Displaying publications 1 - 20 of 41 in total

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  1. Reeves S, Poh BK, Chong YT, Lee JAC, Cheah WL, Hafizah YN, et al.
    Int J Environ Res Public Health, 2023 Aug 20;20(16).
    PMID: 37623197 DOI: 10.3390/ijerph20166614
    Prevention and treatment of childhood obesity is a global concern, and in Malaysia, it is considered a national public health priority. Determinants of childhood obesity are multifactorial and include factors that directly and indirectly influence energy balance-related behaviours, including energy intake and energy expenditure. Interventions to address childhood obesity that have multiple components at different levels have been shown to be the most influential. The ToyBox-study is a childhood obesity intervention aimed at preschool-aged children and their families that had been shown to be effective in several European countries and so was chosen for adaption for the Malaysian setting. Materials were translated and adjusted for the Malaysian context and audience and implemented in kindergartens in Peninsular Malaysia and Sarawak. However, during the COVID-19 pandemic and lockdown, teaching transitioned to being online. This brought an opportunity to reach a wider audience and consider the long-term sustainability of the intervention, and thus eToybox was born. eToybox aims to bring support for healthy energy balance behaviours directly to the teachers, into kindergartens and homes, to encourage families to be active and eat healthily, and prevent or reduce obesity. Through online innovation, the Toybox Study Malaysia programme has been expanded to enhance its potential to impact the promotion of healthy lifestyles among preschoolers and their families, highlighting the importance of a holistic approach to preventing and treating childhood obesity in Malaysia.
  2. Majorie Ensayan J, Cheah WL, Hazmi H
    Malays J Med Sci, 2023 Aug;30(4):147-156.
    PMID: 37655155 DOI: 10.21315/mjms2023.30.4.13
    BACKGROUND: Postpartum depression (PD) among women, if left untreated, may result in long-term health and social consequences for them and their families. This cross-sectional study aimed to determine the factors contributing to PD among working mothers in Kuching, Sarawak, Malaysia.

    METHODS: Systematic sampling was used to recruit working mothers who attended Kuching's maternal and child health clinics. They were interviewed with a validated translated questionnaire to obtain data on sociodemographics, health profiles, and Edinburgh Postnatal Depression Scale (EPDS) and postpartum symptoms. Data were analysed using IBM SPSS version 21.0.

    RESULTS: Out of the total 281 respondents, 15.3% of respondents had depression symptoms. Fatigue (42.7%), back or neck pain (36.3%), breast discomfort (16.4%), dizziness (13.5%) and nipple irritation (11.0%) were the most common physical symptoms experienced by the mothers. Regression analysis showed that working mothers who exhibited higher scores of physical symptoms were 1.26 times more likely to develop PD (adjusted odd ratio 1.26, P < 0.01; 95% CI: 1.071, 1.487).

    CONCLUSION: Physical symptoms were the predictors of PD among working mothers.

  3. Cheah WL, Law LS, Samy AL, Chua BS, Siau CS, Fitriana M, et al.
    Psychol Health Med, 2023 Jan;28(1):189-199.
    PMID: 35437088 DOI: 10.1080/13548506.2022.2063351
    The coronavirus disease (COVID-19) pandemic has affected the well-being of individuals worldwide. Due to the scarcity of information in the Malaysian context, this study aimed at investigating the changes in well-being before and during the Movement Control Order (MCO) in Malaysia and its association with mental health status. This cross-sectional study was part of a Malaysian non-probabilistic online survey on psychosocial well-being in Malaysia, under the Personal and Family Coping with COVID-19 Global South Research Consortium. A total of 543 respondents (≥18 years old) were recruited using snowball sampling. A validated self-administered questionnaire for assessing sociodemographic characteristics, well-being, anxiety, boredom, and loneliness was circulated on social media platforms (such as Facebook, Twitter, and WhatsApp) and emails. Paired samples t-test, chi-square test, and multinomial logistic regression analyses were applied during data analysis. Results revealed significant changes in the mean scores of well-being, anxiety, boredom, and loneliness before and during MCO (p 
  4. Cheah WL, Law LS, Adibah Z, Nur Afiqah MS, Nur Aiennie L, Nik Noor Arba'iyah NH, et al.
    PMID: 36992961 DOI: 10.51866/oa.121
    INTRODUCTION: The COVID-19 Movement Control Order (MCO) has caused a concern on the food consumption among university students. This study aimed to assess food diversity and its relationship with accommodation among university students in Sarawak.

