Prevalence of Hypertension and Its Risk Factors in An Orang Asli Community in Perak, Malaysia

PROGRAMME AND ABSTRACT
3rd INTERNATIONAL PUBLIC HEALTH CONFERENCE & 20th NATIONAL PUBLIC HEALTH COLLOQUIUM New Insights into Non Communicable Disease Prevention: The Next Step
28 29 AUGUST 2013 RIVERSIDE MAJESTIC HOTEL KUCHING, SARAWAK
Organiser: Department of Community Health Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre
Co-Organiser:
United Nations University International Institute for Global Health (UNU-IIGH)
Sarawak State Health Department
Sarawak Nursing Professional Association (SNPA)
In Collaboration with: Universiti Malaysia Sarawak (UNIMAS)
Supported by: Sarawak Convention Bureau
SCIENTIFIC / SYMPOSIUM SPEAKERS / PROCEEDING COMMITTEE 2013
Adviser Professor Dr. Mohd Rizal Haji Abd Manaf Chairperson of Scientific Committee Associate Professor Dr. Aniza Ismail Chairperson of Abstract Book / Proceeding Committee Associate Professor Dr. Zaleha Md Isa Chairperson of Symposium Speakers Committee Associate Professor Dr. Rozita Hod
Members of Scientific Committee Professor Dr. Noor Hassim Ismail Professor Dr. Khadijah Shamsuddin Associate Professor Dr. Mohd Hasni Jaafar Associate Professor Dr. Khalib Latip Associate Professor Dr. Rosnah Sutan Dr. Nazaruddin Safian Dr. Hanizah Mohd Yusoff Dr. Ahmad Taufik Jamil Dr. Halim Ismail Azman Ariff Mohammad Fuad Mohamad Affader Associate Professor Ho Siew Eng (Nursing Department UKMMC) Professor Dr. Mohd Raili Suhaili (UNIMAS) Dr. Hashimah Basri (Sarawak State Health Department) Samasu Johari (Sarawak State Health Department) Members of Abstract Book / Proceeding Committee Associate Professor Dr. Sharifa Ezat Wan Puteh Noorasmaa Husna Mohd Hasni Rahimah Raoh Members of Symposium Speakers Committee Noraliawati Ahmad Dr. Ho Ai Chia (SNPA) Dr. Eunice Meslissa Joseph (SNPA)
CONTENT
NO SUBJECT 1 2 3 4 Foreword By Guest of Honour Foreword By The Vice Chancellor of Universiti Kebangsaan Malaysia Foreword By The Dean & Director of UKM Medical Centre Foreword By The Chairman of The 3rd International Public Health Conference & 20th National Public Health Colloquium Theme and Objectives Organising Committee Pre-Conferences Schedule Opening Ceremony Programme Programme Schedule Conference Day 1 Programme Schedule Conference Day 2 List of Speakers: Keynote Address Plenary Symposium Scientific Paper Presentation (Oral): Epidemiology & Statistics Family Health / Nutrition / Social Work Environmental Health / Occupational Health Health Management / Health Promotion List of Poster Presentation Epidemiology & Statistics Family Health / Nutrition / Social Work Occupational Health Environmental Health Health Management Health Promotion Abstracts Advertisements PAGE i ii iii iv
5 6 7 8 9 10 11
v vi ix xi xii xv
xix xix xix xxiii xxv xxvii xxix
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xxxi xxxiv xxxvi xxxvii xxxviii xxxix 1-138
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New Insights into Non Communicable Disease Prevention: The Next Step
2013
FOREWORD
By Guest of Honour: Pehin Sri Haji Abdul Taib bin Mahmud The Right Honourable Chief Minister of Sarawak
Assalamualaikum Warahmatullahi Wabarakatuh and Salam Sejahtera It gives a great pleasure to welcome all delegates and officials to this 3rd International Public Health Conference & 20th National Public Health Colloquium to this beautiful city of Kuching, our State capital. Our traditional greeting is Selamat Datang ke Bandaraya Kuching. As we all know our region is facing unique health challenges and problems in terms of lifestyle, diet and Non-Communicable Disease (NCD). The common problems on the rise are obesity, cardiovascular diseases and diabetes, which require comprehensive strategies to reduce health threat. Obviously, as healthcare providers, the Government, through the Ministry of Health, both the Federal and State level endeavour to deliver good healthcare to the people. It is making continuous efforts to implement new approaches in preventing the spread of NCD. I am pleased to see that Public Health Specialists, healthcare professionals, nurses and healthcare personnel have been working together towards greater research collaborations in overcoming this problem. I wish to this opportunity to commend all participants for their dedication in research and medical education in the Public Health sector, which actually provide them opportunities to foster good relationship locally and internationally to strengthen research collaboration. Hopefully, this 3rd International Public Health Conference & 20th National Public Health Colloquium will help to enhance ties between the participating countries. Malaysia, on its part, believes in having good and stable relationship among countries in whatever fields at the international arena. I hope foreign delegates will have a pleasant stay in Kuching. You will be able to know more about the city and the local people by venturing out from the venue of this conference. Generally, the people are quite warm and friendly to make you feel welcomed in their city. Thank you. Pehin Sri Haji Abdul Taib bin Mahmud The Right Honourable Chief Minister of Sarawak 3rd International Public Health Conference & 20th National Public Health Colloquium 28-29 August 2013 Riverside Majestic Hotel, Kuching, Sarawak, Malaysia
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FOREWORD
By The Vice Chancellor of Universiti Kebangsaan Malaysia: Professor Tan Sri Dato Seri Dr. Sharifah Hapsah Syed Hasan Shahabudin Universiti Kebangsaan Malaysia
Assalamualaikum Warahmatullahi Wabarakatuh and Salam Sejahtera It gives me great pleasure to welcome all delegates to the 3rd International Public Health Conference & 20th National Public Health Colloquium. Public health is a critical part of the larger concept of health systems and the goal of public health is to improve health outcomes for the population. Modernization has given rise to a new way of life, such as unhealthy diet, sedentary lifestyle, tobacco use and alcohol abuse. This trend is global, affecting both the developed and developing world. Progress in the battle against communicable and non-communicable diseases will demand shared learning among countries, and the deployment of innovations suitably adapted for local needs. Thus, going forward we must devote all resources to bring about awareness and detailed attention to this emerging phenomenon at the level of the individual, community and nation. I urge all delegates to make full use of this conference to foster greater international collaboration in public health for enhancing medical services, education and research.
Thank you. Professor Tan Sri Dato Seri Dr. Sharifah Hapsah Syed Hasan Shahabudin Vice-Chancellor of Universiti Kebangsaan Malaysia
3rd International Public Health Conference & 20th National Public Health Colloquium 28-29 August 2013 Riverside Majestic Hotel, Kuching, Sarawak, Malaysia
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FOREWORD
By The Dean of Faculty of Medicine and Director of UKM Medical Centre: Professor Dato' Dr. Raymond Azman Ali UKM Medical Centre
Assalamualaikum Warahmatullahi Wabarakatuh and Salam Sejahtera It is with great pleasure that I welcome all delegates to the 3rd International Public Health Conference & 20th National Public Health Colloquium. Over the years, this meeting of minds, which was initiated 20 years ago, has seen hundreds of topics discussed and researches shared. New research in the Public Health sector has significantly improved the healthcare delivery system in Malaysia. Collaborations between the Ministry of Education, Ministry of Health and other sectors have been facilitated by this meeting. Young and innovative researchers in this region were provided with a platform to share their findings. This year marks another history as specialists, doctors, nurses and healthcare personnels in the Public Health sector, join forces in sharing their experiences and seek new approaches to curb NonCommunicable Diseases (NCD). I urge all delegates to make full use of this opportunity to strive towards greater local and international collaborations. Ultimately, it will lead to better quality health services, medical education and research. My heartiest congratulations to the Department of Community Health, Faculty of Medicine, UKMMC, United Nations University International Institute for Global Health (UNU-IIGH), Sarawak State Health Department, Sarawak Nurses Professional Association (SNPA), UNIMAS and Sarawak Convention Bureau for their combined effort in realizing this conference. I am confident the commitment shown by all parties will continue for years to come. May you have a meaningful conference.
Thank you. Professor Dato' Dr. Raymond Azman Ali Dean of Faculty of Medicine and Director of UKM Medical Centre
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FOREWORD
By The Chairman of the 3rd International Public Health Conference & 20th National Public Health Colloquium: Professor Dr. Mohd Rizal Haji Abd Manaf Head of Department, Department of Community Health, UKM Medical Centre
Assalamualaikum Warahmatullahi Wabarakatuh and Salam Sejahtera
It is with great honour that I welcome all delegates to the 3rd International Public Health Conference & 20th National Public Health Colloquium. This years conference also marked another milestone in the history of UKM as for the first time we are having this conference outside Klang Valley. Throughout these years the conference had always been conducted in Peninsular Malaysia, but with greater collaboration and commitment by colleagues from East Malaysia we have bridged together to have our annual conference here in Sarawak. The Malaysian National Health Morbidity Survey conducted in 2011 showed that over the span of 5 years from 2006, the prevalence of diabetes among those who are 18 years and above has increased from 11.6% to 15.6%. Hypertension increased from 20% to 36% with circulatory disease and cancer on the rise. Given this alarming scenario the organizing committee has carefully chosen the theme: New Insights into Non Communicable Disease Prevention: The Next Step for us to deliberate throughout the conference. Hopefully, this conference will generate discussions on the challenges and successes pertaining to preventive work in public health. I thank the organizing committee for their dedication in ensuring the success of this conference. May you have a successful conference.
Thank you. Professor Dr. Mohd Rizal Haji Abd Manaf Chairman of 3rd International Public Health Conference & 20th National Public Health Colloquium Head of Department, Department of Community Health, UKM Medical Centre
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THEME:
OBJECTIVES:
To deliberate issues related to the theme above. To bring together public health specialist, medical specialists, scientists and healthcare practitioners to share advances and knowledge by presenting current and new findings. To create a platform to promote and enhance scientific collaborations around the world. To provide opportunities for healthcare practitioners / students to present scientific paper at international level. To provide networking and knowledge exchange opportunities across a wide range of disciplines and sectors.
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ORGANISING COMMITTEE
PATRON Professor Tan Sri Dato Seri Dr. Sharifah Hapsah Syed Hasan Shahabudin Vice Chancellor, Universiti Kebangsaan Malaysia Professor Dato Dr. Raymond Azman Ali Dean Faculty of Medicine and Director of UKM Medical Centre Datu Dr Zulkifli Jantan State Health Director, Sarawak State Health Department Professor Dr. Mohd Rizal Haji Abd Manaf Head, Department of Community Health, UKM Medical Centre Dr. Norfazilah Ahmad Dr. Azimatun Noor Aizuddin
ADVISOR
CO-ADVISOR
CHAIRMAN
SECRETARY TREASURER
SUB-COMMITTEE MEMBERS:
SECRETARIAT Chairman Members Dr. Norfazilah Ahmad Dr. Azmawati Mohammed Nawi Dr. Faiz Daud Wan Aishah Wan Nawi Rohana Mohd Zawawi Dr. Razitasham Safii (Sarawak State Health Department) Matron Margareth Wong Ai Yung (SNPA)
FINANCE & FUNDRAISING Chairman Dr. Azimatun Noor Aizuddin Members Dr. Mohd Rohaizat Hassan Qistina Mohd Ghazali Rozaina Mohd Zain Mokhtar Keling Lee Na (SNPA) Khing Sai Ngo (SNPA) IT SUPPORT & WEBS Sazman Wahab Norafiza Othman (Sarawak State Health Department) Mohd Ismail Ibrahim (Sarawak State Health Department) Lee Hui Khuang (Sarawak State Health Department) 3rd International Public Health Conference & 20th National Public Health Colloquium 28-29 August 2013 Riverside Majestic Hotel, Kuching, Sarawak, Malaysia
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SCIENTIFIC Chairman Members
Assoc. Prof. Dr Aniza Ismail Prof. Dr. Noor Hassim Ismail Prof. Dr. Khadijah Shamsuddin Assoc. Prof. Dr. Mohd Hasni Jaafar Assoc. Prof. Dr. Khalib Latip Assoc. Prof. Dr. Rosnah Sutan Dr. Nazaruddin Safian Dr. Hanizah Mohd Yusoff Dr. Ahmad Taufik Jamil Dr. Halim Ismail Azman Ariff Mohammad Fuad Mohamad Affader Assoc. Prof. Ho Siew Eng (Nursing Department UKMMC) Prof. Dr. Mohd Raili Suhaili (UNIMAS) Dr. Hashimah Basri (Sarawak State Health Department) Samasu Johari (Sarawak State Health Department)
SYMPOSIUM SPEAKERS Chairman Assoc. Prof. Dr. Rozita Hod Members Noraliawati Ahmad Dr. Ho Ai Chia (SNPA) Dr. Eunice Meslissa Joseph (SNPA) PROCEEDINGS Chairman Members
Assoc. Prof. Dr. Zaleha Md Isa Assoc. Prof. Dr. Sharifa Ezat Wan Puteh Noorasmaa Husna Mohd Hasni Rahimah Raoh
LOGISTICS & ACCOMODATION Chairman Rodzaini Sabran Members Mohammed Hairol Isa Maria Resen (Sarawak State Health Department) Salmiah Abg Alias Sebli (Sarawak State Health Department) SCIENTIFIC EVENTS & EQUIPMENTS Chairman Khairul Hazdi Yusof Members Abdul Kadir Mohamad Anis (Sarawak State Health Department) PROTOCOL & GIFTS Chairman Noor Mujanah Kormin Members Jacqueline Kho (SNPA) Juriah Sulehan (SNPA) Amelna Anuar (Sarawak State Health Department) Salinah Morni (Sarawak State Health Department)
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PRE-CONFERENCE WORKSHOP Chairman Assoc. Prof. Dr. Shamsul Azhar Shah Members Mohd Rizam Abd Rahman Dr Deburra Ngadan (SNPA) Chin Siew Kiaw CONFERENCE MARKETING Chairman Mohd Firdaus Habib Members Christina Baun Lian (SNPA) Anna Nasef (SNPA) ANNOUNCEMENT Chairman DINNER Chairman Members
Assoc. Prof. Dr. Azmi Mohd Tamil
Bisek Senduk (SNPA) Dina Matan (SNPA) Jimen Rinyui (SNPA) Lina Tan (SNPA) Hamiah Jamain (SNPA) Enah Hj Jara'ee (SNPA) Lipen Ramut (SNPA)
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3rd INTERNATIONAL PUBLIC HEALTH CONFERENCE & 20th NATIONAL PUBLIC HEALTH COLLOQUIUM
PRECONFERENCE WORKSHOP
Date: 27th August 2013 (Tuesday)
TIME 9.00am 4.00pm
PROGRAMME WORKSHOP A, WORKSHOP B, WORKSHOP C, WORKSHOP D & WORKSHOP E (Concurrent) WORKSHOP A: Statistical Analysis Workshop (Survival Analysis) Moderator: Associate Professor Dr. Mohd Ayub Sadiq @ Lin Naing Associate Professor (Biostatistics), PAPRSB Institute of Health Sciences, University Brunei Darussalam, Brunei Darussalam Room: Sarawak Chamber 2 (3rd Floor)
9.00am 4.00pm
9.00am 4.00pm
WORKSHOP B: Scientific Manuscript Writing Moderator: Professor Dr. Srijit Das Professor in Anatomy, Department of Anatomy, Faculty of Medicine, UKM Medical Centre, Malaysia Associate Professor Dr. Shamsul Azhar Shah Associate Professor in Epidemiology and Statistics, Department of Community Health & Head of Clinical Epidemiology Unit, Faculty of Medicine, UKM Medical Centre, Malaysia
Room: Window of Kuching Suite 1 & 2 (18th Floor) 9.00am 4.00pm WORKSHOP C: Public Health and Disaster: Preparedness and Response Moderator: Professor Dr. Mohamad Raili Suhaili & Associate Professor Dr. Md Mizanur Rahman Department of Community Medicine & Public Health, Faculty of Medicine and Health Science, Universiti Malaysia Sarawak (UNIMAS), Malaysia Room: Window of Kuching Suite 5 & 6 (18th Floor)
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9.00am 4.00pm
WORKSHOP D: Health Technology Assessment for Public Health Interventions Moderator: Dr. Junainah Sabirin (Senior Principal Assistant Director ) Dr. Izzuna Mudla Mohamed Ghazali (Senior Principal Assistant Director) Madam Noormah Mohd Darus (Senior Principal Assistant Director) Madam Sin Lian Thye (Nurse) Malaysian Health Technology Assessment Section (MaHTAS), Medical Development Division, Ministry of Health, Malaysia Room: Deer Suite (3rd Floor)
9.00am 4.00pm
WORKSHOP E: Challenges in Diagnosing Occupational Diseases: Case Studied Moderator: Professor Tar-Ching Aw Interim Dean, College of Medicine & Health Sciences, UAE University, United Arab Emirates Professor Dr. David Koh Chair Professor, PAPRSB Institute of Health Sciences, University Brunei Darussalam, Brunei Darussalam
Room: Lady Suite (3rd Floor)
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OPENING CEREMONY PROGRAMme

Date: 28th August 2013 (Wednesday) Venue: Riverside Majestic Hotel, Kuching, Sarawak Room: Sarawak Chamber 2 & 3 (3rd Floor)
TIME 10.15am-10.30am 10.30am 10.35am 10.35am-10.40am
PROGRAMME Arrival of invited guests Prayer/Dua Recitation Speech by the Chairman of Organizing Committee: YBhg Professor Dr. Mohd Rizal Haji Abdul Manaf Head, Department of Community Health, Faculty of Medicine, UKM Medical Centre
10.40am-10.50am
Speech by Patron of the Conference: YBhg Professor Datuk Dr. Noor Azlan Ghazali Deputy Vice Chancellor (Academic & International Affair), Universiti Kebangsaan Malaysia
10.50am-11.00am
Opening Speech by Guest of Honour: Pehin Sri Haji Abdul Taib Mahmud The Right Honourable Chief Minister of Sarawak
11.00am
Conference schedule recommence
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CONFERENCE DAY 1
Date: 28th August 2013 (Wednesday)
TIME 8.00am 9.00am 9.00am 9.45am
PROGRAMME REGISTRATION PLENARY 1 Title: Nutrition and Cancer Prevention: Recent Research on Lifestyle and Nutrition Professor Dr. Colin Binns John Curtin Distinguished Professor of Public Health & Deputy Editor in Chief, Asia Pacific Journal of Public Health, School of Public Health and Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia Chairperson: Professor Dr. Khadijah Shamsuddin Technician/ Time Keeper: Suwandy bin Pairan / Khairul Hazdi Yusof Room: Sarawak Chamber 2 & 3 (3rd Floor)
9.45am 10.15am
TEA BREAK (Room: Foyer of 3rd Floor) & POSTER PRESENTATION (Room: Wind Suite II - 3rd Floor)
10.15 am 11.00am
OPENING CEREMONY Pehin Sri Haji Abdul Taib Mahmud The Right Honourable Chief Minister of Sarawak Room: Sarawak Chamber 2 & 3 (3rd Floor)
11.00am 11.45am
KEYNOTE ADDRESS Title: New Insight into Non Communicable Disease Prevention: The Next Step Dr. Graham Harrison WHO Representative to Malaysia, Brunei Darussalam and Singapore Chairperson: Professor Dr. Mohd Rizal Haji Abd Manaf Technician/ Time Keeper: Suwandy bin Pairan / Khairul Hazdi Yusof Room: Sarawak Chamber 2 & 3 (3rd Floor)
11.45am 1.30pm
SYMPOSIUM 1 & 2 (CONCURRENT) SYMPOSIUM 1 EPIDEMIOLOGY Chairperson: Associate Professor Dr. Shamsul Azhar Shah Technician/ Time Keeper: Mohd Ismail bin Ibrahim / Noorasmaa Husna Mohd Hasni Room: Sarawak Chamber 2 & 3 (3rd Floor)
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11.45am 12.20pm SYMP1-1
1.
Title: Diabetes Prevention: Bridging the Gap between Clinical and Public Health Surveillance Professor Dr. Norlela Shukor Consultant Endocrinologist, Faculty of Medicine, UKM Medical Centre, Malaysia Title: Statistical Risk Factor Modelling for Non Communicable Diseases Associate Professor Dr. Mohd Ayub Sadiq@Lin Naing Associate Professor (Biostatistics), PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam Title: Progression, Aetiology and Pathways of Non Communicable Disease From a Life Course Epidemiology Perspective Associate Professor Dr. Abdullah Al Mamun School of Population Health, The University of Queensland, Australia
12.20pm 12.55pm SYMP1-2
2.
12.55pm 1.30pm SYMP1-3
3.
SYMPOSIUM 2 HEALTH AND HOSPITAL MANAGEMENT Chairperson: Associate Professor Dr. Sharifa Ezat Wan Puteh Technician/ Time Keeper: Famiza Elmida bt Kipli /Mohamad Fuad Mohamad Affander Room: Window of Kuching Suite 1, 2, 3 & 4 (18th Floor) 11.45am 12.20pm SYMP2-1 1. Title: Social Health Insurance Financing to Combat Non Communicable Diseases (Thailand Experience) Associate Professor Dr Siripen Supakankunti Director, Centre for Health Economics & Programme Director, MSc in Health Economics and Health Care Management, Faculty of Economics, Chulalongkorn University, Bangkok, Thailand Title: New Health Technologies for Non Communicable Diseases - How Safe and Effective? Dr. Junainah Sabirin Senior Principal Assistant Director, Malaysian Health Technology Assessment Section (MaHTAS), Medical Development Division, Ministry of Health, Malaysia Title: Clinical Pathway of Non Communicable Diseases Improve Quality of Care and Hospital Cost at Tertiary Hospital in Malaysia Associate Professor Dr. Aniza Ismail Medical Lecturer & Public Health Medicine Specialist, Department of Community Health, UKM Medical Centre, Malaysia
12.20pm 12.55pm SYMP2-2
2.
12.50pm 1.30pm SYMP2-3
3.
1.30pm - 2.30pm 2.30pm - 4.30pm
LUNCH (Room: Sarawak Chamber 1 & 2 3rd Floor) & PRAYER SYMPOSIUM 3 & 4 (CONCURRENT) SYMPOSIUM 3 HEALTH PROMOTION & EDUCATION Chairperson: Associate Professor Dr. Khalib Latiff Technician/ Time Keeper: Rozaidi bin Rebi / Noraliawati Ahmad Room: Window of Kuching Suite 1, 2, 3 & 4 (18th Floor)
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2.30pm-3.10pm SYMP3-1
1.
Title: Evaluating Health Promotion Programmes in the Real World: Issues and challenges Associate Professor Dr. Wong Mee Lian Saw Swee Hock School of Public Health, National University of Singapore, Singapore Title: Unrevealed Risks in Health Promotion Dr. Antono Suryoputro Faculty of Public Health, Universitas Diponegoro, Indonesia Title: Values, Tradition and Forgotten Interventions in Disease Prevention: The Sarawak Story Datu Dr. Andrew Kiyu Consultant Epidemiologist, Sarawak State Health Department, Malaysia
3.10pm-3.50pm SYMP3-2 3.50pm-4.30pm SYMP3-3
2.
3.
SYMPOSIUM 4 SPECIAL: NURSING AND ALLIED HEALTH Chairperson: Associate Professor Ho Siew Eng Technician/ Time Keeper: Norafiza Othman / Rohana Mohd Zawawi Room: Sarawak Chamber 2 & 3 (3rd Floor) 2.30pm-3.10pm SYMP4-1 1. Title: Health Informatics as New Clinical Sub-Specialty: Vision, Rationale, Potential, Roles and Values Dr. HM Goh Medical Director/ Chief Operating Officer, University of Malaya Specialist Centre (UMSC), Malaysia Title: Use of Multimedia Apps for Children with Special Needs Dr. Chin Saw Sian Honorary Research Fellow, Institute of Social Information and Innovation (ISITI), Universiti Malaysia Sarawak (UNIMAS), Malaysia Title: The Challenges and Opportunities of Patients Health Monitoring Systems for Rural and Remote Population Dr. Jacey-Lynn Minoi Research Fellow, Institute of Social Informatics and Technological Innovations Centre of Rural Informatics (ISITI-CoeRI) & Senior Lecturer, Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak
3.10pm-3.50pm SYMP4-2
2.
3.50pm-4.30pm SYMP4-3
3.
(UNIMAS), Malaysia
4.30pm 5.00pm TEA (Room: Foyer of 3rd Floor & Lounge of 18th Floor) & POSTER PRESENTATION (Room: Wind Suite II - 3rd Floor) 7.30pm- 9.00pm DINNER
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CONFERENCE DAY 2
Date: 29th August 2013 (Thursday)
TIME 8.30am 9.15am
PROGRAMME PLENARY 2 Title: Cardiovascular Diseases: Surveillance, Prevention and Healthcare Professor William Cairns Stewart Smith OBE Faculty of Medicine, UKM Adjunct Professor & Professor of Public Health, Institute of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, United Kingdom Chairperson: Associate Professor Dr. Rosnah Sutan Technician/ Time Keeper: Suwandy bin Pairan / Khairul Hazdi Yusof Room: Sarawak Chamber 2 & 3 (3rd Floor)
9.15am - 10.15am
SCIENTIFIC PAPER 1 PRESENTATION 4 CONCURRENT SESSIONS

(A1/B1/C1/D1) Session A1: Epidemiology/ Statistics Chairperson: Dr. Ho Ai Chia Technician/ Time Keeper: Suwandy Pairan / Mohamad Fuad Mohamad Affander Room: Sarawak Chamber 2 & 3 (3rd Floor) Session B1: Family Health/ Nutrition/ Social Work Chairperson: Dr. Eunice Melissa Joseph Technician/ Time Keeper: Mohd Ismail Ibrahim / Qistina Mohd Ghazali Room: Window of Kuching 5 & 6 (18th Floor) Session C1: Occupational Health / Environmental Health Chairperson: Dr. Dayang Rafidah Technician/ Time Keeper: Norafiza Othman / Noorasmaa Husna Mohd Hasni Room: Window of Kuching Suite 1 & 2 (18th Floor) Session D1: Health Management / Health Promotion Chairperson: Dr. Johnny Pangkas Technician/ Time Keeper: Famiza Elmida Kipli / Rozaina Mohd Zain Room: Window of Kuching Suite 3 & 4 (18th Floor)
10.15am - 10.45am
TEA (Room: Foyer of 3rd Floor & Lounge of 18th Floor) & POSTER PRESENTATION (Room: Wind Suite II - 3rd Floor)
10.45am 12.45pm
SYMPOSIUM 5 & 6 (CONCURRENT)
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SYMPOSIUM 5 FAMILY HEALTH Chairperson: Associate Professor Dr. Abdullah Al Mamun Technician/ Time Keeper: Rozaidi Rebi / Rohana Mohd Zawawi Room: Sarawak Chamber 2 & 3 (3rd Floor) 10.45am 11.25am SYMP5-1 1. Title: Progress and Challenges in Child and Adolescent Public Health Professor Dr. Colin Binns John Curtin Distinguished Professor of Public Health & Deputy Editor in Chief, Asia Pacific Journal of Public Health, School of Public Health and Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia Title: Challenges and Opportunities for Mainstreaming Gender and Womens Health in Health Research Professor Dr. Khadijah Shamsuddin Professor in Public Health (Family and Women Health), Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia Title: A Child Welfare Evidence based Practice Model: A Social Work Perspective Madam Durin Edward Head, Medical Social Work Unit, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
11.25am 12.05pm SYMP5-2
2.
