Displaying publications 41 - 60 of 304 in total

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  1. Wong LP, Atefi N, Majid HA, Su TT
    BMC Public Health, 2014;14 Suppl 3(Suppl 3):S1.
    PMID: 25438066 DOI: 10.1186/1471-2458-14-S3-S1
    BACKGROUND: This study aimed to investigate the prevalence of pregnancy experience and its association with contraceptive knowledge among single adults in a low socio-economic suburban community in Kuala Lumpur, Malaysia.

    METHODS: A cross-sectional survey was conducted in 2012 among the Kerinchi suburban community. Of the total 3,716 individuals surveyed, young single adults between 18 and 35 years old were questioned with regard to their experience with unplanned pregnancy before marriage. Contraceptive knowledge was assessed by a series of questions on identification of method types and the affectivity of condoms for the prevention of sexually transmitted diseases.

    RESULTS: A total of 226 female and 257 male participants completed the survey. In total, eight female (3.5%) participants reported experience with an unplanned pregnancy before marriage, and five male (1.9 %) participants had the experience of impregnating their partners. The participants had a mean total score of 3.15 (SD = 1.55) for contraceptive knowledge out of a possible maximum score of five. Female participants who had experienced an unplanned pregnancy had a significantly lower contraceptive knowledge score (2.10 ± 1.48) than who had never experienced pregnancy (3.30 ± 1.35), p<0.05. Likewise, male participants who had experienced impregnating their partners had a significantly lower contraceptive knowledge score (1.60 ± 1.50) than those who did not have such experience (3.02 ± 1.59), p<0.05.

    CONCLUSION: The results showed evidence of premarital unplanned pregnancy among this suburban community. The low level of contraceptive knowledge found in this study indicates the need for educational strategies designed to improve contraceptive knowledge.

  2. Bauman A, McNeil N, Nicholson M, O'Halloran P, Seal E, Randle E, et al.
    BMC Public Health, 2023 Feb 15;23(1):333.
    PMID: 36793043 DOI: 10.1186/s12889-023-15091-2
    INTRODUCTION: Addressing gender inequalities in physical activity is an important public health goal. A major campaign, 'This Girl Can' (TGC) was conducted by Sport England from 2015, and TGC was licenced in 2018 by VicHealth in Australia for development and use in a 3-year mass media campaign. The campaign was adapted through formative testing to Australian conditions and implemented within the state of Victoria. The purpose of this evaluation was to assess the initial population impact of the first wave of the TGC-Victoria.

    METHODS: We assessed campaign impact using serial population surveys, with the target population being women living in Victoria who were not meeting the current physical activity guidelines. Two surveys were carried out before the campaign (October 2017 and March 2018), and the post-campaign survey immediately following the first wave of TGC-Victoria mass media (May 2018). Analyses were primarily on the cohort sample of 818 low-active women followed across all three surveys. We measured campaign effects using campaign awareness and recall, and self-report measures of physical activity behaviour and perceptions of being judged. Changes in perceptions of being judged and in reported physical activity were assessed in relation to campaign awareness over time.

    RESULTS: Overall, TGC-Victoria campaign recall increased from 11.2% pre-campaign to 31.9% post-campaign, with campaign awareness more likely among younger and more educated women. There was a slight increase of 0.19 days in weekly physical activity following the campaign. Feeling that being judged was a barrier to physical activity declined at follow up, as did the single item perceptions of feeling judged (P 

  3. Md Yusop NB, Mohd Shariff Z, Hwu TT, Abd Talib R, Spurrier N
    BMC Public Health, 2018 03 01;18(1):299.
    PMID: 29490648 DOI: 10.1186/s12889-018-5206-2
    BACKGROUND: Interventions that encompass behavioural modifications of dietary intake and physical activity are essential for the management of obesity in children. This study assessed the effectiveness of a stage-based lifestyle modification intervention for obese children.

    METHODS: A total of 50 obese children (7-11 years old) were randomized to the intervention group (IG, n = 25) or the control group (CG, n = 25). Data were collected at baseline, at follow-up (every month) and at six months after the end of the intervention. IG received stage-based lifestyle modification intervention based on the Nutrition Practice Guideline for the Management of Childhood Obesity, while CG received standard treatment. Changes in body composition, physical activity and dietary intake were examined in both the intervention and control groups.

