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HIV Treatment Adherence - A Shared Burden for Patients, Health-Care Providers, and Other Stakeholders

Abdulrahman SA, Ganasegeran K, Rampal L, Martins OF

AIDS Rev, 2019;21(1):28-39.
PMID: 30899114 DOI: 10.24875/AIDSRev.19000037

Successful HIV treatment is contingent on sustained high levels of treatment adherence. Several barriers to optimal adherence have been documented. In this article, we first review the global burden of non-adherence among HIV/AIDS positive individuals on a public health scale. Second, we synthesized available evidence from different study designs and stratified across the European, African, and Asian literature to determine the factors influencing adherence to scheduled clinic appointments and medication non-adherence. Third, we discuss common measurement techniques that quantify the magnitude of non-adherence, their relative advantages and limitations in current practice. From January to May 2018, we reviewed guidelines, standard operating procedures, journal articles, and book chapters on treatment adherence among HIV patients receiving adherence to antiretroviral therapy (ART) globally. We searched PubMed, Medline, Google Scholar, and Cochrane Database of Systematic Reviews with the search terms "adherence," "adherence behavior," "medication adherence," and "HIV patients," or "HIV/AIDS," and "Antiretroviral Therapy" or "ART" or "ARVs" or "highly active ART " from 2000 to 2017. We also identified articles through searches of authors' files and previous research on HIV. We included only papers published in English in this review. We then generated a final list of reference on the basis of originality and the broad scope of this review. We found rich literature evidence of research findings and best practice recommendations on the importance of adherence in HIV/AIDS management, a general understanding of factors associated with non-adherence and approaches to investigating non-adherence behavior among different populations. We observed significant contextual differences exist with regard to barriers and burden of non-adherence among these populations.
Conceptual Framework for Investigating and Influencing Adherence Behavior among HIV-Positive Populations: An Applied Social Cognition Model

Abdulrahman SA, Ganasegeran K, Rampal L, Martins OF

AIDS Rev, 2019 Aug 06;21(3):157-159.
PMID: 31386650

Non-adherence remains a significant barrier to achieving successful HIV treatment outcomes. This review aimed to holistically examine the concept of adherence in the light of current research evidence and to provide a basic and adaptable conceptual framework for investigating and influencing adherence behavior among various HIV populations. We reviewed published journal articles and gray literature within the period from 2000 to 2017. A comprehensive search from major online databases and repositories such as PubMed, Scopus, Medline, Google Scholar, and Cochrane Database of Systematic Reviews was conducted using focused search terms that included "social cognition models" or "theories and models of health behavior change" or "behavior change in health psychology" or "theory-based interventions" or "behavioral frameworks" and "adherence behavior" or "medication adherence," and "HIV patients" or "HIV/AIDS." Only papers published in English were included in this study. We found varied and extensive literature evidence supporting the use of psychobehavioral models to promote conceptual understanding of adherence behavior among HIV-positive patients globally. We observed that certain approaches at investigating nonadherence worked better among certain populations and epidemics than others, largely because of contextual differences in barriers and burden of non-adherence among these populations. We synthesized the evidence and applied social cognition models in explaining and providing a basic, evidence-based and adaptable conceptual framework for investigating and influencing adherence behavior among HIV-positive populations around the world, regardless of geographical and HIV epidemiological context.
Fulltext Prevalence of emotional disorders among medical students in a Malaysian university

Mohd Sidik S, Rampal L, Kaneson N

Asia Pac Fam Med, 2003;2(4):213-217.

Background: Emotional disorder, one of the common human emotional states is defined as feelings of sadness and tiredness in response to life events, such as disappointments. It is one of the major problems among students and although it consists of more than half of all mental disorders, it is often left untreated each year worldwide. Aim: To determine the prevalence of emotional disorders among medical students at a university in Malaysia.
Methods: A cross sectional study design was used. All medical students at a local university in Malaysia were included in the study. A questionnaire similar to the General Health Questionnaire (GHQ-12) was used as a screening instrument.
Results: A total of 41.9% of the medical students were found to have emotional disorders. Factors found to have a significant association with emotional disorders were relationship of the respondents with their parents (chi-square=6.02, d.f.=1, p<0.05), siblings (chi-square=6.94, d.f.=1, p<0.05) and lecturers (chi-square=4.80, d.f.=1, p<0.05), as well as pressure prior to exams (chi-square=10.30, d.f.=1, p<0.05).
Conclusion: The prevalence of emotional disorders among medical students was high. There was significant association between emotional disorders and respondents' relationship with their parents, siblings and lecturers, as well as level of pressure prior to exam. Early detection of this condition is important to prevent psychological morbidity and its unwanted effects on medical students and young doctors.
Fulltext The prevalence and factors associated with obesity among adult women in Selangor, Malaysia

