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Abdullah SR, Wan Mohd Zin RM, Azizul NH, Sulaiman NS, Khalid NM, Mohd Salim Mullahi Jahn RJ, Khalil MKN, Abu Seman N, Zainal Abidin NA, Ali A, Tan YZ, Omar A, Seman Z, Yahya A, Md Noh MF. The Effect of a Combined Intermittent Fasting Healthy Plate Intervention on Anthropometric Outcomes and Body Composition Among Adults With Overweight and Obesity: Nonrandomized Controlled Trial. JMIR Form Res 2024; 8:e51542. [PMID: 38598283 PMCID: PMC11043932 DOI: 10.2196/51542] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Adult obesity and overweight pose a substantial risk to global public health and are associated with various noncommunicable diseases. Although intermittent fasting (IF) is increasingly used as a relatively new dietary strategy for weight loss, the effectiveness of 2 days per week of dry fasting remains unknown. OBJECTIVE This study aims to evaluate the effectiveness of a combined dry IF and healthy plate (IFHP) and healthy plate (HP) intervention in improving anthropometric outcomes and body composition. METHODS This nonrandomized controlled trial involved 177 adults who were overweight and obese. Among them, 91 (51.4%) were allocated to the IFHP group and 86 (48.6%) were allocated to the HP group. The overall study duration was 6 months (October 2020 to March 2021). The intervention was divided into 2 phases: supervised (3 months) and unsupervised (3 months). The data were collected at baseline, after the supervised phase (month 3), and after the unsupervised phase (month 6). Anthropometric (weight, height, waist circumference, and hip circumference) and body composition (body fat percentage, body fat mass, skeletal muscle mass, and visceral fat area) data were measured at all 3 data collection points. Sociodemographic data were obtained using a questionnaire at baseline. RESULTS Most participants were female (147/177, 83.1%) and Malay (141/177, 79.7%). After 3 months, there were significant reductions in weight (difference -1.68; P<.001), BMI (difference -0.62; P<.001), body fat percentage (difference -0.921; P<.001), body fat mass (difference -1.28; P<.001), and visceral fat area (difference -4.227; P=.008) in the IFHP group, whereas no significant changes were observed in the HP group. Compared to baseline, participants in the IFHP group showed a significant decrease in weight (difference -1.428; P=.003), BMI (difference -0.522; P=.005), body fat percentage (difference -1.591; P<.001), body fat mass (difference -1.501; P<.001), visceral fat area (difference -7.130; P<.001), waist circumference (difference -2.304; P=.001), and hip circumference (difference -1.908; P=.002) at month 6. During the unsupervised phase, waist (IFHP difference -3.206; P<.001, HP difference -2.675; P=.004) and hip (IFHP difference -2.443; P<.001; HP difference -2.896; P<.001) circumferences were significantly reduced in both groups (P<.01), whereas skeletal muscle mass (difference 0.208; P=.04) and visceral fat area (difference -2.903; P=.003) were significantly improved in the IFHP group only. No significant difference in the between-group comparison was detected throughout the intervention (all P>.05). CONCLUSIONS A combined IFHP intervention was effective in improving anthropometric outcomes and body composition in adults with overweight and obesity. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/33801.
