Introduction This paper aims to investigate the potential pesticide dermal contamination
among the agricultural community by observing the microenvironmental and
macroactivity interaction between farm children and adult farmer.
Methods A 24 hours timeline activity was observed and recorded in the agricultural
farming village, Kuala Selangor. In this study, 2 homes were monitored for 2
days following a pesticide application. A total of 2 adult farmers and 5
children (7-10 year old) were recruited to participate in this study. Twentyfour
hour videotape segments and time-activity diaries were collected during
the study.
Results The microenvironment and macroactivity interaction were modelled in this
study. By considering only the potential dermal exposure pathway, the
different biological vulnerability and exposure pattern to pesticides were
observed. Finding showed a greater extent of interaction between human and
its environment, where adult farmers are the main contributor of
environmental contaminants, and children is one of the vulnerable receivers
of the contaminants’ residuals from the environment.
Conclusion The daily activities and behaviors practiced by the agricultural community
were among the contributing factors which help to highlight the pesticide
dermal contamination pathway in the farming village. This study
recommends the necessary to consider the microenvironment and
macroactivity of the target community when assess their exposure levels to
the environment contaminants.
Introduction An Analysis of a Survey Questionnaire on health care workers’ knowledge and practices regarding of infection control and complains them to apply universal precautions. Health care workers are at substantial risk of acquiring blood borne pathogen infections through exposure to blood or other products of patients. To assess of infection control among health care workers in Sana'a healthcare centers, Yemen.
Methods A cross-sectional study was conducted in the health center to assess knowledge and practices regarding of infection control among 237 health workers in Sana,a city. A structured self-administered questionnaires were used and data was analyzed using SPSS version 20 and the associations were tested with chi-square, with p-value of < 0.05.
Results The health care workers in public centers ware (51.1%) and (48.9%) of them works in private centers. One hundred and seventeen (49.4%) respondents had poor infection control knowledge, 113 (43.5%) had fair knowledge, and 17 (7.2%) had good knowledge. The knowledge was significantly associated with type of center (P < 0.018), such that the public center had the highest proportion with poor knowledge. And nurses and midwife having the highest proportion with fair knowledge of infection control. Eight (3.4%) respondents had a poor practice of universal precautions, 93 (39.2%) had fair practice, and 136 (57.4%) good practice. The practice was significantly associated with the profession, level of education and work experience (P < 0.001), (P < 0.006), (P < 0.001) respectively, and nurses and midwives as the profession with the highest proportion with good practice.
Conclusion We conclude that the practices and knowledge of universal precautions were low and that's need for intensive programmes to educate health care workers on various aspects of standard precautions and infection control programmes and policies.
Introduction Family satisfaction is referred to the extent in which family members feel happy and fulfilled with each other. However, there has been lack of evidences on the family satisfaction scale within the Malaysian context. Therefore, the aim of this study was to assess validity of the Malay version of the Olson’s Family Satisfaction Scale. This is to allow Malaysian researchers to bring family satisfaction in line with the different field of studies.
Methods This study was conducted among 567 Malaysian working women. Data were collected using self-administrated questionnaires. This study conducted exploratory and confirmatory factor analysis, convergent validity and internal consistency using Cronbach’s alpha.
Results The findings of this study support the uni-dimensionality of the Malay version of the family satisfaction scale. The 10 items of the scale account for 68.1% of the total variance and the un-rotated factor loadings ranged from 0.76 to 0.87. Confirmatory factor analysis was run and supported the structure of family satisfaction scale. The results of confirmatory factor analysis using AMOS 21 in the current study reported the following indices: RMSEA= 0.06, CFI= 0.94, NFI= 0.94, TLI= 0.93. The convergent validity (average variance extracted= 0.65) and the internal consistency (Cronbach’s alpha= 0.94) of this construct were adequately supported.
Conclusions The findings support the factor structure, convergent validity and the internal consistency of the examined construct. Therefore, Malay version of the family satisfaction scale is a valid and reliable instrument among Malaysian working women.
Introduction There is a strong and increased worldwide interest on the aspects of
prevention of oral disease and oral health promotion in dental education.
However, some studies imply that dental students are not knowledgeable
enough in this issue. This study aimed to evaluate the knowledge of, attitude
towards and practice on preventive dentistry among senior dental students in
Yemen.
Methods Self-administered questionnaires were distributed among senior dental
students in six dental schools in Yemen. The questionnaire obtained personal
information, and questions about knowledge on preventive dental care,
attitudes towards and practice on preventive dentistry.
