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  1. Lim, Kuang Hock, Sumarni Mohd Ghazali, Kee, Chee Cheong, Hejar Abdul Rahman, Amal Nasir Mustafa
    Int J Public Health Res, 2012;2(1):85-92.
    MyJurnal
    Accepted 8 February 2012.
    Introduction Social norms, though an important contributing factor of adolescent smoking in developed countries, has not been extensively studied in Malaysia. The objective of this study was to determine the association between certain perceived norms regarding smoking with smoking status among Malaysian secondary school students in Kota Tinggi, Johor.
    Methods Data were collected from 2311 respondents consisting of 1379 male and 923 female secondary school students in Kota Tinggi district via a self administered questionnaire. Five perceived norms regarding smoking were assessed, namely: perceived peer smoking prevalence, perceived parental reaction towards adolescent smoking, perceived public perception of adolescent smoking, ever noticed peers smoking inside and outside school and perceived enforcement of anti-smoking policy in school and their association with smoking status. Multiple logistic regressions controlling for gender, peer smoking and family smoking was performed.
    Results Of the five perceived norms, four were associated with smoking status, (perceived peer smoking prevalence (p
  2. Lim, Kuang Kuay, Chan, Ying Ying, Ahmad Ali Zainuddin, Teh, Chien Huey, Hasimah Ismail, Lim, Kuang Hock, et al.
    Int J Public Health Res, 2014;4(1):419-424.
    MyJurnal
    Introduction Iodine deficiency disorders (IDD), is one of the most important micronutrient
    deficiencies which has multiple adverse effects on growth and development.
    The aim of this study was to determine the prevalence of IDD among school
    children and to elucidate the distribution of iodized salt at household level in
    Sarawak, East Malaysia.

    Methods This cross-sectional study was conducted among school children aged 8 to 10
    years in 2008. A multi-stage probability proportionate to population size
    (PPS) cluster sampling method was used to obtain a representative state
    sample of 1200 school children. Spot urine samples were collected for the
    determination of urinary iodine concentration while the iodine content in salt
    was determined using field rapid test kits. The thyroid status was determined
    by palpation.

    Results Response rate was 92.0% (n=1104/1200). The prevalence of goitre among
    school children in Sarawak was 2.9% (5.2% in urban, 0.7% in rural). The
    median urinary iodine concentration (UIC) among the school children was
    102.1 μg/L (IQR, 62.3-146.5 μg/L). Urban children had significantly higher
    median UIC of 109.3 μg/L (IQR, 72.4-159.0 μg/L) than their rural
    counterparts [91.9 μg/L (IQR, 55.7-140.2 μg/L)]. The salt samples tested by
    rapid test kit (RTK) showed only 46.0% of household salt contained iodine.

    Conclusions The present study revealed that the population in Sarawak were of borderline
    iodine sufficient with mild IDD seen in rural areas. Hence, the state IDD
    control programmes need to encourage and advocate the consumption of
    iodized salt in order to eliminate IDD-related health problems in Sarawak.
  3. Lim, Kuang Kuay, Jambai Endu, Chan, Ying Ying, Teh, Chien Huey, Hasimah Ismail, Lim, Kuang Hock, et al.
    Int J Public Health Res, 2015;5(2):631-636.
    MyJurnal
    Introduction Following the reveal of borderline iodine sufficiency among the Sarawakians
    from the 2008 National Iodine Deficiency Disorders (IDDs) survey, a
    mandatory universal salt iodization (USI) was implemented in Sarawak
    thereafter. This study aimed to determine the current status of USI in
    Sarawak after a 3-year implementation of USI from 2008 to 2011.

    Methods The IDD survey was conducted between Jun 2011 to July 2011 involving six
    districts in Sarawak (Sarikei, Mukah, Kapit, Sibu, Bintulu and Miri). The
    schools were selected via multistage proportionate-to-population size
    sampling technique and the children were randomly selected via systematic
    sampling. A total of 19 schools and 661 children were recruited into the
    survey. Thyroid size was determined by palpation and was and graded
    according to the classification of the World Health Organization (grade 0-2).
    The iodine excretion level in spot morning urine was measured using inhouse
    microplate method. The urinary iodine concentration (UIC) values
    were compared by Kruskal-Wallis test and Chi-square tests were used to
    compare categorical variables.

