This study sought to understand the factors associated with street racing among the illegal motorcycle racers in Malaysia or known as the "Mat Rempit".
With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs.
Deficiencies of micronutrients can affect the growth and development of children. There is increasing evidence of vitamin D deficiency world-wide resulting in nutritional rickets in children and osteoporosis in adulthood. Data on the micronutrient status of children in Malaysia is limited. The aim of this study was to determine the anthropometric and micronutrient status of primary school children in the capital city of Kuala Lumpur.
Betel quid chewing is a common habit widely practiced in Southern Asian populations. However, variations are seen in the content of a betel quid across the different countries. Factors associated with commencement and cessation of this habit has been numerously studied. Unfortunately, data on Malaysian population is non-existent. This study aims to determine the factors associated with the inception and also cessation of betel quid chewing behaviour among Malaysian adults.
A1. The post discharge stroke care services in Malaysia: a pilot analysis of self-reported practices of family medicine specialists at public health centres
Authors: Aznida Firzah Abdul Aziz, Nor Azah Aziz, Saperi Sulong and Syed Mohamed Aljunid
A2. Home-based carer-assisted therapy for people with stroke: findings from a randomised controlled trial
Authors: Nor Azlin Mohd Nordin, Noor Azah Aziz, Saperi Sulong and Syed Mohamed Aljunid
A3. Disaster management: a study on knowledge, attitude and practice of emergency nurse and community health nurse
Authors: Nurul’Ain Ahayalimudin, Aniza Ismail and Ismail Mohd Saiboon
A4. Patient-reported outcomes after one year of periodontal treatment at public specialist dental clinics in Peninsular Malaysia
Authors: Tuti Ningseh Mohd Dom, Syed Mohamed Al Junid, Mohd Rizal Abd Manaf, Khairiyah Abd Muttalib, Ahmad Sharifuddin Mohd Asari, Rasidah Ayob, Yuhaniz Ahmad Yaziz, Noorlin Ishak, Hanizah Abdul Aziz and Noordin Kasan
A5. Level of patients' satisfaction toward National Health Insurance in Istanbul City-Turkey
Authors: Saad Ahmed Ali Jadoo, Sharifa Ezat Wan Puteh, Zafar Ahmed and Ammar Jawdat
A6. Epidemiological pattern of acute respiratory infection among under-fives in Almazar Aljanoubi District -South Jordan
Authors: Ibrahim Al-nawaiseh, Ahmad Alkafajei, Jamal Hisham Hashim, Zaleha Md Isa, Nedal Awad Alnawaiseh and Samar Jameel Salahat
A7. Function and quality of life following stroke rehabilitation: have our stroke patients gained optimum recovery?
Authors: Nor Azlin Mohd Nordin, Noor Azah Aziz, Saperi Sulong and Syed Mohamed Aljunid
A8. Health impact of intimate partner violence and implication on services in Malaysia
Authors: Siti Hawa Ali, Tengku Nur Fadzilah Tengku Hassan, Halim Salleh and Harmy Mohamed Yusoff
A9. Human impact and financial loss of floods in Southeast Asia, from 2007 to 2011
Authors: Isidore Koffi Kouadio, Hasanain Faisal Ghazi and Syed Mohamed Aljunid
A10. Factors affecting demand for individual health insurance in Malaysia
Authors: Arpah Abu Bakar, Angappan Regupathi, Syed Mohamed Aljunid and Mohd Azahadi Omar
A11. Case control study on risk factors associated with esophageal cancer in Yemen
Authors: Al-abed Ali Ahmed Al-abed, Azmi Mohd Tamil and Sami Abdo Radman Al-Dubai
A12. Obesity and the poor women living in urban slum areas: health system response
Authors: Digna N Purwaningrum, Mubasysyir Hasanbasri and Laksono Trisnantoro
A13. Potential of mobile technology in meeting the public health needs in developing countries
Authors: Isidore Koffi Kouadio, Hasanain Faisal Ghazi, Namaitijiang Maimaiti, Azam Rahimi and Syed Mohamed Aljunid
A14. Quality of life among Jordanian patients on haemodialysis and their caregivers
Authors: Emad A Shdaifat and Mohd Rizal Abdul Manaf
A15. Patient satisfaction with services in physiotherapy clinics: a cross sectional study at teaching hospitals in Klang Valley
Authors: Mohamad Nasaruddin Mahdzir and Aniza Ismail
A16. How should the health system react to informal drug dispensaries? The case of self-medication in Yogyakarta Province
Authors: Eunice Setiawan, Mubasysyir Hasanbasri and Laksono Trisnantoro
A17. Cervical cancer in Malaysia: can we improve our screening and preventive practice?
