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Noor AM, Ghazali SM, Bakar ZA, Ruzan IN. Diagnostic performance of Xpert MTB/RIF ultra in detecting Mycobacterium tuberculosis and Rifampicin Resistance in AFB Smear-negative Pulmonary and Extrapulmonary Tuberculosis samples in Malaysia. Diagn Microbiol Infect Dis 2024; 109:116230. [PMID: 38507965 DOI: 10.1016/j.diagmicrobio.2024.116230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 01/19/2024] [Accepted: 02/21/2024] [Indexed: 03/22/2024]
Abstract
Rapid and highly accurate diagnostic tools are critically needed to diagnose Mycobacterium tuberculosis and rifampicin resistance in AFB smear-negative samples. In this study, we evaluated the diagnostic performance of Xpert MTB/RIF Ultra (Ultra) as a rapid test to diagnose tuberculosis in smear-negative cases in Malaysia. A retrospective study of 1960 smear-negative pulmonary and extrapulmonary samples obtained from patients was conducted. Culture was used as the reference standard for the study. The overall sensitivity and specificity of Ultra on the tested samples were 88.7 % and 77.2 %, respectively, while the PPV was 32.3 % and the NPV was 98.2 %. Ultra showed slightly higher sensitivity in pulmonary (89.9 %) compared to extrapulmonary samples (86.1 %). The overall accuracy of Ultra was 78.5 % (kappa=0.37; 95 %CI: 0.32,0.42). Ultra showed good diagnostic accuracy for detecting MTB and rifampicin resistance in various AFB smear-negative samples. Ultra also had excellent capability in rifampicin resistance detection.
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Affiliation(s)
- Azura Mohd Noor
- Infectious Disease Research Center, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia 40170, Setia Alam, Shah Alam, Selangor, Malaysia.
| | - Sumarni Mohd Ghazali
- Biomedical Epidemiology Unit, Special Resource Center, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia 40170, Setia Alam, Shah Alam, Selangor, Malaysia
| | - Zamzurina Abu Bakar
- Institute of Respiratory Medicine, Jalan Pahang 50590, Kuala Lumpur, Malaysia
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Lim KH, Cheong YL, Lim HL, Cheong KC, Hashim MHM, Marine AA, Cheah YK, Lim JH, Mohd Ghazali S. Validity and reliability of the Malay language Perception Towards Smoking Questionnaire (BM-PTSQ) among secondary school adolescents: Further validation using Confirmatory Factor Analysis. Tob Induc Dis 2024; 22:TID-22-25. [PMID: 38268983 PMCID: PMC10807019 DOI: 10.18332/tid/176164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Perception is an essential factor influencing smoking among adolescents. Thus, a valid tool for measuring perception is a requisite in smoking studies. This study further establishes the validity and reliability of a Malay language version of the Perception Towards Smoking Questionnaire (BM-PTSQ) for assessing the perception of smoking among secondary school-going adolescents in Malaysia. METHODS We administered the BM-PTSQ to 669 secondary school students selected through multistage sampling; 60% of respondents were male (n=398), and 69.9% (n=463) were from rural areas. Respondents were aged 13-16 years, 36.4% (n=241) were 13 years, 40.0% (n=265) were 14 years, and 23.6% (n=156) were 16 years old. We used parallel and exploratory factor analysis (EFA) to determine the domains of the questionnaire. In addition, we also employed EFA, confirmatory factor analyses (CFA), and Cronbach's alpha to evaluate the construct validity and reliability of the BM-PTSQ. RESULTS EFA and parallel analysis identified two domains in the BM-PTSQ that accounted for 62.9% of the observed variance, and CFA confirmed the two-domain structure. The two domains' internal consistency scores ranged from 0.702 to 0.80, which suggested adequate reliability. CONCLUSIONS The BM-PTSQ has acceptable psychometric validity and is appropriate for assessing smoking perception and intention among Malaysian secondary school-aged youth. Researchers should further evaluate this tool's applicability in a more sociodemographically diverse population.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Ministry of Health Malaysia, Johor Bahru, Malaysia
| | - Kee Chee Cheong
- Department of Biostatistics, and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Mohd Hazilas Mat Hashim
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Ali Aman Marine
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Putrajaya Hospital, Putrajaya, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Tan LK, Chua EH, Mohd Ghazali S, Cheah YK, Jayaraj VJ, Kee CC. Does Awareness of Malaysian Healthy Plate Associate with Adequate Fruit and Vegetable Intake among Malaysian Adults with Non-Communicable Diseases? Nutrients 2023; 15:5043. [PMID: 38140302 PMCID: PMC10745645 DOI: 10.3390/nu15245043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
The healthy eating plate concept has been introduced in many countries, including Malaysia, as a visual guide for the public to eat healthily. The relationship between Malaysian Healthy Plate (MHP) and adequate fruit and vegetable (FV) intake among morbid Malaysian adults is unknown. Hence, we investigated the relationship between awareness of the MHP and FV intake among morbid Malaysian adults. National survey data on 9760 morbid Malaysian adults aged 18 years and above were analyzed. The relationship between awareness of MHP and FV intake among Malaysian adults with obesity, diabetes mellitus, hypertension, and hypercholesterolemia were determined using multivariable logistic regression controlling for sociodemographic characteristics and lifestyle risk factors. Our data demonstrated that MHP awareness is associated with adequate FV intake among the Malaysian adults with abdominal obesity (adjusted odds ratio (aOR): 1.86, 95% confidence interval (CI): 1.05-3.29), diabetes mellitus (aOR: 4.88, 95% CI: 2.13-22.18), hypertension (aOR: 4.39, 95% CI: 1.96-9.83), and hypercholesterolemia (aOR: 4.16, 95% CI: 1.48-11.72). Our findings indicated the necessity for ongoing efforts by policymakers, healthcare professionals, and nutrition educators to promote the concept of MHP and ensure that morbid Malaysian adults consume a sufficient intake of FV or adopt a healthy eating pattern to achieve and maintain optimal health.
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Affiliation(s)
- Lay Kim Tan
- Sector for Biostatistics & Data Repository, Office of NIH Manager, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia; (V.J.J.); (C.C.K.)
| | - En Hong Chua
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia;
| | - Sumarni Mohd Ghazali
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia;
| | - Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Sintok 06010, Kedah, Malaysia;
| | - Vivek Jason Jayaraj
- Sector for Biostatistics & Data Repository, Office of NIH Manager, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia; (V.J.J.); (C.C.K.)
| | - Chee Cheong Kee
- Sector for Biostatistics & Data Repository, Office of NIH Manager, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia; (V.J.J.); (C.C.K.)
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Jimoh AK, Bolaji OB, Adelekan A, Ghazali SM, Oyekale OT, Adeleke BA, Ojo BO, Popoola GO, Lawal OA, Ajetunmobi WA. Clinical Utility of Procalcitonin and C-Reactive Protein in the Management of Neonatal Sepsis in a Resource-Limited Nigerian Hospital. Niger J Clin Pract 2023; 26:1895-1901. [PMID: 38158358 DOI: 10.4103/njcp.njcp_397_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/10/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Neonatal sepsis is an invasive infection of the bloodstream in neonates and a leading cause of morbidity and mortality among them. AIM To investigate the role of procalcitonin (PCT) and C-reactive protein (CRP) in the management of neonatal sepsis. MATERIALS AND METHODS This was a prospective case-control study over one-year period using convenience sampling. Blood samples for PCT and CRP were taken from all neonates, while blood culture and white blood cell count samples were additionally taken from babies with neonatal sepsis. PCT and CRP were repeated at 24 and 48 hours. The continuous variables were found to have a nonparametric distribution. They were presented as median and interquartile range, and compared using Wilcoxon signed rank and Friedman test as appropriate. RESULTS The blood culture analysis yielded a prevalence of 12.7% with Staphylococcus aureus being the commonest organism. Baseline concentrations of PCT (1.28 ng/ml) and CRP (17.31 mg/L) in neonates with sepsis were higher than that of controls (PCT-0.63 ng/ml, CRP-5.40 mg/L). PCT concentrations decreased after two days of antibiotic treatment, while CRP concentrations decreased after a day. The concentration of both decreased to normal levels after two days of treatment. CONCLUSION This study showed that CRP was more reliable in monitoring antibiotic therapy, unlike other studies which suggested PCT. In cases where the management of neonatal sepsis may be limited by a low blood culture yield, therapeutic monitoring may be aided by CRP and/or PCT.
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Affiliation(s)
- A K Jimoh
- Department of Chemical Pathology, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
| | - O B Bolaji
- Department of Paediatrics, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
| | - A Adelekan
- Department of Chemical Pathology, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
| | - S M Ghazali
- Department of Chemical Pathology, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
| | - O T Oyekale
- Department of Medical Microbiology, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
| | - B A Adeleke
- Department of Chemical Pathology, Federal Teaching Hospital, Ido Ekiti, Ekiti, Nigeria
| | - B O Ojo
- Department of Medical Microbiology, Federal Teaching Hospital, Ido Ekiti, Ekiti, Nigeria
| | - G O Popoola
- Child and Adolescent Mental Health Service, Lincolnshire Partnership NHS Foundation Trust St. George's, Lincoln, Lincolnshire LN1 1FS, United Kingdom
| | - O A Lawal
- Department of Paediatrics, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
| | - W A Ajetunmobi
- Department of Paediatrics, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
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Lim MC, Singh S, Lai CH, Gill BS, Kamarudin MK, Md Zamri ASS, Tan CV, Zulkifli AA, Nadzri MNM, Mohd Ghazali N, Mohd Ghazali S, Md Iderus NH, Ahmad NARB, Suppiah J, Tee KK, Aris T, Ahmad LCRQ. Forecasting the effects of vaccination on the COVID-19 pandemic in Malaysia using SEIRV compartmental models. Epidemiol Health 2023; 45:e2023093. [PMID: 37905314 PMCID: PMC10867513 DOI: 10.4178/epih.e2023093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/03/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVES This study aimed to develop susceptible-exposed-infectious-recovered-vaccinated (SEIRV) models to examine the effects of vaccination on coronavirus disease 2019 (COVID-19) case trends in Malaysia during Phase 3 of the National COVID-19 Immunization Program amidst the Delta outbreak. METHODS SEIRV models were developed and validated using COVID-19 case and vaccination data from the Ministry of Health, Malaysia, from June 21, 2021 to July 21, 2021 to generate forecasts of COVID-19 cases from July 22, 2021 to December 31, 2021. Three scenarios were examined to measure the effects of vaccination on COVID-19 case trends. Scenarios 1 and 2 represented the trends taking into account the earliest and latest possible times of achieving full vaccination for 80% of the adult population by October 31, 2021 and December 31, 2021, respectively. Scenario 3 described a scenario without vaccination for comparison. RESULTS In scenario 1, forecasted cases peaked on August 28, 2021, which was close to the peak of observed cases on August 26, 2021. The observed peak was 20.27% higher than in scenario 1 and 10.37% lower than in scenario 2. The cumulative observed cases from July 22, 2021 to December 31, 2021 were 13.29% higher than in scenario 1 and 55.19% lower than in scenario 2. The daily COVID-19 case trends closely mirrored the forecast of COVID-19 cases in scenario 1 (best-case scenario). CONCLUSIONS Our study demonstrated that COVID-19 vaccination reduced COVID-19 case trends during the Delta outbreak. The compartmental models developed assisted in the management and control of the COVID-19 pandemic in Malaysia.
