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Fulltext Very short answer questions: a viable alternative to multiple choice questions

Puthiaparampil T, Rahman MM

BMC Med Educ, 2020 May 06;20(1):141.
PMID: 32375739 DOI: 10.1186/s12909-020-02057-w

BACKGROUND: Multiple choice questions, used in medical school assessments for decades, have many drawbacks such as hard to construct, allow guessing, encourage test-wiseness, promote rote learning, provide no opportunity for examinees to express ideas, and do not provide information about strengths and weakness of candidates. Directly asked, directly answered questions like Very Short Answer Questions (VSAQ) are considered a better alternative with several advantages.
OBJECTIVES: This study aims to compare student performance in MCQ and VSAQ and obtain feedback. from the stakeholders.
METHODS: Conduct multiple true-false, one best answer, and VSAQ tests in two batches of medical students, compare their scores and psychometric indices of the tests and seek opinion from students and academics regarding these assessment methods.
RESULTS: Multiple true-false and best answer test scores showed skewed results and low psychometric performance compared to better psychometrics and more balanced student performance in VSAQ tests. The stakeholders' opinions were significantly in favour of VSAQ.
CONCLUSION AND RECOMMENDATION: This study concludes that VSAQ is a viable alternative to multiple-choice question tests, and it is widely accepted by medical students and academics in the medical faculty.
Influence of environmental factors on biology and catch composition of Barbonymus schwanenfeldii in a tropical lake, northern Malaysia: implications for conservation planning

Rahman MM, Fathi A

Environ Sci Pollut Res Int, 2022 Feb;29(9):13661-13674.
PMID: 34590229 DOI: 10.1007/s11356-021-16502-w

Very little work has determined the relative importance of uncontrolled environmental factors for affecting fish biology, and how these might influence gillnet catches. This study addresses this deficit for an important Southeast Asian cyprinid (Barbonymus schwanenfeldii). Fish were caught monthly for 12 months using gillnets of three different mesh sizes, each of which was deployed in duplicate at the surface of one of three randomly selected sites in Lake Kenyir, Malaysia, concurrent with determining various environmental parameters and the abundance of phytoplankton (chlorophyll-a). Results indicated that growth co-efficient of B. schwanenfeldii was positively influenced by dissolved oxygen and negatively influenced by total inorganic nitrogen, whereas an opposite result was observed in case of the hepatosomatic index of fish. Water turbidity was a limiting factor only for small fish (mean total length: 15.74±1.10 cm). B. schwanenfeldii could best be caught during the period of high phytoplankton abundance or at the location of high phytoplankton density in the water. Water temperature negatively influenced the gillnet catches of the fish. The remaining environmental factors such as water depth, pH, and phosphate had a weak and insignificant influence (P >0.05) on the biology and gillnet catches of fish. The observed results can be very useful for the ecological monitoring and conservation plans for this species in relation to climate change. Furthermore, the utility of the similar data for other species would be useful not only for regional but also for international fishery by optimizing catches considering environmental conditions.
Fulltext Pseudomonas aeruginosa bacteremia secondary to acute right leg cellulitis: case of community-acquired infection

Wahab AA, Rahman MM

EXCLI J, 2013;12:997-1000.
PMID: 27034639

Pseudomonas aeruginosa is a gram-negative bacillus that causes wide spectrum clinical infections. However, it is most frequently associated with hospital-acquired infection. In this case a 58-year-old male with underlying hypertension and dyslipidaemia was admitted for acute right leg cellulitis. Pseudomonas aeruginosa was identified from the case, though it was not a usual suspected organism. It might be due to community-acquired infection.
Genetical and immunological analysis of recent Asian type A and O foot-and-mouth disease virus isolates

