Introduction: Psychological insulin resistance is the reluctance of diabetes patients or physicians to initiate or in-tensify insulin therapy. The insulin usage among Malaysian type 2 diabetes mellitus (T2DM) patients is low, only 21.4% of audited T2DM patients were on insulin therapy despite 76.2% of the audited T2DM patients had poorly controlled diabetes with HbA1c ≥ 6.5% in year 2012. This study aims to identify the predictors of psychological insulin resistance (PIR) among insulin naïve T2DM patients. Methods: A cross-sectional study using interviewer assisted questionnaires was conducted among adult insulin naïve T2DM patients in government health clinics at a district of Penang, Malaysia. Insulin Treatment Appraisal Scale (ITAS) was used to assess the dependent variable (PIR) and validated self-developed questionnaires were used for assess the independent variables (socio-demographic characteristics, diabetes profile, and individual factors). Multiple linear regression analysis was performed to identify the predictors of PIR. Results: As high as 72.7% out of 385 participants were reluctant to initiate insulin therapy. Emotional factors (fears), perceived personal failure and perceived severity significantly predicted higher PIR whereas perceived benefit and self-efficacy significantly predicted lower PIR. Total 49.8% variability of PIR was explained by the entire individual predictors (R2=49.8%, p = 0.001). Emotional factor was the strongest predictor. Conclusion: This study revealed a high level of PIR among Malaysian T2DM patients. It is vital to tackle the predictors that predict high PIR and strengthen the predictors that lead to low PIR in our health education and health intervention programs.
MeSH terms: Adult; Cross-Sectional Studies; Demography; Diabetes Mellitus, Type 2; Government; Health Education; Health Promotion; Humans; Hyperinsulinism; Insulin; Insulin Resistance; Malaysia; Surveys and Questionnaires; Regression Analysis; Self Efficacy; Insulin, Regular, Human
Introduction: Secondhand tobacco smoke is a known carcinogen and has shown positive association with smok-ing status, susceptibility and cessation. Smoke free environment policy seem to reduce this exposure and influence intention to quit and frequency of quit attempts. Despite having a smoke free policy, smokers are still exposed to second hand smoke and this might influence their smoking behaviour and cessation. The objective of this study was to examine the association between environmental tobacco smoke exposures with intention to quit smoking among young adults in college with smoke free policy. Methods: Data were drawn from a cluster based randomised controlled trial in 10 government colleges in Selangor. Baseline characteristics of 160 college smokers were mea-sured using adapted questionnaire. Intention to quit was measured using Transtheoretical Model and environmental influence of tobacco smoke exposure. Results: Majority of the smokers were male (99.4%), single (100%), of Malay ethnicity (94.4%) and Muslim (95.6%). Most of them are in pre-contemplation stage where they do not have any intention to quit (65.6%). On environmental influence, at work or college environmental exposure, majority were exposed between 1 to 2 hours (36.9%) and 3 to 8 hours (40.6%). On exposure at home or hostel, majority were exposed between 1 to 4 hours (44.4%) and 5 to 14 hours (21.9%). In terms of friend’s exposures, majority have most of their friends smoking (68.1%). We found no statistically significant association between environmental influence and intention to quit smoking. Conclusion: Although we found no relationship, future research should examine the pathway between environmental influence and smoking behaviour.
MeSH terms: Carcinogens; Environmental Exposure; Ethnic Groups; Humans; Islam; Malaysia; Male; Surveys and Questionnaires; Smoking; Tobacco; Tobacco Smoke Pollution; Health Behavior; Smoking Cessation; Friends; Intention; Young Adult; Smoke-Free Policy
Introduction: Overweight and obesity among adults, especially young adults have been increasing for the past 20 years and is an emerging public health concern all over the world, including Malaysia. This study aims to explore the determinants of overweight and obesity among undergraduate students residing in Universiti Putra Malaysia. Methods: A cross-sectional study using random sampling was conducted in three residential colleges. Independent variables include socio-demographic factors, knowledge on physical activity and dietary intake, lifestyle (physical activity, dietary intake, sleep duration and quality and smoking status) and stress. Data was collected using a vali-dated and reliable self-administered questionnaire and anthropometric measurement (weight and height were mea-sured to determine body mass index). IBM Statistical Package for Social Science (SPSS) version 23 was used for data analysis. Multiple logistic regression was employed to find the determinants of overweight and obesity among the respondents. Significant level was set at less than 0.05. Results: A total of 494 respondents participated with 98.8% response rate. Overweight and obesity prevalence among the respondents was 38.1% with 22.9% and 15.9% of the respondents were overweight and obese respectively. The significant associated factors were age group of 24 years and above (AOR=2.671, p=0.04), male (AOR=1.818, p=0.04), Malay ethnicity (AOR=5.34, p=0.008) and Indian ethnicity (AOR=7.155, p = 0.018). Conclusion: Overweight and obesity prevalence among undergraduate students were more than one third. Programmes and policies should be directed to these high-risk groups as identified in this study.
