Osteoporosis-related fractures have been recognized as a major health problem, particularly in the elderly with a high morbidity and mortality rate. The aims of the study were to identify knowledge and perception toward calcium intake among students at UiTM and to explore the differences between genders in dietary calcium intake. A cross sectional study was conducted through 336 students aged 18 to 34 years old. The participants were randomly chosen from the student’s enrolment list. A modified questionnaire was used to obtain the knowledge and perception of the participants. More than half of the participants have low knowledge regarding dietary calcium intake (58.6%), positive view towards the benefits of calcium intake and low perception towards the barrier of calcium intake. Chi square analysis showed a significant difference between male and female for knowledge (p=0.034) and barrier (p=0.002) for calcium intake. Intervention programs should be adopted to increase the knowledge among young adults to improve their health and prevent risk factors. So, health education specifically on calcium intake will be very useful to improve the knowledge and behavior of students.
Introduction: Congenital malformations (CM) comprise a wide range of abnormalities of body structure or function that are present at birth and are of prenatal origin. It has contributed to a significant proportion of infant morbidity and mortality. The aims of this study were to determine the extent and investigate the relationship between CM and its associated demographic variables.
Methods: Data was extracted from Ministry of Health (MOH) database compiled from the reports on Stillbirth & Under 5 Mortality from year 2013 to 2014.
Results Out of 9,827 child death, 2,840 (28.9%) were classified under CM as defined under ICD-10 classification. Majority of those with CMs died at neonatal stage (62.7%) and among mothers aged between 20 to 35 years old (67.3%). The mean age of mothers among CM children was 30.8±6.5 years old. Approximately 5.8%, 6.7% and 3.3 % of total CM were neural tube defects, heart defects and hydrops fetalis respectively. The prevalence of CM in males was 15% higher than females. The difference were evident between CM and age of death of children under 5 years old (p<0.001) as well as between CM and maternal age groups (p<0.001).
Conclusions: CM is responsible for 28.9% of total causes of child death with higher occurrence of malformation in males. A significantly higher risk of CMs among mother aged between 20 to 35 years old was observed. This emphasises the importance of raising awareness and the need to strengthen appropriate response for surveillance and prevention program of common CM in Malaysia.
Keywords: Congenital malformations - Child death - Neonatal - Neural tube defects - ICD-10.
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.
Accepted 23 August 2011.
Introduction There is a strong correlation between stress and the quality of care provided by informal carers. In this regard, an accurate understanding about factors
contributing to stress among informal carers is crucial in order to find appropriate interventions to solve their problems.
Methods A pilot study was conducted in October 2009 in the Klang Valley area, to test the instrument liability in the local context. In-depth interviews were conducted with two informal caregivers who are providing full-time care for their chronically-ill family members.
Results Informal caregivers face multiple types of stress. A variety of factors such as financial problems, an unsupportive community, fatigue, the unavailability of social services to assist them and their inability to accept the fact that their loved ones are terminally ill, contribute to their stress.
Conclusions Differences in factors contribute to stress, and lead to the adoption of different styles of coping strategies: emotion and problem focused coping.
Introduction: Most health advisories related to outdoor physical activity during haze are general in nature. The advisories normally advise everyone to reduce or limit prolonged exertion or heavy exertion without mentioning the acceptable duration for performing outdoor physical activity causing difficulty for public to decide to stop or cancel a particular outdoor or sport event. The aim of this paper is to determine the acceptable duration for performing outdoor physical activity pattern during haze based on API level.
Methods: Health risk assessment approach that comprises of hazard identification, exposure assessment, dose-response, and risk characterization steps was used to determine the potential inhaled dose and risk associated with performing the physical activity during haze. We have considered many factors that include time spent for physical activity patterns for Malaysian adult, age and physical intensity-specific inhalation rate (m3/min), and the indoor/outdoor ratio of PM10. A hypothetical exposure scenario of PM10 was created using the breakpoints of PM10 concentration for the calculation of respective API levels during haze.
