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Non-regulatory related factors leading to off-label prescribing in children: A concept map

Balan S, Hassali MA, Mak VSL

Res Social Adm Pharm, 2017 Nov;13(6):1219-1221.
PMID: 28576615 DOI: 10.1016/j.sapharm.2017.05.013
Matched MeSH terms: Child Health*
Fulltext National Health and Morbidity Survey 2016: Maternal and Child Health. Volume I & II

ISBN: 978-983-2387-28-2

Citation: National Health Morbidity Survey 2016: Maternal Child Health Survey. Kuala Lumpur: Institute for Public Health, Ministry of Health, Malaysia, 2016
Study name: National Health and Morbidity Survey (NHMS-2016)

Volume I.
http://iku.gov.my/images/IKU/Document/REPORT/2016/NHMS2016ReportVolumeI.pdf
Volume II.
http://iku.gov.my/images/IKU/Document/REPORT/2016/NHMS2016ReportVolumeII-MaternalChildHealthFindingsv2.pdf

Matched MeSH terms: Child Health
Fulltext Multilevel interventions as climate change adaptation response to protect maternal and child health: a scoping review protocol

Lokmic-Tomkins Z, Bhandari D, Watterson J, Pollock WE, Cochrane L, Robinson E, et al.

BMJ Open, 2023 Jul 27;13(7):e073960.
PMID: 37500279 DOI: 10.1136/bmjopen-2023-073960

INTRODUCTION: Growing evidence suggests that climate change-related extreme weather events adversely impact maternal and child health (MCH) outcomes, which requires effective, sustainable and culturally appropriate interventions at individual, community and policy levels to minimise these impacts. This scoping review proposes to map the evidence available on the type, characteristics and outcomes of multilevel interventions implemented as adaptational strategies to protect MCH from the possible adverse effects of climate change.
METHODS: The following databases will be searched: Embase, MEDLINE, Emcare, EPPI-Centre database of health promotion research (BiblioMap) EPPI-Centre Database for promoting Health Effectiveness Reviews (DoPHER), Global Health, CINAHL, Joanna Briggs Institute EBP Database, Maternity and Infant Care Database, Education Resource Information Center, PsycINFO, Scopus, Web of Science and Global Index Medicus, which indexes Latin America and the Caribbean, Index Medicus for the South-East Asia Region, African Index Medicus, Western Pacific Region Index Medicus. Cochrane Central Register of Controlled Trials, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, conference proceedings, thesis and dissertations, policy and guidelines and their reference lists will also be searched. Two reviewers will independently screen titles and abstracts and full text based on predefined eligibility criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews using the Population, Concept and Context framework and the Template for Intervention Description and Replication checklist will be used to structure and report the findings.
ETHICS AND DISSEMINATION: Ethics permission to conduct the scoping review is not required as the information collected is publicly available through databases. Findings will be disseminated through a peer-reviewed publication and conference presentations.

Matched MeSH terms: Child Health*
Mortality rates decline in Malaysia

Popul Headl, 1991 Nov;?(200):2.
PMID: 12284509

PIP:
Experiencing remarkable decreases in mortality rates over the past 3 decades, Malaysia currently has one of the lowest mortality rates among developing countries, a rate that compares favorably with those of developed countries. Between 1957 and 1989, the crude death rate dropped from 12.4/1000 population to 4.6. Over the same period, Malaysia recorded even greater decreases in the infant mortality rate, from 75.5/1000 births to 15.2. The Maternal mortality rate also declined from 1.48 in 1970 to 0.24 in 1988. The data indicates that mortality rates vary from state to state, and that rural areas have a higher mortality than urban areas. According to a study by the National Population and Family Development Board, the use of maternal and child health services has played an important role in reducing neonatal, perinatal, infant, child, and maternal mortality rates. Nearly all women in Malaysia receive antenatal services. While the country has achieved great gains on mortality rates, programs focusing on specific age and socioeconomic groups could lead to even greater reductions. The Minister for National Unity and Social Development, Dato Napsiah Omar, has called for the development of programs designed to improve the population's quality of life.

