MATERIALS AND METHODS: We analysed internationally comparable representative household survey data from 33,482 respondents aged ≥ 15 years in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally.
RESULTS: The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina.
CONCLUSIONS: Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.
METHOD: This study was conducted using an exploratory qualitative approach on purposely selected healthcare providers at primary healthcare clinics. Twenty focus group discussions and three in-depth interviews were conducted using a semi-structured interview guide. Consent was obtained prior to interviews and for audio-recordings. Interviews were transcribed verbatim and thematically analysed, guided by the Consolidated Framework for Implementation Research (CFIR), a framework comprised of five major domains promoting implementation theory development and verification across multiple contexts.
RESULTS: The study revealed via CFIR that most primary healthcare providers were receptive towards any proposed changes or intervention for the betterment of NCD care management. However, many challenges were outlined across four CFIR domains-intervention characteristics, outer setting, inner setting, and individual characteristics-that included perceived barriers to implementation. Perception of issues that triggered proposed changes reflected the current situation, including existing facilitating aspects that can support the implementation of any future intervention. The importance of strengthening the primary healthcare delivery system was also expressed.
CONCLUSION: Understanding existing situations faced at the primary healthcare setting is imperative prior to implementation of any intervention. Healthcare providers' receptiveness to change was explored, and using CFIR framework, challenges or perceived barriers among healthcare providers were identified. CFIR was able to outline the clinics' setting, individual behaviour and external agency factors that have direct impact to the organisation. These are important indicators in ensuring feasibility, effectiveness and sustainability of any intervention, as well as future scalability considerations.
METHODS: The data from a cross-sectional study retrieved from the e-Notifikasi System, a national reporting system for communicable diseases provided by the Disease Control Division, Ministry of Health Malaysia and secondary data of all the typhoid cases were obtained from the public and private hospitals and laboratories in Klang Valley. Descriptive analysis was performed to examine the sociodemographic characteristics, spatial mapping was conducted to examine trends, and the crude incidence rates of confirmed typhoid cases and percentage of reporting coverage were calculated. Significant differences between MDR and non-MDR Salmonella typhi were determined in the patient's sociodemographic characteristics, which were analyzed using χ2 test. P values
METHODS: A population-based study was conducted on a total of 890 respondents who were representative of the adult population in Malaysia, i.e., aged ≥18 years old. Respondents were randomly selected using a stratified cluster method. The estimated glomerular filtration rate (eGFR) was estimated from calibrated serum creatinine using the CKD-EPI equation. CKD was defined as eGFR
METHODS: Free vaccination was offered to school girls in secondary school (year seven) in Malaysia, which is usually at the age of 13 in the index year. All recipients of the HPV vaccine were identified through school enrolments obtained from education departments from each district in Malaysia. A total of 242,638 girls aged between 12 to 13 years studying in year seven were approached during the launch of the program in 2010. Approximately 230,000 girls in secondary schools were offered HPV vaccine per year by 646 school health teams throughout the country from 2010 to 2016.
RESULTS: Parental consent for their daughters to receive HPV vaccination at school was very high at 96-98% per year of the programme. Of those who provided consent, over 99% received the first dose each year and 98-99% completed the course per year. Estimated population coverage for the full vaccine course, considering also those not in school, is estimated at 83 to 91% per year. Rates of adverse events reports following HPV vaccination were low at around 2 per 100,000 and the majority was injection site reactions.
CONCLUSION: A multisectoral and integrated collaborative structure and process ensured that the Malaysia school-based HPV immunisation programme was successful and sustained through the programme design, planning, implementation and monitoring and evaluation. This is a critical factor contributing to the success and sustainability of the school-based HPV immunisation programme with very high coverage.
METHODS: Secondary data from MyTB version 2.1, a national database, were analysed using R version 3.6.1. Descriptive analysis and multivariable logistic regression were conducted to identify treatment success and its determinants.
RESULTS: In total, 3630 cases of TB cases were registered among children in Malaysia between 2013 and 2017. The overall treatment success rate was 87.1% in 2013 and plateaued between 90.1 and 91.4% from 2014 to 2017. TB treatment success was positively associated with being a Malaysian citizen (aOR = 3.43; 95% CI = 2.47, 4.75), being a child with BCG scars (aOR = 1.93; 95% CI = 1.39, 2.68), and being in the older age group (aOR = 1.06; 95% CI = 1.03, 1.09). Having HIV co-infection (aOR = 0.31; 95% CI = 0.16, 0.63), undergoing treatment in public hospitals (aOR = 0.38; 95% CI =0.25, 0.58), having chest X-ray findings of advanced lesion (aOR = 0.48; 95% CI = 0.33, 0.69), having EPTB (aOR = 0.58; 95% CI = 0.41, 0.82) and having sputum-positive PTB (aOR = 0.58; 95% CI = 0.43, 0.79) were negatively associated with TB treatment success among children.
CONCLUSIONS: The overall success rate of treatment among children with TB in Malaysia has achieved the target of 90% since 2014 and remained plateaued until 2017. The socio-demographic characteristics of children, place of treatment, and TB disease profile were associated with the likelihood of TB treatment success among children. The treatment success rate can be increased by strengthening contact tracing activities and promoting early identification targeting the youngest children and non-Malaysian children.
