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Fulltext Factors associated with physical activity barriers among adult community in Putrajaya

Mohd Tariq Mhd Noor, Hayati Kadir Shahar

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):48-48.
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Introduction: Prevalence of physical inactivity in the Federal Territory of Putrajaya on 2015 was 32.5% compared to 2011 with 56.5%, as reported in National Health Morbidity Survey. The public do not use the facilities as much as they should, although various facilities have been provided in Putrajaya and was selected as garden city concept town. The objective of this study was to determine the perceived barriers (personal, environmental, total barriers) of physical activity among Komuniti Sihat Pembina Negara (KOSPEN) community in Putrajaya. Methods: A cross sectional study was conducted using adopted self-administered Perceived Barriers questionnaires to assess the per-ceived barriers of physical activity with socio-demographics, economic and personal characteristic. An Independent t-test was used to test the association between independent variables with perceived barriers of physical activity. Re-sults: There were significant association between personal barriers with marital status (p
Fulltext HIV-related stigma among healthcare workers in health clinics in Hulu Langat, Selangor: a preliminary result

Natalia Che Ishak, Hayati Kadir Shahar, Rosliza Abdul Manaf

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):89-89.
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Introduction: HIV-related stigma refers to prejudice, negative attitudes and abuse directed at people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. This study was designed to examine drivers of HIV-related stigma among healthcare workers in health clinics in Hulu Langat, Selangor. Methods: This is a sin-gle-blinded, cluster randomised controlled trial (parallel groups). A total of 158 participants from the intervention group and 158 participants from the control group were randomised via balloting process at the cluster (clinic) level. A comprehensive self-administered questionnaire based on the stigma index tool was used. Data were analysed using IBM SPSS version 25 involving descriptive and bivariate analyses. The baseline results were analysed using the chi-square test and Mann-Whitney U test. Results: The response rate for the intervention group was 83.5% and 81.6% for the control group (82.3% combined response rate). Majority of the respondent’s age between 30 – 39 years old, female, nurses, have experience working with PLHIV and worked for 0 – 9 years in the healthcare setting. Comparison of total infection concern score (p = 0.001) and total willingness to treat key populations (KPs) score (p = 0.025) between intervention and control group at baseline were significant. However, comparison of total opinion/perception about PLHIV score, total knowledge about HIV score, total intention to stigmatise score and total health facility policies and guidelines score between intervention and control group at baseline showed no significant dif-ference. Conclusion: The significant difference between groups on certain scores above might be due to different job category between the two groups thus influence how willing they are in treating PLHIV. These findings may assist stigma reduction intervention programmes targeting healthcare providers in Hulu Langat, Selangor and ensure quality care for PLHIV.
Fulltext Environmental influence and intention to quit smoking among college students

Muhammad Adil Zainal Abidin, Hayati Kadir Shahar, Rosliza Abdul Manaf

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):77-77.
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Introduction: Secondhand tobacco smoke is a known carcinogen and has shown positive association with smok-ing status, susceptibility and cessation. Smoke free environment policy seem to reduce this exposure and influence intention to quit and frequency of quit attempts. Despite having a smoke free policy, smokers are still exposed to second hand smoke and this might influence their smoking behaviour and cessation. The objective of this study was to examine the association between environmental tobacco smoke exposures with intention to quit smoking among young adults in college with smoke free policy. Methods: Data were drawn from a cluster based randomised controlled trial in 10 government colleges in Selangor. Baseline characteristics of 160 college smokers were mea-sured using adapted questionnaire. Intention to quit was measured using Transtheoretical Model and environmental influence of tobacco smoke exposure. Results: Majority of the smokers were male (99.4%), single (100%), of Malay ethnicity (94.4%) and Muslim (95.6%). Most of them are in pre-contemplation stage where they do not have any intention to quit (65.6%). On environmental influence, at work or college environmental exposure, majority were exposed between 1 to 2 hours (36.9%) and 3 to 8 hours (40.6%). On exposure at home or hostel, majority were exposed between 1 to 4 hours (44.4%) and 5 to 14 hours (21.9%). In terms of friend’s exposures, majority have most of their friends smoking (68.1%). We found no statistically significant association between environmental influence and intention to quit smoking. Conclusion: Although we found no relationship, future research should examine the pathway between environmental influence and smoking behaviour.
Fulltext Social determinants of Hepatitis C virus infection among people who inject drug in Negeri Sembilan

