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Epidemiology of malocclusion and orthodontic treatment need of 12-13-year-old Malaysian schoolchildren

Esa R, Razak IA, Allister JH

Community Dent Health, 2001 Mar;18(1):31-6.
PMID: 11421403

Data on malocclusion and orthodontic treatment need in Malaysia are limited. The purpose of this study was to evaluate malocclusion and orthodontic treatment need in a sample of 12-13-year-old schoolchildren using the Dental Aesthetic Index (DAI), and to assess the relationship between malocclusion and socio-demographic variables, perceptions of need for orthodontic treatment, aesthetic perception and social functioning.

Matched MeSH terms: Rural Health/statistics & numerical data
Fulltext Malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement

Suzana S, Boon PC, Chan PP, Normah CD

Malays J Nutr, 2013 Apr;19(1):65-75.
PMID: 24800385 MyJurnal

INTRODUCTION: Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor.
METHODS: A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p < 0.05 for both parameters). Multiple linear regression showed that 19.8% of malnutrition risk was predicted by poor appetite, decreased functional status (IADL) and depression.
CONCLUSION: Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.
Study site; FELDA Sungai Tengi, Selangor, Malaysia
Device, Questionnaire & Scale: Mini Nutritional Assessment Short Form; Simplified Nutritional Appetite Questionnaire, Instrumental Activities of Daily Living (IADL); Elderly Mobility Scale (EMS); handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale (GDS-15); De Jong Gierveld Loneliness Scale

Matched MeSH terms: Rural Health/statistics & numerical data
Fulltext Cohort Profile: The Malaysian Cohort (TMC) project: a prospective study of non-communicable diseases in a multi-ethnic population

Jamal R, Syed Zakaria SZ, Kamaruddin MA, Abd Jalal N, Ismail N, Mohd Kamil N, et al.

Int J Epidemiol, 2015 Apr;44(2):423-31.
PMID: 24729425 DOI: 10.1093/ije/dyu089

The Malaysian Cohort study was initiated in 2005 by the Malaysian government. The top-down approach to this population-based cohort study ensured the allocation of sufficient funding for the project which aimed to recruit 100,000 individuals aged 35-70 years. Participants were recruited from rural and urban areas as well as from various socioeconomic groups. The main objectives of the study were to identify risk factors, to study gene-environment interaction and to discover biomarkers for the early detection of cancers and other diseases. At recruitment, a questionnaire-based interview was conducted, biophysical measurements were performed and biospecimens were collected, processed and stored. Baseline investigations included fasting blood sugar, fasting lipid profile, renal profile and full blood count. From April 2006 to the end of September 2012 we recruited a total of 106,527 participants. The baseline prevalence data showed 16.6% participants with diabetes, 46.5% with hypertension, 44.9% with hypercholesterolaemia and 17.7% with obesity. The follow-up phase commenced in June 2013. This is the most comprehensive and biggest cohort study in Malaysia, and has become a valuable resource for epidemiological and biological research. For information on collaboration and also data access, investigators can contact the project leader at (rahmanj@ppukm.ukm.edu.my).
Study name: The Malaysian Cohort (TMC) project

Matched MeSH terms: Rural Health/statistics & numerical data
Fulltext Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: A review

Rahman MM, Mahadeva S, Ghoshal UC

World J Gastroenterol, 2017 Oct 07;23(37):6788-6801.
PMID: 29085223 DOI: 10.3748/wjg.v23.i37.6788

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.

Matched MeSH terms: Rural Health/ethnology*
Female autonomy and reported abortion-seeking in Ghana, West Africa

Rominski SD, Gupta M, Aborigo R, Adongo P, Engman C, Hodgson A, et al.

Int J Gynaecol Obstet, 2014 Sep;126(3):217-22.
PMID: 24920181 DOI: 10.1016/j.ijgo.2014.03.031

OBJECTIVE: To investigate factors associated with self-reported pregnancy termination in Ghana and thereby appreciate the correlates of abortion-seeking in order to understand safe abortion care provision.
METHODS: In a retrospective study, data from the Ghana 2008 Demographic and Health Survey were used to investigate factors associated with self-reported pregnancy termination. Variables on an individual and household level were examined by both bivariate analyses and multivariate logistic regression. A five-point autonomy scale was created to explore the role of female autonomy in reported abortion-seeking behavior.
RESULTS: Among 4916 women included in the survey, 791 (16.1%) reported having an abortion. Factors associated with abortion-seeking included being older, having attended school, and living in an urban versus a rural area. When entered into a logistic regression model with demographic control variables, every step up the autonomy scale (i.e. increasing autonomy) was associated with a 14.0% increased likelihood of reporting the termination of a pregnancy (P < 0.05).
CONCLUSION: Although health system barriers might play a role in preventing women from seeking safe abortion services, autonomy on an individual level is also important and needs to be addressed if women are to be empowered to seek safe abortion services.
KEYWORDS: Abortion; Autonomy; Empowerment; Low-resource countries; Maternal health; Reproductive health

