Misuse of alcohol among adolescents, particularly schoolchildren has become one of the public health concerns in Malaysia due to its serious effects and an increased risk of alcohol related injuries, especially motor vehicle injuries. This is the most common type of youthful fatal injury in Malaysia. However the availability of data on the extent of alcohol abuse particularly among school children in this country is limited. Therefore, we conducted this study with the objectives of identifying the prevalence of alcohol drinking among school children in Kuala Lumpur, factors rekited to alcohol drinking among the adolescents and to assess health status of their parents through the presence of any related alcohol diseases and the habits of alcohol drinking among their parents.
In this baseline study a two stage stratified sampling design was used to recruit 8532 eligible students from the selected secondary schools in Kuala Lumpur. The prevalence of alcohol drinking was 9.0% (771 / 8532) . Significant factors identihed related to alcohol consumption were akoholic father (OR=1.29), akoholic mother (1 .55) ; elder siblings consume alcohol (2 .49) and the Chinese ethnic group (1 .55) . The study revealed that factors which signihcantly contributed to the habit of alcohol drinking were related to whether their parents consumed alcohol or not or either their eMer siblings were ako taking alcohol. Therefore, the, results from this study could be used as a baseline data to describe the level of alcohol consumption among adolescents particularly school children. Ehfective public health interventions that focus on the familial context of adolescents' drinking habits may be developed.
Great importance has been attributed to birth weight all over the world because it is considered as one of the best predictors of prenatal survival and a good indicator of quality life. The objective of this study was to determine the prevalence of low birth weight babies (LBW) and factors related to it in Baghdad city. A cross sectional study was carried out in four general hospitals in Baghdad city, Iraq. A total of 225 newborn babies, alive, singleton and without congenital malformation were selected randomly from these four general hospitals.The result of the study showed the prevalence rate of low birth weights was 21.3%. Mothers’ educational level, monthly family income, mothers with chronic hypertension, mothers with history of previous low birth weight infants and anemic mothers were significantly associated with low birth weight babies (P= 0.03, 0.01, 0.02,
Merokok merupakan amalan yang dimulakan sewaktu usia remaja. Beberapa kajian yang dijalankan terdahulu di negara maju mendapati keluarga mernpakan faktor penyumbang kepada amalan ini. Meskipun pelbagai kajian di negara·negara rnaju, namun tidak banyak kajian berkaitan aspek ini yang dilaporkan di negara ini. Data kajian lverkait dengan pembolehubah kekeluargaan iaitu hubungan kekeluargaan, pandangan remaja tentang reaksi ibu bapa terhadap amalan rnerokok, struktur keluarga, jumlah ahli keluarga, status merokok di kalangan ibu bapa dan jantina dengan amalan merokok diperolehi dari 251 pelajarpelajar sekolah menengah (Tingkatan 5) (48.2% lelaki dan 51.8%
perempuan} di Daerah Kota Ting?. Johon Kajian ini mendapati sikap ibu bapa yang negatif dan bapa yang tidak merokok merupakan faktor pelindung dari amalan merokok. Hasil kajian mencadangkan faktor kekeluargaan memainkan peranan dalam mempengaruhi amalan merokok di kalangan jantina. Institusi kekeluargaan hendaklah dilibatkan dalam program pencegahan amalan merokok di kalangan remaja.
Land filling is the most common disposal method in most parts of the world and landfill site has always been the final destination in solid waste management hierarchy. Thus, the selection of landfill site is always an essential part in the management of solid waste. Selecting an appropriate site for landfill minimizes any unwarranted ecological and socio-economic effects. Hence, landfill site selection requires a detailed analysis of the area that must be able to meet the local authority requirement and criteria. The present study presents a feasibility assessment of landfill establishment for Khomeynishahr city in Isfahan, applying a multi criteria evaluation (MCE) method using GIS technique. Information layers related to topography, soil, water table, sensitive habitats, land use and geology maps were prepared and superposed using Boolean logic in GIS environment. Essential analysis and regulation, criteria and site selection assessment showed that because of many limitations khomeynishahr city doesn’t have adequate conditions for landfill site establishment. Khomeynishahr city has a dense population and limited area and is not suitable for landfill establishment. In this case consideration of adjacent cities and finding a common landfill site between two or more cities could be a viable solution of solving this problem.
