Stewards TTSH

20/08/2026

Highlights from the 20th Singapore Public Health and Occupational Medicine Conference (PHOM) 2026

Last week, the SteWARdS team attended the 20th Singapore Public Health and Occupational Medicine Conference (PHOM) 2026. This year’s theme, “From Prevention to Preparedness: Safeguarding Health Across Systems” highlighted the importance of building resilient health systems. Our team members had the opportunity to present their work as outlined below, and engaging with fellow researchers and public health professionals from diverse backgrounds.

- Dr Guo Huiling (Invited Speaker) – “Tailoring Strategies and Leveraging Community Spaces for Antimicrobial Resistance Education in Singapore”

- Seema Aithal (Oral Presentation) – “Communication Preferences for Antibiotic Messaging Among Community Residents in Singapore: A Cross-Sectional Survey”

- Eryn Lim (Poster Presentation) – “Understanding the Impact of Health Activation on Willingness to Use and Subscribe to an Exacerbation Forecasting Tool among COPD and Asthma Patients in Singapore”

- Jedrek Goh – “Investigating how Health Literacy can influence the intentions to use and subscribe to an exacerbation forecasting mHealth tool among COPD and asthma patients in Singapore”

🎉 Special congratulations go to: 🎉

- Seema for being awarded 1st Place in the Oral Presentation (Open Category)

- Eryn for being awarded 3rd Place in the Poster Presentation (Open Category)

It was inspiring to see the team's work contributing to the broader dialogue on health preparedness! 💪

09/08/2026

Happy 61st Birthday, Singapore! 🎉

27/07/2026

🔬 𝐍𝐞𝐰 𝐑𝐞𝐬𝐞𝐚𝐫𝐜𝐡 𝐅𝐢𝐧𝐝𝐢𝐧𝐠𝐬: 𝐈𝐝𝐞𝐧𝐭𝐢𝐟𝐲𝐢𝐧𝐠 𝐃𝐢𝐬𝐭𝐢𝐧𝐜𝐭 𝐀𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐁𝐞𝐡𝐚𝐯𝐢𝐨𝐮𝐫𝐚𝐥 𝐏𝐫𝐨𝐟𝐢𝐥𝐞𝐬 𝐢𝐧 𝐒𝐢𝐧𝐠𝐚𝐩𝐨𝐫𝐞’𝐬 𝐆𝐞𝐧𝐞𝐫𝐚𝐥 𝐏𝐨𝐩𝐮𝐥𝐚𝐭𝐢𝐨𝐧: 𝐀 𝐋𝐚𝐭𝐞𝐧𝐭 𝐂𝐥𝐚𝐬𝐬 𝐀𝐧𝐚𝐥𝐲𝐬𝐢𝐬

2,004 Singapore residents were surveyed to identify and characterise antibiotic behavioural profiles using latent class analysis. These findings could inform the development of more tailored interventions to improve antibiotic use practices.

𝐊𝐞𝐲 𝐅𝐢𝐧𝐝𝐢𝐧𝐠𝐬:
• 𝐋𝐚𝐭𝐞𝐧𝐭 𝐜𝐥𝐚𝐬𝐬 𝐛𝐞𝐡𝐚𝐯𝐢𝐨𝐮𝐫𝐚𝐥 𝐩𝐫𝐨𝐟𝐢𝐥𝐞𝐬: Majority of respondents (53.0%) were considered antibiotic appropriates, followed by antibiotic avoiders (24.9%) and antibiotic seekers (22.2%).
• 𝐀𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐬𝐞𝐞𝐤𝐞𝐫𝐬 𝐰𝐞𝐫𝐞 𝐦𝐨𝐫𝐞 𝐥𝐢𝐤𝐞𝐥𝐲 𝐭𝐨: Expect antibiotics for cold/flu, clinic hop to obtain antibiotics, use leftover antibiotics, stop antibiotic courses early and believe antibiotics are effective for cold/flu.
• 𝐂𝐡𝐚𝐫𝐚𝐜𝐭𝐞𝐫𝐢𝐬𝐭𝐢𝐜𝐬 𝐚𝐬𝐬𝐨𝐜𝐢𝐚𝐭𝐞𝐝 𝐰𝐢𝐭𝐡 𝐚𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐬𝐞𝐞𝐤𝐞𝐫𝐬: Poor knowledge of antibiotic use (AOR 3.71), poor AMR knowledge (AOR 3.51), low eHealth literacy (AOR 1.34), and high trust in doctors (AOR 2.14).
• Older adults with lower education levels were more likely to be antibiotic seekers.

