Displaying all 18 publications

  1. Fadilla, Y.I., Sutan, R.
    This study was conducted to determine the proportion and factors associated with periodontal disease among younger adult attended Al Fatah Dental Faculty in Libya. A cross sectional study with universal sampling methods was carried out from July 2010 until September 2010 among 70 Libyan subjects aged between 20-35 years. The data in this study was collected using self administrated questionnaire, followed by oral examination done by trained dentists. The results of this study showed that, the prevalence of periodontal disease in Libyan subjects was 75.7%. Gender, oral care habits, smoking were found significantly associated with presence of periodontal disease. Gingivitis has been found the most common types of periodontal disease (94%). High percentage of periodontal disease in this study was among men (87.9%) compared to women (69.9%). In conclusion, modifiable factors like changing lifestyle such as avoiding smoking and practicing oral care can be promoted to prevent periodontitis.
  2. Leny, S.S., Shuhaila, A., Sutan, R.
    Maternal Home-based Record (MHR) is a concise medical record that can be kept by the pregnant women for regular documentation throughout pregnancy stages. This study was done to assess the usage of the MHR among the pregnant women and its associated factors. A good MHR usage was assigned using mean value as cut-off point that has been agreed by an expert group from scoring system which incorporates usage elements in term of follow-up, information documentation, knowledge seeking, continuity of care and self-monitoring of pregnancy. A cross-sectional survey was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) and a total of 79 pregnant women who attended the antenatal clinic were recruited. A validated self-administered questionnaire was used. The questionnaire was newly developed in Bahasa Malaysia. Content validity and reliability test for internal consistency for the knowledge, satisfaction and usage scale was performed. The Cronbach’s Alpha value for each domain was 0.764, 0.716 and 0.877 respectively. The results showed that the prevalence of good MHR usage was 51.3%. There were significant association found between level of education (Adj OR=0.32, 95% CI 0.12, 0.85, p=0.023) and doctor as birth attendant in previous pregnancies (Adj OR= 2.54, 95% CI 1.97, 6.59, p=0.045) with good usage of MHR. There was a positive significant relationship between satisfaction level among the respondent and the level of the usage (p=0.01, r=0.377), whereby with every increase in 1 score in satisfaction level will increase the usage score by 0.4 (95% CI 0.2 to 0.7) units, p<0.01. Therefore, MHR is still relevant as antenatal care monitoring instruments and it is important to make an effort to improve patient satisfaction in using MHR. Health care providers can use this validated self-administered questionnaire to assess function of MHR to remain relevant to the pregnant women population in their locality.
    Key words: Antenatal care, home-based maternal record, usage, satisfaction
    Study site: Antenatal clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  3. Sutan R, Berkat S
    PMID: 25269390 DOI: 10.1186/1471-2393-14-342
    BACKGROUND: Cultural practice have often overlooked when providing maternal and child health care services. Low birth weight is the second cause of neonatal mortality in the world but it is a major factor in a developing country such as Indonesia. The purpose of this study is to predict the neonatal mortality among low birth weight babies in Aceh Province Indonesia.
    METHODS: Unmatched case control study was conducted using data from year 2010 to 2012 in 8 selected districts of Aceh Province Indonesia. A total of 500 samples were obtained. There were 250 of the samples died in neonatal period (case group) and 250 who were alive (control group). There were 26 variables studied and were grouped into 4 factors: neonatal factor, maternal factor, maternal and child health services and neonatal care practices. The data was analysed using bivariate logistic regression and multivariate logistic regression.
    RESULTS: There were 13 out of 26 variables found as determinant factors of neonatal mortality among low birth weight babies in Aceh Province. The predictors found in this study were: boy (aOR1.80, 95% CI: 1.09-2.96), moderate low birth weight (aOR17.84, 95% CI: 6.20-51.35), preterm (aOR1.84, 95% CI: 1.07- 3.17), presence of maternal illnesses (aOR1.87, 95% CI: 1.06-3.30), too short or too long birth interval (aOR1.80, 95% CI: 1.20-2.91), inappropriate antenatal care (aOR2.29, 95% CI: 1.34-3.91), inappropriate neonatal visit (aOR7.04, 95% CI: 3.67-13.49), not practicing kangaroo mother care (aOR15.32, 95% CI: 2.85-82.56), not using warm bottle padding (aOR20.70, 95% CI: 6.32-67.80), not practicing 'didaring' (aOR4.33, 95% CI: 1.83-10.19), late initiation of breastfeeding (aOR2.03, 95% CI: 1.09-3.80), discard colostrums (aOR3.53, 95% CI: 1.93-6.43) and not practicing exclusive breastfeeding (aOR5.58, 95% CI: 2.89-10.77).
    CONCLUSIONS: Cultural practices are strongly seen among Acehnese. Inappropriate antenatal care and neonatal care, late initiation of breastfeeding, discarding colostrums and not practicing exclusive breastfeeding were related to cultural practices. Improving knowledge heat preservation to prevent hypothermia using Kangaroo mother care, warm bottle padding and 'didaring' were proven methods to reduce neonatal mortality. Strengthening of health services in screening for high risk cases and anticipate intervention tailored to cultural practices are important to decrease neonatal mortality among low birth weight.
  4. Sutan R, Miskam HM
    BMC Womens Health, 2012;12:15.
    PMID: 22708998 DOI: 10.1186/1472-6874-12-15
    Women of reproductive age are vulnerable to psychosocial problems, but these have remained largely unexplored in Muslim women in developing countries. The aim of this study was to explore and describe psychosocial impact and social support following perinatal loss among Muslim women.
  5. Zakaria R, Sutan R, Jaafar R
    PMID: 32642469 DOI: 10.4103/jehp.jehp_497_19
    INTRODUCTION: Educating a mother of a premature baby and providing a structured written educational information can enhance better understanding and practice. This article describes the development and implementation of a health educational package for preemie moms in the care of their premature baby after neonatal intensive care unit discharge.

