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Fulltext Anemia among Men in Malaysia: A Population-Based Survey in 2019

Awaluddin SM, Shahein NA, Che Abdul Rahim N, Mohd Zaki NA, Nasaruddin NH, Saminathan TA, et al.

Int J Environ Res Public Health, 2021 Oct 17;18(20).
PMID: 34682667 DOI: 10.3390/ijerph182010922

This study aimed to determine the prevalence of anemia and factors associated with anemia among men in Malaysia. The researchers used data from the 2019 National Health and Morbidity Survey (NHMS). The hemoglobin levels of men aged 15 years and above who gave their consent was measured using the HemoCue® Hb 201+ System©. The majority of them (87.2%) were men aged 15-59 years, referred to as the younger age group in this study. The prevalence of anemia among men was 12.6% (95% confidence interval (CI): 10.9, 14.5). The prevalence was higher among older men (30.7%; 95% CI: 26.6, 35.1) than younger men (10.0%; 95% CI: 8.2, 12.2). Anemia among men was associated with older age (adjusted odds ratios (aOR) = 3.1; 95% CI: 2.1, 4.4) and those with diabetes (aOR = 1.5; 95% CI: 1.2, 2.1) via a logistic regression analysis. In conclusion, older men were more affected by anemia than younger men in this study. Anemia among older men in Malaysia is at the level of moderate to severe public health significance. The likelihood of developing anemia is increased among older men with diabetes compared to older men without diabetes. These often-overlooked issues among men need to be detected and treated early in order to prevent complications and improve their quality of life.
Fulltext Exploring challenges faced by parents of children with tuberculosis in Klang and Petaling districts of Selangor state, Malaysia: A qualitative study

S Maria Awaluddin, Nurhuda Ismail, Siti Munira Yasin, Yuslina Zakaria, Norzila Mohamed Zainudin, Faridah Kusnin, et al.

Journal of Clinical and Health Sciences, 2020;5(2):46-56.
MyJurnal

Introduction: Parents play an essential role in their children’s tuberculosis (TB) treatment
success despite many challenges from the beginning of their children’s symptoms until
completion of the TB treatment. The challenges can be described as perceived barriers,
according to the Health Belief Model, a theory of behaviour change. This study aims to explore
parents’ experiences on the challenges in achieving a successful TB treatment for their child
in two districts of Selangor state, Malaysia. Methods: The research was carried out using a
phenomenology study design. In-depth interviews were conducted among purposively
sampled parents of children with TB disease who have completed TB treatment or still
undergoing treatment from MyTB version 2.1, a national TB surveillance database. The
collected data was considered as achieving its saturation level if no new themes arise from
the latest interviews’ session. The R-based Qualitative Data Analysis (RQDA) package
version 0.2-8 was used for the thematic data analysis. Results: The total number of
participants in this study was 15 mothers of children with TB disease; 12 (80%) of the children
had completed TB treatment. There were six subthemes identified from this study focusing on
the theme of multiple challenges, such as health symptoms challenges, TB investigation
challenges, personal challenges, healthcare facilities challenges, administration medication
challenges, and community challenges. Conclusions: Parents highlighted many challenges
during the child’s illness phase, and they should be given adequate education and appropriate
support to ensure TB treatment adherence. TB program managers should take action
following the relevant parents’ feedback regarding the quality of TB care in a healthcare
facility
Risk Factors for Illicit Drug Use Among Malaysian Male Adolescents

Rodzlan Hasani WS, Miaw Yn JL, Saminathan TA, Robert Lourdes TG, Ramly R, Abd Hamid HA, et al.

Asia Pac J Public Health, 2019 11;31(8_suppl):48S-56S.
PMID: 31347375 DOI: 10.1177/1010539519865053

This study was carried out to determine the prevalence of illicit drug use and its associated factors among male adolescents in Malaysia. Data of 13 135 adolescents were extracted from the National Health and Morbidity Survey 2017, a cross-sectional survey among school-going adolescents in Malaysia aged between 13 and 17 years, using a 2-stage stratified cluster sampling. A complex sample design analysis and multiple logistic regression analysis were applied. The overall prevalence of lifetime illicit drug use among male adolescents was 6.6%. The multivariable model showed that illicit drug use among male adolescents were associated with younger age, rural school area, marital status of parent, current smoker, ever having sex, truancy, involved in physical fight, and lack of peer support. The findings from this study can assist community and relevant authorities in their efforts to combat illicit drug usage among adolescents using intervention programs that diminishes risk factors and enhances the protective factors.
Factors Associated With Suicidal Attempt Among School-Going Adolescents in Malaysia

Abdul Aziz FA, Abd Razak MA, Ahmad NA, Awaluddin SM, Lodz NA, Sooryanarayana R, et al.

