Introduction Antenatal care is widely acknowledged as an effective tool to prevent adverse outcomes in pregnant women and their children. In Malaysia, early entry to antenatal care refers to a first visit within the 12th week of gestation. Delayed access to antenatal care has not been extensively studied in Malaysia, whereas several studies have reported a high prevalence of late antenatal booking in developing countries. The objective of this study was to determine the factors and barriers associated with late antenatal booking and the level of knowledge about the timing of antenatal booking among women of childbearing age in the Lundu District of Sarawak.
Methods This was a cross-sectional study among 284 pregnant women in all five Maternal and Child Health (MCH) Clinics of Lundu.
Results The prevalence of late antenatal booking in Lundu was 28.2%. Unmarried women were more likely to book their pregnancy late compared to married women. The prevalence of late antenatal booking was also higher among unemployed women than those who were employed. Respondents without their own income also tended to book their pregnancy later than those who had their own income. Significantly, a high percentage of late antenatal booking was also reported among those who never utilize any contraceptive method, did not plan their pregnancy, those without a history of past medical illness or complications in a previous pregnancy and among those who have a problem with their marriage certificate. Those who booked their pregnancy beyond the 12th week of gestation were also reported to have a lower level of knowledge about the need for an antenatal booking, as compared to those who started their antenatal care early.
Conclusions Unplanned pregnancy, marriage certificate issues, an absence of past medical illness and past obstetric complications were significant predictors of late antenatal booking. Correct and appropriate information relating to antenatal care should be delivered to the public. Health education and advocacy are vital to promote the importance of early antenatal booking to achieve the goal of safe motherhood.
Introduction Pneumococcal disease causes considerable morbidity and mortality,
including among adults. Adult pneumococcal vaccines help to prevent these
burdens, yet, they are underutilized. Our objective is to systematically collect
and summarize the available evidence on the potential factors that lead to
pneumococcal vaccination acceptance among of adult community.
Methods A systematic literature search was conducted involving studies published
from January 1999 to December 2015. The studies were identified by
searching electronic resources (PubMed/MEDLINE and Pro Quest database)
and manual searches of references. The keywords “vaccine/ immunization”,
“uptake/ coverage”, “determinant/ factor”, and “Streptococcus pneumoniae/
pneumococcus/ pneumococcal” were used. Final studies result and data were
reviewed by two independent authors. Disagreement was resolved through
discussion and consensus.
Results A total of 171 studies were identified, only 17 studies were included in final
discussion with 10 domains identified in the paper. 7 studies (41%) had
reported that the provider domain, patients’ perception and
socio-demographic factor have had the most effect on the pneumococcal
vaccination acceptance rate. In addition, only 18% (3) of reviewed papers had
highlighted that socio-economic was a factor influenced the pneumococcal
vaccination acceptance while 24% (4 studies) were attributed to the comorbid
Conclusions Healthcare provider and patients’ perception about pneumococcal vaccination
for adult population are significant domains which influence the acceptance
towards vaccination. Strong recommendations from healthcare provider for
pneumococcal vaccination would be an important step to increase vaccination
acceptance among the population.
Introduction Strongyloides stercoralis is an intestinal helminth that infects humans
through contact with soil containing the larvae.
Methods A systematic search was performed for relevant titles, abstract and keywords
in database from Cochrane Library, PLOS One, PubMed and several other
sources in October 2017 based on PICO strategy. Out of 511 papers that were
evaluated for possible inclusion, final assessment for eligibility has yielded a
total of 17 papers to be included which were found suitable for analysis
covering period from 2012 till 2016.
Results A major challenge of giving an overview of prevalence data for S. stercoralis
lies in the low sensitivity of diagnostic method used which resulted in very
low prevalence in certain countries. Cambodia and Laos presented with high
prevalence ranging from 17.4% to 45.9% by using high sensitivity of
diagnostic methods. The current prevalence situation of S. stercoralis in
Southeast Asia still have wide gaps remains due to several reasons.
