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Prevalence, awareness, treatment and control of hypertension in Malaysia: a national study of 16,440 subjects

Rampal L, Rampal S, Azhar MZ, Rahman AR

Public Health, 2008 Jan;122(1):11-8.
PMID: 17981310 DOI: 10.1016/j.puhe.2007.05.008

Study design: A cross-sectional study was conducted in all states of Malaysia to determine the prevalence, awareness, treatment and control of hypertension. A stratified two-stage cluster sampling design with proportional allocation was used.
Methods: Trained nurses obtained two blood pressure measurements from each subject. Hypertension was defined as mean systolic blood pressure >140 mmHg, diastolic blood pressure >90 mmHg, or a self-reported diagnosis of hypertension and taking antihypertensive medication. All data were analysed using Stata 9.2 software and took the complex survey design into account. A two-sided P-value of <0.05 was considered to be statistically significant.
Results: The overall prevalence of hypertension for subjects aged 15 years was 27.8% (95% confidence interval (CI) 26.9-28.8). The prevalence of hypertension was significantly higher in males (29.6%, 95% CI 28.3-31.0) compared with females (26.0%, 95% CI 25.0-27.1). Multivariate logistic regression showed that the odds of having hypertension increased with increasing age, in males, in subjects with a family history of hypertension, with increasing body mass index, in non-smokers and with decreasing levels of education. Only 34.6% of the subjects with hypertension were aware of their hypertensive status, and 32.4 were taking antihypertensive medication. Amongst the latter group, only 26.8% had their blood pressure under control. The prevalence of hypertension amongst those aged 30 years has increased from 32.9% in 1996 to 40.5% in 2004.
Conclusion: In Malaysia, the prevalence of hypertension is high, but levels of awareness, treatment and control are low. There is an urgent need for a comprehensive integrated population-based intervention programme to ameliorate the growing problem of hypertension in Malaysians.
Fulltext Effectiveness of peer-led education on knowledge, attitude and risk behavior practices related to HIV among students at a Malaysian public university--a randomized controlled trial

Ibrahim N, Rampal L, Jamil Z, Zain AM

Prev Med, 2012 Nov;55(5):505-10.
PMID: 22982947 DOI: 10.1016/j.ypmed.2012.09.003

OBJECTIVE: Develop, implement and evaluate the effectiveness of a peer-led education program related to HIV/AIDS among university students.
METHOD:
DESIGN: randomized controlled trial with 276 university students at Faculty of Medicine and Health Sciences University Putra Malaysia (UPM), Serdang in 2011.
INTERVENTION: A peer-led education program on HIV prevention by university students.
OUTCOME: differences in knowledge, attitude and risk behavior practices related to HIV between baselines, immediate follow-up after intervention and after three months.
RESULTS: Significant improvement in sound knowledge in the intervention group as compared to the control group (Odds ratio, 1.75; 95% CI 1.01, 3.00; p=0.04) and improvement in good attitude related to HIV (Odds ratio 2.22; 95% CI 1.37, 3.61; p=0.01). The odds of high substance risk behavior was significantly reduced in the intervention group as compared to the control group (Odds ratio 0.07; 95% CI 0.02, 0.34; p=0.01). The association between good knowledge and intervention was modified by the different time points (baseline, immediately after intervention and 3 months after intervention), ethnicity and gender.
CONCLUSION:
Peer-led education program in HIV prevention improves knowledge, attitude and substance risk behavior. Changes in sexual risk behavior may require a longer follow-up.
Fulltext Ethnic differences in the prevalence of metabolic syndrome: results from a multi-ethnic population-based survey in Malaysia

Rampal S, Mahadeva S, Guallar E, Bulgiba A, Mohamed R, Rahmat R, et al.

PLoS One, 2012;7(9):e46365.
PMID: 23029497 DOI: 10.1371/journal.pone.0046365

The prevalence of metabolic syndrome is increasing disproportionately among the different ethnicities in Asia compared to the rest of the world. This study aims to determine the differences in the prevalence of metabolic syndrome across ethnicities in Malaysia, a multi-ethnic country.
Fulltext Mobile phone reminders and peer counseling improve adherence and treatment outcomes of patients on ART in Malaysia: A randomized clinical trial

