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Fulltext Oral cancer prognosis based on clinicopathologic and genomic markers using a hybrid of feature selection and machine learning methods

Chang SW, Abdul-Kareem S, Merican AF, Zain RB

BMC Bioinformatics, 2013;14:170.
PMID: 23725313 DOI: 10.1186/1471-2105-14-170

Machine learning techniques are becoming useful as an alternative approach to conventional medical diagnosis or prognosis as they are good for handling noisy and incomplete data, and significant results can be attained despite a small sample size. Traditionally, clinicians make prognostic decisions based on clinicopathologic markers. However, it is not easy for the most skilful clinician to come out with an accurate prognosis by using these markers alone. Thus, there is a need to use genomic markers to improve the accuracy of prognosis. The main aim of this research is to apply a hybrid of feature selection and machine learning methods in oral cancer prognosis based on the parameters of the correlation of clinicopathologic and genomic markers.

Matched MeSH terms: Logistic Models
A hybrid prognostic model for oral cancer based on clinicopathologic and genomic markers

Chang SW, Merican AFMA, Rosnah Zain, Kareem SA

Sains Malaysiana, 2014;43:567-573.

There are very few prognostic studies that combine both clinicopathologic and genomic data. Most of the studies use only clinicopathologic factors without taking into consideration the tumour biology and molecular information, while some studies use genomic markers or microarray information only without the clinicopathologic parameters. Thus, these studies may not be able to prognoses a patient effectively. Previous studies have shown that prognosis results are more accurate when using both clinicopathologic and genomic data. The objectives of this research were to apply hybrid artificial intelligent techniques in the prognosis of oral cancer based on the correlation of clinicopathologic and genomic markers and to prove that the prognosis is better with both markers. The proposed hybrid model consisting of two stages, where stage one with ReliefF-GA feature selection method to find an optimal feature of subset and stage two with ANFIS classification to classify either the patients alive or dead after certain years of diagnosis. The proposed prognostic model was experimented on two groups of oral cancer dataset collected locally here in Malaysia, Group 1 with clinicopathologic markers only and Group 2 with both clinicopathologic and genomic markers. The results proved that the proposed model with optimum features selected is more accurate with the use of both clinicopathologic and genomic markers and outperformed the other methods of artificial neural network, support vector machine and logistic regression. This prognostic model is feasible to aid the clinicians in the decision support stage and to identify the high risk markers to better predict the survival rate for each oral cancer patient.

Matched MeSH terms: Logistic Models
Fulltext Food Security and Hygiene Practice among Adolescent Girls in Maiduguri Metropolitan Council, Borno State, Nigeria

Charles Shapu R, Ismail S, Ahmad N, Lim PY, Abubakar Njodi I

Foods, 2020 Sep 10;9(9).
PMID: 32927593 DOI: 10.3390/foods9091265

Inadequate food security contributes to poor health outcome for all, including adolescent girls. The study aims at determining the level of food security and hygiene among adolescent girls. A school-based cross-sectional study was carried out among adolescent girls aged 10 to 19 years old from six schools in Maiduguri Metropolitan Council, Borno State. The instrument for data collection was a questionnaire using KoBoCollect Toolbox between June and July 2019. Multivariable logistic regression was used to identify the predictors of food security and hygiene among respondents. A majority of the respondents (73.5%) were in a very low food security level. Three factors were significantly associated with food security level, these included schools (p = 0.007), age of mother (p = 0.004), and occupation of mother (p < 0.001). School (p = 0.003), age (father p = 0.017; mother; p = 0.012), hygiene (p = 0.005), and occupation of mother (p = 0.002) were predictors of food security. About (46.6%) of respondents had poor hygiene practice, school (p = 0.016) was significantly associated with hygiene practice. School (p = 0.019; and p = 0.005) and food security (p = 0.009) were predictors of hygiene practice. This study reveals a high prevalence of low food security among adolescent girls.

