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The COVID-19 pandemic has become a significant challenge to humanity, especially marginalized groups such as indigenous people. This study aimed to assess the knowledge, attitude, and practice towards COVID-19 prevention among the indigenous population in Lipis district, Pahang, Malaysia. A cross-sectional study was conducted among the indigenous population and the data were collected through face-to-face interviews using a validated questionnaire. The mean score of knowledge, attitude, and practice were 2.35 (SD 1.104), 32.84 (SD 4.756), and 9.64 (SD 3.227), respectively. In the bivariable analysis, the younger the age (p < 0.001), and the higher the education level (p = 0.001) of the participants, the higher the knowledge score on COVID-19. Meanwhile, the female participants (p = 0.043) and the higher the household income, the higher the attitude score of the participants (p = 0.006). Factors that contributed to a higher score of practice towards COVID-19 prevention were younger age (p = 0.013), female (p < 0.001), no religion (p = 0.026), unemployed (p < 0.001), and higher household income (p = 0.012). There was a positive correlation between knowledge score and practice score (p = 0.001) and a positive correlation between attitude score and practice score (p < 0.001), respectively. Multivariable regression analysis showed that the younger age (p < 0.001) was significantly associated with a higher knowledge score. Furthermore, female (p = 0.018), unemployed (p = 0.001), higher knowledge score (p < 0.001), and higher attitude score (p < 0.001) were significantly associated with a higher score of practice towards COVID-19 prevention among the participants, respectively. Indigenous people in Malaysia have a good knowledge, attitude, and practice towards COVID-19. However, strategic planning and programmes related to preventive practices against infectious disease outbreaks need to be conducted continuously to reduce the outbreaks in the future.
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COVID-19 , Conocimientos, Actitudes y Práctica en Salud , Pueblos Indígenas , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Malasia/epidemiología , Femenino , Adulto , Estudios Transversales , Masculino , Pueblos Indígenas/psicología , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven , SARS-CoV-2/aislamiento & purificación , AdolescenteRESUMEN
BACKGROUND: There has been a significant increase in the incidence of cardiovascular disease (CVD) in Malaysia. It is important to identify the group at high risk of CVD. This study aimed to assess the population distribution and factors associated with 10-year CVD risk among adults aged 40 to 74 years in Malaysia. METHODS: This study used secondary data from the NHMS 2019, a nationally representative cross-sectional population study. The following measurements were collected: anthropometric, systolic blood pressure, fasting blood glucose, total cholesterol, smoking, and sociodemographic. The 2019 WHO Southeast Asia laboratory-based charts were used to estimate individuals' CVD risk. These charts predict significant cardiovascular events over ten years. Multiple logistic regression analysis was employed to ascertain the factors that are linked to elevated or extremely elevated risk of CVD. RESULTS: A total of 5,503 respondents were included in the analysis. Less than one-quarter of the respondents were current smokers and obese. Approximately 41.7%, 30.9%, and 22.5% of the participants had extremely low risk (less than 5%), low risk (between 5% and less than 10%), and moderate risk (between 10% and less than 20%), respectively. A total of 4.9% of the participants were categorised as having high (20% to < 30%) or very high (CVD) risk (≥ 30%). This classification was more prevalent among males (7.3%) than among females (2.5%; p < 0.001). The factors associated with high/very high CVD risk were unemployment (aOR = 1.88, 95% CI = 1.47-2.40), those with non-formal and primary education level (aOR = 2.36, 95% CI = 1.36 - 4.12 and aOR = 3.28, 95% CI = 2.10 - 5.12, respectively), and being physically inactive with obesity (aOR = 2.19, 95% CI = 1.18 - 4.08). CONCLUSIONS: This study revealed that almost 5% of the population in Malaysia has a high 10-year CVD risk. These findings highlight Malaysia's urgent need for comprehensive CVD prevention efforts.
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Enfermedades Cardiovasculares , Humanos , Enfermedades Cardiovasculares/epidemiología , Persona de Mediana Edad , Masculino , Femenino , Malasia/epidemiología , Adulto , Estudios Transversales , Anciano , Medición de Riesgo , Factores de Riesgo , Encuestas Epidemiológicas , Organización Mundial de la Salud , Factores de Riesgo de Enfermedad CardiacaRESUMEN
OBJECTIVE: There is very limited published experience on mangrove pit viper envenomation in the medical literature. This study aims to analyze the clinical characteristics, treatment modalities and outcomes of patients presenting to Selangor middle zone cluster Hospitals in Malaysia with confirmed mangrove pit viper bites. METHODS: We conducted a retrospective observational study, reviewing medical records of patients treated for mangrove pit viper bites between July 1, 2020 to June 30, 2023. Data on patient demographics, clinical characteristic, laboratory findings, treatment modalities and clinical outcomes were collected and analyzed. RESULTS: A total of 25 patients were included in this study. The majority of the patients were male (n = 23, 92%) with the mean age of 38.7 ± 17.6 years. Most frequent anatomical region involved is foot (n = 12, 48%). Common clinical presentation included localized pain (n = 24, 96%), swelling (n = 22, 88%) and fang mark (n = 22, 88%). Systemic symptoms were less common, with 1 patient exhibiting coagulopathy with clinical bleeding at 28 h post bite. Antivenom was administered to 68% (n = 17) of the patients. The majority of the patients (n = 23, 92%) recovered without significant morbidity while 8% (n = 2) of the patients developed skin infection that required antibiotic therapy. No fatalities were reported. CONCLUSION: Mangrove pit viper envenomation encountered in these regions predominantly causes local symptoms while systemic symptoms were less common. This study provides a glimpse to the clinical characteristics and management of mangrove pit viper envenomation, coagulopathy may be delayed due to characteristic of the snake venom and patient's preexisting illness. Further research is needed to enhance our understanding of this snakebite envenomation.