Sidik SM, Rampal L

Asia Pac Fam Med, 2009 Apr 09;8(1):2.
PMID: 19358728 DOI: 10.1186/1447-056X-8-2

INTRODUCTION: The prevalence of obesity in developing countries especially among women is on the rise. This matter should be taken seriously because it can burden the health care systems and lower the quality of life.
AIM: The purpose of this study was to determine the prevalence of obesity among adult women in Selangor and to determine factors associated with obesity among these women.
METHODS: This community based cross sectional study was conducted in Selangor in January 2004. Multi stage stratified proportionate to size sampling method was used. Women aged 20-59 years old were included in this study. Data was collected using a questionnaire-guided interview method. The questionnaire consisted of questions on socio-demographic (age, ethnicity, religion, education level, occupation, monthly income, marital status), Obstetric & Gynaecology history, body mass index (BMI), and the Patient Health Questionnaire (PHQ-9).
RESULTS: Out of 1032 women, 972 agreed to participate in this study, giving a response rate of 94.2%. The mean age was 37.91 +/- 10.91. The prevalence of obesity among the respondents was 16.7% (mean = 1.83 +/- 0.373). Obesity was found to be significantly associated with age (p = 0.013), ethnicity (p = 0.001), religion (p = 0.002), schooling (p = 0.020), educational level (p = 0.016), marital status (p = 0.001) and the history of suffering a miscarriage within the past 6 months (p = 0.023).
CONCLUSION: The prevalence of obesity among adult women in this study was high. This problem needs to be emphasized as the prevalence of obesity keeps increasing, and will continue to worsen unless appropriate preventive measures are taken.
Fulltext A national study on the prevalence of obesity among 16,127 Malaysians

Rampal L, Rampal S, Khor GL, Zain AM, Ooyub SB, Rahmat RB, et al.

Asia Pac J Clin Nutr, 2007;16(3):561-6.
PMID: 17704038

A population-based cross-sectional study was conducted in all states of Malaysia with the aim to determine the prevalence of obesity among Malaysians aged fifteen years and above and factors associated. A stratified two-stage cluster sampling design with proportional allocation was used. Trained interviewers using a standardized protocol obtained the weight and height measurements and other relevant information. Subjects with a body mass index >= 30 kg/m2 were labelled as obese. The results show that the overall national prevalence of obesity among Malaysians aged 15 years old and above was 11.7% (95% CI = 11.1 - 12.4%). The prevalence of obesity was significantly higher in females (13.8%) as compared to 9.6% in males (p< 0.0001). Prevalence of obesity was highest amongst the Malays (13.6%) and Indians (13.5%) followed by the indigenous group of "Sarawak Bumiputra" (10.8%) and the Chinese (8.5%). The indigenous group of "Sabah Bumiputra" had the lowest prevalence of 7.3%. These differences are statistically significant (p< 0.0001). Logistic regression analysis results show that there was a significant association between obesity and age, gender, ethnicity urban/rural status and smoking status. The prevalence of obesity amongst those aged >= 18 years old has markedly increased by 280% since the last National Health and Morbidity Survey in 1996.
Study name: National study on Cardio-Vascular Disease Risk Factors 2004
Variation in the prevalence, awareness, and control of diabetes in a multiethnic population: a nationwide population study in Malaysia

Rampal S, Rampal L, Rahmat R, Zain AM, Yap YG, Mohamed M, et al.

