Injury Hncluding home injury} is an important contributor to the nations’ statistics on mortality and morbidity. However, statistics on injury is still lacking in Malaysia. In 1996, the National Health and Morbidity Survey was conducted nationwide that includes injury as one ofthe scope studied at the community level. It was found that the prevalence of sefreported home injury in Malaysia was 2.5%. The prevalence was higher among the 0-4 years and more than 80 years groups. There was no dwzrence in the prevalence of injury by urban/rural location, ethnicity, citizenship, religion, marital status, level of education, income group or type of occupation. Females however reported a slightht higher figure than males (2. 7% i· 95% CI and 2.3% i 95% CD. Recommendations made include planning and designing of preventive intervention strategies and sreas for future studies.
Study name: National Health and Morbidity Survey (NHMS-1996)
Introduction: Self-harm is an important global health concern as it is a strong predictor and risk factor for completed suicide. This paper is aimed to estimate the incidence rate of self-harm and to describe the profiles of people who self-harmed in 2011. Methods: This is a descriptive study based on secondary data retrieved from the Ministry of Health (MOH) of Malaysia hospitals’ discharge records from the 1st of January to 31st of December 2011. Results: The overall self-harm rate was 16.6 per 100 000 population (n= 4 815). Adults in the state of Johor had the highest rate of self-harm. There were more female self-harmers within the peak age group of 20-29 years. Indians, Muslims and those who were unmarried had the highest rates of self-harm. Male mostly used unspecified chemical (45.89%) while female used non-opioid analgesics (24.79%). Conclusions: In 2011, the rate of self-harm was 16.6 per 100 000 population with slightly higher rate observed among adult females compared to males and twice as high among girls than boys. Less lethal methods of self-harm were employed.
This survey set out to describe patient registries available in the country, to determine their security features, data confidentiality, extent of outputs produced and data quality of the registries.
Introduction: This study is part the Investigator Initiated Research (IIR) project under the mental health suicide and para suicide cluster. Self-harm is an important predictor of suicide and leaves a significant long-lasting psychological effect. Despite the increasing prevalence of rate of self-harm, very little research had been done in Asian countries. The objective of this study is to determine the prevalence of self-harm in selected hospitals, demographic profiles and factors associated with development of self-harm. Methods: This is a multi-centred cross sectional study. Six months of data collection was performed between the 1st November 2013 and 30th April 2014. All cases that were identified to have carried out Self-Harm were interviewed using The World Health Organization (WHO) SUPRE-MISS Ques- tionnaire Annexe 1 which had been adapted to the Malaysian culture by the research committee members. Results: A total of 99 samples were obtained for this study. They mostly came from low socioeconomic background. Majority of the patients were females, and this was consistent with studies worldwide. Poisoning by pesticides was the most frequent method of choice and about 30% of the patients had previous attempts. Conclusion: Sociodemographic factors play a significant role in self-harm. It is important to know the sociodemographic profile to identify which group of people are at risk and intervention can be focused.
BACKGROUND: Self-care plays an important role in diabetes management. One of the instruments used to evaluate self-care in patients with diabetes is the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. A validated instrument in the Malay language is used to assess self-care practice among children and adolescents with diabetes in Malaysia.
OBJECTIVE: To translate and evaluate the psychometric properties of the revised version of the SDSCA questionnaire in the Malay language.
METHODS:Forward and backward translations were performed. An expert panel reviewed all versions for conceptual and content equivalence. The final version was administered to paediatric patients with diabetes between August 2006 and September 2007. Reliability was analysed using Cronbach's alpha and validity was assessed using exploratory factor analysis.
RESULTS: A total of 117 patients aged 10-18 years were enrolled from nine hospitals. The reliability of overall core items was 0.735 (with item 4) while the reliabilities of the four domains were in the range of 0.539-0.838. As core item number 4 was found to be problematic and it was subtituted by item 5a (from the expanded SDSCA) to suit local dietary education and practice; and the reliabilities of the overall core item (0.782) and the four domains (0.620 - 0.838) improved. Factor loadings of all the items were greater than 0.4, loaded into the original domains, and accounted for 73% of the total variance.
CONCLUSION: The Malay translation of the revised English SDSCA is reliable and valid as a guide for Malaysian children and adolescents suffering from diabetes.
KEYWORDS: Adolescents Diabetes self-care; Children; Malay-translated version of SDSCA
Study site: Pediatric Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Objective: To validate the Malay version of Berlin Questionnaire (BQ) as a tool to screen for patients at risk of obstructive sleep apnea (OSA) in primary care Background: Most patients with OSA are unrecognised and untreated. Thus, the BQ has been used as a tool to screen for patients at risk for OSA. However, this tool has not been validated in Malay version. Materials and Methods: A parallel back-to-back translation method was applied to produce the Malay version (Berlin-M). The Malay version was administered to 150 patients in a tertiary respiratory medical centre. Concurrent validity of the Berlin-M was determined using the Apnea Hypopnea Index (AHI) as the gold standard measure. The test-retest reliability and internal consistency of the Berlin-M were determined. Results: Most patients were males (64.0%) and majority of them were Malays (63.3%). Based on the sleep study test, 121 (84.0%) were classified as high risk while 23 (16.0%) as low risk using the Apnea Hypopnea Index (AHI) ≥5 as the cutoff point. The test–retest reliability Kappa value showed a good range between 0.864 – 1.000. The Cronbach’s alpha of BQ was 0.750 in category 1 and 0.888 in category 2. The sensitivity and specificity were 92% and 17% respectively. Conclusion: The BQ showed high sensitivity (92%) but low specificity (17%). Therefore, though the Berlin-M is useful as a screening tool, it is not a confirmatory diagnostic tool.