𝐒𝐭𝐮𝐝𝐲 𝐈𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬:
The use of latent class analysis offers a more nuanced way to categorise behaviour by capturing complex, co-occurring behavioural patterns. Given antibiotic seekers’ high trust in doctors and their tendency to clinic hop for antibiotics, primary care settings may offer opportunities for targeted educational interventions to reduce antibiotic misuse amongst this subgroup, though further research is needed to identify effective engagement strategies.

𝐑𝐞𝐚𝐝 𝐦𝐨𝐫𝐞 𝐡𝐞𝐫𝐞: https://doi.org/10.3390/antibiotics15070671

Background: Inappropriate antibiotic use for upper respiratory tract infections (URTIs) is common. However, existing research typically examines single indicators or broad categories of misuse practices, without considering the probabilistic and co-occurring nature of varying behaviours. This study....

16/07/2026

The Agency for Care Effectiveness (ACE) has recently published the 𝐀𝐂𝐄 𝐂𝐥𝐢𝐧𝐢𝐜𝐚𝐥 𝐆𝐮𝐢𝐝𝐞𝐥𝐢𝐧𝐞 (𝐀𝐂𝐆) 𝐨𝐧 𝐀𝐩𝐩𝐫𝐨𝐩𝐫𝐢𝐚𝐭𝐞 𝐀𝐧𝐭𝐢𝐦𝐢𝐜𝐫𝐨𝐛𝐢𝐚𝐥 𝐔𝐬𝐞 𝐟𝐨𝐫 𝐭𝐡𝐞 𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐨𝐟 𝐔𝐩𝐩𝐞𝐫 𝐑𝐞𝐬𝐩𝐢𝐫𝐚𝐭𝐨𝐫𝐲 𝐓𝐫𝐚𝐜𝐭 𝐈𝐧𝐟𝐞𝐜𝐭𝐢𝐨𝐧𝐬 (𝐔𝐑𝐓𝐈𝐬). The guideline provides evidence-based recommendations to support clinical decision-making on the appropriate antimicrobial use for treating URTIs in primary and generalist care settings.

We are delighted and honoured that our research has contributed to the ACG, including the Evidence-to-Recommendation (EtR) framework that provides the evidence base and rationale behind its recommendations. Several of our publications have been cited in the ACG. We are proud to have made an impact on Singapore’s efforts in promoting appropriate antimicrobial use! 🌟

📚Explore our publications here: https://sites.google.com/view/stewards-ttsh-ace-guideline

📙Read more on ACG here: https://www.ace-hta.gov.sg/healthcare-professionals/ace-repository-for-clinical-guidelines/upper-respiratory-tract-infections--urtis---rational-antimicrobial-use/

Click the images to access the publications

06/07/2026

𝐇𝐢𝐠𝐡𝐥𝐢𝐠𝐡𝐭𝐬 𝐟𝐫𝐨𝐦 𝐈𝐧𝐭𝐞𝐫𝐧𝐚𝐭𝐢𝐨𝐧𝐚𝐥 𝐏𝐚𝐧𝐝𝐞𝐦𝐢𝐜 𝐒𝐜𝐢𝐞𝐧𝐜𝐞𝐬 𝐂𝐨𝐧𝐟𝐞𝐫𝐞𝐧𝐜𝐞 (𝐈𝐏𝐒𝐂) 𝟐𝟎𝟐𝟔

The International Pandemic Sciences Conference (IPSC) 2026, held from 1-3 July 2026, brought together healthcare professionals, researchers and policy makers to share insights and experiences on pandemic preparedness through panel discussions, dialogue and presentations.

Our Senior Consultant, Dr Angela Chow delivered a presentation titled 'Dancing with COVID-19: A Singaporean Hospital's Experience' at the Parallel Session on Ethics and Context, sharing key lessons learned from protecting staff, patients and visitors from nosocomial infection of COVID-19 at Tan Tock Seng Hospital. Dr Chow shared the contexts for routine staff sickness surveillance and fit-testing for high-filtration N95 respirators during non-outbreak periods, and daily temperature reporting, rostered routine testing, quarantine, and safe management measures during the various phases of the COVID-19 pandemic. These insights and experiences underscore the importance of context in shaping infection prevention and control measures, informing preparedness plans for future outbreaks.