Asia Pac J Public Health, 2010 Apr;22(2):194-202.
PMID: 19443875 DOI: 10.1177/1010539509334816

The purpose of this study was to determine the association between different ethnic groups and the prevalence, awareness, and control of diabetes in Malaysia. A population-based cross-sectional study using multistage sampling was conducted in Malaysia. Diabetes is defined as having a fasting blood glucose > or =7 mmol/L or a self-reported diabetic on treatment. Among the 7683 respondents aged > or =30 years, the prevalence of diabetes mellitus was 15.2% (95% CI = 14.1, 16.4). Multivariate analysis showed that compared with Malays, Chinese had lower odds (adjusted odds ratio [aOR] 0.71; 95% CI = 0.56, 0.91) and Indians had higher odds of having diabetes (aOR 1.54; 95% CI = 1.20, 1.98). The odds of diabetes increased with age, family history of diabetes, body mass index, and lower education levels. Among those with diabetes mellitus, 45.0% were aware and 42.7% were under treatment. Among treated diabetics, 25.1% had their fasting blood sugar under control. There is a significant association between prevalence of diabetes and different ethnic groups.
Factors associated with chronic illness among the elderly in a rural community in Malaysia

Sherina MS, Rampal L, Mustaqim A

Asia Pac J Public Health, 2004;16(2):109-14.
PMID: 15624788 DOI: 10.1177/101053950401600206

Chronic illness is one of the major causes of mortality and morbidity among the elderly. To determine the prevalence and factors associated with chronic illness among the elderly in a rural community setting. A cross sectional study design was used. Stratified proportionate cluster sampling method was used to select respondents in Mukim Sepang, Sepang, Selangor, Malaysia. Out of 263 elderly residents (6.2% of the total population), 223 agreed to participate in the study giving a response rate of 84.8%. The prevalence of chronic illness among the elderly in Mukim Sepang was 60.1%. Out of 223 respondents, 134 were diagnosed as having chronic illness such as hypertension, diabetes mellitus, ischaemic heart disease, bronchial asthma or gout. Chronic illness was found to be significantly associated with functional dependence among the elderly (chi2=6.863, df=1, p<0.05). The prevalence of chronic illness among the elderly in the rural community is very high. Problems facing this age-group should be addressed comprehensively in order to formulate appropriate programmes for the health care of the elderly.
Socioeconomic Predictors of Adherence Behavior Among HIV-Positive Patients Receiving Antiretroviral Therapy in Selangor, Malaysia

Abdulrahman SA, Rampal L, Othman N, Ibrahim F, Kadir Shahar H, Radhakrishnan AP

Asia Pac J Public Health, 2017 May;29(4):304-314.
PMID: 28397533 DOI: 10.1177/1010539517700471

Medication adherence remains a critical link between the prescribed ART regimen and treatment outcome. Several factors may influence adherence behavior. This cross-sectional study aimed to highlight socioeconomic predictors of adherence behavior among a cohort of 242 adult Malaysian patients receiving antiretroviral therapy in Hospital Sungai Buloh, Malaysia, where they were enrolled in a parent study (single-blinded randomized controlled trial) between January and December 2014. Statistical analysis of secondary data on adherence behavior and sociodemographic characteristics of the patients revealed mean age of 33.4 years and ranged from 18 to 64 years; 88.8% were males. A total of 224 (93%) patients who completed 6 months' adherence assessment were included in the model. Of these, 135 (60.3%) achieved optimal adherence. Multivariate binary logistic regression analysis revealed that patient's income and ethnicity were significant predictors of adherence behavior. This may be valuable for targeted programmatic interventions to further enhance successful treatment outcomes among the target population.
Fulltext Prevalence, associated factors and predictors of anxiety: a community survey in Selangor, Malaysia

Kader Maideen SF, Mohd Sidik S, Rampal L, Mukhtar F

BMC Psychiatry, 2015;15:262.
PMID: 26497745 DOI: 10.1186/s12888-015-0648-x

Anxiety is the most common mental health disorders in the general population. This study aimed to determine the prevalence of anxiety, its associated factors and the predictors of anxiety among adults in the community of Selangor, Malaysia.
Descriptive epidemiology of nasopharyngeal carcinoma in Peninsular Malaysia

Prasad U, Rampal L

Cancer Causes Control, 1992 Mar;3(2):179-82.
PMID: 1562708 DOI: 10.1007/BF00051659

