Displaying publications 21 - 40 of 48 in total

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  1. Lim HH, Ong CN, Domala Z, Phoon WO, Khoo HE
    Public Health, 1985 Jan;99(1):23-9.
    PMID: 3991872
  2. Khan A, Uddin R
    Public Health, 2020 Nov;188:1-3.
    PMID: 33032239 DOI: 10.1016/j.puhe.2020.08.024
    OBJECTIVES: Parental and peer support can foster adolescents' activity behaviours; however, little is known about how such support are linked with adolescents' active lifestyle in non-Western settings. The study aimed to explore associations of parental and peer support with an active lifestyle of adolescents in Malaysia.

    STUDY DESIGN: This is a cross-sectional study.

    METHODS: We used data from the 2012 Malaysian Global School-based Student Health Survey, which covered adolescents aged 11-17 years (51% girls). Adolescents were asked about their physical activity, sitting time, and levels of parental and peer support. Participants with ≥60 min of moderate to vigorous physical activity per day and ≤2 h of sitting time per day were categorised as having an 'active lifestyle'. Binary logistic regression was used to examine the relationships by gender and age group (11-14 and 15-17 years).

    RESULTS: Of the participating adolescents (n = 12,081), 15.3% reported to have an active lifestyle (boys: 22.0%; girls: 8.8%). About 31% reported to have higher levels of parental support, whereas 47% reported higher levels of peer support. Higher parental and peer support were significantly associated with an active lifestyle of boys across both age groups. Girls with higher parental support had higher odds of reporting an active lifestyle in both age groups, whereas higher peer support was significantly associated with an active lifestyle among girls aged 11-14 years.

    CONCLUSIONS: This study uniquely extends the current evidence by examining the associations of parental and peer support with physical activity and sitting time combined. More research is needed to understand how different types of social support can influence adolescents' active lifestyle.

  3. M Yatim H, Wong YY, Neoh CF, Lim SH, Hassali MA, Hong YH
    Public Health, 2019 Aug;173:5-8.
    PMID: 31207425 DOI: 10.1016/j.puhe.2019.04.020
    OBJECTIVE: The objective of this study was to explore factors influencing patients with hypertension to participating in a hypertension self-management education (HSME) programme and challenges of sustaining the learnt self-care practices.

    STUDY DESIGN: This was a qualitative study with focus group discussions.

    METHODS: Focus group discussions using a semistructured moderator guide were conducted among participants who had attended the HSME programme. Data were audio recorded, transcribed verbatim and analysed using a thematic analysis approach.

    RESULTS: Three focus groups involving 19 participants were conducted. Four major themes emerged from the data collected. Most participants enjoyed the group-based HSME sessions because sharing experiences with those having similar health problems can reduce their sense of isolation. However, the participants highlighted the difficulty in sustaining self-care practices in the presence of friends and family influences.

    CONCLUSION: A number of patient-, family- and community-level motivators and barriers to patients' hypertension self-management have been identified. Efforts to tailor behavioural interventions to sustain daily self-care activities during social and cultural events are imperative.
  4. Azimatun Noor A, Saperi S, Aljunid SM
    Public Health, 2019 Oct;175:129-137.
    PMID: 31473369 DOI: 10.1016/j.puhe.2019.07.008
    OBJECTIVES: Currently, Malaysia faces great challenges in allocating adequate resources for healthcare services using a tax-based system. Therefore, Malaysia has no choice but to reform its healthcare financing system. The objective of this study is to assess Malaysian household willingness to pay and acceptance levels to the proposed National Health Financing Scheme.

    STUDY DESIGN: This is a cross-sectional study.

    METHODS: In total, 774 households from four states in Malaysia completed face-to-face interviews. A validated structured questionnaire was used, which was composed of a combination of open-ended questions, bidding games and contingent valuation methods regarding the participants' willingness to pay.

    RESULTS: The study found that the majority of households supported the establishment of the National Health Financing Scheme, and half proposed that a government body should manage the scheme. Most (87.5%) of the households were willing to contribute 0.5-1% of their salaries to the scheme through monthly deductions. Over three-quarters (76.6%) were willing to contribute to a higher level scheme (1-2%) to gain access to both public and private healthcare basic services. Willingness to pay for the National Health Financing Scheme was significantly higher among younger persons, females, those located in rural areas, those with a higher income and those with an illness.