    Results A total of 610 school children were participated in the study (92.3%). The
    TGR of grade 1 and 2 was found to be 0.3% (n = 2). Overall the median UIC
    level was 154.2 (IQR, 92.7 - 229.8) μg/L, with the highest median UIC been
    observed in Sarikei [178.0 (IQR, 117.6 - 308.9) μg/L], followed by Mukah
    [174.8 (IQR, 99.0 - 224.3) μg/L)], Miri [158.6 (IQR, 92.3 - 235.4) μg/L],
    Sibu [147.0 (IQR, 89.8 - 221.4) μg/L], Bintulu [142.3 (IQR, 52.8 - 245.1)
    μg/L] and Kapit [131.0 (IQR, 88.6 - 201.9) μg/L]. One in every ten child was
    of iodine deficient (UIC < 50μg/L) while a third of the child (32%) were of
    adequate level of UIC.

    Conclusion The present findings indicate that the mandatory USI successfully improves
    the iodine level of children in Sarawak. However, regular and proper
    monitoring of the UIC level in the communities is needed to prevent
    excessive iodine intake.
  4. Cheah YK, Lim HK, Kee CC
    J Pediatr Nurs, 2019 07 29;48:92-97.
    PMID: 31369963 DOI: 10.1016/j.pedn.2019.07.012
    PURPOSE: The objective of this study was to investigate the relationships between high-risk behaviours and personal and family factors among adolescents in Malaysia.

    METHODS: A nationwide data set was examined for this secondary data analysis. The dependent variable was the degree of risk, which was measured based on the number of high-risk behaviours in which adolescents participated. Age, gender, ethnicity, self-rated academic performance, family size, parental marital status and parental academic attainment were included as independent variables. Analyses stratified by educational level were conducted. Odds ratios (ORs) were calculated using ordered logit.

    RESULTS: The most common high-risk behaviour among Malaysian adolescents was physical inactivity (35.97%), followed by smoking (13.27%) and alcohol consumption (4.45%). The majority of adolescents had low risks (52.93%), while only a small proportion had high risks (6.08%). Older age was associated with increased odds of having high risks (OR: 1.26). Male adolescents had higher odds of being in a high-risk category compared to female adolescents (OR: 1.28). Compared to Malays, Chinese adolescents had higher odds of being in a high-risk category (OR: 1.71), whereas Indian adolescents had lower odds (OR: 0.65). Excellent academic performance was associated with reduced odds of participating in high-risk behaviours (OR: 0.41).

    CONCLUSION: Personal factors are important determinants of high-risk behaviours. This study provides a better understanding of those adolescent groups that are at greater risk.

    PRACTICAL IMPLICATIONS: An intervention directed towards reducing participation in high-risk behaviours among adolescents who have both poor academic performance and less-educated parents may yield promising outcomes.

  5. Tah PC, Kee CC, Majid HA
    Nutr Clin Pract, 2020 Oct;35(5):942-950.
    PMID: 31556167 DOI: 10.1002/ncp.10416
    BACKGROUND: Malnutrition among hospitalized patients is closely associated with various medical complications. This study aimed to determine the validity and reliability of a 3-Minute Nutrition Screening (3-MinNS) tool in identifying the risk of malnutrition among hospitalized patients that can be administered by healthcare professionals.

    METHODS: A cross-sectional study was conducted between January and December 2012. A total of 350 adult patients in a teaching hospital were screened for risk of malnutrition using 3-MinNS and Subjective Global Assessment (SGA). To assess interrater reliability, each patient was screened for risk of malnutrition using 3-MinNS by 2 different nurses on 2 different occasions within 24 hours after admission. To assess the validity of 3-MinNS, the level of risk of malnutrition identified by the nurses using 3-MinNS was compared with the risk of malnutrition as assessed by a dietitian using SGA within 48 hours after the patients' enrolment into the study. The sensitivity, specificity, and predictive values were calculated in detecting patients at risk of malnutrition. Interrater reliability was determined using κ statistics.