    SUBJECTS AND METHODS: The package known as "Preemie Mom: A Guide for You" was designed based on Stufflebeam's model and has four phases: (1) content evaluation from available sources of information, (2) input evaluation based on mothers' need related to premature baby care, (3) process evaluation for package designing and content drafting, and (4) product evaluation to determine its feasibility. The contents were extracted and collated for validation by consulting various specialists in related fields. A final draft was drawn based on comments given by experts. Comments from the mothers were taken for formatting, visual appearance, and content flow for easy understanding and usage.

    RESULTS: All ten existing articles and eight relevant documents were gathered and critically appraised. The package was designed based on 11 main components related to the care of premature baby after discharge. The content validation was accepted at a minimum score of 0.85 for the item-level content validity index analysis. Both experts and mothers were agreed that the package is easy to use and well accepted as a guide after discharge. The agreement rate by the mothers was at 93.33% and greater for the front page, writing style, structure, presentation, and motives of the package.

    CONCLUSIONS: "Preemie Mom: A Guide for You" is a validated health educational package and ready to be used to meet the needs of the mother for premature baby care at home.

  6. Sutan R, Mihat M, Azmi MT
    Med J Malaysia, 2021 Nov;76(6):804-810.
    PMID: 34806664
    INTRODUCTION: Pre-pregnancy care (PPC) is an established health care program for women of reproductive age that has been widely implemented globally. The implementation of these services varies between countries based on the guidelines advocated. Thus, a standard level of assessment on measuring the performance of the service was difficult. This study aimed to measure the status of implementation PPC services among health workers using the transtheoretical model framework.

    METHODS: A cross-sectional study was conducted among 445 healthcare workers using a validated questionnaire based on local PPC guideline published by the Ministry of Health Malaysia (MOH).

    RESULTS: The results showed that many respondents were in the implementation action stage (57%), followed by the maintenance stage (20%), preparation stage (19%), contemplation stage (4%) and pre-contemplation stage (<1%). Further categorisation showed that only 43% of the respondents are successfully implementing PPC according to the standard of MOH. Clinics lead by the Family Medicine Specialist (Adjusted Odds Ratio, AOR 2.845; 95% Confidence Interval, 95%CI: 1.839, 4.40), daily usage of teleprimary care system (TPC) in the clinic (AOR 1.563; 95%CI: 1.019, 2.397), and attended TPC training (AOR 3.358; 95%CI: 2.221, 5.075) were significantly determining the success of PPC implementation.

    CONCLUSION: The emphasis on motivation and rewards among the healthcare workers, provision of good internet connection at health clinics and developing a comprehensive model of PPC training targeting the specific healthcare workers are mandatory to enhance the PPC services implementation.

