Result of Research

Title of Manuscript:

Regional disparities in health services is a crucial problem in Cambodia

Author:

Yurie Kobashi1, 2, Hong Chhay1, Thyryfong Savat3, Manabu Okawada4,Masaharu Tsubokura2, and Yoshifumi Hayashi3

Result:

One hundred sixteen (55.8%) females were included in the total sample size of 208 participants; the majority (52.9%) were between 35 and 65 years of age. Twenty-five participants (12%) were current smokers, and 44 (21%) were current alcohol drinkers.
Eighty (38.5%) participants had hypertension and 44 participants
(21.2%) had a body mass index over 25. Alcohol drinking and smoking habits were more common among men. The five most frequent medical complaints were headache (18.3%), lower back pain (14.4%), foot and hand pain (13.9%), joint pain (10.1%), and difficulty breathing (10.1%).
The medical need for doctor consultations regarding chronic disease and chronic pain might be higher in poor rural areas in Cambodia.

Publication medium:

Journal of Rural Medicine

Publication date:

May/19/2021

Result of Research

Title of Manuscript:

Prevalence of Metabolic Syndrome and Its Components in Urban Cambodia: A Cross‑Sectional Study

Author:

Miharu Tamaoki, Ikumi Honda, Keisuke Nakanishi, Sophathya Cheam, Manabu Okawada,

Hisataka Sakakibara

Result:

Among the 6090 (3174 men and 2916 women) participants who were enrolled in the study, the prevalence of MetS was 60.1% in men and 52.4% in women. The prevalence of elevated blood pressure was 73.2% in men and 65.3% in women, and was the highest MetS component in both men and women. In contrast, the lowest prevalence rates were observed for abdominal obesity (44.8%) in men and for high triglyceride levels (33.5%) in women. The MetS group showed a significantly higher proportion of patients with hypertension, diabetes, dyslipidemia, and obesity compared with the non-MetS group. Conclusion The high prevalence of MetS in this study was attributed to urbanization, as in economically developed countries. It is necessary to explore the lifestyle habits of Cambodians that contribute to MetS and to develop preventive measures to reduce the incidence and prevalence of MetS.

Publication medium:

Journal of Epidemiology and Global Health

Publication date:

Aug/10/2021

Result of Research

Title of Manuscript:

Regional Differences in Admission Rates of Emergency Patients Who Visited a Private General Hospital in the Capital City of Cambodia: A Three-Year Observational Study

Author:

Yurie Kobashi1, Sophathya Cheam, Yoshifumi Hayashi, Masaharu Tsubokura, Veyleang Ly, Chanmakara Noun, Takehiro Kozuma, Buntongyi Nit, Manabu Okawada

Result:

A total of 6167 patients who visited the emergency department at SJH between January 2017 and September 2019 were included in the analysis. The proportion of patients who needed to be hospitalized or transferred increased with the distance from the capital. The proportion of patients who finished consultation decreased with the distance from the capital (P < .01: Chi-square test). The results of the logistic regression analysis showed that the admission rate in rural areas was significantly higher only among males as compared to that of the capital in multivariate analyses adjusted for age, time, and season.

Publication medium:

International Journal of Health Policy and Management

Publication date:

May/19/2021

Result of Research

Title of Manuscript:

Difference of sociodemographic characteristics among the disabled population in Cambodia: a cross-sectional study of the demographic and health survey data

Author:

Kanika Kep, Yurie Kobashi, Erica Jynn Abarca Lopez, Masaharu Tsubokura, Manabu Okawada

Result:

The results showed that the proportion of people with disabilities greatly increased with age. The rural-urban residence difference affected the disability proportion in univariate analysis; however, the effect was not significant after adjusting for covariables in multivariate analysis. The odds of having a disability were 0.85 times lower for the high economic status group than for the low economic status group.

Publication medium:

Journal of Rural Medicine

Publication date:

May/17/2022

Result of Research

Title of Manuscript:

Vulnerable groups and protective habits associated with the number of symptoms caused by pesticide application in Kratie, Cambodia: a cross-sectional questionnaire study

Author:

Yurie Kobashi, Lihorn Srou, Masaharu Tsubokura,

Yoshitaka Nishikawa, Ngy Laymithuna, Songhy Hok,

Manabu Okawada

Result:

The observed number of symptoms was 1.16 times higher among women (P=0.004), increased with the duration of work, and decreased with age. In addition, we identified five significant pesticide-protective behaviors: 1) preparing using gloves, 2) using protective equipment, 3) avoiding wiping sweat, 4) avoiding leaking, and 5) resting when feeling ill. Pesticide-protective behaviors tended to decrease with the duration of working years in the low-education group (B=−0.04, SE=0.01), whereas no association was observed in the high-education group (B=0.01, SE=0.01).