Matched MeSH terms: Logistic Models
Fulltext Knowledge, Attitude, and Practice of Adolescent Girls towards Reducing Malnutrition in Maiduguri Metropolitan Council, Borno State, Nigeria: Cross-Sectional Study

Charles Shapu R, Ismail S, Ahmad N, Ying LP, Abubakar Njodi I

Nutrients, 2020 Jun 04;12(6).
PMID: 32512907 DOI: 10.3390/nu12061681

Addressing the gap in knowledge, attitude, and practice among adolescent girls are important as malnutrition has a negative effect on their future generation. This study aimed to determine the knowledge, attitude, and practice of adolescent girls towards reducing malnutrition in Maiduguri Metropolitan Council, Borno State, Nigeria. This was a school-based cross-sectional study conducted among 612 adolescent girls (10 to 19 years old). KoBo collect toolbox was used for the data collection between 3 June and 31 July 2019. Multivariable logistic regression was used to identify predictors of knowledge, attitude, and practice towards reducing malnutrition. The majority of respondents (451, 80.2%; 322, 57.3%) had poor knowledge and attitude towards reducing malnutrition respectively, 278 (49.5%) had poor practice towards reducing malnutrition. Schooling (GGSS; p = 0.022; Shehu Garbai; p = 0.003) was a significant predictor of knowledge. Religion (p = 0.023), information (p < 0.001) and motivation (p < 0.001) were significant predictors of attitude. School (GGSS; p < 0.001; GGC; p < 0.001; Shehu garbai; p < 0.001; Bulabulin; p = 0.030; Zajeri day; p = 0.049), education of father (p = 0.001), information (p = 0.026) and behavioral skill (p = 0.019) were significant predictors of practice. There is a need to focus on both school-based and community-based health education intervention to address the poor knowledge, attitude, and practice among adolescent girls for a healthier future.

Matched MeSH terms: Logistic Models
Fulltext Factors associated with occupational exposure to blood and body fluids among healthcare worker in a government hospital in Sabah

Che Wan Ilmiyah Ahmad, Raja Muhammad Raja Omar, Khamisah Awang Lukman

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):32-32.
MyJurnal

Introduction: Healthcare workers (HCWs) are exposed to occupational blood and body fluid exposure (OBBE) that potentially cause blood-borne infection such as HIV, Hepatitis B and Hepatitis C, with risk of transmission 0.3%, 6 to 30% and 0-10% respectively. They are exposed to these infections through percutaneous injury, splash exposure of blood and body fluids to mucous membrane and non-intact skin. Aim of this study was to determine prevalence and risk factors associated with occupational exposure of blood and body fluid in a tertiary government hospital in Sabah. Methods: A cross sectional study was conducted involving 10 places, was chosen by stratified random sampling and involved various job categories (specialist, medical officer, house officer, nurse, hospital assistant and Sedafiat worker). Self-administered questionnaire used as study tool. The data was analysed by using SPSS version 22.0. Association of risk factors and OBBE incidence were determined by Chi-square test and simple logistic regression. Results: A total of 334 respondents involved in this study. Prevalence of OBBE was 25.2% with 95% CI of 20.6% to 30.2% and highest (41.3%) among HCWs working in medical ward. Nurses were less likely to have occupational exposure to blood and body fluids (Crude OR=0.33, 95% CI: 0.20, 0.57). Needle recapping (Crude OR=3.77, 95% CI: 1.99, 7.10) and never attend training in infection prevention (Crude OR=3.19, 95% CI: 1.69, 6.05) were associ-ated with higher odds of OBBE. There was 76.3% of respondents adhere to universal precaution. HCWs who did not work in shift (Crude OR=3.04, 95% CI: 1.49, 6.21) and non-nurses (Crude OR=2.04, 95% CI: 1.06, 3.92) profession had better adherence to universal precaution. Conclusion: Prevalence of OBBE was 25.2%. Modifiable risk factors for OBBE were identified including needle recapping and training on infection prevention. Shift work is associated with adherence to universal precaution. Adequate training, increasing knowledge and awareness may help to reduce OBBE burden.

Matched MeSH terms: Logistic Models
Risk factors associated with neonatal hypothermia during cleaning of newborn infants in labour rooms