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Affiliation(s)
- Mei Cheng Lim
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Sarbhan Singh
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Chee Herng Lai
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Balvinder Singh Gill
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Mohd Kamarulariffin Kamarudin
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Ahmed Syahmi Syafiq Md Zamri
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Cia Vei Tan
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Asrul Anuar Zulkifli
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Mohamad Nadzmi Md Nadzri
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Nur'ain Mohd Ghazali
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Nuur Hafizah Md Iderus
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Nur Ar Rabiah Binti Ahmad
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Jeyanthi Suppiah
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Kok Keng Tee
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tahir Aris
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Lonny Chen Rong Qi Ahmad
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, Malaysia
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Md Iderus NH, Singh SSL, Ghazali SM, Zulkifli AA, Ghazali NAM, Lim MC, Ahmad LCRQ, Md Nadzri MN, Tan CV, Md Zamri ASS, Lai CH, Nordin NS, Kamarudin MK, Wan MK, Mokhtar N, Jelip J, Gill BS, Ahmad NAR. The effects of the COVID-19 pandemic on dengue cases in Malaysia. Front Public Health 2023; 11:1213514. [PMID: 37693699 PMCID: PMC10484591 DOI: 10.3389/fpubh.2023.1213514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
Background Globally, the COVID-19 pandemic has affected the transmission dynamics and distribution of dengue. Therefore, this study aims to describe the impact of the COVID-19 pandemic on the geographic and demographic distribution of dengue incidence in Malaysia. Methods This study analyzed dengue cases from January 2014 to December 2021 and COVID-19 confirmed cases from January 2020 to December 2021 which was divided into the pre (2014 to 2019) and during COVID-19 pandemic (2020 to 2021) phases. The average annual dengue case incidence for geographical and demographic subgroups were calculated and compared between the pre and during the COVID-19 pandemic phases. In addition, Spearman rank correlation was performed to determine the correlation between weekly dengue and COVID-19 cases during the COVID-19 pandemic phase. Results Dengue trends in Malaysia showed a 4-year cyclical trend with dengue case incidence peaking in 2015 and 2019 and subsequently decreasing in the following years. Reductions of 44.0% in average dengue cases during the COVID-19 pandemic compared to the pre-pandemic phase was observed at the national level. Higher dengue cases were reported among males, individuals aged 20-34 years, and Malaysians across both phases. Weekly dengue cases were significantly correlated (ρ = -0.901) with COVID-19 cases during the COVID-19 pandemic. Conclusion There was a reduction in dengue incidence during the COVID-19 pandemic compared to the pre-pandemic phase. Significant reductions were observed across all demographic groups except for the older population (>75 years) across the two phases.
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Affiliation(s)
- Nuur Hafizah Md Iderus
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Sarbhan Singh Lakha Singh
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Sumarni Mohd Ghazali
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Asrul Anuar Zulkifli
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nur Ain Mohd Ghazali
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Mei Cheng Lim
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Lonny Chen Rong Qi Ahmad
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Mohamad Nadzmi Md Nadzri
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Cia Vei Tan
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Ahmed Syahmi Syafiq Md Zamri
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Chee Herng Lai
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nur Shuhada Nordin
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Mohd Kamarulariffin Kamarudin
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Ming Keong Wan
- Vector-Borne Disease Sector, Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | - Norhayati Mokhtar
- Vector-Borne Disease Sector, Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | - Jenarun Jelip
- Vector-Borne Disease Sector, Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | - Balvinder Singh Gill
- Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nur Ar Rabiah Ahmad
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
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Suppiah J, Ali EZ, Mohd Khalid MKN, Mohd Ghazali S, Tee KK, Zulkifli MMS, Ramli N, Adiee AH, Ramly MN, Robert F, Lakha Singh SS, Mohd Zain R, Thayan R. Resurgence of Dengue Virus Serotype 4 in Malaysia: A Comprehensive Clinicodemographic and Genomic Analysis. Trop Med Infect Dis 2023; 8:409. [PMID: 37624348 PMCID: PMC10458033 DOI: 10.3390/tropicalmed8080409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
Dengue virus serotype 4 (DENV-4) has been the rarest circulating serotype in Malaysia, resulting in it being an understudied area. A recent observation from institutional surveillance data indicated a rapid increase in DENV-4-infected cases. The present study aimed to investigate the resurgence of DENV-4 in relation to the demographic, clinical and genomic profiles of 75 retrospective dengue samples. First, the demographic and clinical profiles obtained between 2017 and July 2022 were statistically assessed. Samples with good quality were subjected to full genome sequencing on the Illumina Next Seq 500 platform and the genome data were analysed for the presence of mutations. The effect of the mutations of interest was studied via an in silico computational approach using SWISS-MODEL and AlphaFold2 programs. The predominance of DENV-4 was discovered from 2021 to 2022, with a prevalence of 64.3% (n = 9/14) and 89.2% (n = 33/37), respectively. Two clades with a genetic divergence of 2.8% were observed within the dominant genotype IIa. The majority of DENV-4-infected patients presented with gastrointestinal symptoms, such as vomiting (46.7%), persistent diarrhoea (30.7%) and abdominal pain (13.3%). Two mutations, His50Tyr and Pro144Ser, located at the wing domain of the NS1 protein were discovered to be unique to the recently sequenced DENV-4.
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Affiliation(s)
- Jeyanthi Suppiah
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Ernie Zuraida Ali
- Inborn Error of Metabolism and Genetic Unit, Nutrition, Metabolic & Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia
| | - Mohd Khairul Nizam Mohd Khalid
- Inborn Error of Metabolism and Genetic Unit, Nutrition, Metabolic & Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia
| | - Sumarni Mohd Ghazali
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia
| | - Kok Keng Tee
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Murni Maya Sari Zulkifli
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Nuraisyah Ramli
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Amir Hussin Adiee
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Muhamad Nurrani Ramly
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Fionie Robert
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Sarbhan Singh Lakha Singh
- Biomedical Epidemiology Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia
| | - Rozainanee Mohd Zain
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
| | - Ravindran Thayan
- Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia; (M.M.S.Z.)
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Lim KH, Cheong YL, Sulaiman N, Yah XY, Mahadzir ME, Lim JH, Kee CC, Mohd Ghazali S, Lim HL. Agreement between the Fagerström test for nicotine
dependence (FTND) and the heaviness of smoking index
(HSI) for assessing the intensity of nicotine dependence
among daily smokers. Tob Induc Dis 2022; 20:105. [DOI: 10.18332/tid/155376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/18/2022] [Accepted: 10/13/2022] [Indexed: 11/27/2022] Open
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Labadin J, Hong BH, Tiong WK, Gill BS, Perera D, Rigit ARH, Singh S, Tan CV, Ghazali SM, Jelip J, Mokhtar N, Rashid NBA, Bakar HBA, Lim JH, Taib NM, George A. Development and user testing study of MozzHub: a bipartite network-based dengue hotspot detector. Multimed Tools Appl 2022; 82:17415-17436. [PMID: 36404933 PMCID: PMC9649007 DOI: 10.1007/s11042-022-14120-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Traditionally, dengue is controlled by fogging, and the prime location for the control measure is at the patient's residence. However, when Malaysia was hit by the first wave of the Coronavirus disease (COVID-19), and the government-imposed movement control order, dengue cases have decreased by more than 30% from the previous year. This implies that residential areas may not be the prime locations for dengue-infected mosquitoes. The existing early warning system was focused on temporal prediction wherein the lack of consideration for spatial component at the microlevel and human mobility were not considered. Thus, we developed MozzHub, which is a web-based application system based on the bipartite network-based dengue model that is focused on identifying the source of dengue infection at a small spatial level (400 m) by integrating human mobility and environmental predictors. The model was earlier developed and validated; therefore, this study presents the design and implementation of the MozzHub system and the results of a preliminary pilot test and user acceptance of MozzHub in six district health offices in Malaysia. It was found that the MozzHub system is well received by the sample of end-users as it was demonstrated as a useful (77.4%), easy-to-operate system (80.6%), and has achieved adequate client satisfaction for its use (74.2%).
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Affiliation(s)
- Jane Labadin
- Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Malaysia
| | - Boon Hao Hong
- Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Malaysia
| | - Wei King Tiong
- Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Malaysia
| | | | - David Perera
- Institute for Health and Community Medicine, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Malaysia
| | | | - Sarbhan Singh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Cia Vei Tan
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
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10
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Mohd Yusoff MF, Lim KH, Saminathan TA, Rodzlan Hasani WS, Robert Lourdes TG, Ghazali SM, Abd Hamid HA, Ab Majid NL, Mat Rifin H, Miaw Yn JL. The pattern in prevalence and sociodemographic factors
of smoking in Malaysia, 2011–2019: Findings from national
surveys. Tob Induc Dis 2022; 20:84. [PMID: 36249344 PMCID: PMC9521184 DOI: 10.18332/tid/152410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/11/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Smoking is a major contributor to morbidity and mortality worldwide, with Malaysia no exception. Through the Ministry of Health and other ministries in the government of Malaysia, numerous anti-smoking measures have been introduced to prevent and control smoking in the country. Continuous monitoring of smoking prevalence in the community is essential in order to evaluate the effectiveness of anti-smoking policies. This study aims to update the sociodemographic factors associated with smoking in the past decade in Malaysia. METHODS The study utilized data from three national household surveys in Malaysia, namely the Global Adult Tobacco Survey (GATS) 2011, the National Health and Morbidity Survey (NHMS) 2015 and the National Health and Morbidity Survey (NHMS) 2019. These surveys adopted a multistage stratified sampling design that represents the population in Malaysia. Smoking status was determined based on the GATS protocol and definitions. Complex sample design estimates and complex multivariable logistic regression were used in the analysis. RESULTS A total of 4250, 21410 and 11111 respondents aged ≥15 years participated in GATS 2011, NHMS 2015 and NHMS 2019, respectively, with a response rate between 85% and 87%. The prevalence of smoking was 23.1% (95% CI: 21.2–25.2) in 2011, 22.8% (95% CI: 21.9–23.8) in 2015 and 21.3% (95% CI: 19.9–22.8) in 2019. The prevalence was consistently higher in males (40.5–43.9%), adults aged 25–44 years (25.4–29.0%), Malay (22.6–24.7%), other ethnicities (30.0–35.0%), and the self-employed (33.7–44.6%). Multiple logistic regression analysis showed that the adjusted odds ratio (AOR) of smoking was higher in males, in younger and middle age groups, Malays, and those with lower education level. CONCLUSIONS There were slight changes in the sociodemographic factors of smoking in the past decade in Malaysia. Stern measures and more aggressive strategies are needed to address all the risk factors in controlling smoking behavior in the country.