Conclusions The information we have today only scratches the surface which cannot truly
reflect the true burden of S. stercoralis in Southeast Asia The main risk factor
is personal hygiene practices especially amongst males.
Pengenalan Penjagaan pesakit kanak-kanak leukemia memerlukan pemerhatian dan
tumpuan yang tinggi untuk memastikan rawatan yang disarankan oleh Pakar
Perubatan dapat dilaksanakan dengan baik. Perkara ini sedikit sebanyak akan
menjejaskan fungsi sosial, meningkatkan stres, kebimbangan dan
kemurungan dalam kalangan penjaga. Oleh itu, kajian irisan lintang ini
dijalankan untuk mengkaji prevalen serta faktor-faktor yang mempengaruhi
stres, kebimbangan dan kemurungan dalam kalangan penjaga kepada pesakit
Metodologi Sampel kajian adalah seramai 54 orang. Data diukur menggunakan DASS-21
versi Bahasa Malaysia yang telah divalidasi oleh kajian lepas.
Keputusan Hasil kajian mendapati bahawa prevalen stres tahap rendah dalam kalangan
penjaga kepada pesakit leukemia kanak-kanak adalah sebanyak 88.9%
manakala prevalen stres tahap tinggi adalah sebanyak 11.1%. Prevalen
kebimbangan tahap rendah adalah sebanyak 90.7% dan prevalen
kebimbangan tahap tinggi adalah sebanyak 9.3%. Prevalen kemurungan
tahap rendah adalah sebanyak 96.3% dan prevalen kemurungan tahap tinggi
adalah sebanyak 3.7% dalam kalangan penjaga. Terdapat beberapa faktor
yang mempengaruhi stres dan kemurungan dalam kalangan penjaga secara
Introduction The use of dietary supplements had risen over the years among chronic
disease patients with most of it were of patients' own initiative. This study
aimed to describe the supplements use, assess the knowledge and attitude
towards supplements and its interaction with prescribed medication, and
determine whether knowledge and attitude towards supplements could
influence treatment adherence in chronic disease patients.
Methods A cross-sectional study was conducted among chronic disease patients in
Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur from
September to November 2016 upon their written informed consent. This
study consists of a collection of validated instruments that measured the use
of dietary supplements and its reason; the knowledge and attitude on dietary
supplements and supplements-drug interaction and medication adherence.
Results A total number of 250 respondents were interviewed and 72.4% was found to
use supplements of own initiatives. Most of the respondents were using
supplements to maintain health (78.8%), prevent health problems (72.4%)
and improve overall health (63.2%). It was found that respondents'
knowledge on supplement-drug interactions were not at the satisfactory level.
The treatment adherence was found not to be associated with knowledge and
attitude towards supplements nor numbers of supplements use.
Conclusions Chronic disease patients mainly knew on the purpose of supplements for
health and wellness, but had less knowledge on supplement-drug interactions,
warranting patients' education on that particular field.
Introduction Iodine deficiency disorders (IDD) during pregnancy may impair the
neurological development of the fetus. The aim of this study is to determine
the iodine status among pregnant women (PW) in Sarawak after introduction
of mandatory universal salt iodisation (USI) for seven years.
Methods A total of 508 first trimester PW attending government Maternal and Child
Health Care clinics in all 11 divisions in Sarawak between 1st April and 15th
June 2015 were recruited. Urine samples were obtained and analysed for
urinary iodine concentration (UIC) using the modified Sandell-Kolthoff
reaction method. For pregnant women, an adequate iodine intake was defined
as a median UIC between 150-249 µg/L according to the
WHO/UNICEF/ICCIDD’s criterion. For further analyses, the 11 divisions
were then combined into 3 regions, namely Northern (Miri, Bintulu,
Limbang), Central (Kapit, Mukah, Sibu, Sarikei, Betong) and Southern (Kota
Samarahan, Kuching, Sri Aman).