Many studies reported poorer quality of life (QoL) in youth with diabetes compared to healthy peers. One of the tools used is the Diabetes Quality of Life for Youth (DQoLY) questionnaire in English. A validated instrument in Malay is needed to assess the perception of QoL among youth with diabetes in Malaysia.
Background: Diabetic ketoacidosis (DKA) is a late presentation of newly diagnosed type 1 diabetes mellitus (DM) in children. The aim of this study was to determine the clinical characteristics of type 1 DM at presentation so that appropriate actions can be taken to promote early diagnosis.
Methods: This was a retrospective cohort review from a patient registry database. Data on all patients younger than 20 years old diagnosed with type 1 DM who had been registered with the Malaysian Diabetes in Children and Adolescents Registry (DiCARE) from its inception in 2006 until 2009 were analysed.
Results: The study included 490 children and adolescents, out of which 57.1% were female. The mean (SD) age at diagnosis was 7.5 (3.7) years, which increased from year 2000 to 2009 [6.6 (3.3) years to 9.6 (3.5) years; p = 0.001]. An increasing percentage of DKA at diagnosis was observed from year 2000 (54.5%) to year 2009 (66.7%), which remained high and leveled between 54.5% and 75.0%. DKA was more common in patients with normal weight (p = 0.002) with no significant association with age, gender, ethnicity and status of family history of diabetes mellitus.
Conclusion: An increasing trend of age at diagnosis of patients with type 1 DM was observed. Besides that, proportion of DKA at diagnosis had remained high over the past decade. This study found that normal weight was associated with status of DKA, thus more detailed investigations are required to determine the risk factors for DKA.
Introduction: We assessed the predictors of poor glycaemic control among older patients with type 2 diabetes mellitus (T2DM) in Malaysia.
Methods: This cross-sectional study used the data of 21,336 patients aged ≥ 60 years with T2DM from the Adult Diabetes Control and Management Registry 2008-2009.
Results: Predictors of poor glycaemic control were: age groups 60-69 years (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.66-2.33) and 70-79 years (OR 1.43, 95% CI 1.20-1.71); Malay (OR 1.53, 95% CI 1.41-1.66) and Indian (OR 1.32, 95% CI 1.19-1.46) ethnicities; T2DM durations of 5-10 years (OR 1.46, 95% CI 1.35-1.58) and > 10 years (OR 1.75, 95% CI 1.59-1.91); the use of oral antidiabetic agents only (OR 5.86, 95% CI 3.32-10.34), insulin only (OR 17.93, 95% CI 9.91-32.43), and oral antidiabetic agents and insulin (OR 29.42, 95% CI 16.47-52.53); and elevated blood pressure (OR 1.10, 95% CI 1.01-1.20), low-density lipoprotein cholesterol (OR 1.48, 95% CI 1.38-1.59) and triglycerides (OR 1.61, 95% CI 1.51-1.73). Hypertension (OR 0.71, 95% CI 0.64-0.80), hypertension and dyslipidaemia (OR 0.68, 95% CI 0.61-0.75), pre-obesity (OR 0.89, 95% CI 0.82-0.98) and obesity (OR 0.76, 95% CI 0.70-0.84) were less likely to be associated with poor glycaemic control.
Conclusion: Young-old and middle-old age groups (i.e. < 80 years), Malay and Indian ethnicities, longer T2DM duration, the use of pharmacological agents, and elevated blood pressure and lipid levels were associated with poor glycaemic control. The presence of comorbidities, pre-obesity and obesity were less likely to be associated with poor glycaemic control.
Keywords: Malaysia; diabetes mellitus; glycaemic control; older patients; registry.
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.
The aims of the present study were to assess the control of glycemia and other cardiovascular disease risk factors, and the association between age and these controls among older adults with type 2 diabetes in Malaysia.
This study aimed to examine the control of cardiovascular risk factors among the ethnic groups with type 2 diabetes in Malaysia. The authors analyzed the data of 70 092 adults from the Malaysian diabetes registry database. Malays had the worst achievement of target for most of the risk factors. Indians had poor achievement of control for waist circumference (odds ratio [OR] = 0.6, 95% confidence interval [CI] = 0.6-0.7) and high-density lipoprotein cholesterol (OR = 0.5, 95% CI = 0.4-0.5). As compared with the Malays, the Chinese had a better achievement of target control for the risk factors, including the following: body mass index (OR = 1.3, 95% CI = 1.2-1.4), blood pressure (OR = 1.3, 95% CI = 1.3-1.4), total cholesterol (OR = 1.7, 95% CI = 1.6-1.8), low-density lipoprotein cholesterol (OR = 1.7, 95% CI = 1.6-1.8), glycated hemoglobin A1c (OR = 1.4, 95% CI = 1.3-1.4) and fasting blood glucose (OR = 1.4, 95% CI = 1.3-1.5). Ethnicity, sociocultural factors, and psychobehavioral factors should be addressed in designing and management strategies for the control of cardiovascular risk factors among type 2 diabetes patients.