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  1. Mohd Isa, S., Hashim, A.H., Kaur, M., Ng, C.G.
    MyJurnal
    Objective: As Internet use becomes ubiquitous among adolescents, Internet
    addiction turns out to be as a potential problem in adolescents. The aim of
    this cross-sectional study was to examine the prevalence of internet addiction
    and its associated factors among the adolescents in Malaysia.

    Methods: The
    association between internet addiction and attention deficit hyperactivity
    disorder (ADHD) symptoms was also examined in this cross-sectional study,
    which was conducted at four secondary schools in Malaysia. In this study,
    Malaysian Version of Internet Addiction Test (MVIAT), Conners-Wells
    Adolescent Self-report: Short Form (CASS:S), The Conners Teachers Rating
    Scale: Short Form (CTRS:S) and The Conners’ Parents Rating Scale: Short
    For (CPRS: S) were used.

    Results: The results demonstrated 28.6% of the
    subjects were addicted to the internet and there was a positive association
    with ADHD symptoms. Male gender, early age of first internet use, longer
    total time of internet use are associated with internet addiction problem
    among the adolescents. Internet addiction has become highly prevalent
    among the adolescent in Malaysia.

    Conclusions: It is important to provide
    support for this group of adolescent with internet use problem. Measure to
    prevent the worsening of the situation and future research on the causal
    factors of internet addiction such as ADHD is needed.
  2. Isa SH, Wong M, Khalid BA
    Med J Malaysia, 2006 Dec;61(5):630-2.
    PMID: 17623967
    A patient with beta hCG-secreting germ cell carcinoma of the pineal and suprasellar regions presented with hydrocephalus, Parinaud's syndrome, hypopituitarism and polyuria. Central diabetes insipidus was strongly suspected although the water deprivation test was not diagnostic. The polyuria however, responded to ADH analogue when the hypothyroidism and hypocortisolism were treated. Pubertal development was evident and serum testosterone was normal despite the low FSH/LH, suggesting hCG stimulation of Leydig cells. This case illustrates that a beta hCG-germ cell tumour of the suprasellar region causing hypopituitarism can mask the presence of central diabetes insipidus and hypogonadotrophic hypogonadism.
  3. Wong M, Isa SH, Zahiah M, Azmi KN
    World J Surg, 2007 Mar;31(3):586-92.
    PMID: 17322973
    This study assessed the sensitivities of preoperative localisation modalities such as computed tomography (CT), magnetic resonance imaging (MRI), arteriography and arterial stimulation venous sampling (ASVS) using serum insulin and C-peptide gradients to intraoperative techniques in localising insulin-secreting tumours in our institution.
  4. Wong M, Isa SH, Kamaruddin NA, Khalid BA
    Med J Malaysia, 2007 Jun;62(2):168-70.
    PMID: 18705457
    We report a case of a 45 year-old man who presented initially with a non-functioning pituitary macroadenoma. A routine chest radiography done preoperatively revealed a right lung nodule which was confirmed by computed tomography (CT) of the thorax. Transfrontal hypophysectomy was performed while a conservative approach was taken for the lung nodule. Four years later, he presented acutely with adrenocorticotrophic hormone (ACTH) dependent Cushing's syndrome which resolved following a right lobectomy. Histological examination revealed an atypical carcinoid. To our knowledge, this is the first reported case of an ectopic ACTH secreting pulmonary carcinoid found in association with a non-functioning pituitary macroadenoma.
  5. Vallennie V, Isa SNI, Mazlan AZ, Shaifuddin SNM
    Med J Malaysia, 2024 Mar;79(Suppl 1):82-87.
    PMID: 38555890
    INTRODUCTION: The palm oil (PO) industry is one of the most important sectors in the Malaysian economy. Workers at PO mills are, however, at risk for a number of health and safety issues, including heat stress, as the PO is one of the industries with high heat exposure. Heat stress occurs when a person's body cannot get rid of excess heat. Heat stress can result in heat cramps, heat exhaustion, heat rash, and heat stroke. It also results in physiological and psychological changes that can have an impact on a worker's performance. Therefore, this study aimed to evaluate the impact of heat stress on health-related symptoms and physiological changes among workers in a PO mill.

