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To examine the association between socioeconomic status (SES), financial subsidies and awareness-related factors such as age, cancer stage and family history, and the uptake of cancer genetic testing, with a focus on equitable access to care.
Retrospective cohort study.
Tertiary care cancer genetics service in Singapore.
The study population included 2687 individuals of all ages, genders and ethnicities who attended pretest counselling between 2014 and 2020 and were eligible for genetic testing for hereditary cancer syndromes.
The primary outcome was the uptake of genetic testing. The main explanatory variables were SES (proxied by Housing Index), subsidy status, age, cancer stage and family history. Analyses examined whether associations varied across SES and age subgroups.
Receipt of financial subsidies was strongly associated with testing uptake (adjusted OR 9.15, 95% CI 2.68 to 31.20). Uptake exceeded 90% among subsidised individuals across all socioeconomic strata, compared with 56–68% among non-subsidised individuals, with the largest gains in the lowest SES group (43 vs 28 percentage points (pp) in the highest). The level of subsidy was not associated with uptake. Younger patients (18–39 years) had higher uptake than those aged 60+ (66% vs 57%); patients with advanced cancer (stage IV) had the highest uptake (82% vs 57–66% in earlier stages); and family history was associated with increased uptake, strongest for having a child with cancer (+28 pp). Interaction analysis suggested that the additive effects of subsidies were greatest in lower SES groups and in older adults.
Financial subsidies were strongly associated with higher genetic testing uptake. Awareness indicators like age, cancer stage and family history were associated with higher uptake. The association between subsidies and uptake varied by SES and age, suggesting that subsidies may help reduce disparities and improve equitable access to genetic testing services.
by F. N. U. Nahiduzzaman, Tasnim Zarin, Chandra Shaker Chouhan, Md. Zaminur Rahman, Mst. Minara Khatun, A. K. M. Anisur Rahman, Md. Ariful Islam, Md Azizul Haque
Foodborne infections, particularly from street-vended fresh-cut fruits, are a growing public health concern in urban settings of developing countries. This study evaluated the gastrointestinal effects of consuming street-vended fruits in a randomized controlled trial (RCT) in Mymensingh, Bangladesh. A total of 300 participants were recruited and randomized into Treatment (n = 150) and Control (n = 150) groups. Treatment participants consumed guava, pineapple, or watermelon purchased from street vendors, while Control participants avoided street-vended fruits. Microbial analysis of fruits included total viable count (TVC), S. aureus, and E. coli. Participants recorded GI symptoms for 4 days post-intervention, with a 10-day follow-up. At least one GI symptom occurred in 41 (27.3%) treatment participants compared with 15 (10%) controls. Nausea affected 20 (13.3%) versus 2 (1.3%) participants (RR = 10, 95% CI: 2.38–42.03, p E. coli (6–10% prevalence) showed the strongest correlations with abdominal cramps, weakness, and diarrhea (ρ = 0.69–0.78, p S. aureus (20–34%) correlated primarily with weakness and abdominal cramps (ρ = 0.44–0.47, pby Ismat Tasnim, Md. Asif Iqbal, Ismat Ara Begum, Mohammad Jahangir Alam, Morten Graversgaard, Paresh Kumar Sarma, Kiril Manevski
Food insecurity and agriculture in South Asia, including Bangladesh, pose significant threats to the well-being and livelihoods of its people. Building adaptive capacities and resilient food systems is crucial for sustainable livelihoods. This study employs the Resilience Index Measurement and Analysis II framework to construct a Resilience Capacity Index (RCI) and analyze its relationship with food security using data from the Bangladesh Integrated Household Survey 2018. The study applies Exploratory Factor Analysis and Structural Equation Modeling to examine the impact of key resilience components such as Access to Basic Services, Adaptive Capacity, and Assets on household resilience. The findings reveal that access to basic services, land assets, and farm equipment positively influences households’ resilience capacity. However, the presence of livestock assets has a negative impact, potentially due to market volatility, climate vulnerability, and disease outbreaks. Additionally, adaptive capacity has a positive but insignificant influence on RCI, suggesting that without enhancing economic opportunities, institutional support, and inclusive development strategies, adaptive capacity could not be enough to foster resilience. However, resilient capacity enhances food security metrics such as the Food Consumption Score and Expenditure. These findings underscore the importance of policies that focus on increasing and maintaining access to basic services, promoting sustainable land management practices, and strengthening social safety nets. This study emphasizes the importance of focusing on livestock assets to ensure their sustainability by stabilizing the livestock market, improving veterinary services, and providing subsidies to reduce maintenance costs.
FreshRSS 