Displaying publications 81 - 100 of 203 in total

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  1. Al-Mekhlafi MS, Atiya AS, Lim YA, Mahdy AK, Ariffin WA, Abdullah HC, et al.
    PMID: 18613540
    Despite great development in socioeconomic status throughout 50 years of independence, Malaysia is still plagued with soil-transmitted helminthiases (STH). STH continue to have a significant impact on public health particularly in rural communities. In order to determine the prevalence of STH among rural Orang Asli children and to investigate the possible risk factors affecting the pattern of this prevalence, fecal samples were collected from 292 Orang Asli primary schoolchildren (145 males and 147 females) age 7-12 years, from Pos Betau, Kuala Lipis, Pahang. The samples were examined by Kato-Katz and Harada Mori techniques. Socioeconomic data were collected using pre-tested questionnaires. The overall prevalence of ascariasis, trichuriasis, and hookworm infections were 67.8, 95.5 and 13.4%, respectively. Twenty-nine point eight percent of the children had heavy trichuriasis, while 22.3% had heavy ascariasis. Sixty-seven point seven percent of the children had mixed infections. Age > 10 years (p = 0.016), no toilet in the house (p = 0.012), working mother (p = 0.040), low household income (p = 0.033), and large family size (p = 0.028) were identified as risk factors for ascariasis. Logistic regression confirmed low income, no toilet in the house and working mother as significant risk factors for ascariasis. The prevalence of STH is still very high in rural Malaysian communities. STH may also contribute to other health problems such as micronutrient deficiencies, protein-energy malnutrition and poor educational achievement. Public health personnel need to reassess current control measures and identify innovative and integrated ways in order to reduce STH significantly in rural communities.
    Matched MeSH terms: Social Class
  2. Yu CP, Whynes DK, Sach TH
    Int J Health Plann Manage, 2006 10 19;21(3):193-210.
    PMID: 17044546
    Throughout the world, policy makers are considering or implementing financing strategies that are likely to have a substantial impact on the equity of health financing. The assessment of the equity implication is clearly important, given the potential impact that alternative finance sources have on households. Households incur out-of-pocket payment directly from their budget, apart from their public or private insurance. Out-of-pocket payment is the primary concern, given their undesirable impact on households. Progressivity measures departures from proportionality in the relationship between out-of-pocket payment and ability to pay. It is the most frequently used yardstick to assess the equity of out-of-pocket payments in empirical studies. This paper provides an evaluation of such progressivity measures, undertaken using four approaches (proportion approach, tabulation approach, concentration curve and Kakwani's index), in order to reveal their usefulness and underlying notion. It is illustrated empirically with data on out-of-pocket payment for health care in Malaysia for 1998/ 1999, based on the nationally representative Household Expenditure Survey. Results indicate that out-of-pocket payments are mildly progressive, whilst the four approaches have their benefits and limitations in assessing equity implications. This analysis is of interest from a policy perspective, given Malaysia's heavy reliance on out-of-pocket payments to finance health care.
    Matched MeSH terms: Social Class
  3. Mahadeva S, Goh KL
    World J. Gastroenterol., 2006 May 07;12(17):2661-6.
    PMID: 16718749 DOI: 10.3748/wjg.v12.i17.2661
    Dyspepsia refers to group of upper gastrointestinal symptoms that occur commonly in adults. Dyspepsia is known to result from organic causes, but the majority of patients suffer from non-ulcer or functional dyspepsia. Epidemiological data from population-based studies of various geographical locations have been reviewed, as they provide more realistic information. Population-based studies on true functional dyspepsia (FD) are few, due to the logistic difficulties of excluding structural disease in large numbers of people. Globally, the prevalence of uninvestigated dyspepsia (UD) varies between 7%-45%, depending on definition used and geographical location, whilst the prevalence of FD has been noted to vary between 11%-29.2%. Risk factors for FD have been shown to include females and underlying psychological disturbances, whilst environmental/ lifestyle habits such as poor socio-economic status, smoking, increased caffeine intake and ingestion of non-steroidal anti-inflammatory drugs appear to be more relevant to UD. It is clear that dyspepsia and FD in particular are common conditions globally, affecting most populations, regardless of location.