    CONCLUSION: There is a high level of acceptance for the National Health Financing Scheme in the Malaysian community, and they are willing to pay for a scheme organised by a government body. However, acceptance and willingness to pay are strongly linked to household socio-economic status. Policymakers should initiate plans to establish the National Health Financing Scheme to provide the necessary financing for a sustainable health system.

  5. Rajah R, Hassali MAA, Murugiah MK
    Public Health, 2019 Feb;167:8-15.
    PMID: 30544041 DOI: 10.1016/j.puhe.2018.09.028
    OBJECTIVES: Health literacy is increasingly recognized as a public health concern. Most of the literature on health literacy concentrate in the Western countries. Therefore, this study aimed to systematically review and examine the available studies on health literacy in Southeast Asian countries and estimate its prevalence in this region.

    STUDY DESIGN: Systematic review.

    METHODS: A search for relevant articles was carried out using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE (via EBSCOhost), Scopus, Science Direct, PubMed and Google Scholar with multiple search terms. Inclusion criteria comprised articles published in English language and assessing general health literacy. Risk of bias reduced with the involvement of two independent reviewers in the screening of the literature and the quality assessment process.

    RESULTS: A total of 11 studies were included, which only consist of studies from five countries out of 11 making up the Southeast Asian region. The overall prevalence of limited health literacy varied considerably, 1.6%-99.5% with a mean of 55.3% (95% confidence interval [CI]: 35.1%-75.6%). A much higher prevalence was noted in studies conducted in healthcare settings, 67.5% (95% CI: 48.6%-86.3%). The most common factors associated with limited health literacy were education attainment, age, income and socio-economic background. Other factors identified were gender and health behaviours.

    CONCLUSIONS: In summary, despite the little evidence available and existences of high heterogeneity among studies, limited health literacy is still prevalent in Southeast Asian countries. Urgent strategies to improve and promote health literacy in the region are highly warranted. Besides, more studies on health literacy with better quality on the methodology aspect are needed.

    Matched MeSH terms: Public Health
  6. Tang KHD, Chin BLF
    Public Health, 2021 Sep;198:96-101.
    PMID: 34391039 DOI: 10.1016/j.puhe.2021.07.007
    OBJECTIVES: The transmission of COVID-19 has sent Malaysia into cycles of tightening and relaxation of movement control, which are still continuing currently in line with local fluctuations of new COVID-19 cases. During movement control, measures comprising physical distancing, hand cleaning or sanitizing, and sanitization of premises are consistently implemented while self-isolation and travel restrictions are adaptively enforced. This study aims to examine if the control of COVID-19 transmission has an effect on the national influenza occurrences as some measures for COVID-19 control are similar to those for influenza.

    STUDY DESIGN: For this study, data of weekly new cases of influenza and COVID-19 were obtained from official platforms for non-parametric statistical analysis.

    METHODS: This study compared the influenza occurrences before and after the onset of COVID-19 using the Mann-Whitney U-test and explored Spearman's correlations between COVID-19 and influenza incidences after the onset of COVID-19.

    RESULTS: It shows that influenza incidences before and after the onset of COVID-19 were significantly different and that influenza cases have significantly reduced after the onset of COVID-19. The weekly cases of influenza and COVID-19 were significantly and negatively correlated.

    CONCLUSIONS: This study underscores the co-benefits of COVID-19 control measures and alleviates the concern for the risk of COVID-19 and influenza co-infection.

  7. Romli MH, Tan MP, Mackenzie L, Lovarini M, Suttanon P, Clemson L
    Public Health, 2017 Apr;145:96-112.
    PMID: 28359399 DOI: 10.1016/j.puhe.2016.12.035
    OBJECTIVES: The older population in the Southeast Asian region is accelerating and is expected to surpass the proportion of the ageing population in North America and Europe in the future. This study aims to identify the research literature related to falls among older people in Southeast Asia, to examine current practice and discuss the future direction on falls prevention and interventions in the region.

    STUDY DESIGN: A scoping review design was used.

    METHODS: A systematic literature search was conducted using the Medline, CINAHL, AMED, Ageline, PsycINFO, Web of Sciences, Scopus, Thai-Journal Citation Index, MyCite and trial registries databases.