Matched MeSH terms: Maternal-Child Health Centers*
Fulltext Mixture of anxiety and depression among parents of physical disabled children in rural Sabah. [Campuran kebimbangan dan kemurungan dalam kalangan ibu bapa kanak-kanak kurang upaya fizikal di luar bandar Sabah]

Lineker T, Ferlis B, Nurul Hudani Mohd N

Jurnal Psikologi Malaysia, 2016;30:61-73.

Previous researchers have shown that parents of children with physical disabilities have a higher risk of mental health problems that may be caused by significant challenges in raising children with disabilities. This challenge is compounded by the difficulty of living in rural areas. This study aimed to identify whether parents of children with physical disabilities experience Mixed Anxiety and Depression (MAD) and build a deep understanding of "why" parents experienced MAD. Material for this case study was obtained using the Kessler psychological stress scale (K-10) and in-depth interviews. Six parents who have MAD has been interviewed. Inductive content analysis with the help of computer program ATLAS.ti 7 has produced six symptoms of MAD among parents (sleep disturbance, irritable, anxious, easy crying, expecting something worse will happen, hopeless about the future) and five sources of MAD (lack of support, acceptance problems, lack of information and experience, the rural factor, child health problem). It can be concluded, this finding relates to the challenges faced by parents in raising children with physical disabilities in rural Sabah.

Matched MeSH terms: Child Health
Fulltext Mental health, pregnancy and self-rated health in antenatal women attending primary health clinics

Sonkusare S, Adinegara, Hebbar S

Med J Malaysia, 2007 Dec;62(5):402-8.
PMID: 18705476 MyJurnal

The purpose of this study was to study the determinants of self rated health in the low-risk pregnant women of Melaka Tengah in Malaysia. A total of 387 subjects were analysed. The role of mental health, psychosocial stressors, support from husband, coping skills, socio-economic status and pregnancy characteristics in determining self- rated health were studied. Health items were taken from the Duke Health Profile. Bad obstetric history, poor mental health, stress from the family were found to be significantly associated with poor self - rated health whereas good support from the husband was related to good self - rated health.

Matched MeSH terms: Maternal-Child Health Centers
Fulltext Meningococcal diseases: post men c vaccination era

Bazlin Ramly

Malaysian Journal of Paediatrics and Child Health, 2019;23(2):36-44.
MyJurnal

Meningococcal Diseases: Post Men C Vaccination EraMalaysian Journal of Paediatrics and Child Health, Vol. 23 (2), December 2017: 36-44© 2017 MJPCH. All Rights Reserved.36ORIGINAL ARTICLEMENINGOCOCCAL DISEASES: POST MEN C VACCINATION ERABazlin RamlyPaediatric Department, Letterkenny University Hospital, Co Donegal, Ireland.AbstractIntroduction: Meningococcal infections are caused by Neisseria Meningitidis and they are manifested in a spectrum of disease in particular meningitis. There are different strains of this bacteria which are A, C, B, W and Y. Mortality rates are from 5-15% with 10-15% suffering permanent disability. After the introduction of Men C vaccination in the year 2000, the incidences of meningitis caused by both Neisseria Meningitidis Serotype C and Serotype B have significantly reduced. Methods: A retrospective study of children whomlumbar puncture was performed with the preliminary diagnosis of meningococcal disease/ meningitis. Total numbers of children were 30 after excluding neonates, those with non-infectious diagnosis and failed lumbar puncture. Symptoms, signs and investigations results were collected in a data collection sheet using the documented data from the patients’ chart. Results: Five children had positive results in either the cultures or the PCR samples sent. None of these children had Serotype C. Three children had Serotype B and 2 others were Serotype W135. Conclusions: There were presence of Nisseria Meningitidis Serotype B and Serotype W135 when blood and cerebrospinal fluid samples were sent. It shows how significant is the value of lumbar puncture to be done to secure a definite diagnosis of meningitis. The preventive strategy to include Men B vaccination in the national vaccination schedule is definite so that death and morbidity can be reduced.