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Affiliation(s)
| | - Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | | | | | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Nur Liana Ab Majid
- Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia
| | - Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia
| | - Jane Ling Miaw Yn
- Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia
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11
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Lim KH, Cheong YL, Lim HL, Kee CC, Ghazali SM, Heng PP, Teh CH, Hashim MHM, Cheah YK, Lim JH. Validation of the Malay Version of the Decisional Balance
Inventory (MDBI) among secondary school-going adolescents. Tob Induc Dis 2022; 20:79. [PMID: 36188418 PMCID: PMC9483825 DOI: 10.18332/tid/152409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/05/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Chee Cheong Kee
- Department of Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Yong Kang Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Hospital Putrajaya, Putrajaya, Malaysia
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12
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Md Iderus NH, Lakha Singh SS, Mohd Ghazali S, Yoon Ling C, Cia Vei T, Md Zamri ASS, Ahmad Jaafar N, Ruslan Q, Ahmad Jaghfar NH, Gill BS. Correlation between Population Density and COVID-19 Cases during the Third Wave in Malaysia: Effect of the Delta Variant. Int J Environ Res Public Health 2022; 19:ijerph19127439. [PMID: 35742687 PMCID: PMC9223655 DOI: 10.3390/ijerph19127439] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023]
Abstract
In this study, we describe the incidence and distribution of COVID-19 cases in Malaysia at district level and determine their correlation with absolute population and population density, before and during the period that the Delta variant was dominant in Malaysia. Methods: Data on the number of locally transmitted COVID-19 cases in each of the 145 districts in Malaysia, between 20 September 2020 and 19 September 2021, were manually extracted from official reports. The cumulative number of COVID-19 cases, population and population density of each district were described using choropleth maps. The correlation between population and population density with the cumulative number of COVID-19 cases in each district in the pre-Delta dominant period (20 September 2020–29 June 2021) and during the Delta dominant period (30 June 2021–19 September 2021) were determined using Pearson’s correlation. Results: COVID-19 cases were strongly correlated with both absolute population and population density (Pearson’s correlation coefficient (r) = 0.87 and r = 0.78, respectively). A majority of the districts had higher numbers of COVID-19 cases during the Delta dominant period compared to the pre-Delta period. The correlation coefficient in the pre-Delta dominant period was r = 0.79 vs. r = 0.86 during the Delta dominant period, whereas the pre-Delta dominant population density was r = 0.72, and in the Delta dominant period, r = 0.76. Conclusion: More populous and densely populated districts have a higher risk of transmission of COVID-19, especially with the Delta variant as the dominant circulating strain. Therefore, extra and more stringent control measures should be instituted in highly populated areas to control the spread of COVID-19.
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Lim KH, Cheong YL, Lim HL, Ghazali SM, Kee CC, Cheah YK, Heng PP, Hashim MHM, Tan CV, Lim JH. Correlates of dual/poly tobacco use among school-going
adolescents in Malaysia: Findings from a nationwide school-based
study. Tob Induc Dis 2022; 20:52. [PMID: 35733644 PMCID: PMC9164214 DOI: 10.18332/tid/148247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Dual/poly tobacco use is common among youths globally. However, in Malaysia information on dual/poly tobacco use is scarce, thus the present study examines the prevalence and factors associated with dual/poly tobacco users among school-going adolescents in Malaysia. METHODS We derived data on tobacco and e-cigarette use among Malaysian adolescents from a nationwide school-based study conducted in 2016. A total of 13135 adolescents responded in the cross-sectional survey which used multi-stage sampling to select a representative sample of school-going adolescents aged 11–19 years. A standard validated questionnaire was used to obtain the data and multiple logistic regression was conducted to assess factors associated with dual/ poly tobacco use. RESULTS The prevalence of dual/poly tobacco use was 6.5%, more than half of which were both conventional and e-cigarette users. Multivariable logistic regression revealed that the likelihood of dual tobacco use was significantly higher among males (AOR=14.73; 95% CI: 9.11–23.81), secondary school students, those aged 16–19 years (AOR=5.99; 95% CI: 4.04–8.87), natives of Sabah (AOR=7.41; 95% CI: 3.48–15.79), and those never been taught on the health hazards of tobacco at school, exposed to secondhand smoke (SHS) at home, school or other public areas, and had a positive perception of e-cigarettes and lower perception of the harms of tobacco smoking. CONCLUSIONS Although the prevalence of dual/poly users was still low among Malaysian school-going adolescents, proactive measures should be taken to reduce dual tobacco use among youth in Malaysia with focus on the factors identified in this study.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Department of Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Yong Kang Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Cia Vei Tan
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Hospital Putrajaya, Putrajaya, Malaysia
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14
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Lim KH, Cheong YL, Lim HL, Kee CC, Ghazali SM, Pradmahan Singh BSG, Omar MA, Hashim MHM, Cheah YK, Lim JH. Assessment of association between smoking and all-cause
mortality among Malaysian adult population: Findings from a
retrospective cohort study. Tob Induc Dis 2022; 20:50. [PMID: 35702648 PMCID: PMC9150905 DOI: 10.18332/tid/147656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/22/2022] [Accepted: 03/23/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Smoking is a known risk factor for many chronic diseases. Illness and death due to smoking are a significant public health burden in many countries. This study aims to address the information gap in smoking-related mortality in Malaysia by estimating the risk of cardiovascular disease and all-cause mortalities due to smoking among Malaysian adults. METHODS We analyzed data on 2525 respondents, aged 24–64 years, of the Malaysian Non-Communicable Disease Surveillance survey conducted September 2005 to February 2006. Mortality records from the Malaysian National Registration Department were linked to the MYNCDS-1 data to determine respondents’ mortality status over 12 years from 2006 to 2018. Associations between smoking and all-cause mortalities were assessed using Cox proportional hazards regression with adjustments for non-communicable disease and sociodemographic and lifestyle factors. RESULTS The prevalence of daily smoking was 21.2% (95% CI: 19.0–23.7). During the 31668 person-years follow-up, 213 deaths from all causes occurred, where 68 deaths were among smokers (13.2%), and 452 were among non-smokers (6.3%). Smoking was associated with a significantly increased risk of all-cause mortality (adjusted hazard ration, AHR=1.79; 95% CI: 1.12– 2.97). These associations remained significant after excluding mortalities in the first two years of follow-up. CONCLUSIONS Daily smoking is associated with a significantly higher risk of all-cause death. Behavioral and pharmacological smoking cessation interventions should be intensified among smokers to reduce the risk of mortality.
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Affiliation(s)
| | | | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Chee Cheong Kee
- Department of Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | | | | | - Mohd Azahadi Omar
- Department of Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | | | - Yong Kang Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Hospital Putrajaya, Putrajaya, Malaysia
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15
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Cheong YL, Ghazali SM, Che Ibrahim MKB, Kee CC, Md Iderus NH, Ruslan QB, Gill BS, Lee FCH, Lim KH. Assessing the Spatiotemporal Spread Pattern of the COVID-19 Pandemic in Malaysia. Front Public Health 2022; 10:836358. [PMID: 35309230 PMCID: PMC8931737 DOI: 10.3389/fpubh.2022.836358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction The unprecedented COVID-19 pandemic has greatly affected human health and socioeconomic backgrounds. This study examined the spatiotemporal spread pattern of the COVID-19 pandemic in Malaysia from the index case to 291,774 cases in 13 months, emphasizing on the spatial autocorrelation of the high-risk cluster events and the spatial scan clustering pattern of transmission. Methodology We obtained the confirmed cases and deaths of COVID-19 in Malaysia from the official GitHub repository of Malaysia's Ministry of Health from January 25, 2020 to February 24, 2021, 1 day before the national vaccination program was initiated. All analyses were based on the daily cumulated cases, which are derived from the sum of retrospective 7 days and the current day for smoothing purposes. We examined the daily global, local spatial autocorrelation and scan statistics of COVID-19 cases at district level using Moran's I and SaTScan™. Results At the initial stage of the outbreak, Moran's I index > 0.5 (p < 0.05) was observed. Local Moran's I depicted the high-high cluster risk expanded from west to east of Malaysia. The cases surged exponentially after September 2020, with the high-high cluster in Sabah, from Kinabatangan on September 1 (cumulative cases = 9,354; Moran's I = 0.34; p < 0.05), to 11 districts on October 19 (cumulative cases = 21,363, Moran's I = 0.52, p < 0.05). The most likely cluster identified from space-time scanning was centered in Jasin, Melaka (RR = 11.93; p < 0.001) which encompassed 36 districts with a radius of 178.8 km, from November 24, 2020 to February 24, 2021, followed by the Sabah cluster. Discussion and Conclusion Both analyses complemented each other in depicting underlying spatiotemporal clustering risk, giving detailed space-time spread information at district level. This daily analysis could be valuable insight into real-time reporting of transmission intensity, and alert for the public to avoid visiting the high-risk areas during the pandemic. The spatiotemporal transmission risk pattern could be used to monitor the spread of the pandemic.
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Affiliation(s)
- Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Yoon Ling Cheong
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | | | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nuur Hafizah Md Iderus
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Qistina binti Ruslan
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Balvinder Singh Gill
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Florence Chi Hiong Lee
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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16
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Md Zamri ASS, Singh S, Ghazali SM, Herng LC, Dass SC, Aris T, Ibrahim HM, Gill BS. Effectiveness of the movement control measures during the third wave of COVID-19 in Malaysia. Epidemiol Health 2021; 43:e2021073. [PMID: 34607399 PMCID: PMC8891114 DOI: 10.4178/epih.e2021073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Starting in March 2020, movement control measures were instituted across several phases in Malaysia to break the chain of transmission of coronavirus disease 2019 (COVID-19). In this study, we developed a susceptible-exposed-infected-recovered (SEIR) model to examine the effects of the various phases of movement control measures on disease transmissibility and the trend of cases during the third wave of the COVID-19 pandemic in Malaysia. METHODS Three SEIR models were developed using the R programming software ODIN interface based on COVID-19 case data from September 1, 2020, to March 29, 2021. The models were validated and subsequently used to provide forecasts of daily cases from October 14, 2020, to March 29, 2021, based on 3 phases of movement control measures. RESULTS We found that the reproduction rate (R-value) of COVID-19 decreased by 59.1% from an initial high of 2.2 during the nationwide Recovery Movement Control Order (RMCO) to 0.9 during the Movement Control Order (MCO) and Conditional MCO (CMCO) phases. In addition, the observed cumulative and daily highest numbers of cases were much lower than the forecasted cumulative and daily highest numbers of cases (by 64.4-98.9% and 68.8-99.8%, respectively). CONCLUSIONS The movement control measures progressively reduced the R-value during the COVID-19 pandemic. In addition, more stringent movement control measures such as the MCO and CMCO were effective for further lowering the R-value and case numbers during the third wave of the COVID-19 pandemic in Malaysia due to their higher stringency than the nationwide RMCO.