Matched MeSH terms: Rural Health Services
Fulltext Effect of periodontal therapy on circulating levels of endotoxin in women with periodontitis: a pilot clinical trial

Jacob SP, Nath S, Zade RM

Indian J Dent Res, 2012 Nov-Dec;23(6):714-8.
PMID: 23649051 DOI: 10.4103/0970-9290.111244

Periodontitis is a potential risk factor for adverse pregnancy outcomes due to the presence of a subgingival load of pathogenic bacteria. Instrumentation of periodontal pockets during treatment may result in bacteremia and/or endotoxemia.

Matched MeSH terms: Rural Health
Prevalence and sociodemographic factors of malnutrition among children in Malaysia

Khambalia AZ, Lim SS, Gill T, Bulgiba AM

Food Nutr Bull, 2012 Mar;33(1):31-42.
PMID: 22624296

For many developing countries undergoing rapid economic growth and urbanization, trends in nutritional status indicate a decrease in malnutrition with an associated rise in the prevalence of obesity. An understanding of the situation among children in Malaysia is lacking.

Matched MeSH terms: Rural Health
Fulltext Knowledge, attitude and practice (KAP) concerning cervical cancer and screening among rural and urban women in six provinces of the Democratic People's Republic of Korea

Tran NT, Choe SI, Taylor R, Ko WS, Pyo HS, So HC

Asian Pac J Cancer Prev, 2011;12(11):3029-33.
PMID: 22393985

BACKGROUND: This study assessed women from the Democratic People's Republic of Korea for: (i) their level of knowledge of cervical cancer and attitudes and practices concerning cervical screening (KAP); and (ii) differences in KAP between rural and urban groups.

METHODS: In a descriptive cross-sectional study, a purposive sample of 200 women in 6 provinces of DPRK (rural: n=99, urban: n=101) were interviewed using a standardized questionnaire. Differences between proportions were assessed using the χ2 test. Significance was defined as p<0.05.

RESULTS: 63% of rural and 60% of urban participants had heard of cervical cancer (p>0.05). 42% knew that it is the most common cancer of the female reproductive tract, 55% knew that all women are at risk, but only 36% were aware of cervical cancer's preventability. Some 13% of rural and 29% of urban respondents had heard of cervical cytology testing (p<0.001). Only 6% of participants had ever received a cervical cytology smear. Among the reasons for not screening, 48% mentioned a lack of awareness of cervical cytology; 47% their dislike of pelvic examinations; 17% of rural and 31% of urban interviewees reported the absence of symptoms (p<0.05); and 62% of rural and 0% of urban women mentioned travelling long distances to service delivery points (p<0.001).

CONCLUSIONS: There is a reasonable level of knowledge of cervical cancer among North Korean women; however, there are major gaps regarding awareness of its preventability and actual uptake of cytology screening services. There are no significant differences between rural and urban women with regard to their KAP. Large scale health promotion campaigns are needed to educate women and the community about cervical cancer and its preventability through screening. The national health care system needs to ensure that screening services are effective, accessible, feasible and acceptable to women.

Matched MeSH terms: Rural Health
Knowledge, attitude and practice (KAP) concerning cervical cancer and screening among rural and urban female healthcare practitioners in the Democratic People's Republic of Korea

Tran NT, Taylor R, Choe SI, Pyo HS, Kim OS, So HC

Asian Pac J Cancer Prev, 2011;12(11):3023-8.
PMID: 22393984

BACKGROUND AND OBJECTIVE: Little is known about cervical cancer (CC) in the Democratic People's Republic of Korea (DPRK). This study examines the knowledge, attitudes and practices (KAP) concerning CC and screening among female health care practitioners (HCPs), and whether differences exist between rural and urban HCPs.

METHOD: In a descriptive cross-sectional study, a purposive sample of 200 women HCPs from 128 health care centers in 6 provinces of DPRK was interviewed using a standardized questionnaire.