    MATERIALS AND METHODS: This cross-sectional study was conducted in a PO mill located in Mukah, Sarawak, Malaysia. Thirty-one workers from the four workstations (sterilizer, boiler, oil, and engine rooms) were selected as the respondents in this study. Wet Bulb Globe Thermometer was used in this study to measure the environmental temperature (WBGTin). Body core temperature (BCT), blood pressure (BP), and heart rate (HR) were recorded both before and after working in order to assess the physiological effects of heat stress on workers. A set of questionnaires were used to determine sociodemographic characteristics of the respondents and their symptoms related to heat stress. Data were then analyzed using SPSS Ver28.

    RESULTS: The WBGTin was found to be above the ACGIH threshold limit value of heat stress exposure in the engine room, sterilizer, and boiler workstations (>28.0°C). Additionally, there was a significant difference in the worker's BCT in these three workstations before and after work (p<0.05). Only the systolic BP and HR of those working at the boiler workstation showed significant difference between before and after work (p<0.05). The most typical symptoms that workers experience as a result of being exposed to heat at work include headache and fatigue. However, statistical analysis using Spearman Rho's test showed that there is no correlation between heat stress level with physiological changes and health-related symptoms among study respondents (p>0.05).

    CONCLUSION: Results of the present study confirmed that workers in PO mill were exposed to high temperatures while at work. Although the evidence indicates the physiological parameters in general are not significantly affected while working, it also demonstrated that worker's body adapts and acclimates to the level of heat. Even so, precautions should still be taken to reduce future heat exposure. It is recommended that a physiological study be carried out that focuses on cognitive function impairment to support the evidence regarding the effects of heat stress on PO mill workers.

  6. Mohd Anuar AH, Mohamad Anuar NN, Isa SNI, Bahari M
    Med J Malaysia, 2024 Mar;79(Suppl 1):88-95.
    PMID: 38555891
    INTRODUCTION: Several necessary initiatives have been made to create a readily available vaccine against the Coronavirus Disease 2019 (COVID-19) worldwide pandemic. However, the vaccination program's success is dependent on the population's willingness as well as their knowledge of vaccination. Hence, the present study aimed to assess the level of knowledge and acceptance towards the COVID-19 vaccine among the community in Johor Bahru, Johor.

    MATERIALS AND METHODS: A cross-sectional study was conducted using an online survey between February and May 2022, with 423 respondents. The questionnaire consisted of socio-demographic, assessment of knowledge level and acceptance level towards COVID-19 vaccine. The descriptive analysis and non-parametric tests were employed to investigate the study outline objectives.

    RESULTS: Of all 423 participants, 293 (69.3%) of the participants had a high level of knowledge about the COVID- 19 vaccine (median knowledge score 6; IQR = 3), and 239 (56.5%) were reported to have a low level of vaccine acceptance (median acceptance scores 4; IQR=2). The knowledge level towards the COVID-19 vaccine was significantly associated with the vaccine acceptance level (p<0.001).

    CONCLUSION: The community's level of knowledge towards COVID-19 vaccine was high; however, the vaccine acceptance was low.