Asia Pac J Public Health, 2019 11;31(8_suppl):73S-79S.
PMID: 31353928 DOI: 10.1177/1010539519862161

Various factors contribute to suicidal attempt. This study aims to determine the relationship between suicidal attempt and its associated factors among school-going adolescents in Malaysia. Data from the National Health and Morbidity 2017 survey were analyzed. This survey was implemented as a nationwide school-based survey targeting adolescents 13 to 17 years old. Descriptive and multiple logistic regression analysis was done using SPSS version 20. A total of 27 399 adolescents participated in this survey. The prevalence of suicidal attempt was 6.9% (95% confidence interval = 6.2-7.7). Multivariate analysis found that the odds of suicidal attempt among adolescent with depression is 4.3 (adjusted odds ratio = 4.3; 95% confidence interval = 3.9-4.8). Other significant factors are young adolescent, non-Malay ethnicities especially Indian, adolescent with parents living apart, and those without peer support and parental connectedness. A holistic approach for the planning of preventative strategies and public health policies should be made according to these risk factors.
Study name: National Health and Morbidity Survey (NHMS-2017)
Fulltext Association of Internet Addiction with Adolescents' Lifestyle: A National School-Based Survey

Ying Ying C, Awaluddin SM, Kuang Kuay L, Siew Man C, Baharudin A, Miaw Yn L, et al.

Int J Environ Res Public Health, 2020 12 29;18(1).
PMID: 33383635 DOI: 10.3390/ijerph18010168

Internet addiction (IA) among adolescents is an issue of growing concern with adverse effects on adolescents' health and social functioning. This study aims to determine the prevalence of IA among school-going adolescents in Malaysia and its associated factors-specifically, lifestyle factors. A nationwide cross-sectional school-based health survey was conducted in 2017 among 27,497 students from 212 randomly selected secondary schools. Information regarding sociodemography, lifestyle, and internet use was obtained using a self-administered questionnaire. IA was measured using the Malay Version of Internet Addiction Test (MVIAT). The prevalence of internet addiction was 29.0%. A multivariable logistic analysis revealed that inadequate fruit and vegetable intakes, consumed carbonated soft drinks at least once a day, consumed fast food at least three days/week, sedentary behavior, current E-cigarette users, and ever/current alcohol drinkers were lifestyle factors significantly associated with IA. Adolescents from urban schools, of higher school grade, and those whose parents are married but living apart were also found to have a greater risk for internet addiction. A positive association was found between IA with unhealthy dietary and lifestyle behaviors among adolescents. The modification of lifestyle factors needs to be considered while developing strategies and interventions for awareness-raising and prevention of IA among adolescents.
The Association of Internet Addiction and Perceived Parental Protective Factors Among Malaysian Adolescents

Awaluddin SMB, Ying Ying C, Yoep N, Paiwai F, Lodz NA, Muhammad EN, et al.

Asia Pac J Public Health, 2019 Nov;31(8_suppl):57S-64S.
PMID: 31523984 DOI: 10.1177/1010539519872642

Parental protective factors do play an important role in preventing Internet addiction. A self-administered questionnaire was used to measure health risk behaviors among Malaysian adolescents. The prevalence of Internet addiction was significantly higher among adolescents with perceived lack of parental supervision (30.1% [95% confidence interval (CI) = 28.7-31.4]) and lack of parental connectedness (30.1% [95% CI = 28.5-31.7]), compared with their counterparts. Adolescents who perceived a lack of parental supervision, respect for privacy, connectedness, and bonding were more likely to have Internet addiction: (adjusted odds ratio [aOR] = 1.39; 95% CI = 1.27-1.52), (aOR = 1.23; 95% CI = 1.16-1.31), (aOR = 1.09; 95% CI = 1.02-1.16), (aOR = 1.06; 95% CI = 1.00-1.12), respectively. Among girls, Internet addiction was associated with those who perceived lack in all 4 parental factors, while among boys, those who perceived lack of parental supervision and respect for privacy were more prone to Internet addiction.
Prevalence of Nonfatal Serious Injury Due to Motor Vehicle Accidents Among Malaysian School-Going Adolescents: Findings From the Adolescent Health Survey 2017

Awaluddin SM, Ahmad FH, Jeevananthan C, Ganapathy SS, Sooryanarayana R, Mohamad Anuar MF, et al.