MeSH terms: Adult; Body Weight; Cross-Sectional Studies; Ethnic Groups; Humans; Life Style; Malaysia; Male; Obesity; Public Health; Surveys and Questionnaires; Students; Exercise; Body Mass Index; Prevalence; Logistic Models; Overweight; Young Adult
ABSTRACTS FOR INTERNATIONAL FAMILY HEALTH CONFERENCE 2019 (I-FaH 2019). Health Intervention Towards Community Wellness, Held at Oriental Crystal Hotel, Kajang, Selangor, Malaysia .4-5th September, 2019
Introduction: Obesity, a major risk factor for chronic disease, is a growing problem in Malaysia. Current data from the National Health Morbidity Survey (NHMS) shows that prevalence of overweight for children under five years has increased from 6.5% (NHMS 2011) to 7.6 % (NHMS 2015). Childhood obesity needs to be addressed as studies also have shown that childhood obesity contributes to adult chronic disease. Increase in chronic diseases will cause an increase in health care cost. Intervention programmes are available and currently target schoolchildren and adults. No programme yet targeting at children under five years. This survey was conducted to understand parents level of knowledge with regards to healthy lifestyle among children under-5 years.
Methods: Parents attending Health Clinics in the state of Perak were given self-administered questionnaire.
Results: Twenty two (22) Health Clinics from 11 districts in Perak were involved in the survey. A total of 600 parents or care givers participated. Majority were unaware of good sleep hygiene and screen time limitation.
Conclusion: Awareness of healthy lifestyle for children under 5 years has not been given due attention. Health intervention via promotion is needed for prevention of obesity.
Introduction: With the increasing number of international students joining various universities worldwide, including Malaysia, acculturative stress resulting from their attempts to adjust to the cultures of host countries is one of the most challenging issues affecting their life in general and academic life in particular. The purpose of this study is to determine the level of acculturative stress and intention to dropout among new postgraduate international students in public universities, Malaysia. Methods: a cross-sectional study was conducted among 522 new international post-graduate students joining Malaysian public universities on their first semester. A multistage sampling method was adapted, and data were collected via self-administered questionnaire by using a validated questionnaire. Results: Out of the overall number of 522 respondents, (68.60%) of them were males while (31.40%) were females, the mean age of respondents was 28.95 ±5.91 years. The majority of the participants 60.54% (326) were single, whereas those who are married students represented 205 (39.3%). This study showed that 410 (78.5%) of the new postgraduate international students experienced a moderate level of acculturative stress with a median value of 107.00, while 63 (12.1 %) high level of stress and 49 (4.9 %) experience low level of acculturative stress .Consequently224 ,42.1 % of the participants students they have intention to dropout from the university for any reason , while 298 (57.1 % ) they don’t have any intention to dropout from the university Conclusions: This study showed the importance of educational intervention program among new international postgraduate students towards adapting to the Malaysian culture, in relation with increasing their cultural knowledge and interaction with host nationals and to reduce their acculturative stress and their intention to dropout from the university.