Azline Abdilah,, Sri Ganesh Muthiah, Hayati Kadir Shahar

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):62-62.
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Introduction: Hepatitis C virus (HCV) infection is a major leading cause of morbidity and mortality worldwide. Per-sistent HCV infection is associated with major liver complications such as liver failure, liver cancer and fatality. It is estimated that 5.6 million people who inject drugs (PWID) were chronically infected with HCV globally, meanwhile, 59% of those diagnosed as HCV in Malaysia were PWID. The objective of this study was to determine the social determinants of HCV infection among PWID in Negeri Sembilan, Malaysia. Methods: A cross-sectional study was conducted based on stratified proportionate to size sampling among registered Methadone Maintenance Therapy (MMT) clients with PWID attending health clinics in Negeri Sembilan from February 2018 to July 2018. All eligi-ble respondents were randomly selected. Data were collected using an interviewer-guided questionnaire and was analysed using Statistical Package of IBM SPSS version 23. Independent T test and Chi-square test (χ2) were used to determine the associations between the variables. Results: Majority of the respondents in this study were between 20 and 63 years of age, Malay (90.1%) and infected with HCV (89%). There was a significant association between the respondent’s age (p
Fulltext Interventions to reduce HIV-related stigma in the healthcare settings: a scoping systematic review

Natalia Che Ishak, Hayati Kadir Shahar, Rosliza Abdul Manaf

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):284-290.
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HIV-related stigma will discourage the efforts in preventing new infections and engaging people to receive treatment, care and support programmes. Identifying the valuable interventions programmes to reduce HIV-related stigma in a healthcare setting is vital in order to deliver the best health services. A scoping systematic review was conducted. Articles were searched based on Pubmed and ScienceDirect search engines. The key words used were HIV stigma, intervention and healthcare. Published English articles in the past ten years involving HIV stigma intervention studies, and studies that involved healthcare workers in a healthcare setting were included. Reviewed articles, systematic review and meta-analysis articles were excluded. Primary screening of titles and abstract of 85 articles were done. Secondary screening of 19 articles resulted in 8 articles, included in this manuscript. Most of the reviewed articles showed, application of the Integrated Theoretical Model in the intervention programme as a guide and utilising combined intervention components are effective tools in delivering the intervention programme. The stigma reduc- tion-intervention programme should focus on the intervention components as a whole including training of HCW, role plays, group discussions, games, sharing of information and contacts with PLHIV as well presentations and lec- tures. An integrative model of behavioural prophecy is perceived and it is particularly essential for interventions that focus on creating and fortifying the aim in conducting the chosen behaviour.
Fulltext Systematic Review on The Effectiveness of Using Carbon Monoxide Measurement in Smoking Cessation Interventio

Muhammad Adil Zainal Abidin,, Hayati Kadir @ Shahar, Rosliza Abdul Manaf

IIUM Medical Journal Malaysia, 2019;18(102):52-0.
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Carbon monoxide measurement is one of the biomedical risk assessments in smoking cessation. With the advancement in medical devices, risk assessment among smoker using carbon monoxide can be an effective intervention for quit smoking. A systematic review was conducted on the effectiveness of using carbon monoxide measurement in smoking cessation intervention. Material and methods: A systematic review and narrative synthesis were done using PRISMA guideline. A broad database search on English literature was conducted including Medline, PubMed, Scopus and Science Direct from 2008 till 2017. Additional studies were also searched through snowballing technique by searching the bibliographies of selected studies. Five studies met the criteria with two studies were done in clinical settings while the other was done at population settings. The studies were conducted in the United States of America, United Kingdom and South Korea. All study were two-arm randomized controlled trials with variation in the outcome measurement mainly intention to quit, quit attempt and smoking abstinence. There was also variation in the duration of follow up ranging from 1 week to 12 months. Results: Only three studies found statistically significant increased in motivation or intention to quit smoking but only at 1 month follow up. All five study found no significant difference in frequency of quit attempt or smoking abstinence. Most of the studies recruited participants based on voluntary participation thus limiting the generalizability of the results. Conclusions: The present review has found limited studies on the effect of carbon monoxide measurement intervention for quit smoking. It may only be beneficial at the motivational level and not translated into behavioural changes. However, the effect too was short term and not sustained in the long term.
Fulltext Effectiveness of Malaria intervention programmes among patent medicine vendors: a systematic review

