INTRODUCTION: A study was carried out in a primary healthcare clinic in the Hulu Langat district of Malaysia to assess the parental knowledge, attitudes and antibiotic use for common childhood acute upper respiratory tract infection (URTI).
METHODS: A cross-sectional study involving 421 parents, who were surveyed by using an interviewer-administered questionnaire, from April to June 2001.
RESULTS: Approximately 59 percent of parents from this study believed that weather was the main cause of acute URTI of their children, 13 percent thought it was due to food, and only about 27 percent said it was caused by germs. Nearly 68 percent, 69 percent and 76 percent of them believed that antibiotics was helpful in treating the common cold, cough and fever, respectively. 29 percent of parents who thought that their child with acute URTI needed antibiotics were not prescribed with any. On the other hand, 17 percent believed that antibiotics were unnecessary when prescribed. 28 percent of parents had requested for antibiotics, and 93 percent received what they requested for their child with acute URTI. About 31 percent of parents who did not request any antibiotics claimed that private general practitioners habitually prescribed antibiotics. The antibiotic compliance was poor with only 74 percent completing the entire course, with 85 percent of them stopping once they improved symptomatically. 15 percent of parents gave "leftover" antibiotics, 24 percent gave "shared" antibiotics, and 5.5 percent bought antibiotics for their child with acute URTI without consulting a doctor.
CONCLUSION: This study shows that parents often have inadequate knowledge and misconceptions on antibiotic use for acute URTI in children. Improved parental education may reduce unnecessary antibiotic prescription and antimicrobial resistance in the community.
Study site: Klinik Kesihatan Batu 9, Hulu Langat, Selangor, Malaysia
The increasing prevalence of childhood asthma has become a concern among health practitioners. Effective management emphasizes long-term management and inhaled therapy has become the mainstay home management for children. However, proper utilization of medication is pertinent in improving control. Proper asthma education is mandatory in improving skills and confidence amongst parents. To assess the skills of using the metered-dose inhaler (MDI) with a spacer among asthmatic children before and after educational intervention and to analyse any difficulties which may occur amongst the participants in executing the assessment steps. A cross-sectional clinic based study involving 85 parents and children with asthma. A standardized metered-dose inhaler-spacer checklist of eight steps of medication usage and five steps of cleaning the spacer were used as the assessment tools for pre and post intervention. The performance on using the inhaler-spacer and spacer cleaning knowledge pre and two months post intervention was evaluated. One point was given for each correct step and zero points for incorrect answers/steps. The mean score for skills of inhaler technique improved significantly after educational intervention (3.51 to 6.01, p < 0.0001) as did the mean score for parental knowledge of spacer cleaning technique (1.35 to 3.16, p 0.001). Analysis showed only a limited improvement even after an educational session in three steps of inhalation technique: step 5 (23.5%/69.4%), step 6 (28.2%/68.2%) and step 7 (25.9%/61.2%). Parents with asthmatic children had poor skills in utilizing their children's medication. A short-term educational intervention was able to improve overall knowledge and skill but certain skills need more emphasizing and training.
Study site: Klink HUKM Taman Jaya, Cheras, Kuala Lumpur, Malaysia (primary care clinic for Hospital University Kebangsaan Malaysia)
The purpose of this study was to examine the measurement (configural, metric, scalar, and residual) and structural (factor variance, factor covariance, and factor means) invariance of parent ratings of the attention-deficit/hyperactivity disorder - inattention (ADHD-IN), ADHD - hyperactivity/impulsivity (ADHD-HI), and oppositional defiant disorder (ODD) symptoms as described in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) across boys and girls. In an American pediatric sample (N = 1,015) and a Malaysian elementary school-age sample (N = 928), there was strong support for configural, metric, scalar, residual, factor variance, and covariance invariance across gender within each sample. Both American and Malaysian boys had significantly higher scores on the ADHD-IN and ADHD-HI factor means than did girls, whereas only in the American sample did boys score significantly higher on the ODD factor than did girls. The implications of the results for the study of gender, ethnic, and cultural differences associated with ADHD and ODD are discussed.
