Violence-Related Behaviors Among School Going Adolescents In Peninsular Malaysia

@#Violence among adolescents is a significant public health issue. The focus was on school-going adolescents because of the life-long negative impact at an individual level both for the perpetrator and victim. Besides, it increases the costs to provide health, welfare, and criminal justice as well as decreases general productivity at the community level. The study aims to determine the prevalence of violence-related behavior, characteristics of both victims and perpetrators, in addition to inter and intrapersonal factors associated with violence-related behaviors. A study was carried out in 2013, which involved all upper secondary school students (aged 16 to 17 years). It was a part of the Malaysian Adolescent Health Risk Behavior (MyAHRB) study, which was conducted in 11 states in Peninsular Malaysia. Standardized, validated questionnaires were used for data collection. The prevalence of violence-related behaviors was 22.4%, and this was higher among male students as compared to females (29.1% vs. 16.3%). Multivariable analysis revealed that the odds of violence-related behaviour increased among males, Malay race, drug use, smoking, had exposure to sex, which sometimes and always felt lonely and had attempted suicide. Agreeable to ensure that their lifestyles do not transgress religious limit and belief was significantly protective. This study provides evidence for a targeted approach to combat violence-related behaviors among adolescents.

Regulatory T cells (CD4+CD25+FOXP3+) in lupus nephritis

Background: Systemic lupus erythromatosus (SLE) is an autoimmune disease with 20–65% of patients developing lupus nephritis (LN). Studies have reported 10% of LN patients will end up with end stage renal disease and their mortality rate is higher compared to patients without LN. Abnormality of regulatory T cells (Tregs) level is thought to be a potential factor for this LN development. The aim of study was to evaluate the percentage of Tregs in LN patients.Methods: This was a comparative cross sectional study involving LN patients and age and gender matched controls with a 2:1 ratio. The patients were grouped into active and inactive LN based on their lupus activity index; complement levels, ANA, dsDNA antibodies, ESR, SLE Disease Activity Index (SLEDAI2K) score and also urine PCI (uPCI>0.05 for active group). Disease history, demographic data, routine blood test, peripheral blood for differentials count were taken and recorded. Peripheral blood mononuclear cells were stained with CD4, CD25 and Foxp3 antibodies and percentage of Tregs was analysed using BD fluorescence-activated cell sorting (FACS) cytometer. We compared demographic and laboratory parameters between healthy controls and LN patients as well as active and inactive LN patients.Results: A total of 34 LN patients (32 females, 2 males) were recruited. Their mean age and disease duration were 37.97±11.14 years and 110.95±65.07 months respectively.  Thirteen matched controls with mean age 35.23±7.89 years were enrolled. There was no demographic difference between 2 groups of LN patients. Tregs were significantly lower in active LN compared to inactive LN and healthy control (0.44±0.37% vs. 1.89±0.46% vs. 3.12±0.56% of the CD4+, P<0.001). C3 and C4 complement fragments were significantly reduced in patients with active disease (C3; 50.92±28.43 vs. 76.31±25.63, P=0.011) and (C4; 11.17±8.41 vs. 16.70±6.50 P=0.044). Proteinuria was significantly higher while serum albumin levels were significantly lower in active patients compared to inactive patients and healthy control (urine PCI; 0.25(0.15-0.3) vs. 0.03(0.01-0.05) vs. 0.01, P<0.001) and (albumin; 29.89±6.87 vs. 36.87±3.58 vs. 40.62±1.89mmol/L, P<0.001). We found positive inversely correlation between Tregs with SLEDAI2K (r = -0.572, P=0.011) and proteinuria (r = -0.451, P=0.007).Conclusions: Tregs, C3 and C4 complements, and albumin were significantly lower while proteinuria was significantly higher in active LN. There was positive inversely correlation between the percentage of Tregs with SLEDAI2K score and proteinuria.