    Matched MeSH terms: Social Class
  4. Cheong HT, Ng KT, Ong LY, Chook JB, Chan KG, Takebe Y, et al.
    PLoS ONE, 2014;9(10):e111236.
    PMID: 25340817 DOI: 10.1371/journal.pone.0111236
    A novel HIV-1 recombinant clade (CRF51_01B) was recently identified among men who have sex with men (MSM) in Singapore. As cases of sexually transmitted HIV-1 infection increase concurrently in two socioeconomically intimate countries such as Malaysia and Singapore, cross transmission of HIV-1 between said countries is highly probable. In order to investigate the timeline for the emergence of HIV-1 CRF51_01B in Singapore and its possible introduction into Malaysia, 595 HIV-positive subjects recruited in Kuala Lumpur from 2008 to 2012 were screened. Phylogenetic relationship of 485 amplified polymerase gene sequences was determined through neighbour-joining method. Next, near-full length sequences were amplified for genomic sequences inferred to be CRF51_01B and subjected to further analysis implemented through Bayesian Markov chain Monte Carlo (MCMC) sampling and maximum likelihood methods. Based on the near full length genomes, two isolates formed a phylogenetic cluster with CRF51_01B sequences of Singapore origin, sharing identical recombination structure. Spatial and temporal information from Bayesian MCMC coalescent and maximum likelihood analysis of the protease, gp120 and gp41 genes suggest that Singapore is probably the country of origin of CRF51_01B (as early as in the mid-1990s) and featured a Malaysian who acquired the infection through heterosexual contact as host for its ancestral lineages. CRF51_01B then spread rapidly among the MSM in Singapore and Malaysia. Although the importation of CRF51_01B from Singapore to Malaysia is supported by coalescence analysis, the narrow timeframe of the transmission event indicates a closely linked epidemic. Discrepancies in the estimated divergence times suggest that CRF51_01B may have arisen through multiple recombination events from more than one parental lineage. We report the cross transmission of a novel CRF51_01B lineage between countries that involved different sexual risk groups. Understanding the cross-border transmission of HIV-1 involving sexual networks is crucial for effective intervention strategies in the region.
    Matched MeSH terms: Social Class
  5. Shohaimi S, Boekholdt MS, Luben R, Wareham NJ, Khaw KT
    BMC Public Health, 2014 Aug 28;14:782.
    PMID: 25179437 DOI: 10.1186/1471-2458-14-782
    BACKGROUND: Data on the relationship between plasma levels of cholesterol and triglycerides and social class have been inconsistent. Most previous studies have used one classification of social class.

    METHODS: This was a cross-sectional population based study with data on occupational social class, educational level obtained using a detailed health and lifestyle questionnaire. A total of 10,147 men and 12,304 women aged 45-80 years living in Norfolk, United Kingdom, were recruited using general practice age-sex registers as part of the European Prospective Investigation into Cancer (EPIC-Norfolk). Plasma levels of cholesterol and triglycerides were measured in baseline samples. Social class was classified according to three classifications: occupation, educational level, and area deprivation score according to Townsend deprivation index. Differences in lipid levels by socio-economic status indices were quantified by analysis of variance (ANOVA) and multiple linear regression after adjusting for body mass index and alcohol consumption.

    RESULTS: Total cholesterol levels were associated with occupational level among men, and with educational level among women. Triglyceride levels were associated with educational level and occupational level among women, but the latter association was lost after adjustment for age and body mass index. HDL-cholesterol levels were associated with both educational level and educational level among men and women. The relationships with educational level were substantially attenuated by adjustment for age, body mass index and alcohol use, whereas the association with educational class was retained upon adjustment. LDL-cholesterol levels were not associated with social class indices among men, but a positive association was observed with educational class among women. This association was not affected by adjustment for age, body mass index and alcohol use.

    CONCLUSIONS: The findings of this study suggest that there are sex differences in the association between socio-economic status and serum lipid levels. The variations in lipid profile with socio-economic status may be largely attributed to potentially modifiable factors such as obesity, physical activity and dietary intake.