    RESULTS: Both groups had significant increases in weight (IG: 1.5 ± 0.5 kg; CG: 3.9 ± 0.6 kg) (p 

  4. Lim AH, Ab Rahman N, Nasarudin SNS, Velvanathan T, Fong MCC, Mohamad Yahaya AH, et al.
    BMC Public Health, 2024 Jan 03;24(1):79.
    PMID: 38172715 DOI: 10.1186/s12889-023-17579-3
    BACKGROUND: There are two parallel systems in Malaysian primary healthcare services: government funded public primary care and privately-owned practices. While there have been several studies evaluating antibiotic utilisation in Malaysian public healthcare, there is a lack of literature on the use of antibiotics in the private sector. There is a dire need to evaluate the more recent performance of public vs. private community healthcare in Malaysia. As such, this study aimed at measuring and comparing the utilisation of antibiotics in the public and private community healthcare sectors of Malaysia in 2018-2021.

    METHODS: This study was a retrospective analysis of antibiotic utilisation in Malaysian primary care for the period of 1 January 2018 until 31 December 2021 using the nationwide pharmaceutical procurement and sales data from public and private health sectors. Rates of antibiotic utilisation were reported as Defined Daily Doses per 1000 inhabitants per day (DID) and stratified by antibiotic classes. The secondary analysis included proportions of AWaRe antibiotic category use for each sector and proportion of antibiotic utilisation for both sectors.

    RESULTS: The overall national antibiotic utilisation for 2018 was 6.14 DID, increasing slightly to 6.56 DID in 2019, before decreasing to 4.54 DID in 2020 and 4.17 DID in 2021. Private primary care antibiotic utilisation was almost ten times higher than in public primary care in 2021. The public sector had fewer (four) antibiotic molecules constituting 90% of the total antibiotic utilisation as compared to the private sector (eight). Use of Access antibiotics in the public sector was consistently above 90%, while use of Access category antibiotics by the private sector ranged from 64.2 to 68.3%. Although use of Watch antibiotics in the private sector decreased over the years, the use of Reserve and 'Not Recommended' antibiotics increased slightly over the years.

    CONCLUSION: Antibiotic consumption in the private community healthcare sector in Malaysia is much higher than in the public sector. These findings highlight the need for more rigorous interventions targeting both private prescribers and the public with improvement strategies focusing on reducing inappropriate and unnecessary prescribing.

  5. Wong CY, Zalilah MS, Chua EY, Norhasmah S, Chin YS, Siti Nur'Asyura A
    BMC Public Health, 2015;15:680.
    PMID: 26194643 DOI: 10.1186/s12889-015-2058-x
    Double-burden of malnutrition (DBM) is an emerging public health concern among the Orang Asli (indigenous peoples) of Peninsular Malaysia. This study aimed to identify the presence of DBM at the community and household levels in Orang Asli population and its associated demographic and socio-economic factors.
  6. Kaur KN, Niazi F, Thakur R, Saeed S, Rana S, Singh H
    BMC Public Health, 2023 May 26;23(1):979.
    PMID: 37237332 DOI: 10.1186/s12889-023-15840-3
    INTRODUCTION: The healthcare system is critical to the country's overall growth, which involves the healthy development of individuals, families, and society everywhere. This systematic review focuses on providing an overall assessment of the quality of healthcare delivery during COVID-19.

    METHODOLOGY: The literature search was conducted from March 2020 till April 2023 utilising the databases "PubMed," "Google Scholar," and "Embase." A total of nine articles were included. Descriptive statistics was performed using Microsoft Excel. PROSPERO registration ID- CRD42022356285.

    RESULTS: According to the geographic location of the studies included, four studies were conducted in Asia [Malaysia(n = 1); India (Madhya Pradesh) (n = 1); Saudi Arabia(n = 1); Indonesia (Surabaya) (n = 1)], three in Europe [U.K. (n = 1); Poland (n = 1); Albania (n = 1)] and two in Africa [Ethiopia(n = 1); Tunisia (n = 1)]. Overall patient satisfaction was found highest among studies conducted in Saudi Arabia (98.1%) followed by India (Madhya Pradesh) (90.6%) and the U.K. (90%).

