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  1. Sahril N, Shahein NA, Yoep N, Mahmud NA, Sooryanarayana R, Maw Pin T, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:33-37.
    PMID: 33370863 DOI: 10.1111/ggi.13980
    AIM: Falls are a common problem among older people, leading to major morbidity and increased mortality. The study aimed to determine the prevalence of falls among older persons in Malaysia and its associated factors.

    METHODS: Data were obtained from the National Health and Morbidity Survey 2018 (NHMS 2018), a cross-sectional study using stratified cluster sampling design. Older persons were defined as aged ≥60 years in this study. Descriptive and logistic regression analyses were conducted using SPSS version 25.0.

    RESULTS: Overall, 14.1% (95% confidence interval [CI]: 12.46, 15.84) of older persons reported having experienced at least one fall during the past 12 months. Univariate analyses revealed an association between the history of falls with not being employed (odds ratio [OR]: 1.35 [95% CI: 1.03, 1.77]), diabetes mellitus (OR: 1.65 [95% CI: 1.33, 2.04]), limitation in activities of daily living (ADL) (OR: 1.90 [95% CI: 1.43, 2.54]) or instrumental ADL (OR: 1.47 [95% CI: 1.16, 1.84]). Multiple logistic regression revealed that falls were positively associated with those who had diabetes mellitus (OR: 1.55 [95% CI: 1.23, 1.94]) and limitation in ADL (OR: 1.56 [95% CI: 1.14, 2.15]); 43.9% of falls occurred outdoors.

    CONCLUSION: One in six older Malaysian people experience at least one fall over a 12-month period. Diabetes mellitus and limitation in ADL were the factors associated with falls among older persons. A comprehensive and targeted program designed to reduce risk of falls is urgently needed. Future research should identify suitable programs for our setting to reduce the potential society burden of falls in older Malaysians. Geriatr Gerontol Int 2020; 20: 33-37.

  2. Abdul Mutalip MH, Mahmud MAF, Lodz NA, Yoep N, Muhammad EN, Ahmad A, et al.
    BMJ Open, 2019 01 21;9(1):e023359.
    PMID: 30670512 DOI: 10.1136/bmjopen-2018-023359
    INTRODUCTION: Leptospirosis is the most common zoonotic disease that causes morbidity and mortality worldwide. The disease can cause sporadic epidemics and recent epidemics have become more apparent in urban localities. There is lack of documented evidence on the specific risk factors of leptospirosis infection among the urbanites, thereby impeding initiatives for prevention in urban settings. We aim to systematically search published articles and synthesise evidence on the risk factors associated with leptospirosis infection among the susceptible populations in urban localities, particularly to identify the risk factors of non-recreational leptospirosis infection.

    METHODS AND ANALYSIS: We will conduct a systematic review of observational studies that investigated environmental risk factors of leptospirosis in urban localities. The search will be performed for any eligible articles from selected electronic databases from 1970 until May 2018. The study will include any studies that investigated risk factors of confirmed leptospirosis cases who acquired the infection in urban locality, particularly exposures from the non-recreational and non-water-related activities. Study selection and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Meta-Analysis of Observational Studies in Epidemiology guideline. All data will be extracted using a standardised data extraction form and quality of the studies will be assessed using the Newcastle-Ottawa Scale guideline. Descriptive and meta-analysis will be performed by calculating the standardised median ORs and risk ratios for types of the non-recreational risk factors stratified by social, living conditions and environmental exposures, types of reservoirs and transmissions and types of activities and employments associated with leptospirosis infection in urban locality.

    ETHICS AND DISSEMINATION: No primary data will be collected thus no formal ethical approval is required. The results will be disseminated though a peer-reviewed publication and conference presentation.

    PROSPERO REGISTRATION NUMBER: CRD42018090820.

  3. Mahmud NA, Shahein NA, Yoep N, Mahmud MAF, Maw Pin T, Paiwai F, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:26-32.
    PMID: 33370856 DOI: 10.1111/ggi.14029
    AIM: Studies on the influence of social support on activity limitation among older persons remain limited. A better understanding of this relationship will help with resource planning and policy making aimed to reduce burden of care. The objective of this study was to assess the influence of social support on limitation in daily living among older persons in Malaysia.

    METHODS: Data from the National Health and Morbidity Survey 2018, a nation-wide, cross-sectional survey using a two-stage stratified sampling design, were analyzed. A representative sample of individuals aged ≥60 years identified through national sampling frames throughout Malaysia was included. Face-to-face interviews were conducted using validated questionnaires on activities of daily living (ADL) and instrumental ADL (IADL). Social support was measured using the Duke Social Support Index.

    RESULTS: The overall prevalence of the presence of any limitations in ADL and IADL was 17.0% and 42.9% respectively. Overall prevalence of the older persons with low to fair social support was 30.8% and high to very high social support was 69.2%. Logistic regression analysis identified the following factors as being associated with limitations in ADL and IADL: being female, of older age, having a monthly income

  4. Mahmud MAF, Abdul Mutalip MH, Lodz NA, Muhammad EN, Yoep N, Hashim MH, et al.
    BMJ Open, 2019 05 15;9(5):e026101.
    PMID: 31097485 DOI: 10.1136/bmjopen-2018-026101
    INTRODUCTION: Dengue is among the most important mosquito-borne diseases, with more than half of the world's population at risk of infection in dengue endemic countries. Environmental management, which includes any activities that involve environmental modification, environmental manipulation and changes to human behaviour have been used to mitigate the risk of dengue transmission. In this protocol, we will integrate the data from various sources to assess the overall effect of environmental management on the incidence of dengue and other entomological indices.