    Matched MeSH terms: Social Class
  6. Misra V, Pandey R, Misra SP, Dwivedi M
    World J. Gastroenterol., 2014 Feb 14;20(6):1503-9.
    PMID: 24587625 DOI: 10.3748/wjg.v20.i6.1503
    Helicobacter pylori (H. pylori) is a gram negative microaerophilic bacterium which resides in the mucous linings of the stomach. It has been implicated in the causation of various gastric disorders including gastric cancer. The geographical distribution and etiology of gastric cancer differ widely in different geographical regions and H. pylori, despite being labeled as a grade I carcinogen, has not been found to be associated with gastric cancer in many areas. Studies in Asian countries such as Thailand, India, Bangladesh, Pakistan, Iran, Saudi Arabian countries, Israel and Malaysia, have reported a high frequency of H. pylori infection co-existing with a low incidence of gastric cancer. In India, a difference in the prevalence of H. pylori infection and gastric cancer has been noted even in different regions of the country leading to a puzzle when attempting to find the causes of these variations. This puzzle of H. pylori distribution and gastric cancer epidemiology is known as the Indian enigma. In this review we have attempted to explain the Indian enigma using evidence from various Indian studies and from around the globe. This review covers aspects of epidemiology, the various biological strains present in different parts of the country and within individuals, the status of different H. pylori-related diseases and the molecular pathogenesis of the bacterium.
    Matched MeSH terms: Social Class
  7. Otgontuya D, Oum S, Buckley BS, Bonita R
    BMC Public Health, 2013;13:539.
    PMID: 23734670 DOI: 10.1186/1471-2458-13-539
    BACKGROUND: Recent research has used cardiovascular risk scores intended to estimate "total cardiovascular disease (CVD) risk" in individuals to assess the distribution of risk within populations. The research suggested that the adoption of the total risk approach, in comparison to treatment decisions being based on the level of a single risk factor, could lead to reductions in expenditure on preventive cardiovascular drug treatment in low- and middle-income countries. So that the patient benefit associated with savings is highlighted.
    METHODS: This study used data from national STEPS surveys (STEPwise Approach to Surveillance) conducted between 2005 and 2010 in Cambodia, Malaysia and Mongolia of men and women aged 40-64 years. The study compared the differences and implications of various approaches to risk estimation at a population level using the World Health Organization/International Society of Hypertension (WHO/ISH) risk score charts. To aid interpretation and adjustment of scores and inform treatment in individuals, the charts are accompanied by practice notes about risk factors not included in the risk score calculations. Total risk was calculated amongst the populations using the charts alone and also adjusted according to these notes. Prevalence of traditional single risk factors was also calculated.
    RESULTS: The prevalence of WHO/ISH "high CVD risk" (≥20% chance of developing a cardiovascular event over 10 years) of 6%, 2.3% and 1.3% in Mongolia, Malaysia and Cambodia, respectively, is in line with recent research when charts alone are used. However, these proportions rise to 33.3%, 20.8% and 10.4%, respectively when individuals with blood pressure > = 160/100 mm/Hg and/or hypertension medication are attributed to "high risk". Of those at "moderate risk" (10- < 20% chance of developing a cardio vascular event over 10 years), 100%, 94.3% and 30.1%, respectively are affected by at least one risk-increasing factor. Of all individuals, 44.6%, 29.0% and 15.0% are affected by hypertension as a single risk factor (systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg or medication).
    CONCLUSIONS: Used on a population level, cardiovascular risk scores may offer useful insights that can assist health service delivery planning. An approach based on overall risk without adjustment of specific risk factors however, may underestimate treatment needs.At the individual level, the total risk approach offers important clinical benefits. However, countries need to develop appropriate clinical guidelines and operational guidance for detection and management of CVD risk using total CVD-risk approach at different levels of health system. Operational research is needed to assess implementation issues.
    Matched MeSH terms: Social Class
  8. Azzani M, Roslani AC, Su TT
    Support Care Cancer, 2016 10;24(10):4423-32.