    METHOD: This cross-sectional study was conducted among students of the University Malaysia Sarawak in Kota Samarahan during the MCO. Data on socio-demographic characteristics and food diversity were collected using an online questionnaire.

    RESULTS: A total of 478 respondents participated in this study. The majority of the respondents were women (77.4%), and almost half were Malays (49.6%). Half of the respondents stayed at home with their family, while 36.4% stayed in their college dormitories. Except for legumes, nuts and seeds and milk and milk products, all other food groups were common in the respondents' diet, with the highest consumption observed from cereal and cereal products, followed by meat and meat products and water. One-way ANOVA showed that there were significant differences in the intake of fish and seafood; legumes, nuts and seeds; milk and milk products; and fruits between those who stayed in college dormitories, at home with their families and in rented houses (P<0.01).

    CONCLUSION: Despite reduction in food availability and accessibility, the total energy intake of the university students did not change. University students should be continuously educated on the importance of a balanced diet consisting of all food groups.

  5. Kangan RZ, Cheah WL, Hazmi H
    PMID: 36992958 DOI: 10.51866/oa.211
    INTRODUCTION: Hypertension is an emerging health concern among children owing to its increasing prevalence and association with obesity. However, hypertension screening is uncommon, and childhood hypertension-related data are limited. This cross-sectional study determined the prevalence and associated factors of hypertension among primary school children in Kuching, Sarawak.

    METHOD: Standard procedures and validated equipment were used to measure blood pressure and anthropometric indicators. The body mass index (BMI)-for-age and waist-to-height ratio (WHtR) were calculated. Questionnaires were used to obtain family sociodemographic data and health history.

    RESULTS: A total of 1,314 children aged 6-12 years were enrolled, of whom 107 (8.1%) and 178 (13.5%) were hypertensive and pre-hypertensive, respectively. The chi-squared test indicated that hypertension was significantly associated with male sex (P<0.05), >1 standard deviation BMI-for-age (P<0.001), percentage of excess body fat (BF)(P<0.001), 5th to 95th height percentile (P<0.001), >90th excess waist circumference (WC) percentile (P<0.001), >90th WHtR percentile (P<0.001), clerical, service, sales and skilled parental work (P<0.05), excess weight (P<0.05) and cardiovascular disease (P<0.01). Multivariate logistic regression analysis showed that the percentage of excess BF [odds ratio (OR): 4.84, 95% confidence interval (CI): 2.01-11.66] and excess WC (OR: 2.33, 95% CI: 1.15-4.72) were significantly related to hypertension after adjusting for sex and age.

    CONCLUSION: The prevalence of hypertension among the study population is higher than that among children worldwide. Childhood hypertension-related factors must be identified to aid in routine blood pressure screening, which is crucial for early detection and intervention to reduce future morbidity burden.

  6. Majorie Ensayan AJ, Cheah WL, Helmy H
    Malays Fam Physician, 2023;18:48-100.
    PMID: 37719695 DOI: 10.51866/oa.167
    INTRODUCTION: Most working women experience poor physical and mental health during their postpartum period. This prospective study aimed to describe the physical and mental health issues faced by working mothers during their postpartum period.

    METHODS: Respondents were recruited using the proportional sampling method among mothers who attended the Maternal and Child Health Clinic in the Kuching division in Sarawak, Malaysia. Face-to-face interview was conducted using a questionnaire that consisted of items on socio-demographic data as well as perinatal, prenatal and postpartum factors, and the Edinburgh Postnatal Depression Scale and a checklist of 28 specific postpartum symptoms were used during the first 6 weeks and after 12 weeks of childbirth.

    RESULTS: A total of 281 respondents participated in this study. Fatigue (42.7%), back or neck pain (36.3%), breast discomfort (16.4%), dizziness (13.5%) and nipple irritation (11.0%) were among the most common symptoms experienced by the mothers during the first 6 weeks after childbirth. There was a significant decrease in the physical symptom scores of the respondents from the first 6 weeks to after 12 weeks of childbirth (1.73±1.96 vs 0.16±0.42; P<0.0005). A significant decrease was also found in the depression scores (6.26±4.26 vs 1.35±1.85, P<0.0005).