Asia Pac J Public Health, 2019 Nov;31(8_suppl):65S-72S.
PMID: 31522523 DOI: 10.1177/1010539519872662

Serious injury due to motor vehicle accidents (MVAs) significantly contributes to the adolescents' health status. The objective of this study was to estimate the prevalence of nonfatal injury due to MVAs and its associated factors among Malaysian school-going adolescents. Nationally representative samples were selected via 2-stage stratified cluster sampling. Data was collected using a validated self-administered questionnaire. Logistic regression analysis was conducted to examine the associations between the variables. A total of 1088 out of 27 497 adolescents reported that they had sustained serious injury due to MVAs with a prevalence of 4.1% (95% confidence interval [CI] = 3.7-4.5). Serious injury due to MVAs among adolescents was positively associated with being current cigarette smokers (adjusted odds ratio [aOR] = 2.5; 95% CI = 2.2-2.9), followed by Malay ethnicity (aOR = 2.4; 95% CI = 1.9-3.0), current drug users (aOR = 2.3; 95% CI = 1.9-3.0), boys (aOR = 2.1; 95% CI = 1.8-2.4), Indian ethnicity (aOR = 1.8; 95% CI = 1.2-2.5), and those who were in upper secondary school (aOR = 1.3; 95% CI = 1.2-1.5). Targeted intervention and curbing substance use among boys may reduce the morbidities from MVAs and its resulting complications.
Prevalence and Factors Associated With Physical Abuse at Home Among School-Going Adolescents in Malaysia: A Population-Based Nationwide Study

Saminathan TA, Ganapathy SS, Sooryanarayana R, Hasim MHB, Mohd Anuar MF, Ahmad FH, et al.

Asia Pac J Public Health, 2019 11;31(8_suppl):88S-96S.
PMID: 31680535 DOI: 10.1177/1010539519883139

We assessed the current situation of physical abuse among adolescents at home in Malaysia. A total of 27 497 school-going adolescents answered a self-administered questionnaire during the Malaysian National Health and Morbidity Survey 2017. A complex sampling analysis was applied to identify factors associated with physical abuse among adolescents using multivariate logistic regression analysis. The prevalence of physical abuse at home among students was 11.8%. Our result shows that adolescents aged 13 years had significantly higher odds of such abuse, with odds decreasing as the adolescents age. Girls and adolescents from Indian ethnicity (minority ethnic group) had higher odds of such abuse. Other associated factors were mental health problems, substance abuse, and problems at school. Physical abuse among adolescents at home should be countered with appropriate measures.
Advanced maternal age and adverse pregnancy outcomes in Muar, Johor, Malaysia

Herny Erdawati Mohd Rashed, S Maria Awaluddin, Noor Ani Ahmad, Nurul Huda Md Supar, Zubidah Md Lani, Fauziah Aziz, et al.

Sains Malaysiana, 2016;45:1537-1542.

Various factors may contribute to adverse pregnancy outcomes; either maternal or foetal outcomes. This study aimed was
to determine the association between advanced maternal age and adverse pregnancy outcomes. This is a cross sectional
study. Data were collected from the birth records from January 1st 2012 until December 31st 2012 in Muar District.
Descriptive and multiple logistic regression analyses were done and the results were presented as adjusted odds ratio
(aOR) with p-value <0.05. The proportion of birth in Muar district, Johor was 14.8% among mothers aged 35 years
and older and 85.2% among mothers aged 20 to 34 years. Advanced maternal age was associated with pregnancyinduced
hypertension (aOR: 5.00; 95%CI: 1.95-12.65), gestational diabetes mellitus (aOR: 2.32; 95%CI: 1.35-4.00)
and Caesarean section (aOR: 2.21; 95%CI: 1.53-3.19). Anaemia was negatively associated with advanced maternal
age (aOR: 0.50; 95%CI: 0.32-0.78). No significant association was found between advanced maternal age and adverse
foetal outcomes. In view of the findings, special attention should be paid to the antenatal mothers aged 35 years and
older, even to those without any pre-existing medical problems.
Fulltext Cause-specific mortality estimates for Malaysia in 2013: results from a national sample verification study using medical record review and verbal autopsy

Omar A, Ganapathy SS, Anuar MFM, Khoo YY, Jeevananthan C, Maria Awaluddin S, et al.

BMC Public Health, 2019 Jan 24;19(1):110.
PMID: 30678685 DOI: 10.1186/s12889-018-6384-7

BACKGROUND: Mortality indicators are essential for monitoring population health. Although Malaysia has a functional death registration system, the quality of information on causes of death still needs improvement, since approximately 30% of deaths are classified to poorly defined causes. This study was conducted to verify registered causes in a sample of deaths in 2013 and utilise the findings to estimate cause-specific mortality indicators for Malaysia in 2013.