The Session also featured a diverse range of international speakers who explored topics such as ethical considerations in AMR mitigation and the importance of equity-focused strategies for vector-borne disease response. It was inspiring to see and learn from the wide range of perspectives and innovations shaping the field of pandemic sciences! 🌟

17/06/2026

𝐇𝐢𝐠𝐡𝐥𝐢𝐠𝐡𝐭𝐬 𝐟𝐫𝐨𝐦 𝐭𝐡𝐞 𝟏𝟓𝐭𝐡 𝐈𝐧𝐭𝐞𝐫𝐧𝐚𝐭𝐢𝐨𝐧𝐚𝐥 𝐒𝐲𝐦𝐩𝐨𝐬𝐢𝐮𝐦 𝐨𝐧 𝐀𝐧𝐭𝐢𝐦𝐢𝐜𝐫𝐨𝐛𝐢𝐚𝐥 𝐀𝐠𝐞𝐧𝐭𝐬 𝐚𝐧𝐝 𝐑𝐞𝐬𝐢𝐬𝐭𝐚𝐧𝐜𝐞 (𝐈𝐒𝐀𝐀𝐑) 𝟐𝟎𝟐𝟔

The 15th International Symposium on Antimicrobial Agents and Resistance (ISAAR) was held in Hong Kong from 12 to 14 June 2026, focusing on the theme “Fighting the Ongoing Pandemic of Antimicrobial Resistance (AMR)”.

Our Principal Epidemiologist, Dr Guo Huiling, presented findings from two studies at the symposium. These studies examined distinct antibiotic behavioural profiles within Singapore’s general population and among cat and dog owners using latent class analysis. The findings provide valuable insights to inform the development of targeted and personalized strategies to promote appropriate antibiotic use among both the general population and pet owners. We are incredibly proud of Dr Guo Huiling and the impactful research showcased at this international platform! 🌟

Speakers from around the world also shared valuable insights on topics ranging from using AI to combat infectious disease and AMR, to the clinical implications of rapid microbiologic tests. It was inspiring to see the team's work contributing to the global dialogue on tackling AMR. 💪

10/06/2026

🔬 New Research Findings: 𝐇𝐚𝐯𝐢𝐧𝐠 𝐚 𝐫𝐞𝐠𝐮𝐥𝐚𝐫 𝐝𝐨𝐜𝐭𝐨𝐫 𝐚𝐧𝐝 𝐟𝐫𝐢𝐞𝐧𝐝𝐬 𝐭𝐨 𝐝𝐢𝐬𝐜𝐮𝐬𝐬 𝐚𝐛𝐨𝐮𝐭 𝐡𝐞𝐚𝐥𝐭𝐡 𝐜𝐚𝐧 𝐢𝐧𝐜𝐫𝐞𝐚𝐬𝐞 𝐢𝐧𝐟𝐥𝐮𝐞𝐧𝐳𝐚 𝐯𝐚𝐜𝐜𝐢𝐧𝐚𝐭𝐢𝐨𝐧 𝐮𝐩𝐭𝐚𝐤𝐞: 𝐀 𝐜𝐫𝐨𝐬𝐬-𝐬𝐞𝐜𝐭𝐢𝐨𝐧𝐚𝐥 𝐬𝐭𝐮𝐝𝐲

This cross-sectional study surveyed 2,004 Singapore residents from a nationally representative cohort to identify factors associated with influenza vaccination uptake, in particular, the influence of healthcare and social contacts.

𝐊𝐞𝐲 𝐅𝐢𝐧𝐝𝐢𝐧𝐠𝐬:
• 𝐏𝐞𝐫𝐬𝐨𝐧𝐚𝐥: Among individuals aged 21 years and above, those aged 40–64 years were least likely to have received influenza vaccination in the preceding year, with 39% lower odds compared to those aged 21-39 years. Conversely, those who reported greater health information orientation were significantly more likely to have received the vaccination.
• 𝐇𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 𝐜𝐨𝐧𝐭𝐚𝐜𝐭: Those with a regular doctor were more likely (46% higher odds) to have received influenza vaccination in the preceding year.
• 𝐒𝐨𝐜𝐢𝐚𝐥 𝐜𝐨𝐧𝐭𝐚𝐜𝐭: Among those without chronic diseases, having friends to discuss health issues with were nearly twice as likely as those not having such friends to have received influenza vaccination in the preceding year.

𝐒𝐭𝐮𝐝𝐲 𝐢𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬:
Maintaining healthcare contact with a regular doctor and encouraging discussions among friends for individuals without chronic diseases can facilitate influenza vaccination uptake. Future research could assess the effectiveness of strategies that leverage on friends from occupational and community settings to normalise and promote influenza vaccination, particularly among middle-aged adults who are least likely to be vaccinated.

