Undernutrition is the result of complex interplay of factors such as household food security, childcare, feeding practices, nutrition and sanitation. Therefore, this study aimed to determine the prevalence of stunting, wasting, underweight based on WHO child growth standards 2006 and undernutrition based on Composite Index Anthropometric Failure (CIAF) and its association with the biological, behavioural, socio-economic and physical environment factors among children under-5 years. This was a cross sectional study involving children aged between 6 and 59 months recruited through stratified random sampling from the Tenom district. Sociodemographic background was obtained from mothers via a questionnaire. Height and weight measurements were measured using standardised instrument. The height-for-age, weight-for-age and BMI-for-age were classified according to the WHO Child Growth Standard 2006. Bivariate analysis and multivariate logistic regression analysis were conducted. The prevalence of undernutrition based on CIAF was 42.3%, underweight 34.7%, stunting 33.3% and wasting 10.0%. After adjusting for all confounders, childhood undernutrition was significantly associated with unimproved sanitation (adjusted OR 2.98, 95% CI: 1.082 to 8.225) and frequent illness (adjusted OR 2.07, 95% CI: 1.015 to 3.274). These findings support the association of biological and physical environmental factors with the nutritional status of children under-5 years old.

Stress is accepted as the accumulation of unpleasant state of physical, mental and emotion on a person. Medical education has been known as one of the most stressful academic curriculum. Hence, medical students may subjected to multiple psychological changes and challenges throughout the years of medical education. The aim of this study was to determine the prevalence of stress and its associated factors among medical students. This cross sectional study was conducted from April to May 2018 in medical school in Sabah. It involved 396 medical students through universal sampling. Self-administered questionnaires were used as an instrument for data collection. The questionnaires included were Sociodemographic Questionnaire, Depression, Anxiety and Stress Scales 21 (DASS-21) and Medical Student Stressors Questionnaire (MSSQ). Bivariate analysis (Chi Square test, Fisher’s Exact Test, Independent T test and Man-Whitney U test) were used to analyse the association. The response rate was 90.2%. The prevalence of stress among medical students were 33.3%. Significant associated factors include financial support inadequacy (p=0.010) and all categories of medical student stressors. The mean score of the academic related stressors was found to be at 2.117 (±0.758) which was the highest mean score among medical student stressors assessed by MSSQ. The result of this study can be used as a basis for implementation of preventive measures such as provision of comprehensive, integrated and responsive mental health care services in university-based settings.
Stress, stressor, medical students, medical education, mental health, DASS, MSSQ

Introduction: Addressing the challenge of mortality among tuberculosis (TB) patients undergoing treatment is a significant concern in Malaysia. It is essential to identify the factors linked to TB mortality to evaluate national TB control programs and identify high-risk individuals. The objective of this study was to assess the percentage of TB mortality among patients receiving treatment over a three-year duration and identify the associated factors in Hulu Langat District. Method: The study used secondary data collected from the national TB registry from 2019 to 2021, and all registered TB cases that met the inclusion and exclusion criteria were included. The data in the study were tested using regressions. Results: The results showed that 11.5% of total registered TB patients had died during their course of treatment, and multiple logistic regression identified several significant factors associated with TB mortality, including gender (aOR= 0.75, 95%CI: 0.58, 0.97; p=0.026), age (aOR= 16.94, 95%CI: 5.14, 55.81; p<0.001), household income level (aOR= 1.56, (95%CI: 1.22, 1.99; p<0.001), living area (aOR= 1.53, 95%CI: 1.00, 2.32; p=0.048) education level (aOR= 1.89, 95%CI: 1.06, 3.35; p=0.030), the severity of chest x-ray (aOR= 5.03, 95%CI: 2.95, 8.58; p<0.001), and HIV status (aOR= 3.72, 95%CI: 2.71, 5.19; p<0.001). Conclusion: TB mortality in the Hulu Langat district is a significant public health concern and interventions such as intensified case finding, home visits for elderly patients, and health promotion are needed to reduce TB mortality and achieve the WHO End TB strategy milestone.