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Antivenenos , Mordeduras de Serpientes , Humanos , Mordeduras de Serpientes/complicaciones , Estudios Retrospectivos , Masculino , Malasia/epidemiología , Adulto , Femenino , Persona de Mediana Edad , Animales , Antivenenos/uso terapéutico , Adulto Joven , Anciano , Venenos de Crotálidos/toxicidad , AdolescenteRESUMEN
Numerous studies have been conducted in other countries on the health effects of exposure to particulate matter with a diameter of 10 microns or less P M 10 , but little research has been conducted in Malaysia, particularly during the haze season. This study intends to investigate how exposure of P M 10 influenced hospital admissions for respiratory diseases during the haze period in peninsula Malaysia and it was further stratified by age group, gender and respiratory diseases categories. The study includes data from all patients with respiratory diseases in 92 government hospitals, as well as P M 10 concentration and meteorological data from 92 monitoring stations in Peninsula Malaysia starting from 1st January 2000 to 31st December 2019. A quasi-poison time series regression with distributed lag nonlinear model (DLNM) was employed in this study to examine the relationship between exposure of P M 10 and hospital admissions for respiratory diseases during the haze period. Haze period for this study has been defined from June to September each year. According to the findings of this study, P M 10 was positively associated with hospitalisation of respiratory disease within 30 lag days under various lag patterns, with lag 25 showing the strongest association (RR = 1.001742, CI 1.001029,1.002456). Using median as a reference, it was discovered that females were more likely than males to be hospitalized for P M 10 exposure. Working age group will be the most affected by the increase in P M 10 exposure with a significant cumulative RR from lag 010 to lag 030. The study found that P M 10 had a significant influence on respiratory hospitalisation in peninsula Malaysia, particularly for lung diseases caused by external agents(CD5). Therefore, it is important to implement effective intervention measures to control P M 10 and reduce the burden of respiratory disease admissions.
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Hospitalización , Material Particulado , Enfermedades Respiratorias , Humanos , Malasia/epidemiología , Femenino , Masculino , Hospitalización/estadística & datos numéricos , Material Particulado/análisis , Material Particulado/efectos adversos , Persona de Mediana Edad , Enfermedades Respiratorias/epidemiología , Enfermedades Respiratorias/etiología , Adulto , Anciano , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/efectos adversos , Contaminación del Aire/efectos adversos , Estaciones del Año , Adolescente , Adulto Joven , Niño , PreescolarRESUMEN
INTRODUCTION: Cardiovascular disease (CVD) is a major health concern worldwide, particularly in low- and middle-income countries. The COVID-19 pandemic that emerged in late 2019 may have had an impact on the trend of CVD mortality. This study aimed to investigate the trend and changes in CVD mortality rates in Malaysia, using age-standardized mortality rates (ASMR) from 2010 to 2021. METHODS: The Malaysian population and mortality data from 2010 to 2021 were obtained from the Department of Statistics Malaysia (DOSM). ASMRs from CVD per 100,000 population were calculated based on the World Health Organization (2000-2025) standard population using the direct method. The ASMRs were computed based on sex, age groups (including premature mortality age, 30-69 years), and CVD types. The annual percent change (APC) and average annual percent change (AAPC) of the ASMR with corresponding 95% confidence intervals (95% CI) were estimated from joinpoint regression model using the Joinpoint Regression Program, Version 4.9.1.0. RESULTS: Throughout the study period (2010-2021), ASMRs for CVD exhibited an increase from 93.1 to 147.0 per 100,000, with an AAPC of 3.6% (95% CI: 2.1 to 5.2). The substantial increase was observed between 2015 and 2018 (APC 12.6%, 95% CI: 5.4%, 20.3%), with significant changes in both sexes, and age groups 50-69, 70 years and over, and 30-69 (premature mortality age). Notably, the ASMR trend remained consistently high in the premature mortality age group across other age groups, with males experiencing higher rates than females. No significant changes were detected before or after the COVID-19 pandemic (between 2019 and 2021), except for females who died from IHD (10.3% increase) and those aged 0-4 (25.2% decrease). CONCLUSION: Overall, our analysis highlights the persistently high burden of CVD mortality in Malaysia, particularly among the premature mortality age group. These findings underscore the importance of continued efforts to address CVD risk factors and implement effective prevention and management strategies. Further research is needed to fully understand the impact of the COVID-19 pandemic on CVD mortality rates and to inform targeted interventions to reduce the burden of CVD in Malaysia.
