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Discrepancies and Similarities in Attitudes, Beliefs, and Familiarity with Vaccination Between Religious Studies and Science Students in Malaysia: A Comparison Study

Elkalmi RM, Jamshed SQ, Suhaimi AM

J Relig Health, 2021 Aug;60(4):2411-2427.
PMID: 33661436 DOI: 10.1007/s10943-021-01212-x

Little is known about the impact of religion on vaccine receptivity in Malaysia. Improved vaccine uptake is positively reflected in the reduction of vaccine-preventable diseases. This study aimed to explore and compare the attitudes, religious beliefs, and familiarity regarding vaccination between the religious studies and science students. A survey-based cross-sectional study was conducted between a convenient sample of students (N = 300) of religious studies and applied sciences in Kuantan, Malaysia. A new, face- and content-validated questionnaire was used for data collection. A total of 206 students responded to the questionnaire, giving a response rate of 86.6%. Overall, participants demonstrated positive attitudes towards vaccination (n = 185, 89.9%). Only a minority of respondents expressed an opposition to vaccination (n = 21, 10.2%). Religious factors (permissibility) of vaccines (n = 12, 57.1%) and harm associated with the vaccine (n = 13, 61.9%) were the most common reasons for not supporting vaccination among the non-supporters. Most (n = 135, 65.5%) respondents agreed that vaccination is parallel with the Islamic concept of protecting life and preventing harm. Almost half of the respondents (n = 98, 47.6%) admit to declaring "Fatwa" to oblige parents to vaccinate their children. Religious beliefs and safety issues surrounding immunisation were reported as the major barriers for the support of immunisation. Well-designed programs are recommended to reshape the religious beliefs and convictions among students toward vaccination.
Fulltext Knowledge, perceptions, and attitudes toward complementary and alternative medicines among pharmacy students of a Malaysian public university

Jamshed SQ, Khan MU, Ahmad A, Elkalmi RM

J Pharm Bioallied Sci, 2016 3 10;8(1):34-8.
PMID: 26957866 DOI: 10.4103/0975-7406.171686

BACKGROUND: The use of complementary and alternative medicine (CAM) is consistently on the rise worldwide. Consumers often consider pharmacists as a major source of information about CAM products and their safety. Due to the limitation of data, it is worth exploring the knowledge, perceptions, and attitudes of pharmacy students toward CAM.
OBJECTIVE: The objective of this study was to explore the knowledge, perceptions, and attitudes of pharmacy students regarding the use of CAM in Malaysia.
MATERIALS AND METHODS: A cross-sectional study was conducted for 3 months among Bachelor of Pharmacy students in a public sector University of Malaysia. A pretested, self-administered questionnaire, comprised four sections, was used to collect the data from 440 participants. Descriptive analysis was used, and Chi-square test was used to test the association between dependent and independent variables.
RESULTS: Of 440 questionnaire distributed, 287 were returned giving a response rate of (65.2%). The results showed that 38.6% participants gave correct answers when asked about the use of herbal products with digoxin. Majority of the participants were knowledgeable about supplementary therapy (25.3%) while the lack of knowledge was mostly evident in traditional Chinese medicines (73.7%). Majority of the students were either neutral (49.5%) or disagreed that (42.8%) CAM use is unsafe. Females were more in disagreement to the statements than males (P = 0.007). Majority of students also agreed to use CAM therapies for their health and well-being (51.2%).
CONCLUSION: The study revealed that pharmacy students did not have adequate knowledge of CAM though their attitudes and perceptions were relatively positive.
The use of sunscreen products among final year medicine and pharmacy students: A cross-sectional study of knowledge, attitude, practice, and perception

Awadh AI, Jamshed S, Elkalmi RM, Hadi H

J Res Pharm Pract, 2016 Jul-Sep;5(3):193-9.
PMID: 27512711 DOI: 10.4103/2279-042X.185731

