EY1920 Year Book

225 224 Research attachment in School of Public Health, the University of Hong Kong MAIN PROJECT TITLE: ABSTRACT: Aims To estimate changes in prevalence and life expectancy of diabetes and prediabetes of Hong Kong adults, and how policy measures could be modified to combat these changes. Methods Diabetes and prediabetes patients were identified using World Health Organization (WHO) and American Diabetes Association (ADA) guidelines in 2019, as well as records of diagnosis codes and medication data. Abridged life tables were developed to estimate life expectancies using the Chiang method. Results We identified 604,319 people with diabetes and 944,522 people with prediabetes. In 2017, the overall prevalence of diabetes was 9.18% (95% CI: 8.41% to 9.96%), and life expectancy at an attained age of 30 was an additional 48.7 years for males and 53.4 years for females. Prevalence and life expectancy for type 2 diabetes in Hong Kong during 2007 - 2017 Prevalence has an overall increasing trend from 2007 to 2017, slightly decreasing towards the end. Life expectancy has increased steadily for both genders. THINGS I HAVE LEARNT: Using for data extraction, cleaning and manipulation - generating visualization of geographical data on map and different types - of graphs inc. interactive ones ( ‘ggplot2’ & ‘rgdal’ packages ) - conducting survival analysis, producing survival curves and fit to - Cox proportional hazards model ( ‘flexsurf’ & ‘survminer’ ) - engineering disease progression model ( ‘simmer’ ) MBBS Enrichment Year 2019/20 Yuen Yuet Hin Sem 1 < R A - Prevalence and life ex p ectancy for ty p e 2 diabetes in Hong Kong during 2 007 - 2 0 1 7 at School of Public Health, HKU, Hong Kong >; Sem 2 < IC - Elective Courses at HKU, Hong Kong > Yuen Yuet Hin Yum Hin Hei Samson Master of Public Health Capstone Project Interventions to encourage seasonal influenza vaccination uptake among children in primary care settings: A systematic review and meta-analysis of randomised controlled trials E. Reference 1. Troeger C, Blacker B, Khalil IA, Rao PC, Cao J, Zimsen SR, Albertson SB, Deshpande A, Farag T, Abebe Z, AdetifaIM. Estimates of the global, regional,and national morbidity,mortality,and aetiologiesof lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the GlobalBurden of Disease Study 2016. The Lancet infectiousdiseases. 2018 Nov 1;18(11):1191-210. 2. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, Abbastabar H, Abd- Allah F, Abdela J, AbdelalimA, AbdollahpourI. Global, regional,and national incidence,prevalence,and years lived with disability for 354 diseases and injuries for 195 countries and territories,1990–2017: a systematicanalysis for the Global Burden of Disease Study 2017. The Lancet. 2018 Nov 10;392(10159):1789-858. 3. Nichol KL. Cost-effectivenessand socio-economicaspects of childhood influenza vaccination.Vaccine. 2011 Oct 6;29(43):7554-8. 4. Rémy V, Zöllner Y, Heckmann U. Vaccination:the cornerstone of an efficient healthcaresystem. Journal of marketaccess & healthpolicy. 2015 Jan 1;3(1):27041. 5. Ehreth J. The global value of vaccination.Vaccine. 2003 Jan 30;21(7-8):596-600. 6 The LegislativeCouncil Commission (The Commission).Seasonal influenza vaccination[Internet].Legco.gov.hk.2018 [cited19 February2020]. Availablefrom: https://www.legco.gov.hk/research-publications/english/essentials-1718ise06- seasonal-influenza-vaccination.htm A. Background: - Influenza is the 2 nd most important aetiology contributing to the lower respiratory tract infection incidence in 2016 globally 1,2 - Vaccination is the 2 nd most cost-effective intervention after ensuring safe water access and could offer herd immunity to local communities and beyond national borders 3-5 - Vaccination rates in different jurisdictions for children, even if subsidies are offered, vary widely (Hong Kong: 17% among children aged 6 months to 12 years old vs. United States: 70% for children aged 6 months to 4 years) 6 B. Eligibility criteria of the systematic review: Inclusion criteria Exclusion criteria P atient population Children aged 19 or below or their parents or primary care practitioners N/A I ntervention Interventions in primary care settings to increase uptake of human seasonal influenza vaccine N/A O utcome Proportion of uptake of influenza vaccine N/A S tudy design Randomised controlled trials or cluster randomised controlled trials Observa- tional studies or reviews Records identified through database searching (n = 635) Databases: PubMed (n = 287) Ovid EMBASE (n = 15) Cochrane Central Register of Controlled Trials (n = 333) Identification Full-text articles assessed for eligibility (n = 52) Articles included in quantitative synthesis (meta-analysis) (n = 14) Articles included in qualitative synthesis (n = 15) Records after search results combined and duplicates removed (n = 443) Records screened based on titles and abstracts (n = 443) Screening Eligibility Included C. PRISMA flow diagram Full-text articles assessed for eligibility (n = 52) Articles include in qualita ive synthesis (n = 15) D. Results - Pooled analyses under the random-effects model of both patient- and practitioner-based interventions show a 7% higher uptake of influenza vaccines among children after 1 influenza season compared with usual care or placebo (pooled RR, 1.07; 95% CI, 1.03-1.12) - Subgroup analyses indicate pooling studies with the main interventions being patient reminders (pooled RR, 1.09; 95% CI, 1.02-1.15) or electronic health record prompts for physicians pooled RR, 1.09; 95% CI, 1.04-1.13) yield statistically significance of higher influenza vaccine uptake among children. - Funnel plot appears to be asymmetrical , but given the small number of studies in this meta-analysis, heterogeneity or chance could be potential causes of asymmetry. MBBS Enrichment Year 2019/20 Yum Hin Hei Samson Full Year < IC - MPH at HK U, H o ng K o ng >