Abdulrahman SA, Rampal L, Ibrahim F, Radhakrishnan AP, Kadir Shahar H, Othman N

PLoS One, 2017;12(5):e0177698.
PMID: 28520768 DOI: 10.1371/journal.pone.0177698

BACKGROUND: Adherence to treatment remains the cornerstone of long term viral suppression and successful treatment outcomes among patients receiving Antiretroviral Therapy (ART).
OBJECTIVE(S): Evaluate the effectiveness of mobile phone reminders and peer counseling in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia.
METHODS: A single-blind, parallel group RCT conducted in Hospital Sungai Buloh, Malaysia in which 242 adult Malaysian patients were randomized to intervention or control groups. Intervention consisted of a reminder module delivered through SMS and telephone call reminders by trained research assistants for 24 consecutive weeks (starting from date of ART initiation), in addition to adherence counseling at every clinic visit. The length of intended follow up for each patient was 6 months. Data on adherence behavior of patients was collected using specialized, pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires. Data on weight, clinical symptoms, CD4 count and viral load tests were also collected. Data was analyzed using SPSS version 22 and R software. Repeated measures ANOVA, Friedman's ANOVA and Multivariate regression models were used to evaluate efficacy of the intervention.
RESULTS: The response rate after 6 months follow up was 93%. There were no significant differences at baseline in gender, employment status, income distribution and residential location of respondents between the intervention and control group. After 6 months follow up, the mean adherence was significantly higher in the intervention group (95.7; 95% CI: 94.39-96.97) as compared to the control group (87.5; 95% CI: 86.14-88.81). The proportion of respondents who had Good (>95%) adherence was significantly higher in the intervention group (92.2%) compared to the control group (54.6%). A significantly lower frequency in missed appointments (14.0% vs 35.5%) (p = 0.001), lower viral load (p = 0.001), higher rise in CD4 count (p = 0.017), lower incidence of tuberculosis (p = 0.001) and OIs (p = 0.001) at 6 months follow up, was observed among patients in the intervention group.
CONCLUSION: Mobile phone reminders (SMS and telephone call reminders) and peer counseling are effective in improving adherence and treatment outcomes among HIV positive patients on ART in Malaysia. These findings may be of potential benefit for collaborative adherence planning between patients and health care providers at ART commencement.
Fulltext Effectiveness of health education intervention in improving knowledge, attitude, and practices regarding Tuberculosis among HIV patients in General Hospital Minna, Nigeria - A randomized control trial

Bisallah CI, Rampal L, Lye MS, Mohd Sidik S, Ibrahim N, Iliyasu Z, et al.

PLoS One, 2018;13(2):e0192276.
PMID: 29470530 DOI: 10.1371/journal.pone.0192276

INTRODUCTION: The risk of development of active TB in HIV-infected individuals is 20-37 times higher than those that are HIV negative. Poor knowledge of TB amongst people living with HIV has been associated with high transmission.
OBJECTIVES: To determine the effectiveness of a new health education intervention module in improving knowledge, attitude, and practice (KAP) regarding tuberculosis among HIV patients in General Hospital Minna, Nigeria.
METHODS: A randomized control trial was carried out from July 2015 to June 2017. A random number generating program was used to allocate 226 respondents into 2 groups. The intervention group received health education regarding tuberculosis using the developed module. The control group received the normal services provided for HIV patients. Data were collected from December 2015 to September 2016 at baseline, immediate post intervention, three, six and nine months. The outcome measures were knowledge, attitude, and practice.
RESULTS: There was no significant difference with respect to socio-demographic characteristics, KAP of the respondents in the intervention and control group at baseline. However, there was significant improvement in knowledge in the intervention group compared to the control group, group main effect (F = (1,218) = 665.889, p = 0.001, partial ἠ2 = 0.753, d = 5.4); time (F = (3.605, 218) = 52.046, p = 0.001, partial ἠ2 = 0.193, d = 1.52) and interaction between group with time (F = (3.605, 218) = 34.028, p = 0.001, partial ἠ2 = 0.135, d = 1.23). Likewise, there was significant improvement in attitude, group main effect (p = 0.001, d = 1.26) and time (p = 0.001, p, d = 0.65). Similarly, there was improvement in practice, group main effect, time, and interaction of group with time (p < 0.05).
CONCLUSION: The health education intervention program was effective in improving KAP regarding tuberculosis among HIV patients.
Fulltext Effects of a school-based intervention to reduce cardiovascular disease risk factors among secondary school students: A cluster-randomized, controlled trial

Amoah J, Said S, Rampal L, Manaf R, Ibrahim N, Owusu-Agyei S, et al.