RESULTS: 98% of HCPs were aware of CC. Awareness of the national CC policy was significantly lower in rural (44%) than urban (62%) respondents (p<0.05). Fewer rural (71%) than urban (89%) HCPs knew of cervical cytology (p<0.05). Around 30% of HCPs were aware of the association between CC and human papillomavirus infection. Only 13% of HCPs had ever had a cervical cytology smear. Only 4% of rural and 21% of urban practitioners (p<0.05) provided cytology; all used unaided visual inspection of the cervix without staining to determine whether cytology testing was indicated. For all, screening intervals depended on presence of symptoms.

CONCLUSION: Misconceptions and ineffective clinical practices regarding screening need to be urgently addressed among both rural and urban HCPs. There are no major differences between rural and urban HCPs regarding their KAP.

Matched MeSH terms: Rural Health
Fulltext A multidimensional assessment of nutritional and health status of rural elderly Malays

Shahar S, Ibrahim Z, Fatah AR, Rahman SA, Yusoff NA, Arshad F, et al.

Asia Pac J Clin Nutr, 2007;16(2):346-53.
PMID: 17468093

A multidimensional assessment of nutritional and health status comprised of subjective global assessment (SGA), anthropometry function, biochemistry, dietary intake, social and health aspects was carried out on 820 older people (52.8% men and 47.2% women) from four rural areas of Peninsular Malaysia. A proportion of the subjects had been classified as either overweight (25.7%) or chronic energy deficient (20.3%). Although 49% of subjects had normal body weight, 68.4% have been classified as having mild to moderate malnutrition according to the SGA. Only 1.1% and 2.3% had low serum albumin and ferritin, respectively. Almost 80% of subjects, especially men, were at high risk of cardiovascular diseases on the basis of the assessment of total cholesterol and LDL-cholesterol. The majority of the subjects (87.2%) were fully independent in performing daily tasks, with men having a significantly higher score compared to women (p<0.001). However, men were less likely to be able to perform a flexibility test (50.7%) than were women (27.0%) (p<0.05). The mean energy intake for men (1412 +/- 461 kcal/d) and women (1201 +/- 392 kcal/d) were below the Recommended Nutrient Intake (RNI) for Malaysia, although this is a difficult assertion to make in an age-group which generally experiences declining energy expenditure. Moreover, 52.5% of men and 47.5% of women might have underreported their food intake. Dietary micronutrients most likely to be deficient were thiamin, riboflavin and calcium. It is concluded that a substantial proportion of rural elderly Malays had problems related to both undernutrition and overnutrition. An appropriate nutrition intervention program is needed to improve the nutritional status of rural elderly Malays.

Matched MeSH terms: Rural Health
Fulltext Predominance of Blastocystis sp. Infection among School Children in Peninsular Malaysia

Nithyamathi K, Chandramathi S, Kumar S

PLoS One, 2016;11(2):e0136709.
PMID: 26914483 DOI: 10.1371/journal.pone.0136709

BACKGROUND: One of the largest cross-sectional study in recent years was carried out to investigate the prevalence of intestinal parasitic infections among urban and rural school children from five states namely Selangor, Perak, Pahang, Kedah and Johor in Peninsula Malaysia. This information would be vital for school authorities to influence strategies for providing better health especially in terms of reducing intestinal parasitism.
METHODS AND PRINCIPAL FINDINGS: A total of 3776 stool cups was distributed to 26 schools throughout the country. 1760 (46.61%) responded. The overall prevalence of intestinal parasitic infection in both rural and urban areas was 13.3%, with Blastocystis sp (10.6%) being the most predominant, followed by Trichuris trichiura (3.4%), Ascaris lumbricoides (1.5%) and hook worm infection (0.9%). Only rural school children had helminthic infection. In general Perak had the highest infection (37.2%, total, n = 317), followed by Selangor (10.4%, total, n = 729), Pahang (8.6%, total, n = 221), Kedah (6.2%, total, n = 195) and Johor (3.4%, total, n = 298). School children from rural schools had higher infection (13.7%, total, n = 922) than urban school children (7.2%, total, n = 838). Subtype (ST) 3 (54.3%) is the most predominant ST with persons infected with only ST1 and ST3 showing symptoms. Blastocystis sp infection significantly associated with low household income, low parent's education and presence of symptoms (p<0.05).
CONCLUSION: It is critical that we institute deworming and treatment to eradicate the parasite especially in rural school children.