    CONCLUSION: This review concluded five different aspects of patients satisfaction level i.e. reliability, responsiveness, assurance, empathy, and tangibility. It was found that the empathy aspect had the greatest value of the five factors, i.e., 3.52 followed by Assurance with a value of 3.51.

  7. Nur Atikah AH, Wee LH, Nur Zakiah MS, Chan CMH, Mohamed Haniki NM, Swinderjit JS, et al.
    BMC Public Health, 2019 Jun 13;19(Suppl 4):579.
    PMID: 31196055 DOI: 10.1186/s12889-019-6857-3
    BACKGROUND: This study focused on the associations between socioeconomic status (SES) and adolescent smoking among secondary school students (13 to 17 years) in the Federal Territory of Kuala Lumpur, Malaysia. Our objective was to evaluate the relationships between adolescent demographics, socioeconomic status and smoking status.

    METHODS: The survey data were based on baseline findings from a cross-sectional study (N = 422 adolescents). Chi-square test was used to assess the relationship between demographic characteristics, socioeconomic status (household monthly income and daily allowance) and adolescent smoking status. Exhaled carbon monoxide (CO) reading and the Hooked on Nicotine Checklist (HONC) were used to evaluate adolescent smoking status. A Multivariate Multinomial Logistic Regression (MMLR) was employed to test selected demographic and socioeconomic predictors of smoking status.

    RESULTS: Of the 422 adolescents (M age = 15.58, SD = 1.24), more than half of the participants initiated smoking between 13 to 17 years old (59.0%). A total of 308 (73.0%) were electronic cigarette users, with more than 50% comprising of single users. The mean CO reading was 2.14 ppm with 78.0% of adolescents scoring more than 0 on the Hooked on Nicotine Checklist (HONC). Males and participants aged 15 and 16 years were at increased risks of sole CC smoking. Meanwhile, males, those who are not hooked on smoking and with a non-smoker CO reading were at increased risks of sole EC smoking. Finally, Bumiputeras were at less risk of EC smoking.

    CONCLUSIONS: Demographic variables such as age, gender and ethnicity predicted smoking status predicted smoking risk, but not socioeconomic factors. The findings allow policy makers to target specific high-risk demographic groups when designing smoking cessation programs for adolescents.
  8. Wee LH, Yeap LLL, Chan CMH, Wong JE, Jamil NA, Swarna Nantha Y, et al.
    BMC Public Health, 2019 Jun 13;19(Suppl 4):540.
    PMID: 31196096 DOI: 10.1186/s12889-019-6860-8
    BACKGROUND: Organization productivity is strongly linked to employees' socioeconomic characteristics and health which is marked by absenteeism and presenteeism. This study aims to identify anteceding factors predicting employees' absenteeism and presenteeism by income, physical and mental health.

    METHODS: An online health survey was conducted between May to July 2017 among employees from 47 private companies located in urban Malaysia. A total of 5235 respondents completed the 20-min online employee health survey on a voluntary basis. Chi-Square or Fisher's exact tests were used to determine association between income with demographic and categorical factors of absenteeism and presenteeism. Multivariate linear regression was used to identify factors predicting absenteeism and presenteeism.

    RESULTS: More than one third of respondents' monthly income were less than RM4,000 (35.4%), 29.6% between RM4,000-RM7,999 and 35.0% earned RM8,000 and above. The mean age was 33.8 years (sd ± 8.8) and 49.1% were married. A majority were degree holders (74.4%) and 43.6% were very concerned about their financial status. Mean years of working was 6.2 years (sd ± 6.9) with 68.9% satisfied with their job. More than half reported good general physical health (54.5%) (p = 0.065) and mental health (53.5%) (p = 0.019). The mean hours of sleep were 6.4 h (sd ± 1.1) with 63.2% reporting being unwell due to stress for the past 12 months. Mean work time missed due to ill-health (absenteeism) was 3.1% (sd ± 9.1), 2.8% (sd ± 9.1) and 1.8% (sd ± 6.5) among employees whose monthly income was less than RM4,000, RM4,000-RM7,999 and over RM8,000 respectively (p = 0.0066). Mean impairment while working due to ill-health (presenteeism) was 28.2% (sd ± 25.3), 24.9% (sd ± 25.5) and 20.3% (sd ± 22.9) among employees whose monthly income was less than RM4,000, RM4,000-RM7,999 and over RM8,000 respectively (p 