12.05pm 12.45pm SYMP5-3
3.
SYMPOSIUM 6 SPECIAL: United Nations University-International Institute for Global Health (UNU-IIGH) Chairperson: Professor Dr. Mohamad Raili Suhaili Technician/ Time Keeper: Mohd Ismail Ibrahim / Noraliawati Ahmad Room: Window of Kuching 5 & 6 (18th Floor) 10.45am 11.15am SYMP6-1 1. Title: Non-Communicable Disease Prevention and Universal Coverage in Developing Countries: Role of UNU-IIGH Professor Dato' Dr. Syed Mohamed Aljunid Professor of Health Economics & Senior Research Fellow, United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia Title: Influence of Environmental Hazards on Non-Communicable Diseases Professor Dr. Jamal Hisham Hashim Professor of Environmental Health & Research Fellow, United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia Title: New Approach in Mental Health Prevention Dr. Atsuro Tsutsumi Research Fellow on Newly Emerging and Re-Emerging & Non-Communicable Disease, United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia Title: Open Source ICT Solutions for Prevention of Non-Communicable Dr. Nurhizam Shafie Research Fellow(Management), United Nations University-International Institute for Global Health (UNU-IIGH),Malaysia
11.15am 11.45am SYMP6-2
2.
11.45am 12.15pm SYMP6-3
3.
12.15pm - 12.45pm SYMP6-4
4.
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12.45pm - 2.00pm 2.00pm - 3.00pm
LUNCH (Room: Sarawak Chamber 1 & 2 3rd Floor) & PRAYER SCIENTIFIC PAPER 2 PRESENTATION 5 CONCURRENT SESSIONS (A2/B2/C2/D2) Session A2: Epidemiology/ Statistics Chairperson: Dr. Ho Ai Chia Technician/ Time Keeper: Suwandy Pairan / Rahimah Raoh Room: Sarawak Chamber 2 & 3 (3rd Floor) Session B2: Family Health/ Nutrition/ Social Work Chairperson: Dr. Eunice Melissa Joseph Technician/ Time Keeper: Mohd Ismail Ibrahim / Noor Mujanah Kormin Room: Window of Kuching Suite 5 & 6 (18th Floor) Session C2: Occupational Health / Environmental Health Chairperson: Dr. Dayang Rafidah Technician/ Time Keeper: Norafiza Othman / Noorasmaaa Husna Mohd Hasni Room: Window of Kuching Suite 1 & 2 (18th Floor) Session D2: Health Management / Health Promotion Chairperson: Dr. Johnny Pangkas Technician/ Time Keeper: Famiza Elmida Kipli / Mohamad Fuad Mohamad Affander Room: Window of Kuching Suite 3 & 4 (18th Floor)
3.00pm 5.00pm
SYMPOSIUM 7& 8 (CONCURRENT) SYMPOSIUM 7 OCCUPATIONAL HEALTH Chairperson: Professor Dr. Noor Hassim Ismail Technician/ Time Keeper: Rozaidi Rebi / Rahimah Raoh Room: Sarawak Chamber 2 & 3 (3rd Floor)
3.00pm 3.40pm SYMP7-1
1.
Title: Occupational Mortality - Cause and Prevention Professor Dr. David Koh Chair Professor, PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam Title: The Global Burden of Asbestos-Related Diseases and the Role of Public Health Professor Dr. Ken Takahashi Professor and Chair of Environmental Epidemiology, IIES, Director of the International Center, Director of the WHO Collaborating Center for Occupational Health (IIES), University of Occupational and Environmental Health, Kitakyushu, Japan Title: Occupational Health: A Forgotten Area of Public Health Professor Tar-Ching Aw Interim Dean, College of Medicine & Health Sciences, UAE University, United Arab Emirates
3.40pm 4.20pm SYMP7-2
2.
4.20pm 5.00pm SYMP7-3
3.
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SYMPOSIUM 8 ENVIRONMENTAL HEALTH Chairperson: Associate Professor Dr. Mohd Hasni Jaafar Technician/ Time Keeper: Mohd Ismail Ibrahim / Noor Mujanah Kormin Room: Window of Kuching Suite 5 & 6 (18th Floor) 3.00pm 3.40pm SYMP8-1 1. Title: Particulate Air Pollution - A Risk Factor for Cardiovascular Disease Professor Dr. Bin Jalaludin Director Center for Research, Evidence Management and Surveillance (REMS) Conjoint Professor, University of New South Wales, Australia Title: Food Insecurity, Obesity and Chronic Diseases: What Do We Know? Professor Dr. Zalilah Mohd Sharif Deputy Dean (Academic), Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, University Putra Malaysia, Malaysia Title: Lead and Public Health: Issues That Were Never Solved Associate Professor Dr. Shamsul Bahari Shamsudin Director, Centre of Occupational Safety and Health, Universiti Malaysia Sabah, Malaysia
3.40pm 4.20pm SYMP8-2
2.
4.20pm 5.00pm SYMP8-3
3.
5.00pm - 6.00pm
BEST ORAL & POSTER PRESENTER AWARD CLOSING CEREMONY Room: Sarawak Chamber 2 & 3 (3rd Floor) TEA BREAK (Room: Foyer of 3rd Floor)
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LIST OF SPEAKERS
PAGE KEY NOTE ADDRESS Title: New Insight into Non Communicable Disease Prevention: The Next Step Dr. Graham Harrison WHO Representative to Malaysia, Brunei Darussalam and Singapore PLENARY PLENARY 1 Title: Nutrition and Cancer Prevention: Recent Research on Lifestyle and Nutrition Professor Dr. Colin Binns John Curtin Distinguished Professor of Public Health & Deputy Editor in Chief, Asia Pacific Journal of Public Health, School of Public Health and Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia PLENARY 2 Title: Cardiovascular Diseases: Surveillance, Prevention and Healthcare Professor William Cairns Stewart Smith OBE Faculty of Medicine, UKM Adjunct Professor & Professor of Public Health, Institute of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, United Kingdom SYMPOSIUM SYMP 1-1 Title: Diabetes Prevention: Bridging the Gap between Clinical and Public Health Surveillance Professor Dr. Norlela Shukor Consultant Endocrinologist, Faculty of Medicine, UKM Medical Centre, Malaysia SYMP 1-2 Title: Statistical Risk Factor Modelling for Non Communicable Diseases Associate Professor Dr. Mohd Ayub Sadiq@Lin Naing Associate Professor (Biostatistics), PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam SYMP 1-3 Title: Progression, Aetiology and Pathways of Non Communicable Disease From a Life Course Epidemiology Perspective Associate Professor Dr. Abdullah Al Mamun School of Population Health, The University of Queensland, Australia SYMP 2-1 Title: Social Health Insurance Financing to Combat Non Communicable Diseases (Thailand Experience) Associate Professor Dr. Siripen Supakankunti Director, Centre for Health Economics & Programme Director, MSc in Health Economics and Health Care Management, Faculty of Economics, Chulalongkorn University, Bangkok, Thailand -
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SYMP 2-2 Title: New Health Technologies for Non Communicable Diseases - How Safe and Effective? Dr. Junainah Sabirin Senior Principal Assistant Director, Malaysian Health Technology Assessment Section (MaHTAS), Medical Development Division, Ministry of Health, Malaysia SYMP 2-3 Title: Clinical Pathway of Non Communicable Diseases Improve Quality of Care and Hospital Cost at Tertiary Hospital in Malaysia Associate Professor Dr. Aniza Ismail Medical Lecturer & Public Health Medicine Specialist, Department of Community Health, UKM Medical Centre, Malaysia SYMP 3-1 Title: Evaluating Health Promotion Programmes in the Real World: Issues and challenges Associate Professor Dr. Wong Mee Lian Saw Swee Hock School of Public Health, National University of Singapore, Singapore SYMP 3-2 Title: Unrevealed Risks in Health Promotion Dr. Antono Suryoputro Faculty of Public Health, Diponegoro University, Indonesia SYMP 3-3 Title: Values, Tradition and Forgotten Interventions in Disease Prevention: The Sarawak Story Datu Dr. Andrew Kiyu Consultant Epidemiologist, Sarawak State Health Department, Malaysia SYMP 4-1 Title: Health Informatics as New Clinical Sub-Specialty: Vision, Rationale, Potential, Roles and Values Dr. HM Goh Medical Director/ Chief Operating Officer, University of Malaya Specialist Centre (UMSC), Malaysia SYMP 4-2 Title: Use of Multimedia Apps for Children with Special Needs Dr. Chin Saw Sian Honorary Research Fellow, Institute of Social Information and Innovation (ISITI), Universiti Malaysia Sarawak (UNIMAS), Malaysia SYMP 4-3 Title: The Challenges and Opportunities of Patients Health Monitoring Systems for Rural and Remote Population Dr. Jacey-Lynn Minoi Research Fellow, Institute of Social Informatics and Technological Innovations - Centre of Rural Informatics (ISITI-CoeRI) & Senior Lecturer, Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak (UNIMAS), Malaysia SYMP 5-1 Title: Progress and Challenges in Child and Adolescent Public Health Professor Dr. Colin Binns John Curtin Distinguished Professor of Public Health & Deputy Editor in Chief, Asia Pacific Journal of Public Health, School of Public Health and Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia
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SYMP 5-2 Title: Challenges and Opportunities for Mainstreaming Gender and Womens Health in Health Research Professor Dr. Khadijah Shamsuddin Professor in Public Health (Family and Women Health), Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia SYMP 5-3 Title: A Child Welfare Evidence based Practice Model: A Social Work Perspective Madam Durin Edward Head, Medical Social Work Unit, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia SYMP 6-1 Title: Non-Communicable Disease Prevention and Universal Coverage in Developing Countries: Role of UNU-IIGH Professor Dato' Dr. Syed Mohamed Aljunid Professor of Health Economics & Senior Research Fellow, United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia SYMP 6-2 Title: Influence of Environmental Hazards on Non-Communicable Diseases Professor Dr. Jamal Hisham Hashim Professor of Environmental Health & Research Fellow, United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia SYMP 6-3 Title: New Approach in Mental Health Prevention Dr. Atsuro Tsutsumi Research Fellow on Newly Emerging and Re-Emerging & Non-Communicable Disease, United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia SYMP 6-4 Title: Open Source ICT Solutions for Prevention of Non-Communicable Dr. Nurhizam Shafie Research Fellow (Management), United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia SYMP 7-1 Title: Occupational Mortality - Cause and Prevention Professor Dr. David Koh Chair Professor, PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam SYMP 7-2 Title: The Global Burden of Asbestos-Related Diseases and the Role of Public Health Professor Dr. Ken Takahashi Professor and Chair of Environmental Epidemiology, IIES, Director of the International Center, Director of the WHO Collaborating Center for Occupational Health (IIES), University of Occupational and Environmental Health, Kitakyushu, Japan SYMP 7-3 Title: Occupational Health: A Forgotten Area of Public Health Professor Tar-Ching Aw Interim Dean, College of Medicine & Health Sciences, UAE University, United Arab Emirates
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SYMP 8-1 Title: Particulate Air Pollution - A Risk Factor for Cardiovascular Disease Professor Dr. Bin Jalaludin Director Center for Research, Evidence Management and Surveillance (REMS) Conjoint Professor, University of New South Wales, Australia SYMP 8-2 Title: Food Insecurity, Obesity and Chronic Diseases: What Do We Know? Professor Dr. Zalilah Mohd Sharif Deputy Dean (Academic), Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, University Putra Malaysia, Malaysia SYMP 8-3 Title: Lead and Public Health: Issues That Were Never Solved Associate Professor Dr. Shamsul Bahari Shamsudin Director, Centre of Occupational Safety and Health, Universiti Malaysia Sabah, Malaysia
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SCIENTIFIC PAPER PRESENTATION Epidemiology / Statistics (Session A1)

Date: 29th August 2013 (Thursday) Time: 9.15am-10.15am Room: Sarawak Chamber 2 & 3 (3rd Floor) Chairperson: Dr. Ho Ai Chia Technician / Time Keeper: Suwandy Pairan / Mohamad Fuad Mohamad Affander
PAGE OP A1-1: Time:9.15am Title: Non-Compliance towards Tuberculosis Treatment among TB/HIV Co-Infection Patients in Malaysia: Contribution of Patient and Treatment Factors Ruhana Che Yusof*, Nyi Nyi Naing & Aniza Abd. Aziz OP A1-2: Time:9.23am Title: The Malaysian Version of Susceptibility to Peer Pressure Scale: Examining Its Construct Validity among Students in Institutions of Higher Learning Shazimah Abdul Samad*, Noran Naqiah Mohd Hairi & Maslinor Ismail OP A1-3: Time:9.31am Title: The Needs of Adult Family Members of The ICU Patients as Perceived by Family Members and Nurses Sofee Mohamed Akhlak* OP A1-4: Time:9.39am Title: Non-Communicable Diseases Contributing Risk Factors Evaluation in Palestine Farid AW Ghrayeb*, Mohammad Rusli A, Ayesha Al Rifai & Mohd Ismail I OP A1-5: Time:9.47am Title: Single Nucleotide Polymorphism Genotyping of Salmonella Enterica Serovar Typhi Isolates in Kelantan Malaysia Using Pyrosequencing Assigned Haplotypes Jaafar Nuhu Ja'afar*, Holt Katheryn Elizabeth, Wong Vanessa, Subhash Bhore Janardhan, Prabha Balaram, Ismail Asma & Phua Kia Kien OP A1-6: Time:9.55am Title: How GIS Can Help in Preventing Dengue Mohamed Ismail Lasa*, Sazidah Mohd Karli , Mohd Imran Mohammed Abdul Wahab, Md. Nornekman Aman & Che Mohd Fazriel Hanif Che Daud OP A1-7: Time:10.03am Title: An Outbreak of Legionellosis at A Business Centre in Kuala Lumpur Rohani Hj Ismail*, Norma Sabtu, Nurul Hafizah Mohd Yusof, Ummi Kalthum Shamsuddin & Balachandran a/l Sathiamurty OP A1-8: Time:10.11am Title: Risk Taking Sexual Behaviors among Antiretroviral Therapy Patients in Lafia, Nasarawa State, Nigeria Bako Ishaku Ara*, Audu Esther Solomon, Araoye Margaret Olabisi & Audu Onyemocho 22
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Epidemiology / Statistics (Session A2)

Date: 29th August 2013 (Thursday) Time: 2.00pm-3.00pm Room: Sarawak Chamber 2 & 3 (3rd Floor) Chairperson: Dr. Ho Ai Chia Technician / Time Keeper: Suwandy Pairan / Rahimah Raoh
PAGE OP A2-1: Time: 2.00pm Title: Prevalence, Awareness, Treatment and Control of Diabetes Mellitus among The Elderly: The 2011 National Health and Morbidity Survey, Malaysia Ho Bee Kiau*, Jasvindar Kaur, Gurpreet Kaur, Lim Kuang Hock, Ambigga Devi, Cheong Siew Man & Suthahar Ariaratnam OP A2-2: Time: 2.08pm Title: Association of Body Mass Index, Waist Circumference and Hypertension in Older People at Cimahi, Indonesia Sri Quintina Indriyana*, Salli Fitriyanti & Anastasia Yani Triningtyas OP A2-3: Time: 2.16pm Title: Use of Complementary Medicine amongst Type 2 Diabetes Patients in Negeri Sembilan: A Focus Group Analysis Nizam Baharom*, Rotina Abu Bakar & Shamsul Azhar Shah OP A2-4: Time: 2.24pm Title: The Selected Socio-Demographic and Economic Factors which were Associated with Diabetic Patients Medication Adherence Cliffton Akoi Pangarah*, Mohd Syafiq Abdullah, Md Mizanur Rahman & Andrew Kiyu OP A2-5: Time: 2.32pm Title: Prevalence and Determinants of VCT among Clients of Needle Syringe Exchange Program (NSEP) in Kelantan Sahrol Azmi Termizi * & Wan Mohd Zahiruddin Wan Mohammad OP A2-6: Time: 2.40pm Title: A Qualitative Study of The Factors Influencing The Quality of Life among Stroke Survivors in Kano, Nigeria Ashiru Hamza Mohammad*, Nabilla Al-Sadata Abdul Mohsein & Loh Siew Yim OP A2-7: Time: 2.48pm Title: Prevalence and Factors Associated with Post-Traumatic Stress Disorder (PTSD) among Internally Displaced Women in Saada City, Yemen Redhwan Ali Omar AlShalfa*, ShamsulAzhar Shah & Khadijah Shamsuddin OP A2-8: Time: 2.56pm Title: Psychometric Properties of The Malaysian Version of Reasons Scale for Medication Adherence: Factorial Validation among Hypertensive Patients in Primary Healthcare Setting Razatul Shima Abdul Razak*, Farizah Hairi & Hazreen Abdul Majid 26
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Family Health / Nutrition / Social Work (Session B1)

Date: 29th August 2013 (Thursday) Time: 9.15am-10.15am Room: Window of Kuching Suite 5 & 6 (18th Floor) Chairperson: Dr. Eunice Melissa Joseph Technician / Time Keeper: Mohd Ismail Ibrahim / Qistina Mohd Ghazali
PAGE OP B1-1: Time:9.15am Title: Post-Secondary School Employment among Young Malaysian Adults with Learning Disabilities Dzalani Harun* & Khadijah Shamsuddin OP B1-2: Time:9.23am Title: Womens Sexual and Reproductive Health Care in Rural Areas of South Australia Wendy F Abigail & Cara A Flynn* OP B1-3: Time:9.31am Title: Factors Associated with Diabetes Self-Management Practice among Elderly Diabetes Patients in Primary Care Clinics in Selangor Salmiah Baharudin*, Khadijah Shamsuddin & Rahmah Mohd Amin OP B1-4: Time:9.39am Title: Anxiety and Depression among Pregnant Women: A Cross Sectional Study Siti Khuzaimah Ahmad Sharoni* & Hasni Embong OP B1-5: Time:9.47am Title: Vitamin D Intake and Bone Mineral Density Status of Government Employees in Padang City, Indonesia: Cross Sectional Study Azrimaidaliza* OP B1-6: Time:9.55am Title: Sustaining Breastfeeding among Working Mothers: Experience of Breastmilk Expression Siti Harirotul Hamrok Asis*, Nabilla Al-Sadat, Hazreen Abdul & Mohamed Ismail Lasa OP B1-7: Time:10.03am Title: Intimate Partner Violence (IPV) at A Tertiary Institution Kalli Spencer*, M Haffejee, G Candy & E Kaseke OP B1-8: Time:10.11am Title: Quality of Life among Obese and Overweight in Selangor Ahmad Fareed A Rahman*, Mohd Rizal Abdul Manaf & Aniza Ismail OP B1-9: Time:10.19am Title: Cost Effective Analysis (CEA) of the Different Method of Recall for a Cervical Cancer Screening Program in Klang. Rima Marhayu Bt Abdul Rashid* Maznah Dahlui 33
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Family Health / Nutrition / Social Work (Session B2)

Date: 29th August 2013 (Thursday) Time: 2.00pm-3.00pm Room: Window of Kuching Suite 5 & 6 (18th Floor) Chairperson: Dr. Eunice Melissa Joseph Technician / Time Keeper: Mohd Ismail Ibrahim / Noor Mujanah Kormin
PAGE OP B2-1: Time: 2.00pm Title: Psychological Risk Factors Associated with Falls among Elderly People in Baghdad City, Iraq Mohammed A. Abdal Qader*, Rahmah Mohd. Amin, Shamsul Azhar Shah, Zaleha Md. Isa & Hasanain Faisal Ghazi OP B2-2: Time: 2.08pm Title: Quality of Life Associated with Overweight and Obesity among Young Adult in Hulu Langat, Selangor Azmawati Mohammed Nawi, Farrah Ilyani Che Jamaludin* & Suraya Hani Sharom OP B2-3: Time: 2.16pm Title: Neonatal Mortality among Low Birth Weight in Aceh Province, Indonesia Satrinawati* & Rosnah Sutan OP B2-4: Time: 2.24pm Title: The Effects of Community-Based Reproductive Health Workers on The Utilization of Family Planning Services in Yemen Fekri Dureab*, Amen A. Bawazir & Rainer Kuelker OP B2-5: Time: 2.32pm Title: The Quality of Life of Cleft Lip and / or Palate Children Aged Less than 5 Years Old: Parents Perception Khairol Niza Ahmad* & Jennifer Geraldine Doss OP B2-6: Time: 2.40pm Title: Nutrition and Exercise among Elderly: Knowledge, Attitude and Practice Study among Chinese Community in Sibu, Sarawak Annaletchumy a/p Loganathan*, Annie, Wong Siew Mee & Kavitha Subramaniam OP B2-7: Time:2.48pm Title: Effect of Clothing and Vitamin D-Fortified Milk on Vitamin D Status in Female Office Workers in Jakarta: A Pilot Study Amelinda Angela*, Astri Kurniati, Kamalita Pertiwi & Susana OP B2-8: Time: 2.56pm Title: Tooth Wear and Erosive Tooth Wear among 16-Year-Old Malaysian Adolescent Noorhazayti Ab. Halim*, Rashidah Esa & Chew Hooi Pin OP B2-9: Time:3.04pm Title: Outdoor Air Pollution and Incidence of Acute Respiratory Infection among Children in Klang Valley Siti Rahmah Abdul Rahman*, Sharifah Norkhadijah Syed Ismail, Muhammad Firuz Ramli & Mohd Talib Latiff 38
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Occupational Health / Environmental Health (Session C1)

Date: 29th August 2013 (Thursday) Time: 9.15am-10.15am Room: Window of Kuching Suite 1 & 2 (18th Floor) Chairperson: Dr. Dayang Rafidah Technician / Time Keeper: Norafiza Othman / Noorasmaa Husna Mohd Hasni
PAGE OP C1-1: Time:9.15am Title: Distribution of Selected Endocrine Disrupting Chemicals in Male Vegetarians and NonVegetarians Rafidah Hod*, Ruby Husain & Mustafa Ali Mohd OP C1-2: Time:9.23am Title: Prevalence and Associated Factors of Musculoskeletal Symptoms among Bus Drivers in Universiti Putra Malaysia Aini Nurliyana Azhar & Huda Zainuddin* OP C1-3: Time:9.31am Title: The Effects of Backpack Load and Placement on Postural Deviation in Healthy School Children: A Pilot Study Abdul Mujid Abdullah*, Rachael McDonald & Shapour Jaberzadeh OP C1-4: Time:9.39am Title: Physical Activity among Workers and Vascular Age Shafizah Ahmad Shafei*, Norfazilah Ahmad & Noorhassim Ismail OP C1-5: Time:9.47am Title: Effectiveness of Intervention Programme in Improving Knowledge, Attitude and Practice among Smokers in Mukim Peringat, Kelantan Aziah Daud* & Group A CFCS 2012/2013 OP C1-6: Time:9.55am Title: The Impact of Body Mass Index on Sickness Absence among Healthcare Workers in Kuala Selangor in 2012 Azizah Wahab* & Rozita Hod OP C1-7: Time:10.03am Title: Occupational Depression among Employees of Esfahan Steel Company, Iran: Prevalence and Associated Factors Lotfizadeh M* & Noor Hassim Ismail OP C1-8: Time:10.11am Title: Publication of Simplified Version of Cancer Educational Material Norsidawati Abdul Gani*, Othman Omar & Mazanah Muhamad OP C1-9: Time:10.19am Title: A Pilot Study Examining Anemia And Obesity Among Women Worker Salli Fitriyanti*, Anastasia Yani Triningtyas, Sri Quintina Indriyana 45
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Occupational Health / Environmental Health (Session C2)

Date: 29th August 2013 (Thursday) Time: 2.00pm-3.00pm Room: Window of Kuching Suite 1 & 2 (18th Floor) Chairperson: Dr. Dayang Rafidah Technician / Time Keeper: Norafiza Othman / Noorasmaa Husna Mohd Hasni
PAGE OP C2-1: Time: 2.00pm Title: Prevalence of Metabolic Syndrome and Combat Related and Psychological Risk Factors Among Military Personnel Aged 30-55 Years in Sri Lanka Light Infantry Regiment of Srilankan Army Chathurani Mekala Wickramaarachchi* OP C2-2: Time: 2.08pm Title: Prevalence of Obstructive Sleep Apnoea among Commercial Truck Drivers in Malaysia Wahida Ameer Batcha, Ilhamah Othman, Aimi Mohd Fahmi & Mohamad Suffian Ahmad* OP C2-3: Time: 2.16pm Title: Musculoskeletal Problems among Agricultural Workers in Felda Sungai Kelamah, Gemas, Negeri Sembilan Mohd Dzulkhairi Mohd Rani*, Zairina A Rahman, Nooriah Mohamed Salleh & Mohd Yunus Abdullah OP C2-4: Time: 2.24pm Title: Validating Effort of an Occupational Back Pain Questionnaire with Standards from A Social Security Organization Based on A Heterogenously Populated Developing Country. Tam Jenn Zhueng*, Mohd Idris Awang, Noor Hassim Ismail & Sharifa Ezat Wan Puteh OP C2-5: Time: 2.32pm Title: Knowledge, Attitude and Practice Related to Occupational Safety and Health among Medical Laboratory Personnel in Hospital Raja Permaisuri Bainun Ipoh, Malaysia: An Intervention Study Suresh Narayanan*, Anto Cordelia Tanislaus Antony Dhanapal, Mohana Suppiah, Norain Karim & Zuraida Mohamad OP C2-6: Time: 2.40pm Title: Religiosity, Coping and Post Traumatic Stress Disorder among Survivors of The 2009 Padang Earthquake Rafidah Bahari* & Norlaili Abdul Aziz OP C2-7: Time: 2.48pm URTI Outbreak at Islamic Religious School Hostel, Cheras, Kuala Lumpur Haliza AM* & Asyraf Z OP C2-8: Time: 2.56pm Title: The Impact of Work Environment on Nurses Competencies Nor Aida M*, Krauss S.E , Mazanah M & Nik Hasnaa NM OP C2-9: Time:3.04pm Title: Housewives in Sepang Selangor Fat or Fit Sabariah AH*, Manan NA & Mohamad AR 50
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Health Management / Health Promotion (Session D1)

Date: 29th August 2013 (Thursday) Time: 9.15am-10.15am Room: Window of Kuching Suite 3 & 4 (18th Floor) Chairperson: Dr. Johnny Pangkas Technician / Time Keeper: Famiza Elmida Kipli / Rozaina Mohd Zain
PAGE OP D1-1: Time: 9.15am Title: Coping with Death: Variations by Gender among Visitors to Seberang Jaya Hospital, Penang, West Malaysia Nur Atikah Mohamed Hussin* OP D1-2: Time: 9.23am Title: Health Promotion Targeting Marginalised Populations Laurie Perkins* OP D1-3: Time: 9.31am Title: Knowledge, Attitude and Practice towards Organ Donation among The Students of Universiti Sains Islam Malaysia (USIM) Nazefah Abdul Hamid*, Mohd. Dzulkhairi Mohd. Rani, Marlini Muhamad, Mohd. Hairulhisyam Ngatiman, Rosliza Ghazali, Mustafa Afifi Ab. Halim & Nooriah Mohamed Salleh OP D1-4: Time: 9.39am Title: The Impact of Migraine on Quality of Life in Females Munvar Miya Shaik*, Norul Badriah Hassan, Huay Lin Tan, Shalini Bhaskar & Siew Hua Gan OP D1-5: Time: 9.47am Title: The Effectiveness of Dietary Counseling by Dietitian on Knowledge, Attitude and Practice and Quality of Life of Diabetic Patients in Klinik Kesihatan Bandar Kuantan Nurfarhana Ezzaity Anuar, Noraishah Mohamed Nor & Nor Azlina A.Rahman* OP D1-6: Time: 9.55am Title: Perception of End Users on I-Kelahiran in Sabah State Health Department Dhesi Baha Raja Selva Raja* & Cheah Whye Lian OP D1-7: Time:10.03am Title: Embodying Knowledge of Teaching Public Health: Qualitative Study Mzwandile Andi Mabhala* OP D1-8: Time: 10.11am Title: Factors Contributing to The Delay of Treatments among Breast Cancer Women in Universiti Kebangsaan Malaysia Medical Centre Raja Lexshimi RG* & Mohd Arif Atarhim 58
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Health Management / Health Promotion (Session D2)

Date: 29th August 2013 (Thursday) Time: 2.00pm-3.00pm Room: Window of Kuching Suite 3 & 4 (18th Floor) Chairperson: Dr. Johnny Pangkas Technician / Time Keeper: Famiza Elmida Kipli / Mohamad Fuad Mohamad Affander
PAGE OP D2-1: Time: 2.00pm Title: Improvement of Awareness, Knowledge and Attitudes Via Interactive Animated Epilepsy Education Programme (IAEEP) for Children with Epilepsy Pei Lin Lua*, Neni Widiasmoro Selamat, Jimmy Lee Kok Foo & Zariah Abd Aziz OP D2-2: Time: 2.08pm Title: Haemodialysis in Jordan: Socio-Demographic Data, Clinical Analysis and Projecting Burden Emad Adel Shdaifat* & Mohd Rizal Manaf OP D2-3: Time: 2.16pm Title: Construction of Health Adaptation Model Chih-Hsun Huang* & Chien Yu OP D2-4: Time: 2.24pm Title: Civil Servants Valuation of Caries Prevention Package Nurul Ashikin Bt Husin* & Asma' Bt Mohammed OP D2-5: Time: 2.32pm Title: Describing The Proportion and Characteristics of Unprotected Population by Health Assurance Scheme in Padang City Indonesia Ade Suzana*, Syed Aljunid & Amrizal M Nur OP D2-6: Time: 2.40pm Title: Illness Perception among Hypertensive Patients Attending Polyclinics in Kuching, Sarawak Haironi Yusoff* & Rasidah Abd Wahap OP D2-7: Time: 2.48pm Title: Promoting Primary Care Smoking Cessation Support with Quitline: The Experience of Smoke-Free Melaka Project Noraryana Hassan*, Ismail Ali, Maizurah Omar, Sulastri Samsudin & Haslina Hashim OP D2-8: Time: 2.56pm Title: Managed Care: What Do Private General Practitioners (GPs) Think? Shamsinar Ibrahim*, Mohd Rizal Abd. Manaf & Azimatun Noor Azimuddin 62
