Displaying publications 21 - 40 of 97 in total

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  1. Bulgiba AM
    Prev Med, 2005 Jun;40(6):696-701.
    PMID: 15850867
    The objective of this study is to look at how well patient history and examination findings can be used in screening for angina.
  2. Bulgiba AM, Noran MH
    Asia Pac J Public Health, 2003;15(2):127-34.
    PMID: 15038688
    A cross-sectional study of medical students using a self-administered questionnaire was carried out in the Faculty of Medicine, University of Malaya, Malaysia from December 2000 to January 2001 to determine IT usage, perceptions and literacy of medical students. 366 of 653 (56.0%) students reported owning some type of personal computer. Students mainly used the computer to get onto the Internet, do word-processing and make presentations. Junior (Year One and Two) students and those who had used computers before entering university were more likely to use the Internet. Those who own computers were more likely to feel comfortable with software (OR 1.61, 95% CI: 1.09, 2.38). Students who use the Internet were more likely to perceive that IT facilitated their studies (OR 4.61, 95% CI: 2.35, 9.05). The highest self-reported IT skill was e-mailing followed by surfing the World Wide Web and word-processing. Male students and junior students had significantly higher self-reported IT literacy scores compared to female students and senior students. Significant predictors for an IT identifier score after adjusting for other variables were self-reported rating of computer knowledge, number of siblings, parents' income and gender.
  3. Bulgiba AM, Fisher MH
    Health Informatics J, 2006 Sep;12(3):213-25.
    PMID: 17023409 DOI: 10.1177/1460458206066665
    The study investigated the effect of different input selections on the performance of artificial neural networks in screening for acute myocardial infarction (AMI) in Malaysian patients complaining of chest pain. We used hospital data to create neural networks with four input selections and used these to diagnose AMI. A 10-fold cross-validation and committee approach was used. All the neural networks using various input selections outperformed a multiple logistic regression model, although the difference was not statistically significant. The neural networks achieved an area under the ROC curve of 0.792 using nine inputs, whereas multiple logistic regression achieved 0.739 using 64 inputs. Sensitivity levels of over 90 per cent were achieved using low output threshold levels. Specificity levels of over 90 per cent were achieved using threshold levels of 0.4-0.5. Thus neural networks can perform as well as multiple logistic regression models even when using far fewer inputs.
  4. Choo WY, Hairi NN, Sooryanarayana R, Yunus RM, Hairi FM, Ismail N, et al.
    BMJ Open, 2016 05 25;6(5):e011057.
    PMID: 27225651 DOI: 10.1136/bmjopen-2016-011057
    INTRODUCTION: Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences.

    METHODS AND ANALYSIS: This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression.

    ETHICS AND DISSEMINATION: The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences.

  5. Dahlui M, Azahar N, Bulgiba A, Zaki R, Oche OM, Adekunjo FO, et al.
    PLoS One, 2015;10(12):e0143749.
    PMID: 26658767 DOI: 10.1371/journal.pone.0143749
    HIV/AIDS remain a major public health concern in Nigeria. People living with HIV/AIDS (PLWHA) face not only personal medical problems but also social problems associated with the disease such as stigma and discriminatory attitudes. This study provides an insight into HIV/AIDS related stigma and discrimination against PLWHA in Nigeria.
  6. Dahlui M, Ng C, Al-Sadat N, Ismail S, Bulgiba A
    Asian Pac J Cancer Prev, 2011;12(2):369-72.
    PMID: 21545196
    OBJECTIVES: This study aimed to determine the rate of breast self examination (BSE) among the female staff of University of Malaya and to determine the role of BSE in detecting breast abnormalities.

    METHODS: A total of 1598 questionnaires were posted to all female staff, aged 35 years and above. Their knowledge on breast cancer, practice of BSE and detection rate of breast abnormality as confirmed by CBE was determined.

    RESULTS: The response rate for this study was 45 percent (714 respondents). The rate of respondents having awareness on breast cancer was 98.7 percent. Eighty four percent (598) of the respondents had performed BSE in their lifetime. However, in only 41% was it regular at the recommended time. Forty seven percent (334) had undergone CBE at least once in a lifetime but only 26% (185) had CBE at least once in the past 3 years, while 23% (165) had had a mammogram. There was a significant relationship between CBE and BSE whereby those who had CBE were twice more likely to do BSE. Nineteen percent (84 respondents) of those who did BSE claimed they had detected a breast lump. Of these, 87% (73) had gone for CBE and all were confirmed as such.

