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Fulltext Population & social indicators of food and nutrition in Peninsular Malaysia

Chong YH

Med J Malaysia, 1982 Jun;37(2):134-40.
PMID: 6813659

Health, including nuirition is not independent but is closely associated with the social and economic environment. Malnutrition itself can cause death, but more commonly, it can cause considerable ill-health, physical retardation, impaired mental performance, loss in productivity and a decline in the quality of life. The effects of malnutrition as obstacles to socio-economic development are now well recognised. In a rapidly developing country like Malaysia, the nutritional and nutritionally-related problems present themselves with contrasting features. While population indicators such as toddler mortality, incidence of low birthweight and food balance sheet studies suggest an improving nutritional situation, methods of direct assessment have shown that chronic protein-energy malnutrition and anaemia are sWI common amongst pre-school children in both the rural and urban disadvantaged sectors. Moderate anaemia also affects a significant proportion of older children and women of childbearing age. Intestinal parasites, another indicator of under development at the local level, are ubiquitous in the rural setting and urban slums owing to unsatisfactory waste disposal. In striking contrast, diseases associated with dietary excesses and increasing affluence have now emerged as the major killers. This changing pattern of mortality and morbidity along the lines encountered by the industrialised societies is now dramatised by the fact that road accidents are now claiming a large number of victims. It is clear that while continued efforts should be given to the improvement of the nutritional health of both rural and urban poverty communities, little time should be wasted in considering the adoption of public health measures aimed at stemming the rising number of deaths associated with our increasing affluence, particularly those diseases that are nutritionally linked, such as coronary heart disease, hypertension and diabetes mellitus, not forgetting the increasing road toll afflicted by the motor vehicle.

Matched MeSH terms: Health Status Indicators
Fulltext Population 70 million: a consideration of health aspects

Zulkifli SN, Yusof K

Med J Malaysia, 1985 Jun;40(2):62-79.
PMID: 3834289

A 70 million population for Malaysia by the year 2010 has been officially targetted for in the Mid-Term Review of the Fourth Malaysia Plan, 1981-1985. In response to this, a preliminary investigation was undertaken into the health aspects of population growth. For this exercise, infant mortality rate was used as the health indicator. From trends seen vis-a-vis population growth, it appears that thus far, population growth has not been associated negatively with health (as measured by IMR). In recognition of the relevance of the medical, economic and education factors to health, trends in Malaysia's population ratio, per capita GNP and rates of school enrolment were also drawn; the selection of these as proxies being based on completeness of time-serial records. Although statistical regressions established the high correlation between medical doctors.population ratio and school enrolment rate with IMR, the limitations in this analysis did not permit any reliable inferences. In view of the difficulties in projections of trends, a comparison of health and related variables was carried out for several countries with high populations as near to 70 million as were available. The characteristics associated with low mortality and high life expectancy (health indices) were identified as low population growth, high literacy and high per capita GNP; this being stated with explicit qualifications. Other determinants of health were also discussed in brief, and the need for careful planning in the distribution of human and material resources was noted.

Matched MeSH terms: Health Status Indicators
Fulltext Innovations in child health care in Asia

Chen PCY

Med J Malaysia, 1985 Sep;40(3):177-84.
PMID: 3842713
Matched MeSH terms: Health Status Indicators
Fulltext The health of the aging Malaysian: policy implications

Chen PCY

Med J Malaysia, 1987 Sep;42(3):146-55.
PMID: 3506636

In Malaysia, the elderly are still a relatively neglected group of people in that little priority is given to the important health issues associated with an aging population. This paper examines some of the relevant findings obtained during a survey which was carried out in 1984/1985. These findings have serious policy implications concerning family support, work, income, retirement, community involvement, social network, transport, and housing as pertaining to the elderly. There is an urgent need, as the population ages and social changes occur in society, for health planners, politicians and policy-makers to scrutinise the existing policies and develop new policies so as to retain those traditional practices that support, improve and maintain the psychological and social well-being of the elderly; and to develop new policies and programmes thus promoting a better lease of life for this small but important group to whom we owe so much.