Cheah FC, Boo NY

J Trop Pediatr, 2000 Feb;46(1):46-50.
PMID: 10730042

Cleaning newborn infants with coconut oil shortly after birth is a common practice in Malaysian labour rooms. This study aimed: (1) to determine whether this practice was associated with a significant decrease in the core temperature of infants; and (2) to identify significant risk factors associated with neonatal hypothermia. The core temperature of 227 randomly selected normal-term infants immediately before and after cleaning in labour rooms was measured with an infrared tympanic thermometer inserted into their left ears. Their mean post-cleaning body temperature (36.6 degrees C, SD = 1.0) was significantly lower than their mean pre-cleaning temperature (37.1 degrees C, SD = 1.0; p < 0.001). Logistic regression analysis showed that the risk factors significantly associated with pre-cleaning hypothermia (< 36.5 degrees C) were: (1) not being placed under radiant warmer before cleaning p = 0.03); and (2) lower labour room temperature (p < 0.001). Logistic regression analysis also showed that the risk factors significantly associated with post-cleaning hypothermia were: (1) lower labour room temperature (p < 0.001); (2) lower pre-cleaning body temperature (p < 0.001); and (3) longer duration of cleaning (p = 0.002). In conclusion, to prevent neonatal hypothermia, labour room temperature should be set at a higher level and cleaning infants in the labour room should be discouraged.

Matched MeSH terms: Logistic Models
Fulltext The socio-demographic determinants of smoking and alcohol consumption: a cross sectional study in Penang, Malaysia

Cheah Y.K.

Medicine & Health, 2014;9(1):62-73.
MyJurnal

The primary objective of the present study was to investigate the impact of sociodemographic factors on smoking and alcohol consumption among adults in Penang (Malaysia). A cross-sectional primary survey data with 398 respondents was used for analysis. The present study applied logistic regression models to examine the factors affecting the odds of smoking and alcohol consumption. The results showed that gender, ethnicity and education could significantly affect smoking. In particular, males (OR: 26.678) had a higher likelihood of smoking compared to the females, whereas Chinese (OR: 0.177), Indians/others (OR: 0.331) and individuals with tertiary education (OR: 0.258) had a lower likelihood of smoking than others. In terms of alcohol, gender, ethnicity and marital status were found to have a significant influence on the likelihood of alcohol consumption. Specifically, males (OR: 5.051), Chinese (OR: 37.796) and Indians/others (OR: 10.863) were more likely to consume alcohol than others, while married individuals (OR: 0.380) were less likely to consume alcohol than unmarried individuals. Based on the findings of the present study, numerous population-based intervention measures were suggested.

Matched MeSH terms: Logistic Models
Fulltext Exploring factors influencing smoking behaviour in Malaysia

Cheah YK, Naidu BM

Asian Pac J Cancer Prev, 2012;13(4):1125-30.
PMID: 22799293

OBJECTIVE: The objective of present study is to investigate the determinants of smoking behaviour among adults in Malaysia.
METHOD: Findings of the Third National Health and Morbidity Survey (NHMS-3) by the Ministry of Health, Malaysia, were used. The sample consisted of 34,539 observations. A logistic regression model was thus applied to estimate the probability to participate in smoking.
RESULTS: Age, income, gender, marital status, ethnicity, employment status, residential area, education, lifestyle and health status were statistically significant in affecting the likelihood of smoking. Specifically, youngsters, low income earners, males, unmarried individuals, Malays, employed individuals, rural residents and primary educated individuals were more likely to smoke.
CONCLUSION: In conclusion, socio-demographic, lifestyle and health factors have significant impacts on smoking participation in Malaysia. Based on these empirical findings, several policy implications are suggested.
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Logistic Models
Fulltext Sociodemographic, lifestyle and health factors associated with depression among adults in Malaysia: an ethnic comparison

Cheah, Y.K., Azahadi, M., Phang, S.N., Abd Manaf, N.H.

JUMMEC, 2019;22(1):33-40.
MyJurnal

Background: Depression is a serious mental health illness worldwide. The purpose of the study was to
investigate the relationships between depression and its risk factors of sociodemography, lifestyle, and health
among the adults of the different ethnic groups in Malaysia.

Method: A nationwide database with 10141 observations was used. Multivariable logistic regression analyses
stratified by ethnicity were estimated.

Results: Ethnicity and gender, age, education, marital status and self-rated health were correlated to the
likelihood of having depression. Malay females and smokers (AOR: 2.083) were more likely to suffer from
depression than Malay males (AOR: 0.305) and non-smokers. Higher-income Chinese displayed higher odds of
having depression than lower-income Chinese (AOR: 1.009). Indians and others with secondary-level education
displayed a lower likelihood of developing depression compared to those with primary-level education (AOR:
0.587).

