Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with adverse effects. However, NSAIDs are among the most popular pain killers and easily available over the counter. This study aimed to determine the prevalence of NSAIDs use in Malaysian adults and among those with chronic diseases such as arthritis, kidney disease, hypertension, heart disease and asthma. It also examined the factors associated with NSAIDs use. Data from the National Health Morbidity Survey (NHMS) 2011, a nation-wide survey was analysed. A total of 18231 respondents aged 18 years and above responded to this module. Multivariate logistic regression was used to investigate the association between NSAIDs use and associated factors. The overall prevalence of NSAIDs use among Malaysian adults was 14.2% (95%CI 13.3-15.1). Of the respondents, 4.2% (95%CI 3.8-4.7) took NSAIDs once daily. NSAIDs use was highly associated with those who were ever-told to have arthritis (aOR: 3.03; 95%CI 2.60-3.52) and have difficulty of performing daily activities or work (aOR: 2.06; 95%CI 1.86-2.28). Those who were ever-told to have kidney disease (aOR: 2.36; 95%CI 1.74-3.20), ever-told to have asthma (aOR: 1.36; 95%CI 1.17-1.58), ever-told to have heart disease (aOR: 1.34; 95%CI 1.08-1.65), known hypertension (aOR: 1.22; 95%CI 1.08-1.37) also were associated with NSAIDs use. By socio-demographic profiles, NSAIDs use was positively associated with those who have government benefit scheme or private health insurance (aOR: 1.44; 95%CI 1.31-1.58), higher education level (aOR: 1.35; 95%CI 1.20-1.51), higher household income (aOR: 1.26; 95%CI 1.11-1.44, aOR: 1.12; 95%CI 1.02-1.24), currently working (aOR: 1.25; 95%CI 1.13-1.39) and female (aOR: 1.17; 95%CI 1.07-1.28). NSAIDs use was less likely among those aged 60 years and above (aOR: 0.83; 95% CI 0.72-0.97), Chinese (aOR: 0.41; 95% CI 0.36-0.47) and ‘Others’ ethnicity (aOR: 0.82; 95% CI 0.67-0.99) compared to Malay ethnicity. NSAIDs use is prevalent in Malaysian adults and associated with co-morbidities and higher socio-demographic status, thus appropriate awareness should be promoted and highlighted in the community.
Study name: National Health and Morbidity Survey (NHMS-2011)
There are several methods available for assessment of sodium intake, including dietary and urinary excretion, which are fraught with methodological difficulties. Therefore, the aim of this study was to validate dietary and urinary excretion methods against 24-hour urinary excretion method in estimating sodium intake in Malaysian adults. A cross-sectional study has been carried out between November to December 2015. About 1568 adults aged 18 to 59 years old have participated from 16 study sites located in the 13 states and two federal territories of Malaysia. The study collected basic socio-demographic data and habitual dietary intake by Food Frequency Questionnaire (FFQ). Respondents were also asked to complete a two-day food intake diary (2FD) and collect their 24-hours urine and spot urine using standard protocols. A total of 1116 adults successfully completed the survey, yielding a response rate of 71%. Sodium intake from 24-hour urine excretion was estimated at 2585.9mg/day which is above the recommendation by World Health Organization (WHO). The 2FD showed the nearest mean estimate to the reference method but the spot urine with Tanaka’s predictive equation showed the least bias. The estimation of sodium from spot urine alone or with Kawasaki’s predictive equation and FFQ method showed poor mean estimates and a large bias compared to the reference method. The 2FD and spot urine with Tanaka’s prediction equation can be good alternatives for estimating daily sodium intake at the population level but not at the individual level.