Freiberg B, Rahman MM, Marquardt O

Virus Genes, 1999;19(3):167-82.
PMID: 10595408

This report extends the knowledge on the epizootical situation of foot-and-mouth disease in Asia. RNA from six samples of type A and five of type O virus, isolated between 1987 and 1997 in Bangladesh, Iran, Malaysia and Turkey, was subjected to reverse transcription-dependent polymerase chain reactions that amplify large parts of the capsid protein VP1 encoding genome region. The amplification products were sequenced, and the sequences aligned to each other and to published sequences. This showed the type O isolates of 1987-1997 from Bangladesh to be of same genotype and closely related to isolates of 1988 and later from Saudi Arabia, 1990 from India, 1996 from Greece and Bulgaria, and 1997 from Iran. Among the analyzed type A isolates, those of 1992 and 1996 from Turkey were of same genotype and related to previously described isolates of 1987 from Iran and of 1992 from Saudi Arabia. The isolate of 1997 from Malaysia was found to be related to isolates from Thailand of 1993 and 1996. The isolates of 1987 from Bangladesh and 1997 from Iran, however, represent different so far not described genotypes. Monoclonal antibodies, raised against the vaccine production strains A22 Iraq, Asial Shamir, O1 Kaufbeuren and O1 Manisa, and the recent type A field isolates Saudi Arabia/92 and Albania/96, were used in an ELISA to compare the reaction patterns of many of the field isolates. The monoclonal antibodies were further characterized for virus-neutralizing activity and binding to trypsinized homologous virus. The failure of neutralizing antibodies in binding to trypsinized homologous as well as to heterologous virus suggested the epitopes to reside at the major antigenic component of the virus, which is the capsid protein VP1. Two non-neutralizing antibodies that bind to trypsin-sensitive epitopes cross-reacted, however, with heterologous virus. This indicates the existence of a trypsin-sensitive antigenic site outside of VP1. In summary, the results obtained by ELISA confirm the observed sequence differences, but indicate further sequence differences at minor antigenic sites that do not reside on VP1.
Fulltext Barriers, strength and weakness of pre-pregnancy clinic services in Sarawak: a qualitative analysis from provider perspectives

Abdul Rahim N, Rahman MM

Malaysian Journal of Public Health Medicine, 2018;18(1):149-157.
MyJurnal

Pre-pregnancy Clinic (PPC) services is one the plausible efforts towards achieving the Millennium Development Goals. However, various issues still need to be addressed for improvement of the services. Considering this view, an attempt was made to explore the barriers, strength and weakness of current practice of pre-pregnancy clinic services in Sarawak, since the programme has been implemented in this state from the year 2011. This cross-sectional study was conducted at nine selected health care facilities throughout Sarawak. A multistage sampling procedure was adapted to select the health care facilities. An unstructured open-ended questionnaire was administered to get the in-depth perceived views and current practice of pre-pregnancy clinic services. A total of 322 health care providers from nine selected health care facilities gave their feedback. In the present paper, a qualitative analysis was done for the openended questions to get in-depth views of barriers, strength and weakness of pre-pregnancy clinic services. The results of the study were narrated in textual form and a thematic analysis was done manually. The identified themes for perceived barriers to the provision of pre-pregnancy care were perception, attitude and acceptance of PPC services, socio-economic issues, services and client factors. The perceived weaknesses of the services are listed under two main themes: working environment and service factors, while, the strength of services produced three thematic areas which are preparation for pregnancy, prevention of mortality and morbidity and comprehensive services. Though prepregnancy services are beneficial for society wellbeing, various issues still need to be considered for the improvement of the quality of services. Lack of awareness, no ministerial guidelines or Standard Operating Procedures (SOP) and knowledge pertaining to the services were few of the main areas which need to be pondered upon. Promotional activities and campaigns should be geared up ensuring availability the services to the general population.
Fulltext Factors determining attempt-to-quit smoking among adult current smokers in Sarikei, Sarawak, Malaysia

Wong KY, Rahman MM

Malaysian Journal of Public Health Medicine, 2017;17.