Results Among 346 students who filled the questionnaire, a total of 91.6% has good
knowledge about fissure sealant effectiveness, only 34.7% knows about the
importance of fluoride toothpaste compared to brushing technique in
preventing caries, with significant gender difference (p=0.005). Odds of good
knowledge among non-Qat chewers was 1.9 (95%CI: 1.26-4.42).
Multivariable regression analysis indicated that female gender was associated
with higher positive attitudes (OR: 2.03, 95%CI:1.21-3.36,p=0.007).
Attitudes were significantly associated with Qat chewing (OR = 1.95,
95%CI: 1.04-3.66, p=0.03), type of university (OR = 0.59, 95%CI: 0.36-0.94,
p=0.02), and mothers' level of education (OR = 1.91, 95%CI: 1.05-3.47,
p=0.03). There was a high percentage of competency in practicing preventive
measures among students (80.9%).
Conclusions Dental education should emphasize the overall aspects of preventive dentistry
with early exposure of preventive dental training in order to improve
students' knowledge and attitudes and consequently practice on preventive
care.
Introduction Helminthiasis is a common parasitic condition particularly among children in
rural areas in developing countries where poor hygiene standard is practiced.
The study aimed to determine the prevalence of helminthiasis among Indian
preschoolers in urban areas in Penang and its associated factors.
Methods A total of 194 urban Indian preschoolers aged 4 to 6 years old were selected
randomly from 11 kindergartens in the state of Penang for this cross sectional
study. Data collection was carried out in 2 phases. First, microscopic stool
examinations were done to examine the presence of helminths. Second, self
administered questionnaires which inquired about human, environment and
socioeconomic factors were completed by the parents/guardians.
Results The overall prevalence of helminthiasis was 7.2% and the most frequently
encountered infective agent was Ascaris lumbricoides (57.1%) and followed
by the tapeworms (42.86%). The logistic regression indicated that habitual
thumb sucking (AOR= 5.6. 95%CI: 1.73-18.39) and families owning
domestic pets (AOR= 3.2; 95%CI: 1.03-10.14) were the significant
contributing factors to helminthiasis among the Indian pre-schoolers in urban
Penang. Although the prevalence of helminth infection among the urban
Indian preschoolers is lower than rural area, it is still a public health concern.
Children habitual thumb sucking and rearing domestic pets at home were the
significant contributing factors in helminthiasis.
Conclusion Prevention strategy should focus on health education and promotion among
adults and children, awareness on domestic animal hygiene and maintaining
good environmental sanitation. Multi agency collaboration is clearly
essential, especially between state health, education and veterinary
departments in curbing this disease.
Introduction Anxiety and depression were known to bring detrimental outcome in patients
with ischemic heart disease (IHD). Notwithstanding their high prevalence
and catastrophic impact, anxiety and depression were unrecognized and
untreated. The aim of this study was to determine the prevalence of anxiety
and depression among IHD patients and the association of this condition with
clinical and selected demographic factors.
Methods This was a cross-sectional study on 100 IHD patients admitted to medical
ward in UKMMC. Patients diagnosed to have IHD were randomly assessed
using Hospital Anxiety and Depression Scale (HADS) and Perceived Social
Support (PSS) Questionnaire. Socio-demographic data were obtained by
direct interview. Fifteen percent of IHD patients in this sample were noted to
have anxiety, fourteen percent noted to have depression while thirty two
percent was noted to have both anxiety and depression. Patients’ age group
and the duration of illness were found to have significant association with
anxiety. Socio-demographic data were obtained by direct interview.
Results Fifteen percent of IHD patients in this sample were noted to have anxiety,
fourteen percent noted to have depression while thirty two percent was noted
to have both anxiety and depression. Patients’ age group and the duration of
illness were found to have significant association with anxiety. The other
clinical and selected demographic factors such as gender, race, marital status,
education level, occupation, co-existing medical illness and social support
were not found to be significantly associated with anxiety or depression
among the IHD patients.
Conclusions In conclusion, proper assessment of anxiety and depression in IHD patients,
with special attention to patients’ age and duration of illness should be
carried out routinely to help avert detrimental consequences.
Introduction Physical activity reduces risk of non-communicable diseases. Physical
activity prevalence is low due to barriers to physical activity. This study was
conducted to translate the Barrier to Physical Activity (BPA) questionnaire
into Malay and assess the reliability and validity of the translated version
among nurses.