OBJECTIVE: To evaluate the knowledge, attitude, perception, and practice of medical and pharmacy students toward the usage of sunscreen as protection for the skin against ultraviolet (UV) radiation.
METHODS: This cross-sectional study was conducted among final year medical and pharmacy undergraduates at the International Islamic University Malaysia. Validated questionnaires were distributed to 134 medical students and 100 pharmacy students. Descriptive and inferential statistics were used where appropriate.
FINDINGS: One hundred and sixty-one out of 234 participants completed the questionnaires. The participants comprised 101 medical students (75.4%) and sixty pharmacy students (60.0%). The majority of the respondents were females (102; 63.4%), and 59 (36.6%) were males. The median of the knowledge scores of the final year medical students was significantly lower than that of the final year pharmacy students (P < 0.001). The female students showed significantly higher knowledge scores than the male students (P = 0.027). This study reported that 24 (39.3%) pharmacy students were influenced by the media to use sunscreen, whereas 35 (34.7%) medical students were influenced the most by friends to use sunscreen. The final year pharmacy students had a better perception compared to the medical students, with the total perception score of the final year pharmacy students being significantly higher than that of the final year medical students (P = 0.020). Most of the participants were also aware of the harmful effects of UV radiation and had a positive reaction toward the usage of sunscreen to prevent those harmful effects.
CONCLUSION: The knowledge and perception of final year pharmacy students were significantly higher than the knowledge and perception of final year medical students with regard to the usage of sunscreen.
KEYWORDS: Attitude; knowledge; perception; practice; sunscreen
Fulltext Retrospective Assessment of the Reporting of Adverse Drug Reactions in a Malaysian Clinical Training Center: A Short Communication

Elkalmi RM, Elnaem MH, Sapar NM, Blebil A

J Pharm Bioallied Sci, 2021 11 24;13(3):325-330.
PMID: 35017889 DOI: 10.4103/jpbs.JPBS_577_20

Objectives: This study aimed to assess the completeness and quality of adverse drug reaction (ADR) reports that were submitted to the Pharmacovigilance Unit (PVU) in clinical training center (CTC), Faculty of Medicine, UiTM Sungai Buloh Campus.
Materials and Methods: A retrospective study was conducted using all ADR reports that were submitted to the PVU in CTC from December 31, 2000, to December 31, 2018. The completeness was assessed by reviewing all the required elements to be filled in the ADR reports. The quality was assessed by investigating the required information in the ADR reporting form. Descriptive statistics have been used to present the findings.
Key Findings: In a total of 31 reports that were submitted to the PVU in CTC, 98.9% of patient's information and 100% of ADR descriptions were completed. Suspected drug information and the reporter's details were completed by 52.2% and 79.6%, respectively. Of 58.0% of the information about seriousness recorded, 38.9% (n = 7) is mild, 44.4% (n = 8) is moderate, and 16.7% (n = 3) is severe. Among all the suspected medicines, drug class of antibiotics (32.4%, n = 12) is the most reported suspected drugs that caused ADR, followed by opioid analgesic (8.1%, n = 3) and nonsteroidal anti-inflammatory drugs (8.1%, n = 3).
Conclusion: Further efforts and relevant interventions should be considered to increase the reporting frequency and to enhance the completeness and the quality of the ADR reports in the study setting.
Fulltext New pharmacovigilance course at the International Islamic University Malaysia-IIUM

Al-lela OQ, Elkalmi RM, Jamshed SQ

Am J Pharm Educ, 2013 Jun 12;77(5):106.
PMID: 23788817 DOI: 10.5688/ajpe775106
Fulltext Immunization knowledge and practice among Malaysian parents: a questionnaire development and pilot-testing

