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Prothrombotic markers in Thalassemia major patients: A paradigm shift

Sultan S, Irfan SM, Zaidi SM

Med J Malaysia, 2018 08;73(4):185-189.
PMID: 30121679

BACKGROUND: It is being increasingly recognised that thalassemia major patients, like intermedia, have increased propensity for thromboembolism. Deficiency of natural anticoagulants is more recently defined finding contributing to the hypercoagulable state. The aim this study is to determine natural anticoagulants levels and their correlation with maternal characteristics, haematological and biochemical markers.
METHODS: This is a prospective case-control study. We registered 80 patients and 60 healthy controls from Jan 2009 to Dec 2013. Complete blood counts, prothrombin time, activated partial thromboplastin time, protein C, protein S, antithrombin, serum ferritin, liver enzymes; HbsAg and Anti- HCV were evaluated.
RESULT: There were 42 males and 38 females with mean age of 12.30±5.50 years. The mean protein C, protein S and antithrombin in patients and control were 58.25±22.5 versus 110.67±22.60, 67.90±19.58 versus 98.70±21.54 and 89.73±18.09 versus 104.0±10.98 (p<0.001) respectively. Protein C was predominantly deficient in 65% followed by protein S and antithrombin in 35% and 20% respectively. Protein C deficiency divulged positive correlation with protein S deficiency (p = 0.035) and antithrombin deficiency with hemoglobin of ≤8gm% (p<0.0025). No significant correlation of prothrombotic markers was established with maternal characteristics, hepatic dysfunction, hepatitis and serum ferritin.
CONCLUSION: Substantial decrement in prothrombotic markers, primarily protein C, may be implicated in elevated thrombosis; however follow-up data is required to establish definitive thromboembolic events.

Matched MeSH terms: Adolescent
Fulltext Anemia in pregnancy in Malaysia: a cross-sectional survey

Haniff J, Das A, Onn LT, Sun CW, Nordin NM, Rampal S, et al.

Asia Pac J Clin Nutr, 2007;16(3):527-36.
PMID: 17704035

Anemia is the most prevalent nutritional deficiency during pregnancy. Except for a study conducted 10 years ago in Kelantan, Malaysia's available statistics are based on isolated small urban maternity hospital studies from the 1980s. There was therefore, a need for a large study at national level to estimate the magnitude of the problem in the country as well as to understand its epidemiology. This multi-center, cross-sectional study was conducted from February to March 2005, to assess the prevalence of anemia. Multistage stratified random sampling technique was used and 59 Ministry of Health (MOH) primary health care clinics were selected. Our final dataset consisted of 1,072 antenatal mothers from 56 clinics. The overall prevalence of anemia in this population was 35 % (SE 0.02) if the cut off level is 11 g/dL and 11 % (SE 0.03) if the cut-off level is 10 g/dL. The majority was of the mild type. The prevalence was higher in the teenage group, Indians followed by Malays and Chinese being the least, grandmultiparas, the third trimester and from urban residence. After multiple linear regression analysis, only gestational age remained significant. These findings are useful for our Maternal Health program planners and implementers to target and evaluate interventions. Work is in progress for outcomes and cost-effectiveness studies to best tackle this problem. In conclusion, the prevalence of anemia is 35% and mostly of the mild type and more prevalent in the Indian and Malays.

Matched MeSH terms: Adolescent
Fulltext The value of routine chest radiographs in acute asthma admissions

