The health of newborns is inextricably linked to that of their mothers. Some maternal factors can influence neonatal survival, particularly for low birth weight babies who are more vulnerable to diseases than normal weight babies. The aim of this study is to assess the impact of maternal factors on neonatal mortality among low birth weight babies in Aceh Province, Indonesia. Study design was unmatched case control. Data collected from 2010 to 2012 in 8 districts in Aceh province, Indonesia. Total sample was 500, divided into 250 LBW who died in neonatal period (case group) and 250 who did not die in neonatal period (control group). There were 6 maternal variables analysed. Three of six variables analysed were not associated with neonatal mortality among LBW (P > 0.05); these were: maternal death, parity and education level. The age of the mother had a significant association with neonatal mortality among LBW (P < 0.05), but was not a determinant factor. The maternal illness and birth interval were determinant factors of neonatal mortality among LBW(P < 0.05); maternal illness (Adj OR= 2.6; 95 % CI: 1.68 - 4.0) and birth interval (Adj OR= 1.8; 95 % CI: 1.20 - 2.91). Maternal illness and birth interval were determinant factors of neonatal mortality among LBW. Appropriate care throughout stages of pregnancy and increasing women’s knowledge on high risk pregnancy are the key factors to the decrease of the neonatal mortality related to the maternal factors.​
Infant Mortality ; Infant, Low Birth Weight ; Indonesia

Prevalence of adolescents involved in sexual and reproductive problems is on rise and it was associated with its knowledge. Several factors found to be associated with the knowledge and various sources of knowledge are chosen by adolescents for this information. Thus, this study was to determine the knowledge score, its influencing factors and the preference of the sources of knowledge. A cross-sectional study was done using adopted questionnaire involving 330 respondents aged 18 and 19 years old in Kolej MARA Seremban selected by simple random sampling. They were gathered in the halls and 338 adolescents from 454 students consented to involve in this study. Self-administered questionnaire was used whereby a correct response was given a score of 2, 0 for an incorrect response and 1 for an answer of don’t know. Total score for all correct answers was 42. Descriptive analysis, bivariate and multivariate analysis was done in the analysis. The mean knowledge score was 37.32 (±2.967) with a significant difference for gender. Internets were the most common and preferred sources of the knowledge among them. There was 5.2% of them had heard on SMS intervention and 37.0% of them disagreed on SMS intervention. The result showed that the knowledge score was lower in males than females and internets were the most preferred source of the knowledge. Thus, interventions for knowledge improvement should be more on male adolescents.​
Reproductive Health ; Sex Education ; Adolescent ; Knowledge

The aim of the Fourth Millennium Developmental Goal is to reduce mortality among children less than 5 years by two thirds between 1990 and 2015. Efforts are more focus on improving children’s health. The aim of this study was to describe the trend of stillbirth and neonatal deaths in University Kebangsaan Malaysia Medical Centre from 2004 to 2010. A retrospective cross-sectional study was conducted using hospital data on perinatal mortality and monthly census delivery statistics. There were 45,277 deliveries with 526 stillbirths and neonatal deaths. More than half of the stillborn cases were classified as normally formed macerated stillbirth and prematurity was common in neonatal deaths. The trend of SB and NND was found fluctuating in this study. However, by using proportionate test comparing rate, there was a transient significant decline of stillbirth but not neonatal deaths rates between 2004 and 2006. On the other hand, the neonatal deaths rate showed significant increment from 2006 to 2008. When both mortality rates were compared using proportionate test, from the start of the study, year 2004 with end of the study, year 2010, there was no significant decline noted. Trends of stillbirth and neonatal death rates in University Kebangsaan Malaysia Medical Centre within 7 years study period did not show the expected outcome as in Millennium Developmental Goal of two thirds reduction.
Stillbirth ; Infant Mortality

