Displaying publications 1 - 20 of 108 in total

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  1. Lee LH, Cheah YK, Mohd Sidik S, Ab Mutalib NS, Tang YL, Lin HP, et al.
    World J Microbiol Biotechnol, 2012 May;28(5):2125-37.
    PMID: 22806035 DOI: 10.1007/s11274-012-1018-1
    The present study aimed to isolate actinobacteria from soil samples and characterized them using molecular tools and screened their secondary metabolites for antimicrobial activities. Thirty-nine strains from four different location of Barrientos Island, Antarctica using 12 types of isolation media was isolated. The isolates were preceded to screening of secondary metabolites for antimicrobial and antifungal activities. Using high-throughput screening methods, 38% (15/39) of isolates produced bioactive metabolites. Approximately 18% (7/39), 18% (7/39), 10% (4/39) and 2.5% (1/39) of isolates inhibited growth of Candida albicans ATCC 10231(T), Staphylococcus aurues ATCC 51650(T), methicillin-resistant Staphylococcus aurues (MRSA) ATCC BAA-44(T) and Pseudomonas aeruginosa ATCC 10145(T), respectively. Molecular characterization techniques like 16S rRNA analysis, Enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR), Random amplified polymorphic DNA (RAPD) and composite analyses were used to characterize the actinobacteria strains. Analysis of 16S rRNA sequences is still one of the most powerful methods to determine higher taxonomic relationships of Actinobacteria. Both RAPD and ERIC-PCR fingerprinting have shown good discriminatory capability but RAPD proved to be better in discriminatory power than ERIC-PCR. Our results demonstrated that composite analysis of both fingerprinting generally increased the discrimination ability and generated best clustering for actinobacteria strains in this study.
  2. Shah AH, Saleha AA, Zunita Z, Cheah YK, Murugaiyah M, Korejo NA
    Vet Microbiol, 2012 Dec 7;160(3-4):355-61.
    PMID: 22739058 DOI: 10.1016/j.vetmic.2012.05.037
    Arcobacter is getting more attention due to its detection from wide host-range and foods of animal origin. The objective of this study was to determine the prevalence of Arcobacter spp. in various sources at farm level and beef retailed in markets in Malaysia and to assess the genetic relatedness among them. A total of 273 samples from dairy cattle including cattle (n=120), floor (n=30), water (n=18) and milk (n=105) as well as 148 beef samples collected from retail markets were studied. The overall prevalence of Arcobacter in various sources was 15% (63/421). However, source-wise detection rate of Arcobacter spp. was recorded as 26.66% (8/30) in floor, 26.3% (39/148) in beef, 11.11% (2/18) in water, 7.6% (8/105) in milk and 6.66% (8/120) in cattle. Arcobacter butzleri was the frequently isolated species however, a total of 75%, 66.7%, 53.8%, 50% and 12.5%% samples from floor, milk, beef, water and cattle, respectively, were carrying more than one species simultaneously. One (12.5%) cattle and beef sample (2.5%) found to be carrying one Arcobacter spp., A. skirrowii, only. Typing of Arcobacter isolates was done though pulsed field gel electrophoresis (PFGE) after digested with Eag1 restriction endonuclease (RE). Digestion of genomic DNA of Arcobacter from various sources yielded 12 major clusters (≥ 50% similarity) which included 29 different band patterns. A number of closely related A. butzleri isolates were found from beef samples which indicate cross contamination of common type of Arcobacter. Fecal shedding of Arcobacter by healthy animals can contaminate water and milk which may act as source of infection in humans.
  3. Pui CF, Wong WC, Chai LC, Lee HY, Noorlis A, Zainazor TC, et al.
    Trop Med Health, 2011 Mar;39(1):9-15.
    PMID: 22028607 DOI: 10.2149/tmh.2010-20
    Salmonellosis outbreaks involving typhoid fever and human gastroenteritis are important diseases in tropical countries where hygienic conditions are often not maintained. A rapid and sensitive method to detect Salmonella spp., Salmonella Typhi and Salmonella Typhimurium is needed to improve control and surveillance of typhoid fever and Salmonella gastroenteritis. Our objective was the concurrent detection and differentiation of these food-borne pathogens using a multiplex PCR. We therefore designed and optimized a multiplex PCR using three specific PCR primer pairs for the simultaneous detection of these pathogens. The concentration of each of the primer pairs, magnesium chloride concentration, and primer annealing temperature were optimized before verification of the specificity of the primer pairs. The target genes produced amplicons at 429 bp, 300 bp and 620 bp which were shown to be 100% specific to each target bacterium, Salmonella spp., Salmonella Typhi and Salmonella Typhimurium, respectively.
  4. Lim KH, Ghazali SM, Lim HL, Kee CC, Cheah YK, Singh BSGP, et al.
    Tob Induc Dis, 2020;18:80.
    PMID: 33013276 DOI: 10.18332/tid/127231
    INTRODUCTION: Periodic surveys on tobacco use patterns and other aspects of tobacco use among school-going adolescents in Malaysia provide information on the effectiveness of anti-smoking measures implemented. However, such information is limited in Malaysia. We investigated the prevalence of smoking and other related aspects among middle-secondary school students in Malaysia from the years 2003-2016 to fill this gap.

