PUBLIC HEALTH
MEDICINE
PUBLIC HEALTH
MEDICINE
EDITORIAL BOARD
Chief Editor
Prof. Dato’ Dr. Syed Mohamed Aljunid
(United Nations University – International Institute for Global Health)
Deputy Chief Editor
Assoc. Prof. Dr. Sharifa Ezat Wan Puteh
(Universiti Kebangsaan Malaysia)
Members
:
Assoc. Prof. Sharifah Zainiyah Syed Yahya University Putra Malaysia
Dr. Lokman Hakim Sulaiman
Ministry of Health Malaysia
Assoc. Prof. Dr. Retneswari Masilamani University Malaya
Assoc. Prof. Dr. Mohamed Rusli Abdullah
University Sains Malaysia
Assoc. Prof. Dr. Saperi Sulong
University Kebangsaan Malaysia
Assoc. Prof. Dr. Maznah Dahlui
University Malaya
Dr. Roslan Johari Ministry of Health Malaysia
Dr. Othman Warijo
Dr. Norfazilah Ahmad
Ministry of Health Malaysia
University Kebangsaan Malaysia
Dr. Amrizal Muhd Nur United Nations University–International
Institute for Global Health (UNU-IIGH)
Chief Editor
Malaysian Journal of Public Health Medicine (MJPHM)
United Nations University-International Institute for Global Health (UNU-IIGH)
Universiti Kebangsaan Malaysia Medical Centre (UKMMC)
MJPHM
Official Journal of Malaysian
Public Health Physicians’Association
3
rdINTERNATIONAL PUBLIC HEALTH CONFERENCE &
20
thNATIONAL PUBLIC HEALTH COLLOQUIUM
“New Insights into Non Communicable Disease Prevention:
The Next Step”
28 – 29 AUGUST 2013
RIVERSIDE MAJESTIC HOTEL
KUCHING, SARAWAK
Organiser:
Department of Community Health
Faculty of Medicine
Universiti Kebangsaan Malaysia Medical Centre
Co-Organiser:
United Nations University
SCIENTIFIC & PROCEEDING COMMITTEE 2013
Adviser
Professor Dr. Mohd Rizal Haji Abd Manaf
Chairperson of Scientific Committee
Associate Professor Dr. Aniza Ismail
Chairperson of Abstract Book / Proceeding Committee
Associate Professor Dr. Zaleha Md Isa
Members of Scientific Committee
Professor Dr. Noor Hassim Ismail
Professor Dr. Khadijah Shamsuddin
Associate Professor Dr. Mohd Hasni Jaafar
Associate Professor Dr. Khalib Latip
Associate Professor Dr. Rosnah Sutan
Dr. Nazaruddin Safian
Dr. Hanizah Mohd Yusoff
Dr. Ahmad Taufik Jamil
Dr. Halim Ismail
Azman Ariff
Mohammad Fuad Mohamad Affader
Associate Professor Ho Siew Eng (Nursing Department UKMMC)
Professor Dr. Mohd Raili Suhaili (UNIMAS)
Dr. Hashimah Basri (Sarawak State Health Department)
Samasu Johari (Sarawak State Health Department)
Members of Abstract Book / Proceeding Committee
Associate Professor Dr. Sharifa Ezat Wan Puteh
Noorasmaa Husna Mohd Hasni
SCIENTIFIC PAPER PRESENTATION - EPIDEMIOLOGY / STATISTICS
PRO-A1 THE MALAYSIAN VERSION OF SUSCEPTIBILITY TO PEER PRESSURE SCALE: EXAMINING ITS CONSTRUCT VALIDITY AMONG STUDENTS IN INSTITUTIONS OF HIGHER LEARNING
Shazimah A. Samad, Noran N. Hairi, Maslinor Ismail
1
PRO-A2 THE NEEDS OF ADULT FAMILY MEMBERS OF THE ICU PATIENTS AS PERCEIVED BY ADULT FAMILY MEMBERS AND INTENSIVE CARE NURSES
Sofee Mohamed Akhlak
2
PRO-A3 SINGLE NUCLEOTIDE POLYMORPHISM GENOTYPING OF SALMONELLA ENTERICA
SEROVAR TYPHI ISOLATES IN KELANTAN MALAYSIA USING PYROSEQUENCING ASSIGNED HAPLOTYPES
Ja’afar N. Ja’afar, Kathryn E.Holt, Vanessa Wong, Subhash J. Bhore, Prabha Balaram, Asma Ismail, Kia Kien Phua
3
PRO-A4 AN OUTBREAK OF LEGIONELLOSIS AT A BUSINESS CENTRE IN KUALA LUMPUR
Rohani I, Normah S, Nurul Hafizah MY, Ummi Kalthum S, Balachandran S, Monica 4
PRO-A5 THE ASSOCIATION BETWEEN BODY MASS INDEX, WAIST CIRCUMFERENCE, AND HYPERTENSION IN ELDERLY PEOPLE AT CIMAHI, INDONESIA
Sri Quintina Indriyana, Salli Fitriyanti, Anastasia Yani Triningtyas
5
PRO-A6 WHAT IMPROVES QUALITY OF LIFE- VIEWS FROM POST-STROKE SURVIVORS IN KANO, NIGERIA
Ashiru M. Hamza, Al-Sadat S. Nabilla, Siew Y. Loh
6
PRO-A7 PSYCHOMETRIC PROPERTIES OF THE MALAYSIAN VERSION OF REASONS SCALE FOR MEDICATION ADHERENCE: RELIABILITY AND FACTORIAL VALIDATION AMONG HYPERTENSIVE PATIENTS IN PRIMARY HEALTH CARE SETTING
Shima R, Farizah Hairi, Hazreen A. Majid
7
SCIENTIFIC PAPER PRESENTATION -
FAMILY HEALTH / NUTRITION / SOCIAL WORK
PRO-B1 WOMEN’S SEXUAL AND REPRODUCTIVE HEALTH CARE IN RURAL AREAS OF SOUTH AUSTRALIA
Wendy Abigail & Cara Flynn
PRO-B4 THE ASSOCIATION BETWEEN BODY MASS INDEX AND QUALITY OF LIFE AMONG ADULTS IN SELANGOR
Mohd Rizal A.M, Aniza I, Ahmad Fareed A.R
11
PRO-B5 THE QUALITY OF LIFE OF CLEFT LIP AND/OR PALATE CHILDREN AGE LESS THAN 5 YEARS OLD: PARENTS’ PERCEPTION
Khairol N. Ahmad & Jennifer G. Doss
12
PRO-B6 NUTRITION AND EXERCISE AMONG ELDERLY: KNOWLEDGE, ATTITUDE AND PRACTICE (KAP) STUDY AMONG CHINESE COMMUNITY IN SIBU, SARAWAK Annaletchumy L, Annie Wong SM, Kavitha Subramaniam
13
PRO-B7 TOOTH WEAR AND EROSIVE TOOTH WEAR AMONG 16-YEAR-OLD MALAYSIAN ADOLESCENTS
Noorhazayti Ab. Halim, Rashidah Esa, Chew Hooi Pin
14
PRO-B8 HOUSEWIVES IN SEPANG SELANGOR – FAT OR FIT
Sabariah AH & Manan NA 15
SCIENTIFIC PAPER PRESENTATION -
OCCUPATIONAL HEALTH / ENVIRONMENTAL
HEALTH
PRO-C1 EFFECTIVENESS OF INTERVENTION PROGRAMME IN IMPROVING KNOWLEDGE, ATTITUDE AND PRACTICE AMONG SMOKERS IN MUKIM PERINGAT, KELANTAN Aziah Daud & Group A CFCS 2012/2013
16
PRO-C2 THE IMPACT OF BODY MASS INDEX ON SICKNESS ABSENCE AMONG HEALTHCARE WORKERS IN KUALA SELANGOR IN 2012
Azizah Wahab, Rozita Hod, Hanizah M Yusoff, Halim Ismail, Azmawati M Nawi, Norfazilah Ahmad, Zaharah Zainuddin
17
PRO-C3 OCCUPATIONAL DEPRESSION AMONG EMPLOYEES OF ESFAHAN STEEL COMPANY, IRAN: PREVALENCE AND ASSOCIATED FACTORS
Masoud Lotfizadeh & Noor Hassim Ismail
PRO-C7 MUSCULOSKELETAL PROBLEMS AMONG AGRICULTURAL WORKERS IN FELDA SUNGAI KELAMAH, GEMAS, NEGERI SEMBILAN