MeSH terms: Acculturation; Adult; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Marriage; Surveys and Questionnaires; Students; Universities; Intention; Young Adult
Introduction: The Ministry of Health Malaysia introduced the national best practices for adolescent-friendly health services in 2018 and it served as an assessment tool in the accreditation of adolescent-friendly clinic status. This study was conducted in Kelantan with the objective to determine the proportion of adolescent-friendly clinics and its determinants and perceptions of healthcare providers regarding the facilitating factors in providing adoles-cent-friendly health services. Methods: The research design was sequential explanatory mixed method. State wide clinics assessment was done to estimate the proportion of adolescent-friendly clinics and to determine the factors associated with adolescent-friendly health services provision. Perceptions of healthcare providers on the facilitating factors for adolescent-friendly health services were explored through in-depth interviews. Descriptive statistics and linear regression analysis were performed for quantitative data, and thematic analysis for qualitative data. Results: Out of 85 health clinics, 30 (35.3%) clinics were accredited as adolescent-friendly. Availability of trained health-care providers in adolescent health modules, private room for adolescent counselling, dedicated team in charge of adolescent programme and adolescent health promotional activities were the statistically significant determinants for adolescent-friendly health services (p
MeSH terms: Adolescent Health; Accreditation; Adolescent; Counseling; Health Personnel; Humans; Malaysia; Patients' Rooms; Regression Analysis; Adolescent Health Services
Introduction: Hepatitis C virus (HCV) infection is a major leading cause of morbidity and mortality worldwide. Per-sistent HCV infection is associated with major liver complications such as liver failure, liver cancer and fatality. It is estimated that 5.6 million people who inject drugs (PWID) were chronically infected with HCV globally, meanwhile, 59% of those diagnosed as HCV in Malaysia were PWID. The objective of this study was to determine the social determinants of HCV infection among PWID in Negeri Sembilan, Malaysia. Methods: A cross-sectional study was conducted based on stratified proportionate to size sampling among registered Methadone Maintenance Therapy (MMT) clients with PWID attending health clinics in Negeri Sembilan from February 2018 to July 2018. All eligi-ble respondents were randomly selected. Data were collected using an interviewer-guided questionnaire and was analysed using Statistical Package of IBM SPSS version 23. Independent T test and Chi-square test (χ2) were used to determine the associations between the variables. Results: Majority of the respondents in this study were between 20 and 63 years of age, Malay (90.1%) and infected with HCV (89%). There was a significant association between the respondent’s age (p
MeSH terms: Cross-Sectional Studies; Hepatitis C; Liver Neoplasms; Malaysia; Methadone; Surveys and Questionnaires; Substance Abuse, Intravenous; Chi-Square Distribution; Hepacivirus; Liver Failure; Hepatic Insufficiency; Opiate Substitution Treatment; Social Determinants of Health
Introduction: Evidently, stigma has potentially prompted the negative outcome in Tuberculosis (TB) control through delayed diagnosis and poor adherence to treatment. Amidst accelerating treatment interruption in Selangor, little attention is paid to the quantitative assessment of stigma, thus warrant further characterisation of TB stigma in ur-ban districts, Selangor. This study aimed to determine the predictors of internalised stigma among newly diagnosed PTB smear positive in urban districts, Selangor. Methods: A multi-centric longitudinal study recruited 345 newly diagnosed PTB smear positive patients who started TB treatment from November 2018 until June 2019. Baseline assessments utilised pre-tested self-administered questionnaire and standardised data collection form. Using IBM SPSS version 25.0, multiple linear regression was computed to determine the predictors. Results: The response rate was 84.7% with most of respondents were married and attained educational level up to secondary school. Other than low mean score of social support [mean (SD)=33.39(5.86)], the prominent findings were lacking knowledge of anti-TB side effect and wrongly perceived damaging effect of anti-TB drug to internal organ. The mean internalised stigma score was 24.88 (SD=4.70), which predicted by age, educational level (no formal education), employment status (retiree), alternative medicine practice, baseline symptoms score, perceived barrier, and social support, with entire group of variables significantly predicted TB stigma (F [9, 331] =21.476, p
MeSH terms: Complementary Therapies; Attention; Employment; Humans; Longitudinal Studies; Surveys and Questionnaires; Tuberculosis; Linear Models; Delayed Diagnosis; Social Stigma
Introduction: Universal HBV and HCV screening among pregnant women is not a current practice in Malaysia. It is aimed to conduct a systematic review on available evidences in an effort to strengthen the national hepatitis screen-ing programs. Methods: Systematic search was performed from databases; Medline, Cochrane, PubMed and IN-AHTA. Relevant studies according to inclusion/exclusion criteria were critically appraised and evidence graded. Re-sults: From 782 titles identified, two systematic reviews, two retrospective cohort studies, two cross-sectional studies, one cost-utility analysis and one cost-effectiveness analysis were included. Universal antenatal HBV screening was associated with almost complete vaccination coverage for newborns. Replacing targeted screening with universal HBV screening was associated with increased identification of newborns indicated for HBV-immunization from 50% to 96%. Universal antenatal HBV screening had incremental cost-effectiveness ratio (ICER)s ranged from €2,032 to €26,181 per life year (LY) gained. As for HCV, targeted antenatal screening was associated with low HCV prevalence. Universal screening did not detect significantly more women with HCV infection than did targeted screening. One cost-effectiveness analysis found that universal antenatal HCV screening had ICER of €52,473 per LY gained and one cost-utility analysis reported ICER of £9,139 per QALY gained. Conclusion: Based on the above review, universal HBV screening in pregnant women is effective in increasing vaccination coverage for newborns. However, the ICERs had wide range. Therefore, local economic evaluation is needed to estimate cost implications before considering addition into national screening program. While for HCV, both universal and targeted screening in pregnant women had low detection rate thus high-risk approach screening is appropriate in Malaysia.