  9. Lew B, Osman A, Chan CMH, Chen WS, Ibrahim N, Jia CX, et al.
    BMC Public Health, 2021 02 09;21(1):322.
    PMID: 33563254 DOI: 10.1186/s12889-021-10370-2
    BACKGROUND: There is a need to understand the psychological characteristics of suicide attempters to prevent future suicide attempts. This study aims to examine potential differences between individuals who have attempted suicide and those who have not done so, on several risk and protective measures.

    METHOD: Participants were 11,806 undergraduate students from seven provinces in China, of which 237 reported a non-fatal suicide attempt. We used the random numbers generator function within the SPSS to randomly select a control subset of 1185 participants to be used as the comparison group based on a 1:5 case-control ratio. Scores on three commonly used risk measures (depression, hopelessness, and psychache) and three protective measures (social support, self-esteem, and purpose in life) for suicidality were adopted to compare the responses of the two groups.

    RESULTS: Suicide attempters had indicated higher Median scores for all three risk factor measurements. Suicide attempters also reported significantly lower Median scores for all three protective factor measurements compared to non-suicide attempters. The results suggest that the suicide attempters' group had higher risks of suicidality compared to the non-attempter group.

    CONCLUSIONS: Suicide attempters continued to report higher scores of risk factors and lower scores of protective factors, indicating that they may continue to be at a higher likelihood of a suicide attempt. Key protective factors should be identified for each individual in order to deliver appropriate clinical interventions to reduce their risk of reattempting.

  10. Sukirman R, Wahyono TYM, Shivalli S
    BMC Public Health, 2020 Jun 15;20(1):933.
    PMID: 32539758 DOI: 10.1186/s12889-020-09035-3
    BACKGROUND: Reducing maternal mortality ratio (MMR) is a high priority public health issue in developing countries such as Indonesia. The current MMR in Indonesia is 126/100,000 live births. Optimum use of available healthcare facilities for delivery can avert maternal deaths. This study aimed to determine the factors associated with healthcare facility utilization for childbirth in Kuantan Singingi regency, Riau province, Indonesia 2017.

    METHODS: We conducted a community-based cross-sectional study in 15 sub-districts of Kuantan Singingi regency from May-June 2017. We selected 320 mothers from 15 sub-districts who delivered in the last 3 months (February-April 2017). Trained data enumerators collected the relevant data by using a pre-tested semi-structured questionnaire. We used Cox regression analysis to determine the factors associated with delivery at healthcare facilities. Prevalence Ratio (PR) with a 95% confidence interval (CI) for childbirth at healthcare facilities was the key outcome measure.

    RESULTS: Only 54.4% (174) of the 320 mothers delivered at healthcare facilities. Knowledge about pregnancy danger signs (PR = 1.59, 95%CI:1.15-2.2), attitude towards healthcare services (PR = 0.79, 95%CI:0.33-1.89), and access to health care services (PR = 0.39, 95%CI:0.18-0.84) were the dominant factors of childbirth at healthcare facilities. There was an interaction between attitude and access to healthcare influencing delivery at healthcare facilities.

    CONCLUSIONS: Utilization of healthcare facilities for childbirth was low in Kuantan Singingi regency. Knowledge of pregnancy danger signs was an independent correlate of childbirth at healthcare facilities. Also, the interaction between attitude and access to healthcare showed a significant influence on childbirth at healthcare facilities. We recommend strengthening of existing maternal and child health program with a particular emphasis on complete and quality antenatal care, health education on danger signs of pregnancy and childbirth, and promoting positive attitudes towards healthcare facilities.

  11. Ng CM, Kaur S, Kok EY, Chew WL, Takahashi M, Shibata S
    BMC Public Health, 2023 Sep 16;23(1):1803.
    PMID: 37716989 DOI: 10.1186/s12889-023-16655-y
    BACKGROUND: Psychological wellbeing during pregnancy is imperative for optimal maternal outcomes. The present study aimed to determine the association between sleep quality, light exposure at night, and psychological wellbeing in the 2nd and 3rd trimesters of pregnancy.

