Displaying publications 21 - 40 of 144 in total

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  1. Does breastfeeding really save lives, or are apparent benefits due to biases?
    Habicht JP, DaVanzo J, Butz WP
    Am J Epidemiol, 1986 Feb;123(2):279-90.
    PMID: 3946377
    Analysis of mothers' recall data collected in 1976-1977 by a probability survey in Peninsular Malaysia shows an association between breastfeeding up to six months of age and improved survival of infants throughout the first year of life. Inappropriate sample selection and inadequate control of confounding can introduce large biases in these analyses. The magnitude and direction of these biases are presented. Even when these biases are dealt with, unsupplemented breastfeeding appears more beneficial than supplemented breastfeeding. The younger the infant and the longer the breastfeeding, the greater the estimated benefits in terms of deaths averted. The use of powdered infant formula did not appear to offset the detrimental effects of early weaning and supplementation. The positive relationships found in these analyses between breastfeeding and survival are not due to death precluding or terminating breastfeeding. Nor are they likely to be due to a shift away from breastfeeding because of recent illness, which was also controlled in the analyses. Nor are they likely to be due to other factors that both increase mortality risk and shorten breastfeeding; when such factors are taken into account, the beneficial effects of breastfeeding become stronger and imply that, if there had been no breastfeeding in this sample, twice as many babies would have died after the first week of life.
    Matched MeSH terms: Infant Mortality*
  2. On consanguineous marriages and the genetic load
    Chakraborty R, Chakravarti A
    Hum Genet, 1977 Apr 07;36(1):47-54.
    PMID: 870410
    It has been reported that studies of the genetic consequences of inbreeding should adopt a different strategy in populations having a relatively old inbreeding history and where inbreeding levels have varied over time. This contention is tested with a series of 39,495 single-birth records from Bombay, India, collected in a World Health Organization survey on congenital malformations. Our analysis reveals that: 1. the incidence of major malformations is significantly higher among the inbred offspring (1.34%) as compared to that among non-inbred ones (0,81%)--a finding at variance with a previous study in the same area; 2. the inbreeding effect on perinatal mortality (stillbirths and mortality during the first few days of life) is also found to be significant. In view of the above findings, the genetic load as disclosed by inbreeding is computed for perinatal mortality, major malformations and pooling these together. A + B, the measure of the number of lethal equivalents per gamete, is found to be at variance with other reports. Such variability can be ascribed to non-genetic factors. Supporting evidence collected from Brazil and Malaysia in the same survey is also presented.
    Matched MeSH terms: Infant Mortality
  3. Changes in the process of care and outcome over a 10-year period in a neonatal nursery in a developing country
    Ho JJ, Chang AS
    J Trop Pediatr, 2007 Aug;53(4):232-7.
    PMID: 17578848
    Over a 10-year period there was increasing involvement by clinicians in the generation and implementation of evidence-based practices in the neonatal intensive care unit (NICU). For two cohorts of very low birth weight (VLBW) babies admitted 10 years apart to a developing country, NICU were compared and changes occurring in process of care that might have contributed to any change in outcome were documented.
    Matched MeSH terms: Infant Mortality
  4. A hazard rate analysis of fertility using duration data from Malaysia
    Chang C
    Res Popul Econ, 1988;6:137-59.
    PMID: 12280927
    Matched MeSH terms: Infant Mortality*
  5. Pneumonia and diarrhoeas: killers of toddlers in developing countries
    Chen ST
    Trop Geogr Med, 1975 Mar;27(1):103-8.
    PMID: 806152
    Pneumonia and diarrhoeas are an important cause of toddler mortality and morbidity in developing countries. Of the 147 children admitted to the University Hospital at Kuala Lumpur in 1971 for pneumonia and diarrhoeas 50 (34%) were found to be suffering from protein-calorie malnutrition of varying degrees of severity. The malnourished children tended to come from poorer homes, and to have a larger number of siblings born in rapid succession when compared with normal weight children. Anemia was more common among the malnourished children. The interaction of infection and malnutrition and the social implications of these diseases are important. It is vital that hospitals in developing countries promote health in addition to their traditional curative role.