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Affiliation(s)
| | | | | | | | | | - Tahir Aris
- Institute for Medical Research, SHAH ALAM, Malaysia
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17
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Hock LK, Li LH, Mohd Ghazali S, Ling CY, Cheong KC, Heng Pei Pei, Teh Chien Huey, Tan Cia Vei, Mohd Hazilas Mat Hashim, Cheah Yong Kang, Lim Jia Hui. INFLUENCES OF PARENTS AND PEERS ON ADOLESCENT SMOKING INITIATION: FINDINGS FROM A LONGITUDINAL STUDY IN KOTA TINGGI DISTRICT, JOHOR, MALAYSIA. MJPHM 2021. [DOI: 10.37268/mjphm/vol.21/no.2/art.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Studies have shown that parents and peers are among the dominant factors that contribute to smoking initiation among non-smoking adolescents. The paucity of this information in Malaysia warrants a longitudinal study to determine the actual factors associated smoking initiation. The study aims to address the gaps in our knowledge on the factors that associated with smoking initiation among non-smoking school-going adolescents. We carried out a longitudinal study among non-smoking secondary school-going adolescents in Kota Tinggi district, Johor. A representative sample of 1682 was selected via multi-stage sampling and respondents were followed-up for a period of one year. A pre-validated questionnaire was used to collect data from the selected respondents and multivariable logistic regression was employed to determine the factors associated with smoking initiation among non-smoking school-going adolescents. Approximately 1 in 10 non-smoking school-going adolescents-initiated smoking at the end of follow-up. Having peers and a father who smokes were significantly associated with smoking in univariate analysis, similarly, a relationship was also observed in multivariable analysis between parents who smoked with smoking initiation after the effect of other independent variables were controlled (Adjusted relative risk: 1.81, 95% CI 1.06-2.95). The study revealed that parental influence was more dominant than peer influence with regard to smoking initiation. Therefore, intervention programmes should involve parents/guardians to enhance their chances of success and reduce the incidence of smoking among non-smoking school-going adolescents.
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Lim KH, Lim HL, Mohd Ghazali S, Kee CC, Tain MZ, Cheong YL, Cheah YK, Ismail SA, Heng PP, Lim JH. USING THE THEORY OF REASONED ACTION TO PREDICT SMOKING INTENTION AMONG NON-SMOKING SECONDARY SCHOOL GOING ADOLESCENTS IN PENINSULAR MALAYSIA. MJPHM 2021. [DOI: 10.37268/mjphm/vol.21/no.2/art.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The study aims to determine the relationship of attitude and social-norm with the intention to smoke in the future among non-smoking youth. Data were derived from a study on smoking among form four students in a selected secondary school in Peninsular Malaysia, which utilised a pre-validated questionnaire to obtain data from the selected respondents. Descriptive statistics and structural equation modelling (SEM) were used in data analysis. The study revealed independent variables accounted for 22.6% of the variance in intention to initiate smoking and the model had a good fit. A significant relationship was observed between subjective norm and intention to initiate smoking (R=0.46). The study revealed that attitude and social norm substantially explained intention to smoke among non-smoking adolescents. Future measures should concentrate on correcting the subjective norms to reduce the intention to initiate smoking among non-smoking youth.
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Chee Cheong K, Lim KH, Ghazali SM, Teh CH, Cheah YK, Baharudin A, Lim HL, Abdul Hamid AM, Mustapha FI, Omar MA. Association of metabolic syndrome with risk of cardiovascular disease mortality and all-cause mortality among Malaysian adults: a retrospective cohort study. BMJ Open 2021; 11:e047849. [PMID: 34408040 PMCID: PMC8375738 DOI: 10.1136/bmjopen-2020-047849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES This study is aimed at determining the association between metabolic syndrome and risk of cardiovascular disease (CVD) mortality and all-cause mortality among Malaysian adults. DESIGN Retrospective cohort study. SETTING The Malaysian Non-Communicable Disease Surveillance (MyNCDS-1) 2005/2006. PARTICIPANTS A total of 2525 adults (1013 men and 1512 women), aged 24-64 years, who participated in the MyNCDS-1 2005/2006. METHODS Participants' anthropometric indices, blood pressure, fasting lipid profile and fasting blood glucose levels were evaluated to determine the prevalence of metabolic syndrome by the Harmonized criteria. Participants' mortality status were followed up for 13 years from 2006 to 2018. Mortality data were obtained via record linkage with the Malaysian National Registration Department. The Cox proportional hazards regression model was applied to determine association between metabolic syndrome (MetS) and risk of CVD mortality and all-cause mortality with adjustment for selected sociodemographic and lifestyle behavioural factors. RESULTS The overall point prevalence of MetS was 30.6% (95% CI: 28.0 to 33.3). Total follow-up time was 31 668 person-years with 213 deaths (111 (11.3%) in MetS subjects and 102 (6.1%) in non-MetS subjects) from all-causes, and 50 deaths (33 (2.9%) in MetS group and 17 (1.2%) in non-MetS group) from CVD. Metabolic syndrome was associated with a significantly increased hazard of CVD mortality (adjusted HR: 2.18 (95% CI: 1.03 to 4.61), p=0.041) and all-cause mortality (adjusted HR: 1.47 (95% CI: 1.00 to 2.14), p=0.048). These associations remained significant after excluding mortalities in the first 2 years. CONCLUSIONS Our study shows that individuals with MetS have a higher hazard of death from all-causes and CVD compared with those without MetS. It is thus imperative to prescribe individuals with MetS, a lifestyle intervention along with pharmacological intervention to improve the individual components of MetS and reduce this risk.
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Affiliation(s)
- Kee Chee Cheong
- Sector for Biostatistics & Data Repository, National Institutes of Health, Shah Alam, Selangor, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Setia Alam, Shah Alam, Selangor, Malaysia
| | | | - Chien Huey Teh
- Institute for Medical Research, Setia Alam, Shah Alam, Selangor, Malaysia
| | | | - Azli Baharudin
- Centre for Nutrition Epidemiology Research, Institute for Public Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Hui Li Lim
- Hospital Sultan Ismail, Johor Bahru, Johor Darul Ta'zim, Malaysia
| | - Abdul Muneer Abdul Hamid
- Sector for Biostatistics & Data Repository, National Institutes of Health, Shah Alam, Selangor, Malaysia
| | - Feisul Idzwan Mustapha
- NCD Section, Disease Control Division, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics & Data Repository, National Institutes of Health, Shah Alam, Selangor, Malaysia
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Yusoff AF, Mohd Sharani ZZ, Kee CC, Md Iderus NH, Md Zamri ASS, Nagalingam T, Mohamad Bashaabidin MS, Wan Ibadullah WAH, Ghazali SM, Yusof AY, Ching YM, Mohamed Nor N, Kamarudin B, Ahmad N, Arip M. Seroprevalence of diphtheria toxoid IgG antibodies in the Malaysian population. BMC Infect Dis 2021; 21:581. [PMID: 34134646 PMCID: PMC8207650 DOI: 10.1186/s12879-021-06285-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background Despite high childhood immunization coverage, sporadic cases of diphtheria have been reported in Malaysia in recent years. This study aims to evaluate the seroprevalence of diphtheria among the Malaysian population. Methods A total of 3317 respondents age 2 years old to 60 years old were recruited in this study from August to November 2017. Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of IgG antibody against the toxoid of C. diphtheriae in the blood samples of respondents. We classified respondent antibody levels based on WHO definition, as protective (≥0.1 IU/mL) and susceptible (< 0.1 IU/mL) to C. diphtheriae infection. Results Among the 3317 respondents, 57% were susceptible (38.1% of children and 65.4% of adults) and 43% (61.9% of children and 34.6% of adults) had protective antibody levels against diphtheria. The mean antibody level peaked among individuals aged 1–2 years old (0.59 IU/mL) and 6–7 years old (0.64 IU/mL) but generally decreased with age, falling below 0.1 IU/mL at around 4–6 years old and after age 20 years old. There was a significant association between age [Children: χ2 = 43.22(df = 2),p < 0.001)], gender [Adults: χ2 = 5.58(df = 1),p = 0.018] and ethnicity [Adults: χ2 = 21.49(df = 5),p = 0.001] with diphtheria toxoid IgG antibody level. Conclusions About 57% of the Malaysian population have inadequate immunity against diphtheria infection. This is apparently due to waning immunity following childhood vaccination without repeated booster vaccination in adults. Children at age 5–6 years old are particularly vulnerable to diphtheria infection. The booster vaccination dose normally given at 7 years should be given earlier, and an additional booster dose is recommended for high-risk adults.