Introduction: Methadone Maintenance Treatment (MMT) is the commonly used intervention for opioid dependents among Malays in FELDA settlements. However, relapse is common. Since majority of Malays are Muslims, Islamic Rehabilitation Intervention Module (ISRIM) using Health Belief Model (HBM) can be implemented as an intervention for reduction of relapse among opioid dependents in FELDA community. The objective of this study were to develop, implement and evaluate the effectiveness of ISRIM in the reduction of relapse among opioids dependent Malay males in FELDA communities in Jengka, Pahang. Methods: A single blind, cluster randomized controlled trial utilizing simple randomization was conducted, involving 10 MMT clinics. Intervention group received ISRIM for one session per week for four consecutive weeks, while control group were put on wait-list. Outcome was relapse, measured monthly for 6 months follow-up by the positive urine for drugs rapid test. Generalized Estimating Equations (GEE) was used as the main effectiveness analysis. Intention-to-treat (ITT), per protocol (PP) analysis, interaction terms, construct terms and key assumption terms were utilized. Results: Individual participation rate was 88.3%. All group comparisons at baseline were not significant (p>0.05). Cumulative relapse after 6-months follow-up for intervention and control group was 13.8% and 31.2%. There was significant difference in relapse between baseline, post-inter-vention and 6-months follow-up within intervention and control group (Q=29.06 vs 61.39,p
MeSH terms: Analgesics, Opioid; Follow-Up Studies; Islam; Malaysia; Male; Methadone; Opioid-Related Disorders; Random Allocation; Recurrence; Single-Blind Method; Control Groups; Intention to Treat Analysis; Opiate Substitution Treatment
Introduction:Orang Asli (OA) in Malaysia is considered vulnerable to social, economic and legal abuse. The in-crease in prevalence of Non-Communicable Diseases (NCDs) among OA was reported due to their lifestyle changes. Our study aimed to determine the level of knowledge on NCDs among OA community and its’ association with demographic factors. Methods: A cross-sectional study by face-to-face interview was conducted among consented adult OA in Jelebu, Negeri Sembilan using a validated questionnaire. Their knowledge on risk factors, complica-tions and treatment of cardiovascular diseases, diabetes mellitus, and chronic obstructive pulmonary diseases was asked. Respective thresholds and ranges for poor, moderate and good categories were set as 0-15, 15–21 and 21-28. Mann-Whitney and Kruskal-Wallis test was used to test the association between the demographic profile and knowledge score since the data was not normally distributed. Results: A total of 325 respondents with mean age 39.94 (±13.196) ranged from 18 to 83-year-old participated in this study. Majority were females (71.1%) with pri-mary education (39.1%) and mean household income of RM 615.47 (± 446.79). Their mean knowledge score was 12.82 (±9.671). Majority of them had poor knowledge (51.7%). The respondents with higher education background had significantly better knowledge score compared to lower education background (p
MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Cardiovascular Diseases; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Life Style; Malaysia; Middle Aged; Surveys and Questionnaires; Risk Factors; Prevalence; Pulmonary Disease, Chronic Obstructive; Young Adult
ABSTRACTS FOR INTERNATIONAL FAMILY HEALTH CONFERENCE 2019 (I-FaH 2019)
Introduction: Diabetes is a global epidemic and the public knowledge on this progressive disease is important to control the disease. This study aims to determine the diabetes knowledge of a community in Sungai Petani and the associated factors.
Methods: A cross-sectional study using multi-stage sampling was carried out in Sungai Petani, Kedah, Malaysia between April to May 2019, by a validated and reliable questionnaire. Data was analysed using IBM SPSS version 25.0. Mann-Whitney U and Kruskal Wallis test were used.