    PMID: 27225528 DOI: 10.1007/s00520-016-3283-2
    BACKGROUND: In Malaysia, the healthcare system consists of a government-run universal healthcare system and a co-existing private healthcare system. However, with high and ever rising healthcare spending on cancer management, cancer patients and their families are likely to become vulnerable to a healthcare-related financial burden. Moreover, they may have to reduce their working hours and lose income. To better understand this issue, this study aims to assess the financial burden of colorectal cancer patients and their families in the first year following diagnosis.

    METHODS: Data on patient costs were collected prospectively in the first year following diagnosis by using a self-administered questionnaire and telephone interviews at three time points for all four stages of colorectal cancer. The patient cost data consisted of direct out-of-pocket payments for medical-related expenses such as hospital stays, tests and treatment and for non-medical items such as travel and food associated with hospital visits. In addition, indirect cost data related to the loss of productivity of the patient and caregiver(s) was assessed. The patient's perceived level of financial difficulty and types of coping strategy were also explored.

    RESULT: The total 1-year patient cost (both direct and indirect) increased with the stage of colorectal cancer: RM 6544.5 (USD 2045.1) for stage I, RM 7790.1 (USD 2434.4) for stage II, RM 8799.1 (USD 2749.7) for stage III and RM 8638.2 (USD 2699.4) for stage IV. The majority of patients perceived paying for their healthcare as somewhat difficult. The most frequently used financial coping strategy was a combination of current income and savings.

    CONCLUSION: Despite the high subsidisation in public hospitals, the management of colorectal cancer imposes a substantial financial burden on patients and their families. Moreover, the majority of patients and their families perceive healthcare payments as difficult. Therefore, it is recommended that policy- and decision-makers should further consider some financial protection strategies and support for cancer treatment because cancer is a very costly and chronic disease.

    Matched MeSH terms: Social Class
  9. Armstrong RW, Imrey PB, Lye MS, Armstrong MJ, Yu MC, Sani S
    Int. J. Cancer, 1998 Jul 17;77(2):228-35.
    PMID: 9650558
    We interviewed 282 histologically confirmed cases of nasopharyngeal carcinoma (NPC) in Chinese residents of Selangor and the Federal Territory, Malaysia, and an equal number of Chinese age-, sex-, and length-of-residence-matched controls sampled from the general population. Consumption of 55 dietary items during childhood, and 5 years pre-diagnosis of NPC, was analyzed by univariate and multivariate methods. Four salted preserved foods (fish, leafy vegetables, egg and root), fresh pork/beef organ meats and beer and liquor consumption exhibited strong positive associations, and 4 vegetable/fruit combinations strong negative associations with NPC. Factor analysis and multivariable modeling using estimated factor scores strongly supported separate effects on NPC of vegetables/fruits, salted preserved foods, pork/beef organ meats and beer/liquor consumption. Multivariable modeling associated NPC most clearly with high consumption of salted fish, salted eggs, pork/beef liver and beer and low consumption of Chinese flowering cabbage, oranges/tangerines and shrimp. A strong residual association of social class with NPC remained after adjustment for diet, which is consistent with a substantial role for non-dietary environmental factors.
    Matched MeSH terms: Social Class
  10. Shariff ZM, Bond JT, Johnson NE
    Asia Pac J Clin Nutr, 2000 Dec;9(4):264-73.
    PMID: 24394502
    The relationship between nutrition, health and educational achievement of school-age population in less developed countries has been of interest to many researchers due to the frequent observation that many children did not complete primary school and those who completed, did not do as well as children in the developed countries. Nevertheless, nutritional and health status by itself is not the only variable affecting educational achievement, since biological, psychological, socioeconomic and cultural factors could directly or indirectly affect both nutrition, health status and educational achievement. The mechanism by which health and nutrition influence educational achievement is not well established, but poor health and malnutrition in early childhood may affect cognitive abilities, necessary for learning process and consequently educational achievement. A study was conducted in Kuala Lumpur, Malaysia, to investigate the relationship between nutritional status and educational achievement among primary schoolchildren from low income households (n = 399). A high percentage of them were mild-significantly underweight (52%), stunted (47%) and wasted (36%) and increasingly overweight (6%). In general, more boys than girls were found to experience some form of malnutrition. While weight-for-height did not differ significantly according to family, child and school factors, weight-for-age and height-for-age differed significantly by gender. Also, height-for-age was significantly related to household income. This indicates that stunting may be a consequence of prolonged socioeconomic deprivation. Educational achievement was measured based on test scores for Malay language (ML), English language (EL) and mathematics (MT). While a majority of the schoolchildren obtained optimum scores (>75) for ML and MT, the majority of them had insufficient scores (<50) for EL. Children's total score (TS) for the three subjects was significantly associated with household socioeconomic status, gender, birth order and heightfor- age. Even after controlling for household socioeconomic status, significant association between TS and height-for-age persisted. In this sample of schoolchildren, household income, gender, birth order and height-forage were significant predictors of TS. The finding that height-for-age is related to educational achievement agrees with other studies, which have reported that height-for-age, compared to weight-for-height or weight-forage is linked to educational achievement. Height-for-age reflects the accumulation of nutritional deprivation throughout the years, which may consequently affect the cognitive development of the children.