Authors: Shanthi Varatharajan, M Majdah, Syed Aljunid, Won-Sun Chen, A Mukarramah and Chee-Meng Yong
A18. Burden of risk factors for non-communicable diseases: an epidemiological review of the evidence from INDEPTH Health and Demographic Surveillance System (HDSS) in Indonesia
Authors: Dwidjo Susilo, Istiti Kandarina, Siwi Padmawati and Laksono Trisnantoro
A19. Carbonated drinks, chips intake and their relation to Intelligence Quotient (IQ) among primary school children in Baghdad city, Iraq
Authors: Hasanain Faisal Ghazi, Zaleha Md Isa, Mohammed A AbdalQader, Isidore Koffi Kouadio, Azam Rahimi, Namaitijiang Maimaiti and Syed Mohamed Aljunid
A20. Outcomes of home health care and telephone home visit by pharmacist in type 2 diabetes patients on hospital readmission: a case study at Bangplama Hospital, Suphanburi Province, Thailand
Authors: Nilawan Upakdee and Suwicha Mankongdee
A21. Selection of HMG-coenzyme A reductase inhibitors using multiattribute scoring tool
Authors: Azuana Ramli, Syed Mohamed Aljunid, Saperi Sulong and Faridah Aryani Mohd Yusof
A22. Role of microRNAs in the pathophysiology of sporadic colorectal cancer
Authors: Fung Lin Yong, Chee Wei Law and Chee Woon Wang
A23. Health systems, policies and infant mortality in developing countries
Authors:David Baguma, Jamal Hisham Hashim and Syed Mohamed Aljunid
A24. Health system for maternal health – a case study from Papua, Indonesia
Authors: Tiara Marthias and Laksono Trisnantoro
A25. Main challenges in developing biotechnology industry in Malaysia: perspectives from the innovative biotechnology firms
Authors: Gulifeiya Abuduxike, Syed Mohamed Aljunid and Saperi Sulong
A26. Periodontal disease as an indicator of chronic non-communicable diseases: evidence from literatures
Authors:Tuti Ningseh Mohd Dom, Shahida Mohd Said, Aznida Firzah Abdul Aziz, Mohd Rizal Abdul Manaf and Syed Mohamed Aljunid
A27. Alert Village: an awareness and health promotion programme on healthy behaviors
Authors: Asmaripa Ainy, Misnaniarti Makky and Nur Alam Fajar
A28. Burden of non-communicable diseases among the Orang Asli community and patient satisfaction on non-communicable diseases management at public health facilities
Authors: Netty Darwina and Sharifa Ezat Wan Puteh
A29. Beta-thalassaemia major – a public health problem in Malaysia: impacts, coping strategies and needs of parents with affected children
Authors: Nursalihah Muhammad, Jin Ai Mary Anne Tan, Elizabeth George and Wong Li Ping
A30. Incidence of bacterial meningitis in South East Asia region
Authors: Namaitijiang Maimaiti, Zaleha Md Isa, Azam Rahimi, Isidore Koffi Kouadio, Hasanain Faisal Ghazi and Syed Mohamed Aljunid
A31. Evidence-based budgeting policy in maternal and child health programme: do they work?