Nasopharyngeal carcinoma (NPC) is one of the most common cancers in Malaysia, a country in Southeast Asia with a multiracial population. While hospital-based data on NPC and data from a few states have been reported, a comprehensive study involving every known NPC patient in the whole of Peninsular Malaysia in one particular year had never been done. In the present study, the computed incidence rate was not only adjusted for age, sex, ethnicity, and place of residence, but also direct standardization methods of Rothman and Dever were used to reduce any distortion. The mean age of the 365 new cases of NPC registered in 1988 was 46.8 years (SD +/- 12.2 years). The ages of patients ranged from 10 to 80 years. The incidence in both sexes rose after the age of 20-29 years and reached a plateau between 40 and 49 years. No further rise was exhibited after age 60 years. The Chinese had the highest age-adjusted incidence rates, particularly for the age group 40-49 years, where the incidence rate was 40.1 per 100,000 for males and 14.9 for females. The average age-adjusted male/female ratio was 2.8:1. Age-adjusted incidence varied by place of residence. The pattern that emerged from the data indicated the possibility of interaction between genetic susceptibility and environmental cofactors in the etiology of NPC.
Association of LDLR, TP53 and MMP9 Gene Polymorphisms With Atherosclerosis in a Malaysian Study Population

Ahmad Z, Blin J, Rampal L, Adnan RS, Mohtarrudin N, Abang Yusuf DSY

Curr Probl Cardiol, 2023 Feb 22;48(6):101659.
PMID: 36822563 DOI: 10.1016/j.cpcardiol.2023.101659

Preliminary research has shown that low density lipoprotein receptor (LDLR), tumor protein (TP53) and matrix metalloproteinase 9 (MMP9) genes expression levels were significantly increased in atherosclerosis coronary artery tissue (ACAT) compared to non-atherosclerotic coronary artery tissue (NCAT) samples. Thus, further investigation was carried out to study the association of LDLR, TP53 and MMP9 gene polymorphisms and the risk of developing atherosclerosis (ATH) in a Malaysian population. Single nucleotide polymorphisms of C88S, TP53 codon 72 and MMP9C>T were analyzed in 76 ACAT samples and 149 NCAT samples, representing cases and controls, respectively. In results, heterozygous CT genotype of MMP9C>T polymorphism was significantly higher in ACAT compared to NCAT samples (57.9% vs 27.5%, χ2 = 19.758, df= 1, P < 0.05). The CT genotype was found to be significantly associated with the risk of developing ATH (OR = 3.622, 95% CI = 2.028-6.470). However, the distribution of the CT genotype in a healthy Malaysian study population was incomparable regardless of gender and ethnicity. The DNA sequencing results validated the C88S, TP53 codon 72, and MMP9C>T polymorphisms. In conclusion, the CT genotype of the MMP9-1562C>T polymorphism was found to have a strong association with the risk of developing ATH.
Fulltext Effect of chemotherapy counseling by pharmacists on quality of life and psychological outcomes of oncology patients in Malaysia: a randomized control trial

Periasamy U, Mohd Sidik S, Rampal L, Fadhilah SI, Akhtari-Zavare M, Mahmud R

Health Qual Life Outcomes, 2017 May 15;15(1):104.
PMID: 28506305 DOI: 10.1186/s12955-017-0680-2

BACKGROUND: Cancer is now becoming a leading cause of death. Chemotherapy is an important treatment for cancer patients. These patients also need consultation during their treatment to improve quality of life and decrease psychological disorders. The objectives of the study were to develop, implement and evaluate the effectiveness of a chemotherapy counseling module by pharmacists among oncology patients on their quality of life and psychological outcomes in Malaysia.
METHOD: A single-blind randomized controlled trial was carried out among 162 oncology patients undergoing chemotherapy from July 2013 to February 2014 in a government hospital with oncology facilities in Malaysia. Participants were randomized to either the intervention group or the control group. Chemotherapy counseling using the module on 'Managing Patients on Chemotherapy' by Pharmacists was delivered to the intervention group. The outcome measures were assessed at baseline, first follow-up and second follow-up and third follow-up post-intervention. Chi-square, independent samples t-test and two-way repeated measures ANOVA were conducted in the course of the data analyses.
RESULTS: In assessing the impact of the chemotherapy counseling module, the study revealed that the module along with repetitive counseling showed significant improvement of quality of life in the intervention group as compared to the control group with a large effect size in physical health (p = 0.001, partial Ƞ2 = 0.66), psychological (p = 0.001, partial Ƞ2 = 0.65), social relationships (p = 0.001, partial Ƞ2 = 0.30), and environment (p = 0.001, partial Ƞ2 = 0.67) and decrease in the anxiety (p = 0.000; partial Ƞ2 = 0.23), depression (p = 0.000; partial Ƞ2 = 0.40).
CONCLUSION: The module on 'Managing Patients on Chemotherapy' along with repetitive counseling by pharmacists has been shown to be effective in improving quality of life and decreasing anxiety and depression among oncology patients undergoing chemotherapy.
TRIAL REGISTRATION NUMBER: National Medical Research Register (NMRR) of Malaysia and given a registration number NMRR-12-1057-12,363 on 21 December 2012.
Fulltext Determinants of quality of life among Malaysian cancer patients: a cross-sectional study