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COVID-19 , Enfermedades Cardiovasculares , Humanos , Malasia/epidemiología , Enfermedades Cardiovasculares/mortalidad , Masculino , Femenino , Persona de Mediana Edad , Adulto , Anciano , COVID-19/mortalidad , Mortalidad/tendencias , Adulto Joven , Mortalidad Prematura/tendenciasRESUMEN
BACKGROUND: Point-of-care testing (POCT) is commonly used in epidemiological surveys due to its various advantages, such as portability and immediate test results. The CardioChek® PA analyser 3-in-1 lipid panel measures total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol. This study tested the reliability and diagnostic accuracy of the CardioChek® PA analyser using a 3-in-1 lipid panel. METHODS: A cross-sectional study design with quota sampling was used. A total of 203 respondents aged 18 years and above from a research centre in the Ministry of Health, Malaysia, were recruited. Venous blood was sent to the laboratory and tested with Siemens Atellica CH, while a POCT analyser was used for capillary blood measurements. Intraclass coefficient correlation (ICC) analysis was employed to determine the agreement between capillary and venous blood parameters. The diagnostic performance of the evaluated tests was evaluated using STATA version 12. RESULTS: The agreement between capillary and laboratory venous blood was moderate (0.64-0.67) for TC and HDL, good (0.75) for LDL and excellent (0.91) for TG). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were as follows: TC, 57.1%, 94.3%, 92.3% and 64.8%; TG, 76.0%, 100%, 100%, and 96.6%; HDL, 96.2%, 83.2%, 47.2% and 99.3%; and LDL, 81.0%, 100%, 100% and 68.3%, respectively. CONCLUSIONS: The CardioChek® PA analyser showed acceptable diagnostic accuracy for screening high-risk individuals more often in places where laboratories are inaccessible. It could also be used in clinical settings where patients would benefit from swift treatment decisions.
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HDL-Colesterol , LDL-Colesterol , Pruebas en el Punto de Atención , Triglicéridos , Humanos , Pruebas en el Punto de Atención/normas , Masculino , Femenino , Adulto , Persona de Mediana Edad , Triglicéridos/sangre , Estudios Transversales , LDL-Colesterol/sangre , HDL-Colesterol/sangre , Malasia/epidemiología , Reproducibilidad de los Resultados , Anciano , Colesterol/sangre , Adulto Joven , Lípidos/sangre , Sensibilidad y Especificidad , AdolescenteRESUMEN
Background: Bone fractures represent a significant health issue and impose a considerable burden on healthcare systems globally. However, data pertaining to bone fractures, especially among reproductive-age women in Malaysia, are very limited. Micronutrients like calcium, magnesium and phosphorus play vital roles in bone health, influencing bone mineral density and fracture risk. The objective of this study was to determine the prevalence of bone fractures among reproductive-age women and the association with dietary micronutrient intakes. Methods: In this cross-sectional study, a total of 1,730 participants of reproductive-age women from the Malaysia Prospective Urban and Rural Epidemiological (PURE) study were recruited. The participants' dietary intakes were assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Selected micronutrients in the participants' diets were calculated using the Malaysian food composition and the US Department of Agriculture food composition databases. The association between micronutrient intakes, comorbidities and physical activity levels with bone fractures were evaluated to identify predictors of bone fractures among reproductive-age women. Results: The prevalence of bone fractures among Malaysian reproductive-age women was low (3.7%). The multiple logistic regression analysis showed that none of the micronutrients was associated with bone fractures. However, factors of diabetes and passive smoking in this study showed 2.6- and 4.0-times-higher odds of having bone fractures, respectively (AOR 2.580; 95% CI: 1.173-5.672) and (AOR 4.012; 95% CI: 2.265-7.107). Conclusions: It was found that the majority of women in this study were taking lower micronutrient intakes of calcium, magnesium, and vitamin K than the Malaysia recommended nutrient intakes (RNI). Although this study showed that a low micronutrient intake is not significantly associated with bone fractures, it is recommended that future studies focus on controlled trials or prospective data analyses to establish causal relationships and the optimal micronutrient requirements for maintaining strong and healthy bones in women of reproductive age.
