coexistence of dual form of malnutrition in a sample of rural Malaysia

The co-existence of under and over nutrition might be influenced by a marked shift in dietary and lifestyle practices of people in developing countries. This study aims to identify the factors associated with the occurrence of a dual form of malnutrition in the same households in a rural district in Peninsular Malaysia. This study was conducted in two phases. The first phase involved a survey of 223 mother-child pairs that fit the required criteria [223 non-pregnant, non-lactating mothers aged 18 to 55 years old and 223 children aged 2 to 12 years old]. Anthropometric indices: Weight-for-age Z score [WAZ] /= 25 kg/m2 was used to measure overweight status among mothers. The results showed that the prevalence of overweight mother/underweight child [OWM/UWC] pairs was 66 [29.6%], and that the prevalence of normal weight mother/normal weight child [NWM/NWC] pairs was 34 [15.2%]. The second phase of the study involved a case-control comparison of the 66 OWM/UWC pairs and the 34 NWM/NWC pairs. A pre-tested questionnaire was used to gather socio-economic-demographic data, whereas food frequency questionnaire was used to assess diet diversity. The results indicated that 61.0% of the children were underweight and 61.4% were stunted, whereas the prevalence of overweight and obesity in women were 35% and 17%, respectively. The study did not report any association between the dual burden of malnutrition and household size, number of children, educational level of the mother, total income, income per capita, and food expenditure. The only association reported was with household type [OR: 5.01; 95% CI; 63, 15.34; P = 0.005]. In general, the total diet diversity score of both types of mother-child pairs was low. Compared with overweight mothers, normal weight mothers had a higher diet diversity score for at least six food groups and for the total diet diversity score, although these differences were not significant. The clustering of dual forms of malnutrition in the same household poses big challenges for food intervention programs. Although, this study cannot make an inference for the whole population, the results shed light on a serious public health issue that must be addressed

National response to neurological diseases in Malaysia: planning for the future.

The number of cases of neurological disease is expected to rise in the next 10 years, making this the second leading cause of morbidity and mortality after heart disease in Malaysia. The lack of human resources in the neurological field currently serving the Malaysian population may cause a deficiency in specialized care, especially in rural areas where neurological and neurosurgical care may be lacking. Thus, a resolve was made to increase the numbers of specialists by the Universiti Sains Malaysia (USM) with the help of the Ministry of Health of Malaysia. A study was made to evaluate the number of referral centers needed in strategic parts of Malaysia. Our calculation was based on service demands and operative procedures following the guidelines of the Association of British Neurologists (ABN) where 15 minutes of service time was equivalent to 1 unit. Based on 2 million population covered in the state of Kelantan by this University Hospital, 4.27 neurologists are needed to meet service demands with a consultant to population ratio (CPR) of 1:468,384, compared to 7.46 neurosurgeons, with a CPR of 1:268,097. According to the current service demands, one neurologist has to work more than 407 hours per year and one neurosurgeon 1,219 hours per year in our hospital. Hospitals with a larger catchment area would need to have more neurologists and neurosurgeons for optimal care in their area. Thus, more neurologists and neurosurgeons are needed to be produced, since the existing numbers are too small for quality care in Malaysia.