    CONCLUSION: The prevalence of postnatal depression was higher during the first 6 weeks of postpartum than after 12 weeks of postpartum. Screening and treatment of poor postpartum mental health among working women are essential owing to the impacts on occupational outcomes.

  7. Cheah WL, Shin ECV, Hazmi H
    Nutr Health, 2022 Oct 26.
    PMID: 36285456 DOI: 10.1177/02601060221132597
    Background: Disordered eating is common among late adolescents and young adults who pursue an idealised body image. Aims: This study aims to determine the prevalence of disordered eating between males and females and its associated factors among college and university students in Sarawak. Methods: A cross-sectional study involving 20 public and private colleges and universities in Sarawak, from September 2017 to March 2020. Respondents completed self-administered questionnaires both in the English and Malay language. Data about sociodemographic characteristics, body mass index, eating attitude, body dissatisfaction, perceived sociocultural pressure, self-esteem, drive for muscularity and perfectionism were collected. Results: A total of 776 respondents (male: 30.9%; female: 69.1%) aged 19 to 25 years old took part in the study. The overall prevalence of disordered eating was 25.2% (95% confidence interval (CI) 21.9; 28.7) with females (28.6%, 95% CI 24.6; 32.9) higher than males (15.6%, 95% CI 10.5; 21.9). Multivariate analysis showed for both male and female models, perceived sociocultural pressure (male: β = 1.125, p 
  8. Cheah WL, Law LS, Teh KH, Kam SL, Voon GEH, Lim HY, et al.
    Health Sci Rep, 2021 Sep;4(3):e362.
    PMID: 34466663 DOI: 10.1002/hsr2.362
    Background and Aims: This study aimed to examine the quality of life (QoL) and health satisfaction of undergraduate university students in Sarawak during MCO and its association with socio-demographic profiles.

    Methods: In this cross-sectional study, QoL and satisfaction of health of 503 undergraduate university students (63.4% females) from a public university was assessed online using the World Health Organization QoL (WHOQOL)-BREF instrument.

    Results: The overall QoL and satisfaction with health were 3.7 ± 0.87 and 3.9 ± 0.82, respectively. Male students showed significantly lower mean scores for the environmental domains than female students (63.37 ± 16.21 vs 68.10 ± 14.00, P 

  9. Saad MF, Cheah WL, Hazmi H
    J Prev Med Public Health, 2021 May;54(3):199-207.
    PMID: 34092066 DOI: 10.3961/jpmph.20.584
    OBJECTIVES: Physical inactivity is the fourth leading global risk factor for mortality, followed by obesity. The combination of these risk factors is associated with non-communicable diseases, impaired physical function, and declining mental function. The World Health Organization recommends physical activity to reduce the mortality rate. Thus, this study examined the effects on anthropometric measurements of a 12-week walking program for elderly people in Samarahan, Sarawak, Malaysia with a 7000-step goal and weekly group walking activities.

    METHODS: A quasi-experimental study was conducted involving 109 elderly people with a body mass index (BMI) ≥25.0 kg/m2. BMI, body composition, and average daily steps were measured at baseline, 6 weeks, and 12 weeks. Data were analyzed using SPSS version 26.0, and repeated-measures analysis of variance with the paired t-test for post-hoc analysis was conducted.

    RESULTS: In total, 48 participants in the intervention group and 61 participants in the control group completed the study. A significant interaction was found between time and group. The post-hoc analysis showed a significant difference between pre-intervention and post-intervention (within the intervention group). The post-intervention analysis revealed an increase in the mean number of daily steps by 3571.59, with decreases in body weight (-2.20 kg), BMI (-0.94 kg/m2), body fat percentage (-3.52%), visceral fat percentage (-1.29%) and waist circumference (-2.91 cm). Skeletal muscle percentage also showed a significant increase (1.67%).

    CONCLUSIONS: A 12-week walking program combining a 7000-step goals with weekly group walking activities had a significant effect on the anthropometric measurements of previously inactive and overweight/obese elderly people.