Yahaya Mohammed Katagum, Hayati Kadir @ Shahar, Faisal Ibrahim

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):81-91.
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Poor diagnosis, treatment and prevention practices had characterised Patent Medicine Vendor (PMV) activities in malaria control despite expectations on their contributions to check the menace. Interventions reversing this situation reduces disease burden and legitimise PMV inclusion in basic healthcare delivery. This study seeks to identify and review studies addressing this priority problem. Steps outlined in PRISMA guidelines were adopted to search and conduct reviews via electronic databases. Randomized trials with intervention effects on PMVs were considered and thirteen articles were ultimately reviewed and narratively evaluated. Analysis of search outputs identified intervention types, methods used, sample sizes, intervention periods, knowledge, attitude and practice variables, other outcomes and listing of priority systematic review topics, using pre-determined criteria. All reviewed studies were found to be effective despite adopting different intervention approaches. Furthermore, identifying and prioritizing reviews greatly improves future malaria interventions and results thereof, thereby maximising opportunities to deliver appropriate and evidence-based healthcare.
Fulltext Acculturative stress and intention to dropout from the university among new postgraduate international student in publicuniversities, Malaysia

Musheer AL-Jaberi, Muhamad Hanafiah Juni, Hayati Kadir Shahar, Siti Irma Ismail

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):65-65.
MyJurnal

Introduction: With the increasing number of international students joining various universities worldwide, including Malaysia, acculturative stress resulting from their attempts to adjust to the cultures of host countries is one of the most challenging issues affecting their life in general and academic life in particular. The purpose of this study is to determine the level of acculturative stress and intention to dropout among new postgraduate international students in public universities, Malaysia. Methods: a cross-sectional study was conducted among 522 new international post-graduate students joining Malaysian public universities on their first semester. A multistage sampling method was adapted, and data were collected via self-administered questionnaire by using a validated questionnaire. Results: Out of the overall number of 522 respondents, (68.60%) of them were males while (31.40%) were females, the mean age of respondents was 28.95 ±5.91 years. The majority of the participants 60.54% (326) were single, whereas those who are married students represented 205 (39.3%). This study showed that 410 (78.5%) of the new postgraduate international students experienced a moderate level of acculturative stress with a median value of 107.00, while 63 (12.1 %) high level of stress and 49 (4.9 %) experience low level of acculturative stress .Consequently224 ,42.1 % of the participants students they have intention to dropout from the university for any reason , while 298 (57.1 % ) they don’t have any intention to dropout from the university Conclusions: This study showed the importance of educational intervention program among new international postgraduate students towards adapting to the Malaysian culture, in relation with increasing their cultural knowledge and interaction with host nationals and to reduce their acculturative stress and their intention to dropout from the university.
Fulltext Dengue prevention practices and their associated factors among wet market in Hilir Perak District, Malaysia

Nur Intan Kartiniewatie Kamaruddin, Salmiah Md Said, Hayati Kadir @ Shahar, Lim Poh Ying

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):46-46.
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Introduction: Wet markets are predisposed to Aedes breeding due to nature of daily activities that involve frequent water storage and usage of water collecting containers. Large numbers of visitors patronising wet markets could cause rapid spread of dengue infection. This study aimed to determine the level of dengue prevention practices among wet market traders in Hilir Perak District and their associated socioecological factors. Methods: A cross sectional study using stratified sampling method was conducted where 246 wet market traders were interviewed to collect data on dengue prevention practices (prevention of Aedes mosquitoes breeding and prevention of mosquito bites), and so-cioecological factors. Chi square test and logistic regression modelling were performed to identify socioecological factors associated with dengue prevention practices. Results: Response rate for this study was 88.9%. Majority of the respondents were male, above 40 years old, had secondary education and above, had monthly income of above MYR2000, were owner of the shop lots, was or had ever married and sold fish, vegetable or groceries products. Most of the respondents had high level of dengue prevention practices (78%). Those who were owner of shop lots, had high perceived susceptibility, high family support, and high perceived dengue prevention and control laws and reg-ulations were predicted to have high level of dengue prevention practices. Conclusion: Level of dengue prevention practices is determined not only by individual factors, but also other factors from relationship to societal level which must also be considered in planning or evaluating current dengue control programmes.
Fulltext Baseline adherence, socio-demographic, clinical, immunological, virological and anthropometric characteristics of 242 HIV positive patients on ART in Malaysia

Abiola, Abdulrahman Surajudeen, Lekhraj Rampal, Norlijah Othman, Faisal Ibrahim, Hayati Kadir@Shahar, Anuradha P. Radhakrishnan

