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Lim KH, Cheong YL, Lim HL, Cheong KC, Hashim MHM, Marine AA, Cheah YK, Lim JH, Mohd Ghazali S. Validity and reliability of the Malay language Perception Towards Smoking Questionnaire (BM-PTSQ) among secondary school adolescents: Further validation using Confirmatory Factor Analysis. Tob Induc Dis 2024; 22:TID-22-25. [PMID: 38268983 PMCID: PMC10807019 DOI: 10.18332/tid/176164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Perception is an essential factor influencing smoking among adolescents. Thus, a valid tool for measuring perception is a requisite in smoking studies. This study further establishes the validity and reliability of a Malay language version of the Perception Towards Smoking Questionnaire (BM-PTSQ) for assessing the perception of smoking among secondary school-going adolescents in Malaysia. METHODS We administered the BM-PTSQ to 669 secondary school students selected through multistage sampling; 60% of respondents were male (n=398), and 69.9% (n=463) were from rural areas. Respondents were aged 13-16 years, 36.4% (n=241) were 13 years, 40.0% (n=265) were 14 years, and 23.6% (n=156) were 16 years old. We used parallel and exploratory factor analysis (EFA) to determine the domains of the questionnaire. In addition, we also employed EFA, confirmatory factor analyses (CFA), and Cronbach's alpha to evaluate the construct validity and reliability of the BM-PTSQ. RESULTS EFA and parallel analysis identified two domains in the BM-PTSQ that accounted for 62.9% of the observed variance, and CFA confirmed the two-domain structure. The two domains' internal consistency scores ranged from 0.702 to 0.80, which suggested adequate reliability. CONCLUSIONS The BM-PTSQ has acceptable psychometric validity and is appropriate for assessing smoking perception and intention among Malaysian secondary school-aged youth. Researchers should further evaluate this tool's applicability in a more sociodemographically diverse population.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Ministry of Health Malaysia, Johor Bahru, Malaysia
| | - Kee Chee Cheong
- Department of Biostatistics, and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Mohd Hazilas Mat Hashim
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Ali Aman Marine
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Putrajaya Hospital, Putrajaya, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Cheah YK, Zainuddin NH, Kee CC, Lim KH, Omar MA, Cheong YL. Lifestyles and Sexual Behaviour Among School-Going Adolescents: A Mediational Role of Mental Health. Clin Child Psychol Psychiatry 2023; 28:1341-1357. [PMID: 36428238 DOI: 10.1177/13591045221142497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Sexual behaviour and mental health among adolescents are major public health issues. This study examines how lifestyles affect sexual behaviour among school-going adolescents in Malaysia, and the potential mediational role of mental health. It is the first to our knowledge to explore the mediating effect of mental health on sexual behaviour with a focus on a fast-growing developing country. Data were obtained from the National Health and Morbidity Survey 2017 (n = 27,497). Structural equation modelling was utilized to examine depression and anxiety as mediators of the relationships between sexual behaviour and smoking, alcohol drinking and illicit drug use, controlling for sociodemographic factors. Results showed that adolescents who smoked, consumed alcohol, used illicit drugs, and had depression and anxiety were more likely to engage in sexual behaviour than others. Depression and anxiety partially mediated the relationships between sexual behaviour and smoking, and illicit drug use. The association between alcohol drinking and sexual behaviour was fully mediated by depression and anxiety. In conclusion, lifestyles may affect sexual behaviour through mediation of mental health. Therefore, policymakers should take mental health factors into consideration when designing adolescent sexual behaviour preventative interventions.
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Affiliation(s)
- Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Sintok, Kedah, Malaysia
| | - Nabilah Hanis Zainuddin
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Kuang Hock Lim
- Special Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Yoon Ling Cheong
- Special Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
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Teh CH, Rampal S, Lim KH, Omar A, Aris T. Age, period, and cohort analysis of smoking intensity among current smokers in Malaysia, 1996-2015. Nicotine Tob Res 2023:7069853. [PMID: 36879440 DOI: 10.1093/ntr/ntad035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Indexed: 03/08/2023]
Abstract
INTRODUCTION Tobacco use is one of the major preventable risk factors for premature death and disability worldwide. Understanding the trend of tobacco use over time is important for informed policymaking. METHODS The present study used an age-period-cohort (APC) approach to examine the changes in mean daily cigarette consumption among random samples of the Malaysian current smoker population over 20 years. We conducted APC analysis using a multilevel Hierarchical Age-Period-Cohort (HAPC) model and data from four nationally representative, repeated cross-sectional surveys (National Health and Morbidity Survey) conducted in 1996, 2006, 2011, and 2015 among individuals aged 18 to 80 years. Analyses were also stratified by gender and ethnicity. RESULTS Overall, mean daily cigarette consumption (smoking intensity) among current smokers increased with age until 60, after which a drop was observed. There were increases in daily cigarette consumption across birth cohorts. Age and cohort trends did not vary by gender but by ethnicity. The decreasing cigarette consumption after age 60 among the current smoker population was consistent with those observed among the Chinese and Indians, a trend that was not observed in Malays and other aborigines. In contrast, the increasing cohort trend was consistent with those observed among the Malays and other bumiputras. CONCLUSION The present study highlighted important ethnic-specific trends for mean daily cigarette consumption among the current smoker population in Malaysia. These findings are essential in guiding the formulation of interventional strategies or implementation of national tobacco control policies and help achieve the Ministry of Health Malaysia's 2025 and 2045 targets for smoking prevalence. IMPLICATIONS This is the first APC study on smoking intensity among current smokers in a multiracial, middle-income nation. Very few studies had performed gender- and ethnic-stratified APC analyses. The ethnic-stratified APC analyses provide useful insights into the overall age and cohort trends observed among the current smoker population in Malaysia. Therefore, the present study could add evidence to the existing literature on the APC trends of smoking intensity. The APC trends are also important in guiding the government to develop, implement, and evaluate anti-smoking strategies.
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Affiliation(s)
- Chien Huey Teh
- Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.,Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170 Setia Alam, Malaysia
| | - Sanjay Rampal
- Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170 Setia Alam, Malaysia
| | - Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, 40170 Setia Alam, Malaysia
| | - Tahir Aris
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170 Setia Alam, Malaysia
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Lim KH, Yun YX, Cheong YL, Sulaiman N, Mahadzir ME, Lim JH, Hashim MHM, Lim HL. Construct validity and reliability of the Malay version of the Fagerström test for nicotine dependence (FTND): A confirmatory factor analysis. Tob Induc Dis 2023; 21:36. [PMID: 36909814 PMCID: PMC9993235 DOI: 10.18332/tid/159624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/11/2022] [Accepted: 01/21/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION The Fagerström test for nicotine dependence (FTND) was forward-backwards translated into the Malay language (FTND-M) and administered to 152 daily smokers who sought treatment for smoking cessation in government health clinics in Selangor state, Malaysia. METHODS Using confirmatory factor analysis (CFA), four measurement models with the best relative fit were compared, one uni-dimensional model, and three different two-domain (morning and daytime smoking) models. RESULTS The findings indicate that the best model of the FTND-M was a two-domain model, wherein domain one represented morning smoking (time to first cigarette of the day, smoking more in the morning, and which cigarette would you hate to give up) and domain two represented daytime smoking (cigarettes per day, difficulty refraining from smoking, and smoking when ill) which showed good model fit [χ2/df=1.932, goodness of fit (GFI) of 0.967, comparative fix index (CFI) of 0.945, incremental fit index (IFI) of 0.98, Tucker-Lewis index (TLI) of 0.95 and a real mean square end of approximation (RMSEA) of 0.079, and substantial reliability >0.70]. CONCLUSIONS This study indicates that the FTND-M can be used to assess these two dimensions of nicotine addiction among daily smokers in a clinical setting.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Yah Xin Yun
- Selangor Pharmacy Enforcement Branch, Selangor State Health Department, Selangor, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Mas Eliana Mahadzir
- Pharmacy Department, Shah Alam Hospital, Shah Alam, Malaysia.,Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Putrajaya Hospital, Putrajaya, Malaysia
| | | | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
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Lim KH, Cheong YL, Sulaiman N, Yah XY, Mahadzir ME, Lim JH, Kee CC, Mohd Ghazali S, Lim HL. Agreement between the Fagerström test for nicotine
dependence (FTND) and the heaviness of smoking index
(HSI) for assessing the intensity of nicotine dependence
among daily smokers. Tob Induc Dis 2022; 20:105. [DOI: 10.18332/tid/155376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/18/2022] [Accepted: 10/13/2022] [Indexed: 11/27/2022] Open
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Mohd Yusoff MF, Lim KH, Saminathan TA, Rodzlan Hasani WS, Robert Lourdes TG, Ghazali SM, Abd Hamid HA, Ab Majid NL, Mat Rifin H, Miaw Yn JL. The pattern in prevalence and sociodemographic factors
of smoking in Malaysia, 2011–2019: Findings from national
surveys. Tob Induc Dis 2022; 20:84. [PMID: 36249344 PMCID: PMC9521184 DOI: 10.18332/tid/152410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/11/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Smoking is a major contributor to morbidity and mortality worldwide, with Malaysia no exception. Through the Ministry of Health and other ministries in the government of Malaysia, numerous anti-smoking measures have been introduced to prevent and control smoking in the country. Continuous monitoring of smoking prevalence in the community is essential in order to evaluate the effectiveness of anti-smoking policies. This study aims to update the sociodemographic factors associated with smoking in the past decade in Malaysia. METHODS The study utilized data from three national household surveys in Malaysia, namely the Global Adult Tobacco Survey (GATS) 2011, the National Health and Morbidity Survey (NHMS) 2015 and the National Health and Morbidity Survey (NHMS) 2019. These surveys adopted a multistage stratified sampling design that represents the population in Malaysia. Smoking status was determined based on the GATS protocol and definitions. Complex sample design estimates and complex multivariable logistic regression were used in the analysis. RESULTS A total of 4250, 21410 and 11111 respondents aged ≥15 years participated in GATS 2011, NHMS 2015 and NHMS 2019, respectively, with a response rate between 85% and 87%. The prevalence of smoking was 23.1% (95% CI: 21.2–25.2) in 2011, 22.8% (95% CI: 21.9–23.8) in 2015 and 21.3% (95% CI: 19.9–22.8) in 2019. The prevalence was consistently higher in males (40.5–43.9%), adults aged 25–44 years (25.4–29.0%), Malay (22.6–24.7%), other ethnicities (30.0–35.0%), and the self-employed (33.7–44.6%). Multiple logistic regression analysis showed that the adjusted odds ratio (AOR) of smoking was higher in males, in younger and middle age groups, Malays, and those with lower education level. CONCLUSIONS There were slight changes in the sociodemographic factors of smoking in the past decade in Malaysia. Stern measures and more aggressive strategies are needed to address all the risk factors in controlling smoking behavior in the country.
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Affiliation(s)
| | - Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | | | | | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Nur Liana Ab Majid
- Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia
| | - Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia
| | - Jane Ling Miaw Yn
- Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia
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Lim KH, Cheong YL, Lim HL, Kee CC, Ghazali SM, Heng PP, Teh CH, Hashim MHM, Cheah YK, Lim JH. Validation of the Malay Version of the Decisional Balance
Inventory (MDBI) among secondary school-going adolescents. Tob Induc Dis 2022; 20:79. [PMID: 36188418 PMCID: PMC9483825 DOI: 10.18332/tid/152409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/05/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Chee Cheong Kee
- Department of Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Yong Kang Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Hospital Putrajaya, Putrajaya, Malaysia
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Lim KH, Dorris C, Thomson A, Ardis M, Devlin B, Gray G. 715 Implementation of Enhanced Recovery After Surgery (ERAS) in Total Laryngectomies. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Aim
The Enhanced Recovery After Surgery (ERAS) protocol for total laryngectomies was first implemented in our tertiary head and neck centre from November 2019. It includes pre-operative carbohydrate loading and an early swallow test which facilitates recommencement of oral intake to improve outcomes. Protocol adherence rate and patient outcomes were measured to determine the effectiveness and benefits of ERAS in laryngectomy patients.
Method
22 total laryngectomy patients from November 2019 to September 2021 were enrolled onto the ERAS protocol, 18 primary and 3 salvage cases. An analysis of the respective patient cohorts was performed to determine adherence to the ERAS protocol and outcomes such as complications and length of inpatient stay were measured.
Results
19 patients (86%) received pre-operative carbohydrate loading successfully, while 3 patients were contraindicated due to background of diabetes. Early swallow test was performed in 59% of patients. Potential reasons for delay were stoma dehiscence or clinical suspicion of neo-pharyngeal leak. 59% of primary cases were deemed medically fit for discharge within the target timeframe of 12–14 days whereas no target was set for salvage cases due to expected poor healing. Main complication in primary cases was neo-pharyngeal leak followed by stoma dehiscence with 28% and 11% respectively.
Conclusion
Limitations of our study include small sample size due to the COVID-19 pandemic. Despite its infancy, the ERAS protocol has achieved good outcomes in early recommencement of oral intake post-laryngectomy and encouraging early safe discharge from hospital. Future plans include establishment of Prehab Clinic and application of ERAS to neck dissection patients.