With economic growth and significant technological advances in the health sector, many countries have developed aggregate outcomes in terms of both health services and individual well-being. Life expectancy has seen a remarkable increase of more than fifty per cent between 1950 and 2009. Achievement is uneven, however, and some groups are better able to access health services than others. In our review, we explore the need and how to maximize health equity, efficiency and effectiveness. Methodology is the review and web surfing on public health, social science, humanity and development literature. The increasing gap in health inequality, however, calls for further reform of the health system to achieve both equity and efficiency. Health is essential for survival and human capability. Good health enables people to participate in society. A new approach to efficient and cost-effective health service provision is community participation in health development. Participation can increase the skills and knowledge of local people, thus providing opportunities to improve their lives (empowerment). Analysis suggests four functional changes to achieve equity and efficiency in maximizing health outputs: reforms targeting universal coverage to achieve universal access to health; people-centred service delivery through concentrating on health services based on need; public policy change targeting integrated and multi-system health planning; and collective health system and community response to achieve health for all.
Food poisoning is still a major problem in the state of Terengganu. The study was conducted during an episode of food poisoning outbreak which occurred in October, 1999, at Universiti Tekonologi Mara (UiTJ1rO, Dungun to determine the etiology, mode of transmission, source and the risk factors of the outbreak and hence to take appropriate remedial actions and preventive measures. A retrospective cohort study was conducted amongst 925 students using a standard questionnaire as well as environmental investigation and bacterial subtyping. All the samples were Malay females, age ranging jrom /9 — 22 years. It was found that majority ofthe victims (72 %) presented with abdominal cramp, 68.5% headache, 60.0% diarrhea, 55.2% fever, 45.0% nausea, 39.0% muscle
ache and 3]. 7% vomiting. The epidemic curve suggested of a common source of infection and the most probable food that has been contaminated was taken during lunch hour on October 20'I'1999, Statistical analysis showed that spices jiied chicken and "nasi minyak" were significantly associated with the illness (p < 0. 05). The most likely causative organism was Salmonella spp as supported by the clinical presentation and incubation period of the disease, identdication of contaminated food, bacterial subtyping result and environmental findings. Following the outbreaks, several remedial actions were taken including immediate close—up ofthe canteen for I4 days, treatment for the cases and health examination and typhoid immunization for all food handlers.
Functional dependence is common in hte life and may be due to the normal process of ageing or associated with physical disorders. This study was done to determine the prevalence and factors affecting functional dependence among the elderly in a rural community setting. A cross sectional study design using stratifed proportionate cluster sampling method was used in this study. All elderly residents aged 60 years old and above in the selected kampungs in Mukim Sepang were selected as respondents. The Barthel`s Index ( B1) was used to screen for functional dependence among the respondents. Functional dependence in basic Activities of Daily Living (ADL) implies that the respondent needs assistance in one or more of these tasks. Out of the 263 elderly residents, 223 agreed to participate givinga response rate 84.8%. The mean age was 69.7 years with a SD of 6.8 years. Age ranged from 60-99 years. Thirtyyfive (15.7%) of the respondents were dependent in at kast one function of the ADL. The most common problem identifed was urinary incontinence (9.9%). Functional dependence is common among our elderly population. This problem needs to be addressed by the health care personnel to improve the quality of life of the elderly.
It is known that lifting tasks are one of the risk factors of musculoskeletal disorders in the automotive industry.