Ismail Y, Loo CS, Zahary MK

Singapore Med J, 1994 Apr;35(2):171-2.
PMID: 7939814

We reviewed 116 chest radiographs done in 70 adult asthmatic patients who were admitted to the Hospital Universiti Sains Malaysia from January to December 1989. The chest radiographs were abnormal in 23% of cases. Twelve percent showed hyperinflation and 7% had pneumonia. Eight patients diagnosed clinically to have pneumonia had normal chest radiographs. Seven patients had radiographic findings of conditions which were unsuspected clinically. These included two cases of pneumonia, one case each of fibrosing alveolitis, pneumothorax, pneumomediastinum, mitral stenosis with left ventricular failure and right pleural effusion. In conclusion, we found that significant chest radiograph abnormalities in adult patients admitted for asthma were uncommon although chest radiographs were helpful in detecting complications or coincidental conditions. Chest radiograph is therefore an important investigation in adult asthmatic patients who are admitted. However, considering the cost and the risk of radiation, it should be done only in selective cases rather than as a routine procedure.
Study site: Hospital Universiti Sains Malaysia, Kelantan, Malaysia

Matched MeSH terms: Adolescent
Retinal Vasculature Fractal Dimension Measures Vessel Density

Ab Hamid F, Che Azemin MZ, Salam A, Aminuddin A, Mohd Daud N, Zahari I

Curr Eye Res, 2016 Jun;41(6):823-31.
PMID: 26268475 DOI: 10.3109/02713683.2015.1056375

PURPOSE: The goal of this study was to provide the empirical evidence of fractal dimension as an indirect measure of retinal vasculature density.
MATERIALS AND METHODS: Two hundred retinal samples of right eye [57.0% females (n = 114) and 43.0% males (n = 86)] were selected from baseline visit. A custom-written software was used for vessel segmentation. Vessel segmentation is the process of transforming two-dimensional color images into binary images (i.e. black and white pixels). The circular area of approximately 2.6 optic disc radii surrounding the center of optic disc was cropped. The non-vessels fragments were removed. FracLac was used to measure the fractal dimension and vessel density of retinal vessels.
RESULTS: This study suggested that 14.1% of the region of interest (i.e. approximately 2.6 optic disk radii) comprised retinal vessel structure. Using correlation analysis, vessel density measurement and fractal dimension estimation are linearly and strongly correlated (R = 0.942, R(2) = 0.89, p

Matched MeSH terms: Adolescent
Fulltext Factors associated with postpartum family planning in a cohort of Kelantanese women with previous caesarean delivery in Malaysia

Hafizah I, Tengku Alina TI, Suhaily MH, Zaharah S

IIUM Medical Journal Malaysia, 2020;19(1):85-97.
MyJurnal

This community-based, cross-sectional study aimed to identify the factors associated with
postpartum family planning use among a cohort of women with recent caesarean delivery in a state with the
lowest contraceptive use in Malaysia. Materials and Methods: A total of 281 women aged between 18-49
years old who had caesarean delivery in government tertiary centres in Kelantan from January until April
2017 were enrolled in this study. The study was conducted from January until April 2018. Women were
selected through stratified random sampling with probability proportional to size. Data were collected
through a validated structured questionnaire. The main outcome was binary (postpartum family planning use
or non-use). The factors included socio-demographic details, reproductive history, previous contraceptive
use, contraceptive health education received, knowledge, and social support. Simple and multiple logistic
regression were conducted to identify significant determinants of postpartum family planning use. Results:
The factors associated with postpartum family planning use included a secondary and below education level
of women (AOR= 2.37, 95% CI (1.05, 5.34)), previous contraceptive use (AOR= 9.82, 95% CI (4.81, 20.06)),
individual health education (AOR= 4.19, 95% CI (1.23, 14.30)), higher knowledge score (AOR= 1.12, 95% CI
(1.03, 1.23)), and higher social support score (AOR= 1.09, 95% CI (1.03, 1.16)). Conclusions: here remains a
need to enhance personalised contraceptive counselling in the primary care setting as well as to promote
longer acting reversible contraceptive methods.

Matched MeSH terms: Adolescent
Validation of the Malay Version of Children Depression Inventory (CDI) among children and adolescents attending outpatient clinics in Kota Bharu, Kelantan

Rosliwati MY, Rohayah H, Jamil BYM, Zaharah S

Malaysian Journal of Psychiatry, 2008;17:23-29.