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Affiliation(s)
- KH Lim
- Royal Victoria Hospital , Belfast , United Kingdom
| | - C Dorris
- Royal Victoria Hospital , Belfast , United Kingdom
| | - A Thomson
- Royal Victoria Hospital , Belfast , United Kingdom
| | - M Ardis
- Royal Victoria Hospital , Belfast , United Kingdom
| | - B Devlin
- Royal Victoria Hospital , Belfast , United Kingdom
| | - G Gray
- Royal Victoria Hospital , Belfast , United Kingdom
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Cheah YK, Lim KK, Ismail H, Salleh R, Kee CC, Lim KH, Cheong YL. Awareness of Body Mass Index and Its Associated Factors: A Cross-Sectional Study. Nurs Health Sci 2022; 24:726-734. [PMID: 35785425 DOI: 10.1111/nhs.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 11/28/2022]
Abstract
This study explores the correlates of sociodemographic factors, smoking and caloric knowledge to body mass index awareness with a focus on Malaysia. Logistic regressions were estimated to examine sociodemographic factors associated with body mass index awareness. More than half of respondents were unaware of their body mass index (54.8%). Age was negatively associated with body mass index awareness (aOR: 0.993, 95% CI: 0.984, 1.001). Adults without formal education were less likely to know their body mass index than those with tertiary-level education (aOR: 0.279, 95% CI: 0.170, 0.457). Adults were less likely to be aware of their body mass index if they engaged in smoking (aOR: 0.779, 95% CI: 0.594, 1.023). Adults with knowledge of the definition of calories were more aware of their body mass index than others (aOR: 2.224, 95% CI: 1.805, 2.742). The findings emphasise the urgent need for a forthcoming sociodemographic factors-specific policy directed towards improving body mass index awareness to lower the prevalence of obesity in Malaysia.
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Affiliation(s)
- Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Sintok, Kedah, Malaysia
| | - Kuang Kuay Lim
- Centre for Occupational Health Research, Institute for Public Health, Ministry of Health Malaysia, No. 1, Jln Setia Murni U13/52, Seksyen U13, Shah Alam, Selangor, Malaysia
| | - Hasimah Ismail
- Centre for Non-Communicable Diseases Research, Institute for Public Health, Ministry of Health Malaysia, No. 1, Jln Setia Murni U13/52, Seksyen U13, Shah Alam, Selangor, Malaysia
| | - Ruhaya Salleh
- Centre for Nutrition Epidemiology Research, Institute for Public Health, Ministry of Health Malaysia, No. 1, Jln Setia Murni U13/52, Seksyen U13, Shah Alam, Selangor, Malaysia
| | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, No. 1, Jln Setia Murni U13/52, Seksyen U13, Shah Alam, Selangor, Malaysia
| | - Kuang Hock Lim
- Special Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Yoon Ling Cheong
- Special Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
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Lim KH, Cheong YL, Lim HL, Ghazali SM, Kee CC, Cheah YK, Heng PP, Hashim MHM, Tan CV, Lim JH. Correlates of dual/poly tobacco use among school-going
adolescents in Malaysia: Findings from a nationwide school-based
study. Tob Induc Dis 2022; 20:52. [PMID: 35733644 PMCID: PMC9164214 DOI: 10.18332/tid/148247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Dual/poly tobacco use is common among youths globally. However, in Malaysia information on dual/poly tobacco use is scarce, thus the present study examines the prevalence and factors associated with dual/poly tobacco users among school-going adolescents in Malaysia. METHODS We derived data on tobacco and e-cigarette use among Malaysian adolescents from a nationwide school-based study conducted in 2016. A total of 13135 adolescents responded in the cross-sectional survey which used multi-stage sampling to select a representative sample of school-going adolescents aged 11–19 years. A standard validated questionnaire was used to obtain the data and multiple logistic regression was conducted to assess factors associated with dual/ poly tobacco use. RESULTS The prevalence of dual/poly tobacco use was 6.5%, more than half of which were both conventional and e-cigarette users. Multivariable logistic regression revealed that the likelihood of dual tobacco use was significantly higher among males (AOR=14.73; 95% CI: 9.11–23.81), secondary school students, those aged 16–19 years (AOR=5.99; 95% CI: 4.04–8.87), natives of Sabah (AOR=7.41; 95% CI: 3.48–15.79), and those never been taught on the health hazards of tobacco at school, exposed to secondhand smoke (SHS) at home, school or other public areas, and had a positive perception of e-cigarettes and lower perception of the harms of tobacco smoking. CONCLUSIONS Although the prevalence of dual/poly users was still low among Malaysian school-going adolescents, proactive measures should be taken to reduce dual tobacco use among youth in Malaysia with focus on the factors identified in this study.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Department of Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Yong Kang Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Cia Vei Tan
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Hospital Putrajaya, Putrajaya, Malaysia
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Lim KH, Cheong YL, Lim HL, Kee CC, Ghazali SM, Pradmahan Singh BSG, Omar MA, Hashim MHM, Cheah YK, Lim JH. Assessment of association between smoking and all-cause
mortality among Malaysian adult population: Findings from a
retrospective cohort study. Tob Induc Dis 2022; 20:50. [PMID: 35702648 PMCID: PMC9150905 DOI: 10.18332/tid/147656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/22/2022] [Accepted: 03/23/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Smoking is a known risk factor for many chronic diseases. Illness and death due to smoking are a significant public health burden in many countries. This study aims to address the information gap in smoking-related mortality in Malaysia by estimating the risk of cardiovascular disease and all-cause mortalities due to smoking among Malaysian adults. METHODS We analyzed data on 2525 respondents, aged 24–64 years, of the Malaysian Non-Communicable Disease Surveillance survey conducted September 2005 to February 2006. Mortality records from the Malaysian National Registration Department were linked to the MYNCDS-1 data to determine respondents’ mortality status over 12 years from 2006 to 2018. Associations between smoking and all-cause mortalities were assessed using Cox proportional hazards regression with adjustments for non-communicable disease and sociodemographic and lifestyle factors. RESULTS The prevalence of daily smoking was 21.2% (95% CI: 19.0–23.7). During the 31668 person-years follow-up, 213 deaths from all causes occurred, where 68 deaths were among smokers (13.2%), and 452 were among non-smokers (6.3%). Smoking was associated with a significantly increased risk of all-cause mortality (adjusted hazard ration, AHR=1.79; 95% CI: 1.12– 2.97). These associations remained significant after excluding mortalities in the first two years of follow-up. CONCLUSIONS Daily smoking is associated with a significantly higher risk of all-cause death. Behavioral and pharmacological smoking cessation interventions should be intensified among smokers to reduce the risk of mortality.
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Affiliation(s)
| | | | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Chee Cheong Kee
- Department of Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | | | | | - Mohd Azahadi Omar
- Department of Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | | | - Yong Kang Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Hospital Putrajaya, Putrajaya, Malaysia
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Cheong YL, Ghazali SM, Che Ibrahim MKB, Kee CC, Md Iderus NH, Ruslan QB, Gill BS, Lee FCH, Lim KH. Assessing the Spatiotemporal Spread Pattern of the COVID-19 Pandemic in Malaysia. Front Public Health 2022; 10:836358. [PMID: 35309230 PMCID: PMC8931737 DOI: 10.3389/fpubh.2022.836358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction The unprecedented COVID-19 pandemic has greatly affected human health and socioeconomic backgrounds. This study examined the spatiotemporal spread pattern of the COVID-19 pandemic in Malaysia from the index case to 291,774 cases in 13 months, emphasizing on the spatial autocorrelation of the high-risk cluster events and the spatial scan clustering pattern of transmission. Methodology We obtained the confirmed cases and deaths of COVID-19 in Malaysia from the official GitHub repository of Malaysia's Ministry of Health from January 25, 2020 to February 24, 2021, 1 day before the national vaccination program was initiated. All analyses were based on the daily cumulated cases, which are derived from the sum of retrospective 7 days and the current day for smoothing purposes. We examined the daily global, local spatial autocorrelation and scan statistics of COVID-19 cases at district level using Moran's I and SaTScan™. Results At the initial stage of the outbreak, Moran's I index > 0.5 (p < 0.05) was observed. Local Moran's I depicted the high-high cluster risk expanded from west to east of Malaysia. The cases surged exponentially after September 2020, with the high-high cluster in Sabah, from Kinabatangan on September 1 (cumulative cases = 9,354; Moran's I = 0.34; p < 0.05), to 11 districts on October 19 (cumulative cases = 21,363, Moran's I = 0.52, p < 0.05). The most likely cluster identified from space-time scanning was centered in Jasin, Melaka (RR = 11.93; p < 0.001) which encompassed 36 districts with a radius of 178.8 km, from November 24, 2020 to February 24, 2021, followed by the Sabah cluster. Discussion and Conclusion Both analyses complemented each other in depicting underlying spatiotemporal clustering risk, giving detailed space-time spread information at district level. This daily analysis could be valuable insight into real-time reporting of transmission intensity, and alert for the public to avoid visiting the high-risk areas during the pandemic. The spatiotemporal transmission risk pattern could be used to monitor the spread of the pandemic.
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Affiliation(s)
- Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Yoon Ling Cheong
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | | | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nuur Hafizah Md Iderus
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Qistina binti Ruslan
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Balvinder Singh Gill
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Florence Chi Hiong Lee
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Jane Ling MY, Ahmad N, Mohd Yusoff MF, Lim KH. Current e-cigarette use among in-school adolescents in West Malaysia: Examining the interactions between sociodemographic characteristics and lifestyle risk behaviours. PLoS One 2022; 17:e0263355. [PMID: 35100321 PMCID: PMC8803165 DOI: 10.1371/journal.pone.0263355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Adolescent e-cigarette use has increased dramatically. Most e-cigarette liquids contain nicotine, which can harm the developing adolescent brain. Local studies examining the risk factors of adolescent e-cigarette use and interactions between its risk factors are limited. This study was aimed at determining the prevalence of current e-cigarette use and its associated factors among in-school adolescents in West Malaysia. We also examined the possible sociodemographic characteristic, lifestyle risk behaviour and parental factor interactions that affect the probability of current e-cigarette use. Methods We conducted a cross-sectional study using data from the National Health and Morbidity Survey 2017. Respondents aged 13–18 years were included in the study. The data were analysed using STATA (v.15). Results The prevalence of current e-cigarette use was 9.1%. Male gender, older age, Malay ethnicity, schooling in urban area, current smoking, current alcohol use, current drug use, having parents that are not married and living together and parental tobacco product use were significantly associated with current e-cigarette use. There were significant interactions between: i) gender with age, ethnicity, current smoking, current alcohol use and current drug use, ii) ethnicity with current smoking and current alcohol use, iii) locality with ethnicity, current smoking and current alcohol use, iv) current drug use with age, ethnicity, current smoking and current alcohol use, v) parental marital status with gender, age and ethnicity, and vi) parental tobacco use with ethnicity and current smoking. Conclusion Our findings identify significant associations between sociodemographic characteristics, lifestyle risk behaviours and parental factors with current e-cigarette use. They also provide new insight into the interactions between these factors that affect the probability of current e-cigarette use among West Malaysian adolescents. Efforts to tackle e-cigarette use in Malaysian adolescents should target sociodemographic characteristics, lifestyle risk behaviours and parental factors such as smoking cessation intervention for parents.
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Affiliation(s)
- Miaw Yn Jane Ling
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norfazilah Ahmad
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- * E-mail:
| | | | - Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Wee LH, Tee GH, Chan CMH, Draman S, Jamalludin AR, Ho BK, Yn Ling JM, Lim KH, Mohd Yusoff MF, Baharom N, Robson N, Kartiwi M, Ab Rahman NS, Siau CS, Nik Mohamed MH. The Role of Media and Retailer Message Recall on Malaysian Male Perceptions of E-Cigarette Use: The 2016 National Study of E-Cigarettes Prevalence. INQUIRY 2022; 59:469580221079683. [PMID: 35225040 PMCID: PMC8891842 DOI: 10.1177/00469580221079683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the perceptions of current smokers on electronic cigarette (EC) use, after exposure to information on EC use and its potential harms from various media and retail outlets. This cross-sectional study is a sub-analysis of the National Study of Electronic Cigarettes Prevalence (N = 4289) using the multi-stage stratified sampling method. Respondents were interviewed face-to-face by a trained data collector using a structured questionnaire printed in both Bahasa Malaysia and English. The analysis included 376 males who smoked conventional cigarettes and/or used ECs and reported ever seeing messages on ECs/vape in various platforms were analyzed using weighted simple and multiple logistic regression. Our findings showed different media types resulted in differing perceptions among smokers towards EC use especially between social media and conventional media. Those exposed to messages promoting EC in social media had higher odds of believing that ECs help people quit smoking (OR: 2.28), the urge to smoke is reduced by ECs (OR: 1.86), ECs are more effective than medication for quitting smoking (OR: 1.96), breathing is improved after using ECs (OR: 2.85), the smell of EC is better than a tobacco cigarette (OR: 2.73), and ECs should be regulated rather than banned completely (OR: 3.08). Vape shops, social, and conventional media provided very different perceptions among smokers towards EC use. Beyond using traditional communication channels, EC promoters have successfully utilized social media to promote ECs among smokers.
