Introduction : Stillbirth is one of the important adverse pregnancy outcomes that has been used as a health indicator for the measurement of the health status of a country especially for its obstetric care management. However, the aetiology of the occurrence of the stillbirth was commonly difficult to identify because of limitations in the classification system.
Methods : A review of existing, available information published up to January 2007 on stillbirths in Malaysia was used to obtain the basic background on the determinant factors of stillbirths. Results : Malaysia, which is a fast developing country, reported a stillbirth rate in the range of 4 to 5 per 1000 births. Almost 30- 40% were recorded as normally formed macerated stillbirths. This was based on a rapid reporting system of perinatal deaths using the modified version of the Wigglesworth’s pathophysiology classification. Those of extreme maternal age (less than 19 years and more than 35 years), those reside in rural areas, of the ‘Bumiputera’ and Indian ethnic groups were at higher risk of stillbirth. On detailed analysis it was seen that the risks of having a normally formed macerated stillbirth increased among those who had a preterm delivery and hypertension. Stillbirth rates were also higher in those with shorter gestational age and in those with parity between 2 and 5. No other factors related to stillbirth were found in this review.
Conclusion : This is a review based on existing published data which has a lot of limitation when it comes to analysing other important factors that might be related with the risk of the stillbirth. However, extreme maternal age and mothers from rural areas are the two factors that were persistently found in almost all literature. When these factors are combined with signs of pre term delivery, they indicate that close monitoring needs to be done.
Introduction The health of newborns is inextricably linked to that of their mothers. Some
maternal factors can influence neonatal survival, particularly for low birth
weight babies who are more vulnerable to diseases than normal weight
babies. The aim of this study is to assess the impact of maternal factors on
neonatal mortality among low birth weight babies in Aceh Province,
Methods Study design was unmatched case control. Data collected from 2010 to 2012
in 8 districts in Aceh province, Indonesia. Total sample was 500, divided into
250 LBW who died in neonatal period (case group) and 250 who did not die
in neonatal period (control group). There were 6 maternal variables analysed.
Results Three of six variables analysed were not associated with neonatal mortality
among LBW (P > 0.05); these were: maternal death, parity and education
level. The age of the mother had a significant association with neonatal
mortality among LBW (P < 0.05), but was not a determinant factor. The
maternal illness and birth interval were determinant factors of neonatal
mortality among LBW(P < 0.05); maternal illness (Adj OR= 2.6; 95 % CI:
1.68 - 4.0) and birth interval (Adj OR= 1.8; 95 % CI: 1.20 - 2.91).
Conclusions Maternal illness and birth interval were determinant factors of neonatal
mortality among LBW. Appropriate care throughout stages of pregnancy and
increasing women’s knowledge on high risk pregnancy are the key factors to
the decrease of the neonatal mortality related to the maternal factors.
Introduction Prevalence of adolescents involved in sexual and reproductive problems is on
rise and it was associated with its knowledge. Several factors found to be
associated with the knowledge and various sources of knowledge are chosen
by adolescents for this information. Thus, this study was to determine the
knowledge score, its influencing factors and the preference of the sources of
Methods A cross-sectional study was done using adopted questionnaire involving 330
respondents aged 18 and 19 years old in Kolej MARA Seremban selected by
simple random sampling. They were gathered in the halls and 338
adolescents from 454 students consented to involve in this study. Selfadministered
questionnaire was used whereby a correct response was given a
score of 2, 0 for an incorrect response and 1 for an answer of don’t know.
Total score for all correct answers was 42. Descriptive analysis, bivariate and
multivariate analysis was done in the analysis.
Results The mean knowledge score was 37.32 (±2.967) with a significant difference
for gender. Internets were the most common and preferred sources of the
knowledge among them. There was 5.2% of them had heard on SMS
intervention and 37.0% of them disagreed on SMS intervention.
Conclusions The result showed that the knowledge score was lower in males than females
and internets were the most preferred source of the knowledge. Thus,
interventions for knowledge improvement should be more on male
Introduction: The magnitude of drowning as one of the leading causes of death among children in Malaysia may have been underestimated. Little is known on the level of awareness on water safety among parents as it might be associated with appropriateness and adequacy of the supervision. This study aims to describe perceptions of water safety among parents of primary school children. Methods: A cross-sectional survey with 719 respondent conduct- ed to obtain information on parents self-reported on their children’s water-involved activity and swimming ability, self-estimated ability to rescue their child and perceptions of the risk of drowning and water safety for their children. Results: The result revealed that about 21.6% of respondents did not perceive drowning as one of the unintentional injury leading causes of death among children. Parents reported that their children had experienced a near- drown- ing incident (16.1%), and only 12.2% of the child had attended a formal swimming lesson. Majority of the parents did not involve in any water safety program (98.7%), can’t swim (61.6%), not been certified in CPR (87.3%) and not confident (87.3%) to perform resuscitation (CPR). Respondents also perceived their children could swim (42.1%), and they felt confident when their child in the water (45.6%). There were statistical differences between parents who reported their child had a near-drowning experience with their perception of children’s swimming ability. Conclu- sion: An exploration of parent’s perception of water safety provided an overview of the need for promoting aware- ness on drowning risk and water safety education in this country.