Conclusion: This study could contribute significantly to the formulation and development of an effective
policy directed towards reducing the prevalence of depression in the vulnerable. These were the adults, in
the younger age group, with lower education, with self-rated poor health, being female, unmarried, Malay
and Chinese, and Indians and others. A nationwide policy targeted towards the Malay females to reduce
their depression, with attention to the Chinese with a high income, and to the Indians and others with poor
educational background to improve their knowledge of mental health, would be worthy of consideration.

Matched MeSH terms: Logistic Models
Fulltext Association between Availability of Neighborhood Fast Food Outlets and Overweight Among 5⁻18 Year-Old Children in Peninsular Malaysia: A Cross-Sectional Study

Chee Cheong K, Yoon Ling C, Kuang Hock L, Mohd Ghazali S, Chien Huey T, Che Ibrahim MK, et al.

Int J Environ Res Public Health, 2019 02 18;16(4).
PMID: 30781699 DOI: 10.3390/ijerph16040593

A growing number of fast-food outlets in close proximity to residential areas raises a question as to its impact on childhood overweight and obesity. This study aimed at determining the relationship between the availability of fast-food outlets that were in close proximity to residential areas and overweight among Malaysian children aged 5 to 18 years. Measurement data on the weight and height of 5544 children (2797 boys, 2747 girls) were obtained from the National Health and Morbidity Survey 2011. Overweight (including obesity) is defined as BMI-for-age z-score > +1 SD based on the WHO growth reference. Geographic information system geospatial analysis was performed to determine the number of fast-food outlets within 1000 m radius from the children's residential address. Multiple logistic regression was conducted to examine the association between the availability of fast-food outlets (none or more than one outlet) and overweight with adjustment for age, sex, ethnicity, monthly household income, parental educational level, residential area and supermarket density. Our results showed that the prevalence of overweight was 25.0% and there was a statistically significant association between the density of fast-food outlets and overweight (odds ratio: 1.23, 95% confidence interval: 1.03, 1.47). Our study suggested that the availability of fast-food outlets with close proximity in residential areas was significantly associated with being overweight among children. Limiting the number of fast-food outlets in residential areas could have a significant effect in reducing the prevalence of overweight among Malaysian children.

Matched MeSH terms: Logistic Models
Fulltext Nutritional Assessment of Pre-School Children in Rural Villages of the Family Dynamics, Lifestyles and Nutrition Study (1997-2001) II. Prevalence of Undernutrition and Relationship to Household Socio-Economic Indicators

Chee H, Khor G, Arshad F, Wan Muda W, Mohdtaib M, Safii N, et al.

Malays J Nutr, 2002 Mar;8(1):33-53.
PMID: 22692438

This paper describes the nutritional status of pre-school children and analyzes its relationship to various household socio-economic indicators. Padi, rubber and fishing villages from the Functional Groups Study (1992-1996) were selected for having a high prevalence of child undernutrition, and all children between the ages of 12 and 72 months were measured for their weights and heights in April-May 1998. The NCHS reference values were used to calculate z-scores, which were categorised according to WHO (1983) recommendations. Children between minus 2SD and minus 1SD of reference median were classified as mildly malnourished. Prevalence of underweight was higher (30.5%) than stunting (22.3%), while wasting was only 9.7%. Padi villages had the highest prevalence of undernutrition, followed by fishing, and then rubber villages. Mean household incomes were found to be significantly lower for children with worse nutritional status, and undernutrition was higher in households below the poverty line income. The odds ratios for having stunted children were significantly higher for households whose heads were agricultural own-account workers (OR 3.66, 95% CI = 1.37-9.79), agricultural waged workers (OR 2.75, 95% CI = 1.06-7.10), and non-agricultural manual workers (OR 2.49, 95% CI = 1.04-6.00) compared to non-manual workers. Various household socio-economic indicators showed significantly higher odds ratios for underweight, stunting and wasting. After adjusting for confounding effects by logistic regression analysis, however, only mother's education was found to be a significant predictor for stunting, while poverty level and access to piped water supply were significant predictors for both underweight and stunting. Households without livestock were significant predictors for wasting. Thus, this study identified specific socio-economic factors that should be prioritized for policy and research towards the amelioration of childhood malnutrition in rural areas.

Matched MeSH terms: Logistic Models
Fulltext Body mass index and factors related to overweight among women workers in electronic factories in Peninsular Malaysia

Chee HL, Kandiah M, Khalid M, Shamsuddin K, Jamaluddin J, Nordin NA, et al.