The Use of Complementary and Alternative Medicine among Malaysian Chronic Kidney Disease Patients

@#Many of our chronic kidney disease (CKD) patients venture into complementary and alternative medicine (CAM) to seek a cure for the disease beyond conventional management. The objective of this study was to determine the prevalence and pattern of CAM usage; and its association with the progression of CKD in our population. This was a cross-sectional survey recruited CKD patients from Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Data was collected via interview using questionnaires which explore the demographics, type and pattern of CAM use. Patients’ comorbidities and serum creatinine were extracted from the medical notes to assess the association between progression of CKD and usage of CAM. Chi-square, Independent Samples t-test, Mann-Whitney U test and logistic regression were used to evaluate for an association. Three hundred and seventy two eligible patients were recruited. The prevalence of CAM use was 29% in the past year. Younger age, higher education and higher income level were associated with significantly more usage of CAM. Natural products were the commonest type of CAM used (86.1%). The belief in the effectiveness of CAM was the main reason for its uptake and about 57.8% revealed their practice to their physician. We found that the use of CAM in Malaysian CKD patients did not influence the progression of the disease.

Bacteraemia in Haematopoietic Stem Cell Transplant Recipients in a Single Tertiary Referral Centre

@#Bacteraemia is a common and one of the serious complications in haematopoietic stem cell transplantation (HSCT). To date, there are no published data on antibiotic resistance and clinical outcome among HSCT recipients in Malaysia. The aims of the present study was to analyse the prevalence, antibiotic resistance and clinical outcome of bacteraemia in HSCT recipients within 100 days following transplantation. We retrospectively analysed the prevalence, antibiotic resistance pattern and mortality rate of early bacteraemia among HSCT recipients in a single centre over a 5-year period (2013-2017). Thirty patients of 85 HSCT recipients developed bacteraemia with 40 positive cultures resulting in prevalence of 47% (40/85). Gram negative bacteria (GNB) accounted for 60.5% of total isolates. Enterobacteriaceae and Coagulase negative Staphylococcus (CoNS) were the commonest pathogens isolated. GNB showed a high resistance rate to ciprofloxacin. Only 30% of recipients responded to first line empirical antibiotics for febrile neutropenia (FN). The mortality rate was 13.3% (4/30), of which 50% was attributed to multi-drug resistance (MDR) Acinetobacter and 25% to extended spectrum beta-lactamase (ESBL) Enterobacteriaceae. Bacteraemia is a frequent and life-threatening early complication among HSCT recipients with MDR GNB being the commonest cause of mortality. The high rate of resistance to ciprofloxacin and failure of the first line empirical antibiotics to treat FN calls for a thorough evaluation of the current antibiotic prophylaxis and empirical treatment protocols. These findings have important clinical implications regarding the use and selection of both prophylactic and empiric antibiotic regimens to treat FN.

Geographical Information System (Gis) Application In Tuberculosis Spatial Clustering Studies: A Systematic Review

@#Tuberculosis (TB) is known as a disease that prone to spatial clustering. Recent development has seen a sharp rise in the number of epidemiologic studies employing Geographical Information System (GIS), particularly in identifying TB clusters and evidences of etiologic factors. The aim of this systematic review is to determine evidence of TB clustering, type of spatial analysis commonly used and the application of GIS in TB surveillance and control. A literature search of articles published in English language between 2000 and November 2015 was performed using MEDLINE and Science Direct using relevant search terms related to spatial analysis in studies of TB cluster. The search strategy was adapted and developed for each database using appropriate subject headings and keywords. The literature reviewed showed strong evidence of TB clustering occurred in high risk areas in both developed and developing countries. Spatial scan statistics were the most commonly used analysis and proved useful in TB surveillance through detection of outbreak, early warning and identifying area of increased TB transmission. Among others are targeted screening and assessment of TB program using GIS technology. However there were limitations on suitability of utilizing aggregated data such as national cencus that were pre-collected in explaining the present spatial distribution among population at risk. Spatial boundaries determined by zip code may be too large for metropolitan area or too small for country. Nevertheless, GIS is a powerful tool in aiding TB control and prevention in developing countries and should be used for real-time surveillance and decision making.