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Affiliation(s)
- Shazana Rifham Abdullah
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Ruziana Mona Wan Mohd Zin
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nur Hayati Azizul
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nur Suffia Sulaiman
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Norhayati Mustafa Khalid
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Roshan Jahn Mohd Salim Mullahi Jahn
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Muhamad Khairul Nazrin Khalil
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Norhashimah Abu Seman
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nur Azlin Zainal Abidin
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Azizan Ali
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - You Zhuan Tan
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Azahadi Omar
- Sector for Biostatistic and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Zamtira Seman
- Sector for Biostatistic and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Abqariyah Yahya
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mohd Fairulnizal Md Noh
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
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Henry Basil J, Premakumar CM, Mhd Ali A, Mohd Tahir NA, Seman Z, Voo JYH, Mohamed Shah N. Nurses' perception of medication administration errors and factors associated with their reporting in the neonatal intensive care unit. Int J Qual Health Care 2023; 35:mzad101. [PMID: 38102640 DOI: 10.1093/intqhc/mzad101] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/06/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023] Open
Abstract
Medication administration is a complex process, and nurses play a central role in this process. Errors during administration are associated with severe patient harm and significant economic burden. However, the prevalence of under-reporting makes it challenging when analysing the current landscape of medication administration error (MAE) and hinders the implementation of improvements to the existing system. The aim of this study is to describe the reasons for the occurrence of MAEs and the reasons behind the under-reporting of MAEs, to determine the estimated percentage of MAE reporting and to identify factors associated with them from the nurses' perspective. This cross-sectional study was conducted using a validated self-administered questionnaire. The questionnaire contained 65 questions which were divided into three sections: (i) reasons for the occurrence of MAEs, which consisted of 29 items; (ii) reasons for not reporting MAEs, which consisted of 16 items; and (iii) percentage of MAEs actually reported, which consisted of 20 items. It was distributed to 143 nurses in the neonatal intensive care units of five public hospitals in Malaysia. Multivariable logistic regression was used to identify the factors associated with MAE reporting. The estimated percentage of MAE reporting was 30.6%. The most common reasons for MAEs were inadequate nursing staff (5.14 [SD 1.25]), followed by drugs which look alike (4.65 [SD 1.06]) and similar drug packaging (4.41 [SD 1.18]). The most common reasons for not reporting MAEs were that nursing administration focuses on the individual rather than looking at the systems as a potential cause of the error (4.56 [SD 1.32]) and that too much emphasis is placed on MAEs as a measure of the quality of nursing care (4.31 [SD 1.23]). Factors statistically significant with MAE reporting were administration response (adjusted odds ratio [AOR] = 6.90; 95% confidence interval (CI) = 2.01-23.67; P = 0.002), reporting effort (AOR = 3.67; 95% CI = 1.68-8.01; P = 0.001), and nurses with advanced diploma (AOR = 0.29; 95% CI = 0.13-0.65; P = 0.003). Our findings show that under-reporting of MAEs is still common and less than a third of the respondents reported MAEs. Therefore, to encourage error reporting, emphasis should be placed on the benefits of reporting, adopting a non-punitive approach, and creating a blame-free culture.
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Affiliation(s)
- Josephine Henry Basil
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Chandini Menon Premakumar
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Adliah Mhd Ali
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Nurul Ain Mohd Tahir
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Zamtira Seman
- Sector for Biostatistics & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Persiaran Murni, Setia Alam, Shah Alam, Selangor 40170, Malaysia
| | - James Yau Hon Voo
- Department of Pharmacy, Hospital Duchess of Kent, Ministry of Health Malaysia, KM 3.2, Jalan Utara, Sandakan, Sabah 90000, Malaysia
| | - Noraida Mohamed Shah
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
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Khairul Hasni NA, Ismail R, Muhamad Robat R, Mohamad N, Suib FA, Pahrol MA, Mahmud H, Osman B, Lim YC, Seman Z, Shaharudin R. The effect of N95 designs on respirator fit and its associations with gender and facial dimensions. PLoS One 2023; 18:e0288105. [PMID: 38019763 PMCID: PMC10686483 DOI: 10.1371/journal.pone.0288105] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/28/2023] [Indexed: 12/01/2023] Open
Abstract
This study examined the association of various brands of NIOSH-certified N95 filtering face-piece respirators (FFR) fit with facial dimensions and gender. One hundred and thirty-five participants (77 females and 58 males) were recruited from the previous facial anthropometry study among Malaysians in 2020. Quantitative respirator fit testing of six FFR were performed using the TSI Portacount Pro+ 8038 which comprised of four exercises (bending over, talking, up-down head movement, and side to side head movement). An overall fit factor (FF) of ≥ 100 was considered a pass for each FFR. Analysis was done using T-test, Pearson's correlations, and generalised linear regression. The passing rates for the six FFR were 36.3% (Cup B), 50.4% (Trifold A), 54.1% (Duckbill A), 57.0% (Cup A), 74.1% (Trifold B), and 83.7% (Duckbill B). Both Duckbill B and Trifold B had the highest passing rates for both genders. However, certain FFR models (Cup B, Trifold A, Trifold B, and Duckbill A) fit better for participants with large facial size who were mostly males, while others (Cup A and Duckbill B) specifically fit better for those with small facial size, who were mostly females. This study showed significant positive effect of nose protrusion, nasal root and subnasale-sellion and the negative effect of menton-sellion, bigonial breadth and nose breadth on fit factors of various FFR. The results of this study emphasized the importance of choosing and designing FFR based on local anthropometry data, with careful consideration on the dimensions that affect the respirator fit. Since N95 are commonly used in the healthcare settings to prevent airborne transmission, the practice of respirator fit testing and selecting N95 with high passing rates for healthcare workers need to be emphasized.