Malaysian Journal of Medicine and Health Sciences, 2015;11(2):45-58.
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Adherence to antiretroviral therapy (ART) prevents disease progression, and the emergence of resistant mutations. It also reduces morbidity, and the necessity for more frequent, complicated regimens which are also relatively more expensive. Minimum adherence levels of 95% are required for treatment success. Poor adherence to treatment remains a stumbling block to the success of treatment programs. This generates major concerns about possible resistance of the human immunodeficiency virus (HIV) to the currently available ARVs. This paper aims to describe baseline results from a cohort of 242 Malaysian patients receiving ART within the context of an intervention aimed to improve adherence and treatment outcomes among patients initiating ART. A single-blinded Randomized Controlled Clinical Trial was conducted between January and December, 2014 in Hospital Sungai Buloh. Data on socio-demographic factors, clinical symptoms and adherence behavior of respondents was collected using modified, pre-validated Adult AIDS Clinical Trials Group (AACTG) adherence questionnaires. Baseline CD4 count, viral load, weight, full blood count, blood pressure, Liver function and renal profile tests were also conducted and recorded. Data was analyzed using SPSS version 22 and R software. Patients consisted of 215 (89%) males and 27 (11%) females. 117 (48%) were Malays, 98 (40%) were Chinese, 22 (9%) were Indians while 5 (2%) were of other ethnic minorities. The mean age for the intervention group was 32.1 ± 8.7 years while the mean age for the control group was 34.7 ± 9.5 years. Mean baseline adherence was 80.1 ± 19.6 and 85.1 ± 15.8 for the intervention and control groups respectively. Overall mean baseline CD4 count of patients was 222.97 ± 143.7 cells/mm³ while overall mean viral load was 255237.85 ± 470618.9. Patients had a mean weight of 61.55 ± 11.0 kg and 61.47 ± 12.3 kg in the intervention and control groups, respectively. Males account for about 90% of those initiating ART in the HIV clinic, at a relatively low CD4 count, high viral load and sub-optimal medication adherence levels at baseline.
Fulltext Determinants of Leptospirosis preventive practices among the community in a flood-prone residential area in Kuantan, Malaysia

Edre Mohammad Aidid, Hayati Kadir@Shahar, Salmiah Md Said, Sharifah Norkhadijah Syed Ismail

Malaysian Journal of Medicine and Health Sciences, 2018;14(3):27-33.
MyJurnal

Introduction: Leptospirosis is a preventable zoonosis of public health importance. Due to increasing incidence of leptospirosis and seasonal floods affecting Kuantan community, a study was conducted to identify the determinants of leptospirosis preventive practices. Methods: A cross-sectional study was carried out in Perkampungan Sungai Isap, Kuantan, Pahang, Malaysia, which obtained 568 respondents by stratified proportionate random sampling technique. Data was collected using a modified guided questionnaire and analysed using IBM SPSS version 22.0. Results: Majority of the respondents were females (52.6%), Malay ethnicity (98.8%), attended up to secondary school (57.2%), worked in low-risk occupational group (96.0%) and reside in moderate-risk stratum (55.6%). Overall, majority (68%) of the respondents had good knowledge. However, only 38% of the respondents had satisfactory attitude and 18% had satisfactory practice. There were significant associations between stratum and leptospirosis preventive practices (χ2=11.84, df=2, p=0.003), age group and leptospirosis preventive practices (χ2=7.41, df=2, p=0.03) and personal income and leptospirosis preventive practices (χ2=6.32, df=1, p=0.01). Multivariate logistic regression showed that the predictors of satisfactory leptospirosis preventive practices were high-risk stratum (aOR: 3.69, 95% CI: 1.71-8.00, p=0.001) and monthly personal income of less than RM1000 (aOR: 1.65, 95% CI: 1.05-2.59, p=0.03). Conclusions: Leptospirosis can be prevented by having adequate awareness regarding the disease through health promotional activities especially before, during and after flooding, targeting more on those in low to moderate risk areas and higher income group to prevent potential outbreaks.
Fulltext Correction to: Randomized community trial on nosocomial infection control educational module for nurses in public hospitals in Yemen: a study protocol

Alrubaiee G, Baharom A, Faisal I, Hayati KS, Daud SM, Basaleem HO

BMC Nurs, 2019;18:15.
PMID: 31019377 DOI: 10.1186/s12912-019-0340-4

[This corrects the article DOI: 10.1186/s12912-019-0333-3.].
Fulltext Randomized community trial on nosocomial infection control educational module for nurses in public hospitals in Yemen: a study protocol