  7. Sutan R, Campbell D, Prescott GJ, Smith WC
    J Perinatol, 2010 May;30(5):311-8.
    PMID: 19829298 DOI: 10.1038/jp.2009.158
    To determine the factors contributing to unexplained antepartum stillbirth in Scotland.
  8. Farizan NH, Sutan R, Mani KK
    Iran J Public Health, 2020 Oct;49(10):1921-1930.
    PMID: 33346223 DOI: 10.18502/ijph.v49i10.4695
    Background: We aimed to assess the effectiveness of the health educational booklet intervention in improving parents/guardian's knowledge on prevention of child drowning and, the perception of drowning risk and water safety practice.

    Methods: A quasi-experimental study was conducted in year 2017 in Selangor, Malaysia among 719 parents/guardians of primary school children. The parent/guardians were randomly assigned as the intervention groups and were given a health educational Be-SAFE booklet on drowning prevention and water safety. The pretest was conducted before the intervention and posttest was done one month of intervention. The data collection tool was using a validated questionnaire on knowledge, attitude and practice for drowning prevention and water safety.

    Results: There were 719 respondents (response rate of 89.9%) participated at baseline and 53.7% at end line (after the intervention). Significant differences found in knowledge, attitudes and practice on drowning prevention and water safety for the intervention and control groups after the intervention (P<0.001). There was a significant difference in mean scores for knowledge and attitude before and after the intervention, whereas no significant findings noted for practices (P<0.001).

    Conclusion: Be SAFE booklet contributed to the increase in parents/guardian's knowledge and attitudes towards drowning prevention and water safety to prevent the risk of child drowning.

  9. Aminuddin NA, Sutan R, Mahdy ZA
    Front Med (Lausanne), 2020;7:596405.
    PMID: 33553199 DOI: 10.3389/fmed.2020.596405
    Background: Preeclampsia is a significant cause of maternal and perinatal mortality worldwide. Oxidative stress plays a key role in its pathophysiology, hence antioxidants such as tocotrienol may be preventive against preeclampsia. In 2018, the ISSHP revised the definition of preeclampsia. In accordance with the new definition, we report a secondary data analysis from a clinical trial comparing palm oil vitamin E in the form of tocotrienol-rich fraction (TRF) against placebo, in preventing preeclampsia. Method: A randomized double-blind controlled trial was conducted in 2002-2005 to assess the benefits of TRF in preeclampsia prevention. A total of 299 primigravidae were recruited. The intervention group was supplemented with TRF 100 mg daily in super-olein capsules, whereas the placebo group was prescribed super-olein capsules without TRF, beginning from 12 to 16 gestational weeks until delivery. The primary outcome measure was incidence of preeclampsia. Results: The total incidence of pregnancy induced hypertension (PIH) was 5%, whereas the incidence of preeclampsia was 2.3%. The odds of developing PIH (adjusted OR 0.254; 95% CI: 0.07-0.93; p-value 0.038) and preeclampsia (adjusted OR 0.030; 95% CI: 0.001-0.65; p-value 0.025) were significantly lower in the TRF arm compared to the placebo arm. Conclusion: Antenatal supplementation with palm oil vitamin E in the form of TRF is associated with significant reductions in the incidence of preeclampsia and PIH in a single urban tertiary hospital. Palm oil vitamin E deserves further scrutiny as a potential public health preventive measure against preeclampsia and PIH.
  10. Ahmad N, Sutan R, Tamil AM, Hajib N
    Child Health Nurs Res, 2021 Oct;27(4):317-327.
    PMID: 35004520 DOI: 10.4094/chnr.2021.27.4.317
    Purpose: This study aimed to identify small for gestational age (SGA) infants' growth patterns, nutritional status, and associated factors.

    Methods: This prospective cohort study was conducted at primary-care child health clinics in Greater Kuala Lumpur, Malaysia. The sample consisted of infants who fulfilled the criteria and were born in 2019. The anthropometric data of infants were assessed at birth and at 1, 3, 6, 9, and 12 months.

    Results: A total of 328 infants were analysed. In total, 27.7%(n=91) of the subjects were SGA infants, and 237 of them were not. Significant differences in the median weight-for-age and length-for-age z-scores were observed between SGA and non-SGA infants at birth, 1 month, 6 months, and 12 months. There was a significant difference between the growth patterns of SGA and non-SGA infants. Birth weight and sex significantly predicted the nutritional status(stunting and underweight) of SGA infants during their first year of life.

    Conclusion: SGA infants can catch up to achieve normal growth during their first year of life. Even though the nutritional status of SGA infants trends worse than non-SGA infants, adequate infant birth weight monitoring and an emphasis on nutritional advice are crucial for maintaining well-being.

