six months of birth. FINDINGS: About 90% of participants intended to breastfeed during pregnancy and 85.7% reported breastfeeding in the past 24 h. More than half reported their breastfeeding duration being as planned or longer despite COVID-19. Multivariate logistic regression models showed that being multiparous, ever tested COVID-19 positive, and having positive breastfeeding beliefs were associated with increased odds for intention to breastfeed during pregnancy. Lower maternal educational level, being primiparous, ever tested COVID-19 positive, and experiencing food insecurity were associated with decreased odds for breastfeeding duration being as planned or longer. Vaginal birth, currently working or on maternity leave, breastfeeding beliefs, breastfeeding support from spouse/partner/friend/relative, online support groups, and in-person or telephone contact with healthcare professionals were associated with increased odds for breastfeeding duration being as planned or longer. CONCLUSION: Breastfeeding intention and behaviour remained high during the COVID-19 pandemic. Online support groups and telephone contact with health professionals were effective during the pandemic.

Utilization of Postnatal Care Services among Thai Women during the COVID-19 Pandemic: Results of a Web-Based Survey.

The postnatal period is an underserved aspect of maternity care, potentially worsened by the COVID-19 pandemic. This study aims to identify postnatal care (PNC) use by health personnel within the 42 days of childbirth among postpartum mothers in Thailand. This web-based, cross-sectional study was conducted from July to October 2021 (n = 840). Multiple binary and ordinal logistic regressions were conducted to predict three outcome variables (≥2 times, ≥3 times, or level of PNC use). Women who received PNC were in low numbers (≥2: 30.7% and (≥3: 12.9%), while 54.4% of women reported no barriers to access PNC, and 31.9% reported barriers, including worries over COVID-19 infection, followed by movement restrictions imposed by the government (11.7%) and the closure of healthcare centers (10%). Women working in a self-employed capacity, living in urban areas, and undergoing a Caesarean section with no/less worry about COVID-19 infection were more likely to utilize postnatal care (≥2 or number of PNC). This study provides timely information, revealing that a relatively low percentage of postpartum women received PNC, particularly among the socially deprived group. Since the fear of COVID infection is listed as a major barrier, the provision of PNC services, including a telehealth program should be considered.

Prevalence and Factors Associated with Postpartum Depression in Primary Healthcare Centres in Yangon, Myanmar.

BACKGROUND: Postpartum depression (PPD) can have serious consequences on both the mother and infant. Despite the higher prevalence, there are limited numbers of studies on PPD in low-and middle-income countries, like Myanmar. This study aimed to explore the prevalence and associated factors of PPD in primary healthcare settings in Myanmar. METHODS: This cross-sectional online study was conducted with 220 mothers under 6 months postpartum in April-May 2020 and who registered in public health centres in Kungyangone Township, Yangon, Myanmar. The postpartum depression was measured with the Edinburgh postpartum depression scale (EPDS, ≥ 13 scores). Independent variables included sociodemographic factors, obstetric and infant factors, psychosocial factors (social support and social media usage), health services utilisation and accessibility factors. Chi-square tests and multiple logistic regression were performed. RESULTS: Overall prevalence of depressive symptoms in 220 women under 6 months postpartum was 31.8% (95% confidence interval [CI]: 25.9, 37.3). In multiple logistic regression, unplanned pregnancy (adjusted odds ratio [AOR]: 2.946), less than four times antenatal care (ANC) visits (AOR: 2.518), travel time more than 1 h to reach health centres (AOR: 3.068) and birth interval more than 5 years (AOR: 4.594) were more likely to be associated with PPD, while preterm delivery (AOR: 0.091) was inversely associated. CONCLUSION: This study showed the relatively high prevalence of PPD and the strong association with preterm delivery, pregnancy intention, breastfeeding status, birth interval as well as frequency of ANC received and travel time to health centre. It may suggest that maternal mental health services should be integrated with existing maternal and child health (MCH) services for early detection and prevention of depression symptoms with promotion of MCH services utilisation and improved accessibility among mothers in primary healthcare setting.