Matched MeSH terms: Health Status Indicators*
Fulltext Industrialization and urbanization--the impact on health: the experience of Peninsular Malaysia

Arokiasamy JT

J Hum Ergol (Tokyo), 1990 Dec;19(2):201-12.
PMID: 2130092 DOI: 10.11183/jhe1972.19.201
Matched MeSH terms: Health Status Indicators*
Regional inequalities of child mortality in peninsular Malaysia with special reference to the differentials between Perlis and Kuala Terengganu

Brehm U

Soc Sci Med, 1993 May;36(10):1331-4.
PMID: 8511619

In Peninsular Malaysia child mortality rates (5q0) vary from 13 to 63 per thousand at district level. The spatial pattern is closely associated with the regional distribution of socio-economic factors. But due to multicollinearity it is difficult to isolate the influence of socio-economic variables from other variables by employing aggregated data. However, individual data collected in a case-control-study that was conducted in Perlis and Kuala Terengganu confirm the important role of socio-economic factors. So it should be possible to achieve a further reduction of child mortality by raising the income and educational level of the under-privileged groups. Apart from that, as the case of Perlis shows, the provision of family planning and preventive medical services may also contribute to lower child mortality independent from socio-economic changes. But, as the comparison with Kuala Terengganu shows, the utilization of family planning and preventive medical services is not only influenced by the accessibility to, but also by the socio-culturally determined acceptability of such services.

Matched MeSH terms: Health Status Indicators
Drug utilization studies: their transferability between industrialized and developing countries

Lee D, Balasubramaniam K, Ali HM

WHO Reg Publ Eur Ser, 1993;45:193-218.
PMID: 8442847
Matched MeSH terms: Health Status Indicators
Maternal and child health in urban Sabah, Malaysia: a comparison of citizens and migrants

Zulkifli SN, U KM, Yusof K, Lin WY

Asia Pac J Public Health, 1994;7(3):151-8.
PMID: 7794653 DOI: 10.1177/101053959400700302

This paper describes selected maternal and child health indicators based on a cross-sectional study of citizens and migrants in Sabah, Malaysia. A total of 1,515 women were interviewed from a multi-stage random sample of households in eight urban centers. Among the 1,411 women in the sample who had experienced a pregnancy before, 76% were local citizens and 24% were migrants. There were statistically significant differences between citizens and migrants in ethnicity, religion, education, household income, and access to treated water supply and sanitary toilet facilities. Significantly fewer migrants practiced any form of contraception and obtained any antenatal care during any pregnancy. Furthermore, citizens tended to initiate care as early as three months but migrants as late as seven months. Despite these differences, only the infant mortality rate, and not pregnancy wastage, was statistically significantly higher among migrants. Pregnancy interval was also similar between the two groups. The influence of several socioeconomic factors on pregnancy wastage and infant mortality was explored.

Matched MeSH terms: Health Status Indicators*
Role of schools of public health on maternal and child health programmes in the Asia-Pacific region

Zulkifli SN, Yun-Low W, Yusof K

Asia Pac J Public Health, 1998;10(1):10-6.
PMID: 10050201

This paper assessed the role of public health schools on maternal and child health programmes in the Asia Pacific region. Economic development and its associated effects, particularly in the ASEAN countries, for example, migrant labour, ageing, environmental health, turbulence and social climate, has a tremendous impact on maternal and child health. Based on these current issues, it is evident that public health schools can play a major role in maternal and child health in terms of policy formulation and programme development. Several areas were proposed as to what schools of public health can do, namely, through networking, communication, research and training.