Mohd Dzulkhairi Mohd Rani, Zairina A Rahman, Mohd Yunus Abdullah, Nooriah Mohamed Salleh
23
PRO-C8 VALIDATING EFFORT OF AN OCCUPATIONAL BACK PAIN QUESTIONNAIRE WITH STANDARDS FROM A SOCIAL SECURITY ORGANIZATION BASED IN A DEVELOPING COUNTRY
Jenn Z Tam, Sharifa E W Puteh, Noor H Ismail
24
PRO-C9 RELIGIOSITY, COPING AND POST TRAUMATIC STRESS DISORDER AMONG EARTHQUAKE SURVIVORS
Rafidah Bahari & Norlaili Abdul Aziz
25
PRO-C10 URTI OUTBREAK AT SCHOOL X, CHERAS, KUALA LUMPUR
Haliza AM, Asyraf Z, Rohani I 26
PRO-C11 A PILOT STUDY EXAMINING ANEMIA AND OBESITY AMONG WOMEN WORKER
Salli Fitriyanti, Anastasia Yani Triningtyas, Sri Quintina Indriyana 27
SCIENTIFIC PAPER PRESENTATION -
HEALTH MANAGEMENT / HEALTH PROMOTION
PRO-D1 KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS ORGAN DONATION AMONG THE STUDENTS OF UNIVERSITI SAINS ISLAM MALAYSIA (USIM)
Nazefah Abdul Hamid, Mohd. Dzulkhairi Mohd. Rani, Marlini Muhamad, Mohd. Hairulhisyam Ngatiman, Rosliza Ghazali, Mustafa ‘Afifi Ab. Halim, Nooriah Mohamed Salleh
28
PRO-D2 THE IMPACT OF MIGRAINE ON QUALITY OF LIFE (QOL) IN FEMALES
Munvar Miya Shaik, Norul Badriah Hassan, Huay Lin Tan, Shalini Bhaskar, Siew Hua Gan
29
PRO-D3 THE EFFECTIVENESS OF DIETARY COUNSELLING BY DIETICIAN ON KNOWLEDGE, ATTITUDE AND PRACTICE AND QUALITY OF LIFE OF DIABETIC PATIENTS IN KLINIK KESIHATAN BANDAR KUANTAN
Ezzaity N Anuar, Noraishah M Nor, Nor Azlina A Rahman
30
PRO-D4 PERCEPTION OF END USERS ON I-KELAHIRAN IN SABAH HEALTH DEPARTMENT
PRO-D7 ILLNESS PERCEPTION AMONG HYPERTENSIVE PATIENTS ATTENDING POLYCLINICS IN KUCHING, SARAWAK
Haironi Yusoff & Rasidah Abd Wahap
34
PRO-D8 INJURIES AT HOME AND RISK REDUCTION PRACTICES
EPIDEMIOLOGY / STATISTICS
PRO-A1
The Malaysian Version of Susceptibility to Peer Pressure Scale:
Examining Its Construct Validity among Students in Institutions of
Higher Learning
Shazimah A. Samad1,2,3, Noran N. Hairi1,2, Maslinor Ismail1
1. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia 2. Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Malaysia
3. Ministry of Health, Malaysia
Introduction: Adolescence is a transitional stage predisposing adolescents to detach themselves from their family. As a result, they would depend on their peers for support and relationship. This heightened peer interaction may give rise to undesired consequences. An instrument to measure this peer pressure, the susceptibility to Peer Pressure Scale was developed and validated among adolescents in Singapore. The present study aimed at examining the reliability and construct validity of the susceptibility to Peer Pressure Scale.
Materials and Methods: A cross-sectional study involving 515 students in three tertiary level institutions was conducted between December 2012 and February 2013. The scale consisted of 35 hypothetical scenarios utilizing a 4-point Likert-type scale. Both forward and backward translations were performed prior to pilot test. The scale’s reliability was determined by Cronbach’sα and Kappa statistics, while its construct validity was assessed using exploratory and confirmatory factor analyses.
Results: The findings supported a two-factor structure instead of the original four-factor structure. The two factors explained 45.1% of the total variance. Cronbach’s α for the two factors were .91 and .89, respectively. Majority of the items reached moderate to substantial agreement in test-retest analysis (.4 to .61). Multi-group analyses demonstrated stability across gender.
Conclusion: The Malay version of the susceptibility to Peer Pressure Scale displayed good psychometric properties. This 18-item scale is a valid and reliable instrument in the evaluation of the susceptibility to peer pressure. However, future studies to assess its stability across the different ethnic groups are warranted.
Acknowledgement: We would like to thank the author of the scale for the permission to utilize and modify the scale. The cooperation of the Students’ Affairs of the tertiary level institutions and the respondents are greatly appreciated.
The Needs of Adult Family Members of the ICU Patients as Perceived
by Adult Family Members and Intensive Care Nurses
Sofee Mohamed Akhlak
Department of Nursing, Universiti Teknologi MARA, Puncak Alam, Malaysia
Introduction: The admission of a critically ill patient into intensive care is universally accepted as a crisis for both patients and their families. Family members of critically ill people may experience emotional turmoil and therefore have many needs throughout the course of the relative’s illness. It has been identified that nurses are best placed to meet families’ needs. The aim of the study was to explore the needs of adult family members of the Intensive Care Unit (ICU) patients as perceived by adult family members and intensive care nurses
Materials and Methods: A descriptive study using the Critical Care Family Needs Inventory (CCFNI) questionnaire was employed to measure, rank and compare a series of family needs at ICU unit in Sungai Buloh Hospital. A total of 110 participants (59 family members and 51 ICU nurses) were enrolled in the study.
Results:The 10 most important needs perceived by family members were from the subscale of assurance need, information need, support and proximity need. The 10 most important needs perceived by nurses were assurance need, information need, support and proximity need. T-test results showed a significant difference in the rank order of the need statements listed in the CCFNI amongst family members and nurses (p<0.05).