    Matched MeSH terms: Infant Mortality
  6. Fulltext Population & social indicators of food and nutrition in Peninsular Malaysia
    Chong YH
    Med J Malaysia, 1982 Jun;37(2):134-40.
    PMID: 6813659
    Health, including nuirition is not independent but is closely associated with the social and economic environment. Malnutrition itself can cause death, but more commonly, it can cause considerable ill-health, physical retardation, impaired mental performance, loss in productivity and a decline in the quality of life. The effects of malnutrition as obstacles to socio-economic development are now well recognised. In a rapidly developing country like Malaysia, the nutritional and nutritionally-related problems present themselves with contrasting features. While population indicators such as toddler mortality, incidence of low birthweight and food balance sheet studies suggest an improving nutritional situation, methods of direct assessment have shown that chronic protein-energy malnutrition and anaemia are sWI common amongst pre-school children in both the rural and urban disadvantaged sectors. Moderate anaemia also affects a significant proportion of older children and women of childbearing age. Intestinal parasites, another indicator of under development at the local level, are ubiquitous in the rural setting and urban slums owing to unsatisfactory waste disposal. In striking contrast, diseases associated with dietary excesses and increasing affluence have now emerged as the major killers. This changing pattern of mortality and morbidity along the lines encountered by the industrialised societies is now dramatised by the fact that road accidents are now claiming a large number of victims. It is clear that while continued efforts should be given to the improvement of the nutritional health of both rural and urban poverty communities, little time should be wasted in considering the adoption of public health measures aimed at stemming the rising number of deaths associated with our increasing affluence, particularly those diseases that are nutritionally linked, such as coronary heart disease, hypertension and diabetes mellitus, not forgetting the increasing road toll afflicted by the motor vehicle.
    Matched MeSH terms: Infant Mortality
  7. Aspects of ecology of food and nutrition in Peninsular Malaysia
    Chong YH
    J Trop Pediatr Environ Child Health, 1976 Oct;22(5):238-56.
    PMID: 1051830
    Matched MeSH terms: Infant Mortality
  8. Six year trend of neonatal septicaemia in a large Malaysian maternity hospital
    Boo NY, Chor CY
    J Paediatr Child Health, 1994 Feb;30(1):23-7.
    PMID: 8148183
    A study carried out in the Maternity Hospital, Kuala Lumpur over a 6 year period from 1986 to 1991, showed that the annual rates of septicaemia ranged from 5.2 to 10.2/100 admissions. Septicaemia accounted for between 11.0 to 30.4% of all neonatal deaths. The case fatality ratios ranged from 23.0 to 52.2%, being highest in 1989 when basic facilities were compromised. Low birthweight neonates accounted for 55.5% of those with septicaemia. The most common causative organisms were Staphylococcus epidermidis and Staphylococcus aureus in 1986 and 1987, but from 1988 Klebsiella species became the most common. More than 50% of neonatal septicaemia occurred after the age of 2 days. The results of the study demonstrated the dynamism of infection control: when control measures introduced earlier were not sustained, outbreaks of nosocomial infection recurred or worsened.
    Matched MeSH terms: Infant Mortality
  9. Birth weight and the effects of birth spacing and breastfeeding on infant mortality
    Millman SR, Cooksey EC
    Stud Fam Plann, 1987 Jul-Aug;18(4):202-12.
    PMID: 3629662 DOI: 10.2307/1966871
    Analyses previously reported, based on data from the World Fertility Survey (WFS), are replicated here with data from the Malaysian Family Life Survey. Comparison of results, when data limitations inherent in the World Fertility Surveys are reproduced or relaxed, suggests that these limitations cause little distortion, and thus bolsters confidence in the validity of results based on WFS data in which these limitations are inescapable. Generalizations based on the present investigation and on the body of previous work that it tends to validate are presented. Most significantly, these include the greater importance of both breastfeeding and birth spacing under generally unfavorable conditions, the variability of durations to which some benefit of continued breastfeeding persists, and the observation that the great majority of birth-spacing effects operate through some mechanism other than the association of breastfeeding with birth interval lengths.
