This is a cross sectional community study in Johor Bahru District. The aim of this study is to estimate the overall prevalence of emotional and behavioural deviance among the school children in three different geographical areas, and to identify their correlates. This paper presents the findings of phase one of a two-stage procedure involving a total of 589 children aged 10-12 years. Using the cut-off point validated locally, the prevalence of deviance on the parental scale was 40% in the rural school, 30.2% in the agricultural resettlement (Felda) school and 32.3% in the urban school. On the teachers' assessment, the prevalence of deviance was 40.8% in the rural school, 10.8% in the Felda School and 8.9% in the urban school. There was significantly higher prevalence of deviance in the rural school on the teachers' scale. In the rural school, significantly higher prevalence of deviance was found among boys.
A large-scale study was undertaken in the state of Kelantan, to determine the prevalence of goitre. A total of 2,450 subjects above the age of 15 years were selected from 31 localities in the state and examination for goitre was done using the technique of Perez. The state was divided into 3 areas--coastal area (area 1), inland area (area 2) and the area in between the coast and the inland area (area 3). The overall prevalence of goitre was 36.8% and the prevalence in areas 1, 2 and 3 were 23.0%, 35.9% and 44.9% respectively and ranged from 6.9% in a locality in area 1 to 59.7% in a locality in area 3. In all areas, the prevalence was higher in females than in males. The prevalence of grades I, II and III goitres were 21.5%, 1.0% and 0.5% respectively in area 1, 33.6%, 1.5% and 0.7% respectively in area 2 and 41.7%, 2.2% and 1.0% respectively in area 3. Amongst age groups, goitre prevalence was highest in the 36 to 45 years age group in area 1 (33.9%), in the 15 to 25 years age group in area 2 (39.6%) and in the 26 to 35 years age group in area 3 (54.3%). In all the areas, goitre prevalence was lowest in the above 56 years age group. We concluded that the prevalence of goitre was high in Kelantan and there were regional differences in the prevalence rate within the state.
A cross-sectional study was carried out to determine the prevalence of diabetes mellitus and its relationship with age, physical activity, nutritional status and diet amongst rural Malays in Kuala Selangor. By simple random sampling 360 subjects were selected for the study. Besides guided questionnaires, subjects also underwent a 2 hours post prandial (2HPP) test to determine the diabetic status as recommended by WHO. The crude prevalence of diabetes mellitus was 14.6% which increases with age. The prevalence of diabetes adjusted for age was 12.2%. Physical activity status seemed to be a significant risk factor for diabetes. A greater proportion of diabetics was obese and their mean fat intake was higher than normal subjects (p < 0.05). The prevalence of diabetes mellitus in this study was significantly higher compared with data from 1984 (3.9%), representing a marked increment of 212.8 per cent over a 10-year period.
Microbial diseases continue to occur in Malaysia despite the marked socio-economic development that has been taking place in the country along with improvements in the medical, health, and environmental sectors. This paper highlights the continuing presence of the numerous microbial diseases including the emergence of new problems such as AIDS. Local publications dealing with work on several microbial diseases is reviewed to show that this group of diseases will pose challenges for a long while. Undoubtedly several other diseases that were relatively unrecognised in the past are increasingly being identified owing to recent availability of diagnostic facilities and equipments. The need for continued vigilance is emphasised.
The data presented is part of the findings from a four-year collaborative research project between Universiti Putra Malaysia, the Institute for Medical Research and the Ministry of Health Malaysia. The project assessed the nutritional status of the major functional groups in Peninsular Malaysia. Mukim Sayong and Pulau Kemiri in the District of Kuala Kangsar, Perak were two of the subdistricts selected to represent small rubber holdings in Peninsular Malaysia. This paper attempts to analyse the socio-economic profile of the households and the nutritional status of children below 9 years of age. A total of 307 households were studied. Approximately 63% of the households were involved in rubber activities and the majority of them were hired tappers. The average monthly income of the households was RM467 and the income ranged between RM30 to RM2120. Based on the per capita poverty line income of RM84.38, it was found that 14.1% of the households earned less than RM42.19, which can be considered as hard-core poor, while 32.7% were poor (monthly per capita income between RM42.19 and RM84.38). Slightly more than half (52.7%) earned income above the poverty line. The average family size was 4.5, ranging from 1 through to 16. The majority of the heads of households (56.6%) had between 3 and 6 years of education, and 14.5% did not receive any formal education. The prevalence of stunting among children 0-5 years of age was 26%, while 31.5% were underweight and 3.8% wasted. Among children aged between 5 and 9 years, almost the same pattern of nutritional status was noted. The overall percentages of stunting, underweight and wasting among these children were 29.2%, 26.1% and 0.62%, respectively. Analysis on nutritional status according to income level showed a noticeable difference in the prevalence of malnutrition in children above and below the poverty line income. The Student's t-test indicated significant differences in weight-for-age and weight-for-height between the two poverty line income for children below 5 years of age. Pearson's correlation coefficient showed a significant correlation between height-for-age with household size (r = -0.26, p<0.05), and monthly per capita income with weight-for-height (r = 0.25, p<0.05). There was a highly significant correlation between acreage of land cultivated and weight-for-height (r = 0.42, p<0.01), and weight-for-age (r = 0.25, p<0.05). The findings indicated the influence of socio-economic factors on the nutritional status of children.