    RESULTS: Thirty-seven studies and six study protocols were included, from Thailand, Malaysia, Singapore, Vietnam, Indonesia and the Philippines. One-sixth of the studies involved interventions, while the remainder were observational studies. The observational studies mainly determined the falls risk factors. The intervention studies comprised multifactorial interventions and single interventions such as exercises, educational materials and visual correction. Many of the studies replicated international studies and may not have taken into account features unique to Southeast Asia.

    CONCLUSION: Our review has revealed studies evaluating falls and management of falls in the Southeast Asian context. More research is required from all Southeast Asian countries to prepare for the future challenges of managing falls as the population ages.

  8. Cheah YK, Azahadi M, Phang SN, Hazilah N
    Public Health, 2017 May;146:84-91.
    PMID: 28404478 DOI: 10.1016/j.puhe.2017.01.009
    OBJECTIVES: The rapid rise in the prevalence of physical inactivity-related diseases has become a serious public health issue worldwide. The objective of the present study is to examine the factors affecting participation in physical activity among urban dwellers in Malaysia.
    STUDY DESIGN: This cross-sectional study measures physical activity using a rigorous regression model.
    METHODS: Data are obtained from the National Health and Morbidity Survey 2011 (NHMS 2011). A lognormal hurdle model is used to analyse the participation decision and the amount decision of physical activity.
    RESULTS: The results show that income, gender, ethnicity, marital status and employment status are significantly associated with participation decision and amount decision. However, age, insurance and self-rated health only affect participation decision, whereas family size, education and smoking only affect amount decision.
    CONCLUSIONS: It can, thus, be concluded that sociodemographic, insurance, lifestyle and health factors play an important role in determining physical activity behaviour among urban dwellers. When formulating policies, special attention must be paid to these factors.
    Study name: National Health and Morbidity Survey (NHMS-2011)
  9. Singh SK, Enzhong L, Reidpath DD, Allotey P
    Public Health, 2017 Mar;144:78-85.
    PMID: 28274388 DOI: 10.1016/j.puhe.2016.11.022
    OBJECTIVE: To explore the initiating factors of waterpipe tobacco smoking (WTS) among youth.

    STUDY DESIGN: The analytic framework for this scoping review was performed using the methodology outlined by Arksey and O'Malley, which includes identification of the research question, study selection, charting the data, collating, summarizing and reporting the results that were primarily guided by the research question; 'what is known about the initiation of shisha smoking among youth?'

    METHODS: Electronic databases such as Cochrane, MEDLINE and PsycINFO were used to search for relevant articles. Articles included were all in English and published within the year of 2006 to 2015. Inclusion criteria; i) age range of 10 to 29 years; ii) examined the reasons why youth started or tried WTS; iii) in full text. Therefore, 26 articles were included in this scoping review.

    RESULTS: This review has identified and classified the initiating factors of WTS among youth in four subtopics: individual factors, interpersonal influences, cigarettes and alcohol use, and media influences. Individual factors and interpersonal influences played an important role in initiation factors of WTS among youth.

    CONCLUSION: This study concludes that public health professionals within the Southeast Asia region need to promote innovative preventive measures through peer-to-peer led interventions that are also easily assessable on social media platforms. The public health messages need to address the misconceptions of risk associated to WTS use.
    Matched MeSH terms: Public Health
  10. NoorAni A, Rajini S, Balkish MN, Noraida MK, SMaria A, Fadhli MY, et al.
    Public Health, 2018 Aug 16;163:105-112.
    PMID: 30121437 DOI: 10.1016/j.puhe.2018.06.018
    OBJECTIVE: This article examines the trends in morbidities and healthcare utilisation in Malaysian older people aged 60 years and above.
    STUDY DESIGN: This is a repeated cross-sectional study.
    METHODS: Data from three nation-wide community-based surveys, which were conducted in 1996, 2006, and 2015 were analysed. Multivariate analysis was performed for 2015 data to identify factors associated with healthcare utilisation.
    RESULTS: Analysis noted increasing trends in the prevalence of diabetes, hypertension, hypercholesterolaemia and obesity from 1996 to 2015. Decreasing trends were noted in the prevalence of current smokers and drinkers over this 20-year period, whereas health service utilisation increased with age in all surveys. In 2015, both inpatient and outpatient care are significantly associated with increasing age and diabetes.
    CONCLUSIONS: Increasing trends of health problems and healthcare utilisation were observed among older people in Malaysia. Policymakers should plan for appropriate resources to meet the challenges of an ageing population in Malaysia.
    Study name: National Health and Morbidity Survey (NHMS-1996, NHMS-2006, NHMS-2015)
  11. Aghakhanian F, Wong C, Tan JSY, Yeo LF, Ramadas A, Edo J, et al.
    Public Health, 2019 Nov;176:106-113.
    PMID: 30509859 DOI: 10.1016/j.puhe.2018.10.001
    OBJECTIVES: This study was undertaken to investigate the occurrence of metabolic syndrome (MetS) and cardiovascular disease (CVD) risk in Orang Asli (OA), the indigenous people of Peninsular Malaysia. OA consist of Negrito, Proto-Malay, and Senoi groups who collectively comprise only 0.76% of the population of Peninsular Malaysia. Owing to the challenges in accessing their remote villages, these groups are often excluded in larger government health surveys. Although tropical diseases were scourges in the past, with rapid national development, many OA communities have been gradually urbanized. We believe an epidemiological transition is occurring and non-communicable diseases are on the rise.