Asia Pac J Clin Nutr, 2004;13(3):248-54.
PMID: 15331336

Factors related to overweight were examined in a cross-sectional survey that included 1612 women workers from 10 large electronics assembly factories in Peninsular Malaysia. Respondents were Malaysian citizens, direct production workers below the supervisory level, and had worked at least a year in the factory where they were presently employed. Heights and weights were taken to calculate the body mass index (BMI). Weights and BMI increased with increasing age. After adjusting for age, odds ratios for overweight were significantly raised for married women in relation to not married women (OR 1.5, 95% CI=1.15-2.02), lower secondary education in relation to higher than upper secondary education (OR 1.8, 95% CI=1.06-3.14), monthly income RM800-999 (OR 1.7, 95% CI=1.21-2.45) and >/=RM1,000 (OR 1.8, 95% CI=1.23-2.72) in relation to

Matched MeSH terms: Logistic Models
Relation between sick leave and selected exposure variables among women semiconductor workers in Malaysia

Chee HL, Rampal KG

Occup Environ Med, 2003 Apr;60(4):262-70.
PMID: 12660374

To determine the relation between sick leave and selected exposure variables among women semiconductor workers.

Matched MeSH terms: Logistic Models
Fulltext Toxoplasma gondii - Prevalence and Risk Factors in HIV-infected Patients from Songklanagarind Hospital, Southern Thailand

Chemoh W, Sawangjaroen N, Siripaitoon P, Andiappan H, Hortiwakul T, Sermwittayawong N, et al.

Front Microbiol, 2015;6:1304.
PMID: 26635769 DOI: 10.3389/fmicb.2015.01304

Toxoplasmosis is one of the most common opportunistic parasitic diseases in patients living with HIV/AIDS. This study aimed to determine the seroprevalence of Toxoplasma infection in HIV-infected patients and to identify associated risk factors in Toxoplasma seropositive patients. This study was conducted at a regional public hospital in Hat Yai, southern Thailand during October 2009 to June 2010. Blood samples were collected from 300 HIV-infected patients. Each subject also answered a socio-demographic and risk factors associated with Toxoplasma infection. The prevalence of anti-Toxoplasma IgG antibodies in HIV-infected patients was 109 (36.3%), of which 83 (76.2%) had past infection and 26 (23.9%) had recently acquired Toxoplasma infection as indicated by their IgG avidity. Multivariate analysis using logistic regression showed that gender difference (adjusted OR = 1.69, 95% CI = 1.05-2.72) was the only factor associated with Toxoplasma infection. From the results obtained, these HIV-infected patients could be at high risk of developing clinical evidence of severe toxoplasmosis. Therefore, it is necessary to introduce primary behavioral practices to prevent Toxoplasma infection among HIV-infected patients.

Matched MeSH terms: Logistic Models
Fulltext Association between prehospital time and outcome of trauma patients in 4 Asian countries: A cross-national, multicenter cohort study

Chen CH, Shin SD, Sun JT, Jamaluddin SF, Tanaka H, Song KJ, et al.

PLoS Med, 2020 10;17(10):e1003360.
PMID: 33022018 DOI: 10.1371/journal.pmed.1003360

