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  1. Fulltext A Colorimetric pH Sensor Based on Clitoria sp and Brassica sp for Monitoring of Food Spoilage Using Chromametry
    Ahmad NA, Yook Heng L, Salam F, Mat Zaid MH, Abu Hanifah S
    Sensors (Basel), 2019 Nov 05;19(21).
    PMID: 31694284 DOI: 10.3390/s19214813
    A developed colorimetric pH sensor film based on edible materials for real-time monitoring of food freshness is described. The mixed natural dyes from edible plants Clitoria sp and Brassica sp were extracted and incorporated into ι-carrageenan film as a colorimetric pH sensor film for monitoring food spoilage and its freshness. The color changes of the developed colorimetric sensor film were measured with chromametry and UV-vis spectroscopy, respectively. Experimental results show that colorimetric pH sensor film demonstrated statistically significant differences (p < 0.05) between CIE-L*a*b* coordinates color system indicated that the developed colorimetric sensor film was able to give a gradual change in color over a wide pH range. The color of the colorimetric sensor film also changes discretely and linearly with factors that contribute to food spoilage using shrimp and durian samples. Moreover, the developed colorimetric pH sensor film has the potential to be used as a safe, non-destructive testing and also a flexibly visual method for direct assessment of food freshness indicator during storage.
  2. Fulltext A Kinetic Approach of DPPH Free Radical Assay of Ferulate-Based Protic Ionic Liquids (PILs)
    Ahmad NA, Jumbri K, Ramli A, Abd Ghani N, Ahmad H, Lim JW
    Molecules, 2018 Dec 05;23(12).
    PMID: 30563037 DOI: 10.3390/molecules23123201
    The antiradical efficiency (AE) and kinetic behavior of a new ferulate-based protic ionic liquids (PILs) were described using 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical assay. The reduction of the DPPH free radical (DPPH•) was investigated by measuring the decrease in absorbance at 517 nm. The time to reach steady state for the reaction of parent acid (ferulic acid) and synthesized PILs with DPPH• was continuously recorded for 1 h. Results revealed that the AE of 2-butylaminoethanol ferulate (2BAEF), 3-dimethylaminopropanol ferulate (3DMAPF) and 3-diethylaminopropanol ferulate (3DEAPF) PILs have improved compared to ferulic acid (FA) as the reaction class changes from low to medium. This attributed to the strong hydrogen abstraction occurred in the PILs. Furthermore, these PILs were found to have a good kinetic behavior compared to FA due to the high rate constant (k₂) (164.17, 242.84 and 244.73 M-1 s-1, respectively). The alkyl chain length and more alkyl substituents on the nitrogen atom of cation were believed to reduce the cation-anion interaction and speed up the hydrogen atom transfer (HAT) and electron transfer (ET) mechanisms; hence, increased rate constant was observed leading to a strong antioxidant activity of the synthesized PILs.
  3. Fulltext A Mixed-Methods Evaluation of Parent-Assisted Children's Friendship Training to Improve Social Skills and Friendship Quality in Children with Autism in Malaysia
    Ong SY, Roslan S, Ahmad NA, Ayub AFM, Ping CL, Zaremohzzabieh Z, et al.
    Int J Environ Res Public Health, 2021 Mar 04;18(5).
    PMID: 33806563 DOI: 10.3390/ijerph18052566