Factors Influencing the Willingness of Palliative Care Utilization among the Older Population with Active Cancers: A Case Study in Mandalay, Myanmar.

Palliative care is an effective, multidisciplinary healthcare service to alleviate severe illness patients from physical, psychological, and spiritual pain. However, global palliative care has been underutilized, especially in developing countries. This cross-sectional survey aimed to examine the factors associated with older cancer patients' willingness to utilize palliative care services in Myanmar. The final sample was composed of 141 older adults, 50-years of age and above who suffered from cancers at any stage. Simple random sampling was applied to choose the participants by purposively selecting three oncology clinics with daycare chemotherapy centers in Mandalay. We collected data using structured questionnaires composed of five sections. The sections include the participant's socio-economic information, disease status, knowledge of palliative care, psychosocial and spiritual need, practical need, and willingness to utilize palliative care services. The study found that approximately 85% of older cancer patients are willing to receive palliative care services. The significant predictors of willingness to utilize palliative care services include place of living, better palliative care knowledge, more need for spiritual and psychosocial support, and practical support. This study can guide health policymakers in increasing the rate of palliative care utilization. The suggested policies include developing community-level palliative care services in Myanmar, especially in rural areas, promoting palliative care knowledge, applying appropriate religious and spiritual traditions at palliative treatment, and developing suitable medicines for the critically ill.

Double burden of malnutrition and its association with infant and young child feeding practices among children under-five in Thailand.

OBJECTIVE: This study examined the prevalence of stunting-overweight and socio-demographic determinants among children under-five years of age, as well as associations with infant and young child feeding (IYCF) among children aged 6-23 months. DESIGN: Secondary data analysis based on the Thailand Multiple Indicator Cluster Survey 2015-2016. SETTING: Cross-national study. PARTICIPANTS: Nationally representative sample of children under-five years of age (n 12 313). RESULTS: The prevalence of wasting, stunting, overweight and stunting-overweight was 5·3, 10·5, 10·1 and 1·6 %, respectively. In multivariate analyses, children under 6 months, children from low and middle wealth tertiles, and children living in rural areas were prone to being wasted. Male children, low wealth tertile and a non-Thai speaking household head were positively and children aged 48-59 months and a one-child household were inversely associated with stunting. Children from a low wealth tertile were less likely to be overweight, while older age, male children and children from a one-child household were more likely to be overweight. Stunting-overweight was associated with children aged 24-47 months, male children, mothers having secondary education, a one-child household, a non-Thai speaking household head and an urban area. In terms of IYCF indicators, despite no association with stunting and stunted-overweight children, current breast-feeding and inadequate meal frequency were associated with being wasting, while current breast-feeding and dietary diversity were inversely associated with being overweight. CONCLUSIONS: This study revealed the double burden of malnutrition at the individual and population levels among Thai children under-five, which calls for concrete integrated interventions to tackle all forms of malnutrition.

Prevalence and regional variations of coexistence of child stunting and maternal overweight or obesity in Myanmar.

OBJECTIVE: The current study aimed to investigate double burden of malnutrition within households at the national and subnational levels and to identify its association with sociodemographic factors in Myanmar. DESIGN: All the variables were extracted from children's file of the Myanmar Demographic and Health Survey 2015-2016. Children under five were identified as stunted based on a height-for-age < -2 sd below the WHO reference median. Maternal overweight/obesity was defined as a BMI ≥ 23 kg/m2. A stunted child with an overweight/obese mother (SCOM) was classified as a double-burden household. SETTING: A national household survey in Myanmar. PARTICIPANTS: Children under five and their mothers (n 3954 pairs). RESULTS: Mean ages of children and mothers were 29 (se 0·14) months and 30·9 (se 0·32) years, respectively. National prevalence of childhood stunting and maternal overweight/obesity was 28·0 % and 39·4 %, respectively, and the prevalence of SCOM was 9·1 %. Significant regional differences were found in SCOM, ranging from 3·6 % in Naypyitaw to 12 % in Kachin and Mon and 14·6 % in Kayah. In the multinomial logistic regression analysis, relative to neither a stunted child nor an overweight/obese mother, child's age, maternal age, maternal experience of a teen birth, short mothers, mothers with primary education and in middle or rich wealth tertiles, and some regions (Kachin, Kayah, Shan, Sagaing, Taninthayi, Ayeyarwaddy, Mon and Yangon) were associated with greater odds of SCOM. CONCLUSIONS: The current study showed a relatively high national prevalence of SCOM and significant regional variations. Overarching policies and programmes with culturally sensitive strategies need to be formulated and implemented.