Methods The Malay version of BPA was developed after translating the English
version of BPA through back to back translation process. The Malay BPA
was distributed among 306 volunteered nurses from 5 government hospitals
in Selangor state. Factor analysis, Cronbach’s alpha test and test – retest
reliability was conducted to determine psychometric properties of BPA.
Results Chronbach’s alpha coefficient was 0.79 for perceived benefits items and 0.51
for perceived barrier items (overall was 0.73). The ICC was 0.88 (95% CI:
0.78-0.93) for test-retest testing after 7 days. Two factors components were
yielded through exploratory factor analysis with eigenvalues of 3.9 and 2.0
respectively. Both the factors accounts for 31.4 % of the variance. Factor 1
included 14 items and explained 19.9% of the variance. Factor 2 consisted of
5 items and explained 11.5% of variance. CFA yielded two factor structures
with acceptable goodness of fit indices [x2/df = 23.99; GFI = 0.82, SRMR =
0.09; PNFI = 0.49 and RMSEA = 0.10 (90%CI = 0.09-0.11)].
Conclusions The Malay version of BPA had demonstrated satisfactory level of validity
and reliability to assess barriers to physical activity. Therefore, this
questionnaire is valid in assessing barriers to physical activity among
working population.
Introduction This study investigates work engagement of employed breast cancer
survivors in comparison to unmatched control samples of healthy working
women without cancer and any other chronic diseases from the general
population.
Methods A case-control study design using unmatched controls was adopted in this
study. The case comprised of 80 female breast cancer survivors who have
returned to full-time employment selected using purposive sampling
technique. Meanwhile, controls were 88 healthy female working women in
full time paid employment, selected using quota sampling. Questionnaire
covering socio-demographic characteristics and self-rated work engagement
measured using Utrecht Work Engagement Scale (UWES) was distributed to
the cancer survivors through face-to-face meeting during their hospital visits.
For the healthy controls the questionnaires were distributed using drop-andcollect
method through the human resource personnel of the participating
organization.
Results The results revealed, after controlling for age, marital status, ethnic group and
tenure with organization, no significant differences in the overall work
engagement was found between the breast cancer survivors [mean (SD) =
4.66 (0.92)] and the healthy controls [mean (SD) = 4.75 (0.85)]; F(1, 163)
=1.70. In comparison to the work engagement domains, only the Vigor
domain was found to be significantly lower for the survivors, survivors [F (1,
163) =14.94; p
Introduction Healthy dietary practice is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing the rate of diabetes complication development. It is, therefore, important at all levels of diabetes prevention. The objective of this study was to determine the association of dietary practice with glycaemic control among Type 2 diabetes mellitus (T2DM) patients, who received treatment from an urban Health Clinic in Kuala Lumpur.
Methods A total of 307 patients with T2DM aged 18 years and above participated in this study. A pre-tested structured questionnaire with guided interview was used to collect information on socio-demographic, clinical and dietary practice. Anthropometric and biological measurements were also taken. Descriptive statistics and Chi-square were used in the data analysis. Good glycaemic control was defined as HbA1c level less than 6.5%.
Results The prevalence of good glycaemic control was only 27% (n=83). The highest percentage of good glycaemic control were among male patients (29.1%), aged 60 and above (33.3%), educational level of primary school (35.4%) and those with monthly income group between RM1001 to RM1500 (32.0%). About three quarter of T2DM patient (n=224) had poor control of HbA1c (≥6.5%). Age (p=0.045) and working status (p=0.039) had significant relationship with the level of HbA1c. Dietary practice showed no significant relationship with the HbA1c level.
Conclusions Effective interventional health education strategies are needed, focussing on modification of dietary behaviour in order to achieve glycaemic control among diabetic patients.
Study site: Klinik Kesihatan, Kuala Lumpur, Malaysia
Introduction Breast cancer is ranked number one from the ten most frequent cancers in
female, Peninsular Malaysia. Various studies provide negative evidence on
malignancies and one of the end results is impaired quality of life (QOL).
Studies show lifestyle approaches are key factors in enhancing the QOL
among cancer survivors. The purpose of this study is to describe the lifestyle
practices (LP) among breast cancer survivors (BCS) which consist of dietary
intake, exercise habits, and stress management and to determine whether
these practices have influence on the QOL among Malaysian BCS.
Methods This study adopts a cross-sectional study design using a self-administered
questionnaire. A total of 280 BCS from public and private hospitals
throughout Peninsular Malaysia had participated. The questionnaire covers
QOL and LP items which consist of dietary intake (consumption of high-fat
food, high-fibre food, fruits and vegetables), exercise habits, and stress
management. Descriptive statistics and one-way ANOVA were used to
determine the relationship between LP and QOL.