Achieving smoking cessation is an arduous process, where smokers try different methods or approaches to achieve cessation. Quit smoking attempts play an important role in smoking cessation.Thus, this study was conducted to determine the factors associated with attempt-to-quit smoking among the currentsmokers in Sarawak.This cross-sectional study was conducted among adult smokers in Sarikei, Sarawak by face-to-face interview using an adapted and validated questionnaire. Non-probability sampling method was used to select the study place. An adult smoker was selected systematically from each selected household. A total of 482 smoker households were identified with a response rate of 92.3%. Data was analysed using IBM SPSS Version 22.0. A p-value of <0.05 was considered statistically significant. The mean (SD) age of the smokers was 36.3(13.3) years. However, the mean (SD) age of smoking initiation was 18.5(4.8) years. Majority of the smokers were male (91.5%), with the male to female ratio being 1:0.1. Mean (SD) score on The Fagerström Test for Nicotine Dependence was 4.75(2.4), while motivation to quit smoking score was 3.04(1.0). Majority of the smokers (83.1%) hadever seen pictorial health warnings on cigarette packs. More than half of the smokers (54.8%) had ever tried to quit smoking. Binary logistic regression analysis revealed that marital status, religion, ethnicity, pictorial health warnings on cigarette packs and motivation to quit smoking appeared to be the significant predictors of attempt-to-quit smoking (p<0.05). Understanding the attempts to quit smoking will assist inclinical expectations. Thus, a smoking cessation programme should be designed in line with these factors, to aid quit smoking attempts.
Does work-family balance mediate the relationship between work-family conflicts and job satisfaction of academicians?

Rahman MM, Ali NA

J Community Psychol, 2021 03;49(2):361-374.
PMID: 33131092 DOI: 10.1002/jcop.22464

Extreme workloads and strict work schedules make an individual cut their time and energy from their family domain, which may create a conflict, and this situation is called Work-Family Conflict (W-FC). Besides this, Work Family Balance (WFB) and Job Satisfaction (JS) issues are significant for academics because they have to play two roles (Job and Family) at the same time. This paper's fundamental objective was to investigate the indirect effect (mediation) of WFB through both forms of W-FC and JS. Following the convenience sampling technique, 250 married academicians from different private universities were considered for the sample size. Analysis of Moment Structures (AMOS) and Statistical Package for the Social Sciences (SPSS) was used to complete the data analyses. The outcomes of this study showed that out of the two forms, only W to F has significant adverse effects on JS. Also, it was found that to some extent, WFB showed a partial mediating effect only between W to FC and JS, whereas there was no mediating effect through F to WC and JS. These findings will help both academicians and higher authorities of private universities in Bangladesh. The higher authorities and decision-makers of the private universities in Bangladesh can identify the sources of W-FCs and take the necessary steps to mitigate the level of W-FCs.
Fulltext The United Nations (UN) Card, Identity, and Negotiations of Health among Rohingya Refugees

Rahman MM, Dutta MJ

Int J Environ Res Public Health, 2023 Feb 15;20(4).
PMID: 36834082 DOI: 10.3390/ijerph20043385

Being persecuted and expelled from Myanmar, Rohingya refugees are now distributed throughout the world. The Southeast Asian nation of Malaysia has been a preferred destination for Rohingyas fleeing Myanmar's state-sponsored genocide and more recently in a bid to change their fates from the refugee camps in Bangladesh. Refugees are one of the most vulnerable groups in Malaysia and often face dire circumstances, in which their health and wellbeing are compromised. Amidst a plethora of structural challenges, Rohingya refugees try to claim some of their rights with the aid of the UN card (UNHCR ID cards) in Malaysia. Guided by the culture-centered approach (CCA), this study examined the perspectives and experiences of healthcare among Rohingya refugees while living in Malaysia, now resettled in Aotearoa, New Zealand. The participants' narratives showed that the UN card not only materialized their refugee status in Malaysia but also offered them a way of living in a world where documents anchor the materiality of health.
Effects of deep frying on proximate composition and micronutrient of Indian mackerel (Rastrelliger kanagurta), eel (Monopterus albus) and cockle (Anadara granosa)