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POSTER PRESENTATION Date: 28th 29th August 2013 Room: Wind Suite II (3rd Floor)
EPIDEMIOLOGY / STATISTICS PAGE
PP1 Title: The Effectiveness of Lifestyle Intervention among Pre-Diabetes Patients in Melaka, Malaysia Norma Sabtu*, Noraryana Hassan, Azmi Mohd Tamil & Zaleha Md Isa PP2 Title: Factor Associated with Diabetic Retinopathy among Type 2 Diabetes Patients in Pahang Noor Azurah Wan Chik & Khalib Abdul Latiff* PP3 Title: Lesson Learnt in Cholera A Outbreak, Bintulu Sarawak, 2012 Razitasham Safii* & Azlee Ayub PP4 Title: Who are at Risk for Depression among Type II Diabetics? A Study in Klang Valley, Malaysia Gurpreet Kaur*, Tee Guat Hiong, Suthahar Ariaratnam, Ambigga S Krishnapillai & Karuthan Chinna PP5 Title: Self-Monitoring of Blood Glucose Level and Glycemic Control among Type 2 Diabetes Mellitus Patients Attending an Urban Health Clinic in Kuala Lumpur Hasimah Ismail*, Rashidah Ambak, Tahir Aris, Lim Kuang Kuay, Lim Kuang Hock & Akmal Naziah PP6 Title: Prevalence of Non Communicable Disease among Rural Population in Batu Pahat Johor Linayanti Rosli*, Marina Mohd Said & Arbaiah Othman PP7 Title: Risk Factor Identification for Extrapulmonary Tuberculosis in Klang District: Two Year Retrospective Study Nirmalah Subramaniam*, Mohd Helmi Zakariah, Che Azlan Shah Shahari, Noriah Ismail & Noormala Zakaria PP8 Title: Human Brucellosis: First Jerantut District Experience Wan Abdul Rahim Wan Muhammad*, Mohamed Sapian Mohamed & Mohd Rahim Sulong PP9 Title: Progress of Journey towards Malaria Elimination in Sarawak Ooi Choo Huck*, Sarina Shuib, Jamilah Hashim, Jitos Gubes, Jurizam Saili, Mitchell Jahai & Mohd Faizal Ali PP10 Title: Lessons Learned from The Spread of Influenza A in A Private Hospital in Penang Saraswathi Bina Rai*, Vasantha Thiruvengadam, Anand Sanmarkan & Hafiz Abdullah
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PP11 Title: Reliability of Knowledge, Attitude and Practices towards Prevention on CNS Tuberculosis among Healthcare Workers Farhanah Abd Wahab*, Sarimah Abdullah, Jafri Malin Abdullah & Wan Mohd Zahiruddin Wan Mohammad PP12 Title: Prognostic Factors of Breast Cancer in Malaysia Norsaadah Bachok* PP13 Title: The Effect of Treatment Delay on Breast Cancer Mortality Norsaadah Bachok* PP14 Title: A Sero-Prevalence Study of Hepatitis A Infection among Residents in Kampung Orang Asli Gapam, Jasin, Melaka - A Preliminary Study Noor Aizam Bin Mohd Said*, Normadiah Jabar, Ismail Ali & Intan Azura Mohd Din PP15 Title: The 2012 Measles Outbreak in Petaling District: Have We Done Enough to Prevent It? Mazliza Bt Ramly*, Prema T. Rajendran & Kuhanesan Satiananden PP16 Title: Negative Life Events, Depression, Anxiety and Stress Mariam Mohamad*, Zaliha Ismail, Nik Nairan Abdullah, Waqar Al-Kubaisy & Nor Aini Mohd Noor PP17 Title: Glycemic Control and Prevalence of Diabetic Complications and Comorbidities among Diabetic Patients in Kuantan Ahmad Zulfadli Mohamed Nor*, Sahrol Azmi Termizi & Amirullah Mohd Arshad PP18 Title: Knowledge, Attitude and Preventive Practices on CNS Tuberculosis Cases among Healthcare Workers Farhanah Abd Wahab, Sarimah Abdullah*, Jafri Malin Abdullah & Wan Mohd Zahiruddin Wan Mohammad PP19 Title: Insulin Therapy Refusal among Type II Diabetes Mellitus Patients in Kubang Pasu District Kedah Tan Wl*, Noor Liani H & Siti Fairous A PP20 Title: Outbreak of Human Adenovirus among Police Trainees in Port Dickson, 2011 Lokman R., Haslina H.*, Rehemey S.R. & Muhammad Bazlan A.R. PP21 Title: Evidence on Variability of Blood Pressure Measured on Both Arms in Female Adults in Eastern Kenya Zipporah Bukania*, Moses Mwangi, Lydia Kaduka & Richard Mutisya
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PP22 Title: Effects of Inhaled Ginger Aromatherapy on Dietary Intake, Nausea and Vomiting among Breast Cancer Chemotherapy Recipients Pei Lin Lua*, Noor Salihah Zakaria & Nik Mazlan Mamat PP23 Title: Phylogenetic Analysis of Wolbachia Found in Aedes Albopictus from Malaysia Sylvia Joanne*, Indra Vythilingam, Zulqarnain Mohamed & Sazaly Abu Bakar PP24 Title: Association between Supplement Used and Prehypertension among First Year Undergraduate Students in A Government University, Malaysia Salmiah Md. Said*, Ahmed Dahiru Balami & Nor Afiah Mohd Zulkefli PP25 Title: Tuberculosis Cases in Seremban District, Negeri Sembilan Jenn Zhueng Tam*, Shafizah Ahmad Shafei, Suklvinder Singh, Mohammed Paid Mohd Yusof, Suk Chyn Gun, Mustafa Bakri Adnan, Sharifa Wan Ezat Wan Puteh & Noor Hassim Ismail PP26 Title: Factors Associated with Microalbuminuria among Type 2 Diabetic Patients in A Government Health Clinic in Melaka Siti Nurbaya Abdul Aziz* & Azmi Mohd Tamil PP27 Title: Modifiable Risk Factors of Cardiovascular Disease among Adulthood in Tanjung Karang Selangor : A Cross Sectional Study Nurmawati Ahmad* & Aniza Ismail PP28 Title: The Prevalence of Constipation among Psychiatric Patients in Long-Stay Care Home in Hong Kong: A Survey Li Mei Kuen*, Chow Uen Ching, Chow Uen Ue, Ho Yuen Kwan, Lam Ngan Mui, Lau Wing Ka, Leung Wing Yee, Li Kam Sim, Tai Hiu Yu, Wai Man Sum & Wan Shuk Han PP29 Title: Prevalence of Hypertension and Its Risk Factors in an Orang Asli Community in Perak, Malaysia K. K. Nyo*, Nagaraja Kumari N., Shakila S., J. R. Peela, J. Vejayan, Rakesh Rampal, Almas Khan, Ernest Chan Chit Chyn & Frances Kaviarasan PP30 Title: Assessment of Physical Inactivity and Associated Barriers among The Type 2 Diabetes Mellitus Patients in The UKMMC Primary Clinic Siti Norbayah Yusof* & Azmawati Mohammed Nawi PP31 Title: Obesity Related Hypertension Gender Specific Analysis among Adults in Tanjung Karang, Selangor Juhaida Mohd Noor* & Aniza Ismail
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PP32 Title: Comparison of Risk Factor of Cardiovascular Disease between Urban and Rural Areas in Selangor, Malaysia Noor Hassim I, Khairul Hazdi Y*, Arma Noor, Mohd Hasni J, Azmi M.T, Zaleha M.I & Azman A PP33 Title: An Association between Obesity Level and Depression among The Malaysian Working Population Santhna Letchmi Panduragan*, Ang Ciau Wooi, Norizan Min, Nooraishah Saadon, Ruban Dalayan & Ho Siew Eng PP34 Title: Plasmodium Knowlesi in Pahang Malaysia. Are We Experience Enough to Diagnose by Microscopic Examination? Abu Hassan Shaari Abd Kadir*, Masran Muhamad, Rosli Ismail , Rahimi Hassan, Azuwa Ariff & Rafidah Abd Latiff PP35 Title: Mushroom Poisoning: A Case Report from Saratok Johny Anak Kelak* & Aren Sinedeh Anak Lemin
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FAMILY HEALTH / NUTRITION / SOCIAL WORK PP36 Title: A Cross-Sectional Study on Knowledge and Risk Factor for Osteoporosis among Final Year Female Students in Faculty of Science, Universiti Tunku Abdul Rahman, (UTAR) Kampar Campus Kavitha Subramaniam, Chan Wei Lian & Annaletchumy Loganathan* PP37 Title: Health Screening Utilization and Its Influencing Factors among Women UKM Staff in Year 2012 Aniza Ismail*, Siti Fatimah Abd Ghaffar, Khadijah Shamsuddin & Zailliza PP38 Title: Factors Influencing Psychosocial Effect on Thalassemia Patients Azimatun Noor A* & Zunianfih S PP39 Title: Iodine Nutritional Status of School Children in Rural Sarawak Lim Kuang Kuay*, Chan Ying Ying, Ahmad Ali Zainuddin, Teh Chien Huey & Hasimah Ismail PP40 Title: Underweight and Overweight among 10-Year Old School Children Norsaadah Bachok* & Aniza Abd. Aziz PP41 Title: Do Elderly Women in Malaysia Go for Mammogram Screening? Rahmah MA*, Aniza I & Che Engku Nor Bahiyah CEM
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PP42 Title: Chronic Pain and Pattern of Health Care Utilization among Malaysian Elderly Population Lily Rafidah Binti Mohamed Zaki* & Noran Naqiah Hairi PP43 Title: Infant Feeding Attitude among Malaysian Mothers Tuty Aridzan Irdawati Bt Mohsinon* & Wong Yut Lin PP44 Title: Psychosocial Loss, Social Support and Post-Traumatic Stress Disorder among Adolescents After Earthquake in Padang West Sumatera Firdawati* & Rosnah Sutan PP45 Title: Predictor of Falls among Older Persons Living Nearby Rural Clinics in Limbang District, Sarawak Teh Jo Hun* PP46 Title: Cultural Practice amongst Yemeni Parents and Its Relation to Unintentional Home Child Injury Al-Abed Ali Ahmed Al-Abed* & Syed Mohamed Aljunid PP47 Title: Quality of Life and Its Associated Factors among Young Adult in Rural Area of Hulu Langat District, Selangor Madihah Mustafa* & Norfazilah Ahmad PP48 Title: The Effect of Work-Family Conflict on Psychological Distress among Married Working Women in Malaysia Aazami S*, Syaqirah A, Rahmah MA & K Shamsuddin PP49 Title: Childhood Injury Proneness: Perception of Urban Mothers Attending Maternal and Child Health Clinics in Kuala Lumpur Nadeeya Ayn Umaisara Mohd Nor*, Khadijah Shamsuddin, Rosnah Sutan & Zairina Abdul Rahman PP50 Title: Unmet Need for Infertility Care among Women Working in Malaysian Public Services Syaqirah Akmal*, Khadijah Shamsuddin, Sharifa Ezat Wan Puteh & Sanaz Aazami PP51 Title: Predicting Low Birth Weight Infants in UKM Medical Centre: A Matched Case Control Study Mazlina Mokhtar*, Aimi Nazri Mahat, Rosnah Sutan & Azmi Mohd Tamil PP52 Title: Postpartum Depression among Mothers in Kota Kinabalu, Sabah Aza Sherin*, Colin Binns & Andy Lee
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PP53 Title: Factors Associated with Non-Exclusive Breastfeeding in Government Health Clinics Batu Pahat, Johor Rahmat Dapari* & Shamsul Azhar Shah PP54 Title: Association between Nutritional Status and Number of Teeth in an Older Population in Kuala Pilah, Negeri Sembilan Tanti Irawati Rosli*, Rahimah Abd Kadir, Tengku Aizan Abd Hamid & Zaiton Yassin PP55 Title: Preliminary Study: Knowledge, Attitude and Practice on Nutrition among Children in Two Selected Orphanages and Its Relationship with BMI Wan Noraini Wan Sulaiman*, Mohd Dzulkhairi Mohd Rani, Nazefah Abdul Hamid, Syimir Shaziman, Marlini Muhammad & Ku Mastura Ku Mohd Noor
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OCCUPATIONAL HEALTH PP56 Title: Job Satisfaction among Libyan General Physicians in Public Sector Mohamed Sryh* & Azimatun Noor Aizuddin PP57 Title: Prevalence of Low Back Pain and Its Associated Risk Factors Industry Workers in Malacca Norfazilah Ahmad* & Ahmad Faizal Zuli
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PP58 Title: Health Effects among On Call Doctors in Universiti Kebangsaan Malaysia Medical Centre Azimatun Noor A* & Nurul Syahira ML PP59 Title: Exposure to PM2.5 and Carbon Black and Its Relationship with Respiratory Health among Workers at The Printing Industry in Selangor Nurfatin Athirah Malik, Emilia Zainal Abidin* & Irniza Rasdi PP60 Title: Determinants of Return to Work among Workers with Occupational Injuries in Malaysia Erlendawati Mohd Anuar*, Azlan Darus & Choo Wan Yuen PP61 Title: The Relationship between Shift Work and Job Stress in Plumbon International Textile Factory, Cirebon, Indonesia Jaenudin* & Irfan A. R. PP62 Title: Test Anxiety and Its Related Factors among Medical Students, Shahrekord, Iran Lotfizadeh Masoud* & Ghafari Mahin
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PP63 Title: Reliability and Validity of Job Content Questionnaire among Research Laboratory Staffs Nehzat Fadaei*, Huda Zainuddin & Syed Tajuddin Syed Hassan
ENVIRONMENTAL HEALTH PP64 Title: Air Quality Study in Petaling Jaya, Selangor Jeffry S*, Normah A & Azmawati MN PP65 Title: Injury and Risk Reduction Practices of Road Traffic Accidents Magesiwaran M, Nor Haniza Z*, Aisah M, Vinoth Viknesh M & Roslinah A PP66 Title: Injuries at Recreational Areas and Risk Reduction Practices Mohd Fairuz AR, Norrina J, Sumithra N, Shahrul Nizam A & Noriah B* PP67 Title: Injuries at Home and Risk Reduction Practices Melvyn CYC, Eliana M*, Nabilah H & Mohd Idris O PP68 Title: Injuries at School Mu'izuddin S, Nik Nur Eliza M, Nor Filzatun B, Chang NK* & Roslinah A PP69 Title: Food Handlers Personal Hygiene in Universiti Kebangsaan Malaysia Cafeteria Nurul'izzah Ismail*, Hasnah Haron, Zurina Mahadi & Hukil Sino PP70 Title: Health Risks from Cadmium Exposure Via Consumption of Food Crops at Intensively Farmed Area, Cameron Highlands Sharifah Norkhadijah Syed Ismail*, Raagheni M & Sarva Mangala Praveena PP71 Title: Blastocystis Infection in Malaysia: Evidence of Waterborne and Human-To-Human Transmissions among The Proto-Malay, Negrito and Senoi Tribes of Orang Asli Tengku Shahrul Anuar*, Norhayati Moktar, Siti Nor Azreen, Fatmah Md Salleh, Mohamed Kamel & Abdul Ghani PP72 Title: Evaluation of Serum Zinc, Copper and Magnesium Levels in Beta Thalassemia Major Patients in Kota Kinabalu, Sabah, Malaysia Shazia Qaiser*, Mohammad Zahirul Hoque, Mohammad Iqbal & D Kamarudin D Mudin
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PP73 Title: Implementation of Clinical Pathway in Tertiary Hospital in Malaysia: Measuring Knowledge and Practice on Clinical Pathways among Healthcare Professionals Aniza Ismail*, Haris Cendera Khazaani Osman & Saperi Sulong PP74 Title: A Cross Sectional Study on Patient Satisfaction among Outpatients at University Kebangsaan Malaysia Medical Centre (UKMMC) Aniza Ismail*, Hashimah Razali & Ahmad Taufik Jamil PP75 Title: Providing and Maximizing Access to Healthcare: Introduction of HPV Vaccination in Malaysia Saidatul Norbaya Buang*, Rohani Jahis, Norsaleha Ibrahim Thambi, Majdah Mohammad, Rohana Ismail, Azila Azmi, Tan Phaik Sim & Mohd Shahriel Mad Noh PP76 Title: Patient Satisfaction: An Independent Perspective Noriah B, Nabilah H*, Mohd Idris O, Aisah M, Eliana M, Nor Filzatun B & Roslinah A PP77 Title: Healthcare Utilization Pattern and Willingness to Pay among Malaysian Household: Results from The Third National Health Morbidity Survey (NHMS III) 2006 Zaleha Md Nor* & Azimatun Noor Aizuddin PP78 Title: Cost Analysis of Contraceptive Pills Compared to Implanon : From Malaysian Experience Rizal AM, Nasaruddin M*, Rosilawati AR, Noraliza R, Artim AR, Asmah J, Huzaimah H & Aniza I PP79 Title: Study of The Knowledge, Attitude and Practice between The Mothers / Caretakers of The Recipients and Non-Recipients of The Rehabilitation Program for Undernourished Children Regarding Child Nutrition in Kuching Division, Sarawak Haseanti Hussein*, Zainab Tambi & Md Mizanur Rahman PP80 Title: Factors Influencing Support for National Health Insurance among Patients Attending Urban Specialist Clinics in Malaysia Sharifa Ezat Alkaff*, Yasmin Almualm, Syed Aljunid & Syed Sagoff Alsagoff PP81 Title: Home Care Service Provided by Universiti Kebangsaan Malaysia Medical Centre Fuziah Hamid, Wan Fatimah Wan Daud, Jamilah Fakir Mohamad, Roslina Rasip, Masrifah Zakaria. J. Sanarina Abd Jabbar, Roslizaton Che Mamat, Zurina Mohd Saleh & Ho Siew Eng* PP82 Title: The Willingness to Pay for Drugs among State Population in Malaysia Siti Nurul Akma Ahmad, Sharifa Ezat Wan Puteh*, Azimatun Noor Aizuddin, Ramli Zainal & Ruhaini Ismail
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PP83 Title: The Influence of Cultural Beliefs on The Utilisation of Rehabilitation Services in A Rural Community In South Africa Liezel Wegner* & Anthea Rhoda PP84 Title: Physician Attributes Boosting Satisfaction and Encouraging Utilization of Primary Care by Patients with Chronic Disease Abdalla Abdelwahid Saeed* PP85 Title: HIV/AIDS-Related Knowledge and Attitudes of HIV-INFECTED Patients and Their Caregivers in Terengganu Norhayati Mustapha*, Pei Lin Lua & Ahmad Kashfi Abdul Rahman PP86 Title: To Study The Effectiveness of Diabetic Review Team in Managing Patients with Uncontrolled Type 2 Diabetes Mellitus in A Primary Care Clinic Tan Wee Yong* & Wan Fadhilah Wan Ismail PP87 Title: An Innovative Approach to Improving Outcomes in Ncd-Related Complications: Stroke and Diabetic Foot Ulcer Mathavan G, Teo SW, Seo ST, Selvarajah N, Khong KC, Choo SB, Salleh H, Katiman HH & Chandrasegaram PD*
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HEALTH PROMOTION PP88 Title: Factors Influencing Smoking Initiation among The Secondary School Students in Bangladesh: A Cross Sectional Study Md Mizanur Rahman* PP89 Title: Community Attitute towards Mentally Ill Patients and Associated Factors: A Study in Tampoi, Johor Norfazilah Ahmad*, Siti Zubaidah Semail & Azmawati Mohammed Nawi PP90 Title: Smoking Behaviours and Attitudes toward Tobacco Control among Assistant Environmental Health Officer Trainees in Malaysia Tee Guat Hiong*, Gurpreet Kaur, Noran N Hairi, Zarihah Zain & Fadzilah Kamaludin PP91 Title: Study on Knowledge, Attitudes and Beliefs Related to HIV/AIDS among Secondary School Students in Batu Pahat District 2013 Zuraini Ahmad*, Marina Mohd Said, Linayant Rosli & Arbaiah Othman PP92 Title: From Torment to Freedom Laurie Perkins*
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PP93 Title: Interactive Animated Epilepsy Education Programme (IAEEP) for Children With Epilepsy: Development and Evaluation Pei Lin Lua* PP94 Title: Hygiene Practices among Semaq Beri and Batek Orang Asli in Terengganu and Kelantan Pei Lin Lua*, Aryati Ahmad, Ramle Abdullah, Sahar Sadi Hashim, Nor Shahirah Mansor & Mohamad Asmawi Ibrahim PP95 Title: Beliefs on The Behaviour of Exclusive Breastfeeding for Six Months among Women in Kelantan, Malaysia Tengku Alina Tengku Ismail*, Wan Manan Wan Muda & Mohd Isa Bakar PP96 Title: Effectiveness of A Health Promotion Approach in Reducing Over Weight among Adults in Kunchikulama Village of Mihintale Moh Area, Sri Lanka B.L.G.Upuli Bhagya*, Y.Sivakumar, C.M.Punchihewa, T.M.I Lakmali, R.G.Isanka Jayathilake, Hirani kumarathunga, Duminda Guruge & Manoj Fernando PP97 Title: An Investigation of The Characteristics of Health Adaption Risk Group Chih-Hsun Huang* & Chien Yu PP98 Title: The Effectiveness of Audiovisual Media in Health Education of Personal Hygiene toward The Knowledge and The Student Attitude in SD Negeri Pusmalang, Wukirsari, Cangkringan, Sleman, Yogyakarta Linda Setiyowati* & Mubasysyir Hasanbasri PP99 Title: Sociodemographic Relationship with Leisure Time Activities among The Local Community of Felda Gedangsa Rizam A.R, Khairul Hazdi Y*, Faiz D, Sazman W, Hairol M.I, Noorasma Husna M.H, Mohd Firdaus H, Mohammad Fuad M.A, Azman A & Noor Hassim I PP100 Title: Spirituality and Mental Adjustment among Breast Cancer Women in Universiti Kebangsaan Malaysia Medical Centre Raja Lexshimi RG*, Sharifah Ezat, Mohd Fahmi Elias, Lee Siew Choo, Nor Suhana Hassan & Nor Hazirah Hamzah PP101 Title: KanHelpLine Othman Omar*, Nor Aida Maskor, Mazanah Muhamad & Rosemary S. Caffarella PP102 Title: Clinical Validation Studies of A Novel Self-Administered Cervical Smear Kit Cervisafe, for Early Cervical Cancer Screening and Sexually Transmitted Infection Detection Latifah A. Latiff *, Wong Yong Wee & Sabariah Abd.Rahman
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PP103 Title: What Motivate Cancer Care Volunteers? Mazanah Muhamad, Nor Wahiza Abdul Wahat, Rahimah Ibrahim, Kauthar Mohamad Kamaludin & Nor Aini Mohamed* PP104 Title: UPM-Community Engagement Initiative: The Case of Cancer Education Program Mazanah Muhamad, Othman Omar & Nurfaizah Saibul* PP105 Title: Improved Exercise Tolerence and Health Related Quality of Life of Copd Patients Undergoing Pulmonary Rehabilitation Programme Zaleha Md Isa* & Ayiesah PP106 Title: An Opinion Survey in Eastern Ghana: Health Behaviours and Knowledge of Diabetes in Diagnosed Diabetes Mellitus Type 2 Patients Gemma Buston* PP107 Title: Development of Valid and Reliable Questionnaire Saad Ahmed Ali Jadoo*, Ammar Jawdat, Mustafa Ali Mustafa Alabbasi, Al-Abed Ali Ahmed Al-Abed & Namaitijiang Maimaiti PP108 Title: Cardiovascular Risk Factors: Do We Fit to be The Role Model? P Hafizah, A R Siti Zubaidah, Z Nur Aiza & M Fadilla Norli* PP109 Title: Validity of The Malay Version of The Revised Illness Perception Questionnaire Rasidah Abd Wahab* & Haironi Yusoff
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plenary
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PLE 1 NUTRITION AND CANCER PREVENTION: RECENT RESEARCH ON LIFESTYLE AND NUTRITION Professor Dr. Colin Binns John Curtin Distinguished Professor of Public Health & Deputy Editor in Chief, Asia Pacific Journal of Public Health, School of Public Health and Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia In most high-income countries cancer is in the top two causes of death and will soon become the most important in most countries of our region. In 2005 cancer was responsible for the deaths of 7.6 million people, 75% from low and middle income countries. By 2015, the number of deaths from cancer is expected to rise to 9 million and to increase further to 11.5 million in 2030. (WHO Stats) The increase is due to the changing demographics of the world population, the reduction in other causes of death and an increase in the prevalence of some risk factors, notably smoking in less developed countries. It is estimated that 40% if these cancers are preventable given present knowledge. Cancer is a generic term used to describe a collection of many distinct diseases that can arise from every organ in the body and are characterised by the uncontrolled proliferation of abnormal cells. Cancer epidemiology is complicated because of variations in types and invasiveness, but variations in lifestyle and cultures, including food patterns, give an opportunity to explore risk factor associations. Cancer is the outcome of genetic damage; age has by far the strongest association with cancer of and risk factor. The age adjusted rates for many types of cancer are actually falling, but the total number of cases is increasing due to demographic change. A study of China suggests that these factors will lead to a three-fold increase in the number of new cases of cancer between 2000 and 2050. The 6 million new cases with require literally thousands of new hospitals to manage their treatment The study of cancer involves many different disciplines. Because it is not ethical to experiment on humans, we have to rely on observational studies to understand potential causes and preventive strategies for cancer, including case-control and cohort studies. When we have developed possible prevention measures, then the principles of epidemiology are used to guide clinical trials and laboratory studies to understand the biomolecular mechanisms. Much useful information is also obtained from animal studies and cell cultures, but sometimes animal models cannot be directly related to humans. Almost all cancers are age related as cell damage is much more likely to occur in older people. Recent developments in cell biology and genomics have resulted in the identification of a number of oncogenes. Ultimately modification of genetic material may provide avenues of prevention. For the foreseeable future the prevention of cancer will rely on modification of lifestyle factors. The most common causes of cancer with potential for modification are: Smoking Diet Obesity Lack of exercise Exposure to chemicals, carcinogens (eg asbestos) Radiation and sun exposure Infection Epidemiological methods range in complexity from the large prospective cohort and intervention studies to smaller case-control studies. The analysis of pooled data adds to the strength of the data. Recently we have undertaken case-control studies of ovarian and prostate cancer in China to identify nutrition and other lifestyle factors that might be applied in prevention. Populations in China are particularly suitable for epidemiological studies because of the population size and the existence stable food, drink and other lifestyle habits over several decades. Our studies have shown that green tea is preventive against prostate and ovarian cancer. Green tea also prolongs life after the development of ovarian cancer. There are a number of polyphenols present in green tea, but the most active ingredient appears to be epigallocatechin-3-gallate (EGCG). When tea is made into black tea, the fermentation process causes the oxidation and polymerization of most of the catechins to form theaflavins. These