Results Mean age of the study sample was at 41 (SD=7.37). Majority of them were
Malay (74%), 53% were diagnosed with breast cancer between 1 to 2 years
whereas 54% were presented with stage 2 at diagnosis. There was a
statistically significant difference (p
Introduction The aim of this study was to examine the aspect of information disclosure by doctor-investigator during the process of obtaining informed consent in clinical trials.
Methods This research employed a mixed-method data collection that is library research and interview. A qualitative methodology and analysis were used in an open-ended, face-to-face interviews with 17 patient-subjects. The interview questions were based on information that needed to be disclosed to patient-subjects during the process of obtaining informed consent. Each interview took place in Kajang Hospital and National Heart Institute and lasted 25-30 minutes. Interviews were conducted in Bahasa Melayu and English. The interviews were tape-recorded, and the main points from the interviews were jotted down to ensure that all information was adequately gathered. Interviewed occurred in Kajang Hospital and National Heart Institute. The participants were patients who had been referred to the Kajang Hospital and National Heart Institute. They were recruited (8 from Kajang Hospital and 9 from National Heart Institute) by their own doctors to participate in a study to evaluate the safety and effectiveness of the investigational stent after been diagnosed with coronary artery disease and also in a study to investigate drug for antidepressant. respectively.
Results The study revealed that doctor-investigators fail to disclose full information to patient-subjects. Instead, doctor-investigators only disclosed information which they thought were necessary for the patient-subjects to know. The study also showed that there were doctor-investigators who did not disclose information at all to the patient-subjects.
Conclusions This study implies that the aspect of information disclosure in the process of obtaining informed consent in clinical trials is rather poor and did not fulfill the criterion of good medical practice. A random monitoring task to be conducted by the research ethics commitees during the informed consent process is suggested.
Introduction Prevalence of adolescents involved in sexual and reproductive problems is on
rise and it was associated with its knowledge. Several factors found to be
associated with the knowledge and various sources of knowledge are chosen
by adolescents for this information. Thus, this study was to determine the
knowledge score, its influencing factors and the preference of the sources of
knowledge.
Methods A cross-sectional study was done using adopted questionnaire involving 330
respondents aged 18 and 19 years old in Kolej MARA Seremban selected by
simple random sampling. They were gathered in the halls and 338
adolescents from 454 students consented to involve in this study. Selfadministered
questionnaire was used whereby a correct response was given a
score of 2, 0 for an incorrect response and 1 for an answer of don’t know.
Total score for all correct answers was 42. Descriptive analysis, bivariate and
multivariate analysis was done in the analysis.
Results The mean knowledge score was 37.32 (±2.967) with a significant difference
for gender. Internets were the most common and preferred sources of the
knowledge among them. There was 5.2% of them had heard on SMS
intervention and 37.0% of them disagreed on SMS intervention.
Conclusions The result showed that the knowledge score was lower in males than females
and internets were the most preferred source of the knowledge. Thus,
interventions for knowledge improvement should be more on male
adolescents.
Introduction In Malaysia although mortality rate among women of reproductive ages has
reduced over the years, the reduction has been stagnant for the past ten years.
In order to achieve the 5th Millennium Development Goal, several measures
need to be taken including a proper implementation of pre-pregnancy
services in this country. This study explores the awareness, intention and
usage of pre-pregnancy care (PPC) services and its determinant among
women of reproductive ages in Kedah, Malaysia.
Methods This is a qualitative study, which consisted of a focus group discussion
(FGD) among women in the ages of 18 to 45 years old from all ethnic groups
who attended four government clinics in the state of Kedah. The mothers
were chosen through purposive sampling from twelve districts that were
selected through a multistage random sampling. A semi-structured
questionnaire was utilized during the FGD. The results from the FGD were
recorded verbatim and thematic analysis was finalized once saturation of
information from respondents was achieved.
Results These are two themes was identified, namely personal reasons and reasons of
service and there are several subthemes under two main themes. Under the
Personal reason themes, the subthemes including awareness and intention to
used the services, knowledge, perception, social support and history of
medical illness. While under pre-pregnancy care services themes, the
subthemes including the promotion of the services, the communication
relationship with the health staff, the waiting time and also the accessibility
of the service.
Conclusions As a conclusion, there is still part of society who was unaware of prepregnancy
services and its importance in reducing maternal mortality rate as
well as producing good pregnancy outcome. Information and knowledge on
pre-pregnancy care services should be disseminated among community
members through various means including roadshows and pre wedding
workshops.