Results The median UIC of the PW in Sarawak was 105.6 µg/L, indicating iodine
deficiency. A total of 330 (65.0%) PW had UIC
Introduction Parkinson’s disease (PD) is the second most common neurodegenerative
disease after Alzheimer’s disease (AD) and the most frequent sub-cortical
degenerative disease, characterized by universal progressive disorder of the
nervous system that affects movement. This cross sectional study aimed to
determine the prevalence and correlates of PD among elderly attending the
neurology clinic in Serdang Hospital.
Methods A total of 150 records of patients attended the clinic from January to
December 2016 were randomly selected. Data was collected using a
proforma form seeking information related to age, gender, race, locality, and
presence of comorbidity particularly diabetes mellitus. The data was analysed
using the Statistical Package for Social Science (IBM SPSS) version 22.0.
Results The prevalence of PD among the elderly involved in the study was 34%.
Majority of the respondents were aged 60 to 70 years old (54.7%), male
(53.3%), Chinese (56.7%), from urban locality (93.0%) and were not diabetic
(69.3%). The inferential statistics showed no significant association between
all the factors with PD. However, the associations between age and diabetes
mellitus with PD were almost significant with p values of 0.07 and 0.08
Conclusions Overall, the prevalence of PD among elderly who attended the neurology
clinic in year 2016 was less than half with none of the factors under study
were significantly associated with PD. However with bigger sample size,
possible significant association may be obtained between age and diabetes
Introduction The Acquired Immuno Deficiency Syndrome (AIDS) is caused by Human
Immunodeficiency Virus (HIV) infection and a disease with high morbidity
and mortality.Young mothers are sub-populations that are at high risk for HIV
through sexual activity. In addition, information on the level of knowledge,
attitude and practice among young mothers in Malaysia regarding HIV/AIDS
prevention is still limited.Therefore, the objective of this study is to examine
the level of knowledge, attitudes and practices towards the prevention of
HIV/AIDS among young mothers and the factors that influence them.
Methods A cross-sectional study was conducted at a tertiary hospital in a city center
among 147 young mothers aged 18-30 years old at the Post Natal and
Obstetrics and Gynecology Ward (O & G). Data collection was conducted in
April-November 2014 and the respondents' selection was based on simple
random sampling. A questionnaire containing validated instruments was used
in this study. Approval for conducting research has been obtained from the
UKM Research Ethics Committee before the data collection procedure is
Results Majority of the young mothers have good knowledge (78.8%) and practice
(71.2%) towards HIV/AIDS prevention. While more than half of them (56.7%)
have positive attitude towards the prevention of HIV/AIDS. Living in the
urban area and being married are significantly associated with having good
knowledge and positive attitude towards HIV/AIDS prevention. While,
mothers who are 5 years older compared to the younger ones and being
married are significantly associated with having good practice towards
Conclusions The level of knowledge, attitudes and practices as well as the associated
factors could be the baseline to formulate health intervention to prevent
HIV/AIDS among this vulnerable group.
Introduction Non-specific low back pain is one of the most common physical ailments
affecting millions of people worldwide. This condition constitutes a
significant public health problem and was listed as a prevalent health
complaint in most societies. Even though there are many anecdotal claims
for reflexology in the treatment of various conditions such as a migraine,
arthritis and multiple sclerosis, but very little clinical evidence exists for
reflexology on the management of low back pain per se. This study aims to
evaluate the effects of foot reflexology therapy as an adjunctive treatment to
the Malaysian low back pain standard care in relieving pain and promoting
health-related quality of life among people with non-specific low back pain.
Methods This is a parallel randomized controlled trial with pre and post-treatment
study design. The study setting for the intervention located at Penawar
Reflexology Center, Kuala Terengganu, Malaysia. A total of 100
participants with non-specific low back pain will be allocated to one of two
groups, using a randomization computer program of Research Randomizer.