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substances also have some anti-cancer activity, but not as much as the catechins. Other factors are important in the prevention of these cancers and include lycopenes (eg tomatoes), isoflavones (soy), exercise and body mass index. Breastfeeding is protective against ovarian cancer. Subjects who ate more pickles and preserved foods had a higher incidence of cancer. We are now studying several other cancers. . Cancer is becoming a more important public health issue because of the prevention of other diseases and the ageing population. Recent reviews by the World Cancer Research Foundation and the National Health and Medical Research Council provide evidence for prevention programs. The collaborative work of many disciplines will be needed to modify the impact of cancer during our productive years of life. PLE 2 CARDIOVASCULAR SURVEILLANCE, PREVENTION AND HEALTHCARE Professor William Cairns Stewart Smith OBE Faculty of Medicine, UKM Adjunct Professor & Professor of Public Health, Institute of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, United Kingdom Cardiovascular diseases are a major component of non-communicable diseases including coronary heart disease, stroke and peripheral vascular disease. Public health strategies to address cardiovascular disease have three elements: surveillance, health promotion, and individual health care. Surveillance includes monitoring of mortality and morbidity as well as surveys of risk factors. Data on mortality from cardiovascular diseases are readily available and analysed by age and sex specific rates looking are secular trends, geographical and ethnical group variations and international comparisons. Many deaths from cardiovascular disease occur suddenly and the cause of death may be registered without autopsy or any other validation. Cardiovascular morbidity information is more difficult to collate and interpret. Accurate incidence data on cardiovascular events require disease registers, robust diagnostic criteria, and completeness of ascertainment all of which is challenging in for many health systems. Chronic manifestations such as angina and claudication require surveys to assess prevalence. Cardiovascular morbidity information is closely related to availability and access to health care. Periodic surveys of cardiovascular risk factors are essential in monitoring the underlying trends in blood pressure, smoking, cholesterol, obesity, and diabetes. Levels and trends in disease and its risk factors are important intelligence in predicting future trends, and planning prevention current risk factor trend analysis in Malaysia show adverse trends for blood pressure, fasting blood glucose, total cholesterol and body mass index. The focus of prevention and health promotion activities is based on the data on the levels and trends in cardiovascular disease and its risk factors. There has been debate about population health promotion and individual health care strategies, but is clear both are necessary. Cigarette smoking, nutrition and physical exercise are the main behaviours to be addressed but these are complex and require multifaceted approaches. Education alone is insufficient to change health behaviours and health promotion needs to look to changing attitudes. Legislation, taxation and other fiscal interventions have been shown to be effective however these can be difficult for legislators as there are other competing interests, particularly in the area of nutrition and tobacco. The banning of smoking in public areas has been widely accepted however it is only one step in a long battle. Countries trying implement minimum pricing on alcohol and advertising bans face many legal and political challenges. Creating health promoting environments that make healthy behaviour choices easier can be beneficial, particularly related to smoking bans and opportunities for physical exercise. Health promotion actions can target specific groups such as schools, occupational settings and hard to reach groups. There has also been debate over whether health promotion or individual health care interventions are more effective in reducing the burden of cardiovascular disease. Again clearly both are important and the dilemma has been over which has the greatest contribution and which is more cost-
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effective. In practice the urgency of clinical need has tended to favour funding individual health care but it is important that health promotion interventions are also resourced and pursued vigorously. Acute coronary and stroke care while increasingly effective is expensive. Management of high risk patients and secondary prevention is also effective as management of diabetes and individual measures support smoking cessation. A balanced approach health promotion and individual health care recommended. is to of is
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SYMPOSIUM
3rd International Public Health Conference & 20th National Public Health Colloquium 28-29 August 2013 Riverside Majestic Hotel, Kuching, Sarawak
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SYMP 1-1 DIABETES PREVENTION: BRIDGING THE GAP BETWEEN CLINICAL AND PUBLIC HEALTH SURVEILLANCE Professor Dr. Norlela Sukor Professor of Medicine, Consultant Endocrinologist, Department of Medicine, UKM Medical Centre, Malaysia Type 2 diabetes is a chronic, complex and progressive disease. At present, it is the leading cause of blindness, chronic kidney disease, nontraumatic lower-limb amputation and a major cause of cardiovascular disease, resulting in premature death. According to the Centers for Disease Control and Prevention, the number of individuals with type 2 diabetes in the United States will escalate more than triple by 2050 from the current estimate of 26 million. The increasing incidence of type 2 diabetes is largely attributable to changes in lifestyle and obesity. The impact is global and has substantial adverse effects on health status and life span. Therefore, prevention of type 2 diabetes is a major public health challenge. Effective strategies are needed to reduce the burden of the disease. Diabetes is usually silent in its initial stages, and irreversible complications may develop before treatment is begun. Prediabetes, comprising of impaired fasting glucose and impaired glucose tolerance is frequently undiagnosed. The Diabetes Prevention Program demonstrated that prediabetic individuals are at extremely high risk for progression to overt diabetes. In addition, pre-diabetes may be associated with increased risk of microvascular and macrovascular complications. Thus, it constitutes an important public health problem particularly given the enormous number of individuals involved. In the United States alone, 79 million individuals are diagnosed to have prediabetes. It is mandatory to detect this condition early when prevention and reversibility are more likely to occur. Thus, bridging the gap between clinical and public health surveillance is fundamental in diabetes prevention. SYMP 1-2 STATISTICAL RISK FACTOR MODELLING FOR NON COMMUNICABLE DISEASES Associate Professor Dr. Mohd Ayub Sadiq@Lin Naing Associate Professor (Biostatistics), PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam Understanding of risk factors of non-communicable diseases is important for identifying high-risk groups and determining interventions in epidemiology. There are several statistics or measures of risks (such as incidence rate ratio, risk ratio, and odds ratio) presented in literature. Logistic regression, which gives odds ratios, is the most common statistical models used to study risk factors for non-communicable studies. Poisson regression gives incidence rate ratios, and generalised linear regression for binomial family with log link gives risk ratios. Though these all are different analyses, the principles of handling these analyses are the same. The presentation will highlight the fundamental principles of analysis procedures, common issues in using these models, and reporting inadequacy in current literature. SYMP 1-3 PROGRESSION, ETIOLOGY AND PATHWAYS OF NON-COMMUNICABLE DISEASES FROM A LIFE COURSE EPIDEMIOLOGY PERSPECTIVE Associate Professor Dr. Abdullah Al Mamun, PhD School of Population Health, University of Queensland, Brisbane, Australia Non-communicable diseases (NCD) including cardiovascular disease (CVD), diabetes and cancer are the leading cause of morbidity, disability and mortality in the developed and developing countries men and women. Recent epidemic of obesity around the world is one of the major driver of these chronic health problems. The progression and pathways of NCD and obesity might start from pregnancy. Although there are three critical periods such as
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pregnancy, childhood and adolescence for the development of CVD risks, pregnancy has been defined as a most important critical period to the development of CVD risk factors specially obesity for mothers and offspring both in short and longterm. The aims of this study are to (i) investigate whether reproductive events including pregnancy obesity, gestational weight gain and hypertensive disorder in pregnancy predict long-term post-partum weight retention, obesity, hypertension and diabetes for mothers and (ii) examine whether these pregnancy events also predict obesity, hypertension and diabetes of their adult offspring. To examine these aims we use life course epidemiology perspective into the ongoing long follow-up of the Mater-University of Queensland Study of Pregnancy (MUSP) mother-offspring pair cohort study. We followed a subsample of 2500 women and their offspring from an original cohort of 7223 women who gave birth in Brisbane, Australia, between 1981 and 1983. These mothers and offspring were followed-up at 6 month, 5, 14 and 21yr postpartum. GWG in kg per gestational week and Institute of Medicine (IOM) categories (inadequate, adequate and excess weight gain) of combined prepregnancy BMI and GWG were considered. Maternal post-partum weight-retention, BMI and hypertension were measured at 21y post-delivery. Doctor diagnosed diabetes was self-reported by the mother at 21y follow-up. Similarly, offspring BMI, hypertension and diabetes was measured at 21 years. Potential confounding factors around pregnancy including parental socioeconomic status, race, maternal age, parity, maternal tobacco and alcohol consumption, physical activity and TV watching are considered in the multivariate analyses. Analyses with IOM categories showed a greater postnatal increase in BMI for women defined as having excessive GWG (3.7, on average; 95% CI: 3.1, 4.3) than for women with adequate GWG. The women who gained excess weight during pregnancy had increased odds of being overweight [OR: 2.2; 95% CI: 1.6, 2.8] or obese (OR: 4.5; 95% CI; 3.4, 5.9) 21y after the index pregnancy. Women who had hypertensive disorder in pregnancy they were at greater risk of obesity, hypertension and diabetes at 21y post-partum. Similarly, the women who gained excess weight during pregnancy their offspring had increased odds of being obese (OR 1.5, 95% CI: 1.0, 2.1) and hypertensive at 21y. All these associations were independent of potential confounding factors. Findings of this study suggest that pregnancy is one of the critical periods and pathway for the development of NCD including CVD risk factors of obesity, hypertension and diabetes for mothers and their offspring in long-term. Intervention to reduce post-partum risk of CVD risk factors including obesity, hypertension and diabetes for women should start from pregnancy. Similarly, intervention program to reduce offspring obesity, hypertension and diabetes in young adulthood should start from pregnancy. SYMP 2-1 SOCIAL HEALTH INSURANCE FINANCING TO COMBAT NON COMMUNICABLE DISEASES (THAILAND EXPERIENCE) Associate Professor Dr. Siripen Supakankunti Director, Centre for Health Economics & Programme Director, MSc in Health Economics and Health Care Management, Faculty of Economics, Chulalongkorn University, Bangkok, Thailand It is clear that Thailand is rapidly becoming an aging society, with serious health consequences particularly the non communicable disease. The spread of noncommunicable diseases (NCDs) such as stroke, diabetes, cancers, heart disease, and chronic respiratory disease presents a global crisis; in almost all countries and in all income groups, men, women, and children are at risk of these diseases. The reasons for the increasing incidence of NCDs are two-fold; the first is demographic, the second epidemiological. As a result, today the country has an increasingly changing disease profile skewed towards chronic illnesses. This challenge is now threatened by crises climate change, finance and food insecurities. The UN General Assembly on the progress made in the implementing multisectoral actions to address noncommunicable diseases at the country level. To ensure that domestic resources on health have substantial budget for non-communicable diseases, particularly for health promotion and disease prevention at the primary health care level and
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advocate to the people to adopt healthy lifestyles i.e., avoiding tobacco consumption, increasing vegetable and fruit consumption in the diet, engaging in regular physical activity and avoiding harmful use of alcohol . Study on burden of disease in Thailand found that there are changes between 2004 and 1999. The total numbers of DALYs loss in 2004 were a little higher than those in 1999 both in men and women. Noncommunicable diseases contributed to DALYs larger than Communicable, nutritional, childhood and maternal diseases and injuries. Burden attributed to non-communicable disease increased largely due to demographic change. Among the top twenty leading causes of DALYs, it is apparent that only three communicable diseases were listed in the top twenty. DALY rate in Thailand was far different from that of South East Asia (SEA) region and more close to the estimates for East Asia and Pacific (EAP). The Thai health system has historically been linked to the countrys political rulings and its perception that the state is the main provider of health care. A unique characteristic of the Thai health system is the governments consistent investment in health infrastructure in the areas of health facilities and medical education. The MoPH is the principal agency responsible for promoting, supporting, controlling and coordinating all health service activities and it controls approximately two thirds of all hospitals nationwide. Access to health services does not just vary across regions but also across groups of population. The government has attempted to improve access to health care among the poor, providing them with financial protection through public welfare programs. It has since been followed by a number of public health insurance schemes, notably the Social Security Scheme, the Civil Servant Medical Benefit Scheme and, most recently, universal health coverage. Financial hurdles to health care are lowered for all Thai citizens. Specifically, it needed to help reduce the growing burden of NCDs through social health insurance to avoid leading to catastrophic medical expenditures. SYMP 2-2 NEW HEALTH TECHNOLOGIES FOR NONCOMMUNICABLE DISEASES (NCDs): HOW SAFE AND EFFECTIVE? Rugayah B, Roza S & Junainah S* Malaysian Health Technology Assessment Section (MaHTAS), Medical Development Division, Ministry of Health, Malaysia Health technology is any intervention used to promote health, to prevent, diagnose or treat disease or for rehabilitation or long-term care, which is broadly categorized into drugs, biologics, devices, medical and surgical procedures, support system, organizational and managerial system. Both new and emerging technologies advance at an unforeseen pace and offer opportunities for humankind. New health technologies may be categorized as technologies which are not established be it in the conceptual, experimental or investigational stage of diffusion. Emerging technologies are technologies that are not yet adopted by the healthcare system such as pharmaceuticals in their phase II or phase III trials. Scope of health technologies as defined by World Health Organization (WHO) is the application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives. Health Technology Assessment (HTA) is a structured analysis of properties, effects or other impacts of a health technology, a multidisciplinary field of policy analysis examining the medical, economic and organizational implications of the incremental value, diffusion and use of a medical technology in health care with firm root in research and scientific method. It considers the effectiveness, appropriateness and cost of technologies, intended to provide a bridge between research and decisionmaking, by asking fundamental questions: does the technology work, for whom, at what cost, and how does it compare with alternatives? The purpose of HTA is to inform policymaking for technology in health care, in formulating health policies that are safe, effective, cost-effective and patient-focused. It may address the direct and intended consequences of technologies as well as their indirect and unintended consequences. Four categories of diseases;
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cardiovascular diseases, cancers, chronic respiratory diseases and diabetes make the largest contributions to NCDs morbidity and mortality. They are the main focus of the WHO Action Plan 2013-2020. Innovation is being developed to overcome some existing technologies that are not suited to the local needs to combat NCD. Some of Malaysian Health Technology Assessment Section (MaHTAS) experience in assessing technologies in relation to those diseases to name a few include technologies for screening of colorectal cancer using serum alfa fetoprotein and/or ultrasound, non invasive technology using sudomotor function as a predictor for diabetes risk. We also assess new programmes such as nasopharyngeal and prostate cancer screening programme. Sparse and limited information on these new technologies posed a challenge in conducting an unbiased, robust and systematic assessment. Another glaring challenge is the use of HTA for efficient and cost-effective resource allocation. As NCDs constitute major burden of illness and disability worldwide, sufficient resources and incentivize research for innovation of health technologies in combating NCD is crucial to support the use of proven technologies, and circumvent the impact of NCD, not only in health but in the nation development and economic growth. SYMP 2-3 CLINICAL PATHWAY OF NON COMMUNICABLE DISEASES IMPROVE QUALITY OF CARE AND HOSPITAL COST AT TERTIARY HOSPITAL IN MALAYSIA Associate Professor Dr. Aniza Ismail Medical Lecturer & Public Health Medicine Specialist, Department of Community Health, UKM Medical Centre, Malaysia The demand for high quality of health care and services without increasing the healthcare cost has pressed health service providers to re-evaluate the clinical management system. Health organizations need persistently to evaluate patient care processes to deliver optimum quality care. Clinical pathway is defined as a comprehensive patient care pathway which conforms to best treatment and evidence-based medicine. It comprises complete activities and processes in treating a specific disease agreed by a multidisciplinary team involved in giving treatment to a patient within a stipulated time frame. Clinical pathway is a tool used as a guide to plan, co-ordinate, deliver, monitor, review, and document care concurrently translating evidence based medicine into a clinical setting to improve the quality of care. The goal is to achieve a better positive clinical and financial outcome. The first study in Malaysia was conducted in year 2009 until 2012 through collaborative efforts between UKMMC and UNUIIGH and four CPs were developed, implemented and evaluated at UKMMC. The CPs are for treatment of ST Elevation Myocardial Infarction (STEMI), Elective Total Knee Replacement (TKR), Chronic Obstructive Pulmonary Diseases (COPD) and Elective Lower Segment Caesarean Section (LSCS). The study demonstrated the cost and clinical outcomes of patients managed by using CPs improved performance without reducing quality of care. The positive results of this study are extremely encouraging with usage of CP in UKMMC and should be extended to public and private hospitals in Malaysia. SYMP 3-1 EVALUATING HEALTH PROMOTION PROGRAMMES: ISSUES AND CHALLENGES Associate Professor Dr. Wong Mee Lian Saw Swee Hock School of Public Health, National University of Singapore, Singapore The evaluation of health promotion programmes is complex and poses many challenges. The use of randomised controlled trials, the gold standard for evaluating clinical interventions, is often not feasible or appropriate for the evaluation of community-based health promotion programmes because of ethical and logistic problems in maintaining randomisation of subjects over long periods, absence of experimental conditions in the real-world setting, control group contamination, and the multidimensional nature of health promotion interventions. Randomised, controlled trials should be used to evaluate the effectiveness of health education and behavioural interventions in clinical settings. When such trials are not feasible, quasi-experimental designs provide
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strong evidence of the effectiveness of communitybased health promotion interventions. Multiple methods, using both quantitative and qualitative data, are needed to evaluate health promotion programmes to reflect their multidimensional nature and a holistic view of health. In addition, there is a need to match evaluation methods with the nature of intervention and to develop process and outcome measures appropriate for the nature of intervention. In this presentation, the different typesof evaluation designs and the steps that should be taken to assess the quality of evidence of health promotion interventions are discussed. There is a need for more research into appropriate immediate and long term outcome measures, as well as process evaluation, an area that is poorly understood and practised less often than outcome evaluation. SYMP 3-2 UNREVEALED PROMOTION system including behavioral, social, and economic risk factors. As the primary drivers of NCDs and related mortality, recent evidence suggests that reducing the prevalence of these four behavioral risk factors through targeted interventions will also reduce the burden of NCDs. However, the fundamental drivers of the rising prevalence of NCDs (behavioural, social, and economic risk factors) are outside of the health system and heath sector. Thus, multisectoral policymaking is necessary to address these risk factors which are some of them still unrevealed. Shifting the mindset of healh prevention and promotion from KAP (Knowledge, Attitude, Practice) based approach to multi sectoral policy based approach is necessary in dealing with NCD risk prevention. The unrevealed factors beyond health should be explored and identified in order to make more effective health prevention and promotion effort in reducing the rising burden of NCDs. SYMP 3-3 VALUES, TRADITIONS AND FORGOTTEN INTERVENTIONS IN DISEASE PREVENTION: THE SARAWAK STORY Andrew Kiyu1, Mohd Taha Arif2, Flora Ong1, Jamilah Hashim1, Chin Zin Hing1, Zulkifli Jantan1 & Mohd Raili Suhaili2
1. 2.
RISKS
IN
HEALTH
Dr. Antono Suryoputro Faculty of Public Health, Diponegoro University, Indonesia For ages, the mindset of public health has been geared towards the prevention and control of infectious diseases. It has been geared towards episodes of acute illness, and not towards long-term care or towards prevention that requires efforts well beyond the health sector. This mindset must change, and that will not be easy - (Dr. Margaret Chan, WHO, 2012)Non-communicable diseases (NCD) have being the major burden of global health. It becomes the leading causes of death globally. The rising burden of these diseases has widespread social and economic impacts in almost all level of society such as health care system, household and national and global economies. There are four primary behavioral risk factors of NCDs which are based on individual lifestyle choices such as tobacco use, alcohol consumption, physical inactivity and unhealthy diets. It Indicate that the underlying causes of NCDs are outside of the health
Sarawak Health Department, Malaysia Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), Malaysia
Sarawak Health Department underwent a transition from a fully independent and autonomous entity (colonial health service) to a partially independent one (late 1970s), before full integration into the Malaysian Health service in the late 1990s. During the early phases of the transition, the Department practised the following values: (a) medicine is a calling, a vocation, not just an occupation, (b) health is a human right; so basic health care must be provided to the whole population, by any means possible, and by staff who can be trained to do so; with emphasis on women and children; (c) do whatever needed to be done to provide health care
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and to prevent disease; (d) use gotong royong to make the community feel responsible for their health and to give them a sense of ownership of the facilities provided to them; and (e) innovate and continuously improve. These values became traditions and ethos that subsequent state health directors, deputy directors and divisional health officers proudly and conscientiously embodied and inculcated upon the following generations. It was during this period and in the permissive climate of It is amazing what you can accomplish if you do not care who gets the credit, that Sarawak Health Department developed many interventions to prevent disease occurrence, paying special attention to causes of causes of disease. These interventions can be grouped according to the levels of disease prevention, and health care delivery system and management, primary health care and community empowerment, as well as staffing. The interventions include: Salt iodination plant; expectant mothers staying at rural clinics to wait delivery from the 38th week of gestation; measles immunisation; Rural Health Improvement Scheme; protocol drugs for medical assistants; extraction of carious teeth by medical assistants in rural clinics; Applied Nutrition Programme; integrated health care delivery system; Klinik Desa management system; Village Health Promoters; community nurses replacing midwives and assistant nurses; and many more. Sadly, many of these context-specific, and culturally appropriate and needed interventions gradually disappeared over time. They have either been discarded and forgotten, or replaced with national practices in the name of uniformity, conformity and a one system fits all, monolithic culture. We have to wait for future enlightened leadership and devolution to "Let a hundred flowers blossom" again. SYMP 4-1 HEALTH INFORMATICS AS NEW CLINICAL SUB-SPECIALTY: VISION, RATIONALE, POTENTIAL, ROLES AND VALUES Dr. HM Goh Medical Director/ Chief Operating Officer, University of Malaya Specialist Centre (UMSC), Malaysia This paper will provide the history how IT evolved over the last four (4) decades. It describes how this emerging domain develops from the subject of computer sciences, information and communication technology and public health. The roles of key disruptive technologies will be discussed on how they influenced the roles of health informatics in the dayto-day clinical practice. Author will focus on four main areas of Health Informatics namely: Clinical Care domain: How Health Informatics impact quality of care and health outcomes? Research domain: How research benefited from Health Informatics and its roles in driving high impact research Education domain: How Health Informatics should be taught and designed in medical curriculum Commercial domain: How to leverage on the commercial potential of health informatics and unlock its value in health market. The potentials and pitfalls of each domain will be outlined. Case studies will be presented for each domain. This paper will conclude by defining the vision for health informatics in Malaysia.