Results: Of 370 non-diabetic adults participated in this study with majority of them were females (61.9%), Malays (79.2%), had at least secondary education (53.5%), married (78.6%), overweight (34.6%), not-hypertensive (80.8%), had no family history of diabetes (52.2%) and not-smoking (86.8%). The mean ±SD age was 46.1 ±13. And median (IQR) monthly income was RM3037.40 ±3005.90. The diabetes knowledge median (IQR) score was 26.0 (9.0). Half of respondents did not know about items on “the different types of diabetes”, “diabetics should carry sweets when they are out” and “diabetics should not do-nate blood”. Diabetes knowledge was found to have significant association with diabetes screening uptake, income level, education level, marital status, BMI, family history of diabetes and smoking.
Conclusion: Diabetes knowledge among Sungai Petani community was found to be adequate but there is still misconception regarding diabetes and its management. Collective efforts should be taken to improve the general population’s knowledge on diabetes.
MeSH terms: Adult; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Malaysia; Surveys and Questionnaires; Body Mass Index; Marital Status; Overweight
Introduction: Prevalence of physical inactivity in the Federal Territory of Putrajaya on 2015 was 32.5% compared to 2011 with 56.5%, as reported in National Health Morbidity Survey. The public do not use the facilities as much as they should, although various facilities have been provided in Putrajaya and was selected as garden city concept town. The objective of this study was to determine the perceived barriers (personal, environmental, total barriers) of physical activity among Komuniti Sihat Pembina Negara (KOSPEN) community in Putrajaya. Methods: A cross sectional study was conducted using adopted self-administered Perceived Barriers questionnaires to assess the per-ceived barriers of physical activity with socio-demographics, economic and personal characteristic. An Independent t-test was used to test the association between independent variables with perceived barriers of physical activity. Re-sults: There were significant association between personal barriers with marital status (p
MeSH terms: Cross-Sectional Studies; Health Surveys; Morbidity; Surveys and Questionnaires; Exercise; Prevalence; Marital Status; Gardens
Introduction: Wet markets are predisposed to Aedes breeding due to nature of daily activities that involve frequent water storage and usage of water collecting containers. Large numbers of visitors patronising wet markets could cause rapid spread of dengue infection. This study aimed to determine the level of dengue prevention practices among wet market traders in Hilir Perak District and their associated socioecological factors. Methods: A cross sectional study using stratified sampling method was conducted where 246 wet market traders were interviewed to collect data on dengue prevention practices (prevention of Aedes mosquitoes breeding and prevention of mosquito bites), and so-cioecological factors. Chi square test and logistic regression modelling were performed to identify socioecological factors associated with dengue prevention practices. Results: Response rate for this study was 88.9%. Majority of the respondents were male, above 40 years old, had secondary education and above, had monthly income of above MYR2000, were owner of the shop lots, was or had ever married and sold fish, vegetable or groceries products. Most of the respondents had high level of dengue prevention practices (78%). Those who were owner of shop lots, had high perceived susceptibility, high family support, and high perceived dengue prevention and control laws and reg-ulations were predicted to have high level of dengue prevention practices. Conclusion: Level of dengue prevention practices is determined not only by individual factors, but also other factors from relationship to societal level which must also be considered in planning or evaluating current dengue control programmes.
MeSH terms: Aedes; Animals; Breeding; Cross-Sectional Studies; Dengue; Income; Insect Bites and Stings; Male; Marriage; Surveys and Questionnaires; Vegetables; Water; Chi-Square Distribution; Logistic Models; Family Conflict
Introduction: HIV and syphilis testing has been part of Malaysia’s comprehensive maternal & child health pro-gramme for more than 2 decades. Part of this antenatal package include lifelong antiretroviral (ARV) treatment to HIV+ pregnant women, free antiretroviral therapy (ART) prophylaxis/ infant formula for all HIV-exposed infants and appropriate management for syphilis positive antenatal mothers. The objective of this paper is to present the analysis of Malaysia’s achievement in obtaining the elimination of mother-to-child transmission of HIV (eMTCT) and syphilis status from the World Health Organisation (WHO). Methods: This survey is based on our surveillance and analysis of data on HIV and syphilis testing on pregnant women over a three-year period, beginning from 2015. Results: Malaysia’s national health survey revealed 97.4% of pregnant women in Malaysia had a minimum of four antenatal visits. The MOH’s surveillance system also showed 95.1% and 95.8% of pregnant women received HIV/ syphilis screening in 2015 and 2016 respectively, whilst the HIV vertical transmission rate declined from 16.12% in 2000 to 2.46% and 1.99% in 2015 and 2016 respectively. Congenital syphilis rates declined from 6.0 / 100,000 live births in 2012 to 5.0 and 4.0/ 100,000 live births in 2015 and 2016 respectively. In addition, more than 95% of antenatal mothers living with HIV received ARV and almost 100% of TPHA positive (Treponema pallidum haemagglutination) of expectant mothers received appropriate treatment. Conclusion: Based on such impressive findings, Malaysia was recognised by WHO in May 2018 as the first country in the Western Pacific Region to have successfully “eliminated” a significant public health problem.