    Background: This study evaluates the effectiveness of parent-assisted children's friendship training intervention for enhancing friendship quality and social skills among children with autism spectrum disorders (ASD). We conducted a quasi-experimental study to investigate the effective outcomes of social skills and friendship quality in the pre-and post-parent-assisted CFT intervention phases; Methods: to conduct a 12-week field session, 30 children with their parents were selected. The Social Skills Improvement System Rating Scales and the Quality of Play Questionnaire-Parent were used to assess the effectiveness of the parent-assisted children's friendship training during pre-and post-intervention. A semi-structured interview with parents was conducted at the end of the session; Results: findings revealed that intervention improved the social skills of these children. Additionally, the friendship quality of children with ASD improved before and after the intervention, however, engagement remained unchanged. Parents also showed some sort of improvement after the session as they reported a heightened sense of fear and resistance, awareness, learning and adjustment, change is not easy, and identifying support; Conclusions: there was clear evidence that children with ASD benefitted from parent-assisted CFTs in terms of social skills and friendship quality. However, larger and controlled studies are required to draw firm conclusions about this kind of intervention.
  4. Fulltext A population-based study measuring the prevalence of chronic kidney disease among adults in West Malaysia
    Hooi LS, Ong LM, Ahmad G, Bavanandan S, Ahmad NA, Naidu BM, et al.
    Kidney Int, 2013 Nov;84(5):1034-40.
    PMID: 23760287 DOI: 10.1038/ki.2013.220
    In this population-based study, we determine the prevalence of chronic kidney disease in West Malaysia in order to have accurate information for health-care planning. A sample of 876 individuals, representative of 15,147 respondents from the National Health and Morbidity Survey 2011, of the noninstitutionalized adult population (over 18 years old) in West Malaysia was studied. We measured the estimated glomerular filtration rate (eGFR) (CKD-EPI equation); albuminuria and stages of chronic kidney disease were derived from calibrated serum creatinine, age, gender and early morning urine albumin creatinine ratio. The prevalence of chronic kidney disease in this group was 9.07%. An estimated 4.16% had stage 1 chronic kidney disease (eGFR >90 ml/min per 1.73 m(2) and persistent albuminuria), 2.05% had stage 2 (eGFR 60-89 ml/min per 1.73 m(2) and persistent albuminuria), 2.26% had stage 3 (eGFR 30-59 ml/min per 1.73 m(2)), 0.24% had stage 4 (eGFR 15-29 ml/min per 1.73 m(2)), and 0.36% had stage 5 chronic kidney disease (eGFR <15 ml/min per 1.73 m(2)). Only 4% of respondents with chronic kidney disease were aware of their diagnosis. Risk factors included increased age, diabetes, and hypertension. Thus, chronic kidney disease in West Malaysia is common and, therefore, warrants early detection and treatment in order to potentially improve outcome.
    Study name: National Health and Morbidity Survey (NHMS-2011)
  5. Fulltext A preliminary study on the specificity and sensitivity values and inter-rater reliability of MINI International Neuropsychiatric Interview (MINI) in Malaysia
    Mukhtar F, Abu Bakar AK, Mat Junus M, Awaludin A, Abdul Aziz S, Midin M, et al.
    ASEAN Journal of Psychiatry, 2012;13(2):157-164.
    MyJurnal
    Objective: The MINI International Neuropsychiatric Interview (MINI) is a short, structured diagnostic interview compatible with the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). It was designed for clinical practice, research in psychiatric, primary care settings and epidemiological surveys. This preliminary study aims to evaluate the reliability and validity of the Malaysian Version of MINI for Major Depressive Disorder and Generalized Anxiety Disorder symptoms criteria only.