Conclusion:The results of this study indicated that families had specific and identifiable needs. Providing families of critically ill patients with a clear, simple and updated information about the patients’ and assuring them about the quality of care the patients receive appears to be the priority identified by both family members and nurses.
Single Nucleotide Polymorphism Genotyping of
Salmonella Enterica
Serovar Typhi Isolates in Kelantan Malaysia Using Pyrosequencing
Assigned Haplotypes
Ja’afar N. Ja’afar1, Kathryn E.Holt2, Vanessa Wong3, Subhash J. Bhore4, Prabha Balaram5, Asma Ismail1, Kia Kien
Phua1
1. Typhoid and other Enteric Diseases Research Cluster, Institute for Research in Molecular Medicine
(INFORMM), Universiti Sains Malaysia, Malaysia
2. Department of Biochemistry and Molecular Biology, Bio21 Institute, University of Melbourne, Australia 3. The Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire, United Kingdom
4. Department of Biotechnology, Faculty of Applied Sciences, AIMST University, Malaysia 5. QUEST International University Perak, Malaysia
Introduction: Although the Kelantan state public health authorities have a stringent policy on Typhoid surveillance and reporting of every outbreak, no detailed molecular tracking method is yet available to determine the predominant haplotypes of S. Typhi, if any, circulating in the state. From previous studies, only nine isolates from Malaysia were used in a global study to determine the haplotype of S. Typhi. In the current study, the haplotypes of 271 isolates from the state of Kelantan Malaysia were determined.
Materials and Methods: A single nucleotide polymorphisms (SNP) genotyping platform using pyrosequencing was utilized to investigate 37 known polymorphic variations in 271 individual S. Typhi isolates isolated within an 11-year period. Sequence data on the 37-SNP locations for all the isolates was processed and each isolate was assigned a haplotype by mapping the allele information to an additional 500 individual S. Typhi isolates previously genotyped at 1500 loci using Illumina Golden Gate.
Results: Majority of the isolates (80.4%) belonged to haplotype H50. This suggests the predominance of this haplotype within the state. Only two isolates assigned H58 and H59 were found. H58 is known to represent isolates that are multi-drug resistant. In contrast, H59 has previously been reported to be geographically restricted to Indonesia.
Conclusion: The predominance of haplotype H50 shows the limited genetic diversity of S. Typhi in the state of Kelantan for almost three decades as far back as 1986. However, the finding of haplotypes H58 and H59 in the state is an early warning sign of emergence of the multiple drug resistant strain and diversification of S. Typhi genotypes from its neighbouring country, Indonesia. Therefore, active screening of foreigners working as food-handlers is imperative to curtail any possible emergence of new S.Typhi strains in the country.
Acknowledgement:We would like to acknowledge the support of Universiti Sains Malaysia by funding the project [grant numbers 1001/CIPPM/844078, 1001/PSKBP/86300111].
An Outbreak of Legionellosis at a Business Centre in Kuala Lumpur
Rohani I, Normah S, Nurul Hafizah MY, Ummi Kalthum S, Balachandran S, Monica
Jabatan Kesihatan Wilayah Persekutuan Kuala Lumpur, Malaysia
Introduction: Legionnaires’ disease was first described by Fraser et al following an outbreak of pneumonia among the participants of the American Legion Convention in Philadelphia in 1976. The disease was caused by Legionella pneumophila, commonly found in aquatic environment and the term “Legionellosis” was used to describe these infections that range from mild (Pontiac fever) to severe form ( Legionnaires’ disease). The business centre is located at the central of Federal Territory of Kuala Lumpur. The block involved, Block A, located in the middle of four office blocks. The air conditioning system for the building is centralized using cross flow cooling system and the cooling tower is located at the roof top of Block B, adjacent to Block A. Notification was received on 12thApril
2013 on two cases admitted at different private hospital with similar respiratory symptoms and one of them had passed away seven days prior to notification. Both of them work in the same department in Block A.
Materials and Methods: It is a cohort study involving all employees at Block A. This study includes the epidemiological, environmental and laboratory studies. The objectives of these studies were to verify the outbreak and describe it epidemiologically, to identify the etiology and source of the pathogen and to take preventive and control measures to contain the outbreak.
Results: A total of 1, 365 workers from the same block were examined and 382 (attack rate: 27.9%) were found to have symptoms based on case definition. Blood samples taken from 188 of cases revealed that 70 of them were found positive for IgM Legionella (37.2%). There was no significant findings on the department or level involved. Water and swab samples from the cooling tower at the same block showed positive for Legionella pneumophila Serogroup 1 and2.
Discussion: The outbreak caused by Legionella pneumophila Serogroup 1 originated from the cooling tower. Improper maintenance of the cooling towers can lead to accumulation of pathogen and spread to the environment. The largest outbreak of confirmed cases Legionella (449) attributed to cooling towers was reported in City Hospital, Spain in year 2003 and study on building complexes cooling towers in Kuala Lumpur in 1992, showed Legionella viable count ranging from 100 to 2000 CFUml.
Conclusion: There was a Legionellosis outbreak among 382 workers at a business centre in Kuala Lumpur starting from 21st March 2013. The organism causing the outbreak was Legionella pneumophila Serogroup 1 which was
found in the cooling tower. The maintenance company was instructed to manually clean the cooling tower immediately.
The Association between Body Mass Index, Waist Circumference, and
Hypertension in Elderly People at Cimahi, Indonesia
Sri Quintina Indriyana1, Salli Fitriyanti2, Anastasia Yani Triningtyas3
1. Public Health Department, Faculty of Medicine, Jenderal Achmad Yani University, Cimahi, Indonesia 2. Medical Nutrition Department, Faculty of Medicine, Jenderal Achmad Yani University, Cimahi, Indonesia
Introduction: Only few studies allow direct comparison of the association between BMI, waist circumference and hypertension in Asian elderly populations. The aim of this study was to allow direct comparison of the association between BMI, waist circumference, and hypertension.
Materials and Methods: As many as 330 participants were recruited, taken by simple random sampling. The definition of hypertension was based on JNC VII, and waist circumference and BMI measurements were based on the World Health Organization standards for Asian ethnicities. Logistic regression model was used to test predictors of hypertension.
Results: Majority of participants (mean age 61.2 y (SD 9.6 y)) are female (79.1%) with hypertension (32.6%), high risk waist circumference (78.2%), and obesity (53.7%). This study showed that waist circumference had significant relationship to hypertension risk (p<0.01, odds ratio (OR) 3.004).
Discussion: This study showed that waist circumference was a significant factor associated with hypertension. Waist circumference (WC) is used as a surrogate marker of abdominal fat mass. BMI and WC are strongly correlated with total-body adipose tissue mass, but WC is a better predictor of intra-abdominal adipose tissue than is BMI. Recent findings also indicate that WC is a stronger marker of health risk than is BMI. A population sample of Chinese adults indicates that BMI and WC are independently associated with CVD risk factors. Another finding indicates that BMI coupled with WC did not predict an increase in obesity related health risk better than did WC alone. Future studies are required to determine whether WC alone can be used as an indicator of hypertension.
Conclusion: Study showed that waist circumference had direct association with hypertension in Asian elderly ethnicities.