PLoS One, 2021;16(11):e0259581.
PMID: 34762713 DOI: 10.1371/journal.pone.0259581

BACKGROUND: Cardiovascular diseases (CVDs) are the number cause of death worldwide. In Ghana CVD has been the leading cause of death since 2001. The prevalence of CVD risk factors among adolescents in Ghana has been increasing. This study seeks to develop, implement and evaluate the effects of a behavioral modification intervention program to reduce CVD risk factors among secondary school students in Brong Ahafo, Ghana.
METHODS: A cluster-randomized controlled trial was conducted with schools as clusters over a period of six-months with pre and post intervention evaluations. Participants were public secondary school students (14-19 years) from four schools in Brong Ahafo, Ghana. Students in the intervention group were trained by the researchers whereas those of the control group received no intervention. The intervention included health education and physical activity modules. Follow-up data using same questionnaire were collected within two weeks after the intervention was completed. Intention-to-treat analysis was performed after replacing missing values using the multiple imputation method. The generalized linear mixed model (GLMM) was used to assess the effects of the intervention study.
RESULTS: The GLMM analyses showed the intervention was effective in attaining 0.77(p<0.001), 0.72(p<0.001), 0.47(p<0.001), 0.56(p<0.001), and 0.39(p = 0.045) higher total physical activity, fruits, vegetables, seafood, and water scores respectively for the intervention group over the control group. The intervention was also significant in reducing -0.15(p<0.001),-0.23(p<0.001),-0.50(p<0.001),-0.32(p<0.001),-0.90(p<0.001),-0.87(p<0.001),-0.38(p<0.001), -0.63(p<0.001), -1.63(p<0.001), 0.61(p<0.001), and -1.53(p = 0.005) carbohydrates, fats and oils, fried eggs, fried chicken, carbonated drinks, sugar, sweet snacks, salted fish, weight, BMI, and diastolic BP. The odds of quitting alcohol use in the intervention group were 1.06 times more than the control group. There was no significant effect on reducing smoking and systolic BP.
CONCLUSION: There is an urgent need for the intervention program to be integrated into the existing curriculum structure of secondary school schools. Implementing the intervention will allow for longer and more consistent impact on the reduction of CVD risk factors among secondary school students.
Fulltext Prevalence, associated factors and predictors of depression among adults in the community of Selangor, Malaysia

Kader Maideen SF, Sidik SM, Rampal L, Mukhtar F

PLoS One, 2014;9(4):e95395.
PMID: 24755607 DOI: 10.1371/journal.pone.0095395

INTRODUCTION: Depression is one of the most common mental health disorders and is an emerging public health problem. The objectives of this paper were to determine the prevalence of depression, its associated factors and the predictors of depression among adults in the community of Selangor.
METHODS: A cross sectional study was conducted in three districts in Selangor, from 11th June to 30th December 2012. The sampling frame was obtained from the Department of Statistics Malaysia (DOS) in May 2012, using the National Population and Housing Census 2010. Adults aged 18 years and above, living in the selected living quarters were approached to participate in the study and requested to complete a set of questionnaires.
RESULTS: A total of 1,556 out of 2,152 participants participated in this study, giving an overall study response rate of 61.90%. Patient Health Questionnaire 9 (PHQ-9) was used to determine the presence of depression. The prevalence of depression was 10.3%, based on the PHQ-9 cut off point of 10 and above. Based on multiple logistic regression analysis, the predictors of depression were presence of anxiety, serious problems at work, unhappy relationship with children, high perceived stress, domestic violence, unhappy relationship with spouse, low self-esteem, unhappy relationship with family, serious financial constraint and presence of chronic diseases. When reanalyzed after removing anxiety, high perceived stress and low self-esteem, additional predictors of depression were found to be serious marital problems and religiosity.
CONCLUSION: The prevalence of depression in this study is similar to that found in other studies. Findings from this study are being used as baseline data to develop an effective program to assist in the management of common mental health disorders in the community, in particular depression. The identification of predictors of depression in the community is important to identify the target population for the program.
Fulltext Sociodemographic profile and predictors of outpatient clinic attendance among HIV-positive patients initiating antiretroviral therapy in Selangor, Malaysia

Abdulrahman SA, Rampal L, Othman N, Ibrahim F, Hayati KS, Radhakrishnan AP

Patient Prefer Adherence, 2017;11:1273-1284.
PMID: 28794617 DOI: 10.2147/PPA.S141609

BACKGROUND: Inconsistent literature evidence suggests that sociodemographic, economic, and system- and patient-related factors are associated with clinic attendance among the HIV-positive population receiving antiretroviral therapy (ART) around the world. We examined the factors that predict outpatient clinic attendance among a cohort of HIV-positive patients initiating ART in Selangor, Malaysia.

