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@#Introduction: Childhood obesity is a public health problem in Malaysia. Intake of sugar-sweetened beverages (SSB) is associated with obesity in children. There is a lack of studies on factors associated with SSB consumption in Malaysia. This study aimed to determine the sociodemographic factors associated with SSB consumption among Malaysian adolescents. Methods: Data of 2,021 students, aged 10-17 years on sociodemographic, SSB intake and anthropometrics were drawn from the school-based Adolescent Nutrition Survey 2017. A multistage stratified cluster sampling was used to obtain a nationally representative sample of primary and secondary school students. Body mass index (BMI)-for-age status was determined based on calculated z-score using the World Health Organization 2007 reference. SSB consumption was obtained from a food frequency questionnaire. Results: The prevalence of overweight and obesity among Malaysian adolescents were 16.6% and 14.7%, respectively. Malaysian adolescents consumed 1.4 cups of SSB per day. Rural children had a significantly higher SSB intake (1.5 cups) than urban (1.3 cups) children, while males (1.5 cups) had a significantly higher intake than females (1.3 cups). There were no significant differences in SSB consumption between thin, normal, overweight and obese adolescents. Conclusion: Almost all Malaysian adolescents consumed SSB during one month prior to the survey and the average amount consumed was 1.4 cups per day. Rural locality and male were associated with higher SSB consumption. There were differences in SSB consumption between Chinese and Malays, between Chinese and Indians, and between Chinese and Bumiputra Sarawak. There were no differences in consumption between the different BMI-for-age categories.
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@#Introduction: Prevalence of malnourished children in Putrajaya was unexpectedly high in 2016. This paper describes the study protocol for a case-control study conducted to identify the associated factors of malnutrition among children under 5 years old in Putrajaya. Methods: This study involved two phases. Phase I was ‘screening’ where all children aged 6-59 months in 118 preschools and four government health clinics were measured for their weight and height. The World Health Organization Anthro software was used to determine the nutritional status of these children. Phase II was the ‘interview’ where children from screening were sampled into four pairs of case and control. The optimum sample size for the case of stunted, wasted, underweight, and overweight were 380, 335, 318, and 308, respectively. The same number of controls were recruited. Parents/caregivers of selected children were approached to obtain data on parental factors, children factors, food intake factors, and environmental factors that contributed to malnutrition. Data analysis was performed by multiple logistic regression in SPSS version 26. Results: Screening phase successfully measured 8,261 (50.1%) children from an estimated 16,500 children under 5 years old in Putrajaya. The number of children who were stunted, wasted, underweight, and overweight were 2,105 (25.5%), 512 (6.2%), 1,516 (18.4%), and 248 (3.0%), respectively. As overweight was undersampled, the number of controls for overweight was doubled to increase the power of the study. Parents/caregivers of selected cases and controls were interviewed in their household or any other venues at their convenience. Conclusion: This protocol promises beneficial outputs to stakeholders and policy makers that can be used for combating malnutrition in children.
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@#Excessive salt intake has been linked to the development of hypertension and non-communicable diseases. This study aims to explore the different types of salt reduction intervention implemented among adults aged ≥18 years and to identify the suitable settings, duration and tools used for effective salt reduction interventions. This review adapted the established structured scoping review framework by Arksey and O’Malley. Related articles from the year 2008 to 2018 were retrieved based on the study objectives using keywords in electronic databases and through a bibliographic search of books, reports, conference proceedings, posters and summaries. Out of 130 potentially relevant full-text articles assessed, 14 articles were included in the review. Suitable salt reduction initiatives for the community who regularly consume home-cooked food are through cooking and usage of a tool such as a salt-restriction spoon, together with awareness on the benefits of salt reduction in their daily diet. Healthy catering initiative should be implemented in the workplace or institution-based settings. Policy development targeting the source of salts such as mandatory usage of salt-substitutes or Front-of-Pack labelling of salt content in all food products suitable for population-level intervention.
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@#Introduction: Adolescence is an important growth period for individuals. High prevalence of obesity among adolescents in Malaysia in recent years is worrying. This study aims to assess associations of gender and BMI-for-age status (BAZ) with nutrient intake of adolescents between 13-17 years old in Malaysia. Methods: Data of 999 respondents were drawn from Adolescent Nutrition Survey 2017; a cross-sectional school-based survey involving adolescents aged 10 to 17 years old. Respondents were selected using multistage stratified cluster sampling from 13 states and three federal territories in Malaysia to ensure nationally representative data. Data collection was undertaken from March until May 2017. Dietary intake was assessed using a single 24-hours dietary recall conducted via face-to-face interview by trained nutritionists. Nutritionist ProTM Diet Analysis Software was used to calculate nutritional intake values. Anthropometric measurements were measured using validated equipment. Nutritional status of the respondents was assessed using BMI-for-Age z-score and categorised based on WHO Growth Reference 2007. Results: The mean energy intake of the adolescents was 1972 kcal/day. Majority of the adolescents had normal BMI (74.6%) while overweight, obese and thinness were 12.0%, 7.2% and 6.2% respectively. Boys had significantly higher intakes of energy, carbohydrate, protein, fat, sugar, cholesterol, thiamin, Vitamin A, calcium, iron, sodium and potassium compared to the girls. Obese adolescents had significantly higher energy, carbohydrate, fat, sugar, Vitamin A and calcium intakes compared to other BMI groups. Conclusion: The findings highlighted the need for cultivating self-awareness on healthy eating among adolescents.