What Improves Quality of Life- Views from Post-stroke Survivors in
Kano, Nigeria
Ashiru M. Hamza1, Al-Sadat S. Nabilla1, Siew Y. Loh2
1. Center for Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University
of Malaya, Malaysia
2. Department of Rehabilitation Medicine, Faculty of Medicine Building, University of Malaya, Malaysia
Introduction: The residual physical consequences after stroke are not necessarily associated with Quality of Life (QOL) as some survivors are able to adapt to their disabilities while others are devastated even by a minor sequelae.
Materials and Methods: Using qualitative interviews with 15 informants, this study explore the complexity of factors influencing the quality of life of post-stroke survivors. Thematic analysis via constant comparative method and aided by N-Vivo 9 software was used for the qualitative analysis.
Results: The 19 sub themes emerged from the in-depth interview. These themes influencing stroke survivor’s quality of life were regrouped into 7 themes. Of these, 4 themes have further related issues whilst 3 were independent issues: adaptive and coping strategies, the impact of the extent of disability (effects of activities of daily living on functioning, effect on self and identity, effect on religious activities, effect on occupation and return to work), social relationship and support system (social and instrumental supports, communication, autonomy, social role adjustments, sexual relationship), resources (medical services and rehabilitation, spiritual and resources, educational skills and experiences), anxiety and distress due to financial resources, perceived change in body image, fear of uncertainties, increased forgetfulness, pains and stigma.
Conclusion: The finding of this study supports that priorities should be focused on socio-cultural activities considered most essential to an individual’s identity; drawing on existing resources including health services and rehabilitation, social relationship and support system to address individual’s identity.
Acknowledgement: The authors would like to thank the University of Malaya Postgraduate Research Grant for supporting us with the funds to conduct this study (project number: PS034-2012A). We are also grateful to staff and the volunteered stroke patients of the Aminu Kano Teaching Hospital and Murtala Mohammad Specialist Hospital, Nigeria for their active involvement in the translation process.
Psychometric Properties of the Malaysian Version of Reasons Scale for
Medication Adherence: Reliability and Factorial Validation among
Hypertensive Patients in Primary Health Care Setting
Shima R1,2, Farizah Hairi1, Hazreen A. Majid1
1. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia 2. Ministry of Health, Malaysia
Introduction: This article describes the reliability and constructs validity of a modified Malay version of the Reasons Scale for Medication Adherence (RSMA).
Materials and Methods:In this cross-sectional study, the 15-items RSMA was administered among 665 hypertensive patients who attended four government primary health clinics under the Hulu Langat and Klang districts in Selangor, Malaysia, between early December 2012 until end of March 2013. The construct validity was examined through two phases. In phase I, translation of the English version, content validity via expert panels, face validity via small preliminary test among hypertensive patients and exploratory factor analysis (EFA) were carried out. In phase II, calculation of internal consistency reliabilities and confirmatory factor analysis (CFA) were done. Results:
The EFA verified the existing five factors. CFA extracted four items. The final model with four factor structure provided good evidence of convergent and discriminant validity. Composite reliability (CR) for all the remaining domains was at least 0.7 and factorial invariance was present across gender and ethnicity. Cronbach’s α
coefficient was above 0.7 indicating a good internal consistency of the items in the construct. The results suggest that the modified RSMA has good internal consistency and construct validity.
Conclusion: This study demonstrated that the modified Malaysian version of the RSMA suitable to be used to improve the delivery of clinical services by understanding the reasons for non-adherence to antihypertensive medications by the patients. However, the comprehensiveness of other factors need further exploration.
Acknowledgement: We would like to thank the Director General of Health of Malaysia for granting us the permission to publish this study. Our thanks to Professor Karuthan Chinna for his valuable input and guidance on the statistical aspects of the research, and to the District Health Officer of Hulu Langat, Dr. Hanif Bin Zailani for his assistance.
PRO-B1
Women’s Sexual and Reproductive Health Care in Rural Areas of South
Australia
Wendy Abigail & Cara Flynn
School of Nursing and Midwifery, Flinders University, Adelaide, Australia
Introduction: Quality sexual and reproductive health care for women is fundamental to good family planning health. To understand the issues rural and remote women in Australia face, a 10 year period (2003-2013) literature review was conducted.
Materials and Methods:Articles included were Australian primary research reports which discussed rural women’s access to sexual and reproductive health. Articles excluded were discussion or opinion pieces, non-Australian studies, non-English language publications and articles prior to 2002. There were 11 articles identified as most relevant. Thematic analysis of the articles was conducted.
Results: The majority of the articles were nationally based (n=6). Research methodologies used were both qualitative articles (n=6) and qualitative studies (n=5).The specific sexual and reproductive health areas reported on included: poor access to services, adolescent health issues, levels of sexual and reproductive health knowledge, and fertility issues. Most of the articles called for increased public awareness through policy development and advocacy work to help these disadvantaged women.
Discussion: Australia is a very large country with significant rural and remote regions. Women residing in these areas are disadvantaged with inequitable sexual and reproductive health service provision and care. Improved outcomes are required for Australia to meet the Millennium Development Goal 5 ‘Improve maternal health’.
Conclusion: Understanding the issues for women in rural areas is important for service provision, policy development and funding. This information has implications for areas where poor access to sexual and reproductive health exists.
Acknowledgement: This research was funded by an Establishment Grant from Flinders University, Adelaide Australia. The authors have both contributed equally to the literature review presented.
Self Efficacy, Diabetes Attitude and Social Support are related to
Diabetes Self-Management Practice among Elderly Diabetes Patients
Salmiah B, K Shamsuddin, Rahmah MA
Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
Introduction:Diabetes is a chronic disease that requires routine and complex self care. For elderly with diabetes, diabetes self-management (DSM) behaviour is necessary to prevent diabetes complications and to improve their quality of life. There are several factors which influence the elderly in performing diabetes self management. The study examined the relationship between respondents' demographic and clinical characteristics, self efficacy, diabetes knowledge and attitudes, and social support with diabetes self-management (DSM) in elderly, diabetic patients in primary health care clinics, Selangor.
Materials and Methods:This is a cross sectional study using questionnaire adapted from the Summary of Diabetes Self Care Activities (SDSCA), Diabetes Self Management Self Efficacy (DSMSE), Diabetes Care Profile (DCP), Diabetes Attitude Scale-3 (DAS-3) and Michigan Diabetes Knowledge (MDKT) instruments for data collection among elderly diabetics on follow-up in primary health care clinics in Selangor.
Results: Preliminary analysis of 389 respondents showed significant linear relationship between respondents’ self efficacy level and DSM ability (p<0.001), social support received (p=0.008), as well as respondents’ diabetes attitude (p<0.001) and DSM ability. Analysis also showed a significant difference in DSM scores of patients treated with combination of insulin and oral hypoglycemia agents (OHA) from patients treated with OHA only (p= 0.001). Patients treated with combination of OHA and insulin on average has a score of 2.8 lower compared to patients treated with OHA only. However, there is no significant difference in DSM scores between patients treated with insulin only with patients treated with OHA only (p=0.113). Other variables did not show significant relationships with diabetes self-management.
