1.Methodology of Global Adult Tobacco Survey (GATS), Malaysia, 2011
Azahadi Omar ; Muhammad Fadhli Mohd Yusoff ; Tee Guat Hiong ; Tahir Aris ; Jeremy Morton ; Sameer Pujari
International Journal of Public Health Research 2013;3(2):297-305
Malaysia participated in the second phase of the Global Adult Tobacco Survey (GATS) in 2011. GATS, a new component of the Global Tobacco Surveillance System, is a nationally representative household survey of adults 15 years old or above. The objectives of GATS Malaysia were to (i) systematically monitor tobacco use among adults and track key indicators of tobacco control and (ii) track the implementation of some of the Framework Convention of Tobacco Control (FCTC)-recommended demand related policies. GATS Malaysia 2011 was a nationwide cross-sectional survey using multi-stage stratified sampling to select 5112 nationally representative households. One individual aged 15 years or older was randomly chosen from each selected household and interviewed using handheld device. GATS Core Questionnaire with optional questions was pre-tested and uploaded into handheld devices after repeated quality control processes. Data collectors were trained through a centralized training. Manuals and picture book were prepared to aid in the training of data collectors and during data collection. Field-level data were aggregated on a daily basis and analysed twice a week. Quality controls were instituted to ensure collection of high quality data. Sample weighting and analysis were conducted with the assistance of researchers from the Centers for Disease Control and Prevention, Atlanta, USA. GATS Malaysia received a total response rate of 85.3% from 5112 adults surveyed. Majority of the respondents were 25-44 years old and Malays. The robust methodology used in the GATS Malaysia provides national estimates for tobacco used classified by socio-demographic characteristics and reliable data on various dimensions of tobacco control.
Tobacco
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Data Collection
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Malaysia
2.Food Label Reading and Understanding among Obese Adults: A Population Study in Malaysia
Rashidah Ambak ; Balkish Mahadir Naidu ; Mohd Azahadi Omar ; Nor Azian Mohd Zaki ; Syafinaz Mohd Sallehuddin and Tahir Aris
International Journal of Public Health Research 2014;4(2):449-456
Food labeling regulation has been implemented to enable consumers, including those with chronic diseases to make healthy informed choices before purchasing pre-packaged foods. The purpose of this study is to determine the prevalence of obese adults in Malaysia who practice reading food labels. It explored types of labels read and understanding of the information. Findings presented in this study were captured from the secondary analysis of National Health and Morbidity Survey’s (NHMS, 2006) food label study which focused only on obese adults (BMI > 30 kg/m2) aged 18 and above. This nation-wide cross sectional study was conducted from April to August 2006 using an interview-based questionnaire. Complex data analysis was done using Stata version 12.0. There were 4565 obese respondents with the mean age of 33 ± 9.7 (18 – 60 years old). About 54.7% completed high-school and 9.9% were higher degree holders. Prevalence of obese adults who claimed to read label was 80.5% (95%CI: 79.3, 81.6). Findings showed significant results in reading and understanding labels among all age group categories, Malay, Indian and other Bumiputras, all education categories and married respondents. Expiry date was the highest percentage being read (74.5%), followed by fat content (15.3%), vitamin (11.8%) and carbohydrate (10.9%). The obese population in Malaysia claimed to read and understand the food label but did not focus on specific macronutrients related to their health condition. Findings can be used to implement effective education programmes targeting the relevant groups to instill an awareness to read, understand and use the label information as one of the means in combating obesity.
Obesity
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Adult
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Food Labeling
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Malaysia
3.Reliability and Validity of the Physical Activity Questionnaire for Older Children (PAQ-C) In Malay Language
Nor Azian Mohd Zaki ; Norhafizah Sahril ; Mohd Azahadi Omar ; Muhammad Hasnan Ahmad ; Azli Baharudin ; Noor Safiza Mohd Nor
International Journal of Public Health Research 2016;6(1):670-676
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.
4.Undiagnosed Type 2 Diabetes Mellitus and Its Risk Factors among Malaysians: Findings of a Nationwide Study
Lim Kuang Kuay ; Hasimah Ismail ; Mohd Azahadi Omar ; Anis Aqilah Noor Hisham ; Tahir Aris ; Rashidah Ambak ; Mohammad Fadhli Mohd Yusoff
International Journal of Public Health Research 2016;6(1):677-684
The prevalence of Type 2 diabetes mellitus (T2DM) is increasing worldwide and many of these affected individuals remain unidentified. Undiagnosed T2DM may impose substantial public health implications because these individuals remain untreated and at risk for complications. The objective of this study was to determine the national prevalence of undiagnosed T2DM and to identify the associated risk factors. A nationwide cross-sectional study was conducted involving 17,783 respondents. Two-stage stratified sampling design was used to select a representative sample of the Malaysian adult population. Structured validated questionnaires with face to face interviews were used to obtain data. Respondents, who claimed that they were not having diabetes, were then asked to perform a fasting blood glucose finger-prick test by Accutrend GC machine. The prevalence of undiagnosed T2DM was 8.9% (n=1587). The highest percentage of undiagnosed T2DM was found among males (10.2%), 55-59 years old (13.4%), highest education attainers of primary school (11.1%), Indians (10.3%), married (10.3%), working (8.9%) and living in the urban areas (9.2%). Multivariate analyses showed that factors associated with undiagnosed T2DM were gender, age group, ethnicity, marital status, obesity and hypertension. This study found an increasing trend of undiagnosed T2DM in Malaysia compared to 2006. This finding is alarming as risk factors associated with undiagnosed diabetes were related to most of the socio-demographic factors studied. Therefore, early diabetic screening is crucial especially among adults aged 30 and above to prevent more serious complications of this disease.
