Demographic, lifestyle, social, and psychological factors associated with worry-related sleep problems among school-going adolescents in Timor-Leste.

OBJECTIVE: Adolescent sleep problems are a worldwide public health issue. The present study examines factors associated with worry-related sleep problems among school-going adolescents. The country of interest is Timor-Leste, a low-income country, where studies pertaining to adolescent sleep problems are lacking. DESIGN AND MEASURES: Data were analysed from the Global School-Based Student Health Survey Timor-Leste (n = 3455). An ordered probit model was used to assess the effects of demographic, lifestyle, social, and psychological factors on different levels of worry-related sleep problems (i.e., no, mild and severe sleep problems). RESULTS: School-going adolescents were more likely to face mild or severe worry-related sleep problems if they were older, passive smokers, alcohol drinkers and moderately active. School-going adolescents who sometimes or always went hungry were more likely to experience worry-related sleep problems than those who did not. Involvement in physical fights, being bullied, and loneliness were positively associated with the probability of having modest or severe worry-related sleep problems. CONCLUSION: Age, exposure to second-hand smoke, alcohol consumption, physical activity, going hungry, physical fights, being bullied and loneliness are the important determining factors of adolescent worry-related sleep problems. Policymakers should pay special attention to these factors when formulating intervention measures.

Can the association between hypertension and physical activity be moderated by age?

Objectives: Physical inactivity, hypertension and non-communicable diseases are major public concerns across the globe. To our knowledge, there is a lack of research that has investigated the moderating effect of age on the relationship between hypertension and physical activity in developing countries. This study had two objectives: (1) investigating hypertension and sociodemographic factors associated with physical activity and (2) investigating whether age moderates the relationship between hypertension and physical activity. Methods: Nationally representative data of Malaysia were used to generate cross-sectional evidence. The sample size was 2156 respondents. An ordered probit regression was utilized to assess factors associated with the practice of physical activity. Results: Respondents aged 40-49 years with hypertension were 7.3% less likely to participate in high-level physical activity when compared to those without hypertension. The probability of having a low level of physical activity was 12.3% higher among hypertensive patients aged ≥60. Males, married individuals, less-educated adults, low-income earners, and individuals who were aware of their BMI, had a higher tendency to indulge in a highly active lifestyle than others. Conclusion: The effect of hypertension on physical activity was moderated by age. Factors influencing physical activity levels among adults were income, gender, marital status, education, employment status, and BMI awareness.

Occupational Disease and Injury in Malaysia: A Thematic Review of Literature from 2016 to 2021.

Introduction: Working people are exposed to occupational hazards and are at risk of having occupational disease or injury in a rapidly industrializing country like Malaysia. This study aims to review and summarize the occupational disease and injury in Malaysia from 2016 to 2021. Methods: This study used PubMed and Scopus databases to conduct a systematic literature search using a set of keywords. The selected records dated from 1 January 2016 to 8 September 2021 were extracted into the Mendeley Desktop and ATLAS.ti 8 software. Systematic screening was conducted by two independent researchers and finalized by the third researcher. Data were coded and grouped according to the themes. The results were presented as the table for descriptive analysis and cross-tabulation between the themes. Results: A total of 120 records were included in this study. Under the theme of main health problems, the findings showed that mental health, infectious disease, and work-related musculoskeletal disorders are the top three problems being discussed in the literature for the working people in Malaysia. The findings also showed an increasing trend of mental health problems during pandemic COVID-19 years. In addition, hospital was the highest workplace where the occupational health problems were reported.Discussion/Conclusion. There was substantial work on the mental health problem, infectious diseases, and work-related musculoskeletal disorders as the main health problem among workers in Malaysia in the past five years. The employers must report any occupational health and injury case to the authority and prompt intervention can be initiated.

Awareness of body mass index and its associated factors: A cross-sectional study.

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. Adults without formal education were less likely to know their body mass index than those with tertiary-level education. Adults were less likely to be aware of their body mass index if they engaged in smoking. Adults with knowledge of the definition of calories were more aware of their body mass index than others. The findings emphasize the urgent need for a forthcoming sociodemographic factors-specific policy directed toward improving body mass index awareness to lower the prevalence of obesity in Malaysia.

Prevalence and factors associated with physical inactivity among older adults in Malaysia: A cross-sectional study.