  11. Sutan R, Batarfi SA, Ismail H, Bin-Ghouth AS
    BMJ Open, 2022 Feb 17;12(2):e055841.
    PMID: 35177459 DOI: 10.1136/bmjopen-2021-055841
    INTRODUCTION: Although immunisation prevents the death of millions of infants and children each year, the vaccination coverage of routine childhood vaccination does not reach its target. The reasons for low vaccination uptake can be related to both demand and supply side determinants. The prevalence of vaccine hesitancy is increasing globally. However, data on vaccine hesitancy in low-income Arabic countries are scarce. To investigate this issue in Yemen, an Arabic low-income country, we aim to examine the link between vaccine hesitancy and the immunisation status of children living in Costal Hadhramout, Yemen, from the perspective of their parents and healthcare providers.

    METHODS AND ANALYSIS: We will use a mixed-method research design. The study will be conducted in Costal Hadhramout in three phases. Phase 1 will involve a situational analysis using secondary data from records of the national expanded immunisation programme in Costal Hadhramout to examine the trend for previous years. Phase 2 will be a quantitative study aimed at assessing the prevalence of vaccination status of children aged <2 years and the determinants of parental vaccine hesitancy perception through a validated questionnaire. Lastly, phase 3 will be a qualitative study that explores vaccine hesitancy in Yemen using in-depth interviews and focus group discussions with parents and healthcare providers, respectively.

    ETHICS AND DISSEMINATION: The study has been approved by the Research Committee of the Faculty of Medicine, University Kebangsaan Malaysia. The findings will be disseminated via publication in peer-reviewed academic journals, academic conferences and public presentations.

  12. Al-Abed AA, Sutan R, Al-Dubai SA, Aljunid SM
    Biomed Res Int, 2014;2014:505474.
    PMID: 24982886 DOI: 10.1155/2014/505474
    Khat chewing is associated with unfavourable health outcomes and family dysfunction. Few studies have addressed the factors associated with khat chewing among Yemeni women. However, the family and husband effects on chewing khat by women have not been addressed. This study aimed to determine the prevalence of khat chewing among Yemeni women and its associated factors, particularly husbands and family factors. A cross-sectional study was conducted among 692 adult Yemeni women in the city of Sana'a in Yemen using structured "face to face" interviews. Mean (±SD) age of women was 27.3 years (±6.10). The prevalence of chewing khat by women was 29.6%. Factors associated with chewing khat among women were chewing khat by husbands (OR = 1.8; 95% CI: 1.26, 2.53), being married (OR = 2.0; 95% CI: 1.20, 3.37), frequent family social gatherings (OR = 1.5; 95% CI: 1.06, 2.10), high family income (OR = 1.57; 95% CI: 1.12, 2.21), larger house (OR = 1.63; 95% CI: 1.16, 2.31), and age of women (OR = 0.64; 95% CI: 0.44, 0.92). It is concluded that khat chewing by women in this study was significantly associated with family factors and with khat chewing by their husbands. Urgent action is needed to control khat chewing particularly among women.
  13. Amin RM, Said ZM, Sutan R, Shah SA, Darus A, Shamsuddin K
    Int Breastfeed J, 2011;6(1):4.
    PMID: 21342506 DOI: 10.1186/1746-4358-6-4
    This cross-sectional study assesses factors that contribute to discontinuing breastfeeding among employed mothers in Malaysia.
  14. Sutan R, Amin RM, Ariffin KB, Teng TZ, Kamal MF, Rusli RZ
    J Zhejiang Univ Sci B, 2010 Mar;11(3):209-17.
    PMID: 20205307 DOI: 10.1631/jzus.B0900245
    To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors.
  15. Nasreen HE, Rahman JA, Rus RM, Kartiwi M, Sutan R, Edhborg M
    BMC Psychiatry, 2018 06 15;18(1):195.
    PMID: 29902985 DOI: 10.1186/s12888-018-1781-0
    BACKGROUND: Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers.

    METHODS: We used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS).

    RESULTS: Prevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband's depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife's depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers.

    CONCLUSION: Both ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.
  16. Abu Talib R, Idris IB, Sutan R, Ahmad N, Abu Bakar N
    Iran J Public Health, 2018 Nov;47(11):1694-1702.
    PMID: 30581786
    Background: This cross-sectional was aimed to assess the prevalence of pre-pregnancy care services usage and its determinant factors among women of reproductive age in Kedah, Malaysia.