Participants were 230 adult Malaysians who estimated their own, their parents', and their partners' overall IQs and 10 multiple intelligences. In accordance with both the previous literature and the authors' hypotheses, men rated themselves higher than did women on overall, verbal, logical-mathematical, and spatial intelligences. There were fewer gender differences in ratings of parents and in those of partners. Participants believed that they were more intelligent than both parents (but not their partners) and that their fathers were more intelligent than their mothers. Regressions indicated that participants believed that verbal intelligence and--to a lesser extent--logical-mathematical intelligence were the main predictors of overall intelligence. The authors discussed results in terms of the extant cross-cultural literature in the field.
OBJECTIVES: Determination of the psychosocial status and assessment of the level of satisfaction in Malaysian cleft palate patients and their parents.
DESIGN: Cross-sectional study.
PARTICIPANTS AND METHODS: Sixty cleft lip and palate patients (12 to 17 years of age) from Hospital Universiti Sains Malaysia and their parents were selected. The questionnaires used were the Child Interview Schedule, the Parents Interview Schedule, and the Cleft Evaluation Profile (CEP), administered via individual interviews.
RESULTS: Patients were teased because of their clefts and felt their self-confidence was affected by the cleft condition. They were frequently teased about cleft-related features such as speech, teeth, and lip appearance. Parents also reported that their children were being teased because of their clefts and that their children's self-confidence was affected by the clefts. Both showed a significant level of satisfaction with the treatment provided by the cleft team. There was no significant difference between the responses of the patients and their parents. The features that were found to be most important for the patients and their parents, in decreasing order of priority, were teeth, nose, lips, and speech.
CONCLUSIONS: Cleft lip and/or palate patients were teased because of their clefts, and it affected their self-confidence. The Cleft Evaluation Profile is a reliable and useful tool to assess patients' level of satisfaction with treatment received for cleft lip and/or palate and can identify the types of cleft-related features that are most important for the patients.
Cerebral Palsy (CP) describes a group of chronic conditions affecting body movement and muscle coordination caused by damage to one or more areas of the brain, occurring at any time during foetal development to infancy. This research was carried out to learn how parents of children with cerebral palsy (CP) had found and accessed services provided for them in Selangor and Kuala Lumpur. It was based in the Spastic Children's Association of Selangor and Federal Territory (SCAS&FT) among 96 of 201 parents of children who use the facilities and services provided by the SCAS&FT through questionnaires and face-to-face interviews. There was a satisfactory level of availability and accessibility of contacting and using the services provided by SCAS&FT in terms of respondent satisfaction. However, parents had varying levels of awareness of the different classes and activities carried out by the school. Efforts to improve knowledge regarding the services available for children with CP in the general population and among parents of these children should be promoted.
Certain human papillomavirus (HPV) types are strongly associated with cervical cancer. Recently-described effective vaccines against these HPV types represent a great medical breakthrough in preventing cervical cancer. In Malaysia, the vaccine has just received regulatory approval. We are likely to face similar barriers to implementing HPV vaccination as reported by countries where vaccination has been introduced. Most women have poor understanding of HPV and its link to cervical cancer. Physicians who will be recommending HPV vaccines may not have extensive knowledge or experience with HPV-related disease. Furthermore, a vaccine against a sexually-transmitted infection may elicit negative reactions from potential recipients or their carers, particularly in a conservative society. Given the high cost of the vaccine, reaching the most vulnerable women is a concern. To foster broad acceptance of HPV vaccine, education must be provided to health care providers, parents and young women about the risks of HPV infection and the benefits of vaccination.
