Introduction: Anemia in pregnancy is still a public health problem in developing countries including Malaysia. Early screening of pregnant mothers who have risk factors of anemia could help identifying these potential anemic mothers and hence targeted for intervention.
Methodology: A cross sectional study IN 2008 was conducted among pregnant women who attended government health clinics in Johor Bahru district to assess the prevalence of anemia in pregnancy and factors associated with it using a structured questionnaire.
Result: Prevalence of anemia in pregnancy (Hb<11.0 g/dl) was 36.6% and majority in mild category (Hb 9-<11 g/dl). The associated factors of anemia in pregnancy were birth spacing, dietary intake with high iron content and iron pill consumption. Multivariate analyses revealed that iron pill intake was the most important factor influencing anemia in pregnancy.
Discussion and conclusion: Even though Johor Bahru is a big town with good health facilities, the prevalence of anemia in pregnancy was quite high. Results were compared with previous studies. Emphasis on compliance to iron pills is very important in prevention and treating anemia in pregnancy
Key Words: anemia in pregnancy, birth spacing and iron pill intake
Study site: Four urban and two rural klinik kesihatan, Johor, Malaysia
Improvement in the service quality system of health clinics in Malaysia had increase with the increase of national development. However, customer dissatisfaction towards regular service still has become an issue in the provision of health service in clinics throughout this country. This study aims to identify factors that influence customer satisfaction such as sociodemographic factors of patients, the location of clinic (rural or urban) and the most important SERVQUAL dimensions in determining customer satisfaction. This study conducted in October and November 2008 in Hulu Langat District. SERVQUAL questionnaires were used. Probabilistic sampling was used for the selection of respondents and the number of samples for each clinic was based on the workload of the clinic. Overall, the results showed that there are differences in levels of customer satisfaction between urban clinic (25.8%) and rural (30.7%). The most critical service quality dimensions for urban clinics are the responsiveness and reliability dimensions with a mean value of -0.7018 and -0.7434. Responsiveness, existence and reliability are the weakest quality service dimensions (mean -0.6317, -0.6718 and -0.6028) in rural clinics. It was found that customers’ ethnicity and education affect customer satisfaction in both the urban and rural clinics. Gender and type of work are factors that affect customer satisfaction only in urban clinics. Overall customer satisfaction at health clinics in Hulu Langat District is low. The difference between urban and rural clinics show the customers' needs in the area is different.
Key words: Customer satisfaction, SERVQUAL, health clinics, services.
The purpose of this study was to determine the dental health status of a representative sample of Johannesburg Chinese schoolchildren, all 250 attending the only Chinese school in the city. In 18 preschoolchildren, 3--5 years old, 16.7% were caries-free, mean dmft was 7.1 +/- 5.8 and labial caries was present in 33.3%. In 165 primary schoolchildren aged 5--16 years, the mean dmft was 590 +/- 3.2 with 20% of the primary dentition caries-free and the mean DMFT was 2.4 +/- 1.9 4.8% of the primary schoolchildren were caries-free. In 67 high school pupils of 11--17 years, 4.5% were caries-free and the mean DMFT score was 7.1 +/- 3.9. Caries prevalences among the Chinese were similar to corresponding groups of children of Chinese immigrants in the United Kingdom and Malaysia.
The weights and heights of 3,312 Malaysian primary school boys and girls, aged 6 to 11 years, belonging to various ethnic groups in Malaysia were measured. On the whole, the Chinese children were taller and heavier than the Malay and the Indian children who were the least heavy among the three ethnic groups. Economically the Indians were the poorest among the three ethnic groups and they also had the largest family size. When the household incomes were taken into consideration it was found that the growth achievement of the higher income children was better than that of the poorer children, irrespective of their ethnic groups. It is interesting to note that, although the Indian children as a whole, were the least heavy of the three ethnic groups, yet the growth achievement of the higher income Indian children was similar to that of the higher income Chinese children. The differences in growth achievement of the various ethnic groups are probably due to environmental differences, rather than genetic differences. It seems likely that Malaysian children of different ethnic groups (Malay, Chinese and Indian) can attain similar statures if environmental conditions are similar.
944 adenosine deaminase phenotypings of Malay, Chinese, and Indian blood donors and newborns at Kuala Lumpur, Malaysia, yielded ADA1 gene frequency estimates of 0.885 for the Malays, 0.939 for the Chinese, and 0.853 for the Indians.
Misuse of alcohol among adolescents, particularly schoolchildren has become one of the public health concerns in Malaysia due to its serious effects and an increased risk of alcohol related injuries, especially motor vehicle injuries. This is the most common type of youthful fatal injury in Malaysia. However the availability of data on the extent of alcohol abuse particularly among school children in this country is limited. Therefore, we conducted this study with the objectives of identifying the prevalence of alcohol drinking among school children in Kuala Lumpur, factors rekited to alcohol drinking among the adolescents and to assess health status of their parents through the presence of any related alcohol diseases and the habits of alcohol drinking among their parents.