Akhtari-Zavare M, Mohd-Sidik S, Periasamy U, Rampal L, Fadhilah SI, Mahmud R

Health Qual Life Outcomes, 2018 Aug 13;16(1):163.
PMID: 30103759 DOI: 10.1186/s12955-018-0989-5

BACKGROUND: Cancer is a serious public health problem not only in Malaysia, also worldwide. The aim of this study was to determine the determinants of quality of life (QOL) among cancer patients in Peninsular Malaysia.
METHODS: A cross sectional study was conducted among 2120 cancer patients in Peninsular Malaysia, between April 2016 to January 2017. All cancer patients aged 18 years old and above, Malaysian citizens and undergoing cancer treatment at government hospitals were approached to participate in this study and requested to complete a set of validated questionnaires. Inferential statistical tests such as t-test and one-way ANOVA were used to determine the differences between demographic variables, physical effects, clinical factors, psychological effects and self-esteem with the quality of life of cancer patients. Predictor(s) of quality of life were determined by using Multivariate linear regression models.
RESULT: A total 1620 out of 2120 cancer patients participated in this study, giving a response rate of 92%. The majority of cancer patients were female 922 (56.9%), Malays 1031 (63.6%), Muslim 1031 (63.6%), received chemotherapy treatment 1483 (91.5%). Overall, 1138 (70.2%) of the patients had depression and 1500 (92.6%) had anxiety. Statistically significant associations were found between QOL and clinical factors, physical side effects of cancer, psychological effects and self-esteem (p
Fulltext Effects of Counselling on Quality of Life among Cancer Patients in Malaysia: A Randomized Controlled Trial

Periasamy U, Mohd-Sidik S, Akhtari-Zavare M, Rampal L, Ismail SIF, Mahmud R

Iran J Public Health, 2020 Oct;49(10):1902-1911.
PMID: 33346212 DOI: 10.18502/ijph.v49i10.4693

Background: We aimed to assess whether "Managing Patients on Chemotherapy" book is effective to improve quality of life (QOL) of cancer patient via counselling by pharmacist.
Methods: A randomized control trial study was run among 2120 cancer patients in public hospitals in Peninsular Malaysia, from Apr 2016-Jan 2018. The treatment group received counselling regarding chemotherapy by using developed module. The data were collected at three time-points: baseline, 1st, 2nd and 3rd follow-ups after counseling by Validated Malay version of the WHOQOL-BREF of questionnaire. Data analyses were done using χ2 and two-way repeated measure ANOVA.
Results: The treatment group improved significantly as compared to control group in physical health, psychological health, social relationship, environment and overall QOL (P<0.00).
Conclusion: The "Managing Patients on Chemotherapy" book along with repetitive counselling by pharmacists is a useful intervention for improving QOL of cancer patients undergoing treatment.
Fulltext A Web-Based Psychoeducational Intervention Program for Depression and Anxiety in an Adult Community in Selangor, Malaysia: Protocol of a Randomized Controlled Trial

Kader Maideen SF, Mohd Sidik S, Rampal L, Mukhtar F, Ibrahim N, Phang CK, et al.

JMIR Res Protoc, 2016;5(2):e112.
PMID: 27329333 DOI: 10.2196/resprot.4622

Mental disorders are a major public health problem and are debilitating in many nations throughout the world. Many individuals either do not or are not able to access treatment. The Internet can be a medium to convey to the community accessible evidenced-based interventions to reduce these burdens.
Fulltext Effectiveness of a Pelvic Floor Muscle Exercise Intervention in Improving Knowledge, Attitude, Practice, and Self-Efficacy among Pregnant Women: A Randomized Controlled Trial

