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HIV/AIDS in Malaysia

Ismail R

AIDS, 1998;12 Suppl B:S33-41.
PMID: 9679627
Matched MeSH terms: Substance-Related Disorders/epidemiology
Fulltext Social Network Strategies to Address HIV Prevention and Treatment Continuum of Care Among At-risk and HIV-infected Substance Users: A Systematic Scoping Review

Ghosh D, Krishnan A, Gibson B, Brown SE, Latkin CA, Altice FL

AIDS Behav, 2017 Apr;21(4):1183-1207.
PMID: 27125244 DOI: 10.1007/s10461-016-1413-y

Social network analysis (SNA) and social network-based interventions (SNI) are important analytical tools harnessing peer and family influences critical for HIV prevention and treatment among substance users. While SNA is an effective way to measure social network influences, SNI directly or indirectly involves network members in interventions. Even though these methods have been applied in heterogeneous ways, leading to extensive evidence-based practices, systematic reviews are however, lacking. We searched five bibliographic databases and identified 58 studies involving HIV in substance users that had utilized SNA or SNI as part of their methodology. SNA was used to measure network variables as inputs in statistical/mathematical models in 64 % of studies and only 22 % of studies used SNI. Most studies focused on HIV prevention and few addressed diagnosis (k = 4), care linkage and retention (k = 5), ART adherence (k = 2), and viral suppression (k = 1). This systematic review highlights both the advantages and disadvantages of social network approaches for HIV prevention and treatment and gaps in its use for HIV care continuum.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Betel-quid dependence domains and syndrome associated with betel-quid ingredients among chewers: an Asian multi-country evidence

Lee CH, Chiang SL, Ko AM, Hua CH, Tsai MH, Warnakulasuriya S, et al.

Addiction, 2014 Jul;109(7):1194-204.
PMID: 24650227 DOI: 10.1111/add.12530

Betel-quid (BQ) contains biologically psychoactive ingredients; however, data are limited concerning the symptoms and syndrome of BQ dependence among chewers. The aims of this study were to evaluate the ingredients-associated BQ dependence syndrome and country-specific chewing features and behaviour for BQ dependence among chewers from six Asian communities.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
HIV infection in females dependent on drugs

Wai BH, Singh S, Varma SL

Addiction, 1996 Mar;91(3):435-8.
PMID: 8867206

One hundred and seventy-one drug-dependent females in a drug rehabilitation centre were studied to estimate the prevalence of HIV infection among them. Twenty-four (14%) were positive on the Western Blot test. The presence of HIV infection was significantly correlated with syphilis (p < 0.03) and age (p < 0.001); 83% of those who were HIV positive were intravenous drug users. The need for harm reduction programmes to prevent spread of HIV infection among injecting drug users is stressed.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Fulltext The syndemic of HIV, HIV-related risk and multiple co-morbidities among women who use drugs in Malaysia: Important targets for intervention

Loeliger KB, Marcus R, Wickersham JA, Pillai V, Kamarulzaman A, Altice FL

Addict Behav, 2016 Feb;53:31-9.
PMID: 26436520 DOI: 10.1016/j.addbeh.2015.09.013

Substance use and HIV are syndemic public health problems in Malaysia. Harm reduction efforts to reduce HIV transmission have primarily focused on men with substance use disorders.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Risk and protective factors for recreational and hard drug use among Malaysian adolescents and young adults

Razali MM, Kliewer W

Addict Behav, 2015 Nov;50:149-56.
PMID: 26135336 DOI: 10.1016/j.addbeh.2015.06.022

This study investigated risk and protective factors for recreational and hard drug use in Malaysian adolescents and young adults.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Tobacco consumption and illegal drug use among Bangladeshi males: association and determinants

Kabir MA, Goh KL, Khan MM

Am J Mens Health, 2013 Mar;7(2):128-37.
PMID: 23065136 DOI: 10.1177/1557988312462737