5.Prevalence, awareness, treatment and control of Hypertension among the elderly: the 2006 National Health and Morbidity Survey III in Malaysia.
Kiau, Bo Bee ; Kau, Jasvindar ; Nainu, Balkish Mohadir ; Omar, Mohd Azahadi ; Saleh, Mohmad ; Keong, Yau Weng ; Hock, Lim Kuang
The Medical Journal of Malaysia 2013;68(4):332-7
The objective of this study was to determine the prevalence and factors associated with the awareness, treatment and control of hypertension among the elderly population in Malaysia.
6.Limited Health Literacy And Its Associated Factors Among Overweight And Obese Housewives Living In Klang Valley Low Cost Flats: Findings From The My Body Is Fit And Fabulous At Home (Mybff@Home) Study
Siti Nurbaya Shahrir ; Khadijah Shamsuddin ; Noor Safiza Mohamad Nor ; Cheong Siew Man ; Mohd. Azahadi Omar ; Mohamad Hasnan Ahmad ; Rashidah Ambak
Malaysian Journal of Public Health Medicine 2018;18(1):19-27
Limited health literacy is highly associated with poor health status. The concept of health literacy in public health relates to the concern that people with lower health literacy were also less likely to engage in health promoting behaviours. This is an analysis on health literacy and its associated factors among housewives and also a sub analysis of the Malaysian My Body is Fit and Fabulous at Home (MyBFF@home) study involving 328 overweight and obese housewives living in low cost flats in Klang Valley, part of a weight loss programme recruited using convenient sampling. Health literacy was measured using the Malay version of Newest Vital Sign (NVS) test with scores ranging from 0 to 6. Total score of ≤2 indicate limited health literacy and total scores of >2 indicate adequate health literacy. Descriptive analysis, chi-square test and multiple logistic regression were used to analyse the data.The mean(SD) NVS score was 1.07(1.19) with most (87.5%) housewives having limited health literacy. Factors that were significantly associated with limited health literacy were older age of 45 to 59 years old (p = 0.040), primary education and below (p = 0.001) and absence of internet connectivity (p = 0.001). In the final model, absence of internet connectivity (OR 2.61; 95%CI 1.31 to 5.22) was associated with limited health literacy. Majority of the housewives have limited health literacy and providing internet connectivity to housewives may increase their health literacy.
housewives
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health literacy
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low cost flats
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Newest Vital Sign
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obese
7.Identification of dietary patterns associated with characteristics of successful aging
Nik Nur Izzati Nik Mohd Fakhruddin ; Suzana Shahar ; Roslee Rajikan ; Mohd Azahadi Omar ; Normah Che Din ; Rosdinom Razali ; Sakinah Harith ; Hamid Jan Jan Mohamed ; Bibi Nabihah Abdul Hakim
Malaysian Journal of Nutrition 2019;25(1):47-57
Introduction: This study aimed to identify dietary patterns (DPs) and their association with successful aging (SA).
Methods: A comparative cross-sectional study was conducted among 579 elderly subjects recruited from four states in Malaysia through a multistage random sampling method. SA was defined as having no chronic illnesses, no functional limitation, normal global function, no depression, a good quality of life and good self-perceived health. Information on dietary intake was obtained using a diet history questionnaire. Cognitive functions were assessed using the Mini Mental State Examination (MMSE), depressive symptoms using Geriatric Depression Score-15 items (GDS-15) and a question regarding their perceived health and quality of life. Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to determine functional status. DPs were obtained using the principal component analysis (PCA) approach. An ordinal logistic regression model was used to examine associations between DP scores and SA.
Results: Five DPs were identified namely ‘sweet foods-beverages’, ‘meat-vegetablesrice and noodles’, ‘local snacks-fish and seafood-high salt foods’, ‘fruits-legumes’, and ‘tropical fruits-oats’. A higher score for ‘tropical fruits-oats’ DP was associated with SA [Adjusted OR=1.59 (95% CI: 1.08-2.32)]. However, the association diminished when the model was adjusted for education level. Further analysis indicated that this DP increased the chance of SA among those with secondary education and above [Adjusted OR=2.43 (95% CI: 1.09–5.42)].
Conclusion: Tropical fruits-oats’ DP is associated with SA among elderly with secondary education and above. There is a need to investigate DPs among those with lower education.