Perceived Susceptibility To Chronic Disease Among Healthy People Questionnaire: Development, Validity And Reliability Among Young Iraqi Adults

@#Chronic non-communicable diseases are the new emerging epidemic, and they are thought to challenge only rich countries; cardiovascular disease, cancer, diabetes, and other non-communicable diseases (NCDs) are now the leading cause of death and disability in low-income and middle-income countries, where they killed almost 8 million people younger than 60 years in 2013. Therefore, there is a need to develop a valid and reliable tool to measure the beliefs that influence people’s general behaviour, and a used to measure beliefs about chronic disease perceived susceptibility. The purpose of this study was to develop and validate the use of perception questionnaire among the young Iraqi adults. A total of 200 young adults participated who are free from any chronic diseases under study, and are living in Baghdad. The questionnaire, validated by an expert’s panel, translated to Arabic language, and pretested. Analyses included descriptive statistics of all the study variables, reliability estimates, and construct validity using confirmatory factor analysis (CFA). Results showed that mean age of respondents was 30 years old, majority were males 71.5%, and EFA showed that factor loading was more than 0.4. CFA results show that Chi-square (df) = 1.213(2); p value (>0.05) = 0.297. Internal consistency reliability analysis on health-related behaviour; special practice, information seeking and perceived probability of diseases have good Cronbach’s α value of between 0.8 - 0.9. These findings revealed that validation is favourable and can be utilized on larger scale of sample to proceed with main study on chronic disease perceived susceptibility among healthy people.

Barriers and Motivation Factors towards Treatment Compliance from the Perspective of Defaulted Tuberculosis Patients in Kuala Lumpur / Jurnal Sains Kesihatan Malaysia

There is a large volume of published studies describing the adverse relationship between treatment non-adherence with tuberculosis treatment outcome. Non-adherence could result in increased risks of prolonged infectiousness, drug resistance, relapse cases and poor survival among tuberculosis patients. Nevertheless, few studies are to be found providing detailed on the reason of defaulting treatment among tuberculosis patients in Malaysia. Hence the goal of this paper is to find out the barriers and motivations factors that affect patients’ treatment compliance among our local tuberculosis patients. This is a qualitative study which included 12 in-depth interviews with tuberculosis non-compliance patients who were treated at Institute of Respiratory Medicine, Kuala Lumpur. All the conversations were recorded, transcribed and analysed by using thematic analysis. It was found that low knowledge, self-negative attitudes, traditional believes, negative perceptions towards health caregiver, drug side effects, stigma, financial problems, less family support and work commitments are the barriers that prevent the patients from religiously taking their anti-tuberculosis treatment. Meanwhile, factors that encourage them to continue their treatment were the believes of bad effects of the disease onto their lives and health, good relationship between patient and health caregiver and social support from people around them. In conclusion, non-adherence involved a dynamic influence of individual, socio-economic and treatment-related factors on the patients. The results presented here may facilitate improvement in the activities in promoting compliance among tuberculosis patients in the future which tailored to the patients’ specific needs.

What It Takes To Set Up Travel Health Services: A Review From Countries With Established Service

@#As air travelling now becomes cheaper and available to almost all people of any walk of life, travelling across international borders is fast becoming a lifestyle of many. Having travel health service as part of health care services is important to address the issues of travel related illnesses among travellers. However, lacks of published guidelines pertaining to travel health service rendering many countries to overlook its importance. The aim of this paper is to review published literatures and authoritative websites on the components needed to develop guideline to establish travel health services. A systematic literature search was done using pre-specified keywords for literatures published between years 2000 – 2016. Literatures written in English and fully accessible were all included. No exclusion criteria was set before the search. Online authoritative websites pertaining to travel health were also referred. A total of six literatures ranging from expert opinion, review paper and original study, together with three authoritative websites related to travel health were reviewed. Among the important components needed to be considered for developing the guideline for establishing travel health services are to prioritise pre-travel health service, to set up specialised travel health clinic, to produce travel health/medicine specialist, to emphasize on continuous education and training of the practitioners and to apply multiagency and multidisciplinary approach with adequate fund for research in travel health. As a conclusion, policy makers should prioritise and select the most important components in developing guideline for travel health service.