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SYMP 4-2 USE OF MULTIMEDIA APPS FOR CHILDREN WITH SPECIAL NEEDS Dr. Chin Saw Sian Honorary Research Fellow, Institute of Social Information and Innovation (ISITI), Universiti Malaysia Sarawak (UNIMAS), Malaysia Since the intervention of computer, IT and mobile technologies have added a new dimension to delivery of education and medical intervention. Recent studies showed that computer-aided programme, especially mobile multimedia Apps act as a complimentary tool in helping children with special needs in improving areas of speech, cognitive function, etc. Mobile multimedia Apps have been developed to facilitate a broader range of educational activities to meet a variety of needs for students with mild learning disorders and isolated speech delay. Recently, more specific Apps are developed to those children with more severe disabilities to become active learners in the classroom alongside their peers who do not have disabilities. This is increasingly evidenced among children with Autism, where multimedia Apps with social interface programe helping them to communicate with others and learn daily living skills. This article provides an overview of the role mobile Apps can play in providing skill training for children with special needs within the health service. We will also look into the recommendations of multimedia screen time for children by American Academy of Pediatrics. SYMP 4-3 THE CHALLENGES AND OPPORTUNITIES OF PATIENTS HEALTH MONITORING SYSTEMS FOR RURAL AND REMOTE POPULATION Dr. Jacey-Lynn Minoi Research Fellow, Institute of Social Informatics and Technological Innovations - Centre of Rural Informatics (ISITI-CoeRI) & Senior Lecturer, Faculty of Computer Science and Information Technology, Universiti Malaysia Sarawak (UNIMAS), Malaysia
This paper presents findings from semi and rural health monitoring, the challenges faced and the opportunities with emphasis on patients with hypertension in areas using commercialised blood pressure health monitoring systems. The health monitoring system stores and sends blood pressure (BP) data wirelessly to a cloud-based remote server. Medical doctors can view the data at regular basis remotely from a website. This community-based participatory research study carried out BP monitoring on residents at villages in Sarawak, and conducted follow-up assessments on the available of health care for them. The research methodology included structured questionnaires, observations and evaluations. We concluded that there is a need to determine the degree to which remote health monitoring interventions can be integrated into telecentres and clinics to increase awareness in healthy living and wellness. SYMP 5-1 PROGRESS AND CHALLENGES IN CHILD AND ADOLESCENT PUBLIC HEALTH Professor Dr. Colin Binns John Curtin Distinguished Professor of Public Health & Deputy Editor in Chief, Asia Pacific Journal of Public Health, School of Public Health and Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia In the past 50 years substantial progress has been in made in improving the health and wellbeing of all ages in our region, particularly of infants and adolescents. Fifty years ago infant mortality was around 130 per 1000 live births in the East Asia and Pacific Regions, although in some of the remote areas of Papua New Guinea at that time the infant mortality was above 500. Now infant mortality in the region averages 17 and is as low as 3 in Japan, but still close to 100 in remote PNG. During the same period life expectancy has increased from 50 years to 72 years, although again the range has widened and is now as high as 83 in Japan. During the 1960s research on the interactions of nutrition and infection led to a
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realisation of the importance of nutrition in protecting infants from nutrition and the improvement in vaccination effectiveness if conducted in conjunction with nutrition programs. Much of the improvement in health has followed the improvement in food supplies and nutrition. More recent research has documented the importance of early life nutrition and health on subsequent disease. A major contributor to the current epidemic of chronic disease is the rate of low birth weight and early under nutrition which predisposes to later obesity, diabetes and heart disease. Further research on infant feeding has shown the importance of breastfeeding to reduce infections and mortality and its importance in maximising the childs IQ. Additional benefits for mothers of breastfeeding include a reduction in ovarian and premenopausal breast cancer. Goal Four of the Millennium Development Goals is to reduce child mortality and within this goal are targets related to infant mortality, child mortality (under 5 years) and immunisation. Specifically the target for child deaths is to reduce the under-five mortality by two thirds, between 1990 and 2015. Within the Asia Pacific Region (South East Asian and Western Pacific Regions of WHO) there are still 10 countries (out of 48) with infant mortality rates above 50 deaths/1000 live births and the region accounts for about 40% of all infant and child deaths globally. The most common causes of death in young children remain diarrhoeal disease and lower respiratory tract infection, but in 50-60% of these, under-nutrition is the predisposing cause. In early childhood breastfeeding provides most protection against infection and death, even in in cases when the mother herself may have sub optimal nutrition. The best health and nutrition outcomes are achieved in infants who are exclusively breastfed until 6 months of age and who then continue to breastfeed while complementary feeds are introduced. Rates of exclusive breastfeeding in our region are below optimum, a consequence of widespread and increasing use of prelacteal feeds. It will be necessary to boost breastfeeding, further reduce protein-energy malnutrition and provide supplements to overcome micronutrient deficiencies if there is to be any hope of reaching the 2015 target. The present generation of adolescents may have been subjected to under nutrition during the prenatal period and in the early years of life. This leaves them vulnerable to a range of chronic diseases, including higher rates of obesity and the beginning of an increase in diabetes. It is important to develop specific health promotion programs for adolescents to assist them in overcoming this predisposition. In particular programs promoting health weight and increased physical activity are needed. Overall substantial progress has been made in our region and continuing public health efforts are needed to continue the improvements. SYMP 5-2 CHALLENGES AND OPPORTUNITIES FOR MAINSTREAMING GENDER AND WOMENS HEALTH IN HEALTH RESEARCH Professor Dr. Khadijah binti Shamsuddin Professor in Public Health (Family and Women Health), Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia The setting of research agenda is often not only based on needs or problems, but often world views or ideologues. As much as we disdain this, the reality remains that priority-setting is not ideology-free or apolitical. In understanding health and illness, and the subsequent health research, for a long time the biomedical approach precede and dominate the social understanding of health. Biomedicine had developed as a highly gendered discipline and the researches especially clinical trials within these disciplines are male dominated. For women, traditionally, researches focused on studies related to reproduction essentially pregnancy, deliveries and lactation; In the best interest of the growing fetus, women of reproductive age were excluded from drug trials, until recently. Along with the growth of feminist writings on health in the 1980s, Women Health is a discipline that has evolved beyond obstetrics and gynaecology with its sex-based biomedical roots, has a more open view to social understanding of disease and health, and a keen sense that health and illness are also the results of gender disparities in knowledge, power to decide, access and abilities to pay for services. As with other disciplines, womens health research focusing on health problems of women has to
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compete with the other disciplines for limited funds in research. In contrast, gender analysis in health research is an approach not merely focusing on the difference in health status of the sexes as a demographic variable but the differences in risk, disease development and prognosis due to gender roles, norms and dynamics in society are also studied. Thus mainstreaming a gender perspective in deciding what get researched and how research are conducted, analyzed and used should be in the more efficient and equitable way of doing research for improving the health status of both men and women. Gender refers to social and culturally determined characteristics of men and womens behaviours, roles, expectations and responsibilities which may be more varied than biology in their manifestation over time and groups. Gender mainstreaming in health research requires advocacy, training and support. It is not enough to create the awareness, but practical empowerment is also necessary. For starters, revisits of available national or existing databases may be useful and sex segregated analysis should be required although sex was just included as a demographic or a biological variable. Training of researchers in the use of gender frameworks will help in framing of research questions, selection of study design, recruitment and sampling of subjects and analysis. For women who had been relatively sidelined from large funded research for a long time, a move from the biomedical to the social and gender understanding of diseases and health allow better understanding of what ail population since they suffer not only pregnancy and childbirth, and cancers of the breast and uterus but also malnutrition, STDs, heart diseases, lung cancers and violence. Advocating womens health research and mainstreaming gender in health research of other disciplines can help lessens the long term disparity. SYMP 5-3 A CHILD WELFARE EVIDENCE BASED PRACTICE MODEL: A SOCIAL WORK PERSPECTIVE Madam Durin Edward1 & Associate Professor Dr Adi Fahrudin2
1.
2.
Head, Medical Social Work Unit, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia Associate Professor of Social Work, Department of Social Welfare, Faculty of Social and Political Sciences, University of Muhammadiyah Jakarta, Indonesia
The purpose of this paper is to address the major components of the Evidence Based Practice Model in child welfare. After discussing this model, a brief overview of the social work perspective in child welfare is examined. The purpose of this review is to aid the helping professional in understanding how professional social work fits within the context of child welfare and to clarify the foundational base of the Child Welfare Evidence Based Practice (CWEBP) model. Research and writings on child welfare to date have focused basically on residual policies, services and programmes available for children and their family. As the child welfare field is governed by these policies and services, very little research and material concerning the application of a universal model of practice has been implemented. Therefore, a major principle in the model proposed is that the approach taken must have a consistent and underlying base of value and ethic that interconnect the child, family, social workers, environment and society.
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SYMP 6-1 NON-COMMUNICABLE DISEASE PREVENTION AND UNIVERSAL COVERAGE IN DEVELOPING COUNTRIES: ROLE OF UNU-IIGH Professor Dato' Dr. Syed Mohamed Aljunid Professor of Health Economics & Senior Research Fellow, United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia Universal Coverage is accepted as the new goal for health systems in the world today. The concept was endorsed by all UN member states in67th Session of World Health Assembly in December 2012. Without universal coverage it is estimated that 100 million people are pushed into poverty every year because of their direct spending on health care needs. Lack of financial resources is one of the major obstacles to achieve universal coverage. Increasing prevalence of chronic non-communicable diseases (CNCD) is an important factor that poses great challenge to developing countries to allocate resources to manage these conditions. It is estimated that, at least 60% of all deaths globally is due to CNCD As high as 80% of deaths due to chronic diseases occur in low and middle-income countries. In 2020, the economic burden of common CNCD such as diabetes mellitus, cardiovascular diseases, chronic respiratory diseases and common cancers is 12.5%, 14.8% and 12.9% of GDPs of Malaysia, India and China. If effective actions are taken, 388 million deaths due to CNCD can be prevented in the next 10 years. Primary and secondary prevention offers the best solutions for managing the long-term burden of CNCD. Multiple health financing methods are required to provide financial resources to achieve universal coverage. The common methods are tax-based system, mandatory social health insurance, private health insurance, direct out-of-pocket payment and voluntary private health insurance. Preventive services to reduce the burden of CNCD are normally funded through tax-based system and mandatory social health insurance programme. In many developing countries, preventive and promotive received less than 30% of the overall government expenditure for health. Policy makers in developing countries need to find innovative ways to raise adequate funding for these public goods. UNU-IIGH, as a research centre and builder of human resource capacities has been working with a number of developing countries to support the implementation of mandatory SHI. UNU-IIGH is directly involved in designing innovative provider payment package by providing incentives to provide a balance between preventive and curative care. SYMP 6-2 INFLUENCE HAZARDS DISEASES
OF ON
ENVIRONMENTAL NON-COMMUNICABLE
Professor Dr. Jamal Hisham Hashim Professor of Environmental Health & Research Fellow, United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia The influence of environmental hazards in the expression and propagation of communicable diseases are well understood since the time when John Snow first demonstrated the association between the occurrence of cholera and faecalcontaminated well water in the London cholera epidemic of 1854. Since then, much scientific information has been documented on the impats of a poorly managed environment and housing on the spread of air-, water-, food- and vector-borne diseases. The discovery of the associations between environmental hazards and non-communicable diseases is however more recent. Perhaps, among the earlier documented associations between environmental hazards and non-communicable diseases are those related to radiation sickness from the atomic bombing of Nagasaki and Hiroshima which ended the Second World War in 1945. Among the earlier records that connect environmental chemicals to human health was in 1955 when Dr. Hagino and his colleagues suspected cadmium as the cause of the Itai-itai disease in the Toyama Prefecture, Japan. At about the same time, Minamata disease due to methyl mercury exposure which was first discovered in Minamata City in Kumamoto Prefecture, Japan, in 1956. The book Silent Spring by Rachel Carson published in 1962 launched an environmental movement in the U.S. which focused on the impact of pesticides, especially DDT, on the
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ecosystem including man. The use of Agent Orange as a defoliant herbicide which was contaminated with 2,3,7,8-TCDD during the Vietnam War between 1962 and 1971, was perhaps the greatest single impact of pesticide on human health, even though the total impact was never adequately assessed. Recently, the Red Cross estimated that a million Vietnamese may have disabilities or health problems associated with Agent Orange. Lead is probably the single most ubiquitous chemical pollutant in the world which has had a direct and long-lasting impact on human health through worldwide consumption of leaded gasoline since the 1920s. According to the World Health Organization, the 5 main environmental risks that contribute to mortality and DALYs are unsafe water, indoor smoke from solid fuels, urban air pollution, climate change and lead exposure. Except for unsafe water and climate change which may relate to communicable diseases, the other risks are associated with non-communicable diseases. SYMP 6-3 NEW APPROACH IN MENTAL HEALTH PREVENTION Dr. Atsuro Tsutsumi Research Fellow on Newly Emerging and ReEmerging & Non-Communicable Disease, United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia Globally, an estimated one in four people will experience a mental health condition in their lifetime. Annually, approximately one million people die due to suicide which is higher than the number of death related to war or murder. Among young people, suicide is the third leading cause. Depression is the largest single cause of disability worldwide (11 per cent of all years lived with disability globally). Economic loss due to problems related to mental well-being is vast: A recent study estimated that the cumulative global impact of mental disorders in terms of lost economic output will amount to US$16.3 trillion between 2011 and 2030, while reasonable investment in mental well-being can contribute to better mental well-being. In this regard, new approach on mental health is required not only as a medical issue but also social and development ones. In most of middle and low income counties, human and economic resources on mental health are not sufficient. Therefore, it has been regarded that training on mental health for non-specialists is important. However, there is no standard guideline for them to use so far. Therefore, WHO has recently launched the Mental Health Gap Action Programme (mhGAP). It is a technical treatment guideline for important mental health problems to be utilized by non-mental health specialist, such as general physicians and primary health workers. Other United Nations agencies, funds and programmes have started to integrate mental and psychosocial well-being into their policies and programmes. The United Nations University International Institute for Global Health (UNU-IIGH), as a think-tank for the United Nations system, closely collaborating with those agencies, has conducted research and capacity development programmes with the perspectives on new approach of mental health and psychosocial well-being as a key indicator of efforts to achieve peace, development. In this symposium, information of new approach on mental health will be presented. SYMP 6-4 OPEN SOURCE ICT SOLUTIONS FOR PREVENTION OF NON-COMMUNICABLE DISEASES Dr. Nurhizam Shafie Research Fellow (Management), United Nations University-International Institute for Global Health (UNU-IIGH), Malaysia Non-communicable diseases (NCD) such as diabetes, cancer, cardiovascular diseases and chronic respiratory diseases are some of the leading causes of death and disease in both developing countries and developed economies alike. They dominate healthcare expenditures and needs in most developed as well as most developing countries. Globally, of the 57 million deaths, NCDs contribute to an estimated 36 million deaths annually, including 14 million people dying between the ages of 30 to 70 years. The impact of NCDs goes beyond health; their
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socioeconomic effects are staggering. The cost of not taking action to address this global threat is already severe and will intensify over time. It is one of the leading threats to global economic development and growth. Over the next 15 years, NCDs will cost developing countries more than USD 7 trillion. Open source ICT refers to a computer software in which the source code is available to the end user for use and/or modification. The source code is typically created as a collaborative effort in which programmers improve upon the code and share the changes within the community. Open source sprouted in the technological community as a response to proprietary software owned by corporations. Among the unique advantages of open source ICT solutions are the flexibility to adapt to specific needs, lower cost for software application development, users empowerment in controlling the ICT solutions as well as lack of proprietary license fee. These advantages led to sustainable ICT solutions in healthcare sector. Among open source ICT solutions for prevention of NCDs are: Mobile Health initiative to use mobile technology, particularly text messaging and apps, to address prevention and treatment of NCDs and their common risk factors tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol; and Geographical Information System (GIS) initiative in identifying population effected by NCDs, constructing NCDs map and atlases as well as NCDs surveillance for healthcare planning purposes. In this symposium, both open source ICT solutions for prevention on NCDs shall be presented. SYMP 7-1 OCCUPATIONAL MORTALITY-CAUSES AND PREVENTION Professor Dr. David Koh Chair Professor, PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam Over 6,300 people die from work related accidents or diseases per day (ILO). Deaths resulting from workplace accidents are attention grabbing and rightly attract significant preventive efforts, albeit sometimes too late. On the other hand, deaths from occupational diseases are not as highly visible or dramatic and preventive efforts directed towards occupational diseases are often underdeveloped and inadequate. Available data show that globally, 2.34 million deaths from work-related accidents or diseases occurred in 2008. Of these, only 14% were caused by workplace accidents or injury. The overwhelming majority of deaths (86%) resulted from various types of work related diseases. Among these diseases were malignant neoplasms (29%), communicable diseases (25%), circulatory diseases (21%), and respiratory disease (7%). These are needless and largely avoidable deaths. Preventive efforts against occupational mortality should be strengthened, for both injuries as well as diseases. At the workplace, hazardous exposures should be eliminated by removal of the hazards (e.g. carcinogens), substitution of work materials with less hazardous alternatives, engineering controls to minimize exposure, administrative measures, provision of appropriate personal protective equipment, health surveillance, enforcement of health and safety legislation and education of employers, employees and health care providers. SYMP 7-2 THE NEXT STEP TO TAKE IN THE ELIMINATION OF ASBESTOS-RELATED DISEASES Professor Dr. Ken Takahashi Professor and Chair of Environmental Epidemiology, IIES, Director of the International Center, Director of the WHO Collaborating Center for Occupational Health (IIES), University of Occupational and Environmental Health, Kitakyushu, Japan The burden of asbestos-related diseases (ARDs), e.g, mesothelioma, lung cancer and asbestosis, has hitherto been shouldered mostly by the industrialized countries of the West, or the rich West. This is a consequence of the heavy dependence on asbestos use up to around the 1970s by those countries. The industrializing countries, in general, started to depend on asbestos use after the 1970s and thus have not yet reached the sufficient latency time for ARDs to
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manifest. The few which have reached the latency time, lack the necessary infrastructure to detect ARDs. Sadly enough, the majority of countries that decided to move towards banning or a de facto nondependence of asbestos had to first experience the tragic burden of ARDs in their own countries. Many industrializing countries, especially those in Asia, along with several Commonwealth of Independent State countries, continue to use asbestos at substantial levels without yet experiencing the burden of ARDs. However, it is important to recognize the time-race against the latency time, quickly being used up in industrializing countries where the political will for asbestos ban is poor and the technology for medical recognition, reporting and recording of ARDs is lacking. The industrialized countries thus have a moral obligation to share their lessons and transfer the relevant preventive technologies in an efficient manner. The goal of eliminating the burden of ARDs is justifiable and necessary, but distinctions should be made between present and future burdens. The present (as well as the immediate future) burden is a consequence of historical use and we can only prepare ourselves for its manifestation. The key to countering the future burden is undoubtedly to stop the use of all asbestos, but we must also promote industrial hygiene during the transition period without compromising the cause for a total ban. The recognition, diagnosis, treatment and compensation of ARDs should be established or improved, particularly in countries that report no or few ARDs despite having a known history of asbestos use. To this end, we call on the international community to promote worldwide cooperation involving countries with a wide range of experiences in asbestos, i.e., from asbestos-dependent countries to banned and in transition countries. This would have the advantage of bringing together complementing technologies and experiences to match the varied needs of the beneficiaries. SYMP 7-3 OCCUPATIONAL HEALTH: A FORGOTTEN AREA OF PUBLIC HEALTH Professor Tar-Ching Aw Interim Dean, College of Medicine & Health Sciences, UAE University, United Arab Emirates Public health purports to deal with the health concerns of the community. The workforces constitute a large part of the population. In many developed countries such as the UK and the US, and in rapidly developing countries including those in the Middle East and the Far East, there are large numbers of expatriate workers from different countries contributing to the economy. Their health needs of this component of the workforce are often not accorded high priority. This may be due to many factors, including competing demand for resources, insufficient occupational health data on exposure and health effects, transient stay of expatriate workers, and a shortage of trained occupational health professionals. However there are innovative steps being taken to address these issues. In the United Arab Emirates initiatives include a Delphi exercise to determine occupational health priorities; collaboration between partners in government, industry, and educational establishments to raise the profile for occupational health and safety; and targeting occupational health issues relevant to the country e.g. reducing the occurrence of heat-related illness; Universities have an important role in conducting training and research on health issues affecting the community and the workforce. These efforts are also applicable to other countries in the region. International organizations such as the WHO, IOSH, and the Royal College of Physicians of Ireland have supported and developed training programs for workers health, and to increase the pool of trained occupational health and safety practitioners. Much more needs to be done to put in place structures and systems for prevention of occupational injuries and diseases, especially in the areas of risk communication and risk reduction. Until such measures are in place, occupational health may remain an often forgotten aspect of public health.
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SYMP 8-1 PARTICULATE AIR POLLUTION - A RISK FACTOR FOR CARDIOVASCULAR DISEASE Professor Dr. Bin Jalaludin Director Center for Research, Evidence Management and Surveillance (REMS) Conjoint Professor, University of New South Wales, Australia Worldwide, there were just over 3 million deaths attributable to exposure to excessive levels of particulate air pollution in 2010. This is similar to the number of deaths attributable to high blood sugar (3.4 million) but less than the number of deaths attributed to smoking (5.7 million) and excessive alcohol consumption (5.0 million). Globally, ambient particulate air pollution was the 9th leading cause of premature deaths and most of the disease attributable to exposure to ambient particulate air pollution is cardiovascular disease. In recent years there has been increased interest in the effects of outdoor air pollution on cardiovascular disease morbidity and mortality including editorials in clinical journals. Both shortterm and long-term exposure to outdoor particulate matter has been associated with a wide range of adverse health effects (for example, heart rate variability, development of atherosclerosis, myocardial ischaemia, myocardial infarction, stroke and deaths). Despite this, particulate air pollution has not, to date, had the same recognition as an important risk factor for cardiovascular disease morbidity and mortality compared to more well known risk factors, for example, cigarette smoking. Evidence is mounting that it is now time to re-evaluate the contribution of particulate air pollution to cardiovascular disease. SYMP 8-2 FOOD INSECURITY, OBESITY AND CHRONIC DISEASES: WHAT DO WE KNOW? Professor Dr. Zalilah Mohd Sharif Deputy Dean (Academic), Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, University Putra Malaysia, Malaysia Despite being common public health problems globally, it is only recently that food insecurity, obesity and diet-related chronic diseases are viewed as interrelated domains. More than a decade ago, William Dietz described the phenomenon of food insecurity-obesity paradox in the United States as an adaptive process to limited household food supply which entails diminishing quality and variety of foods in the diet and dependence on inexpensive energy dense foods that can contribute to excessive weight gain and obesity. Since then, studies have produced conflicting findings regarding the association between food insecurity and obesity while only few studies have examined the relationship between food insecurity with chronic diseases and their risk factors. When households or individuals are food secure, they have consistent and dependable access to nutritionally adequate and safe food and able to acquire food in socially acceptable ways. The prevalence of food insecurity may vary by income levels, age groups, household types (single vs intact), racial / ethnic groups, urban and rural areas and geographical locations. This presentation will focus on food insecurity at the household level, particularly non-elderly adults (men and women) and children. The assessment of food insecurity of interest here is based on calculated responses of households to questions pertaining to conditions and behaviors related to meeting basic food needs. Current understanding on the relationships between food insecurity with obesity and chronic diseases will be discussed separately for children and adults. As poverty is a common socioeconomic factor for food insecurity, obesity and chronic diseases, the presentation will provide insights to whether income is the independent cause of food insecurity obesity / chronic diseases relationship. Possible mechanisms that connect food insecurity with obesity and chronic diseases, strategies to simultaneously consider these
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nutritional problems and future research directions in this area will also be addressed. SYMP 8-3 LEAD AND PUBLIC HEALTH: ISSUES THAT WERE NEVER SOLVED Associate Professor Dr. Shamsul Bahari Shamsudin Director, Centre of Occupational Safety and Health, Universiti Malaysia Sabah, Malaysia Lead is a heavy metal that has for centuries proved can affect human health, ranging from molecular cell stage through to the adult human. Lead is one of the chemical elements that exist naturally in the earth's surface layer and in natural conditions the concentration levels of lead in the air is about 0.24 g/m3. Admission of lead toxicity in the body and the effect is based on the type and chemical properties, molecular size and solubility in water or fats. For example, lead sulfate and carbonate is highly soluble, it has a more toxic effect than lead sulfide, tetra-ethyl lead is highly toxic pure because at room temperature it can penetrate the lungs and has a high degree of solubility in adipose fat tissue cause the diffusion through the skin and able to be absorbed by all organs and tissues body. The main effects of lead toxicity occurred in hematology system, neurological, renal, gastrointestinal and reproductive. In addition, the presence of lead in the blood may interfere with the metabolism of vitamin D, vitamin C and erythropoietin pyrimidine. Lead has many uses and the most important is the production of batteries. It has been widely used in the automotive industry, the manufacture of ammunition, metal products, manufacture of pigments in paints, ceramic materials and cosmetic products. Lead dioxide and lead sulfate is a major component in the battery, while the lead halides were used for coating of asbestos brake linings and clutch disks as well as the use of lead sulfate as a pigment in metallic paint. The development of the manufacturing industry, particularly consumer goods from developing countries also contribute to the increase in products that contain lead in the world market. This is because most countries do not have laws or policies specifically related to the manufacture and sale of products containing lead in their respective markets. Acute effects of ingested lead result in large quantities can cause death. Various previous study suggest event at low level of blood lead concentration of children 5.0 g/dL can cause decreased intelligent quotient (IQ), reduced hearing ability and physical growth interrupt. Currently there are also a number of study investigated the association between lead toxicity and action of juvenile behavior in adolescents. Apart from the blood lead can also be transferred directly from mothers to their fetuses during pregnancy. Pregnant women and their fetuses and children are the group most at risk for lead poisoning. Previous studies often examine the toxicity of lead to systems and organs of the body at the micro level, but in the present study are more focused on the study of lead toxicity on the cells or genome which is at micro level. Although studies of lead toxicity is not new internationally but in Malaysia still lack the information and research data that can be used for reference purposes.