    Methods: Six hours of MINI training was given as part of a National Health Morbidity Survey training program for layman interviewers (n=229) and three videos were prepared by an expert psychiatrist for inter-rater reliability purposes. Meanwhile, for validity purposes, the MINI was administered to patients with Major Depressive Disorder (n=30), Generalized Anxiety Disorder (n=20) and to a normal population (n=60), to conform against the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) that was administered by psychiatrists.

    Results: Overall the inter-rater reliability was satisfactory (0.67 to 0.85) and the concordance between the MINI’s and expert diagnoses was good, with kappa values of greater than 0.88.

    Conclusions: The Malay version of the MINI is adjusted to the clinical setting and for the assessment of positive cases in a community setting. Modifications were highlighted to correct any identified problems and to improve the reliability of the MINI for future research and clinical use.
  6. Fulltext A stochastic total least squares solution of adaptive filtering problem
    Javed S, Ahmad NA
    ScientificWorldJournal, 2014;2014:625280.
    PMID: 24688412 DOI: 10.1155/2014/625280
    An efficient and computationally linear algorithm is derived for total least squares solution of adaptive filtering problem, when both input and output signals are contaminated by noise. The proposed total least mean squares (TLMS) algorithm is designed by recursively computing an optimal solution of adaptive TLS problem by minimizing instantaneous value of weighted cost function. Convergence analysis of the algorithm is given to show the global convergence of the proposed algorithm, provided that the stepsize parameter is appropriately chosen. The TLMS algorithm is computationally simpler than the other TLS algorithms and demonstrates a better performance as compared with the least mean square (LMS) and normalized least mean square (NLMS) algorithms. It provides minimum mean square deviation by exhibiting better convergence in misalignment for unknown system identification under noisy inputs.
  7. Fulltext Accurate Indoor-Positioning Model Based on People Effect and Ray-Tracing Propagation
    Firdaus F, Ahmad NA, Sahibuddin S
    Sensors (Basel), 2019 Dec 15;19(24).
    PMID: 31847488 DOI: 10.3390/s19245546
    Wireless local area networks (WLAN)-fingerprinting has been highlighted as the preferred technology for indoor positioning due to its accurate positioning and minimal infrastructure cost. However, its accuracy is highly influenced by obstacles that cause fluctuation in the signal strength. Many researchers have modeled static obstacles such as walls and ceilings, but few studies have modeled the people's presence effect (PPE), although the human body has a great impact on signal strength. Therefore, PPE must be addressed to obtain accurate positioning results. Previous research has proposed a model to address this issue, but these studies only considered the direct path signal between the transmitter and the receiver whereas multipath effects such as reflection also have a significant influence on indoor signal propagation. This research proposes an accurate indoor-positioning model by considering people's presence and multipath using ray-tracing, we call it (AIRY). This study proposed two solutions to construct AIRY: an automatic radio map using ray tracing and a constant of people's effect for the received signal strength indicator (RSSI) adaptation. The proposed model was simulated using MATLAB software and tested at Level 3, Menara Razak, Universiti Teknologi Malaysia. A K-nearest-neighbor (KNN) algorithm was used to define a position. The initial accuracy was 2.04 m, which then reduced to 0.57 m after people's presence and multipath effects were considered.
  8. Fulltext Adaptive Indoor Positioning Model Based on WLAN-Fingerprinting for Dynamic and Multi-Floor Environments
    Alshami IH, Ahmad NA, Sahibuddin S, Firdaus F
    Sensors (Basel), 2017 Aug 05;17(8).
    PMID: 28783047 DOI: 10.3390/s17081789
    The Global Positioning System demonstrates the significance of Location Based Services but it cannot be used indoors due to the lack of line of sight between satellites and receivers. Indoor Positioning Systems are needed to provide indoor Location Based Services. Wireless LAN fingerprints are one of the best choices for Indoor Positioning Systems because of their low cost, and high accuracy, however they have many drawbacks: creating radio maps is time consuming, the radio maps will become outdated with any environmental change, different mobile devices read the received signal strength (RSS) differently, and peoples' presence in LOS between access points and mobile device affects the RSS. This research proposes a new Adaptive Indoor Positioning System model (called DIPS) based on: a dynamic radio map generator, RSS certainty technique and peoples' presence effect integration for dynamic and multi-floor environments. Dynamic in our context refers to the effects of people and device heterogeneity. DIPS can achieve 98% and 92% positioning accuracy for floor and room positioning, and it achieves 1.2 m for point positioning error. RSS certainty enhanced the positioning accuracy for floor and room for different mobile devices by 11% and 9%. Then by considering the peoples' presence effect, the error is reduced by 0.2 m. In comparison with other works, DIPS achieves better positioning without extra devices.