    METHODS: This prospective study was conducted in 9 randomly selected government maternity clinics in Kuala Lumpur, Malaysia. Healthy women aged 20-48 years old with single pregnancy were recruited using convenience sampling (n = 169). Sleep quality, light exposure at night, and psychological wellbeing were self-reported using the Pittsburgh Sleep Quality Index (PSQI), Harvard Light Exposure Assessment (H-LEA), and Depression, Anxiety, and Stress Scale (DASS-21) in the 2nd trimester and followed-up at the 3rd trimester.

    RESULTS: During the 2nd and 3rd trimesters of pregnancy, mild to severe symptoms of stress (10.7 and 11.3%), anxiety (42 and 44.3%), and depression (9.6 and 16.6%) were observed among the participants. Adjusted multiple linear regression revealed that poor sleep quality and higher light exposure at night were attributed to greater stress and depression symptoms in the 3rd trimester. Higher lux level exposed from 10 pm to 

  12. Khor GL, Shariff ZM
    BMC Public Health, 2019 Dec 16;19(1):1685.
    PMID: 31842826 DOI: 10.1186/s12889-019-8055-8
    The purpose of this correspondence is to express our disappointment with the coverage of the BMC Public Health supplement: Vol 19 (4) titled "Health and Nutritional Issues Among Low Income Population in Malaysia", which neglected to include the fundamental health and nutrition issues that are adversely affecting the lives and livelihood of the indigenous peoples. The Supplement comprised 21 papers. Two of these papers included indigenous peoples as study subjects. These two papers addressed peripheral, albeit important health issues, namely visual impairment and quality of life, and not the persistent and rising health concerns impacting this population. We will provide evidence from research and reports to justify our critique that the Supplement missed the opportunity to spotlight on the serious extent of the health and nutritional deprivations of the indigenous peoples of Malaysia. As researchers of the indigenous peoples, we ought to lend our voice to the "silenced minority" by highlighting their plight in the media including scientific journals.
  13. Teo CH, Chin YS, Lim PY, Masrom SAH, Shariff ZM
    BMC Public Health, 2019 Oct 30;19(1):1427.
    PMID: 31666034 DOI: 10.1186/s12889-019-7708-y
    BACKGROUND: Malnutrition among school children may contribute to adverse health consequences such as non-communicable diseases, poor cognitive performance, psychological distress and poor quality of life that may persist into adulthood. In order to prevent childhood malnutrition, an intervention programme that integrates nutrition education and healthy school food environment is needed to provide nutrition information and reinforce the skills on healthy eating behaviours in schools. This paper describes a study protocol of a school-based intervention programme that integrates nutrition education and healthy school food environment, namely School Nutrition Programme (SNP). The SNP is a primary prevention programme that promotes healthy lifestyle among primary school children in light of the high prevalence of malnutrition in Malaysian children.

    METHODS/DESIGN: This quasi-experimental study aimed to evaluate the effectiveness of the SNP between intervention and comparison groups before and after the SNP, and after a 3-month follow-up. The SNP consisted of two main components, whereby three nutrition education sessions were implemented by trained teachers using three standardised modules, and healthy school food environment was implemented by the canteen food handlers with the provision of healthy menu to children during school recess times. Children from intervention group participated in the SNP, in addition to the standard Physical and Health Curriculum. The comparison group attended only the standardised Physical and Health Curriculum and the school canteen food handlers were reminded to follow the standard canteen guidelines from the Ministry of Education Malaysia. The assessment parameters in evaluating the effectiveness of the programme were knowledge, attitude and practice on nutrition, eating behaviours, physical activity, body composition, psychological distress, cognitive performance and health-related quality of life. Assessments were conducted at three time points: pre-intervention, post-intervention and 3-month follow-up.

    DISCUSSION: It was hypothesised that the SNP would be effective in promoting healthy lifestyle among school children, and further contributes in preventing malnutrition problem, enhancing cognitive performance and improving health-related quality of life among school children. Findings of the present study can be expanded to other schools in future on ways to improve nutrition education and healthy school food environment.