Introduction: Rheumatic Heart Disease (RHD) has been thought as a disease of poor socioeconomic status. It is more prevalent in underdeveloped and developing countries than in developed countries. It is also common among the population with multiple social issues such as overcrowded dwellings, undernutrition, poor sanitation and suboptimal medical care. This study was done to review the socio demographic profiles of RHD patients in Hospital Queen Elizabeth (HQE) II, Kota Kinabalu, Sabah.
Methods: A secondary data review of all patients registered under the RHD registry in HQE II for one- year starting from July 2013 to June 2014.
Results: 204 RHD patients were included. Nearly three quarter (74.0%) were female. The mean age was 40.43 (14.75) years old. 61.1% has completed secondary
education. 42.7% were housewives. The mean monthly income was RM 1363.83 (1297.05) which was categorized under the vulnerable income group. When they were categorized under the poverty level and the vulnerable income group, 42.6% and 76.5% of them fell under those categories respectively. The nearest health facilities to their houses were district hospitals (33.3%) with the mean distance of 9.17 km and health clinics (30.8%) with the mean distance of 4.27 km. Only 11.5% of them lived near the specialist hospitals with the mean distance of 21.32 km.
Conclusions: Results from this review suggested that majority of RHD patients were in the low socioeconomic group with less access to health care facilities with specialist care. They are the most vulnerable groups and need to be prioritized in the specialized care program. .
Introduction The prevalence of non-communicable diseases (NCDs) in Malaysia shows a
rising trend that influences the society in many respects. Country specific
evidence is vital for effective intervention. The aims of this study were to
identify the role of gender and urbanisation status on NCDs prevalence and
its effect on health care demand, specifically doctor visits among elderly in
Malaysia. We focused on two of the highest occurrence NCDs in the country
– diabetes mellitus and hypertension.
Methods A total of 1,414 respondents aged 60 years and above were selected using a
multistage sampling for face-to-face interview. We started the analysis with
descriptive analysis of the prevalence, taking the effect of gender and
urbanisation status of residing area. We extended the study with parametric
analysis to find the effect of these health problems on the likelihood of doctor
visits as it reflects the equity for access and utilisation issues.
Results Results showed that there were no significant difference of prevalence by
gender and urbanisation for hypertension and diabetes mellitus. By utilising
probit model, we found that those with diabetes mellitus or hypertension,
controlling for other variables, were more likely to utilise doctor services.
Conclusion This result implies that the prevalence of NCDs may further increase demand
for health care, especially in the state with a high proportion of older age
groups.
Introduction Drug abuse has been a global threat not only in Malaysia but worldwide,
especially among adolescents. This is alarming issue had been a serious
public health problem worldwide. The aim of the study is to access the
knowledge and attitude on drug abuse among Pahang Matriculation students
in 2016.
Methods A cross¬-sectional study was conducted involving 217 matriculation
students. A self-determined questionnaire was distributed among the students
regarding knowledge and attitude about drugs.
Results The prevalence of good knowledge on drug abuse was (82.03%). The
prevalence of students’ attitude on drug abuse has higher number of good
attitude with the sum of 182 (83.9 %). Only gender showed a significant
association with students’ knowledge (P= 0.046).
Conclusion The knowledge, attitude, and practice of drug abuse among Pahang
Matriculation students are good.
Introduction Low bone mineral density is a significant problem in children with Thalassemia which may lead to increased risk for fragility fractures and suboptimal peak bone mass. This cross-sectional study was conducted to
determine the bone health status of Thalassemia children Universiti Kebangsaan Malaysia Medical Centre and Paediatrics Insititute Kuala Lumpur Hospital.
Methods A total of 81 respondents diagnosed with transfusion dependant beta Thalassemia (41 boys and 40 girls) aged between 7 to 19 years old completed the study. The data collected were demographic information, anthropometric measurements, dairy frequency questionnaires, dietary habits of the respondents and their parents, dietary intakes and bone densitometry using Ultrasound Bone Densitometer.
Results For Quantitative Ultrasound (QUS) parameters, T-score of 9.8% participants were lower than -1.0 and 30.9% of the participants had lower Speed of Sound (SOS) than healthy SOS. This study showed there was no difference in bone density by sex (p>0.05). The median bone density of boys was 1616.00 m/sec (IQR= 39.00) and girls’ was 1579.00 m/ sec (IQR= 116.00). SOS was not increased with age, height and weight; but girls’ Body Mass Index (BMI). Malay children had significantly higher SOS than non-Malay children.