    PIP: Analyses previously reported, based on data from the World Fertility Survey (WFS) are replicated with data from the Malaysian Family Life Survey, based on a stratified probability sample for 1,262 ever-married women 50 years of age in Peninsular Malaysia. Comparison of the results, when data limitations inherent in the WFS are reproduced or relaxed, suggests that these limitations cause little distortion, and thus bolsters confidence in the validity of results based on WFS data in which these limitations are inescapable. Generalizations based on the present investigation and on the body of previous work that it tends to validate are presented. The greater importance of both breastfeeding and birth spacing under generally unfavorable conditions becomes clear. The relationship between breastfeeding and survival for all births, as well as for the last 2 births, emphasized in this model, has a logit coefficint significant at the .01 level for the 1st month of life as well as the period from birth to 1 year. The durations to which some benefit of continued breastfeeding persists, are variable. In countries where the situation generally is more favorable to child survival, as indicated by rates of infant mortality, breastfeeding's positive effects on child survival are less significant. Breastfeeding promotion and continuation should be the goal especially for programs operating among very poor groups. The great majority of birth spacing effects operate through some mechanism other than the association of breastfeeding with birth interval lengths, as indicated by the fact that significant survival advantages are often associated with birth spacing after controlling for breastfeeding
    Matched MeSH terms: Infant Mortality*
  10. A short investigation of infantile mortality and child welfare on estates in Kedah
    Cross B
    Journal of the Malaya Branch of the British Medical Association, 1940;4:141-63.
    Matched MeSH terms: Infant Mortality
  11. Fulltext Impact of increasing capacity for generating and using research on maternal and perinatal health practices in South East Asia (SEA-ORCHID Project)
    SEA-ORCHID Study Group, Lumbiganon P, McDonald SJ, Laopaiboon M, Turner T, Green S, et al.
    PLoS One, 2011;6(9):e23994.
    PMID: 21915274 DOI: 10.1371/journal.pone.0023994
    BACKGROUND: Maternal and neonatal mortality and morbidity remain unacceptably high in many low and middle income countries. SEA-ORCHID was a five year international collaborative project in South East Asia which aimed to determine whether health care and health outcomes for mothers and babies could be improved by developing capacity for research generation, synthesis and use.

    METHODS: Nine hospitals in Indonesia, Malaysia, the Philippines and Thailand participated in SEA-ORCHID. These hospitals were supported by researchers from three Australian centres. Health care practices and outcomes were assessed for 1000 women at each hospital both before and after the intervention. The capacity development intervention was tailored to the needs and context of each hospital and delivered over an 18 month period. Main outcomes included adherence to forms of care likely to be beneficial and avoidance of forms of care likely to be ineffective or harmful.

    RESULTS: We observed substantial variation in clinical practice change between sites. The capacity development intervention had a positive impact on some care practices across all countries, including increased family support during labour and decreased perineal shaving before birth, but in some areas there was no significant change in practice and a few beneficial practices were followed less often.

    CONCLUSION: The results of SEA-ORCHID demonstrate that investing in developing capacity for research use, synthesis and generation can lead to improvements in maternal and neonatal health practice and highlight the difficulty of implementing evidence-based practice change.

    Matched MeSH terms: Infant Mortality
  12. Infant mortality and socioeconomic development: evidence from Malaysian household data
    DaVanzo J
    Demography, 1988 Nov;25(4):581-95.
    PMID: 3267541
    Household data from Malaysia are used to assess the roles of a number of mortality correlates in explaining the inverse relationship between the infant mortality rate (IMR) and socioeconomic development. Increases in mothers' education and improvements in water and sanitation are the most important household-level changes that accompany regional and temporal development and contribute to the inverse relationship between the IMR and development. One concomitant of development--reduced reduced breastfeeding--has kept the relationship from being even stronger. Continued prevalence of extended breastfeeding in the poorer states of Peninsular Malaysia and a narrowing of educational and sanitation differentials helped close the IMR gap between the richer and the poorer states.
    Matched MeSH terms: Infant Mortality*
  13. Environmental factors in the relationship between breastfeeding and infant mortality: the role of sanitation and water in Malaysia
    Butz WP, Habicht JP, DaVanzo J
    Am J Epidemiol, 1984 Apr;119(4):516-25.