PATIENTS AND METHODS: This cross-sectional study analyzed secondary data on outpatient clinic attendance and sociodemographic, economic, psychosocial, and patient-related factors among 242 adult Malaysian patients initiating ART in Selangor, Malaysia. Study cohort was enrolled in a parent randomized controlled trial (RCT) in Hospital Sungai Buloh Malaysia between January and December 2014, during which peer counseling, medication, and clinic appointment reminders were provided to the intervention group through short message service (SMS) and telephone calls for 24 consecutive weeks. Data on outpatient clinic attendance were extracted from the hospital electronic medical records system, while other patient-level data were extracted from pre-validated Adult AIDS Clinical Trial Group (AACTG) adherence questionnaires in which primary data were collected. Outpatient clinic attendance was categorized into binary outcome - regular attendee and defaulter categories - based on the number of missed scheduled outpatient clinic appointments within a 6-month period. Multivariate regression models were fitted to examine predictors of outpatient clinic attendance using SPSS version 22 and R software.

RESULTS: A total of 224 (93%) patients who completed 6-month assessment were included in the model. Out of those, 42 (18.7%) defaulted scheduled clinic attendance at least once. Missed appointments were significantly more prevalent among females (n=10, 37.0%), rural residents (n=10, 38.5%), and bisexual respondents (n=8, 47.1%). Multivariate binary logistic regression analysis showed that Indian ethnicity (adjusted odds ratio [AOR] =0.235; 95% CI [0.063-0.869]; P=0.030) and heterosexual orientation (AOR =4.199; 95% CI [1.040-16.957]; P=0.044) were significant predictors of outpatient clinic attendance among HIV-positive patients receiving ART in Malaysia.

CONCLUSION: Ethnicity and sexual orientation of Malaysian patients may play a significant role in their level of adherence to scheduled clinic appointments. These factors should be considered during collaborative adherence strategy planning at ART initiation.

Study site: Outpatient clinic, Hospital Sungai Buloh Malaysia
Fulltext Effectiveness of chemotherapy counselling on self-esteem and psychological affects among cancer patients in Malaysia: Randomized controlled trial

Mohd-Sidik S, Akhtari-Zavare M, Periasamy U, Rampal L, Fadhilah SI, Mahmud R

Patient Educ Couns, 2018 05;101(5):862-871.
PMID: 29336859 DOI: 10.1016/j.pec.2018.01.004

OBJECTIVES: The aim of this study was to implement and evaluate the outcomes of chemotherapy counselling based on the "Managing Patients on Chemotherapy" module on self-esteem and psychological affect (anxiety, depression) of cancer patients by pharmacists in ten selected government hospitals in Peninsular Malaysia.
METHODS: A randomized control trial was conducted among 2120 cancer patients from April 2016 to January 2017 in ten selected government hospitals in Peninsular Malaysia. Cancer patients were randomly assigned to intervention and control groups. The intervention group received chemotherapy counselling by pharmacists based on the "Managing Patients on Chemotherapy" module. The outcomes were assessed at baseline, 1st, 2nd and 3rd follow-ups after counselling. In the course of data analysis; independent sample t-test, chi-square and two-way repeated measures ANOVA were conducted.
RESULTS: Mean scores of self-esteem in the intervention group had significant difference in comparison with those of the control group in the 1st, 2nd and 3rd follow-ups after counselling (P 
Fulltext Prevalence of cardiovascular risk factors in a rural community in mukim dengkil, selangor