BACKGROUND: Whether rapid transportation can benefit patients with trauma remains controversial. We determined the association between prehospital time and outcome to explore the concept of the "golden hour" for injured patients.
METHODS AND FINDINGS: We conducted a retrospective cohort study of trauma patients transported from the scene to hospitals by emergency medical service (EMS) from January 1, 2016, to November 30, 2018, using data from the Pan-Asia Trauma Outcomes Study (PATOS) database. Prehospital time intervals were categorized into response time (RT), scene to hospital time (SH), and total prehospital time (TPT). The outcomes were 30-day mortality and functional status at hospital discharge. Multivariable logistic regression was used to investigate the association of prehospital time and outcomes to adjust for factors including age, sex, mechanism and type of injury, Injury Severity Score (ISS), Revised Trauma Score (RTS), and prehospital interventions. Overall, 24,365 patients from 4 countries (645 patients from Japan, 16,476 patients from Korea, 5,358 patients from Malaysia, and 1,886 patients from Taiwan) were included in the analysis. Among included patients, the median age was 45 years (lower quartile [Q1]-upper quartile [Q3]: 25-62), and 15,498 (63.6%) patients were male. Median (Q1-Q3) RT, SH, and TPT were 20 (Q1-Q3: 12-39), 21 (Q1-Q3: 16-29), and 47 (Q1-Q3: 32-60) minutes, respectively. In all, 280 patients (1.1%) died within 30 days after injury. Prehospital time intervals were not associated with 30-day mortality. The adjusted odds ratios (aORs) per 10 minutes of RT, SH, and TPT were 0.99 (95% CI 0.92-1.06, p = 0.740), 1.08 (95% CI 1.00-1.17, p = 0.065), and 1.03 (95% CI 0.98-1.09, p = 0.236), respectively. However, long prehospital time was detrimental to functional survival. The aORs of RT, SH, and TPT per 10-minute delay were 1.06 (95% CI 1.04-1.08, p < 0.001), 1.05 (95% CI 1.01-1.08, p = 0.007), and 1.06 (95% CI 1.04-1.08, p < 0.001), respectively. The key limitation of our study is the missing data inherent to the retrospective design. Another major limitation is the aggregate nature of the data from different countries and unaccounted confounders such as in-hospital management.
CONCLUSIONS: Longer prehospital time was not associated with an increased risk of 30-day mortality, but it may be associated with increased risk of poor functional outcomes in injured patients. This finding supports the concept of the "golden hour" for trauma patients during prehospital care in the countries studied.

Matched MeSH terms: Logistic Models
Factors relating to adolescent suicidal behavior: a cross-sectional Malaysian school survey

Chen PC, Lee LK, Wong KC, Kaur J

J Adolesc Health, 2005 Oct;37(4):337.
PMID: 16182146

This study was undertaken to examine factors relating to adolescent suicide behavior.

Matched MeSH terms: Logistic Models
GIS-based groundwater potential analysis using novel ensemble weights-of-evidence with logistic regression and functional tree models

Chen W, Li H, Hou E, Wang S, Wang G, Panahi M, et al.

Sci Total Environ, 2018 Sep 01;634:853-867.
PMID: 29653429 DOI: 10.1016/j.scitotenv.2018.04.055

The aim of the current study was to produce groundwater spring potential maps using novel ensemble weights-of-evidence (WoE) with logistic regression (LR) and functional tree (FT) models. First, a total of 66 springs were identified by field surveys, out of which 70% of the spring locations were used for training the models and 30% of the spring locations were employed for the validation process. Second, a total of 14 affecting factors including aspect, altitude, slope, plan curvature, profile curvature, stream power index (SPI), topographic wetness index (TWI), sediment transport index (STI), lithology, normalized difference vegetation index (NDVI), land use, soil, distance to roads, and distance to streams was used to analyze the spatial relationship between these affecting factors and spring occurrences. Multicollinearity analysis and feature selection of the correlation attribute evaluation (CAE) method were employed to optimize the affecting factors. Subsequently, the novel ensembles of the WoE, LR, and FT models were constructed using the training dataset. Finally, the receiver operating characteristic (ROC) curves, standard error, confidence interval (CI) at 95%, and significance level P were employed to validate and compare the performance of three models. Overall, all three models performed well for groundwater spring potential evaluation. The prediction capability of the FT model, with the highest AUC values, the smallest standard errors, the narrowest CIs, and the smallest P values for the training and validation datasets, is better compared to those of other models. The groundwater spring potential maps can be adopted for the management of water resources and land use by planners and engineers.

Matched MeSH terms: Logistic Models
Fulltext Poor glycemic control in younger women attending Malaysian public primary care clinics: findings from adults diabetes control and management registry

Cheong AT, Lee PY, Sazlina SG, Mohamad Adam B, Chew BH, Mastura I, et al.