Awadh AI, Hassali MA, Al-lela OQ, Bux SH, Elkalmi RM, Hadi H

BMC Public Health, 2014;14:1107.
PMID: 25346471 DOI: 10.1186/1471-2458-14-1107

Parents are the main decision makers for their children vaccinations. This fact makes parents' immunization knowledge and practices as predictor factors for immunization uptake and timeliness. The aim of this pilot study was to develop a reliable and valid instrument in Malaysian language to measure immunization knowledge and practice (KP) of Malaysian parents.
Fulltext Does an educational intervention improve parents' knowledge about immunization? Experience from Malaysia

Awadh AI, Hassali MA, Al-Lela OQ, Bux SH, Elkalmi RM, Hadi H

BMC Pediatr, 2014;14:254.
PMID: 25284603 DOI: 10.1186/1471-2431-14-254

Parents' knowledge about immunization is an important predictor factor for their children's immunization status. The aims of this study were to assess parents' knowledge and to evaluate the effect of a short educational intervention on improving parents' knowledge of childhood immunization.
Community pharmacists' attitudes, perceptions, and barriers toward adverse drug reaction reporting in Malaysia: a quantitative insight

Elkalmi RM, Hassali MA, Ibrahim MI, Jamshed SQ, Al-Lela OQ

J Patient Saf, 2014 Jun;10(2):81-7.
PMID: 24618640 DOI: 10.1097/PTS.0000000000000051

This study was designed to explore awareness and attitudes of community pharmacists toward the national ADR reporting system activities in the northern states of Malaysia.
Effect of Religious Beliefs on the Smoking Behaviour of University Students: Quantitative Findings From Malaysia

Elkalmi RM, Alkoudmani RM, Elsayed TM, Ahmad A, Khan MU

J Relig Health, 2016 Dec;55(6):1869-75.
PMID: 26429730 DOI: 10.1007/s10943-015-0136-0

The Malaysian official Islamic authorities have issued a "fatwa" (Islamic ruling) regarding smoking practice which prohibits Muslims from smoking because of its potential harm to health. Since the prevalence of smoking among Malaysian students is high, this study was designed to explore the perceptions and opinions of Malaysian Muslim students towards smoking in International Islamic University of Malaysia. A prospective, cross-sectional study was conducted among School of Science students in International Islamic University Malaysia. Convenience sampling approach was used to recruit 323 students based on sample size calculation. A content- and face-validated questionnaire was used to collect the data from the participants. Non-smokers highly supported the fatwa on smoking forbiddance than smokers (94 vs 64.3 %, p = 0.001). A significant proportion of non-smokers believed that Islam prohibits smoking because of its potential harm (94.9 vs 71.4 %, p = 0.001). Majority of smokers agreed that addiction is the main barrier towards smoking cessation (78.6 vs 61.5 %, p = 0.019). The results showed positive influences of Islamic beliefs on the non-smokers. Further studies are required to validate these findings by surveying other universities of Malaysia.
Fulltext Perceptions and Practices of Community Pharmacists towards Antimicrobial Stewardship in the State of Selangor, Malaysia

