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Fulltext The status of men's health in Asia

Ng CJ, Teo CH, Ho CC, Tan WP, Tan HM

Prev Med, 2014 Oct;67:295-302.
PMID: 25117523 DOI: 10.1016/j.ypmed.2014.08.007

This study aims to compare health status and its risk factors between men and women who are from countries of different income status in Asia.

Matched MeSH terms: Social Class
Fulltext The role of general practitioners in the management of erectile dysfunction-a qualitative study

Ng CJ, Low WY, Tan NC, Choo WY

Int J Impot Res, 2004 Feb;16(1):60-3.
PMID: 14963472 DOI: 10.1038/sj.ijir.3901141

The objective of this study was to explore the roles and perceptions of general practitioners (GPs) in the management of erectile dysfunction (ED). This qualitative study used focus group discussions and in-depth interviews. This study was conducted based on 28 GPs from an urban area in Malaysia who had managed patients with ED and prescribed anti-ED drugs. Main outcome measures included the roles of GPs in managing patients with ED (active or passive), perceptions regarding ED and the treatment, and factors influencing their decision to prescribe. Majority of the GPs assumed a passive role when managing patients with ED. This was partly due to their perception of the disease being nonserious. Some also perceived ED as mainly psychological in nature. The anti-ED drugs were often viewed as a lifestyle drug with potentially serious side effects. The fear of being perceived by patients as 'pushing' for the drug and being blamed if the patients were to develop serious side effects also hampered the management of this disease. GPs who participated in this study remained passive in identifying and treating patients with ED and this was attributed to their perception of the disease, drug treatment and patient's background.

Matched MeSH terms: Social Class
The relationship between socioeconomic deprivation, atypical respiratory infections and survival outcome in elderly stroke and medical patients

Ngeh J, Hackshaw A, Gupta S

Cerebrovasc Dis, 2007;24(6):546-7.
PMID: 18042982
Matched MeSH terms: Social Class*
The role of socioeconomic status in the relationship between social support and burden among cancer caregivers

Nikbakht Nasrabadi A, Pahlevan Sharif S, Allen KA, Naghavi N, Sharif Nia H, Salisu WJ, et al.

Eur J Cancer Prev, 2022 Mar 01;31(2):198-203.
PMID: 33899748 DOI: 10.1097/CEJ.0000000000000683

While much research has focused on the direct impact of socioeconomic status on cancer patients, what is not clear is the impact of socioeconomic status on social support and the burden of care for caregivers. In this study, a cross-sectional method, using a convenience sampling approach, was adopted to collect the data of 191 caregivers of cancer patients who were referred to the oncology clinic and cancer institute of hospitals affiliated with Tehran University of Medical Sciences, Iran. The participants completed a questionnaire on basic demographics, the short version of the Burden Scale for Family Caregivers, and Zimet Multidimensional Perceived Social Support. A maximum likelihood exploratory factor analysis with oblique rotation to assess the factor structure of the constructs and the measurement model was conducted. The two-factor model consisting of 22 items explained 65.116% of the variance. There was a significant negative relationship between social support and burden (b = -0.771, P < 0.001) and also between economic status and burden (b = -0.308, P < 0.01). Moreover, there was a significant positive association between the interaction of social support and economic status and burden (b = 0.138, P < 0.05). More specifically, the negative relationship between social support and burden was statistically stronger for participants with weak economic status (b = -0.663, P < 0.001) than those with good economic status (b = -0.356, P < 0.01). Social support and an individual's economic status are essential determinants of caregiver burden. Further studies are recommended to better inform the precise support needed by caregivers to enhance their quality of life, and ultimately, that of the patients under their care.