  9. Air pollution effects on adult mortality rate in developing countries
    Ahmad NA, Ismail NW, Ahmad Sidique SF, Mazlan NS
    Environ Sci Pollut Res Int, 2021 Feb;28(7):8709-8721.
    PMID: 33068244 DOI: 10.1007/s11356-020-11191-3
    Although industrialisation is a crucial aspect of economic growth across developing nations, through the release of air contaminants, industrial activities may also create adverse environmental health consequences. Noting that continuous production and other economic activities are crucial for continued survival, this study explores this issue by including the role of governance that is deemed essential but the literature is relatively sparse particularly in the context of developing countries. This research empirically analyses the relationship between air pollution and adult mortality rates from 72 developing countries from the period of 2010 until 2017. Particulate matter (PM2.5) and carbon dioxide (CO2) are used as indicators of air pollution. From the generalized method of moments (GMM) estimations, the results reveal that air pollution negatively affects adult mortality rate. The result reveals that a 10% increase in the PM2.5 level induces the adult mortality rates to increase between 0.04% and 0.06%. In addition, the government significantly moderates the negative effect of air pollution on adult mortality, whereby a one-unit enhancement in governance quality index reduces mortality among the adults in the developing countries by 0.01%. On the other hand, CO2 emission also appears to be positive, but not statistically significant. The results suggest that governance and public health interplay in the sense of a transition towards economic development for improved living and health states can be achievable with improved governance quality.
  10. Air pollution, governance quality, and health outcomes: evidence from developing countries
    Ahmad NA, Ismail NW, Sidique SFA, Mazlan NS
    Environ Sci Pollut Res Int, 2023 Mar;30(14):41060-41072.
    PMID: 36630041 DOI: 10.1007/s11356-023-25183-6
    While studies have demonstrated that air pollution can be catastrophic to the population's health, few empirical studies are found in the economic literature because a considerable proportion of the evidence comes from epidemiological studies. Because of the crucial role of governance in the health community, good governance has been a contentious issue in public sector management in recent years. Therefore, the aim of this study is to examine the effects of air pollution and the role of governance on health outcomes. This study employed the generalized method of moment (GMM) estimation techniques to analyse panel data for 72 developing countries from 2010 to 2017. The empirical results confirm that higher PM2.5 and CO2 levels have a detrimental influence on life expectancy and healthy life expectancy, whereas the role of governance has a positive impact on life expectancy and healthy life expectancy. Furthermore, the findings show governance quality plays a role in moderating the negative effect of PM2.5 on health outcomes. The ongoing rise in air pollution has had a significant impact on the health of developing countries. It appears that governance quality has improved health outcomes. The findings have important policy implications, such that strengthening governance can reduce air pollution emissions in developing countries. However, to reduce the health effects of air pollution, developing countries must implement effective environmental development policies and track the implementation and enforcement of such policies.
  11. An overview of the methodology and general findings from the National Health and Morbidity Survey (NHMS) 2018: Older persons' health in Malaysia
    Sooryanarayana R, Wong NI, Ahmad NA, Razak MAA, Yusoff MFM, Chan YY, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:7-15.
    PMID: 33370855 DOI: 10.1111/ggi.14094
    AIM: This article describes the methodology of the 2018 Malaysian National Health and Morbidity Survey, and provides an overview of the sociodemographic details of the respondents and key findings on the health of older adults.