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Affiliation(s)
- Nurul Amalina Khairul Hasni
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Rosnawati Muhamad Robat
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Nadia Mohamad
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Fatin Amirah Suib
- Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Muhammad Alfatih Pahrol
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
| | - Haalah Mahmud
- National Institute of Occupational Safety and Health, Ministry of Human Resources, Malaysia
| | - Baderin Osman
- National Institute of Occupational Safety and Health, Ministry of Human Resources, Malaysia
| | - Yin Cheng Lim
- Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Zamtira Seman
- Sector for Biostatistics & Data Repository, National Institutes of Health, Ministry of Health, Malaysia
| | - Rafiza Shaharudin
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Malaysia
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Ramli SR, Abdul Hadi FS, Nor Amdan NA, Kamaradin IH, Zabari N, Maniam S, Sulaiman NS, Ghazali S, Seman Z, Hashim R, Ahmad N. Secondary and Co-Infections in Hospitalized COVID-19 Patients: A Multicenter Cross-Sectional Study in Malaysia. Antibiotics (Basel) 2023; 12:1547. [PMID: 37887248 PMCID: PMC10604684 DOI: 10.3390/antibiotics12101547] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 10/28/2023] Open
Abstract
Bacterial and fungal secondary and co-infections are commonly identified with viral respiratory infections. This study was undertaken to determine the incidence and factors associated with bacterial and fungal infections in patients with COVID-19 as well as antibiotics prescription patterns within the first and second waves of the outbreak in Malaysia. Clinical records of 3532 COVID-19 patients admitted to hospitals in Malaysia between 4 February and 4 August 2020 were analyzed. Co-morbidities, clinical features, investigations, treatment, and complications were captured using the REDCap database. Culture and sensitivity test results were retrieved from the WHONET database. Univariate and multivariate regression analyses were used to identify associated determinants. A total of 161 types of bacterial and fungal infections were found in 81 patients, i.e., 2.3%. The most common bacterial cultures were Gram-negative, i.e., Pseudomonas aeruginosa (15.3%) and Klebsiella pneumoniae (13.9%). The most common fungal isolate was Candida albicans (41.2%). Augmentin, ceftriaxone, tazocin, meropenem, and azithromycin were the five most frequently prescribed antibiotics. The latter four were classified under the "Watch" category in the WHO AwaRe list. Our data showed that bacterial and fungal secondary and co-infections were frequently found in severely ill COVID-19 patients and were associated with a higher mortality rate.