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Dieta , Fracturas Óseas , Micronutrientes , Humanos , Malasia/epidemiología , Femenino , Micronutrientes/administración & dosificación , Adulto , Estudios Transversales , Fracturas Óseas/epidemiología , Prevalencia , Adulto Joven , Magnesio/administración & dosificación , Estudios Prospectivos , Persona de Mediana Edad , Ejercicio Físico , Modelos Logísticos , Factores de RiesgoRESUMEN
BACKGROUND: Occupational diseases are one of the most important health problems related to employment However, in Malaysia, there are few epidemiological studies discussing these issues, especially among workers in the industry. For that, this study aimed to screen workers from high-risk industrial sectors, identify hazards in the workplace and recommend improvement measures in the workplace to prevent occupational diseases. METHODS AND ANALYSIS: This is a 3-year project in which a survey of 100 000 workers from all 13 states in Malaysia will be conducted using a web-based screening tool that is comprised of two parts: occupational disease screening tool and hazard identification, risk assessment and risk control method. Data will be collected using a multistage stratified sampling method from 500 companies, including seven critical industrial sectors. The independent variables will be sociodemographic characteristics, comorbidities, previous medical history, high-risk behaviour and workplace profile. The dependent variable will be the types of occupational diseases (noise-induced hearing loss, respiratory, musculoskeletal, neurotoxic, skin and mental disorders). Subsequently, suggestions of referral for medium and high-risk workers to occupational health clinics will be attained. The approved occupational health service clinics/providers will make a confirmatory diagnosis of each case as deemed necessary. Subsequently, a walk-through survey to identify workplace hazards and recommend workplace improvement measures to prevent these occupational diseases will be achieved. Both descriptive and inferential statistics will be used in this study. Simple and adjusted binary regression will be used to find the determinants of occupational diseases. ETHICS AND DISSEMINATION: This study has been approved by the MARA University of Technology Research Ethics Board. Informed, written consent will be obtained from all study participants. Findings will be disseminated to the Department of Occupational Health and Safety, involved industries, and through peer-reviewed publications.
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Enfermedades Profesionales , Lugar de Trabajo , Humanos , Estudios Transversales , Malasia/epidemiología , Medición de Riesgo/métodos , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/prevención & control , Tamizaje Masivo/métodos , Masculino , Salud Laboral , Femenino , Encuestas y Cuestionarios , Proyectos de Investigación , Exposición Profesional/efectos adversos , Exposición Profesional/prevención & control , AdultoRESUMEN
INTRODUCTION: Oesophageal atresia (EA) is a life-threatening congenital oesophageal deformity that causes considerable newborn morbidity and death. Many prognostic variables have been linked to the survival of infants with EA, although the results of the studies are still conflicting. Furthermore, studies on EA effects in developing countries still need to be included. Here, we aimed to determine the survival of children with EA and link it to prognostic variables in a particular developing country. MATERIALS AND METHODS: A cross-sectional observational retrospective study was conducted using medical records of paediatric patients with EA at our institution from January 2014 to December 2020. RESULTS: A total of 53 children with EA were included in the study. Log-rank analysis showed that definitive surgery and thrombocytopenia were significantly associated with the survival of children with EA, with a p-value of 0.007 and 0.002, respectively, whereas, sex, EA type, pneumonia and sepsis were not (p = 0.898, 0.919, 0.255, and 0.499, respectively). Multivariate analysis revealed that thrombocytopenia and definitive surgery were strongly associated with the survival of children with EA with a pvalue of 0.014 (hazard ratio (HR) = 2.67 [95% confidence interval (CI) = 1.22-5.85]) and 0.022 (HR =0.39 [95% CI = 0.17- 0.87]), respectively. CONCLUSION: Our study shows that thrombocytopenia might increase mortality, while definitive surgery might be beneficial for the survival of paediatric patients with EA. It implies that definitive surgery should be performed as early as necessary to prevent further morbidity and mortality. Our study comprehensively provides the survival of children with EA and links it to prognostic variables in a particular developing country. It serves as a potential research project that can be applied to the clinical setting to help clinicians manage EA better.
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Atresia Esofágica , Humanos , Atresia Esofágica/mortalidad , Atresia Esofágica/cirugía , Femenino , Masculino , Estudios Retrospectivos , Estudios Transversales , Pronóstico , Recién Nacido , Lactante , Malasia/epidemiología , Trombocitopenia/mortalidad , Trombocitopenia/etiologíaRESUMEN
Evaluating dietary guidelines using diet quality (DQ) offers valuable insights into the healthfulness of a population's diet. We conducted a forensic analysis using DQ metrics to compare the Malaysian Dietary Guidelines (MDG-2020) with its former version (MDG-2010) in relation to cardiometabolic risk (CMR) for an adult Malaysian population. A DQ analysis of cross-sectional data from the Malaysia Lipid Study (MLS) cohort (n = 577, age: 20-65yrs) was performed using the healthy eating index-2015 (HEI-2015) framework in conformation with MDG-2020 (MHEI2020) and MDG-2010 (MHEI2010). Of 13 dietary components, recommended servings for whole grain, refined grain, beans and legumes, total protein, and dairy differed between MDGs. DQ score associations with CMR, dietary patterns and sociodemographic factors were examined. Out of 100, total DQ scores of MLS participants were 'poor' for both MHEI2020 (37.1 ± 10.3) and MHEI2010 (39.1 ± 10.4), especially among young adults, males, Malays, and those frequently 'eating out' as well as those with greatest adherence to Sugar-Sweetened Beverages pattern and lowest adherence to Food Plant pattern. Both metrics shared similar correlations with CMR markers, with MHEI2020 exhibiting stronger correlations with WC, BF%, TG, insulin, HOMA2-IR, and smallLDL than MHEI2010, primarily attributed to reduced refined grain serving. Notably, participants with the highest adherence to MHEI2020 scores exhibited significantly reduced odds for elevated TG (AOR 0.44, 95% CI 0.21-0.93, p = 0.030), HOMA2-IR (AOR 0.44, 95% CI 0.21-0.88, p = 0.022), and hsCRP (AOR 0.54, 95% CI 0.31-0.96, p = 0.040, compared to those with the lowest adherence. Each 5-unit increase in MHEI2020 scores reduced odds for elevated BMI (- 14%), WC (- 9%), LDL-C (- 32%), TG (- 15%), HOMA2-IR (- 9%) and hsCRP (- 12%). While MHEI2020 scores demonstrated better calibration with CMR indicators, the overall sub-optimally 'poor' DQ scores of this population call for health promotion activities to target the public to achieve adequate intake of healthful fruits, non-starchy vegetables and whole grain, and moderate intake of refined grain, added sugar and saturated fat.
