In a study of suicide in Singapore in 1980 there were 230 cases and the suicide rate for the general population was 9.5 per 100,000. The age-specific rates increased steeply after 50 years and there was a male preponderance especially in the age group 60 years and over. Comparing the three major ethnic groups in Singapore, the highest rate was seen in the Indians and Chinese, whereas the Malays had the lowest. Amongst the suicides there were 59 (25.7%) with mental illness, mainly schizophrenia, and they were of a younger age group, 20-39 years. The commonest method of suicide was jumping from high-rise flats.
A study was carried out at the University Hospital, Kuala Lumpur, Malaysia to determine the age-specific prevalence of measles infection by serology and the age specific - seroconversion rates following measles vaccination. The results show that the percentage of children with passively acquired measles antibodies decreased with increasing age fill three to five months of age. From 12 months of age, the percentage of positivity increased sharply due probably to natural infection. The geometric mean antibody titre was low at birth, but from six months it started to increase. These results indicate that measles infection is common in Malaysia and a small number of children began to acquire natural measles infection from six to eight months of age; however the peak age for the acquisition of measles infection was from 12 months to five years of age. Seroconversion rates following vaccination from nine months of age, ranged from 94-99%. However, the rates and the geometric mean titre were higher among those vaccinated at 11 months of age or older compared with those vaccinated at nine or ten months of age. Based on the above results, it is concluded that the optimum age for measles immunization in Malaysia should be 11 months.
The prevalence rate of 749 cases of oral squamous cell carcinomas (SCC) recorded between 1978-1984 was studied. Results showed that the Indians formed the dominant group (63.8%) followed by the Malays (19.6%) and Chinese (16.6%). The peak incidences were generally located between the sixth and eighth decades. Only in the Chinese group a male preponderance was noted. In the Indians, the buccal mucosa was the most prevalent site; in the Malays and Chinese males, the gingiva and alveolus; and the Chinese female, the tongue. In all three groups, the well-differentiated SCC was the commonest type and the poorly differentiated least common.
A descriptive epidemiology of cancer in Sarawak, based on histopathology records in the Central Medical Laboratory, Kuching, Sarawsk, in 1981 and 1982 was presented. There were 8,219 patients from whom biopsies were taken and 485 from whom marrow biopsies were taken. Out of these, 1,326 were reported malignant. Most of the cases were from Kuching. There were slightly more males than females. The Chinese formed the majority of cases followed by the Sea Dayaks and Malays. The most common cancer sites among males were lymph nodes, nasopharynx, skin and stomach, while in the females the most common sites were the breast, cervix and lymph nodes. Among the Chinese the most common cancers were those of the nasopharynx in males, and breast in females. Among the Sea Dayaks, the most common cancers were those of the lymph nodes in males and cervix in females. Among the Malays, skin cancers were relatively common, and among the Land Dayaks nasopharyngeal cancers were common. Most of the patients were in the older age groups. The pattern of cancers has not changed much since 1966 and the findings of the present study are very similar to the series from the Institute of Medical Research, Kuala Lumpur, in 1969 to 1971.
An epidemiological survey of filariasis and malaria in Banggi Island and Upper Kinabatangan, Sabah, revealed microfilarial rates of 7.2% and 8.6% respectively and malaria prevalence of 9.7% and 16.9% respectively. Wuchereria bancrofti was a rural nocturnally periodic type with a periodicity index of 137.2 and average peak hour at 01.32 hrs; 9.2% of microfilaremic carriers as compared to 2.4% amicrofilaremic subjects had clinical filariasis. The Plasmodium falciparum: P. vivax: P. malariae ratios were 1:1:0.17 and 1.4:1:0.12 for Banggi and Upper Kinabatangan respectively. Anopheles flavirostris was incriminated as a new malaria vector in Banggi where the well-known primary malaria vector is An. balabacensis. The latter was also found for the first time to be a vector of rural W. bancrofti in Upper Kinabatangan. Experimental feeding also showed that L3 larvae of W. bancrofti were recovered at low rates from An. balabacensis. Aedes togoi appeared to be a suitable laboratory vector for W. bancrofti.
A study of 207 benign ovarian tumors seen at the University Hospital, Kuala Lumpur between 1968 and 1975 was made to evaluate the clinical features that might be useful in the preoperative differentiation of mucinous cystadenoma, serous cystadenoma, and cystic teratoma of the ovary. This study indicated that the pertinent information included the mean age of the patient, the marital and menstrual status, and the estimated tumor size. The racial background was an additional factor in serous cystadenoma. Features like parity, the location of the tumor, and ABO blood group pattern were of no value in the preoperative differentiation.
Data from Malaysia on the reproductive goals of husbands and wives are analyzed to determine level of agreement, using new scale measures on preferences for number and sex of children as well as the conventional measure of desired number of children. The level of agreement between husband and wife varies considerably depending on the focus of analysis and the measure of agreement used. Overall aggregate agreement of men and women is high but lower for subgroups of the population, particularly among various ethnic groups. For marital partners, the agreement is much lower, especially on sex preferences. The level observed depends on whether the measure is identity of responses or an index of homogeneity which allows for couple concordance based on chance or common socialization factors. The views about the reproductive goals of one marital partner cannot with confidence be assumed to represent the views of the other.
This paper examines the symbolic properties and cultural relevance of latah, a behavioral state noted in Malay and Indonesia since the 19th Century. Most interpretations of latah have been psychological, latah being perceived as a 'mental disorder.' In the following, it is concluded that latah is intimately related to other aspects of Malayo-Indonesian culture and that it is a well-known cultural pattern and not a mental disorder as such, though it may occur among persons, largely women, in a socially and psychologically marginal situation. Latah is a symbolic representation of marginality, and it is as appropriate to certain mythological and religious figures to the socially marginal.