Yunus AM, Mohd Sidik S, Nor Afiah M, Rampal L, Tiew Kh

Malays J Nutr, 2004 Mar;10(1):5-11.
PMID: 22691743 MyJurnal

Hypertension and obesity are established and independent risk factors for cardiovascular diseases. There are important inter-relationships between these two factors that may explain the aetiology of coronary heart disease. To determine the prevalence of hypertension and obesity in a rural community setting in Malaysia, and to identify their associated factors, a cross-sectional study was conducted among residents aged 15 years and above in Mukim Dengkil, Selangor from June to October 1999. Sample size was 570, giving a response rate of 86.7%. Prevalence of hypertension was 26.8%, with the highest prevalence among those aged 60 years and above (57.3%), and 50 to 59 years old (53.3%). Factors found to be significantly associated with hypertension were male (χ²=4.71, df=1, p<0.05) and age (t=10.7, df=568, p<0.01). Prevalence of obesity was 11.4%, with the highest prevalence among those aged 40 to 49 years (22.7%) and 30 to 39 years (14.4%). The factors associated with obesity were age (p<0.01), female (χ²=12.45, df=1, p<0.05) and ethnicity (Fisher's Exact probability, p<0.05) with Chinese and Malays having a higher prevalence compared to other ethnic groups. However, there was no significant association between hypertension and obesity (OR=1.14, 95% CI=0.65, 2.02). The prevalence of hypertension and obesity in this study is high. There is a need for prevention programs for these risk factors in rural communities in Malaysia.
Fulltext Smoking in Kelantan State, Malaysia : has it changed since the national survey in 1996?

Rampal L, Aziz SI, Razin A, Sanjay R

Malaysian Journal of Public Health Medicine, 2004;4(2):54-58.
MyJurnal

A cross sectional study was conducted in Kelantan state with the objectives to determine the prevalence of smoking in 2004 and to determine the relationship between smoking and age, sex, educational level, family and peer influence. All residents aged 15 years and above from all the selected households were included in this study. A standardized pre-tested structured questionnaire was used in this study. Out of 1025 respondents interviewed the prevalence of ever and current smokers was 34% and 25.1% respectively.The prevalence of ever smokers and current smokers was significantly higher In males as compared to females (p.<0.001). The mean initiation age for the males current smokers was 10.4 (95% CI = 19.4, 21.5) years with a range from 7 to 66 years. For the females the mean initiation age was 31 (95% Cl =26.8, 35.2) years with a range from 15 to 64 years. The difference between the mean initiation age between male and female smokers was statistically significant (p<0.0001). The overall mean duration of smoking was 23.9 years with a median of 23 years. It ranged from less than 1 year to 66 years. There was no significant difference between the mean duration of smoking between male and females current smokers (p =0.59). There was a significant association between current smoking status and education level (p<0.01 ) and between smoking and peer influence (p<0.01). There was no significant difference in smokers whose parents were smokers as compared to non-smokers whose parents were smokers. In conclusion the prevalence of smoking in Kelantan state in 2004 is lower than the reported prevalence in 1996. However, it is still very high especially in the males.
Key words: Smoking, peer influence, Kelantan
Fulltext The prevalence of hypertension and smoking in the subdistrict of Dengkil, Selangor

Mohd Yunus, A., Sherina, M.S., Nor Afiah, M.Z., Rampal, L., Tiew, K.H.

Malaysian Journal of Public Health Medicine, 2003;3(2):5-9.
MyJurnal

Hypertension and smoking are established and independent risk factors for cardiovascular diseases. There are important inter-relationships between these two factors that may explain the aetiology of coronary heart disease. This study was conducted to determine the prevalence of hypertension and smoking in a rural community setting in Malaysia, and to identify their associated factors. A cross sectional study was conducted among residents aged 15 years and above in Mukim Dengkil, Sepang, Selangor, Malaysia from June to October 1999. Systematic random sampling was used to select the respondents. Results: Five-hundred and seventy respondents agreed to participate giving a response rate of 86.7%. The overall prevalence of hypertension was 26.8%. The prevalence was 31.7% among males, and 23.5% among females. Factors found to be significantly associated with hypertension were males and age. The overall prevalence of smoking was 21.2%. The prevalence among males was 48.7%, where as the prevalence was only 2.6% among females. The factors associated with smoking were males, ethnicity with Malays showing the highest prevalence of 27.2% and age. However, there was no significant association between hypertension and smoking. The prevalence of hypertension in this study is high. However, the prevalence of smoking in this study was slightly lower compared to the result found by the 2nd Malaysian National Health and Morbidity Survey (NHMS2).
Fulltext The prevalence of depressive symptoms and potential risk factors that may cause depression among adult women in Selangor.

Sherina, M.S., Rampal, L., Azhar, M.Z.