Matched MeSH terms: Social Class
University of Malaya dental students' attitudes towards communication skills learning: implications for dental education

Nor NA, Yusof ZY, Shahidan MN

J Dent Educ, 2011 Dec;75(12):1611-9.
PMID: 22184601

The Ministry of Higher Education in Malaysia has called for the implementation of a soft skills module in all public universities in Malaysia. In response to this and as part of curriculum development efforts for a new integrated program for 2011, a study was undertaken to improve the University of Malaya (UM) Faculty of Dentistry's communication skills course. One of the study objectives was to investigate dental students' attitudes towards communication skills learning and the association between their attitudes and demographic and education-related characteristics. A cross-sectional survey--using a self-administered twenty-four-item adapted Communication Skills Attitude Scale (CSAS) that contained both positive (PAS) and negative (NAS) attitude subscales--was carried out targeting all final-year dental students at the UM and the Universiti Kebangsaan Malaysia (UKM). A total of 148 students completed the survey, yielding a response rate of 88.1 percent. Overall, UKM students had significantly more positive attitudes towards communication skills learning (PAS score: mean=48.69, SD=4.48, p<0.001) than UM students (mean=46.03, SD=4.22). There was no statistically significant difference in negative attitudes between the two groups. UKM students with more positive attitudes tended to be female (p<0.05). UM students with more negative attitudes perceived themselves as poor communicators (p<0.05), and UKM students with more negative attitudes tended to have poor English proficiency (p<0.05). This study found that both UM and UKM final-year dental students have positive and negative attitudes towards learning communication skills. These attitudes were significantly associated with certain background and education-related attributes. Outcomes of this study served as a valuable guide in strengthening the communication skills course for the UM's new, integrated dental curriculum.

Matched MeSH terms: Social Class
Fulltext Prevalence and predictors of erectile dysfunction in adult male outpatient clinic attendees in Johor, Malaysia

Nordin RB, Soni T, Kaur A, Loh KP, Miranda S

Singapore Med J, 2019 Jan;60(1):40-47.
PMID: 29774359 DOI: 10.11622/smedj.2018049

INTRODUCTION: Erectile dysfunction (ED) is a serious global burden that affects men as well as their partners. This study aimed to determine the prevalence and predictors of ED among male outpatient clinic attendees in Johor, Malaysia.
METHODS: We conducted a cross-sectional study of Malaysian men aged ≥ 18 years attending two major outpatient clinics in Johor Bahru and Segamat in Johor, Malaysia, between 1 January 2016 and 31 March 2016. Subjects were chosen via simple random sampling and 400 patients were recruited. The study instrument was a survey form that consisted of three sections: sociodemographic and comorbid profile, validated English and Malay versions of the 15-item International Index of Erectile Function, and the 21-item Depression Anxiety Stress Scale.
RESULTS: The overall prevalence of self-reported ED was 81.5%. The prevalence of ED according to severity was as follows: mild (17.0%), mild to moderate (23.8%), moderate (11.3%) and severe (29.5%). Multivariate analysis showed that ED was associated with increasing age (odds ratio [OR] 4.023, 95% confidence interval [CI] 1.633-9.913), Indian as compared to Malay ethnicity (OR 3.252, 95% CI 1.280-8.262), secondary as compared to tertiary education (OR 2.171, 95% CI 1.203-3.919), single as compared to married status (OR 6.119, 95% CI 2.542-14.734) and stress (OR 4.259, 95% CI 1.793-10.114).
CONCLUSION: ED has significant prevalence and severity among adult male outpatient clinic attendees in Johor. Increasing age, Indian ethnicity, lower educational level, singlehood and stress were significant predictors of ED.

Matched MeSH terms: Social Class
Fulltext Enterobius vermicularis infection among children aged 1-8 years in a rural area in Malaysia

Norhayati M, Hayati MI, Oothuman P, Azizi O, Fatmah MS, Ismail G, et al.

Southeast Asian J. Trop. Med. Public Health, 1994 Sep;25(3):494-7.
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
Fulltext The quality of life of people with epilepsy at a tertiary referral centre in Malaysia

Norsa'adah B, Zainab J, Knight A

Health Qual Life Outcomes, 2013;11:143.
PMID: 23972031 DOI: 10.1186/1477-7525-11-143

Epilepsy, a chronic disorder of brain characterised by a predisposition to generate epileptic seizures, has an effect on the psychosocial well-being of sufferers. Measuring the quality of life (QOL) of people with epilepsy (PWE) is increasingly recognized as an important component of clinical management. QOL measures differ between countries and there is limited information regarding PWE in Malaysia. The aim of this study was to determine the health related QOL and its relationship with the presence of seizures in PWE at a Malaysian tertiary referral center.

