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Fulltext Perceived norms and smoking status among secondary school students in Kota Tinggi, Johor, Malaysia

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
Fulltext Iodine deficiency disorder and goitre among school children in Sarawak - a nationwide study

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.
Fulltext Iodine status after a 3-year universal salt iodisation in Sarawak, Malaysia

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.
Fulltext Prevalence of smoking and its associated risk factors among secondary school students in Kelantan, Malaysia

Lim Hui Li, Heng Pei Pei, Teh Chien Huey, Kee Chee Cheon, Sumarni Mohd Ghazali, Lim Kuang Hock, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):44-50.
MyJurnal

Introduction: Minimizing smoking initiation among adolescents has been identified as a strategy to reduce the preva- lence of tobacco induced diseases among Malaysian adults. The aims of this study were to investigate the prevalence and factors associated with smoking among secondary school- going adolescents in the state of Kelantan, Malaysia. Methods: A school-based survey was carried out in Kelantan to determine the prevalence and associated factors of smoking among Kelantanese adolescents. Two-stage cluster sampling was used to ensure the representativeness of the sample. A self-administered validated questionnaire was utilised to obtain data from the selected respondents. Multiple logistic regression analysis was used to determine the factors associated with smoking behaviour among school-going adolescents. Results: The study revealed that 10.1% (95 CI 8.5-11.9%) of the selected respondents were current smokers. The prevalence of male who smoked was significantly higher compared to female. MLR revealed that, males, respondents with at least one smoking parent/guardian, as well as the respondents with less supportive parents/ guardian were more likely to smoke. However, by having a few numbers of close friends and helpful peers in the school had shown no significant association for being the current smokers. Conclusion: The study showed that the prevalence of smoking was a bit lower than the national prevalence, and smoking behaviour was predominant among male adolescents in Kelantan state. Comprehensive measures with the involvement of parents/guardians were imperative to tackle smoking habits among adolescents by targeting high-risk groups identified in the study.
Fulltext Implementation of MPOWER approach for tobacco control in Malaysia: findings from the Global Adult Tobacco survey (GATs)

Lim Kuang Hock, Heng Pei Pei, Muhammad Fadhli Mohd Yusoff, Teh Chien Huey, Sumarni Mohamad Ghazali, Lim Hui Li, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):144-154.
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.
Fulltext Awareness, knowledge and acceptance of community on a noncommunicable disease intervention – Findings from the “Healthy Community, Developed Nation” (KOSPEN) in the Southern Zone of Peninsular Malaysia

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.
Fulltext Inadequate iodine intake among school children in Terengganu-findings from the national iodine deficiency disorder survey 2008

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.
Sociodemographic differences in smoking knowledge in Malaysia

Cheah YK, Teh CH, Lim KH

Journal of Drug Issues, 2019.
DOI: 10.1177/0022042618821195

The objective of the present study is to examine the sociodemographic determinants of amount of smoking knowledge in Malaysia. Data are obtained from the Global Adult Tobacco Survey (GATS). The GATS uses a multistage stratified sampling. A total of 4,153 respondents are used for analyses. The effects of sociodemographic factors on smoking knowledge are examined using a negative binomial regression. Age, wealth index, education, ethnicity, house locality, and smoking behavior are significantly associated with smoking knowledge. In particular, there are negative relationships between smoking knowledge and higher wealth index, less-educated individuals, Chinese, rural dwellers, and smokers. The present study concludes that sociodemographic factors play an important role in determining smoking knowledge. Hence, as an intervention measure directed toward improving the knowledge of smoking among Malaysian population, effective policies should pay special attention to individuals who are likely to have poor information on smoking.
Study name: Global Adults Tobacco Survey (GATS-2011)
Fulltext Construct validity and reliability of Rosenberg Self-Esteem Scale-Malay (RSES-M) among upper secondary school students in Malaysia

Lim, Hui Li, Ling, Miaw Yn, Teh, Chien Huey, Heng, Pei Pei, Kee, Chee Cheong, Sumarni Mohd Ghazali, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(2):32-38.
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.
Fulltext Prevalence and factors associated with total smoking restriction at home in Malaysia: findings from a nationwide population-based study

