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Fulltext Perceived susceptibility to chronic disease among healthy people questionnaire: development, validity and reliability among young Iraqi adults

Harith Alaa, Shamsul Azhar Shah

Malaysian Journal of Public Health Medicine, 2018;18(1):1-7.
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Chronic non-communicable diseases are the new emerging epidemic, and they are thought to challenge only rich countries; cardiovascular disease, cancer, diabetes, and other non-communicable diseases (NCDs) are now the leading cause of death and disability in low-income and middle-income countries, where they killed almost 8 million people younger than 60 years in 2013. Therefore, there is a need to develop a valid and reliable tool to measure the beliefs that influence people’s general behaviour, and a used to measure beliefs about chronic disease perceived susceptibility. The purpose of this study was to develop and validate the use of perception questionnaire among the young Iraqi adults. A total of 200 young adults participated who are free from any chronic diseases under study, and are living in Baghdad. The questionnaire, validated by an expert’s panel, translated to Arabic language, and pretested. Analyses included descriptive statistics of all the study variables, reliability estimates, and construct validity using confirmatory factor analysis (CFA). Results showed that mean age of respondents was 30 years old, majority were males 71.5%, and EFA showed that factor loading was more than 0.4. CFA results show that Chi-square (df) = 1.213(2); p value (>0.05) = 0.297. Internal consistency reliability analysis on health-related behaviour; special practice, information seeking and perceived probability of diseases have good Cronbach’s α value of between 0.8 - 0.9. These findings revealed that validation is favourable and can be utilized on larger scale of sample to proceed with main study on chronic disease perceived susceptibility among healthy people.
Fulltext Apolipoprotein E genotypes and behavioural and psychological symptoms of dementia (BPSD) in Malaysian patients with dementia

Rosdinom Razali, Zanariah Mat Saher, Elinda Tunan, Wan Zurinah Wan Ngah, Then Sue Mian, Suriati Mohamed Saini, et al.

Sains Malaysiana, 2013;42(3):409-416.

The aim of this study was to determine the relationships between ApoE genotypes and ‘behavioural and psychological symptoms of dementia’ (BPSD). A cross-sectional study was conducted on 46 outpatients with dementia (aged 60 and above) and their caregivers attending the psychogeriatric clinics at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and Hospital Kuala Lumpur. Neuropsychiatric Inventory (NPI) was used for the assessment of BPSD. The patients’ blood samples were taken for Apolipoprotein genotyping after consented by the caregivers. There were more female (69.6%) and Chinese (50%) patients with a mean age of 73.7 years. ApoE ε3/ε3 was the most common ApoE allele (60.7%) and mostly found in Chinese patients. ApoE genotype was significantly associated with ethnicity (p=0.03) and marital status (p=0.01). Alzheimer disease was the most common subtype of dementia (41.3%) and the highest carrier of ApoE ε3/ε3 (30.4%). The ApoE ε4/ ε4 scored highest in BPSD median score 44 (17.5 to 90) but the relationships
between ApoE genotypes and subtypes of dementia or BPSD scores were not significant (p=0.20; p=0.64). Agitation was the most common symptom, with delusions showing the highest scores on the NPI with no significant association to ApoE 4 allele. In conclusion, there was no significant relationship between ApoE genotypes and severity or types of BPSD in dementia patients.
Fulltext Risk factors of insulin refusal among type 2 diabetes mellitus patients with poor glycaemic control at Tanglin Health Clinic, Kuala Lumpur

Puvanese Rebecca Pillai Simon, Salmiah Md. Said, Ahmad Zaid Fattah, Shamsul Azhar Shah

Malaysian Journal of Medicine and Health Sciences, 2019;15(2):84-92.
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Introduction: The number of patients with poor glycaemic control who refuse insulin therapy is alarming. Factors that contribute to insulin refusal are important to study to identify high risk groups so that appropriate measures can be taken to prevent progression of uncontrolled diabetes. The objective of this study is to determine the risk factors of insulin refusal among type 2 diabetes mellitus patients with poor glycaemic control at Tanglin Health Clinic, Kuala Lumpur, Malaysia. Methods: A case control study was conducted among 216 cases and 230 controls using stratified sampling method. Cases were defined as patients with HbA1C more than 7.5% but not on insulin therapy despite being offered by the doctor whereas controls consist of patients with HbA1C of more than 7.5% but already on insulin therapy. Data was collected from April until May 2018, using a self-administered questionnaire. Analysis was done via IBM SPSS version 23.0. Results: Response rate for cases was 93.9% and response rate for controls was 100%. Risk factors of insulin refusal among poor glycaemic control includes age above 60 years old, tertiary level education, duration of diabetes less than 10 years, poor level of knowledge on insulin, fear on injection pain and fear to bruising due to injections. Conclusion: Hence, efforts must be taken to tackle the modifiable factors such as knowledge on insulin and diabetes, and fear on injections and bruises.
Fulltext Prevalence and factors associated with overweight and obesity among healthcare workers in Pejabat Kesihatan Daerah Melaka Tengah