Matched MeSH terms: Social Class
Fulltext Factors associated with different smoking statuses among Malaysian adolescent smokers: a cross-sectional study

Nur Atikah AH, Wee LH, Nur Zakiah MS, Chan CMH, Mohamed Haniki NM, Swinderjit JS, et al.

BMC Public Health, 2019 Jun 13;19(Suppl 4):579.
PMID: 31196055 DOI: 10.1186/s12889-019-6857-3

BACKGROUND: This study focused on the associations between socioeconomic status (SES) and adolescent smoking among secondary school students (13 to 17 years) in the Federal Territory of Kuala Lumpur, Malaysia. Our objective was to evaluate the relationships between adolescent demographics, socioeconomic status and smoking status.

METHODS: The survey data were based on baseline findings from a cross-sectional study (N = 422 adolescents). Chi-square test was used to assess the relationship between demographic characteristics, socioeconomic status (household monthly income and daily allowance) and adolescent smoking status. Exhaled carbon monoxide (CO) reading and the Hooked on Nicotine Checklist (HONC) were used to evaluate adolescent smoking status. A Multivariate Multinomial Logistic Regression (MMLR) was employed to test selected demographic and socioeconomic predictors of smoking status.

RESULTS: Of the 422 adolescents (M age = 15.58, SD = 1.24), more than half of the participants initiated smoking between 13 to 17 years old (59.0%). A total of 308 (73.0%) were electronic cigarette users, with more than 50% comprising of single users. The mean CO reading was 2.14 ppm with 78.0% of adolescents scoring more than 0 on the Hooked on Nicotine Checklist (HONC). Males and participants aged 15 and 16 years were at increased risks of sole CC smoking. Meanwhile, males, those who are not hooked on smoking and with a non-smoker CO reading were at increased risks of sole EC smoking. Finally, Bumiputeras were at less risk of EC smoking.

CONCLUSIONS: Demographic variables such as age, gender and ethnicity predicted smoking status predicted smoking risk, but not socioeconomic factors. The findings allow policy makers to target specific high-risk demographic groups when designing smoking cessation programs for adolescents.

Matched MeSH terms: Social Class
Adolescent pregnancy outcomes and risk factors in Malaysia

Omar K, Hasim S, Muhammad NA, Jaffar A, Hashim SM, Siraj HH

Int J Gynaecol Obstet, 2010 Dec;111(3):220-3.
PMID: 20800837 DOI: 10.1016/j.ijgo.2010.06.023

OBJECTIVE: To assess the outcomes and risk factors of adolescent pregnancies in 2 major hospitals in Malaysia.
METHODS: We conducted a case-control study of pregnant girls aged 10 through 19 years. The controls were women aged 20 through 35 years who did not become pregnant in their adolescence. Cases and controls were matched for parity and place of delivery. Data were collected from questionnaires and the hospitals' medical records.
RESULTS: The study included 102 cases and 102 controls. There were significant associations between adolescent pregnancy and low education level, low socioeconomic status, being raised by a single parent, not engaging in extracurricular school activities, engaging in unsupervised activities with peers after school, and substance abuse (P<0.05 for all); being anemic, being unsure of the expected delivery date, and having few antenatal visits and a late delivery booking; and low Apgar scores and perinatal complications.
CONCLUSION: Adolescent pregnancies are high-risk pregnancies. Better sexual health strategies are required to address the associated complications.

Matched MeSH terms: Social Class
Maternal mental health in families of children with spina bifida

Ong LC, Norshireen NA, Chandran V

World J Pediatr, 2011 Feb;7(1):54-9.
PMID: 21191777 DOI: 10.1007/s12519-011-0246-z

this study aimed to compare mental health of mothers of children with spina bifida with mothers of able-bodied controls.