    Matched MeSH terms: Social Class
  11. Ravindran J, Tan YI, Ngeow YF
    Med. J. Malaysia, 1998 Mar;53(1):16-21.
    PMID: 10968132
    Chlamydia trachomatis is recognized as the most prevalent sexually transmitted organism in many parts of the world. Most complications associated with chlamydial infection in women and their infants can be avoided by appropriate treatment. However, treatment is often not initiated because infections are frequently asymptomatic. The identification of at risk patients and treatment of these patients is a practical clinical approach in the reduction of transmission and prevention of complications. The prevalence of chlamydial infection among patients with pelvic inflammatory disease admitted to Seremban General Hospital was 22.7%. The difference in seropositivity between PID patients (20.5%) and antenatal controls (2.3%) was statistically significant. The corresponding cervical antigen detection rates were 6.8% and 2.3% respectively. Chlamydial infection should be screened for in gynaecological patients and antibiotic policies should take cognizance of the aetiological role played by this organism in pelvic inflammatory disease.
    Matched MeSH terms: Social Class
  12. Strickland SS, Duffield AE
    Asia Pac J Clin Nutr, 1998 Dec;7(3/4):300-6.
    PMID: 24393688
    The effects of population pressure on agricultural sustainability in the delicate tropical and subtropical ecosystems have often been thought to explain high prevalence rates of malnutrition in rural South-East Asia. However, recent studies in rural Sarawak suggest that processes of modernisation have resulted in increased variations in energy nutritional status in adults. A contributory factor may be consumption of the areca nut (Malay pinang, of the palm Areca catechu). This is thought to influence energy balance through effects on appetite and resting metabolic rate. Body mass index (BMI, kg/m2) data for 325 Iban men and 438 non-pregnant Iban women, measured in 1990 and again in 1996, have been analysed in relation to areca use, smoking behaviour, socio-economic status, and reported morbidity. Body composition derived from skinfold thickness measurements for 313 men and 382 women was also analysed. The results suggest that use of areca nut is associated with significantly lower age-related increments in BMI and percentage body fat in women after allowing for age, smoking, reported morbidity, and confounding socio-economic factors. Therefore, the impact of recent economic and social development seen in rising prevalences of 'over-nutrition' may be modulated by use of the areca nut.
    Matched MeSH terms: Social Class
  13. Vohra U
    IIPS Newsl, 1993 Jul;34(3):4-6.
    PMID: 12287408
    Matched MeSH terms: Social Class
  14. Agus MR
    Warasan Prachakon Lae Sangkhom, 1990 Jan;2(2):205-21, 242-3.
    PMID: 12283536
    The focus of this study is on urbanization in Malaysia. "This paper is divided into three parts. The first part examines the trend of uneven urban development in West Malaysia. The second part discusses the change [in] ethnic composition of urban population between 1970 and 1980 intercensal period. The third part analyses the impact of the urbanization process on the Malays in the context of housing problems of the lower income groups." (SUMMARY IN THA)
    Matched MeSH terms: Social Class
  15. Norhayati M, Hayati MI, Oothuman P, Azizi O, Fatmah MS, Ismail G, et al.
    PMID: 7777914
    The infection rate and relationship of enterobiasis with socio-economic status were determined in children aged 1-8 years, living in a rural area in Malaysia. Of the 178 subjects 40.4% were infected with Enterobius vermicularis. The distribution of enterobiasis among these children were analyzed in relation to age groups and sex. The rate of infection was significantly higher in older children (5-7 years). The association of enterobiasis with other factors studied such as number of persons per house, household income per months and mother's employment status were not significant. The sensitivity of three successive days anal swabs compared to a single swab was found to be statistically significant.