    PMID: 6711541
    Mothers' recall data collected in Malaysia in 1976-1977 are analyzed to study correlates of mortality of 5471 infants. Respondent population is 1262 women living in 52 primary sampling units of Peninsular Malaysia. Lengths of unsupplemented and supplemented breastfeeding and presence of piped household water and toilet sanitation are related to infant mortality in regressions that also control other correlates. The analysis is disaggregated into three periods of infancy. Through six months of feeding, unsupplemented breastfeeding is more strongly associated with fewer infant deaths than is supplemented breastfeeding. Type of sanitation is generally more strongly associated with mortality than is type of water supply. The effects of breastfeeding and the environmental variables are shown to be strongly interactive and to change systematically during the course of infancy. Breastfeeding is more strongly associated with infant survival in homes without piped water or toilet sanitation. In homes with both modern facilities, supplemented breastfeeding has no significant effect, and unsupplemented breastfeeding is statistically significant only for mortality in days 8-28. Presence of modern water and sanitation systems appears unimportant for mortality of infants who are breastfed without supplementation for six months.
    Matched MeSH terms: Infant Mortality*
  14. Fulltext Ethnicity and infant mortality in Malaysia
    Dixon G
    Asia Pac Popul J, 1993 Jun;8(2):23-54.
    PMID: 12287522
    PIP: Malaysian infant mortality differentials are a worthwhile subject for study, because socioeconomic development has very clearly had a differential impact by ethnic group. The Chinese rates of infant mortality are significantly lower than the Malay or Indian rates. Instead of examining the obvious access to care issues, this study considered factors related to the culture of infant care. Practices include the Chinese confinement of the mother in the first month after childbirth ("pe'i yue") and Pillsbury's 12 normative rules for Malaysian Chinese care. Malay practices vary widely by region and history. Indian mothers are restricted by diet. Data-recording flaws do not permit analysis of Sarawak or Sabah. The general assumption that Western medicine favors better health for mothers and infants is substantiated among peninsular communities, however, there are also negative impacts which affect infant mortality. The complex interaction of factors impacting on infant mortality reported in seven previous studies is discussed. A review of these studies reveals that immediate causes are infections, injuries, and dehydration. Indirect causes are birth weight or social and behavioral factors such as household income or maternal education. Indirect factors, which are amenable to planned change and influence the biological proximate determinants of infant mortality, are identified as birth weight, maternal age at birth, short pregnancy intervals or prior reproductive loss, sex of the child, birth order, duration of breast feeding and conditions of supplementation, types of household water and sanitation, year of child's birth, maternal education, household income and composition, institution of birth, ethnicity, and rural residence. Nine factors are identified empirically as not significant: maternal hours of work in the child's first year, maternal occupation, distance from home to workplace, presence of other children or servants, incidence of epidemics in the child's first year of life, community types of sanitation, prices and availability of infant foods, and access to various types of medical care. Future empirical study should consider factors such as class differences, place of residence, or extent of illiteracy as underlying or related to ethnicity. Policy-makers should be aware that future decline in infant mortality rates may depend on the blending of traditional with modern practices.
    Matched MeSH terms: Infant Mortality*
  15. Life expectancy in an aboriginal Malaysian population
    Dobbins JG
    Southeast Asian J. Trop. Med. Public Health, 1979 Mar;10(1):106-14.
    PMID: 483006
    A life table for an aboriginal Malaysian population, the Semelai, living in West Malaysia, was constructed using censuses from 1965, 1969, and 1974; and interview data from 1974. The life expectancy at birth for this population, 54.0 years, was compared to that of other Malaysian populations and selected Asian populations. This comparison indicated that the Semelai were at a disadvantage compared to the Malaysian populations, but in a favorable position when compared with the other Asian populations.
    Matched MeSH terms: Infant Mortality
  16. NORMS FOR FAMILY SIZE IN UNDERDEVELOPED AREAS
    FREEDMAN R
    Proc. R. Soc. Lond., B, Biol. Sci., 1963 Dec 10;159:220-45.
    PMID: 14087992 DOI: 10.1098/rspb.1963.0074
    Matched MeSH terms: Infant Mortality*
  17. Child survivorship estimation: methods and data analysis
    Feeney G
    Asian Pac Popul Forum, 1991;5(2-3):51-5, 76-87.
