Displaying publications 61 - 80 of 95 in total

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  1. Normaz Wana Ismail, Sudha Sivadas
    MyJurnal
    Introduction: Urbanisation is a key determinant of population health. Malaysia’s exemplary economic growth in the early 1990s and the consequent development and urbanisation led to significant changes in health, lifestyle and quality of life. Rising expectations, changing demographics and nutrition and disease transitions were challenges synonymous to an increasingly urban Malaysia. As the Government targets optimal population health, this paper aims to explore one of the many challenges of urbanisation, namely the prevalence of non-communicable diseases or NCDs. For the purpose of this paper, NCD is proxied by Diabetes Mellitus. Methods: This study is based the 2015 National Health and Morbidity Survey, which is a cross-sectional population-based survey, involving 30,000 re- spondents. Given the binomial nature of the survey variables, the multinomial Probit model was employed using the STATA statistical software. Results: Generally, age, gender and race are significant in determining health outcomes. Socioeconomically, all three variables of income, education and employment are significant. For lifestyle factors, findings show that only the weight and physically active status have a role in determining health outcomes. Finally, the urban variable is also positive and significant. Conclusion: Findings show that the prevalence of Diabetes Melli- tus, is rising along with urbanisation and that there is a health penalty for the urban population and also for those who do not embrace healthy lifestyles. Additionally, other factors are equally important as urban health determinants, encompassing both the demographic and socioeconomic factors.
    Matched MeSH terms: Urban Health
  2. 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: Urban Health Services
  3. Ho TM
    Int J Health Serv, 1988;18(2):281-91.
    PMID: 3378859 DOI: 10.2190/EJ77-C1UH-KHMQ-8HAX
    This article examines the numerous problems faced by primary health care in Malaysia, care that traditionally has been a private sector activity. While general practitioners have adapted, and are continually adapting, to the needs of a multiracial society with diverse cultural patterns, it is hoped that with the emergence of a dynamic discipline of family practice, family doctors will be able to provide a sophisticated form of primary health care that will serve the needs of the people.
    Matched MeSH terms: Urban Health
  4. Chen CD, Benjamin S, Saranum MM, Chiang YF, Lee HL, Nazni WA, et al.
    Trop Biomed, 2005 Jun;22(1):39-43.
    PMID: 16880752
    Ovitrap surveillance was conducted in two urban residential areas (Taman Samudera Timur and Taman Samudera Selatan) and in a settlement area (Kampung Banjar), which is located 16 km from Kuala Lumpur city center, Malaysia. In Taman Samudera, dengue cases were reported monthly in 2003/2004. Thus, a study was initiated to determine the distribution and abundance of dengue vectors, Aedes aegypti and Ae. albopictus. The ovitrap surveillance indicated that Ae. aegypti and Ae. albopictus were present both indoors and outdoors. The residential sites had 73 - 79% of the ovitraps with just Ae. aegypti population and Kg. Banjar had 56% of the ovitraps with just Ae. aegypti. In the indoor and outdoor of the residential areas, together with the settlement area, the Ae. aegypti density was significantly more than Ae. albopictus (p < 0.05) by 3 - 50 folds. There was no significant difference in the larval numbers of Ae. aegypti between indoors and outdoors (p > 0.05), thus implicating that adult gravid female Ae. aegypti are present both indoors and outdoors and they do oviposit indoors and outdoors. Ae. aegypti can be incriminated as the principal dengue vector in the urban residential site, Taman Samudera and in the settlement area, Kg. Banjar.