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Affiliation(s)
- Lei Hum Wee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Guat Hiong Tee
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Caryn Mei Hsien Chan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Samsul Draman
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Ab Rahman Jamalludin
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Bee Kiau Ho
- Bandar Botanik Health Centre, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan, Malaysia
| | - Jane Miaw Yn Ling
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Nizam Baharom
- Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| | - Noorzurani Robson
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Mira Kartiwi
- Kulliyyah of ICT, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Norny Syafinaz Ab Rahman
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Ching Sin Siau
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Mohamad Haniki Nik Mohamed
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
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15
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Heng PP, Daud F, Yusoff MFM, Lim KH. Susceptibility to e-cigarette initiation among tobacco product naïve adolescents in Malaysia: Findings from the tobacco and e-cigarette survey among Malaysian adolescents (TECMA). Tob Induc Dis 2021; 19:89. [PMID: 34887718 PMCID: PMC8611510 DOI: 10.18332/tid/142900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Predicting susceptibility to e-cigarette (EC) initiation among adolescents is crucial to optimize preventive measures before the health risk behavior persists through adulthood. The identification of susceptible groups is needed in response to the surge of EC use. This study aimed to determine the prevalence and determinants associated with EC susceptibility among tobacco product naïve (never users of any single tobacco product) school-going adolescents in Malaysia. METHODS Data were derived from the Tobacco and EC Survey among Malaysians (TECMA), which recruited a total of 13162 school-going adolescents aged 10– 19 years from 138 randomly selected schools via a two-stage stratified cluster sampling design. A validated self-administered questionnaire adapted from the Global Youth Tobacco Survey was utilized as the study instrument. The data were analyzed using SPSS version 22.0 descriptively and with multivariable logistic regression to determine the associated factors of EC susceptibility. RESULTS About 15.7% of the tobacco naïve adolescents were susceptible to EC initiation, with the proportion of susceptibility significantly higher among males, mid-adolescents, rural adolescents, those reporting exposure to tobacco advertisement and those not taught in school about the danger of tobacco use. Multivariable logistic regression revealed that the male students (AOR=2.20; 95% CI: 1.86–2.59) from a rural locality (AOR=1.45; 95% CI: 1.23–1.71), those reporting no lessons on the danger of tobacco use at school (AOR=1.66; 95% CI: 1.39–1.99) and those exposed to tobacco advertisement (AOR=1.67; 95% CI: 1.07–2.61), were more susceptible to EC initiation, while no significant association was found between secondhand smoke exposure and EC susceptibility. CONCLUSIONS Comprehensive EC preventive strategies are critically needed together with the implementation of targeted, gender, and culturally impressionable interventions. In addition, future studies should focus on the evaluation of the impacts of the preventive and control efforts to ensure their effectiveness in preventing EC initiation among Malaysian adolescents.
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Affiliation(s)
- Pei Pei Heng
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.,Institute for Public Health, National Institutes of Health, Setia Alam, Malaysia
| | - Faiz Daud
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | | | - Kuang Hock Lim
- Institute for Public Health, National Institutes of Health, Setia Alam, Malaysia
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Cheah YK, Kee CC, Lim KH, Omar MA. Mental health and truancy among high school students in Malaysia: A comparison between ethnic minority groups. Journal of Affective Disorders Reports 2021. [DOI: 10.1016/j.jadr.2021.100285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Tan TL, Tan-Loh J, Chiew SC, Lim KH, Ng WW, Akmal M, Khor SH, Lee LY. Risk factors and outcome of community onset Pseudomonas aeruginosa bacteraemia in two Malaysian district specialist hospitals. Med J Malaysia 2021; 76:820-827. [PMID: 34806667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Despite the ever-growing number of community onset (CO) Pseudomonas aeruginosa (P. aeruginosa) bacteraemia, there is a dearth of district hospital-based research examining this significant infection, which is associated with high mortality. The objectives of this study were as following: (1) to determine the risk factors of CO P. aeruginosa bacteraemia, (2) to compare the 30-day mortality rate between P. aeruginosa and Escherichia coli bacteraemia and (3) to identify the predictors of 30-day mortality for CO gram negative bacteraemia. METHODS This is a retrospective case control study in Hospital Seri Manjung and Hospital Teluk Intan, Perak, Malaysia. P. aeruginosa bacteraemia cases that occurred between 1st January 2015 to 31st December 2019 were included, whilst E. coli bacteraemia cases that occurred within the same period were recruited successively until 1:2 case control ratio was achieved. Subjects below 12-year-old and those with polymicrobial bacteraemia were excluded. Demographic, clinical and treatment data were collected using pre-tested data collection forms by trained investigators. RESULTS A total of 61 patients with P. aeruginosa bacteraemia and 122 patients with E. coli bacteraemia were included. Recent admission in the earlier three months, regular haemodialysis, immunosuppressive therapy in the past 30 days, chronic wound/pressure sore at presentation and indwelling urinary catheter at presentation were identified as independent predictors of CO pseudomonal bacteraemia. Whilst older age was identified as a negative predictor of CO Pseudomonal bacteraemia (all p<0.05). The 30-day mortality rate was 34.4% in subjects with P. aeruginosa bacteraemia and 27.0% in those with E. coli bacteraemia (p=0.302). Predictors of 30-day mortality for community onset gram negative bacteraemia were as follow: older age, underlying solid tumours, neutropaenia at presentation, in-patient mechanical ventilation, and inpatient nasogastric tube insertion. Unexpectedly, receipt of inappropriate empirical antibiotics which was switched later (delayed and non-delayed switching) was identified as the negative predictors of mortality (all p<0.05). CONCLUSION It is prudent to restrict the usage of empirical anti-pseudomonal antibiotics among individuals at risk as liberal usage of broad-spectrum antibiotics engenders emergence of drug resistant organism, particularly in district setting where community onset pseudomonal bacteraemia remains scarce. Subjects with elevated risk of mortality should receive early escalation of care as per sepsis management guidelines.
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Affiliation(s)
- T L Tan
- Hospital Seri Manjung, Internal Medicine Department, Perak, Malaysia.
| | - J Tan-Loh
- Hospital Teluk Intan, Internal Medicine Department, Perak, Malaysia
| | - S C Chiew
- Hospital Seri Manjung, Clinical Research Centre, Perak, Malaysia
| | - K H Lim
- Hospital Seri Manjung, Internal Medicine Department, Perak, Malaysia
| | - W W Ng
- Hospital Teluk Intan, Internal Medicine Department, Perak, Malaysia
| | - M Akmal
- Hospital Teluk Intan, Microbiology Department, Perak, Malaysia
| | - S H Khor
- Hospital Seri Manjung, Pathology Department, Microbiology Unit, Perak, Malaysia
| | - L Y Lee
- Hospital Seri Manjung, Internal Medicine Department, Perak, Malaysia
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Cheah YK, Kee CC, Lim KH, Omar MA. Mental health and risk behaviors among secondary school students: A study on ethnic minorities. Pediatr Neonatol 2021; 62:628-637. [PMID: 34353744 DOI: 10.1016/j.pedneo.2021.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/24/2021] [Accepted: 05/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mental health disorders are highly correlated with risk behaviors. The objective of the present study is to examine the relationship between risk behaviors and mental health among school-going students with a focus on ethnic minorities. METHODS The National Health and Morbidity Survey (NHMS) 2017 (n = 8230) was used for analyses. It was a nationwide survey conducted in Malaysia. The dependent variables were measured by three risk behaviors (cigarette smoking, alcohol drinking and use of illicit drugs). Probit regressions were utilized to examine the effect of mental health on the probability of smoking, drinking and using illicit drugs. Demographic and lifestyle factors were used as the control variables. Truancy was identified as a mediating variable. RESULTS Anxiety, depression and suicidal ideation affected cigarette smoking, alcohol drinking and use of illicit drugs through mediation of truancy. After controlling for demographic and lifestyle factors, students with anxiety, depression and suicidal ideation were more likely to smoke, drink and use illicit drugs compared with their peers without any mental health disorders. Furthermore, the likelihood of consuming cigarettes, alcohol and illicit drugs was found to be higher among students who played truant than those who did not. CONCLUSION Mental health plays an important role in determining participation in risk behaviors among ethnic minority students in Malaysia. Public health administrators and schools have to be aware that students who suffer from mental health disorders are likely to indulge in risk behaviors.
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Affiliation(s)
- Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, 06010 UUM Sintok, Kedah Darul Aman, Malaysia.
| | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, No. 1, Jln Setia Murni U13/52, Seksyen U13, 40170 Shah Alam, Selangor, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, No. 1, Jln Setia Murni U13/52, Seksyen U13, 40170 Shah Alam, Selangor, Malaysia
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Lim KH, Lim HL, Mohd Ghazali S, Kee CC, Tain MZ, Cheong YL, Cheah YK, Ismail SA, Heng PP, Lim JH. USING THE THEORY OF REASONED ACTION TO PREDICT SMOKING INTENTION AMONG NON-SMOKING SECONDARY SCHOOL GOING ADOLESCENTS IN PENINSULAR MALAYSIA. MJPHM 2021. [DOI: 10.37268/mjphm/vol.21/no.2/art.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The study aims to determine the relationship of attitude and social-norm with the intention to smoke in the future among non-smoking youth. Data were derived from a study on smoking among form four students in a selected secondary school in Peninsular Malaysia, which utilised a pre-validated questionnaire to obtain data from the selected respondents. Descriptive statistics and structural equation modelling (SEM) were used in data analysis. The study revealed independent variables accounted for 22.6% of the variance in intention to initiate smoking and the model had a good fit. A significant relationship was observed between subjective norm and intention to initiate smoking (R=0.46). The study revealed that attitude and social norm substantially explained intention to smoke among non-smoking adolescents. Future measures should concentrate on correcting the subjective norms to reduce the intention to initiate smoking among non-smoking youth.
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Chee Cheong K, Lim KH, Ghazali SM, Teh CH, Cheah YK, Baharudin A, Lim HL, Abdul Hamid AM, Mustapha FI, Omar MA. Association of metabolic syndrome with risk of cardiovascular disease mortality and all-cause mortality among Malaysian adults: a retrospective cohort study. BMJ Open 2021; 11:e047849. [PMID: 34408040 PMCID: PMC8375738 DOI: 10.1136/bmjopen-2020-047849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES This study is aimed at determining the association between metabolic syndrome and risk of cardiovascular disease (CVD) mortality and all-cause mortality among Malaysian adults. DESIGN Retrospective cohort study. SETTING The Malaysian Non-Communicable Disease Surveillance (MyNCDS-1) 2005/2006. PARTICIPANTS A total of 2525 adults (1013 men and 1512 women), aged 24-64 years, who participated in the MyNCDS-1 2005/2006. METHODS Participants' anthropometric indices, blood pressure, fasting lipid profile and fasting blood glucose levels were evaluated to determine the prevalence of metabolic syndrome by the Harmonized criteria. Participants' mortality status were followed up for 13 years from 2006 to 2018. Mortality data were obtained via record linkage with the Malaysian National Registration Department. The Cox proportional hazards regression model was applied to determine association between metabolic syndrome (MetS) and risk of CVD mortality and all-cause mortality with adjustment for selected sociodemographic and lifestyle behavioural factors. RESULTS The overall point prevalence of MetS was 30.6% (95% CI: 28.0 to 33.3). Total follow-up time was 31 668 person-years with 213 deaths (111 (11.3%) in MetS subjects and 102 (6.1%) in non-MetS subjects) from all-causes, and 50 deaths (33 (2.9%) in MetS group and 17 (1.2%) in non-MetS group) from CVD. Metabolic syndrome was associated with a significantly increased hazard of CVD mortality (adjusted HR: 2.18 (95% CI: 1.03 to 4.61), p=0.041) and all-cause mortality (adjusted HR: 1.47 (95% CI: 1.00 to 2.14), p=0.048). These associations remained significant after excluding mortalities in the first 2 years. CONCLUSIONS Our study shows that individuals with MetS have a higher hazard of death from all-causes and CVD compared with those without MetS. It is thus imperative to prescribe individuals with MetS, a lifestyle intervention along with pharmacological intervention to improve the individual components of MetS and reduce this risk.