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Factores de Riesgo Cardiometabólico , Dieta , Política Nutricional , Humanos , Masculino , Adulto , Femenino , Persona de Mediana Edad , Estudios Transversales , Malasia/epidemiología , Anciano , Adulto Joven , Enfermedades Cardiovasculares/prevención & control , Dieta SaludableRESUMEN
INTRODUCTION: Since the emergence of COVID-19, the Malaysian government has made wearing a face mask in public mandatory since August 1, 2020, as an effort by the government to control the transmission of COVID-19. However, Malaysians' willingness to wear face masks in public is unknown. OBJECTIVE: Thus, this study aimed to evaluate their perception of face mask wearing during COVID-19 and its contributing factors. METHODOLOGY: A total of 1024 respondents, aged ≥ 18 years, participated in this online cross-sectional survey from October 2021 to December 2021. The Face Mask Perception Scale (FMPS) was used to measure their perceptions. RESULTS: Most of the respondents perceived wearing a face mask as uncomfortable. Our findings also revealed statistically significant differences and a small effect (f2 = 0.04) in which respondents who were concerned about being infected by the virus perceived face mask wearing appearance positively (B = - 0.09 units of log-transformed, 95% CI = - 0.15, - 0.04), whereas married respondents perceived it negatively (B = 0.07 units of log-transformed, 95% CI = 0.03, 0.09). There were no statistically significant differences in other domains of FMPS. CONCLUSION: In conclusion, discomfort was a major complaint. Marital status and fear of COVID-19 infection affected their perceptions. The public health implications of these findings highlight the importance of addressing discomfort and societal perceptions, particularly those influenced by factors such as marital status and COVID-19 experience, to promote widespread acceptance and consistent usage of face masks, which is crucial in mitigating the spread of COVID-19.
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COVID-19 , Máscaras , Pandemias , SARS-CoV-2 , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , COVID-19/psicología , Malasia/epidemiología , Estudios Transversales , Masculino , Femenino , Adulto , Persona de Mediana Edad , Pandemias/prevención & control , Adulto Joven , Encuestas y Cuestionarios , Adolescente , Neumonía Viral/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/psicología , Infecciones por Coronavirus/epidemiología , Percepción , Anciano , BetacoronavirusRESUMEN
BACKGROUND: Wolbachia symbiosis in Aedes aegypti is an emerging biocontrol measure against dengue. However, assessing its real-world efficacy is challenging due to the non-randomised, field-based nature of most intervention studies. This research re-evaluates the spatial-temporal impact of Wolbachia interventions on dengue incidence using a large battery of quasi-experimental methods and assesses each method's validity. METHODS: A systematic search for Wolbachia intervention data was conducted via PUBMED. Efficacy was reassessed using commonly-used quasi-experimental approaches with extensive robustness checks, including geospatial placebo tests and a simulation study. Intervention efficacies across multiple study sites were computed using high-resolution aggregations to examine heterogeneities across sites and study periods. We further designed a stochastic simulation framework to assess the methods' ability to estimate intervention efficacies (IE). RESULTS: Wolbachia interventions in Singapore, Malaysia, and Brazil significantly decreased dengue incidence, with reductions ranging from 48.17% to 69.19%. IEs varied with location and duration. Malaysia showed increasing efficacy over time, while Brazil exhibited initial success with subsequent decline, hinting at operational challenges. Singapore's strategy was highly effective despite partial saturation. Simulations identified Synthetic Control Methods (SCM) and its variant, count Synthetic Control Method (cSCM), as superior in precision, with the smallest percentage errors in efficacy estimation. These methods also demonstrated robustness in placebo tests. CONCLUSIONS: Wolbachia interventions exhibit consistent protective effects against dengue. SCM and cSCM provided the most precise and robust estimates of IEs, validated across simulated and real-world settings.