    Matched MeSH terms: Urban Health
  5. Vythilingam I, Tan CH, Nazni WA
    Trop Biomed, 2005 Jun;22(1):83-5.
    PMID: 16880760 MyJurnal
    Laboratory strain of the Malaysian Culex quinquefasciatus was susceptible to Wuchereria bancrofti. Thirty three percent of the Cx. quinquefasciatus that fed on W. bancrofti patient were infective after 12-14 days. There is a possibility for W. bancrofti to occur in the urban areas of the Malaysia in the near future.
    Matched MeSH terms: Urban Health
  6. Majid HA, Amiri M, Mohd Azmi N, Su TT, Jalaludin MY, Al-Sadat N
    Sci Rep, 2016 07 28;6:30544.
    PMID: 27465116 DOI: 10.1038/srep30544
    Insufficient physical activity and growing obesity levels among Malaysian adolescents are becoming a public health concern. Our study is to identify the trends of self-reported physical activity (PA) levels, blood lipid profiles, and body composition (BC) indices from a cohort of 820 adolescents. The self-reported PA was assessed using a validated Malay version of the PA Questionnaire for Older Children (PAQ-C). Fasting blood samples were collected to investigate their lipid profiles. Height, weight, waist and hip circumferences as well as body fat percentage were measured. The baseline and the first follow-up were conducted in 2012 and 2014, respectively. A downward trend in the PA level was seen in all categories with a significant reduction among all rural adolescents (P = 0.013) and more specifically, PA among girls residing in rural areas dropped significantly (P = 0.006). Either a significant reduction in high-density lipoprotein (HDL) or a significant increment in BC indices (i.e., body mass index [BMI], waist circumference [WC], hip circumference, and body fat percentage [BF %]) were seen in this group. Female adolescents experienced more body fat increment with the reduction of physical activity. If not intervened early, adolescents from rural areas may increase their risk of developing cardiovascular diseases earlier.
    Matched MeSH terms: Urban Health
  7. Patil Sapna S., Hasamnis Ameya A., Pathare Rooma S., Parmar Aarti, Rashid A.K., Narayan K.A.
    MyJurnal
    Background: The World Health Organization recommends the practice of exclusive breastfeeding of infants for the first 6 months after birth. The objective of present study was to estimate the prevalence and the factors influencing exclusive breastfeeding. The perceptions of mothers about breastfeeding in an urban slum area of Western India were also enquired.
    Methods: This cross sectional study was conducted over six months amongst 200 mothers of children in the age group of 6 – 12 months attending the growth and development clinic in one of the urban health centres. Data was collected using a pre-tested, structured questionnaire on breastfeeding practices. Factors related to exclusive breastfeeding were analysed using bivariate and multivariate analysis.
    Results: Prevalence of exclusive breastfeeding reported by the participants was 61.5%. Having a male child, maternal age < 30 years, level of education of mother parity, receiving infant feeding advice, initiation of breastfeeding within one hour of birth and administration of colostrum to the baby were associated with exclusive breastfeeding (p
    Matched MeSH terms: Urban Health
  8. Azmoude E, Aradmehr M, Dehghani F
    Malays J Med Sci, 2018 May;25(3):120-128.
    PMID: 30899193 DOI: 10.21315/mjms2018.25.3.12
    Objectives: Midwives have a crucial role in providing optimal care for pregnant women. One of the most important policies for quality improvement in maternity care is implementation of evidence-based practice. However, the application of evidence-based practice within the maternity health care setting faces many challenges. The purpose of this study was to describe Iranian midwives' attitude and perceived barriers of evidence based practice in maternity care.