    CONCLUSION: BSE is still relevant as a screening tool of breast cancer since those who detect breast lump by BSE will most probably go for further check up. CBE should be done to all women, especially those at highest risk of breast cancer, to encourage and train for BSE.

  7. Eng JY, Moy FM, Bulgiba A
    PLoS One, 2016;11(2):e0148307.
    PMID: 26840508 DOI: 10.1371/journal.pone.0148307
    INTRODUCTION: Workplace health promotion is important in the prevention of non-communicable diseases among employees. Previous workplace health programs have shown benefits such as lowered disease prevalence, reduced medical costs and improved productivity. This study aims to evaluate the impact of a 6-year workplace health promotion program on employees' blood pressure in a public university.

    METHODS: In this prospective cohort study, we included 1,365 employees enrolled in the university's workplace health promotion program, a program conducted since 2008 and using data from the 2008-2013 follow-up period. Participants were permanent employees aged 35 years and above, with at least one follow up measurements and no change in antihypertensive medication during the study period. Baseline socio-demographic information was collected using a questionnaire while anthropometry measurements and resting blood pressure were collected during annual health screening. Changes in blood pressure over time were analyzed using a linear mixed model.

    RESULTS: The systolic blood pressure in the hypertension subgroup decreased 2.36 mmHg per year (p<0.0001). There was also significant improvement in systolic blood pressure among the participants who were at risk of hypertension (-0.75 mmHg, p<0.001). The diastolic blood pressure among the hypertensive and at risk subgroups improved 1.76 mmHg/year (p<0.001) and 0.56 mmHg/year (p<0.001), respectively. However, there was no change in both systolic and diastolic blood pressure among participants in the healthy subgroup over the 6-year period.

    CONCLUSION: This study shows that continuing participation in workplace health promotion program has the potential to improve blood pressure levels among employees.

  8. Eng JY, Moy FM, Bulgiba A, Rampal S
    J Acad Nutr Diet, 2018 07;118(7):1249-1262.e3.
    PMID: 29615325 DOI: 10.1016/j.jand.2018.01.014
    BACKGROUND: Dietary pattern analysis is a complementary method to nutrient analysis in evaluating overall diet-disease hypotheses. Although studies have been conducted to derive dietary patterns among Malaysians, their consistency across subgroups has not been examined.

    OBJECTIVE: The study aimed to derive dietary patterns empirically and to examine the consistency and generalizability of patterns across sex, ethnicity, and urban status in a working population.

    DESIGN: This was a cross-sectional study using data from the Clustering of Lifestyle Risk Factors and Understanding its Association with Stress on Health and Well-Being among School Teachers in Malaysia study collected between August 2014 and November 2015. Dietary intake was assessed using a food frequency questionnaire, and dietary patterns were derived using factor analysis.

    PARTICIPANTS/SETTING: Participants were teachers from selected public schools from three states in Peninsular Malaysia (n=4,618).

    MAIN OUTCOME MEASURES: Dietary patterns derived using factor analysis.

    STATISTICAL ANALYSES PERFORMED: Separate factor analysis was conducted by sex, ethnicity, and urban status to identify dietary patterns. Eigenvalue >2, scree plot, Velicer's minimum average partial analysis, and Horn's parallel analysis were used to determine the number of factors to retain. The interpretability of each dietary pattern was evaluated. The consistency and generalizability of dietary patterns across subgroups were assessed using the Tucker congruence coefficient.

    RESULTS: There was no subgroup-specific dietary pattern found. Thus, dietary patterns were derived using the pooled sample in the final model. Two dietary patterns (Western and Prudent) were derived. The Western dietary pattern explained 15.4% of total variance, characterized by high intakes of refined grains, animal-based foods, added fat, and sugar-sweetened beverages as well as fast food. The Prudent dietary pattern explained 11.1% of total variance and was loaded with pulses, legumes, vegetables, and fruits.