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Aedes , Dengue , Wolbachia , Wolbachia/fisiología , Dengue/prevención & control , Dengue/epidemiología , Animales , Aedes/microbiología , Aedes/virología , Humanos , Brasil/epidemiología , Singapur/epidemiología , Malasia/epidemiología , Incidencia , Control de Mosquitos/métodos , Mosquitos Vectores/microbiología , Simbiosis , Control Biológico de Vectores/métodos , Control Biológico de Vectores/estadística & datos numéricosRESUMEN
BACKGROUND: The majority of persons with dementia (PWD) are mainly cared for by their family members in the home. Evidence is however scarce on family caregivers' psychosocial burden and quality of life in Asian countries including Malaysia. This study describes the baseline data of a telephone-delivered psychoeducational intervention study and examines the determinants of outcome measures (caregiver burden, depressive and anxiety symptoms, quality of life and caregiving self-efficacy) among Malaysian family caregivers to PWD. METHODS: This was a cross-sectional study originated from the baseline survey of a randomized control trial of 121 family caregivers recruited from lists of PWD who were registered at memory and psychiatry clinics in three tertiary care hospitals in Malaysia. The participants were assessed for caregiver burden by the Zarit Burden Interview, depressive and anxiety symptoms by the Hospital Anxiety and Depression Scale, quality of life by the Control, Autonomy, Self-Realization, and Pleasure Scale, and caregiving self-efficacy by the Revised Scale for Caregiving Self-Efficacy. RESULTS: Prevalence of caregiver burden was 69.4%, depressive symptoms 32.2% and anxiety symptoms 32.2%. Family caregivers to PWD having perceived peer support e.g., social/family/friend/significant other supports were less likely to report caregiver burden, depressive and anxiety symptoms, and more likely to report higher levels of quality of life and caregiving self-efficacy. Being married and PWD's ability to self-care were associated with lesser likelihood of experiencing caregiver burden, depressive and anxiety symptoms. The other determinants of greater probability of reporting better quality of life were caregivers' employment and having Islamic faith. Marital status (married), PWD's ability to self-care, spousal relationship with PWD and shared caregiving process were associated with higher likelihood of reporting caregiving self-efficacy. CONCLUSION: Caregiver burden, depressive and anxiety symptoms are prevalent in family caregivers to PWD in Malaysia. Social support and caregiving related factors influence family caregivers' quality of life and caregiving self-efficacy. Implementing psychoeducational intervention and support in the psychiatry and memory clinics may help improve the psychosocial burden, quality of life and caregiving self-efficacy in family caregivers of PWD. TRIAL REGISTRATION: ISRCTN14565552 (retrospectively registered).
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Cuidadores , Demencia , Salud Mental , Calidad de Vida , Autoeficacia , Humanos , Calidad de Vida/psicología , Masculino , Cuidadores/psicología , Femenino , Malasia/epidemiología , Estudios Transversales , Demencia/psicología , Persona de Mediana Edad , Anciano , Carga del Cuidador/psicología , Anciano de 80 o más Años , Adulto , Costo de EnfermedadRESUMEN
BACKGROUND: The effect of nirmatrelvir/ritonavir on preventing post-COVID condition (PCC) in the BA4, BA5, and XBB Omicron predominant periods is not well understood. The purpose of this study was to assess how nirmatrelvir/ritonavir treatment affected both PCC and health-related quality of life. METHODS: This retrospective cohort study enrolled 2,524 adults aged 18 years and older who were eligible for nirmatrelvir/ritonavir between July 14 to November 14, 2022. All outcomes were observed from the patient's first visit to the primary health clinic, 1 week, 1 month, 3 months, and 6 months after testing positive for COVID-19. The primary outcome was the presence of PCC. Secondary outcomes included the effects on health-related quality of life, such as walking, bathing and dressing, activities, cause adverse emotions or signs that prevent individuals from leading normal lives over a 180-day observation period. RESULTS: There were no significant differences observed between the nirmatrelvir/ritonavir and those not administered (control group) in terms of PCC symptoms at 3 months (OR 0.71 95% CI 0.31, 1.64) and 6 months (OR 1.30 95% CI 0.76, 2.21). At 3 months, the use of nirmatrelvir/ritonavir was associated with a 26% reduction in symptoms causing negative emotions (OR 0.74 95% CI 0.60, 0.92) and an increased likelihood of symptoms limiting walking (OR 1.58 95% CI 1.10, 2.27). However, there were no significant differences between the nirmatrelvir/ritonavir and the control group in terms of the impact of PCC on health-related quality of life at 6 months. CONCLUSIONS: Our study indicates that the administration of nirmatrelvir/ritonavir does not significantly reduce PCC after 3 months and 6 months in a population with high vaccination coverage.