This article aimed to identify the determinants of tobacco consumption and illegal drug use (IDU) as well as to examine the association between these two variables using a representative sample of 3,771 Bangladeshi males aged 15 to 54 years. Data were collected through Bangladesh Demographic and Health Survey 2007. To identify the determinants, the patterns of tobacco consumption and IDU were analyzed by age, education and occupation, residence, mass media, premarital sex, wealth, and sexually transmitted infections (STIs). Prevalence of smoking cigarette and bidi was roughly 60%. However, the prevalence of IDU was 3.4%, and this proportion is statistically significant (Z = 11.32, p = .000). After bivariate analysis, almost all variables except STIs were significantly associated with tobacco consumption. Similarly, all variables except residence and mass media were associated with IDU. Based on multivariable adjusted logistic regression analysis, the likelihood of using IDU was approximately twofold (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.23-2.53) among bidi smokers and fourfold (OR = 3.8, 95% CI = 2.62-5.56) among cigarette smokers as compared with nonsmokers.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Fulltext Population burden of betel quid abuse and its relation to oral premalignant disorders in South, Southeast, and East Asia: an Asian Betel-quid Consortium Study

Lee CH, Ko AM, Warnakulasuriya S, Ling TY, Sunarjo, Rajapakse PS, et al.

Am J Public Health, 2012 Mar;102(3):e17-24.
PMID: 22390524 DOI: 10.2105/AJPH.2011.300521

We investigated the population burden of betel quid abuse and its related impact on oral premalignant disorders (OPDs) in South, Southeast, and East Asia.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Fulltext Latent tuberculosis infection screening in foreign-born populations: a successful mobile clinic outreach model

Morano JP, Zelenev A, Walton MR, Bruce RD, Altice FL

Am J Public Health, 2014 Aug;104(8):1508-15.
PMID: 24922157 DOI: 10.2105/AJPH.2014.301897

OBJECTIVES: We evaluated the efficacy of a mobile medical clinic (MMC) screening program for detecting latent tuberculosis infection (LTBI) and active tuberculosis.
METHODS: A LTBI screening program in a MMC in New Haven, Connecticut, used medical surveys to examine risk factors and tuberculin skin test (TST) screening eligibility. We assessed clinically relevant correlates of total (prevalent; n = 4650) and newly diagnosed (incident; n = 4159) LTBI from 2003 to 2011.
RESULTS: Among 8322 individuals, 4159 (55.6%) met TST screening eligibility criteria, of which 1325 (31.9%) had TST assessed. Similar to LTBI prevalence (16.8%; 779 of 4650), newly diagnosed LTBI (25.6%; 339 of 1325) was independently correlated with being foreign-born (adjusted odds ratio [AOR] = 8.49; 95% confidence interval [CI] = 5.54, 13.02), Hispanic (AOR = 3.12; 95% CI = 1.88, 5.20), Black (AOR = 2.16; 95% CI = 1.31, 3.55), employed (AOR = 1.61; 95% CI = 1.14, 2.28), and of increased age (AOR = 1.04; 95% CI = 1.02, 1.05). Unstable housing (AOR = 4.95; 95% CI = 3.43, 7.14) and marijuana use (AOR = 1.57; 95% CI = 1.05, 2.37) were significantly correlated with incident LTBI, and being male, heroin use, interpersonal violence, employment, not having health insurance, and not completing high school were significantly correlated with prevalent LTBI.
CONCLUSIONS: Screening for TST in MMCs successfully identifies high-risk foreign-born, Hispanic, working, and uninsured populations and innovatively identifies LTBI in urban settings.
Study site: Mobile clinic, New Haven, Connecticut, United States

Matched MeSH terms: Substance-Related Disorders/epidemiology
Smoking and nicotine dependence in Singapore: findings from a cross-sectional epidemiological study