The aim of this study is to validate the Malay version of CDI among children and adolescents attending outpatient clinics at Universiti Sains Malaysia Hospital (USM), Kota Bharu, Kelantan. Sixty children and adolescents attending outpatient clinics were interviewed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and completed the Malay version of CDI. Reliability and validity of the Malay version of CDI were analyzed. Validation study showed that the Malay version of CDI had a satisfactory reliability (Cronbach's alpha 0.83). At the cut-off score of 18, the Malay version CDI had 90% sensitivity and 98% specificity in detecting depression. In conclusion, the Malay version of CDI has a satisfactory validity and reliability. Keywords :Children Depression Inventory, depression

Matched MeSH terms: Adolescent
Bone regeneration performance of surface-treated porous titanium

Amin Yavari S, van der Stok J, Chai YC, Wauthle R, Tahmasebi Birgani Z, Habibovic P, et al.

Biomaterials, 2014 Aug;35(24):6172-81.
PMID: 24811260 DOI: 10.1016/j.biomaterials.2014.04.054

The large surface area of highly porous titanium structures produced by additive manufacturing can be modified using biofunctionalizing surface treatments to improve the bone regeneration performance of these otherwise bioinert biomaterials. In this longitudinal study, we applied and compared three types of biofunctionalizing surface treatments, namely acid-alkali (AcAl), alkali-acid-heat treatment (AlAcH), and anodizing-heat treatment (AnH). The effects of treatments on apatite forming ability, cell attachment, cell proliferation, osteogenic gene expression, bone regeneration, biomechanical stability, and bone-biomaterial contact were evaluated using apatite forming ability test, cell culture assays, and animal experiments. It was found that AcAl and AnH work through completely different routes. While AcAl improved the apatite forming ability of as-manufactured (AsM) specimens, it did not have any positive effect on cell attachment, cell proliferation, and osteogenic gene expression. In contrast, AnH did not improve the apatite forming ability of AsM specimens but showed significantly better cell attachment, cell proliferation, and expression of osteogenic markers. The performance of AlAcH in terms of apatite forming ability and cell response was in between both extremes of AnH and AsM. AcAl resulted in significantly larger volumes of newly formed bone within the pores of the scaffold as compared to AnH. Interestingly, larger volumes of regenerated bone did not translate into improved biomechanical stability as AnH exhibited significantly better biomechanical stability as compared to AcAl suggesting that the beneficial effects of cell-nanotopography modulations somehow surpassed the benefits of improved apatite forming ability. In conclusion, the applied surface treatments have considerable effects on apatite forming ability, cell attachment, cell proliferation, and bone ingrowth of the studied biomaterials. The relationship between these properties and the bone-implant biomechanics is, however, not trivial.

Matched MeSH terms: Adolescent
Mutation spectrum of dystrophin gene in malaysian patients with Duchenne/Becker muscular dystrophy

Rani AQ, Sasongko TH, Sulong S, Bunyan D, Salmi AR, Zilfalil BA, et al.

J. Neurogenet., 2013 Jun;27(1-2):11-5.
PMID: 23438214 DOI: 10.3109/01677063.2012.762580

We undertook the clinical feature examination and dystrophin analysis using multiplex ligation-dependent probe amplification (MLPA) and direct DNA sequencing of selected exons in a cohort of 35 Malaysian Duchenne/Becker muscular dystrophy (DMD/BMD) patients. We found 27 patients with deletions of one or more exons, 2 patients with one exon duplication, 2 patients with nucleotide deletion, and 4 patients with nonsense mutations (including 1 patient with two nonsense mutations in the same exon). Although most cases showed compliance to the reading frame rule, we found two unrelated DMD patients with an in-frame deletion of the gene. Two novel mutations have been detected in the Dystrophin gene and our results were compatible with other studies where the majority of the mutations (62.8%) are located in the distal hotspot. However, the frequency of the mutations in our patient varied as compared with those found in other populations.