Khan MU, Hassali MA, Ahmad A, Elkalmi RM, Zaidi ST, Dhingra S

PLoS One, 2016;11(2):e0149623.
PMID: 26901404 DOI: 10.1371/journal.pone.0149623

BACKGROUND: Increasing antimicrobial resistance is one of the pressing concerns globally. Injudicious use of antibiotics is one of the modifiable factors responsible for antimicrobial resistance. Given the widespread use of antimicrobials in community settings, pharmacists have an important role in ensuring appropriate use of antibiotics. The objective of this study was to assess the perception and self-reported practices of community pharmacists towards antimicrobial stewardship.
METHODS: A cross-sectional study was conducted among community pharmacists between March-April, 2015, using a self-administered, pre-tested questionnaire in the State of Selangor, Malaysia. A simple random sampling approach was used to select pharmacy sites. Descriptive and inferential statistical methods were used to analyse the data.
RESULTS: A total of 188 pharmacists responded to the survey, giving a response rate of 83.5%. The majority of participants (n = 182, 96.8%) believed that antimicrobial stewardship program helps healthcare professionals to improve the quality of patient care. However, more than half of pharmacists were neutral in their opinion about the incorporation of antimicrobial stewardship programs in community pharmacies (n = 102, 54.2%). Though collaboration was often done by pharmacists with other health professionals over the use of antibiotics (n = 104, 55.3%), a significant proportion of participants (n = 102, 54.2%) rarely/occasionally participate in antimicrobial awareness campaigns. Pharmacists having postgraduate qualification were more likely to held positive perceptions of, and were engaged in, antimicrobial stewardship than their non-postgraduate counterpart (p<0.05). Similarly, more experienced pharmacists (> 10 years) held positive perceptions towards antimicrobial stewardship (p<0.05).
CONCLUSION: The study highlighted some gaps in the perception and practices of community pharmacist towards antimicrobial stewardship. Development of customized interventions would be critical to bridging these gaps and improve their perception and practices towards antimicrobial stewardship.
Fulltext Prevalence of depression among health sciences students: Findings from a public university in Malaysia

Fata Nahas ARM, Elkalmi RM, Al-Shami AM, Elsayed TM

J Pharm Bioallied Sci, 2019 6 1;11(2):170-175.
PMID: 31148894 DOI: 10.4103/jpbs.JPBS_263_18

Background: High rates of psychological problems including depression among university students have been reported in various studies around the world. The objectives of this study were to explore the prevalence of depressive disorder, as well as the associated sociodemographic factors (gender, origin, school, and year of study) among health sciences students.
Materials and Methods: This cross-sectional study was conducted among 425 students from 5 different schools of health sciences at International Islamic University Malaysia, using the Patient Health Questionaire-9 (PHQ-9).
Results: With a response rate of 85.9% (n = 365), the results showed a depressive disorder prevalence of 36.4%. The mean PHQ-9 score of the respondents was 8.10 (SD = 4.9), indicating mild depression severity. A statistically significant association was revealed between gender and severity of depression (P = 0.03), as well as between students' origin and severity of depression (P = 0.02).
Conclusion: The findings indicated high prevalence of depression among undergraduate health sciences students. While providing significant information to students' affairs department, the study findings suggest the necessity to address depressive disorder in health sciences university students in Malaysia. Future research is needed to confirm these results in larger samples.
Study site: International Islamic University Malaysia (IIUM), Kuantan health campus, Pahang, Malaysia
Fulltext Familiarity, perception, and reasons for electronic-cigarette experimentation among the general public in Malaysia: Preliminary insight

Elkalmi RM, Bhagavathul AS, Ya'u A, Al-Dubai SA, Elsayed TM, Ahmad A, et al.

J Pharm Bioallied Sci, 2016 Jul-Sep;8(3):240-7.
PMID: 27413354 DOI: 10.4103/0975-7406.180768

OBJECTIVES: The objectives of this study were to assess the general public views and familiarity toward electronic cigarette (e-cigarette) in Kuantan, Malaysia.
METHODOLOGY: A total of 277 Kuantan people were involved in this study. The questionnaire was distributed at random in shops, businesses, and public places in Kuantan. Statistical analysis was performed using SPSS (version 17.0).
RESULTS: From 400 participants, a total number of 277 (160, 57.7% men and 117, 42.4% women) respondents completed the questionnaire. The mean age was 26.89 ± 9.8 years old. The majority of the study participants were male (57.7%), Malay (83.8%), Muslims (83.8%), singles (69%), and employed (75.8%), with about 83 (29.9%) of the respondents were smokers. The prevalence of e-cigarettes smokers was found to be only 1.4% (n = 4). About one-third of the respondents (n = 72, 26%) have tried e-cigarette before. Job status was significantly associated with smoking e-cigarette among the population (P = 0.02). Main factors for a person to start e-cigarette smoking were curiosity (37.5%) and cheaper price (40.8%). Majority of respondents agreed that e-cigarette would not affect health as normal cigarette, and that variety of flavors contribute to better enjoyment (51.6% and 66.7%, respectively).
CONCLUSION: The results of the current study demonstrate that the prevalence of e-cigarettes smoking and its popularity, familiarity, and knowledge are still insufficient among Kuantan population. Further studies should be done to tackle this problem before it getting worse.
KEYWORDS: Electronic-cigarette; Malaysia; experimentation; perception; prevalence
Comment in: Farsalinos KE, Le Houezec J. Electronic cigarette experimentation in the Malaysian city of Kuantan: Was there an association with the smoking status? J Pharm Bioallied Sci. 2016 Oct-Dec;8(4):347-348
Fulltext Statin Therapy Prescribing for Patients with Type 2 Diabetes Mellitus: A Review of Current Evidence and Challenges