    TRIAL REGISTRATION: UMIN Clinical Trial Registration UMIN000032914 (Date of registration: 7th June 2018, retrospectively registered).

    PROTOCOL VERSION: 16th September 2019 & Version 4.

  14. Murukesu RR, Singh DKA, Shahar S
    BMC Public Health, 2019 Jun 13;19(Suppl 4):529.
    PMID: 31196015 DOI: 10.1186/s12889-019-6870-6
    BACKGROUND: Urinary incontinence (UI) is known to be more prevalent among women and is associated with decline in quality of life. The aim of our study was to investigate the prevalence, risk factors of urinary incontinence and its impact on quality of life among community dwelling older women living in urban and rural populations.

    METHODS: This study was conducted based on secondary data analysed from the third phase of the longitudinal study "Neuroprotective Model for Health Longevity among Malaysian Elderly" (LRGS TUA). Stratification of urban and rural study areas were in accordance to that determined by the Department of Statistics. A total of 814 community dwelling older women (53% urban, 47% rural), aged 60 years and above, across four states within Peninsular Malaysia were included in this analysis. Interview-based questionnaires were used to obtain respondents' sociodemographic details and clinical characteristics. The Timed Up and Go test and Handgrip Strength tests were used to assess physical function. Urinary incontinence was self-reported, and quality of life of those with incontinence was assessed using the King's Health Questionnaire (KHQ).

    RESULTS: Prevalence of urinary incontinence was 16% and 23% among older women living in urban and rural areas, respectively. Ethnicity was significantly associated with incontinence among older women in both urban and rural population (p 

  15. Nawi AM, Ismail R, Ibrahim F, Hassan MR, Manaf MRA, Amit N, et al.
    BMC Public Health, 2021 Nov 13;21(1):2088.
    PMID: 34774013 DOI: 10.1186/s12889-021-11906-2
    BACKGROUND: Drug abuse is detrimental, and excessive drug usage is a worldwide problem. Drug usage typically begins during adolescence. Factors for drug abuse include a variety of protective and risk factors. Hence, this systematic review aimed to determine the risk and protective factors of drug abuse among adolescents worldwide.

    METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was adopted for the review which utilized three main journal databases, namely PubMed, EBSCOhost, and Web of Science. Tobacco addiction and alcohol abuse were excluded in this review. Retrieved citations were screened, and the data were extracted based on strict inclusion and exclusion criteria. Inclusion criteria include the article being full text, published from the year 2016 until 2020 and provided via open access resource or subscribed to by the institution. Quality assessment was done using Mixed Methods Appraisal Tools (MMAT) version 2018 to assess the methodological quality of the included studies. Given the heterogeneity of the included studies, a descriptive synthesis of the included studies was undertaken.

    RESULTS: Out of 425 articles identified, 22 quantitative articles and one qualitative article were included in the final review. Both the risk and protective factors obtained were categorized into three main domains: individual, family, and community factors. The individual risk factors identified were traits of high impulsivity; rebelliousness; emotional regulation impairment, low religious, pain catastrophic, homework completeness, total screen time and alexithymia; the experience of maltreatment or a negative upbringing; having psychiatric disorders such as conduct problems and major depressive disorder; previous e-cigarette exposure; behavioral addiction; low-perceived risk; high-perceived drug accessibility; and high-attitude to use synthetic drugs. The familial risk factors were prenatal maternal smoking; poor maternal psychological control; low parental education; negligence; poor supervision; uncontrolled pocket money; and the presence of substance-using family members. One community risk factor reported was having peers who abuse drugs. The protective factors determined were individual traits of optimism; a high level of mindfulness; having social phobia; having strong beliefs against substance abuse; the desire to maintain one's health; high paternal awareness of drug abuse; school connectedness; structured activity and having strong religious beliefs.

    CONCLUSION: The outcomes of this review suggest a complex interaction between a multitude of factors influencing adolescent drug abuse. Therefore, successful adolescent drug abuse prevention programs will require extensive work at all levels of domains.