Authors: M Faozi Kurniawan, Deni Harbianto, Digna Purwaningrum and Tiara Marthias
A32. Improving mental health policy in the case of schizophrenia in Thailand: evidence-based information for efficient solutions
Authors: Pudtan Phanthunane, Theo Vos, Harvey Whiteford and Melanie Bertram
A33. A study on social determinants of infant mortality in Malaysia
Authors: Amaluddin Ahmad
A34. Expression of circulating micro-RNAs in hypertensive patients with left ventricular hypertrophy
Authors: Soh Zi Ling, Chee Kok Han, Wong Chew Ming and Wang Chee Woon
A35. The influence of mother’s embrace on the level of infant pain during injection
Authors:Arie Kusumaningrum and Regina Natalia
A36. Information needs as perceived by caregivers and patients following stroke: a qualitative systematic review
Authors: Nor Haty Hassan, Syed Mohamed Aljunid and Peter Davis
A37. Factors influencing willingness to pay for healthcare
Authors: Azimatun Noor Aizuddin, Saperi Sulong and Syed Mohamed Aljunid
A38. Influence of antenatal care on birth weight: a cross sectional study in Baghdad City, Iraq
Authors: Mohammed A Abdal Qader, Idayu Badilla, Rahmah Mohd Amin and Hasanain Faisal Ghazi
A39. Asthma treatment adherence among asthmatic patients in Yazd
Authors: Azam Rahimi, Saperi Sulong, Namaitijiang Maimaiti, Hasanain Faisal Ghazi, Koffi Isidore Kouadio and Hidayatulfathi Othman
A40. Cost analysis of colorectal cancer (CRC) management in UKM Medical Centre using clinical pathway
Authors: Natrah Mohd, Sharifa Ezat, Syed Mohamed Aljunid, Mohd Rizal Abdul Manaf, Saperi Sulong, Ismail Sagap and Muhd Azrif
The continuous increase in number of people living with HIV/AIDS (PLWHA) represents a serious health and economic burden. HIV positive individuals with oral lesions have significantly lower oral health-related quality of life than HIV positive individuals without oral lesions. The objective of this study was to assess the knowledge, attitude and practices (KAP) within a cohort of HIV/AIDS positive patients towards HIV/AIDS associated oral lesions.
In the health systems literature one can see discussions about the trade off between the equity achievable by the system and its efficiency. Essentially it is argued that as greater health equity is achieved, so the level of efficiency will diminish. This argument is borrowed from economics literature on market efficiency. In the application of the economic argument to health, however, serious errors have been made, because it is quite reasonable to talk of both health equity being a desirable output of a health system, and the efficient production of that output. In this article we discuss notions of efficiency, and the equity-efficiency trade off, before considering the implications of this for health systems.
Malaysia has relatively liberal abortion laws in that they permit abortions for both physical and mental health cases. However, abortion remains a taboo subject. The stagnating contraceptive prevalence rate combined with the plunging fertility rate suggests that abortion might be occurring clandestinely. This qualitative study aimed to explore the experiences of women and their needs with regard to abortion.
BACKGROUND: Tobacco consumption peak in developed countries has passed, however, it is on the increase in many developing countries. Apart from cigarettes, consumption of local hand-rolled cigarettes such as bidi and rokok daun are prevalent in specific communities. Although factors associated with smoking initiation and cessation has been investigated elsewhere, the only available data for Malaysia is on prevalence. This study aims to investigate factors associated with smoking initiation and cessation which is imperative in designing intervention programs.
METHODS: Data were collected from 11,697 adults by trained recording clerks on sociodemographic characteristics, practice of other risk habit and details of smoking such as type, duration and frequency. Smoking commencement and cessation were analyzed using the Kaplan-Meier estimates and log-rank tests. Univariate and multivariate Cox proportional hazard regression models were used to calculate the hazard rate ratios.
RESULTS: Males had a much higher prevalence of the habit (61.7%) as compared to females (5.8%). Cessation was found to be most common among the Chinese and those regularly consuming alcoholic beverages. Kaplan-Meier plot shows that although males are more likely to start smoking, females are found to be less likely to stop. History of betel quid chewing and alcohol consumption significantly increase the likelihood of commencement (p < 0.0001), while cessation was least likely among Indians, current quid chewers and kretek users (p < 0.01).
CONCLUSIONS: Gender, ethnicity, history of quid chewing and alcohol consumption have been found to be important factors in smoking commencement; while ethnicity, betel quid chewing and type of tobacco smoked influences cessation.
BACKGROUND: The increasing trend of premarital sexual experience and unintended pregnancies in Malaysia warrants sustained and serious attention. The sensitivities of sex-related issues in a Muslim-majority country create various types of barriers to sexual and reproductive health information, support and practices. This study aims to gain understanding of knowledge, attitudes and behaviours of young women in Malaysia concerning reproductive, contraception and premarital sexual practices.
METHODS: A cross-sectional study was performed, using an anonymous self-administered questionnaire carried out among 1695 female university students in a public university in Malaysia.