Falls are the most common injury causing death or long term disability particularly among children. This study aimed to identify the risk factors of the unintentional injuries due to falls in children aged less than five years in Yemen. This cross sectional study enrolled a total of 439 children under five years old from the emergency department of 6 hospitals in Sana'a city. Multistage sampling was used to select six hospitals from public and private sectors in Sana'a city. Face to face interviews were conducted by using a structured questionnaire. Simple logistic regression and multiple logistic regression were used in the analysis. The prevalence of falls among children under five years old was 21.2%. In the multivariate analysis, factors associated with falls among children were young mother (aOR= 0.9, 95% CI 0.81-0.91), working of mother (aOR= 4.5 95% CI 2.40-7.65), frequent family social gatherings (aOR= 2.7, 95% CI 1.54-4.61), number of children at home (aOR= 2.6, 95% CI 1.43-4.64), chewing khat by father (aOR= 2.4, 95% CI 1.38-4.10), presence of staircase in the house (aOR= 2.1, 95% CI 1.24-3.70), number of rooms at home (aOR= 2.2, 95% CI 1.17-3.99) and disabled children (aOR= 3.3, 95% CI 1.20-9.27). In the study, socio-economic and cultural factors such as family gathering and chewing khat were associated with home fall injury among children under 5 years old in Yemen. Health promotion program should take place to reduce the occurrence of fall injury.
Accidental Falls ; Child Welfare ; Accidents, Home ; Child

Adherence to antiretroviral therapy (ART) plays an important role in the treatment outcomes of human immunodeficiency virus (HIV) infection. Poor adherence would result in failure to prevent viral replication as well as an increased risk of developing drug resistance. Adherence to a life long treatment such as antiretroviral therapy is usually a complicated issue that requires careful and continuous collaboration of patient, family and healthcare provider. The objective of this study was to assess adherence to antiretroviral therapy and its associated factors among people living with HIV. This is a health facility-based cross sectional study conducted among adults’ people living with HIV in Omdurman HIV/AIDS centre, Sudan. Data was collected through direct interview using semi-structured questionnaire. There were only 144/846 (17.02%) who adhered to antiretroviral therapy as prescribed by their doctors. The remaining 51.18% were taking the therapy but not regularly, 31.21% were taking it but currently not and 0.59% stated that they have never taken any antiretroviral therapy. Factors associated with poor adherence that have been identified include female gender (Adj. OR = 3.46 (95%CI: 1.46–8.21), P = 0.005), younger age (Adj. OR = 1.14 (95%CI: 1.02–1.28), P = 0.022), being unemployed (Adj. OR = 5.94 (95%CI: 1.51–23.40), P = 0.011), those who were divorced, separated or widowed (Adj. OR = 11.35 (95%CI: 1.74–73.96), P = 0.011) and respondents who perceived that their health status is poor (Adj. OR = 5.21 (95%CI: 1.44–18.81), P = 0.012) or very poor (Adj. OR = 4.04 (95%CI: 1.27–12.81), P = 0.018). Educational level and social support against HIV-related stigma and discrimination were not significantly associated with adherence. Adherence to antiretroviral therapy among the respondents is very poor. Urgent interventions based on modifiable factors and mainly targeting females and younger age group are needed to improve adherence to antiretroviral therapy among people living with HIV.
HIV ; Antiretroviral Therapy, Highly Active ; Therapeutics ; Adult

​In Malaysia although mortality rate among women of reproductive ages has reduced over the years, the reduction has been stagnant for the past ten years. In order to achieve the 5th Millennium Development Goal, several measures need to be taken including a proper implementation of pre-pregnancy services in this country. This study explores the awareness, intention and usage of pre-pregnancy care (PPC) services and its determinant among women of reproductive ages in Kedah, Malaysia. This is a qualitative study, which consisted of a focus group discussion (FGD) among women in the ages of 18 to 45 years old from all ethnic groups who attended four government clinics in the state of Kedah. The mothers were chosen through purposive sampling from twelve districts that were selected through a multistage random sampling. A semi-structured questionnaire was utilized during the FGD. The results from the FGD were recorded verbatim and thematic analysis was finalized once saturation of information from respondents was achieved. These are two themes was identified, namely personal reasons and reasons of service and there are several subthemes under two main themes. Under the Personal reason themes, the subthemes including awareness and intention to used the services, knowledge, perception, social support and history of medical illness. While under pre-pregnancy care services themes, the subthemes including the promotion of the services, the communication relationship with the health staff, the waiting time and also the accessibility of the service. As a conclusion, there is still part of society who was unaware of pre-pregnancy services and its importance in reducing maternal mortality rate as well as producing good pregnancy outcome. Information and knowledge on pre-pregnancy care services should be disseminated among community members through various means including roadshows and pre wedding workshops.​