Patterns of tobacco and alcohol misuse among presumptive TB Patients in Myanmar: prevalence and sociodemographic associations.

This study aimed to assess the prevalence and patterns of tobacco and alcohol use and the associations with socio-demographic variables among presumptive TB patients. A cross-sectional study was conducted among 397 presumptive TB patients in a tertiary hospital in Myanmar. Global Adult Tobacco Survey (GATS) questionnaire and AUDIT-C were used to measure daily tobacco use (single, any or dual use of smoked and smokeless tobacco) and harmful alcohol use, respectively. Multiple and multinomial logistic regression were used to examine the associations with socio-demographic factors. The prevalence of daily use of dual tobacco and any tobacco was 28.2% and 65.7%, respectively. Harmful alcohol use was also high (44.8%). While single use of daily tobacco and harmful alcohol was 28.2% and 7.3%, respectively, concurrent tobacco and alcohol use was 37.5%. While being male and having low education were associated with tobacco use, concurrent tobacco and harmful alcohol use were associated with male gender, low education, and occupation with the government or a company. Due to the high prevalence of tobacco and alcohol misuse, identifying those at risk of tobacco and alcohol misuse and providing integrated care services in a health facility should be considered as a joint activity in national TB and tobacco control programmes.

Multiple self-care behaviors and associated factors in community-dwelling patients with hypertension in Myanmar.

This study aimed to identify the prevalence of self-care behaviors and the associated factors among hypertensive patients in primary care in Myanmar. This cross-sectional study was conducted from April to May 2019 among 410 hypertensive patients in Myitkyina Township, Kachin State, Myanmar. Hypertensive patients aged 30-70 years old and being registered at the community health centers in Myitkyina Township were selected using multi-stage cluster random sampling. Self-care behaviors were measured by Hypertensive Self-Care Activity Level Effect (H-SCALE). Chi-square test and multiple logistic regression analysis were used to explore the associated factors. Prevalence of adherence to multiple self-care behaviors were low: avoidance of tobacco use at 50.2%, followed by physical activity at 24.9%, medication at 24.1%, weight management at 9.5%, and healthy diet at 2.7%, while abstinence from harmful alcohol drinking was high at 97.8%. Multiple logistic regression analysis indicated that younger patients, low family income, inadequate knowledge, and no comorbidity were associated with non-adherence to medication. Living in rural area and having poor self-efficacy were associated with non-adherence to weight management, while being younger, female and having poor self-efficacy were also associated with non-adherence to physical activity. Compared with Kachin, other ethnics were more likely to be non-adherent to avoidance of tobacco use. Although a majority of respondents were not harmful drinkers, adherence to medication, healthy diet, physical activity, weight management and avoidance of tobacco use were very low. Health practitioners should provide education programs for hypertensive patients to direct them towards practical techniques in managing their blood pressure.

Prevalence and determinants of poor sleep quality and depression among postpartum women: a community-based study in Ramechhap district, Nepal.