RESULTS: Respondents had low scores for knowledge of reproduction and pregnancy (median=4, of maximum score 10), contraceptive uses (median=6, of maximum score 16) and contraceptive availability (median=3, of maximum score 13). The majority of women surveyed do not have liberal values in relation to premarital sexual behaviour (median=37, of maximum 40); higher scores on this scale corresponded to opposing premarital sex. The multivariate analyses showed that ethnic group was the strongest correlate of knowledge and attitude scores; being of Malay Muslim ethnicity was associated significantly with lower knowledge scores and premarital sex permissiveness. Other significant correlates were year of study, maternal occupational groups, level of religious faith, dating status and urban-rural localities. Level of premarital sex permissiveness was inversely correlated with reproduction and pregnancy knowledge score, and contraceptive knowledge scores.
CONCLUSION: Reproductive health knowledge and attitudes were intricately linked to religious values and cultural norms differences surrounding sexual issues.
Malaysia has been at the forefront of the development and scale up of One-Stop Crisis Centres (OSCC) - an integrated health sector model that provides comprehensive care to women and children experiencing physical, emotional and sexual abuse. This study explored the strengths and challenges faced during the scaling up of the OSCC model to two States in Malaysia in order to identify lessons for supporting successful scale-up.
Segmented service delivery with consequent inefficiencies in health systems was one of the main concerns raised during scaling up of disease-specific programs in the last two decades. The organized response to NCD is in infancy in most LMICs with little evidence on how the response is evolving in terms of institutional arrangements and policy development processes.
BACKGROUND: Hepatitis B (HBV) is the leading cause of cirrhosis and hepatocellular carcinoma worldwide. This study assessed the knowledge, attitudes and practices of people with chronic HBV and the associated factors.
METHODS: This cross-sectional study was conducted at an outpatient adult hepatology clinic at a tertiary hospital in Kuala Lumpur. A self-administered questionnaire was administered on a one-to-one basis to assess knowledge, attitudes, and lifestyle practices of people with chronic HBV.
RESULTS: The response rate was 89% (n = 483/543). Participants had a mean age of 46.3 (±14.7) years and the mean duration of HBV from time of diagnosis was 12.2 (±8.8) years. The mean knowledge score was 12.57/20 (standard deviation: ±4.4, range: 0-19). Participants aged 30-39 years, with higher educational attainment, employed in professional jobs, longer duration of diagnosis and those without cirrhosis had significantly higher knowledge scores. Age, education level and duration of diagnosis were significant predictors of the knowledge score on standard multiple regression analysis. More than half of the participants were worried of spreading HBV infection to family and friends and worried since the diagnosis. A third of the participants (33.5%) were embarrassed to reveal their diagnosis to the public but most of them (93.6%) would inform their family. Those who reported feeling worried since their diagnosis were more likely to be middle-aged, of Malay ethnicity, have shorter duration of diagnosis of less than 10 years and have received therapy. About half of the participants (50.6%) did not share dining utensils and the majority (93.2%) believed that HBV can be transmitted by sharing of eating and drinking utensils. Older patients were significantly less likely to share utensils. Those who felt worried since diagnosis had significant higher knowledge of HBV.
CONCLUSION: The findings highlight the stigma and misconceptions that still exist among the HBV patients. More patient and public education about HBV and its prevention are essential to increase awareness and to demystify the disease.
Study site: Hepatology clinic, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
BACKGROUND: The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public-private) health system.
METHODS: In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010-11. Healthcare professionals consisting of general practitioners (n = 11), medical officers (n = 8), diabetes educators (n = 3), government policy makers (n = 4), family medicine specialists (n = 10) and endocrinologists (n = 2) were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach.
RESULTS: Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients' peer group sessions; increasing awareness and demystifying insulin via public campaigns; and subsidising glucose monitoring equipment. Finally, the healthcare professionals proposed the establishment of multidisciplinary teams as a strategy to increase the rate of insulin initiation. Having team members from different ethnic backgrounds would help to overcome language and cultural differences when communicating with patients.
CONCLUSION: The challenges faced by a dual-sector health system in delivering insulin initiation may be addressed by greater collaborations between the private and public sectors and governmental and non-government organisations, and among different healthcare professionals.
Study site: Healthcare professionals from three states (Wilayah Federal Territory, Negeri Sembilan and Selangor) and from both urban and semi-rural locations (including Klinik Kesihatan), Malaysia
Environmental factors play a very important role in the child development process, especially in a situation like that of Iraq. Thirteen years of economic sanctions followed by the 2003 war and 8 years of unstable security have affected the daily life of Iraqi families and children. The objective of this study was to assess the associations between living environment domains and child intelligence quotient (IQ) score.