    METHODS: We analyzed data from the Global Youth Tobacco Survey (GYTS) 2003, GYTS 2009, and the Tobacco and Electronic Cigarette Survey among Malaysia Adolescents (TECMA) 2016. The surveys employed multistage sampling to select representative samples of adolescents attending secondary school in Malaysia. Data were collected using a pre-validated self-administered anonymous questionnaire adopted from the GYTS.

    RESULTS: Between 2003 and 2016, major changes occurred in which there were reductions in the prevalence of ever smoking, current smoking, and susceptibility to smoking. Reductions were also observed in exposure to SHS in public places and in the home. The proportion of school-going adolescents who support a ban on smoking in public places increased between 2013 to 2016, and there was a significant reduction in the proportion of respondents that were offered 'free' cigarettes by tobacco company representatives. However, there was no difference in the proportion of adolescents who initiated smoking before the age of 10 years and current smokers seeking advice to quit smoking across the time period.

    CONCLUSIONS: Our study indicates that the smoking policies and measures have been effective in reducing smoking prevalence, secondhand smoke exposure, and access to cigarettes, among school-going adolescents in Malaysia. However, measures to reduce smoking initiation and increase smoking cessation need to be strengthened to reduce the burden of smoking-related diseases in Malaysia in the long-term.

  5. Lim KH, Lim HL, Teh CH, Kee CC, Heng PP, Cheah YK, et al.
    Tob Induc Dis, 2018;16.
    DOI: 10.18332/tid/95188
    Introduction: Understanding the prevalence of secondhand smoke (SHS) exposure and the associated factors is beneficial for the formulation of effective measures to reduce exposure to SHS. The purpose of this study was to determine SHS exposure at home and workplace, and its associated factors among non-smoker Malaysian adults. Methods: Data were extracted from the Global Adult Tobacco Survey-Malaysia (GATS-M) that involved a representative sample of 5112 Malaysian adults. Logistic regression analyses were performed to examine the association between SHS exposure, sociodemographic factors, knowledge on the danger of SHS, and smoking restrictions at home and at work among non-smokers. Results: Among non-smoker Malaysians, age ≥15 years, 27.9% (equivalent to approximately 4.21 million non-smokers) and 33.9% (equivalent to approximately 1.37 million non-smokers) reported that they were exposed to SHS at home and the workplace, at least once a month, respectively. Women (AOR=2.12, 95% CI: 1.61.2.78), young individuals (AOR=3.06, 95% CI: 1.48.6.33), Malays (AOR=2.39, 95% CI: 1.56.3.64) or other Bumiputra ethnic groups (AOR=2.40, 95% CI: 1.39.4.19) and those who worked as other than government employees were more likely to report SHS exposure at home (non-government employee: AOR=1.88, 95% CI: 1.06.3.36). Respondents with a total smoking restriction at home did not report any SHS exposure at home. Similarly, those whose workplace had smoking restrictions were less likely to report SHS exposure at the work compared to their counterparts whose workplace had partial (AOR=3.08, 95% CI: 1.84.5.15) or no smoking restrictions (AOR=15.33, 95% CI: 6.75.34.86). Conclusions: A substantial proportion of Malaysian adults were exposed to SHS at home and at work. The findings emphasize the need for policies on smoking restrictions at work and the need to promote the adoption of a completely smoke-free home, among the Malaysian population.
    Study name: Global Adults Tobacco Survey (GATS-2011)
  6. Lim KH, Cheong YL, Lim HL, Cheong KC, Hashim MHM, Marine AA, et al.
    Tob Induc Dis, 2024;22.
    PMID: 38268983 DOI: 10.18332/tid/176164
    INTRODUCTION: Perception is an essential factor influencing smoking among adolescents. Thus, a valid tool for measuring perception is a requisite in smoking studies. This study further establishes the validity and reliability of a Malay language version of the Perception Towards Smoking Questionnaire (BM-PTSQ) for assessing the perception of smoking among secondary school-going adolescents in Malaysia.