Alagirisamy P, Sidik SM, Rampal L, Ismail SIF

Korean J Fam Med, 2022 Jan;43(1):42-55.
PMID: 35130639 DOI: 10.4082/kjfm.21.0011

BACKGROUND: The awareness and practice of pelvic floor muscle exercise (PFME) in the prevention and reduction of the rate of urinary incontinence among pregnant women was considerably poor, despite the increased prevalence of urinary incontinence during pregnancy across Malaysia. There healthcare providers do not give adequate attention to the potential impact of PFME on urinary incontinence and there is limited local intervention addressed urinary incontinence during pregnancy. The objective of this study was to determine the effectiveness of a newly developed PFME intervention in terms of knowledge, attitude, practice, self-efficacy, and urinary symptoms.
METHODS: A single-blinded, two-armed, randomized control trial was included pregnant women from 18 to 20 weeks of gestation and was conducted at the Maternity Hospital of Kuala Lumpur. The intervention group received PFME in addition to the usual perinatal care. The data were collected using validated questionnaires at 4 time points: baseline, post-intervention in the early third trimester, late third trimester, and early postnatal period. The intervention effects were analyzed using a generalized estimating equation.
RESULTS: The primary analysis included pregnant women who had at least one follow-up; 122 women (71.8%) in the intervention group had significant improvement in knowledge, attitude, practice, and self-efficacy, as well as in the severity of urinary incontinence over time. However, improvement was not observed in self-reported urinary incontinence.
CONCLUSION: PFME can be considered an effective initial intervention to provide information about urinary incontinence prevention to pregnant women.
Fulltext Sound HIV knowledge and common misconceptions about HIV among university students

Normala I, Zubaidah JO, Nik Shaliza H, Hamidin A, Noorjan KON, Siti Irma Fadhilah I, et al.

Malaysian Journal of Medicine and Health Sciences, 2013;9(1):29-34.
MyJurnal

The objective of the study was to determine the proportion of sound HIV knowledge and common misconceptions about HIV among university students. A set of pre tested and validated questionnaire assessing sound HIV knowledge and common misconceptions about HIV was used in this cross sectional study. HIV knowledge was defined as sound when one was able to identify correctly two ways of preventing the sexual transmission of HIV and reject three major misconceptions about HIV. Out of 300 respondents, 298 completed the questionnaire giving a response rate of 99.3%. A total of 40.9% of university students have sound HIV knowledge. The majority of those who lacked sound HIV knowledge were young (60.2%) and female (60.4%). A significant proportion still believed that HIV can be transmitted via social contact (13.8%), by sneezing or coughing (11.4%) and mosquito bites (10.1%). About 6.7% were believed wrongly that HIV can be treated by vaccine and healthy-looking people cannot have HIV.
Study site: Universiti Putra Malaysia (UPM), Malaysia
Fulltext Prevalence of hypertension among Malay adolescents in Putrajaya secondary schools, Malaysia, 2010

Rampal L, Ng KC, Nur Izzati I, Farah Izzati Z, Mohammad Nazrul I, Faisal I, et al.

Malaysian Journal of Medicine and Health Sciences, 2011;7(2):53-60.
MyJurnal

Background: In Malaysia, the prevalence of hypertension amongst adults aged 30 years and above has increased from 32.9% in 1996 to 40.5% in 2004 and to 42.6% in 2006. Information on the prevalence of hypertension among adolescents is lacking.
Objective: to determine the prevalence of hypertension among Malay secondary school students in Putrajaya.
Methods: A cross sectional study was carried out in Putrajaya, Malaysia. The sampling frame consisted of a list of all the 12 secondary schools in Putrajaya. Three schools were selected using table of random numbers. All Malay students aged 13 years old to 17 years old from the three selected school students were included in the study. Blood pressure was measured after the respondents had rested for at least 5 minutes using a standard mercury sphygmomanometer. Three blood pressure measurements were taken for each respondent. Systolic blood pressure [SBP] was defined as the average of three SBP readings and diastolic blood pressure [DBP] was defined as the average of three DBP readings. Data was analyzed using SPSS 18.
Results: The overall mean SBP and DBP were 108.9 mmHg and 63.2 mmHg respectively. The prevalence of pre-hypertension and hypertension among the male was 16.2% and 12.9% respectively as compared to 5.8% and 10.2% respectively in the females. The overall prevalence of prehypertension and hypertension was 11.1% and 11.6% respectively. The prevalence increased with age (p<0.05). There was a significant positive correlation between BMI and SBP (r = 0.52, r2 = 0.27, p= 0.001) and BMI and DBP (r = 0.38, r2 = 0.15, p= 0.001). The mean SBP was significantly higher in males (111.7 mmHg) as compared to 106 mmHg in females (p<0.001). The mean DBP in males (63.5 mmHg) was slightly higher as compared to 62.9 mmHg in females but the difference was not significant.
Conclusions: Prevalence of hypertension and pre-hypertension is high. There is an urgent need for implementation of a comprehensive CVD prevention program and routine blood pressure measurements should be taken in school children to improve the detection, prevention and treatment of hypertension
Keywords: Prevalence, Hypertension, Adolescents, Putrajaya, Malaysia
Fulltext Prevalence of urban poor and its health related factors in the state of Selangor, Malaysia