MeSH terms: Child; Female; Hemagglutination; Hemagglutination Tests; Humans; Infant; Malaysia; Mothers; Pregnancy; Public Health; Syphilis; Syphilis Serodiagnosis; Syphilis, Congenital; Treponema pallidum; World Health Organization; HIV Infections; Infectious Disease Transmission, Vertical; Infant Formula; Anti-Retroviral Agents; Live Birth
Introduction: The National Immunization Program in Malaysia began in the 1950s and was integrated into the Ma-ternal and Child Health Program. Administrative data showed that coverage for all vaccinations was more than 95% except for measles vaccination. Despite the high coverage, there were clusters of outbreaks of vaccine preventable diseases. One of the reasons is the increasing phenomena of vaccines refusals following the rapid spread of negative perception and concerns through social media. Nurses as front liners play an important role to communicate on vac-cine safety and adverse events (AEFI). A survey was conducted to identify the level of knowledge among nurses who deal with immunisation programme. Methods: Nurses from all states attending a National seminar on immunisation communication in Putrajaya were asked to answer a Digital online questionnaire. They were asked to answer 12 questions on knowledge of vaccines, immunization schedule and cold chain management. Results: A total of 74% (429) of the seminar participants responded to the questionnaire, of which 85% were from the government sector and 15% from private. Findings showed that although about 75% of the nurses had formal training on immunisation, 50% had lack of knowledge about vaccination schedule for defaulters and 63.2% (268) had knowledge gaps related to questions on vaccines and handling of vaccines. Conclusion: In view of the knowledge gap from this survey, there is a need for ongoing training for the nurses and evaluation by supervisors on the knowledge and practices among nurses.
Introduction: Under 5 mortality is a leading indicator of the level of child health and overall development of a coun-try. In Malaysia, progressive reduction has been observed from 1990 however since 2000 progress has been static. Further understanding about this trend is crucial. The objective of this study was to identify causes of mortality for better policy development in order to further reduce this rate. Methods: Analysis of mortality trends was done using data from Department of Statistics and causes of mortality using data collected through the Stillbirth and Under 5 Mortality Reporting System (SU5MR) in 2016. Results: The trend for Under 5 mortality rate between 2006 till 2016 is still plateaued and hovered between 8 to 9 per 1000 live births at the national level. High percentage of death is seen among the neonatal group (51%), followed by children 28 days to 1year (31%) and toddlers 1-4 years (18%). Percentage of preventable deaths increased with age i.e. 21% among neonates, 41% among children 28 days to 1year and 48% among toddlers. The leading causes of death are conditions from perinatal period (34.4%), congen-ital malformation (30%), injuries and external causes (6.4%), respiratory (5.6%) and certain infectious and parasitic disease (5.1%). Conclusion: To further reduce under -5 mortality focus needs to be on preventable deaths; to reduce neonatal deaths will require political commitment to ensure adequate resources; interagency collaboration is needed to reduce toddler mortality and family and community awareness on prevention of injury and infection.
