Animals, Wild ; Borneo ; Malaysia ; Biosurveillance

Introduction: There is an increasing number of publications on health literacy from Malaysia. We conducted a systematic review of Malaysian studies to determine the prevalence of limited general health literacy and the associated factors among Malaysian adults. Materials and Methods: We conducted a comprehensive search for Malaysian studies on health literacy using PubMed, Scopus and Google Scholar. Cross-sectional studies that measured general health literacy using specific rating scales among adults in Malaysia were retrieved for qualitative analysis. Quantitative synthesis of the prevalence of limited health literacy measured using two rating scales (Newest Vital Sign, NVS and various versions of European Health Literacy Survey, HLS) was performed using random effect model. Results: Twenty-five studies measuring general health literacy were retrieved for qualitative analysis; the majority were various versions of HLS and NVS. Pooled prevalence rates of limited health literacy were: HLS: 48.59%; NVS: 91.41%. Subgroup analysis of participant type revealed prevalence of limited health literacy measured using NVS was lower in clinical samples vs non-clinical samples (85.67% vs 94.70%). Moderator analysis revealed a small effect of ethnicity on prevalence of health literacy measured using HLS. Assessment of included studies showed very few of them had statistically significant associations between socio-demographic factors and limited health literacy. Conclusion Prevalence of limited health literacy in Malaysian adults was very high: almost one in two adults in HLS studies and nine out of ten adults in NVS studies. Socio-demographic factors associated with limited health literacy were inconsistent with other studies.
Adult ; Health Literacy ; Malaysia ; Prevalence ; Systematic Review [Publication Type]

Background: Pre-exposure prophylaxis (PrEP) is an evidence-based strategy recommended for at-risk populations for prevention of HIV transmission. However, the level of PrEP awareness and acceptance among Malaysian undergraduate students is currently unknown. Objectives: To assess the sexual activities, sexual behaviors, risk perception, awareness, and acceptance of PrEP of medical compared to non-medical students in a private medical university. Method: Demographic data, sexuality, sexual activity and behaviors, source of HIV knowledge, self- perceived risk of HIV, awareness and acceptance of PrEP were collected using an online anonymous survey among medical and non-medical students at a private medical university. Descriptive, comparative and regression analyses were performed where applicable. A p-value < 0.05 was considered statistically significant. Results: A total of 369 (187 medical, 182 non-medical) students responded. The median age was 22 with female:male ratio of 2:1. Eighty-one (22%) were sexually active of which 54% used condoms inconsistently, 58% had condomless sex in the preceding six months and 35% had casual or transactional sex. Despite this, 33 perceived themselves to be at low risk of HIV. Most learned about HIV from their coursework. PrEP awareness was 40% versus 20% while PrEP acceptance was 69% versus 67%, between medical and non-medical students, respectively. Conclusion Awareness of PrEP among medical students was low and even lower among non-medical students. PrEP acceptance was fair after viewing an introductory video on PrEP. PrEP must be included in the course curriculum. Studies to identify reasons for PrEP-hesitancy should be conducted to help guide policies and initiatives toward promoting PrEP as an additional tool in HIV prevention.
Malaysia ; HIV ; Awareness

Introduction: Cyberbullying is the use of information and communication technologies to support deliberate, repeated, and hostile behaviour by an individual or group to harm others. Cyberbullying may negatively affect the studies, personal lives and mental health of victims who are students. We report on the prevalence of cyberbullying and its effects on personal lives, studies, and mental health among medical students. Methods: A self-administered online questionnaire was used to collect demographic data, determine the prevalence of cyberbullying, and its effects on personal lives, studies and mental health of medical students. Student-t test was used for comparison of means, and logistic analysis was used to identify predictors of being cyberbullied. Results: 40 out of 261 study participants reported being cyberbullied in the preceding 6 months (prevalence: 15.3%). Cyberbullying did not negatively affect the studies and personal lives of victims. Most victims reported none or minimal-to-mild depression. Malay ethnicity was a predictor of being cyberbullied. Female students were 5-times more likely to be cyberbullied because of their lifestyle compared to males. Conclusion The prevalence of cyberbullying among medical students in this study was relatively low compared to reports from other universities. Cyberbullying had little to no effect on the studies, personal life, and mental health of medical students in our study. Malay ethnicity was a significant predictor to being cyberbullied. Females were more likely to be cyberbullied for their lifestyle. Support systems, awareness of good internet etiquette, and promotion of early help-seeking behaviour, especially targeted at identified vulnerable groups, should be put in place to check the practice of cyberbullying.
Malaysia ; Students, Medical ; Mental Health