    Methods: In this descriptive, cross-sectional study, a census sample of 76 midwives from two public hospitals and urban health centers in Torbat Heydariyeh, a city east of Iran were surveyed. Data collection tools were two reliable and valid questionnaires that measure midwives' attitudes and barriers of implementation of evidence-based practice. Data were analysed using SPSS version 16.

    Results: The mean age and years of experience were 29.30 ± 4.86 and 5.22 ± 4.21 years, respectively. The mean score of attitude was 40.85 ± 4.84 (range = 30-60). This study also found time constraints (2.70 ± 0.92), inadequate facilities (2.64 ± 0.72), non-compilation of literature in one place (2.59 ± 0.92), lack of cooperation of physicians (2.48 ± 1.06) and the feeling of inadequate authority (2.45 ± 0.88) as the top five barriers to implementing EBP.

    Conclusion: Survey participants demonstrated a positive attitude toward EBP. Organisational comprehensive strategies such as time efficiency, adequate material and human resources, familiarity with organisations such as the Cochrane Collaboration and managerial support for increasing professional legitimate authority are recommended to promote the use of Evidence-Based Practice in Iran.

    Matched MeSH terms: Urban Health
  9. Selvarajah S, Haniff J, Kaur G, Hiong TG, Cheong KC, Lim CM, et al.
    Eur J Prev Cardiol, 2013 Apr;20(2):368-75.
    PMID: 22345688 DOI: 10.1177/2047487312437327
    BACKGROUND: This study aimed to estimate the prevalence of cardiovascular risk factors and its clustering. The findings are to help shape the Malaysian future healthcare planning for cardiovascular disease prevention and management.
    METHODS: Data from a nationally representative cross-sectional survey was used. The survey was conducted via a face-to-face interview using a standardised questionnaire. A total of 37,906 eligible participants aged 18 years and older was identified, of whom 34,505 (91%) participated. Focus was on hypertension, hyperglycaemia (diabetes and impaired fasting glucose), hypercholesterolaemia and central obesity.
    RESULTS: Overall, 63% (95% confidence limits 62, 65%) of the participants had at least one cardiovascular risk factor, 33% (32, 35%) had two or more and 14% (12, 15%) had three risk factors or more. The prevalence of hypertension, hyperglycaemia, hypercholesterolaemia and central obesity were 38%, 15%, 24% and 37%, respectively. Women were more likely to have a higher number of cardiovascular risk factors for most age groups; adjusted odds ratios ranging from 1.1 (0.91, 1.32) to 1.26 (1.12, 1.43) for the presence of one risk factor and 1.07 (0.91, 1.32) to 2.00 (1.78, 2.25) for two or more risk factors.
    CONCLUSIONS: Cardiovascular risk-factor clustering provides a clear impression of the true burden of cardiovascular disease risk in the population. Women displayed higher prevalence and a younger age shift in clustering was seen. These findings signal the presence of a cardiovascular epidemic in an upcoming middle-income country and provide evidence that drastic measures have to be taken to safeguard the health of the nation.
    Study name: National Health and Morbidity Survey (NHMS-2006)
    Matched MeSH terms: Urban Health/statistics & numerical data
  10. Esa R, Razak IA, Allister JH
    Community Dent Health, 2001 Mar;18(1):31-6.
    PMID: 11421403
    Data on malocclusion and orthodontic treatment need in Malaysia are limited. The purpose of this study was to evaluate malocclusion and orthodontic treatment need in a sample of 12-13-year-old schoolchildren using the Dental Aesthetic Index (DAI), and to assess the relationship between malocclusion and socio-demographic variables, perceptions of need for orthodontic treatment, aesthetic perception and social functioning.
    Matched MeSH terms: Urban Health/statistics & numerical data
  11. Jamal R, Syed Zakaria SZ, Kamaruddin MA, Abd Jalal N, Ismail N, Mohd Kamil N, et al.
    Int J Epidemiol, 2015 Apr;44(2):423-31.
    PMID: 24729425 DOI: 10.1093/ije/dyu089
    The Malaysian Cohort study was initiated in 2005 by the Malaysian government. The top-down approach to this population-based cohort study ensured the allocation of sufficient funding for the project which aimed to recruit 100,000 individuals aged 35-70 years. Participants were recruited from rural and urban areas as well as from various socioeconomic groups. The main objectives of the study were to identify risk factors, to study gene-environment interaction and to discover biomarkers for the early detection of cancers and other diseases. At recruitment, a questionnaire-based interview was conducted, biophysical measurements were performed and biospecimens were collected, processed and stored. Baseline investigations included fasting blood sugar, fasting lipid profile, renal profile and full blood count. From April 2006 to the end of September 2012 we recruited a total of 106,527 participants. The baseline prevalence data showed 16.6% participants with diabetes, 46.5% with hypertension, 44.9% with hypercholesterolaemia and 17.7% with obesity. The follow-up phase commenced in June 2013. This is the most comprehensive and biggest cohort study in Malaysia, and has become a valuable resource for epidemiological and biological research. For information on collaboration and also data access, investigators can contact the project leader at (rahmanj@ppukm.ukm.edu.my).
    Study name: The Malaysian Cohort (TMC) project
    Matched MeSH terms: Urban Health/statistics & numerical data
  12. Sekhar WY, Soo EH, Gopalakrishnan V, Devi S
    Singapore Med J, 2000 Aug;41(8):370-5.
    PMID: 11256343