Malaysian Journal of Psychiatry, 2008;17(2):1-9.
MyJurnal

Introduction: Women are exposed to stress such as working full time while still being responsible for the family and house.
Objective: The objective of this study was to determine the prevalence of depressive symptoms among adult women in Selangor, and to determine the potential risk factors associated with depression.
Method: A community based cross sectional study was conducted in all districts of Selangor state, Malaysia in July 2004. Multi stage stratified proportionate to size sampling method was used to collect data. The Patient Health Questionnaire (PHQ-9) was used to determine the presence or absence of depressive symptoms among the respondents. All respondents aged 20 to 59 years old in the selected households were interviewed.
Results: Out of 1032 women, 972 agreed to participate in this study, giving a response rate of 94.2%. The mean age of the respondents was 37.91 ± 10.91. Majority were Malays (54.9%), married (83.8%) and had secondary education (54.5%). The results showed that the prevalence of depressive symptoms was 8.3% in Selangor. Race, religion, education level, history of having a miscarriage within the last 6 months and history of difficulty in getting pregnant were significantly associated with depressive symptoms (p<0.05). Women with history of a miscarriage within the last 6 months and absence of formal education were potential risk factors for depressive symptoms (OR, CI = 2.576 (1.165-5.696), p<0.01 and OR, CI = 5.766 (1.949-17.053), p < 0.01).
Conclusion: Depressive symptoms among adult women in Selangor was 8.3% and was associated with race, religion, education, history of miscarriage and difficulty in getting pregnant. The main potential risk factors were having a miscarriage within the last 6 months and absence of formal education.
Keywords: Depressive symptoms, Prevalence and Risk Factors, Selangor Women
Fulltext Sound HIV knowledge and common misconceptions about HIV among university students

Normala I, Zubaidah JO, Nik Shaliza H, Hamidin A, Noorjan KON, Siti Irma Fadhilah I, et al.

Malaysian Journal of Medicine and Health Sciences, 2013;9(1):29-34.
MyJurnal

The objective of the study was to determine the proportion of sound HIV knowledge and common misconceptions about HIV among university students. A set of pre tested and validated questionnaire assessing sound HIV knowledge and common misconceptions about HIV was used in this cross sectional study. HIV knowledge was defined as sound when one was able to identify correctly two ways of preventing the sexual transmission of HIV and reject three major misconceptions about HIV. Out of 300 respondents, 298 completed the questionnaire giving a response rate of 99.3%. A total of 40.9% of university students have sound HIV knowledge. The majority of those who lacked sound HIV knowledge were young (60.2%) and female (60.4%). A significant proportion still believed that HIV can be transmitted via social contact (13.8%), by sneezing or coughing (11.4%) and mosquito bites (10.1%). About 6.7% were believed wrongly that HIV can be treated by vaccine and healthy-looking people cannot have HIV.
Study site: Universiti Putra Malaysia (UPM), Malaysia
Fulltext Prevalence of hypertension among Malay adolescents in Putrajaya secondary schools, Malaysia, 2010

Rampal L, Ng KC, Nur Izzati I, Farah Izzati Z, Mohammad Nazrul I, Faisal I, et al.

Malaysian Journal of Medicine and Health Sciences, 2011;7(2):53-60.
MyJurnal

Background: In Malaysia, the prevalence of hypertension amongst adults aged 30 years and above has increased from 32.9% in 1996 to 40.5% in 2004 and to 42.6% in 2006. Information on the prevalence of hypertension among adolescents is lacking.
Objective: to determine the prevalence of hypertension among Malay secondary school students in Putrajaya.
Methods: A cross sectional study was carried out in Putrajaya, Malaysia. The sampling frame consisted of a list of all the 12 secondary schools in Putrajaya. Three schools were selected using table of random numbers. All Malay students aged 13 years old to 17 years old from the three selected school students were included in the study. Blood pressure was measured after the respondents had rested for at least 5 minutes using a standard mercury sphygmomanometer. Three blood pressure measurements were taken for each respondent. Systolic blood pressure [SBP] was defined as the average of three SBP readings and diastolic blood pressure [DBP] was defined as the average of three DBP readings. Data was analyzed using SPSS 18.
Results: The overall mean SBP and DBP were 108.9 mmHg and 63.2 mmHg respectively. The prevalence of pre-hypertension and hypertension among the male was 16.2% and 12.9% respectively as compared to 5.8% and 10.2% respectively in the females. The overall prevalence of prehypertension and hypertension was 11.1% and 11.6% respectively. The prevalence increased with age (p<0.05). There was a significant positive correlation between BMI and SBP (r = 0.52, r2 = 0.27, p= 0.001) and BMI and DBP (r = 0.38, r2 = 0.15, p= 0.001). The mean SBP was significantly higher in males (111.7 mmHg) as compared to 106 mmHg in females (p<0.001). The mean DBP in males (63.5 mmHg) was slightly higher as compared to 62.9 mmHg in females but the difference was not significant.
Conclusions: Prevalence of hypertension and pre-hypertension is high. There is an urgent need for implementation of a comprehensive CVD prevention program and routine blood pressure measurements should be taken in school children to improve the detection, prevention and treatment of hypertension
Keywords: Prevalence, Hypertension, Adolescents, Putrajaya, Malaysia
Fulltext Prevalence of urban poor and its health related factors in the state of Selangor, Malaysia

Sherina, M.S., Rampal, L., Hejar, A.R., Rozali, A., Mohd Yunusn, A.