Prevalence Of Premature Ejaculation And Erectile Dysfunction And Their Associated Factors Among Urban And Rural Population Of Malaysia

@#The purpose of this study was to determine the prevalence and factors associated with of Premature Ejaculation &Erectile Dysfunctionamong Malaysian men.A cross-sectional study was conducted in urban and rural areas using standardized and validated self-administeredquestionnaires.A total of 319 samples were recruited for PE screening. The overall prevalence of PE was 31.7% with 20.7% and 40.8% for urban and rural arearespectively. Depression, anxiety and frequent masturbation were significantly associated with PE. While For ED, infrequent sexual intercourse was the sole factor significantly associated with ED.PE and ED were highly prevalent in both urban and rural areas; with several significant preventable associated factors.

Use of traditional medicine among type 2 diabetic Libyans

The use of traditional medicines is common among patients with chronic illnesses and this practice might pose health risks. The use among Libyan patients with diabetes is unknown. Therefore, this study aimed to estimate the prevalence of traditional medicine use in the previous year among Libyans with type 2 diabetes and to examine the association between its use and sociodemographic and clinical characteristics of the patients. A cross-sectional study was conducted at a large diabetes centre in Tripoli. A self-reported questionnaire was used for data collection. Of the 523 respondents, 28.9% used traditional remedies. Sex was the only variable significantly associated with traditional medicine use; more women used traditional medicines [P = 0.01]. A total of 77 traditional medicine items were reported to be used, of which herbs were the most common. The use of traditional medicine for diabetes is prevalent and some of the reported items could pose health risks. Health education programmes are suggested to raise the awareness of the health risks of this practice

Neigbourhood Factors on Mental Health Questionnaire: Development, Validity, and Reliability among Malaysian Adolescents

The risk factors associated with mental health among adolescents are usually described by researchers at an individual level. Neighbourhood factors and health have opened a new insight into the field of epidemiology. The aim of this study was to assess the reliability and validity of a newly developed Neighbourhood Factors on Mental Health Questionnaire among Malaysian adolescents. A cross-sectional study was conducted in four secondary schools in Kuala Lumpur, Malaysia using a newly developed questionnaire which comprised of two main domains and seven items. Exploratory factor analysis and Cronbach’s alpha were used to measure the instrument’s construct validity and reliability. A total of 106 adolescents participated in this research. The majority of adolescents were 13 years old (40.6%), female (55.7%), Malays (68.9%), have parents who only studied until secondary school (66.0%) and lived in flats (32.1%). Bartlett’s Test of Sphericity was significant (Chi-square = 258.361, p<0.001) and Kaiser-Meyer-Olkin (KMO) value was 0.820. The final model of the instrument contained two domains, the neighbourhood physical environment and neighbourhood social environment factors. Factor loadings for all items were satisfactory ranging from 0.591 to 0.870. The overall Cronbach’s alpha was 0.810. The Neigbourhood Factors on Mental Health Questionnaire was found to be a valid and reliable instrument. It can be used to assess neighbourhood physical and social factors that can influence mental health of adolescents in Malaysia.​

Previous treatment, sputum-smear nonconversion, and suburban living: the risk factors of multidrug-resistant tuberculosis among Malaysians