In this baseline study a two stage stratified sampling design was used to recruit 8532 eligible students from the selected secondary schools in Kuala Lumpur. The prevalence of alcohol drinking was 9.0% (771 / 8532) . Significant factors identihed related to alcohol consumption were akoholic father (OR=1.29), akoholic mother (1 .55) ; elder siblings consume alcohol (2 .49) and the Chinese ethnic group (1 .55) . The study revealed that factors which signihcantly contributed to the habit of alcohol drinking were related to whether their parents consumed alcohol or not or either their eMer siblings were ako taking alcohol. Therefore, the, results from this study could be used as a baseline data to describe the level of alcohol consumption among adolescents particularly school children. Ehfective public health interventions that focus on the familial context of adolescents' drinking habits may be developed.
Serum samples from Sinhalese subjects, from Punjab and from Singapore have been studied. The Gm phenotypes found are very numerous and we can observe some similarities concerning the Gm gene frequencies between the Singapore Indians with the Indians of North India, and with the Sinhalese. In contrast, Gm gene frequencies found among Chinese and Malays from Singapore are quite different from those found among Indians of Singapore. Our results here are very similar to those obtained in Malaya studies.
Introduction: The common cold is the commonest reason for primary care encounters worldwide. This paper aims to describe the reasons that influence patients to seek medical consultation for the common cold.
Methods: This was a cross-sectional survey conducted among adult patients of an urban teaching primary care clinic. An adapted bilingual survey form was administered by the researchers to obtain data regarding their decision to seek medical consultation for a cold and the reasons for their decision. Quantitative analyses were done to describe the close-ended responses. Open-ended responses were analysed using a qualitative approach and
the frequencies of the themes were reported. Results: A total of 320 respondents participated in this study, with a response rate of 91.4%. They were predominantly females (59.4%), Malay (70.9%), and had tertiary education (65.9%). More than half of the patients (52.5%) said they would seek consultation for cold symptoms. Fever was the commonest symptom (57-61%) which compelled them to seek consultation. The commonest reason for seeking consultation was to get medications (41.7%), whereas the commonest reason not to seek consultation was the practice of self-medication (44.2%). Ethnicity was found to be significantly associated with the decision to seek doctor’s consultation.
Conclusion: Colds are usually self-limiting and do not result in complications. Empowering
patients by providing appropriate self-care knowledge can help to reduce the burden of primary care services.
Patients should be taught about red flag symptoms as well as drug safety for medications commonly taken for
colds.
Keywords: Upper respiratory tract infections, patient acceptance of health care, primary health care.
Serum levels were determined in urban Chinese, Malays and Indians and in the forest-residing Orang Asli of age group 11 to 50. There was no difference in the IgM levels in the Chinese, Indians and Malays, but the serum IgG was elevated (p less than 0.05) in the Malays and the serum IgA level (p less than 0.01) in the Indians, when compared to the other two races. In contrast to the three other races there was a significant elevation of all three immunoglobulins in the Orang Asli. The mean immunoglobulin levels of the urban Malaysians are comparable to those reported for Caucasians residing in temperate countries. However, in the Orang Asli, the immunoglobulin levels were higher than observed for populations of the temperate regions but are comparable to the levels reported for several other populations of the tropical regions. Females had higher IgM levels than males in the Chinese, Indian and Malays but in the Orang Asli there was no sex difference in the immunoglobulin levels.
A case of haemoglobin H (HbH) disease associated with pregnancy is presented and discussed in the light of reports in the literature. The variable symptomatology is commented upon, although mild to moderate chronic haemolytic anaemia seems to be a constant feature. The roles of folic acid supplements and of splenectomy; the avoidance of oxidant drugs, and the mode of inheritance in HbH disease are briefly commented upon. Available reports indicate that HbH disease probably has no adverse effect on pregnancy. However, the association of the two conditions is uncommon, and reports are too few, therefore, to allow definite conclusions on the outcome in all instances.
Child multilingual phonological errors are under-explored. Cross-linguistic studies suggest monolingual children make phonological errors that are subject to effects of language universality and ambient language characteristics. Bilingual Chinese children were observed to use not only typical, but also atypical phonological errors compared to monolingual peers acquiring similar languages. Atypical errors are a result of specific bilingual pair effects. Close-language-relatedness (Cantonese-Mandarin) is claimed to be responsible for the nonexistence of atypical errors in both languages, whilst distant-language-relatedness (Cantonese-English) is observed to cause atypical errors in both languages. The present novel cross-sectional study investigated phonological acquisition in three typologically distant languages: English-Mandarin-Malay by 64 multilingual Chinese children aged 2½-4½. The present research aimed to explore if multilingual Chinese children exhibit phonological errors which commensurate to that of monolingual and bilingual Chinese children acquiring similar languages as described in the literature. The single-word phonological test results revealed that the multilinguals exhibited typical and atypical phonological patterns which largely commensurate with the monolinguals and bilinguals. Similar to bilingual children, the multilingual children showed more atypical errors in English than in Mandarin, demonstrating effects of individual language irrespective of potential interaction with additional languages. The present result did not fully support the link between closeness in typology of languages and the absence of atypical errors. Rare atypical errors were found in Mandarin and Malay, two typologically different languages, and both were also interacting with English, another typologically different language. The present findings provided useful preliminary multilingual speech norms for the use of speech therapists.