  10. Chai SS, Cheah WL, Goh KL, Chang YHR, Sim KY, Chin KO
    Comput Math Methods Med, 2021;2021:2794888.
    PMID: 34917164 DOI: 10.1155/2021/2794888
    This study outlines and developed a multilayer perceptron (MLP) neural network model for adolescent hypertension classification focusing on the use of simple anthropometric and sociodemographic data collected from a cross-sectional research study in Sarawak, Malaysia. Among the 2,461 data collected, 741 were hypertensive (30.1%) and 1720 were normal (69.9%). During the data gathering process, eleven anthropometric measurements and sociodemographic data were collected. The variable selection procedure in the methodology proposed selected five parameters: weight, weight-to-height ratio (WHtR), age, sex, and ethnicity, as the input of the network model. The developed MLP model with a single hidden layer of 50 hidden neurons managed to achieve a sensitivity of 0.41, specificity of 0.91, precision of 0.65, F-score of 0.50, accuracy of 0.76, and Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of 0.75 using the imbalanced data set. Analyzing the performance metrics obtained from the training, validation and testing data sets show that the developed network model is well-generalized. Using Bayes' Theorem, an adolescent classified as hypertensive using this created model has a 66.2% likelihood of having hypertension in the Sarawak adolescent population, which has a hypertension prevalence of 30.1%. When the prevalence of hypertension in the Sarawak population was increased to 50%, the developed model could predict an adolescent having hypertension with an 82.0% chance, whereas when the prevalence of hypertension was reduced to 10%, the developed model could only predict true positive hypertension with a 33.6% chance. With the sensitivity of the model increasing to 65% and 90% while retaining a specificity of 91%, the true positivity of an adolescent being hypertension would be 75.7% and 81.2%, respectively, according to Bayes' Theorem. The findings show that simple anthropometric measurements paired with sociodemographic data are feasible to be used to classify hypertension in adolescents using the developed MLP model in Sarawak adolescent population with modest hypertension prevalence. However, a model with higher sensitivity and specificity is required for better positive hypertension predictive value when the prevalence is low. We conclude that the developed classification model could serve as a quick and easy preliminary warning tool for screening high-risk adolescents of developing hypertension.
  11. Noor Hafizah Y, Ang LC, Yap F, Nurul Najwa W, Cheah WL, Ruzita AT, et al.
    PMID: 31783477 DOI: 10.3390/ijerph16234722
    As there are few food frequency questionnaires (FFQ) to assess the dietary intake of preschool children, this study examined the validity and reliability of an FFQ for this purpose. A total of 210 preschoolers aged 4 to 6 years participated in the validation study, while a subsample of 66 participants joined the reliability study. The FFQ is modified from the ToyBox-study and South East Asian Nutrition Surveys (SEANUTS), and comprised 108 food items from 13 food groups. A three-day estimated dietary record (3DR) was used as reference and reliability was assessed through a second administration of the FFQ (FFQ2), four weeks after the first administration (FFQ1). For the validation study, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ and 3DR. Cross-classification of quartile analysis showed moderate agreement between the two methods. As for reliability, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ1 and FFQ2. Cronbach's alpha values (0.708 to 0.824) and intraclass correlation coefficients (0.710 to 0.826) showed good agreement between repeated FFQs. The results suggest that the FFQ has acceptable validity and good reliability. Hence, the FFQ can be used to assess preschool children's food intake.
  12. Awang H, Low WY, Tong WT, Tan LY, Cheah WL, Benedict Lasimbang H, et al.
    J Biosoc Sci, 2019 03;51(2):282-291.
    PMID: 29978769 DOI: 10.1017/S0021932018000214
    The aim of this study was to assess the knowledge of East Malaysian adolescents on sexual and reproductive health issues. Data were collected in March-July 2015 from 2858 adolescents aged 13-18 years from selected East Malaysian secondary schools using a self-administered questionnaire. Twelve items relating to sexual and reproductive health were used to measure respondents' knowledge based on their responses 'True', 'False' or 'Don't know', with the proportion of correct answers being the variable of interest. Cronbach's alpha for the twelve items was 0.761 and the mean knowledge score was 6.8. While the majority of the respondents knew that a woman can get pregnant if she has sex with a man and that HIV and AIDS can be transmitted through sexual intercourse, knowledge about Malaysia's abortion laws, that a woman can get pregnant if she has sex only once and that people with sexually transmitted infections may look healthy was poor. Older respondents and those from urban schools reported significantly higher knowledge than younger respondents and those from rural schools, respectively. More emphasis should be given in schools to the specific topics for which low levels of sexual and reproductive health knowledge were found, with greater attention being given to younger adolescents and those in rural areas.
  13. Grace Kho WF, Cheah WL, Hazmi H
    Cent. Eur. J. Public Health, 2018 Mar;26(1):16-21.
    PMID: 29684292 DOI: 10.21101/cejph.a5186
    OBJECTIVES: Hypertension is a health issue affecting adolescents. Accumulating evidence affirms that elevated blood pressure begins in childhood and tracks into adulthood. This cross-sectional study was conducted to determine the prevalence of elevated blood pressure and its predictors among secondary school students in Sarawak, Malaysia.