Matched MeSH terms: Adolescent
Fulltext Rapamycin and its analogues (rapalogs) for Tuberous Sclerosis Complex-associated tumors: a systematic review on non-randomized studies using meta-analysis

Sasongko TH, Ismail NF, Nik Abdul Malik NM, Zabidi-Hussin ZA

Orphanet J Rare Dis, 2015;10:95.
PMID: 26259610 DOI: 10.1186/s13023-015-0317-7

Rapamycin has gained significant attention for its potential activity in reducing the size of TSC-associated tumors, thus providing alternative to surgery. This study aimed at determining the efficacy of rapamycin and rapalogs for reducing the size of TSC-associated solid tumors in patients with Tuberous Sclerosis Complex (TSC).

Matched MeSH terms: Adolescent
Combination of Multiple Ligation-Dependent Probe Amplification and Illumina MiSeq Amplicon Sequencing for TSC1/TSC2 Gene Analyses in Patients with Tuberous Sclerosis Complex

Ismail NF, Rani AQ, Nik Abdul Malik NM, Boon Hock C, Mohd Azlan SN, Abdul Razak S, et al.

J Mol Diagn, 2017 03;19(2):265-276.
PMID: 28087349 DOI: 10.1016/j.jmoldx.2016.10.009

Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disorder characterized by tumor growth in multiple organs and caused by mutations in either TSC1 or TSC2 genes. Because of their relatively large genomic sizes, absence of hotspots, and common type of mutations, mutation detection in TSC1 and TSC2 genes has been challenging. We devised a combination of multiple ligation-dependent probe amplification (MLPA) and amplicon sequencing (AS) to simplify the detection strategy, yet we come up with reasonably high detection rate. Thirty-four Malaysian patients diagnosed with TSC were referred to Human Genome Center, Universiti Sains Malaysia. We used a combination of MLPA to detect large copy number changes and AS to detect smaller mutations. TSC1 pathogenic or likely pathogenic mutations were found in 6 patients (18%) and TSC2 in 21 patients (62%), whereas 6 patients (18%) show no mutations and 1 patient (2%) showed only TSC2 missense variant with uncertain significance. Six of the mutations are novel. Our detection strategy costs 81% less and require 1 working week less than the conventional strategy. Confirmatory sequencing using Sanger method on a few representative mutations showed agreement with results of the AS. Combination of MLPA and Illumina MiSeq AS provides a simplified strategy and reasonably high detection rate for TSC1/TSC2 mutation, which suggested application of the strategies into clinical molecular diagnostics.

Matched MeSH terms: Adolescent
Culture, gender, and the self: variations and impact of social comparison processes

Guimond S, Branscombe NR, Brunot S, Buunk AP, Chatard A, Désert M, et al.

J Pers Soc Psychol, 2007 Jun;92(6):1118-34.
PMID: 17547492

Psychological differences between women and men, far from being invariant as a biological explanation would suggest, fluctuate in magnitude across cultures. Moreover, contrary to the implications of some theoretical perspectives, gender differences in personality, values, and emotions are not smaller, but larger, in American and European cultures, in which greater progress has been made toward gender equality. This research on gender differences in self-construals involving 950 participants from 5 nations/cultures (France, Belgium, the Netherlands, the United States, and Malaysia) illustrates how variations in social comparison processes across cultures can explain why gender differences are stronger in Western cultures. Gender differences in the self are a product of self-stereotyping, which occurs when between-gender social comparisons are made. These social comparisons are more likely, and exert a greater impact, in Western nations. Both correlational and experimental evidence supports this explanation.

Matched MeSH terms: Adolescent
The location of the mental foramen in a selected Malay population

Ngeow WC, Yuzawati Y

J Oral Sci, 2003 Sep;45(3):171-5.
PMID: 14650583

Knowledge of the position of the mental foramen is important both when administering regional anesthesia and performing periapical surgery in the mental region of the mandible. This study determines the position of the mental foramen in a selected Malay population. One hundred and sixty nine panoramic radiographs of Malay patients retrieved from a minor oral surgery waiting list were selected to identify the normal range for the position of the mental foramen. The foramen was not included in the study if there was any mandibular tooth missing between the lower left and right first molars (36-46). The findings indicated the most common position for the mental foramen was in line with the longitudinal axis of the second premolar (69.2%) followed by a location between the first and second premolar (19.6%). The right and left foramina were bilaterally symmetrical in three of six recorded positions in 67.7% patients. The mental foramen was most often in line with the second premolar.