  7. Nordin NM, Fen CK, Isa S, Symonds EM
    Malays J Med Sci, 2006 Jul;13(2):52-60.
    PMID: 22589605 MyJurnal
    The aim of the study was to assess the outcomes of grandmultiparous women receiving the current obstetric care in Maternity Hospital Kuala Lumpur. Recent data regarding some of the complications are conflicting and the significance of grandmultiparity is now in question. Therefore, a retrospective cohort study of 237 grandmultiparous and 254 multiparous women were undertaken. Chi-squared and t test were used (P<0.05) where appropriate. The results revealed that grandmultiparous women tend to be Malays, age above 35, have late antenatal booking and suffered from anemia and non-proteinuric hypertension. There was no significant difference in diabetes and glucose intolerance, ante partum and post partum hemorrhage. There was a significantly lower risk of first and second-degree perineal tear, and prolonged first stage of labor. There was a significant increased in induction of labor but there was no uterine rupture and no increased in Cesarean Section. There was an increased in meconium stain liquor but there was no increased risk of fetal distress. The fetal outcome was good and there was no tendency to macrosomic infants or shoulder dystocia. With adequate care, the maternal fetal outcome of grandmutiparous women is good and comparable to the multiparous women. Anemia is still common and patient education is important to overcome this problem.
  8. Abd Aziz A, Izyan Farhana Nordin N, Mohd Noor N, Bachok N, Nor Ismalina Isa S
    Fam Pract, 2014 Apr;31(2):236-44.
    PMID: 24317538 DOI: 10.1093/fampra/cmt062
    Background. Patient satisfaction influences the outcomes of the patient-physician encounter.
    Objective. The objective of this study was to validate the Malay version patient satisfaction
    (MISS-21) questionnaire using a confirmatory validity approach.
    Methods. A cross-sectional study was conducted involving 252 patients attending primary health
    clinic, Hospital Universiti Sains Malaysia. Construct validity (convergent and discriminant) using
    confirmatory factor analysis and internal consistency were performed after the translation, content
    validity and face validity processes. Criterion validity was assessed using Pearson correlations
    with the scale of shared decision making 9-item questionnaire (SDMQ-9). The data was
    analysed using Analysis of Moment Structure version 19.
    Results. A total of 252 (100%) outpatients responded to this study. The final model that consists
    of three domains with 11 items had a good fit; (χ2
    (df) = 65.805 (32), P 
  9. Salim H, Shariff Ghazali S, Lee PY, Cheong AT, Harrun NH, Mohamed Isa S, et al.
    BMC Public Health, 2021 06 22;21(1):1186.
    PMID: 34158013 DOI: 10.1186/s12889-021-11194-w
    BACKGROUND: Limited health literacy among people with asthma is associated with poor adherence to self-management activities, thus poor clinical outcomes. This study aimed to determine the prevalence of health literacy level and its determinants among people with asthma in the Malaysian primary healthcare settings.

    METHOD: A cross-sectional study was conducted among participants aged > 18 years with asthma who attended five primary health clinics in Malaysia. Systematic random sampling was employed with a final sample of 550 participants. The questionnaires included the validated Malay version of Health Literacy Scale (HLS) and asthma control questionnaire (ACQ). Statistical analysis was done using SPSS version 25. Multiple logistic regression was performed to determine the determinants for limited health literacy.

    RESULTS: The participants mean age of the participants was 48 (SD15.4) years. Most of the participants were women (64%) and of Malay ethnicity (51.1%). Nearly half had a secondary level of education, n = 112, (45.8%). Mean duration of asthma diagnosis is 20.6 (SD 15.9) years. More than half (62.5%) had a family history of asthma. About half (50.9%) had uncontrolled asthma, with 87.3% self-rated themselves as having controlled asthma. About a third (29.1%) received education on of asthma action plan, but only 7.1% of these owned a written version an asthma action plan. Limited health literacy accounts for 60.5% of the participants. The significant determinants for limited health literacy included lower educational attainment (p 

  10. Leong Bin Abdullah MFI, Tan KL, Mohd Isa S, Yusoff NS, Chear NJY, Singh D
    PLoS One, 2020;15(6):e0234639.
    PMID: 32525924 DOI: 10.1371/journal.pone.0234639
    BACKGROUND AND AIM: Kratom, or Mitragyna speciosa Korth., is a tropical plant that has been reported to exhibit opioid-like effects. Although opioids have been demonstrated to alter the lipid profile of regular users, data on the lipid-altering effects of kratom are scarce. This study aimed to compare the fasting lipid profile of regular kratom users to that of healthy subjects who do not use kratom. It also determined the association between various characteristics of kratom users and the serum triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels of regular kratom users.

    METHODS: A total of 200 participants (n = 100 kratom users and n = 100 healthy subjects who do not use kratom) were recruited for this analytical cross-sectional study. Data on sociodemographic status, kratom use characteristics, cigarette smoking, physical activity, body mass index (BMI), fasting serum lipid profile, and liver function were collected from all participants.

    RESULTS: The liver parameters of the study participants were within normal range. The serum total cholesterol and LDL of kratom users were significantly lower than those of healthy subjects who do not use kratom. There were no significant differences in the serum triglyceride and HDL levels. However, higher average daily frequency of kratom use and increasing age were associated with increased serum total cholesterol among kratom users. Other kratom use characteristics such as age of first kratom intake, duration of kratom use, and quantity of daily kratom intake were not associated with increased serum triglyceride, total cholesterol, LDL, and HDL levels.

    CONCLUSIONS: Our findings suggest regular kratom consumption was not linked to elevated serum lipids, except when there is a higher frequency of daily kratom intake. However, the study was limited by the small sample size, and hence a more comprehensive study with larger sample size is warranted to confirm the findings.