    METHODS: The survey included 3977 community-dwelling respondents, aged ≥60 years across Malaysia. Two-stage stratified random sampling with selection of enumeration blocks from both urban and rural areas ensured the findings were representative of the Malaysian older population.

    RESULTS: Complex sampling analyses ensured that findings on various geriatric syndromes, non-communicable diseases, nutritional status, functional status, social well-being and quality of life are representative of the Malaysian older population. Among the limitations are that the composition of older persons varied slightly from the general older population.

    CONCLUSIONS: This article presents the methodology of the survey, and a baseline of the major health issues for older persons in Malaysia to provide clear guidance to researchers, program managers and policymakers to fully utilize the data from the Malaysian National Health and Morbidity Survey toward achieving healthy aging. The findings might stimulate more research on the health problems faced by older people to provide inputs for policymaking and program implementation. Geriatr Gerontol Int 2020; 20: 7-15.

  12. Fulltext Anemia among Men in Malaysia: A Population-Based Survey in 2019
    Awaluddin SM, Shahein NA, Che Abdul Rahim N, Mohd Zaki NA, Nasaruddin NH, Saminathan TA, et al.
    Int J Environ Res Public Health, 2021 Oct 17;18(20).
    PMID: 34682667 DOI: 10.3390/ijerph182010922
    This study aimed to determine the prevalence of anemia and factors associated with anemia among men in Malaysia. The researchers used data from the 2019 National Health and Morbidity Survey (NHMS). The hemoglobin levels of men aged 15 years and above who gave their consent was measured using the HemoCue® Hb 201+ System©. The majority of them (87.2%) were men aged 15-59 years, referred to as the younger age group in this study. The prevalence of anemia among men was 12.6% (95% confidence interval (CI): 10.9, 14.5). The prevalence was higher among older men (30.7%; 95% CI: 26.6, 35.1) than younger men (10.0%; 95% CI: 8.2, 12.2). Anemia among men was associated with older age (adjusted odds ratios (aOR) = 3.1; 95% CI: 2.1, 4.4) and those with diabetes (aOR = 1.5; 95% CI: 1.2, 2.1) via a logistic regression analysis. In conclusion, older men were more affected by anemia than younger men in this study. Anemia among older men in Malaysia is at the level of moderate to severe public health significance. The likelihood of developing anemia is increased among older men with diabetes compared to older men without diabetes. These often-overlooked issues among men need to be detected and treated early in order to prevent complications and improve their quality of life.
  13. Anti-S Antibodies Against SARS-CoV-2 Infection Among Four Types of Vaccines in Malaysia
    Lodz NA, Mat Tamizi NF, Abd Mutalip MH, Ganapathy SS, Lin CZ, Ismail R, et al.
    Asia Pac J Public Health, 2024 Jan;36(1):96-103.
    PMID: 38166431 DOI: 10.1177/10105395231223332
    Monitoring SARS-CoV-2 antibody levels can provide insights into a person's immunity to COVID-19 and inform decisions about vaccination and public health measures. Anti-S may be useful as an indicator of an effective immune response. Thus, we conducted this study that aimed to determine the immune response of anti-S antibodies against SARS-CoV-2 for all the vaccine types over time among adult recipients in Malaysia and to determine the associated factors. This study was a cohort that recruited 2513 respondents aged 18 years and above from June to December 2021. Each participant was followed-up for 1-year period from the initial vaccine dose (baseline). We found that the anti-S antibody generally increased for all vaccine types and peaked at two weeks after the second dose vaccination, with Pfizer recipients having the highest median of 100 (100.00-100.00). During the third-month follow-up, the seropositivity of anti-S antibody and the median level decreased for all vaccines. We found that type of vaccines, comorbid status, infection, and booster status were significantly associated with the anti-S antibody level after one year.
  14. Assessing Gender Identity and Sex in Diverse Low-, Middle-, and High-Income Settings: Findings from a WHO/HRP Consultative Process
    Tucker JD, Bajos N, Mercer CH, Gitau E, Ahmad NA, Gonsalves L
    Sex Transm Dis, 2022 Feb 01;49(2):e42-e44.
    PMID: 34321451 DOI: 10.1097/OLQ.0000000000001525
    Obtaining detailed data on gender identity and sex in population-based sexual health studies is important. We convened a group to develop consensus survey items. We identified 2 items to capture data on gender identity and sex that can be used in diverse settings.
  15. Fulltext Association between Availability of Neighborhood Fast Food Outlets and Overweight Among 5⁻18 Year-Old Children in Peninsular Malaysia: A Cross-Sectional Study
    Chee Cheong K, Yoon Ling C, Kuang Hock L, Mohd Ghazali S, Chien Huey T, Che Ibrahim MK, et al.
    Int J Environ Res Public Health, 2019 02 18;16(4).
    PMID: 30781699 DOI: 10.3390/ijerph16040593
    A growing number of fast-food outlets in close proximity to residential areas raises a question as to its impact on childhood overweight and obesity. This study aimed at determining the relationship between the availability of fast-food outlets that were in close proximity to residential areas and overweight among Malaysian children aged 5 to 18 years. Measurement data on the weight and height of 5544 children (2797 boys, 2747 girls) were obtained from the National Health and Morbidity Survey 2011. Overweight (including obesity) is defined as BMI-for-age z-score > +1 SD based on the WHO growth reference. Geographic information system geospatial analysis was performed to determine the number of fast-food outlets within 1000 m radius from the children's residential address. Multiple logistic regression was conducted to examine the association between the availability of fast-food outlets (none or more than one outlet) and overweight with adjustment for age, sex, ethnicity, monthly household income, parental educational level, residential area and supermarket density. Our results showed that the prevalence of overweight was 25.0% and there was a statistically significant association between the density of fast-food outlets and overweight (odds ratio: 1.23, 95% confidence interval: 1.03, 1.47). Our study suggested that the availability of fast-food outlets with close proximity in residential areas was significantly associated with being overweight among children. Limiting the number of fast-food outlets in residential areas could have a significant effect in reducing the prevalence of overweight among Malaysian children.
  16. Association between functional limitations and depression among community-dwelling older adults in Malaysia
    Ahmad NA, Abd Razak MA, Kassim MS, Sahril N, Ahmad FH, Harith AA, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:21-25.
    PMID: 33370850 DOI: 10.1111/ggi.14012
    AIM: This study aimed to assess the relationship between functional limitations and depression among community-dwelling older adults in Malaysia.