Conclusions This study highlights a need of proper intervention for the high risk group to achieve optimal bone health.
Study site: inpatient or outpatient, Institut Pediatrik (Hospital Kuala Lumpur), Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Introduction It is well known that low back pain among working population is a global
problem throughout the world. However, the current situation of occupational
low back pain in Malaysia is still vague due to limited number of studies
conducted locally.
Objective A cross sectional study was conducted among three automotive industry
workers in Selangor, Malaysia from October 2010 to April 2011.
Methods This study aims to determine the prevalence and risk factors of low back pain
among automotive industry workers performing manual material handling
tasks using self-administered questionnaire survey.
Results A modified Standardised Nordic Questionnaire was used to assess low back
pain problem, to obtain personal and psychosocial risk factors information.
The prevalence of low back pain showed increment in the point prevalence of
57.9%, 49.5%, and 35.1 % for 12 months, one month, and of 7 days
respectively. Working hour, frequency of overtime, stress at work, work
pace, and faster movement were found to be significantly associated with the
12 months prevalence for low back pain.
Conclusions This finding indicates that psychosocial risk factors are associated to the
occurrence of low back pain.
Introduction Iodine deficiency disorders (IDD), is one of the most important micronutrient
deficiencies which has multiple adverse effects on growth and development.
The aim of this study was to determine the prevalence of IDD among school
children and to elucidate the distribution of iodized salt at household level in
Sarawak, East Malaysia.
Methods This cross-sectional study was conducted among school children aged 8 to 10
years in 2008. A multi-stage probability proportionate to population size
(PPS) cluster sampling method was used to obtain a representative state
sample of 1200 school children. Spot urine samples were collected for the
determination of urinary iodine concentration while the iodine content in salt
was determined using field rapid test kits. The thyroid status was determined
by palpation.
Results Response rate was 92.0% (n=1104/1200). The prevalence of goitre among
school children in Sarawak was 2.9% (5.2% in urban, 0.7% in rural). The
median urinary iodine concentration (UIC) among the school children was
102.1 μg/L (IQR, 62.3-146.5 μg/L). Urban children had significantly higher
median UIC of 109.3 μg/L (IQR, 72.4-159.0 μg/L) than their rural
counterparts [91.9 μg/L (IQR, 55.7-140.2 μg/L)]. The salt samples tested by
rapid test kit (RTK) showed only 46.0% of household salt contained iodine.
Conclusions The present study revealed that the population in Sarawak were of borderline
iodine sufficient with mild IDD seen in rural areas. Hence, the state IDD
control programmes need to encourage and advocate the consumption of
iodized salt in order to eliminate IDD-related health problems in Sarawak.
Introduction Cardiovascular diseases are a major component of non-communicable
diseases and include coronary heart disease, stroke and peripheral vascular
disease. Public health strategies to address cardiovascular disease require
three elements: surveillance, health promotion, and individual health care.
Methods Surveillance includes monitoring of mortality and morbidity as well as
surveys to monitor risk factors levels in the community. Data on mortality
from cardiovascular diseases are readily available and analysed by age and
sex specific rates looking are secular trends, geographical and ethnical group
variations and international comparisons. However many deaths from
cardiovascular disease occur suddenly and the cause of death may be
registered without autopsy or any other validation. Cardiovascular morbidity
information is more difficult to collate and interpret as it is closely related to
availability and access to health care. Periodic surveys of cardiovascular risk
factors are essential in monitoring the underlying trends in blood pressure,
smoking, cholesterol, obesity, and diabetes as they predict future trends, and
support planning for prevention and healthcare.
Results Prevention and health promotion activities are informed by the levels and
trends in cardiovascular disease and its risk factors. There has been debate
about population health promotion and individual health care strategies, but
both are necessary. Cigarette smoking, nutrition and physical exercise are the
main behaviours to be addressed but these are complex and require
multifaceted approaches. Education alone is insufficient to change health
behaviours and health promotion needs to look to changing attitudes.
Legislation, taxation and other fiscal interventions have been shown to be
effective however these can be difficult for legislators as there are other
competing interests, particularly in the area of nutrition and tobacco. Creating
health promoting environments that make healthy behaviour choices easier
can be beneficial.
Conclusions Health care interventions are also effective in reducing the burden of
cardiovascular disease. A balanced approach of health promotion and
individual health care is recommended in the development of a strategy for
cardiovascular disease.