Rahman MM, Zamri M, Fadilla N

Pak J Biol Sci, 2012 Jun 15;15(12):589-94.
PMID: 24191621

This study was conducted to determine the proximate composition and four micronutrients (Cd, Cu, Mn and Zn) of Indian Mackerel (Rastrelliger kanagurta), Eel (Monopterus albus) and Cockle (Anadara granosa). All fish and shellfish were purchased from local fish market in Kuantan city. All samples of each species were mixed and divided into two groups based on random selection. Each group were again divided into 3 sub-groups which were considered as replications. The first group were kept uncooked. The second group were fried in a beaker of 400 mL palm cooking oil capacity at a temperature approximately of 180 degrees C for a 15 min period. Both raw and fried samples were analysed following standard methods to determine protein, lipid, ash, moisture, carbohydrate, Cd, Cu, Mn and Zn contents. Results showed that protein content was higher in Indian mackerel and eel than cockle while overall Cd, Cu, Mn and Zn contents were higher in cockle than Indian mackerel and eel. Therefore, fish is better than shellfish in the nutritional point of view. Fried fish and shellfish had very high fat content. Therefore, frying cannot be recommended to prepare a healthy diet. More research is needed including all cooking methods of fish to know the nutritional changes by each cooking method. Fish contains many important fatty acids and amino acids which might be lost during frying. Therefore, future study should include the effects of different cooking methods on amino acids and fatty acids compositions of fish and shellfish.
Fulltext Comparative efficacy sensitivity and specificity of the tests used for the diagnosis of Helicobacter pylori

Suhaila N, Hussin S, Rahman MM

Pak J Biol Sci, 2010 Nov 01;13(21):1057-61.
PMID: 21313878

Abstract: A total number of 157 samples were examined by 4 different tests-In-house rapid urease (iRUT), Culture, Histopathology and Immunochromatography (Immuno CardSTAT) for the detection of Helicobacter pylori from the patients reported to Hospital Kuala Lumpur, Malaysia during 2007 to 2008. Out of the samples examined 47 (29.9%) were positive for H. pylori by the tests used in the laboratory. Efficacy of detection of the bacteria by the tests- In-house rapid urease, Culture, Histopathology and Immuno CardSTAT were 31.8, 13.9, 30.3 and 32.8%, respectively. However, sensitivity and specificity of the iRUT were 91.5 and 93.6%, respectively and the Positive Predictive Value (PPV) was 86% and the Negative Predictive Value (NPV) was 96.3%. The sensitivity for Immuno CardSTAT rapid test was 100% and the specificity was 79.3%. The PPV was 50% and the NPV was 100%. Convenient methods to the authors were 'In house rapid urease test and Immunochromatography though variability of specificities were observed.
Fulltext Influenza and Respiratory Syncytial viral infections in Malaysia: Demographic and Clinical perspective

Rahman MM, Wong KK, Hanafiah A, Isahak I

Pak J Med Sci, 2014 Jan;30(1):161-5.
PMID: 24639853 DOI: 10.12669/pjms.301.4272

Respiratory infections represent a major public health problem worldwide. The study aimed to determine the prevalence of respiratory syncytial and influenza virus infections and analyzed in respect to demography and clinical perspective. Methods : The specimens were processed by cell culture and immunofluorescent assay (IFA) and real-time reverse transcriptase-PCR (rRT-PCR) for detection of respiratory viruses. Results : Out of 505 specimens 189 (37.8%) were positive, in which RSV was positive in 124(24.8%) cases and influenza A was positive in 65(13%) cases. Positive cases for influenza virus A and RSV were analyzed based on demography: age, gender, ethnicity and clinical symptoms. There were no significant differences among gender, ethnicity and clinical symptoms in both RSV and influenza A virus infections. It was observed that children below 3 years of ages were more prone to RSV infections. On the contrary, influenza virus A infected all age groups of humans.
Attitudes towards the use of fluorides for oral health among Islamic clerics in Kelantan Province, Malaysia

Nazita Y, Jaafar N, Doss JG, Rahman MM

Community Dent Health, 2013 Mar;30(1):30-3.
PMID: 23550504

To assess the knowledge, attitudes and practices of Imams (Islamic clerics) concerning fluoride toothpaste and fluoridated water to improve oral health in Kelantan.
Fulltext Enhanced accumulation of copper and lead in amaranth (Amaranthus paniculatus), Indian mustard (Brassica juncea) and sunflower (Helianthus annuus)