    METHODS: A total of 2,461 secondary school students aged 12-17 years from 19 schools in Sarawak participated in the study. Questionnaire was used to obtain socio-demographic data, parental history of hypertension, and self-reported physical activity. Anthropometric and blood pressure measurements were taken. Data was entered and analysed using SPSS version 23.0.

    RESULTS: The prevalence of adolescents with elevated blood pressure, overweight, central obesity, and overfat were 30.1%, 24.3%, 13.5%, and 6.7%, respectively. Multivariate logistic regression demonstrated the predictors significantly associated with elevated blood pressure among respondents: overweight (adjusted odds ratio=3.144), being male (adjusted odds ratio=3.073), being Chinese (adjusted odds ratio=2.321) or Iban (adjusted odds ratio=1.578), central obesity (adjusted odds ratio=2.145), being overfat (adjusted odds ratio=1.885), and being an older adolescent (adjusted odds ratio=1.109). Parental history of hypertension, locality, and physical activity showed no significant associations.

    CONCLUSION: The obesity epidemic must be tackled at community and school levels by health education and regulation of school canteen foods.

  14. Bo MS, Cheah WL, Lwin S, Moe Nwe T, Win TT, Aung M
    J Nutr Metab, 2018;2018:7027624.
    PMID: 30116641 DOI: 10.1155/2018/7027624
    Background: Atherogenic index of plasma (AIP) was found to be one of the strongest markers in predicting the cardiovascular disease (CVD) risk. This study was to determine the AIP and its relationship with other CVD risk factors.

    Materials and Methods: This cross-sectional study was done among 349 staff of a public university in Sarawak. Data were collected using questionnaire, blood sampling, and anthropometric and blood pressure measurement. Data were analyzed using IBM SPSS version 20.

    Results: A total of 349 respondents participated with majority females (66.8%), aged 38.5 ± 7.82 years. Nearly 80% of the respondents were overweight and obese, 87.1% with high and very high body fat, and 46.9% with abnormal visceral fat. For AIP category, 8.9% were found to be in intermediate and 16.4% were at high risk. Elevated lipid profile showed that total cholesterol (TC) is 15.5%, low density lipoprotein (LDL) is 16.1%, and triglyceride (TG) is 10.6%. AIP was significantly correlated with body mass index (r=0.25), visceral fat (r=0.37), TC (r=0.22), LDL (0.24), HDL (r=-0.72), TG (r=0.84), glucose (r=0.32), systolic blood pressure (r=0.22), and diastolic blood pressure (r=0.28).

    Conclusion: It indicated that AIP is associated with other CVD risk factors. Modification of lifestyle is strongly recommended.