The number of multidrug-resistant tuberculosis patients is increasing each year in many countries all around the globe. Malaysia has no exception in facing this burdensome health problem. We aimed to investigate the factors that contribute to the occurrence of multidrug-resistant tuberculosis among Malaysian tuberculosis patients. An unmatched case-control study was conducted among tuberculosis patients who received antituberculosis treatments from April 2013 until April 2014. Cases are those diagnosed as pulmonary tuberculosis patients clinically, radiologically, and/or bacteriologically, and who were confirmed to be resistant to both isoniazid and rifampicin through drug-sensitivity testing. On the other hand, pulmonary tuberculosis patients who were sensitive to all first-line antituberculosis drugs and were treated during the same time period served as controls. A total of 150 tuberculosis patients were studied, of which the susceptible cases were 120. Factors found to be significantly associated with the occurrence of multidrug-resistant tuberculosis are being Indian or Chinese [odds ratio 3.17, 95% confidence interval 1.04-9.68; and odds ratio 6.23, 95% confidence interval 2.24-17.35, respectively], unmarried [odds ratio 2.58, 95% confidence interval 1.09-6.09], living in suburban areas [odds ratio 2.58, 95% confidence interval 1.086.19], are noncompliant [odds ratio 4.50, 95% confidence interval 1.71-11.82], were treated previously [odds ratio 8.91, 95% confidence interval 3.66-21.67], and showed positive sputum smears at the 2[nd] [odds ratio 7.00, 95% confidence interval 2.46-19.89] and 6[th] months of treatment [odds ratio 17.96, 95% confidence interval 3.51-91.99]. Living in suburban areas, positive sputum smears in the 2[nd] month of treatment, and was treated previously are factors that independently contribute to the occurrence of multidrug-resistant tuberculosis. Those with positive smears in the second month of treatment, have a history of previous treatment, and live in suburban areas are found to have a higher probability of becoming multidrug resistant. The results presented here may facilitate improvements in the screening and detection process of drug-resistant patients in Malaysia in the future

Prevalence And Risk Factors Of Premature Coronary Artery Disease: A Comparative Cross-Sectional Study Between Two Time Frames In Malaysia

Limited studies on prevalence and risk factors of Premature Coronary Artery Disease (PCAD) were done in Malaysia, primarily on lipid profile. This cross sectional study aims to identify any changing patterns in prevalence and risk factors of Premature CAD between 2000 and 2012. From 2000 to 2012 we included 21862 patients who underwent the first Percutaneous Coronary Intervention (PCI). Analysis of risk factors was done to 1660 and 2098 patients from year 2007 and 2012 respectively. Age of less than 45 years was taken as PCAD. Data was collected from PCI database of National Heart Institute (NHI), NHI TrakCare System, and patients’ medical records. PCAD significantly decreased from 18.8% (2000) to 11.6% (2012). Malay ethnicity showed increasing trend over the years from 55.1% to 66.9%. Multiple logistic regression analysis in 2007 showed that smoking had the higher risk (AOR=2.52), followed by male gender (AOR=2.06), family history of PCAD (AOR=1.96), Indian ethnicity, (AOR=1.65), triglycerides level (AOR=1.20) and BMI (AOR=1.06). In 2012, family history of PCAD had the highest risk (AOR=2.00) followed by smoking (AOR=1.91) and BMI (AOR=1.11). There are changes in risk factors patterns of premature CAD between 2007 and 2012. Most of them are preventable at earlier stage.

Anxiety and Depressive Symptoms among Ischaemic Heart Disease Patients in a Malaysian Tertiary University Hospital

Anxiety and depression were known to bring detrimental outcome in patients with ischemic heart disease (IHD). Notwithstanding their high prevalence and catastrophic impact, anxiety and depression were unrecognized and untreated. The aim of this study was to determine the prevalence of anxiety and depression among IHD patients and the association of this condition with clinical and selected demographic factors. This was a cross-sectional study on 100 IHD patients admitted to medical ward in UKMMC. Patients diagnosed to have IHD were randomly assessed using Hospital Anxiety and Depression Scale (HADS) and Perceived Social Support (PSS) Questionnaire. Socio-demographic data were obtained by direct interview. Fifteen percent of IHD patients in this sample were noted to have anxiety, fourteen percent noted to have depression while thirty two percent was noted to have both anxiety and depression. Patients’ age group and the duration of illness were found to have significant association with anxiety. Socio-demographic data were obtained by direct interview. Fifteen percent of IHD patients in this sample were noted to have anxiety, fourteen percent noted to have depression while thirty two percent was noted to have both anxiety and depression. Patients’ age group and the duration of illness were found to have significant association wit¬h anxiety. The other clinical and selected demographic factors such as gender, race, marital status, education level, occupation, co-existing medical illness and social support were not found to be significantly associated with anxiety or depression among the IHD patients. In conclusion, proper assessment of anxiety and depression in IHD patients, with special attention to patients’ age and duration of illness should be carried out routinely to help avert detrimental consequences.​