    METHODS: We administered the BM-PTSQ to 669 secondary school students selected through multistage sampling; 60% of respondents were male (n=398), and 69.9% (n=463) were from rural areas. Respondents were aged 13-16 years, 36.4% (n=241) were 13 years, 40.0% (n=265) were 14 years, and 23.6% (n=156) were 16 years old. We used parallel and exploratory factor analysis (EFA) to determine the domains of the questionnaire. In addition, we also employed EFA, confirmatory factor analyses (CFA), and Cronbach's alpha to evaluate the construct validity and reliability of the BM-PTSQ.

    RESULTS: EFA and parallel analysis identified two domains in the BM-PTSQ that accounted for 62.9% of the observed variance, and CFA confirmed the two-domain structure. The two domains' internal consistency scores ranged from 0.702 to 0.80, which suggested adequate reliability.

    CONCLUSIONS: The BM-PTSQ has acceptable psychometric validity and is appropriate for assessing smoking perception and intention among Malaysian secondary school-aged youth. Researchers should further evaluate this tool's applicability in a more sociodemographically diverse population.

  7. Wan KF, Radu S, Cheah YK, Benjamin PG, Ling CM, Hon SF, et al.
    PMID: 15115139
    Enteropathogenic Escherichia coli (EPEC) is a leading cause of diarrhea among infants in developing countries. A total of 38 EPEC isolates, obtained from diarrhea patients of Hospital Miri, Sarawak, were investigated through plasmid profile, antibiotic resistance and randomly amplified polymorphic DNA (RAPD) analysis. From the 8 types of antibiotics used, all isolates were 100% resistant to furoxime, cephalothin and sulphamethoxazole and showed high multiple antibiotic resistant (MAR) indexes, ranging from 0.5 to 1.0. In plasmid profiling, 22 isolates (58%) showed the presence of one or more plasmids in the range 1.0 to 30.9 mDa. The dendrogram obtained from the results of the RAPD-PCR discriminated the isolates into 30 single isolates and 3 clusters at the level of 40% similarity. The EPEC isolates were highly diverse, as shown by their differing plasmid profiles, antibiotic resistance patterns and RAPD profiles.
  8. Poh LW, Rukman AW, Cheah YK, Norital Z, Nazri AM, Mariana NS
    Med J Malaysia, 2012 Dec;67(6):639-40.
    PMID: 23770967 MyJurnal
    Vancomycin-resistant Enterococcus faecium (VREF) in human infections mostly belong to the high-risk, epidemic, clonal complex-17 (CC17) group. Treatment limitation and high conjugation frequency makes it dominant in hospitals worldwide. We investigated positive cultures by Pulse-field gel electrophoresis (PFGE), multi locus sequence typing (MLST). DNA of two strains (A2 and C) appeared to be clonally related by PFGE. Three strains were of ST 18 type (A1, B and C) and strain A2 is of a new ST 596. This ST 18 type strain found in our study is crucial and is believed to be the first in Malaysia.
  9. Edwin Shiaw CS, Shiran MS, Cheah YK, Tan GC, Sabariah AR
    Med J Malaysia, 2010 Jun;65(2):133-7.
    PMID: 23756798 MyJurnal
    This study was done to evaluate various DNA and RNA extractions from archival FFPE tissues. A total of 30 FFPE blocks from the years of 2004 to 2006 were assessed with each modified and adapted method. Extraction protocols evaluated include the modified enzymatic extraction method (Method A), Chelex-100 extraction method (Method B), heat-induced retrieval in alkaline solution extraction method (Methods C and D) and one commercial FFPE DNA Extraction kit (Qiagen, Crawley, UK). For RNA extraction, 2 extraction protocols were evaluated including the enzymatic extraction method (Method 1), and Chelex-100 RNA extraction method (Method 2). Results show that the modified enzymatic extraction method (Method A) is an efficient DNA extraction protocol, while for RNA extraction, the enzymatic method (Method 1) and the Chelex-100 RNA extraction method (Method 2) are equally efficient RNA extraction protocols.
  10. Neo CB, Cheah YK, Chin PW, Tan TV, Wong NC, Yap LM, et al.
    Med J Malaysia, 1987 Dec;42(4):294-8.
    PMID: 3454401
    About two-thirds (67.6%) of 142 Ibans (from birth to 90 years of age) from 26 house-holds in a longhouse in Nanga Atoi in the Second Division of Sarawak were infected with intestinal parasites. The more common helmintic infections were hookworms (47.2%) and Trichuris trichiura (43.0%). Intestinal protozoan infections were less common. Single helmintic infections were more common than multiple infections and the commonest type of multiple infections was Trichuris mixed with hookworms. Malaria and filariasis were not reported among these inhabitants surveyed.
  11. David NCE, Juliana H, Chok M, Gan YZ, Tan YC, Nur Adlina MN, et al.
    Med J Malaysia, 2023 Jan;78(1):80-86.
    PMID: 36715196
    INTRODUCTION: The COVID-19 pandemic has reached a phase where many have been infected at least once. Healthcare workers were not spared from being infected. This study aimed to determine the period prevalence of COVID-19 among the paediatric healthcare workers in Negeri Sembilan as the country transitioned into an endemic phase of the pandemic. Additionally, we investigate potential sociodemographic and occupational characteristics associated with SARS-CoV-2 infection among healthcare workers.