Matched MeSH terms: Child Health
Fulltext Medical students' reflection on the family planning services at primary health clinics in Malaysia

Htay MNN, Than NN, Abas AL, Lwin H, Moe S

J Educ Health Promot, 2018;7:87.
PMID: 30079358 DOI: 10.4103/jehp.jehp_144_17

CONTEXT: Family planning is crucial for everyone within the reproductive age to promote the health and welfare of every member of the family. For the medical students, it is essential to have core knowledge, understanding of family planning concept, and competency in communication skills with the patients. The final-year medical students are posted in Maternal and Child Health Clinics for 3 weeks to gain the knowledge and practical experiences on the primary healthcare in the community.

AIMS: The aim of this study was to explore the experiences of final-year medical students on family planning services offered at community clinics in Malaysia.

SETTINGS AND DESIGN: This was qualitative study.

SUBJECTS AND METHODS: This qualitative study used the data of the students' reflection written in the case reports on family planning. Coding, identification of subthemes, and themes were done by two researchers independently using RQDA software.

STATISTICAL ANALYSIS USED: Thematic analysis.

RESULTS: Final-year medical students who had exposure to the clinical services at primary care clinic, regarding Malay word (Klinik Kesihatan) gained the learning opportunities during family planning session such as learning by observation, clerking, and counseling the patients, understanding the barriers to utilizing services and learning for their self-improvement. These learning opportunities lead to developing the positive attitudes on their learning experiences and the positive attitudes toward the concept and services of family planning.

CONCLUSIONS: To have the better understanding of family planning services and provide the better care to the community in the future, the clinical exposure at the primary care clinics should be promoted for medical students in Malaysia.

Matched MeSH terms: Child Health
Fulltext Medical students' knowledge and perception toward family planning services: A preliminary intervention study

Htay MNN, Latt SS, Abas AL, Chuni N, Soe HHK, Moe S

J Educ Health Promot, 2018;7:137.
PMID: 30596109 DOI: 10.4103/jehp.jehp_104_18

INTRODUCTION: Family planning and contraception is the effective strategy to reduce maternal mortality, child mortality, abortion, and unwanted pregnancies. Since the medical students are the future doctors, it is important to have proper knowledge and training on family planning services. This study aimed to explore the effect of teaching-learning process at maternal and child health (MCH) clinics on the students' knowledge, perceptions toward contraception methods, and family planning counselling.
METHODS: This quasi-experimental study was conducted in the private medical institution in Malaysia. The same questionnaire was used to administer twice, before and after the posting. Moreover, a qualitative question on the issues related to family planning and contraception utilizations in Malaysia was added to the after posting survey. The quantitative data were analyzed using IBM SPSS (version 20) and qualitative data by RQDA software.
RESULTS: A total of 146 participants were recruited in this study. Knowledge on contraception method before posting was 5.11 (standard deviation [SD] ±1.36) and after posting was 6.35 (SD ± 1.38) (P < 0.001). Thematic analysis of the students' answer revealed four salient themes, which were as follows: (1) cultural barrier, (2) misconception, (3) inadequate knowledge, and (4) improvement for the health-care services.
CONCLUSIONS: The teaching-learning process at the MCH posting has an influence on their perception and upgraded their knowledge. It also reflects the role of primary health-care clinics on medical students' clinical exposure and training on family planning services during their postings.

Matched MeSH terms: Child Health
Fulltext Maternal, neonatal, and child health in southeast Asia: towards greater regional collaboration

Acuin CS, Khor GL, Liabsuetrakul T, Achadi EL, Htay TT, Firestone R, et al.