BACKGROUND: Due to the limited number of studies in low- and middle-income countries (LMICs), this study aimed to identify the prevalence and determinants of postpartum poor maternal sleep and depression. METHODS: This cross-sectional study was conducted with 380 women who were 2-12 months postpartum in March and April 2017 in Ramechhap district, Nepal. Multiple logistic regression was used to identify the associated factors. RESULTS: The prevalence of poor sleep quality and depression was 28.2% and 18.7%, respectively. Poor sleep quality was associated with having an occupation (in government or business, odds ratio [OR] 6.69; in agriculture/labour, OR 15.5), a male infant (OR 2.37), home delivery (OR 2.17), mental illness during pregnancy (OR 5.87), complications after delivery (OR 5.58) and postpartum depression (OR 2.86). Meanwhile, postpartum depression was associated with having no post-natal care (OR 98.7), living in a nuclear family (OR 48.5), living in a rural area (OR 26.6), having a male infant (OR 4.61), having complications after delivery (OR 21.9), introducing complementary foods before 6 months of age (OR 4.71) and having poor sleep quality (OR 3.20). CONCLUSIONS: A relatively high prevalence of depression and poor sleep quality were found. The close positive association between poor sleep quality and depression suggests the need for early identification and support for women at risk of poor sleep quality and depression in Nepal.

Rural-urban differences in socioeconomic inequality trends for double burden of malnutrition in Thailand 2005-2016.

BACKGROUND/OBJECTIVES: This study determined time trends in the prevalence of malnutrition and its socioeconomic inequality among children under five at a national level and by urbanity in Thailand. SUBJECTS/METHODS: This study compared malnutrition prevalence and inequality among children under five by wealth index score and urbanity using three Multiple Indicator Cluster Surveys for 2005-06, 2012, and 2015-16. The magnitude of inequality was measured on absolute (slope index of inequality) and relative scales (relative index of inequality). RESULTS: National prevalence of stunting decreased substantially (16% in 2005-06 and 2012 and 10% in 2015-16), whereas overweight prevalence did not meaningfully change. Inequalities in stunting and overweight by wealth decreased over time nationally on both absolute and relative scales (p-trend < 0.001). Similar decreasing patterns in inequalities were seen in both rural and urban areas, though substantial inequalities persisted. Poor children remained stunted (11.6% in the rural poor and 14.8% in the urban poor), wasted (6.6% in the rural poor), and, strikingly, also overweight (from 5.5% in 2005-06 to 9% in 2015-16 for the rural poor and 8% over time for the urban poor). CONCLUSION: Despite favorable time trends in socioeconomic inequality, this study showed the existence of a double burden of malnutrition (under-nutrition and overweight) in young Thai children with persistent inequalities at the national level. Different patterns of this double burden were seen between urban and rural areas. Public health policies should target both under-nutrition and overweight and consider urbanity in this rapidly developing society.

Dietary Diversity, Social Support and Stunting among Children Aged 6-59 Months in an Internally Displaced Persons Camp in Kayin State, Myanmar.

Children living in the internally displaced person (IDP) camp are at higher risk of stunting. This cross-sectional study aimed to assess the prevalence and to identify the associated factors of stunting among children aged 6-59 months at Myaing-Gyi-Ngu IDP camp in Kayin State, Myanmar. According to the World Health Organization Child Growth Standards, children with a height-for-age Z-scores below -2 standard deviation of the reference median (HAZ ≤ -2) were classified as stunted. Multiple logistic regression analysis was performed to identify the strong predictors. Prevalence of stunting has been found very high (59.4%). Adjusted model revealed that children living with illiterate mothers (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.07-3.24), being third/later-birth child (OR, 1.88; 95% CI, 1.13-3.14), consuming less than 4 food groups (OR, 4.22; 95% CI, 1.94-9.16), and older age of child (OR, 6.36 for 13-24 months; 95% CI, 2.74-14.74, 7.45 for 25-36 months; 95% CI, 3.21-17.25 and 12.75 for 37-59 months; 95% CI, 5.51-29.52) had higher odds of becoming stunted. The levels of support availability, presumed support and support received of mothers were generally low, but no significant associations were observed. In conclusion, this study showed high prevalence of stunting, but low dietary diversity and social support in the IDP camp. Due to the significant association of dietary diversity scores with stunting, interventions aiming at improving dietary diversity should be taken to reduce the stunting among children in the IDPs camp.

A descriptive study of gambling practices and problem gambling among internal migrants in Muse, Northern Shan, Myanmar.