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Tratamiento Farmacológico de COVID-19 , Calidad de Vida , Ritonavir , Humanos , Ritonavir/uso terapéutico , Masculino , Femenino , Adulto , Estudios Retrospectivos , Persona de Mediana Edad , Malasia/epidemiología , COVID-19/prevención & control , SARS-CoV-2 , Anciano , Antivirales/uso terapéuticoRESUMEN
In this study of postmenopausal women in Malaysia, total adiposity was inversely associated with total BMD, while regional associations varied. No differences were detected across Malay, Chinese, and Indian ethnicities. Low BMD contributes substantially to morbidity and mortality, and increasing adiposity levels globally may be contributing to this. PURPOSE: To investigate associations of total and regional adiposity with bone mineral density (BMD) among a multi-ethnic cohort of postmenopausal women. METHODS: Dual X-ray absorptiometry (DXA) imaging was undertaken for 1990 postmenopausal women without prior chronic diseases (30% Malay, 53% Chinese, and 17% Indian) from The Malaysian Cohort (TMC). The strength of the associations between standardized total and regional body fat percentages with total and regional BMD was examined using linear regression models adjusted for age, height, lean mass, ethnicity, education, and diabetes. Effect modification was assessed for ethnicity. RESULTS: Women with a higher total body fat percentage were more likely to be Indian or Malay. Mean (SD) BMD for the whole-body total, lumbar spine, leg, and arm were 1.08 (0.11), 0.96 (0.15), 2.21 (0.22), and 1.36 (0.12) g/cm2, respectively. Total body and visceral fat percentage were inversely associated with total BMD (- 0.02 [95% CI - 0.03, - 0.01] and - 0.01 [- 0.02, - 0.006] g/cm2 per 1 SD, respectively). In contrast, subcutaneous and gynoid fat percentages were positively associated with BMD (0.007 [0.002, 0.01] and 0.01 [0.006, 0.02] g/cm2, respectively). Total body fat percentage showed a weak positive association with lumbar BMD (0.01 [0.004, 0.02]) and inverse associations with leg (- 0.04 [- 0.06, - 0.03]) and arm (- 0.02 [- 0.03, - 0.02]) BMD in the highest four quintiles. There was no effect modification by ethnicity (phetero > 0.05). CONCLUSION: Total adiposity was inversely associated with total BMD, although regional associations varied. There was no heterogeneity across ethnic groups suggesting adiposity may be a risk factor for low BMD across diverse populations.
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Absorciometría de Fotón , Densidad Ósea , Posmenopausia , Humanos , Femenino , Malasia/etnología , Malasia/epidemiología , Persona de Mediana Edad , Posmenopausia/fisiología , Posmenopausia/etnología , Anciano , Estudios de Cohortes , Distribución de la Grasa Corporal/estadística & datos numéricos , Etnicidad/estadística & datos numéricos , Vértebras Lumbares/diagnóstico por imagen , Adiposidad/etnología , Adiposidad/fisiologíaRESUMEN
Delayed sputum conversion has been associated with a higher risk of treatment failure or relapse among drug susceptible smear-positive pulmonary tuberculosis patients. Several contributing factors have been identified in many studies, but the results varied across regions and countries. Therefore, the current study aimed to develop a predictive model that explained the factors affecting time to sputum conversion within two months after initiating antituberculosis agents among Malaysian with drug-susceptible smear-positive pulmonary tuberculosis patients. Retrospective data of pulmonary tuberculosis patients followed up at a tertiary hospital in the Northern region of Malaysia from 2013 until 2018 were collected and analysed. Nonlinear mixed-effect modelling software (NONMEM 7.3.0) was used to develop parametric survival models. The final model was further validated using Kaplan-Meier-visual predictive check (KM-VPC) approach, kernel-based hazard rate estimation method and sampling-importance resampling (SIR) method. A total of 224 patients were included in the study, with 34.4 % (77/224) of the patients remained positive at the end of 2 months of the intensive phase. Gompertz hazard function best described the data. The hazard of sputum conversion decreased by 39 % and 33 % for moderate and advanced lesions as compared to minimal baseline of chest X-ray severity, respectively (adjusted hazard ratio (aHR), 0.61; 95 % confidence intervals (95 % CI), (0.44-0.84) and 0.67, 95 % CI (0.53-0.84)). Meanwhile, the hazard also decreased by 59 % (aHR, 0.41; 95 % CI, (0.23-0.73)) and 48 % (aHR, 0.52; 95 % CI, (0.35-0.79)) between active and former drug abusers as compared to non-drug abuser, respectively. The successful development of the internally and externally validated final model allows a better estimation of the time to sputum conversion and provides a better understanding of the relationship with its predictors.
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Antituberculosos , Mycobacterium tuberculosis , Esputo , Tuberculosis Pulmonar , Humanos , Esputo/microbiología , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/microbiología , Tuberculosis Pulmonar/epidemiología , Femenino , Masculino , Antituberculosos/uso terapéutico , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Factores de Tiempo , Mycobacterium tuberculosis/efectos de los fármacos , Malasia/epidemiología , Reproducibilidad de los Resultados , Valor Predictivo de las Pruebas , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND/AIMS: Population surveys are required to measure the prevalence of cataract blindness in the community. We conducted simultaneous surveys in two regions in Malaysia in 2023 to estimate the prevalence of untreated cataract, measure the visual outcomes after cataract surgery and compare the results with the survey in 2014. METHODS: The surveys were done in Eastern and Sarawak administrative regions using the rapid assessment of avoidable blindness technique. It involved a multistage cluster sampling method, each cluster comprising 50 residents aged 50 years and older. The prevalence of cataract was determined through a visual acuity (VA) check and eye examination. The VA of those who had undergone cataract surgery was measured, and the findings were compared with the previous survey. RESULTS: A total of 9709 subjects, 50 years old and older, were examined (percentages of response were 94.5% and 96.2% for Eastern and Sarawak, respectively). Comparing the current to the previous survey in 2014, the prevalence of cataract at all levels of surgical thresholds (except unilateral VA <6/60 and <6/18 in the Eastern) was reduced. The percentages of cataract surgery visual outcomes with good VA (6/12) were improved, and those with poor VA (<6/60) were reduced in both regions. CONCLUSION: There was a reduction in cataract prevalence and improved visual outcomes in both regions. These favourable results could be attributed to the surgical performance monitoring initiatives and the community cataract programme implemented soon after the survey in 2014.