This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children.
One of the challenges to maintain an agenda for universal coverage and equitable health system is to develop effective structuring and management of health financing. Global experiences with different systems of health financing suggests that a strong public role in health financing is essential for health systems to protect the poor and health systems with the strongest state role are likely the more equitable and achieve better aggregate health outcomes. Using Malaysia as a case study, this paper seeks to evaluate the progress and capacity of a middle income country in terms of health financing for universal coverage, and also to highlight some of the key underlying health systems challenges.The WHO Health Financing Strategy for the Asia Pacific Region (2010-2015) was used as the framework to evaluate the Malaysian healthcare financing system in terms of the provision of universal coverage for the population, and the Malaysian National Health Accounts (2008) provided the latest Malaysian data on health spending. Measuring against the four target indicators outlined, Malaysia fared credibly with total health expenditure close to 5% of its GDP (4.75%), out-of-pocket payment below 40% of total health expenditure (30.7%), comprehensive social safety nets for vulnerable populations, and a tax-based financing system that fundamentally poses as a national risk-pooled scheme for the population.Nonetheless, within a holistic systems framework, the financing component interacts synergistically with other health system spheres. In Malaysia, outmigration of public health workers particularly specialist doctors remains an issue and financing strategies critically needs to incorporate a comprehensive workforce compensation strategy to improve the health workforce skill mix. Health expenditure information is systematically collated, but feedback from the private sector remains a challenge. Service delivery-wise, there is a need to enhance financing capacity to expand preventive care, in better managing escalating healthcare costs associated with the increasing trend of non-communicable diseases. In tandem, health financing policies need to infuse the element of cost-effectiveness to better manage the purchasing of new medical supplies and equipment. Ultimately, good governance and leadership are needed to ensure adequate public spending on health and maintain the focus on the attainment of universal coverage, as well as making healthcare financing more accountable to the public, particularly in regards to inefficiencies and better utilisation of public funds and resources.
BACKGROUND: Three National Health and Morbidity Surveys (NHMSs) had been conducted in Malaysia in 10-year intervals from 1986-2006. Based on the latest NHMS survey in 2006, we describe the prevalence of smoking and identify the social and demographic factors associated with smoking among adult males in Malaysia.
METHODS: A cross-sectional study among 15,639 Malaysian adult males aged 18 years and above was conducted using proportional to size stratified sampling method. The socio-demographic variables examined were level of education, occupation, marital status, residential area, age group and monthly household income.
RESULTS: The prevalence of smoking among adult males in Malaysia was 46.5% (95% CI: 45.5-47.4%), which was 3% lower than a decade ago. Mean age of smoking initiation was 18.3 years, and mean number of cigarettes smoked daily was 11.3. Prevalence of smoking was highest among the Malays (55.9%) and those aged 21-30 years (59.3%). Smoking was significantly associated with level of education (no education OR 2.09 95% CI (1.67-2.60), primary school OR 1.95, 95% CI (1.65-2.30), secondary school OR 1.88, 95% CI (1.63-2.11), with tertiary education as the reference group). Marital status (divorce OR 1.67, 95% CI (1.22-2.28), with married as the reference group), ethnicity (Malay, OR 2.29, 95% CI ( 1.98-2.66; Chinese OR 1.23 95% CI (1.05-1.91), Other Bumis OR 1.75, 95% CI (1.46-2.10, others OR 1.48 95% CI (1.15-1.91), with Indian as the reference group), age group (18-20 years OR 2.36, 95% CI (1.90-2.94); 20-29 years OR 3.31 , 95% CI 2.82-3.89; 31-40 years OR 2.85 , 95% CI ( 2.47-3.28); 41-50 years OR 1.93, 95% CI (1.69-2.20) ; 51-60 years OR 1.32, 95% CI (1.15-1.51), with 60 year-old and above as the reference group) and residential area (rural OR 1.12 , 95% CI ( 1.03-1.22)) urban as reference.
CONCLUSION: The prevalence of smoking among Malaysian males remained high in spite of several population interventions over the past decade. Tobacco will likely remain a primary cause of premature mortality and morbidity in Malaysia. Continuous and more comprehensive anti-smoking policy measures are needed in order to further prevent the increasing prevalence of smoking among Malaysian men, particularly those who are younger, of Malay ethnicity, less educated, reside in rural residential area and with lower socio-economic status.