    METHODS AND ANALYSES: We will conduct a systematic review of intervention that assess the effect of environmental management on the incidence of dengue and/or entomological indices. We will include any studies that include intervention through environmental management for dengue control, involving environmental modification, environmental manipulation and changes to human behaviour. A comprehensive search will be performed in electronic databases PUBMED, CENTRAL, SCOPUS, Web of Science and relevant research websites such as PROPSERO, WHO ICTRP and ClinicalTrials.gov to identify studies that meet our inclusion criteria. A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic reviews and Meta-Analysis. Titles, abstract, keywords for eligibility will be examined independently by researchers. The quality of the included studies will be assessed using quality assessment tool for studies with diverse design and Cochrane risk of bias tool. The characteristics of the selected articles will be described based on the study design, types of intervention and outcomes of the study in various countries. These include the types of environmental management intervention methods and the effectiveness of the intervention in reducing dengue cases or incidence and impact on entomological indices.

    ETHICS AND DISSEMINATION: We will register this systematic review with the National Medical Research Register, Ministry of Health Malaysia. This protocol also had been registered with the PROSPERO. No ethical approval is necessary, as there will be no collection of primary data. The results will be disseminated though a peer-reviewed publication and conference presentation.

    TRIAL REGISTRATION NUMBER: CRD42018092189.

  5. Abdul Mutalip MH, Abdul Rahim FA, Mohamed Haris H, Yoep N, Mahmud AF, Salleh R, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:92-97.
    PMID: 33370851 DOI: 10.1111/ggi.13961
    AIM: Quality of life (QoL) among the older persons provides valuable insights into the potential modifiable risk factors that affect well-being in later life. This study aimed to describe the QoL and psychosocial factors of QoL of older persons in Malaysia.

    METHODS: We used the 19-item Control, Autonomy, Self-realization and Pleasure scale, a validated instrument that measures psychological well-being related to QoL in older persons. Scores range from 0 to 57, and higher scores indicate better QoL. We included several factors as covariates. Analysis of complex samples was carried out using Stata 15. Descriptive analysis was carried out to determine QoL by sociodemographic characteristics and other factors. Linear regression analysis was used to identify psychosocial factors that influence QoL.

    RESULTS: A total of 3444 individuals aged ≥60 years completed all 19-item Control, Autonomy, Self-realization and Pleasure items. The estimated mean QoL score was 47.01 (95% CI 46.30-47.72). Adjusted for confounders, QoL was lower among individuals with no formal education (-2.554, 95% CI -3.684, -1.424), probable depression (-1.042, 95% CI -1.212, -0.871) and food insecurity (-0.815, 95% CI -1.083, -0.548). QoL continued to improve with improved ADL score (0.302, 95% CI 0.052, 0.552), IADL score (0.646, 95% CI 0.382, 0.909) and better social support (0.308, 95% CI 0.187, 0.429).

    CONCLUSIONS: Lower education, depression, food insecurity, presence of limited functional status and poor social support negatively influenced QoL in older Malaysians. This study identified potentially modifiable factors that could be targeted for interventions to enhance QoL of older persons in Malaysia. Geriatr Gerontol Int 2020; 20: 92-97.

  6. Awaluddin SMB, Ying Ying C, Yoep N, Paiwai F, Lodz NA, Muhammad EN, et al.
    Asia Pac J Public Health, 2019 Nov;31(8_suppl):57S-64S.
    PMID: 31523984 DOI: 10.1177/1010539519872642
    Parental protective factors do play an important role in preventing Internet addiction. A self-administered questionnaire was used to measure health risk behaviors among Malaysian adolescents. The prevalence of Internet addiction was significantly higher among adolescents with perceived lack of parental supervision (30.1% [95% confidence interval (CI) = 28.7-31.4]) and lack of parental connectedness (30.1% [95% CI = 28.5-31.7]), compared with their counterparts. Adolescents who perceived a lack of parental supervision, respect for privacy, connectedness, and bonding were more likely to have Internet addiction: (adjusted odds ratio [aOR] = 1.39; 95% CI = 1.27-1.52), (aOR = 1.23; 95% CI = 1.16-1.31), (aOR = 1.09; 95% CI = 1.02-1.16), (aOR = 1.06; 95% CI = 1.00-1.12), respectively. Among girls, Internet addiction was associated with those who perceived lack in all 4 parental factors, while among boys, those who perceived lack of parental supervision and respect for privacy were more prone to Internet addiction.
  7. Mahmud MAF, Abdul Mutalip MH, Lodz NA, Muhammad EN, Yoep N, Hasim MH, et al.
    Int J Environ Health Res, 2023 Nov;33(11):1148-1167.
    PMID: 35642722 DOI: 10.1080/09603123.2022.2076815
    Among several vector control methods commonly used, environmental management is one of the control measures to mitigate dengue in such vulnerable communities. Since there is no curative treatment for dengue yet, targeted environmental and ecosystem management is increasingly relevant. Hence, this review was conducted to identify the effectiveness of environmental management intervention strategy to reduce dengue cases. We searched PUBMED, CENTRAL, SCOPUS, Web of Science, CIJE, WHO ICTRP, and ClinicalTrials.gov up to January 2021. A total of 521 articles were screened. Only 16 studies were included in this review. There were 6 studies that applied all three types of environmental management interventions (manipulation, modification and behavior), 8 studies applied two types of interventions (manipulation and behavior) and 2 studies applied one type of intervention (manipulation or behavior). All included studies reported reduction of Aedes entomological indices. The studies showed reduction in dengue cases and density of Aedes population through environmental interventions. It is recommended for the health authority to incorporate environmental management intervention in dengue control activities and enhanced the community involvement to ensure sustainability with high impact on dengue reduction.
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