Picco L, Subramaniam M, Abdin E, Vaingankar JA, Chong SA

Ann Acad Med Singap, 2012 Aug;41(8):325-34.
PMID: 23010809

INTRODUCTION: Smoking is one of the leading preventable causes of death throughout the world and can lead to nicotine dependence, particularly when initiated at a young age. This paper describes the prevalence of smoking and nicotine dependence in the adult Singapore resident population, whilst also exploring rates among the major ethnic groups (Chinese, Malay and Indian), different education levels and those with chronic psychiatric and physical comorbidities.
MATERIAL AND METHODS: The Singapore Mental Health Study (SMHS) is a cross-sectional epidemiological study that was conducted between December 2009 and December 2010. Information on smoking status was assessed using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and the Fagerstrom Test for Nicotine Dependence measured nicotine dependence. Socio-demographic information was also collected.
RESULTS: In total, 6616 respondents participated in the SMHS giving a response rate of 75.9%. We found that 16% of the population were current smokers and 4.5% had nicotine dependence. Current smokers were more likely to be younger (18 to 34 years old), males, Malay and have lower education, whilst males had a 4.6 times higher risk of nicotine dependence to that of females. The prevalence of nicotine dependence was also higher in those with alcohol abuse and those experiencing chronic pain.
CONCLUSION: The results from this study highlight the important differences in the prevalence of smoking and nicotine dependence among different age groups, gender and ethnicity in Singapore and are important for developing future health policies and targeted preventive strategies.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Correlates of current smoking among Malaysian secondary school children

Tee GH, Kaur G

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):70S-80S.
PMID: 24965781 DOI: 10.1177/1010539514540468

Cigarette smoking in adolescent is a significant public health problem, leading to the risk of addiction, morbidity, and mortality in the long term. This study determined the prevalence and correlates of current smoking among adolescent school children. A nationwide school-based survey among 25 507 students between Forms 1 to 5 (aged 12-17) was conducted using a 2-stage cluster sampling design. The prevalence of current smoking was 11.5%. Multivariable logistic regression analysis revealed that current smoking was significantly associated with males (adjusted odds ratio [aOR] = 3.25; 95% confidence interval [CI] = 1.87, 4.98), current drinking (aOR = 2.34; 95% CI = 1.46, 3.74), drug used (aOR = 2.97; 95% CI = 1.24, 7.11), and being bullied (aOR = 1.41; 95% CI = 1.00, 1.98) at least once in the past 12 months. Smoking is associated with several behaviors that pose risks to adolescents, such as social issues and smoking-related health problems. Thus, early and integrated prevention programs that address multiple risk behaviors simultaneously are required.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Prevalence, comorbidities, and cofactors associated with alcohol consumption among school-going adolescents in Malaysia

Manickam MA, Abdul Mutalip MH, Abdul Hamid HA, Kamaruddin RB, Sabtu MY

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):91S-9S.
PMID: 25038196 DOI: 10.1177/1010539514542194

Alcohol is deleterious to physical and mental health as well as social well-being. This study aims to examine the prevalence of alcohol consumption and factors associated with its use among school-going Malaysian adolescents. The Global School-Based Student Health Survey (GSHS) 2012 employed 2-stage clustering design to Malaysian secondary school respondents aged 12 to 17 years. The prevalence of current alcohol usage was 8.9% (95% confidence interval [CI]: 7.8-10.07) overall, 11.2% (95% CI: 9.80-12.80) among males, and 23.4 (95% CI: 21.40-25.50) among Chinese students. Multivariate logistic regression showed that adolescents who had used alcohol were more likely to have used substance (adjusted odds ratio [aOR] = 3.39; 95% CI: 2.33-4.99), experienced injury (aOR = 1.53; 95% CI: 1.20-1.95), and engaged in sexual behaviors (aOR = 1.42, 95% CI: 1.12-1.79), and fights (aOR = 1.23; 95% CI: 1.08-1.41). The current national policies on alcohol should be strengthened to curb alcohol consumption among adolescents.
Study name: Global School-Based Student Health Survey (GSHS)

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Illicit drug use among school-going adolescents in Malaysia

Yusoff F, Sahril N, Rasidi NM, Zaki NA, Muhamad N, Ahmad N

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):100S-7S.
PMID: 25038195 DOI: 10.1177/1010539514542425