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Affiliation(s)
- Siti Roszilawati Ramli
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Fashihah Sherina Abdul Hadi
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Nur Asyura Nor Amdan
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Insyirah Husna Kamaradin
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Noraliza Zabari
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Saraswathiy Maniam
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Nur Suffia Sulaiman
- Nutrition, Metabolism & Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Sumarni Ghazali
- Special Resource Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Zamtira Seman
- Sector for Biostatistics & Data Repository, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Rohaidah Hashim
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
| | - Norazah Ahmad
- Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Setia Alam, Shah Alam 40170, Malaysia
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Yee KOK, Yoon CK, Seman Z, Hong CK, Misron SNF, Lim CH. Ictal Electroencephalogram Visual Pattern Recognition of Seizure Adequacy During Electroconvulsive Therapy Treatment: A Step-by-Step Approach. Malays J Med Sci 2023; 30:83-89. [PMID: 37102040 PMCID: PMC10125233 DOI: 10.21315/mjms2023.30.2.7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/09/2022] [Indexed: 04/28/2023] Open
Abstract
Background The NEURON (Neuropsychiatry and Neuromodulation Unit) electroconvulsive therapy electroencephalogram (ECT-EEG) Algorithmic Rating Scale (NEARS) is a step-by-step approach to ictal electroencephalogram visual pattern recognition of seizure adequacy based on recruitment, amplitude, symmetry, duration and degree of post-ictal suppression. The objectives of this clinical audit were to determine the degree of agreement on the NEARS operational criteria between two neuropsychiatrists, the reliability of electroconvulsive therapy practitioners' administration of NEARS during ECT procedures and the correlation of NEARS scores with Clinical Global Impression scale scores after each ECT treatment session. Methods Systematic random sampling was conducted. Even numbers of ictal tracings were selected for analysis from the total samples collected over 8 consecutive days of ECT overseen by a total of eight different ECT practitioners. Cohen's kappa coefficient was used to measure the inter-rater reliability of the two neuropsychiatrists and determine the level of agreement between NEARS scores and those of the ECT practitioners. The correlation using NEARS scores and post-ECT Clinical Global Impression scores was measured with Spearman's test. The significance level was set at P < 0.05. Results Cohen's kappa showed perfect agreement between the two neuropsychiatrists, at κ = 1.00 (SE = 0.001; P < 0.001), and strong agreement between NEARS scores of overall seizure adequacy and the scores interpreted by the ECT practitioners, at κ = 0.83 (95% CI: 0.66, 0.99; P < 0.001). Spearman's test showed a weak negative association between NEARS scores and post-ECT Clinical Global Impression scores (r = -0.018; P = 0.900). Conclusion NEARS may facilitate a brief, objectively reliable and practical assessment of ictal electroencephalogram quality. The scale is readily applicable by any trained ECT practitioner during an ongoing ECT procedure, especially when a prompt treatment decision is required.
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Affiliation(s)
- Kenny Ong Kheng Yee
- NEURON (Neuropsychiatry and Neuromodulation Unit), Department of Psychiatry and Mental Health, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Chee Kok Yoon
- NEURON (Neuropsychiatry and Neuromodulation Unit), Department of Psychiatry and Mental Health, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Zamtira Seman
- Sector for Biostatistics and Data Repository, National Institutes of Health, Selangor, Malaysia
| | - Chhoa Keng Hong
- NEURON (Neuropsychiatry and Neuromodulation Unit), Department of Psychiatry and Mental Health, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | | | - Chin Han Lim
- NEURON (Neuropsychiatry and Neuromodulation Unit), Department of Psychiatry and Mental Health, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
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Abu Bakar NS, Zainuddin NA, Seman Z, Khamal NR, Ismail MH. Trends of completed suicide rates among Malaysian elderly between 1995 and 2020. BMC Public Health 2023; 23:303. [PMID: 36765292 PMCID: PMC9912222 DOI: 10.1186/s12889-023-15185-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/01/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Suicide among the elderly has become a global public health concern. This study was carried out to determine the trend of completed suicide rates according to age, sex, and ethnicity and the suicidal methods among the elderly in Malaysia. METHODS All suicide-related deaths in elderly aged 60 years and above from the Year 1995 to 2020 reported to the National Registration Department (NRD) were analyzed. Causes of death for suicide were coded based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). The completed suicide rate was calculated by dividing the completed suicide number by the total elderly population for the respective year. RESULTS Overall, the analysis of 1,600 suicide-related deaths was investigated over 26 years. Male was seen to be correlated with higher suicidal risk, with a male-female relative risk (RR) = 1.89 (95%CI:1.46,2.45). The risk of suicide was also found to be significantly higher for those aged 60 to 74 years old and Chinese, with RR = 4.26 (95%CI:2.94, 6.18) and RR = 5.81 (95%CI: 3.70, 9.12), respectively. Hanging was found to be a statistically significant suicide method (IRR:4.76, 95%CI:2.34,9.65) as compared to pesticide poisoning. The completed suicide rate was fluctuating over the years. CONCLUSIONS In conclusion, it is believed that Malaysia's elderly suicide rate has reached an alarmingly high incidence. By identifying the crucial criteria of sociodemographic factors, the government and responsible agencies have the essential and additional information to put together a more effective strategy and approach to overcome the issue in the future.