Lancet, 2011 Feb 05;377(9764):516-25.
PMID: 21269675 DOI: 10.1016/S0140-6736(10)62049-1

Although maternal and child mortality are on the decline in southeast Asia, there are still major disparities, and greater equity is key to achieve the Millennium Development Goals. We used comparable cross-national data sources to document mortality trends from 1990 to 2008 and to assess major causes of maternal and child deaths. We present inequalities in intervention coverage by two common measures of wealth quintiles and rural or urban status. Case studies of reduction in mortality in Thailand and Indonesia indicate the varying extents of success and point to some factors that accelerate progress. We developed a Lives Saved Tool analysis for the region and for country subgroups to estimate deaths averted by cause and intervention. We identified three major patterns of maternal and child mortality reduction: early, rapid downward trends (Brunei, Singapore, Malaysia, and Thailand); initially high declines (sustained by Vietnam but faltering in the Philippines and Indonesia); and high initial rates with a downward trend (Laos, Cambodia, and Myanmar). Economic development seems to provide an important context that should be coupled with broader health-system interventions. Increasing coverage and consideration of the health-system context is needed, and regional support from the Association of Southeast Asian Nations can provide increased policy support to achieve maternal, neonatal, and child health goals.

Matched MeSH terms: Child Health Services
Let us not forget the children of front liners in COVID-19

Tang SP, Azmi A

Med J Malaysia, 2020 09;75(5):587.
PMID: 32918432

No abstract provided.

Matched MeSH terms: Child Health*
Fulltext Late antenatal booking and its predictors in Lundu district of Sarawak, Malaysia

Jiee SF, Safii R, Hazmi H

Int J Public Health Res, 2018;8(2):956-964.
MyJurnal

INTRODUCTION: Antenatal care is widely acknowledged as an effective tool to prevent adverse outcomes in pregnant women and their children. In Malaysia, early entry to antenatal care refers to a first visit within the 12th week of gestation. Delayed access to antenatal care has not been extensively studied in Malaysia, whereas several studies have reported a high prevalence of late antenatal booking in developing countries. The objective of this study was to determine the factors and barriers associated with late antenatal booking and the level of knowledge about the timing of antenatal booking among women of childbearing age in the Lundu District of Sarawak.
METHODS: This was a cross-sectional study among 284 pregnant women in all five Maternal and Child Health (MCH) Clinics of Lundu.
RESULTS: The prevalence of late antenatal booking in Lundu was 28.2%. Unmarried women were more likely to book their pregnancy late compared to married women. The prevalence of late antenatal booking was also higher among unemployed women than those who were employed. Respondents without their own income also tended to book their pregnancy later than those who had their own income. Significantly, a high percentage of late antenatal booking was also reported among those who never utilize any contraceptive method, did not plan their pregnancy, those without a history of past medical illness or complications in a previous pregnancy and among those who have a problem with their marriage certificate. Those who booked their pregnancy beyond the 12th week of gestation were also reported to have a lower level of knowledge about the need for an antenatal booking, as compared to those who started their antenatal care early.
CONCLUSION: Unplanned pregnancy, marriage certificate issues, an absence of past medical illness and past obstetric complications were significant predictors of late antenatal booking. Correct and appropriate information relating to antenatal care should be delivered to the public. Health education and advocacy are vital to promote the importance of early antenatal booking to achieve the goal of safe motherhood.
Study site: Maternal and Child Health Clinics, Lundu, Sarawak, Malaysia

Matched MeSH terms: Child Health; Maternal-Child Health Centers
Fulltext Knowledge, attitudes and practice behaviours of healthcare professionals on association between periodontal disease and preterm and/or low birth weight infants: a malaysian study