    PMID: 12343438
    "The past 20 years have seen extensive elaboration, refinement, and application of the original Brass method for estimating infant and child mortality from child survivorship data. This experience has confirmed the overall usefulness of the methods beyond question, but it has also shown that...estimates must be analyzed in relation to other relevant information before useful conclusions about the level and trend of mortality can be drawn.... This article aims to illustrate the importance of data analysis through a series of examples, including data for the Eastern Malaysian state of Sarawak, Mexico, Thailand, and Indonesia. Specific maneuvers include plotting completed parity distributions and 'time-plotting' mean numbers of children ever born from successive censuses. A substantive conclusion of general interest is that data for older women are not so widely defective as generally supposed."
    Matched MeSH terms: Infant Mortality*
  18. Low birth weight in Kuala Lumpur
    Tahir HM, Ismail NN, Gebbie DA
    Asia Oceania J Obstet Gynaecol, 1991 Jun;17(2):135-42.
    PMID: 1867582
    Low birth weight babies are defined as those weighing under 2,500 g. They make 13.5% of all births at the Maternity Hospital, Kuala Lumpur but contribute to 74.8% of all deaths. They are most likely to be Indian babies and least likely to be Chinese. Among all 3 communities, the primigravidae tend to produce smaller babies than multiparae but this is also true for the Indian of parity more than 3. The Malay teenager is more likely to produce small babies than their older counterparts but not so with the Indian and Chinese. There are definite clinical factors associated with or causing the births of small babies and the lighter the baby, the more influential are these factors. Maternal hypertension, antepartum haemorrhage, multiple pregnancy and unexplained intrauterine death are the 4 outstanding associations with both low birth weight and perinatal death. Although the spontaneous (often premature) onset of labour was the commonest preceding factor, it was much less important in the lowest birth weight groups of babies and was a less important contributor to perinatal death.
    Matched MeSH terms: Infant Mortality
  19. Women's autonomy and child survival: a comparison of Muslims and non-Muslims in four Asian countries
    Ghuman SJ
    Demography, 2003 Aug;40(3):419-36.
    PMID: 12962056 DOI: 10.1353/dem.2003.0021
    In this article, I evaluate the hypothesis that higher infant and child mortality among Muslim populations is related to the lower autonomy of Muslim women using data from 15 pairs of Muslim and non-Muslim communities in India, Malaysia, the Philippines, and Thailand. Women's autonomy in various spheres is not consistently lower in Muslim than in non-Muslim settings. Both across and within communities, the association between women's autonomy and mortality is weak, and measures of autonomy or socioeconomic status are generally of limited import for understanding the Muslim disadvantage in children's survival.
    Matched MeSH terms: Infant Mortality*
  20. Fulltext Epidemiology of necrotising enterocolitis in Malaysian neonates
    Boo NY, Goon HK
    Singapore Med J, 1989 Oct;30(5):444-8.
    PMID: 2617297
    Over a 21-month period, 108 of 45,770 neonates born in the Maternity Hospital, Kuala Lumpur, developed necrotising enterocolitis (NEC). The incidence of NEC was 2.4 per 1000 livebirths or 2.7 per 100 special care nursery (SCN) admissions in this Hospital. There was no significant difference in the incidence between the sexes or among the different races. NEC was most common (9.4%) in the very low birthweight (VLBW: neonates weighing less than 1500 grams) and the preterms of less than 34 week gestation (8.4%). 54.6% of the patients developed the condition during the first week of life. NEC occurred throughout the year in our nursery with clustering of cases intermittently. The case fatality ratio of the condition was 28.7%. NEC accounted for 5.7% of our Hospital's neonatal (less than 28 days of life) and postneonatal (greater than or equal to 28 days of life) deaths. There was no significant difference in the rates of occurrence of placental praevia, prolonged rupture of amniotic membranes, maternal pregnancy-induced hypertension, birth asphyxia, apnoea, respiratory distress, patent ductus arteriosus and exchange blood transfusion in neonates with NEC and those in the control group. Our findings on Malaysian neonates were comparable with those reported in the literature on neonates in developed countries.
    Matched MeSH terms: Infant Mortality
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