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Affiliation(s)
- Nurul Salwana Abu Bakar
- Centre for Health Policy Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia.
| | - Nur Azmiah Zainuddin
- grid.415759.b0000 0001 0690 5255Centre for Health Policy Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Zamtira Seman
- grid.415759.b0000 0001 0690 5255Sector for Biostatistics & Data Repository, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Noor Raihan Khamal
- grid.415759.b0000 0001 0690 5255Non-Communicable Diseases Section, Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | - Masrol Hafizal Ismail
- grid.511700.20000 0001 0674 1596Big Data Analytics Core Team, Department of Statistics, Putrajaya, Malaysia
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Henry Basil J, Premakumar CM, Mhd Ali A, Mohd Tahir NA, Seman Z, Mohamed Shah N. Development and validation of a risk prediction model for medication administration errors among neonates in the neonatal intensive care unit: a study protocol. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001765. [PMID: 36754439 PMCID: PMC9923322 DOI: 10.1136/bmjpo-2022-001765] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/28/2023] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Medication administration errors (MAEs) are the most common type of medication error. Furthermore, they are more common among neonates as compared with adults. MAEs can result in severe patient harm, subsequently causing a significant economic burden to the healthcare system. Targeting and prioritising neonates at high risk of MAEs is crucial in reducing MAEs. To the best of our knowledge, there is no predictive risk score available for the identification of neonates at risk of MAEs. Therefore, this study aims to develop and validate a risk prediction model to identify neonates at risk of MAEs. METHODS AND ANALYSIS This is a prospective direct observational study that will be conducted in five neonatal intensive care units. A minimum sample size of 820 drug preparations and administrations will be observed. Data including patient characteristics, drug preparation-related and administration-related information and other procedures will be recorded. After each round of observation, the observers will compare his/her observations with the prescriber's medication order, hospital policies and manufacturer's recommendations to determine whether MAE has occurred. To ensure reliability, the error identification will be independently performed by two clinical pharmacists after the completion of data collection for all study sites. Any disagreements will be discussed with the research team for consensus. To reduce overfitting and improve the quality of risk predictions, we have prespecified a priori the analytical plan, that is, prespecifying the candidate predictor variables, handling missing data and validation of the developed model. The model's performance will also be assessed. Finally, various modes of presentation formats such as a simplified scoring tool or web-based electronic risk calculators will be considered.