Lim, Kuang Hock, Lim, Hui Li, Kee, Chee Cheong, Sumarni Mohd Ghazali, Heng, Pei Pei, Cheah, Yong Kang, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(3):20-28.
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.
Parental smoking status, stress, anxiety, and depression are associated with susceptibility to smoking among non-smoking school adolescents in Malaysia

Lim KH, Chong Z, Khoo YY, Kaur J

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):81S-90S.
PMID: 25038194 DOI: 10.1177/1010539514542426

Susceptibility to smoking is a reliable predictor of smoking initiation. This article describes its prevalence and associated factors among Malaysian school adolescents. Data were obtained from the Global School-Based Student Health Survey (GSHS) 2012, a nationwide representative sample of school adolescents. The overall prevalence of susceptibility to smoking was 6.0% and significantly higher among males (9.5%) compared with females (3.6%). Multivariable analyses revealed that males (adjusted odds ratio [aOR] 3.34, 95% confidence interval [CI] 2.70-4.18) and school adolescents of indigenous Sabahan or Sarawakian descents (aOR 1.62, 95%CI 1.21-2.18) were significantly more likely to be susceptible to smoking. Susceptible school adolescents had a slightly higher likelihood to have symptoms of stress (aOR 1.31, 95% CI 1.02-1.70), anxiety (aOR 1.19, 95% CI 1.01-1.40), depression (aOR 1.56, 95% CI 1.25-1.96), including those whose one or both parents/guardians were smokers (aOR 1.48, 95% CI 1.21-1.82; aOR 2.33, 95% CI 1.22-4.44, respectively). The findings from this study point out the need for proactive measures to reduce smoking initiation among Malaysian adolescents with particular attention toward factors associated with susceptibility to smoking.
Study name: Global School-Based Student Health Survey (GSHS)
Fulltext Current e-cigarette use among in-school adolescents in West Malaysia: Examining the interactions between sociodemographic characteristics and lifestyle risk behaviours

Jane Ling MY, Ahmad N, Mohd Yusoff MF, Lim KH

PLoS One, 2022;17(1):e0263355.
PMID: 35100321 DOI: 10.1371/journal.pone.0263355

BACKGROUND: Adolescent e-cigarette use has increased dramatically. Most e-cigarette liquids contain nicotine, which can harm the developing adolescent brain. Local studies examining the risk factors of adolescent e-cigarette use and interactions between its risk factors are limited. This study was aimed at determining the prevalence of current e-cigarette use and its associated factors among in-school adolescents in West Malaysia. We also examined the possible sociodemographic characteristic, lifestyle risk behaviour and parental factor interactions that affect the probability of current e-cigarette use.

METHODS: We conducted a cross-sectional study using data from the National Health and Morbidity Survey 2017. Respondents aged 13-18 years were included in the study. The data were analysed using STATA (v.15).

RESULTS: The prevalence of current e-cigarette use was 9.1%. Male gender, older age, Malay ethnicity, schooling in urban area, current smoking, current alcohol use, current drug use, having parents that are not married and living together and parental tobacco product use were significantly associated with current e-cigarette use. There were significant interactions between: i) gender with age, ethnicity, current smoking, current alcohol use and current drug use, ii) ethnicity with current smoking and current alcohol use, iii) locality with ethnicity, current smoking and current alcohol use, iv) current drug use with age, ethnicity, current smoking and current alcohol use, v) parental marital status with gender, age and ethnicity, and vi) parental tobacco use with ethnicity and current smoking.

CONCLUSION: Our findings identify significant associations between sociodemographic characteristics, lifestyle risk behaviours and parental factors with current e-cigarette use. They also provide new insight into the interactions between these factors that affect the probability of current e-cigarette use among West Malaysian adolescents. Efforts to tackle e-cigarette use in Malaysian adolescents should target sociodemographic characteristics, lifestyle risk behaviours and parental factors such as smoking cessation intervention for parents.
Fulltext Mental health and risk behaviors among secondary school students: A study on ethnic minorities

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.
Fulltext Age, Period, and Cohort Analysis of Smoking Intensity Among Current Smokers in Malaysia, 1996-2015

Teh CH, Rampal S, Lim KH, Azahadi O, Tahir A

Nicotine Tob Res, 2023 Jun 09;25(7):1340-1347.
PMID: 36879440 DOI: 10.1093/ntr/ntad035