    MATERIALS AND METHODS: A cross-sectional study was conducted among the healthcare workers in the paediatric department at three public specialist hospitals in Negeri Sembilan between 15 and 21 April 2022. Data were collected through a self-administered questionnaire.

    RESULTS: Out of the 504 eligible healthcare workers, 493 participated in this study (response rate 97.8%). The overall prevalence of COVID-19 (11 March 2020-15 April 2022) among healthcare workers was 50.9%. The majority (80.1%) were infected during the Omicron wave two months before the survey. Household contacts accounted for 35.9% of infection sources. The proportion of non-doctors in the COVID-19-infected group was significantly higher compared to the non-infected group (74.1% vs 64.0%, p=0.016). The COVID-19-infected group had a higher proportion of schoolgoing children (44.6% vs 30.6%, p=0.001) and children who attended pre-school/sent to the babysitter (49.0% vs 24.4%, p<0.001). There were no significant differences between infection rates among the healthcare workers working in the tertiary hospital and the district hospitals. There were also no significant differences in the proportion of COVID-19- infected doctors and nurses when analysed by seniority.

    CONCLUSION: Our study provided an estimate on the prevalence of COVID-19 among paediatric healthcare workers in Negeri Sembilan and the factors associated with infection, which captures the extent and magnitude of this pandemic on the state's paediatric department. Most infections resulted from household contact, with a higher proportion of infected healthcare workers having young children.

  12. Amrina MA, Shahidah M, Sofiah HR, Mirlia SCM, Thilakaveni R, Chong ZL, et al.
    Med J Malaysia, 2023 Jan;78(1):20-24.
    PMID: 36715186
    INTRODUCTION: Healthcare workers (HCWs) were among the first to be fully vaccinated against SARS-CoV-2. However, the antibody responses to the vaccines and potential decline among Malaysian HCW are still unclear. The objective of this study is to follow-up anti-S antibody levels among HCW vaccinated with mRNA vaccine (BTN162b2) and inactivated vaccine (CoronaVac).

    MATERIALS AND METHODS: Plasma samples were collected prevaccination, 2 weeks and 6 months post-vaccination and tested for total immunoglobulin levels using ELISA method.

    RESULTS: A small percentage of HCW (2.2%, 15/677) had elevated anti-S antibody levels in their pre-vaccination plasma samples (median 20.4, IQR 5.8), indicating that they were exposed to SARS-CoV-2 infection prior to vaccination. The mRNA vaccine significantly increased anti-S levels of both previously infected and uninfected individuals to saturation levels (median 21.88, IQR.0.88) at 2 weeks postsecond dose of the vaccine. At 6 months post-vaccination, the antibody levels appeared to be maintained among the recipients of the mRNA vaccine. However, at this time point, anti-S antibody levels were lower in individuals given inactivated vaccine (median 20.39, IQR 7.31, n=28), and interestingly, their antibody levels were similar to anti-S levels in pre-vaccination exposed individuals. Antibody levels were not different between the sexes.

    CONCLUSION: Anti-S levels differ in individuals given the different vaccines. While further study is required to determine the threshold level for protection against SARSCoV- 2, individuals with low antibody levels may be considered for boosters.