    METHODS: Data from a nation-wide community-based cross-sectional study were analyzed. This study was conducted using a two-stage stratified random sampling design. In total, 3772 older adults aged ≥60 years responded to the survey. Depression was identified using a validated Malay version of the Geriatric Depression Scale (M-GDS-14), with those scored ≥6 categorized as having depression. Functional limitations were assessed using both Barthel's Activities of Daily Living (ADL) and Lawton's Instrumental Activities of Daily Living (IADL). The relationship was determined by multivariate logistic regression, adjusted for other variables.

    RESULTS: The prevalence of depression was 11.5% (95% confidence interval [CI] 9.4, 13.4). Multiple logistic regression analysis found that older adults with limitations in ADL were 2.6 times more likely of having depression (adjusted odds ratio [aOR] 2.58, 95% CI 2.01, 3.32), while those with limitations in IADL the risk of having depression was almost doubled (aOR 1.68, 95% CI: 1.32, 2.14). Other significant factors were incontinence (aOR 3.33, 95% CI: 2.33, 4.74), chronic medical illness (aOR 1.44, 95% CI: 1.15, 1.81), current smoker (aOR 4.19, 95% CI: 1.69, 10.39), poor social support (aOR 4.30, 95% CI: 2.98, 6.20), do not have partner, ethnic minorities and low individual monthly income.

    CONCLUSIONS: Older adults with functional limitation in both basic ADL and complex IADL are independently at higher risk of having depression. Geriatr Gerontol Int 2020; 20: 21-25.

  17. Fulltext Association of Internet Addiction with Adolescents' Lifestyle: A National School-Based Survey
    Ying Ying C, Awaluddin SM, Kuang Kuay L, Siew Man C, Baharudin A, Miaw Yn L, et al.
    Int J Environ Res Public Health, 2020 12 29;18(1).
    PMID: 33383635 DOI: 10.3390/ijerph18010168
    Internet addiction (IA) among adolescents is an issue of growing concern with adverse effects on adolescents' health and social functioning. This study aims to determine the prevalence of IA among school-going adolescents in Malaysia and its associated factors-specifically, lifestyle factors. A nationwide cross-sectional school-based health survey was conducted in 2017 among 27,497 students from 212 randomly selected secondary schools. Information regarding sociodemography, lifestyle, and internet use was obtained using a self-administered questionnaire. IA was measured using the Malay Version of Internet Addiction Test (MVIAT). The prevalence of internet addiction was 29.0%. A multivariable logistic analysis revealed that inadequate fruit and vegetable intakes, consumed carbonated soft drinks at least once a day, consumed fast food at least three days/week, sedentary behavior, current E-cigarette users, and ever/current alcohol drinkers were lifestyle factors significantly associated with IA. Adolescents from urban schools, of higher school grade, and those whose parents are married but living apart were also found to have a greater risk for internet addiction. A positive association was found between IA with unhealthy dietary and lifestyle behaviors among adolescents. The modification of lifestyle factors needs to be considered while developing strategies and interventions for awareness-raising and prevention of IA among adolescents.
  18. Association of dietary behaviour and depression among adolescents in Malaysia: a cross-sectional study
    Sahril N, Adnan MAA, Khalil MKN, Chan YM, Yoga Ratnam KK, Lai WK, et al.
    J Health Popul Nutr, 2023 Nov 28;42(1):133.
    PMID: 38017532 DOI: 10.1186/s41043-023-00480-5
    BACKGROUND: Depression is on the rise and has become a significant concern for public health. Limited research has explored the connection between dietary patterns and depression. This investigation aimed to examine how dietary behaviours relate to depression among adolescents attending school in Malaysia.

    METHODS: The study utilized data from the National School-Based Health Survey 2022, a nationwide survey involving school-going adolescents aged 13-17, with a total of 33,523 participants from 239 schools. To assess depression, the study employed the Patient Health Questionnaire (PHQ-9), considering a score of 10 or higher as indicative of depression. Dietary behaviours were assessed using a validated self-administered questionnaire adapted from the World Health Organization's Global School-based Student Health Survey. Descriptive analysis and complex sample logistic regression were carried out using SPSS version 26.0.