Elnaem MH, Mohamed MHN, Huri HZ, Azarisman SM, Elkalmi RM

J Pharm Bioallied Sci, 2017 Apr-Jun;9(2):80-87.
PMID: 28717329 DOI: 10.4103/jpbs.JPBS_30_17

Use of statin therapy in patients with type 2 diabetes mellitus (T2DM) has been recommended by most clinical guidelines. Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among T2DM patients. It has been proved that statins are effective for primary or secondary CVD prophylaxis. Reports have highlighted the underutilization of statins in clinical practice and the suboptimal adherence to guideline recommendations. This review article points to summarize the current evidence confirming the role of statins in T2DM patients and to provide an overview of factors that may affect statins' prescribing patterns and compliance in clinical practice. Initiatives to enhance statin therapy prescribing should recognize the comprehensive nature of the prescribing process. Attempts to assure proper statin prescribing and utilization can help in achieving better clinical outcomes of statin therapy.
Fulltext Attitude, Familiarity and Religious Beliefs about Vaccination among Health Science and Non-Health Science Students in a Malaysian Public University

Elkalmi RM, Dyab E, Mohd Suhaimi A, Blebil AQ, Elnaem MH, Jamshed S, et al.

Eur J Investig Health Psychol Educ, 2021 Nov 18;11(4):1462-1473.
PMID: 34842641 DOI: 10.3390/ejihpe11040104

Vaccine hesitancy has surfaced globally within the last few decades, and the fears and misconceptions of people about vaccine safety and effectiveness have been identified as key factors for their under-utilization. The familiarity, attitudes, and religious beliefs of the public and of future healthcare practitioners regarding vaccination are extensive areas needing exploration. The present exploratory cross-sectional study was designed, planned and carried out on students enrolled in health science and non-health science courses in one of the public universities of Malaysia. A research instrument that had been formulated, validated and subjected to reliability testing was used to collect the data, which were analyzed using descriptive and inferential statistics. A response rate of 80.8% (n = 202) was obtained: the majority were female (n = 161, 79.7%), and had been vaccinated before (n = 190, 97.5%), while a mere 2% did not support vaccination for reasons pertaining to safety issues. The vaccine familiarity score was 10.79 ± 1.4, which significantly differed among the study disciplines (p < 0.001). The mean of the total attitude score was 14.95 ± 1.5, with no significant difference among demographics being noted. The mean of the total religious beliefs score was 24.29 ± 2.8 and significantly differed based on gender (p = 0.040) and study disciplines (p < 0.001). The current findings showed that the participants were familiar with vaccines and had generally positive attitudes and positive religious beliefs toward vaccination; thus, one can expect that their inclusion in immunization campaigns will generate positive outcomes of the immunization program. Although the current research reported few knowledge gaps, these may be handled with the introduction of a specialized immunization course at an undergraduate level.
Fulltext Incorporating an immunization course in the pharmacy curriculum: Malaysian experience