The control group will receive low back pain standard care, while the
intervention group will receive standard care plus eight sessions of foot
reflexology therapy. The pain intensity and health-related quality of life
scores will be measured using Visual Analogue Scale and Euro-quality of
life scale respectively in both groups. The study was approved by the
Human Research Ethics Committee of University Sultan Zainal Abidin
(UHREC/2016/2/011). The study protocol was registered at
ClinicalTrials.gov, with the ID number of NCT02887430.
Measurements Outcome measures will be undertaken at pre-intervention (week 1), postintervention
(week 6) and follow-up (week 10).
Conclusions This will be the first trial to compare the foot reflexology therapy with
control group among people who medically diagnosed with non-specific low
back pain in Malaysia. The result of this study will contribute to better
management of this population, especially for Malaysia healthcare setting.
Introduction There is an increasing trend of obesity in children and adolescent globally.
The objectives of this study were to identify the prevalence of overweight
and obesity among students from secondary schools and to determine the
mean random blood sugar (RBS) for the overweight and obese students.
Methods This was a cross sectional study. Two secondary schools that were scheduled
for visit by the School Health Team, Taiping in July 2016 were included. A
standardized data collection sheet was used to collect the data. Overweight
and obesity were defined based on WHO 2007 reference for BMI-for-age
criteria. Random blood glucose was checked for overweight and obese
Results A total of 184 school students consented and participated. 128 (69.6%) were
female and 90 (48.9%) were Malays. The mean weight and height were 56.21
kg and 1.61 m respectively with BMI of 21.49 kg/m2
. Overall, the prevalence
of obese and overweight were 12.5% and 10.9% respectively. Among the 4
BMI groups, there were no significant difference found in sex (p=0.849) and
races (p=0.536). However, there was significant difference (p=0.042) in
mean RBS for obese and overweight students between races. RBS readings
among overweight and obese students were within normal range with mean
of 5.95 (0.67) mmol/l (range between 4.60 – 7.70 mmol/l).
Conclusions The overall prevalence of overweight and obesity were comparable with
other studies done in Malaysia. Nevertheless, there was no prevalence of
Type II diabetes mellitus among them.
Introduction Married couples often do influence each other’s emotions and behaviors. The
effect of this interpersonal marriage relationship on emotional job demands
and job performance toward work-family conflict (WFC) is still under
research. This article aims to determine the effects of married couple’s job
factors (emotional job demands and job performance) on wife’s WFC.
Methods A total of 120 dyads in private sectors were recruited via private invitations
to social gatherings. Packets of self-administered questionnaires were given
included emotional domain of Demand-Induced Strain Compensation,
Spielberger Trait Anger Scale, work-family conflict and job performance
measures. Dyadic analysis using Actor-Partner Interdependence Model was
Results The emotional demand of wife significantly contribute higher effect (ES=
0.34 (95%CI: 0.23, 0.45); p
Introduction Tuberculosis (TB) is a major global health challenge especially in low- and
middle-income countries reflects improper, delayed or missed diagnosis.
Contact screening should be utilized both as an efficient and effective
targeted approach to intensify TB case finding.
Methods Through a comprehensive systematic literature review of online database,
this paper aims at providing an insight into the current practice of TB contact
screening and to provide evidence based practice for formulation of
appropriate policies in low- and middle-income countries. There are 24
articles included in this review from studies published from 2005 to 2014.
Results Findings in literature varies substantially. Generally, contact screening is
better intensified with clear operational guidelines, adequate training, include
close contact outside household as appropriate and follow up at least for 1
year. Prioritizing high risk close contacts is helpful in resource limited
setting. Tuberculin skin test is still of value as screening tool and intensified
case finding must be accompanied with effective management protocol.
Prophylaxis treatment is recommended especially for children especially less
than 5 years old, unvaccinated, malnourished, living with person having HIV
and close contact with MDR-TB.
Conclusions Policy recommendations in improving TB management must incorporate
complementary strategies to enhance case finding, effective management
protocol for follow up or prophylaxis treatment, training for public health
capacity and concerted dedication from various stakeholders
Introduction The availability of obesity specific quality of life measurement tool is limited.