Extensive research has been carried out over the years to develop guidelines and determine safe limits in which an
individual can lift. For this reason, the objective of this study is to determine the significant risk factors of
musculoskeletal discomfort among manual lifting task workers in the automotive industry, and propose a
methodological framework for future research on manual lifting tasks. The subjects of this study comprise 211
manual material handling workers from the automotive industry. The subjects completed a set of questionnaires
which are used to elicit information on their demographic characteristics, as well as physical factors and the
prevalence of musculoskeletal discomfort. The Chi-Square test was used to determine the relationship between the
risk factors and musculoskeletal discomfort. The findings of the study show that the following postures (trunk bent
slightly forwards, hands above the knee level (p < 0.05), trunk twisted (over 45o) and bent sideways (p < 0.05) are
the significant risk factors of musculoskeletal discomfort among manual lifting task workers in the automotive
industry. A methodological framework on manual lifting task in the automotive industry is proposed based on the
findings of this study. The framework is developed based on the need to model human lifting capabilities so that task
demands can be designed to fit the workers’ capacity when performing lifting tasks.
Tuberculosis (TB) is known as a disease that prone to spatial clustering. Recent development has seen a sharp rise in the number of epidemiologic studies employing Geographical Information System (GIS), particularly in identifying TB clusters and evidences of etiologic factors. The aim of this systematic review is to determine evidence of TB clustering, type of spatial analysis commonly used and the application of GIS in TB surveillance and control. A literature search of articles published in English language between 2000 and November 2015 was performed using MEDLINE and Science Direct using relevant search terms related to spatial analysis in studies of TB cluster. The search strategy was adapted and developed for each database using appropriate subject headings and keywords. The literature reviewed showed strong evidence of TB clustering occurred in high risk areas in both developed and developing countries. Spatial scan statistics were the most commonly used analysis and proved useful in TB surveillance through detection of outbreak, early warning and identifying area of increased TB transmission. Among others are targeted screening and assessment of TB program using GIS technology. However there were limitations on suitability of utilizing aggregated data such as national cencus that were pre-collected in explaining the present spatial distribution among population at risk. Spatial boundaries determined by zip code may be too large for metropolitan area or too small for country. Nevertheless, GIS is a powerful tool in aiding TB control and prevention in developing countries and should be used for real-time surveillance and decision making.
Occupational cancers, including mesothelioma and lung cancer are linked to the use of asbestos. Annually, at least 100,000 global deaths are attributed to asbestos exposure putting a heavy burden on national budgets. Expenses incurred on treatment of asbestos related diseases (ARDs) reduce households and national resource savings, while ARDs culminate in terminal burdens. The objective of this study is to measure the economic burden of ARDs and to assess the economic impact of asbestos consumption. The health and economic burden of asbestos was estimated in macro-global consumption-production model using production function frontier-based and generalized least squared approach for asbestos products and cost tabulation. Production, in metric tons (Mt) was adopted as a dependent variable among explanatory variables, including consumption. Information on treatment cost of asbestos related diseases (mesothelioma, asbestosis and lung cancer) was obtained from costing information and published literatures. Annual total economic burden of asbestos is at USD 11.92 billion. Out of this cost, USD 4.34 billion per annum is the economic burden of managing three common ARDs. The cost of compensation for patients suffering ARDs is USD 4.28 billion. From the remaining USD 3.3 billion, USD 2.93 billion is the value of asbestos consumed in 2003 and USD372.15 million is the loss of earning due to hospital visits and admissions. For every USD 1 spent on consumption of asbestos, global economy has to absorb almost USD 4 due to health consequences of ARDs. Banning of asbestos production and usage in production of goods has far-reaching impacts on household welfare, health and economic development. The insights revealed are expected to inform decision makers the need to ban all forms of asbestos, especially in developing countries where usage is increasing.