This study was conducted to find out the psychiatric symptomatology in the patients and their families attending a primary health care facility. The most frequent symptoms found were of depression (13.2%), followed by hypochondriacal symptoms (8.2%), anxiety symptoms (6.1%) and psychotic symptoms. A large proportion (21.5%) of children had psychiatric symptoms. The common symptoms include enuresis, hostility, tantrums, problems of conduct and destructiveness. Surprisingly, concern for these symptoms was lacking in both the patient and their family members.
The hepatitis delta virus (HDV) is an RNA containing virus that requires hepatitis B virus (HBV) to supply the envelope proteins. HDV only infect man in the presence of HBV, either as a coinfection or as superinfection in HBV carriers. In the presence of hepatitis B infection, the HDV may cause more severe liver damage than that caused by the hepatitis B virus alone. HDV infection was studied in 44 HBsAg positive serum samples collected from male intravenous drug users sent for screening to the Blood Services Centre (BSC), Hospital Kuala Lumpur (HKL) between 1990 and 1992. The majority (39) were in the 20 to 39 age group. The youngest was 19 years old and the oldest was 61 years old. There were 25 Malays, 13 Chinese, five Indians and one Albanian. Anti hepatitis delta antibody (Anti-HDV) was detected in 15 out of 44 (34%) of the drug addicts. These results shows an increased in delta infection in HBsAg positive intravenous drug addicts compared to the surveillance results in 1985 when no delta antibodies were detected, and the 1986 and 1989 surveillance which showed 17.8% and 20% delta antibody positivity respectively.
A total of 320 faecal specimens obtained from 295 patients (192 children and 103 adults) with diarrhoea and 47 faecal specimens from healthy adults were screened for Cryptosporidium oocysts. Faecal specimens were first screened by modified Ziehl Neelsen stain and specimens with oocysts were confirmed by direct immunofluorescence technique. Cryptosporidium oocysts were detected in 4 children but not in normal healthy adults or in diarrhoeic adults.
In a retrospective analysis of paediatric referrals to a Neurology Outpatient Clinic, the largest single category of 47 patients (32%) presented with acute recurrent headache. There were 30 girls and 17 boys. Age of onset ranged from 4 to 11 years (8.35 +/- 1.98) and duration of headache from half month to 42 months (19.2 +/- 11.9). Only 6 children were unable to describe the quality of their pain. Using conventional criteria, 43 of the children could be classified as classical migraine (10), common migraine (20), basilar migraine (3), ophthalmoplegic migraine (1) and tension tension headache (9). None had any positive physical signs, and all responded to simple measures.
Study site: Paediatric Neurology Clinic, Neurology Institute, Hospital Kuala Lumpur, Malaysia
A retrospective six-month study of serum calcium and albumin in patients treated at the Kuala Lumpur Hospital was carried out. There were 19,291 subjects, of which the prevalences of hypocalcemia (corrected serum calcium of < or = 2.1 mmol/l) and hypercalcemia (corrected serum calcium of > 2.7 mmol/l) were 18.0% (3460 subjects) and 2.4% (468 subjects) respectively. Persistent hypocalcemia (a minimum of first two consecutive corrected serum calcium of < or = 2.1 mmol/l) was found in 408/19,291 subjects 2.1%). Serum calcium values of < 2.00 mmol/l were found in 98.5% of this group. Persistent hypercalcemia (a minimum of first two consecutive corrected serum calcium of > 2.7 mmol/l) was found in 108/19,291 subjects (0.5%) and 52/108 subjects (48.1%) had serum calcium values of > or = 3.0 mmol/l. 2902/3460 subjects (83.8%) and 313/468 subjects (66.9%) the hypocalcemia and hypercalcemia groups respectively failed to be retested (singletons). In the hypocalcemia group, 1115/2902 (38.4%) showed corrected serum calcium values of < 2.00 mmol/l), whilst 100/313 subjects (31.9%) of the hypercalcemia group had corrected serum calcium values of > or = 3.00 mmol/l. There were no significant differences between the mean corrected serum calcium between 3 age groups of the test population, namely in childhood ( < or = 65 years).