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Affiliation(s)
- Ahmad Faudzi Yusoff
- SEAMEO TROPMED Malaysia, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
| | - Zatil Zahidah Mohd Sharani
- Biomedical Epidemiology Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Nuur Hafizah Md Iderus
- Biomedical Epidemiology Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Ahmed Syahmi Syafiq Md Zamri
- Biomedical Epidemiology Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Tharmarajah Nagalingam
- Infection Control Unit, Kuala Lumpur Hospital, Ministry of Health Malaysia, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - Mohd Safrin Mohamad Bashaabidin
- Biomedical Epidemiology Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Wan Abdul Hannan Wan Ibadullah
- Biomedical Epidemiology Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Sumarni Mohd Ghazali
- Biomedical Epidemiology Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Ainur Yusniza Yusof
- Allergy and Immunology Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Yee Ming Ching
- Allergy and Immunology Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Nurhanani Mohamed Nor
- Allergy and Immunology Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Balqis Kamarudin
- Allergy and Immunology Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Norazah Ahmad
- Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Masita Arip
- Allergy and Immunology Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
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Lim KH, Ghazali SM, Lim HL, Cheong YL, Kee CC, Heng PP, Tiunh TY, Mat Hashim MH, Lim JH. Prevalence and factors related to secondhand smoke exposure among secondary school-going adolescents in Malaysia: Findings from Malaysia Global Health School Survey 2012 and 2017. Tob Induc Dis 2021; 19:50. [PMID: 34177412 PMCID: PMC8204740 DOI: 10.18332/tid/136029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/15/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Secondhand (SHS) smoke exposure has caused various health problems. Therefore, continuous monitoring of SHS exposure is important to determine the efficacy of various anti-tobacco measure implemented. The study aims to compare the prevalence and factor(s) associated with SHS exposure among secondary school-going adolescents in Malaysia during 2012 and 2017. METHODS We derived data from the Global School Health Survey (GSHS) 2012 and GSHS 2017, which was carried out in Malaysia using multistage sampling to select representative samples of secondary school-going adolescents. Both surveys used similar questionnaires to measure SHS exposure. Descriptive and multivariate logistic regression was used to determine the prevalence and factors associated with SHS exposure. RESULTS Approximately four in ten respondents were exposed to SHS in the past week in both surveys (41.5% in GSHS 2012 and 42.0% in GSHS 2017, respectively). Both surveys revealed a significantly higher SHS exposure among respondents who smoked than among non-smokers and higher among males compared to females. The likelihood of SHS exposure in both surveys was also similar, with a higher likelihood of SHS exposure among smoking adolescents and non-smoking adolescents who had at least one smoking parent/guardian, regardless of their own smoking status. Male adolescents had a higher risk of SHS exposure compared to their female counterparts. Meanwhile, SHS risk also increased with age, regardless of smoking status. CONCLUSIONS Our findings suggested that there were no changes in the prevalence of SHS exposure and recorded only a slight change in the factors associated with exposure to SHS among school-going adolescents in Malaysia between the years 2012 and 2017. A more pro-active, extensive and comprehensive programme should be implemented to address the problem of SHS exposure. Parents should be advised to stop smoking or abstain from smoking in the presence of their children, and smoking cessation interventions are necessary for smoking adolescents and their parents.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Biostatistics and Data Raspatory Sector, National Institutes of Health, Shah Alam, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Tsye Yih Tiunh
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Jia Hui Lim
- Department of Pharmacy and Pharmaceutical Sciences, Monash University Malaysia, Subang Jaya, Malaysia
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Lim KH, Mohd Ghazali S, Lim HL, Heng PP, Kee Chee Cheong, Teh Chien Huey, Cheah Yong Kang, Lim Jia Hui. STAGES OF SMOKING CESSATION AMONG ADULT CURRENT SMOKERS IN MALAYSIA: FINDINGS FROM THE NATIONAL E-CIGARETTE SURVEY 2016. MJPHM 2020. [DOI: 10.37268/mjphm/vol.20/no.2/art.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Identification of the stages of smoking cessation among smokers is essential to improve the rate of smoking cessation. The aims of this study were to determine the prevalence and factors associated with stages of smoking cessation across the demographic distribution of adult smokers in Malaysia. Data were derived from a population-based study among Malaysian adults aged 18 years and above. Face-to-face interviews were carried out by trained staff using a validated questionnaire to obtain data related to smoking from 4,288 selected respondents. Of 4,288, 438 respondents are current smokers. Multivariable logistic regression analysis was used to determine factors associated with stage of smoking cessation. Approximately 60% (n=269/438) of the current smokers were in the pre-contemplation stage and 40% (n=169/438) were in the contemplation and preparation stages of smoking cessation. The proportion of pre-contemplators was higher among smokers with higher levels of nicotine addiction (71.3%), lower education attainment (71.4%), and those who were single/widowed/divorced (66.9%). Multivariable analysis showed that males, and those who reported low to high level of nicotine addiction were more likely to be in the pre-contemplation stage whilst those in the older age groups were more likely to be in the advanced stage of smoking cessation. The study revealed that the majority of current smokers in Malaysia had no intention to quit smoking within 6 months. Specific interventions targeting males, young adults and smokers with low to high nicotine addiction should be introduced to ensure the smokers proceed to the advanced stage of smoking cessation.
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Gill BS, Jayaraj VJ, Singh S, Mohd Ghazali S, Cheong YL, Md Iderus NH, Sundram BM, Aris TB, Mohd Ibrahim H, Hong BH, Labadin J. Modelling the Effectiveness of Epidemic Control Measures in Preventing the Transmission of COVID-19 in Malaysia. Int J Environ Res Public Health 2020; 17:E5509. [PMID: 32751669 PMCID: PMC7432794 DOI: 10.3390/ijerph17155509] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/14/2020] [Accepted: 07/02/2020] [Indexed: 01/10/2023]
Abstract
Malaysia is currently facing an outbreak of COVID-19. We aim to present the first study in Malaysia to report the reproduction numbers and develop a mathematical model forecasting COVID-19 transmission by including isolation, quarantine, and movement control measures. We utilized a susceptible, exposed, infectious, and recovered (SEIR) model by incorporating isolation, quarantine, and movement control order (MCO) taken in Malaysia. The simulations were fitted into the Malaysian COVID-19 active case numbers, allowing approximation of parameters consisting of probability of transmission per contact (β), average number of contacts per day per case (ζ), and proportion of close-contact traced per day (q). The effective reproduction number (Rt) was also determined through this model. Our model calibration estimated that (β), (ζ), and (q) were 0.052, 25 persons, and 0.23, respectively. The (Rt) was estimated to be 1.68. MCO measures reduce the peak number of active COVID-19 cases by 99.1% and reduce (ζ) from 25 (pre-MCO) to 7 (during MCO). The flattening of the epidemic curve was also observed with the implementation of these control measures. We conclude that isolation, quarantine, and MCO measures are essential to break the transmission of COVID-19 in Malaysia.
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Affiliation(s)
- Balvinder Singh Gill
- Institute for Medical Research (IMR), Ministry of Health, Kuala Lumpur 50588, Malaysia; (B.S.G.); (S.S.); (S.M.G.); (Y.L.C.); (N.H.M.I.); (B.M.S.); (T.B.A.)
| | - Vivek Jason Jayaraj
- Department of Social and Preventive Medicine, Medical Faculty, University Malaya, Kuala Lumpur 50603, Malaysia;
- Ministry of Health, Malaysia, Putrajaya 62590, Malaysia;
| | - Sarbhan Singh
- Institute for Medical Research (IMR), Ministry of Health, Kuala Lumpur 50588, Malaysia; (B.S.G.); (S.S.); (S.M.G.); (Y.L.C.); (N.H.M.I.); (B.M.S.); (T.B.A.)
| | - Sumarni Mohd Ghazali
- Institute for Medical Research (IMR), Ministry of Health, Kuala Lumpur 50588, Malaysia; (B.S.G.); (S.S.); (S.M.G.); (Y.L.C.); (N.H.M.I.); (B.M.S.); (T.B.A.)
| | - Yoon Ling Cheong
- Institute for Medical Research (IMR), Ministry of Health, Kuala Lumpur 50588, Malaysia; (B.S.G.); (S.S.); (S.M.G.); (Y.L.C.); (N.H.M.I.); (B.M.S.); (T.B.A.)
| | - Nuur Hafizah Md Iderus
- Institute for Medical Research (IMR), Ministry of Health, Kuala Lumpur 50588, Malaysia; (B.S.G.); (S.S.); (S.M.G.); (Y.L.C.); (N.H.M.I.); (B.M.S.); (T.B.A.)
| | - Bala Murali Sundram
- Institute for Medical Research (IMR), Ministry of Health, Kuala Lumpur 50588, Malaysia; (B.S.G.); (S.S.); (S.M.G.); (Y.L.C.); (N.H.M.I.); (B.M.S.); (T.B.A.)
| | - Tahir Bin Aris
- Institute for Medical Research (IMR), Ministry of Health, Kuala Lumpur 50588, Malaysia; (B.S.G.); (S.S.); (S.M.G.); (Y.L.C.); (N.H.M.I.); (B.M.S.); (T.B.A.)
| | | | - Boon Hao Hong
- Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak, Kota Samarahan 94300, Malaysia;
| | - Jane Labadin
- Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak, Kota Samarahan 94300, Malaysia;
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Lim KH, Ghazali SM, Lim HL, Cheong KC, Teh CH, Lim KK, Heng PP, Cheah YK, Lim JH. Smoking susceptibility among non-smoking school-going adolescents in Malaysia: findings from a national school-based survey. BMJ Open 2019; 9:e031164. [PMID: 31662384 PMCID: PMC6830643 DOI: 10.1136/bmjopen-2019-031164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE The identification of susceptible non-smoking adolescents is an essential step in reducing smoking initiation among adolescents. The aim of this study was to examine the prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. DESIGN Cross-sectional study. SETTING Primary and secondary schools in Malaysia. PARTICIPANTS 11 246 non-smoking school-going adolescents. OUTCOME MEASURES The prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. RESULTS Approximately 14% of non-smokers were susceptible to smoking, and the prevalence of susceptibility was significantly higher among males, ever-smokers and e-cigarette users. The odds of susceptibility to smoking were higher among males, e-cigarette users, those aged 12 years and under and those who had ever smoked or tried cigarettes. Students from schools with educational programmes on the health effects of second-hand smoke (SHS) and who perceived smoking to be harmful were less likely to be susceptible to smoking. CONCLUSION Smoking susceptibility is prevalent among school-going adolescents. A comprehensive approach that enhances or reinforces health education programmes on the adverse health effects of smoking and SHS among school children, that considers multiple factors and that involves all stakeholders is urgently needed to reduce the prevalence of smoking susceptibility among vulnerable subgroups, as identified from the present findings.