Results: The association between physical activity pattern, API level and risk quotient were presented in the form of risk radar diagram. Based on the 50th percentile inhalation rate, all prolonged exertion and heavy exertion should be avoided when API reach >201 (very unhealthy) and >175 (unhealthy) respectively. Below the said API, the duration for performing prolonged exertion and heavy exertion should be reduced according to the API level. When API reaches 140, high intensity physical activity should be limited to < 90 minutes. A football match which requires 90 minutes, should be postponed of cancelled if API > 140. Whereas, for the same API level, prolonged exertion (moderate intensity physical activity) should be limited to 4 hours.
Conclusions: Reducing the physical activity is an effective strategy to lower the dose of inhaled pollutants and reduce the health risk during poor air quality. Based on the assessment, taking into account the uncertainty of risk assessment methodology, we proposed all prolonged exertion should be avoided when API reach very unhealthy status (>201). Below the said API level, outdoor physical activity should be reduced according to the level of API respectively. The recommendation is not applicable for the sensitive groups. The computed risk radar provide a valuable guide for the public to organize or considering postponing an outdoor event during haze.
Introduction The prevalence of non-communicable diseases (NCDs) in Malaysia shows a
rising trend that influences the society in many respects. Country specific
evidence is vital for effective intervention. The aims of this study were to
identify the role of gender and urbanisation status on NCDs prevalence and
its effect on health care demand, specifically doctor visits among elderly in
Malaysia. We focused on two of the highest occurrence NCDs in the country
– diabetes mellitus and hypertension.
Methods A total of 1,414 respondents aged 60 years and above were selected using a
multistage sampling for face-to-face interview. We started the analysis with
descriptive analysis of the prevalence, taking the effect of gender and
urbanisation status of residing area. We extended the study with parametric
analysis to find the effect of these health problems on the likelihood of doctor
visits as it reflects the equity for access and utilisation issues.
Results Results showed that there were no significant difference of prevalence by
gender and urbanisation for hypertension and diabetes mellitus. By utilising
probit model, we found that those with diabetes mellitus or hypertension,
controlling for other variables, were more likely to utilise doctor services.
Conclusion This result implies that the prevalence of NCDs may further increase demand
for health care, especially in the state with a high proportion of older age
groups.
Background Despite country’s tobacco control law, cigarette smoking by the young people and the magnitude of nicotine dependence among the school personnel is alarming.
Objective To determine the prevalence of smoking and to examine the determinants of smoking behaviour among the secondary school teachers in Bangladesh.
Methods A two-stage cluster sampling was used with a selection of schools on Probability Proportional to Enrolment (PPE) size followed by stratified random sampling of government and private schools and then all the teachers present on the day of the survey were selected for the study. The 66-item questionnaire included smoking behaviour, knowledge, attitude, second-hand smoking, tobacco free school policy, cessation, media advertisement and curriculum related topics. Seven additional questions were included to assess the socio-demographic characteristics of the teachers. Data analysis was performed using SPSS 17 software. A total of 60 schools were selected with school response rate of 98.3%. An anonymous self-administered questionnaire was filled in by all teachers present at the day of the survey. The sample consisted of 559 teachers with response rate of 99.5%.
Results The prevalence of smoking was 17% (95% CI: 14%, 20.4). About half of the teachers (48.4%) smoke daily followed by 25.3% smoke 1-2 days in last 30 days. The mean duration smoking of was 13.7(95% CI: 11.6, 15.9) years. Logistic regression analysis revealed that male teachers smoke 37.46(95% CI: 5.078, 276.432) times higher than their female counterparts. The graduate teachers were 2.179(95% 1.209, 3.926) times more likely to be smoke than master’s degree holder teachers. Smoking by friends appeared to be the strongest predictor for teachers smoking behaviour (OR 4.789, 95% CI: 1.757, 13.050). However, no statistically significant association was found between type of school, second-hand smoking and curriculum related factors and smoking behaviour of the teachers (p>0.05).
Conclusions Prevalence of smoking among the teachers is high in Bangladesh. Effective smoking prevention program should take into account within the dominant of socio-environmental influence to reduce smoking behaviour. The school curriculum items had less impact in preventing smoking behaviour.
Introduction In Malaysia although mortality rate among women of reproductive ages has
reduced over the years, the reduction has been stagnant for the past ten years.