    The aim of the study was to look into the epidemiology of serodiagnosed cases of leptospirosis at the University Hospital and compare two commercial ELISA Assays to the Microscopic Agglutination Test (MAT). Demographic data for all serodiagnosed cases for the years 1991-1997 were collected. From this data, 104 sera (n = 104) were selected as samples for comparative evaluation of the commercial ELISAs (INDX Dip-S-Ticks and PanBio ELISA) to the MAT test. Thirty two (n = 32) negative control sera were selected from serodiagnosed cases of other differential diagnosis of leptospira infection. The MAT test is a standard test that detects agglutination antibodies to leptospira biflexa, while the INDX Dip-S-Ticks is an ELISA dot test assaying for total anti-leptospira antibodies. The PanBio ELISA is a colorometric assay in test well strips to detect anti-leptospira IgM. The sensitivity, specificity, and efficiency of tests were calculated at a MAT cut-off value of 1:320. Demographic data showed that leptospirosis peaks during March-May and Aug-Nov coinciding with the inter-monsoon period with more men being infected than women and more adults than children. The sensitivity, specificity, and efficiency of test for the INDX Dip-S-Ticks were 83.3%, 93.8% and 87.5% while the values for the PanBio ELISA were 54.2%, 96.9% and 71.3%. The suboptimal PanBio result could be related to the blocking effect of high IgG titres or could be related to the diagnostic MAT cut-off values used in this study. The data hence reflects a pattern of transmission that is related to "wet" occupational risk factors. The commercial assays evaluated, are easier to perform but interpretation of results should be based on level of endemicity. The INDX Dip-S-Ticks allows this flexibility and is a practical alternative to the MAT test.
    Matched MeSH terms: Urban Health/statistics & numerical data
  13. Ambigapathy R, Chia YC, Ng CJ
    BMJ Open, 2016 Jan 04;6(1):e010063.
    PMID: 26729393 DOI: 10.1136/bmjopen-2015-010063
    OBJECTIVE: Shared decision-making has been advocated as a useful model for patient management. In developing Asian countries such as Malaysia, there is a common belief that patients prefer a passive role in clinical consultation. As such, the objective of this study was to determine Malaysian patients' role preference in decision-making and the associated factors.
    DESIGN: A cross-sectional study.
    SETTING: Study was conducted at an urban primary care clinic in Malaysia in 2012.
    PARTICIPANTS: Patients aged >21 years were chosen using systematic random sampling.
    METHODS: Consenting patients answered a self-administered questionnaire, which included demographic data and their preferred and actual role before and after consultation. Doctors were asked to determine patients' role preference. The Control Preference Scale was used to assess patients' role preference.
    PRIMARY OUTCOME: Prevalence of patients' preferred role in decision-making.
    SECONDARY OUTCOMES: (1) Actual role played by the patient in decision-making. (2) Sociodemographic factors associated with patients' preferred role in decision-making. (3) Doctors' perception of patients' involvement in decision-making.
    RESULTS: The response rate was 95.1% (470/494). Shared decision-making was preferred by 51.9% of patients, followed by passive (26.3%) and active (21.8%) roles in decision-making. Higher household income was significantly associated with autonomous role preference (p=0.018). Doctors' perception did not concur with patients' preferred role. Among patients whom doctors perceived to prefer a passive role, 73.5% preferred an autonomous role (p=0.900, κ=0.006).
    CONCLUSIONS: The majority of patients attending the primary care clinic preferred and played an autonomous role in decision-making. Doctors underestimated patients' preference to play an autonomous role.
    Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Urban Health
  14. Rominski SD, Gupta M, Aborigo R, Adongo P, Engman C, Hodgson A, et al.
    Int J Gynaecol Obstet, 2014 Sep;126(3):217-22.
    PMID: 24920181 DOI: 10.1016/j.ijgo.2014.03.031
    OBJECTIVE: To investigate factors associated with self-reported pregnancy termination in Ghana and thereby appreciate the correlates of abortion-seeking in order to understand safe abortion care provision.
    METHODS: In a retrospective study, data from the Ghana 2008 Demographic and Health Survey were used to investigate factors associated with self-reported pregnancy termination. Variables on an individual and household level were examined by both bivariate analyses and multivariate logistic regression. A five-point autonomy scale was created to explore the role of female autonomy in reported abortion-seeking behavior.
    RESULTS: Among 4916 women included in the survey, 791 (16.1%) reported having an abortion. Factors associated with abortion-seeking included being older, having attended school, and living in an urban versus a rural area. When entered into a logistic regression model with demographic control variables, every step up the autonomy scale (i.e. increasing autonomy) was associated with a 14.0% increased likelihood of reporting the termination of a pregnancy (P < 0.05).
    CONCLUSION: Although health system barriers might play a role in preventing women from seeking safe abortion services, autonomy on an individual level is also important and needs to be addressed if women are to be empowered to seek safe abortion services.
    KEYWORDS: Abortion; Autonomy; Empowerment; Low-resource countries; Maternal health; Reproductive health
    Matched MeSH terms: Urban Health Services
  15. Khambalia AZ, Lim SS, Gill T, Bulgiba AM
    Food Nutr Bull, 2012 Mar;33(1):31-42.
    PMID: 22624296
    For many developing countries undergoing rapid economic growth and urbanization, trends in nutritional status indicate a decrease in malnutrition with an associated rise in the prevalence of obesity. An understanding of the situation among children in Malaysia is lacking.
    Matched MeSH terms: Urban Health
  16. Tran NT, Choe SI, Taylor R, Ko WS, Pyo HS, So HC
    Asian Pac J Cancer Prev, 2011;12(11):3029-33.
    PMID: 22393985
    BACKGROUND: This study assessed women from the Democratic People's Republic of Korea for: (i) their level of knowledge of cervical cancer and attitudes and practices concerning cervical screening (KAP); and (ii) differences in KAP between rural and urban groups.