Al-lela OQ, Bahari MB, Elkalmi RM, Jawad Awadh AI

Am J Pharm Educ, 2012 Dec 12;76(10):206.
PMID: 23275671 DOI: 10.5688/ajpe7610206
Fulltext Pharmacy students' knowledge and perceptions about pharmacovigilance in Malaysian public universities

Elkalmi RM, Hassali MA, Ibrahim MI, Widodo RT, Efan QM, Hadi MA

Am J Pharm Educ, 2011 Jun 10;75(5):96.
PMID: 21829270 DOI: 10.5688/ajpe75596

To assess senior pharmacy students' knowledge of and perceptions about pharmacovigilance and reporting of adverse drug reactions (ADRs) at 5 public universities in Malaysia.
Fulltext Knowledge, awareness, and perception of contraception among senior pharmacy students in Malaysia: A pilot study

Elkalmi RM, Khan MU, Ahmad A, Srikanth AB, Abdurhaman NS, Jamshed SQ, et al.

J Res Pharm Pract, 2015 Apr-Jun;4(2):94-8.
PMID: 25984548 DOI: 10.4103/2279-042X.155760

OBJECTIVE:This study aimed to assess the knowledge, awareness, and perception of contraception among senior pharmacy students of a public sector university in Malaysia.
METHODS: A cross-sectional, questionnaire-based study was conducted among senior pharmacy students. The pretested questionnaire was used to collect data from the participants over the period of 1-month. The questionnaire was divided into four sections, for gathering the information about students' demographic data, and their knowledge, attitudes, and perception toward contraception. Data were statistically analyzed using SPSS version 20.
FINDINGS: The response rate was 68.6%. The results showed that the contraceptive knowledge was comparatively higher in year four students (P < 0.001), married respondents (P < 0.001) and those taking elective courses (P = 0.022) as compared to their respective counterparts. Majority of the students were well aware and had a positive perception about contraception.
CONCLUSION: Overall findings reflect that the majority of the students had good knowledge, perception, and awareness about contraception. The study recommends future studies to be conducted covering different pharmacy schools across the country to further establish the results.
KEYWORDS: Awareness; contraceptive; knowledge; perception; students
Fulltext Osteoporosis Knowledge among Future Healthcare Practitioners: Findings from a Malaysian Public University

Elnaem MH, Jamshed SQ, Elkalmi RM, Baharuddin MF, Johari MA, Aziz NABA, et al.

J Pharm Bioallied Sci, 2017;9(2):115-120.
PMID: 28717334 DOI: 10.4103/jpbs.JPBS_336_16

BACKGROUND AND OBJECTIVES: Students in relevant health-care academic programs are the future professionals who should play an active role in increasing community awareness regarding chronic diseases such as osteoporosis. This research aimed to evaluate the knowledge of osteoporosis, one of the growing health-care burdens in Malaysia, among students belong to three different health occupations programs in a Malaysian University.
METHODS: A cross-sectional study design was conducted to assess the level of knowledge on osteoporosis and to explore the potential association between the study program and osteoporosis-related knowledge among medicine, pharmacy, and allied health sciences students in a Malaysian University. A total of 348 students were approached. The data were collected using validated revised Osteoporosis Knowledge Test questionnaire.
RESULTS: The results showed variability in knowledge score between students belonging to different study programs. allied health sciences students have the highest overall total score (median = 20) and nutrition score (median = 16), but for exercise score, both students in allied health sciences and medicine programs shared a similar median score (median = 11.5). More than half of the respondents showed adequate knowledge on osteoporosis. The students from allied health sciences exhibited more knowledge on osteoporosis compared to students in other study programs. Among the Kulliyyah of Pharmacy respondents, the majority did not manage to answer correctly on the whole scale. This was evident by total percentage of 69.91% of the respondents scored below than median score.
CONCLUSION: There is a considerable gap of knowledge regarding osteoporosis among students in various health occupations academic programs. Pharmacy students particularly need focused learning related to exercise and nutrition in preventing osteoporosis during their academic program.

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