The Malay version of Impact of Weight on Quality of Life-Lite is an obesity
specific quality of life questionnaire which has been translated for use in
Malaysia. The aim of this study is to evaluate the validity and reliability of this
questionnaire to measure quality of life among different body mass index
Methods One hundred and twenty subjects with different BMI categories who attended
an outpatient government clinic were recruited for this study. The translated
Malay version of IWQOL-Lite was used to assess the impact of weight on
quality of life of respondents. Content validity, criterion validity and construct
validity were used to assess the questionnaire validity while internal
consistencies and test-retest reliability were used to assess the questionnaire
Results The Malay version of IWQOL-Lite showed good psychometric properties. The
content validity was agreed upon by expert panels. The mean score of all
IWQOL-Lite domains were able to discriminate between different BMI
groups. Good internal consistency was demonstrated by Cronbach alpha of
0.936. Test-retest reliability ranged from 0.828 to 0.932. The physical function
score (IWQOL-Lite) correlated positively with Physical Component Summary
of Short Form-36 questionnaire. Exploratory factor analysis found that the
questions loaded on their respective five domains.
Conclusions The results suggested that the Malay version of IWQOL-Lite is a valid and
reliable tool to measure quality of life among obese and overweight subjects in
Introduction Premature ejaculation (PE) is an important sexual problem among men
attending health clinic. Impacts of this condition towards quality of life still
require further exploration. Aims of the study is to determine the proportion
and determinants for PE and its impact on Quality of Life (QOL) among men
attending a public health clinic in Kuantan
Methods A cross-sectional study involving 290 respondents was conducted at a public
health clinic over the period of five months (Nov 2015-March 2016). A
validated self-administrated questionnaire that consisted of sociodemographic
questionnaire, clinical characteristics, premature ejaculation
diagnostic tool (PEDT) and WHO quality of life (WHOQOL-BREF) were
Results The proportion of PE was 33.9% with PE 18.1% (49/271) and probable PE
15.8% (43/271). Multivariate analysis showed that level of education
(p=0.002, OR 3.281/95% CI 1.183, 9.101) and hypertension (p=0.047, OR
1.788/95% CI 1.008, 3.170) were the only significant predictors for PE after
controlling self-reported erectile dysfunction, pulmonary and neurological
disorder. PE patients had lower median scores QOL in all four domain
namely physical health, psychological, social relationship, environment (all
domains with p
Rheumatic heart disease is still endemic in developing countries and among the indigenous population in developed countries. However, there is no comprehensive data on rheumatic heart disease patients in Malaysia. The Cardiology Department of Queen Elizabeth ll Hospital (QEH ll), Sabah started this hospital-based registry in 2010. The objective of this analysis was to report the demographic profile, severity of disease, types of valve involvement and the practice of secondary prophylaxis among these patients.
Health care systems play a vital role in providing health services and in optimising the population’s health of each nation. The Malaysian health care system primarily consists of the public and private health services. One of the prominent private health care services offered in the General Practitioner’s (GP) Clinic. Despite the prominent role GPs play in the health care system in this country, little is known about their practices, the issues and challenges faced by GPs in this country. The objective of this study was to describe the current GP practice operations in Malaysia in terms of its general operations, financial expenditure and revenue, market competitiveness and laboratory services offered by the clinics.