In order to achieve the 5th Millennium Development Goal, several measures
need to be taken including a proper implementation of pre-pregnancy
services in this country. This study explores the awareness, intention and
usage of pre-pregnancy care (PPC) services and its determinant among
women of reproductive ages in Kedah, Malaysia.
Methods This is a qualitative study, which consisted of a focus group discussion
(FGD) among women in the ages of 18 to 45 years old from all ethnic groups
who attended four government clinics in the state of Kedah. The mothers
were chosen through purposive sampling from twelve districts that were
selected through a multistage random sampling. A semi-structured
questionnaire was utilized during the FGD. The results from the FGD were
recorded verbatim and thematic analysis was finalized once saturation of
information from respondents was achieved.
Results These are two themes was identified, namely personal reasons and reasons of
service and there are several subthemes under two main themes. Under the
Personal reason themes, the subthemes including awareness and intention to
used the services, knowledge, perception, social support and history of
medical illness. While under pre-pregnancy care services themes, the
subthemes including the promotion of the services, the communication
relationship with the health staff, the waiting time and also the accessibility
of the service.
Conclusions As a conclusion, there is still part of society who was unaware of prepregnancy
services and its importance in reducing maternal mortality rate as
well as producing good pregnancy outcome. Information and knowledge on
pre-pregnancy care services should be disseminated among community
members through various means including roadshows and pre wedding
workshops.
The relationship between healthcare services and inequalities is more likely when a group that shares a salient identity faces severe inequalities of various kinds. Such inequalities may be catalyzed by economic, social, political or concern cultural status. The objectives of this review are to identify the issues and challenges involve in healthcare inequalities, to compare factors contributes to healthcare inequalities and to purpose suggestions and recommendations for improvement based on issues and challenges between United States and India. Comparing annual year healthcare report, documentation of healthcare institutional, Ministry of Health's report and circular, official institutional website, scientific healthcare journals, articles and reports published in 1994 until 2011 regarding healthcare inequalities between United States and India. Health inequalities in the healthcare system contributed by the different in socioeconomic status and accessibility to the healthcare facility due to high cost of treatment has been common risk 'Catastrophic' factors to the inequalities in both countries. Health financing system and resource allocation that benefit only the upper class social spectrum of the population. Disparities occur due to the imbalance in distribution of wealth, discrimination and change in the world economy. Adapting healthcare system that provides care to all classes of people need improvement as no healthcare system is perfect. This matter must be tackle urgently as it's a matter of national concern.
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.
Introduction Overweight and obesity is a major public health problem in Malaysia. This study aims to determine the prevalence of overweight and obesity among the Malaysian adult population and their association with socio-demographic characteristics (gender, ethnic, and age groups).
Methods A total of 17,257 adults aged 18 years and older (8,252 men, 9,005 women)
were assessed for BMI status, with a response rate of 97.8%, through a household survey from the National Health and Morbidity Survey (NHMS), conducted in all states of Malaysia in 2011.
Results All socio-demographic factors were consistently associated with higher chance of being overweight (except gender and location) and obesity (except location and household income). The identified risk of overweight were
Indian (aOR: 1.8, 95% CI: 1.2-2.8), aged 50-59 years (aOR: 2.8, 95% CI: 2.0-3.9), widower (aOR: 1.6, 95% CI: 1.3-2.0), subject with secondary education (aOR: 1.2, 95% CI: 1.0-1.4), Homemaker/unpaid worker (aOR:
1.3, 95% CI: 1.1-1.4), and with high household income group (aOR: 1.3, 95% CI: 1.2-1.6). The identified risk of obesity were women (aOR: 1.4, 95% CI: 1.2-1.6), Indian (aOR: 1.7, 95% CI: 0.9-3.2), aged 30-39 years (aOR: 3.6,
95% CI: 2.4-5.5), widower (aOR: 1.2, 95% CI: 0.9-1.6), subjects with primary education (aOR: 1.2, 95% CI: 0.9-1.6), Homemaker/unpaid worker (aOR: 1.3, 95% CI: 1.1-1.6), and with middle household income group (aOR: 1.3, 95% CI: 1.2-1.6).