    Matched MeSH terms: Social Class
  16. Chongsuvivatwong V, Mo-Suwan L, Mahahing P
    PMID: 2075485
    A survey was carried out in a Malay-speaking Muslim community in southern Thailand to obtain baseline data for planning of long term multidisciplinary research and development. By using a 30-cluster sampling technique, 210 households of 1,308 subjects were studied in the post-Ramadan period. It was found that the community was in a social transition. The crude birth rate was 4% and 37.6% of the households had at least one migrant. About half of these migrants had been to Malaysia and mainly worked in rubber plantations. Ninety-five per cent of the households had electricity whereas only 23.8% had a latrine. Boiled or rain water was regularly drunk in only 13.3 per cent of the households. Home-grown agricultural products were not sufficient to provide adequate food. Twenty-six per cent of the adults were unemployed and 24.6% were illiterate. Of the pregnancies 26.7% had no antenatal care and complete tetanus toxoid was given to only 27.8%. Traditional birth attendants conducted 81.1% of the deliveries and only 28.9 and 24.4% of the umbilical cords were correctly cut and correctly dressed, respectively. Breast feeding was still a common (87.8%) practice. However, complete immunization was given to only 10.8%, and 37.8% of the infants had at least one diarrheal episode in the previous month. It was concluded that high birth rate, high migration, low education, low income and bad health of infants are major problems. These problems were interlinked and needed a special multidisciplinary approach. In addition to common obstacles for routine health delivery, migration may create international complications, particularly related to maternal and child care.
    Matched MeSH terms: Social Class
  17. Montgomery MR, Sulak DB
    J Dev Econ, 1989 Apr;30(2):225-40.
    PMID: 12342575
    Many studies have shown that schooling levels of husband and wife are important determinants of household behavior in developing countries. This article asks how the schooling levels of husband and wife come to be associated with each other through the marriage market. The Kiefer-Neumann model of labor market search is adapted to marital search, the aim being to explain both the positive sorting on educational levels for spouses, and the positive relationship between female schooling and age at 1st marriage. World Fertility Survey data for Indonesia, Korea, and Malaysia are employed in the analyses.
    Matched MeSH terms: Social Class
  18. Spencer C, Navaratnam V
    Drug Alcohol Depend, 1980 Jun;5(6):411-9.
    PMID: 7379697
    Those Malaysian secondary schoolchildren who have ever used an illicit drug do not differ significantly in terms of social class background, ethnicity or rural/urban location, from the majority of their contemporaries who have not used drugs. The cross-sectional data show a rapid secular trend towards the sexes being equally involved in drug use. Significant differences between ever and never users are, however, found in their attitudes towards drug taking and their beliefs about the properties of drugs, although both groups share the same rather negative image of the typical drug user. Thus, drug users have accepted some of the attitudes towards drug issues which are normative in the non-user group, whilst developing other attitudes which are consistent with their continuing use. It is argued that adolescent drug abuse in Malaysia is not to be linked specifically with social deprivation, but should be seen as being part of the life style of particular groups in all strata of society.
    Matched MeSH terms: Social Class
  19. Lee SM
    Int Migr Rev, 1989;23(2):309-31.
    PMID: 12315959
    "The role of Chinese and Indian women as immigrants and workers in colonial Malaya is examined using data from censuses, immigration records, official reports and secondary sources. The article discusses the main types of work of female immigrants and their contribution to the economic development of colonial Malaya during the late nineteenth and early twentieth centuries in an attempt to redress the neglect of female immigrants' economic role in Malaya's history. Comparisons between male and female immigrants' labor and between Chinese and Indian immigrants, are drawn to highlight the different conditions of migration and labor for the different groups of immigrants."
    Matched MeSH terms: Social Class
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