AIM: Physical inactivity in older adults is linked to increased risk of chronic diseases, disability and various poor health outcomes. As the aging population rises, the prevalence of diseases associated with aging also increases. Regular physical activity in older adults is important to improve overall health and promote healthy aging. This study aimed to determine the prevalence and factors associated with physical inactivity among older adults in Malaysia. METHODS: This study was based on 3969 Malaysian older adults aged ≥60 years who completed the physical activity module in the National Health and Morbidity Survey 2018, a population-based cross-sectional survey. Physical activity was measured using the Global Physical Activity Questionnaire through a face-to-face interview. Participants were classified as physically active or inactive. Associations between physical inactivity, sociodemographic characteristics and a range of selected independent variables were examined using multivariable logistic regression. RESULTS: Overall, three out of 10 (29.8%) Malaysian older adults were physically inactive. Results of multivariable analysis showed that older age group (≥80 years), of Bumiputera Sarawak ethnicity, unemployed/retirees/homemakers, functional limitation, diabetes mellitus and dementia were significantly associated with a higher risk of physical inactivity. Women, with secondary education level and good social support were less likely to be physically inactive. CONCLUSIONS: The present study reported the status of physical inactivity among older adults in Malaysia. There is the need to design effective public health programs and interventions to promote active living and healthy aging among Malaysian older adults, particularly in those at-risk older population subgroups. Geriatr Gerontol Int 2020; 20: 49-56.

Smoking susceptibility among non-smoking school-going adolescents in Malaysia: findings from a national school-based survey.

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.

Prevalence and correlates of physical inactivity among older adults in Malaysia: Findings from the National Health and Morbidity Survey (NHMS) 2015.

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.

Iodine Deficiency Disorders among Pregnant Women in Sarawak, Malaysia

@#Iodine deficiency disorders (IDD) during pregnancy may impair the neurological development of the fetus. The aim of this study is to determine the iodine status among pregnant women (PW) in Sarawak after introduction of mandatory universal salt iodisation (USI) for seven years.

Physical activity and overweight/obesity among Malaysian adults: findings from the 2015 National Health and morbidity survey (NHMS).

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.

Iodine status among pregnant women in rural Sabah, Malaysia.

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.

Prevalence and risk factors associated with suicidal ideation among adolescents in Malaysia.

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.

Undiagnosed Type 2 Diabetes Mellitus and Its Risk Factors among Malaysians: Findings of a Nationwide Study

​The prevalence of Type 2 diabetes mellitus (T2DM) is increasing worldwide and many of these affected individuals remain unidentified. Undiagnosed T2DM may impose substantial public health implications because these individuals remain untreated and at risk for complications. The objective of this study was to determine the national prevalence of undiagnosed T2DM and to identify the associated risk factors. A nationwide cross-sectional study was conducted involving 17,783 respondents. Two-stage stratified sampling design was used to select a representative sample of the Malaysian adult population. Structured validated questionnaires with face to face interviews were used to obtain data. Respondents, who claimed that they were not having diabetes, were then asked to perform a fasting blood glucose finger-prick test by Accutrend GC machine. The prevalence of undiagnosed T2DM was 8.9% (n=1587). The highest percentage of undiagnosed T2DM was found among males (10.2%), 55-59 years old (13.4%), highest education attainers of primary school (11.1%), Indians (10.3%), married (10.3%), working (8.9%) and living in the urban areas (9.2%). Multivariate analyses showed that factors associated with undiagnosed T2DM were gender, age group, ethnicity, marital status, obesity and hypertension. This study found an increasing trend of undiagnosed T2DM in Malaysia compared to 2006. This finding is alarming as risk factors associated with undiagnosed diabetes were related to most of the socio-demographic factors studied. Therefore, early diabetic screening is crucial especially among adults aged 30 and above to prevent more serious complications of this disease.​

Association of physical activity with blood pressure and blood glucose among Malaysian adults: a population-based study.