Matched MeSH terms: Social Class*
The demand for abortion in an urban Malaysian population

Ooi OS

Med J Malaya, 1971 Mar;25(3):175-81.
PMID: 4253243
Matched MeSH terms: Social Class
Fulltext [Anthropometric measurements in Malay children from upper class families in Kuala Lumpur]

Osman A, Suhardi A, Khalid BA

Med J Malaysia, 1993 Mar;48(1):76-82.
PMID: 8341176

This study was done to determine the anthropometric measurement patterns of Malay children from wealthy families in Malaysia and to make a comparison with NCHS reference population. A population of 900 children aged between 3-12 years old from Taman Tun Dr Ismail, Kuala Lumpur (TDI), were examined but only 871 of them were eligible for the study. Weight, height, mid-arm circumference and skin fold thickness were measured. The increment pattern of anthropometric measurements of TDI children was quite similar to NCHS except for having a lower median weight for age and height for age. There was prepubescent increase in skin folds thickness in both sexes, followed by a midpubescent decrease and a late pubescent increase. The study indicated that Malay children from a wealthy background have growth rates comparable to children in the West, hence NCHS percentile charts are suitable as a reference for comparing the nutritional status of Malay children in Malaysia.

Matched MeSH terms: Social Class
Fulltext Assessment of total cardiovascular risk using WHO/ISH risk prediction charts in three low and middle income countries in Asia

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
The contraceptive role of breastfeeding by educational attainment: an assessment based on Malaysian fertility and family survey

Othman A

Malays J Reprod Health, 1985 Jun;3(1):77-83.
PMID: 12314429
Matched MeSH terms: Social Class
Fulltext Epidemiology, Diagnosis, and Risk Factors of Helicobacter pylori Infection in Children

Ozbey G, Hanafiah A

Euroasian J Hepatogastroenterol, 2017 Jan-Jun;7(1):34-39.
PMID: 29201769 DOI: 10.5005/jp-journals-10018-1208

H. pylori infection is a global public health problem associated with some gastrointestinal diseases in children, especially in developing countries, since prevalence of H. pylori is low in the developed world. Both noninvasive (stool antigen test, urea breath test, and blood test) and invasive (histology, rapid urease test, and microbiological culture) tests have been utilized to detect H. pylori infection. However, a single test is not reliable enough and does not provide accurate enough data to determine H. pylori infection among children. Risk factors of H. pylori infection in children were related to ethnicities, household properties, geographic location, living conditions, water sources, type of housing, presence/absence of sewage systems, and garbage collection within the living environment. These risk factors were usually associated with the socioeconomic status of the family. This review article aims to determine the gaps in the knowledge of the epidemiology, risk factors, and diagnostic tests of H. pylori infection among children. How to cite this article: Ozbey G, Hanafiah A. Epidemiology, Diagnosis, and Risk Factors of Helicobacter pylori Infection in Children. Euroasian J Hepato-Gastroenterol 2017;7(1):34-39.

Matched MeSH terms: Social Class
Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

Palafox B, McKee M, Balabanova D, AlHabib KF, Avezum AJ, Bahonar A, et al.

Int J Equity Health, 2016 12 08;15(1):199.
PMID: 27931255

BACKGROUND: Effective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household's ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study.
METHODS: A cross-section of 163,397 adults aged 35 to 70 years were recruited from 661 urban and rural communities in selected low-, middle- and high-income countries (complete data for this analysis from 151,619 participants). Using blood pressure measurements, self-reported health and household data, concentration indices adjusted for age, sex and urban-rural location, we estimate the magnitude of wealth-related inequalities in the levels of hypertension awareness, treatment, and control in each of the 21 country samples.
RESULTS: Overall, the magnitude of wealth-related inequalities in hypertension awareness, treatment, and control was observed to be higher in poorer than in richer countries. In poorer countries, levels of hypertension awareness and treatment tended to be higher among wealthier households; while a similar pro-rich distribution was observed for hypertension control in countries at all levels of economic development. In some countries, hypertension awareness was greater among the poor (Sweden, Argentina, Poland), as was treatment (Sweden, Poland) and control (Sweden).
CONCLUSION: Inequality in hypertension management outcomes decreased as countries became richer, but the considerable variation in patterns of wealth-related inequality - even among countries at similar levels of economic development - underscores the importance of health systems in improving hypertension management for all. These findings show that some, but not all, countries, including those with limited resources, have been able to achieve more equitable management of hypertension; and strategies must be tailored to national contexts to achieve optimal impact at population level.