Matched MeSH terms: Health Status Indicators
Malaysia's 21st century goal: IT-based health gains for one and all

Spohr MH

Healthc Inform, 2000 Apr;17(4):49-52, 54.
PMID: 11066568
Matched MeSH terms: Health Status Indicators
Reliability and validity of the Malay version of the Health-Related Quality of Life instrument in a Malaysian population

Quek KF, Chua CB, Low WY, Razack AH, Loh CS

BJU Int, 2002 Jul;90(1):37-40.
PMID: 12081766

OBJECTIVE: To validate the Malay version of the Health-Related Quality of Life (Mal-HRQOL-20) questionnaire in patients with and without urinary symptoms in a Malaysian population.
PATIENTS AND METHODS: The validity and reliability of the Mal-HRQOL-20 were assessed in patients with and without lower urinary tract symptoms (LUTS). The reliability was evaluated using the test-retest method and the internal consistency using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the score before and after intervention in additional patients with LUTS who underwent transurethral resection of the prostate.
RESULTS: The internal consistency was excellent; there was a high degree of internal consistency for each of the 20 items and for the overall score (Cronbach's alpha > or = 0.57 and 0.79, respectively) in the population study. The test-retest correlation coefficient for the 20 item scores was highly significant. The intra-class correlation coefficient was high (> or = 0.55). The sensitivity and specificity were high for the effects of treatment. There was a very significant agreement between scores before and after treatment across all domains in the treatment cohort, but not in the control group.
CONCLUSION: The Mal-HRQOL-20 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.

Matched MeSH terms: Health Status Indicators
Socioeconomic correlates of iodine status among school children in Sarawak, Malaysia

Wah-Yun Low, Siti Norazah Zulkifli, Rajeswari Karuppiah

Asia Pac J Public Health, 2002;14(2):110-7.
PMID: 12862416 DOI: 10.1177/101053950201400210

Iodine deficiency is recognized as a public health problem. This paper assesses iodine status by socioeconomic factors in school children in Sarawak, East Malaysia. Kuching, Bau and Simunjan districts were chosen based on advice from the Sarawak's Medical and Health Authority. 803 school children, aged eight years, were selected from 19 schools via proportionate systematic sampling. About half the proportion of the school children were from Kuching, 24% from Simunjan and 22% from Bau. Almost all were equally distributed by sex. By mother's race, almost half were Malays, followed by Bidayuh, Iban, Chinese and other races. Mean urinary iodine concentration was 3.36 microg/ 100ml, mean creatinine level was 111.10 mg/100ml and mean creatinine/iodine ratio was 39.45 microg/ gram. Four female children (0.5%) were found to have enlarged thyroid. Urinary iodine levels were significantly different by district, mother's race and household income. It was highest in Kuching, among children with Malay mothers, and with household incomes more than RM500 per month. Conversely, it was lowest in Bau, among children of Iban/Dayak and Chinese mothers, and incomes of RM500 or less per month. Based on the WHO/UNICEF/ICCIDD classification, the Sarawak school children in the present study fall into the moderate IDD category. The low prevalence of goitre is a positive finding indicating that iodine deficiency is corrected over time.

Matched MeSH terms: Health Status Indicators*
Work and lifestyle factors associated with morbidity of electronic women workers in Selangor, Malaysia

Hwei-Mian Lim, Heng-Leng Chee, Mirnalini Kandiah, Sharifah Zainiyah Syed Yahya, Rashidah Shuib

Asia Pac J Public Health, 2002;14(2):75-84.
PMID: 12862411

The objective of this study was to identify sociodemographic, work, living arrangement and lifestyle factors associated with morbidity of electronics women workers in selected factories in Selangor, Malaysia. The research design was a cross-sectional questionnaire-based survey. Most of the 401 respondents were young single Malay women. Morbidity was high as 85.5% of the women reported experiencing at least one chronic health problem, and 25.7% said that an illness or injury prevented them from carrying out normal activities within the last two weeks. Major acute illness symptoms were the common cold, backache, and diarrhoea while chronic health problems such as persistent headache, eye problems, menstrual problems, and persistent backache were also reported. After logistic regression, chronic health problems was significantly associated with room sharing; while illness that prevented normal activities within the last two weeks was significantly associated with overtime work and exercise. Further research is recommended to understand the complex inter-relationship between morbidity and working and living conditions.

