This study aims to validate skinfold (SKF) and bioelectrical impedance analysis (BIA) against dual-energy X-ray absorptiometry (DXA) in determining body fat percentage (BF%) of Malay children aged 7 to 11 years. A total of 160 children had their BF% assessed using SKF and BIA, with DXA as the criterion method. Four SKF equations (SKFBray, SKFJohnston, SKFSlaughter, and SKFGoran) and 4 BIA equations (BIAManufacturer, BIAHoutkooper, BIARush, and BIAKushner) were used to estimate BF%. Mean age, weight, and height were 9.4 ± 1.1years, 30.5 ± 9.9 kg, and 131.3 ± 8.4 cm. All equations significantly underestimated BF% (P < .05). BIA equations had reasonable agreement with DXA and were independent of BF% with BIAManufacturer being the best equation. Although BIA underestimates BF% as compared with DXA, BIA was more suitable to measure BF% in a population that is similar to this study sample than SKF, suggesting a need to develop new SKF equations that are population specific.
A large body of epidemiological data has demonstrated that diet quality follows a sociodemographic gradient. Little is known, however, about food group intake patterns among Malaysian children. This study aimed to assess consumption pattern of 7 food groups, including cereals/grains, legumes, fruits, vegetables, fish, meat/poultry, and milk/dairy products, among children 7 to 12 years of age. A total of 1773 children who participated in SEANUTS Malaysia and who completed the Food Frequency Questionnaire were included in this study. A greater proportion of children aged 10 to 12 years have an inadequate intake of cereals/grains, meat/poultry, legumes, and milk/dairy products compared with children 7 to 9 years old. With the exception of meat/poultry, food consumption of Malaysian children did not meet Malaysian Dietary Guidelines recommendations for the other 6 food groups, irrespective of sociodemographic backgrounds. Efforts are needed to promote healthy and balanced dietary habits, particularly for foods that fall short of recommended intake level.
Children's physical activity has been correlated with child characteristics and social or physical environment. This study aimed to compare preschoolers' physical activity among various sociodemographic characteristics and to determine barriers, motivators, and environmental factors for active play. A total of 835 preschoolers were included in this analysis. Time spent on active play, quiet play, and screen time was reported by parents. Boys spent significantly more time on active play and screen time than girls. Time spent on quiet play was highest in East Coast Peninsular Malaysia and lowest in Sarawak. Some 40% of children achieved active play recommendation while 27% exceeded daily screen time recommendation. Most parents reported that their child played actively in the house area; and that the main barrier and motivator to active play were safety and child's enjoyment, respectively. These findings demonstrate that sociodemographic characteristics and environment should be considered in designing physical activity intervention programs.
MESH: screen time
In a population sample of 385 children, 6 to 11 years old, venous blood parameters-hemoglobin (Hb), ferritin, red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), C-reactive protein (CRP), and α1-acid glycoprotein (AGP)-were determined to get insight into the iron status. The prevalence of anemia was 11.4%; 5.6% had iron deficiency (ID), whereas 0.4% had ID anemia. Correction for inflammation based on CRP and AGP did not markedly change the overall prevalence of ID and ID anemia. Stunted children had lower Hb and ferritin values compared with nonstunted children, and thin children had lower values compared with normal-weight or overweight and obese children. Many nonanemic children had alert values for RBC, MCV, MCH, and MCHC. It is concluded that although the prevalence of anemia is of the magnitude of a mild public health problem, the iron status of many nonanemic children is borderline, as indicated by a high number of children with low values for red blood cytology.
This study examined the factors of successful return to employment among participants in the return to work program (RTW) following work-related injury. Data were obtained from the Social Security Organization database containing 9850 injured workers who underwent RTW in 2010 to 2013. About 65% had successfully returned to employment. Significant factors of successful return include gender, employer interest, motivation, age, intervention duration, and type of injury. Male and motivated employees were more likely to return to employment compared with female and unmotivated employees, respectively. Participants from interested employers were 23.22 times more likely to return to work than those from uninterested employers, whereas participants whose intervention period exceeded 5 months were 41% less likely to return to work compared with those whose intervention period was within 3 months. Appropriate strategy and enhanced collaboration between the stakeholders would improve the proportion of successful return to employment.