Publication medium:

Journal of Rural Medicine

Publication date:

Sep/17/2021

Result of Research

Title of Manuscript:

Lifestyle Factors Associated with Metabolic Syndrome in Urban Cambodia

Author:

Miharu Tamaoki, Ikumi Honda 1, Keisuke Nakanishi,

Maki Nakajima, Sophathya Cheam, Manabu Okawada, Hisataka Sakakibara

Result:

Our results indicated that lifestyles significantly associated with MetS among Cambodians living in urban areas of Cambodia were eating quicker than others, walking faster than those of the same sex of similar age and drinking alcohol in both men and women.

In addition, there were significant associations with normal eating speed for men only and, for women only, skipping breakfast at least three days per week, eating food after dinner at least three days per week and getting enough rest through sleep. Further studies are needed to examine lifestyle factors to derive more suitable content for Cambodians’ living environment, which may lead to efforts for the prevention of MetS tailored to the characteristics of Cambodians.

Publication medium:

International Journal of Environmental Research and Public Health

Publication date:

Aug/13/2022

Result of Research

Title of Manuscript:

Lessons from COVID-19’s impact on medical tourism in Cambodia

Author:

Makoto Kosaka, Yurie Kobashi, Kensuke Kato,

Manabu Okawada Masaharu Tsubokura

Result:

In this COVID-19 era, many patients are affected due to the loss of medical tourism. In Cambodia, where the obvious problem of providing medical care to people in own country as part of lifeline has not yet been solved, medical tourism has become a tentative solution that has prevented fundamental solutions to the problem. The COVID-19 pandemic has forced Cambodia to confront this problem by making medical tourism unfeasible. This experience revealed the need to encourage patients who were unable to undertake medical tourism to visit domestic medical facilities, make efforts to share patient information across countries, and to invest in developing each department in domestic hospitals. Support for patients who are unable to undertake medical tourism is urgently needed. Furthermore, medical tourism for profitmaking purposes might have a negative impact on sustainable healthcare, which needs to be reconsidered.

Publication medium:

Public Health in Practice

Publication date:

Nov/02/2021

Result of Research

Title of Manuscript:

Discrepancy of financial burden among elderly visiting a private general hospital in Phnom Penh, Cambodia:

A three-year cross-sectional study

Author:

Yurie Kobashi, Khemvitou Sok, Yoshifumi Hayashi,

Hong Chhay, Masaharu Tsubokura, Kimhab Chou, Nobukazu Hokamura, Akihiko Ozaki, Yoshitaka Nishikawa,

Manabu Okawada

Result:

The demographic characteristics of the participants are shown in Table 1. A total of 119,938 patients who visited SJH from January 2017 to September 2019 were included Of these, 48.12% were male, and the median age (25th, 75th centiles) was 52 years (36, 66). The most substantial proportion in consultation classification was “Revisit” (37.84%), and that in the next plan classification was “Consultation finish” (37.69%). Approximately 90% spoke the Khmer (Cambodian) language; this proportion was similar to the fact that approximately 90% of Cambodian residents and approximately 10% of foreigners comprise the total population. Only 2% of the patients used insurance, and the OOPP median (25th, 75th centiles] was 73.78 USD. Fig. 1 shows the patients’ age distribution. The line shows the population pyramid in Cambodia in 2018. The proportions of 0–19 years, 20–59 years old, and 60 years and above were 8.22%, 53.47%, and 38.31%, respectively. The population decreasing Notch was admitted around the 40s, affected by the severe war under the Khmer Rouge. Supplemental Fig. 1 shows the age distribution of each consultation classification, and Supplemental Fig. 2 shows the age distribution of each next plan classification. Fig. 2 shows the sequential change in the number of participants in each age group. The median age in years (median [25th, 75th centiles]) in each three-month period is 57 (41, 69), 59 (45, 70), 58 (41,70), and 58 (42, 69) in 2017; 53 (38, 67), 52 (36, 66), 51 (36, 66), and 51 (35, 66) in 2018; and 51 (34, 65), 48 (31, 64), and 49 (32, 64) in 2019. The proportion of elderly people aged 60 years and above was 45.66% for the first three months of 2017. However, this decreased to 32.41% in the last three months of 2019. Supplemental Fig. 3 shows the sequential change in the number of participants in each consultation classification.OOPP for each age, gender, consultation classification, and next plan classification is shown in Table 2. OOPP of those aged over 60 years was higher. The OOPP of an emergency patient was the highest of all consultations. OOPP of those who needed admission was the highest of all next plan classifications. Fig. 3 shows the OOPP for every 10-year age group. A Kruskal-Wallis H test confirmed a statistically significant difference in the average value of OOPP (USD) in each classification (p < 0.01). There were no significant differences between the teens and the 50s age group (p = 0.3716) and between the 80s and the 90s age groups (p = 0.0920) with the Steel-Dwass test. In contrast, a significant difference was observed between all other age groups (p < 0.01) with the Steel-Dwass test. The median OOPP was the lowest in the 20s age group and highest in the 90s. Fig. 4-a shows the OOPP by gender for each of the three age groups (19 years and under, 20 to 59, and 60 and over). A significant difference was observed in the 20–59 years age group with the Wilcoxson rank-sum test (p < 0.01, higher in males). No significant difference was observed in the other age groups.

Publication medium:

Public Health in Practice

Publication date:

Dec/04/2022