    STUDY DESIGN: A retrospective cross-sectional study.

    METHODS: Indigenous Malaysians (n = 629) from three major groups (Negrito, Proto-Malay, and Senoi) were recruited, after ethics approval and informed consent. Body mass index (BMI), body weight, height, waist circumference, and systolic and diastolic blood pressure were measured, and participants were examined for acanthosis nigricans. Venous blood samples were used for measurements of fasting blood sugar, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Insulin resistance was estimated using a surrogate measurement TG/HDL-C. The ratios of TC to HDL-C, and of LDL-C to HDL-C were determined. MetS was accessed according to the Joint Interim Statement of the IDF Tsak Force on Epidemiology and Prevention.

    RESULTS: MetS affected 29.57% of the OA population investigated and was significantly more prevalent (P 

  12. Kc B, Heydon S, Norris P
    Public Health, 2019 Mar;168:157-163.
    PMID: 30415826 DOI: 10.1016/j.puhe.2018.09.018
    OBJECTIVE: The objective is to investigate trekkers' changing demographics, travel patterns and experience of illness in the Annapurna region.

    STUDY DESIGN: A mixed method study comprising a cross-sectional survey was carried out with trekkers who had completed trekking in the Annapurna region.

    METHODS: Interviews were carried out with trekkers using a standardised questionnaire from September to December (main trekking season) 2014 and 2016. The interview format included trekkers' demographic characteristics, travel patterns, preparation and logistics and experiences of illness and treatment.

    RESULTS: The demographic composition of trekkers had changed. Chinese and Nepalese trekkers were the most dominant groups along with other international trekkers from 16 different countries. In terms of the trekking pattern, the Chinese and the Nepalese trekkers spent a median of 7 days each in the trek and trekked to a median altitude of 3500 m, while other international trekkers spent a median of 10 days and trekked to a median altitude of 4000 m. In general, trekkers' food habits and travel patterns were good. They undertook some health preparation by using the Internet, consulting friends and travel guidebooks and consulting a doctor, pharmacist and other healthcare providers and brought medicines accordingly. However, 25% of trekkers, most commonly Chinese, Korean and Nepalese, came without any health preparation and with no medicines. Thirty percent of the trekkers became sick during the trek with common illnesses such as diarrhoea, vomiting, the common cold, headache, fever and altitude-related symptoms.

    CONCLUSIONS: Trekkers' demographic composition has changed from that found in previous studies, and this was reflected in their trekking pattern. Trekkers' health preparations for high-altitude trekking were still inadequate, especially among the newer groups such as the Nepalese, Chinese and Korean trekkers. Issues such as trekkers' health preparation and practice, eating patterns, the length of trek and altitude and health and safety provision need further improvement, especially in the context of these changing trekker demographics.

  13. Alkhawari M, Ali K, Al-Abdul Razzaq F, Saleheen HN, Almuneef M, Al-Eissa MA
    Public Health, 2020 Apr;181:182-188.
    PMID: 32088599 DOI: 10.1016/j.puhe.2020.01.005
    OBJECTIVE: To assess the readiness to implement child maltreatment (CM) prevention programs at a national level.

    STUDY DESIGN: This is a cross-sectional study.