Matched MeSH terms: Adolescent
Fulltext Experience with malignant tumours of the maxillary sinus in the Department of Otolaryngology Universiti Kebangsaan Malaysia, Kuala Lumpur

Lokman S, Said H, Hakim J, Yusop S

Med J Malaysia, 1989 Mar;44(1):64-8.
PMID: 2626115

Thirty one cases of malignant tumours of the maxillary sinus presenting to the Department of Otolaryngology, Universiti Kebangsaan Malaysia over a four year period from 1982 to 1986 are reviewed. 18 cases (58.1%) were squamous cell carcinoma while seven cases (22.5%) were Non-Hodgkin's lymphoma. There were four cases (12.0%) of adenoid cystic carcinoma while in two cases (6.5%) the tumours were undifferentiated. Presentation was generally late. Nasal obstruction, facial swelling and epistaxis were the main presenting symptoms. Nasal involvement was found in 61.3% of cases, while 51.6% had involvement of the palate as well. Metastasis to the cervical lymph node were uncommon (6.5%). Surgery and radiotherapy with or without chemotherapy were the main modes of treatment in the management of malignant tumours of the maxillary sinus.

Matched MeSH terms: Adolescent
Changing the global obesity narrative to recognize and reduce weight stigma: A position statement from the World Obesity Federation

Nutter S, Eggerichs LA, Nagpal TS, Ramos Salas X, Chin Chea C, Saiful S, et al.

Obes Rev, 2024 Jan;25(1):e13642.
PMID: 37846179 DOI: 10.1111/obr.13642

Weight stigma, defined as pervasive misconceptions and stereotypes associated with higher body weight, is both a social determinant of health and a human rights issue. It is imperative to consider how weight stigma may be impeding health promotion efforts on a global scale. The World Obesity Federation (WOF) convened a global working group of practitioners, researchers, policymakers, youth advocates, and individuals with lived experience of obesity to consider the ways that global obesity narratives may contribute to weight stigma. Specifically, the working group focused on how overall obesity narratives, food and physical activity narratives, and scientific and public-facing language may contribute to weight stigma. The impact of weight stigma across the lifespan was also considered. Taking a global perspective, nine recommendations resulted from this work for global health research and health promotion efforts that can help to reduce harmful obesity narratives, both inside and outside health contexts.

Matched MeSH terms: Adolescent
Kesan kelompok bimbingan ke atas konsep kendiri, penilaian konsep kendiri-rakan sebaya, daya tahan dan kelangsangan remaja pertengahan yang sederhana rendah konsep kendiri

Mohammad Aziz Shah MA, Yusooff F

Jurnal Psikologi Malaysia, 2010;olume 24:31-47.

The objective of this experimental study is to investigate the effectiveness of smalla dn big group guidance on the self-concept of the adolescence, using cognitive behaviour therapy and multidimentional self-concept model. The effectiveness of this interventions is measured by looking at the improvement of self concept and the evaluation of self concept by peer group, resiliency and decrease of aggressiveness in the experiment group. This research was carried out among the form four student of two secondary schools in Selangor. The measurement used in this study are questionnaire about personal information, Multi dimentional self concept scale. resiliency scale and aggressiveness scale. A total of 104 subject were selected for this research and they were divided into two groups: controlled and experimental group. The subject in experimental group are given about eight sessions of group guidance within eight weeks. The data were analysed using descriptive analysis, ANOVA, MANCOVA and post hoc test. The result showed that the treatment used in the intervention were effective in improving the self concept and the evaluation of the self concept. The finding implies that the small and big group guidance using cognitive behaviour therapy and multi dimentional self concept model has an effect on the self concept of the student.