Smoking is the leading preventable cause of non-communicable disease mortality worldwide. Therefore, effort for the effective measure in smoking cessation is important. However, the central problem in the nicotine addiction treatment is relapse. A retrospective cohort study was done at Tanglin Quit Smoking Clinic to determine the outcome of smoking cessation and its predictors. A cohort of 770 smokers between 2008 and 2015 were identified through simple random sampling. Smokers were defined as current smoker, while smoking abstinence is defined as cessation more than 6 months and relapse as any smoking episode even a puff since the quit date. Majority were Malays, Muslims and had secondary or higher education. The mean initiating age for smoking was 17.6 years old, with majority smoke between 11 to 20 sticks, and had high nicotine dependence score (43%). At the end of the study 52.5% of them abstinence from smoking. The predictors for smoking cessation were number of quit attempt (1 to 10 times) (AOR = 1.582, 95% CI = 1.012-2.472) and pharmacotherapy (AOR = 0.711, 95% CI=0.511-0.989). More frequent follow up was required during the first crucial 6 months to prevent relapse. Number of follow up can enhance not only the medication compliance but also motivational aspect to smokers to reduce relapse rates. Healthcare provider should give extra attention to the potential relapser especially to those who attempt for the first time.
Keywords: Malaysia, Quit Smoking Clinic, Smoking Cessation, Cohort, Survival analysis
Introduction Tong Nibong is a Bidayuh village located at Sarawak Kalimantan border.
Since the year 2004 to 2009, a total of 537 cases of malaria were recorded in
Serian District of which 14 cases were reported from Kampung Tong
Nibong. Community empowerment programme for malaria infection
prevention showed tremendous improvement in implementation. This
intervention study aims to gauge the effectiveness of community
empowerment approach in malaria elimination programme in Kampung Tong
Methods An intervention study was conducted with pre and post data collection. Data
was collected using validated questionnaire by face to face interview.
Universal sampling method was used to select respondents from head of
household and post data was collected after intervention activities were
carried out within a year of study period.
Results The study showed significant difference on level of knowledge of
respondents on vector of malaria between pre and post data with a P < 0.05.
There was significant difference between pre and post data on practices on
control and prevention of malaria with a P < 0.05. The same goes to level of
positive attitude of respondents towards malaria control.
Conclusions In conclusion, the study can be considered successful because there is
significant difference in knowledge, attitude and practice among the
respondents between pre and post data. This indicates that community
empowerment (voluntary participation) measures can be implemented in high
risk or endemic areas where malaria is a persistent problem to the community
and health institutions faces many limiting factors.
Introduction: Most health advisories related to outdoor physical activity during haze are general in nature. The advisories normally advise everyone to reduce or limit prolonged exertion or heavy exertion without mentioning the acceptable duration for performing outdoor physical activity causing difficulty for public to decide to stop or cancel a particular outdoor or sport event. The aim of this paper is to determine the acceptable duration for performing outdoor physical activity pattern during haze based on API level.
Methods: Health risk assessment approach that comprises of hazard identification, exposure assessment, dose-response, and risk characterization steps was used to determine the potential inhaled dose and risk associated with performing the physical activity during haze. We have considered many factors that include time spent for physical activity patterns for Malaysian adult, age and physical intensity-specific inhalation rate (m3/min), and the indoor/outdoor ratio of PM10. A hypothetical exposure scenario of PM10 was created using the breakpoints of PM10 concentration for the calculation of respective API levels during haze.
Results: The association between physical activity pattern, API level and risk quotient were presented in the form of risk radar diagram. Based on the 50th percentile inhalation rate, all prolonged exertion and heavy exertion should be avoided when API reach >201 (very unhealthy) and >175 (unhealthy) respectively. Below the said API, the duration for performing prolonged exertion and heavy exertion should be reduced according to the API level. When API reaches 140, high intensity physical activity should be limited to < 90 minutes. A football match which requires 90 minutes, should be postponed of cancelled if API > 140. Whereas, for the same API level, prolonged exertion (moderate intensity physical activity) should be limited to 4 hours.
Conclusions: Reducing the physical activity is an effective strategy to lower the dose of inhaled pollutants and reduce the health risk during poor air quality. Based on the assessment, taking into account the uncertainty of risk assessment methodology, we proposed all prolonged exertion should be avoided when API reach very unhealthy status (>201). Below the said API level, outdoor physical activity should be reduced according to the level of API respectively. The recommendation is not applicable for the sensitive groups. The computed risk radar provide a valuable guide for the public to organize or considering postponing an outdoor event during haze.