National Antenatal HIV Screening Programme has been integrated as a routine screening in antenatal care in early 1998 and in Terengganu since May 1998 involving all health centers in the state. As of December 2001, a total number of 57,882 antenatal mothers were screened (97.5% of all new antenatal mothers). The HIV prevalence rate among antenatal mothers was found to be 0.052%. All HIV positive mothers were married and majority were Malays (93 .3%). Ninety percents of them revealed that the only risk factorfor HIV was through sexual contact. HIV positive status was confirmed in 66 .7% ofthe husbands. All twenty eight mothers that managed to be followed up delivered to live birth babies. All newborns reported to have good Apgar score (9 at 5 minutes of life). Mean birth weight was 3 .08 kilograms 1- 0.45 and only 8% were premature babies. The observed rate of HIV vertical transmission was 6.25% and this is lower than the expected mother to child transmission rate of 30% without intervention.
Analysis of count event data such as mortality cases, were often modelled using Poisson regression model. Maximum likelihood procedures were used by using SAS software to estimate the model parameters of a Poisson regression model. However, the Negative Binomial distribution has been widely suggested as the alternative to the Poisson when there is proof of overdispersion phenomenon. We modelled the mortality cases as the dependent variable using Poisson and Negative Binomial regression and compare both of the models. The procedures were done in SAS by using the function PROC GENMOD. The results showed that the mortality data in Poisson regression exhibit large ratio values between deviance to degree of freedom which indicate model misspecification or overdispersion. This large ratio was found to be reduced in Negative Binomial regression. The Normal probability plot of Pearson residual confirmed that the Negative Binomial regression is a better model than Poisson regression in modelling the mortality data. The objective of this study is to compare the goodness of fit of Poisson regression model and Negative Binomial regression model in the application of air pollution epidemiologic time series study by using SAS software.
The practice of diabetes self-care plays an important role in achieving and maintaining good glycaemic control. However, not all patients with insulin-treated diabetes engage in their self-care activities. There is some evidence that self-care practices in patients with insulin-treated diabetes can be understood and predicted by their health beliefs, although studies are often hampered by methodological weaknesses, and the fact that less is known about adults with insulin-treated diabetes in Malaysia. This study was conducted to examine whether health beliefs (as specified in the Health Belief Model: HBM) can predict self-care practices and glycaemic control in patients with insulin-treated diabetes in Malaysia. Longitudinal design with self-reported questionnaire measures was administered at baseline (Time 1:T1) and six months later (Time 2: T2). Participants were recruited from three endocrinology clinics in Malaysia. The measures included self-care practices (diet, insulin intake, exercise and self-blood glucose monitoring: SMBG), health beliefs and diabetes knowledge. Participants’ glycaemic control was examined based on their glycated hemoglobin (HbA1c) results. Data analysis was performed at different points of the study times; T1, T1-T2 and T2. Diabetes knowledge and demographic data were controlled for in predictive statistical analyses. A total of 159 patients with insulin-treated diabetes (aged 18-40 years) completed the measures at T1. Of these, only 108 (67.9%) completed follow-up measures at T2. However, demographic characteristics were not significantly different between those who completed and dropped out of the study (p>0.05). The HBM was significantly predictive of diet self-care at T2, insulin intake practice at T1 and HbA1c at T1-T2 andT2. Of the HBM constructs, perceived benefits significantly predicted good dietary habits at T1 (OR 1.92) and T2 (OR .23) and adherence to insulin injection at T1 (OR 3.17) and T1-T2 (OR 2.68). With the exception of perceived severity, all other HBM constructs significantly predicted HbA1c [perceived susceptibility (β .169) at T1, perceived barriers (β -.206) and perceived benefits (β -.397) at T2 and cues to action (β -.233) at T1-T2]. Health beliefs predict self-care practices and glycaemic control in young to middle-aged adults with insulin-treated diabetes in Malaysia. Diabetes educators could use this knowledge in their efforts to improve diabetes self-care in this patient groupby modifying those beliefs through their diabetes education.