    RESULTS: Using SGA, the estimated prevalence of moderate to severe malnutrition was 36.3% (127/350). There was 94% proportional agreement between 2 nurses using 3-MinNS, and interrater reliability was substantial (κ = 0.79, P < .001). The analysis showed that 3-MinNS had moderate sensitivity (61.4%-68.5%) but high specificity (95.1%).

    CONCLUSIONS: The 3-MinNS is a reliable and valid screening tool for use by healthcare professionals for identifying newly admitted medical and surgical patients who are at risk of malnutrition.

  6. Lim Kuang Hock, Heng Pei Pei, Muhammad Fadhli Mohd Yusoff, Teh Chien Huey, Sumarni Mohamad Ghazali, Lim Hui Li, et al.
    MyJurnal
    Introduction: Tobacco induced illness remains a major contribution to premature death and global burden of dis- eases. The introduction of MPOWER policies by World Health Organization held the value to monitor the imple- mentation of the anti-smoking measures in all signatory countries. This paper aimed to investigate the application of the six MPOWER indicators among Malaysia population. Methods: We utilized the data of Global Adult Tobacco Survey-Malaysia (GATS-M) which recruited 5112 nationally representative samples of Malaysians of 15 years old and above. Descriptive statistical analysis was used to illustrate the social demographic characteristic of the respon- dents while cross tabulation was employed to describe all elements of the MPOWER indicators. Results: About one quarter (23.1%) of Malaysian adults were current tobacco users. The SHS exposure at home (38.4%) and restaurant (42.1%) were high. Approximately eight in ten (80.2%) of the smokers intended to quit, while for those attempted to quit in past one year, 9.0% utilized pharmacotherapy and 4.4% attended counseling. The awareness about tobacco related diseases was generally excellent. The overall tax make up of the cigarettes’ retail price ranging from 41.7% up to 80%. Conclusion: Tobacco consumption remains prevalent and plateau among Malaysian adults over the last two decades with substantial proportion of the population exposed to SHS. The inadequacy in the current anti-smoking policies needs urgent improvement in order to reduce the smoking norms among Malaysians population besides to achieve the ultimate goal of tobacco control end game by year 2045.
  7. Cheah YK, Lim HK, Kee CC
    Int J Pediatr Adolesc Med, 2018 Jun;5(2):49-54.
    PMID: 30805533 DOI: 10.1016/j.ijpam.2018.02.001
    Background and objectives: The objective of the present study is to examine factors affecting time spent in physical activity among adolescents in Malaysia.

    Patients and methods: A nationally representative data of adolescents that consists of 25399 respondents is used. The demographic (age, gender, education) and lifestyle (fruits and vegetables consumption, carbonated soft drink consumption, cigarette smoking, alcohol drinking, sex behaviour, participation in physical education class, obesity) determinants of physical activity are assessed using binomial regression.

    Results: The results show that age is negatively associated with time spent in physical activity. However, being male and education levels are positively related to time spent in physical activity. Having unhealthy lifestyle and being obese are associated with low levels of physical activity. Physical education seems to promote participation in physical activity.

    Conclusion: In conclusion, demographic and lifestyle factors play an important role in determining levels of physical activity among adolescents. In order to reduce the prevalence of physically inactive adolescents, policy makers should focus primarily on late adolescents, females, adolescents who engage in unhealthy lifestyle and seldom attend physical education classes, as well as obese adolescents.