Conclusion: The factors related to diabetes self-management in this study are self efficacy, attitude, received social support and types of treatment of diabetes. As self efficacy, diabetes attitude and social support level increases, diabetes self-management gets better. In term of treatment, patients treated with only OHA had better self management ability compared to those treated with combination OHA and insulin. These findings might help us in developing an individual tailored intervention in this unique group of people.
Acknowledgement: We would like to thank Ministry of Health Malaysia, Selangor State Health Department, health staffs and respondents who were involved in this study. This study was supported by a research grant from the Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre (FF-324-2012).
Vitamin D Intake and Bone Mineral Density Status of Government
Employees in Padang City, Indonesia: Cross Sectional Study
Azrimaidaliza
Public Health Faculty, Andalas University, Indonesia
Introduction:The prevalence of osteoporosis is prone to increase in Indonesia. Current data on the relationship of vitamin D intake with bone mineral density as diagnostic of osteoporosis among employees in Indonesia are scarce. The aim of this study is to assess vitamin D intake and its relationship with bone mineral density status of government employees.
Materials and Methods:A total of 103 employees at national education department in Padang city participated in this study. Nutrient intake was determined using a semi-quantitative food frequency questionnaire and compared to nutritional recommended for adequacy. Physical activity was measured by Baecke’s questionnaire and bone mineral density was measured by bone mineral densitometry. Multivariate logistic regressions by using SPSS program version 15 were used to analyze the main factors that have relationship with bone mineral density status.
Results: Subjects consist of 56.3% female and 43.7% male employees with age range 40-59 years. The result showed that 60.2% workers had osteoporosis risk with low bone mineral density. A higher prevalence of low bone mineral density was among female workers (62.1%). Overall, subjects have adequate vitamin D intake from food (average 10 µg/days). Physical activity of subjects was 40.8% as inactive category. There was no significant relationship between physical activity and bone mineral density status on multivariate analysis. Vitamin D intake was a dominant factor on bone mineral density status (OR=0.85, 95% CI: 0.746-0.972, PV=0.017) after adjusted for education status.
Discussion: In this cross sectional study, we found that vitamin D was the main factor associated with bone mineral density status. Overall, calcium did not appear to be associated with bone mineral density. Adequate vitamin D is important in the prevention of bone loss. Skin exposure to sunlight helped synthesis of vitamin D. Skin exposure to sunlight everyday and exercise once a week before activity at work also contributed to bone mineral density.
Conclusion: An adequacy of vitamin D intake had contribution to prevent osteoporosis by improving bone mineral density status of government employees in Padang city, Indonesia.
The Association between Body Mass Index and Quality of Life among
Adults in Selangor
Mohd Rizal A.M, Aniza I, Ahmad Fareed A.R
Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
Introduction:The global and local prevalence of obesity have been on the rise and becoming an important public health concern. Obese and overweight conditions are often associated with significant risk of health impairments and disease burden. There is also an increasing evidence of the association between body mass index and quality of life. This study aims to identify the quality of life among obese and overweight and its associated factors.
Materials and Methods: A comparative cross sectional study was conducted among obese, overweight and normal adults in Selangor health clinics with 1, 200 respondents involved. The data was obtained through self-administered questionnaires namely the Short Form 36 (SF-36) and the validated Malay version of the Impact of Weight on Quality of Life-LITE (MVIWQOL-LITE).
Results:The mean score of PCS (SF-36) was significantly lower in obese (42.97±7.85) as compared to overweight (46.03±7.82) and normal (49.23±6.65) (F=70.22, p<0.001). However, the mean score of MCS (SF-36) did not differ significantly among obese (46.85±8.63), overweight (47.77±8.66) and normal (47.69±8.12) (F=1.45, p=0.235). The total mean score of MVIWQOL-LITE showed a significant difference for obese, overweight and normal individuals with scores of 69.99±17.54, 81.27±16.24 and 88.64±14.22 respectively (F=136.76, p<0.001). Physical functions and health perceptions scores were found to be lowest among obese and overweight. Multivariate linear regression analysis showed that body mass index, gender, marital status, education level, physical activities and presence of chronic illnesses significantly influenced quality of life (p<0.05).
Discussion: Quality of life is lowest among obese as compared to overweight and normal individuals. The physical and social domain significantly impairs quality of life among obese and overweight while the mental domain did not show any significant difference among the three groups. Increasing body mass index, being female, married, having lower education level, not performing regular physical activities and having chronic illnesses reduce quality of life.
Conclusion: The findings in this study should mandate for more specific interventions and appropriate strategies to improve the quality of life among obese and overweight. Provision of obesity specific policies and health services need to be expedited. Individual and community participation in obesity prevention must be improved as well.
Acknowledgement: The authors would like to acknowledge the UKM Medical Research and Ethical Committee for funding and approving this research (Project code: FF-266-2011). The research is also supported by the UKM Young Researchers Grant (Project code: UKM-GGPM-TKP-065-2010). Special thanks to the Director General of Health Malaysia and all personnels who have helped to facilitate this study.
The Quality of Life of Cleft Lip and/or Palate Children Age Less Than 5
Years Old: Parents’ Perception
Khairol N. Ahmad & Jennifer G. Doss
Department of Community and Clinical Preventive Dentistry, Faculty of Dentistry, University of Malaya, Malaysia
Introduction: Cleft lip and/or palate (CLP) are among the most common congenital malformations that involve a person’s face. It remains undisputed that CLP present variety of difficulties for those affected. Many studies elsewhere have examined the impact of CLP, however locally, there are only very few studies to date that have explored this area.Thus, it is the aim of this present study to provide some baseline data on the impact of this oral impairment on the quality of life (QOL) of children from birth up to 5 years of age in Malaysia. The objective is to assess parents’ perceived impacts of CLP on their child’s QOL and to assess these impacts by family’s socio-demographic characteristics, socio-economic status and child’s clinical details.
Materials and Methods: A cross-sectional study was carried out using ‘face-to-face’ interviews with the PedsQLTM
Questionnaire module. A convenient sample of 131 parents having CLP children (age from after birth to less than 5 years old) were recruited from Cleft Lip and Palate Association of Malaysia (CLAPAM) and monthly combined cleft lip/ palate clinics at two university teaching hospitals. Kruskal Wallis and Mann-Whitney U statistical tests were
used to assess associations. Significance level was set at α = 0.05.
Results: QOL for children aged 1-12 and 13-24 months old was highest in cognitive, psychosocial and physical functioning dimensions and lowest in emotional functioning and physical symptoms. Overall QOL was significantly highest among the older children (25-59 months old) and those of post-treatment status. Children of lower income families (<MYR3000) had better psychosocial health. Infants up to 12 months old having only cleft lip had significantly higher QOL and those with Muslim mothers had significantly higher psychosocial health scores.
Conclusions: Parents perceived that their children’s ‘Psychosocial Health’ was more affected than ‘Physical Health’ in all age categories except for the 1-12 months old category. Overall, the child’s age and treatment status plus household income influenced the child’s QOL while mothers’ religion and type of cleft influenced the QOL of their child’s first year of life.
Acknowledgement: The authors wish to thank parents who willingly shared their time to participate in this study. The QOL study described in this paper was carried out using the PedsQLTM, developed by Professor Dr. James W.