Matched MeSH terms: Health Status Indicators
Economic stability and health status: evidence from East Asia before and after the 1990s economic crisis

Hopkins S

Health Policy, 2006 Feb;75(3):347-57.
PMID: 15896870

The East Asian economies of Indonesia, Malaysia and Thailand suffered declines in their economic growth rates in 1997. The Indonesian and Thai government followed the World Bank prescription for adjustment, which included a cut-back in government spending at a time when there were significant job losses. Malaysia chose its own path to adjustment. Evidence presented in this paper shows that although the declines were short-lived that there was an impact on the health status measured by mortality rates for the populations of Indonesia and Thailand. There was little apparent impact on the health status of Malaysians. The lessons for other developing economies include the importance of social safety nets and the maintenance of government expenditure in minimising the impact of economic shocks on health.

Matched MeSH terms: Health Status Indicators*
Reliability and validity of the National Institutes of Health: Chronic Prostatitis Symptom Index in a Malaysian population

Cheah PY, Liong ML, Yuen KH, Lee S, Yang JR, Teh CL, et al.

World J Urol, 2006 Feb;24(1):79-87.
PMID: 16465553 DOI: 10.1007/s00345-005-0037-z

The objective of the study is to determine the short- and long-term utility of the Chinese, Malay and English versions of the National Institutes of Health--Chronic Prostatitis Symptom Index (NIH-CPSI) in our ethnically diverse population. The NIH-CPSI was translated into Chinese and Malay, and then verified by back translation into English. Subjects included 100 new chronic prostatitis/chronic pelvic pain (CP/CPPS) patients, 71 new benign prostatic hyperplasia patients and 97 healthy individuals. Reliability was evaluated with test-retest reproducibility (TR) by calculating intraclass correlation coefficients (ICC). Internal consistency was evaluated by calculating Cronbach's alpha (alpha). Validity assessments included discriminant and construct validity. (Presented in the order of Chinese, Malay then English). ICC values for short-term (1 week) TR were 0.90, 0.80 and 0.89, while ICC values for long-term (14 weeks) TR were 0.54, 0.61 and 0.61. Cronbach's alpha values were 0.63, 0.62 and 0.57. The NIH-CPSI total score discriminated CP/CPPS patients (P<0.001) from the control groups with receiver operating curve values of 0.95, 0.98 and 0.94, respectively. Construct validity, reflected by the correlation coefficient values between the International Prostate Symptom Score and the NIH-CPSI of CP/CPPS patients were 0.72, 0.49 and 0.63 (all P<0.05). The Chinese, Malay and English versions of the NIH-CPSI each proved effective in our population. Short-term TR and discriminant validity were excellent for all three versions. However, long-term TR was only moderate, which might reflect variation in patients' perceptions of symptoms over time.

Matched MeSH terms: Health Status Indicators*
The influence of ethnicity on health-related quality of life in diabetes mellitus: a population-based, multiethnic study

Wee HL, Li SC, Cheung YB, Fong KY, Thumboo J

J Diabetes Complications, 2006;20(3):170-8.
PMID: 16632237 DOI: 10.1016/j.jdiacomp.2005.06.010