Sociodemographic factors have received considerable attention in the literature with regards its relationship with caries. However, the related information among children ages 12-17 is fairly limited. Birth order has been consistently found to be associated with diseases hypothesized to have an infectious aetiology but only few studies have examined its relationship with dental caries. The aims of this study were to determine the association of birth order and the sociodemographic background of subjects with caries and high caries experience among 16-year-old schoolchildren in Tumpat district, Kelantan. This was a case-control study. A total of 1087 16-year-old schoolchildren were examined intraorally for their caries status. They were categorized into three groups namely caries free (DMFS=0) mild caries (DMFS= 1-7) and high caries (DMFS ≥8) group based on DMFS score. Cases were the caries group and the controls were the caries free group. In each group, 163 subjects were selected by using simple random sampling. A questionnaire was used to obtain personal information of the subjects, birthweight and sociodemographic background. Analysis involved was ordinal logistic regression. The factor that was found to have association with caries and high caries experience determined using multiple ordinal logistic regression analysis was educational level of parents (OR=1.55, 95% CI: 1.06; 2.28). This study showed that birth order was not a significant factor associated with caries experience. Among the sociodemographic factors, only parent’s educational level was found to be associated with caries and high caries experience.
Home phototherapy treatment has been available in the Klang Valley (comprising Petaling ]aya, Kuala Lumpur; Shah Alam and Klang) since 2003. This study was conducted to create awareness of the existence of home phototherapy and its usage in Malaysia. This was a retrospective study using 1297 informed consent forms that parents had to read and sign prior to the commencement of home phototherapy. lt was found that the majority ofthe babies was males (41.2%), at or over 36 weelds gestation (97.2%), from areas in Selangor (57.4%), fully breastfed (53 %) and referred by doctors (98%). The mean age of the babies at initiation of lwme phototherapy was 6. 7 days. The mean bilirubin level at the start of home phototherapy was 243.8 umoVL and the mean bilirubin level at the end of home phototherapy 5 was 139.3 umoVL. The mean decrease in bilirubin level was 103.12 umoVL and the mean number of days of usage was 3.5 days which is a daily decrement of about 29 umoVL (29.46 + 13.8). Home phototherapy remains a viable clinical option for full term babies with physiological jaundice.
Introduction: To date, there are limited published literatures addressing behaviors of Attention Deficit and Hyperactive Disorder (ADHD) children and their parents’ psychological
characteristics. It is also crucial to know the relationship between characteristics of ADHD
behaviors on their parental psychological impacts. Objective: To determine the level of stress, anxiety and depressive among mothers of ADHD children compared to control group and also to determine the associations between domains of children’s behaviors (externalizing or internalizing) that gives most impact to these maternal psychological aspects. Method: This is a cross-sectional study. Seventy mothers of ADHD children who came to Child and Adolescent Clinic, Universiti Kebangsaan Malaysia Hospital completed self-rating questionnaires of Child Behavior Checklist (CBCL), Parenting Stress Index (PSI) and Hospital Anxiety and Depressive Scale (HADS). Seventy mothers of asthmatic children were recruited as a control group. Results: Mothers with ADHD children are more anxious, depressed and stressed (p
Deviations from normal occlusion are known as malocclusion. Orthodontics treatment usually is the choice of management of irregularities and abnormalities of their relation to the surrounding structures i.e malocclusions. Patient or parent commonly seeks orthodontic treatment for aesthetic reasons rather than functional problems such as temporomandibular joint dysfunction. With greater demand for orthodontic treatment due to greater awareness of the people towards dental health, good orthodontic treatment outcome would be expected. Good orthodontic treatment outcome usually related to good clinical management of the patients. (Copied from article).
Domestic paediatric hand injuries make up the bulk of overall paediatric hand injuries. This is a retrospective study of domestic paediatric hand injuries admitted into an urban hospital that required surgical intervention. The most common injuries sustained were tendon injuries (24%), total amputations (20%) and lacerations wounds (16%). Accordingly the most common surgical interventions were tendon repairs (28%), toilet suturing (24%) and refashioning (20%). Parents and care providers need to be more vigilant and careful when supervising children including ensuring the safe storage of dangerous items. Sharp items may require additional safety features and warning labels.