    CONCLUSIONS: The derived Western and Prudent dietary patterns were consistent and generalizable across subgroups of sex, ethnicity, and urban status. Further research is needed to explore associations between these dietary patterns and chronic diseases.

  9. Fadzil SS, Bulgiba A
    Asia Pac J Public Health, 2024 Jan;36(1):119-122.
    PMID: 37864305 DOI: 10.1177/10105395231207234
    Commuting accidents account for 48% of work-related accidents in Malaysia. However, commuting accidents among health care workers are understudied and formally reported commuting accident numbers among nurses are likely to be an underestimate of actual numbers. This is the first study in Malaysia to attempt to establish the true incidence and associated factors for commuting accidents among nurses in Malaysia. A cross-sectional study was conducted to determine the true incidence of commuting accidents and its associated factors among public hospital nurses in Selangor, Malaysia. A validated and pilot-tested self-reported questionnaires were distributed to all nurses via an online-based platform. This study found a significant difference between the incidence of formally reported and self-reported commuting accidents from 2018 to 2022, with incidence rates ranging between 0.3 and 8.6 per 1000 nurses. Multivariable logistic regression showed that nurses working in district hospitals had lower odds to be involved in commuting accidents, while nurses working in clinical departments and traveling longer distances between home and workplaces had increased odds of commuting accidents.
  10. Ghane Kisomi M, Wong LP, Tay ST, Bulgiba A, Zandi K, Kho KL, et al.
    PLoS One, 2016;11(6):e0157987.
    PMID: 27341678 DOI: 10.1371/journal.pone.0157987
    BACKGROUND: Farmworkers are at high-risk for tick bites, which potentially transmit various tick-borne diseases. Previous studies show that personal prevention against tick bites is key, and certain factors namely, knowledge, experience of tick bites, and health beliefs influence compliance with tick bites preventive behaviour. This study aimed to assess these factors and their associations with tick bite preventive practices among Malaysian farmworkers.

    METHODS: A total of eight cattle, goat and sheep farms in six states in Peninsular Malaysia participated in a cross-sectional survey between August and October 2013.

    RESULTS: A total of 151 (72.2%) out of 209 farmworkers answered the questionnaire. More than half of the farmworkers (n = 91) reported an experience of tick bites. Farms with monthly acaricide treatment had significantly (P<0.05) a low report of tick bites. Tick bite exposure rates did not differ significantly among field workers and administrative workers. The mean total knowledge score of ticks for the overall farmworkers was 13.6 (SD±3.2) from 20. The mean total tick bite preventive practices score for all farmworkers was 8.3 (SD±3.1) from 15. Fixed effect model showed the effects of four factors on tick bite prevention: (1) farms, (2) job categories (administrative workers vs. field workers), (3) perceived severity of tick bites, and (4) perceived barriers to tick bite prevention.

    CONCLUSIONS: A high proportion of farmworkers, including administrative workers, reported an experience of tick bites. The effectiveness of monthly acaricide treatment was declared by low reports of tick bites on these farms. Tick bite preventive practices were insufficient, particularly in certain farms and for administrative workers. Our findings emphasise the need to have education programmes for all farmworkers and targeting farms with low prevention practices. Education and health programmes should increase the perception of the risk of tick bites and remove perceived barriers of tick bite prevention.

  11. Ghane Kisomi M, Wong LP, Tay ST, Bulgiba A, Nizam QNH
    J Infect Dev Ctries, 2019 12 31;13(12):1117-1126.
    PMID: 32088699 DOI: 10.3855/jidc.11668
    INTRODUCTION: Farmworkers are considered a high-risk group for tick-borne diseases (TBDs). This qualitative study aimed to gain an in-depth understanding of the farmworkers' experience, knowledge, health beliefs, information needs, and preventive practices of tick bites and TBDs.

    METHODOLOGY: A total of nine focus group discussions with 56 farmworkers across eight animal farms in Peninsular Malaysia were conducted between August and October 2013.