Nik Azis NM, Zainol Abidin K

Malaysian Journal of Public Health Medicine, 2016;16(1):45-52.
MyJurnal

Our study aimed to assess the knowledge, attitudes and practice behaviours of primary healthcare professionals in government Maternal and Child Healthcare Clinics (MCHC) on the association between oral health and pregnancy outcomes namely pre-term and/or low birth weight (PT/LBW) infants and to identify the barriers of utilisation of oral healthcare services by pregnant mothers. Questionnaires were distributed to government healthcare professionals working at all seven government MCHC in the Manjung District, Malaysia. 136 out of 158 questionnaires were returned completed yielding a 92% response rate. The questionnaire covers respondents characteristics, attitude and practice behaviours related to oral health and barriers faced when referring pregnant mothers to the dental clinic. 65% of respondents noticed dental/ gum problems in the pregnant mothers that they encountered. The two most frequent response for outcome of delivery linked to gum/ dental problems were premature delivery (49%) responses and low birth weight (27%). Although 95% of the respondents believed that regular dental check-ups is compulsory for pregnant mothers, only 69% regularly refer pregnant mothers for dental check-ups. There was a significance between healthcare professionals that receive continuing dental education and their referrals of antenatal mothers for dental check-ups .
Study site: Maternal and Child Health Clinics (Klinik Kesihatan), Manjung District, Perak, Malaysia.

Matched MeSH terms: Maternal-Child Health Centers
Knowledge, attitude and practice in breast-feeding among working mothers in Temerloh, Pahang

Omar, K.

Malaysian Journal of Paediatrics and Child Health, 1998;10(2):40-45.
MyJurnal

A cross-sectional study using structured questionnaires was conducted to determine the level of knowledge, attitude and practice on breast-feeding among working mothers. A total of 200 working mothers who attended the Child Health Clinics in Temerloh, for their chil-dren's third DPT/Polio vaccination were interviewed. Eighty-nine percent of the mothers successfully initiat-ed breast-feeding. However, there was a rapid decline in breast-feeding each month especially during the period when the mothers returned to work. Only 33.5% of the mothers had at least one experience in expressing and feeding expressed breast milk to their babies and only 47% reported that they had been taught by health work-ers. The mothers scored highest on the 'benefits of breast-feeding' with a mean knowledge score of 77.9% and lowest on "storage of expressed breast milk" (35.4%). Overall the mothers showed a positive attitude towards breast-feeding. The two main reasons given for stopping breast-feeding were "work" (61.4%) and "insufficient milk" (57.9%). In conclusion, other areas of breast-feeding besides benefits such as "expressing and storing breast milk" and "how" to practise breast-feeding while working away from home are also impor-tant for working mothers.

Matched MeSH terms: Child Health
Knowledge, attitude and practice factors in childhood acute respiratory infections in a peninsular Malaysia health district

Vasanthamala A, Arokiasamy JT

Asia Pac J Public Health, 1989;3(3):219-23.
PMID: 2620023 DOI: 10.1177/101053958900300308

This study compares the knowledge, attitudes and practice of mothers in two ethnic groups with regard to acute respiratory infections (ARI) in their child. Most had traditional beliefs as to the cause of ARI with only a minority knowing the causes. Most mothers were aware of the effect of frequent attacks of ARI on the health status of their child and of the importance of early treatment. Reasons for their becoming worried during an episode of ARI in their child indicated that problems of distance, transportation and arrangements for care of their other children predominate. A large proportion of the respondents felt that their present knowledge of ARI was inadequate and were thus interested in obtaining more information.

Matched MeSH terms: Child Health Services; Maternal-Child Health Centers
Fulltext Knowledge on immunisation among nurses in Malaysia