    METHODS: In a descriptive cross-sectional study, a purposive sample of 200 women in 6 provinces of DPRK (rural: n=99, urban: n=101) were interviewed using a standardized questionnaire. Differences between proportions were assessed using the χ2 test. Significance was defined as p<0.05.

    RESULTS: 63% of rural and 60% of urban participants had heard of cervical cancer (p>0.05). 42% knew that it is the most common cancer of the female reproductive tract, 55% knew that all women are at risk, but only 36% were aware of cervical cancer's preventability. Some 13% of rural and 29% of urban respondents had heard of cervical cytology testing (p<0.001). Only 6% of participants had ever received a cervical cytology smear. Among the reasons for not screening, 48% mentioned a lack of awareness of cervical cytology; 47% their dislike of pelvic examinations; 17% of rural and 31% of urban interviewees reported the absence of symptoms (p<0.05); and 62% of rural and 0% of urban women mentioned travelling long distances to service delivery points (p<0.001).

    CONCLUSIONS: There is a reasonable level of knowledge of cervical cancer among North Korean women; however, there are major gaps regarding awareness of its preventability and actual uptake of cytology screening services. There are no significant differences between rural and urban women with regard to their KAP. Large scale health promotion campaigns are needed to educate women and the community about cervical cancer and its preventability through screening. The national health care system needs to ensure that screening services are effective, accessible, feasible and acceptable to women.
    Matched MeSH terms: Urban Health
  17. Tran NT, Taylor R, Choe SI, Pyo HS, Kim OS, So HC
    Asian Pac J Cancer Prev, 2011;12(11):3023-8.
    PMID: 22393984
    BACKGROUND AND OBJECTIVE: Little is known about cervical cancer (CC) in the Democratic People's Republic of Korea (DPRK). This study examines the knowledge, attitudes and practices (KAP) concerning CC and screening among female health care practitioners (HCPs), and whether differences exist between rural and urban HCPs.

    METHOD: In a descriptive cross-sectional study, a purposive sample of 200 women HCPs from 128 health care centers in 6 provinces of DPRK was interviewed using a standardized questionnaire.

    RESULTS: 98% of HCPs were aware of CC. Awareness of the national CC policy was significantly lower in rural (44%) than urban (62%) respondents (p<0.05). Fewer rural (71%) than urban (89%) HCPs knew of cervical cytology (p<0.05). Around 30% of HCPs were aware of the association between CC and human papillomavirus infection. Only 13% of HCPs had ever had a cervical cytology smear. Only 4% of rural and 21% of urban practitioners (p<0.05) provided cytology; all used unaided visual inspection of the cervix without staining to determine whether cytology testing was indicated. For all, screening intervals depended on presence of symptoms.

    CONCLUSION: Misconceptions and ineffective clinical practices regarding screening need to be urgently addressed among both rural and urban HCPs. There are no major differences between rural and urban HCPs regarding their KAP.
    Matched MeSH terms: Urban Health
  18. Nithyamathi K, Chandramathi S, Kumar S
    PLoS One, 2016;11(2):e0136709.
    PMID: 26914483 DOI: 10.1371/journal.pone.0136709
    BACKGROUND: One of the largest cross-sectional study in recent years was carried out to investigate the prevalence of intestinal parasitic infections among urban and rural school children from five states namely Selangor, Perak, Pahang, Kedah and Johor in Peninsula Malaysia. This information would be vital for school authorities to influence strategies for providing better health especially in terms of reducing intestinal parasitism.