Introduction: Public transit is a sustainable transport mode that can improve the health and well-being of urban population. Following the development of mass rapid transits (MRT) in Greater Kuala Lumpur, this study aims to em- pirically test the behavioral framework behind the intention to use rail transport among private motor vehicle users. Methods: Data was obtained through a cross sectional travel survey (N=509) conducted on the catchment popula- tion of an upcoming MRT line in Greater Kuala Lumpur. The factors in the hypothesized framework were service quality, environmental health concerns, attitude and the intention to use. The data was modeled using the Maximum Likelihood (ML) estimation in structural equations. Results: The validated model indicated that service quality and environmental health concerns significantly affected respondents' intention to use rail transport, mediated by attitude. Reliability, convenience and comfort were the most valued service qualities, while environmental concerns were more valued than health concerns. There were significant moderation by age, income, and having children below 18 years old on the framework. Higher age groups valued more on service quality, while attitude had larger determin- ing effects on the higher income groups. Besides, the lower direct effect of service quality on attitude among higher income groups implied possibility of other affective factors for the subgroup. Conclusion: This study demonstrated the importance of service quality, attitude, and environmental health concerns in encouraging rail transport usage among private motor vehicle users. Certain subpopulations may be targeted for promotion strategies to improve rail transport use in the city.
The aim of the Fourth Millennium Developmental Goal is to reduce mortality among children less than 5 years by two thirds between 1990 and 2015. Efforts are more focus on improving children's health. The aim of this study was to describe the trend of stillbirth and neonatal deaths in University Kebangsaan Malaysia Medical Centre from 2004 to 2010. A retrospective cross-sectional study was conducted using hospital data on perinatal mortality and monthly census delivery statistics. There were 45,277 deliveries with 526 stillbirths and neonatal deaths. More than half of the stillborn cases were classified as normally formed macerated stillbirth and prematurity was common in neonatal deaths. The trend of SB and NND was found fluctuating in this study. However, by using proportionate test comparing rate, there was a transient significant decline of stillbirth but not neonatal deaths rates between 2004 and 2006. On the other hand, the neonatal deaths rate showed significant increment from 2006 to 2008. When both mortality rates were compared using proportionate test, from the start of the study, year 2004 with end of the study, year 2010, there was no significant decline noted. Trends of stillbirth and neonatal death rates in University Kebangsaan Malaysia Medical Centre within 7 years study period did not show the expected outcome as in Millennium Developmental Goal of two thirds reduction.
Falls are the most common injury causing death or long term disability particularly among children. This study aimed to identify the risk factors of the unintentional injuries due to falls in children aged less than five years in Yemen. This cross sectional study enrolled a total of 439 children under five years old from the emergency department of 6 hospitals in Sana'a city. Multistage sampling was used to select six hospitals from public and private sectors in Sana'a city. Face to face interviews were conducted by using a structured questionnaire. Simple logistic regression and multiple logistic regression were used in the analysis. The prevalence of falls among children under five years old was 21.2%. In the multivariate analysis, factors associated with falls among children were young mother (aOR= 0.9, 95% CI 0.81-0.91), working of mother (aOR= 4.5 95% CI 2.40-7.65), frequent family social gatherings (aOR= 2.7, 95% CI 1.54-4.61), number of children at home (aOR= 2.6, 95% CI 1.43-4.64), chewing khat by father (aOR= 2.4, 95% CI 1.38-4.10), presence of staircase in the house (aOR= 2.1, 95% CI 1.24-3.70), number of rooms at home (aOR= 2.2, 95% CI 1.17-3.99) and disabled children (aOR= 3.3, 95% CI 1.20-9.27). In the study, socio-economic and cultural factors such as family gathering and chewing khat were associated with home fall injury among children under 5 years old in Yemen. Health promotion program should take place to reduce the occurrence of fall injury.
Men’s health remain unclear term for majority of general population as well as physician worlwide. Nowadays there is an increase interest in addressing men’s requirement in health care as a separate branch. When discussing about men’s health, it is fair to say that even a man himself does not know much about men’s health. Most of them think that men’s health is just a discussion on sex. This thought is not entirely right. The scope of men’s health is actually larger than the male sex organ itself. To define men’s health, we have to look at man holistically.
Introduction In Malaysia although mortality rate among women of reproductive ages has
reduced over the years, the reduction has been stagnant for the past ten years.