8.Sugar intake and metabolic syndrome among older adults in Peninsular Malaysia
NurZetty Sofia Zainuddin ; Suzana Shahar ; Nik Shanita Safii ; Hasnah Haron ; Mohd Azahadi Omar
Malaysian Journal of Nutrition 2018;24(2):163-174
Introduction: Sugar is widely consumed and excessive intake has been associated
with increased risk of weight gain, diabetes mellitus and cardiovascular diseases,
leading to metabolic syndrome (MetSyn). However, the association between sugar
intake and MetSyn has seldom been studied among multi-ethnic Malaysian older
adults. Methods: A total of 1,057 respondents aged ≥60 years were recruited through
multistage random sampling from selected states. Anthropometric parameters, blood
pressure, blood test for sugar and lipid profile were determined. Dietary intake was
derived using a 7-day dietary history questionnaire (DHQ) and a semi-quantitative
food frequency questionnaire (FFQ) for added sugar intake. Results: Prevalence of
MetSyn was 39.9%, 30.9% and 42.2% using the harmonised definition, International
Diabetes Federation (IDF) and National Cholesterol Education Program’s Adult
Treatment Panel III (NCEP-ATPIII) definitions respectively. Mean total sugar intake
was 40.5±32.0 g (8 tsp) and added sugar intake was 33.0±31.0 g (6 tsp). Excessive
added sugar consumption at 100th percentile increased risks of high total cholesterol
by two-fold (p<0.001) and triglyceride by 1.8 fold (p<0.001). Total sugar intake at
50th percentile increased risk of high blood pressure by 0.68 fold (p<0.05) and total
sugar intake at 50th, 75th and 100th percentile increased total cholesterol risk by
1.7 fold (p<0.01), 1.5 fold (p<0.05) and 2.3 fold (p<0.001) respectively. Conclusion:
Excessive sugar consumption among older adults showed no association with
MetSyn but revealed significant associations with blood pressure and lipid profiles.
Effects of long term excessive consumption of sugar on health outcomes in older
persons should be investigated.
9.A retrospective study of weight-loss predictors following bariatric surgery in Malaysian patients with obesity
Fatin Hanani Mazri ; Suzana Shahar ; Nik Ritza Kosai ; Mohd Azahadi Omar ; Nilsiswati Ramilis ; Reynu Rajan
Malaysian Journal of Nutrition 2019;25(3):423-433
Introduction: A retrospective study was conducted with the aim of determining the factors that affect weight loss among post-bariatric surgery patients.
Methods: A successful weight loss outcome in this study was defined as achieving at least 50% excess weight loss (EWL). Eligible participants were those who had undergone bariatric surgery at least two years prior to the study. Adherence to lifestyle recommendations post-bariatric surgery, binge eating, depression, and social support were assessed.
Results: A total of 51 post-bariatric surgery patients were recruited with a mean post-operative period of 3.2±0.7 years. The mean preoperative weight of 116.6±28.8 kg and body mass index (BMI) 45.2±8.8 kg/m2 were significantly reduced to 86.6±21.0 kg and 33.6±6.7 kg/m2, respectively, during follow-up (p<0.001). A total of 66.7% of participants achieved successful weight loss following bariatric surgery, with a mean EWL of 73.6±21.9% and total weight loss (TWL) of 29.4±8.7%. According to multivariate regression analysis adjusted for age and gender, pre-operative weight (β=-1.580, p<0.05) and BMI (β=-1.398, p<0.05), rate of weight loss (β=1.045, p<0.01), and adherence to eating behaviour recommendations (β=0.177, p<0.05) were significant predictors of weight loss outcomes post-bariatric surgery.
Conclusion: The lower pre-operative weight and BMI, the faster rate of weight loss and higher adherence towards eating behaviour advice were potential predictors of greater EWL and thus could increase the chance of successful weight loss maintenance post–bariatric surgery.
10.Sociodemographic factors associated with consumption of high-sodium foods: Evidence from Malaysia
Yong Kang Cheah ; Sharifah Nazeera Syed Anera ; Chee Cheong Kee ; Kuang Hock Lim ; Mohd Azahadi Omar
Malaysian Journal of Nutrition 2022;28(No.1):43-51
Introduction: The objective of the present study was to investigate the influences
of sociodemographic factors on consumption of high-sodium foods among adults in
Malaysia. Methods: Data were extracted from the Malaysian Community Salt Survey
(MyCoSS) (n=1046). A seemingly unrelated regression (SUR) was utilised to assess
factors associated with the number of servings of high-sodium foods (nasi lemak,
roti canai, fried rice, fried noodles, and fried vermicelli) consumed per week. The
independent variables were sociodemographic factors. Results: Younger individuals
consumed more high-sodium foods than their older counterparts. Adults with
secondary level education consumed more high-sodium foods compared with those
with tertiary level education. Consumption of high-sodium foods was higher among
males and Malays compared to females and non-Malays. Conclusion: Consumption
of high-sodium foods was common in the population. Sociodemographic factors,
such as age, education level, gender, and ethnicity, play an important role in
influencing the decisions of people to consume high-sodium foods.