Alrubaiee G, Baharom A, Faisal I, Hayati KS, Mohd Daud S, Basaleem HO

BMC Nurs, 2019;18:10.
PMID: 30936778 DOI: 10.1186/s12912-019-0333-3

Background: Nosocomial infections remain a global health problem and they are considered as one of the leading causes of increased morbidity and mortality. In-service training courses related to infection control measures can help nurses to make informed and therapeutic decisions which could prevent or reduce the incidence of nosocomial infections. This study protocol is of a hospital-based trial to develop, implement and evaluate an educational module on nosocomial infection control among nurses in public hospitals in Yemen. This study is currently ongoing and at the analysis stage.
Methods: A three-arm single-blinded randomized community hospital-based trial was conducted to evaluate the effectiveness of a newly developed nosocomial infection control educational module among nurses in public hospitals in Yemen. To ensure effective delivery and acquisition of knowledge, the Situated Learning Theory was applied during the course of the intervention. A total of 540 Yemeni in-ward nurses, who had three years nursing diploma and at least a year of working experience in the selected public hospitals were recruited in this study. The hospitals were the unit of randomization whereby eight hospitals were assigned randomly to intervention and waitlist groups. Intervention group-1 (n = 180) received an educational module supported by audio-video CD and a training course for eight weeks. Intervention group-2 (n = 180) was given only the educational module with audio-video CD (without the training course). The waitlist group received no intervention during the period of data collection but they will be given the same training and learning materials after the completion of the study.
Discussion: This study contributes to the lack of a nosocomial infection control educational module for nurses in Yemen. It is hoped that the educational module will serve as an effective approach to increase the nurses' knowledge and improve their practices regarding nosocomial infection control measures and hence decrease the prevalence of nosocomial infections in the future.
Trial registration: ID: ISRCTN19992640, Date of registration: 20/6/2017. This study protocol was retrospectively registered.
Fulltext Sociodemographic profile and predictors of outpatient clinic attendance among HIV-positive patients initiating antiretroviral therapy in Selangor, Malaysia

Abdulrahman SA, Rampal L, Othman N, Ibrahim F, Hayati KS, Radhakrishnan AP

Patient Prefer Adherence, 2017;11:1273-1284.
PMID: 28794617 DOI: 10.2147/PPA.S141609

BACKGROUND: Inconsistent literature evidence suggests that sociodemographic, economic, and system- and patient-related factors are associated with clinic attendance among the HIV-positive population receiving antiretroviral therapy (ART) around the world. We examined the factors that predict outpatient clinic attendance among a cohort of HIV-positive patients initiating ART in Selangor, Malaysia.

PATIENTS AND METHODS: This cross-sectional study analyzed secondary data on outpatient clinic attendance and sociodemographic, economic, psychosocial, and patient-related factors among 242 adult Malaysian patients initiating ART in Selangor, Malaysia. Study cohort was enrolled in a parent randomized controlled trial (RCT) in Hospital Sungai Buloh Malaysia between January and December 2014, during which peer counseling, medication, and clinic appointment reminders were provided to the intervention group through short message service (SMS) and telephone calls for 24 consecutive weeks. Data on outpatient clinic attendance were extracted from the hospital electronic medical records system, while other patient-level data were extracted from pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires in which primary data were collected. Outpatient clinic attendance was categorized into binary outcome - regular attendee and defaulter categories - based on the number of missed scheduled outpatient clinic appointments within a 6-month period. Multivariate regression models were fitted to examine predictors of outpatient clinic attendance using SPSS version 22 and R software.

RESULTS: A total of 224 (93%) patients who completed 6-month assessment were included in the model. Out of those, 42 (18.7%) defaulted scheduled clinic attendance at least once. Missed appointments were significantly more prevalent among females (n=10, 37.0%), rural residents (n=10, 38.5%), and bisexual respondents (n=8, 47.1%). Multivariate binary logistic regression analysis showed that Indian ethnicity (adjusted odds ratio [AOR] =0.235; 95% CI [0.063-0.869]; P=0.030) and heterosexual orientation (AOR =4.199; 95% CI [1.040-16.957]; P=0.044) were significant predictors of outpatient clinic attendance among HIV-positive patients receiving ART in Malaysia.

CONCLUSION: Ethnicity and sexual orientation of Malaysian patients may play a significant role in their level of adherence to scheduled clinic appointments. These factors should be considered during collaborative adherence strategy planning at ART initiation.

Study site: Outpatient clinic, Hospital Sungai Buloh Malaysia

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