BMC Fam Pract, 2013;14:188.
PMID: 24325794 DOI: 10.1186/1471-2296-14-188

BACKGROUND: Women of reproductive age are a group of particular concern as diabetes may affect their pregnancy outcome as well as long-term morbidity and mortality. This study aimed to compare the clinical profiles and glycemic control of reproductive and non-reproductive age women with type 2 diabetes (T2D) in primary care settings, and to determine the associated factors of poor glycemic control in the reproductive age group women.
METHODS: This was a cross-sectional study using cases reported by public primary care clinics to the Adult Diabetes Control and Management registry from 1st January to 31st December 2009. All Malaysian women aged 18 years old and above and diagnosed with T2D for at least 1 year were included in the analysis. The target for glycemic control (HbA1c < 6.5%) is in accordance to the recommended national guidelines. Both univariate and multivariate approaches of logistic regression were applied to determine whether reproductive age women have an association with poor glycemic control.
RESULTS: Data from a total of 30,427 women were analyzed and 21.8% (6,622) were of reproductive age. There were 12.5% of reproductive age women and 18.0% of non-reproductive age women that achieved glycemic control. Reproductive age group women were associated with poorer glycemic control (OR = 1.5, 95% CI = 1.2-1.8). The risk factors associated with poor glycemic control in the reproductive age women were being of Malay and Indian race, longer duration of diabetes, patients on anti-diabetic agents, and those who had not achieved the target total cholesterol and triglycerides.
CONCLUSION: Women with T2D have poor glycemic control, but being of reproductive age was associated with even poorer control. Health care providers need to pay more attention to this group of patients especially for those with risk factors. More aggressive therapeutic strategies to improve their cardiometabolic control and pregnancy outcome are warranted.

Matched MeSH terms: Logistic Models
Prevalence of rubella susceptibility among pregnant mothers in a community-based antenatal clinic in Malaysia: a cross-sectional study

Cheong AT, Khoo EM

Asia Pac J Public Health, 2008;20(4):340-6.
PMID: 19124328 DOI: 10.1177/1010539508322698

INTRODUCTION: routine rubella antibody screening is not done for antenatal mothers in community health clinics in Malaysia. However, congenital rubella syndrome has persisted with its associated health burden.
OBJECTIVES: to determine the prevalence of rubella susceptibility among pregnant mothers and its associated risk factors.
METHODOLOGY: a cross-sectional study was carried out in the Petaling district, Selangor, Malaysia, where 500 pregnant mothers were recruited, and face-to-face interviews were conducted. Rubella IgG tests were performed.
RESULTS: the prevalence of rubella susceptibility among pregnant mothers was 11.4%. Using logistic regression, a history of not having received rubella vaccination or having unknown rubella vaccination status was found to be a significant predictor for mothers to be rubella susceptible (odds ratio = 2.691; 95% confidence interval = 1.539-4.207).
CONCLUSIONS: routine rubella IgG screening tests need to be offered to all antenatal mothers in view of the high prevalence found.
Study site: Antenatal clinics (klinik kesihatan), Petaling, Selangor, Malaysia

Matched MeSH terms: Logistic Models
Optimal BMI cut-off values for predicting diabetes, hypertension and hypercholesterolaemia in a multi-ethnic population

Cheong KC, Yusoff AF, Ghazali SM, Lim KH, Selvarajah S, Haniff J, et al.

Public Health Nutr, 2013 Mar;16(3):453-9.
PMID: 22647482 DOI: 10.1017/S1368980012002911

OBJECTIVE: To determine the optimal cut-offs of BMI for Malaysian adults.
DESIGN: Population-based, cross-sectional study. Receiver operating characteristic curves were used to determine the cut-off values of BMI with optimum sensitivity and specificity for the detection of three cardiovascular risk factors: diabetes mellitus, hypertension and hypercholesterolaemia. Gender-specific logistic regression analyses were used to examine the association between BMI and these cardiovascular risk factors.
SETTING: All fourteen states in Malaysia.
SUBJECTS: Malaysian adults aged ≥18 years (n 32 703) who participated in the Third National Health and Morbidity Survey in 2006.
RESULTS: The optimal BMI cut-off value for predicting the presence of diabetes mellitus, hypertension, hypercholesterolaemia or at least one of these cardiovascular risk factors varied from 23.3 to 24.1 kg/m2 for men and from 24.0 to 25.4 kg/m2 for women. In men and women, the odds ratio for having diabetes mellitus, hypertension, hypercholesterolaemia or at least one cardiovascular risk factor increased significantly as BMI cut-off point increased.
CONCLUSIONS: Our findings indicate that BMI cut-offs of 23.0 kg/m2 in men and 24.0 kg/m2 in women are appropriate for classification of overweight. We suggest that these cut-offs can be used by health professionals to identify individuals for cardiovascular risk screening and weight management programmes.

Matched MeSH terms: Logistic Models

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