  11. Norlinah MI, Hamizah R, Md Isa SH, Wan Nazaimoon WM, Khalid BA
    Indian J Med Sci, 2009 Apr;63(4):131-8.
    PMID: 19414982
    BACKGROUND: The role of endothelial injury and circulating adhesion molecule in the development and progression of diabetic peripheral neuropathy in the long-term has been established previously.
    AIMS: To study the effects of short-term glycemic control using insulin and oral hypoglycemic agent therapy (OHA) on the peroneal nerve function and vascular cell adhesion molecule-1 (VCAM-1) and advanced glycation endproducts (AGE) levels in type 2 diabetic patients.
    SETTINGS AND DESIGN: A randomized controlled study involving poorly controlled (HbA1c, 7.5%-11%) type 2 diabetic patients attending the endocrinology outpatient center in a tertiary hospital in Kuala Lumpur.
    MATERIALS AND METHODS: Twenty-nine patients were randomized to receive insulin (n=15) or OHA (n=14) for 8 weeks. The glycemic variables (HbA1c, fasting plasma glucose [FPG], fructosamine), VCAM-1, serum AGE and the peroneal motor conduction velocity (PMCV) were measured at baseline and at 4-week intervals.
    STATISTICAL ANALYSIS USED: Paired 't' test or Kruskal Wallis test; and the unpaired 't' test or Mann-Whitney U test were used for within-group and between-group analyses, respectively. Correlation was analyzed using Spearman's correlation coefficient.
    RESULTS: Within-group analysis showed significant progressive improvement in HbA1c at weeks 4 and 8 in the insulin group. The PMCV improved significantly in both groups by week 8, and by week 4 (P = 0.01) in the insulin group. PMCV correlated negatively with VCAM-1 (P = 0.031) and AGE (P = 0.009) at week 8.
    CONCLUSION: Aggressive glycemic control with insulin improves the peroneal nerve function within 4 weeks. Improvement in the serum VCAM-1 and AGE levels correlated significantly with improvement in peroneal nerve conduction velocity only in the insulin group.
    Study site: Tertiary endocrinology outpatient center in Kuala Lumpur, Malaysia
  12. Md Isa SH, Najihah I, Nazaimoon WM, Kamarudin NA, Umar NA, Mat NH, et al.
    Diabetes Res Clin Pract, 2006 Apr;72(1):48-52.
    PMID: 16253380 DOI: 10.1016/j.diabres.2005.09.011
    We studied the efficacy of four different treatment regimens (sulphonylurea and metformin+/-acarbose versus glimepiride and rosiglitazone versus glimepiride and bedtime NPH insulin versus multiple actrapid and NPH insulin injections) in poorly controlled type 2 diabetes subjects on hs-CRP, VCAM-1 and AGE at 4, 8 and 12 weeks of treatment. Multiple insulin injections rapidly improved HbA(1c) by 0.6+/-0.9% (p<0.005), 1.2+/-1.3% (p<0.0005) and 1.3+/-1.4% (p<0.0005) at week 4, at week 8 and week 12, respectively. Subjects who continued their existing combination treatment of sulphonylurea, metformin+/-acarbose also showed a significant reduction in HbA(1c) (p<0.05). Although effective in reducing glycemic parameters, there was no reduction in CRP levels in either treatment group. The treatment regimen consisting of rosiglitazone and glimepiride significantly lowered hs-CRP by -2.6 (3.9) mg/L (p<0.05) at week 12 in spite of no improvement in blood glucose. AGE improved in all groups irrespective of type of treatment, glycaemic control and CRP levels. Our data indicate rapid glycaemic control alone does not necessarily result in improvement in markers of inflammation in type 2 diabetes patients.
  13. Abrar SS, Azmel Mohd Isa S, Mohd Hairon S, Yaacob NM, Ismail MP
    Cureus, 2024 Oct;16(10):e71359.
    PMID: 39534844 DOI: 10.7759/cureus.71359
    Cervical cancer is the fourth most common cancer among women worldwide, with particularly high incidence and mortality rates in low- and middle-income countries, with Asia reporting the highest number of cases in 2022. Despite this significant burden, the prognostic factors specific to Asian populations remain underexplored. This scoping review aimed to identify and evaluate prognostic factors associated with cervical cancer outcomes in Asia, focusing on clinical, socio-demographic, and treatment-related variables. The review followed the Arksey and O'Malley framework and included 44 studies published between 2013 and 2023. The majority of research was concentrated in East Asia, particularly in China, Japan, and South Korea. Key prognostic factors affecting overall survival and disease-free survival included tumor size, histology, age, lymphovascular invasion, and lymph node metastasis. Non-squamous cell carcinoma histology, especially adenocarcinoma, was consistently linked to poorer outcomes. Older age and medical comorbidities, such as anemia and diabetes, also negatively impacted survival. Treatment-related factors, though less frequently reported, demonstrated the significance of adjuvant therapy, chemotherapy, and treatment intensity in improving outcomes. This review underscores the complexity of cervical cancer prognosis in Asian populations and highlights the need for targeted research and region-specific interventions to address the rising incidence of cervical cancer. It also highlights the scarcity of research on cervical cancer prognostic factors in West, Central, and South Asian countries. Future research should aim to address the gaps in understanding treatment-related factors and explore the potential for region-specific interventions to improve outcomes in cervical cancer across Asia.
  14. Omar J, Isa S, Ismail TST, Yaacob NM, Soh NAAC
    Malays J Med Sci, 2019 Jul;26(4):61-69.
    PMID: 31496894 MyJurnal DOI: 10.21315/mjms2019.26.4.7
    Background: As an early recognition of neonatal sepsis is important for triggering the initiation of treatment, this study was thus designed to assess the diagnostic performance and discrimination value of procalcitonin (PCT) in neonatal sepsis cases.