Lidwina Edwin Amir

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):21-21.
MyJurnal

Introduction: The National Immunization Program in Malaysia began in the 1950s and was integrated into the Ma-ternal and Child Health Program. Administrative data showed that coverage for all vaccinations was more than 95% except for measles vaccination. Despite the high coverage, there were clusters of outbreaks of vaccine preventable diseases. One of the reasons is the increasing phenomena of vaccines refusals following the rapid spread of negative perception and concerns through social media. Nurses as front liners play an important role to communicate on vac-cine safety and adverse events (AEFI). A survey was conducted to identify the level of knowledge among nurses who deal with immunisation programme. Methods: Nurses from all states attending a National seminar on immunisation communication in Putrajaya were asked to answer a Digital online questionnaire. They were asked to answer 12 questions on knowledge of vaccines, immunization schedule and cold chain management. Results: A total of 74% (429) of the seminar participants responded to the questionnaire, of which 85% were from the government sector and 15% from private. Findings showed that although about 75% of the nurses had formal training on immunisation, 50% had lack of knowledge about vaccination schedule for defaulters and 63.2% (268) had knowledge gaps related to questions on vaccines and handling of vaccines. Conclusion: In view of the knowledge gap from this survey, there is a need for ongoing training for the nurses and evaluation by supervisors on the knowledge and practices among nurses.

Matched MeSH terms: Child Health
Knowledge of HIV/AIDS among pregnant women in an urban health clinic - a preliminary study

Vinothini A, Khoo EM, Kamarulzaman A

Family Physician, 2005;13(1):10-15.

Introduction. The aim of this study is to determine pregnant women's knowledge regarding AIDS and to identify factors affecting their knowledge This information would provide some baseline data in designing health education measures for this target group.
Methods. A face-to-face interview was carried out on one-hundred pregnant women attending an urban antenatal clinic in Malaysia between October and November 1999.
Results. The mean age of the women was 27.8 years old (SD = 5.0, range 20 - 40 years). In general, these women had good knowledge of HIV and AIDS. More than 80% of them were aware of the main modes of HIV transmission. However, only half knew that HIV could be transmitted through breastfeeding. Sixty percent of women had the misconception that the virus could be acquired through blood donation. There was a lack of knowledge regarding the symptoms and the progression of AIDS. More than 90% of the women knew that AIDS is incurable. Three quarters of them were aware that early treatment can slow down the progression of the disease, but only 16% knew that maternal HIV transmission can be reduced by treatment. Good knowledge was positively correlated with higher level of education (p<0.05).
Discussion. Although health education programs in Malaysia have succeeded in educating pregnant women regarding AIDS in general, certain important information is still not being disseminated. Future health education should formulate targeted strategies to overcome this problem.

Matched MeSH terms: Maternal-Child Health Centers
Fulltext Knowledge and attitude about child abuse and its reporting among childcare providers in Kemas preschools in Kota Bharu and Tumpat

Siti Mariam Ja’afa, Azriani Ab Rahman, Wan Nor Ariffin Wan Mansor

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):108-108.
MyJurnal

Introduction: Child abuse is an epidemic and in Malaysia, the numbers are rising. Statistic showed that 60% of the victims were below seven years old. Since most of them goes to preschool at this age, the role of childcare providers (CPs) in addressing this issue is crucial. However, previous data showed that referrals made by them to the author-ities was less than 1%. The objective of this study was to determine the knowledge and attitude of CPs in KEMAS preschools towards child abuse. Methods: This is a cross-sectional study involving CPs working in the KEMAS pre-schools in Kota Bharu and Tumpat, Kelantan, Malaysia, from April to June 2019. Results: From 218 respondents, 78% and 83% of them had good awareness on signs of neglect and physical abuse respectively compared to sexual abuse (64.6%). In terms of knowledge, 80% answered correctly about signs of abuse. However, only 18.8% an-swered correctly about sexual abuse. Moreover, 86.7% of CPs believed that they should be responsible to lodge a report, while only 6% of them objected. Although 76.1% were correct about the information to be prepared for reporting, only 4.6% of them realised that suspicions about a case would suffice to lodge a report. There were 94.5%, and 65.1% of CPs who correctly answered about the protection of the reporter under the law and its penalty respectively. But, only 26.6% of the CPs were correct about the category of mandated reporters according to the law. Conclusion: Although majority of CPs had good knowledge and awareness, there was still 26.6% who did not realise that they were mandated to report suspected cases. Therefore, educational programs need to be planned to increase awareness and knowledge on abuse and its legal aspects among CPs.