Matched MeSH terms: Rural Health
The prevalence of malnutrition and geo-helminth infections among primary schoolchildren in rural Kelantan

Zulkifli A, Anuar AK, Atiya AS, Yano A

Southeast Asian J. Trop. Med. Public Health, 2000 Jun;31(2):339-45.
PMID: 11127336

A cross-sectional study of the nutritional status of schoolchildren aged 7-10 years from the Kuala Betis Resettlement Scheme in Gua Musang, Kelantan was done. A total of 291 schoolchildren were examined but only 183 (62.9%) fecal samples were returned for geo-helminth infection analysis. The prevalence of stunting was 40.4% and underweight was 28.4%. A total of 127 schoolchildren (69.4%) were positive for at least one of the 3 geo-helminth infections. The most common geo-helminth was Ascaris lumbricoides (62.8%), followed by Trichuris trichiura (38.9%), and hookworm infection was relatively low (12.6%). All the anthropometric indices measured were lower in the geo-helminth infected children compared to the uninfected childen, except for the weight-for-height z-score. However the differences were insignificant Geo-helminth infections may not be a significant factor in malnutrition of these schoolchildren. However, with the availability of safe, efficacious and cheap broad spectrum anthelmintics, regular mass treatment should be given in selected areas where the prevalence of geo-helminth infections is still high, so that these schoolchildren will be able to achieve their growth potential during their school years.

Matched MeSH terms: Rural Health
Fulltext Differences in Anopheles composition and malaria transmission in the village settlements and cultivated farming zone in Sarawak, Malaysia

Chang MS, Matusop A, Sen FK

Southeast Asian J. Trop. Med. Public Health, 1999 Sep;30(3):454-9.
PMID: 10774651

Anopheles mosquitos were surveyed using three trapping technics in four longhouse settlements and their respectively farming zone in western Sarawak, Malaysia. The study area was mountainous with tropical rain forest. An. leucosphyrus and An. donaldi were predominant in the farm huts. An. tessellatus and An. subpictus were more abundant in the village settlements. In both ecotypes, human baited traps yielded a significantly greater proportion of Anopheles mosquito than CDC light traps and landing biting catches. Circumsporozoite antigen positively rate, mosquito survival rate and parasite rate showed that malaria transmission is more intense in farm huts than in longhouse settlements. The entomological inoculation rate of An. donaldi and An. leucosphyrus in farm huts was 0.035 and 0.023, respectively. No sporozoite infections were observed in the main settlements.

Matched MeSH terms: Rural Health
Fulltext Helminthic infections of urban and rural schoolchildren in Penang Island, Malaysia: implications for control

Rahman WA

Southeast Asian J. Trop. Med. Public Health, 1998 Sep;29(3):596-8.
PMID: 10437964

The intestinal parasites of schoolchildren from an urban and a rural area on Penang island, Malaysia were compared. Examination of stool samples for helminth eggs showed that helminths found were Trichuris, Ascaris and hookworms. The results indicate that there is no significant difference (p<0.05) between rural and urban schoolchildren as regards to the prevalence of the three species of helminths. An extensive control program targetted at schoolchildren to monitor the helminth problem on the island is suggested.

Matched MeSH terms: Rural Health
Lead exposure among Malaysian school children using delta-aminolevulinic acid as an indicator

Ming LO, Surif S, Abdullah A

Sci Total Environ, 1997 Jan 30;193(3):207-13.
PMID: 9092077

A study on lead exposure among school children aged between 7 and 12 years from Kajang and Sepang in the state of Selangor, Malaysia was carried out using delta-aminolevulinic acid (delta-ALA) levels in the urine as an index. The delta-ALA levels in urine were linked to variables which could contribute to lead exposure. Out of 1628 school children studied [Kajang (43.5%) and Sepang (56.5%)], only 194 subjects (16 and 8.8% from Kajang and Sepang, respectively) had urinary delta-ALA levels between 0.6 and 2.0 mg/100 ml. However, chi 2 analysis demonstrated significant association between delta-ALA of this group to some of the variables. The strongest association was found in the habit of biting fingernails (P < 0.025). Other statistically significant correlations were found between delta-ALA and father's occupation (P < 0.05) and the amount of time spent playing in the field (P < 0.01). Generally, this study indicates that school children in Kajang and Sepang are still relatively safe from excessively high lead exposure. However, a more sensitive indicator, which is based on a lower tolerable lead limits, such as lead in blood, are necessary to affirm this finding.

Matched MeSH terms: Rural Health
Fulltext Smokeless tobacco use among rural Kadazan women in Sabah, Malaysia

Gan CY

Southeast Asian J. Trop. Med. Public Health, 1995 Jun;26(2):291-6.
PMID: 8629063

A survey was conducted to document and bring attention to the use of smokeless tobacco among rural Kadazan women in Sabah, East Malaysia. Of the 472 women interviewed, 59.5% had used tobacco among the ingredients that they habitually chewed. Women with low education were more likely to be chewers. The chewing habit was usually acquired during the teenage years and the practice was perceived mainly as a cultural norm. 73.3% of these smokeless tobacco users were unaware of any adverse health effect of this type of tobacco use as compared to 53.9% of the non-tobacco users. The high prevalence of smokeless tobacco use is easily maintained as tobacco is cheap, locally produced and its use is socially accepted. The low level educational status of the women compounds the problem and intervention programs to curb this form of tobacco use is warranted.