OBJECTIVES: The aims of this study were to evaluate the influence of ethnicity on health-related quality of life (HRQoL) in diabetic participants using both profile [the Short-Form 36 (SF-36)] and single-index (the SF-6D) instruments and to evaluate the usefulness of the SF-6D as a summary measure for the SF-36.
RESEARCH DESIGN AND METHODS: Using data from a cross-sectional, population-based survey of Chinese, Malay, and Indians in Singapore, we analyzed the influence of ethnicity and other variables on each SF-36 scale and SF-6D scores using linear regression models to adjust for the influence of known determinants of HRQoL.
RESULTS: Data from 309 diabetic respondents were analyzed. Compared with other ethnicities, Indians were most likely to report impaired HRQoL. The unadjusted influence of ethnicity on HRQoL exceeded the minimum clinically important difference (MCID) for all SF-36 scales (MCID: 5 points) and the SF-6D (MCID: 0.033 points). After adjusting for gender, age, and education, the influence of Chinese ethnicity exceeded the MCID for all SF-36 scales, except vitality (VT) and mental health (MH), as well as for the SF-6D. The influence of Malay ethnicity exceeded the MCID only for the SF-36 MH scale and the SF-6D. The influence of ethnicity on HRQoL persisted after adjusting further for other determinants of HRQoL. The SF-6D reflected the ethnic trends for some but not all SF-36 scales.
CONCLUSIONS: After adjusting for demographic, socioeconomic, and other factors known to influence HRQoL, ethnicity remained an important factor influencing HRQoL in this population-based multiethnic sample of diabetic Asians. Further studies to identify modifiable factors explaining the ethnic disparities in HRQoL among diabetic participants are needed. The SF-6D may be a useful summary measure for the SF-36.

Matched MeSH terms: Health Status Indicators*
General health mediates the relationship between loneliness, life satisfaction and depression. A study with Malaysian medical students

Swami V, Chamorro-Premuzic T, Sinniah D, Maniam T, Kannan K, Stanistreet D, et al.

Soc Psychiatry Psychiatr Epidemiol, 2007 Feb;42(2):161-6.
PMID: 17180631

OBJECTIVE: To examine the associations between life satisfaction, loneliness, general health and depression among 172 medical students in Malaysia.
METHOD: Participants completed a questionnaire battery, which included the 12-item General Health Questionnaire, Beck's Depression Inventory, the Revised UCLA Loneliness Scale and the Satisfaction With Life Scale.
RESULTS: Life satisfaction was negatively and significantly correlated with suicidal attitudes, loneliness and depression; and positively with health, which was negatively and significantly correlated with depression and loneliness. Self-concept was negatively correlated with loneliness and depression, depression was positively and significantly correlated with loneliness. Mediational analyses showed that the effects of loneliness and life dissatisfaction on depression were fully mediated by health.
CONCLUSION: Even though less satisfied, and particularly lonelier, individuals are more likely to report higher levels of depression, this is only the case because both higher loneliness and life dissatisfaction are associated with poorer health. These results are discussed in terms of their implications for the diagnosis and treatment of mental health disorders in developing nations.

Matched MeSH terms: Health Status Indicators
Fulltext Intramuscular injection of botulinum toxin for the treatment of wrist and finger spasticity after stroke

Jahangir AW, Tan HJ, Norlinah MI, Nafisah WY, Ramesh S, Hamidon BB, et al.

Med J Malaysia, 2007 Oct;62(4):319-22.
PMID: 18551937 MyJurnal

Botulinum toxin is effective in reducing spasticity post stroke. As there are limited data on post stroke spasticity in Asia, we undertake this study to determine the effectiveness and safety of intramuscular injection of botulinum toxin type-A (BTX-A), in the treatment of chronic focal post-stroke hand spasticity, and the impact of BTX-A on the activities of daily living and quality of life, in comparison to placebo, in Malaysian stroke patients. This was a randomized, double-blind, placebo-controlled study to assess the efficacy and safety of BTX-A in 27 subjects with wrist and finger spasticity after a stroke. The outcome measures were assessed with the Modified Ashworth Scale (MAS) to assess spasticity of the flexor muscles, Barthel Index (BI) for activities of daily living and EQ-5D and EQ VAS for quality of life. Assessments were performed at baseline and 1 and 3 months after injection. Compared to placebo, the BTX-A group had greater improvement in the flexor tone of the wrist and fingers (p = 0.001 and p < 0.001, respectively), at first month follow-up visit and sustained the improvement through to three months. Although there was an improvement in the measures of global function and quality of life in the BTX-A group, there was no significant improvement in between the two groups. No serious BTX-A related adverse effects were reported. The results of this study demonstrate that intramuscular injection of botulinum toxin A is safe and effective in the treatment of chronic focal post-stroke spasticity of the hand.