Conclusions Our data indicate a high prevalence of overweight and obesity in the
population. Several sociodemographic characteristics are associated with both overweight and obesity. This study highlights the serious problem ofoverweight and obesity among Malaysia adults. Documentation of these problems may lead to research and policy agendas that will contribute both to our understanding and to the reduction of these problems.
Study name: National Health and Morbidity Survey (NHMS-2011)
Introduction Prevalence of adolescents involved in sexual and reproductive problems is on
rise and it was associated with its knowledge. Several factors found to be
associated with the knowledge and various sources of knowledge are chosen
by adolescents for this information. Thus, this study was to determine the
knowledge score, its influencing factors and the preference of the sources of
knowledge.
Methods A cross-sectional study was done using adopted questionnaire involving 330
respondents aged 18 and 19 years old in Kolej MARA Seremban selected by
simple random sampling. They were gathered in the halls and 338
adolescents from 454 students consented to involve in this study. Selfadministered
questionnaire was used whereby a correct response was given a
score of 2, 0 for an incorrect response and 1 for an answer of don’t know.
Total score for all correct answers was 42. Descriptive analysis, bivariate and
multivariate analysis was done in the analysis.
Results The mean knowledge score was 37.32 (±2.967) with a significant difference
for gender. Internets were the most common and preferred sources of the
knowledge among them. There was 5.2% of them had heard on SMS
intervention and 37.0% of them disagreed on SMS intervention.
Conclusions The result showed that the knowledge score was lower in males than females
and internets were the most preferred source of the knowledge. Thus,
interventions for knowledge improvement should be more on male
adolescents.
Introduction The health of newborns is inextricably linked to that of their mothers. Some
maternal factors can influence neonatal survival, particularly for low birth
weight babies who are more vulnerable to diseases than normal weight
babies. The aim of this study is to assess the impact of maternal factors on
neonatal mortality among low birth weight babies in Aceh Province,
Indonesia.
Methods Study design was unmatched case control. Data collected from 2010 to 2012
in 8 districts in Aceh province, Indonesia. Total sample was 500, divided into
250 LBW who died in neonatal period (case group) and 250 who did not die
in neonatal period (control group). There were 6 maternal variables analysed.
Results Three of six variables analysed were not associated with neonatal mortality
among LBW (P > 0.05); these were: maternal death, parity and education
level. The age of the mother had a significant association with neonatal
mortality among LBW (P < 0.05), but was not a determinant factor. The
maternal illness and birth interval were determinant factors of neonatal
mortality among LBW(P < 0.05); maternal illness (Adj OR= 2.6; 95 % CI:
1.68 - 4.0) and birth interval (Adj OR= 1.8; 95 % CI: 1.20 - 2.91).
Conclusions Maternal illness and birth interval were determinant factors of neonatal
mortality among LBW. Appropriate care throughout stages of pregnancy and
increasing women’s knowledge on high risk pregnancy are the key factors to
the decrease of the neonatal mortality related to the maternal factors.
Introduction Married couples often do influence each other’s emotions and behaviors. The
effect of this interpersonal marriage relationship on emotional job demands
and job performance toward work-family conflict (WFC) is still under
research. This article aims to determine the effects of married couple’s job
factors (emotional job demands and job performance) on wife’s WFC.
Methods A total of 120 dyads in private sectors were recruited via private invitations
to social gatherings. Packets of self-administered questionnaires were given
included emotional domain of Demand-Induced Strain Compensation,
Spielberger Trait Anger Scale, work-family conflict and job performance
measures. Dyadic analysis using Actor-Partner Interdependence Model was
used.