    RESULTS: Farmworkers explained their experience of tick bites, but no one reported TBDs. Many farmworkers indicated that they did not seek any medical treatment. There was a misconception that ticks are solely pathogenic to farm animals. Farmworkers perceived low severity and susceptibility of tick bites, and low self-efficacy of tick bite prevention, however, a group also perceived susceptibility to getting tick bites due to the characteristics of their job. Barriers for prevention were related to the perception and knowledge towards ticks. Farmworkers requested information about TBDs.

    CONCLUSIONS: This study of farmworkers identified gaps in the knowledge of TBDs, barriers of the tick bite preventive measures and information needs. These findings suggest a need for education programs to improve the knowledge of ticks and TBDs, change health beliefs and address the barriers of tick bite preventive measures.

  12. Hairi NN, Bulgiba A, Peramalah D, Mudla I
    Prev Med, 2013 Jan;56(1):8-11.
    PMID: 23103916 DOI: 10.1016/j.ypmed.2012.10.016
    Managing stairs is a challenging activity of daily living (ADL) for older people. This study aims to examine the association between visual impairment and difficulty in managing stairs among older people living alone and those living with others.
  13. Hairi NN, Bulgiba A, Mudla I, Said MA
    Prev Med, 2011 Oct;53(4-5):343-6.
    PMID: 21864564 DOI: 10.1016/j.ypmed.2011.07.020
    To determine prevalence and prevalence ratio of functional limitation amongst older people with combined chronic diseases and co-morbid depressive symptoms compared with older people with either chronic disease or depressive symptoms alone.
  14. Hairi NN, Bulgiba A, Cumming RG, Naganathan V, Mudla I
    BMC Public Health, 2010;10:492.
    PMID: 20716377 DOI: 10.1186/1471-2458-10-492
    The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries.
  15. Ismail I, Bulgiba A
    PLoS One, 2013;8(8):e73250.
    PMID: 23951346 DOI: 10.1371/journal.pone.0073250
    BACKGROUND: Mortality among TB/HIV co-infected patients is still high particularly in developing countries. This study aimed to determine the predictors of death in TB/HIV co-infected patients during TB treatment.
    METHODS: We reviewed medical records at the time of TB diagnosis and subsequent follow-up of all newly registered TB patients with HIV co-infection at TB clinics in the Institute of Respiratory Medicine and three public hospitals in the Klang Valley between January 2010 and September 2010. We reviewed these medical records again twelve months after their initial diagnosis to determine treatment outcomes and survival. We analysed using Kaplan-Meier and conducted multivariate Cox proportional hazards analysis to identify predictors of death during TB treatment in TB/HIV co-infected patients.
    RESULTS: Of the 227 patients studied, 53 (23.3%) had died at the end of the study with 40% of deaths within two months of TB diagnosis. Survival at 2, 6 and 12 months after initiating TB treatment were 90.7%, 82.8% and 78.8% respectively. After adjusting for other factors, death in TB/HIV co-infected patients was associated with being Malay (aHR 4.48; 95%CI 1.73-11.64), CD4 T-lymphocytes count < 200 cells/µl (aHR 3.89; 95% CI 1.20-12.63), three or more opportunistic infections (aHR 3.61; 95% CI 1.04-12.55), not receiving antiretroviral therapy (aHR 3.21; 95% CI 1.76-5.85) and increase per 10(3) total white blood cell count per microliter (aHR 1.12; 95% CI 1.05-1.20).
    CONCLUSION: TB/HIV co-infected patients had a high case fatality rate during TB treatment. Initiation of antiretroviral therapy in these patients can improve survival by restoring immune function and preventing opportunistic infections.
  16. Ismail I, Bulgiba A
    Prev Med, 2013;57 Suppl:S27-30.
    PMID: 23295172 DOI: 10.1016/j.ypmed.2012.12.023
    To determine predictors of unsuccessful treatment in HIV-infected tuberculosis (TB) patients.
  17. Ismail N, Hairi F, Choo WY, Hairi NN, Peramalah D, Bulgiba A
    Asia Pac J Public Health, 2015 Nov;27(8 Suppl):62S-72S.
    PMID: 26058900 DOI: 10.1177/1010539515590179