Matched MeSH terms: Adolescent
Fulltext Source and understanding of the concept of 1Malaysia among teenagers: a survey. [Sumber dan kefahaman konsep 1 Malaysia dalam kalangan remaja: Satu kajian tinjauan]

Desa A, Yusooff F

Jurnal Psikologi Malaysia, 2014;28:3-11.

1Malaysia concept was introduced by Datuk Seri Mohd. Najib Tun Razak on April 3, 2009 with the theme, "People First, Achievement Is Priority", 1Malaysia seen as an attempt to foster unity among the various races in Malaysia with 8 important values as the catalyst for social transformation that leads to the growth and well-being of people. This descriptive study was conducted to investigate the source and extent of the understanding of 1Malaysia concept among the three groups of primary school (n = 100), secondary school (n = 100) and university students (n = 98). Data were collected through a survey method with the use of a set of questionnaires and were then analysed with SPSS software. The results showed that the main source of this concept for all three groups of students is through television, followed by the newspaper. For the understanding of the concept, it was found that almost 70% of the respondents do understand some basic aspects related to it. However, there are still aspects which respondents still do not know about. Thus there is a need for the educators to play an important role to explain in detail to the students so that the concept can be understood and appreciated, and that it is not misinterpreted to cause negative impact on race relations in Malaysia.

Matched MeSH terms: Adolescent
Fulltext Treatment patterns and outcomes in management of solid cancer patients suffering from anemia in Penang hospital

Hassan BA, Yusoff ZB

Asian Pac J Cancer Prev, 2011;12(6):1573-6.
PMID: 22126501

INTRODUCTION: Anemia is one of the most frequent hematological demonstration of malignant diseases, leading to impairment of function in all tissues and organs of cancer patients and associated with serious stress. This major problem may be exacerbated by radiotherapy or chemotherapy. It is characterized by lower hemoglobin (Hb) level or inadequate circulating red blood cells (RBCs). The present study evaluated the effectiveness of treatment guidelines for anemia among solid cancer patients in Penang hospital and to find associations between treatments and anemia onset and severity.

METHODS: This is a retrospective observational study was conducted on 534 cancer patients with anemia who were admitted to a government hospital on Penang island i.e., Penang General Hospital in the period between 2003 to 2009.

RESULTS: Effectiveness of standard anemia treatment guidelines was not sufficient because correction of anemia was just temporary.

CONCLUSION: According to the results, erythropoietin must be used as a cornerstone even for patients who suffer from moderate anemia and blood transfusion should be used just for emergency cases when anemia leads to a critical situation.

Matched MeSH terms: Adolescent
Ergonomic evaluation of postural stress in school workshop

Hashim AM, Dawal SZ, Yusoff N

Work, 2012;41 Suppl 1:827-31.
PMID: 22316824 DOI: 10.3233/WOR-2012-0249-827

The objective of this study is to compare the evaluation of postural analysis between a self-report questionnaire and physical assessments methods for students aged 13 to 15 years old in school workshop. 336 students were volunteered as participants to fill in the questionnaire and being observed in the workshop. Total of 104 positions were selected and analyzed while students performing their tasks. Questionnaire data was examined to specify the prevalence of postural stress symptoms. The relationship of postural stress by physical assessment methods (RULA and REBA methods) was defined to identify the risk level of students' working posture. From the results, comparison of four factors categorized from total of 22 questions among ages, the mean values were lower for 13 years old students meaning that they were faced higher posture problems while using the workstation. The obtained results from both physical assessment methods and questionnaire analysis have identified 13 years old students faced higher risk exposure. Analysis results emphasized the fact that self-reports questionnaire method has almost accurate as postural evaluation methods to identify physical risks in workplace. The result also shows that an intervention is needed to overcome the posture problems.