MeSH terms: Child Health; Cause of Death; Child; Child, Preschool; Communicable Diseases; Female; Humans; Infant Mortality; Infant, Newborn; Malaysia; Parasitic Diseases; Policy Making; Pregnancy; Stillbirth; Live Birth; Perinatal Death
Introduction: Female Genital Cutting (FGC) is a sensitive issue as this topic is always associated with religion and culture in Malaysia. In the past, FGC is performed by the traditional midwives. However, this practice has been med-icalized nowadays. This study aimed to understand the reasons of performing FGC, the decision making, the practice and the future of FGC among rural community in Northern Malaysia. Methods: Focus group discussions (FGD) were conducted on three groups of young women aged 18-45, older women aged 45 and above and a group of married adult men. All of them were Malay Muslims who were conveniently selected from a rural village in Northern Malay-sia. A semi-structured interview guide was used to conduct the FGD focusing on the reasons, decision making, the practice and the future of FGC. Data was collected until saturation of information was achieved. These participants were chosen based on their willingness to take part in the discussion and also based on their personality of being talkative and able to give feedback to the questions. Results: The result of the interviews revealed that religion is the reason of practicing FGC. All of the participants from each FGD prefer to go to the doctor in the clinic compared to the traditional midwives. The men in this FGD mentioned that they rarely involved in the decision making of the FGC and only the mother or the grandmother to take the responsibility to decide. Conclusion: Generally, majority Malay Muslims community from the rural areas in Northern Malaysia believed that FGC is compulsory in Islam and they prefer to go to the doctors to perform FGC.
Introduction: Gestational diabetes mellitus is one of the most common complications during pregnancy which affects 15% of pregnant women globally. Gestational diabetes mellitus patients have seven times lifetime risk of developing type 2 diabetes compared to women with normal pregnancies. Despite these facts, gestational diabetes mellitus patients may not perceive themselves to be at risk for future diabetes. Thus, this study aimed to determine the perception of risk for developing diabetes and factors associated with high risk perception among gestational di-abetes mellitus patients in Johor Bahru. Methods: A cross sectional study was conducted between April to May 2019 among 200 gestational diabetes mellitus patients attending primary health clinics in Johor Bahru, Malaysia. Data was collected using Malay translated and validated Risk Perception Survey on Developing Diabetes questionnaire. Multiple logistic regression analysis was performed using SPSS version 24.0. Results: There were 200 cases which fulfilled the inclusion and exclusion criteria in this study. The mean (SD) age of gestational diabetes mellitus patients in this study was 32.2 (4.8) years. Majority of them were from Malay ethnicity (74.5%) and 42.5% obtained higher education. Of these, 77.0% perceived themselves as high risk for developing diabetes. Higher knowledge scores and greater personal control were significantly associated with high perceived risk for developing diabetes (Adj. OR 2.08; 95% CI: 1.02,4.25; p=0.045 and Adj. OR 2.32; 95% CI: 1.16,4.63; p=0.017 respectively). Conclusion: Majority of gestational diabetes mellitus patients in this study accurately perceived themselves as having a high risk to develop diabetes in the future. Nevertheless, health education needs to be individualized and strengthened to ensure more patients are aware of the risk. In addition, further studies are needed to translate perceived risk into preventive health behaviours.
MeSH terms: Awareness; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Ethnic Groups; Female; Health Education; Humans; Malaysia; Pregnancy; Preventive Health Services; Surveys and Questionnaires; Health Behavior; Logistic Models; Diabetes, Gestational
Introduction: Adolescent aggression has become a serious public health problem with the escalating juvenile cases and violence among secondary school students by inflicting harm to others. The objective of this study was to deter-mine the biopsychosocial predictors of adolescent aggression among Form Four students in Hulu Langat. Methods: Cross-sectional study was conducted by proportionate population sampling method among Form Four students from all public secondary schools in Hulu Langat. Pre-tested questionnaires distributed to measure students’ ag-gression, demographic (ethnicity, family income), biological (sex, head injury, nutritional deficiency, breakfast skip-ping), psychological (attitude towards aggression, normative beliefs to aggression, personality trait, and emotional intelligence), and social factors (family environment, single parent status, domestic violence, peer deviant affiliation, alcohol, smoking, and substance abuse). Data was analysed using multivariate analysis to determine the significant predictors. Results: 480 students from four randomly selected schools participated in the study with response rate of 96.5%. The median aggression score was low, which was 23.00 (IQR=12.00). From simple linear regression, 15 factors had significant relationship with adolescent aggression. The predictors of adolescent aggression were lower family income, Malay ethnicity, nutritional deficiency, attitude towards aggression, and peer deviant affiliation (F [8, 244] =15.980, p-value
MeSH terms: Adolescent; Aggression; Cross-Sectional Studies; Ethnic Groups; Humans; Malaysia; Public Health; Surveys and Questionnaires; Schools; Silver; Smoking; Students; Single Parent; Multivariate Analysis; Linear Models; Domestic Violence; Breakfast