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Affiliation(s)
- Kuang Hock Lim
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | | | - Hui Li Lim
- Pathology Unit, Hospital Sultan Haji Ahmad Shah, Mentakab, Malaysia
| | - Kee Chee Cheong
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Chien Huey Teh
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Kuang Kuay Lim
- Occupational Health Center, Institute of Public Health, Setia Alam, Malaysia
| | - Pei Pei Heng
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Yong Kang Cheah
- College of Business, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- School of Pharmacy, Monash University, Malaysia Campus, Bandar Sunway, Malaysia
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Lim KH, Lim HL, Teh CH, Ghazali SM, Kee CC, Heng PP, Shaharuddin R, Lim JH. Is the implementation of smoke-free policies at workplaces associated with living in a smoke-free home?: Findings from a national population-based study in Malaysia. Tob Induc Dis 2019; 17:51. [PMID: 31516494 PMCID: PMC6662793 DOI: 10.18332/tid/100692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 12/12/2018] [Accepted: 12/12/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Studies have shown that the implementation of smoke-free policies at workplaces have shifted the social norms towards secondhand smoke (SHS) exposure at home. This study aimed to investigate whether working in a smoke-free workplace is associated with living in a smoke-free home (SFH). METHODS The data were derived from the Malaysian Global Adult Tobacco Survey (GATS-M), collected in 2011-2012, involving 4250 respondents. Data analyses involved 1343 respondents reported to be in the working population. RESULTS More than half of the respondents (58.5%) were reportedly working in smoke-free workplaces. Almost a quarter (24.8%) of those who worked in smoke-free workplaces stayed in smoke-free homes, which was more than two times higher than their counterparts who worked at non-smoke-free workplaces (24.8% vs 12.0%, p<0.001). Multivariable analyses further substantiated this finding (AOR=2.01, 95% CI: 1.11-3.61, reference group = worked at non-smoke-free workplaces). CONCLUSIONS This study found an association between living in smoke-free homes and working at smoke-free workplaces, which could suggest a positive impact of implementing smoke-free workplaces.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Temerloh, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Rafiza Shaharuddin
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Jia Hui Lim
- School of Science, Monash University Malaysia, Subang Jaya, Malaysia
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Ghazali SM, Huey TC, Cheong KC, Li LH, Fadhli M, Yusoff M, Yusoff AF, Hock LK. Prevalence and factors associated with secondhand smoke exposure among Malaysian adolescents. Tob Induc Dis 2019; 17:22. [PMID: 31582933 PMCID: PMC6751970 DOI: 10.18332/tid/102728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/19/2018] [Accepted: 01/09/2019] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Exposure to secondhand smoke (SHS) has been proven to be detrimental to health. However, there is little information on SHS exposure among Malaysian adolescents. This study aims to assess the magnitude of and factors associated with SHS exposure among school-going adolescents in Malaysia. METHODS We performed secondary analysis on data from 25461 respondents of the Global School Health Survey in Malaysia. Descriptive analyses and multivariable logistic regression were performed to determine factors associated with SHS exposure. RESULTS Respondents were adolescents of mean age 14.84 (SD=1.45) years, 50.2% of which were male and 49.8% female. Approximately four in ten respondents were exposed to SHS in the past week (41.5%). SHS exposure was significantly higher among respondents who smoked than among non-smokers (85.8% vs 35.7%, p<0.001). The likelihood of exposure to SHS was higher among smoking adolescents (Adjusted OR=1.66, 95% CI: 1.07-2.56) and non-smoking adolescents (AOR=3.15, 95% CI: 1.48-4.71) who had at least one smoking parent/guardian regardless of their own smoking status. Male adolescents had higher risk of SHS exposure compared to their female counterparts (current smoker AOR=1.66, 95% CI: 1.07-2.56; non-smoker AOR=1.50, 95% CI: 1.12-2.00) and increased with age, regardless of their smoking status. CONCLUSIONS Our findings suggest that prevalence of exposure to SHS among school-going adolescents in Malaysia is high. Parents should be advised to stop smoking or abstain from smoking in the presence of their children. Education programmes are recommended to increase awareness on avoidance of SHS as well as smoking cessation interventions for both adolescents and their parents.
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Affiliation(s)
- Sumarni Mohd Ghazali
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Teh Chien Huey
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Kee Chee Cheong
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Lim Hui Li
- Hospital Sultan Haji Ahmad Shah, Ministry of Health, Temerloh, Malaysia
| | - Muhammad Fadhli
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
- Hospital Sultan Haji Ahmad Shah, Ministry of Health, Temerloh, Malaysia
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Mohd Yusoff
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Ahmad Faudzi Yusoff
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Lim Kuang Hock
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
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Lim HL, Teh CH, Kee CC, Mohd Ghazali S, Pan SA, Lim KH. Exposure to second-hand smoke among secondary school-going adolescents: Findings from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study. Proceedings of Singapore Healthcare 2019. [DOI: 10.1177/2010105818789961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Exposure to second-hand smoke (SHS) is one of the main causes of morbidity and it has been proven to be associated with an increased likelihood of smoking initiation among adolescents. Nonetheless, evidence on SHS exposure among Malaysian adolescents is scarce. Therefore, this article aims to demonstrate the magnitude and factors associated with SHS exposure among school-going adolescents in selected secondary schools in Peninsular Malaysia. Methods: Data were derived from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study conducted in 2013. A total of 2599 adolescent were recruited into the study using a two-stage proportionate-to-size sampling method. Data were obtained from self-administered questionnaires. Descriptive analysis and multivariable logistic regression were performed to determine the risk factors/predictors associated with SHS. Results: More than half of the respondents had been exposed to SHS during the last one week (56.4%), and SHS exposure was significantly higher among respondents who smoked (94.0% vs. 49.9%, p <0.001). Multivariable analysis revealed that the likelihood of exposure to SHS was higher among those who smoked (adjusted odds ratio (aOR) 12.90, 95% confidence interval (CI): 8.01–20.4), had at least one parent/guardian who smoked (aOR 5.49, 95% CI: 4.41–6.94) and adolescents of Malay descent (aOR 2.10, 95% CI: 1.68–2.63). Conclusion: Our findings suggested that the effectiveness of anti-smoking measures implemented in recent years to protect adolescents from the health risks of passive smoking were less evident. Therefore, educational and awareness programmes that emphasize the negative health impacts of SHS exposure on Malaysian adolescents, particularly when among smoking adults, should be intensified to help in preventing adoption of smoking behaviours among adolescents.
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Affiliation(s)
- Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Jalan Maran, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | | | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
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Lim KH, Teh CH, Heng PP, Pan S, Ling MY, Yusoff MFM, Ghazali SM, Kee CC, Shaharudin R, Lim HL. Source of cigarettes among youth smokers in Malaysia: Findings from the tobacco and e-cigarette survey among Malaysian school adolescents (TECMA). Tob Induc Dis 2018; 16:51. [PMID: 31516448 PMCID: PMC6659477 DOI: 10.18332/tid/96297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/17/2018] [Accepted: 09/26/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Understanding how and where youth obtain tobacco products are major factors in the development of suitable intervention programs to reduce youth smoking. This study aimed to determine the source of cigarettes and the associated factors among Malaysian school adolescent smokers. METHODS Our sample consisted of 1348 youth aged 10-17 years who were current smokers (having smoked at least once in the last 30 days). The source of cigarettes (commercial, over-the-counter purchases; or social, borrowing or obtaining from someone else) was the dependent variable, and multivariable logistic regression was employed to determine its association with independent variables (i.e. sociodemographics, smoking behavior, and knowledge of laws prohibiting sales of cigarettes to youth). RESULTS Over half (54.3%) of current smokers obtained cigarettes from commercial sources, with a proportion nearly two times higher (84.2% vs 43.7%) among frequent smokers (i.e. those smoking more than 20 days per month) compared to less-frequent smokers, and among young males (56.5% vs 32.0%) compared young females. Multivariable logistic regression indicated that in urban areas, young females (AOR=12.5, 95% CI: 1.38-99.8) frequent smokers (AOR=4.41, 95% CI: 2.05-9.46), and those studying in lower (AOR=3.76, 95% CI: 1.41-10.02) and upper secondary (AOR=4.74, 95% CI: 1.72-13.06) school students were more likely to obtain cigarettes from a commercial source. On the other hand, in rural areas, only frequent smokers were more likely to get their cigarettes from commercial sources, whilst other variables were not significant. CONCLUSIONS The proportion of youth smokers who obtained cigarettes from commercial sources appeared to be high, suggesting that law enforcement and health promotion activities should be enhanced to reduce the rate of smoking among Malaysian youth.
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Affiliation(s)
| | | | - Pei Pei Heng
- Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Sayan Pan
- Jabatan Kesihatan Negeri Perlis, Perlis, Malaysia
| | - Miaw Yn Ling
- Institute of Public Health, Kuala Lumpur, Malaysia
| | | | | | | | | | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Temerloh, Malaysia
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Lim KH, Lim HL, Teh CH, Kee CC, Heng PP, Cheah YK, Ghazali SM. Secondhand smoke (SHS) exposure at home and at the workplace among non-smokers in Malaysia: Findings from the Global Adult Tobacco Survey 2011. Tob Induc Dis 2018; 16:49. [PMID: 31516446 PMCID: PMC6659505 DOI: 10.18332/tid/95188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/23/2018] [Accepted: 09/17/2018] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Understanding the prevalence of secondhand smoke (SHS) exposure and the associated factors is beneficial for the formulation of effective measures to reduce exposure to SHS. The purpose of this study was to determine SHS exposure at home and workplace, and its associated factors among non-smoker Malaysian adults. METHODS Data were extracted from the Global Adult Tobacco Survey-Malaysia (GATS-M) that involved a representative sample of 5112 Malaysian adults. Logistic regression analyses were performed to examine the association between SHS exposure, sociodemographic factors, knowledge on the danger of SHS, and smoking restrictions at home and at work among non-smokers. RESULTS Among non-smoker Malaysians, age ≥15 years, 27.9% (equivalent to approximately 4.21 million non-smokers) and 33.9% (equivalent to approximately 1.37 million non-smokers) reported that they were exposed to SHS at home and the workplace, at least once a month, respectively. Women (AOR=2.12, 95% CI: 1.61-2.78), young individuals (AOR=3.06, 95% CI: 1.48-6.33), Malays (AOR=2.39, 95% CI: 1.56-3.64) or other Bumiputra ethnic groups (AOR=2.40, 95% CI: 1.39-4.19) and those who worked as other than government employees were more likely to report SHS exposure at home (non-government employee: AOR=1.88, 95% CI: 1.06-3.36). Respondents with a total smoking restriction at home did not report any SHS exposure at home. Similarly, those whose workplace had smoking restrictions were less likely to report SHS exposure at the work compared to their counterparts whose workplace had partial (AOR=3.08, 95% CI: 1.84-5.15) or no smoking restrictions (AOR=15.33, 95% CI: 6.75-34.86). CONCLUSIONS A substantial proportion of Malaysian adults were exposed to SHS at home and at work. The findings emphasize the need for policies on smoking restrictions at work and the need to promote the adoption of a completely smoke-free home, among the Malaysian population.