    METHODS AND PRINCIPAL FINDINGS: A total of 3776 stool cups was distributed to 26 schools throughout the country. 1760 (46.61%) responded. The overall prevalence of intestinal parasitic infection in both rural and urban areas was 13.3%, with Blastocystis sp (10.6%) being the most predominant, followed by Trichuris trichiura (3.4%), Ascaris lumbricoides (1.5%) and hook worm infection (0.9%). Only rural school children had helminthic infection. In general Perak had the highest infection (37.2%, total, n = 317), followed by Selangor (10.4%, total, n = 729), Pahang (8.6%, total, n = 221), Kedah (6.2%, total, n = 195) and Johor (3.4%, total, n = 298). School children from rural schools had higher infection (13.7%, total, n = 922) than urban school children (7.2%, total, n = 838). Subtype (ST) 3 (54.3%) is the most predominant ST with persons infected with only ST1 and ST3 showing symptoms. Blastocystis sp infection significantly associated with low household income, low parent's education and presence of symptoms (p<0.05).

    CONCLUSION: It is critical that we institute deworming and treatment to eradicate the parasite especially in rural school children.

    Matched MeSH terms: Urban Health
  19. Boey CC, Goh KL
    J Gastroenterol Hepatol, 2001 Feb;16(2):154-9.
    PMID: 11207895
    AIM: To look at the predictors of health-care consultation for recurrent abdominal pain among urban schoolchildren in Malaysia.

    METHODS: Recurrent abdominal pain was defined as at least three episodes of abdominal pain, severe enough to affect a child's activities over a period longer than 3 months. A health-care consulter was defined as a child who had been brought to see a doctor regarding recurrent abdominal pain at least once in the past year. Children aged between 9 and 15 years were randomly chosen from schools in the city of Petaling Jaya, given questionnaires to fill in and interviewed to determine whether they fulfilled the above criteria for having symptoms of recurrent abdominal pain and for being a consulter. Bivariate analysis and multiple logistic regression analysis were performed on the data obtained.

    RESULTS: One hundred and forty-three (9.61%) children fulfilled the criteria for recurrent abdominal pain out of a total of 1488 schoolchildren interviewed. There were 65 (45.5%) consulters and 78 (54.5%) non-consulters. Among the consulters, the male to female ratio was 1:1.4, while among the non-consulters, the ratio was 1:1.1. On bivariate analysis, the Chinese had a significantly lower likelihood to consult a doctor (P = 0.02), while the other two races did not show any increase in consultation (Malays, P = 0.08; Indians, P = 0.21). Among those with severe pain, there was a significantly higher prevalence of consulters (P < 0.01). Furthermore, those whose sleep was interrupted by abdominal pain were more likely to consult (P < 0.01). Children who had consulted a doctor were more likely to be missing school because of abdominal pain (P < 0.01). Following multiple logistic regression analysis, ethnicity was no longer a significant predictor.

    CONCLUSIONS: Approximately 45.5% of schoolchildren with recurrent abdominal pain in an urban setting were brought to see a doctor. Predictors of recent health-care consultation were school absence, pain severity and interruption of sleep caused by abdominal pain.

    Matched MeSH terms: Urban Health
  20. Amudha K, Chee KH, Tan KS, Tan CT, Lang CC
    Int J Clin Pract, 2003 Jun;57(5):369-72.
    PMID: 12846339
    Atherosclerosis is a progressive, disseminated condition that affects all the vascular beds. Peripheral arterial disease (PAD), a manifestation of atherosclerosis, measured non-invasively in the legs by ankle-brachial index (ABI) is associated with increased cardiovascular morbidity and mortality. Though several studies in the western industrialised countries have shown that PAD is widely prevalent in the general older population at risk, not much data are available in the South East Asian developing countries. We have conducted an epidemiological survey on the prevalence of PAD in high-risk patients at an urban hospital in Malaysia. A total of 301 consecutive patients aged 32-90 years were recruited during their follow-up clinic visits for established cardiovascular disease, ischaemic stroke or diabetes mellitus > or = 5 years. All participants underwent ABI measurement and were subjected to the Edinburgh claudication questionnaire to assess leg symptoms. The prevalence of PAD in our high-risk population was 23%, of which only 27% were symptomatic with the classical intermittent claudication. All the patients with PAD were diagnosed at the time of the study. PAD was found in 33% of patients with pre-existent cardiovascular disease, 28% in patients with ischaemic stroke and 24% in diabetic patients. PAD was also highly prevalent among the younger patients. Our study has shown that PAD is highly prevalent among high-risk Malaysian patients and is not necessarily a disease of older age. Only 27% of these patients were symptomatic. All the subjects with PAD were diagnosed at the time of the study, which would suggest it is an unrecognised and underdiagnosed condition, even in patients with atherosclerotic risk factors.
    Matched MeSH terms: Urban Health
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