  15. Cheah WL, Chang CT, Hazmi H, Kho GWF
    Int J Hypertens, 2018;2018:6736251.
    PMID: 30155286 DOI: 10.1155/2018/6736251
    This cross-sectional study was conducted to determine the predictive power of anthropometric indicators and recommend cutoff points to discriminate hypertension among adolescents in Sarawak, Malaysia. A total of 2461 respondents aged 12-17 years participated in this study with mean age of 14.5±1.50 years. All anthropometric indicators had significant area under the ROC curve, with body mass index (BMI) and waist circumference (WC) ranging from 0.7 to 0.8. The best anthropometric indicators for predicting hypertension for boys were WC, BMI, and waist-to-height ratio (WHtR). For girls, BMI was the best indicators followed by WHtR and WC. The recommended BMI cutoff point for boys was 20 kg/m2 and 20.7 kg/m2 for girls. For WC, the recommended cutoff point was 67.1 cm for boys and 68.2 cm for girls. BMI and WC indicators were recommended to be used at the school setting where the measurement can easily be conducted.
  16. Kelak JA, Cheah WL, Safii R
    PMID: 29636778 DOI: 10.1155/2018/4735234
    Nondisclosure of traditional and complementary medicine (T&CM) use may cause individual to be at risk of undue harm. This study aimed to explore patient's experience and views on their decision to disclose the use of T&CM to the doctor. An exploratory qualitative study using in-depth interview involving 10 primary care clinics attendees in Kuching was conducted. The results indicated that disclosure of T&CM use will motivate them to get information, increase doctor's awareness, and get support from family and friends for disclosure. Fear of negative relationship and negative response from doctors was a barrier for disclosure. Doctor's interpersonal and communication skills of being involved, treating patients respectfully, listening attentively, respecting privacy, and taking time for the patient were a critical component for disclosure. Intrapersonal trust regarding doctor influences their satisfaction on healthcare. Women are more open and receptive to a health concern and expressing negative emotions and tend to share problems, whereas men always described themselves as healthy, tended to keep their own personal feeling to themselves, and tended to not share. The doctor should consider gender differences in disclosure, their attitude towards T&CM use, and gained patient's trust in the delivery of healthcare services. Good interpersonal and communication skills must be maintained between doctor and patients.
    Study site: Klinik kesihatan, Kuching, Sarawak, Malaysia
  17. Chung MH, Hazmi H, Cheah WL
    J Environ Public Health, 2017;2017:9610928.
    PMID: 28286530 DOI: 10.1155/2017/9610928
    The objective of this study was to assess the role performance among KOSPEN community health volunteer in Kuching district and its associated factors. This was a cross-sectional study, conducted in 21 localities in Kuching with a total of 210 respondents. Data were collected using validated interviewer-administered questionnaires and analyzed using SPSS version 22.0. The respondents comprised 55.2% females, 81.9% married, and 41.4% aged above 45 and above and 72.4% completed their education up to secondary school. The result revealed that 59.0% of the respondents agreed and understood their role performances. Multiple Logistics analysis revealed that factors associated with role performance were age group (p = 0.003), education level (p < 0.001), marital status (p = 0.025), prestige and respect (p = 0.012), being seen as "doctor" in community (p = 0.003), job aids (p = 0.009), training location (p = 0.001), and supervision by community (p < 0.001). To increase and maintain the work performance of CHVs, commitment from the government, policy makers, stakeholders, and the communities is required.
  18. Kelak J, Cheah WL, Razitasham S
    PMID: 28529529 DOI: 10.1155/2017/5146478
    The decision by the patients to disclose traditional and complementary medicine (TCM) use to their doctor is an important area to be explored. This study aimed to determine the disclosure of TCM use and its associated factors to medical doctor among primary care clinic attendees in Kuching Division, Sarawak. It was a cross-sectional study using questionnaire, interviewer administered questionnaire. A total of 1130 patients were screened with 80.2% reporting using TCM. Logistic regression analysis revealed that being female (AOR = 3.219, 95% CI: 1.385, 7.481), perceived benefits that TCM can prevent complication of illness (AOR = 3.999, 95% CI: 1.850, 8.644) and that TCM is more gentle and safer (AOR = 4.537, 95% CI: 2.332, 8.828), perceived barriers of not having enough knowledge about TCM (AOR = 0.530, 95% CI: 0.309, 0.910), patient dissatisfaction towards healthcare providers being too business-like and impersonal (AOR = 0.365, 95% CI: 0.199, 0.669) and paying more for healthcare than one can afford (AOR = 0.413, 95% CI: 0.250, 0.680), and accessibility of doctors (AOR = 3.971, 95% CI: 2.245, 7.023) are the predictors of disclosure of TCM use. An open communication between patients and doctor is important to ensure safe implementation and integration of both TCM and medical treatment.
    Study site: Klinik kesihatan, Kuching, Sarawak, Malaysia
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