METHODS: The scoping review was conducted based on the framework by Arksey and O'Malley. The Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) diagram was used as a guide to record the review process. Articles from year 2008 until 2017 on overweight and obesity among adults aged 18 years and above were retrieved based on the keywords using electronic databases (Embase/Ovid, Pubmed, Cochrane library and Google Scholar). Local journals, Nutrition Research in Malaysia Biblography (2011 and 2016), online local theses databases, virtual library databases were also included in the searches. Consultations with relevant key informants from the National Institutes of Health and local universities were also conducted. Search activities were managed using Endnote software and MS Excelsheet.
RESULTS: The characteristics of the results were described based on the objectives of the review. A total of 2004 articles and reports were retrieved, and 188 articles related to obesity in Malaysia were included in the final review. Scopes and topics of obesity research based on the Nutrition Research Priorities in Malaysia (NRPM) for 11th Malaysia Plan were obesity prevalence, weight loss intervention, association of physical activities and dietary factors with obesity. The majority of obesity research among adults in Malaysia was cross sectional studies and only a small number of intervention studies, qualitative studies and systematic review were indentified. Research gaps were identified in order to make useful recommendations to the stakeholders.
CONCLUSIONS: In the past decade, there has been an emerging evidence on obesity research among adults in Malaysia. More obesity research needs to be conducted particularly on obesity intervention among specific gender, qualitative studies, economic cost and genetic factors of obesity.
METHODS: This is a follow-up study among 84 obese housewives without co-morbidities aged 18 to 59 years old who previously participated as a control group (delayed intervention, G1) in the My Body is Fit and Fabulous at Home (MyBFF@home) Phase II. Baseline data were obtained from 12 month data collection for this group. A new group of 42 obese housewives with co-morbidities (G2) were also recruited. Both groups received a 6 month intervention (July-December 2015) consisting of dietary counselling, physical activity (PA) and self-monitoring tools (PA diary, food diary and pedometer). Study parameters included weight, height, waist circumference, blood pressure and body compositions. Body compositions were measured using a bioelectrical impedance analysis device, Inbody 720. Descriptive and repeated measures ANOVA analyses were performed using SPSS 21.
RESULTS: There were reductions in mean body fat, fat mass and visceral fat area, particularly among obese women without co-morbidities. There were also decreases fat and skeletal muscle from baseline to month six with mean difference - 0.12 (95% CI: -0.38, 0.14) and visceral fat area from month three to month six with mean difference - 9.22 (- 17.87, - 0.56) for G1. G2 showed a decreasing pattern of skeletal muscle from baseline to month six with mean difference - 0.01(95% CI: -0.38, 0.37). There was a significant difference for group effect of visceral fat area (p
METHODS: A total of 322 participants from the MyBFF@home study completed the Newest Vital Sign (NVS) test at baseline. However, only data from 209 participants who completed the NVS test from baseline to WL intervention were used to determine the HL groups. Change of the NVS scores from baseline to WL intervention phase was categorized into two groups: those with HL improvement (increased 0.1 score and above) and those without HL improvement (no change or decreased 0.1 score and more). Independent variables in this study were change of energy intake, nutrient intake, physical activity, anthropometry measurements, and body composition measurements between baseline and WL intervention as well as between WL intervention and WL maintenance. An Independent sample t-test was used in the statistical analysis.
RESULTS: In general, both intervention and control participants have low HL. The study revealed that the intervention group increased the NVS mean score from baseline (1.19 scores) to the end of the WL maintenance phase (1.51 scores) compared to the control group. There was no significant difference in sociodemographic characteristics between the group with HL improvement and the group without HL improvement at baseline. Most of the dietary intake measurements at WL intervention were significantly different between the two HL groups among intervention participants. Physical activity and body composition did not differ significantly between the two HL groups among both intervention and control groups.
CONCLUSION: There was an improvement of HL during the WL intervention and WL maintenance phase in intervention participants compared to control participants. HL shows positive impacts on dietary intake behavior among intervention participants. New research is suggested to explore the relationship between HL and weight loss behaviors in future obesity intervention studies.
METHODS: Baseline and sixth month data from the MyBFF@home study were used for this purpose. A total of 169 of overweight and obese respondents answered the IPAQ-SF and were asked to use a pedometer for 7 days. Data from IPAQ-SF were categorised as inactive and active while data from pedometer were categorised as insufficiently active and sufficiently active by standard classification. Data on sociodemographic and anthropometry were also obtained. Cohen's kappa was applied to measure the agreement of IPAQ-SF and pedometer in determining the physical activity level. Pre-post cross tabulation table was created to evaluate the changes in physical activity over 6 months.
RESULTS: From 169 available respondents, 167 (98.8%) completed the IPAQ-SF and 107 (63.3%) utilised the pedometer. A total of 102 (61.1%) respondents were categorised as active from the IPAQ-SF. Meanwhile, only 9 (8.4%) respondents were categorised as sufficiently active via pedometer. Cohen's κ found there was a poor agreement between the two methods, κ = 0.055, p > 0.05. After sixth months, there was + 9.4% increment in respondents who were active when assessed by IPAQ-SF but - 1.3% reductions for respondents being sufficiently active when assessed by pedometer. McNemar's test determined that there was no significant difference in the proportion of inactive and active respondents by IPAQ-SF or sufficiently active and insufficiently active by pedometer from the baseline and sixth month of intervention.
CONCLUSION: The IPAQ-SF and pedometer were both able to measure physical activity. However, poor agreement between these two methods were observed among overweight and obese women.