1.Sex-specific All-cause Mortality is Associated with Adiposity in the Malaysian Elders Longitudinal Research (MELoR) Study
Nurul Nabilah Akmal HASHIM ; Sumaiyah MAT ; Phyo Kyaw MYINT ; Mirela DELIBEGOVIC ; Sheng Hui KIOH ; Shahrul Bahyah KAMARUZZAMAN ; Noran Naqiah HAIRI ; Selina KHOO ; Ai-Vyrn CHIN ; Maw Pin TAN
Annals of Geriatric Medicine and Research 2025;29(4):496-506
Background:
While adiposity has been found to be protective against adverse outcomes in older adults, the role of muscle in this association remains underexplored. This study sought to evaluate sex-specific mortality associated with available adiposity indices in older adults and the potential role of muscle strength in this relationship.
Methods:
Individuals aged ≥55 years were recruited from 2013 to 2015. Adiposity indices obtained were body mass index (BMI), percentage body fat (%BF), waist-to-hip ratio (WHR), and waist circumference (WC). Vital status up to June 2022 was determined through the National Registry Department.
Results:
Of the 1,347 included participants, mean age of 68.45±7.21 years, 57.1% female, and 11.2% deaths were recorded. Male who were underweight had increased mortality compared to male with normal BMI (hazard ratio [HR]=3.17, 95% confidence interval [CI] 1.35–7.47). Mortality was greater in male with %BF within the highest quartile (Q4) compared to the lowest quartile (Q1) (HR=4.72, 95% CI 2.07–10.78). Increased mortality in both male and female in Q4 for WHR compared to Q1 was influenced by age, as was increased mortality in female in Q4 for %BF. WC did not predict mortality in male or female. Increased mortality risk was present in male with normal muscle strength and increased %BF, and reduced muscle strength in male with low BMI.
Conclusions
Adiposity measured with BMI, WHR and WC had limited value in determining mortality risk at 9-year follow-up among individuals aged ≥55 years. Increased mortality was, however, observed in male with higher %BF but this could not be attributed to muscle strength.
2.Factors Associated with Presence of Human Papillomavirus Infection among Women: Findings from New Cervical Cancer Screening in Kelantan, Malaysia
Nur Dalilah Mohd Zin ; Tengku Alina Tengku Ismail ; Noran Hashim
Malaysian Journal of Medicine and Health Sciences 2023;19(No.4):84-92
Introduction: Human papillomavirus (HPV) infection is known to cause cervical cancer worldwide. Recently, Malaysia introduced HPV DNA detection testing for cervical cancer screening program. However, knowledge regarding
factors for HPV infection among women still limited. Thus, this study aimed to determine the prevalence and factors
associated with HPV infection among women in Kelantan, a north-eastern state of Malaysia. Methods: This study
used secondary data extracted from HPV DNA test registry book and HPV DNA laboratory request forms. Data on
all Malaysian women aged 30 to 49 years old in 2019 reported in registry book were included. Simple random
sampling was applied. All information from book and forms were collected using proforma and analysed using
SPSS. The outcomes were categorised into HPV infection and non-HPV infection. The parameters related to factors
associated with HPV infection were determined using multivariable logistic analysis. Results: The prevalence of HPV
infection among women attending the new cervical screening was 8.4% (95% CI 6.4%, 10.3%). Those aged between
30 and 39 years old (AdjOR 2.09; 95% CI 1.16, 3.78, p=0.014), had 5 or more parities (AdjOR 2.82; 95% CI 1.58,
5.06, p<0.001) and hormonal contraception users (AdjOR 7.48; 95% CI 4.07, 13.76, p<0.001) were significantly
associated with HPV infection. Conclusion: Overall, the prevalence of HPV infection from this study is comparable
to the local and international studies. Age, number of parities and hormonal contraception users influence the HPV
infection. This finding could help in designing more targeted screening for cervical cancer.
3.A Falls And Its Associated Factor Among The Elderly: Results From An Elderly Screening Programme In Kelantan
Wafaak Esa ; Noran Hashim ; Noor Aman Hamid
Malaysian Journal of Public Health Medicine 2021;21(2):141-148
Falls in the elderly is one of the health issues. The aims of this study were to determine the prevalence of fall among the elderly and its associated factor. This was a cross-sectional retrospective record review study. Data from the elderly health screening programme of government health clinics in Kota Bharu, Kelantan were obtained. All elderly who participated in the programme for the year 2014 was eligible. Multiple logistic regression was used to assess for associated factors of falls with self-reported fall events. Data for n=434 participants were retrieved. The prevalence of falls among the elderly who participated in the health screening programme was 23.3% (95% CI: 0.19, 0.27). This study demonstrated that falls was associated with age more than 80 years old (OR adj 32.20, 95% CI: 8.54, 121.39; p<0.001), being female (OR adj 0.46, 95% CI: 0.24, 0.87; p= 0.017), being employed (OR adj 0.04, 95% CI: 0.01, 0.26; p=0.001), obesity (OR adj 2.65, 95% CI: 1.20, 5.86; p= 0.016), symptoms of dizziness (OR adj 6.77, 95% CI: 1.39, 32.98; p= 0.018), imbalance and instability (OR adj 9.92, 95% CI: 1.39, 32.98; p<0.001), polypharmacy (OR adj 4.72, 95% CI: 1.20, 5.86; p=0.001) and increased waist circumference (OR adj 2.54, 95% CI: 1.29, 5.01; p=0.007). This study demonstrated that the prevalence of falls among the elderly is still an issue and its associated factors should be intervened.
4.A Reliability Study of the Malay Version of the Malaysian Ministry of Health’s Adolescent Client Satisfaction Questionnaire among Adolescents Attending Health Clinics in Northeastern Malaysia
Hafizuddin AWANG ; Azriani Ab RAHMAN ; Surianti SUKERI ; Noran HASHIM ; Nik Rubiah Nik Abdul RASHID
Korean Journal of Family Medicine 2020;41(6):412-415
Background:
The need for client feedback in assessing healthcare services is widely recognized. However, little is known about the satisfaction of adolescent clients utilizing healthcare services in Malaysia. To the best of our knowledge, there is no validated instrument to measure the satisfaction of adolescent clients attending health clinics in Malaysia. This cross-sectional study aimed to determine the reliability of the Malay version of the Malaysian Ministry of Health’s Adolescent Client Satisfaction Questionnaire among adolescents attending health clinics in northeastern Malaysia.
Methods:
A cross-sectional study was conducted in January 2019 among adolescents aged 10–19 years attending four designated health clinics in the northeastern state of Peninsular Malaysia. The test for Cronbach’s α was performed to determine the internal consistency reliability.
Results:
There were a total of 85 adolescent clients involved in this study. The mean age of respondents was 15.6 years. The majority of respondents were female, Malay, students, and had attained a secondary level of education. The mean total satisfaction score was 78.35. The internal consistency reliability according to the Cronbach’s α of the domain was 0.854, which is considered highly reliable. The corrected item-total correlation for the domain was acceptable as it was ≥0.4.
Conclusion
The Malay version of the Malaysian Ministry of Health’s Adolescent Client Satisfaction Questionnaire has excellent internal consistency reliability. Therefore, it may be recommended as a tool to measure the satisfaction level among adolescents attending health clinics in Malaysia.


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