Rahman MM, Azirun SM, Boyce AN

PLoS One, 2013;8(5):e62941.
PMID: 23667546 DOI: 10.1371/journal.pone.0062941

Soil contamination by copper (Cu) and lead (Pb) is a widespread environmental problem. For phytoextraction to be successful and viable in environmental remediation, strategies that can improve plant uptake must be identified. In the present study we investigated the use of nitrogen (N) fertilizer as an efficient way to enhance accumulation of Cu and Pb from contaminated industrial soils into amaranth, Indian mustard and sunflower.
Fulltext Psidium guajava and Piper betle leaf extracts prolong vase life of cut carnation (Dianthus caryophyllus) flowers

Rahman MM, Ahmad SH, Lgu KS

ScientificWorldJournal, 2012;2012:102805.
PMID: 22619568 DOI: 10.1100/2012/102805

The effect of leaf extracts of Psidium guajava and Piper betle on prolonging vase life of cut carnation flowers was studied. "Carola" and "Pallas Orange" carnation flowers, at bud stage, were pulsed 24 hours with a floral preservative. Then, flowers were placed in a vase solution containing sprite and a "germicide" (leaf extracts of P. guajava and P. betle, 8-HQC, or a copper coin). Flowers treated with 8-HQC, copper coin, and leaf extracts had longer vase life, larger flower diameter, and higher rate of water uptake compared to control (tap water). The leaf extracts of P. guajava and P. betle showed highest antibacterial and antifungal activities compared to the other treatments. Both showed similar effects on flower quality as the synthetic germicide, 8-HQC. Therefore, these extracts are likely natural germicides to prolong vase life of cut flowers.
Fulltext Molecular epidemiology and phylogenetic analysis of Dengue virus type-1 and 2 isolated in Malaysia

Chew MH, Rahman MM, Hussin S

Pak J Med Sci, 2015;31(3):615-20.
PMID: 26150855 DOI: 10.12669/pjms.313.6340

Detection of different serotypes of dengue virus and provide information on origin, distribution and genotype of the virus.
Fulltext The relevant intervention strategies for improving medication adherence of diabetic patients

Akoi C, Rahman MM, Abdullah MS

Int J Public Health Res, 2013;3(1):236-240.
MyJurnal

Medication adherence is very important for the effective treatment or control of various health problems, including chronic disease like diabetes mellitus (DM). However, medication non-adherence among diabetic patients on follow-up treatment is still a global health problem. This study aimed to identify factors associated with medication adherence and to determine methods on how it could be improved. A cross-sectional study was conducted on medication adherence among Malays, Iban and Melanau ethnic groups in Kota Samarahan and Sarikei, Sarawak using the Health Belief Model framework. Interviews with questionnaires, which were tested for its validity and reliability using the Cronbach’s Alpha, were conducted to collect data on the respondent’s socio-demographic and economic characteristics, and health beliefs of 442 respondents. Data was analyzed using SPSS version 17.0 for frequency distribution, measures of central tendencies, significance testing and logistic regression. The medication adherence rates were low in terms of all the treatment indicators such as amount of medication (31.7%), frequency (38.9%), duration (26%), and follow-up treatment (24.2%). The respondent’s socio-economic and economic characteristics have statistically significant association with medication adherence. The respondents adhered towards medication because they believed in its benefits. They also took their medication because they believed in the severity of DM and their susceptibility to its serious complications. The cues to action (medication taking) such as worrying about their socio-economic well-being, effectiveness of medication, and health campaign on diabetic control have influenced medication adherence. However, forgetfulness, distance of clinic, and costs of transport have caused medication non-adherence. The respondent's health beliefs in the benefits of taking medication, perceived severity and susceptibility to DM and its serious complications have contributed towards medication adherence. Their concerns about the socio-economic well-being, effectiveness of medication, and health campaign on diabetic control were positive cues to medication taking behavior. Therefore, modifying the respondent's related health beliefs and reinforcing the positive cues to actions are the relevant intervention strategies that could be used in improving medication adherence among diabetic patients.
Fulltext Factors affecting satisfaction on antenatal care services in Sarawak, Malaysia: evidence from a cross sectional study

Rahman MM, Ngadan DP, Arif MT

Springerplus, 2016;5(1):725.
PMID: 27375994 DOI: 10.1186/s40064-016-2447-3

High levels of satisfaction among women with the antenatal care services will increase the compliance of antenatal visits during pregnancy. Thus, this study was done to assess the level of satisfaction among women on the quality of antenatal care received and the factors influencing thereof.
Fulltext Factors affecting intention to disclose HIV status among adult population in Sarawak, Malaysia

Lemin AS, Rahman MM, Pangarah CA

J Environ Public Health, 2018;2018:2194791.
PMID: 30186334 DOI: 10.1155/2018/2194791

Background: Disclosure of HIV-positive status is an essential prerequisite for the prevention and care of person living with HIV/AIDS as well as to tackle hidden epidemic in the society.