Background & Objective: Helicobacter pylori infection has been associated with extradigestive diseases including epilepsy. The main aim of the study was to determine the prevalence of Helicobacter pylori using 13C urea breath test (UBT) in epilepsy patients in a teaching hospital in Malaysia and compared to control. Methods: The study subjects were epilepsy patients from the neurology clinic in a teaching hospital. The study was conducted from August 2010 to February 2011. The control consisted of healthy individuals matched for age and gender, not on any acid suppression medications and antibiotics. All subjects underwent UBT as per protocol. Variables such as age, race, household income, types of epilepsy, duration of epilepsy, number of antiepileptic drugs, prognosis were analysed. Good prognosis was defi ned as seizure free for 3 years. Results: Forty eight epilepsy patients and 47 control subjects were studied. Prevalence of H. pylori infection in the epilepsy patients was 37.5% (n=18) and was 36.2% (n=17) in control. There were signifi cantly more subjects in the epilepsy group with lower income. There were also more smokers in the epilepsy group but there was no association between smoking and positive UBT. Epilepsy patients with poor prognosis have a higher UBT positive rate compared to the good prognosis group (64.3% vs 35.7 %). However the difference was not statistically signifi cant. Conclusion: The prevalence of H. pylori infection in epilepsy patients is similar to that of the control in this study involving Malaysian subjects.

Men’s health remain unclear term for majority of general population as well as physician worlwide. Nowadays there is an increase interest in addressing men’s requirement in health care as a separate branch. When discussing about men’s health, it is fair to say that even a man himself does not know much about men’s health. Most of them think that men’s health is just a discussion on sex. This thought is not entirely right. The scope of men’s health is actually larger than the male sex organ itself. To define men’s health, we have to look at man holistically.
Health Services ; Delivery of Health Care ; Men

The evolution in lifestyle and dietary habits of the Malaysian people that have taken place over the last few decades can be largely attributed to both family and social environment. These factors are known to affect the nutritional status of the community, in both children and adults. Reduced physical activity and changes in their diet have been one of the contributing factors to the rising prevalence of overweight and obesity. However, in Malaysia, in which nutrition transition has been a norm, it is worrying when the trends of overweight and obesity have been rising steadily over the years especially among children. Although numerous strategies to control obesity in Malaysia have been taking place, many had shown little effect. Analysing strategies implemented at national level is thus crucial in order to ascertain reasons for the shortfalls of these strategies especially among children. Obesity most commonly begins as early as the ages of 5 and 6 years, or during adolescence. Obesity is indeed a major public health concern due to its huge negative impact on the society at large which is well supported by evidence-based literatures. Managing this issue is complex and holistic approach is thus crucial in reducing its incidence and prevalence.

Purpose: This study aimed to identify small for gestational age (SGA) infants' growth patterns, nutritional status, and associated factors. Methods: This prospective cohort study was conducted at primary-care child health clinics in Greater Kuala Lumpur, Malaysia. The sample consisted of infants who fulfilled the criteria and were born in 2019. The anthropometric data of infants were assessed at birth and at 1, 3, 6, 9, and 12 months. Results: A total of 328 infants were analysed. In total, 27.7%(n=91) of the subjects were SGA infants, and 237 of them were not. Significant differences in the median weight-for-age and length-for-age z-scores were observed between SGA and non-SGA infants at birth, 1 month, 6 months, and 12 months. There was a significant difference between the growth patterns of SGA and non-SGA infants. Birth weight and sex significantly predicted the nutritional status(stunting and underweight) of SGA infants during their first year of life. Conclusion SGA infants can catch up to achieve normal growth during their first year of life. Even though the nutritional status of SGA infants trends worse than non-SGA infants, adequate infant birth weight monitoring and an emphasis on nutritional advice are crucial for maintaining well-being.