METHODS: This is a cross-sectional study involving a nationally representative sample of 14,497 deaths distributed across 19 districts. Registered causes of deaths were verified using standard medical record review protocols for hospital deaths, and locally adapted international standard verbal autopsy procedures for deaths outside hospitals. The findings were used to measure the validity and reliability of the registration data, as well as to establish plausible cause-specific mortality fractions for hospital and non-hospital deaths, which were subsequently used as the basis for estimating national cause-specific mortality indicators.

RESULTS: The overall response rate for the study was 67%. Verified causes of 5041 hospital deaths and 3724 deaths outside hospitals were used to derive national mortality estimates for 2013 by age, sex and cause. The study was able to reclassify most of the ill-defined deaths to a specific cause. The leading causes of deaths for males were Ischaemic Heart Disease (15.4%), Cerebrovascular diseases (13.7%), Chronic Obstructive Pulmonary Disease (8.5%) and Road Traffic Accident (8.0%). Among females, the leading causes were Cerebrovascular diseases (18.3%), Ischaemic Heart Disease (12.7%), Lower Respiratory Infections (11.5%) and Diabetes Mellitus (7.2%).

CONCLUSIONS: Investigation of registered causes of death using verbal autopsy and medical record review yielded adequate information to enable estimation of cause-specific mortality indicators in Malaysia. Strengthening the national mortality statistics system must be made a priority as it is a core data source for policy and evaluation of the public health and healthcare sectors in Malaysia.
Fulltext A 6-Month Open-Label Study of Vortioxetine among Cancer Patients with Major Depressive Disorder (MDD)

Ng CG, Abousheishaa AA, Low SY, Zainal NZ, Thong KS, Awaluddin AB, et al.

Asian Pac J Cancer Prev, 2023 Aug 01;24(8):2583-2591.
PMID: 37642043 DOI: 10.31557/APJCP.2023.24.8.2583

OBJECTIVE: Vortioxetine is a monoaminergic drug with a novel multimodal mechanism of action. We investigated its efficacy on depressive symptoms, cognitive function, and quality of life among cancer patients.
METHODS: In this multicenter, open-label, single-arm, observational study, patients received flexible doses of Vortioxetine for a period of six months. All participants were assessed at baseline and scheduled for monitoring at weeks 2, 4, 8, 12, 16, 20, and 24. Depression severity was assessed using Montgomery-Asberg Depression Rating Scale (MADRS) and the Clinical Global Impression (CGI) scale. The Perceived Deficiency Questionnaire (PDQ-5) assessed the perceived cognitive difficulties in concentration, executive functioning, and memory. The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) was used to assess the patients' quality of life. Side effects of vortioxetine were monitored using the Antidepressant Side-Effect Checklist (ASEC).
RESULTS: Patients experienced a reduction in MADRS scores from 29.89 ± 5.997 at baseline to 11.59 ± 4.629 by Week 24. The PDQ-5 scores showed significant change from Week-4, whereas the EORTC role, emotional, and cognitive functioning scores showed a significant change from Week 2 onwards. CGI-Severity scores decreased from a baseline of 4.39 ± 0.746 to 2.41 ± 1.085 by Week 24. During the 24-Weeks of therapy, around three-quarters of the patients (73.3%) had one or more adverse events reported on the ASEC. The most frequently reported TEAEs were dry mouth, insomnia, somnolence, and headache, with more than a 30% incidence rate.
CONCLUSION: Vortioxetine seems promising in the management of depression and enhancement of cognitive function and quality of life of cancer patients with Major Depressive Disorder.
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Fulltext A planetary health model for reducing exposure to faecal contamination in urban informal settlements: Baseline findings from Makassar, Indonesia

French MA, Fiona Barker S, Taruc RR, Ansariadi A, Duffy GA, Saifuddaolah M, et al.

Environ Int, 2021 10;155:106679.
PMID: 34126296 DOI: 10.1016/j.envint.2021.106679

BACKGROUND: The intense interactions between people, animals and environmental systems in urban informal settlements compromise human and environmental health. Inadequate water and sanitation services, compounded by exposure to flooding and climate change risks, expose inhabitants to environmental contamination causing poor health and wellbeing and degrading ecosystems. However, the exact nature and full scope of risks and exposure pathways between human health and the environment in informal settlements are uncertain. Existing models are limited to microbiological linkages related to faecal-oral exposures at the individual level, and do not account for a broader range of human-environmental variables and interactions that affect population health and wellbeing.
METHODS: We undertook a 12-month health and environmental assessment in 12 flood-prone informal settlements in Makassar, Indonesia. We obtained caregiver-reported health data, anthropometric measurements, stool and blood samples from children

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