Matched MeSH terms: Health Status Indicators
Fulltext Primary intracerebral haemorrhage in Malaysia: in-hospital mortality and outcome in patients from a hospital based registry

Sia SF, Tan KS, Waran V

Med J Malaysia, 2007 Oct;62(4):308-12.
PMID: 18551935 MyJurnal

Primary intracerebral haemorrhage (ICH) results in significant morbidity and mortality among patients. There is a paucity of epidemiological data on this condition in Malaysia. The purpose of this hospital based study was to define the clinical profile in patients with primary spontaneous intracerebral haemorrhage at University of Malaya Medical Centre (UMMC) and to determine the mortality rate of intracerebral haemorrhage at the time of discharge, the prognostic factors and one year outcome of this cohort of patients. Sixty-six patients were admitted at the Neurosurgical unit of University of Malaya Medical Centre for a period of 13 months from March 2002 to March 2003. Fifty percent of the subjects were female. The mean age was 61.6 +/- 16.7 years. Among our patients with intracerebral haemorrhage, the common risk factors were: hypertension (80.3%), diabetes mellitus (25.7%) and smoking (27.2%). Common presenting features for our series were: weakness (61.8%), LOC (58.5%), headache (56.3%) and speech disturbances (45.3%). On neuroimaging, the lesions were seen in basal ganglia/thalamus (45.1%), lobar (32.9%), brainstem (13.4%) and cerebelli (8.5%). The overall 30 days mortality rate for intracerebral haemorrhage (ICH) was 43.9%. The important predictors of for mortality were the GCS score on admission (p < 0.0001), haematoma volume > 30 mls (p < 0.0001), evidence of intraventricular extension (p = 0.011) and ICH score (p < 0.0001). At one year follow up, 48.5% (n = 32) were dead, 33.3% (n = 11) obtained good recovery, 36.4% (n = 12) moderate disability, 18.2% (n = 6) severe disability and 3% remain vegetative state. The overall mortality rate for our series of patients with primary intracerebral haemorrhage is quite similar to previously published epidemiological studies. ICH scoring is useful in the prognostication.

Matched MeSH terms: Health Status Indicators
Fulltext Soluble transferrin receptor, ferritin and soluble transferrin receptor--Ferritin index in assessment of anaemia in rheumatoid arthritis

Pavai S, Jayaranee S, Sargunan S

Med J Malaysia, 2007 Oct;62(4):303-7.
PMID: 18551934

Anaemia of chronic disease (ACD) is a frequent complication of rheumatoid arthritis (RA). A diagnostic difficulty in RA is the distinction between iron deficiency anaemia (IDA) and ACD. The aim of our study was to evaluate the usefulness of serum soluble transferrin receptor (sTfR) and sTfR/log ferritin (TfR-F) index to diagnose iron deficiency in RA patients with anaemia. Routine laboratory indices of anaemia and sTfR were measured in 20 healthy persons to form the control group, 30 patients with iron deficiency anaemia and 28 RA patients with anaemia. Serum sTfR levels were significantly elevated above the cut-off value in patients with IDA and those in the iron depleted RA subgroup (ferritin < 60 microg/L) compared with those in the control and iron repleted RA subgroup (ferritin > 60 microg/L). The same was observed for TfR-F index. However, five patients in the iron repleted RA sub group had an elevated sTfR level, of which two had increased TfR-F index. Serum sTfR correlated well with the markers of anaemia and not with ESR. Ferritin had no correlation with markers of anaemia but correlated well with ESR. Measurement of sTfR and TfR-F index are good indicators of iron deficiency in RA patients with anaemia. To be cost effective, sTfR can be estimated in RA patients with anaemia when the ferritin level is more than 60 microg/L.

Matched MeSH terms: Health Status Indicators

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