Matched MeSH terms: Child Health
Fulltext Knowledge and Concerns of Parents Regarding Childhood Fever at a Public Health Clinic in Kuching, East Malaysia

Bong WT, Tan CE

Open Access Maced J Med Sci, 2018 Oct 25;6(10):1928-1933.
PMID: 30455776 DOI: 10.3889/oamjms.2018.339

BACKGROUND: Parental anxiety regarding fever may be unwarranted as most cases are owing to self-limiting causes.
AIM: To assess the level of knowledge and concerns regarding childhood fever among parents with young children in a public health clinic in Kuching, East Malaysia.
METHODS: This cross-sectional study was conducted among parents recruited from a maternal and child health clinic, with children aged 6 months to 6 years. The participants completed a self-administered questionnaire regarding their knowledge and concerns about childhood fever. Descriptive statistical analyses were performed, and associations between dependent and independent variables were determined.
RESULTS: Only 26.1% of participants were found to have good knowledge. Knowledge regarding childhood fever was significantly associated with parent's ethnicity, education level, and household income. About 72% of parents were always worried about their child's illness. Three major reasons for their concerns were persistently rising temperature; discomfort caused by the fever, and feared complications of fever.
CONCLUSION: Excessive parental anxiety due to poor knowledge and misconceptions about fever may lead to poor quality of life and inappropriate management of fever. Healthcare providers may help by educating parents about fever and serious signs that indicate the need to seek healthcare advice.

Matched MeSH terms: Child Health
Fulltext Iodine deficiency disorders among pregnant women in Sarawak, Malaysia

Lim KK, Chan YY, Mahmud NA, Ismail H, Tan BC, Chua BK, et al.

Int J Public Health Res, 2018;8(2):980-986.
MyJurnal

Introduction Iodine deficiency disorders (IDD) during pregnancy may impair the neurological development of the fetus. The aim of this study is to determine the iodine status among pregnant women (PW) in Sarawak after introduction of mandatory universal salt iodisation (USI) for seven years.
Methods A total of 508 first trimester PW attending government Maternal and Child Health Care clinics in all 11 divisions in Sarawak between 1st April and 15th June 2015 were recruited. Urine samples were obtained and analysed for urinary iodine concentration (UIC) using the modified Sandell-Kolthoff reaction method. For pregnant women, an adequate iodine intake was defined as a median UIC between 150-249 µg/L according to the WHO/UNICEF/ICCIDD’s criterion. For further analyses, the 11 divisions were then combined into 3 regions, namely Northern (Miri, Bintulu, Limbang), Central (Kapit, Mukah, Sibu, Sarikei, Betong) and Southern (Kota Samarahan, Kuching, Sri Aman).
Results TThe median UIC of the PW in Sarawak was 105.6 µg/L, indicating iodine deficiency. A total of 330 (65.0%) PW had UIC<150 µg/L. In terms of urinary iodine levels by region, the median UIC in Northern, Central and Southern regions were 136.3 µg/L, 85.5 µg/L and 97.4 µg/L respectively. The differences in median UIC between regions were significant. In addition, the Northern region (p = 0.001), Malay/Melanau ethnicity (p = 0.015) and parous parity (p = 0.014) were significantly associated with higher median UIC. No significant association was found for locality, age nor gravida.
Conclusions This study indicates inadequate iodine status among PW in Sarawak despite seven years of mandatory USI. In fact, the majority of PW appear not to be protected against IDD and its consequences. In future, a comprehensive study should be carried out to determine the levels of iodine in salt at the retail outlets, villages and households in Sarawak.
Keywords Iodine deficiency disorders - Pregnant women - Mandatory USI - Sarawak

Matched MeSH terms: Maternal-Child Health Centers

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