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Affiliation(s)
| | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Pahang, Malaysia
| | | | | | - Pei Pei Heng
- Institute for Medical Research, Kuala Lumpur, Malaysia
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Lim KH, Teh CH, Nik Mohamed MH, Pan S, Ling MY, Mohd Yusoff MF, Hassan N, Baharom N, Dawam ND, Ismail N, Ghazali SM, Cheong KC, Chong KH, Lim HL. Exposure to tobacco secondhand smoke and its associated factors among non-smoking adults in smoking-restricted and non-restricted areas: findings from a nationwide study in Malaysia. BMJ Open 2018; 8:e017203. [PMID: 29317411 PMCID: PMC5780697 DOI: 10.1136/bmjopen-2017-017203] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Secondhand smoke (SHS) has been associated with increased morbidity and mortality. Therefore, the aims of the paper are to assess SHS exposure among non-smoking adults in Malaysia attending various smoking-restricted and non-restricted public areas according to the Control of Tobacco Product Regulations (CTPR) as well as its relationship with various sociodemographic variables. DESIGN Data were extracted from a cross-sectional study, the Global Adults Tobacco Survey (GATS) 2011 which involved 3269 non-smokers in Malaysia. Data was obtained through face-to-face interviews using a validated pre-tested questionnaire. Factors associated with exposure to SHS were identified via multivariable analysis. RESULTS The study revealed that almost two-thirds of respondents were exposed to SHS in at least one public area in the past 1 month, with a significantly higher exposure among males (70.6%), those with higher educational attainment (81.4%) and higher income (quintile 1%-73.9%). Besides, the exposure to SHS was almost four times higher in non-restricted areas compared with restricted areas under the CTPR (81.9% vs 22.9). Multivariable analysis revealed that males and younger adults at non-restricted areas were more likely to be exposed to SHS while no significant associated factors of SHS exposure was observed in restricted areas. CONCLUSIONS The study revealed the prevalence of SHS exposure was higher among Malaysian adults. Although smoke-free laws offer protection to non-smokers from exposure to SHS, enforcement activities in restricted areas should be enhanced to ensure strict public abidance. In addition, legislation of restricted areas should also be extended to greatly reduce the SHS exposure among non-smokers in Malaysia.
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Affiliation(s)
| | | | | | - Sayan Pan
- Institute of Public Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Miaw Yn Ling
- Institute of Public Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Noraryana Hassan
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Nizam Baharom
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Norliana Ismail
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | | | | | - Kar Hon Chong
- Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang, Malaysia
| | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang, Malaysia
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Cheah YK, Lim HK, Kee CC, Ghazali SM. Factors associated with participation in physical activity among adolescents in Malaysia. Int J Adolesc Med Health 2017; 28:419-427. [PMID: 26356358 DOI: 10.1515/ijamh-2015-0030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 07/02/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND The rising prevalence of non-communicable diseases (NCDs) has become a serious public health issue. Among the multi-factorial drivers behind NCDs are modifiable health risk factors, most notably, physical inactivity. OBJECTIVE In response to the nearly global policy priority of encouraging regular participation in physical activity, the objective of the present study is to examine the factors that determine participation in physical activity among Malaysian adolescents. METHODS Nationally representative data consisting of a large sample size was used. A censored regression model was developed to estimate the likelihood of participation and time spent on physical activity. RESULTS There are significant relationships between physical activity and gender, ethnicity, self-rated academic performance, maternal education, household size and time spent on physical education. CONCLUSION The present study provides new insights into the factors affecting physical activity participation among adolescents. Specifically, self-rated excellent academic performance, household size and physical education can increase the likelihood of being physically active. Evidence of the present study implies that policy makers should pay special attention to females, Chinese, adolescents with self-rated poor academic performance and adolescents who have low maternal education.
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Lim KH, Lim HL, Teh CH, Kee CC, Khoo YY, Ganapathy SS, Jane Ling MY, Mohd Ghazali S, Tee EO. Smoking among school-going adolescents in selected secondary schools in Peninsular Malaysia- findings from the Malaysian Adolescent Health Risk Behaviour (MyaHRB) study. Tob Induc Dis 2017; 15:9. [PMID: 28163668 PMCID: PMC5282817 DOI: 10.1186/s12971-016-0108-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 12/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A multitude of studies have revealed that smoking is a learned behaviour during adolescence and efforts to reduce the incidence of smoking has been identified as long-term measures to curb the smoking menace. The objective of this study was to determine the prevalence as well as the intra and inter-personal factors associated with smoking among upper secondary school students in selected schools in Peninsular Malaysia. METHODS A study was carried out in 2013, which involved a total of 40 secondary schools. They were randomly selected using a two-stage clustering sampling method. Subsequently, all upper secondary school students (aged 16 to 17 years) from each selected school were recruited into the study. Data was collected using a validated standardised questionnaire. RESULTS This study revealed that the prevalence of smoking was 14.6% (95% CI:13.3-15.9), and it was significantly higher among males compared to females (27.9% vs 2.4%, p < 0.001). Majority of smokers initiated smoking during their early adolescent years (60%) and almost half of the respondents bought cigarettes themselves from the store. Multivariable analysis revealed that the following factors increased the likelihood of being a current smoker: being male (aOR 21. 51, 95% CI:13.1-35), perceived poor academic achievement (aOR 3.42, 95% CI:1.50-7.37) had one or both parents who smoked (aOR 1.80, 95% CI:1.32-2.45; aOR 6.50, 95 CI%:1.65-25.65), and always feeling lonely (aOR 2.23, 95% CI:1.21-4.43). In contrast, respondents with a higher religiosity score and protection score were less likely to smoke (aOR 0.51, 95% CI:0.15-0.92; aOR 0.71, 95% CI 0.55-0.92). CONCLUSION This study demonstrated that the prevalence of smoking among Malaysian adolescents of school-going age was high, despite implementation of several anti-smoking measures in Malaysia. More robust measures integrating the factors identified in this study are strongly recommended to curb the smoking epidemic among adolescents in Malaysia.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Melaka Manipal Medical College, Jalan Batu Hampar, Kuala Lumpur, 75150 Melaka Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Yi Yi Khoo
- Institute for Public Health, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | | | - Miaw Yn Jane Ling
- Institute for Public Health, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | | | - Eng Ong Tee
- Allied Health College, Jalan Hospital, 47000 Sg. Buloh, Malaysia
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Chan YY, Lim KH, Teh CH, Kee CC, Ghazali SM, Lim KK, Khoo YY, Tee EO, Ahmad NA, Ibrahim N. Prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia. Int J Adolesc Med Health 2016; 30:/j/ijamh.ahead-of-print/ijamh-2016-0053/ijamh-2016-0053.xml. [PMID: 27508957 DOI: 10.1515/ijamh-2016-0053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 06/29/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Suicidal ideation, defined as thoughts, ideas and the desire to commit suicide, is becoming a major public health problem among adolescents. Indeed, suicidal ideation is known as a key predictor of future suicide risk. OBJECTIVE This study aims to determine the prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia. METHODS This study used data from the 2013 Malaysian adolescent health risk behavior (MyAHRB) study, a cross-sectional school survey conducted in Peninsular Malaysia among school-going adolescents aged 16-17 years (n=2789). Logistic regression analysis was used to determine the risk factors associated with suicidal ideation among Malaysian adolescents. RESULTS The overall prevalence of suicidal ideation among the adolescents was 6.2%. The prevalence was significantly higher among females than males (7.6% vs. 4.7%; p=0.002). Multivariate regression analysis revealed that adolescents who were females [odds ratio (OR)=2.02; 95% confidence interval (CI): 1.40-2.92] or of Indian ethnicity (OR=2.32; 95% CI: 1.35-3.98) were more likely to report suicidal ideation. Loneliness (OR=2.54; 95% CI: 1.57-4.11), anxiety or worry (OR=2.70; 95% CI: 1.70-4.31), no close friends (OR=2.71; 95% CI: 1.43-5.14), and lack of supportive peers (OR=1.69; 95% CI: 1.15-2.47) were identified as risk factors for adolescents' suicidal ideation. Adolescents who ever had sexual intercourse (OR=2.70; 95% CI: 1.48-4.92) and had been in a physical fight (OR=2.45; 95% CI: 1.62-3.70) were also reported to have higher risks of suicidal ideation. CONCLUSION This study provides evidence on risk factors associated with suicidal ideation among Malaysian adolescents. Targeted mental health and health risk behavioral interventions for high-risk adolescents are recommended.
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Affiliation(s)
- Ying Ying Chan
- Institute for Public Health, Ministry of Health Malaysia, 50590 Jalan Bangsar, Kuala Lumpur, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Kuang Kuay Lim
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Yi Yi Khoo
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Eng Ong Tee
- Allied Health Sciences College Sungai Buloh, Ministry of Health, Selangor, Malaysia
| | - Noor Ani Ahmad
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Normala Ibrahim
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
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Lim HK, Teh HC, Lim LH, Lau JK, Kee CC, Ghazali SM, Chan YY, Sabtu MY, Ismail H, Zaki NAM, Thomas LT, Lim KK, Cheong SM, ibrahim N, Yusoff MFM. Smoking among Secondary School Students in Kota Tinggi, Johor, Malaysia - Findings from a Cross-Sectional Study. Asian Pac J Cancer Prev 2015; 16:4563-70. [DOI: 10.7314/apjcp.2015.16.11.4563] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ghazali SM, Seman Z, Cheong KC, Hock LK, Manickam M, Kuay LK, Yusoff AF, Mustafa FI, Mustafa AN. Sociodemographic factors associated with multiple cardiovascular risk factors among Malaysian adults. BMC Public Health 2015; 15:68. [PMID: 25636327 PMCID: PMC4319230 DOI: 10.1186/s12889-015-1432-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 01/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To determine the prevalence and sociodemographic correlates of multiple risk factors for cardiovascular disease (CVD) among Malaysian adults. METHODS We analysed data on 1044 men and 1528 women, aged 24-64 years, participants in the Non Communicable Disease Surveillance 2005/2006, a nationally representative, population-based, cross-sectional study. Prevalence of obesity, high blood pressure, dyslipidaemia, hyperglycemia, physical inactivity, smoking, risky drinking, low vegetable and fruit intake were determined and multivariable logistic regression was used to identify sociodemographic factors associated with having ≥3 of these cardiovascular disease risk factors. RESULTS The response rate was 84.6% (2572/3040). Overall, 68.4% (95% CI: 63.2, 73.1) had at least three risk factors. Among men, older age and Indian ethnicity were independently associated with having ≥3 CVD risk factors; while among women, older age, low education, and housewives were more likely to have ≥3 CVD risk factors. CONCLUSION The prevalence of cardiovascular risk factors clustering among Malaysian adults is high, raising concerns that cardiovascular disease incidence will rise steeply in the near future if no immediate preventive measures are taken. The current national health education and promotion programmes pertaining to modifiable risk factors can be further improved by taking into account the sociodemographic variation in CVD risk factors clustering.
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Affiliation(s)
| | - Zamtira Seman
- Institute for Medical Research, Kuala Lumpur, Malaysia.
| | | | | | - Mala Manickam
- Institute for Public Health, Kuala Lumpur, Malaysia.