Study site: Endocrinology clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Hospital Putrajaya, and Hospital Melaka, Malaysia
The paper puts forth the need for health care workers safety whilst undertaking their job on a daily basis. Presently there are number of factors that are directly linked to the safety of health care workers. However, Occupational Health is very important and useful for health workers that are exposed to their job hazards. Every year, many lives are lost because of the spread of infections in hospitals. Every hospital’s occupational health departments should ensure that all new staff are vaccinated to protect them against microorganisms carried by other patients, and with vaccinated against preventable diseases. This will help to prevent the health workers from occupational exposure to patients’ blood or any other bodily substances, including injury from sharp objects, and also guarantees that the new employees does not infect the patients with infectious diseases. Furthermore, all the new staff should be screened for blood borne pathogenic diseases.
A cross»sectional study was undertaken between April 2005 to _1 uly 2005 to determine the extent of the health problems experienced by individuals involved in the December 2004 tsunami wave disaster in the Northeast District of Penang, Malaysia. The overall health status of the respondents were evaluated using the Short Form 36 (SF-36) questionnaire. Out of 171 respondents, 160(93 .6%) were Malays, 8(4.7%) were Chinese and 3(1.8%) were Indians. The mean age ofrespondents was 45.4 years, 15.9 years. Ninety-four of the respondents were males (55.0%) while 7 7(45.0%) were females. The overall mean physical component score was significantly lower (66.9:23 .O) amongst respondents with low education level compared with those with high education level (76.3:19.1, p=0.004). This mean score was also significantly much lower ( 68.7:22 .3) amongst those who are married compared to those who were not married (79.8:1 7.4, p=0.003) . The overall mental health score was significantly much higher (78.8:14.6) amongst those who were not married compared to those who were married (68.5:19.2, p=0.001). The overall mental health score was also significantly higher amongst those in the younger age»group (62.3:16.1) compared to those in the older age»group (72.4:18.9, p=0.005). Based on the scores obtained on the Physical Health and Mental Health dimensions of the SF-36 questionnaire, it can be concluded that the health of victims with low education, elderly and those who were married were more adversely affected than others. Therefore, it is vital that medical as well as psychological attention should be channeled to these risk groups who responded more adversely to disasters.
The purpose of this study was to determine aluminium (Al) concentrations in groundwater used for drinking and cooking and its related health risk among population of 28th Mile Orang Asli village in Jenderam Hilir, Selangor, Malaysia. A total of 100 respondents were recruited, comprising 51 (51.0 %) male and 49 (49.0 %) female residents. Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine Al concentration, while the LAMOTTE TRACER ORP PockeTester was used to measure pH levels. Statistical Package for Social Science (SPSS) was used to analyze the data. Results showed that Al concentration ranged from 0.041 - 0.136 mg/L with a mean of 0.136 + SD 0.041 mg/L, hence the values obtained were below the standard value (0.2 mg/L). pH levels ranged from 3.82 to 5.84, with a mean of 4.163 + SD 0.411, which is acidic and below the range permitted by the health authorities. The acidic nature may have an impact on the Al concentration in the water. The Hazard Index (HI) was found to be less than 1, thus there was no health risk of Al exposure in drinking water for the respondents involved. The study area was considered safe from having health risk associated with Al exposure.
Students in tertiary level education are mostly young adults that are transiting from the teenage years to adulthood. Since there is less restriction as compared to their teenage years, university and college students might involve in risky behaviours that may affect their health, social and academic performance. Thus, the purpose of this study is to investigate and identify the differences of health risk factors and health promoting behaviour that have been practiced by students in Malaysia. A cross sectional study was conducted using closed-ended questionnaires distributed to university and college students via emails. The results showed that 77.0% students claimed they have no health problem. However 49.0% of the non-medical students did not know whether they have normal BMI. Among the medical students, 62.0% rarely do physical exercise even though most are seriously concern about their fat consumption (95.0%). Only 30.0% of the total students have awareness of wearing seat belt. For health promoting behaviour, 33.0% of female students have never perform breast self examination (BSE), while 65.0% of male students have never perform testicular self examination (TSE). These findings confirmed that there are differences in health risk factors and health promoting behaviour that have been practiced by the students.