𝐑𝐞𝐚𝐝 𝐦𝐨𝐫𝐞 𝐡𝐞𝐫𝐞: https://doi.org/10.1016/j.jvacx.2026.100848

29/05/2026

🔬 New Research Findings: 𝐃𝐞𝐭𝐞𝐫𝐦𝐢𝐧𝐚𝐧𝐭𝐬 𝐨𝐟 𝐖𝐢𝐥𝐥𝐢𝐧𝐠𝐧𝐞𝐬𝐬 𝐭𝐨 𝐑𝐞𝐜𝐞𝐢𝐯𝐞 𝐇𝐞𝐚𝐥𝐭𝐡 𝐈𝐧𝐟𝐨𝐫𝐦𝐚𝐭𝐢𝐨𝐧 𝐟𝐫𝐨𝐦 𝐍𝐞𝐢𝐠𝐡𝐛𝐨𝐮𝐫𝐡𝐨𝐨𝐝 𝐅𝐨𝐨𝐝 𝐚𝐧𝐝 𝐁𝐞𝐚𝐮𝐭𝐲 𝐄𝐬𝐭𝐚𝐛𝐥𝐢𝐬𝐡𝐦𝐞𝐧𝐭𝐬: 𝐂𝐫𝐨𝐬𝐬-𝐒𝐞𝐜𝐭𝐢𝐨𝐧𝐚𝐥 𝐒𝐭𝐮𝐝𝐲

This cross-sectional study conducted on residents from two neighbourhoods in central Singapore, explored the factors associated with willingness to receive health information from non-healthcare services, such as food and beauty establishments.

𝐊𝐞𝐲 𝐅𝐢𝐧𝐝𝐢𝐧𝐠𝐬:
• 𝐖𝐢𝐥𝐥𝐢𝐧𝐠𝐧𝐞𝐬𝐬 𝐭𝐨 𝐫𝐞𝐜𝐞𝐢𝐯𝐞 𝐡𝐞𝐚𝐥𝐭𝐡 𝐢𝐧𝐟𝐨𝐫𝐦𝐚𝐭𝐢𝐨𝐧 𝐟𝐫𝐨𝐦 𝐧𝐨𝐧-𝐡𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 𝐬𝐞𝐫𝐯𝐢𝐜𝐞𝐬: Out of 339 respondents who had never received health information from non-healthcare services before, nearly one-third (31.3%) indicated they would be willing to receive it in the future.
• 𝐃𝐞𝐭𝐞𝐫𝐦𝐢𝐧𝐚𝐧𝐭𝐬 𝐨𝐟 𝐰𝐢𝐥𝐥𝐢𝐧𝐠𝐧𝐞𝐬𝐬 𝐭𝐨 𝐫𝐞𝐜𝐞𝐢𝐯𝐞 𝐡𝐞𝐚𝐥𝐭𝐡 𝐢𝐧𝐟𝐨𝐫𝐦𝐚𝐭𝐢𝐨𝐧 𝐟𝐫𝐨𝐦 𝐧𝐨𝐧-𝐡𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 𝐬𝐞𝐫𝐯𝐢𝐜𝐞𝐬: Respondents with high health information orientation and greater trust were more willing to receive health information from food and beauty services. Younger age groups (21–34 and 35–49 years) and men who trusted the non-healthcare services were significantly more likely to be willing to receive health information from these sources.

𝐒𝐭𝐮𝐝𝐲 𝐢𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬:
The findings highlight the potential of non-healthcare services, especially food and beauty establishments, as avenues for public health messaging. Further research is required to explore the age- and gender- specific approaches that can foster trust and willingness to receive health information from these sources, particularly among adults aged 50 years and above and women.

𝐑𝐞𝐚𝐝 𝐦𝐨𝐫𝐞 𝐡𝐞𝐫𝐞: https://publichealth.jmir.org/2026/1/e86435

Background: Although health care providers are the most trusted sources of health information, service establishments within communities represent important, yet underused, sources of health information. Specifically, food and beauty establishments can act as alternative settings for health communic...