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Ghazali SM, Othman Z, Cheong KC, Hock LK, Wan Mahiyuddin WR, Kamaluddin MA, Yusoff AF, Mustafa AN. Non-practice of breast self examination and marital status are associated with delayed presentation with breast cancer. Asian Pac J Cancer Prev 2014; 14:1141-5. [PMID: 23621202 DOI: 10.7314/apjcp.2013.14.2.1141] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease, resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancer and identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosed with primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data were collected by face-to-face interview using a structured questionnaire and from medical records. We examined associations between delayed presentation (presenting to a physician more than 3 months after self-discovery of a symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benign breast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from others to seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation ranged from tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantly higher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced or widowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married women and women who never performed breast self examination were more likely to delay presentation compared to those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayed presentation for breast cancer symptoms among Malaysian women is high and that marital status and breast self examination play major roles in treatment-seeking for breast cancer symptoms.
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Affiliation(s)
- Sumarni Mohd Ghazali
- Epidemiology and Biostatistics Unit, Institute for Medical Research, Kuala Lumpur, Malaysia.
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Hock LK, Ghazali SM, Cheong KC, Kuay LK, Li LH, Ying CY, Huey TC, Yee LW, Ying OS, Yen YL, Abdullah N, Wymen S, Ibrahim N. Correlates of Susceptibility to Smoking among Secondary School Students in Kota Tinggi District, Johor, Malaysia. Asian Pac J Cancer Prev 2013; 14:6971-8. [DOI: 10.7314/apjcp.2013.14.11.6971] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lim KH, Ibrahim N, Ghazali SM, Kee CC, Lim KK, Chan YY, Teh CH, Tee EO, Lai WY, Nik Mohamad MH, Sidek SM. Stages of smoking cessation among Malaysian adults--findings from national health morbidity survey 2006. Asian Pac J Cancer Prev 2013; 14:805-10. [PMID: 23621242 DOI: 10.7314/apjcp.2013.14.2.805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Increasing the rate of smoking cessation will reduce the burden of diseases related to smoking, including cancer. Understanding the process of smoking cessation is a pre-requisite to planning and developing effective programs to enhance the rate of smoking cessation.The aims of the study were to determine the demographic distribution of smokers across the initial stages of smoking cessation (the pre-contemplation and contemplation stages) and to identify the predictors of smoking cessation among Malaysian adult smokers. Data were extracted from a population-based, cross-sectional survey carried out from April 2006 to July 2006. The distribution of 2,716,743 current smokers across the pre-contemplation stage (no intention to quit smoking in the next six months) or contemplation stage (intended to quit smoking in the next six months) was described. Multivariable logistic regression analysis was used to examine the relationship between socio-demographic variables and the stages of smoking cessation. Of the 2,716,743 current smokers, approximately 30% and 70% were in the pre-contemplative and contemplative stages of smoking cessation respectively. Multivariable analysis showed that male gender, low education level, older age group, married and those from higher income group and number of cigarettes smoked were associated with higher likelihood of pre-contemplation to cease smoking in the next six months. The majority of current smokers in Malaysia were in the contemplative stage of smoking cessation. Specific interventions should be implemented to ensure the pre-contemplative smokers proceed to the contemplative stage and eventually to the preparation stage.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Public Health, Jalan Pahang, Kuala Lumpur, Malaysia.
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Lim HK, Ghazali SM, Kee CC, Lim KK, Chan YY, Teh HC, Yusoff AFM, Kaur G, Zain ZM, Mohamad MHN, Salleh S. Epidemiology of smoking among Malaysian adult males: prevalence and associated factors. BMC Public Health 2013; 13:8. [PMID: 23294728 PMCID: PMC3549287 DOI: 10.1186/1471-2458-13-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 01/04/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Three National Health and Morbidity Surveys (NHMSs) had been conducted in Malaysia in 10-year intervals from 1986-2006. Based on the latest NHMS survey in 2006, we describe the prevalence of smoking and identify the social and demographic factors associated with smoking among adult males in Malaysia. METHODS A cross-sectional study among 15,639 Malaysian adult males aged 18 years and above was conducted using proportional to size stratified sampling method. The socio-demographic variables examined were level of education, occupation, marital status, residential area, age group and monthly household income. RESULTS The prevalence of smoking among adult males in Malaysia was 46.5% (95% CI: 45.5-47.4%), which was 3% lower than a decade ago. Mean age of smoking initiation was 18.3 years, and mean number of cigarettes smoked daily was 11.3. Prevalence of smoking was highest among the Malays (55.9%) and those aged 21-30 years (59.3%). Smoking was significantly associated with level of education (no education OR 2.09 95% CI (1.67-2.60), primary school OR 1.95, 95% CI (1.65-2.30), secondary school OR 1.88, 95% CI (1.63-2.11), with tertiary education as the reference group). Marital status (divorce OR 1.67, 95% CI (1.22-2.28), with married as the reference group), ethnicity (Malay, OR 2.29, 95% CI ( 1.98-2.66; Chinese OR 1.23 95% CI (1.05-1.91), Other Bumis OR 1.75, 95% CI (1.46-2.10, others OR 1.48 95% CI (1.15-1.91), with Indian as the reference group), age group (18-20 years OR 2.36, 95% CI (1.90-2.94); 20-29 years OR 3.31 , 95% CI 2.82-3.89; 31-40 years OR 2.85 , 95% CI ( 2.47-3.28); 41-50 years OR 1.93, 95% CI (1.69-2.20) ; 51-60 years OR 1.32, 95% CI (1.15-1.51), with 60 year-old and above as the reference group) and residential area (rural OR 1.12 , 95% CI ( 1.03-1.22)) urban as reference. CONCLUSION The prevalence of smoking among Malaysian males remained high in spite of several population interventions over the past decade. Tobacco will likely remain a primary cause of premature mortality and morbidity in Malaysia. Continuous and more comprehensive anti-smoking policy measures are needed in order to further prevent the increasing prevalence of smoking among Malaysian men, particularly those who are younger, of Malay ethnicity, less educated, reside in rural residential area and with lower socio-economic status.
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Affiliation(s)
- Hock Kuang Lim
- Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Sumarni Mohd Ghazali
- Epidemiology and Biostatistic unit, Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Cheong Chee Kee
- Epidemiology and Biostatistic unit, Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Kuay Kuang Lim
- Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Ying Ying Chan
- Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Huey Chien Teh
- Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Ahmad Faudzi Mohd Yusoff
- Epidemiology and Biostatistic unit, Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Gurpreet Kaur
- Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Zarihah Mohd Zain
- Disease Control Division, Ministry of Health, 62590, Putrajaya, Malaysia
| | - Mohamad Haniki Nik Mohamad
- Pharmacy Practice Department, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
| | - Sallehuddin Salleh
- Health Division, Kuala Lumpur City Hall, Jalan Raja Laut, 50350, Kuala Lumpur, Malaysia
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Ghazali SM, Abbiyesuku FM. Thyroid dysfunction in type 2 diabetics seen at the University College Hospital, Ibadan, Nigeria. Niger J Physiol Sci 2010; 25:173-179. [PMID: 22314957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Indexed: 05/31/2023]
Abstract
Thyroid dysfunction complicates the metabolic derangement observed in Diabetes Mellitus (DM). It is necessary to recognize and treat it when present in order to achieve stability of metabolic control in these patients. The prevalence of thyroid dysfunction in type-2 diabetics in our environment is not known. This study was therefore designed to determine the prevalence of thyroid dysfunction in Type 2 diabetics seen at the Metabolic Research Unit of University College Hospital, Ibadan, Nigeria. Serum TSH, Free T3 and Free T4 assays were performed using Automated Enzyme Immunoassay platform on fresh sera from volunteers comprising 64 adult type 2 diabetics and 36, age matched, non diabetic controls; weight, height and blood pressures were measured in all subjects. In addition, past lipid profile results of type 2 diabetics were retrieved from medical records. Thyroid dysfunction was present in 19 (29.7%) of 64 type 2 diabetics and 1 (2.8%) of 36 non diabetic controls.The prevalence of thyroid dysfunction is 32.4% in females and 25.9% in males. Secondary hypothyroidism was seen in 78.9%, sub-clinical hypothyroidism in 15.8%, and sub-clinical hyperthyroidism 5.2% of subjects with thyroid dysfunction. Abnormal lipid profiles were seen in 35.4% of euthyroid type 2 diabetics and 100% of hypothyroid type 2 diabetics. 87.5% of type 2 diabetics and 38.8% of controls were hypertensive. 7.8% of type 2 diabetics and 50% of controls were obese. The prevalence of thyroid dysfunction in type 2 is higher in type 2 diabetics than in controls. More of Type 2 diabetics were obese and more of them were hypertensive compared to controls. The approach of using TSH first in screening for thyroid dysfunction is not sufficient in type 2 diabetics. Routine screening for thyroid dysfunction should be carried out in type 2 diabetics.
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Affiliation(s)
- S M Ghazali
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Ghazali SM, Sanusi RA. Waist circumference, waist to hip ratio, and body mass index in the diagnosis of metabolic syndrome in Nigerian subjects. Niger J Physiol Sci 2010; 25:187-195. [PMID: 22314959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Indexed: 05/31/2023]
Abstract
Metabolic syndrome is the commonest controllable precursor of cardiovascular and end stage renal diseases. While central obesity is recognized universally as its strongest component, there is the need for an accurate and affordable tool to screen for the presence of metabolic syndrome in every community. The easiest and cheapest measures of obesity are the body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR). This study investigated the potential of BMI, WHR and WC in diagnosis of metabolic syndrome (MS) in Nigerian subjects.This cross sectional study involved three hundred and thirty eight apparently healthy adult Nigerians recruited within the University College Hospital and its environs were evaluated for the features of metabolic syndrome using the World Health Organisation and the NCEP ATP 111 criteria. BMI, WC, WHR, Blood Pressure, Fasting Lipid Profile and Fasting Plasma Glucose were measured in each participant. Correlation between BMI, WC, WHR and Blood Pressure, Fasting Lipid Profile and Fasting Plasma Glucose which are other components of MS was determined and empirical Receiver Operating Characteristics (ROC) analysis was used to evaluate each of them as predictors of MS. The prevalence of MS in the studied population was significantly higher (36.7%) using NCEP definition than (23.7%) using WHO definition. By both definitions, this prevalence was higher in females than in males. WC was positively correlated with FPG and TG (r=0.560 and 0.436 respectively; P=0.000) in the NCEP category while WC was positively correlated with FPG, SBP and DBP (r=0.254, 0.480, and 0.490 respectively; P>0.05) in the WHO category. ROC Analysis shows WC having the highest AUC (0.785) hence diagnoses MS more accurately than both BMI (0.733) and WHR (0.783) using in the NCEP ATP 111 criteria. The highest Area Under Curve (AUC) was observed in WHR (0.837) followed by WC (0.799) in the WHO category. Both WC and WHR are shown to be good predictors of the presence of MS. It will be appropriate to incorporate WC measurement into routine general physical examination in our clinics.
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Affiliation(s)
- S M Ghazali
- Department of Human Nutrition, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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