    METHODS: This study was completed alongside similar studies undertaken by the rest of the Gulf Cooperation Council (GCC) countries and led by Kingdom of Saudi Arabia (KSA). The study will allow further understanding of possible obstacles that may be encountered while implementing a nationwide prevention program. The 10-dimensional model of readiness had been developed by the World Health Organization (WHO) in collaboration with five countries (Brazil, The Former Yugoslav Republic of Macedonia, Malaysia, Saudi Arabia, and South Africa) through a five-stage process. Stakeholders and decision makers were invited to participate. Scores for each dimension were compared with those for the rest of the GCC countries.

    RESULTS: The overall score of Kuwait was 39.17 out of 100. This was below the mean average score for the GCC countries (47.83). Out of the 10 dimensions, key informants scored the highest on legislation, mandates and policies (6.61). The lowest score was reported on attitudes towards CM prevention (1.94). Informal social resources (5.72) ranked the highest as compared to the rest of the GCC countries.

    CONCLUSIONS: The readiness of Kuwait is weak on several dimensions and needs to be strengthened. Despite that, the country is moderately ready to implement large-scale evidence-based CM prevention programs because it is strong in the infrastructure of knowledge, legislation, mandates, and policies and informal social resources.

  14. Abd Razak MA, Ahmad NA, Chan YY, Mohamad Kasim N, Yusof M, Abdul Ghani MKA, et al.
    Public Health, 2019 Apr;169:84-92.
    PMID: 30826688 DOI: 10.1016/j.puhe.2019.01.001
    OBJECTIVES: This systematic review aims to provide updated and comprehensive evidence on the validity and feasibility of screening tools for mild cognitive impairment (MCI) and dementia among the elderly at primary healthcare level.

    STUDY DESIGN: A review of articles was performed.

    METHODS: A search strategy was used by using electronic bibliographic databases including PubMed, Embase and CENTRAL for published studies and reference list of published studies. The articles were exported to a bibliographic database for further screening process. Two reviewers worked independently to screen results and extract data from the included studies. Any discrepancies were resolved and confirmed by the consensus of all authors.

    RESULTS: There were three screening approaches for detecting MCI and dementia - screening by a healthcare provider, screening by a self-administered questionnaire and caretaker informant screening. Montreal Cognitive Assessment (MoCA) was the most common and preferable tool for MCI screening (sensitivity [Sn]: 81-97%; specificity [Sp]: 60-86%), whereas Addenbrooke's Cognitive Examination (ACE) was the preferable tool for dementia screening (Sn: 79-100%; Sp: 86%).

    CONCLUSION: This systematic review found that there are three screening approaches for detecting early dementia and MCI at primary health care. ACE and MoCA are recommended tools for screening of dementia and MCI, respectively.

  15. Abdullah N, Abdul Murad NA, Mohd Haniff EA, Syafruddin SE, Attia J, Oldmeadow C, et al.
    Public Health, 2017 Aug;149:31-38.
    PMID: 28528225 DOI: 10.1016/j.puhe.2017.04.003
    OBJECTIVE: Malaysia has a high and rising prevalence of type 2 diabetes (T2D). While environmental (non-genetic) risk factors for the disease are well established, the role of genetic variations and gene-environment interactions remain understudied in this population. This study aimed to estimate the relative contributions of environmental and genetic risk factors to T2D in Malaysia and also to assess evidence for gene-environment interactions that may explain additional risk variation.
    STUDY DESIGN: This was a case-control study including 1604 Malays, 1654 Chinese and 1728 Indians from the Malaysian Cohort Project.
    METHODS: The proportion of T2D risk variance explained by known genetic and environmental factors was assessed by fitting multivariable logistic regression models and evaluating McFadden's pseudo R(2) and the area under the receiver-operating characteristic curve (AUC). Models with and without the genetic risk score (GRS) were compared using the log likelihood ratio Chi-squared test and AUCs. Multiplicative interaction between genetic and environmental risk factors was assessed via logistic regression within and across ancestral groups. Interactions were assessed for the GRS and its 62 constituent variants.
    RESULTS: The models including environmental risk factors only had pseudo R(2) values of 16.5-28.3% and AUC of 0.75-0.83. Incorporating a genetic score aggregating 62 T2D-associated risk variants significantly increased the model fit (likelihood ratio P-value of 2.50 × 10(-4)-4.83 × 10(-12)) and increased the pseudo R(2) by about 1-2% and AUC by 1-3%. None of the gene-environment interactions reached significance after multiple testing adjustment, either for the GRS or individual variants. For individual variants, 33 out of 310 tested associations showed nominal statistical significance with 0.001 
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