  8. Lim, Hui Li, Chong, Siew Man, Heng, Pei Pei, Lim, Kuang Kuay, Sumarni Mohd Ghazali, Kee, Chee Cheong, et al.
    Int J Public Health Res, 2020;10(2):1215-1218.
    MyJurnal
    Introduction Community-based health promotion programme has been recognised to reduce modifiable lifestyle risk behaviours for non-communicable diseases. The aim of this study was to evaluate the proportion of the awareness, knowledge and acceptance of a community-based intervention programme, “Komuniti Sihat, Pembina Negara“ (KOSPEN) (Healthy Community, Developed Nation). This cross-sectional study employed a two-stage proportionate sampling method to select a representative sample of communities in the Southern states of Peninsular Malaysia, Negeri Sembilan, Malacca, and Johor. Face-to-face interviews by trained research assistants using pre-validated questionnaires was the study tool applied. The study revealed that approximately two thirds of respondents were aware of the KOSPEN programme (65.5%) and almost half (45.4%) of them were involved in the health promotion activities, namely health screenings (84.8%), health talks (66.4%), and providing plain water in formal occasion (52.9%). About two thirds and one-quarter of them have a very good (73.4%) and good (24.1%) general view on this programme. Four out of ten respondents faced difficulties joining the activities. Lack of time (83.0%) was reported as the main barrier. The KOSPEN programme in overall was moderately accepted by the community. However, the need for future improvement has to be highlighted in order to enhance the involvement and participation of the communities.
  9. Lim, Kuang Kuay, Chan, Ying Ying, Ahmad Ali Zainuddin, Teh, Chien Huey, Rusidah Selamat, Kee, Chee Cheong, et al.
    Int J Public Health Res, 2013;3(1):198-203.
    MyJurnal
    Iodine deficiency is still prevalent worldwide and it is the main cause of goiter, thyroid dysfunction and mental retardation. The aim of the study was to determine the iodine status and goiter prevalence among the school children in Terengganu. The representative sample consists of 1163 primary school children aged 8-10 years old randomly selected from urban and rural schools in Terengganu using stratified systematic random sampling technique. Urinary iodine levels in spot urine were determined by in house modified micro-method while goiter assessment was carried out by palpation of thyroid gland. The status of iodine deficiency was determined by the median urinary iodine concentrations (UIC) and total goiter prevalence (TGP) in accordance with the WHO criteria. The result showed the median [inter-quartile range (IQR)] urinary iodine concentrations was 78.7µg/L (50.1µg/L -120.0µg/L) indicating the iodine intake was slightly lower than recommended range of 100 µg/L. The rural school children had a significantly lower Iodine levels (median UIC=72.4µg/L, IQR=46.7µg/L -113.0µg/L) than the urban school children (median UIC=87.7µg/L, IQR=54.5 µg/L - 127.5µg/L). The total goiter prevalence (TGP) was 5.7%. The prevalence of goiter was significantly higher in rural (TGP=6.9%) compared to urban areas (TGP=3.6%). The study revealed that school children in Terengganu showed mild iodine deficiency and the condition is more pronounced in children from rural areas. The findings emphasize the importance of intervention implementation, universal salt iodization to ensure sufficient intake of iodine among the Terengganu school children.
  10. Lim, Hui Li, Ling, Miaw Yn, Teh, Chien Huey, Heng, Pei Pei, Kee, Chee Cheong, Sumarni Mohd Ghazali, et al.
    MyJurnal
    Introduction: Self-esteem is important for the development of adolescent’s psychological well-being. The Rosenberg
    Self-Esteem Scale (RSES) is the most commonly used instrument for measuring self-esteem. However, the Malay-language version of the RSES (RSES-M) has not been validated among upper secondary school students in Malaysia.
    Methods: We administered the RSES-M to 3349 students who participated in the Malaysia Adolescent Health Risk
    Behavior (MyAHRB) study. The construct validity of the RSES-M was assessed using exploratory factor analysis while
    internal consistency was evaluated by Cronbach alpha. Results: The study identified two factors in the RSES-M.
    The variance for the first and second factor was 30.32% and 19.91%, respectively, Item 7 (I wish I could have
    more respect to myself) which showed a positive correlation with the positive wording contrasted with the original
    RSES. Such contrary may be due to social and cultural background difference. Conclusion: The translated version
    of RSES-M can be considered as a valid tool to measure self-esteem in upper school going adolescents in Malaysia.
    However, future studies to determine the psychometric properties of item 7 in the Malaysian setting are strongly
    recommended to enhance the validity of RSES-M.
  11. Lim, Kuang Hock, Lim, Hui Li, Kee, Chee Cheong, Sumarni Mohd Ghazali, Heng, Pei Pei, Cheah, Yong Kang, et al.
    MyJurnal
    Introduction: Total restriction on smoking in the home is an effective tool to reduce Second-hand smoke (SHS) expo- sure in private dwellings. The aim of this study is to determine the prevalence of total smoking restrictions in Malay- sian homes and factors associated with its adoption. Methods: We analyzed data from a cross-sectional, household study – the Global Adult Tobacco Survey 2011, which involved a representative sample of Malaysian adults. Factors associated with the adoption of a totally smoke free home policy was determined by multivariable logistic regression. Results: Out of the 4250 respondents studied, 40.9% (95% CI 38.1-43.8) adopted a total smoking restriction within their homes. Adoption of total smoke-free home policy was significantly higher among Chinese and Indians, those without smokers in the house, non-smokers and government employees. The likelihood of adopting the total smok- ing restriction at home was lower among current smokers, of Malay ethnicity, low education attainment, having at least one house member who smoked, residing in rural areas, single or widow/widower/divorcee, those working in the private sector or self-employed. Conclusions: Less than half of Malaysian households implemented a total smok- ing restriction in their residence. Targeted activities to encourage the adoption of voluntary smoke-free rules among groups least likely to implement 100% smoking restrictions in the home are urgently needed with participation of all stakeholders to ensure its success.
  12. Cheah YK, Kee CC, Lim KH, Omar MA
    Pediatr Neonatol, 2021 11;62(6):628-637.
    PMID: 34353744 DOI: 10.1016/j.pedneo.2021.05.025
    BACKGROUND: Mental health disorders are highly correlated with risk behaviors. The objective of the present study is to examine the relationship between risk behaviors and mental health among school-going students with a focus on ethnic minorities.