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An Analysis of a Survey Questionnaire on health care workers’ knowledge and practices regarding of infection control and complains them to apply universal precautions. Health care workers are at substantial risk of acquiring blood borne pathogen infections through exposure to blood or other products of patients. To assess of infection control among health care workers in Sana'a healthcare centers, Yemen. A cross-sectional study was conducted in the health center to assess knowledge and practices regarding of infection control among 237 health workers in Sana,a city. A structured self-administered questionnaires were used and data was analyzed using SPSS version 20 and the associations were tested with chi-square, with p-value of < 0.05. The health care workers in public centers ware (51.1%) and (48.9%) of them works in private centers. One hundred and seventeen (49.4%) respondents had poor infection control knowledge, 113 (43.5%) had fair knowledge, and 17 (7.2%) had good knowledge. The knowledge was significantly associated with type of center (P < 0.018), such that the public center had the highest proportion with poor knowledge. And nurses and midwife having the highest proportion with fair knowledge of infection control. Eight (3.4%) respondents had a poor practice of universal precautions, 93 (39.2%) had fair practice, and 136 (57.4%) good practice. The practice was significantly associated with the profession, level of education and work experience (P < 0.001), (P < 0.006), (P < 0.001) respectively, and nurses and midwives as the profession with the highest proportion with good practice. We conclude that the practices and knowledge of universal precautions were low and that's need for intensive programmes to educate health care workers on various aspects of standard precautions and infection control programmes and policies.
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Overweight and obesity is a major public health problem in Malaysia. This study aims to determine the prevalence of overweight and obesity among the Malaysian adult population and their association with socio-demographic characteristics (gender, ethnic, and age groups). A total of 17,257 adults aged 18 years and older (8,252 men, 9,005 women) were assessed for BMI status, with a response rate of 97.8%, through a household survey from the National Health and Morbidity Survey (NHMS), conducted in all states of Malaysia in 2011. All socio-demographic factors were consistently associated with higher chance of being overweight (except gender and location) and obesity (except location and household income). The identified risk of overweight were Indian (aOR: 1.8, 95% CI: 1.2-2.8), aged 50-59 years (aOR: 2.8, 95% CI: 2.0-3.9), widower (aOR: 1.6, 95% CI: 1.3-2.0), subject with secondary education (aOR: 1.2, 95% CI: 1.0-1.4), Homemaker/unpaid worker (aOR: 1.3, 95% CI: 1.1-1.4), and with high household income group (aOR: 1.3, 95% CI: 1.2-1.6). The identified risk of obesity were women (aOR: 1.4, 95% CI: 1.2-1.6), Indian (aOR: 1.7, 95% CI: 0.9-3.2), aged 30-39 years (aOR: 3.6, 95% CI: 2.4-5.5), widower (aOR: 1.2, 95% CI: 0.9-1.6), subjects with primary education (aOR: 1.2, 95% CI: 0.9-1.6), Homemaker/unpaid worker (aOR: 1.3, 95% CI: 1.1-1.6), and with middle household income group (aOR: 1.3, 95% CI: 1.2-1.6). Our data indicate a high prevalence of overweight and obesity in the population. Several sociodemographic characteristics are associated with both overweight and obesity. This study highlights the serious problem of overweight and obesity among Malaysia adults. Documentation of these problems may lead to research and policy agendas that will contribute both to our understanding and to the reduction of these problems.
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Introduction: Child malnutrition continues to be a major public health problem in developing countries. This study aims to determine the current nutritional status of Malaysian school children using the anthropometric indicators of weight for age (WAZ), height for age (HAZ), and body mass index for age (BAZ). Methods: A nationwide school-based survey was undertaken in all Malaysian states and territories, which included 18,078 children aged 8-10 years attending 445 primary schools. The software WHO AnthroPlus was used to calculate zscores for the nutritional status (WAZ, HAZ and BAZ) of the target population relative to the World Health Organization (WHO) 2007 reference. Results: The national prevalence of underweight among school children was 13.6% and in rural areas, this rate was nearly double that of urban areas. The national prevalence rate for stunting was 10.9%, double among rural school children compared to their urban counterparts. As for thinness, the national prevalence was 6.5%. Using the WAZ indicator, we found that the national prevalence of overweight children was 7.6%. Additionally, we found that urban areas showed a higher prevalence of overweight children (8.8%) than rural areas (5.9%). Conclusion: The findings of this study indicate that Malaysian school children face the burden of malnutrition, suffering from both undernourishment and overweight. Malaysia must make a concerted effort to overcome the problems of malnutrition among children.
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Malnutrition can be associated as one of the factors which affect health status. The term is used to describe imbalance of nutrients either over- or under-nourished, resulting in measurable adverse effects on body composition, function and clinical outcome. The National Health And Morbidity Survey (NHMS) 2011 assessed 4304 individuals aged 10-17 years old through a household survey of Malaysian population. Thinness and obesity are the malnutrition indicators based on Centre for Disease Control (CDC) 2000 classification as recommended by WHO (2007). The findings of the survey showed that the national prevalence of thinness (BMI for age <-2SD), was 9.7% (95% Confidence Interval: 8.4-11.2). The state of Sabah/Labuan had the highest thinness of prevalence, 17.0% (11.1-25.2) and lowest in Penang at 5.3% (2.7-10.0). The prevalence of thinness was higher in urban areas than in rural areas at 10.3% (8.5-12.3). Meanwhile; national prevalence of obesity (BMI for age ≥+2SD) was only 5.7% (4.9-6.7). The state of Perak had the highest obesity prevalence 10.0% (6.2-15.8) and lowest in Sabah/Labuan at 2.4% (1.4-4.1). The obesity prevalence was higher among adolescents in urban areas at 6.3% (5.2-7.6) than in rural areas. Thinness as a form of malnutrition is more prevalent than obesity. Even though the prevalence of obesity is low, the impact affects not only the adolescents, but also the family, the society and the nation in the future. The increasing prevalence of obesity will have significant public health implication related to non-communicable diseases.