An investigation of the prevalence and distribution of hypodontia was carried out in Malaysian children between the ages of five to fifteen years. Hypodontia occurred in 2.8 per cent of these children. A greater number of females were found to have hypodontia, the ratio of affected females to males is 1.6:1. The teeth most frequently missing were the maxillary lateral incisors followed by the mandibular lateral incisors, then the mandibular second premolars. The aetiology of the condition is discussed. It is noteworthy that studies showing the lower second premolars to be most commonly missing have younger subjects. This suggests delayed development of these teeth in some individuals.
A postal questionnaire survey was carried out among military doctors during June to August 1979 on habits and attitudes to smoking. An 87% response rate was obtained. Smoking prevalence was found to be 50%. 45% of medical officers are heavy smokers. Age at starting influence the amount smoked. Service life had no influence on smoking habits. Attitudes to smoking vary between the different categories of doctors. The habits and attitudes indicate a mental revolution on the part of doctors is required prior to any anti-smoking programme as they have to be sufficiently motivated to lead the fight.
Five hundred and thirty-six patients were examined for the presence of talon cusps. The anomaly was observed in 28 patients (5.2 per cent). There was no sex predilection in the occurrence. Only two patients had a bilateral occurrence, with the maxillary lateral incisors being the most commonly affected. Radiographic evidence of pulpal extension into the cusp was observed in five patients. Many of the affected teeth presented with deep developmental grooves some of which were carious and/or occlusal interference leading to malocclusion.
A preliminary survey on sixty-nine 7 to 12 year old Temuan tribe school children living some 30 kilometers from Kuala Lumpur was conducted. The examinations were carried out using a chair-table set up with natural daylight as the source of light. The DMF index of klein, Palmer and Knutson was used to assess the dental caries status. In spite of low fluoride content in their water supply, the findings revealed a generally low prevalence of caries experience (DMFT 1.26). The highest DMFT was in the 11 year olds. The relationship between these findings and their possible causes are discussed.
One hundred and forty-five diabetic patients attending diabetic clinic over a four week period were fully examined in an adjacent eye clinic. The fundi were examined with a Halogen light direct ophthalmoscope and the Binocular Indirect Ophthalmoscope after mydriasis to assess the presence of retinopathy. 44.1 percent of patients examined had Opbthalmoscopicaliy detectable retinopathy while 11 percent were found to have 'serious diabetic eye disease'. The prevalence of diabetic retinopathy in Malaysia is comparable to those of Western countries and Japan.
Study site: Diabetic clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
In Malaysia 1,307 randomly selected primary school children were screened to find out the prevalence of hearing loss and middle ear disorders. Seventy-six students (5.81%) failed the screening audiometric test. There were 95 students (7.26%) with middle ear disorders. History of ear discharge was absent in 24 out of 57 cases with CSOM (42.11%) (P less than 0.001). Forty-three out of 95 children having middle ear disorders passed the screening audiometric test (P less than 0.01 Fisher exact test). Screening audiometric test fails to detect about 46% of cases with middle ear disorders. Screening audiometric test and otological examination if conducted by the school health medical officers regularly will be able to detect almost all the cases with hearing loss and middle ear disorders.
The prevalence and symmetrical distribution of enamel defects were studied in 218 Malaysian school children aged 11-12 years old. The tooth prevalence of enamel defect was 40.3 per cent. The first permanent molars were the most severely affected, whereas the lower incisors were the least severely affected. Overall there was no sex difference. Distribution of symmetry was assessed between the right and left tooth pairs as well as for upper and lower teeth. A higher proportion of symmetry was observed for the right and left tooth pairs and the lingual surfaces showed a greater percentage of bilateral distribution.