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Affiliation(s)
- Kee Chee Cheong
- Sector for Biostatistics & Data Repository, National Institutes of Health, Shah Alam, Selangor, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Setia Alam, Shah Alam, Selangor, Malaysia
| | | | - Chien Huey Teh
- Institute for Medical Research, Setia Alam, Shah Alam, Selangor, Malaysia
| | | | - Azli Baharudin
- Centre for Nutrition Epidemiology Research, Institute for Public Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Hui Li Lim
- Hospital Sultan Ismail, Johor Bahru, Johor Darul Ta'zim, Malaysia
| | - Abdul Muneer Abdul Hamid
- Sector for Biostatistics & Data Repository, National Institutes of Health, Shah Alam, Selangor, Malaysia
| | - Feisul Idzwan Mustapha
- NCD Section, Disease Control Division, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics & Data Repository, National Institutes of Health, Shah Alam, Selangor, Malaysia
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Cheong YL, Rosilawati R, Mohd-Khairuddin CI, Siti-Futri FF, Nur-Ayuni N, Lim KH, Khairul-Asuad M, Mohd-Zahari TH, Mohd-Izral YU, Mohd-Zainuldin T, Nazni WA, Lee HL. PesTrapp mobile app: A trap setting application for real-time entomological field and laboratory study. Trop Biomed 2021; 38:171-179. [PMID: 34172707 DOI: 10.47665/tb.38.2.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Diseases such as malaria, dengue, Zika and chikungunya remain endemic in many countries. Setting and deploying traps to capture the host/vector species are fundamental to understand their density and distributions. Human effort to manage the trap data accurately and timely is an exhaustive endeavour when the study area expands and period prolongs. One stop mobile app to manage and monitor the process of targeted species trapping, from field to laboratory level is still scarce. Toward this end, we developed a new mobile app named "PesTrapp" to acquire the vector density index based on the mobile updates of ovitraps and species information in field and laboratory. This study aimed to highlight the mobile app's development and design, elucidate the practical user experiences of using the app and evaluate the preliminary user assessment of the mobile app. The mobile app was developed using mobile framework and database. User evaluation of the mobile app was based on the adjusted Mobile App Rating Scale and Standardized User Experience Percentile Rank Questionnaire. The process flows of system design and detailed screen layouts were described. The user experiences with and without the app in a project to study Aedes surveillance in six study sites in Selangor, Malaysia were elucidated. The overall mean user evaluation score of the mobile app was 4.0 out of 5 (SD=0.6), reflects its acceptability of the users. The PesTrapp, a one-stop solution, is anticipated to improve the entomological surveillance work processes. This new mobile app can contribute as a tool in the vector control countermeasure strategies.
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Affiliation(s)
- Y L Cheong
- Biomedical Museum Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - R Rosilawati
- Medical Entomology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - C I Mohd-Khairuddin
- Biomedical Research, Strategic & Innovation Management Unit, Institute for Medical Research, Ministry of Health Malaysia, Level 6, Block C6, National Institutes of Health (NIH), Setia Alam Selangor, Malaysia
| | - F F Siti-Futri
- Medical Entomology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - N Nur-Ayuni
- Medical Entomology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - K H Lim
- Biomedical Museum Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - M Khairul-Asuad
- Medical Entomology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - T H Mohd-Zahari
- Biomedical Research, Strategic & Innovation Management Unit, Institute for Medical Research, Ministry of Health Malaysia, Level 6, Block C6, National Institutes of Health (NIH), Setia Alam Selangor, Malaysia
| | - Y U Mohd-Izral
- Biomedical Research, Strategic & Innovation Management Unit, Institute for Medical Research, Ministry of Health Malaysia, Level 6, Block C6, National Institutes of Health (NIH), Setia Alam Selangor, Malaysia
| | - T Mohd-Zainuldin
- Biomedical Museum Unit, Special Resource Centre, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - W A Nazni
- Medical Entomology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - H L Lee
- Medical Entomology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health (NIH), Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
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Lim KH, Ghazali SM, Lim HL, Cheong YL, Kee CC, Heng PP, Tiunh TY, Mat Hashim MH, Lim JH. Prevalence and factors related to secondhand smoke exposure among secondary school-going adolescents in Malaysia: Findings from Malaysia Global Health School Survey 2012 and 2017. Tob Induc Dis 2021; 19:50. [PMID: 34177412 PMCID: PMC8204740 DOI: 10.18332/tid/136029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/15/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Secondhand (SHS) smoke exposure has caused various health problems. Therefore, continuous monitoring of SHS exposure is important to determine the efficacy of various anti-tobacco measure implemented. The study aims to compare the prevalence and factor(s) associated with SHS exposure among secondary school-going adolescents in Malaysia during 2012 and 2017. METHODS We derived data from the Global School Health Survey (GSHS) 2012 and GSHS 2017, which was carried out in Malaysia using multistage sampling to select representative samples of secondary school-going adolescents. Both surveys used similar questionnaires to measure SHS exposure. Descriptive and multivariate logistic regression was used to determine the prevalence and factors associated with SHS exposure. RESULTS Approximately four in ten respondents were exposed to SHS in the past week in both surveys (41.5% in GSHS 2012 and 42.0% in GSHS 2017, respectively). Both surveys revealed a significantly higher SHS exposure among respondents who smoked than among non-smokers and higher among males compared to females. The likelihood of SHS exposure in both surveys was also similar, with a higher likelihood of SHS exposure among smoking adolescents and non-smoking adolescents who had at least one smoking parent/guardian, regardless of their own smoking status. Male adolescents had a higher risk of SHS exposure compared to their female counterparts. Meanwhile, SHS risk also increased with age, regardless of smoking status. CONCLUSIONS Our findings suggested that there were no changes in the prevalence of SHS exposure and recorded only a slight change in the factors associated with exposure to SHS among school-going adolescents in Malaysia between the years 2012 and 2017. A more pro-active, extensive and comprehensive programme should be implemented to address the problem of SHS exposure. Parents should be advised to stop smoking or abstain from smoking in the presence of their children, and smoking cessation interventions are necessary for smoking adolescents and their parents.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Biostatistics and Data Raspatory Sector, National Institutes of Health, Shah Alam, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Tsye Yih Tiunh
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Jia Hui Lim
- Department of Pharmacy and Pharmaceutical Sciences, Monash University Malaysia, Subang Jaya, Malaysia
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Lim KH, Mohd Ghazali S, Lim HL, Heng PP, Kee Chee Cheong, Teh Chien Huey, Cheah Yong Kang, Lim Jia Hui. STAGES OF SMOKING CESSATION AMONG ADULT CURRENT SMOKERS IN MALAYSIA: FINDINGS FROM THE NATIONAL E-CIGARETTE SURVEY 2016. MJPHM 2020. [DOI: 10.37268/mjphm/vol.20/no.2/art.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Identification of the stages of smoking cessation among smokers is essential to improve the rate of smoking cessation. The aims of this study were to determine the prevalence and factors associated with stages of smoking cessation across the demographic distribution of adult smokers in Malaysia. Data were derived from a population-based study among Malaysian adults aged 18 years and above. Face-to-face interviews were carried out by trained staff using a validated questionnaire to obtain data related to smoking from 4,288 selected respondents. Of 4,288, 438 respondents are current smokers. Multivariable logistic regression analysis was used to determine factors associated with stage of smoking cessation. Approximately 60% (n=269/438) of the current smokers were in the pre-contemplation stage and 40% (n=169/438) were in the contemplation and preparation stages of smoking cessation. The proportion of pre-contemplators was higher among smokers with higher levels of nicotine addiction (71.3%), lower education attainment (71.4%), and those who were single/widowed/divorced (66.9%). Multivariable analysis showed that males, and those who reported low to high level of nicotine addiction were more likely to be in the pre-contemplation stage whilst those in the older age groups were more likely to be in the advanced stage of smoking cessation. The study revealed that the majority of current smokers in Malaysia had no intention to quit smoking within 6 months. Specific interventions targeting males, young adults and smokers with low to high nicotine addiction should be introduced to ensure the smokers proceed to the advanced stage of smoking cessation.
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Lim KH, Heng PP, Nik Mohamed MH, Teh CH, Mohd Yusoff MF, Ling JMY, Baharom N, Wee LH, Chan CMH, Ho BK, Robson Z, Draman S, Ab Rahman NS, Kartiwi M, Ab Rahman J. Prevalence and Factors Associated With Attempts to Quit and Smoking Cessation in Malaysia. Asia Pac J Public Health 2020; 31:22S-31S. [PMID: 31802718 DOI: 10.1177/1010539519874944] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Smoking cessation significantly reduces risk of smoking-related diseases and mortality. This study aims to determine the prevalence and factors associated with attempts to quit and smoking cessation among adult current smokers in Malaysia. Data from the National E-Cigarette Survey 2016 were analyzed. Forty nine percent of current smokers had attempted to quit at least once in the past 12 months and 31.4% of the respondents were former smokers. Multivariable analysis revealed that current smokers with low nicotine addiction and aged below 45 years were more likely to attempt to quit smoking. Being married, older age group, and having tertiary education were significantly associated with smoking cessation. Only half of the current smokers ever attempted to quit smoking and only a third of smokers quit. Stronger tobacco control policies are needed in Malaysia to encourage more smokers to quit smoking. Improved access to cessation support for underprivileged smokers is also needed.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Jane Miaw Yn Ling
- Institute of Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Nizam Baharom
- Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Bee Kiau Ho
- Klinik Kesihatan Bandar Botanik, Klang, Malaysia
| | | | - Samsul Draman
- International Islamic University Malaysia, Kuantan, Malaysia
| | | | - Mira Kartiwi
- International Islamic University Malaysia, Kuantan, Malaysia
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Cvasciuc IT, Gull S, Oprean R, Lim KH, Eatock F. Changing pattern of pheochromocytoma and paraganglioma in a stable UK population. Acta Endocrinol (Buchar) 2020; 16:78-85. [PMID: 32685043 DOI: 10.4183/aeb.2020.78] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Context Pheochromocytomas and paragangliomas (PCC/PGLs) are diagnosed variously with increasing incidence and changing clinical and pathology pattern. Objective The aim was to further characterize PCC/PGLs in a stable population. Methods A retrospective, single institution study analysed adrenalectomies for PCC/PGLs between January 2010 - January 2019. Demographics, symptoms, blood pressure, preoperative hormones, imaging, histology, hospital stay, complications and three subgroups [based on the modality of diagnosis - incidentaloma group (IG), genetic group (GG) and symptomatic group (SG)] were noted. Results 86 patients included IG 51 (59.3%), GG 10 (11.62%) and SG 25 patients (29.06%). Incidence was 5.30 cases/1 million population. 33.34% of the IG had a delayed diagnosis with a mean interval of 22.95 months (4-120 months). Females presented more often with paroxysmal symptoms (PS) (p=0.011). Patients with PS and classic symptoms were younger (p=0.0087, p=0.0004) and those with PS required more inotropes postoperatively (p=0.014). SG had higher preoperative hormone levels (p=0.0048), larger tumors (p=0.0169) and more likely females. GG are younger compared with those from the IG (p=0.0001) or SG (p= 0.178). Conclusion Majority of patients had an incidental and delayed diagnosis. If symptomatic, patients are more likely to be young females with higher hormone levels and larger tumors.
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Affiliation(s)
- I T Cvasciuc
- Royal Victoria Hospital, United Kingdom of Great Britain and Northern Ireland
| | - S Gull
- Royal Victoria Hospital, United Kingdom of Great Britain and Northern Ireland
| | - R Oprean
- Ulster Hospital, Dundonald, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - K H Lim
- Altnagelvin Area Hospital, Londonderry, United Kingdom of Great Britain and Northern Ireland
| | - F Eatock
- Royal Victoria Hospital, United Kingdom of Great Britain and Northern Ireland
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Lim KH, Ghazali SM, Lim HL, Cheong KC, Teh CH, Lim KK, Heng PP, Cheah YK, Lim JH. Smoking susceptibility among non-smoking school-going adolescents in Malaysia: findings from a national school-based survey. BMJ Open 2019; 9:e031164. [PMID: 31662384 PMCID: PMC6830643 DOI: 10.1136/bmjopen-2019-031164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE The identification of susceptible non-smoking adolescents is an essential step in reducing smoking initiation among adolescents. The aim of this study was to examine the prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. DESIGN Cross-sectional study. SETTING Primary and secondary schools in Malaysia. PARTICIPANTS 11 246 non-smoking school-going adolescents. OUTCOME MEASURES The prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. RESULTS Approximately 14% of non-smokers were susceptible to smoking, and the prevalence of susceptibility was significantly higher among males, ever-smokers and e-cigarette users. The odds of susceptibility to smoking were higher among males, e-cigarette users, those aged 12 years and under and those who had ever smoked or tried cigarettes. Students from schools with educational programmes on the health effects of second-hand smoke (SHS) and who perceived smoking to be harmful were less likely to be susceptible to smoking. CONCLUSION Smoking susceptibility is prevalent among school-going adolescents. A comprehensive approach that enhances or reinforces health education programmes on the adverse health effects of smoking and SHS among school children, that considers multiple factors and that involves all stakeholders is urgently needed to reduce the prevalence of smoking susceptibility among vulnerable subgroups, as identified from the present findings.