Syafiq Taib, Siti Nor Mat, Norzaher Ismail, Fairuz Rahmat, Noor Aizam Said, Shamsul Azhar Shah

Int J Public Health Res, 2019;9(2):117-1126.
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Overweight and obesity are a serious public health problem globally. Healthcare workers in some countries have been reported to be having a high prevalence of being overweight despite them being well informed of the aetiology and risks of excessive body weight. However, the problem of being overweight and obese among Malaysian healthcare workers is still poorly understood. The aim of this study is to assess the prevalence and factors associated with overweight and obesity among healthcare workers in Pejabat Kesihatan Daerah (PKD) Melaka Tengah.
Fulltext Internal consistency study of EORTC QLQ-C30 and QLQ-PR25 questionnaires for quality of life assessment among prostate cancer patients in a University Hospital, Kuala Lumpur, Malaysia

Norzaher Ismail, Shamsul Azhar Shah, Nazarudin Safian, Syafiq Taib, Siti Nor Mat

Int J Public Health Res, 2020;10(1):1158-1165.
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Prostate cancer is forth most common diagnosed tumors in Malaysian male. The use of a self-reported, quality of life assessment is important for clinical practice, care taker and researcher to evaluate the level of quality of life. The aim of this study was to measure the internal consistency of the translated Malay Language EORTC QLQ-C30 and EORTC PR-25 questionnaires among prostate cancer patient at National University of Malaysia hospital in Kuala Lumpur, Malaysia.
Fulltext HPV positivity and its' influencing factors among invasive cervical cancer women in Malaysia

Sharifa Ezat Wan Puteh, Norin Rahayu Samsuddin, Sharifah Noor Akmal Syed Hussain, Shamsul Azhar Shah, Syed Mohamed Aljunid

Int J Public Health Res, 2011;1(1):13-22.
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Accepted 10 August 2011.
Introduction Cervical cancer (CC) is the second most prevalent female cancer in Malaysia. Almost 70% of its’ causal factors are attributable to oncogenic human papillomavirus (HPV) types 16, 18 and other risk factors. HPV genotypes distributions are also noted to differ by geographical area.
Methods This was cross sectional study conducted in 2007, to determine the influencing factors of HPV positivity and prevalence of HPV infections among patients with cervical cancer in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Patients’ paraffin-embedded cervical tissues kept in the Pathology Department from 1999 to 2007 were randomly selected. A total of 81 medical records with complete information were chosen as samples and patients were contacted for consent. Tissue samples were further derived for PCR DNA for HPV genotyping. Analyses included descriptive statistics; bivariate χ2 test and correlation were used to determine relationship between factors and HPV positivity. Significance level of less than 0.05 was taken as statistically significant.
Results Mean age of cancer diagnosis was at 52 ± 12.2 years. Women of Chinese ethnicity was the highest ethnicity to be HPV positive at 65.4% and squamous cell carcinoma was more commonly found (59.3%) compared with other types of cancers. The prevalence of HPV positivity was 92.6% with type 16 being the most common (74.1%), followed by type 33 (30.9%) and 18 (22.2%). Multiple HPV infections were a common finding at 54.3%. Factors thought to influence positivity i.e. age of intercourse, number of sexual partners, number of parity, smoking status of patients and their partners, oral contraceptive usage, presence of chronic illnesses and cancer stage were not significantly associated with HPV positivity. Increased CC severity level was not associated with increased number of HPV infections (Pearson correlation 0.58; p =0.607).
Conclusions High HPV positivity at 92.6% was found among ICC patients. Factors thought to influence HPV positivity were not significant. The top three HPV genotypes were type 16 followed by type 33 and 18. However, local women HPV serotypes findings need to be replicated in a larger population sample.
Fulltext Neighbourhood factors on mental health questionnaire: development, validity, and reliability among Malaysian adolescents

Zahir Izuan Azhar, Shamsul Azhar Shah, Tan, Susan, M.K., Syed Sharizman Syed Abdul Rahim

Int J Public Health Res, 2016;6(1):713-718.
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Introduction The risk factors associated with mental health among adolescents are usually
described by researchers at an individual level. Neighbourhood factors and
health have opened a new insight into the field of epidemiology. The aim of
this study was to assess the reliability and validity of a newly developed
Neighbourhood Factors on Mental Health Questionnaire among Malaysian
adolescents.

Methods A cross-sectional study was conducted in four secondary schools in Kuala
Lumpur, Malaysia using a newly developed questionnaire which comprised
of two main domains and seven items. Exploratory factor analysis and
Cronbach‟s alpha were used to measure the instrument‟s construct validity
and reliability.