    METHODS: The National Health and Morbidity Survey (NHMS) 2017 (n = 8230) was used for analyses. It was a nationwide survey conducted in Malaysia. The dependent variables were measured by three risk behaviors (cigarette smoking, alcohol drinking and use of illicit drugs). Probit regressions were utilized to examine the effect of mental health on the probability of smoking, drinking and using illicit drugs. Demographic and lifestyle factors were used as the control variables. Truancy was identified as a mediating variable.

    RESULTS: Anxiety, depression and suicidal ideation affected cigarette smoking, alcohol drinking and use of illicit drugs through mediation of truancy. After controlling for demographic and lifestyle factors, students with anxiety, depression and suicidal ideation were more likely to smoke, drink and use illicit drugs compared with their peers without any mental health disorders. Furthermore, the likelihood of consuming cigarettes, alcohol and illicit drugs was found to be higher among students who played truant than those who did not.

    CONCLUSION: Mental health plays an important role in determining participation in risk behaviors among ethnic minority students in Malaysia. Public health administrators and schools have to be aware that students who suffer from mental health disorders are likely to indulge in risk behaviors.

  13. Ahmad Ali Zainuddin, Mala A. Manickam, Azli Baharudin, Rusidah Selamat, Kee, Chee Cheong, Noor Ani Ahmad, et al.
    Int J Public Health Res, 2016;6(1):661-669.
    MyJurnal
    Introduction Overweight and obesity is a major public health problem in Malaysia. This study aims to determine the prevalence of overweight and obesity among the Malaysian adult population and their association with socio-demographic characteristics (gender, ethnic, and age groups).
    Methods A total of 17,257 adults aged 18 years and older (8,252 men, 9,005 women)
    were assessed for BMI status, with a response rate of 97.8%, through a household survey from the National Health and Morbidity Survey (NHMS), conducted in all states of Malaysia in 2011.
    Results All socio-demographic factors were consistently associated with higher chance of being overweight (except gender and location) and obesity (except location and household income). The identified risk of overweight were
    Indian (aOR: 1.8, 95% CI: 1.2-2.8), aged 50-59 years (aOR: 2.8, 95% CI: 2.0-3.9), widower (aOR: 1.6, 95% CI: 1.3-2.0), subject with secondary education (aOR: 1.2, 95% CI: 1.0-1.4), Homemaker/unpaid worker (aOR:
    1.3, 95% CI: 1.1-1.4), and with high household income group (aOR: 1.3, 95% CI: 1.2-1.6). The identified risk of obesity were women (aOR: 1.4, 95% CI: 1.2-1.6), Indian (aOR: 1.7, 95% CI: 0.9-3.2), aged 30-39 years (aOR: 3.6,
    95% CI: 2.4-5.5), widower (aOR: 1.2, 95% CI: 0.9-1.6), subjects with primary education (aOR: 1.2, 95% CI: 0.9-1.6), Homemaker/unpaid worker (aOR: 1.3, 95% CI: 1.1-1.6), and with middle household income group (aOR: 1.3, 95% CI: 1.2-1.6).
    Conclusions Our data indicate a high prevalence of overweight and obesity in the
    population. Several sociodemographic characteristics are associated with both overweight and obesity. This study highlights the serious problem ofoverweight and obesity among Malaysia adults. Documentation of these problems may lead to research and policy agendas that will contribute both to our understanding and to the reduction of these problems.
    Study name: National Health and Morbidity Survey (NHMS-2011)
  14. Teh CH, Rampal S, Kee CC, Azahadi O, Tahir A
    Int J Obes (Lond), 2023 Dec;47(12):1302-1308.
    PMID: 37833560 DOI: 10.1038/s41366-023-01391-5
    OBJECTIVE: The global obesity epidemic remains a significant threat to public health and the economy. Age-period-cohort (APC) analysis is one method to model the trajectory of obesity. However, there is scarce published evidence of such analyses among the South East Asian population. This study aims to explore the sex and ethnic variations of BMI and waist circumference trajectories over time among non-institutionalized Malaysian adults aged 18 to 80 years.