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Affiliation(s)
- Kuang Hock Lim
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | | | - Hui Li Lim
- Pathology Unit, Hospital Sultan Haji Ahmad Shah, Mentakab, Malaysia
| | - Kee Chee Cheong
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Chien Huey Teh
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Kuang Kuay Lim
- Occupational Health Center, Institute of Public Health, Setia Alam, Malaysia
| | - Pei Pei Heng
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Yong Kang Cheah
- College of Business, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- School of Pharmacy, Monash University, Malaysia Campus, Bandar Sunway, Malaysia
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Ling MYJ, Rodzlan Hasani WS, Mohd Yusoff MF, Abd Hamid HA, Lim KH, Tee GH, Baharom N, Ab Majid NL, Robert Lourdes TG, Mat Rifin H, Saminathan TA. Cigarette Smoking Among Secondary School-Going Male Adolescents in Malaysia: Findings From the National Health and Morbidity Survey 2017. Asia Pac J Public Health 2019; 31:80S-87S. [PMID: 31537102 DOI: 10.1177/1010539519874948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Smoking is a learned behavior during adolescence, and it is found predominantly among male adolescents in Malaysia. Our study aimed to investigate the prevalence and predictive factors of current cigarette smoking among school-going male adolescents in Malaysia. Data were derived from the National Health and Morbidity Survey: Adolescent Health Survey 2017, a cross-sectional study that utilized a 2-stage stratified cluster sampling to select a nationally representative sample of school-going adolescents in Malaysia (n = 27 497). Multiple logistic regression analysis was performed to identify factors associated with current cigarette smoking among male adolescents in Malaysia. Male adolescents aged 16 to 17 years (adjusted odds ratio [AOR] = 1.55; 95% confidence interval [CI] = 1.41-1.70), current illicit drug users (AOR = 8.14; 95% CI = 6.37-10.41), current alcohol users (AOR = 1.92; 95% CI = 1.65-2.23), those from rural schools (AOR = 1.60; 95% CI = 1.46-1.76), those whose parents were widowed/divorced/separated (AOR = 1.37; 95% CI = 1.21-1.55), and those whose parents/guardians were tobacco product users (AOR = 3.47; 95% CI = 2.33-5.16) were more likely to be current cigarette smokers. Tobacco control strategies should be aimed at both adolescents at risk and at promoting parental smoking cessation.
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Affiliation(s)
- Miaw Yn Jane Ling
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Wan Shakira Rodzlan Hasani
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Muhammad Fadhli Mohd Yusoff
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Hamizatul Akmal Abd Hamid
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Guat Hiong Tee
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Nizam Baharom
- Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Nur Liana Ab Majid
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Tania Gayle Robert Lourdes
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Thamil Arasu Saminathan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
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Ho BK, Mohamad Haniki NM, Jamalludin AR, Samsul D, Mira K, Norny Syafinaz AR, Robson N, Chan C, Lim KH, Baharom N, Ismail N, Tee GH, Ling MY, Wee LH. Prevalence and characteristics of e-cigarette users among Malaysian current and ex-smokers. Malays Fam Physician 2019; 14:10-17. [PMID: 31827730 PMCID: PMC6818688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Electronic cigarettes (ECs) are new devices that have been accepted widely by both smokers and non-smokers. However, the evidence on EC used in Malaysia is scarce. The objective of this study was to determine the prevalence of EC use and the socio-demographic and smoking characteristics associated with current EC use among Malaysian current and ex-smokers. METHODS This was a sub-analysis of data from a cross-sectional, national-population- based EC study conducted from May to June in 2016 in Malaysia. A detailed description of the sampling methods can be found in the National E-cigarette Survey (NECS) 2016 report. Briefly, data were obtained from 1396 individuals who had ever been smokers, i.e., 957 (68.6%) current smokers and 439 (31.4%) ex-smokers. RESULTS Current EC use was found predominantly among current smokers (8.0%) as compared with ex-smokers (4.3%). Among current smokers, the main reasons given for smoking ECs were wanting to try it (44.7%), followed by intention to quit tobacco smoking (15.8%) and to reduce tobacco smoking (10.5%). Using multiple logistic regression analysis, we found that among current smokers, current EC users were more likely to be younger, i.e., 18-44 years (aOR= 4.83, 95% CI= 1.97-11.86, p=0.001), urban residents (aOR= 1.89, 95% CI= 1.15-3.11, p=0.012), single/ divorced/ widowed (aOR= 2.11, 95% CI= 1.24-3.61, p=0.006) and students (aOR= 2.25, 95% CI= 1.01-5.01, p=0.048). Among exsmokers, only younger respondents (18-44 years old) was reported as being more likely to be current EC users (aOR= 3.81, 95% CI= 1.14-12.76, p=0.030). CONCLUSION This study showed that currently using and ever having used ECs were more prevalent among current smokers. The reasons given for initiating EC use among current smokers were mainly wanting to try it, followed by intention to quit and to reduce tobacco smoking. Current EC use appears to be common among current smokers who are younger, urban residents, single/divorced/widowed and students. Therefore, EC cessation intervention strategies and policies should target these high-prevalence groups.
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Affiliation(s)
- B K Ho
- MBBS, M Fam Med, Bandar Botanic Health Center, Blok, A, Jalan Langat, Bandar Botanic, 41200 Klang, Selangor Darul, Ehsan, Malaysia.
| | - N M Mohamad Haniki
- B.Pharm(Hons), PharmD(TN, USA), International Islamic University Malaysia, Kuantan, Malaysia.
| | - A R Jamalludin
- MD, MPH, International Islamic University Malaysia, Kuantan, Malaysia.
| | - D Samsul
- MD, M Fam Med, International Islamic University Malaysia, Kuantan, Malaysia.
| | - K Mira
- B.Com, PhD(InfoSys), International Islamic University Malaysia, Gombak, Malaysia.
| | - A R Norny Syafinaz
- B.Pharm(Hons), PhD(Pharmacy Practice), International Islamic University Malaysia, Kuantan, Malaysia.
| | - N Robson
- MBBS, PhD(Addiction), University Malaya Medical Centre, Kuala Lumpur
| | - Cmh Chan
- PhD(Psycho-oncology), National University of Malaysia Kuala Lumpur, Malaysia.
| | - K H Lim
- BSc Enc Science, MSc Env Science, Institute for Medical Research Kuala Lumpur, Malaysia.
| | | | - N Ismail
- DrPH, Ministry of Health, Malaysia.
| | - G H Tee
- BBioMedSC(Hons), MMedSc(Public Health), Institute for Public Health, Kuala, Lumpur
| | - M Y Ling
- BBioMedSC(Hons), MMedSc(Public Health), Institute for Public Health, Kuala, Lumpur
| | - L H Wee
- BA(Hons), PhD(MHlth Comm), National University of Malaysia Kuala Lumpur, Malaysia.
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Teh CH, Teh MW, Lim KH, Kee CC, Sumarni MG, Heng PP, Mohd Zahari TH, Chan YY, Nuur Hafiza MI, Tee EO, Fadzilah K. Clustering of lifestyle risk behaviours and its determinants among school-going adolescents in a middle-income country: a cross-sectional study. BMC Public Health 2019; 19:1177. [PMID: 31455283 PMCID: PMC6712662 DOI: 10.1186/s12889-019-7516-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 08/19/2019] [Indexed: 01/07/2023] Open
Abstract
Background Lifestyle risk behaviours such as smoking, alcohol consumption, physical inactivity, sedentary behaviour and low fruit/vegetable intake have been identified as the major causes of chronic diseases. Such behaviours are usually instigated in adolescence and tend to persist into adulthood. Studies on the clustering of lifestyle risk behaviours among adolescents are scarce, particularly in developing countries. Therefore, the present paper aimed to determine the clustering of lifestyle risk behaviours and its determinants among school-going adolescents in Malaysia. Methods Data were extracted from a cross-sectional study, the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study, which was conducted from May to September 2013 across 11 states in Peninsular Malaysia. A two-stage proportionate-to-size sampling method was employed to select a total of 3578 school-going adolescents aged 16–17 years from 20 selected schools in urban and rural settlements, respectively. The MyAHRB study adopted a set of self-administered questionnaires adapted from the Global School-based Student’s Health Survey (GSHS) and the Youth Risk Behaviour Surveillance. Results The results from the analysis of 2991 school-going adolescents aged 16–17 years showed that 16 (in boys) and 15 (in girls) out of 32 combinations of lifestyle risk behaviours clustered. Girls (aOR 2.82, 95% CI: 2.32–3.43) were significantly more likely to have clustered risk behaviours than boys; however, no significant associated factors were observed among girls. In contrast, boys of Malay descent (aOR 0.64, 95% CI: 0.46–0.89) or boys who had at least three friends (aOR 0.65, 95% CI: 0.43–0.99) were less likely to engage in multiple risk behaviours. Conclusion The present study demonstrated the clustering of multiple risk behaviours that occurred in both genders; these results suggest that multiple behaviour intervention programmes, instead of programmes based on siloed approaches, should be advocated and targeted to the high-risk sub-populations identified in the present study.
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Affiliation(s)
- Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia.
| | - Ming Woey Teh
- Hospital Tengku Ampuan Rahimah, Jalan Langat, 41200, Klang, Selangor, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Mohd Ghazali Sumarni
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Tajul Hassan Mohd Zahari
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Ying Ying Chan
- Institute for Public Health, Ministry of Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Md Iderus Nuur Hafiza
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Eng Ong Tee
- Allied Health Science College, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
| | - Kamaludin Fadzilah
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
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30
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Lim KK, Chan YY, Teh CH, Ismail H, Yusof R, Muhi J, Lim KH, Foo LH. Iodine status among pregnant women in rural Sabah, Malaysia. Asia Pac J Clin Nutr 2019; 26:861-866. [PMID: 28802296 DOI: 10.6133/apjcn.092016.06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES In 2000, legislation on mandatory universal salt iodisation was enacted in Sabah, Malaysia, to reduce the incidence of iodine deficiency disorders among its population. To evaluate the iodine levels among pregnant women from selected rural divisions in Sabah 13 years after the enactment of the universal salt iodisation programme. METHODS AND STUDY DESIGN This cross-sectional study was conducted from 1 May to 30 June, 2013, in three rural divisions of Sabah (the Interior, the West Coast, and Kudat). Data regarding domestic iodised salt use and iodine-containing supplement consumption were obtained from respondents through face-to-face interviews; goitre enlargement was examined through palpation and graded according to the World Health Organization classification. Spot urine samples were also obtained to assess urinary iodine levels by using an in-house modified micromethod. RESULTS In total, 534 pregnant women participated. The prevalence of goitre was 1.0% (n=5), noted only in the West Coast and Kudat divisions. Although all pregnant women consumed iodised salt, overall median urinary iodine concentration was only 106 μg/L, indicating insufficient iodine intake, with nearly two-thirds of the women (60%) having a median urinary iodine concentrations of <150 μg/L. CONCLUSIONS Pregnant women from the rural divisions in Sabah still exhibit iodine deficiency disorder despite the mandatory universal salt iodisation programme. Iodine supplementation programmes targeting pregnant women are warranted.
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Affiliation(s)
- Kuang Kuay Lim
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia.
| | - Ying Ying Chan
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Hasimah Ismail
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Rafidah Yusof
- Sabah State Health Department, Ministry of Health, Kota Kinabalu, Malaysia
| | - Jamail Muhi
- Sabah State Health Department, Ministry of Health, Kota Kinabalu, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Leng Huat Foo
- School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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31
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Lim KH, Lim HL, Teh CH, Ghazali SM, Kee CC, Heng PP, Shaharuddin R, Lim JH. Is the implementation of smoke-free policies at workplaces associated with living in a smoke-free home?: Findings from a national population-based study in Malaysia. Tob Induc Dis 2019; 17:51. [PMID: 31516494 PMCID: PMC6662793 DOI: 10.18332/tid/100692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 12/12/2018] [Accepted: 12/12/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Studies have shown that the implementation of smoke-free policies at workplaces have shifted the social norms towards secondhand smoke (SHS) exposure at home. This study aimed to investigate whether working in a smoke-free workplace is associated with living in a smoke-free home (SFH). METHODS The data were derived from the Malaysian Global Adult Tobacco Survey (GATS-M), collected in 2011-2012, involving 4250 respondents. Data analyses involved 1343 respondents reported to be in the working population. RESULTS More than half of the respondents (58.5%) were reportedly working in smoke-free workplaces. Almost a quarter (24.8%) of those who worked in smoke-free workplaces stayed in smoke-free homes, which was more than two times higher than their counterparts who worked at non-smoke-free workplaces (24.8% vs 12.0%, p<0.001). Multivariable analyses further substantiated this finding (AOR=2.01, 95% CI: 1.11-3.61, reference group = worked at non-smoke-free workplaces). CONCLUSIONS This study found an association between living in smoke-free homes and working at smoke-free workplaces, which could suggest a positive impact of implementing smoke-free workplaces.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Temerloh, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Rafiza Shaharuddin
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Jia Hui Lim
- School of Science, Monash University Malaysia, Subang Jaya, Malaysia
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Ab Rahman J, Mohd Yusoff MF, Nik Mohamed MH, Mahadir Naidu B, Lim KH, Tee GH, Mohamad MS, Kartiwi M, Draman S, Ab Rahman NS, Aris T. The Prevalence of E-Cigarette Use Among Adults in Malaysia. Asia Pac J Public Health 2019; 31:9S-21S. [DOI: 10.1177/1010539519834735] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Electronic cigarettes (e-cigarettes) are a new method for the consumption of nicotine. A nationwide survey among 4288 Malaysian adults was conducted in 2016 to measure the prevalence and to describe the population characteristics of e-cigarette users. A complex sampling design was used, and data were collected using a face-to-face questionnaire. The overall prevalence of current, ever, former, and dual users of e-cigarettes in Malaysia were 3.2% (95% confidence interval [CI] = 2.5-4.1), 11.9% (95% CI = 10.5-13.5), 8.6% (95% CI = 7.5-9.8), and 2.3% (95% CI = 1.8-3.1), respectively. The prevalence of all type of e-cigarette use was higher in urban than in rural areas. Current e-cigarette users were likely to be younger, males, and with higher education level. Among current e-cigarette users, 74% (95% CI = 64-82) also smoked conventional cigarettes (dual user). E-cigarette use is prevalent in Malaysia. It is common among younger adults, males, and cigarette smokers.