Malaysian Journal of Medicine and Health Sciences, 2011;7(1):-.
MyJurnal

The objectives of this study were to determine the prevalence of the urban poor and its health related factors in Selangor. This cross-sectional study was conducted in the community of Selangor. Data was collected from January 2006 to June 2006. Three out of nine districts were selected to be involved in the study, which were Klang, Kuala Langat and Petaling. A Multistage Stratified Proportionate Systematic Random Sampling was used for this study. The sampling was carried out by the Statistics Department of Malaysia. The survey frame was based on the information gathered from the Population and Housing Census in year 2000. The respondents were interviewed by trained research assistants using a structured pre-tested standardized questionnaire prepared in Malay and English languages. A monthly income of RM706 and less was used to define urban poor based on the guidelines given by the Economy Planning Unit of Malaysia (2004). SPSS 16.0 version was used to analyze the data. Out of 2535 respondents interviewed in this study, 2491 respondents answered the questionnaire completely (response rate 98.3%). Out of 2491 respondents, 202 (8.1%) had a monthly income of RM706 and less. Analysis of the urban poor respondents found that majority were aged between 18 to 40 years old (55.9%), and 29.7% had diagnosed medical illnesses, where hypertension, diabetes and asthma were the most common illnesses at 12.4%, 10.9% and 5.0% respectively. About 10% of the urban poor respondents had physical disabilities such as blurring of vision (7.9%), hearing problems (1.0%) and other disabilities (1.0%).
Fulltext Prevalence of hypertension and its associated factors among university staff

Rampal, L., Somayeh, A. B., Salmiah, M. S., Faisal, I., Sharifah Zainiyah, S. Y.

Malaysian Journal of Medicine and Health Sciences, 2011;7(2):61-71.
MyJurnal

Introduction: In Malaysia, cardiovascular diseases (CVD) have been the leading cause of death for the past 40 years. Hypertension is the leading treatable risk factor for CVD mortality.
Objectives: to determine the prevalence and factors associated with hypertension among University Putra Malaysia staff.
Methods: A Cross sectional study design was used in this study. The sample was selected using table of random numbers. Two blood pressure measurements were taken from respondents aged 30 years and above. Data on socio-demographic variables and lifestyle-related risk factors were collected using a pre-tested structured questionnaire. Weight and height measurements were also taken.
Results: Out of 517 respondents selected, 454 subjects agreed to participate, giving a response rate of 87.8%. The overall mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) for 454 respondents was 126.2 mmHg and 80.17 mmHg respectively. The mean SBP was significantly higher in males (129.68 mmHg) as compared to the females (122.65 mmHg). The mean SBP and DBP significantly increased with age in both males and females (p<0.05). There was a significant relationship between SBP and BMI (r = 0.55, r2 = 0.30 p <0.001) and diastolic blood pressure and BMI (r = 0.53, r2 = 0.28, p <0.001). The overall prevalence of hypertension was 34.4% and 33.9% had pre hypertension. Hypertension was significantly associated with age, gender, family history of hypertension, BMI and alcohol consumption. Conclusions: Prevalence of hypertension and pre-hypertension is high. There is an urgent need for implementation of a comprehensive CVD prevention program. Routine blood pressure measurements should be taken to improve the detection, prevention and treatment of hypertension.
Keywords: Hypertension, Prevalence, Risk Factors, University Staff, Prevalence
Fulltext Prevalence of smoking and Its associated factors among university staff

Fasoro, A.A., Rampal, L., Sherina, M.S., Salmiah, M.S.