    METHODS: Data from four population-based National Health and Morbidity Surveys conducted in 1996, 2006, 2010, and 2015 were pooled. Hierarchical Age-Period-Cohort (HAPC) analysis explored the trajectories of BMI and waist circumference across the life course and birth cohorts by sex and ethnicity. These models assumed no period effect.

    RESULTS: Generally, BMI and waist circumference trajectories increased across age and birth cohorts. These trajectories varied by sex and ethnicity. Females have more profound increasing BMI and waist circumference trajectories than their male counterparts as they age and as cohort recency increases. Chinese have less profound BMI and waist circumference increases across the life course and birth cohorts than other ethnic groups.

    CONCLUSIONS: The profound increasing cohort trajectories of obesity, regardless of sex and ethnicity, are alarming. Future studies should focus on identifying factors associated with the less profound cohort effect among the Chinese to reduce the magnitude of trajectories in obesity, particularly among future generations.

  15. Binti Shuhairi NN, Bt Abdul Jalil A, Lau SH, Bt Mohd Ghazali S, Kee CC
    Int J Paediatr Dent, 2021 Jul;31(4):496-503.
    PMID: 32815206 DOI: 10.1111/ipd.12719
    BACKGROUND: Globally, research on oral and maxillofacial lesions among newborns and infants remains limited.

    AIM: To describe demographic patterns, histopathological findings, and locations of oral and maxillofacial lesions in newborns (birth-1 month) and infants (>1 month-2 years) reported over 51 years.

    DESIGN: A retrospective cross-sectional study on histopathological records of newborns and infants was conducted. Patients' demographic characteristics (age, gender, and race), histopathological diagnosis, and lesion's location were gathered. Pearson's chi-square or Fisher's exact test was performed to determine associations between demographic characteristics and different categories of lesions.

    RESULTS: Out of 66,546 specimens received, 0.44% (290 specimens) were from patients aged 2 years and younger (27 newborns and 263 infants). The most common category was inflammatory/reactive (44.2%), followed by tumour/tumour-like (42.0%), cystic/pseudocystic (6.6%), and miscellaneous lesions (5.5%). Mucous extravasation cysts (23.4%) and Langerhans cell histiocytosis (7.2%) were the most common histopathological diagnoses. Tumour/tumour-like lesions were significant in newborns (P = .021), and majority were congenital epulis (40.7%). Inflammatory/reactive lesions were significantly higher in male (P = .025) and infants (P = 