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Affiliation(s)
| | | | | | | | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Guat Hiong Tee
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Mira Kartiwi
- International Islamic University Malaysia, Kuantan, Malaysia
| | - Samsul Draman
- International Islamic University Malaysia, Kuantan, Malaysia
| | | | - Tahir Aris
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
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Lim HL, Teh CH, Kee CC, Mohd Ghazali S, Pan SA, Lim KH. Exposure to second-hand smoke among secondary school-going adolescents: Findings from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study. Proceedings of Singapore Healthcare 2019. [DOI: 10.1177/2010105818789961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Exposure to second-hand smoke (SHS) is one of the main causes of morbidity and it has been proven to be associated with an increased likelihood of smoking initiation among adolescents. Nonetheless, evidence on SHS exposure among Malaysian adolescents is scarce. Therefore, this article aims to demonstrate the magnitude and factors associated with SHS exposure among school-going adolescents in selected secondary schools in Peninsular Malaysia. Methods: Data were derived from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study conducted in 2013. A total of 2599 adolescent were recruited into the study using a two-stage proportionate-to-size sampling method. Data were obtained from self-administered questionnaires. Descriptive analysis and multivariable logistic regression were performed to determine the risk factors/predictors associated with SHS. Results: More than half of the respondents had been exposed to SHS during the last one week (56.4%), and SHS exposure was significantly higher among respondents who smoked (94.0% vs. 49.9%, p <0.001). Multivariable analysis revealed that the likelihood of exposure to SHS was higher among those who smoked (adjusted odds ratio (aOR) 12.90, 95% confidence interval (CI): 8.01–20.4), had at least one parent/guardian who smoked (aOR 5.49, 95% CI: 4.41–6.94) and adolescents of Malay descent (aOR 2.10, 95% CI: 1.68–2.63). Conclusion: Our findings suggested that the effectiveness of anti-smoking measures implemented in recent years to protect adolescents from the health risks of passive smoking were less evident. Therefore, educational and awareness programmes that emphasize the negative health impacts of SHS exposure on Malaysian adolescents, particularly when among smoking adults, should be intensified to help in preventing adoption of smoking behaviours among adolescents.
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Affiliation(s)
- Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Jalan Maran, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | | | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
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Chan YY, Sooryanarayana R, Mohamad Kasim N, Lim KK, Cheong SM, Kee CC, Lim KH, Omar MA, Ahmad NA, Mohd Hairi NN. Prevalence and correlates of physical inactivity among older adults in Malaysia: Findings from the National Health and Morbidity Survey (NHMS) 2015. Arch Gerontol Geriatr 2018; 81:74-83. [PMID: 30521992 DOI: 10.1016/j.archger.2018.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/16/2018] [Accepted: 11/16/2018] [Indexed: 11/18/2022]
Abstract
Malaysia has an increasingly aging population. Despite the substantial benefits of physical activity for healthy aging, older adults are considered the most physically inactive segment of the Malaysian population. The purpose of this study was to determine the prevalence of physical inactivity among older adults in Malaysia and its correlates. We analysed data on adults aged ≥60 years (n = 3790) from the National Health and Morbidity Survey (NHMS) 2015, a cross-sectional, nationwide population-based survey covering information on socio-demographic characteristics, physical activity and other lifestyle-related variables, health conditions, and functional limitations. Individuals included in this study were classified as physically active or physically inactive. Logistic regression was used to determine factors associated with physical inactivity. The overall prevalence of physical inactivity among older adults aged ≥60 years old was 48.8%. Physical inactivity was significantly more prevalent among females, older age groups, Indians, those being single/widowed/divorced, those with no formal education, those who reported high sedentary time (≥7 h/day), those with diabetes, anaemia, and functional limitations (p < 0.001). In fully adjusted analyses, females, older age, high household income (≥MYR4000), inadequate fruits and vegetables consumption (<5 servings/day), high sedentary time, having diabetes, and having mobility impairment were all associated with physical inactivity. Approximately half of the Malaysian older population are physically inactive. Identifying the correlates of physical inactivity among Malaysian older adults will help to develop public health policies and interventions that encourage active living among older people and promote healthy aging in Malaysia.
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Affiliation(s)
- Ying Ying Chan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Jalan Bangsar, Kuala Lumpur, Malaysia.
| | - Rajini Sooryanarayana
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Jalan Bangsar, Kuala Lumpur, Malaysia.
| | - Noraida Mohamad Kasim
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Jalan Bangsar, Kuala Lumpur, Malaysia.
| | - Kuang Kuay Lim
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Jalan Bangsar, Kuala Lumpur, Malaysia.
| | - Siew Man Cheong
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Jalan Bangsar, Kuala Lumpur, Malaysia.
| | - Chee Cheong Kee
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia.
| | - Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia.
| | - Mohd Azahadi Omar
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Jalan Bangsar, Kuala Lumpur, Malaysia.
| | - Noor Ani Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Jalan Bangsar, Kuala Lumpur, Malaysia.
| | - Noran Naqiah Mohd Hairi
- Centre for Epidemiology and Evidence Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Lim KH, Teh CH, Heng PP, Pan S, Ling MY, Yusoff MFM, Ghazali SM, Kee CC, Shaharudin R, Lim HL. Source of cigarettes among youth smokers in Malaysia: Findings from the tobacco and e-cigarette survey among Malaysian school adolescents (TECMA). Tob Induc Dis 2018; 16:51. [PMID: 31516448 PMCID: PMC6659477 DOI: 10.18332/tid/96297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/17/2018] [Accepted: 09/26/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Understanding how and where youth obtain tobacco products are major factors in the development of suitable intervention programs to reduce youth smoking. This study aimed to determine the source of cigarettes and the associated factors among Malaysian school adolescent smokers. METHODS Our sample consisted of 1348 youth aged 10-17 years who were current smokers (having smoked at least once in the last 30 days). The source of cigarettes (commercial, over-the-counter purchases; or social, borrowing or obtaining from someone else) was the dependent variable, and multivariable logistic regression was employed to determine its association with independent variables (i.e. sociodemographics, smoking behavior, and knowledge of laws prohibiting sales of cigarettes to youth). RESULTS Over half (54.3%) of current smokers obtained cigarettes from commercial sources, with a proportion nearly two times higher (84.2% vs 43.7%) among frequent smokers (i.e. those smoking more than 20 days per month) compared to less-frequent smokers, and among young males (56.5% vs 32.0%) compared young females. Multivariable logistic regression indicated that in urban areas, young females (AOR=12.5, 95% CI: 1.38-99.8) frequent smokers (AOR=4.41, 95% CI: 2.05-9.46), and those studying in lower (AOR=3.76, 95% CI: 1.41-10.02) and upper secondary (AOR=4.74, 95% CI: 1.72-13.06) school students were more likely to obtain cigarettes from a commercial source. On the other hand, in rural areas, only frequent smokers were more likely to get their cigarettes from commercial sources, whilst other variables were not significant. CONCLUSIONS The proportion of youth smokers who obtained cigarettes from commercial sources appeared to be high, suggesting that law enforcement and health promotion activities should be enhanced to reduce the rate of smoking among Malaysian youth.
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Affiliation(s)
| | | | - Pei Pei Heng
- Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Sayan Pan
- Jabatan Kesihatan Negeri Perlis, Perlis, Malaysia
| | - Miaw Yn Ling
- Institute of Public Health, Kuala Lumpur, Malaysia
| | | | | | | | | | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Temerloh, Malaysia
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Lim KH, Lim HL, Teh CH, Kee CC, Heng PP, Cheah YK, Ghazali SM. Secondhand smoke (SHS) exposure at home and at the workplace among non-smokers in Malaysia: Findings from the Global Adult Tobacco Survey 2011. Tob Induc Dis 2018; 16:49. [PMID: 31516446 PMCID: PMC6659505 DOI: 10.18332/tid/95188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/23/2018] [Accepted: 09/17/2018] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Understanding the prevalence of secondhand smoke (SHS) exposure and the associated factors is beneficial for the formulation of effective measures to reduce exposure to SHS. The purpose of this study was to determine SHS exposure at home and workplace, and its associated factors among non-smoker Malaysian adults. METHODS Data were extracted from the Global Adult Tobacco Survey-Malaysia (GATS-M) that involved a representative sample of 5112 Malaysian adults. Logistic regression analyses were performed to examine the association between SHS exposure, sociodemographic factors, knowledge on the danger of SHS, and smoking restrictions at home and at work among non-smokers. RESULTS Among non-smoker Malaysians, age ≥15 years, 27.9% (equivalent to approximately 4.21 million non-smokers) and 33.9% (equivalent to approximately 1.37 million non-smokers) reported that they were exposed to SHS at home and the workplace, at least once a month, respectively. Women (AOR=2.12, 95% CI: 1.61-2.78), young individuals (AOR=3.06, 95% CI: 1.48-6.33), Malays (AOR=2.39, 95% CI: 1.56-3.64) or other Bumiputra ethnic groups (AOR=2.40, 95% CI: 1.39-4.19) and those who worked as other than government employees were more likely to report SHS exposure at home (non-government employee: AOR=1.88, 95% CI: 1.06-3.36). Respondents with a total smoking restriction at home did not report any SHS exposure at home. Similarly, those whose workplace had smoking restrictions were less likely to report SHS exposure at the work compared to their counterparts whose workplace had partial (AOR=3.08, 95% CI: 1.84-5.15) or no smoking restrictions (AOR=15.33, 95% CI: 6.75-34.86). CONCLUSIONS A substantial proportion of Malaysian adults were exposed to SHS at home and at work. The findings emphasize the need for policies on smoking restrictions at work and the need to promote the adoption of a completely smoke-free home, among the Malaysian population.
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Affiliation(s)
| | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Pahang, Malaysia
| | | | | | - Pei Pei Heng
- Institute for Medical Research, Kuala Lumpur, Malaysia
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Lim KH, Teh CH, Nik Mohamed MH, Pan S, Ling MY, Mohd Yusoff MF, Hassan N, Baharom N, Dawam ND, Ismail N, Ghazali SM, Cheong KC, Chong KH, Lim HL. Exposure to tobacco secondhand smoke and its associated factors among non-smoking adults in smoking-restricted and non-restricted areas: findings from a nationwide study in Malaysia. BMJ Open 2018; 8:e017203. [PMID: 29317411 PMCID: PMC5780697 DOI: 10.1136/bmjopen-2017-017203] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Secondhand smoke (SHS) has been associated with increased morbidity and mortality. Therefore, the aims of the paper are to assess SHS exposure among non-smoking adults in Malaysia attending various smoking-restricted and non-restricted public areas according to the Control of Tobacco Product Regulations (CTPR) as well as its relationship with various sociodemographic variables. DESIGN Data were extracted from a cross-sectional study, the Global Adults Tobacco Survey (GATS) 2011 which involved 3269 non-smokers in Malaysia. Data was obtained through face-to-face interviews using a validated pre-tested questionnaire. Factors associated with exposure to SHS were identified via multivariable analysis. RESULTS The study revealed that almost two-thirds of respondents were exposed to SHS in at least one public area in the past 1 month, with a significantly higher exposure among males (70.6%), those with higher educational attainment (81.4%) and higher income (quintile 1%-73.9%). Besides, the exposure to SHS was almost four times higher in non-restricted areas compared with restricted areas under the CTPR (81.9% vs 22.9). Multivariable analysis revealed that males and younger adults at non-restricted areas were more likely to be exposed to SHS while no significant associated factors of SHS exposure was observed in restricted areas. CONCLUSIONS The study revealed the prevalence of SHS exposure was higher among Malaysian adults. Although smoke-free laws offer protection to non-smokers from exposure to SHS, enforcement activities in restricted areas should be enhanced to ensure strict public abidance. In addition, legislation of restricted areas should also be extended to greatly reduce the SHS exposure among non-smokers in Malaysia.