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Affiliation(s)
- Josephine Henry Basil
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chandini Menon Premakumar
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Adliah Mhd Ali
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Ain Mohd Tahir
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zamtira Seman
- Sector for Biostatistics & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Noraida Mohamed Shah
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Nik Mazlan SA, Abdul Hadi Sabri FS, Mohamed Zahidi J, Seman Z, Ahmad N, Ramli SR. Human brucellosis: Six years retrospective study on seropositivity in Malaysia. Malays J Pathol 2022; 44:269-276. [PMID: 36043590] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Human brucellosis is a zoonotic disease in Malaysia. This study analysed six-year retrospective seropositivity trends of human brucellosis cases from 2014 to 2019. METHODS AND MATERIALS A total of 1,281 serum samples were obtained from suspected brucellosis patients were included. The sera were tested using an enzyme-linked immunosorbent assay for IgM and IgG antibodies for Brucella spp. Samples with equivocal or positive antibody index were confirmed with an immunocapture agglutination. RESULTS During the study period, 5.8% (n=74) of suspected cases showed seropositivity for human brucellosis. The central region has the highest seropositivity cases of human brucellosis. Consumption of unpasteurised milk was significantly associated with human brucellosis in this study with adjusted odds ratio ((AOR) = 4.56, 95% CI = 2.6, 8.02, p-value < 0.001). The age group of less than 15 years old was more likely to contract brucellosis ((AOR) = 2.81, 95% CI = 1.01, 7.84 p-value < 0.048). CONCLUSION Serological tests have been widely used for the diagnosis of human brucellosis. However, diagnosis using serology is often challenging without the presence of a convalescent sample. In conclusion, even though human brucellosis has a low prevalence rate, the disease has serious public health implications. The usage of effective diagnostic tools as well as implementation of 'One Health' approach are the way forward to prevent and control of brucellosis in the country.
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Affiliation(s)
- S A Nik Mazlan
- National Institutes of Health, Institute for Medical Research, Infectious Disease Research Centre, Bacteriology Unit, Selangor, Malaysia
| | - F S Abdul Hadi Sabri
- National Institutes of Health, Institute for Medical Research, Infectious Disease Research Centre, Bacteriology Unit, Selangor, Malaysia
| | - J Mohamed Zahidi
- National Institutes of Health, Institute for Medical Research, Infectious Disease Research Centre, Bacteriology Unit, Selangor, Malaysia
| | - Z Seman
- National Institutes of Health, Biostatistics and Data Repository Sector, Selangor, Malaysia
| | - N Ahmad
- National Institutes of Health, Institute for Medical Research, Infectious Disease Research Centre, Selangor, Malaysia
| | - S R Ramli
- National Institutes of Health, Institute for Medical Research, Infectious Disease Research Centre, Bacteriology Unit, Selangor, Malaysia.
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Shariff Ghazali S, Seman Z, Zainuddin NH, Omar MA, Sooryanarayana R, Ariaratnam S, Mohd Tohit N, Ho BK, Krishnapillai AD, Zainal Abidin SI. Prevalence and factors associated with multimorbidity among older adults in Malaysia: a population-based cross-sectional study. BMJ Open 2021; 11:e052126. [PMID: 34670764 PMCID: PMC8529977 DOI: 10.1136/bmjopen-2021-052126] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 11/05/2022] Open
Abstract
OBJECTIVES To determine the prevalence and factors associated with multimorbidity among community-dwelling older adults in Malaysia. DESIGN A population-based cross-sectional study. SETTING 13 states and 3 Federal Territories in Malaysia. PARTICIPANTS A total of 3966 adults aged 60 years and above were extracted from the nationwide National Health and Morbidity Survey (NHMS) 2018 data set. PRIMARY OUTCOME MEASURES Multimorbidity was defined as co-occurrence of at least two known chronic non-communicable diseases in the same individual. The chronic diseases included hypertension, type 2 diabetes mellitus, dyslipidaemia and cancer. RESULTS The prevalence of multimorbidity among Malaysian older adults was 40.6% (95% CI: 37.9 to 43.3). The factors associated with multimorbidity were those aged 70-79 years (adjusted OR (AOR)=1.30; 95% CI=1.04 to 1.63; p=0.019), of Indian (AOR=1.69; 95% CI=1.14 to 2.52; p=0.010) and Bumiputera Sarawak ethnicities (AOR=1.81; 95% CI=1.14 to 2.89; p=0.013), unemployed (AOR=1.53; 95% CI=1.20 to 1.95; p=0.001), with functional limitation from activities of daily livings (AOR=1.66; 95% CI=1.17 to 2.37; p=0.005), physically inactive (AOR=1.28; 95% CI=1.03 to 1.60; p=0.026), being overweight (AOR=1.62; 95% CI=1.11 to 2.36; p=0.014), obese (AOR=1.88; 95% CI=1.27 to 2.77; p=0.002) and with abdominal obesity (AOR=1.52; 95% CI=1.11 to 2.07; p=0.009). CONCLUSION This study highlighted that multimorbidity was prevalent among older adults in the community. Thus, there is a need for future studies to evaluate preventive strategies to prevent or delay multimorbidity among older adults in order to promote healthy and productive ageing.