  13. Mok SF, Karuthan C, Cheah YK, Ngeow WC, Rosnah Z, Yap SF, et al.
    Malays J Pathol, 2017 Apr;39(1):1-15.
    PMID: 28413200 MyJurnal
    The human oral microbiome has been known to show strong association with various oral diseases including oral cancer. This study attempts to characterize the community variations between normal, oral potentially malignant disorders (OPMD) and cancer associated microbiota using 16S rDNA sequencing. Swab samples were collected from three groups (normal, OPMD and oral cancer) with nine subjects from each group. Bacteria genomic DNA was isolated in which full length 16S rDNA were amplified and used for cloned library sequencing. 16S rDNA sequences were processed and analysed with MOTHUR. A core oral microbiome was identified consisting of Firmicutes, Proteobacteria, Fusobacteria, Bacteroidetes and Actinobacteria at the phylum level while Streptococcus, Veillonella, Gemella, Granulicatella, Neisseria, Haemophilus, Selenomonas, Fusobacterium, Leptotrichia, Prevotella, Porphyromonas and Lachnoanaerobaculum were detected at the genus level. Firmicutes and Streptococcus were the predominant phylum and genus respectively. Potential oral microbiome memberships unique to normal, OPMD and oral cancer oral cavities were also identified. Analysis of Molecular Variance (AMOVA) showed a significant difference between the normal and the cancer associated oral microbiota but not between the OPMD and the other two groups. However, 2D NMDS showed an overlapping of the OPMD associated oral microbiome between the normal and cancer groups. These findings indicated that oral microbes could be potential biomarkers to distinguish between normal, OPMD and cancer subjects.
  14. Cheah YK
    Malays J Med Sci, 2014 Nov-Dec;21(6):36-44.
    PMID: 25897281 MyJurnal
    In the context of global increases in the prevalence of non-communicable diseases, the objective of the present study is to investigate the factors affecting individuals' decisions to use health-promoting goods and services.
  15. Cheah YK
    Malays J Med Sci, 2013 Jan;20(1):46-55.
    PMID: 23613658 MyJurnal
    In light of the fact that chronic diseases were becoming more prevalent recently, the primary objective of the study was to examine the socio-demographic, health, and lifestyle determinants of the use of preventive medical care in Penang, Malaysia.
  16. Heng MP, Sinniah SK, Teoh WY, Sim KS, Ng SW, Cheah YK, et al.
    PMID: 26057090 DOI: 10.1016/j.saa.2015.05.095
    Testosterone thiosemicarbazone, L and its nickel (II) complex 1 were synthesized and characterized by using FTIR, CHN, (1)H NMR, and X-ray crystallography. X-ray diffraction study confirmed the formation of L from condensation of testosterone and thiosemicarbazide. Mononuclear complex 1 is coordinated to two Schiff base ligands via two imine nitrogens and two tautomeric thiol sulfurs. The cytotoxicity of both compounds was investigated via MTT assay with cisplatin as positive reference standard. L is more potent towards androgen-dependent LNCaP (prostate) and HCT 116 (colon). On the other hand, complex 1, which is in a distorted square planar environment with L acting as a bidentate NS-donor ligand, is capable of inhibiting the growth of all the cancer cell lines tested, including PC-3 (prostate). It is noteworthy that both compounds are less toxic towards human colon cell CCD-18Co. The intrinsic DNA binding constant (Kb) of both compounds were evaluated via UV-Vis spectrophotometry. Both compounds showed Kb values which are comparable to the reported Kb value of typical classical intercalator such as ethidium bromide. The binding constant of the complex is almost double compared with ligand L. Both compounds were unable to inhibit the action topoisomerase I, which is the common target in cancer treatment (especially colon cancer). This suggest a topoisomerase I independent-cell death mechanism.
  17. Agbolade O, Nazri A, Yaakob R, Ghani AA, Cheah YK
    Sci Rep, 2021 10 21;11(1):20767.
    PMID: 34675349 DOI: 10.1038/s41598-021-99944-z
    Angelman syndrome (AS) is one of the common genetic disorders that could emerge either from a 15q11-q13 deletion or paternal uniparental disomy (UPD) or imprinting or UBE3A mutations. AS comes with various behavioral and phenotypic variability, but the acquisition of subjects for experiment and automating the landmarking process to characterize facial morphology for Angelman syndrome variation investigation are common challenges. By automatically detecting and annotating subject faces, we collected 83 landmarks and 10 anthropometric linear distances were measured from 17 selected anatomical landmarks to account for shape variability. Statistical analyses were performed on the extracted data to investigate facial variation in each age group. There is a correspondence in the results achieved by relative warp (RW) of the principal component (PC) and the thin-plate spline (TPS) interpolation. The group is highly discriminated and the pattern of shape variability is higher in children than other groups when judged by the anthropometric measurement and principal component.