Due to rapid economic growth in China, many gambling sites have emerged along the neighboring countries, including Myanmar, which place migrants at risk of developing gambling problems. This study aimed at identifying: i) types of gambling, ii) gambling involvement and intensity, and iii) the associations with problem gambling. A community-based cross-sectional study was conducted in Muse, Myanmar. A convenience sample of 273 internal migrants (18-49 years) filled a self-administered questionnaire. Chi-square tests and multiple logistic regression explored associations between gambling practices and problem gambling. Among the categories of gambling, the popular gambling types were lottery games (Aung Bar Lay, Thone-Lone and Nhit-Lone) and card games, as well as the use of Electronic Gambling Machines (EGMs). An average number of past-year gambling types involved and of gambling types engaged in regularly were 1.61 (SD=0.95) and 1.22 (SD=0.70), respectively. In association with PG, Nhit-Lone, EGMs, cards, and dice games were strongly associated among the gambling types. Those with PG had a higher number of involvement by past-year gambling types (1.92 vs. 1.18 for no PG) and spent 5 times higher amount of money on gambling. In conclusion, this study showed that types of gambling, such as Nhit-Lone, cards and dice games and higher involvement and intensity were associated with problem gambling. The findings provide new and important insights into gambling behavior among internal migrant workers in the border area with China and highlight the need for culturally specific preventive measures for the Myanmar population, with preference to gambling types.

Parental misperception of child's weight and related factors within family norms.

PURPOSE: Parental perception of their child's weight may be a crucial factor in parental ability for action with regard to their child's weight problem. This aim of this study was to investigate parental perception of their child's weight status and dietary healthiness, amount of food consumed and physical activity level and its related factors. METHODS: A cross-sectional survey was conducted among children (Grades 4-6) selected by cluster sampling in two schools. Children were invited to participate in the measurements of anthropometry and their parents were asked to classify their child's weight and health behaviors. RESULTS: In total, 41.8% of parents misperceived their child's weight, of which 82% underestimated their child's weight, in particular regarding overweight or obesity. As parents of overweight or obese children underestimated their child's weight, around 65% were not concerned with their child's current weight and about becoming overweight in the future. Factor associated with underestimation of overweight children was not having a sibling, while among children with normal weight, the underestimation was associated with boys, lower body mass index (BMI), maternal employment and low household income. Furthermore, parents underestimating their child's weight were more likely to be optimistic about their child's dietary healthiness, food amount taken, and physical activity level than those with correct child's weight estimates. CONCLUSIONS: Findings show a high proportion of parental misperception of their child's weight status. Family-based weight control interventions will need to incorporate parental misperceptions of the body weight and health behaviors of their children.

Early Adolescent Patterns of Alcohol and Tobacco Use in Eight Association of South-East Asian Nations (ASEAN) Member States.

BACKGROUND: Though alcohol and tobacco are the most commonly used substances among adolescents, little is known about the patterning of early adolescent substance use in Association of South-East Asian Nations (ASEAN) member states. OBJECTIVES: This study examined past month patterns of substances use and its gender difference among adolescents. METHODS: Cross-sectional samples among adolescents aged 13-16 years who completed the Global School-based Student Health Survey (GSHS) from eight ASEAN countries were included in the analysis (n = 40,212). RESULTS: Prevalence of past month any tobacco use was relatively high in Brunei, Indonesia, Malaysia, Thailand, and the Philippines (11-15%), but prevalence of dual cigarette and other forms of tobacco use was about 2-5% in the five countries. Past month alcohol consumption prevalence was also high in Thailand, Viet Nam, and the Philippines (16-24%), compared to the rest countries (1.4-8.2%). Moreover, prevalence of the concurrent alcohol and tobacco use was higher in Thailand and the Philippines (7 and 10%, respectively), particularly in boys (13 and 15%, respectively). Conclusions/importance: Almost 30-40% of the boys and 10-20% of girls in Malaysia, Philippines, Thailand, and Viet Nam are engaged in at least one of the two risk behaviors, and the concurrent alcohol and tobacco use was also relatively high among boys in those countries (5-15%). This study may provide some valuable insights on alcohol and tobacco policy in the region and requires to begin prevention and treatment programs in ASEAN member states.