    Methods: Overall, 1347 respondents who attended 24 government health clinics, were chosen using systematic multistage random sampling. A validated self-administered questionnaire which consisted of sections including socio-demographic characteristics, social support, knowledge on pre-pregnancy care, perception on risk of pregnancy, health status, as well as intention and awareness on pre-pregnancy care services were distributed.

    Results: The prevalence of utilization of pre-pregnancy care services was still low i.e. 44.0%. Bivariate and multivariate analysis showed consistent significant level between all factors and pre-pregnancy care usage except for family planning practice. The factors that showed significant difference with the usage of pre-pregnancy care services were age of more than 35 (P<0.001), high education level (P<0.001), non-working mothers (P<0.001), multipara (P=0.001), awareness on the existence of pre-pregnancy care services in government health facilities (P<0.001), intention to use the services (P=0.0030), having medical illness (P=0.005), having social support (P=0.001), high knowledge (P<0.001), and positive perception (P<0.001).

    Conclusion: Low usage of pre-pregnancy care services can be improved through health screening on reproductive-aged women with positive determinant factors at the triage level in integrated clinics. Information and knowledge on pre-pregnancy services should be disseminated among community members through various means including roadshows and pre-wedding workshops.
  17. Khamal R, Isa ZM, Sutan R, Noraini NMR, Ghazi HF
    Ann Glob Health, 2019 01 22;85(1).
    PMID: 30741516 DOI: 10.5334/aogh.2425
    INTRODUCTION: Indoor air quality in day care centers (DCCs) is an emerging research topic nowadays. Indoor air pollutants such as particulate matter (PM) and microbes have been linked to respiratory health effects in children, particularly asthma-related symptoms such as night coughs and wheezing due to early exposure to indoor air contaminants.

    OBJECTIVE: The aim of this study was to determine the association between wheezing symptoms among toddlers attending DCCs and indoor particulate matter, PM10, PM2.5, and microbial count level in urban DCCs in the District of Seremban, Malaysia.

    METHODS: Data collection was carried out at 10 DCCs located in the urban area of Seremban. Modified validated questionnaires were distributed to parents to obtain their children's health symptoms. The parameters measured were indoor PM2.5, PM10, carbon monoxide, total bacteria count, total fungus count, temperature, air velocity, and relative humidity using the National Institute for Occupational Safety and Health analytical method.

    RESULTS: All 10 DCCs investigated had at least one indoor air quality parameter exceeding the acceptable level of standard guidelines. The prevalence of toddlers having wheezing symptoms was 18.9%. There was a significant different in mean concentration of PM2.5 and total bacteria count between those with and those without wheezing symptoms (P = 0.02, P = 0.006).

    CONCLUSIONS: Urban DCCs are exposed to many air pollutants that may enter their buildings from various adjacent sources. The particle concentrations and presence of microbes in DCCs might increase the risk of exposed children for respiratory diseases, particularly asthma, in their later life.

  18. Za'im Sahul Hameed M, Sutan R, Mahdy ZA, Tamil AM, Sulong S
    Front Med (Lausanne), 2021;8:592462.
    PMID: 34113624 DOI: 10.3389/fmed.2021.592462
    Adverse perinatal outcomes such as stillbirth, low birth weight and small for gestational age are still reported to be of high prevalence despite advanced healthcare technology and good quality hospital services in Malaysia. The purpose of this study is to create a model to evaluate individualized birth weight customized for maternal characteristics in a Malaysian population. Three phases are involved in designing the customized fetal growth chart (GROW-My). Baseline data is collected from previous pregnancies in the UKM Medical Centre from year 2010 to 2017. Specific maternal attributes were screened for its completeness and validity, namely maternal height and weight at booking, maternal ethnicity and parity, and the baby's birth weight, for all singleton pregnancies. The design and construction of a Malaysian customized fetal growth chart, Growth Related Optimal Weight (GROW-MY) was based on baseline birth data. The customized chart is used in the implementation phase for testing its feasibility, taking into consideration feedback from caregivers and patients before and after implementation. The current study provides staunch information and data regarding the needs and strategies for using maternal variables for estimating birth weight and the risk of being small for gestational age, in order to facilitate screening and appropriate management. With improved diagnosis of fetal growth restriction, medical care and treatment costs can be reduced.
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