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Abstract@#Introduction: Sustained optimal adherence to antiretroviral therapy (ART) is required for long-term suppression of viral replication. However, adherence level in Jos, Nigeria has been reported to be below optimal adherence, thus this study investigates the predictors of adherence to antiretroviral therapy among Human Immunodeficiency Virus (HIV) patients there. Methods: A validated and pretested questionnaire was used in this cross-sectional study to collect data on sociodemographic characteristics, duration of being on ART, alcohol consumption, presence of symptoms, drug type and disclosure status from 224 randomly selected adult HIV patients. Chi-square and binary logistics regression were used for data analysis. Level of significance was set at 0.05. Results: Only 14.3% of the respondents had optimal adherence. Adherence to ART is significantly associated with gender (p = 0.043), duration of ART use (p = 0.041), alcohol (p = 0.029), drug type (p = 0.001), and disclosure status (p = 0.004). Binary logistics regression reveals that females are 2.4 times more likely to have optimal adherence than males, patients on ART for over 10 years are 2.5 times more likely to have optimal adherence than those less than 10 years, and patients with disclosed HIV status are 3.3 times more likely to have optimal adherence than those who had not. Conclusion: Generally, the patients had suboptimal adherence. Being female, having longer duration on ART and disclosure status are predictors for optimal adherence. Intervention with emphasis on males and new patients on ART is recommended to educate on optimal adherence and motivate patients to disclose their status.
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According to the Youth Behaviour Risk Factor Surveillance (YBRFSS, 2011) in Malaysia, the prevalence of smokers nationally among Form 1, 2 and 4 students government secondary school students was 9.1% (ever smokers) and 8.7% (current smokers). However, there is limited information on the prevalence of smoking among religious secondary school students and self-esteem as risk factor. Thus, this study was conducted to determine the prevalence and factors associated with smoking among the religious secondary school students in Petaling district, Selangor. Methods: A cross-sectional study was conducted among 899 students. The schools were selected using cluster sampling and self-administered questionnaire was used. Data was analyzed using chi-square test and multivariate logistic regression to identify the independent factors for smoking. Results: The response rate was 94%. The prevalence of ever smoking was 10.1%; 3.9% among female and 18.6% among male. The median age (interquartile range) of smoking initiation was 12.00 (4.01) years. The results showed that independent factors for smoking were: males (OR= 5.47); age group 14-15years (OR=2.82) and 16-17 years (OR=3.63) and having low self -esteem (OR=6.24). Conclusion: prevalence of ever smokers is higher when compared to YBRFSS, (2011) and it was revealed that most of the smokers started smoking even before secondary school. The results also revealed the importance of promoting self-esteem. Efforts in smoking prevention should therefore be focused on curbing the initiation of the acts and improving students’ self-worth
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Primary care providers play an important gatekeeping role in ensuring appropriate referrals to secondary care facilities. This cross-sectional study aimed to determine the level, pattern and rate of referrals from health clinics to hospitals in the public sector, and whether the placement of resident family medicine specialist (FMS) had made a significant difference. The study was carried out between March and April in 2012, involving 28 public primary care clinics. It showed that the average referral rate was 1.56% for clinics with resident FMS and 1.94% for those without resident FMS, but it was not statistically significant. Majority of referred cases were considered appropriate (96.1%). Results of the multivariate analysis showed that no prior consultation with senior healthcare provider and illnesses that were not severe and complex were independently associated with inappropriate referrals. Severity, complexity or uncertain diagnosis of patients’ illness or injury significantly contributed to unavoidable referrals. Adequate facilities or having more experienced doctors could have avoided 14.5% of the referrals. The low referral rate and very high level of appropriate referrals could indicate that primary care providers in the public sector played an effective role as gatekeepers in the Malaysian public healthcare system.
Subject(s)
Gatekeeping , Primary Health CareABSTRACT
Pre-hypertension increased the risk of morbidity and mortality from non-communicable diseases. Whereas, psychological factors such as depression, anxiety and stress have been associated with increased in blood pressure. However, previous studies more focuses on psychological determinants of hypertension than prehypertension. Thus, this study aims to determine the association between these psychological factors with pre-hypertension. A cross-sectional study was conducted in 2012 among first year students of a public Malaysian university. A random cluster sampling was used to select 5 out of 15 faculties and a total of 495 students participated in this study. The Malay version of DASS-21 was used to elicit their levels of depression, anxiety and stress. Blood pressures were measured twice using sphygmomanometer and the averages were taken. Data analyses used chi-square test and binary multiple logistic regression. The prevalence of pre-hypertension was 30.1%. The percentage of severe and extremely severe depression was 3.8% and 1.2%; both severe and extremely severe anxiety was 16.4%; and severe and extremely severe stress was 4.2% and 0.2% respectively. Severe/extremely severe depression had more than 3 times higher in getting pre-hypertension than no depression. In conclusions, almost one third of respondents had pre-hypertension and only severe/extremely depression was associated with pre-hypertension.
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PrehypertensionABSTRACT
There is an increasing trend in smoking among rural adolescents compared to urban adolescents in Malaysia. This study was to determine the relationship between religious personality and smoking among form two students from the rural schools in Malacca. Methods: This was an unmatched case-control study conducted from May 2010 to August 2010 among form two school children from rural area in Malacca. There were 484 cases, and 444 controls selected using randomized cluster sampling. The dependent variable was smoking, and the independent factors were religious personality. Validated and reliability-tested questionnaires were used for data collection. Results: The mean age (year) at which smoking was first tried among the cases was 11.39 + 2.107. There were eleven out of twenty three significant differences between religious personality statements in the cases and control group. Those were: reciting the Quran/Holy book/Scriptures even when busy, making efforts to deepen the understanding of the religion, trying to understand the teachings of the religion in the Holy book/Quran, inviting others to perform solat/prayer/religious service, making sure all the family members are following the teachings according to the religion, referring to the learned people when feeling uncertain about the rulings/teachings of the religion, performing work duties enthusiastically because of the religion/God, making efforts to remember death and afterlife often, making efforts to internalize the ethical conduct of the religion in daily life, setting aside money every year for religious purposes and looking for opportunities to give charity. Conclusion: Religious personality is an important factor which may influence adolescents volved in smoking.