    Methods: This cross-sectional study, which was carried out at the Paediatric Intensive Care Unit of Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia, had involved 60 neonates admitted for suspected sepsis. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and the area under receiver operating characteristics curve (AUC) for PCT were determined at initial presentation (0 h) as well as 12 h and 24 h after presentation in comparison to blood culture as the gold standard.

    Results: The study consisted of 27 (45.0%) male and 33 (55.0%) female neonates with a mean (SD) age of 76.8 (48.25) h. At cut-off PCT value of > 2 ng/mL, the sensitivity, specificity, PPV and NPV were 66.7%, 66.7%, 33.3% and 88.9% at 0 h. The respective parameters were 83.3%. 56.3%, 32.3% and 93.1% at 12 h and 83.3%, 52.1%, 30.3% and 92.6% at 24 h. AUC was 71.6%, 76.6% and 71.7% at 0 h, 12 h and 24 h.

    Conclusions: Diagnostic performance and discrimination values of PCT for diagnosis of neonatal sepsis varied with time of obtaining the blood samples. The PCT result at 12 h demonstrates the most optimal diagnostic performance and discrimination values.

  15. Yeow TP, Khir AS, Ismail AA, Ismail IS, Kamarul Imran M, Khalid BA, et al.
    Diabet Med, 2012 Nov;29(11):1378-84.
    PMID: 22803824 DOI: 10.1111/j.1464-5491.2012.03741.x
    AIMS: Cardiovascular disease is the foremost cause of mortality in Malaysia but little is known about the prevalence of the metabolic syndrome and its associations with other known cardiovascular risk markers. We undertook a population-based study to examine these.
    METHODS: For the study, 4341 subjects were selected using a multistage stratified sampling method. Subjects were interviewed for personal and past medical history. Biomedical markers and anthropometric indices were measured. The metabolic syndrome was defined using the harmonized criteria. The associations between the metabolic syndrome and cardiovascular risk markers, including high-sensitivity C-reactive protein, microalbuminuria and HbA(1c) were examined.
    RESULTS: The prevalence of the metabolic syndrome was 42.5%. Subjects with the metabolic syndrome are significantly more likely to have higher BMI (> 25 kg/m(2)), HbA(1c) [≥ 42 mmol/mol (6.0%)], LDL (≥ 2.6 mmol/l), elevated albumin:creatinine ratio (> 2.5 μg/mmol creatinine for men, 3.5 μg/mmol creatinine for women) and high-sensitivity C-reactive protein (> 3 mg/l); odds ratio 5.48, 6.14, 1.44, 3.68 and 1.84, respectively, P < 0.001. The presence of an elevated albumin:creatinine ratio and high-sensitivity C-reactive protein are strong predictors for the presence of a higher number of positive criteria of the metabolic syndrome. HbA(1c) > 48 mmol/mol (6.5%) is associated with increased relative risk of elevated albumin:creatinine ratio, high-sensitivity C-reactive protein and LDL (relative risk 3.10, 2.46 and 1.65 respectively, P < 0.001).
    CONCLUSIONS: We confirmed the high prevalence of the metabolic syndrome in Malaysia. Our study revealed a strong relationship between risk markers of elevated BMI, HbA(1c), LDL, albumin:creatinine ratio and high-sensitivity C-reactive protein with the presence of the metabolic syndrome, putting them at a statistically high risk for cardiovascular mortality.
  16. Wan Nazaimoon WM, Md Isa SH, Wan Mohamad WB, Khir AS, Kamaruddin NA, Kamarul IM, et al.
    Diabet Med, 2013 Jul;30(7):825-8.
    PMID: 23413941 DOI: 10.1111/dme.12161