Varni. The financial support for this study was provided by the University Malaya Postgraduate Research Fund, Grant: PPPC/C1-2012/DPGA/01.
Nutrition and Exercise among Elderly: Knowledge, Attitude and
Practice (KAP) Study among Chinese Community in Sibu, Sarawak
Annaletchumy L, Annie Wong SM, Kavitha Subramaniam
Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar, Malaysia
Introduction: Elderly population is on the rise globally and locally with increasing life expectancy. The lack of knowledge on nutrition and exercise among the elderly has been widely reported. However, there is paucity in studies that explored on knowledge towards nutrition intake and exercise in our local community-dwelling elderly people. The objective is to explore the knowledge, attitudes and practices (KAP) toward nutrition and exercise among elderly.
Materials and Methods: A descriptive cross sectional survey was conducted from October to December 2012 at Sibu, Sarawak, Malaysia. A self-designed questionnaire was employed to assess the elderly knowledge, attitude and practice toward nutrition and exercise. Elderly people were selected purposively, a total of 150 respondents have participated in this survey and the response rate was 75%. The data were tested for statistical significance using Chi-square test by using Epi Info statistical software with significance taken as p< 0.05.
Results: Overall, 74% (n=111) of the elderly had good nutrition knowledge. A total of 89.3% (n=134) of respondents had positive attitude towards nutrition. Most of the elderly often consume fruits, juice, vegetables, meat, fish and eggs and they seldom consume dairy products, fried food, sweetened food and snacks. Respondents also showed good knowledge towards exercise 94%, (n=141) and good exercise attitudes, 76.7% (n=115). Majority of the respondents exercise once per day and they spent more than twenty minutes on exercise. There were significant association between educational status, p=0.003 and nutrition knowledge and health condition and knowledge on balanced diet, p=0.005.
Discussion: Despite many studies reported poor practices and attitudes towards exercise, Sibu Chinese elderly has significantly good KAP towards exercise. Hong Kong Chinese also had good knowledge and attitudes towards exercise.
Conclusion: Chinese elderly of Sibu have good nutrition and exercise knowledge. However, more nutrition and exercise education programmes should be conducted to improve and sustain elderly nutrition and health status.
Acknowledgement: We would like to thank all the study participants and Faculty of Science, Universiti Tunku Abdul Rahman (UTAR) for the support and facilitation.
Tooth Wear and Erosive Tooth Wear among 16-Year-Old Malaysian
Adolescents
Noorhazayti Ab. Halim1, Rashidah Esa1, Chew Hooi Pin2
1. Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya,
Malaysia
2. Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Malaysia
Introduction: General tooth wear (GTW) (indiscriminate of aetiology) and more specifically erosive wear (ETW) are relatively new emerging public health problems globally. Study about their prevalence has not been sufficiently explored in Malaysia. This study aimed to determine the prevalence and severity of GTW and ETW among 16-year-old adolescents in Kuantan, Malaysia.
Materials and Methods: A cross sectional study was carried out using multistage cluster sampling technique. The study group consisted of 16-year-old adolescents attending secondary schools in Kuantan. A total of 598 adolescents (228 males and 370 females) with a total of 16,521 teeth were examined from 5 different schools. The prevalence and severity of GTW and ETW were recorded using the Smith and Knight’s Tooth Wear Index (TWI) and the Basic Erosive Wear Examination (BEWE) index respectively.
Results:The prevalence of GTW was 99.8% (597 subjects) at a subject level and 62.9% (10,400 teeth) at a tooth level. The most frequently affected surfaces were the incisal or occlusal surfaces (99.9%). As for the severity of GTW, most of the affected tooth surfaces (99.8%) exhibited surface loss limited to enamel only (TWI Score 1). The prevalence of ETW however was 45% (269 subjects) at a subject level and 2.7% (451 teeth) at a tooth level. The most frequently affected surfaces were again the incisal or occlusal surfaces (98.2%). Severity results of ETW showed that most of the affected tooth surfaces (98.9%) exhibited a BEWE score of 2 which meant distinct hard tissue loss ≤ 50% of the surface area.
Conclusions: GTW and ETW among 16-year-old adolescents in Kuantan are highly prevalent and similar to some results published in western countries. The results of this study indicate that the local adolescents should be provided with oral health information regarding GTW and ESW. Similar studies should also be carried out in other cities in Malaysia.
Acknowledgement: The authors wish to thank all Principals, teachers, school administrators and students of secondary schools in Kuantan for giving their full cooperation in this study. The study was supported by grants from University of Malaya, Malaysia. Grant: PPPC/C1-2012/DPGA/06
Housewives in Sepang Selangor – Fat or Fit
Sabariah AH & Manan NA
Faculty of Medicine, Cyberjaya University College of Medical Sciences, Selangor, Malaysia
Introduction:Obesity increases the risk of many diseases and it is showing increasing trend among adult females and in rural area. This study investigates the differences and compares weight status among housewives in rural and urban area of Sepang, Selangor.
Materials and Methods: A cross-sectional study was conducted in a village and housing estate area in Sepang, Selangor with sample of 196 in Kg Ulu Teris and 174 in Taman Mawar. A simple random sample of female adults age 18 years and above were selected. Data were collected by an interviewed questionnaire, physical measurements and blood collection.
Results: Overall, 69% of housewives in rural and 72% in urban areas were at least overweight. The rural-urban difference in waist circumference was greatest with 62% in urban had obesity, whereas 100% in rural was normal. Urban housewives (86%) were more likely than rural housewives (76%) not having appropriate exercise. The reasons for not exercising were no time, lazy and lack of facilities.
Conclusion:Though the data may not represent a larger population, it is crucial for this group of subjects to have their weight reduced by methods such as dietary control and physical exercise. Health education should also be targeted on this aspect.
Acknowledgements: This study was supported by the Cyberjaya University College of Medical Sciences under the Community Medicine Programme. The authors thank the support and help from Assoc Prof Dr Muhammad Najib Mohamad Alwi. We also acknowledge all Class 2010 students in the Department of Community Medicine, CUCMS for helping in the data collection.
PRO-C1
Effectiveness of Intervention Programme in Improving Knowledge,
Attitude and Practice among Smokers in Mukim Peringat, Kelantan
Aziah Daud & Group A CFCS 2012/2013
Department of Community Medicine, School of Medical Sciences, University of Science Malaysia Health Campus, Malaysia
Introduction: Cigarette smoking is a major health concern in most societies because the diseases and deaths that result from it are in fact preventable. It is estimated that tobacco-related deaths will be the most important cause of deaths in developing countries by 2020. Therefore, the aim of this study is to determine the changes in knowledge, attitude and practice following intervention programme among smokers in Mukim Peringat, Kelantan.
Materials and Methods: The intervention programme was focused mainly on smoking and it was divided into two different phases. The first phase was centred on community-tailored activities with the intention to educate the respondents in regard to cease smoking habit among them using the slogan “Puasa Rokok Sihat Sokmo”. The second phase was more specific towards sustaining our efforts to tackle smoking in the village for a long term by developing special programme. Our study population was 168 smokers (active and passive) in Mukim Peringat. The inclusion criteria was subjects who were 15 years old and above at the time the study was conducted and subjects who were mentally and physically insufficient was the exclusion criteria. The data were obtained using the interviewer guided validated questionnaire on knowledge, attitude and practice about smoking by Universiti Sains Malaysia researchers group and data were analysed using SPSS version 20.0.