Keyword: SOCSO
This cross-sectional study aimed to determine the prevalence and the factors associated with sexual initiation among the late adolescents in 6 institutions of higher learning in Malaysia. A total of 1572 students completed self-administered questionnaires between April and September 2013. Hierarchical multivariate logistic regression analyses stratified by gender were employed to identify the correlates of sexual initiation. The analyses were further adjusted by sampling weights. The overall prevalence of sexual initiation was 9.8% (95% confidence interval [CI] = 8.3-11.6), 18.1% (95% CI = 15.1-21.5) among males, and 4.1% (95% CI = 2.9-5.9) among females. The risk factors identified in this study supported the influence of the individual, family, and peer factors in the social-ecological model on adolescents' behaviors. The findings suggest the need for risk-reduction strategies aimed at the individual, family, and peer levels as well as the importance of gender-specific focus in assuring better outcomes.
This article aims to describe the eating habits of Malaysian children using a nationally representative data set from the South East Asian Nutrition Surveys (SEANUTS) in Malaysia. A total of 2797 children aged 2 to 12 years were included in this analysis. Eating habits and dietary intakes of children were assessed using questionnaires. Overall, 56.1% of children consumed 3 main meals every day. Approximately 20% of children snacked 3 times per day, whereas 9.7% ate fast food on a weekly basis. Irregular meal patterns were significantly associated with lower micronutrient intakes, and the groups with higher odds for this pattern were older children, Malays, and those living in rural areas. Considering the relatively high rate of irregular meal consumption and its potential influence on dietary nutrient intake, persistent efforts must be continued to promote and inculcate healthy eating habits among children from an early age.
This study describes the physical activity of primary school children according to sociodemographic characteristics and activity domains. Using the Malaysian South East Asian Nutrition Surveys data, 1702 children aged 7 to 12 years were included in the analysis. Physical activity was reported as a total score and categorized into low, medium, and high levels based on Physical Activity Questionnaire for Older Children. Higher overall activity scores were found in boys, younger age, non-Chinese ethnicity, and normal body mass index category. Sex, age, and ethnicity differences were found in structured or organized, physical education, and outside-of-school domain scores. Transport-related scores differed by age group, ethnicity, household income, and residential areas but not among the three physical activity levels. Participation of girls, Chinese, and older children were low in overall and almost all activity domains. Sociodemographic characteristics are important factors to consider in increasing the different domains of physical activity among Malaysian children.
Leptospirosis is an important zoonotic disease globally and is endemic in Malaysia. A study was conducted in the Rejang basin of Sarawak from June 2011 to May 2013 to determine the seroprevalence of leptospirosis among the communities and dominant infecting Leptospira serovars. A total of 508 human sera were analyzed using ELISA and the microscopic agglutination test (MAT). The seroprevalence of leptospirosis in the study area was 37.4%, with the highest prevalence in Kapit division. More women were positive for leptospirosis (59.5%), and the mean age of seropositive individuals was 42.2 (SD = 18.7) years. Antibody titers between 1:50 and 1:1600 were reported, and serovars djasiman (22.1%), shermani (13.2%), and pomona (7.9%) predominated, with varied distribution between geographical locations. This study highlighted the endemicity and diversity of existing Leptospira serovars within the community. This information should be communicated to local health personnel and communities at risk, and rapid diagnostic capability should be made available to local health facilities.
The study investigated the association between breakfast types consumed, daily energy intake, and body mass index for age Z-score (BAZ). Cross-sectional data from 1258 children aged 7 to 12.9 years were analyzed for breakfast type, nutrient intakes, BAZ, and proportion of overweight or obesity. Analysis of covariance was used to compare energy and nutrient intakes, BAZ, and proportion of overweight/obese children between breakfast groups. Only 19% of children had adequate energy intake from breakfast. Those consuming snacks had a significantly lower BAZ (Z = -0.73), with 5% of them being overweight/obese. Those consuming beverages and desserts had the lowest total daily energy intake (1314 kcal) and lowest protein intake (8.4 g). The results suggest that breakfast type is associated with daily energy intake and BAZ. Most breakfasts are not adequate. School-based nutrition education programs involving families, teachers, and health professionals can contribute to improve this situation.
Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Recent research evidence is reviewed in this study, building on previous authoritative reviews. The recent World Health Organization reviews of the short- and long-term benefits of breastfeeding concluded that there was strong evidence for many public health benefits of breastfeeding. Cognitive development is improved by breastfeeding, and infants who are breastfed and mothers who breastfeed have lower rates of obesity. Other chronic diseases that are reduced by breastfeeding include diabetes (both type 1 and type 2), obesity, hypertension, cardiovascular disease, hyperlipidemia, and some types of cancer.
Physical Activity Scale for the Elderly (PASE) is among the frequently used self-reported physical activity assessment for older adults. This study aims to assess the validity and reliability of a Malay version of this scale (PASE-M). A total of 408 community-dwelling older adults were enrolled. Concurrent validity was evaluated by Spearman's rank correlation coefficients between PASE with physical and psychosocial measures. Test-retest reliability was determined by the intraclass correlation coefficient (ICC). The mean PASE-M scores at baseline and follow-up were 94.96 (SD 62.82) and 92.19 (SD 64.02). Fair to moderate correlation were found between PASE-M and physical function scale, IADL (rs = 0.429, P < .001), walking speed (rs = 0.270, P < .001), grip strength (rs = 0.313-0.339, P < .001), and perceived health status (rs = -0.124, P = .016). Test-retest reliability was adequate (ICC = 0.493). The Malay version of PASE was shown to have acceptable validity and reliability. This tool is useful for assessing the physical activity level of elderly Malaysians.
This qualitative study aimed to explore the influence of social networks such as family members, friends, peers, and health care providers toward the help-seeking behaviour (HSB) of patients with type 2 diabetes mellitus in the public and private primary care settings. In-depth interviews of 12 patients, 9 family members, and 5 health care providers, as well as 3 focus groups among 13 health care providers were conducted. All interviews were audio-taped and transcribed verbatim for qualitative analysis. Social influences play a significant role in the help-seeking process; once diagnosed, patients source information from people around them to make decisions. This significant influence depends on the relationship between patients and social networks or the level of trust, support, and comforting feeling. Thus, the impacts on patients' help-seeking behavior are varied. However, the help-seeking process is not solely an individual's concern but a dynamic process interacting with the social networks within the health care system.
Extreme events, both natural and anthropogenic, increasingly affect cities in terms of economic losses and impacts on health and well-being. Most people now live in cities, and Asian cities, in particular, are experiencing growth on unprecedented scales. Meanwhile, the economic and health consequences of climate-related events are worsening, a trend projected to continue. Urbanization, climate change and other geophysical and social forces interact with urban systems in ways that give rise to complex and in many cases synergistic relationships. Such effects may be mediated by location, scale, density, or connectivity, and also involve feedbacks and cascading outcomes. In this context, traditional, siloed, reductionist approaches to understanding and dealing with extreme events are unlikely to be adequate. Systems approaches to mitigation, management and response for extreme events offer a more effective way forward. Well-managed urban systems can decrease risk and increase resilience in the face of such events.
Maternal morbidity is a concept of increasing interest in maternal health. This review aims to assess the contributory factors for severe maternal morbidity over the past one decade worldwide. A comprehensive electronic search was conducted. The search was restricted to articles written in the English language published from 2004 to 2013. Qualitative studies were excluded. A total of 24 full articles were retrieved of which 9 cohort, 7 case-control, 3 cross-sectional studies, and 5 unmentioned designs were included. The contributory factors were divided into 3 components: (a) sociodemographic characteristics, (b) medical and gynecological history, and (c) past and present obstetric performance. This review informs emerging knowledge regarding contributory factors for severe maternal morbidity and has implications for education, clinical practice and intervention. It enables a better understanding of the problem and serves as a foundation for the development of an effective preventive strategy for maternal morbidity and mortality.