  16. Lim KH, Lim HL, Teh CH, Kee CC, Heng PP, Cheah YK, et al.
    Tob Induc Dis, 2018;16.
    DOI: 10.18332/tid/95188
    Introduction: Understanding the prevalence of secondhand smoke (SHS) exposure and the associated factors is beneficial for the formulation of effective measures to reduce exposure to SHS. The purpose of this study was to determine SHS exposure at home and workplace, and its associated factors among non-smoker Malaysian adults. Methods: Data were extracted from the Global Adult Tobacco Survey-Malaysia (GATS-M) that involved a representative sample of 5112 Malaysian adults. Logistic regression analyses were performed to examine the association between SHS exposure, sociodemographic factors, knowledge on the danger of SHS, and smoking restrictions at home and at work among non-smokers. Results: Among non-smoker Malaysians, age ≥15 years, 27.9% (equivalent to approximately 4.21 million non-smokers) and 33.9% (equivalent to approximately 1.37 million non-smokers) reported that they were exposed to SHS at home and the workplace, at least once a month, respectively. Women (AOR=2.12, 95% CI: 1.61.2.78), young individuals (AOR=3.06, 95% CI: 1.48.6.33), Malays (AOR=2.39, 95% CI: 1.56.3.64) or other Bumiputra ethnic groups (AOR=2.40, 95% CI: 1.39.4.19) and those who worked as other than government employees were more likely to report SHS exposure at home (non-government employee: AOR=1.88, 95% CI: 1.06.3.36). Respondents with a total smoking restriction at home did not report any SHS exposure at home. Similarly, those whose workplace had smoking restrictions were less likely to report SHS exposure at the work compared to their counterparts whose workplace had partial (AOR=3.08, 95% CI: 1.84.5.15) or no smoking restrictions (AOR=15.33, 95% CI: 6.75.34.86). Conclusions: A substantial proportion of Malaysian adults were exposed to SHS at home and at work. The findings emphasize the need for policies on smoking restrictions at work and the need to promote the adoption of a completely smoke-free home, among the Malaysian population.
    Study name: Global Adults Tobacco Survey (GATS-2011)
  17. Lim KH, Mohd Ghazali S, Lim HL, Kee CC, Teh CH, Lim JH
    MyJurnal
    Introduction: Expansion of smoke-free areas in public domains is suspected to displace smoking into the home. However, the scarcity of such information in Malaysia warrants an investigation to determine SHS exposure at home among adults in Malaysia.
    Methods: This study studied 4,250 and 21,445 adults who participated in the 2011 Global Adult Tobacco Survey-Malaysia (GATS-M) and, the National Health and Morbidity Survey (NHMS) 2015, respectively. Multivariable logistic regression modelling was used to compare the odds of SHS exposure at home among adults in 2011 (GATS-M) to odds of SHS exposure at home among adults in 2015 (NHMS 2015).
    Results: Approximately one third of respondents were exposed to SHS at home in 2011 (38.4%) and 2015 (37.9%). MLR analysis revealed the odds of SHS exposure at home was not significantly different from 2011 [AOR 1.14, 95 % CI (0.99-1.31). 2015 exposure to SHS as reference]. This study also indicates no significant displacement of smoking into the home by socio-demographic and smoking status between 2011 and 2015.
    Conclusion: The findings suggest that smoking has not been displaced into the home in the past four years although the number of smoke-free public areas have increased. More public smoke free areas should be established.
    Study name: 2011
    Global Adult Tobacco Survey-Malaysia (GATS-M); National Health and Morbidity Survey (NHMS-2015)

  18. Cheah YK, Syed Anera SN, Kee CC, Lim KH, Omar MA
    Hypertens Res, 2022 Feb 16.
    PMID: 35173284 DOI: 10.1038/s41440-022-00858-8
    The prevalence of high sodium-related diseases is increasing across the globe. Knowledge plays an important role in disease prevention. The objective of the present study was to examine sociodemographic factors associated with knowledge of high sodium-related diseases. The Malaysian Community Salt Survey (MyCoSS) was used in the present study for secondary analyses. It is a nationwide cross-sectional survey that was conducted in Malaysia. A non-parametric test to evaluate trends and a negative binomial regression were utilised to assess knowledge of high sodium-related diseases. Income, educational level, gender, ethnicity, house locality and hypertension were found to be significantly associated with knowledge of high sodium-related diseases. In particular, higher income earners, well-educated people, women, Malays, urban dwellers and hypertensive adults were more likely to have acquired a lot of knowledge of high sodium-related diseases compared to that acquired by lower income earners, less-educated people, men, individuals of other ethnic groups, rural dwellers and nonhypertensive adults. In conclusion, sociodemographic factors and hypertension play an important role in knowledge acquired about high sodium-related diseases. The findings of the present study could inform a future policy directed towards increasing knowledge about high sodium-related diseases among the population in Malaysia.
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