    AIM: The prevalence of diabetes mellitus among Malaysians aged ≥ 30 years of age has increased by more than twofold over a 20-year period. This study aimed to determine the current status and to evaluate the diagnostic usefulness of the HbA(1c) cut-off point of 48 mmol/mol (6.5%).
    METHODS: Using a two-stage stratified sampling design, participants aged ≥ 18 years were recruited from five zones selected to represent Malaysia. An oral glucose tolerance test was performed on all those not known to have diabetes.
    RESULTS: A total of 4341 subjects were recruited. By World Health Organization criteria, the prevalence of diabetes mellitus was 22.9%; of that percentage, 10.8% was known diabetes and 12.1% was newly diagnosed diabetes. Diabetes was most prevalent amongst Indians (37.9%) and Malays (23.8%). Prevalence of new diabetes mellitus was only 5.5% (95% CI 4.9-6.3) when based on the HbA(1c) diagnostic criteria of 48 mmol/mol (6.5%) and, although the cut-off point was highly specific (98.1%), it was less sensitive (36.7%) compared with 45 mmol/mol (6.3%), which showed the optimal sum of sensitivity (42.5%) and specificity (97.4%) in identifying new diabetes mellitus.
    CONCLUSION: This study recorded an overall diabetes prevalence of 22.6%, almost a twofold increase from 11.6% reported in 2006. This was likely attributable to the higher prevalence of new diabetes (12.1%) diagnosed following an oral glucose tolerance test. An HbA(1c) of 45 mmol/mol (6.3%) was found to be a better predictive cut-off point for detecting new diabetes in our multi-ethnic population.
  17. Koh WM, Abu Bakar AI, Hussein N, Pinnock H, Liew SM, Hanafi NS, et al.
    Health Expect, 2021 Dec;24(6):2078-2086.
    PMID: 34449970 DOI: 10.1111/hex.13352
    BACKGROUND: Supported self-management improves asthma outcomes, but implementation requires adaptation to the local context. Barriers reported in Western cultures may not resonate in other cultural contexts. We explored the views, experiences and beliefs that influenced self-management among adults with asthma in multicultural Malaysia.

    METHODS: Adults with asthma were purposively recruited from an urban primary healthcare clinic for in-depth interviews. Audio-recordings were transcribed verbatim and analysed thematically.

    RESULTS: We interviewed 24 adults. Four themes emerged: (1) Participants believed in the 'hot and cold' concept of illness either as an inherent hot/cold body constitution or the ambient temperature. Hence, participants tried to 'neutralize' body constitution or to 'warm up' the cold temperature that was believed to trigger acute attacks. (2) Participants managed asthma based on past experiences and personal health beliefs as they lacked formal information about asthma and its treatment. (3) Poor communication and variable advice from healthcare practitioners on how to manage their asthma contributed to poor self-management skills. (4) Embarrassment about using inhalers in public and advice from family and friends resulted in a focus on nonpharmacological approaches to asthma self-management practice.

    CONCLUSIONS: Asthma self-management practices were learnt experientially and were strongly influenced by sociocultural beliefs and advice from family and friends. Effective self-management needs to be tailored to cultural norms, personalized to the individuals' preferences and clinical needs, adapted to their level of health literacy and underpinned by patient-practitioner partnerships.

    PATIENT AND PUBLIC CONTRIBUTIONS: Patients contributed to data. Members of the public were involved in the discussion of the results.

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