Matched MeSH terms: Adolescent
Fulltext Dental patient knowledge about the effects of smoking and attitudes about the role of dentists in smoking cessation

Yahya NA, Saub R, Nor MM, Yusoff N

Southeast Asian J. Trop. Med. Public Health, 2017 Mar;48(2):473-84.
PMID: 29642311

Dentists can offer their patients who smoke tobacco assistance with smoking cessation. We conducted this study to assess dental patient knowledge about the effects of smoking and perceptions and attitudes regarding the role of dentists in smoking cessation counselling. We conducted this study to inform tobacco cessation programs that could potentially include dentists. We conducted a cross-sectional study using a self-administered questionnaire among 375 patients. The mean age of subjects was 33.4 years; females comprised 51.5%. Participants were divided into 3 groups: those who never smoked (n = 263, 70.7%), smokers (n = 92, 24.7%), and ex-smokers (n = 17, 4.5%). Significantly more participants (p = 0.046) who never smoked (92.9%) knew smoking can cause bad breath than smokers(86.9%). Significantly more participants (p = 0.002) who never smoked (74.8%) knew smoking can cause periodontal disease than smokers (57.6%). Significantly
more participants (p < 0.001) who never smoked (84.5%) knew smoking can cause
oral cancer than smokers (66.7%). Significantly more participants (p < 0.001) who never smoked (86.7%) knew smoking can cause lung cancer than smokers (69.7%). Significantly more participants who never smoked (85.5%) felt dentists should be interested in the smoking status of their patients (p = 0.004) than smokers (72.6%). Significantly more participants (p = 0.08) who never smoked (69.6%) stated dentists should give smoking cessation advice than smokers/ex-smokers (59.0%). Smoker/ex-smokers had less knowledge about the effects of smoking on oral and general health than non-smokers. Both smokers/ex-smokers and non-smokers felt dentists should provide smoking cessation advice.

Matched MeSH terms: Adolescent
Fulltext Exposure to secondhand smoke among school-going adolescents in Malaysia: Findings from the tobacco and e-cigarettes survey among Malaysian adolescents (TECMA)

Ling MYJ, Lim KH, Hasani WSR, Rifin HM, Majid NLA, Lourdes TGR, et al.

Tob Induc Dis, 2020;18:96.
PMID: 33262682 DOI: 10.18332/tid/128622

INTRODUCTION: Many studies have revealed that exposure to secondhand smoke (SHS) substantially increases the risk of smoking related diseases especially among the vulnerable groups, yet data on the location of SHS exposure among youth in Malaysia are still lacking. The study aims to describe the prevalence and factors associated with SHS exposure at home, outside the home, and inside the school among school-going adolescents in Malaysia.
METHODS: We derived the data from the TECMA study, which used a cross-sectional study design and multi-stage sampling method to obtain a representative sample of school-going adolescents aged 11-19 years in Malaysia in 2016. Data were collected through a self-administered approach using a pre-validated standard questionnaire. Descriptive and multivariate analyses were used to analyze the data, and results are presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI).
RESULTS: SHS exposure for the past seven days was higher outside the home (51.2%; 95% CI: 49.2-53.2) compared to at home (37.8%; 95% CI: 35.8-39.9) while 27.3% (95% CI: 25.1-29.5) of school-going adolescents reported exposure to SHS inside the school in the past one month. In the regression analyses, older adolescents, those of Malay and Bumiputra Sarawak ethnicities, adolescents from rural areas and current smokers had higher likelihood of exposure to SHS at home, outside home and inside the school. Our study also found that adolescents who were current smokers had higher odds of being exposed to SHS at home (AOR=2.87; 95% CI: 2.57-3.21), outside the home (AOR=3.46; 95% CI: 3.05-3.92) and in the school (AOR=2.25; 95% CI: 2.01-2.51).
CONCLUSIONS: Health promotion measures should target parents/guardians and household members to reduce SHS exposure among adolescents. In addition, smoke-free regulation should be fully enforced in school. Furthermore, more public places should be designated non-smoking areas to reduce SHS exposure and denormalize smoking behavior.

Matched MeSH terms: Adolescent

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