Results The emotional demand of wife significantly contribute higher effect (ES=
0.34 (95%CI: 0.23, 0.45); p
Smoking is the leading preventable cause of non-communicable disease mortality worldwide. Therefore, effort for the effective measure in smoking cessation is important. However, the central problem in the nicotine addiction treatment is relapse. A retrospective cohort study was done at Tanglin Quit Smoking Clinic to determine the outcome of smoking cessation and its predictors. A cohort of 770 smokers between 2008 and 2015 were identified through simple random sampling. Smokers were defined as current smoker, while smoking abstinence is defined as cessation more than 6 months and relapse as any smoking episode even a puff since the quit date. Majority were Malays, Muslims and had secondary or higher education. The mean initiating age for smoking was 17.6 years old, with majority smoke between 11 to 20 sticks, and had high nicotine dependence score (43%). At the end of the study 52.5% of them abstinence from smoking. The predictors for smoking cessation were number of quit attempt (1 to 10 times) (AOR = 1.582, 95% CI = 1.012-2.472) and pharmacotherapy (AOR = 0.711, 95% CI=0.511-0.989). More frequent follow up was required during the first crucial 6 months to prevent relapse. Number of follow up can enhance not only the medication compliance but also motivational aspect to smokers to reduce relapse rates. Healthcare provider should give extra attention to the potential relapser especially to those who attempt for the first time.
Keywords: Malaysia, Quit Smoking Clinic, Smoking Cessation, Cohort, Survival analysis
The aim of the Fourth Millennium Developmental Goal is to reduce mortality among children less than 5 years by two thirds between 1990 and 2015. Efforts are more focus on improving children's health. The aim of this study was to describe the trend of stillbirth and neonatal deaths in University Kebangsaan Malaysia Medical Centre from 2004 to 2010. A retrospective cross-sectional study was conducted using hospital data on perinatal mortality and monthly census delivery statistics. There were 45,277 deliveries with 526 stillbirths and neonatal deaths. More than half of the stillborn cases were classified as normally formed macerated stillbirth and prematurity was common in neonatal deaths. The trend of SB and NND was found fluctuating in this study. However, by using proportionate test comparing rate, there was a transient significant decline of stillbirth but not neonatal deaths rates between 2004 and 2006. On the other hand, the neonatal deaths rate showed significant increment from 2006 to 2008. When both mortality rates were compared using proportionate test, from the start of the study, year 2004 with end of the study, year 2010, there was no significant decline noted. Trends of stillbirth and neonatal death rates in University Kebangsaan Malaysia Medical Centre within 7 years study period did not show the expected outcome as in Millennium Developmental Goal of two thirds reduction.
Mortality estimates are important parameters for health monitoring and are routinely used as evidence for health policy and planning. This study aimed to estimate the mortality component of Burden of Disease in Malaysia in 2008. The 2008 mortality data from the Statistics Department were used to estimate cause-specific mortality (by age and sex) in Malaysia. Data were coded using the ICD10 (International Classification of Disease) coding. Calculation of mortality component of Burden of Disease (ie: Years of Life Lost (YLL) was done using the standard Global Burden of Disease Methodology. The total estimated deaths in Malaysia in 2008 were 124,857, of which 72,202 (57.8%) were males. The total years of life lost (YLL) for the Malaysian population in 2008 was 1.51 million in which 0.92 million (60.7%) was among males. Almost three quarter (68%) of the burden of premature deaths resulted from non-communicable diseases, followed by communicable diseases (20%) and injury (12%). Among the top three leading causes of YLL were ischaemic heart disease (17.1%), stroke (9.6%) and road traffic injuries (8.3%). In Malaysia, premature mortality mainly contributed by non-communicable diseases followed by communicable diseases and injury. A multi-agency collaboration is needed to prevent premature death and to improve quality of life.
There is an enduring disconnect between the routine surveillance of mosquitoes that transmit dengue viruses and control activities to limit disease spread. A great variety of methods used to collect vector surveillance data exists globally, with program design typically influenced by historical, socio-cultural and cost factors. Surveillance data can be expensive to collect, meaning that without demonstration of its usefulness in directing mosquito control it may be deprioritized or even abandoned. Given that universally prescribed surveillance methods are unlikely to be sustainable and successful, we propose that strategies be designed according to the local terroir of dengue transmission. Strategy design should consider not only costs, but the amenability of workers and the public to various methods, the utility of methods for directing control and reducing disease, and the underlying spatial structure of the vector populations locally. A process of evaluating each of these factors should precede strategy design and be part of on-going review processes. In the case that the usefulness of vector surveillance cannot be demonstrated, then it may be argued that resources could be allocated to other aspects of disease control.