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Affiliation(s)
- Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Laboratory of Medical Gerontology, Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zamtira Seman
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nabilah Hanis Zainuddin
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Rajini Sooryanarayana
- Elderly Health Sector, Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Suthahar Ariaratnam
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Cawangan Selangor, Kampus Selayang, Batu Caves, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Malaysia
| | - Bee Kiau Ho
- Klinik Kesihatan Bandar Botanik, Ministry of Health Malaysia, Bandar Botanic, Klang, Malaysia
| | - Ambigga Devi Krishnapillai
- Department of Family Medicine, Faculty of Medicine and Health, National Defense University of Malaysia, Kem Sg. Besi, Malaysia
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Abdullah SR, Azizul NH, Wan Mohd Zin RM, Sulaiman NS, Mustafa Khalid N, Mohd Salim Mullahi Jahn RJ, Khalil MKN, Abu Seman N, Zainal Abidin NA, Ali A, Tan YZ, Omar A, Johari MZ, Abdul Aziz NS, Baharudin A, Seman Z, Ibrahim Wong N, Md Rasip ML, Yusof HM, Md Noh MF. Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting among Overweight and Obese Civil Servants in Malaysia (CAIFA): Study Protocol for A Non-Randomized Controlled Trial (Preprint). JMIR Res Protoc 2021; 11:e33801. [PMID: 35930331 PMCID: PMC9496805 DOI: 10.2196/33801] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/14/2022] [Accepted: 05/11/2022] [Indexed: 11/21/2022] Open
Abstract
Background Overweight and obesity among adults are a growing global public health threat and an essential risk factor for various noncommunicable diseases. Although intermittent fasting is a generally new dietary approach to weight management that has been increasingly practiced worldwide, the effectiveness of 2 days per week dry fasting remains unclear. Objective The Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting study aims to determine the cardiometabolic, anthropometric, dietary intake, and quality of life changes among civil servants with overweight and obesity, following combined intermittent fasting and healthy plate (IFHP) and healthy plate (HP) and explore the participants’ experiences. Methods We designed a mixed methods quasi-experimental study to evaluate the effectiveness of the IFHP and HP methods among adults with overweight and obesity. A total of 177 participants were recruited for this study, of which 91 (51.4%) were allocated to the IFHP group and 86 (48.6%) to the HP group. The intervention comprised 2 phases: supervised (12 weeks) and unsupervised (12 weeks). Data collection was conducted at baseline, after the supervised phase (week 12), and after the unsupervised phase (week 24). Serum and whole blood samples were collected from each participant for analysis. Data on sociodemographic factors, quality of life, physical activity, and dietary intake were also obtained using questionnaires during data collection. Results Most of the participants were female (147/177, 83.1%) and Malay (141/177, 79.7%). The expected outcomes of this study are changes in body weight, body composition, quality of life, physical activity, dietary intake, and cardiometabolic parameters such as fasting blood glucose, 2-hour postprandial blood glucose, hemoglobin A1c, fasting insulin, and lipid profile. Conclusions The Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting study is a mixed methods study to evaluate the effectiveness of combined IFHP and HP interventions on cardiometabolic and anthropometric parameters and explore participants’ experiences throughout the study. Trial Registration ClinicalTrials.gov NCT05034653; https://clinicaltrials.gov/ct2/show/NCT05034653 International Registered Report Identifier (IRRID) RR1-10.2196/33801
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Affiliation(s)
- Shazana Rifham Abdullah
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Nur Hayati Azizul
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Ruziana Mona Wan Mohd Zin
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Nur Suffia Sulaiman
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Norhayati Mustafa Khalid
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Roshan Jahn Mohd Salim Mullahi Jahn
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Muhamad Khairul Nazrin Khalil