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ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS
ORAL PRESENTATION EPIDEMIOLOGY & STATISTICS
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OP A1-1 NON-COMPLIANCE TOWARDS TUBERCULOSIS TREATMENT AMONG TB/HIV CO-INFECTED PATIENTS IN MALAYSIA: CONTRIBUTION OF PATIENT AND TREATMENT FACTORS Ruhana Che Yusof*, Nyi Nyi Naing & Aniza Abd Aziz Unit of Biostatistics & Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia *For any correspondence: er_nw@yahoo.com Introduction: Patients compliance towards TB treatment was a major problem demands a longer treatment duration and daily high pill burden. Even though DOT strategy had been implemented in many places and countries, this issue is still unsolved. Thus, this study aimed to evaluate the predictors associated with TB treatment compliance among HIV/TB coinfected patients in Malaysia by focusing on patient and treatment factors. Methods: A retrospective records review study was conducted at two tertiary hospitals. A total of 284 medical records of TB/HIV co-infected patients from 2005 t0 2012 were reviewed to obtain related information such as social-demographic, social and medical history, signs and symptoms at diagnosis, treatment and the treatment compliance outcome. Multiple logistic regression was applied to determine the factors predicting treatment compliance Results: Most of the patients were male (87.0%), stayed at rural area (59.9%), Malaysian residence (87.3%), Malay ethnicity (65.1%), single status (46.8%), received HAART treatment (70.8%) and pulmonary TB (35.6%). The mean age of HIV diagnosed were 34.23 (8.57) and mean age of TB diagnosed were 36.90 (7.77). The non-compliance rate was (20.4%). Re-treatment cases (AOR=2.25, 95%CI: 1.05, 4.83), had hepatitis infection (AOR=2.91, 95%CI: 1.57, 5.39), older age during diagnosed TB (AOR=1.05, 95%CI: 1.01, 1.09) and longer length of TB treatment (AOR=1.08, 95%CI: 1.01, 1.16) were more likely not to comply with TB treatment. Conclusion: Treatment compliance was mostly influenced by patient and treatment factors. Another approach such as patients knowledge, attitude and practice (KAP) study towards anti TB treatment should be evaluated together since it might be affected patients decision to compliance to the treatment. Keywords: Compliance, HIV/TB co-infection, patients characteristics OP A1-2 THE MALAYSIAN VERSION OF SUSCEPTIBILITY TO PEER PRESSURE SCALE: EXAMINING ITS CONSTRUCT VALIDITY AMONG STUDENTS IN INSTITUTIONS OF HIGHER LEARNING Shazimah Abdul Samad*, Noran Naqiah Mohd Hairi & Maslinor Ismail Department of Social and Preventive Medicine, University of Malaya, Malaysia *For any correspondence: shazimah_eema@yahoo.com Introduction: Adolescence is a period of rapid growth posing challenges which might be hazardous to ill-equipped individuals. This period is also associated with heightened peer interaction which may result in undesirable consequences. Adolescents started to detach themselves from their parents and started to depend on their peers for support and advice. The present study aimed at examining the reliability and validity of the Singaporean's Susceptibility to peer pressure scale (SPP). Methods: A cross-sectional study was conducted in mid-December 2012 until early February 2013 involving 515 students in three tertiary level institutions. The scale underwent both forward and backward translations. The sample was randomly split into two sub-sample for exploratory and confirmatory factor analyses. The reliability of the scale was determined through composite reliability while the construct validity was assessed using Maximum Likelihood Estimation. The-retest reliability was investigated using Kappa statistics. Results: Exploratory factor analysis supported a two factor structure instead of the original five factor
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structure. Furthermore, confirmatory factor analysis indicated a good fit for the structure with sufficient convergent and discriminant validity. Composite reliability for Family-School Involvement and Peer Involvement domains was 0.90 and 0.87, respectively. The majority of the items reached moderate to substantial agreement in reliability analysis. Multi-group analyses demonstrated that the two factor structure was stable across gender group. Conclusion: The findings suggest that this 17-item scale is a valid and reliable instrument in the evaluation of susceptibility to peer pressure among adolescents. However, further validation of the scale to assess its stability across the different ethnic groups is warranted. Keywords: Susceptibility to peer pressure, adolescents, exploratory factor analysis, confirmatory factor analysis OP A1-3 THE NEEDS OF ADULT FAMILY MEMBERS OF THE ICU PATIENTS AS PERCEIVED BY FAMILY MEMBERS AND NURSES Sofee Mohamed Akhlak* Nursing Department, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), Malaysia *For any correspondence: sofee_nn@yahoo.com Introduction: The admission of a critically ill patient into intensive care is universally accepted as a crisis for both patients and their families. Family members of critically ill people may experience emotional turmoil and therefore have many needs throughout the course of the relatives illness. It has been identified that nurses are best placed to meet families needs. The objective of the study was to explore the needs of adult family members of the Intensive Care Unit (ICU) patients as perceived by family members and intensive care nurses. Methods: A descriptive study using the Critical Care Family Needs Inventory (CCFNI) questionnaire was employed to measure, rank and compare a series of family needs at the ICU unit at Sungai Buloh Hospital, on April 2011. A total of 110 participants (59 family members and 51 ICU nurses) were enrolled in the study.
2.
Results: The results of this study indicated that families had specific and identified needs. Providing families of critically ill patients with a clear, simple and updated information about the patients and assuring them about the quality of care the patients receive appears to be the priority identified by both family members and nurses. However, there is a significant difference in several needs ranked by family members and ICU nurses. Conclusion: Critical care nurses are in an ideal position to assist families because they are continually at the bedside and serve as the mediator between the patient, family, and other healthcare professionals. Meeting basic family needs may lower the level of stress in the family member which can result in better outcomes for both patients and families. Keywords: Family needs, critical care, family system. OP A1-4 NON-COMMUNICABLE CONTRIBUTING RISK EVALUATION IN PALESTINE
DISEASES FACTORS
Farid AW Ghrayeb1*, Mohammad Rusli A1, Ayesha Al Rifai2 & Mohd Ismail I1
1.
Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Malaysia UNRWA, West-Bank, Palestine
*For any correspondence: ghrayeb2000@yahoo.com Introduction: Unhealthy dietary habits, sedentary life and physical inactivity are considered the contributing factors to adolescent overweight and obesity. Consequently, overweight and obesity have been considered the most contributing predisposing factors for many non-communicable diseases. The purpose is to determine the prevalence of overweight and obesity and the associated unhealthy lifestyles among Palestinian adolescents 13 to 17 years of age in grade 7 through 11 at four public schools, living in the southern rural area in Palestine, based on gender. Methods: A descriptive cross-sectional study was conducted in Tarqumia, Palestine, in 2011; with 680 participants involved (343 males and 337 females).
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Instruments of the survey were: self-administered Arabic version of the international Global School Health Survey (GSHS, 2003), and anthropometric measures using standard scales. STATA version 11 was used to describe the data and Chi-Square Test was used to compare the association of obesity and gender. Results: The overall prevalence of overweight and obesity among students were 17.5% and 8.8% respectively. The overall prevalence of skipping breakfast because of no time to eat and because they cant eat early was 21.5% and 19.9% respectively. While the overall prevalence of fast food consumption and drinking carbonated soft drinks was 18.2% and 39.2%, respectively. Results revealed a strong association between obesity and gender. Conclusion: High prevalence of overweight and obesity in Palestine is considered a reason for public health concern. There is an urgent need for an effective education intervention program to halt this trend. Keywords: Non-communicable disease, overweight, obesity, dietary behaviour, Palestine. OP A1-5 SINGLE NUCLEOTIDE POLYMORPHISM GENOTYPING OF SALMONELLA ENTERICA SEROVAR TYPHI ISOLATES IN KELANTAN MALAYSIA USING PYROSEQUENCING ASSIGNED HAPLOTYPES Jaafar Nuhu Ja'afar1*, Holt Katheryn Elizabeth2, Wong Vanessa3, Subhash Bhore Janardhan4, Prabha Balaram5, Ismail Asma1 & Phua Kia Kien1
1.
*For any correspondence: jnjaafar@yahoo.com Introduction: Although the Kelantan state public health authorities have a stringent policy of typhoid surveillance and reporting of every outbreak, no detailed molecular tracking method is yet available to determine the predominant haplotypes of S. Typhi, if any, circulating in the state. From previous studies, only nine isolates from Malaysia were used in a global study to determine the haplotype of S. Typhi. In the current study, the haplotypes of 271 isolates from the state of Kelantan Malaysia were determined. Methods: A single nucleotide polymorphisms (SNP) genotyping platform using pyrosequencing was utilized to investigate 37 known polymorphic variations in 271 individual S. Typhi isolates isolated within an 11-year period. Sequence data on the 37SNP locations for all the isolates was processed and each isolate was assigned a haplotype by mapping the allele information to an additional 500 individual S. Typhi isolates previously genotyped at 1500 loci using Illumina Golden Gate. Results: Majority of the isolates (80.4%) belonged to haplotype H50. This suggests the predominance of this haplotype within the state. Only two isolates assigned H58 and H59 were found. H58 is known to represent isolates that are multi-drug resistant. In contrast, H59 has previously been reported to be geographically restricted to Indonesia. Conclusion: The predominance of haplotype H50 shows the limited genetic diversity of S. Typhi in the state of Kelantan for almost three decades as far back as 1986. However, the finding of haplotypes H58 and H59 in the state is an early warning sign of emergence of the multiple drug resistant strain and diversification of S. Typhi genotypes from its neighbouring country, Indonesia. Therefore, active screenings of foreigners working as food-handlers are imperative to curtail any possible emergence of new S. Typhi strains in the country. Keywords: Typhoid, S. Typhi, nucleotide polymorphisms, Kelantan
2.
3.
4.
5.
Typhoid and other Enteric Diseases Research Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Malaysia Department of Biochemistry and Molecular Biology, Bio21 Institute, University of Melbourne, Australia The Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire, United Kingdom Department of Biotechnology, Faculty of Applied Sciences, AIMST University, Malaysia QUEST International University Perak, Malaysia
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OP A1-6 HOW GIS CAN HELP IN PREVENTING DENGUE Mohamed Ismail Lasa*, Sazidah Mohd Karli , Mohd Imran Mohammed Abdul Wahab, Md. Nornekman Aman & Che Mohd Fazriel Hanif Che Daud Pejabat Kesihatan Daerah Kuala Langat, Malaysia *For any correspondence: drismaillasa@sel.moh.gov.my Introduction: Dengue fever remains a significant and serious public health issue. In the absence of vaccine, the primary (1) preventive measure to reduce dengue infections is the control of mosquito populations. In 2010, 524 cases have been reported in Kuala Langat district with 2 deaths, and in 2011, 167 cases with 1 death while in 2012, 189 cases. In view of these problems, PKD Kuala Langat has strategized a way to have better control of dengue. PKD Kuala Langat has implemented GIS in managing and controlling dengue. Methods: This system have lot of means and ways in managing in controlling dengue i.e., 1) by viewing and locating the cases in real situation, 2) able to do listing and locate cases, previous cases, last case pertaining to present cases, 3) can locate AI & BI, 4) locate potential breeding including commercial, school and public area by looking of the map and overall view of potential area, 5) measure exact distant for fogging and perhaps can cover area of potential area nearby by blanket fogging. All these can be seen, analysed at one time, and prompt decision in managing and controlling dengue activities can be made. Results: Trough these strategies tremendous reduction of dengue cases has been achieved. Up to epidemiological week 19 in 2013, Kuala Langat Health District manages to reduce the number of cases up to 57% (38 cases) compared to same epidemiological week in 2012 (89 cases). Conclusion: Thus, benefit of GIS information is undoubtfully can enhance controlling and preventive activities for dengue. Keywords: Dengue Fever, control of dengue, GIS OP A1-7 AN OUTBREAK OF LEGIONELLOSIS AT A BUSINESS CENTRE IN KUALA LUMPUR Rohani Hj Ismail*, Norma Sabtu, Nurul Hafizah Mohd Yusof, Ummi Kalthum Shamsuddin & Balachandran a/l Sathiamurty Jabatan Kesihatan Wilayah Persekutuan Kuala Lumpur, Malaysia *For any correspondence: ani1432@yahoo.com Introduction: Legionellosis was caused by Legionella pneumophila and it was used to describe these infections that range from mild (Pontiac fever) to severe form (Legionnaires disease). This disease emerged due to the alteration of the environment and commonly found in aquatic environment. Notification was received on 12th April 2013, on two cases from same office were admitted with similar respiratory symptoms with one of them had passed away prior to notification. Both of them are working at the same department and level at a business centre in Kuala Lumpur. Methods: It is a cohort study and samples were among all employees at the same block with cases. This study includes the epidemiological, environmental and laboratory studies. The objectives of these studies were to describe the outbreak by time, place and person, to identify the source of the outbreak and to take preventive and control measures to contain the outbreak. Results: A total of 1365 workers from the same block were examined and 382 (attack rate: 27.9%) was found to have symptoms. Blood samples taken from 188 of the cases revealed that 70 of them were found positive for IgM Legionella (37.2%). Water samples from the cooling tower and fountain at the block showed positive for Legionella pneumophila Serogroup 1 and 2. The swab taken from the same cooling tower also showed positive for Legionella pneumophila Serogroup 2. The study showed the outbreak was started from 21st Mac 2013 at one block in a business centre, involving 382 workers (case attack rate: 27.9%) with 4 admission and one death. Further studied showed that the organism caused the outbreak was Legionella pneumophila
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Serogroup 1 and the source of the outbreak was from the cooling tower. Conclusion: There is a Legionellosis outbreak among 382 workers at a business centre in Kuala Lumpur starting from 21st Mac 2013. The management was instructed to clean the cooling tower and advised to maintain it on a regular basis. Keywords: Outbreak of legionellosis, Legionellosis, Legionella pneumophila OP A1-8 RISK TAKING SEXUAL BEHAVIOUR AMONG ANTIRETROVIRAL THERAPY PATIENTS IN LAFIA, NASARAWA STATE, NIGERIA Bako Ishaku Ara1*, Audu Esther Solomon2, Araoye Margaret Olabisi1 & Audu Onyemocho1
1.
2.
Department of Epidemiology and Community Health, Benue State University, Makurdi, Nigeria Special Treatment Clinic, Dalhatu Araf Specialist Hospital, Lafia, Nigeria
non-regular partner in the previous year. Participants who were younger age (P=0.003), who had secondary education or higher (P<0.001), who did not disclose their HIV status (P<0.001) and who have been on ART for less than two years (P=0.041) were more likely to engage in sex with non-regular partners. Among the sexually active participants, 49% of females and 84% of males had unprotected sex at last sexual intercourse with their regular sexual partners. Conclusion: This study has demonstrated that sexual risk taking behaviours is high among persons receiving antiretroviral therapy in Lafia, Nigeria. Age, gender, level of education, disclosure of HIV positive status of regular partner and duration of treatment affect risk taking behaviours of PLHIV. People living with HIV need to be targeted for prevention interventions. Keywords: Antiretroviral, risky behaviour, HIV/AIDS OP A2-1 PREVALENCE, AWARENESS, TREATMENT AND CONTROL OF DIABETES MELLITUS AMONG THE ELDERLY: THE 2011 NATIONAL HEALTH AND MORBIDITY SURVEY, MALAYSIA Ho Bee Kiau1*, Jasvindar Kaur2, Gurpreet Kaur2, Lim Kuang Hock2, Ambigga Devi3, Cheong Siew Man2& Suthahar Ariaratnam3
1. 2. 3.
*For any correspondence: bakoiara@yahoo.com Introduction: Nasarawa State, Nigeria has an estimated HIV Prevalence of 7.5%, which is above the national average of 4.1%. The government with support from development partners is providing free anti-retroviral therapy for all qualified persons living with HIV and AIDS. HIV prevention efforts have however not targeted HIV-positive individuals partly due to inadequate data on their risk taking behaviours. The objective of the study was to determine sexual behaviours of Persons living with HIV (PLHIV) receiving antiretroviral therapy at the Dalhatu Araf Specialist Hospital, Lafia, Nigeria and determine the factors associated with such behaviours. Methods: The study was a cross-sectional survey among PLHIV receiving antiretroviral therapy. An interviewer administered questionnaire to a total of 320 Patients aged 18 years and above who tested HIV positive and were enrolled in the ARV programme of Dalhatu Araf Specialist Hospital, Lafia, Nigeria. Results: Sixty seven (67%) percent of females and 87% of males were sexually active. Almost a quarter of the participants (24%) reported having sex with a
Selangor Health Department, Malaysia Institute for Public Health, Malaysia Universiti Teknologi MARA (UiTM), Malaysia
*For any correspondence: bkho@hotmail.com Introduction: Diabetes mellitus (DM) is a major public health problem and it is also an important cardiovascular risk factor. The objective of this study is to provide population based estimates on the prevalence, awareness, treatment and control rate of diabetes among the elderly population aged 60 years and older in Malaysia. Methods: Analysis of secondary data from a crosssectional national population based survey using two stages stratified random sampling conducted from April to July 2011 throughout Malaysia. Adults aged
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60 and older who had participated in the survey were included in the study. A combination of a face-toface interview using a structured questionnaire (DM Module) on demographic characteristics and objective measurement of finger-pricked fasting blood glucose was taken. Statistical analyses were done using SPSS version 16. Results: A total of 2764 respondents (15.5%) were elderly from the 17,783 respondents aged 18 years old and above for DM module in NHMS 2011. The overall prevalence of diabetes (known and undiagnosed) among elderly was 34.4%. More than half i.e. 65.2% were aware of their diabetes status. Of those who were aware of diabetes, 87.5% had been treated. However, only 21.8% of those treated had their diabetes controlled. The results of multiple logistic regression showed factors associated with higher awareness rates were females, Indians ethnic group and higher income groups; factors associated with higher treatment rates were urban residents and those who were married and widow /widower/ divorcee. Conclusion: There was a higher overall prevalence, awareness and treatment rate of diabetes among the elderly in Malaysia but with low control rate. Keywords: Prevalence, awareness, treatment, control, diabetes, elderly, Malaysia OP A2-2 THE ASSOCIATION BETWEEN BODY MASS INDEX, WAIST CIRCUMFERENCE, AND HYPERTENSION IN ELDERLY PEOPLE Sri QuintinaIndriyana1*, Anastasia YaniTriningtyas1
1.
in Indonesia increased every year.Only few studies allow direct comparison of the association between BMI, waist circumference and hypertension in Asian eldery populations. The aim of this study was to allow direct comparison between the association BMI, waist circumference, and hypertension. Methods: The study was a cross sectional design. We recruited 330 participants (mean age 61.2 y (SD 9.6 y)) from local health station in Cimahi, which taken by simple random sampling. We definehypertension if blood pressure 140/90 mmHg (JNC VII). To assess direct association between BMI,waist circumference, and hypertension, we stratified BMI based on the World Health Organization standards BMI for Asian populations. We determined waist circumference <80 cm as low risk and >80 cm as high risk. We used logistic regression models to test predictors of hypertension. Results: Logistic regression showed that waist circumference had significant factor associated with increasing risk of hypertension compare to BMI. This study shown that waist circumference had significant relationship to hypertension risk (p<0.01, odds ratio (OR) 3.004). Conclusion: Study showed that waist circumference had direct association with hypertension in Asian elderly populations. Keywords: hypertension risk, waist circumference, body mass index OP A2-3 USE OF COMPLEMENTARY MEDICINE AMONGST TYPE 2 DIABETES PATIENTS IN NEGERI SEMBILAN: A FOCUS GROUP ANALYSIS Nizam Baharom1*, Rotina Abu Bakar2 & Shamsul Azhar Shah1
1.
SalliFitriyanti2
&
2.
Public Health Department Faculty of Medicine JenderalAchmadYani University, Cimahi, Indonesia Medical Nutrition Department Faculty of Medicine JenderalAchmadYani University, Cimahi, Indonesia
2.
*For any correspondence: sri.quintina@gmail.com Introduction: Previous study reportedthe high prevalences of overweight and obesity. Obesity is an important risk factor for cardiometabolic diseases, including hypertension. The prevalence hypertension
Department of Community Health, UKM Medical Centre, Kuala Lumpur, Malaysia State Health Department, Negeri Sembilan, Malaysia
*For any correspondence: drnizamb@yahoo.co.uk
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Introduction: Type 2 diabetes is a demanding chronic illness and patients often turn to traditional and complementary health products as part of a holistic health management that conventional treatment alone may not provide. This qualitative study aims to explore patients' perceptions on the use of complementary medicine for diabetes. Methods: Sixteen adults with type 2 diabetes participated in two focus group discussions at the Seremban and Kuala Pilah health clinics. The focus group moderator used a prepared set of open ended questions to guide the 90-minute sessions. The sessions were tape-recorded, transcribed, and analysed by a set procedure for qualitative analysis to identify patients perspectives on using complementary medicine for managing type 2 diabetes. Results: A variety of complementary medicines were used in managing diabetes. Although some patients perceive conventional medicine as harmful, it is still the mainstay treatment and traditional and other health products are mere complementary. Herbal medicines are viewed as the more natural and safer treatment if taken in moderation. Use of complementary medicines is also driven by the need to control own health and fear of diabetes complications. There was also concern about harmful effects from complementary health products. Most patients never discussed the use of complementary medicine with the health care provider. Conclusion: Complementary medicine plays a role in managing type 2 diabetes although the conventional medication is still the mainstay treatment. Patients use complementary medicine because it is perceived as natural and safe, its perceived efficacy and due to the perceived severity of diabetes. Healthcare professionals should incorporate the issue of complementary medicine use as part of a holistic approach in managing type 2 diabetes. Keywords: Complementary medicine, Type 2 Diabetes, conventional medicine OP A2-4 THE SELECTED SOCIO-DEMOGRAPHIC AND ECONOMIC FACTORS WHICH WERE ASSOCIATED WITH DIABETIC PATIENT MEDICATION ADHERENCE Cliffton Akoi Pangarah1*, Mohd Syafiq Abdullah1, Md Mizanur Rahman1 & Andrew Kiyu2
1
Faculty of Medicine & Health Sciences, Universiti Malaysia Sarawak, Malaysia 2 State Health Department, Sarawak, Malaysia *For any correspondence: pcakoi@fmhs.unimas.my Introduction: Studies have shown that various factors were associated with medication adherence. This study aimed to identify socio-demographic and economic factors which were associated with medication adherence among diabetic patients with follow-up treatment at Sarikei and Kota Samarahan divisions. Methods: A cross-sectional study was conducted on 442 respondents selected by stratified random sampling. Information on the selected sociodemographic and economic aspects was obtained. Assessment of adherence rates was accordingly made and validated. Data were analysed using SPSS for Personal Computer Version 17.0 for frequency distribution, measures of central tendencies and significance testing. Results: Most of the participants were above 51 years old (61.6%). The highest were Malays (63.1%). About 74.9% have no formal education, and 72.7% of the subjects earned less than RM1000 per month. Most of them (75.6%) lived beyond nine kilometres away from the clinic. The medication adherence rates were generally low for all the treatment indicators: follow-up treatment (24.2%), duration of treatment (26%), amount (31.7%), and frequency of taking medication (38.9%). The highest adherence rate was in term of frequency in taking medication, and the lowest for follow-up treatment. Those aged 60 and above have poor medication adherence in terms of the treatment indicators such as the amount, frequency, and duration of treatment. The sociodemographic factors such as age, education level,
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household income, and distance of clinic were significantly associated with medication adherence. Conclusion: There were significant association between socio-demographic and economic factors with diabetic patient's medication adherence. Therefore, it is important to address these factors in order to improve medication adherence, and ultimately achieving better diabetic control among diabetic patients on follow-up treatment. Keywords: Medication adherence, diabetic patients, socio-demographic, economic factors OP A2-5 PREVALENCE AND DETERMINANTS OF VCT AMONG CLIENTS OF NEEDLE SYRINGE EXCHANGE PROGRAM (NSEP) IN KELANTAN Sahrol Azmi Termizi* & Wan Mohd Zahiruddin Wan Mohammad Department of Community Medicine, School of Medical Sciences, University Sains Malaysia, Malaysia *For any correspondence: sahrol.azmi@gmail.com Introduction: The objective of this study is to determine the prevalence and determinants of Voluntary Counselling and Testing (VCT) of HIV among clients of Needle Syringe Exchange Program (NSEP). Methods: This is a cross sectional study using simple random sampling since January 2011 till March 2011. A face to face interview was administered using a validated questionnaire for clients of the Needle Syringe Exchange Program in Kota Bharu, Bachok and Pasir Mas who fulfilled the study criteria. Descriptive statistics and multivariate regression analysis were applied using PAWS 20.0. Results: Two hundred and seven NSEP clients responded to the questionnaire. The mean (SD) age was 34.6 (6.7). Most of the clients were males (99.0%) and Malay (97.6%). Three quarters of clients (75.4%) having been either tested for HIV or received counselling or both. Overall 118 (57.0%), 111 (53.6%) and 117 (56.5%) of clients had good knowledge, good attitude and good practice respectively. Factors independently associated with VCT uptake after adjusting for confounders, includes history of receiving medical care, history of admission to rehabilitation centre/prison, attitude level and practice level. Conclusion: Clients who had a history of admission to rehabilitation centre or prison and history of receiving medical care, having a good attitude and good practice towards VCT were more likely to accept VCT service. Thus, in scaling up VCT services and other HIV preventions, these determinants should be taken into consideration to ensure successful implementation of the programs. Further studies are needed to assess other important predictors. Keywords: Voluntary Counselling and Testing, Needle Syringe Exchange Program, HIV OP A2-6 A QUALITATIVE STUDY OF THE FACTORS INFLUENCING THE QUALITY OF LIFE AMONG STROKE SURVIVORS IN KANO, NIGERIA Ashiru Hamza Mohammad1*, Nabilla Al-Sadata Binti Abdul Mohsein1 & Loh Siew Yim2
1.
2.