Illicit drug use among adolescents has become a public health issue in Malaysia. This study was from the Global School-Based Student Health Survey (GSHS) and aimed to determine the prevalence of and factors associated with illicit drug use among school-going adolescents in Malaysia. A 2-stage stratified cluster sampling method was used and data were collected via a self-administered questionnaire. A total of 25 507 students participated in the study. The prevalence of adolescents who ever used illicit drugs was 1.7%. Adolescents who ever used illicit drugs were associated with current smoking (adjusted odds ratio [aOR] = 6.99; 95% CI = 5.19, 9.40), current alcohol use (aOR = 4.63; 95% CI = 3.43, 6.26), ever having sex (aOR = 4.76; 95% CI = 3.54, 6.41), truancy (aOR = 1.43; 95% CI = 1.07, 1.90), lack of peer support (aOR = 1.47; 95% CI = 1.07, 2.03), and lack of parental monitoring (aOR = 1.71; 95% CI = 1.22, 2.39). Public health intervention should be addressed to prevent illicit drug used among adolescents.
Study name: Global School-Based Student Health Survey (GSHS)

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Prevalence and factors associated with physical fighting among Malaysian adolescents

Mat Hussin SF, Abd Aziz NS, Hasim H, Sahril N

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):108S-15S.
PMID: 25038192 DOI: 10.1177/1010539514542423

Physical fighting among adolescents is one manifestation of interpersonal violence that is an important issue globally, but attention to this problem in Malaysia has been limited. We analyzed data available from the Malaysia Global School-Based Health Survey conducted in 2012. Of the 25 507 respondents, 27.4% reported having been in a physical fight in the past 12 months. Being bullied (adjusted odds ratio [aOR] = 3.01; 95% confidence interval [CI] = 2.67-3.39) was significantly and highly associated with involvement in physical fighting. Smoking (aOR = 2.56; 95% CI = 2.20-2.97), males (aOR = 1.77; 95% CI = 1.62-1.93), using drugs (aOR = 1.73; 95% CI = 1.09-2.15), and drinking alcohol (aOR = 1.42; 95% CI = 1.24-1.63) were other factors associated with physical fighting. Parental supervision showed no significant association with physical fighting. These findings indicate that more attention needs to be given to bullying at school by school authorities and parents.
Study name: Global School-Based Student Health Survey (GSHS)

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Impact of maternal marital status on birth outcomes among young Malaysian women: a prospective cohort study

Mohd Zain N, Low WY, Othman S

Asia Pac J Public Health, 2015 Apr;27(3):335-47.
PMID: 25005933 DOI: 10.1177/1010539514537678

This study evaluated the impact of maternal marital status on birth outcomes among young Malaysian women and investigated other risk factors influencing the birth outcomes. Pregnant women with and without marital ties at the point of pregnancy diagnosis were invited to participate in this study. Participants were interviewed using a structured questionnaire at pregnancy diagnosis and shortly after childbirth. From a total of 229 unmarried and 213 married women who participated, marital status was significantly associated with preterm birth (odds ratio [OR], 1.66; 95% confidence interval [CI], 1.05-2.61) and low birth weight (OR, 3.61; 95% CI, 1.98-6.57). Other factors significantly associated with birth outcomes was prenatal care (OR, 4.92; 95% CI, 1.43-16.95), "use of drugs" (OR, 10.39; 95% CI, 1.14-94.76), age (OR, 1.12; 95% CI, 1.07-1.16), and number of prenatal visits (OR, 1.03; 95% CI, 1.00-1.07). Promoting access to prenatal care and social support programs for unmarried mothers may be important to reduce adverse pregnancy outcomes.