Sherina, M.S., Rampal, L., Hejar, A.R., Rozali, A., Mohd Yunusn, A.

Malaysian Journal of Medicine and Health Sciences, 2011;7(1):-.
MyJurnal

The objectives of this study were to determine the prevalence of the urban poor and its health related factors in Selangor. This cross-sectional study was conducted in the community of Selangor. Data was collected from January 2006 to June 2006. Three out of nine districts were selected to be involved in the study, which were Klang, Kuala Langat and Petaling. A Multistage Stratified Proportionate Systematic Random Sampling was used for this study. The sampling was carried out by the Statistics Department of Malaysia. The survey frame was based on the information gathered from the Population and Housing Census in year 2000. The respondents were interviewed by trained research assistants using a structured pre-tested standardized questionnaire prepared in Malay and English languages. A monthly income of RM706 and less was used to define urban poor based on the guidelines given by the Economy Planning Unit of Malaysia (2004). SPSS 16.0 version was used to analyze the data. Out of 2535 respondents interviewed in this study, 2491 respondents answered the questionnaire completely (response rate 98.3%). Out of 2491 respondents, 202 (8.1%) had a monthly income of RM706 and less. Analysis of the urban poor respondents found that majority were aged between 18 to 40 years old (55.9%), and 29.7% had diagnosed medical illnesses, where hypertension, diabetes and asthma were the most common illnesses at 12.4%, 10.9% and 5.0% respectively. About 10% of the urban poor respondents had physical disabilities such as blurring of vision (7.9%), hearing problems (1.0%) and other disabilities (1.0%).
Fulltext Prevalence of hypertension and its associated factors among university staff

Rampal, L., Somayeh, A. B., Salmiah, M. S., Faisal, I., Sharifah Zainiyah, S. Y.

Malaysian Journal of Medicine and Health Sciences, 2011;7(2):61-71.
MyJurnal

Introduction: In Malaysia, cardiovascular diseases (CVD) have been the leading cause of death for the past 40 years. Hypertension is the leading treatable risk factor for CVD mortality.
Objectives: to determine the prevalence and factors associated with hypertension among University Putra Malaysia staff.
Methods: A Cross sectional study design was used in this study. The sample was selected using table of random numbers. Two blood pressure measurements were taken from respondents aged 30 years and above. Data on socio-demographic variables and lifestyle-related risk factors were collected using a pre-tested structured questionnaire. Weight and height measurements were also taken.
Results: Out of 517 respondents selected, 454 subjects agreed to participate, giving a response rate of 87.8%. The overall mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) for 454 respondents was 126.2 mmHg and 80.17 mmHg respectively. The mean SBP was significantly higher in males (129.68 mmHg) as compared to the females (122.65 mmHg). The mean SBP and DBP significantly increased with age in both males and females (p<0.05). There was a significant relationship between SBP and BMI (r = 0.55, r2 = 0.30 p <0.001) and diastolic blood pressure and BMI (r = 0.53, r2 = 0.28, p <0.001). The overall prevalence of hypertension was 34.4% and 33.9% had pre hypertension. Hypertension was significantly associated with age, gender, family history of hypertension, BMI and alcohol consumption. Conclusions: Prevalence of hypertension and pre-hypertension is high. There is an urgent need for implementation of a comprehensive CVD prevention program. Routine blood pressure measurements should be taken to improve the detection, prevention and treatment of hypertension.
Keywords: Hypertension, Prevalence, Risk Factors, University Staff, Prevalence

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