Recent research has shown that children born before and after short birth intervals run a considerably greater risk of dying in infancy or childhood than do others. This report investigates which women have short interbirth intervals, under what circumstances, and for what reasons. The analysis uses data from the Malaysian Family Life Survey to examine influences on the two main behaviors--breastfeeding and contraceptive use--that affect birth interval length, and assesses the the impact of these same variables on the probability of having a birth interval of less than 15 months. The analysis shows that many of the independent variables affect breastfeeding and contraceptive use in opposite directions, with no significant net effect on the likelihood of a short interval. For example, a woman's education is negatively related to the probability that she breastfeeds, positively related to the probability that she uses contraceptives, and has no significant effect on the likelihood that the interpregnancy interval is less than 15 months. Having a family planning clinic nearby is associated with less breastfeeding, offsetting whatever positive effects family planning clinics have on contraceptive use in terms of the percentage of birth intervals that are so short as to be detrimental to infant and child health. Hence, factors that increase contraceptive use do not necessarily reduce the incidence of short interbirth intervals, because they are also associated with reduced breastfeeding. We simulate the proportion of intervals that would be short for alternative combinations of breastfeeding and contraceptive use in the population and show that over the period covered by the data (1961-75), breastfeeding had a considerably greater effect on preventing short interbirth intervals than did contraceptive use.
There has been a rapid increase in the past five years in the numbers of hospitalized drug dependents. While the studied population was clearly unrepresentative of the country-wide drug using population, it illustrates how the problem is neither limited to one particular stratum of society, nor to the few "traditional" drugs. Indeed, an increasingly youthful group of individuals drawn from all backgrounds is not only becoming dependent upon opiates, but is also using a range of other drugs, all of which are available on the market at relatively low cost. The market prices of drugs have an effect on the pattern of drug use; and many individuals move directly from tobacco to heroin smoking. Drug abuse continues to be a considerable public and governmental concern, and enforcement and treatment programmes are rapidly expanding in attempts to resolve this problem.
A study was made of the clinical statistics of odontogenic cysts treated at two hospitals in West Malaysia over a 6-year period. The general incidence of the individual cyst-types is similar to that reported in previous studies. A marked difference in the age distribution of radicular cysts emerged and 80% of the residual cysts in the survey occurred amongst the Chinese population. Reasons for the distribution variation are discussed.
Cancer of the cervix is exceedingly uncommon in the Malaysian Orang Asli (aborigine), despite the presence of factors associated with an increased risk of developing this malignancy. In only three patients was the diagnosis of carcinoma of the cervix established, out of a total of nearly 18,000 female inpatients, admitted to the Gombak Orang Asli Hospital over a 13-year period. Over this same period, 81 female patients were diagnosed as having cancer. Interviews with female Orang Asli patients show the presence of alleged risk factors for cervical cancer, including early age of first intercourse, multiparity and non-circumcision of husbands. The low incidence of cancer of the cervix in this aborigine community may be due to the strict moral code of the Orang Asli, limiting extramarital sexual activity and associated venereal infection.
This is the first epidemiological survey of mental disorders among children in a Malaysian village. The WHO Research Questionnaire for Children (RQC) was used for initial screening followed by a semistructured interview, the Follow-up Interview for Children (FIC) at its second stage. Diagnosis was obtained by using Rutter's multi-axial classification. The prevalence rates obtained for the diagnostic categories were described in 3 age groups, in accordance with the age of attending school in Malaysia. Of 507 children screened aged 1-15, 6.1% were classified as having a mental disorder.
The maximum oxygen consumption (VO2 max) of 421 healthy adult males from three ethnic groups (Chinese, Malay and Indian), aged 25-54 years, was assessed from direct analyses of their expired respiratory gases during all-out runs on a treadmill as a measure of aerobic fitness. The subjects were divided into three age groups: group 1, 25-34 years; group 2, 35-44 years; group 3, 45-54 years. Each group was further subdivided into non-exercisers (NE), non-regular exercisers (NRE) and regular exercisers (RE). Consistently within each age group, regular exercisers produced significantly higher VO2 max values compared to non-regular exercisers and non-exercisers. They also met the VO2 max requirements for heavy physical work and compared favourably with the standards of the National Physical Fitness Award of Singapore and Cooper's aerobic fitness classification standards based on North American males. Non-regular exercisers and non-exercisers only met the VO2 max requirements for moderate physical work and compared poorly in both of the aerobic fitness standards.
Fifty cases of septicaemic melioidosis were reviewed. There was a preponderance of disease among males (male:female ratio 3.2:1) and those aged over 30 years. The presenting clinical features were very varied and not pathognomonic, ranging from fever, cough and septicaemia to fulminant septicaemia and shock. Pulmonary involvement was recorded in 58% of the patients. Skin and soft tissue sepsis was seen in 24%, but many had signs and symptoms of multiorgan involvement. Associated underlying illness was identified in 76% of patients, diabetes mellitus being the commonest (38%), while 34% had more than one predisposing factor. The mortality of 65% in our series is a reflection of the less than satisfactory status of the diagnosis and therapy of septicaemic melioidosis. Only 24% of our patients received appropriate empirical antibiotic therapy. A high index of suspicion of melioidosis in endemic areas and the use of appropriate empirical antimicrobial therapy would be a step towards reducing the high mortality rate.