Objective: To determine the intention to disclose the HIV/AIDS status among adult population in Sarawak, Malaysia, and factors affecting thereof.

Methods: This cross-sectional community-based study was conducted among adult population aged 18 years and above in Sarawak, Malaysia. A gender-stratified multistage cluster sampling technique was adopted to select the participants. A total of 900 respondents were successfully interviewed by face-to-face interview using interview schedule. Stepwise binary logistic regression models were fitted in SPSS version 22.0 to identify the factors associated with the disclosure of HIV/AIDS status. A p value less than 0.05 was considered as statistically significant.

Results: The mean (SD) age of male and female respondents was 41.57 (13.45) and 38.99 (13.09) years, respectively. A statistically significant difference of intention to disclosure of HIV status was found between males and females (p < 0.05). A stepwise binary logistic regression analysis revealed that age, occupation, knowledge on HIV transmission, and content of discussion about HIV/AIDS appeared to be potential predictors for male respondents to disclose HIV status, while ethnicity and content of discussion on HIV/AIDS were found to be important predictors among the female respondents (p < 0.05).

Conclusion and Recommendation: Though the study did not depict the national prevalence of disclosure of HIV/AIDS status, the findings of the study would provide an important basic information for programme intervention, policy, and future research agenda.
Fulltext Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: A review

Rahman MM, Mahadeva S, Ghoshal UC

World J Gastroenterol, 2017 Oct 07;23(37):6788-6801.
PMID: 29085223 DOI: 10.3748/wjg.v23.i37.6788

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.
Suicide risk among adolescents in Sarawak, Malaysia: prevalence and determining factors

Ying WK, Rahman MM, Kiyu A

Int J Adolesc Med Health, 2024 Aug 01;36(4):399-407.
PMID: 38997223 DOI: 10.1515/ijamh-2024-0081

OBJECTIVES: Adolescent suicide is a significant global public health concern. Although numerous studies have investigated factors that influence the risk of suicide among adolescents around the world, limited data are available in the Malaysian context, especially among the diverse ethnic communities of Sarawak. This study aimed to determine the factors associated with the risk of suicide among adolescents in Sarawak, Malaysia.
METHODS: A community-based cross-sectional study was conducted among 1,344 adolescents in Sarawak using face-to-face interviews. Hierarchical binary logistic regression analysis was performed to identify factors that determine the risk of suicide among adolescents.
RESULTS: Two predictive models were constructed. Both models revealed that being female (OR=1.578, 95 % CI: 1.191, 2.092, p=0.001), having Malay ethnicity (OR=1.733, 95 % CI: 1.236, 2.429, p=0.001) and having a disease significantly increased the risk of suicide (OR=1.895, 95 % CI: 1.221, 2.942, p=0.004). In particular, Model 2, which showed a better fit, found that occasional religious practice (OR=1.610, 95 % CI: 1.126, 2.303, p=0.009), poor parental relationships (OR=1.739, 95 % CI: 1.035, 2.922, p=0.037) and higher addiction (OR=1.015, 95 % CI: 1.008, 1.022, p=0.001), depression (OR=1.919, 95 % CI: 1.241, 2.968, p=0.003), and stress (OR=2.707, 95 % CI: 1.689, 4.340, p=0.001) scores were significantly associated with an increased risk of suicide.
CONCLUSIONS: This study sheds light on multiple factors that contribute to the risk of suicide among adolescents in Sarawak. These findings underscore the importance of holistic prevention strategies, including psychological and social dimensions, to mitigate the risk of suicide in this population. Further research is warranted to understand the complex interplay of these factors and guide the development of targeted interventions.

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