Introduction: There are many factors that determine the survival of patients with VSD. Among these include size of VSD, position, pulmonary hypertension, bacterial sepsis, valvular involvement, associated anomalies with VSD, associated syndromes and age at first diagnosis. There has been no published local data as far as we know and this information will be useful especially for consultation with parents. Even though VSD in general has a good prognosis, whenever they have added risks for example pulmonary hypertension then they are at risk of further morbidity and mortality. Objective: To determine the factors that are associated with survival of patients with VSD. Design: Retrospective cohort. Materials and methods: All cases of isolated VSDs admitted to HUSM from 1996 to 2003 were reviewed. Results: Univariate Cox regression of survival time of patients with VSDs revealed that 4 factors had prognostic significance namely bacterial sepsis (HR= 287.7, 95% CI 51.1, 1618.5, P < 0.001), Down syndrome (HR = 14.89, 95% CI 3.00, 73.92, P = 0.001), pulmonary hypertension (HR=14.58, 95% CI 1.69, 125.7, P=0.015) and large VSDs (HR=8.23, 95% CI 1.5, 45, P=0.015). Bacterial sepsis was the only significant prognostic factors for the survival of patients with VSDs using the multivariate Cox proportional hazard model. Conclusion: Bacterial sepsis, pulmonary hypertension, large VSD and Down syndrome were the significant prognostic factors from Univariate Cox analysis, however bacterial sepsis was the only significant prognostic factor from Multivariate Cox analysis.
Data on the prevalence and causes of functional low vision (FLV) in adults and children are lacking but are important for planning low-vision services. This study was conducted to determine the prevalence and causes of FLV among children recruited in eight population-based prevalence surveys of visual impairment and refractive error from six countries (India [2 locations]; China [2 locations]; Malaysia, Chile, Nepal, and South Africa).
AIM: This study aimed to determine which factors could influence (i) parents' decision to seek medical consultatin and (ii) their preference for either public or private medical service in children with upper respiratory tract infection.
METHODS: This cross-sectional study was conducted at the Gombak district, which is an urban area in Malaysia. We randomly selected parents of kindergarten children aged 4-5 years to participate in this questionnaire survey. The main outcome measures were predictors of early medical consultation and type of service utilisation (public versus private).
RESULTS: We achieved a response rate of 84.5% (n = 1033/1223). 64.1% sought early medical consultation and 70.9% preferred to consult a private doctor. Early consultation was predicated by the parent gender being male (OR 1.50; 95% CI 1.09, 2.05), non-Chinese (OR 1.75%; 95% CI 1.10, 2.79), and those who preferred child specialists (OR 2.02; 95% CI 1.27, 3.23). Lower income group (OR 4.28; 95% CI 2.30, 7.95) and not having a regular doctor (OR 4.99%; 95% CI 3.19, 7.80) were predictors of using the public health services.
CONCLUSIONS: Parent's gender, ethnicity and income influenced their decision to seek early medical consultation for their children's respiratory illness while income and having a regular doctor could predict their choice of healthcare services.
The objective of this cross-sectional study is to determine the prevalence and pattern of herbal medicines use during pregnancy among women in Tumpat district, Kelantan. A total of 210 mothers were interviewed using a structured questionnaire. There were 108 mothers (51.4%) who used at least one type of herbal medicines during pregnancy. The most common herbal medicines used (63.9%) was coconut oil which was ingested during the third trimester of pregnancy only. The most common indication was (89.8%) to facilitate labour. The majority of users (79.6%) used herbal medicines during the third trimester of pregnancy only. Many of them (81.5%) believed that herbal medicines were effective to solve their health problems and fulfilled the indications for use. The older generation like parents and in laws (63.9%) were the most common persons who suggested using herbal medicines. The majority of them used the herbs only once (56.5%) and one type (87.0%) throughout the pregnancy. Further research focusing on local commonly used herbal medicines is to be carried out to evaluate the safety and efficacy of the herbs.