Introduction Neonatal jaundice occurs in about 60% of newborns. If not managed properly, it can progress to severe neonatal jaundice (SNNJ) leading to death or permanent disability. The incidence of SNNJ in Kuching District increased from 119.3 per 100,000 live births in 2005 to 123.3 per 100,000 live births in 2008, which was above the Standard National QAP Indicator of 100 per 10,000 live births. SNNJ can be prevented by early detection and proper management of neonatal jaundice. The objective is to increase the knowledge and practise of early detection of neonatal jaundice by nurses in Kuching District. Methods This was an interventional study covering a period of six months. The sample comprised 113 nurses of all categories working in urban and rural maternal and child health clinics in Kuching District. Tools used in the study were self-administered questionnaires in English and Bahasa Malaysia. The preintervention survey started in July 2009 while the post-intervention survey was done in January 2010. The interventions were done through Continuing Nursing Education sessions and included new nursing formats and new reporting procedures. New vehicles were also provided for home nursing. Data was collected and analyzed using MS Excel program. Results The pre-intervention survey on nurses showed that only 56.6% were able to identify the risk of factors causing jaundice; 94.6% able to define jaundice; 41.5% able to detect jaundice while 70.8% knew sign of Kernicterus. In term of recommended post natal nursing schedule only 40.7% able to practice the schedule while only 69.0% able to give advice on management of jaundice. Post intervention; 63.2% of nurses were able to identify the risk factors causing jaundice; 97.2% able to define jaundice while 97.2% were able to detect jaundice and 88.6% know sign of Kernicterus. On recommended post natal nursing schedule, 49.9 % practice the recommended schedule while 92.0% were able to give advice to mother on management of jaundice. The incident of jaundice of Severe Neonatal Jaundice dropped to 78 per 100,000 live births in 2010.
Conclusions The study shows that the interventions taken helped to improve the knowledge and practice of recommended measures to detect neonatal jaundice early. Stronger emphasis must be placed on using the new reporting procedures and new nursing sheets. Continuous monitoring through regular nursing audits by clinic supervisors is also essential to reduce the incidence of SNNJ. Provision of vehicles for all busy maternal and child health clinics for home nursing care is highly recommended.
Introduction The most effective and affordable public health strategy to prevent
hypertension, stroke and renal disease is by reducing daily salt consumption.
Therefore, this study aims to determine the association of knowledge, attitude
and practice on salt diet intake and to identify foods contributing to high
sodium intake.
Methods Secondary data analysis was performed on MySalt 2016 data. It was
conducted from November 2015 until January 2016 which involving Ministry
of Health Staff worked at 16 study sites in Malaysia. Salt intake was
measured using 24 hours urinary sodium excretion. Food frequency
questionnaire was used to determine the sodium sources. Knowledge, attitude
and practice of salt intake were assessed using a validated questionnaire
adapted from WHO. Demographic data and anthropometric measures also
were collected. Sodium levels of more than 2400mg/day was categorised as
high sodium intake. Data were analysed using SPSS software version 21.
Results The mean sodium intake estimated by 24 hours urinary sodium excretion was
2853.23 + 1275.8 mg/day. Food groups namely rice/noodles (33.8%),
sauces/seasoning (20.6%), meat and poultry (12.6%) and fish/seafoods
(9.3%) were the major contributors of dietary sodium. In multiple logistic
regression analysis, being a male (aOR=2.83, 95% CI 2.02 – 3.96) and obese
(aOR=6.78, 95% CI 1.98 – 23.18) were significantly associated with high
urinary sodium excretions. In addition, those who were unsure that high salt
intake can cause hypertension (aOR=1.24, 95% CI 0.65 – 2.36), those who
think that they consumed too much salt (aOR=2.10, 95% CI 1.13 – 3.87) and
those who only use salt rather than other spices for cooking (aOR=2.07, 95%
CI 1.29 – 3.30) were significantly associated with high urinary sodium
excretion.
Conclusions This study showed that the main sources of sodium among Malay healthcare
staff is cooked food. Poor knowledge and practice towards reducing salt
consumption among them contributes to the high sodium consumption. The
practice of healthy eating among them together with continuous awareness
campaign is essential in order to educate them to minimize sodium
consumption and to practice healthy eating.