Results: Our results showed that there was significant increment between the pre-intervention and post intervention survey evaluations for knowledge, attitude and practice on smoking. Mean knowledge score was significantly different (p<0.001, 95% CI) with the mean (SD) knowledge score post-intervention [35.52 (5.36)] was higher than pre-intervention [29.12 (7.12)], in which there was a 22.0% increment. For the mean (SD) attitude score post-intervention was higher [26.44 (5.43)] than pre-intervention [24.44 (5.35)] with an 8.2% increment and lastly for the practice part, there was an increase in mean Fagerstrom score (nicotine dependence level) among smokers after intervention.
Conclusion: Our intervention programme has provided the smokers of Mukim Peringat, Kelantan with good foundations on knowledge, attitude and practice on smoking.
The Impact of Body Mass Index on Sickness Absence among Healthcare
Workers in Kuala Selangor in 2012
Azizah Wahab1, Rozita Hod1, Hanizah M Yusoff1, Halim Ismail1, Azmawati M Nawi1, Norfazilah Ahmad1, Zaharah
Zainuddin2
1. Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Malaysia 2. Occupational Health and Safety Unit, Selangor State Health Department, Malaysia
Introduction: Prevalence of obesity among healthcare workers is higher as compared to the general population and the complex nature of the occupational hazards at the health centres may increase the incidence of sickness absence among healthcare workers. Therefore, the aim of this study is to determine the relationship between body mass index (BMI) and sickness absence among healthcare workers.
Materials and Methods: Retrospective record review study was conducted among healthcare workers aged of 40 years old and above in public health centres in Kuala Selangor. A simple random sampling of 174 healthcare workers was selected from a list containing the names of all 203 healthcare workers age 40 years old and above. Data of annual health checks and sickness absence from January to December 2012, were recorded and analysed. All statistical analyses were performed by using Statistical Package for Social Sciences (SPSS), version 20. This study was approved by the Research and Ethics Committee, Medical Faculty Universiti Kebangsaan Malaysia (UKM)(FF-2013-315) and as well as National Medical Research Registry, Ministry of Health (NMRR-13-389-14931).
Results: Out of 173 respondents, 101 (58.3%) took sick leave in the past year with 306 spells and 932 sick-off days. The prevalence of pre-obese and obese was 34.1% and 46.2% respectively and higher BMI was significantly associated with sickness absence (p<0.001). There was a fair positive linear relationship between BMI and duration of sick leave (rs=0.3). Regular fix daytime working hour was also significantly associated with sickness absence
(p=0.003).
Discussion: These study findings confirmed those of previous studies that have shown significant associations of obesity with sickness absence in both sexes. Healthcare workers with high BMI prone to have various health problems such as musculoskeletal disease, cardiovascular disease and cancer which could decrease physical functioning and interfere them in providing good quality of health services.This study also consistent with Ala-Mursula et al. (2005) that found shift workers have significantly lower rates of sickness absence than day workers10
because they have higher control over working schedule than workers with fix daytime working hour. As found by Ishizaki et al. (2006), increased job control and supervisor or co-worker support were significantly associated with lower levels of sickness absence in men. The limitation of this study is the lack of information on other potential confounders such as perceived workload, job autonomy and decision latitude.
Occupational Depression among Employees of Esfahan Steel Company,
Iran: Prevalence and Associated Factors
Masoud Lotfizadeh1& Noor Hassim Ismail2
1. Department of Community Health, Shahrekord University of Medical Sciences, Shahrekord, Iran 2. Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
Introduction:Recently, depression has become one of the most serious community health challenges in the world especially in developing countries and there has been a great deal of public attention on it. Depression is described by changes in state of mind, self-attitude, aware performance, sleep, decreases quality of life, change in appetite, and level of energy. Depression is a common but serious illness, and most humans who practice it need handling to get well. However, this is one of the premier studies about occupational depression among industrial employees in Iran.
Materials and Methods:The aim of the present study is to investigate the prevalence and associated factors of depression among Esfahan Steel Company Employees, Iran. A sample of 400 males between the ages of 20 and 58, from the operational divisions of an Iranian steel company took part in the current study. The participants who provide data in this study were all the full time employees in Esfahan steel company (ESCO), IRAN and the design used in this study is cross-sectional carried out in 2008. The depression, anxiety, and stress scale (DASS) were selected for this research. The questionnaires were filled out through interviews and all the questionnaires were anonymous, informed written consents were taken from the participants and the manager of ESCO as well. The collected data were analyzed by using SPSS version 18.
Results: The prevalence of depression was 70.8%. Analyses did not exhibit significant relationship between depression and age, marital status, experience, literacy and shift work. Conversely, high significant relationship was found between income, work position, family related problems, work environment, job position and depression. Multivariate logistic regression showed that financial problems were the most common reasons for depression among the employees and the main contributors to depression were work environment, task type, financial problems and the income below 500 US $ (p<0.05).
Discussion: Based on the results of the study, about three quarters of the ESCO employees suffer from symptoms of depression compared with other industrialized countries, Iranian employees appeared to have much higher prevalence of depression.
Publication of Simplified Version of Cancer Material
Nosidawati Abdul Gani1, Latiffah Abdul Latiff1,4, Othman Omar2, Mazanah Muhammad3
1. Cancer Resource & Education Center (CaRE), Universiti Putra Malaysia, Malaysia 2. Malaysian Foundation for Innovation, Cyberjaya, Malaysia
3. Faculty of Educational Studies, Universiti Putra Malaysia, Malaysia
4. Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia
Introduction: Information is important for cancer patients and their caregivers. This information ought to be tailored based on the culture and literacy of the patients. This paper deliberates on the publication of educational materials appropriate for Malaysians cancer patients. A survey in 2005 on the booklets prepared by Universiti Putra Malaysia (UPM)-Cornell Collaboration Cancer Education & Research (CaEd) project showed that there is a need to have a more simplified version of this education material (Othman et al. 2008). Thus, CaEd project initiated the development of simplified versions of education materials in 8 titles.
Material and Methods:The CaEd project booklets were adapted and translated from the education material of the American Cancer Society. A questionnaire was used to assess the feedback on the appropriateness of the booklets. The custom design instrument consisted of 40 likert scale questions. The instrument consisted of 5 sections including content, design, visual, overall, and demography. The booklets were distributed randomly between 48 cancer survivors and their caregivers. Descriptive statistics were used to analyse the data.
Results: The results showed that the majority of readers (98%) clearly understood the content, 100% liked the cover, color, font size, and size of the booklet and 100% found the booklet informative and useful. The feedback also pointed out the need for further improvement of visuals, adding glossary for difficult words and booklet development into other major languages in Malaysia.
Discussion:Although the booklet was found acceptable to cancer survivors in terms of content and appearance, amendments should be done to the booklet especially in terms of the visuals based on the reader’s feedback. It is important to meet the needs of readers in order to bridge the gap in health communication.
Conclusion: The participation of target audience will reflect better to them to make informed decisions. Both patients and health professional involvement are required to produce effective educational material (Kavin et al. 2011).