  16. Kaur S, Kok EY, Jamil NA, Sebayang SK
    BMC Public Health, 2024 Jan 09;24(1):122.
    PMID: 38195450 DOI: 10.1186/s12889-024-17677-w
    INTRODUCTION: Gestational weight gain (GWG) is influenced by various factors during pregnancy. This study attempts to explore the relationship between environmental factors i.e., sunlight exposure and psychological health i.e. psychological well-being and sleep quality during pregnancy with total gestational weight gain.

    METHODS: This was a prospective observational study conducted in government maternity clinics in Kuala Lumpur. Pregnant women aged 19-39 years without comorbidities were recruited during second trimester and followed up until birth. The participants were required to wear a UVB dosimeter for a total of three consecutive days (2 weekdays and 1 weekend) to determine sunlight exposure (SED) during their second trimester. The PSQI and DASS-21 were used to determine sleep quality and psychological wellbeing, respectively. GWG data were collected from clinic health records. The association of sun exposure and psychological health with total GWG was determined using multiple linear regression.

    RESULTS: A total of 73 pregnant women aged 27.9 ± 3.3 years were included in the analysis. The prevalence of pregnant women exhibiting stress, anxiety, and depression symptoms was 11%, 40%, and 16% respectively. The global PSQI median score was 5 (IQR = 3), with 59% having poor sleep quality. Median sleep duration was 7 h (IQR = 2) while median sleep efficiency was 92% (IQR = 14). The median SED was 0.04 (IQR = 0.09), with 51% of them being under the 50th percentile. The majority had adequate GWG (58%). Sleep parameters were not found to be correlated with total GWG except for sleep latency (ρ = -0.356, p = 0.002). Sunlight exposure was found to have no significant relationship with sleep and total GWG. Adjusted multiple linear regression showed that greater depression is associated with higher total GWG (β = 0.239, p = 0.039) while controlling for sleep quality.

    CONCLUSION: Depression was associated with total GWG when sleep quality was controlled for while sunlight exposure had no significant association with GWG. Future studies should study the complex relationship between factors of mental health, sleep, and weight gain during pregnancy. Healthcare providers may be better equipped to develop interventions aimed to prevent negative maternal and fetal health outcomes.

  17. Sreeramareddy CT, Shidhaye RR, Sathiakumar N
    BMC Public Health, 2011;11:403.
    PMID: 21619613 DOI: 10.1186/1471-2458-11-403
    BACKGROUND: Observational epidemiological studies and a systematic review have consistently shown an association between maternal exposure to biomass smoke and reduced birth weight. Our aim was to further test this hypothesis.
    METHODS: We analysed the data from 47,139 most recent singleton births during preceding five years of 2005-06 India Demographic Health Survey (DHS). Information about birth weight from child health card and/or mothers' recall) was analysed. Since birth weight was not recorded for nearly 60% of the reported births, maternal self-report of child's size at birth was used as a proxy. Fuel type was classified as high pollution fuels (wood, straw, animal dung, and crop residues kerosene, coal and charcoal), and low pollution fuels (electricity, liquid petroleum gas (LPG), natural gas and biogas). Univariate and multivariable logistic regression models were developed using SURVEYLOGISTIC procedure in SAS system. We used three logistic regression models in which child factors, maternal factors and demographic factors were added step-by-step to the main exposure variable. Adjusted Odds Ratios (AORs) and their 95% CI were calculated. A p-value less than 0.05 was considered as significant.
    RESULTS: Child's birth weight was available for only 19,270 (41%) births; 3113 from health card and 16,157 from mothers' recall. For available data, mean birth weight was 2846.5 grams (SD = 684.6). Children born in households using high pollution fuels were 73 grams lighter than those born in households using low pollution fuels (mean birth weight 2883.8 grams versus 2810.7 grams, p < 0.001). Use of biomass fuels was associated with size at birth. Unadjusted OR was 1.41 (95% CI, 1.27 1.55). Adjusted OR after controlling for child factors was 1.41 (95% CI 1.29, 1.57). AOR after controlling for both child and maternal factors was 1.21 (95% CI 1.06, 1.32). In final model AOR was 1.07 (95% 0.94, 1.22) after controlling for child, maternal and demographic factors. Gender, birth order, mother's BMI, haemoglobin level and education were significant in all three models.
    CONCLUSIONS: Use of biomass fuels is associated with child size at birth. Future studies should investigate this association using more direct methods for measurement of exposure to smoke emitted from biomass fuels and birth weight.
  18. Jailani AS, Balqis-Ali NZ, Tang KF, Fun WH, Samad SA, Jahaya R, et al.
    BMC Public Health, 2023 Nov 14;23(1):2243.
    PMID: 37964260 DOI: 10.1186/s12889-023-17132-2
    INTRODUCTION: High-risk human papillomavirus (HPV) screening is vital for early cervical cancer detection and treatment. With the introduction of the national cervical cancer screening programme and screening registry in Malaysia, there is a need to monitor population-based HPV screening uptake and high-risk HPV prevalence as part of cervical cancer surveillance.