Validation of the Malay Version of the Parental Bonding Instrument among Malaysian Youths Using Exploratory Factor Analysis

Background: Parenting behaviour is culturally sensitive. The aims of this study were (1) to translate the Parental Bonding Instrument into Malay (PBI-M) and (2) to determine its factorial structure and validity among the Malaysian population. Methods: The PBI-M was generated from a standard translation process and comprehension testing. The validation study of the PBI-M was administered to 248 college students aged 18 to 22 years. Results: Participants in the comprehension testing had difficulty understanding negative items. Five translated double negative items were replaced with five positive items with similar meanings. Exploratory factor analysis showed a three-factor model for the PBI-M with acceptable reliability. Four negative items (items 3, 4, 8, and 16) and item 19 were omitted from the final PBI-M list because of incorrect placement or low factor loading (< 0.32). Out of the final 20 items of the PBI-M, there were 10 items for the care factor, five items for the autonomy factor and five items for the overprotection factor. All the items loaded positively on their respective factors. Conclusion: The Malaysian population favoured positive items in answering questions. The PBI-M confirmed the three-factor model that consisted of care, autonomy and overprotection. The PBI-M is a valid and reliable instrument to assess the Malaysian parenting style. Confirmatory factor analysis may further support this finding.

Factors Related To Low Birth Weight Babies In Baghdad City, Iraq

Great importance has been attributed to birth weight all over the world because it is considered as one of the best predictors of prenatal survival and a good indicator of quality life. The objective of this study was to determine the prevalence of low birth weight babies (LBW) and factors related to it in Baghdad city. A cross sectional study was carried out in four general hospitals in Baghdad city, Iraq. A total of 225 newborn babies, alive, singleton and without congenital malformation were selected randomly from these four general hospitals.The result of the study showed the prevalence rate of low birth weights was 21.3%. Mothers’ educational level, monthly family income, mothers with chronic hypertension, mothers with history of previous low birth weight infants and anemic mothers were significantly associated with low birth weight babies (P= 0.03, 0.01, 0.02,<0.01, 0.02) respectively. It is clearly evidenced the lack of equity in populations and disparity in socioeconomic status are common related factors for the low birth weight babies as can be seen as a public and global health problem.

Chronic Kidney Disease Stage 3B among Malaysian Diabetics in Primary Care and its Associated Factors: A Pilot 5-Year Case Control Study

The present study aimed to determine the factors associated with CKD stage 3b among type 2 diabetics attending primary care follow-up, specifically the role of angiotensin blockade dosage. This was a pilot unmatched case-control study conducted in a teaching primary care centre. Clinical data of 25 cases of diabetic patients with CKD stage 3b (GFR 30-45ml/min/1.73m2) in 2012 were selected for this study, as well as 103 controls who were diabetic patients with GFR more than 45ml/min/1.73m2 in 2012. Systematic random sampling was employed. Data was obtained from patients’ diabetic records, computerised clinical medical information system and medical case notes. Univariate analysis was done using Chi-square, t-test, Fisher’s exact test and Mann-Whitney U-test. Multiple logistic regression was used to determine the associated factors for development of CKD stage 3b. Cases and controls were different in terms of age, duration of diabetes, use and dosage of angiotensin blockade medications, systolic blood pressure and baseline GFR. Multiple logistic regression revealed that systolic blood pressure (Adjusted OR= 1.08, 95% CI= 1.02-1.14, p=0.013) and baseline GFR (Adjusted OR= 0.90, 95% CI= 0.85-0.95, p<0.001) was significantly associated with the development of CKD stage 3b among diabetics. Maximizing the dose of angiotensin blockade had a protective effect (Adjusted OR= 0.14, 95% CI=0.85-0.95, p=0.025). The results of the present study supports the need for good control of systolic blood pressure among diabetic patients to reduce the risk of chronic kidney disease progression. Dose of angiotensin blockade medications should be optimised in these patients.