  18. Chew SY, Ho KL, Cheah YK, Ng TS, Sandai D, Brown AJP, et al.
    Sci Rep, 2019 02 26;9(1):2843.
    PMID: 30808979 DOI: 10.1038/s41598-019-39117-1
    The human fungal pathogen Candida glabrata appears to utilise unique stealth, evasion and persistence strategies in subverting the onslaught of host immune response during systemic infection. However, macrophages actively deprive the intracellular fungal pathogen of glucose, and therefore alternative carbon sources probably support the growth and survival of engulfed C. glabrata. The present study aimed to investigate the role of the glyoxylate cycle gene ICL1 in alternative carbon utilisation and its importance for the virulence of C. glabrata. The data showed that disruption of ICL1 rendered C. glabrata unable to utilise acetate, ethanol or oleic acid. In addition, C. glabrata icl1∆ cells displayed significantly reduced biofilm growth in the presence of several alternative carbon sources. It was also found that ICL1 is crucial for the survival of C. glabrata in response to macrophage engulfment. Disruption of ICL1 also conferred a severe attenuation in the virulence of C. glabrata in the mouse model of invasive candidiasis. In conclusion, a functional glyoxylate cycle is essential for C. glabrata to utilise certain alternative carbon sources in vitro and to display full virulence in vivo. This reinforces the view that antifungal drugs that target fungal Icl1 have potential for future therapeutic intervention.
  19. Cheah YK, Azahadi M, Phang SN, Hazilah N
    Public Health, 2017 May;146:84-91.
    PMID: 28404478 DOI: 10.1016/j.puhe.2017.01.009
    OBJECTIVES: The rapid rise in the prevalence of physical inactivity-related diseases has become a serious public health issue worldwide. The objective of the present study is to examine the factors affecting participation in physical activity among urban dwellers in Malaysia.
    STUDY DESIGN: This cross-sectional study measures physical activity using a rigorous regression model.
    METHODS: Data are obtained from the National Health and Morbidity Survey 2011 (NHMS 2011). A lognormal hurdle model is used to analyse the participation decision and the amount decision of physical activity.
    RESULTS: The results show that income, gender, ethnicity, marital status and employment status are significantly associated with participation decision and amount decision. However, age, insurance and self-rated health only affect participation decision, whereas family size, education and smoking only affect amount decision.
    CONCLUSIONS: It can, thus, be concluded that sociodemographic, insurance, lifestyle and health factors play an important role in determining physical activity behaviour among urban dwellers. When formulating policies, special attention must be paid to these factors.
    Study name: National Health and Morbidity Survey (NHMS-2011)
  20. Cheah YK
    Psychol Health Med, 2024 Mar 04.
    PMID: 38438275 DOI: 10.1080/13548506.2024.2326532
    Adolescent loneliness is prevalent and has serious adverse impacts on mental and physical health outcomes. This study aimed at examining factors associated with loneliness among school-going adolescents. The country of interest is a low-income country, Timor-Leste, where empirical studies are lacking. Data from the Global School-Based Student Health Survey Timor-Leste 2015 (n = 3455) were used for secondary analyses. An ordered probit model was utilized to assess demographic, lifestyle, social, and parental factors correlated with different levels of loneliness (no loneliness, moderate loneliness, and severe loneliness). Approximately 46.3% of adolescents felt moderately lonely and about 13.5% felt severely lonely. Older adolescents were more likely to experience severe and moderate loneliness than younger adolescents. Going hungry and being bullied were associated with an increased likelihood of being severely and moderately lonely. Adolescents had a higher probability of experiencing moderate and severe loneliness if they had sleep difficulties and were physically active. Having understanding parents was positively associated with the likelihood of severe loneliness. In conclusion, a large proportion of adolescents in Timor-Leste have feelings of loneliness, which have been found to be associated with demographic, lifestyle, social, and parental factors. Policymakers should recognize the correlated factors of loneliness in order to formulate a more effective intervention strategy.
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