In order to achieve the 5th Millennium Development Goal, several measures
need to be taken including a proper implementation of pre-pregnancy
services in this country. This study explores the awareness, intention and
usage of pre-pregnancy care (PPC) services and its determinant among
women of reproductive ages in Kedah, Malaysia.
Methods This is a qualitative study, which consisted of a focus group discussion
(FGD) among women in the ages of 18 to 45 years old from all ethnic groups
who attended four government clinics in the state of Kedah. The mothers
were chosen through purposive sampling from twelve districts that were
selected through a multistage random sampling. A semi-structured
questionnaire was utilized during the FGD. The results from the FGD were
recorded verbatim and thematic analysis was finalized once saturation of
information from respondents was achieved.
Results These are two themes was identified, namely personal reasons and reasons of
service and there are several subthemes under two main themes. Under the
Personal reason themes, the subthemes including awareness and intention to
used the services, knowledge, perception, social support and history of
medical illness. While under pre-pregnancy care services themes, the
subthemes including the promotion of the services, the communication
relationship with the health staff, the waiting time and also the accessibility
of the service.
Conclusions As a conclusion, there is still part of society who was unaware of prepregnancy
services and its importance in reducing maternal mortality rate as
well as producing good pregnancy outcome. Information and knowledge on
pre-pregnancy care services should be disseminated among community
members through various means including roadshows and pre wedding
Social participation with reference to older persons refers to their integration into the social network of their family and friends, as well as their integration into the communities they live in and into the society as a whole, in as much as their socialization and engagement in recreational, cultural, educational, and spiritual activities are concerned. A social network is a network of social interactions and personal relationships, which are very essential for an individual’s well-being. People are linked together with family and friends, and also with wider communities on account of shared interests, sympathies or living circumstances. Individuals may also form less cordial networks with people whom they encounter through various activities and life situations. Developing and maintaining social relations and social communications are essential and necessary among eldely. However, due to illness and health problems among elderly, they tend to be alone and lost contact with their peers. In addition, getting older reduces the number of friends, and if we add the loss of the own partner, may lead to their social isolation. Such situations are likely to grow increasingly, given the global demographic changes.
The evolution in lifestyle and dietary habits of the Malaysian people that have taken place over the last few decades can be largely attributed to both family and social environment. These factors are known to affect the nutritional status of the community, in both children and adults. Reduced physical activity and changes in their diet have been one of the contributing factors to the rising prevalence of overweight and obesity. However, in Malaysia, in which nutrition transition has been a norm, it is worrying when the trends of overweight and obesity have been rising steadily over the years especially among children. Although numerous strategies to control obesity in Malaysia have been taking place, many had shown little effect. Analysing strategies implemented at national level is thus crucial in order to ascertain reasons for the shortfalls of these strategies especially among children. Obesity most commonly begins as early as the ages of 5 and 6 years, or during adolescence. Obesity is indeed a major public health concern due to its huge negative impact on the society at large which is well supported by evidence-based literatures. Managing this issue is complex and holistic approach is thus crucial in reducing its incidence and prevalence.
Adherence to antiretroviral therapy (ART) plays an important role in the treatment outcomes of human immunodeficiency virus (HIV) infection. Poor adherence would result in failure to prevent viral replication as well as an increased risk of developing drug resistance. Adherence to a life long treatment such as antiretroviral therapy is usually a complicated issue that requires careful and continuous collaboration of patient, family and healthcare provider. The objective of this study was to assess adherence to antiretroviral therapy and its associated factors among people living with HIV. This is a health facility-based cross sectional study conducted among adults’ people living with HIV in Omdurman HIV/AIDS centre, Sudan. Data was collected through direct interview using semi-structured questionnaire. There were only 144/846 (17.02%) who adhered to antiretroviral therapy as prescribed by their doctors. The remaining 51.18% were taking the therapy but not regularly, 31.21% were taking it but currently not and 0.59% stated that they have never taken any antiretroviral therapy. Factors associated with poor adherence that have been identified include female gender (Adj. OR = 3.46 (95%CI: 1.46-8.21), P = 0.005), younger age (Adj. OR = 1.14 (95%CI: 1.02-1.28), P = 0.022), being unemployed (Adj. OR = 5.94 (95%CI: 1.51-23.40), P = 0.011), those who were divorced, separated or widowed (Adj. OR = 11.35 (95%CI: 1.74-73.96), P = 0.011) and respondents who perceived that their health status is poor (Adj. OR = 5.21 (95%CI: 1.44-18.81), P = 0.012) or very poor (Adj. OR = 4.04 (95%CI: 1.27-12.81), P = 0.018). Educational level and social support against HIV-related stigma and discrimination were not significantly associated with adherence. Adherence to antiretroviral therapy among the respondents is very poor. Urgent interventions based on modifiable factors and mainly targeting females and younger age group are needed to improve adherence to antiretroviral therapy among people living with HIV.