Predictors of mortality in patients with Acute Coronary Syndrome (ACS) undergoing Percutaneous Coronary Intervention (PCI): Insights from National Cardiovascular Disease Database (NCVD), Malaysia

The aim of this study is to determine risks factor of mortality among patient with post percutaneous coronary intervention. Estimation of post operative mortality risk factor is essential for planning prevention modalities. This is retrospective cohort study based on secondary data extracted from the National Cardiovascular Disease Database (NCVD-ACS and NCVD PCI). Both these registries were interlinked and was further matched to JPN (Jabatan Pendaftaran Negara/National registration Department) to assess mortality among the patients who underwent PCI and all death which occurred in between 2007, 2008 and 2009. There were 630 patients in this studied. Age, history of diabetes mellitus, peripheral vascular, renal failure and previous percutaneous coronary intervention were univariately associated with mortality. However based on logistics stepwise method, only age and history of renal failure had showed statistically significant and sizeable odds ratio in predicting the patient died of coronary death. Older age and renal failure are the predicting factors for mortality among patients with post percutaneous coronary intervention.

Factors Influencing Childhood Immunization Defaulters in Sabah, Malaysia

The purpose of this study was to determine the prevalence of defaulters of immunization, and their associated risk factors among children age 12 to 24 months. Materials and Methods: A cross-sectional study was conducted in all government's maternal child health clinics in District of Kota Kinabalu, Sabah. Data was collected using a standardised questionnaire from July to November 2006. Results: The prevalence rate for defaulting immunization was 16.8% from the 315 respondents. Bivariable analysis showed various significant factors associated with defaulters such as mother’s employment status, family mobility, transportation and cost. Nonetheless, multivariable analysis showed only mother’s age, mother employment status and family size were the significant predictors for defaulting immunization. Immunization that had the highest rate of defaulters was DPT–OPV booster dose (56.6%), followed by MMR immunization (43.4 %) and DPT-Hib/OPV and Hep B third dose (37.7%).Conclusion: Employed mothers with bigger family size should be more closely monitored and advised to reduce the chance of defaulting on the immunization. Health promotion activities also should focus to these groups of mothers.

Parental Concerns and Control in Feeding of 9 to 12-Year-Old Children in a Primary School in Kuala Lumpur, Malaysia

Introduction: Body weight of children is affected by many factors including food habits which are influenced by their parents. Studies in the West have shown that parents tend to control child feeding in response to their child’s weight status. The aim of this study was to assess Malaysian parental concerns about child weight and the control they exert on child feeding. Methods: This crosssectional study was conducted on parents and their children aged 9 to 12 years from a primary school in Kuala Lumpur. The weight status of the children was classified according to the body mass index-for-age growth chart. Parental concerns about child weight and control in child feeding was assessed using the adapted Malay version of Child Feeding Questionnaire. Results: A total of 204 parents participated in this study. The study found that being a female served as a protective factor against becoming overweight (OR:0.28, CI:0.13-0.62). Parents with overweight children were significantly older (OR:1.08, CI:1.01-1.15), concerned about their child’s weight (OR:2.77, CI:1.49-5.12) and controlled their child’s feeding by restricting food intake(OR:2.70, CI:1.30-5.60). They were less likely to pressure their children to eat (OR:0.32, CI:0.19-0.56). Parents from the low income group were more likely to have underweight children (OR: 4.15, CI:1.28-13.47). Conclusion: There was significant difference in level of parental concern across differing child weight status. Parents with overweight children were likely to be more concerned about their child’s weight, tending to control their feeding. In contrast, parents with underweight children did not exert control on their feeding.