Health system reform has been a major concern for different countries. The aim of this research was to develop a reliable and valid questionnaire suitable to assess the consequences of health reform process from people's perspective. An extensive literature review used to extract a set of statements as possible indicators for health system reform. Expert panel used to determine the content validity rate (CVR) and the content validity index (CVI). The first version produced in Turkish language and pre-piloted with 20 heads of household. Qualified committee used to translate the Turkish version to English version. Group of eighteen academics and graduate students recruited to tests both versions for parallel test validity. The construct validity of the questionnaire was determined using principal components analysis with Varimax rotation method (PCA). Internal consistency and questionnaire's reliability were calculated by Cronbach's alpha and the test–retest reliability test. A 17- items questionnaire was developed through the qualitative phase. The Bartlett's test was significant (p < 0.001), and the KMO value (0.842) showed that using principal component analysis (PCA) was suitable. Eigenvalues equal or higher than 1 were considered significant and chosen for interpretation. By PCA, 4 factors were extracted (accessibility, attitude and preference, quality of care and availability of resources) that jointly accounted for 85.2% of observed variance. The Cronbach's alpha coefficient showed excellent internal consistency (alpha=0.97), and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (Intra-class coefficient = 0.96). The findings showed that the designed questionnaire was valid and reliable and can be used easily to assess the consequences of health reform process by comparing the situation before and after the reform from people's perspective.
A cross-sectional study on helminthiasis among rural primary schoolchildren aged 9 to 10 years Bachok, Kelaritan was perfumed. A total of 680 schoolchildren participated in the study. Stool specimens were examined for the presence of the ova of Ascaris lumbricoides, Trichuris trichiura and hoolcwonn. The worm load was then measured using the modified Stoll`s volumetric dilution
technique. The overall prevalence of helminthiasis was 77 .2%. Trichuris trichiura were the commonest type of heminth noted - 66.8%, compared with Ascaris lumlrricoides (49.7%) and hookworm (1.8%). Mixed infections with Ascaris lumlyricoides and Trichuris trichiura was the commonest type of infection 249(41 .5%) . For Ascaris lumbncoides, 34.6% had mild and 5 I .3% had moderate worm load while for Trichurb trichiura, 66.5% had mild and 30.8 % had moderate worm load. Only 14.1% and 2.7% 4 of the schoolchildren had a heavy load of Ascaris lumlwicoides and Trichuris trichiura respectively. All the schookhildren with hookworm were only mildly infected. Targeted mass treatment for rural Mahysian schoolchildren is still essential, especially in areas where poverty and malnutrition are still prevalent.
The objectives of this study were to determine the prevalence of HI V iryfection, risk factors and to measure the knowledge on AIDS among fishermen in Terengganu. In this survey fishermen registered with the Malaysian Fishery Development Board in Terengganu were studied. There were 600 eligible fishermen based on a list provided by the Malaysian Fishery Development Board (MFDB). Study sites were at 6 loading centres where health personnel awaited returning fishermen between 4. 00pm —7. 00 pm during a period of one month, A total of 542 registeredfshermen were studied and this corresponded to a response rate of 90.3 %. The majority of the fishermen were Malays (98.6%}, Nine fishermen were tested positive to HIV antibody and this corresponds to a
g prevalence of I. 7%. Prevalence of HIV is higher among those with a positive history of drug use, single marital status and also among the unskilled workers who represented the socio-economically poorer group of fishermen. Almost 89% of respondents have heard about HIV/AIDS and among these, 93% received information through TV and radio. The mean knowledge score was significantly higher among fishermen admitting to drug taking, sex with prostitutes, and those who have had at least a secondary school education. The Prevalence of HIV infection among fishermen is higher than in the general population. Risk characterisation of HI V injection was statistically signyicant onlv among fishermen who gave positive history of drug used. Findings also suggest that poorer fishermen based on multiple indicators to socioeconomic status had a higher risk of being HIV positive as well as being less knowledgeable about AIDS, Health promotion strategies should focus on the use of TV and radio as an interactive medium to reach out to risk groups among fishermen as its popularity has been determined by this study.