Malaysian Journal of Medicine and Health Sciences, 2013;9(2):45-51.
MyJurnal

Globally, one person dies every six seconds as a result of tobacco use. This makes tobacco use the cause of every one out of 10 deaths in adults and the single largest and leading cause of preventable death in the world. The objective of this study was to determine the prevalence of smoking among staff of Universiti Putra Malaysia. For the purpose of this study an analytical cross sectional study design was used and a standardized, pre-tested, while a validated well-structured questionnaire was used for data collection. The prevalence of smoking was found to be 10.0% (26.5% among males and 0.5% among females). In addition, significant associations were found between smoking and gender, religion, marital status, highest educational level, occupation, and family income (p < 0.05). In particular, gender and educational level were significant predictors of smoking. In conclusion, the prevalence of smoking among university staff was shown to be considerably lower than that stated for the national level. However, the University could aim at achieving zero prevalence in the years to come.
Fulltext Attitude towards sex: study of secondary schoolchildren in Selangor state

Maha, A., Azhar, M. Z., Sherina, M. S., Sharmili, V., Rampal, L., Abdah, A., et al.

Malaysian Journal of Medicine and Health Sciences, 2010;6(1):33-61.
MyJurnal

Introduction: HIV/AIDS is one of the leading health problems worldwide. There is an increasing rate among the ages between 13 to 49 years old. School based intervention is an important component of community-based interventions for HIV/AIDS and is the best stage to promote abstinence which is best maintained among those not sexually experienced. Objectives: This study was carried out to determine attitude towards sex among secondary school children in Selangor state. Methods: A cross-sectional study design was used. Four out of nine districts in Selangor state were selected at random. Students were divided according to gender, academic performance (good or poor) with no behavioural problems
and students with evidence of behaviour problems (at risk). Results: Out of 149 students, the majority (56.4%) were females. The majority of students did not think sex should be discussed in depth and do not speak to parents, teachers, religious teachers, counselors, relatives, doctors or nurses but speak to friends regarding sex. More than half watch pornography. A significantly higher percentage of male students in the weak and at-risk group admit to thinking of intimacy (hugging and kissing) with the opposite gender. A higher number of these students would try sex out of curiosity, for fun, because it was difficult to say ‘no’ to and that they would like it. A significantly higher percentage will try sex because they did not want to hurt their girlfriends’ feeling by saying ‘no’. While the majority of students think intimacy will end in sex, a significantly higher percentage of male at-risk students think just talking with the opposite gender will end in sex. The majority of male students responded feeling attracted to the picture of a girl in sexy clothing but a significantly higher percentage of at-risk students also felt attracted to the picture of a girl properly attired. A significantly higher percentage of male at-risk students say parents do not say sex before marriage is wrong and a significantly higher percentage of
male students of weak and at-risk groups say girlfriends say sex before marriage is okay. A significantly higher percentage of weak and at-risk students speak to doctors regarding sex and think sex should be discussed in depth. Conclusion: Weak and at-risk male students appeared to have a more vulnerable attitude towards sex. This may predispose them to risky sexual behaviours leading to HIV/AIDS. Poor academic performance and behaviour problems may not be different as potential sexual risk predictors. The information obtained will be useful in designing intervention programmes in the prevention of HIV/AIDS.
Fulltext Major dietary patterns and their associations with socio-demographic characteristics and obesity among adolescents in Petaling district, Malaysia

Garba, J.A., Rampal, L., Hejar, A.R., Salmiah, M.S.

Malaysian Journal of Medicine and Health Sciences, 2014;10(1):13-21.
MyJurnal

Dietary pattern analysis has emerged as important instruments to identify modifiable dietary risk factors for non-communicable diseases. The aim of this study was to determine the major dietary patterns among adolescents in Petaling District, Selangor and their associations with socio-demographic characteristics and obesity. An analytic cross- sectional study design was conducted in selected secondary schools in Petaling District. Sampling with probability proportionate to size was used and five schools were selected. Self-administered semi-quantitative food frequency questionnaire was used for data collection. Weight was measured with a digital bathroom scale (TANITA model) and height was measured using SECA body meter. Principal component factor analysis using varimax orthogonal transformation was used to identify the dietary patterns. Chi square was used to test for associations of dietary patterns with socio-demographic characteristics and obesity. Three major dietary patterns were identified: firstly, fruits and vegetables; secondly, sugar and fatand finally, meat and chicken which explained for 12.7%, 11.6% and 10.7% variation in food intake, respectively. There were significant associations between ethnicity, religion, family income, educational level of parents and the dietary patterns. However, there was no significant association between obesity and the dietary patterns. It may be more effective to describe a healthy diet using results of dietary pattern analysis in public health intervention, rather than describing single food items or nutrients. It is recommended that nutrition education programmes should be implemented in schools so as to prevent the development of obesity in the non-obese.

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