This study examined differential symptom functioning (DSF) in ADHD symptoms across Malay and Chinese children in Malaysia. Malay (N=571) and Chinese (N=254) parents completed the Disruptive Behavior Rating Scale, which lists the DSM-IV ADHD symptoms. DSF was examined using the multiple indicators multiple causes (MIMIC) structural equation modeling procedure. Although DSF was found for a single inattention (IA) symptom and three hyperactivity-impulsivity (HI) symptoms, all these differences had low effect sizes. Controlling for these DSF, Chinese children had higher IA and HI latent factor scores. However the effect sizes were small. Together, these findings suggest adequate support for invariance of the ADHD symptoms across these ethno-cultural groups. The implications of the findings for cross-cultural invariance of the ADHD symptoms are discussed.
BACKGROUND: Worldwide the prevalence of overweight and obesity in children is escalating. Parents’ recognition of overweight or obesity in their own children is very important for a successful intervention in these children. This study examined parental perception of their children’s weight status, and its association with their knowledge on nutrition and obesity.
MATERIALS AND METHODS: This was a cross sectional study of parents with children aged 9 to 12 years, in a primary school of Kuala Lumpur. Parents responded to a self-administered questionnaire which contains parental perception of their child weight status as well as knowledge on nutrition and obesity. The parents’ perception of the children’s weight status was then compared with the actual measured weight status.
RESULTS: There were 204 parents who participated in the study. Parents were found to underestimate their child weight status and 38.2% were inaccurate in their perception. The mean score of knowledge on nutrition and obesity was 78.5±14.4; and this did not associate with the accuracy of their perception on the child weight status. Parents showed inadequate knowledge in food pyramid and preparation of low fat meals.
CONCLUSION: The Malaysian Health Campaigns had resulted in overall good knowledge on nutrition and obesity in the parents except in few domains. However, this was insufficient to make the parents recognize the growing overweight and obesity problem in their children.
Key Words: overweight, obesity, children, parental perception, knowledge
Background: Mothers play an important role in preventing fluorosis due to inadvertent swallowing of fluoridated toothpaste and enhancing the effectiveness of toothbrushing amongst preschool children through proper supervision.
Aim: To investigate the knowledge of mothers with regards to the benefits and risks of fluoride toothpaste usage among preschool children and to assess the level of parental supervision during toothbrushing. In additional, we wish to investigate the toothpaste purchasing behaviour of mothers in relation to brand, price, flavour, fluoride content and the influence of advertisement.
Methodology: Cross-sectional study of a representative random sample of 373 mothers of 5-6 year old preschool children through self-administered questionnaires.
Result: The response rate was 90.3% (337). The majority (61.7%) of the mothers reported that the amount of toothpaste their children used was half-length. Most mothers (70.6%) claimed they usually apply toothpaste for their child. About one-half (50.4%) reported the children applied the toothpaste themselves. Only 41.2% of the respondents supervised their children every time during toothbrushing. The mean age at which the child started brushing and using toothpaste was about 34 months (S.D. 14.9) and 37 months (S.D.14.8) respectively. Almost all (95.8%) reported that their children rinsed their mouth after toothbrushing. The mothers’ choice of toothpaste for their child was influence by brand (91.4%), flavour (91.4%) and fluoride content (84.6%) with price being the least of the factors. The majority of the respondents (82.7%) had average to good overall knowledge scores. There was significant association (P=0.034) between the level of education of the mothers and their level of knowledge on fluoride toothpaste usage.
Conclusion: Future oral health messages for preschool children and mothers in Perlis should target areas found lacking in terms of knowledge and practices with regards to fluoride toothpaste usage. This includes regular supervision of preschool children during toothbrushing by parents and using only a small amount of toothpaste for young children.