Introduction: Lymphoma is a diverse group of malignant proliferations that arise as discrete tissue masses. The 5th edition of the World Health Organization classification of Tumours of Haematopoietic and Lymphoid Tissues was released on 22nd June 2022. The WHO-HAEM5 classification of Mature T and NK neoplasms is further subclassified into various categories which are detailed in this review. Methods: A search was conducted using bibliographic databases, various repositories, and the Clinical Research Centre website retrieving journal articles, conference proceedings, book Chapters, guidelines, and thesis. The search terms used were Malaysia AND lymphoma. Results: The search earmarked a total of 561 papers. There were nine case series retrieved from 1967 to 2022. The site, age distribution, prognostic markers, and the various subclassification of NK/T cell lymphomas were studied. The gastrointestinal tract was the commonest site for extranodal lymphomas. Prognostic markers associated were EBV, C-MYC protein and staining for CD2, CD3, CD20, CD56, and CD57 antigens. For anaplastic large cell lymphoma (ALCL), CD30 (Ki-1) and ALK antigens were noted as important. The use of 18F-Fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PETCT) has emerged as an important investigation. Various chemotherapeutic regimens, surgical interventions where necessary and autologous peripheral blood stem cell transplantation when indicated are the mainstay of treatment. Conclusion Research on NK/T cell lymphoma, including ALCL, has been ongoing in recent years. This review adds on to the existing literature on lymphoma in Malaysia that can lead to further research, into the diagnosis and treatment of lymphoma in Malaysia and around the world.
Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Malaysia

Introduction: The number of unvaccinated children and the rate of vaccination refusal among parents have recently increased despite the robust vaccination programme in Malaysia. The purpose of this study was to determine the level of knowledge of the Malaysian National Immunisation Programme among Malaysian parents as well as the variables that contribute to poor knowledge. Methods: This study used systematic random sampling to recruit 375 parents from seven health clinics in the Dungun District of Malaysia. The participants were asked to complete a self-administered validated questionnaire that included sociodemographic and knowledge questions. A multiple logistic regression analysis was applied to determine the associated factors of poor knowledge of immunisation. P-values of <0.05 were considered statistically significant. Results: A total of 189 (50.4%) respondents had poor knowledge of immunisation. The multiple logistic regression analyses revealed that a low educational level (adjusted odds ratio (OR): 1.92; 95% CI 1.25–2.95) was associated with poor knowledge while the age-group of 30-40 years old (adjusted OR: 0.56; 95% CI 0.34–0.93) was protected against it as compared to the age-group of <30 years old. Conclusion The prevalence of poor knowledge of immunisation among parents in Dungun, Terengganu, is relatively high. The focus of health promotion and education must be switched to increasing immunisation knowledge among the public, particularly among high-risk groups.
Knowledge ; Immunization ; Malaysia

Introduction: SABINA III assessed short-acting β2-agonist (SABA) prescription patterns and their association with asthma-related outcomes globally. Herein, we examined SABA prescription and clinical outcomes in the Malaysian cohort of SABINA III. Methods: In this observational, cross-sectional study, patients (≥12 years) were recruited between July and December 2019 from 15 primary and specialty care centres in Malaysia. Prescribed asthma treatments and severe exacerbation history within 12 months prior and asthma symptom control during the study visit were evaluated. Associations of SABA prescription with asthma control and severe exacerbation were analysed using multivariable regression models. Results: Seven hundred thirty-one patients (primary care, n=265 [36.3%]; specialty care, n=466 [63.7%]) were evaluated. The prevalence of SABA over-prescription (≥3 SABA prescriptions/year) was 47.4% (primary care, 47.1%; specialty care, 47.6%), 51.8% and 44.5% among all patients and patients with mild and moderate-to-severe asthma, respectively. Altogether 9.0% (n=66) purchased SABA without a prescription; among them, 43.9% (n=29) purchased ≥3 inhalers. The mean (standard deviation) number of severe asthma exacerbations was 1.38 (2.76), and 19.7% (n=144) and 25.7% (n=188) had uncontrolled and partly controlled symptoms, respectively. Prescriptions of ≥3 SABA inhalers (vs 1–2) were associated with lower odds of at least partly controlled asthma (odds ratio=0.42; 95% confidence interval [CI]=0.27–0.67) and higher odds of having severe exacerbation(s) (odds ratio=2.04; 95% CI=1.44–2.89). Conclusion The prevalence of SABA over-prescription in Malaysia is high, regardless of the prescriber type, emphasising the need for healthcare providers and policymakers to adopt latest evidence-based recommendations to address this public health concern.
Asthma ; Malaysia