Center for Population Health, Department of Social and Preventive Medicine, University of Malaya, Malaysia Department of Rehabilitation Medicine, University of Malaya, Malaysia
*For any correspondence: physioash@yahoo.com Introduction: Cerebrovascular Accident or Stroke is currently the main cause of neurological disability in Nigeria; however, the residual physical consequences are not necessarily associated with Quality of Life (QOL) as some survivors are able to adapt to their disabilities while others are devastated even by a minor sequel. Methods: Using qualitative interviews with 15 respondents, this study examines the complexity of factors influencing the quality of life after stroke. Thematic analysis using constant comparative methods and aided by NVivo 9 software were used for the qualitative analysis. Results: The 19 key themes that emerged (either improving or diminishing quality of life) suggesting the factors influencing stroke survivors quality of
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life were regrouped into 7 categories. Of these, 4 categories have further break downs and 3 were independent issues: adaptive and coping strategies, the impact of the extent of disability (effects of activities of daily living on functioning, effect on self and identity, effect on religious activities, effect on occupation and return to work), social relationship and support system (social and instrumental supports, communication, autonomy, social role adjustments, sexual relationship), resources (medical services and rehabilitation, spiritual and resources, educational skills and experiences), anxiety and distress due to (financial resources, perceived change in body image, fear of uncertainties, increased forgetfulness), pains and stigma. Much of the discussions with the patients consisted of narratives indicating the significance of impact of stroke on quality of life of survivors. Conclusion: The finding of this study supports that measure of stroke-related quality of life should be subjective and multidimensional. Priorities should be focused on thus activities considered most essential to an individuals identity; drawing on existing resources including health services and rehabilitation, social relationship and support system so as to maintain the important aspects of an individuals identity. Keywords: Cerebrovascular Accident, stroke, quality of life OP A2-7 PREVALENCE AND FACTORS ASSOCIATED WITH POST-TRAUMATIC STRESS DISORDER (PTSD) AMONG INTERNALLY DISPLACED WOMEN IN SHADOW CITY, YEMEN Redhwan Ali Omar AlShalfa*, ShamsulAzhar Shah & Khadijah Shamsuddin Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: r_alshalfa@yahoo.com Introduction: Post-traumatic stress disorder is a major psychological problem among women who are internally displaced and refugees. The objective is to determine the prevalence and factors associated with PTSD among Internal Displaced Women in Saada City, Yemen. Methods: Cross-section study it conducted 1200 internal displaced camps women in the eight IDCs women in Saada city Yemen, Harvard Trauma Questionnaires (HTQ) was used to measure PTSD. It was administered by face to face interview. Multivariate analysis was done to determine factors associated with PTSD. Results: Majority the respondents aged 15 to30 years (64%), were non-educated (78.5%), married (78%) and had no monthly income (47%). The prevalence of PTSD was 44.8%. In multivariate analysis, the PTSD was significantly predicted by factors associated death of child loss , death of spouse loss, death of a family member , physical injury during the war and khat chewing (p<0.05). Conclusion: Women in this study had a high prevalence of PTSD. So aid and more support are needed by the government and NGOs. Further research is recommended. Keywords: Post-Traumatic Stress, women, Yemen OP A2-8 PSYCHOMETRIC PROPERTIES OF THE MALAYSIAN VERSION OF REASONS SCALE FOR MEDICATION ADHERENCE: FACTORIAL VALIDATION AMONG HYPERTENSIVE PATIENTS IN PRIMARY HEALTH CARE SETTING Razatul Shima Abdul Razak*, Farizah Hairi & Hazreen Abdul Majid Department of Social and Preventive Medicine, University of Malaya, Malaysia *For any correspondence: razatulshima@yahoo.com Introduction: This study attempts to examine the psychometric properties of the Reasons Scale for Medication Adherence using a Malay language version of the instrument adapted from Wroe et al (2002). A priori propositioned could be explained by the five aforementioned domains. Methods: In this cross-sectional study, the translated self-reported Reasons Scale for Medication Adherence was administered among hypertensive patients attending four primary health clinics under Hulu Langat and Klang districts in Selangor (n=665) between early December until end of February 2013.
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The reliability and construct validity of the scale were examined. Results: The Exploratory Factor Analysis (EFA) verified the existing four domains. Confirmatory Factor Analysis (CFA) provided good evidence of convergent and discriminant validity. Composite reliability (CR) for all the domains were at least 0.7 and factorial invariance was present. Conclusion: This study demonstrated that the Malaysian version of the Reasons Scale for Medication Adherence is psychometrically sound instrument and suitable for hypertensive patients in primary health care in Malaysia. Keywords: Reasons Scale for Medication Adherence, validation, hypertension, psychometric, exploratory factor analysis, confirmatory factor analysis, structural equation modelling
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ORAL PRESENTATION: FAMILY HEALTH / NUTRITION / SOCIAL WORK
ORAL PRESENTATION FAMILY HEALTH / NUTRITION / SOCIAL WORK
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OP B1-1 POST-SECONDARY SCHOOL EMPLOYMENT AMONG YOUNG MALAYSIAN ADULTS WITH LEARNING DISABILITIES Dzalani Harun1, 2* & Khadijah Shamsuddin
1.
2.
Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia Department of Occupational Therapy, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
employment. Lack of employment opportunities and having inadequate work skills were among the main reasons given by those who were unemployed. Conclusion: Young adults with LD in this study reported experiencing low employment rate, were underpaid, and had low job satisfaction. The current policies and practices for enhancing employment among persons with LD need to be further improved to better prepare them with necessary skills relevant for the current job market so that they could improve their employability. Keywords: Learning disabilities, transition outcomes, employment, youths. OP B1-2 WOMENS SEXUAL AND REPRODUCTIVE HEALTH CARE IN RURAL AREAS OF SOUTH AUSTRALIA Wendy F Abigail & Cara A Flynn* Flinders University, Adelaide Australia, Australia *For any correspondence: wendy.abigail@flinders.edu.au Introduction: Quality sexual and reproductive health care for women is fundamental to good family planning health. To understand the issues rural and remote women in Australia face, a 10 year period (2003-2013) literature review was conducted. Methods: Articles included were Australian primary research reports which discussed rural womens access to sexual and reproductive health. Articles excluded discussion or opinion pieces, nonAustralian studies, non-English language publications and articles prior to 2002. There were 11 articles identified as most relevant. Thematic analysis of the articles was conducted. Results: The majority of the articles were nationally based (n=6). Research methodologies used were both qualitative articles (n=6) and qualitative studies (n=5). The specific sexual and reproductive health areas reported on included: poor access to services, adolescent health issues, levels sexual and reproductive health knowledge, and fertility issues. Most of the articles called for increased public awareness through policy development and advocacy work to help these disadvantaged women.
*For any correspondence: liedza69@yahoo.com Introduction: For young adults being able to secure a job and earning money is an important transition outcome. In the current competitive job market, this is more challenging for those with learning disabilities (LD). A job meant better opportunity for more independent life, meaningful community participation and increased prospect for establishing interdependent networks and friendship. This paper examined employment experiences of young adults with LD after they left the secondary schools system. Methods: This was a cross-sectional survey of young adults with LD who left the special education programs (SEP) in secondary schools in Kuala Lumpur and Selangor. They were interviewed faceto-face either at home or at an agreed upon convenient place on their working experiences and other transition outcomes after leaving secondary schools. Results: A total 77 young adults with LD, aged 1825 years participated in the study. Of these, 74.0% reported having work experience since leaving secondary school and 64.9% were working at the time of interview. Among currently employed respondents, 92.0% were working in competitive employment, 90% were full time workers and the majority reported receiving basic benefits such as SOCSO/health insurance, EPF/pension, Medical leave and Annual leave. However, most of them were working in low/elementary job, receiving low salary and reported getting their jobs through the help of significant others. They also faced barriers and reported being less satisfied with their current
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Conclusion: Australia is a very large country with significant rural and remote regions. Women residing in these areas are disadvantaged with inequitable sexual and reproductive health service provision and care. Improved outcomes are required for Australia to meet the Millennium Development Goal 5 Improve maternal health. Understanding the issues for women in rural areas is important for service provision, policy development and funding. This information has implications for areas where poor access to sexual and reproductive health exists. Keywords: Family health, sexual and reproductive health, rural OP B1-3 FACTORS ASSOCIATED WITH DIABETES SELF-MANAGEMENT PRACTICE AMONG ELDERLY DIABETES PATIENTS IN PRIMARY CARE CLINICS IN SELANGOR Salmiah Baharudin*, Khadijah Shamsuddin & Rahmah Mohd Amin Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: salmidr@yahoo.com , kshams57@yahoo.com Introduction: Diabetes is a chronic disease that requires routine and complex self care. For elderly with diabetes, diabetes self-management (DSM) behaviour is necessary to prevent diabetes complications and to improve their quality of life. There are several factors which influence the elderly in performing diabetes self management. The study examined the relationship between respondents' demographic and clinical characteristics, diabetes knowledge and attitudes, and social support with DSM in elderly, diabetic patients in primary health care clinics, Selangor. Methods: This is a cross sectional study using questionnaire adapted from the Summary of Diabetes Self Care Activities (SDSCA), Diabetes Self management Self Efficacy (DSMSE), Diabetes Care Profile (DCP), Diabetes attitude Scale-3 (DAS-3) and Michigan Diabetes Knowledge (MDKT) instruments for data collection among elderly diabetics on followup in primary health care clinics in Selangor. Results: Preliminary analysis of 389 respondents showed significant linear relationship between respondents self efficacy level and DSM ability (p<0.001), social support received (p=0.008), as well as respondents diabetes attitude (p<0.001) and DSM ability. Analysis also showed a significant difference in DSM scores of patients treated with combination insulin and oral hypoglycemia agents (OHA) from patients treated with OHA only (p= 0.001). Patients treated with combination OHA and insulin on average has a score of 2.8 lower compared to patients treated with OHA only. However, there is no significant difference in DSM scores between patients treated with insulin only with patients treated with OHA only (p=0.113). Other variables did not show significant relationships with diabetes selfmanagement. Conclusion: The factors related to diabetes selfmanagement in this study are self efficacy, attitude, received social support and types of treatment of diabetes. Keywords: Diabetes, diabetes self-management OP B1-4 ANXIETY AND DEPRESSION AMONG PREGNANT WOMEN: A CROSS SECTIONAL STUDY Siti Khuzaimah Ahmad Sharoni* & Hasni Embong Nursing Department, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), Malaysia *For any correspondence: sitik123@yahoo.com Introduction: Pregnancy can be a time of feeling happiness to become a mother. However, several factors have been found to increase the risk of anxiety and depression during the antenatal period. This situation will persist until after birth if not treated. The purpose of this study is to identify the prevalence of anxiety and depression, to examine the association between anxiety and depression and to determine the significant relationship between anxiety and depression with socio-demographic characteristics. Methods: A cross-sectional study was conducted in Obstetrics and Gynecology Clinic, Hospital Universiti Sains Malaysia, from April 2011 to June
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2012. Self-administered questionnaires of the Malay Version of Hospital Anxiety and Depression Scale were distributed to 224 pregnant women. Results: The prevalence of anxiety and depression were 27.2% and 12.5% respectively. There was a significant positive correlation between anxiety and depression (rs=0.417, p=0.001). Significant differences were found between anxiety with occupation (X2= 6.782, df=2, p=0.034) and household income (X2= 13.617, df=3, p=0.003) as well as depression with occupation (X2= 22.229, df=2, p=0.001), household income (X2= 13.335, df=3, p=0.004) and education level (X2= 15.331, df=2, p=0.001). Respondents who are unemployed with less household income had higher scores perceived anxiety and depression. Conclusion: Prevention and early detection for those high risk groups are required to reduce further complications for both mother and fetus. Keywords: Anxiety, depression, pregnant, women OP B1-5 VITAMIN D INTAKE AND BONE MINERAL DENSITY STATUS OF GOVERNMENT EMPLOYEES IN PADANG CITY, INDONESIA: CROSS SECTIONAL STUDY Azrimaidaliza* Faculty of Public Health, University of Andalas, West Sumatera, Indonesia *For any correspondence: uniminda@yahoo.com Introduction: The prevalence of osteoporosis is prone to increase in Indonesia. Current data on the relationship of vitamin D intake with bone mineral density as diagnostic of osteoporosis among employees in Indonesia are scarce. The aim of this study is to assess vitamin D intake and its relationship with bone mineral density status of government employees. Methods: A total of 103 employees at national education department in Padang city were participated in this study. Nutrient intake was determined using a semi-quantitative food frequency questionnaire and compared to nutritional recommended for adequacy. Physical activity was measured by Baeckes questionnaire and bone mineral density was measured by bone mineral densitometry. Multivariate logistic regressions were used to analyze factors that have relationship with bone mineral density status. Results: Subjects were consists of 56.3% female and 43.7% male employees with range age 40-59 years. The result showed that 60.2% workers had osteoporosis risk with low bone mineral density. A higher prevalence of low bone mineral density was female workers (62.1%). Overall, subjects were adequate vitamin D intake from food (average 10 g/days). Physical activities of subjects were 40.8% as category inactive. There was no significant relationship between physical activities with bone mineral density status on multivariate analysis. Vitamin D intake was dominant factor on bone mineral density status (OR=0.85, 95% CI: 0.7460.972, P=0.017) after adjusted with education status. Conclusion: An adequacy vitamin D intake had contribution to prevent osteoporosis by improving bone mineral density status of government employees in Padang city, Indonesia. Keywords: Vitamin D, bone mineral density, employees OP B1-6 SUSTAINING BREASTFEEDING AMONG WORKING MOTHERS: EXPERIENCE OF BREASTMILK EXPRESSION Siti Harirotul Hamrok Asis1, 2*, Nabilla Al-Sadat1, Hazreen Abdul1 & Mohamed Ismail Lasa2
1.
2.
Centre for Population Health, University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia Kuala Langat District Health Office, Ministry of Health, Malaysia
*For any correspondence: ctharirotul@yahoo.com Introduction: Breastmilk expression is one of the factors that facilitate mothers combining work and breastfeeding. The aim of the study was to explore the experience of breast milk expression in workplace and to identify in depth the facilitating factors to sustain breastmilk expression among working mothers.
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Methods: Qualitative study using grounded theory was conducted from 15 April, 2011 to 31 July, 2011.The sampling procedures was purposive sampling from the working mothers recruited in earlier study done in Kuala Langat District, Peninsular Malaysia who expressed breast milk during working and exclusively or predominantly breastfeeding up to four month of baby's age. The sampling method was theoretical sampling and the data collection technique was in depth interview. The interviews were audio taped and transcribed verbatim. The transcribed data were analysed via thematic analysis. Results: A total of 15 mothers were interviewed and 4 major themes were identified. The themes were as follows: (i) Personal factors (ii)Worksite support for breastfeeding which were flexible hours to express breastmilk, support from employer and other employee, provision facilities to express breast milk mainly place for expression and refrigerator though mother had to buy their own breast pump,(iii )Preparation for mothers absence while working which were learning to express breastmilk and educate baby to drink expressed breast milk during confinement, stockpiling expressed breast milk and trained baby's carer the right way to express breastmilk,(iv) baby's carer assistance which were supporting mothers by feeding the baby with expressed breastmilk and maintaining the baby's care charges. Conclusion: Supportive employer and working environment, as well as giving education to baby's carer can aid in improving breastfeeding practice among working mothers. Keywords: Breastfeeding, breast milk expression, working mothers OP B1-7 INTIMATE PARTNER VIOLENCE (IPV) AT A TERTIARY INSTITUTION Kalli Spencer1*, M Haffejee1, G Candy2 & E Kaseke3
1. 2. 3.
Department of Urology, Wits University Department of Surgery, Wits University Department of Social Work, Wits University
Introduction: The study aims to ascertain the prevalence of IPV within a South African tertiary institution population with a diverse demographic profile. Methods: Undergraduate students from the University Medical School and Social Sciences were asked to complete an anonymous questionnaire, derived from international studies, which assessed demographics, the extent of IPV, whether participants were victims or even perpetrators of IPV. Permission was obtained from the Deans of Health Sciences and Social Sciences. Students were made aware of psychological counseling services that were available. Data was recorded in an EXCEL spreadsheet and analysed using Statistical using a Chi-squared test with correction as appropriate. Results: Responses were obtained from 1360 of 1593 students (68% female; 45.9% African; 32.7% Caucasian; 14.7% Eastern ancestry). Most respondents were aged between 20 and 24 years of age (62%) and female (68%). 94% were heterosexual and 47% were in a relationship, engaged or married, with 57% indicating that they were sexually active. 77% were HIV negative. 35% admitted to being emotionally abused, 19% physically abused, and 9% sexually abused (2.5% males; 12.6% females) with 16.8% of African female students indicating they had been sexually abused. Of the total victims of sexual abuse victims, 45% were able to negotiate at least protected sex. Older respondents were more likely to have jealous partners who kept them away from family. About 2 percent of respondents indicated they had Often or Sometimes contemplated harming themselves or committing suicide as a result of IPV. 13% of respondents admitted they had physically hurt someone close to them. Only 3 perpetrators of sexual abuse had been sexually abused. 59% of respondents knew where to get help. Conclusion: The extent of IPV amongst students is unacceptably high. The survey should be undertaken at other centres of higher learning to determine regional difference of IPV prevalence. Keywords: Intimate partner violence, perpetrator, sexual abuse
*For any correspondence: kallispencer@gmail.com
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OP B1-8 QUALITY OF LIFE AMONG OBESE AND OVERWEIGHT INDIVIDUALS IN SELANGOR Ahmad Fareed A Rahman*, Mohd Rizal Abdul Manaf & Aniza Ismail Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: u_nix_med@yahoo.com Introduction: The prevalence of obesity and overweight globally and locally are on the rise as a result of rapid industrialization and high economic growth. Furthermore, both conditions are associated with increased morbidity and mortality including impairment of their quality of life. This study aims to identify the quality of life among obese and overweight and its influencing factors. Methods: A comparative cross sectional study was conducted among obese, overweight and normal adults in Selangor health clinics with 1200 respondents involved. The data was obtained through self-administered questionnaires namely the Short Form 36 (SF-36) and the validated Malay version of the Impact of Weight on Quality of Life-LITE (MVIWQOL-LITE). Results: The mean score of PCS (SF-36) was significantly lower in obese (42.977.85) as compared to overweight (46.037.82) and normal (49.236.65) (F=70.22, p<0.001). However, the mean score of MCS (SF-36) did not differ significantly among obese (46.858.63), overweight (47.778.66) and normal (47.698.12)(F=1.45, p=0.235). The total mean score of MVIWQOL-LITE showed a significant difference for obese, overweight and normal individuals with scores of 69.9917.54, 81.2716.24 and 88.6414.22 respectively (F=136.76, p<0.001). Physical function and health perception scores were found to be lowest among obese and overweight. Multivariate linear regression analysis showed that body mass index, age, gender, marital status, education level, physical activities and presence of chronic illnesses significantly influence quality of life (p<0.05). Conclusion: The findings in this study should mandate for more specific interventions and appropriate strategies to improve the quality of life among obese and overweight. Keywords: Quality of life, obesity, overweight, body mass index OP B1-9 COST EFFECTIVE ANALYSIS (CEA) OF RECALL METHODS FOR CERVICAL CANCER SCREENING PROGRAM IN SELANGOR - WHICH IS THE BEST? Rima Marhayu Abdul Rashid1, 2*, Maznah Dahlui1, Majdah Mohamed2 & Zaleha Abdul Hamid2
1.
2.
Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia Family Health Development Division, Ministry of Health Malaysia, Malaysia
*For any correspondence: rimamarhayu77@gmail.com Introduction: The objective of this study was to determine the CEA of different types of recall in the cervical cancer screening program in Klang i.e. postal letter, registered letter, SMS or a phone call in terms of patients' response and uptake for pap smear. Methods: This RCT was carried out from May to December 2011. A total of 1108 samples were selected among women who passed the inclusion and exclusion criteria from the study population. A random table of 1000 participants was generated using the computer generated randomization among these women. Baseline analysis of different age group and races done showed that the groups were comparable (p=0.447 and p=0.721) respectively. These participants were allocated equally into four different intervention groups and were given recall to repeat pap smear according to the respective group they were assigned to. Results: There were a significant increase in the uptake for a repeat smear in other intervention groups compared to the postal letters (18.8% vs 20.0%, 21.6% and 32.8% for registered letters, sms and phone calls respectively, p=0.001) and among patients who response to the recall (18.8% vs 20.4%, 23.6% and 35.6% for registered letters, sms and phone calls respectively, p<0.05). The cost per pap smear done for a registered letter is highest among all
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the interventions, followed by postal letter, a phone call and sms (RM 51.01+0.03, RM 49.31+0.02, RM 49.13+0.05 and RM 48.81+0.03 respectively). However, the CER was lowest for phone call compared to other interventions at RM 149.79+0.15 compared to RM 225.97+0.14, RM 255.05+0.15 and RM 262.29+0.11 for SMS, registered letter and letter respectively. Conclusion: Therefore, the recall method using phone calls produced a significant effect on improving the continuity of care for a repeat smear among patients who had normal findings on the previous smear and is the most cost effective method among other interventions used. Keywords: Cost Effective Analysis (CEA), pap smear, cervical cancer OP B2-1 PSYCHOLOGICAL RISK FACTORS ASSOCIATED WITH FALLS AMONG ELDERLY PEOPLE IN BAGHDAD CITY, IRAQ Mohammed A. Abdal Qader*, Rahmah Mohd. Amin, Shamsul Azhar Shah, Zaleha Md. Isa & Hasanain Faisal Ghazi Department of Community Health, UKM Medical Centre, Malaysia *For any correspondence: dr_mohamed_aj@yahoo.com Introduction: Ageing of the population is one of the most important demographic facts that came to the foreground in the 21st century. Apart from social and economic problems, the elderly population is very much associated with health problem. Psychological problems of depression, loneliness and dependency feelings are also common. To assess the relationship between psychological factors (depression, loneliness, using anxiolytic medicine and fear from falls) and falls among elderly people in Baghdad City, Iraq. Methods: A matched 1:1 community based casecontrol study involving 716 elderly respondents, recruited randomly from six Non Governmental Organization (NGO) in different areas of Baghdad. Interview to each respondent was done accordingly. Geriatric depression scale (GDS) was used to assess depression among the elderly. Results: The minimum age for cases and controls were 60, the maximum age for cases was 87 years old and 85 years old for controls. Females were predominant than males 53.6% and 46.4% respectively. The association between depression and falls was statistically significant (p<0.001). Living alone or with others (spouse, children and others) was of p value equal to 1. Fear from fall was significantly associated with falls (p<0.001) and using anxiolytic medicine was also a significant risk factor. Conclusions: Psychological factors especially depression among elderly is one of the important risk factors contributing to falls. Elderly who fear from falls was also among psychological risk factors associated with falls among elderly, using anxiolytic medicine was a significant risk factor. Keywords: Falls, elderly, depression, fear from fall, Baghdad OP B2-2 QUALITY OF LIFE ASSOCIATED WITH OVERWEIGHT AND OBESITY AMONG YOUNG ADULT IN HULU LANGAT, SELANGOR Azmawati Mohammed Nawi, Farrah Ilyani Che Jamaludin* & Suraya Hani Sharom Department of Community Health, UKM Medical Centre, Malaysia *For any correspondence: pa_ilya@yahoo.com Introduction: The prevalence of overweight and obesity in developing counties is on the rise. It should be taken seriously to decrease the burden on health care and improve the quality of life. Lack of physical activities is believed to cause obesity. It is noted that, physical patterns have also been deviated from playing at the field to playing computer games, watching television and the internet. The aim of this study was to determine the prevalence of obesity and overweight among young adult aged 18 to 35 years old and to determine the association between sociodemographic and body mass index (BMI) as well as quality of life (QoL).
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Methods: A cross-sectional survey was conducted throughout Hulu Langat District between March and April 2013. The sample population was 226 adult of both gender aged 18 -35 years. Results: The prevalence of overweight and obesity among young adult in Hulu Langat is 32.7% and 18.1% respectively. There was no significant association between BMI and QoL. However, the results showed there was significant association between marital status with BMI among adult in Hulu Langat, Selangor. Conclusion: Having ideal body weight can yield important health benefits and may increase the quality of life among young adult Keywords: Overweight, obesity, BMI, quality of life OP B2-3 NEONATAL MORTALITY AMONG LOW BIRTH WEIGHT IN ACEH PROVINCE, INDONESIA Satrinawati* & Rosnah Sutan Department of Community Health, UKM Medical Centre, Malaysia *For any correspondence: Satrin_aceh@yahoo.com Introduction: Low birth weight is defined as babies born with a birth weight less than 2,500 grams. The low birth weight is the crucial problems that related with neonatal mortality in the worlds. Although low birth weight was not a direct cause of mortality, but it was the major contributor of neonatal death. The objective of this study was to assess factors related to neonatal mortality among low birth weight neonates in Aceh province, Indonesia. Study hypothesis were: presence of maternal and neonatal factor, lower social economic status, inadequate maternal and child health services and inappropriate neonatal home care was significantly associated with neonatal mortality among LBW. Methods: Mixed methods population based study was performed in 8 districts of Aceh Province. Unmatched case control study of ratio 1:1 with 500 low birth weights as sample size (250 cases and 250 controls) was used. In-depth interview using grounded theory in qualitative study with 12 mothers and 10 midwifes as the respondent was performed. Multivariate analysis for quantitative study and descriptive analysis with thematic analysis of qualitative study design were performed. Results: Determinant factors of neonatal mortality among low birth weight were: male (OR=1.8; 95 % CI:1.1-2.9), very low birth weight (OR=17.8; 95 % CI:6.2- 51.3), preterm birth (OR= 1.84; 95 % CI:1.13.1), maternal ill (OR= 1.86; 95 % CI:1.1.- 3.3), antenatal visit < 4 times (OR= 2.28; 95 % CI:1.33.9), not obtained early of breastfeeding (OR= 2.0 ; 95 % CI:1.1- 3.7), not obtained colostrums (OR= 3.5; 95 % CI:1.9- 6.4) and not exclusive of breastfeeding (OR= 5.5; 95 % CI:2.8- 10.7). Conclusion: Presence of maternal and neonatal factor, inadequate maternal and child health services and inappropriate neonatal home care was significantly associated with neonatal mortality among low birth weight. Strengthening the maternal and child health through community participation in enhancing effectiveness of it services need to be considered. Keywords: Low birth weight, neonatal mortality, maternal and neonatal services OP B2-4 THE EFFECTS OF COMMUNITY-BASED REPRODUCTIVE HEALTH WORKERS ON THE UTILIZATION OF FAMILY PLANNING SERVICES IN YEMEN Fekri Dureab1*, Amen A. Bawazir2 & Rainer Kuelker3
1. 2.
3.
World Health Organization (WHO), Yemen Community Medicine Department, Faculty of Medicine, Aden Public Health Institute, Heidelberg Uni.
*For any correspondence: fekridureab@yahoo.com Introduction: This study focuses on community health workers who were trained within the project of community-based reproductive health promotion (CBRHP). The purpose of this study is to explore the effects of community-based intervention on utilization of family-planning services in communities which implemented CBRHP.