Matched MeSH terms: Substance-Related Disorders/epidemiology
Fulltext Sexual abuse and substance abuse increase risk of suicidal behavior in Malaysian youth

Chan LF, Maniam T, Saini SM, Shah SA, Loh SF, Sinniah A, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:123-6.
PMID: 23857848 DOI: 10.1111/appy.12057

INTRODUCTION: The aim of this study was to determine the association between sexual abuse, substance abuse and socio-demographic factors with suicidal ideation (SI), plans (SP) and deliberate self-harm (DSH) and propose steps to prevent youth suicidal behavior.
METHODS: This was a cross-sectional study of 6786 adolescents aged 17-18 years, selected randomly from all Malaysian adolescents to undergo compulsory youth camps located in Selangor, Malaysia (2008-2009). Participants were assessed using self-administered questionnaires developed to reflect the local cultural setting. However, only 4581 subjects were analyzed after excluding incomplete data.
RESULTS: The rates of SI, SP and DSH were 7.6%, 3.2% and 6.3%, respectively. The multivariable-adjusted odds ratio showed that sexual abuse was associated with SI 1.99 (95% CI: 1.56-2.55), SP 1.57 (95% CI: 1.09-2.27) and DSH 2.26 (95% CI: 1.75-2.94); illicit drug use was associated with SI 4.05 (95% CI: 2.14-7.67), SP 2.62 (95% CI: 1.05-6.53) and DSH 2.06, (95% CI: 1.05-4.04); for alcohol use DSH was 1.34 (95% CI: 1.00-1.79). Being female was associated with all suicidal behaviors: SI 2.51 (95% CI: 1.91-3.30), SP 2.07 (95% CI: 1.39-3.08) and DSH 1.59 (95% CI: 1.19-2.11).
DISCUSSION: Given the well-founded concern of increasing risk of suicidal behavior among youth, preventive efforts should adopt a more comprehensive approach in dealing with sexual abuse and substance abuse, and their sequelae, especially in girls.
KEYWORDS: adolescent; risks; sexual abuse; substance abuse; suicidal behavior

Matched MeSH terms: Substance-Related Disorders/epidemiology
Fulltext Factors affecting commencement and cessation of betel quid chewing behaviour in Malaysian adults

Ghani WM, Razak IA, Yang YH, Talib NA, Ikeda N, Axell T, et al.

BMC Public Health, 2011;11:82.
PMID: 21294919 DOI: 10.1186/1471-2458-11-82

Betel quid chewing is a common habit widely practiced in Southern Asian populations. However, variations are seen in the content of a betel quid across the different countries. Factors associated with commencement and cessation of this habit has been numerously studied. Unfortunately, data on Malaysian population is non-existent. This study aims to determine the factors associated with the inception and also cessation of betel quid chewing behaviour among Malaysian adults.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Drug injecting and HIV infection among the population of drug abusers in Asia

Poshyachinda V

Bull Narc, 1993;45(1):77-90.
PMID: 8305908

Opium has been produced and consumed since the nineteenth century in the areas of Asia currently referred to as the Golden Crescent and the Golden Triangle. In the 1970s and 1980s, most countries from Afghanistan to Japan experienced a heroin epidemic of varying degrees of severity. Opium and heroin abuse appeared to be more severe in countries and areas where those drugs were produced, an exception being Hong Kong, which has had a large population of heroin abusers for more than two decades. Drug injecting was far more common in countries of the Golden Triangle than in those of the Golden Crescent. In Myanmar and Thailand, for example, up to 90 per cent of chronic heroin abusers practised intravenous injection, which appeared to spread to heroin abusers in nearby territories such as the State of Manipur in India. Yunnan province in China, as well as Malaysia and Viet Nam. Amphetamine abuse was more frequent in Japan and the Republic of Korea for a number of years, while illicit production and consumption in the Philippines have recently shown significant increases. The injection of amphetamines was common only in the Republic of Korea. The prevalence of injecting among institutionalized methamphetamine abusers was reported at about 90 per cent. Most countries in Asia first reported cases of infection with the human immunodeficiency virus (HIV) in the mid-1980s. An extremely rapid spead of the epidemic and high prevalence, at rates of from 30 to 90 per cent, of HIV infection among the sample of intravenous heroin abusers were observed in a few countries with a high prevalence of intravenous injecting, such as India (in the State of Manipur), Myanmar and Thailand. The rest had either few reported cases or none at all, even though needle-sharing was found to be common. Great caution should be exercised in interpreting prevalence because of vast differences in methods of assessment. Given the vulnerability of intravenous drug abusers to rapid transmission of HIV infection, the prevention of drug injecting is of paramount importance in arresting the spread of the epidemic. Efforts to contain drug abuse, though difficult, are a principal means of achieving that end.