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Affiliation(s)
| | | | | | - Sayan Pan
- Institute of Public Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Miaw Yn Ling
- Institute of Public Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Noraryana Hassan
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Nizam Baharom
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Norliana Ismail
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | | | | | - Kar Hon Chong
- Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang, Malaysia
| | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang, Malaysia
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Chan YY, Lim KK, Lim KH, Teh CH, Kee CC, Cheong SM, Khoo YY, Baharudin A, Ling MY, Omar MA, Ahmad NA. Physical activity and overweight/obesity among Malaysian adults: findings from the 2015 National Health and morbidity survey (NHMS). BMC Public Health 2017; 17:733. [PMID: 28934939 PMCID: PMC5609047 DOI: 10.1186/s12889-017-4772-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 09/18/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Overweight and obesity are growing health problems both worldwide and in Malaysia due to such lifestyle changes as decreased physical activity (PA), increased sedentary behavior and unhealthy eating habits. This study examined the levels and patterns of PA among normal-weight and overweight/obese adults and to investigate the association between PA level and overweight/obesity in Malaysian adults. METHODS This study used data from the 2015 National Health and Morbidity Survey (NHMS), a nationwide cross-sectional survey that implemented a two-stage stratified random sampling design. Respondents aged 18 years and above (n = 17,261) were included in the analysis. The short version of International Physical Activity Questionnaire (IPAQ) was administered to assess the respondents' PA levels. The respondents' height and weight were objectively measured and body mass index (BMI) was calculated. The respondents were categorized according to BMI as either normal-weight (18.5-24.9 kg/m2) or overweight/obese (≥ 25 kg/m2). Descriptive and complex sample logistic regression analyses were employed as appropriate. RESULTS Overall, approximately 1 in 2 respondents (51.2%) were overweight/obese, even though the majority (69.0%) reporting at least a moderate level of PA (total PA ≥ 10 MET-hours/week). In both normal-weight and overweight/obese groups, a significantly higher prevalence of high PA (total PA ≥ 50 MET-hours/week) was observed among men than women (p < 0.001), but women reported a significantly higher prevalence of low and moderate PA than men (p < 0.001). Men reported significantly higher activity levels (in MET-hours/week) than women with regard to walking, vigorous-intensity PA and total PA (p < 0.001). Overweight/obese men reported a significantly lower level of vigorous-intensity PA and total PA than normal-weight men (p < 0.001). A low level of PA was associated with the risk of overweight/obesity (Adjusted OR = 1.14; 95% CI: 1.01-1.30) compared to a high level of PA among men but not among women. CONCLUSIONS The levels of PA were inversely related to the risk of overweight/obesity in men but not in women. Programs designed to reduce overweight/obesity rates should encourage the practice of moderate- to vigorous-intensity PA. Future research should consider using longitudinal and prospective approaches that simultaneously measure dietary intake, PA and BMI among Malaysian adults to investigate the actual relationship between PA and overweight/obesity.
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Affiliation(s)
- Ying Ying Chan
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Kuang Kuay Lim
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, 50588 Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, 50588 Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, 50588 Malaysia
| | - Siew Man Cheong
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Yi Yi Khoo
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Azli Baharudin
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Miaw Yn Ling
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Mohd Azahadi Omar
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | - Noor Ani Ahmad
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
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Kee CC, Lim KH, Sumarni MG, Teh CH, Chan YY, Nuur Hafizah MI, Cheah YK, Tee EO, Ahmad Faudzi Y, Amal Nasir M. Validity of self-reported weight and height: a cross-sectional study among Malaysian adolescents. BMC Med Res Methodol 2017; 17:85. [PMID: 28577547 PMCID: PMC5457653 DOI: 10.1186/s12874-017-0362-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 05/23/2017] [Indexed: 11/10/2022] Open
Abstract
Background Self-reported weight and height are commonly used in lieu of direct measurements of weight and height in large epidemiological surveys due to inevitable constraints such as budget and human resource. However, the validity of self-reported weight and height, particularly among adolescents, needs to be verified as misreporting could lead to misclassification of body mass index and therefore overestimation or underestimation of the burden of BMI-related diseases. The objective of this study was to determine the validity of self-reported weight and height among Malaysian secondary school children. Methods Both self-reported and directly measured weight and height of a subgroup of 663 apparently healthy schoolchildren from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) survey 2013/2014 were analysed. Respondents were required to report their current body weight and height via a self-administrative questionnaire before they were measured by investigators. The validity of self-reported against directly measured weight and height was examined using intraclass correlation coefficient (ICC), the Bland-Altman plot and weighted Kappa statistics. Results There was very good intraclass correlation between self-reported and directly measured weight [r = 0.96, 95% confidence interval (CI): 0.93, 0.97] and height (r = 0.94, 95% CI: 0.90, 0.96). In addition the Bland-Altman plots indicated that the mean difference between self-reported and direct measurement was relatively small. The mean difference (self-reported minus direct measurements) was, for boys: weight, −2.1 kg; height, −1.6 cm; BMI, −0.44 kg/m2 and girls: weight, −1.2 kg; height, −0.9 cm; BMI, −0.3 kg/m2. However, 95% limits of agreement were wide which indicated substantial discrepancies between self-reported and direct measurements method at the individual level. Nonetheless, the weighted Kappa statistics demonstrated a substantial agreement between BMI status categorised based on self-reported weight and height and the direct measurements (kappa = 0.76, 95% CI: 0.67, 0.84). Conclusion Our results show that the self-reported weight and height were consistent with direct measurements and therefore can be used in assessing the nutritional status of Malaysian school children from the age of 13 to 17 years old in epidemiological studies and for surveillance purposes when direct measurements are not feasible, but not for assessing nutritional status at the individual level.
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Affiliation(s)
- C C Kee
- Epidemiology and Biostatistics Unit, Institute for Medical Research, Jalan Pahang, 50588, Kuala Lumpur, Malaysia.
| | - K H Lim
- Epidemiology and Biostatistics Unit, Institute for Medical Research, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - M G Sumarni
- Epidemiology and Biostatistics Unit, Institute for Medical Research, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - C H Teh
- Epidemiology and Biostatistics Unit, Institute for Medical Research, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - Y Y Chan
- Institute for Public Health, Jalan Bangsar, Federal Hill, 50590, Kuala Lumpur, Malaysia
| | - M I Nuur Hafizah
- Epidemiology and Biostatistics Unit, Institute for Medical Research, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - Y K Cheah
- Universiti Utara Malaysia, UUM, 06010, Sintok, Kedah, Malaysia
| | - E O Tee
- Allied Health Sciences College Sg. Buloh, Jalan Hospital, 47000, Sg. Buloh, Selangor, Malaysia
| | - Y Ahmad Faudzi
- Epidemiology and Biostatistics Unit, Institute for Medical Research, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
| | - M Amal Nasir
- Epidemiology and Biostatistics Unit, Institute for Medical Research, Jalan Pahang, 50588, Kuala Lumpur, Malaysia
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Cheo ST, Lim KH. Authors’ reply: Comment on: Glioblastoma multiforme outcomes of 107 patients treated in two local institutions. Singapore Med J 2017; 58:228. [DOI: 10.11622/smedj.2017032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Lim KH, Lim HL, Teh CH, Kee CC, Khoo YY, Ganapathy SS, Jane Ling MY, Mohd Ghazali S, Tee EO. Smoking among school-going adolescents in selected secondary schools in Peninsular Malaysia- findings from the Malaysian Adolescent Health Risk Behaviour (MyaHRB) study. Tob Induc Dis 2017; 15:9. [PMID: 28163668 PMCID: PMC5282817 DOI: 10.1186/s12971-016-0108-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 12/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A multitude of studies have revealed that smoking is a learned behaviour during adolescence and efforts to reduce the incidence of smoking has been identified as long-term measures to curb the smoking menace. The objective of this study was to determine the prevalence as well as the intra and inter-personal factors associated with smoking among upper secondary school students in selected schools in Peninsular Malaysia. METHODS A study was carried out in 2013, which involved a total of 40 secondary schools. They were randomly selected using a two-stage clustering sampling method. Subsequently, all upper secondary school students (aged 16 to 17 years) from each selected school were recruited into the study. Data was collected using a validated standardised questionnaire. RESULTS This study revealed that the prevalence of smoking was 14.6% (95% CI:13.3-15.9), and it was significantly higher among males compared to females (27.9% vs 2.4%, p < 0.001). Majority of smokers initiated smoking during their early adolescent years (60%) and almost half of the respondents bought cigarettes themselves from the store. Multivariable analysis revealed that the following factors increased the likelihood of being a current smoker: being male (aOR 21. 51, 95% CI:13.1-35), perceived poor academic achievement (aOR 3.42, 95% CI:1.50-7.37) had one or both parents who smoked (aOR 1.80, 95% CI:1.32-2.45; aOR 6.50, 95 CI%:1.65-25.65), and always feeling lonely (aOR 2.23, 95% CI:1.21-4.43). In contrast, respondents with a higher religiosity score and protection score were less likely to smoke (aOR 0.51, 95% CI:0.15-0.92; aOR 0.71, 95% CI 0.55-0.92). CONCLUSION This study demonstrated that the prevalence of smoking among Malaysian adolescents of school-going age was high, despite implementation of several anti-smoking measures in Malaysia. More robust measures integrating the factors identified in this study are strongly recommended to curb the smoking epidemic among adolescents in Malaysia.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Melaka Manipal Medical College, Jalan Batu Hampar, Kuala Lumpur, 75150 Melaka Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Yi Yi Khoo
- Institute for Public Health, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | | | - Miaw Yn Jane Ling
- Institute for Public Health, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia
| | | | - Eng Ong Tee
- Allied Health College, Jalan Hospital, 47000 Sg. Buloh, Malaysia
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Lo YL, Lim KH, Cheng XM, Mesenas S. Steroid Responsive Mononeuritis Multiplex in the Cronkhite-Canada Syndrome. Front Neurol 2016; 7:207. [PMID: 27899913 PMCID: PMC5110953 DOI: 10.3389/fneur.2016.00207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 11/02/2016] [Indexed: 11/13/2022] Open
Abstract
The Cronkhite-Canada syndrome (CCS) is a rare disorder of unknown origin characterized by generalized gastrointestinal polyposis, alopecia, hyperpigmentation, and onychodystrophy. We report a case of CCS with concomitant presentation of mononeuritis multiplex. The electrophysiological findings and steroid responsiveness suggests presence of an autoimmune mechanism.
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Affiliation(s)
- Y L Lo
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore; Due-NUS Medical School, Singapore
| | - K H Lim
- Department of Anatomical Pathology, Singapore General Hospital , Singapore
| | - X M Cheng
- Department of Anatomical Pathology, Singapore General Hospital , Singapore
| | - S Mesenas
- Department of Gastroenterology and Hepatology, Singapore General Hospital , Singapore
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Chan YY, Lim KH, Teh CH, Kee CC, Ghazali SM, Lim KK, Khoo YY, Tee EO, Ahmad NA, Ibrahim N. Prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia. Int J Adolesc Med Health 2016; 30:/j/ijamh.ahead-of-print/ijamh-2016-0053/ijamh-2016-0053.xml. [PMID: 27508957 DOI: 10.1515/ijamh-2016-0053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 06/29/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Suicidal ideation, defined as thoughts, ideas and the desire to commit suicide, is becoming a major public health problem among adolescents. Indeed, suicidal ideation is known as a key predictor of future suicide risk. OBJECTIVE This study aims to determine the prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia. METHODS This study used data from the 2013 Malaysian adolescent health risk behavior (MyAHRB) study, a cross-sectional school survey conducted in Peninsular Malaysia among school-going adolescents aged 16-17 years (n=2789). Logistic regression analysis was used to determine the risk factors associated with suicidal ideation among Malaysian adolescents. RESULTS The overall prevalence of suicidal ideation among the adolescents was 6.2%. The prevalence was significantly higher among females than males (7.6% vs. 4.7%; p=0.002). Multivariate regression analysis revealed that adolescents who were females [odds ratio (OR)=2.02; 95% confidence interval (CI): 1.40-2.92] or of Indian ethnicity (OR=2.32; 95% CI: 1.35-3.98) were more likely to report suicidal ideation. Loneliness (OR=2.54; 95% CI: 1.57-4.11), anxiety or worry (OR=2.70; 95% CI: 1.70-4.31), no close friends (OR=2.71; 95% CI: 1.43-5.14), and lack of supportive peers (OR=1.69; 95% CI: 1.15-2.47) were identified as risk factors for adolescents' suicidal ideation. Adolescents who ever had sexual intercourse (OR=2.70; 95% CI: 1.48-4.92) and had been in a physical fight (OR=2.45; 95% CI: 1.62-3.70) were also reported to have higher risks of suicidal ideation. CONCLUSION This study provides evidence on risk factors associated with suicidal ideation among Malaysian adolescents. Targeted mental health and health risk behavioral interventions for high-risk adolescents are recommended.