BACKGROUND: The health-enhancing benefits of physical activity (PA) on hypertension and diabetes have been well documented for decades. This study aimed to determine the association of PA with systolic and diastolic blood pressure as well as blood glucose in the Malaysian adult population. METHODS: Data were extracted from the 2011 National Health and Morbidity Survey (NHMS), a nationally representative, cross-sectional study. A two-stage stratified sampling method was used to select a representative sample of 18,231 Malaysian adults aged 18 years and above. The PA levels of the respondents were categorised as low, moderate or high according to the International Physical Activity Questionnaire (IPAQ)-short form. Blood pressure and fasting blood glucose levels were measured using a digital blood pressure-measuring device and finger-prick test, respectively. RESULTS: Systolic blood pressure (SBP) level was positively associated with PA level (p = 0.02) whilst no significant association was noted between PA level and diastolic blood pressure (DBP). In contrast, respondents with low (adjusted coefficient = 0.17) or moderate (adjusted coefficient = 0.03) level of PA had significantly higher blood glucose level as compared to those who were highly active (p = 0.04). CONCLUSIONS: A significant negative association was observed between PA level and blood glucose only. Future studies should employ an objective measurement in estimating PA level in order to elucidate the actual relationship between PA, hypertension and diabetes for the development of effective interventions to combat the increasing burden of premature-mortality and cardiovascular disease-related morbidity in Malaysia.

Lifestyle, chronic diseases and self-rated health among Malaysian adults: results from the 2011 National Health and Morbidity Survey (NHMS).

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.

Iodine Status after a 3-Year Universal Salt Iodisation in Sarawak, Malaysia

Following the reveal of borderline iodine sufficiency among the Sarawakians from the 2008 National Iodine Deficiency Disorders (IDDs) survey, a mandatory universal salt iodization (USI) was implemented in Sarawak thereafter. This study aimed to determine the current status of USI in Sarawak after a 3-year implementation of USI from 2008 to 2011. The IDD survey was conducted between Jun 2011 to July 2011 involving six districts in Sarawak (Sarikei, Mukah, Kapit, Sibu, Bintulu and Miri). The schools were selected via multistage proportionate-to-population size sampling technique and the children were randomly selected via systematic sampling. A total of 19 schools and 661 children were recruited into the survey. Thyroid size was determined by palpation and was and graded according to the classification of the World Health Organization (grade 0-2). The iodine excretion level in spot morning urine was measured using in-house microplate method. The urinary iodine concentration (UIC) values were compared by Kruskal-Wallis test and Chi-square tests were used to compare categorical variables. A total of 610 school children were participated in the study (92.3%). The TGR of grade 1 and 2 was found to be 0.3% (n = 2). Overall the median UIC level was 154.2 (IQR, 92.7 - 229.8) µg/L, with the highest median UIC been observed in Sarikei [178.0 (IQR, 117.6 - 308.9) µg/L], followed by Mukah [174.8 (IQR, 99.0 - 224.3) µg/L)], Miri [158.6 (IQR, 92.3 - 235.4) µg/L], Sibu [147.0 (IQR, 89.8 - 221.4) µg/L], Bintulu [142.3 (IQR, 52.8 - 245.1) µg/L] and Kapit [131.0 (IQR, 88.6 - 201.9) µg/L]. One in every ten child was of iodine deficient (UIC < 50µg/L) while a third of the child (32%) were of adequate level of UIC. The present findings indicate that the mandatory USI successfully improves the iodine level of children in Sarawak. However, regular and proper monitoring of the UIC level in the communities is needed to prevent excessive iodine intake.​

Iodine Deficiency Disorder and Goitre among School Children in Sarawak -A Nationwide Study

Iodine deficiency disorders (IDD), is one of the most important micronutrient deficiencies which has multiple adverse effects on growth and development. The aim of this study was to determine the prevalence of IDD among school children and to elucidate the distribution of iodized salt at household level in Sarawak, East Malaysia. This cross-sectional study was conducted among school children aged 8 to 10 years in 2008. A multi-stage probability proportionate to population size (PPS) cluster sampling method was used to obtain a representative state sample of 1200 school children. Spot urine samples were collected for the determination of urinary iodine concentration while the iodine content in salt was determined using field rapid test kits. The thyroid status was determined by palpation. Response rate was 92.0% (n=1104/1200). The prevalence of goitre among school children in Sarawak was 2.9% (5.2% in urban, 0.7% in rural). The median urinary iodine concentration (UIC) among the school children was 102.1 µg/L (IQR, 62.3-146.5 µg/L). Urban children had significantly higher median UIC of 109.3 µg/L (IQR, 72.4-159.0 µg/L) than their rural counterparts [91.9 µg/L (IQR, 55.7-140.2 µg/L)]. The salt samples tested by rapid test kit (RTK) showed only 46.0% of household salt contained iodine. The present study revealed that the population in Sarawak were of borderline iodine sufficient with mild IDD seen in rural areas. Hence, the state IDD control programmes need to encourage and advocate the consumption of iodized salt in order to eliminate IDD-related health problems in Sarawak.