Stroke is a causal factor that commonly caused physical impairments and activity limitations among patients to perform daily activities until at certain level stroke patients will experience disability. The aim of this study is to examine the relationship of each demographic and clinical factors that is believed to associate with physical functioning of patients
those who experienced stroke. This present study also try to compare physical functioning of patients with associated factors and then examine the correlation between those factors with physical functioning. A total of 147 respondents that pass for cognitive screening test involved in this study. Barthel Index (ADL) was administered to the respondents after 6 weeks of stroke attack in order to measure their physical functioning status. Results found that there was a significant difference [F(3, 143) = 4.06; p < 0.01] between level of educations with physical functioning of patients. With respect to clinical factors also showed a significant difference (p < 0.01) was higher in physical functioning when stroke attack
occurred at right hemisphere of brain. There was a significant difference (p < 0.01) in physical functioning with respect to belief of recovery. Furthermore, number of stroke attack also showed a significant difference [F(1, 145) = 11.19; [p < 0.01] in physical functioning of patients. Correlation test that was carried out found a positive significant correlation
(r = 0.24; p < 0.01) between physical functioning with respect to the affected lesion side. In conclusion, demographic and clinical factors also played the roles to determine level of physical functioning among stroke patients and thus these factors should be considered in any studies that intended to enhance physical functioning of patients in future.
Keywords: stroke; physical functioning; disability; physical impairment
The non-structural protein 1 (NS1) of the dengue viral genome has been found useful for diagnosis of acute dengue infections, being detected from one day and up to 18 days post onset of symptoms (1). Rapid Dengue NS1 antigen test was made available in commercial test kits for private clinics in Perak in 2014. This study aimed to determine the use usefulness of dengue NS1 test kits in suspected dengue cases in a general practice clinic in Perak and the period in which positive test results were obtained after the onset of symptoms. Clinic records of all suspected dengue cases seen in the ten months from October 2014 to July 2015 were traced. Patients’ demographic characteristics, presenting symptoms and the use of One Step Dengue NS1 Antigen test (Avo Diagnostics) were analyzed using SPSS version 17. Seventy one suspected dengue fever cases were seen in the study period, the highest number in July 2015 (25%). Majority were Chinese (80%), female (63%), and aged 40 years and above (51%). Most patients presented with fever (99%), body-ache (51%), gastrointestinal symptoms (51%) and headache (44%). Dengue NS1 antigen test was done in 94% of the suspected cases with 61% testing positive. The majority of the cases presenting one day to five days after onset of symptoms tested positive i.e. 59% (1 day), 90% (2 days), 54% (3-4 days) and 89% (5 days). Using dengue NS1 antigen test, positive results can be obtained as early as one day after the onset of symptoms. This test is a useful tool to aid primary care physicians detect dengue fever early.
The current era of globalization has seen a pandemic rise in the number of patients with chronic diseases including end-stage renal disease (ESRD). This led to the study of various factors that affect patients’ health-related quality of life (HRQoL). One of the factors that is getting attention lately is the role of religious coping strategies and how it affects the quality of life of patients with chronic patients. Therefore, the present study examined the role of religious coping strategies (RCS) as a mediator between depression and HRQoL of ESRD patients. It was a cross sectional study, involved 274 ESRD patients who is undergoing dialysis treatment at dialysis centre in the Selangor, Kuala Lumpur and Johor. Instruments used were the Short Form-36 (SF-36), Beck Depression Inventory II (BDI II), and Religious Coping Strategies (RCS). Results showed that there were significant correlations between depression and RCS with HRQoL (Physical component summary PCS] and Mental Component Summary MCS]). Meanwhile, religious coping was a partial mediator between depression with PCS and MCS. The results of this study will facilitate health practitioners in developing appropriate interventions that take into account the role of religion to improve patient quality of life towards a more positive and effective manner.
The objective of the present study is to examine the sociodemographic determinants of amount of smoking knowledge in Malaysia. Data are obtained from the Global Adult Tobacco Survey (GATS). The GATS uses a multistage stratified sampling. A total of 4,153 respondents are used for analyses. The effects of sociodemographic factors on smoking knowledge are examined using a negative binomial regression. Age, wealth index, education, ethnicity, house locality, and smoking behavior are significantly associated with smoking knowledge. In particular, there are negative relationships between smoking knowledge and higher wealth index, less-educated individuals, Chinese, rural dwellers, and smokers. The present study concludes that sociodemographic factors play an important role in determining smoking knowledge. Hence, as an intervention measure directed toward improving the knowledge of smoking among Malaysian population, effective policies should pay special attention to individuals who are likely to have poor information on smoking.
Study name: Global Adults Tobacco Survey (GATS-2011)