Introduction The World Health Organisation (WHO) has recommended iron supplementation to overcome anaemia in pregnancy. In Malaysia, half of pregnant women with anaemia do not comply to iron supplement. The purpose of this study is to develop, assess psychometric properties (via Exploratory Factor Analysis) and validation (via Confirmatory Factor Analysis) of a questionnaire that evaluates attitude towards adherence to iron supplement based on Theory of Planned Behaviour (TPB). Methods Based on the guidelines for construction of the TPB based questionnaire, 18 items were created initially by using the findings from a semi-quantitative survey, literature reviews and experts’ opinion. From content validity by 3 experts, 15 items with content validity ratio (CVR) of ≥0.99 were retained. From a pilot test for exploratory factor analysis (EFA), total of 12 items were retained, and classified into 3 components and termed as “Attitude”, “Subjective Norms” and “Perceived Behaviour Control”. Results Cronbach Alpha for the 12 items was 0.814, and for each component were 0.844, 0.813 and 0.901 respectively, which indicates acceptable internal consistency. During the Confirmatory Factor Analysis (CFA), a final 10 items were retained. Conclusions The construct validity was good where the Fitness Index have achieved the threshold (p-value >0.05, RMSEA <0.08, CFI >0.90 and the ChiSq/df ratio <3.00). The convergent validity and composite reliability were good i.e. Average Variance Extracted (AVE) ≥0.50, and Composite Reliability (CR) ≥0.60 respectively. As a conclusion, this newly developed questionnaire was validated and potentially reliable in assessing attitude and predicting adherence to iron supplement among pregnant women specifically in Malaysia.

OBJECTIVES: Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Hence, this study aimed to determine the effects of maternal folic acid consumption on the risk of childhood cancer. METHODS: A total of 158 related articles were obtained from PubMed, Google Scholar, Scopus, and ProQuest using standardized keywords, of which 17 were included in the final review. RESULTS: Eleven of the 17 articles showed a significant protective association between maternal folic acid supplementation and childhood cancer. Using a random-effects model, pooled odds ratios (ORs) showed a protective association between maternal folic acid supplementation and childhood acute lymphoblastic leukaemia (OR, 0.75; 95% confidence interval [CI], 0.66 to 0.86). However, there was no significant association between maternal folic acid supplementation and acute myeloid leukaemia (OR, 0.70; 95% CI, 0.46 to 1.06) or childhood brain tumours (OR, 1.02; 95% CI, 0.88 to 1.19). CONCLUSIONS: Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.
Brain ; Case-Control Studies ; Delivery of Health Care ; Folic Acid ; Health Education ; Health Promotion ; Odds Ratio ; Pregnancy

OBJECTIVES: Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Hence, this study aimed to determine the effects of maternal folic acid consumption on the risk of childhood cancer. METHODS: A total of 158 related articles were obtained from PubMed, Google Scholar, Scopus, and ProQuest using standardized keywords, of which 17 were included in the final review. RESULTS: Eleven of the 17 articles showed a significant protective association between maternal folic acid supplementation and childhood cancer. Using a random-effects model, pooled odds ratios (ORs) showed a protective association between maternal folic acid supplementation and childhood acute lymphoblastic leukaemia (OR, 0.75; 95% confidence interval [CI], 0.66 to 0.86). However, there was no significant association between maternal folic acid supplementation and acute myeloid leukaemia (OR, 0.70; 95% CI, 0.46 to 1.06) or childhood brain tumours (OR, 1.02; 95% CI, 0.88 to 1.19). CONCLUSIONS Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.

Introduction: Measles outbreaks are endemic in Southeast Asia. A possible reason for such outbreaks is low vaccine coverage. In Malaysia, there is a lack of studies on measles outbreaks. The urban district of Petaling in Selangor, Peninsular Malaysia, reported a high number of outbreaks in 2014–2018. Thus, we analysed the trend of measles outbreaks and identify the common characteristics of measles cases in Petaling District. Methods: This was a cross-sectional study using secondary data from the Petaling District Health Office online surveillance system. Data from 2014 until 2018 from the e-Measles and eWabak systems were extracted, and the trend and common characteristics of measles cases were analysed. Results: A total of 48 outbreaks involving 124 cases were reported during the period investigated. The outbreaks showed an increasing trend from 2.1% in 2014 to 37.5% in 2016, and decreased slightly from 29.2% in 2017 to 27.1% in 2018. The common characteristics were age 1 to <7 years (50.8%), female sex (55.6%), Malay ethnicity (89.5%), Malaysian citizenship (95.2%) and being unvaccinated (55.6%). Of the cases, 63.7% were admitted to hospital, and siblings were the common source of infection (75.8%). Most cases occurred at home (75.8%). Most of the children who were infected at home were unvaccinated (60.6%). Conclusion: Unvaccinated children aged 1 to <7 years are at highest risk of contracting measles and spreading it to their siblings. Thus, awareness of the importance of vaccination needs to be emphasized to their parents to prevent related issues such as vaccine hesitancy.

Introduction: Mental health problem is an important public health issue which causes deterioration in quality of life, function and financial capabilities. According to the National Health and Morbidity Survey (NHMS) 1996, the prevalence of mental problem among adults in Malaysia was 10.7% and this has increased to 29.2% in NHMS 2015. The aim of this study was to evaluate the burden of depression, anxiety and stress among adults in a city in Klang Valley, Malaysia including its associated factors. Methods: A cross-sectional study was conducted by analysing secondary data obtained from screening program performed in six primary health clinics in the city throughout 2016. There were 576 adults participated in the screening program which consisted of mental health screening using Depression, Anxiety, Stress 21 (DASS-21) questionnaire and health status screening using Health Status Screening Form. Results: The prevalence of depression was 20.5%, anxiety was 44.5%, while stress was 10.1%. By using logistic regression, history of being abused was the only significant protective factor associated with depression, anxiety and stress with OR of 0.062 (95% CI 0.007; 0.563, p=0.004), OR of 0.001 (95% CI 0.000; -, p=0.001) and OR of 0.026 (95% CI 0.003; 0.238, p<0.001) respectively. Other independent variables were not statistically significant. Conclusions: As conclusions, surprisingly the risk of depression, anxiety and stress were not increased among participants who reported history of being abused. This was probably due to good coping mechanism among them. Nevertheless, early intervention needs to be emphasized to prevent mental disorders among this group of people in community.