    OBJECTIVE: To determine the prevalence and sociodemographic factors predicting high-risk HPV infection in Malaysia based on a public, community-based cervical cancer screening registry targeting women at risk of getting HPV infection.

    METHODS: The study used data from the Malaysian cervical cancer screening registry established by the Family Health Development Division from 2019 to 2021. The registry recorded sociodemographic data, HPV test details and results of eligible women who underwent HPV screening at public primary healthcare facilities. A vaginal sample (via self-sampling or assisted by a healthcare provider) was used for DNA extraction for HPV detection and genotyping. Registry data were extracted and analysed to determine prevalence estimates of high-risk HPV infection. Multifactorial logistic regression analysis was conducted to determine predictors of high-risk HPV infection. All analyses were performed using Stata version 14.

    RESULTS: The programme screened a total of 36,738 women during the study period. Women who attended the screening programme were mainly from urban areas, aged 30-39 years, and of Malay ethnicity. The prevalence of high-risk HPV infection was 4.53% among women screened, with the yearly prevalence ranging from 4.27 to 4.80%. A higher prevalence was observed among urban settling women, those aged 30-49 years, those of Indian ethnicity, and those without children. The results from logistic regression showed that women from urban areas, lower age groups, of Indian or Chinese ethnicity, and who are self-employed were more likely to be infected with high-risk HPV.

    CONCLUSION: Targeted and robust strategies to reach identified high-risk groups are needed in Malaysia. In addition, the registry has the potential to be expanded for an improved cervical cancer elimination plan.

    TRIAL REGISTRATION: Trial registration number: NMRR ID-22-00187-DJU.

  19. Wan Mohamed Radzi CWJB, Salarzadeh Jenatabadi H, Samsudin N
    BMC Public Health, 2021 01 27;21(1):27.
    PMID: 33499833 DOI: 10.1186/s12889-020-09999-2
    BACKGROUND: Since the last decade, postpartum depression (PPD) has been recognized as a significant public health problem, and several factors have been linked to PPD. Mothers at risk are rarely undetected and underdiagnosed. Our study aims to determine the factors leading to symptoms of depression using Structural Equation Modeling (SEM) analysis. In this research, we introduced a new framework for postpartum depression modeling for women.

    METHODS: We structured the model of this research to take into consideration the Malaysian culture in particular. A total of 387 postpartum women have completed the questionnaire. The symptoms of postpartum depression were examined using the Edinburgh Postnatal Depression Scale (EPDS), and they act as a dependent variable in this research model.

    RESULTS: Four hundred fifty mothers were invited to participate in this research. 86% of the total distributed questionnaire received feedback. The majority of 79.6% of respondents were having depression symptoms. The highest coefficients of factor loading analysis obtained in every latent variable indicator were income (β = 0.77), screen time (β = 0.83), chips (β = 0.85), and anxiety (β = 0.88). Lifestyle, unhealthy food, and BMI variables were directly affected by the dependent variable. Based on the output, respondents with a high level of depression symptoms tended to consume more unhealthy food and had a high level of body mass indexes (BMI). The highest significant impact on depression level among postpartum women was unhealthy food consumption. Based on our model, the findings indicated that 76% of the variances stemmed from a variety of factors: socio-demographics, lifestyle, healthy food, unhealthy food, and BMI. The strength of the exogenous and endogenous variables in this research framework is strong.

    CONCLUSION: The prevalence of postpartum women with depression symptoms in this study is considerably high. It is, therefore, imperative that postpartum women seek medical help to prevent postpartum depressive symptoms from worsening.

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