Results A total of 106 adolescents participated in this research. The majority of
adolescents were 13 years old (40.6%), female (55.7%), Malays (68.9%),
have parents who only studied until secondary school (66.0%) and lived in
flats (32.1%). Bartlett‟s Test of Sphericity was significant (Chi-square =
258.361, p
Neighbourhood influences and its association with the mental health of adolescents in Kuala Lumpur, Malaysia

Zahir Izuan A, Shamsul Azhar S, Tan MKS, Syed-Sharizman SAR

Asian J Psychiatr, 2018 Dec;38:35-41.
PMID: 30408711 DOI: 10.1016/j.ajp.2018.10.018

BACKGROUND: Mental health problems are affecting more children and adolescents worldwide. Individual, family and school factors are often linked with mental health problems among adolescents.
AIM: To determine the neighbourhood factors influencing the prevalence of abnormal mental health status among adolescents in an urban population.
METHOD: A cross-sectional study was conducted among adolescents aged 13, 14 and 16 years old from thirteen secondary schools in Kuala Lumpur using validated questionnaires. A total of 567 adolescents participated in this study.
RESULTS: The prevalence of abnormal mental health status in this study was 4.4%. In multivariable analysis, female (OR = 1.79, 95%CI: 1.11-2.89), having divorced parents (OR = 3.53, 95%CI: 1.96-6.36), high educational stress (OR = 8.18, 95%CI: 4.25-15.75), medium educational stress (OR = 2.99, 95%CI: 1.53-5.83), whose house has been broken in before (OR = 2.02, 95%CI: 1.11-3.68) and living in a neighbourhood with low socioeconomic status (OR = 2.09, 95%CI: 1.23-3.56) were more likely to have abnormal mental health status.
CONCLUSIONS: Neighbourhood factors were found to be significant in determining adolescents' mental health status. The findings emphasize the importance of those in the public health sector to highlight these significant neighbourhood factors to the Ministry of Housing and Local Government. Swift action needs to be taken by the Ministry to provide solutions related to the neighbourhood factors and this can contribute to improvement in the adolescents' mental health.
Fulltext Penggunaan aplikasi GIS dalam penyakit tuberkulosis di Cheras, Kuala Lumpur, Malaysia

Shamsul Azhar Shah, Md. Idris Mohd. Nor, Abdul Hadi Harman Shah, Tahir Aris

Malaysian Journal of Public Health Medicine, 2002;2(2):15-26.
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Tuberkulosis merupakan penyakit yang masih meigadi masalah kesihatan di seluruh dunia amnya dan di Malaysia khasnya. Kajian telah dilakukan ali Cheras, Kuala Lumpur menggunakan aplikasi GIS untuk mengenalpasti taburan geografi dan tren tuberkulosis daripada tahun 1996 sehingga tahun 2000. Kajian ini juga dilakukan untuk melihat kebolehan GIS sebagai alat surveilan penyakit beyangkit. Hasil kajian dengan menggunakan aplikasi GIS mendapati tren peningkatan tuberkulosis di kawasan·kawasan yang tertentu di Cheras. Penumpuan kes-kes tuberkulosis dapat dilihat di kawasan taburan penduduk yang kepadatan tinggi dan sederhana tinggi terutama di kawasan Kampung Pandan, kawasan penempatan Jalan Cheras dan Bandar Tun Razak. Kes—kes tersebut juga kebanyakannya adalah dalam lingkungan 100 meter ke 200 meter di antara satu sama lain. Kesimpulannya secara am, aplikasi GIS memberikan dimensi baru dalam kawalan penyakit dan ia pasti dapat digunakan dalam membantu aktiviti surveilan penyakit tuberkulosis.
Fulltext Factors related to low birth weight babies in Baghdad City, Iraq

Mohammed A. Abdal Qader, Shamsul Azhar Shah, Zaleha Md Isa, Hasanain Faisal Ghazi, Idayu Badilla, Tiba Nezar Hasan

Malaysian Journal of Public Health Medicine, 2014;14(2):45-49.
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Great importance has been attributed to birth weight all over the world because it is considered as one of the best predictors of prenatal survival and a good indicator of quality life. The objective of this study was to determine the prevalence of low birth weight babies (LBW) and factors related to it in Baghdad city. A cross sectional study was carried out in four general hospitals in Baghdad city, Iraq. A total of 225 newborn babies, alive, singleton and without congenital malformation were selected randomly from these four general hospitals.The result of the study showed the prevalence rate of low birth weights was 21.3%. Mothers’ educational level, monthly family income, mothers with chronic hypertension, mothers with history of previous low birth weight infants and anemic mothers were significantly associated with low birth weight babies (P= 0.03, 0.01, 0.02,