INTRODUCTION: Tobacco use is one of the major preventable risk factors for premature death and disability worldwide. Understanding the trend of tobacco use over time is important for informed policy making.
AIMS AND METHODS: The present study aimed to examine the changes in mean daily cigarette consumption among random samples of the Malaysian current smoker population over 20 years using an age-period-cohort (APC) approach. We conducted APC analysis using a multilevel hierarchical age-period-cohort model and data from four nationally representative, repeated cross-sectional surveys (National Health and Morbidity Survey) conducted in 1996, 2006, 2011, and 2015 among individuals aged 18 to 80 years. Analyses were also stratified by gender and ethnicity.
RESULTS: Overall, mean daily cigarette consumption (smoking intensity) among current smokers increased with age until 60, after which a drop was observed. There were increases in daily cigarette consumption across birth cohorts. Age and cohort trends did not vary by gender but by ethnicity. The decreasing cigarette consumption after age 60 among the current smoker population was consistent with those observed among the Chinese and Indians, a trend that was not observed in Malays and other aborigines. In contrast, the increasing cohort trend was consistent with those observed among the Malays and other bumiputras.
CONCLUSIONS: The present study highlighted important ethnic-specific trends for mean daily cigarette consumption among the current smoker population in Malaysia. These findings are essential in guiding the formulation of interventional strategies or implementation of national tobacco control policies and help achieve the Ministry of Health Malaysia's 2025 and 2045 targets for smoking prevalence.
IMPLICATIONS: This is the first APC study on smoking intensity among current smokers in a multiracial, middle-income nation. Very few studies had performed gender- and ethnic-stratified APC analyses. The ethnic-stratified APC analyses provide useful insights into the overall age and cohort trends observed among the current smoker population in Malaysia. Therefore, the present study could add evidence to the existing literature on the APC trends of smoking intensity. The APC trends are also important in guiding the government to develop, implement, and evaluate antismoking strategies.
Fulltext Prevalence, awareness, treatment and control of diabetes mellitus among the elderly: The 2011 National Health and Morbidity Survey, Malaysia

Ho BK, Jasvindar K, Gurpreet K, Ambigga D, Suthahar A, Cheong SM, et al.

Malays Fam Physician, 2014;9(3):12-9.
PMID: 26425300 MyJurnal

Diabetes mellitus is an important cardiovascular risk factor. The objective of this study was to provide population-based estimates on the prevalence, awareness, treatment and control rate of diabetes among the older persons in Malaysia. Analysis of secondary data from a cross-sectional national population-based survey was done, which was conducted in 2011 throughout Malaysia. A total of 2764 respondents (15.5%) were older persons. The overall prevalence of diabetes among older persons was 34.4% in which 65.2% were aware of their diabetes status. Out of those who were aware, 87.5% had been treated. Only 21.8% of those treated had their diabetes controlled. The results of multiple logistic regression showed that the factors associated with higher awareness rates were women, Indians and higher income groups; factors associated with higher treatment rates were urban residents and those who were married and widow/widower/ divorcee. There was a high overall prevalence, awareness and treatment rate of diabetes among older persons in Malaysia but with suboptimal control rate.
Study name: National Health and Morbidity Survey (NHMS-2011)
Predictors of physical inactivity among elderly malaysians: recommendations for policy planning

Kaur J, Kaur G, Ho BK, Yao WK, Salleh M, Lim KH

Asia Pac J Public Health, 2015 Apr;27(3):314-22.
PMID: 24425796 DOI: 10.1177/1010539513517257

Physical inactivity is the fourth leading risk factor for global mortality. Regular moderate-intensity physical activity has significant benefits for health. To determine the socioeconomic predictors of physical inactivity among elderly Malaysian population. A nationwide community-based survey was conducted among 4831 respondents aged ≥60 years with a face-to-face questionnaire. The prevalence of physical inactivity among the elderly was 88.0%, highest in respondents aged older than 80 years (95.4%), females (90.1%), other Bumiputra (92.2%), earning household income less than RM1000 (87.9%), and residing in urban locality (88.4%). In the multivariate model, the predictors of physical inactivity were only sex, ethnicity, locality, and age group (adjusted odds ratio = 1.3-3.6). The predictors of physical inactivity can identify the risk factors to develop policies that will reduce the public health burden of noncommunicable diseases.
Fulltext Prevalence, awareness, treatment and control of Hypertension among the elderly: the 2006 National Health and Morbidity Survey III in Malaysia

Ho BK, Kaur J, Nainu BM, Omar MA, Saleh M, Yau WK, et al.