Association of Diet Practice and Glycaemic Control among Type 2 Diabetes Mellitus Patients Attending Primary Care Clinic in Kuala Lumpur

Healthy dietary practice is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing the rate of diabetes complication development. It is, therefore, important at all levels of diabetes prevention. The objective of this study was to determine the association of dietary practice with glycaemic control among Type 2 diabetes mellitus (T2DM) patients, who received treatment from an urban Health Clinic in Kuala Lumpur. A total of 307 patients with T2DM aged 18 years and above participated in this study. A pre-tested structured questionnaire with guided interview was used to collect information on socio-demographic, clinical and dietary practice. Anthropometric and biological measurements were also taken. Descriptive statistics and Chi-square were used in the data analysis. Good glycaemic control was defined as HbA1c level less than 6.5%. The prevalence of good glycaemic control was only 27% (n=83). The highest percentage of good glycaemic control were among male patients (29.1%), aged 60 and above (33.3%), educational level of primary school (35.4%) and those with monthly income group between RM1001 to RM1500 (32.0%). About three quarter of T2DM patient (n=224) had poor control of HbA1c (≥6.5%). Age (p=0.045) and working status (p=0.039) had significant relationship with the level of HbA1c. Dietary practice showed no significant relationship with the HbA1c level. Effective interventional health education strategies are needed, focussing on modification of dietary behaviour in order to achieve glycaemic control among diabetic patients.​

Stages of smoking cessation among Malaysian adults--findings from national health morbidity survey 2006.

Increasing the rate of smoking cessation will reduce the burden of diseases related to smoking, including cancer. Understanding the process of smoking cessation is a pre-requisite to planning and developing effective programs to enhance the rate of smoking cessation.The aims of the study were to determine the demographic distribution of smokers across the initial stages of smoking cessation (the pre-contemplation and contemplation stages) and to identify the predictors of smoking cessation among Malaysian adult smokers. Data were extracted from a population-based, cross-sectional survey carried out from April 2006 to July 2006. The distribution of 2,716,743 current smokers across the pre-contemplation stage (no intention to quit smoking in the next six months) or contemplation stage (intended to quit smoking in the next six months) was described. Multivariable logistic regression analysis was used to examine the relationship between socio-demographic variables and the stages of smoking cessation. Of the 2,716,743 current smokers, approximately 30% and 70% were in the pre-contemplative and contemplative stages of smoking cessation respectively. Multivariable analysis showed that male gender, low education level, older age group, married and those from higher income group and number of cigarettes smoked were associated with higher likelihood of pre-contemplation to cease smoking in the next six months. The majority of current smokers in Malaysia were in the contemplative stage of smoking cessation. Specific interventions should be implemented to ensure the pre-contemplative smokers proceed to the contemplative stage and eventually to the preparation stage.

Iodized salt supplementation and its effects on thyroid status amongst Orang Asli in Hulu Selangor, Malaysia.

BACKGROUND: This research was performed to determine the prevalence of iodine deficiency disorder (IDD) and the effects of iodized salt supplementation on thyroid status amongst Orang Asli in Hulu Selangor, Malaysia. METHODS: Study respondents were from three target groups, i.e. pre-school children (PSC), primary school-going children (SGC) and adult women. Each household was supplied with iodized salt fortified with iodate fortificant for a period of 12 months and the iodine levels in the salt ranged from 20 to 30 µg/L. Samples collected before and after 6 and 12 months of introduction to iodized salt were urine from all groups, as well as serum samples from adult women. RESULTS: A total of 200 respondents were recruited; 58 (29.0%) PSC, 65 (32.5%) SGC and 77 (38.5%) adult women. The median urine-iodine concentration (mUIC) in all groups were of moderately low before the iodized salt intervention, but increased significantly in all study groups after 6 and 12 months of intervention. However, at the end of the study, there was an increase in severe iodine deficiency (mUIC <20 µg/L) from 7.5% to 12% and about 9% of PSC and SGC respondents had mUIC level of more than 300 µg/L while the adult women showed a significant increase in free triiodothyronine (fT3) levels. CONCLUSION: The study demonstrated that iodized salt supplementation was able to show an improvement in iodine level amongst Orang Asli. However, an increase in severe iodine deficiency and iodine excess indicated that the iodized salt programme needs to be carefully monitored.