11/05/2026

🔬 New Research Findings: 𝐃𝐨𝐜𝐭𝐨𝐫-𝐫𝐞𝐥𝐚𝐭𝐞𝐝 𝐊𝐧𝐨𝐰𝐥𝐞𝐝𝐠𝐞, 𝐀𝐭𝐭𝐢𝐭𝐮𝐝𝐞𝐬 𝐚𝐧𝐝 𝐏𝐫𝐚𝐜𝐭𝐢𝐜𝐞𝐬 (𝐊𝐀𝐏) 𝐟𝐚𝐜𝐭𝐨𝐫𝐬 𝐢𝐧𝐟𝐥𝐮𝐞𝐧𝐜𝐢𝐧𝐠 𝐚𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐩𝐫𝐞𝐬𝐜𝐫𝐢𝐛𝐢𝐧𝐠 𝐟𝐨𝐫 𝐮𝐫𝐢𝐧𝐚𝐫𝐲 𝐭𝐫𝐚𝐜𝐭 𝐢𝐧𝐟𝐞𝐜𝐭𝐢𝐨𝐧𝐬 𝐢𝐧 𝐩𝐫𝐢𝐦𝐚𝐫𝐲 𝐜𝐚𝐫𝐞 𝐢𝐧 𝐒𝐢𝐧𝐠𝐚𝐩𝐨𝐫𝐞: 𝐚 𝐜𝐫𝐨𝐬𝐬-𝐬𝐞𝐜𝐭𝐢𝐨𝐧𝐚𝐥 𝐬𝐭𝐮𝐝𝐲.

This cross-sectional study conducted on 127 primary care physicians (PCPs) from private primary care clinics, explored the knowledge, attitudes and their antibiotic prescribing practices for patients with uncomplicated cystitis. It also shed light on potential areas of intervention to encourage appropriate antibiotic prescription for patients with urinary tract infections (UTIs) in Singapore.

𝐊𝐞𝐲 𝐅𝐢𝐧𝐝𝐢𝐧𝐠𝐬:
• Knowledge: Only 45% (N=57) of PCPs correctly identified all UTI symptoms, and those with greater reliance on urine dipsticks as a diagnostic test tended to experience greater anxiety due to diagnostic uncertainty.
• Attitudes: PCPs who showed greater interest in improving clinical practice were 45% less likely to prescribe antibiotics inappropriately for uncomplicated UTIs whereas experienced PCPs were 4 times more likely to prescribe antibiotics inappropriately for uncomplicated UTIs after adjusting for confounders.
• Practices: Majority of PCPs (N=120, 94%) communicated clearly to their patients on antibiotic prescribing decisions and the options for UTI treatment, but only one-third (N=39, 31%) involved their patients in shared decision-making.

𝐒𝐭𝐮𝐝𝐲 𝐢𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬:
Though more research is needed to assess effectiveness, actively promoting clinical guidance through national guidelines for management of UTI especially among experienced PCPs may help to improve appropriate prescribing of antibiotics for uncomplicated cystitis in the future.

𝐑𝐞𝐚𝐝 𝐦𝐨𝐫𝐞 𝐡𝐞𝐫𝐞: https://link.springer.com/article/10.1186/s12875-026-03298-2

The incidence of antimicrobial resistance (AMR) has been on a constant rise for urinary tract infections (UTIs). This study aimed to assess the knowledge,

01/05/2026

𝐇𝐢𝐠𝐡𝐥𝐢𝐠𝐡𝐭𝐬 𝐟𝐫𝐨𝐦 𝐓𝐓𝐒𝐇 𝐀𝐜𝐚𝐝𝐞𝐦𝐢𝐜 𝐇𝐞𝐚𝐥𝐭𝐡 𝐃𝐚𝐲 - 𝟐𝟑 𝐀𝐩𝐫𝐢𝐥, 𝟐𝟎𝟐𝟔 – 𝐓𝐫𝐚𝐧𝐬𝐟𝐨𝐫𝐦𝐢𝐧𝐠 𝐃𝐢𝐬𝐜𝐨𝐯𝐞𝐫𝐲 𝐢𝐧𝐭𝐨 𝐑𝐞𝐚𝐥 𝐖𝐨𝐫𝐥𝐝 𝐒𝐨𝐥𝐮𝐭𝐢𝐨𝐧𝐬

Last week, at the TTSH Academic Health Day 2026, our Senior Consultant Dr Angela Chow presented insights on population health research at the panel discussion focusing on “Bringing Discoveries into Everyday Care”. She delved into the key areas of the Health4All@ToaPayoh Strategic Research Programme, which included understanding the biopsychosocial determinants of health, examining the social networks within the community that can be leveraged, and co-designing interventions to improve the health of all.

The event also featured discussions on other topics, such as bench-to-bedside translation and the value of research-clinical partnerships, offering meaningful perspectives on bridging the gap between scientific discoveries and meeting the needs of patients and the population at large.

Our Principal Epidemiologist, Dr Guo Huiling, was also awarded the NHG Health-LKC Medicine Clinician-Scientist Career Scheme (CSCS), for her project titled “Co-SteWARdS @ ED – Involving patient voices in the co-design of an educational intervention on antibiotic use for patients presenting to the emergency department with upper respiratory tract infections”.