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Norhashimah Abu Seman
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Nur Azlin Zainal Abidin
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Azizan Ali
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - You Zhuan Tan
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Azahadi Omar
- Sector for Biostatistic and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Mohammad Zabri Johari
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Nur Shahida Abdul Aziz
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Azli Baharudin
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Zamtira Seman
- Sector for Biostatistic and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Norazizah Ibrahim Wong
- Sector for Biostatistic and Data Repository, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Mona Lisa Md Rasip
- Occupational Safety and Health Unit, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Hayati Mohd Yusof
- Faculty of Fisheries and Food Science, Universiti Malaysia Terengganu, Terengganu, Malaysia
| | - Mohd Fairulnizal Md Noh
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
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11
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Harith AA, Ahmad NA, Sahril N, Wahab NA, Kassim NA, Othman S, Din S, Hussin SSC, Mahmud NA, Azlan MS, Seman Z. Prevalence and determinants of hearing disability among older persons in Malaysia: Finding of National Health Morbidity Survey (NHMS) 2018. Geriatr Gerontol Int 2020; 20 Suppl 2:43-48. [PMID: 33370862 DOI: 10.1111/ggi.14039] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/12/2020] [Accepted: 08/27/2020] [Indexed: 11/28/2022]
Abstract
AIM An aging population is a potential burden for unprepared developing countries. Malaysia is foreseen to be an aging country by 2035. Thus, this study aimed to determine the prevalence and factors associated with hearing disability among older persons in Malaysia. METHODS Data from a nationwide survey implemented using a stratified cluster sampling design were analyzed. This study was carried out through face-to-face interviews and guided questionnaires. The questions were based on the Washington Group of Disability (WG) questionnaires, which produce multiple disability identifiers. Hearing disability is defined as at least one domain or question out of four questions coded as "A lot of difficulty" or "Cannot hear at all". RESULTS The prevalence of hearing disability among older persons aged ≥60 years was 6.4% (95% CI 5.0-8.3), whereas 1.5% (95% CI 0.90, 2.50) older persons were reported to be using a hearing aid. The determinants of hearing disability are being male (aOR 2.67, 95% CI 1.94-3.66), being unemployed (retired, homemaker, unemployed; aOR 1.86, 95% CI 1.86-4.14) and had no formal education (aOR 18.25, 95% CI 4.18-79.55). CONCLUSIONS Promoting healthy aging is important and crucial for Malaysia, in preparation toward an aging nation, as it could reduce the country's financial burden in the long term. Health-related agencies should promote health awareness and treatment centers in relation to hearing disability among older persons, as they should be educated and informed about healthcare choices availability, which is aligned with the Global Disability Action Plan 2014-2021. Geriatr Gerontol Int 2020; 20: 43-48.
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Affiliation(s)
- Abdul Aziz Harith
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Noor Ani Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Norhafizah Sahril
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nor'ain Ab Wahab
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Noraida Abdul Kassim
- Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Salimah Othman
- Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Sobani Din
- Otorhinolaryngology Department, Sungai Buluh Hospital, Ministry of Health Malaysia, Sungai Buloh, Malaysia
| | - Siti Suriani Che Hussin
- Otorhinolaryngology Departments, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Nur Azna Mahmud
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Mohd Shaiful Azlan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Zamtira Seman
- Biostatistic and Data Repository Sector, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
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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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