Prevalence of Metabolic Syndrome and Combat Related and
Psychological Risk Factors among Military Personnel Aged 30-55 Years
in Sri Lanka Light Infantry Regiment of Sri Lankan Army
Chathurani M Wickramaarachchi1, Pushpa Fonseka2, Nimalka K Ariyaratne3
1. Postgraduate Institute of Medicine, University of Colombo, Sri Lanka 2. Faculty of Medicine, University of Sri Jayawardhanapura, Sri Lanka 3. Military Hospital, Colombo 05, Sri Lanka
Introduction: Economic, nutritional and demographic transition hand in hand had led to a change from traditional communicable disease burden to more modernized non communicable disease (NCD) modality. Thus, this epidemiological transition has a great impact on lives of mankind leading to more life style related diseases (Popkin 2002). NCD is accountable to majority of global disease burden. Globally in 2000, 59% of deaths were due to NCD (WHO 2001). Four fifths of deaths from NCD occur in lower and middle income countries (WHO 2005). Mortality rates due to NCD are higher in Sri Lanka in comparison to developed countries. In 2008, NCDs were estimated to account for 66.8% of deaths among males and 51.1% of deaths among female in Sri Lanka (WHO 2011). Metabolic Syndrome is an important indicator of NCDs which is a constellation of obesity, hyperglycemia, decreased High Density Lipoprotein (HDL-c), increased Triglyceride (TG) and high blood pressure (Magliano et al. 2006). Metabolic Syndrome is an emerging concern of public health importance. Its positive association with coronary vascular diseases, stroke and diabetes is evident. Substantial evidence indicates that psychological factors are independent risk factors for chronic physical illnesses (Sundaram et al. 2007; Todaro et al. 2003). The objective of this study is to the determine prevalence of Metabolic Syndrome and combat related and psychological risk factors among military personnel aged 30-55 years in Sri Lanka Light Infantry regiment of Sri Lankan Army.
Materials and methods: A population-based cross sectional study was conducted in 2012 to obtain details on Metabolic Syndrome and its associates. A case control study was done in the subsequent step in order to determine combat related and psychological risk factors. Metabolic Syndrome was defined according to American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) definition (Grundy et al 2005). Data were collected using a pre-tested interviewer administered questionnaire on demographic and life style factors. A total of 673 subjects (response rate 98.7%) aged 30-55 years (mean 35.0±3.9) were screened with a physical examination and blood tests. Arterial blood pressure, weight, height, body mass index and waist circumference were measured by standard methods. Fasting Blood Sugar and Lipid profile consisting of HDL and Triglyceride were obtained from military data system.
Conclusion:
Prevalence of Metabolic Syndrome is comparatively high in this population. Depression, distress and severe battle casualty were reported as risk factors for Metabolic Syndrome.
Acknowledgements: Director Army Medical Services, Consultant Pathologist, Consultant Psychiatrist from Sri Lankan Army.
Prevalence of Obstructive Sleep Apnoea among Commercial Truck
Drivers
Wahida Ameer Batcha, Ilhamah Othman, Mohamad Suffian Ahmad, Norlen Mohamed
Vehicle Safety and Biomechanics Research Centre, Malaysian Institute of Road Safety Research, Malaysia
Introduction:Obstructive Sleep Apnoea (OSA) has been recognised as one of significant risk factors of road traffic accident. In Malaysia, the prevalence of OSA among commercial truck driver is not known. Therefore, this study was aimed to identify the prevalence of OSA among commercial truck drivers.
Materials and Methods:A cross sectional study was conducted over a three-month period in 2012. The population of this study was commercial truck drivers travelling within Peninsular Malaysia. Respondents were commercial truck drivers selected from a fleet company operated in Klang Valley. A validated Berlin questionnaire was used as screening tools to identify commercial truck drivers who were at risk of developing OSA.
Results: A total of 130 commercial truck drivers participated in this study and were screened using Berlin questionnaire. All respondents were male, age ranged from 22 to 70 years with an average of 38.9 (±10.7) years old. Screening of OSA based on Berlin questionnaire revealed that about 14.6% of drivers were categorised as having high risk of OSA while 85.4% were having low risk of OSA. Comparison of individual variables between high and low risk of OSA found that the (mean ± SD and p value) for BMI (30.6 ± 3.8, p<0.001) and neck circumference (40.9 ± 2.4, p<0.001) were significantly higher among those with high risk of OSA than the low risk group. This finding is consistent with other studies that had proven a clearly established relation of BMI and OSA. Besides BMI, drivers with high risk of OSA also recorded larger neck circumference. Downey et al. (2009) stated that a neck circumference of 40 cm or greater had a sensitivity of 61 per cent and specificity of 93 per cent for having OSA.
Conclusion:The prevalence of OSA among the commercial truck drivers as reported by our study is alarming. The findings also indicate that BMI and neck circumference could be positive predictors to screen drivers with OSA. Therefore, early detection and treatment of OSA among commercial truck drivers are important preventive measures in reducing the risk of road traffic accidents.
Musculoskeletal Problems among Agricultural Workers in FELDA Sungai
Kelamah, Gemas, Negeri Sembilan
Mohd Dzulkhairi Mohd Rani, Zairina A Rahman, Mohd Yunus Abdullah, Nooriah Mohamed Salleh
Community Health Unit, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Ampang, Malaysia
Introduction: Musculoskeletal problems (MSP) include a diversity of complaints and diseases involving the joints, bones, cartilages, ligaments, tendons, tendon sheaths, bursae and muscles. Work-related musculoskeletal problems are an inevitable consequence of strenous activities in agricultural labor. Thus, to ensure a stable and continuous production of the agriculture especially in the palm oil and rubber estates, MSP should be addressed properly. Hence, the aims of this study are to determine the prevalence of MSP and its association with socio-demographic profile, anthropometric factors, occupational factors and ergonomics, as well as the health seeking behaviours among agricultural workers in FELDA Sungai Kelamah, Gemas, Negeri Sembilan.
Materials and Methods: A cross-sectional study was conducted among adult rubber tappers and palm oil workers from FELDA Sungai Kelamah, Negeri Sembilan, using simple random sampling method. The sample size was calculated using OpenEpi sofware and the minimum sample size determined was 167 with 95% confidence interval. Data for this study were collected from 168 respondents by using pre-tested, self-constructed questionnaire which was modified from established Extended Nordic Musculoskeletal Questionnaire (NMQ-E) through face-to-face interview using validated questionnaire. Data analysis was done using IBM Statistics software version 20.
Results: The prevalence of MSP was 55.4% with the most affected body part was lower back (33.7%), followed by knee (26.2%) and shoulder (25.0%). There was significant association between prevalence of MSP with BMI (p=0.050), working hours (p=0.034), working days per week (p=0.048), and number of trees worked per day (p=0.018). However, there was no significant association between prevalence of MSP with age (p=0.800), working years (p=0.844), working at trees posture (p=0.586), lifting posture (p=0.918), carrying posture (p=0.163) and occupation (p=0.869). Most respondents chose government clinics as their primary choice of treatment (44.6%) and 86.1% of respondents stated that service provided at government health care centre is good.