Matched MeSH terms: Rural Health
A simple pharmacopoeia for out-station skin clinics

Pettit JHS

Trop Doct, 1977 Jul;7(3):107-10.
PMID: 142324
Matched MeSH terms: Rural Health
Fulltext Human Plasmodium knowlesi infections in South-East Asian countries

Zaw MT, Lin Z

J Microbiol Immunol Infect, 2019 Oct;52(5):679-684.
PMID: 31320238 DOI: 10.1016/j.jmii.2019.05.012

Plasmodium knowlesi is now regarded as the fifth malaria parasite causing human malaria as it is widely distributed in South-East Asian countries especially east Malaysia where two Malaysian states namely Sabah and Sarawak are situated. In 2004, Polymerase Chain Reaction (PCR) was applied for diagnosing knowlesi malaria in the Kapit Division of Sarawak, Malaysia, so that human P. knowlesi infections could be detected correctly while blood film microscopy diagnosed incorrectly as Plasmodium malariae. This parasite is transmitted from simian hosts to humans via Anopheles vectors. Indonesia is the another country in South East Asia where knowlesi malaria is moderately prevalent. In the last decade, Sarawak and Sabah, the two states of east Malaysia became the target of P. knowlesi research due to prevalence of cases with occasional fatal infections. The host species of P. knowlesi are three macaque species namely Macaca fascicularis, Macaca nemestrina and Macaca leonina while the vector species are the Leucosphyrus Complex and the Dirus Complex of the Leucophyrus Group of Anopheles mosquitoes. Rapid diagnostic tests (RDT) are non-existent for knowlesi malaria although timely treatment is necessary for preventing complications, fatality and drug resistance. Development of RDT is essential in dealing with P. knowlesi infections in poor rural healthcare services. Genetic studies of the parasite on possibility of human-to-human transmission of P. knowlesi were recommended for further studies.

Matched MeSH terms: Rural Health
Traditional diets and meal patterns in South Africa

Labadarios D, Walker AR, Blaauw R, Walker BF

World Rev Nutr Diet, 1996;79:70-108.
PMID: 9111811
Matched MeSH terms: Rural Health
Fulltext Applicability of the stages of change and Weight Efficacy Lifestyle Questionnaire with natives of Sarawak, Malaysia

Chang CT

Rural Remote Health, 2007 Oct-Dec;7(4):864.
PMID: 18076311

INTRODUCTION: There is an increase in the prevalence of overweight and obesity in Malaysia. Besides prevalence studies, not much is known about either overweight or obese individuals. The objective of this study was to determine the stages of change in losing weight and the self-efficacy in eating control of three indigenous groups of overweight and obese adults in Sarawak, Malaysia.
METHODS: A cross-sectional study was conducted in one rural region in Sarawak using a purposive sample. A structured questionnaire, which included two scales: (1) Weight: Stages of change (SOC) to assess readiness to change; and (2) Weight Efficacy Lifestyle Questionnaire (WEL) (both adopted from the transtheoretical model of change); and a set of pre-tested questionnaires on socio-demographic data, the presence of health problems and self-assessment of weight appropriateness, was used to interview respondents.
RESULTS: The stage distribution for weight loss of these adults respondents (n = 271) showed that 60.5% (n = 164) were in the pre-contemplation stage, 20.7% (n = 56) were in the contemplation stage, 8.5% (n = 23) were in the preparation stage, and 8.9% (n = 24) were in the action stage, while only 1.5% (n = 4) were in the maintenance stage. Except for education, the stage differences were generally stable across age, sex, race, household income, presence or absence of health problem, self-perceived weight and presence of overweight or obesity. Respondents were least able to control their eating under social pressure and food availability, according to their WEL score.
CONCLUSION: A large proportion of the overweight or obese adults was not intending to lose weight. The factor structure of the two WEL original subscales enabled partial differentiation between respondents who were able or unable to resist eating in situations where there were availability of food and experienced physical discomfort. The study results indicate the importance of assessing individuals' SOC score in order to implement stage-matched intervention strategies. More studies should be performed in order to validate the WEL questionnaire for use with a Malaysian sample.

Matched MeSH terms: Rural Health

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