    RESULTS: The study revealed a 26.9% overall prevalence of depression, with higher risks among female adolescents (AOR 2.71, 95% CI 2.51, 2.92) and those in higher grades. Malays (AOR 1.71, 95% CI 1.41, 2.07), Other Bumiputeras (AOR 1.69, 95% CI 1.32, 2.17), and Others (AOR 1.63, 95% CI 1.16, 2.30) had elevated odds of depression compared to Indians. Healthy dietary habits, like consuming less than two servings of fruits daily, correlated with depression (AOR 1.44 95% CI 1.35, 1.54). Additionally, unhealthy dietary behaviours such as fast food consumption (AOR 1.73 [95% CI 1.55, 1.93]) and carbonated soft drink intake (AOR 1.59 [95% CI 1.48, 1.70]) were positively associated with depression.

    CONCLUSIONS: One out of every four Malaysian adolescents was identified to experience depression. Depression was linked to several factors, such as being female, belonging to higher grade levels, identifying as Malays, Other Bumiputeras, or belonging to other ethnicities, and participating in the consumption of fast food, carbonated soft drinks, and fruits. To address these observations, it is crucial to formulate effective public health programmes that prioritize adolescent mental health and encourage the adoption of healthy eating habits.

  19. Being Bullied Is Associated With Depression Among Malaysian Adolescents: Findings From a Cross-Sectional Study in Malaysia
    Abd Razak MA, Ahmad NA, Abd Aziz FA, Jamaluddin R, Sidik SM, Awaluddin SM, et al.
    Asia Pac J Public Health, 2019 11;31(8_suppl):30S-37S.
    PMID: 31402682 DOI: 10.1177/1010539519867796
    Limited evidence on the association of being bullied with depression among adolescents was found in Malaysia. This study aimed to determine the association of being bullied and depression among Malaysian school-going adolescents. Data from the National Health and Morbidity Survey 2017, a cross-sectional study conducted from March to May 2017, was analyzed using descriptive and multiple logistic regression analysis. A validated tool, the Depression, Anxiety, and Stress Scale-21 was used to categorize those with moderate or higher levels of depressive symptoms as having depression. A total of 27 399 school-going adolescents participated and 18.3% were found depressed. Adolescents of Indian ethnicity (adjusted odds ratio [aOR] = 2.02, P < .001), those with parents living apart (aOR = 1.41, P < .001), and those who were being bullied (aOR = 2.98, P < .001) were more likely to have depression. This study demonstrated the association between being bullied and having depression. Comprehensive preventive strategies should be implemented taking into consideration the findings from this study.
  20. Fulltext Cardiovascular disease risk factors among older people: Data from the National Health and Morbidity Survey 2015
    Sazlina SG, Sooryanarayana R, Ho BK, Omar MA, Krishnapillai AD, Mohd Tohit N, et al.
    PLoS One, 2020;15(10):e0240826.
    PMID: 33085718 DOI: 10.1371/journal.pone.0240826
    Study on cardiovascular disease (CVD) risk factors and their prevalence among the older people in Malaysia is limited. We aimed to determine the prevalence and factors associated with CVD risk factors using the non-laboratory Framingham Generalized 10-Year CVD risk score among older people in Malaysia. This was a population-based cross-sectional study using data of 3,375 participants aged ≥60 years from the National Health and Morbidity Survey 2015. Sociodemographic, health factors and clinical assessments (anthropometry and blood pressure) were included. Complex survey analysis was used to obtain prevalence with 95% confidence intervals (CI). We applied ordinal regression to determine the factors associated with CVD risk. The prevalence for the high 10-year CVD risk was 72.1%. Body mass index was higher among those aged 60-69 years in men (25.4kg/m2, 95%CI 25.1-25.8) and women (26.7kg/m2, 95%CI 26.3-27.1) than the other age groups. The factors associated with moderate and high 10-year CVD risk were Malay ethnicity (Odds Ratio(OR) 0.76, 95%CI 0.63-0.92, p = 0.004), unmarried status (OR 1.55, 95%CI 1.22-1.97, p<0.001) and physically inactive (OR 0.72, 95%CI 0.55-0.95, p = 0.020). There is a need for future study to evaluate preventive strategies to improve the health of older people in order to promote healthy ageing.
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