Matched MeSH terms: Social Class*
Fulltext Health poverty among people with type 2 diabetes mellitus (T2DM) in Malaysia

Parra-Mujica F, Roope LS, Abdul-Aziz A, Mustapha F, Ng CW, Rampal S, et al.

Soc Sci Med, 2024 Jan;340:116426.
PMID: 38016309 DOI: 10.1016/j.socscimed.2023.116426

In the context of the escalating burden of diabetes in low and middle-income countries (LMICs), there is a pressing concern about the widening disparities in care and outcomes across socioeconomic groups. This paper estimates health poverty measures among individuals with type 2 diabetes mellitus (T2DM) in Malaysia. Using data from the National Diabetes Registry between 2009 and 2018, the study linked 932,855 people with T2DM aged 40-75 to death records. Cox proportional hazards models were used to estimate the 5-year survival probabilities for each patient, stratified by age and sex, while controlling for comorbidities and area-based indicators of socio-economic status (SES), such as district-level asset-based indices and night-time luminosity. Measures of health poverty, based on the Foster-Greer-Thorbecke (FGT) measures, were employed to capture excessive risk of premature mortality. Two poverty line thresholds were used, namely a 5% and 10% reduction in survival probability compared to age and sex-adjusted survival probability of the general population. Counterfactual simulations estimated the extent to which comorbidities contribute to health poverty. 43.5% of the sample experienced health poverty using the 5% threshold, and 8.9% were health poor using the 10% threshold. Comorbidities contribute 2.9% for males and 5.4% for females, at the 5% threshold. At the 10% threshold, they contribute 7.4% for males and 3.4% for females. If all patients lived in areas of highest night-light intensity, poverty would fall by 5.8% for males and 4.6% for females at the 5% threshold, and 4.1% for males and 0.8% for females at the 10% threshold. In Malaysia, there is a high incidence of health poverty among people with diabetes, and it is strongly associated with comorbidities and area-based measures of SES. Expanding the application of health poverty measurement, through a combination of clinical registries and open spatial data, can facilitate simulations for health poverty alleviation.

Matched MeSH terms: Social Class
Socio-economic determinants of fertility in some countries of Asia

Pathak KB, Murty PK

Artha Vijnana, 1982 Jun;24(2):163-78.
PMID: 12339046
Matched MeSH terms: Social Class
Fulltext Impact of socio-economic status on access and outcome of kidney transplantation in Malaysia

Peter Gan Kim Soon, Sanjay Rampal, Lim Soo Kun, Tin Tin Su

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):33-33.
MyJurnal

Introduction: Low socio-economic status (SES) has been associated with poorer access and worse outcome in kid-ney transplantation (KT) for high-income countries. In contrast, relatively little is known about the KT access and outcome between the socio-economic gradient in Malaysia, which is a low- and middle-income country. The aim is to determine the association of SES with access and outcome of kidney transplantation in Malaysia. Methods: We examined the Malaysian National Renal Registry for kidney transplant candidates listed between 2002 to 2011. Cox’s regression was used to assess associations of SES with transplant access and outcome (survival). Results: 1234 patients were transplanted in 2002-2011 after excluding pediatric patients and multiple transplantations. The mean age of patients was 42.3 ± 12.3 years, 789 (63.9%) were male and 797 (65.0%) were of Chinese ethnicity. After multivariate adjustment, the highest income group were 20% less likely to access KT compared the lowest income group (adjusted HR=0.80, CI: [0.62, 1.04] producing trend for P-Value = 0.001. While patient with highest education were 50% more likely to survive compared to patient with lowest education (adjusted HR=0.50, CI: [0.34, 0.73] producing trend for P-Value < 0.001. Conclusion: Even in a healthcare system that is almost achieving universal health coverage, disparities exist in both extremes of the socio-economic gradient for the access and outcomes for KT in Malaysia. Reducing the SES disparities in KT will require policy initiatives addressing the components of SES (income, education, and employment) as well as the pathways by which this affect the health of KT patient.

Matched MeSH terms: Social Class

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