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Affiliation(s)
- Ying Ying Chan
- Institute for Public Health, Ministry of Health Malaysia, 50590 Jalan Bangsar, Kuala Lumpur, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Kuang Kuay Lim
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Yi Yi Khoo
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Eng Ong Tee
- Allied Health Sciences College Sungai Buloh, Ministry of Health, Selangor, Malaysia
| | - Noor Ani Ahmad
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Normala Ibrahim
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
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Lim KH, Jasvindar K, Cheong SM, Ho BK, Lim HL, Teh CH, Lau KJ, Suthahar A, Ambigga D. Prevalence of smoking and its associated factors with smoking among elderly smokers in Malaysia: findings from a nationwide population-based study. Tob Induc Dis 2016; 14:8. [PMID: 27006650 PMCID: PMC4802631 DOI: 10.1186/s12971-016-0073-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 03/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The determination of smoking prevalence and its associated factors among the elderly could provide evidence-based findings to guide the planning and implementation of policy in order to will help in reducing the morbidity and mortality of smoking-related diseases, thus increase their quality of life. This paper describes the rate of smoking and identifies the factor(s) associated with smoking among the elderly in Malaysia. METHODS A representative sample of 2674 respondents was obtained via a two-stage sampling method in proportion to population size. Face-to-face interviews were conducted using a set of standardized validated questionnaire. Data was weighted by taking into consideration the complex sampling design and non-response rate prior to data analysis. Univariable and multivariable logistic regression were used to determine the factor/s associated with smoking. RESULTS The prevalence of non-smokers, ex-smokers and current smokers among Malaysians aged 60 years and above were 36.3 % (95 % CI = 32.7-39.8), 24.4 % (95 % CI = 21.2-27.5) and 11.9 % (95 % CI = 9.5-14.3), respectively. Current smokers were significantly more prevalent in men (28.1 %) than in women (2.9 %), but the prevalence declined with advancing age, higher educational attainment, and among respondents with known diabetes, hypertension and hypercholesterolemia. Multivariable analysis revealed that males (aOR, 18.6, 95 % CI 10.9-31.9) and other Bumiputras (aOR 2.58, 95 % CI 1.29-5.15) were more likely to smoke. in addition, elderly with lower educational attainment (aOR, 1.70, 95 % CI 1.24-7.41) and those without/unknown hypertension also reported higher likelihood to be current smokers (aOR 1.98, 95 % CI 1.35-2.83). However, there were no significant associations between respondents with no/unknown diabetes or hypercholesterolemia with smoking. CONCLUSIONS In short, smoking is common among elderly men in Malaysia. Therefore, intervention programs should integrate the present findings to reduce the smoking rate and increase the smoking cessation rate among the elderly in Malaysia and subsequently to reduce the burden of smoking-related disease.
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Affiliation(s)
- K H Lim
- Institute for Medical Research, Jalan Pahang, 50590 Kuala Lumpur, Malaysia ; Institute for Public Health, Jalan Bangsar, 50588 Kuala Lumpur, Malaysia
| | - K Jasvindar
- Institute for Public Health, Jalan Bangsar, 50588 Kuala Lumpur, Malaysia
| | - S M Cheong
- Institute for Public Health, Jalan Bangsar, 50588 Kuala Lumpur, Malaysia
| | - B K Ho
- Klang Health Department, Bandar Botanic Clinic, 41200 Klang, Selangor Malaysia
| | - H L Lim
- Melaka Manipal Medical College, Jalan Pengkalan Batu, Bukit Baru, 75150 Melaka Malaysia
| | - C H Teh
- Institute for Medical Research, Jalan Pahang, 50590 Kuala Lumpur, Malaysia
| | - K J Lau
- School of Medical Science, Universiti Sains Malaysia, Kuang Kerian, 15000 Kelantan, Malaysia
| | - A Suthahar
- Faculty of Medicine, University Teknologi Mara, Sg Buloh, 47000 Selangor, Malaysia
| | - D Ambigga
- Faculty of Medicine and Defence Health, University of Defence, Kem Sg. Besi, 57000 Kuala Lumpur, Malaysia
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Chan YY, Teh CH, Lim KK, Lim KH, Yeo PS, Kee CC, Omar MA, Ahmad NA. Lifestyle, chronic diseases and self-rated health among Malaysian adults: results from the 2011 National Health and Morbidity Survey (NHMS). BMC Public Health 2015; 15:754. [PMID: 26246019 PMCID: PMC4527234 DOI: 10.1186/s12889-015-2080-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 07/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-rated health (SRH) has been demonstrated as a valid and appropriate predictor of incident mortality and chronic morbidity. Associations between lifestyle, chronic diseases, and SRH have been reported by various population studies but few have included data from developing countries. The aim of this study was to determine the prevalence of poor SRH in Malaysia and its association with lifestyle factors and chronic diseases among Malaysian adults. METHODS This study was based on 18,184 adults aged 18 and above who participated in the 2011 National Health and Morbidity Survey (NHMS). The NHMS was a cross-sectional survey (two-stage stratified sample) designed to collect health information on a nationally representative sample of the Malaysian adult population. Data were obtained via face-to-face interviews using validated questionnaires. Two categories were used to measure SRH: "good" (very good and good) and "poor" (moderate, not good and very bad). The association of lifestyle factors and chronic diseases with poor SRH was examined using univariate and multivariate logistic regression. RESULTS Approximately one-fifth of the Malaysian adult population (20.1 %) rated their health as poor (men: 18.4 % and women: 21.7 %). Prevalence increases with age from 16.2 % (aged 18-29) to 32.0 % (aged ≥60). In the multivariate logistic regression analysis, lifestyle factors associated with poor SRH included: underweight (OR = 1.29; 95 % CI: 1.05-1.57), physical inactivity (OR = 1.25; 95 % CI: 1.11-1.39), former smoker (OR = 1.38; 95 % CI: 1.12-1.70), former drinker (OR = 1.27; 95 % CI: 1.01-1.62), and current drinker (OR = 1.35; 95 % CI: 1.08-1.68). Chronic diseases associated with poor SRH included: asthma (OR = 1.66; 95 % CI: 1.36-2.03), arthritis (OR = 1.87; 95 % CI: 1.52-2.29), hypertension (OR = 1.39; 95 % CI: 1.18-1.64), hypercholesterolemia (OR = 1.43; 95 % CI: 1.18-1.74), and heart disease (OR = 1.85; 95 % CI: 1.43-2.39). CONCLUSIONS This study indicates that several unhealthy lifestyle behaviours and chronic diseases are significantly associated with poor SRH among Malaysian adults. Effective public health strategies are needed to promote healthy lifestyles, and disease prevention interventions should be enhanced at the community level to improve overall health.
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Affiliation(s)
- Ying Ying Chan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
| | - Chien Huey Teh
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
| | - Kuang Kuay Lim
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
| | - Kuang Hock Lim
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
| | - Pei Sien Yeo
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
| | - Chee Cheong Kee
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
| | - Mohd Azahadi Omar
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
| | - Noor Ani Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
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Wong GW, Lim KH, Wan WK, Low SC, Kong SC. Eosinophilic gastroenteritis: Clinical profiles and treatment outcomes, a retrospective study of 18 adult patients in a Singapore Tertiary Hospital. Med J Malaysia 2015; 70:232-237. [PMID: 26358020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Eosinophilic gastroenteritis (EG) can mimic symptoms of common gastrointestinal (GI) disorders but responds well to appropriate treatment. Accurate diagnosis is central to effective management. Data on EG in Southeast Asia is lacking. We aim to describe the clinical profiles and treatment outcomes of adult patients with EG in a Singapore Tertiary Hospital. MATERIALS AND METHODS This retrospective study involved archival search of patients with GI biopsies that showed eosinophilic infiltration from January 2004 to December 2012. Patients' clinical data from computerised hospital records and clinical notes was reviewed. Diagnostic criteria for EG included presence of GI symptoms with more than 30 eosinophils/high power field on GI biopsies. Patients with secondary causes for eosinophilia were excluded. RESULTS Eighteen patients with EG were identified (mean age 52 years; male/female: 11/7). Fifteen patients (83%) had peripheral blood eosinophilia. Seven patients (39%) had atopic conditions. Most common symptoms were diarrhoea and abdominal pain. Small intestine was the most common site involved. Endoscopic finding was non-specific. Ten patients were treated with corticosteroids (nine prednisolone, one budesonide): eight patients (89%) responded clinically to prednisolone but four patients (50%) relapsed following tapering-off of prednisolone and required maintenance dose. One patient each responded to diet elimination and montelukast respectively. Half of the remaining six patients who were treated with proton-pump inhibitors, antispasmodic or antidiarrheal agents still remained symptomatic. CONCLUSION Prednisolone is an effective treatment though relapses are common. Small intestine is most commonly involved. EG should be considered in the evaluation of unexplained chronic recurrent GI symptoms.
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Affiliation(s)
- Guan-Wee Wong
- Singapore General Hospital, Department of Gastroenterology and Hepatology, Outram Road, Singapore 169608.
| | - K H Lim
- Singapore General Hospital, Department of Pathology, Outram Road, Singapore 169608
| | - W K Wan
- Singapore General Hospital, Department of Pathology, Outram Road, Singapore 169608
| | - S C Low
- Singapore General Hospital, Department of Diagnostic Radiology, Outram Road, Singapore 169608
| | - S C Kong
- Singapore General Hospital, Department of Gastroenterology and Hepatology, Outram Road, Singapore 169608
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Lim KH, Kim JY, Kang MG, Park HK, Kang HR. Two cases of cytarabine syndrome successfully resolved by desensitization. J Investig Allergol Clin Immunol 2015; 25:80-82. [PMID: 25898709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
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Ho BK, Jasvindar K, Gurpreet K, Ambigga D, Suthahar A, Cheong SM, Lim KH. Prevalence, awareness, treatment and control of diabetes mellitus among the elderly: The 2011 National Health and Morbidity Survey, Malaysia. Malays Fam Physician 2014; 9:12-19. [PMID: 26425300 PMCID: PMC4568721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Diabetes mellitus is an important cardiovascular risk factor. The objective of this study was to provide population-based estimates on the prevalence, awareness, treatment and control rate of diabetes among the older persons in Malaysia. Analysis of secondary data from a cross-sectional national population-based survey was done, which was conducted in 2011 throughout Malaysia. A total of 2764 respondents (15.5%) were older persons. The overall prevalence of diabetes among older persons was 34.4% in which 65.2% were aware of their diabetes status. Out of those who were aware, 87.5% had been treated. Only 21.8% of those treated had their diabetes controlled. The results of multiple logistic regression showed that the factors associated with higher awareness rates were women, Indians and higher income groups; factors associated with higher treatment rates were urban residents and those who were married and widow/widower/ divorcee. There was a high overall prevalence, awareness and treatment rate of diabetes among older persons in Malaysia but with suboptimal control rate.
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Affiliation(s)
- B K Ho
- Ho Bee Kiau (Corresponding author) MMed (FamMed) Bandar Botanik Health Center, Blok A, Jalan Langat, Bandar Botanik, 41200 Klang, Selangor, Malaysia.
| | - K Jasvindar
- Jasvindar Kaur MBBS, MPH Institute for Public Health, Malaysia
| | - K Gurpreet
- Gurpreet Kaur MBBS, MMed (FamMed) Institute for Public Health, Malaysia
| | - D Ambigga
- Ambigga Devi MBBS, MMed (FamMed) National Defence University, Malaysia
| | - A Suthahar
- Suthahar Ariaratnam MBBS, MMed (Psych) Universiti Teknologi Mara, Malaysia
| | - S M Cheong
- Cheong Siew Man M Community Nutrition, Institute for Public Health, Malaysia
| | - K H Lim
- Lim Kuang Hock BSc, MSc Institute for Public Health, Malaysia
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Abstract
Duplication of the appendix is extremely rare. A 69-year-old woman was admitted with a 2-day history of right lower quadrant abdominal pain. Physical examination was consistent with acute appendicitis. Ultrasonography and colonoscopy gave a clinical impression of an inflammatory appendiceal mucocoele. Operative findings were an enlarged and inflamed appendix with distal cystic changes. Laparoscopic wedge resection of the caecum was performed. A tubular structure with a true lumen was found in the appendix. Haematoxylin and eosin staining and trichrome staining showed both structures had a true mucosa and a muscular layer. The duplication in this case does not belong to any of the previously described types of duplication.
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Affiliation(s)
- K H Lim
- Kyungpook National University Hospital, Daegu, Korea
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Lim KH, Chong Z, Khoo YY, Kaur J. Parental Smoking Status, Stress, Anxiety, and Depression Are Associated With Susceptibility to Smoking Among Non-Smoking School Adolescents in Malaysia. Asia Pac J Public Health 2014; 26:81S-90S. [DOI: 10.1177/1010539514542426] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Susceptibility to smoking is a reliable predictor of smoking initiation. This article describes its prevalence and associated factors among Malaysian school adolescents. Data were obtained from the Global School-Based Student Health Survey (GSHS) 2012, a nationwide representative sample of school adolescents. The overall prevalence of susceptibility to smoking was 6.0% and significantly higher among males (9.5%) compared with females (3.6%). Multivariable analyses revealed that males (adjusted odds ratio [aOR] 3.34, 95% confidence interval [CI] 2.70-4.18) and school adolescents of indigenous Sabahan or Sarawakian descents (aOR 1.62, 95%CI 1.21-2.18) were significantly more likely to be susceptible to smoking. Susceptible school adolescents had a slightly higher likelihood to have symptoms of stress (aOR 1.31, 95% CI 1.02-1.70), anxiety (aOR 1.19, 95% CI 1.01-1.40), depression (aOR 1.56, 95% CI 1.25-1.96), including those whose one or both parents/guardians were smokers (aOR 1.48, 95% CI 1.21-1.82; aOR 2.33, 95% CI 1.22-4.44, respectively). The findings from this study point out the need for proactive measures to reduce smoking initiation among Malaysian adolescents with particular attention toward factors associated with susceptibility to smoking,
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Affiliation(s)
| | | | - Yi Yi Khoo
- Institute of Public Health, Kuala Lumpur, Malaysia
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