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Ceguera , Extracción de Catarata , Catarata , Agudeza Visual , Humanos , Extracción de Catarata/estadística & datos numéricos , Malasia/epidemiología , Catarata/epidemiología , Catarata/complicaciones , Anciano , Femenino , Masculino , Ceguera/epidemiología , Ceguera/etiología , Prevalencia , Persona de Mediana Edad , Anciano de 80 o más Años , Encuestas Epidemiológicas , Distribución por EdadRESUMEN
OBJECTIVES: Occupational skin diseases (OSDs) pose significant risks to the health and well-being of restaurant workers. However, there is presently limited evidence on the burden and determinants of OSDs among this occupational group. This research aims to estimate the prevalence and associated factors of suspected OSDs among restaurant workers in Peninsular Malaysia. DESIGN: A secondary data analysis of the 2023 Registry of Occupational Disease Screening (RODS) was performed. The RODS survey tool, which included the Nordic Occupational Skin Questionnaire, a symptoms checklist and items on work-relatedness, was used to screen for OSDs. Logistic regression analyses were performed to identify associated factors. SETTING AND PARTICIPANTS: Restaurant workers (n=300) registered in RODS from February 2023 to April 2023, aged 18 years and above and working in restaurants across Selangor, Melaka and Pahang for more than 1 year, were included in the study, whereas workers who had pre-existing skin diseases were excluded. RESULTS: The prevalence of suspected OSDs among study participants was 12.3%. Higher odds of suspected OSDs among study participants were observed among those exposed to wet work (adjusted OR (AOR) 22.74, 95% CI 9.63 to 53.68) and moderate to high job stress levels (AOR 4.33, 95% CI 1.80 to 10.43). CONCLUSIONS: These findings suggest that OSDs are a significant occupational health problem among restaurant workers. Interventions targeting job content and wet work may be vital in reducing OSDs among this group of workers.
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Sistema de Registros , Restaurantes , Humanos , Malasia/epidemiología , Masculino , Femenino , Adulto , Restaurantes/estadística & datos numéricos , Prevalencia , Persona de Mediana Edad , Factores de Riesgo , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/diagnóstico , Adulto Joven , Enfermedades de la Piel/epidemiología , Enfermedades de la Piel/diagnóstico , Encuestas y Cuestionarios , Modelos Logísticos , Análisis de Datos SecundariosRESUMEN
Smoke-free laws (SFL) are more effective with public support. This study investigated the smoking prevalence, public perceptions of smoking rules, and support for comprehensive SFL among 1047 people who smoke (PWS) and 206 people who do not smoke (PNS) aged ≥18 in the 2020 International Tobacco Control Malaysia Survey. Smoking prevalence was highest in nighttime entertainment venues (85.7%), non-air-conditioned eateries (49.7%), and indoor workplaces (34.6%). Respondents reported that smoking was banned in most indoor workplaces (81.7% PNS, 69.2% PWS), air-conditioned eateries (84.7% PNS, 75.7% PWS), and non-air-conditioned eateries (81.2% PNS, 78.7% PWS), but much less so in nighttime entertainment venues (30.1% PNS, 24.6% PWS). Support for comprehensive SFL in public venues was highest among PNS (≥84.9%) but still substantial among PWS (≥49.9%). PWS under 40, Malay, married, and aware of smoking rules supported SFL more. Robust SFL enforcement is essential in Malaysia to reduce secondhand smoke exposure in public places.
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Política para Fumadores , Humanos , Malasia/epidemiología , Adulto , Masculino , Femenino , Política para Fumadores/legislación & jurisprudencia , Persona de Mediana Edad , Adulto Joven , Adolescente , Opinión Pública , Encuestas y Cuestionarios , Contaminación por Humo de Tabaco/legislación & jurisprudencia , Contaminación por Humo de Tabaco/prevención & control , Contaminación por Humo de Tabaco/estadística & datos numéricos , Prevalencia , Anciano , Fumar/legislación & jurisprudencia , Fumar/epidemiologíaRESUMEN
The prevalence of mental health problems among youth worldwide is alarming and a public health concern. This study aimed to determine the prevalence of psychological distress (PD) among youth at two time points, ages 15 and 20 years, and to identify groups that are particularly vulnerable to PD. Utilizing data from the Malaysian Health and Adolescents Longitudinal Research Team study, we analyzed a cohort of 416 participants who underwent mental health assessments in 2014 and 2019/2020. The prevalence of PD increased significantly between the ages of 15 (15.9%) and 20 (34.6%) years. Factors such as parental mental health problems, Indian and other ethnicity, lower maternal education attainment, and alcohol consumption were significantly associated with PD in youth. This study underscores the importance of increasing access to mental health care while improving surveillance and prevention programs to protect youth's psychosocial well-being.