Med J Malaysia, 2013 Aug;68(4):332-7.
PMID: 24145262 MyJurnal

INTRODUCTION: The objective of this study was to determine the prevalence and factors associated with the awareness, treatment and control of hypertension among the elderly population in Malaysia.
METHODS: Analysis of secondary data from a cross-sectional national population based survey using stratified multistage sampling conducted from April to August 2006 throughout Malaysia National Health and Morbidity Survey III (NHMS III). Adults aged 60 and older who had participated in the survey were included in the study.
RESULTS: A total of 4954 respondents (14.3%) were elderly from the 34,539 respondents aged 18 years and above for hypertension module in NHMS III. A total of 4933 elderly had their blood pressure examined (giving a response rate of 99.6%). The overall prevalence of hypertension among elderly was 74.0%, more in elderly female (77.4%) than men (70.1%). Only 49.3% of them were aware of their hypertensive status, 42.4% were currently treated and 22.6% of those being treated were under control. The results of multiple logistic regression showed factors associated with higher awareness and treatment rates were similar i.e. females, young-old age group (age 60-74), urban residents, Chinese ethnic group and higher education. For those elderly who were on treatment, determinants associated with controlled hypertension were Chinese and Indians ethnic groups and higher educational level.
CONCLUSIONS: There was a high prevalence of hypertension among the elderly in Malaysia but with poor awareness, treatment and control rate. Reliable information on these aspects is important for the development of patient education programs, health policies to improve disease management and overall health care resource allocation especially among the elderly in Malaysia.
Study name: National Health and Morbidity Survey (NHMS-2006)
Fulltext Secondhand smoke (SHS) exposure at home and at the workplace among non-smokers in Malaysia: Findings from the Global Adult Tobacco Survey 2011

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)
The awareness, knowledge and acceptance among KEMAS personnel towards the KOSPEN programme in Southern Zone, Malaysia. [Abstract]

Sabtu MY, Lim KK, Ismail H, Mohd Zaki NA, Lim KH

Med J Malaysia, 2015;70 Suppl 1:70.

Introduction: The Ministry of Health had initiated a national programme known as “KOSPEN” to study the prevalence of Non Communicable Diseases (NCDs) and its risk factors among the population. The aim of this study is to assess the awareness, knowledge and acceptance of KOSPEN programme among
Community Development Department (KEMAS) personnel in Southern Zone, Malaysia.
Methods: The cross-sectional study was conducted between October and mid December 2014. The study used validated self-administered questionnaires to collect data from the 2375 KEMAS staff from the state of Johor, Malacca and Negeri Sembilan. SPSS version 20 was used for data analysis.
Results: The results revealed that only 25.5% of respondents were aware that they were on the KOSPEN committee and 65.7% said that they knew the functions of KEMAS in KOSPEN. 90.8% were aware that their responsibilities included identifying localities for KOSPEN, identifying volunteers (85.7%) and attending KOSPEN training (75.3%). In terms of knowledge, most of them knew the objectives of KOSPEN, such as “KEMAS will add on the value of the programmes and its activities” (84.3%) and “to establish trained health volunteers in the community” (85.9%). They also knew that healthy eating habits (94.7%), active lifestyle (93.4%), body weight management (87.0%), no smoking (86.8%) and health screening (92.2%) were the components of KOSPEN. Majority of the respondents perceived that the components for intervention in the community were good. The highest accepted component was health
screening (83.5%), follow by healthy eating habits (82.0%), active lifestyle (80.4%), no smoking habit (76.9%) and body weight management (76.1%).
Conclusion: the awareness, knowledge and acceptance of KOSPEN programme by KEMAS personnel are good. Several measures are currently being carried out to improve and strengthen the implementation of KOSPEN programme such as funding, screening equipment and health education materials.
Sociodemographic correlates of knowledge about high sodium-related diseases among adults in Malaysia

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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