    Physical Activity Scale for the Elderly (PASE) is among the frequently used self-reported physical activity assessment for older adults. This study aims to assess the validity and reliability of a Malay version of this scale (PASE-M). A total of 408 community-dwelling older adults were enrolled. Concurrent validity was evaluated by Spearman's rank correlation coefficients between PASE with physical and psychosocial measures. Test-retest reliability was determined by the intraclass correlation coefficient (ICC). The mean PASE-M scores at baseline and follow-up were 94.96 (SD 62.82) and 92.19 (SD 64.02). Fair to moderate correlation were found between PASE-M and physical function scale, IADL (rs = 0.429, P < .001), walking speed (rs = 0.270, P < .001), grip strength (rs = 0.313-0.339, P < .001), and perceived health status (rs = -0.124, P = .016). Test-retest reliability was adequate (ICC = 0.493). The Malay version of PASE was shown to have acceptable validity and reliability. This tool is useful for assessing the physical activity level of elderly Malaysians.
  18. Jayaraj VJ, Ng CW, Bulgiba A, Appannan MR, Rampal S
    PLoS Negl Trop Dis, 2022 Nov;16(11):e0010887.
    PMID: 36346816 DOI: 10.1371/journal.pntd.0010887
    Malaysia has reported 2.75 million cases and 31,485 deaths as of 30 December 2021. Underestimation remains an issue due to the underdiagnosis of mild and asymptomatic cases. We aimed to estimate the burden of COVID-19 cases in Malaysia based on an adjusted case fatality rate (aCFR). Data on reported cases and mortalities were collated from the Ministry of Health official GitHub between 1 March 2020 and 30 December 2021. We estimated the total and age-stratified monthly incidence rates, mortality rates, and aCFR. Estimated new infections were inferred from the age-stratified aCFR. The total estimated infections between 1 March 2020 and 30 December 2021 was 9,955,000-cases (95% CI: 6,626,000-18,985,000). The proportion of COVID-19 infections in ages 0-11, 12-17, 18-50, 51-65, and above 65 years were 19.9% (n = 1,982,000), 2.4% (n = 236,000), 66.1% (n = 6,577,000), 9.1% (n = 901,000), 2.6% (n = 256,000), respectively. Approximately 32.8% of the total population in Malaysia was estimated to have been infected with COVID-19 by the end of December 2021. These estimations highlight a more accurate infection burden in Malaysia. It provides the first national-level prevalence estimates in Malaysia that adjusted for underdiagnosis. Naturally acquired community immunity has increased, but approximately 68.1% of the population remains susceptible. Population estimates of the infection burden are critical to determine the need for booster doses and calibration of public health measures.
  19. Kho KL, Koh FX, Hasan LI, Wong LP, Kisomi MG, Bulgiba A, et al.
    Emerg Microbes Infect, 2017 Apr 12;6(4):e18.
    PMID: 28400593 DOI: 10.1038/emi.2017.4
    Rickettsioses are emerging zoonotic diseases that are often neglected in many countries in Southeast Asia. Rickettsial agents are transmitted to humans through exposure to infected arthropods. Limited data are available on the exposure of indigenous community and animal farm workers to the aetiological agents and arthropod vectors of rickettsioses in Peninsular Malaysia. Serological analysis of Rickettsia conorii and Rickettsia felis was performed for 102 individuals from the indigenous community at six rural villages and 87 workers from eight animal farms in Peninsular Malaysia in a cross-sectional study. The indigenous community had significantly higher seropositivity rates for R. conorii (P<0.001) and R. felis (P<0.001), as compared to blood donors from urban (n=61). Similarly, higher seropositivity rates for R. conorii (P=0.046) and R. felis (P<0.001) were noted for animal farm workers, as compared to urban blood donors. On the basis of the sequence analysis of gltA, ompA and ompB, various spotted fever group rickettsiae closely related to R. raoultii, R. heilongjiangensis, R. felis-like organisms, R. tamurae, Rickettsia sp. TCM1, R. felis, Rickettsia sp. LON13 and R. hulinensis were identified from tick/flea samples in animal farms, indigenous villages and urban areas. This study describes rickettsial seropositivity of the Malaysian indigenous community and animal farm workers, and provides molecular evidence regarding the presence of rickettsial agents in ticks/fleas infesting domestic animals in Peninsular Malaysia.
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