Introduction: Booster vaccination has been shown to reduce transmission and serious infection with COVID-19. This study examined the willingness to receive a COVID-19 booster vaccine and its associated factors among high-risk patients at Klinik Kesihatan Putrajaya Presint 9. Methods: A cross-sectional study was conducted among patients aged ≥18 years attending Klinik Kesihatan Putrajaya Presint 9 with a high risk of contracting COVID-19 recruited via systematic random sampling. Data were collected using a self-administered questionnaire. A multiple logistic regression analysis was performed to identify the associated factors. Results: The response rate for this study was 97.4% (N=489). The median patient age was 55 years. Approximately 51.7% were men, and 90.4% were Malays. Approximately 81.2% were willing to receive a COVID-19 booster vaccine. The patients who perceived COVID-19 as a serious illness (Adjusted Odd Ratio, AOR=2.414), those who perceived COVID-19 booster vaccines as beneficial (AOR=7.796), those who disagreed that COVID-19 booster vaccines have many side effects (AOR=3.266), those who had no doubt about the content of COVID-19 vaccines (AOR=2.649) and those who were employed (AOR=2.559) and retired (AOR=2.937) were more likely to be willing to receive a booster vaccine than those who were unemployed and those who did not have close friends or family members who contracted severe COVID-19 (AOR=2.006). Conclusion The majority of the participants were willing to receive a COVID-19 booster vaccine. Healthcare authorities should take initiatives to design targeted public intervention programmes to increase the willingness for COVID-19 booster vaccination.
COVID-19 ; Immunization, Secondary ; Vaccines ; Malaysia

Objective: This is a scoping review of Malaysian scientific studies on medication adherence among persons with type 2 diabetes mellitus (T2DM). Methodology: We conducted a bibliographic search of PubMed, Scopus and Google Scholar using the following keywords: “medication adherence,” “drug compliance,” “DMTAC” and “Malaysia.” The search covered all publications up to 31 December 2021. Eligible articles were original studies conducted in Malaysia that measured or quantified medication adherence among persons with T2DM. Results: We identified 64 eligible studies published between 2008 to 2021. Most studies included patients with T2DM in ambulatory facilities. Five studies were qualitative research. The quantitative research publications included clinical trials, and cross-sectional, validation, retrospective and prospective cohort studies. Thirty-eight studies used medication adherence scales. The Morisky Medication Adherence Scale (MMAS-8, used in 20 studies) and Malaysian Medication Adherence Scale (MALMAS, used in 6 studies) were the most commonly used tools. There were 6 validation studies with 4 medication adherence scales. A meta-analysis of 10 studies using MMAS-8 or MALMAS revealed that the pooled prevalence of low medication adherence is 34.2% (95% CI: 27.4 to 41.2, random effects model). Eighteen publications evaluated various aspects of the Diabetes Medication Therapy Adherence Clinics (DMTAC). Conclusion This scoping review documented extensive research on medication adherence among persons with diabetes in Malaysia. The quantitative meta-analysis showed a pooled low medication adherence rate.
Diabetes Mellitus ; Medication Adherence ; Malaysia

ABSTRACT This study investigated personal and professional social media use among orthodontists in Malaysia, to determine marketing strategies and to identify potential determinants associated with their behaviours. A cross sectional study using an online questionnaire distributed to members of the Malaysian Association of Orthodontists (MAO). Data were analysed using SPSS software to derive descriptive statistics and analysis of variance was applied to compare responses between age groups and working sector. Responses to open ended questions were analysed using thematic analysis. A response rate of 41% was obtained (n = 72). Almost all respondents were social media users with Facebook being the most common online platform. Majority relied on traditional methods of marketing such as good service and image practice (94.4%), word of mouth (94.4%) and referrals (93.1%). Only 9.7% of respondents had adopted social media marketing but 23.6% had future plans to adopt it as their marketing strategy. Difference in knowledge of social media marketing was significantly different between age groups (p = 0.024). Concerns over patient confidentiality (p = 0.016) and risk of breaching online professional behaviour (p = 0.025), as reasons discouraging social media marketing was statistically significant between work sector groups. Most orthodontists in Malaysia use social media for personal use but only a minority incorporate it into their marketing strategies. Majority see its potential and predict its use will increase in the future.
Orthodontics ; Social Marketing ; Malaysia