Matched MeSH terms: Substance-Related Disorders/epidemiology
Fulltext Drug abuse in Asia

Suwanwela C, Poshyachinda V

Bull Narc, 1986 Jan-Jun;38(1-2):41-53.
PMID: 3535959

The article focuses on countries and areas of South-East Asia, which are seriously affected by drug abuse and the problems associated with it. Opium has traditionally been used for treating illnesses and alleviating physical and mental stress, as well as for recreational and social purposes. The prohibition of the sale and use of opium in Burma, Hong Kong, Malaysia, Singapore and Thailand forced many habitual opium users to switch to heroin. Over the past two decades there has been an increasing trend towards drug use, often involving experimentation with more than one substance, among youth in and out of school. For example, a survey of students at teachers' colleges in northern Thailand showed that at some time in their lives 30-40 per cent of the male respondents and 3-6 per cent of the female respondents had used cannabis, and that 18-20 per cent of the males and 12-27 per cent of the females had sniffed volatile solvents. The same survey showed that 5-10 per cent of both the males and females had used stimulants and nearly 2 per cent had used heroin. During the 1970s the abuse of heroin and other opiates emerged as a serious problem of epidemic nature, predominantly affecting young people in many countries of South-East Asia. While opiates, including heroin, have been abused by inhaling and by smoking, there has recently been an increasing trend towards injecting heroin of high purity (80-90 per cent pure heroin). Heroin addiction spread first to the populations of capital cities and then to other cities and towns and even to the hill tribes, as studies in Thailand have revealed. Most recent studies have shown that heroin abuse has spread further in Asia, both socially and geographically, involving such countries as India and Sri Lanka, which had no previous experience with the problem. Studies have also shown that the abuse of manufactured psychotropic substances has been increasing and that heroin addicts resort to these substances when heroin is difficult to find. The article also briefly reviews the history of opium use in China and the history of drug abuse in Japan, particularly with regard to the problem of methamphetamine abuse, which has appeared in two epidemic-like waves. The first followed the end of the Second World War and disappeared at the end of the 1950s; the second reappeared in 1975 and since then has gradually been increasing in size.

Matched MeSH terms: Substance-Related Disorders/epidemiology*
Development and application of a system for monitoring drug abuse: the Malaysian experience

Navaratnam V, Foong K

Bull Narc, 1989;41(1-2):53-65.
PMID: 2765720

Monitoring systems are useful epidemiological instruments for assessing the problem of drug abuse. The rapid growth of the drug dependence problem in Malaysia led to increased awareness of the need for a system for continuous monitoring of the situation. Preliminary work on the design of an appropriate monitoring system was initiated in 1976. A fully integrated national reporting system was established in 1978, linking all public services and agencies coming into contact with drug-dependent persons, including law enforcement agencies, drug abuse treatment and rehabilitation centres, and social and welfare institutions. The information system included a mechanism for systematic gathering, processing, analysing and presenting essential data on the prevention, control and management of drug abuse problems. It also included reporting on drug-related events, such as hospitalizations and arrests, as well as data on known drug-dependent persons and new cases of dependence. The system has been used for routine monitoring of the extent, trends, patterns and other characteristics of drug abuse problems in Malaysia, providing basic information for policy-making and programme planning. On the basis of data generated by the system, it was estimated that the prevalence rate of drug-dependent persons per 100,000 population increased from 84.3 in 1976 to 754.6 in 1986. It was estimated that there were 119,001 drug-dependent persons in Malaysia in 1986.

Matched MeSH terms: Substance-Related Disorders/epidemiology*

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