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Methods: A cross-sectional comparative study was conducted in two villages with intervention of the CBRHP program and two non-intervened villages. The study was conducted after 19 months from the intervention date. Stratified proportional random sample was applied for the selection of the household. Equal numbers of participants were interviewed with questionnaire from both study arms with involvement of both sexes. Data analysis was made interpreted with odd ratios (ORs) and 95% confidence interval (CI) additionally, multivariate analysis was included too. Results: The rate of ever use of modern contraceptive methods is higher among people in the intervention areas (74.5%) in comparison to the nonintervention areas (51.1%), however it is much higher than the rate in overall the country (27.9%). Oral contraceptive pills were the most commonly used contraceptives among women in both areas. However, in the intervention areas the usage was higher than the non-intervention areas (63.7% and 27.7% respectively). Women in rural areas prefer the use of a three months injection rather than visit a health facility monthly to get one strip of oral pill. A multiple logistic regression analysis conducted for many socio-demographical factors of p value <0.05. Adjusted odds ratio (AOR= 2.6, (1.03 6.65) and P <0.05) was found the age of the last child is likely associated as determination with the use of FP methods in exposed and non-exposed group to the CBRHP. Conclusion: The study concluded that CBRHP volunteers contributed to provide contraceptive methods for more than two thirds of people in the intervention areas. Keywords: Community-based reproductive health promotion, contraceptive methods, family-planning services OP B2-5 THE QUALITY OF LIFE OF CLEFT LIP AND / OR PALATE CHILDREN AGED LESS THAN 5 YEARS OLD: PARENTS PERCEPTION Khairol Niza Ahmad* & Jennifer Geraldine Doss Department of Community Dentistry, Faculty of Dentistry, University of Malaya, Malaysia *For any correspondence: khairolniza@yahoo.com Introduction: Cleft lip and/or palate (CLP) are among the most common congenital malformations that involve a persons face. It remains undisputed that CLP present variety of difficulties for those affected. The objectives of this study are to assess parents perceived impacts of CLP on their childs Quality of Life (QOL) and to assess these impacts by familys socio-demographic characteristics, socioeconomic status and childs clinical details. Methods: A cross-sectional study was carried out using face-to-face interviews with the PedsQLTM Questionnaire module. A convenient sample of 131 parents having CLP children (aged from after birth to less than 5 years old) was recruited from Cleft Lip and Palate Association of Malaysia (CLAPAM) and monthly combined cleft lip/ palate clinics at two university teaching hospitals. Kruskal Wallis and Mann-Whitney U statistical tests were used to assess associations. Significance level was set at = 0.05. Results: QOL for children aged 1-12 and 13-24 months old was highest in cognitive, psychosocial and physical functioning dimensions and lowest in emotional functioning and physical symptoms. Overall QOL was significantly highest among the older children (25-59 months old) and those of posttreatment status. Children of lower income families (<USD 980) had better psychosocial health. Infants up to 12 months old having only cleft lip had significantly higher QOL and those with Muslim mothers had significantly higher psychosocial health scores. Conclusion: Parents perceived that their childrens Psychosocial Health was more affected than Physical Health in all age categories except for the 1-12 months old category. Overall, the childs age and treatment status plus household income influenced the childs QOL while mothers religion and type of cleft influenced the QOL of their childs first year of life. Keywords: Cleft lip, cleft palate, quality of life, parents perception, PedsQLTM.
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OP B2-6 NUTRITION AND EXERCISE AMONG ELDERLY: KNOWLEDGE, ATTITUDE AND PRACTICE STUDY AMONG CHINESE COMMUNITY IN SIBU, SARAWAK Annaletchumy a/p Loganathan*, Annie, Wong Siew Mee & Kavitha Subramaniam Universiti Tunku Abdul Rahman, Malaysia *For any correspondence: annal@utar.edu.my Introduction: Elderly population is on the rise throughout in the world with an ever increasing life expectancy. It was widely reported that nutrition and exercise knowledge are lacking among the elderly. However there were limited reports explored on knowledge towards nutrition intake and exercise in our local community-dwelling elderly people. This study aimed to explore the knowledge, attitudes and practices towards nutrition and exercise among elderly in Sibu, Sarawak, Malaysia. Methods: A descriptive cross sectional survey was conducted from October to December 2012 at Sibu, Sarawak, Malaysia. A self-designed questionnaire was given to assess the elderlys knowledge, attitude and practice toward nutrition and exercise. Elderly people were selected purposely using snow balling method. A total of 150 respondents have participated in this survey. The data were tested for statistical significance using Chi-square test by using Epi Info statistical software with significance taken as p> 0.05. Results: Overall 74% elderly were categorized as having good nutrition knowledge (n=111). A total of 89.3% of respondents had positive attitude towards nutrition (n=134). Most of the elderly often consume fruits, juice, vegetables, meat, fish and eggs and they seldom consume dairy products, fried food, sweetened food and snacks. On the other hand, overall 94% of respondents showed good knowledge towards exercise (n=141) and 76.7% of them have good exercise attitudes (n=115). Majority of the respondents do exercise once per day and they spent more than twenty minutes to do exercise. Chi-square test showed that there was a significant association between educational status and nutrition knowledge. Conclusion: In conclusion, Chinese elderly of Sibu, Sarawak, Malaysia have good nutrition and exercise knowledge, attitude and practice. Keywords: Elderly, nutrition, exercise OP B2-7 EFFECT OF CLOTHING AND VITAMIN DFORTIFIED MILK ON VITAMIN D STATUS IN FEMALE OFFICE WORKERS IN JAKARTA: A PILOT STUDY Amelinda Angela*, Astri Kurniati, Kamalita Pertiwi & Susana Nutrifood Research Centre, Indonesia *For any correspondence: amelinda.angela@nutrifood.co.id
Introduction: The primary source of vitamin D is exposure of sunlight. Sun exposure may be influenced by several factors, such as clothing and time spent outdoor. Thus, female office workers may be at risk of vitamin D deficiency. The aim of this study was to examine the vitamin D status of female office workers in Jakarta and to investigate the effect of clothing and vitamin D-fortified milk consumption on the vitamin D status. Methods: Therefore, this pilot study consisted of two stages. In the first stage, nine female office workers were recruited. Three of them wore clothing covering the whole body only showing face and hands (veiled) and the rest wore regular clothing (unveiled). Their vitamin D status, daily vitamin D intake, and outdoor activities were assessed. Results: Result showed that 22 % subjects (n = 2) were vitamin D insufficient (serum concentrations of 25-hydroxyvitamin D [25(OH) D] = 20-30 ng/ml) and 78% subjects (n = 7) were vitamin D deficient (serum concentrations of 25(OH)D < 20 ng/ml). Meanwhile, veiled and unveiled female office workers with no significant differences of outdoor activity habits and daily vitamin D intake had no statistically significant differences of 25(OH)D serum concentrations. In the second stage, they were assigned into two intervention groups: daily consumption of HiLo Soleha (400 IU vitamin Dfortified milk) and 2000 IU vitamin D-fortified milk
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for 12 weeks. Daily consumption of 400 IU and 2000 IU vitamin D-fortified milk for 12 weeks significantly increased serum concentrations of 25(OH)D from baseline (+ 7.75 3.30 ng/ml; p = 0.018 and + 16.67 5.86 ng/ml; p = 0.038, respectively). Conclusion: In conclusion, female office workers in Jakarta may not have sufficient vitamin D level despite their clothing. Hence, daily consumption of vitamin D-fortified milk may be effective in improving the vitamin D status. Keywords: Vitamin D, clothing, vitamin D-fortified milk, female office worker OP B2-8 TOOTH WEAR AND EROSIVE TOOTH WEAR AMONG 16-YEAR-OLD MALAYSIAN ADOLESCENT Noorhazayti Binti Ab. Halim1*, Rashidah Esa1 & Chew Hooi Pin2
1.
present with any tooth wear. A total of 16,521 teeth were examined in this study and 10,400 teeth showed signs of general tooth wear. The most frequently affected surface was the incisal or occlusal surface (99.9%). Regarding the severity of general tooth wear, most affected tooth surfaces exhibited loss of enamel (62.84%). Prevalence of erosive tooth wear was 45% throughout the study population. A total of 16,521 teeth were examined in this study and 451 teeth showed signs of erosive tooth wear. The most affected tooth surfaces exhibited distinct defect with hard tissue loss less than 50% of the surface area (dentine). Conclusions: The tooth wear among 16-year-old adolescents is highly prevalent and nearly half (45%) of them exhibited erosive tooth wear. Therefore, it is recommended that a further study should be carried out in a larger sample size and other age groups; and also to include the information regarding tooth wear and its impact in the health education messages. Keywords: Tooth wear, erosive tooth wear, adolescents, epidemiology OP B2-9 OUTDOOR AIR POLLUTION AND INCIDENCE OF ACUTE RESPIRATORY INFECTION AMONG CHILDREN IN KLANG VALLEY Siti Rahmah Abdul Rahman1*, Sharifah 1 Norkhadijah Syed Ismail , Muhammad Firuz Ramli2 & Mohd Talib Latiff3
1.
2.
Department of Community Dentistry, Faculty of Dentistry, University of Malaya, Malaysia Department of Conservative Dentistry, Faculty of Dentistry, University of Malaya, Malaysia
*For any correspondence: drzetty_916@yahoo.com Introduction: In Malaysia, tooth wear is a relatively new emerging public health problem and the studies on its prevalence and associated risk factors have not been sufficiently explored in this country. This study aimed to determine the prevalence and severity of general and erosive tooth wear among 16-year-old adolescents in Kuantan, Pahang. Methods: A cross sectional study was carried out using a multistage cluster sampling technique. The study group consisted of 16-year-old adolescents attending secondary schools in Kuantan District, Peninsular Malaysia. 598 adolescents were examined from 5 different schools; 228 were males and 370 females. The level of general tooth wear and erosive tooth wear were recorded using the Smith and Knights Tooth Wear Index (TWI) and Basic Erosive Wear Examination (BEWE) index respectively. Results: The prevalence of general tooth wear was 99.8% (597). Only one out of 598 participants did not
2. 3.
Department of Environment and Occupational Health, Universiti Putra Malaysia, Malaysia Universiti Putra Malaysia, Malaysia Universiti Kebangsaan Malaysia, Malaysia
*For any correspondence: rahmahbintirahman@gmail.com Introduction: Rapid urban population growth and physical development has given significant pressure to the environment as it increase the air pollution. Air pollution sources from human activity such as motor vehicles and industries continue to be a serious problem that cause harm to human health and welfare especially in more densely populated urban areas. The Klang Valley of Malaysia, which includes the
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largest city of Kuala Lumpur and the new capital city of Putrajaya, is one such area. This study aims to investigate the level of outdoor air pollution and incidence of acute respiratory infection among children in Klang Valley. Methods: The daily variations of air pollutants (mean concentrations of PM10, CO, NO2, SO2, and O3) and meteorological condition in Klang Valley from 2007 to 2011 were obtained from Malaysian Department of Environment. The air pollutants concentration were analyzed and compared with the Recommended Malaysian Ambient Air Quality Guideline. Data on daily acute respiratory infection were obtained from particular District Health Offices in Klang Valley. All these data were examined by using Statistical Package of Social Sciences (SPSS) and Geographical Information Systems (GIS) software to determine the association between the air pollutants and the incidence of acute respiratory infection. Besides, the software was used to determine the contributing factors for increasing air quality data and health registry data. The data then integrated into the software to build digital topographic map and model of the emergence of ARI with regards to air pollution and other factors. Results: There are significant differences of air pollution level and incidence of acute respiratory infection between cities in Klang Valley. Conclusion: There is a significant relationship between the outdoor air pollution and incidence of ARI among children. Keywords: air pollution, acute respiratory infection, GIS, children
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ORAL PRESENTATION: OCCUPATIONAL HEALTH / ENVIRONMENTAL HEALTH
ORAL PRESENTATION OCCUPATIONAL HEALTH / ENVIRONMENTAL HEALTH
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OP C1-1 DISTRIBUTION OF SELECTED ENDOCRINE DISRUPTING CHEMICALS IN MALE VEGETARIANS AND NON-VEGETARIANS Rafidah Hod1*, Ruby Husain1 & Mustafa Ali Mohd2
1.
2.
Department of Physiology, Faculty of Medicine, University of Malaya, Malaysia Department of Pharmacology, Faculty of Medicine, University of Malaya, Malaysia
*For any correspondence: pi38046@gmail.com Introduction: Endocrine disrupting chemicals (EDCs) are substances that can mimic or oppose effects of endogenous hormones. EDCs are either natural or synthetic substances, belonging to various classes and toxicity that are present within the environment, whether in food, air or water. One of the main concerns is EDC effects on endocrine related cancers. EDCs with estrogenic activity are called xenoestrogens such as phytoestrogens, plasticizers (phthalates, bisphenol A) and pesticides. This study looks at the distribution of selected EDCs (daidzein, genistein, equol, formononetin and bisphenol A) among male vegetarians and nonvegetarians in Malaysia. Methods: This study used a validated liquid chromatography tandem mass spectrometry (LCMSMS) method to determine the distribution of selected EDCs among male vegetarians and nonvegetarians. Healthy males aged 18 to 65-year-old whom non-vegetarian and those who practiced vegetarian diet more than three months were recruited. Basic information and informed consent were obtained, and 10 ml of blood sample was withdrawn from the study subjects. Blood samples were assayed from 103 vegetarians and 122 nonvegetarians. Results: The mean plasma concentrations of daidzein, genistein, equol, biochanin A were 36.4, 82.2, 7.4 and 7.8 ng/ml respectively, and were considerably higher in vegetarians. The BPA level of vegetarians (1.46 ng/ml) was significantly higher than non-vegetarians. Testosterone level was weakly correlated with daidzein, genistein, equol, formononetin and biochanin A. The percentage of
equol producer in vegans and non-vegetarians was 58.3% and 24.6%, respectively. In contrast to vegans who have 4-5 types of isoflavone, less than four types of isoflavone were detected in the plasma of nonvegetarians. Conclusion: Vegetarians in this study had a higher exposure to EDCs as compared to the nonvegetarians. This is most likely due to their lifestyles. The result from this study serves as a baseline assessment on the distribution of EDCs among vegetarians and non-vegetarians in Malaysia. Keywords: Non-vegetarian, vegetarian, plasma EDC, LCMSMS OP C1-2 PREVALENCE AND ASSOCIATED FACTORS OF MUSCULOSKELETAL SYMPTOMS AMONG BUS DRIVERS IN UNIVERSITI PUTRA MALAYSIA Aini Nurliyana Azhar1 & Huda Zainuddin2*
1.
2.
Department of Environment and Occupational Health, Universiti Putra Malaysia, Malaysia Department of Community Health, Universiti Putra Malaysia, Malaysia
*For any correspondence: drhuda@medic.upm.edu.my Introduction: Musculoskeletal disorder is a significant public health because of high numbers of cases reported especially in the working population. The aim of this study is to determine the prevalence of musculoskeletal symptoms and its associated risk factors among Universiti Putra Malaysia (UPM) bus drivers. Methods: A cross sectional study was done on all UPM bus drivers. A modified, validated Standardized Nordic Questionnaire was used to obtain information about socio demography, health status, job characteristics, perceived ergonomics risk factors and musculoskeletal symptoms among 47 bus drivers. Height and weight were measured and BMI was calculated. A calibrated Human Vibration Meter was used to measure whole body vibration (WBV) exposure while postural analysis was used to evaluate awkward working posture.
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Results: The prevalence of musculoskeletal symptoms (MSS) among university bus drivers was 97.9%. Majority (78.7%) of the respondents experienced musculoskeletal symptoms involving lower back compared to other body parts. Other common sites were knee (63.8%), leg (59.6%) and neck (53.2%). The level of whole body vibration (WBV) magnitude did not exceed exposure action value (EAV) of European Directive (0.27 m/s2). There was significant association between duration of working hours per day, prolong sitting and awkward posture with MSS (p<0.05). Conclusion: Work related exposures were the significant associated risk factors of musculoskeletal symptoms among university bus drivers. Actions need to be taken by the management to improve the working condition of the bus drivers. Keywords: Musculoskeletal symptoms, bus drivers, risk factors OP C1-3 THE EFFECTS OF BACKPACK LOAD AND PLACEMENT ON POSTURAL DEVIATION IN HEALTHY SCHOOL CHILDREN: A PILOT STUDY Abdul Mujid Abdullah1*, Rachael McDonald2 & Shapour Jaberzadeh3
1.
2.
3.
Faculty of Health Sciences, Universiti Teknologi MARA, Malaysia Department of Occupational Therapy, School of Primary Health Care, Monash University, Australia Department of Physiotherapy, School of Primary Health Care, Monash University, Australia
and placement on postural deviation particularly from sagittal and frontal plane. Methods: A repeated measures experimental design was conducted on 8 school children in Australia. Participants were recruited based on convenience sampling. Inclusion criteria were primary school children age between 6 and 12 years old, free from any musculoskeletal disease or disorder, able to stand upright at least for 30 minutes and happy to wear bike shorts and tight t-shirts during the experiment. Outcome measures used were angles at trunk, neck, gaze, head on neck, lower limb, tragus, acromion and pelvic. There were nine experimental conditions in the experiments which comprises the combinations of three backpack loads (5%, 10% or 15% BW) and three placements on back (T7, T12 or L3). Photographs of sagittal and frontal plane were taken during unloaded and experimental conditions. Postural angles were measured using the UTHSCSA Image Tool software. Differences in postural angles between conditions were determined using repeated measures Analysis of Variance IBM SPSS V21. Results: There were significant differences at all angles while carrying 10% and 15% BW load compared to unloaded condition. The centre of gravity of backpack positioned at T7 produced the largest postural deviation at all angles compared to T12 and L3. Conclusion: Primary school students should avoid placing 10% load and above at T7 in order to reduce postural deviation that may contribute to backpack related musculoskeletal problem. Keywords: Backpack, school children, load limit, load placement OP C1-4 PHYSICAL ACTIVITY AMONG WORKERS AND VASCULAR AGE Shafizah Ahmad Shafei*, Norfazilah Ahmad & Noorhassim Ismail Department of Community Health, UKM Medical Centre, Malaysia *For any correspondence: shafizah73224@hotmail.com
*For any correspondence: abdmujid@gmail.com Introduction: The issue of carrying heavy backpacks by children and the position of this backpack on the spine have become an issue of interest to policy makers and researchers over the last decade. Numerous studies have been conducted during this period but there is no conclusive evidence for the correct load and placement. The objective of this study was to investigate the effect of backpack load
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Introduction: Physical activity has been known to improve cardiovascular health. Assessment of physical activities now includes both leisure time and occupational activities. Vascular age is a new predictor of cardiovascular disease that can be used for early intervention in preventing cardiovascular disease. The objective of this paper is to evaluate the relationship between physical activity and vascular age among workers. Methods: The Physical Activity and Exercise Questionnaire by Norman et al (2001) that encompasses physical activity at work, hours spent on walking or cycling, housework, leisure time inactivity or activity and sleep was used. The activities were calculated as metabolic equivalents (METS) x hour/ day. The vascular age was estimated by photopletysmo graph and was conducted according to the protocol. Approximately 155 male workers from the age of 31 to 66 years old completed the questionnaire. This is a preliminary data from a larger study that also covers occupational factors like noise exposure and stress as well as dietary pattern. Results: The Pearson correlation coefficient between total physical activity and vascular age was -2.48 (p value= <0.05, while its coefficient of determination (r2) was 0.0615. Conclusion: Higher physical activity is correlated with lower vascular age. Engaging in more physical activities does improve the vascular age but it is not enough. Other lifestyle and occupational factors also need to be addressed in improving cardiovascular status among workers. Keywords: Physical activity, vascular age, workers. OP C1-5 EFFECTIVENESS OF INTERVENTION PROGRAMME IN IMPROVING KNOWLEDGE, ATTITUDE AND PRACTICE AMONG SMOKERS IN MUKIM PERINGAT, KELANTAN Aziah Daud* & Group A CFCS 2012/2013 Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Malaysia *For any correspondence: aziah@kb.usm.my Introduction: Cigarette smoking is a major health concern in most societies because the diseases and deaths that result from it are in fact preventable. It is estimated that tobacco-related deaths will be the most important cause of deaths in developing countries by 2020. To determine the changes in knowledge, attitude and practice following intervention programme among smokers in Mukim Peringat, Kelantan. Methods: The intervention study was conducted among smokers in Mukim Peringat, Kelantan. It was held in November 2012 and the study included 168 smokers (active and passive). Our inclusion criteria was subjects who were 15 years old and above and we excluded out subjects who were mentally and physically insufficient. The data were obtained using interviewer guided validated questionnaire containing 3 domains (knowledge, attitude and practice). Results: Our results showed that there was significant increment between the pre-intervention and post intervention survey evaluations for knowledge, attitude and practice on smoking. Conclusion: Our intervention programme has provided the smokers of Mukim Peringat, Kelantan with good foundations on knowledge, attitude and practice on smoking. Keywords: Effectiveness, intervention programme, knowledge, attitude, practice, smokers OP C1-6 THE IMPACT OF BODY MASS INDEX ON SICKNESS ABSENCE AMONG HEALTHCARE WORKERS IN KUALA SELANGOR IN 2012 Azizah Wahab* & Rozita Hod Department of Community Health, UKM Medical Centre, Malaysia *For any correspondence: zahril.12@gmail.com Introduction: Obesity is a global epidemic and has significant impact on work performance. Prevalence of obesity among healthcare workers is higher as compared to general population and the complex nature of the occupational hazards at the health centres may increase the incidence of sickness absence among healthcare workers. The aim of this study is to determine the relationship between body
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mass index (BMI) and sickness absence among healthcare workers. Methods: This comparative cross-sectional study was conducted in public health centres in Kuala Selangor. All healthcare workers aged of 40 years old and above were included in this study. Data of annual health checks and sickness absence data covering oneyear period were used in this study. Results: Out of 192 respondents, 112 (58.3%) took sick leave in the past year with 334 spells and 1003 sick-off days. The prevalence of pre-obese and obese was 33.1% and 45.5% respectively and higher BMI was significantly associated with sickness absence (p<0.001). There was positive linear relationship between BMI and duration of sick leave (p=0.001). Regular daytime working hour was also significantly associated with sickness absence (p=0.003). Conclusion: Obesity and regular daytime working hour are the risk factor of sickness absence. Therefore, promoting healthy weight maintenance particularly at workplace and full implementation of flexible daytime working hours are essential to ensure an optimum occupational functioning and minimizing the costs associated with sickness absence among healthcare workers. Keywords: Body mass index, sickness absence, healthcare worker, obesity, Kuala Selangor OP C1-7 OCCUPATIONAL DEPRESSION AMONG EMPLOYEES OF ESFAHAN STEEL COMPANY, IRAN: PREVALENCE AND ASSOCIATED FACTORS Lotfizadeh M1* & Noor Hassim Ismail2
1.
Depression is described by changes in state of mind, self-attitude, aware performance, sleep, decreases quality of life, change in appetite, and level of energy. It is a common but serious illness, and those who are suffering it need handling to get well. This study is one of the premier studies about occupational depression among industrial employees in Iran. Its aim is to investigate the prevalence of depression and its associated factors among Esfahan Steel Company Employees, Iran. Methods: A sample of 400 males between the ages of 20 and 58, from an Iranian steel company took part in this study. The respondents were all the full-time employees in Esfahan steel company (ESCO) IRAN and the design used in this study is crosssectional carried out in 2008. Depression, anxiety, and stress were selected for this research. Results: The prevalence of depression was found to be 70.8%. Analyses did not exhibit significant relationship between depression and age, marital status, experience, literacy and shift work. Conversely, high significant relationship was found between income, work position, family related problems, work environment, job position and depression. Multivariate logistic regression showed that financial problems were the most common reasons for depression among the employees and the main contributors to depression were work environment, task type, financial problems and the income below US$500 (P<0.05). Conclusion: Based on the results of the study, about three quarters of the ESCO employees suffered from depression. Iranian employees appeared to have much higher prevalence of depression compared to other industrialized countries Keywords: Depression, employees, Esfahan OP C1-8 PUBLICATION OF SIMPLIFIED VERSION OF CANCER EDUCATIONAL MATERIAL Norsidawati Abdul Gani*, Othman Omar & Mazanah Muhamad Cancer Resource & Education Center (CaRE), Universiti Putra Malaysia, Malaysia *For any correspondence: shida.upm@gmail.com
2.
Department of Community Health, Sharekord University of Medical Sciences, Sharekord, Iran Department of Community Health, UKM Medical Centre, Malaysia
*For any correspondence: masoud_lotfizadeh@yahoo.com Introduction: Recently, depression has become one of the most serious community health challenges in the world especially in developing countries and there has been a great deal of public attention to it.
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Introduction: Information is important for patients and caregivers. Educational materials appropriate to their culture and literacy level ought to be available for them. This paper deliberates on the publication of educational materials appropriate for specific readership group, for example Malaysian affected by cancer. Methods: The Cancer Education & Research (CaEd) Project has developed five (5) cancer booklets that were adapted and translated from American Cancer Society. A survey in 2005 on the said booklets showed that there is a need to develop cancer educational materials in simplified version. Thus, CaEd Project initiated the development of simplified version of eight (8) titles. To get feedback on the appropriateness of the booklets, a survey was conducted prior to the publication. The custom designed instrument consists of 40 items. It was divided into 5 parts; (1) content, (2) design, (3) visual, (4) overall, and (5) demography. Forty eight respondents participated in the study. Descriptive statistics were used to analyze the data. Results: The results showed; (1) most readers clearly understand the content, (2) majority like the books cover, color, font size and booklet size, and (3) 100% found the booklets informative and useful to them. The feedback also pointed out the need for; (1) further improvement of visuals, (2) adding glossary for difficult words, and (3) booklet development into other major languages in Malaysia. The project subsequently published eight (8) titles for Malaysian affected by cancer by taking into consideration of the findings. Conclusion: This study suggests the need for readers engagement and feedback for development of meaningful and appropriate health education material. Keywords: patient education, information, publication, readers engagement, health communication OP C1-9 A PILOT STUDY EXAMINING ANEMIA AND OBESITY AMONG WOMEN WORKER Salli Fitriyanti1*, Anastasia Yani Triningtyas2& Sri Quintina Indriyana2
1.
2.
Medical Nutrition Laboratory, Faculty of Medicine, Jenderal Ahmad Yani University, Cimahi, Indonesia Public Health Laboratory, Faculty of Medicine, Jenderal Ahmad Yani University, Cimahi, Indonesia
*For any correspondence: sallifitriyanti@yahoo.com Introduction: The prevalence of anemia in women worker at Indonesia is still high. Anemia in women worker will decrease their productivity. Anemia not just only happens in underweight women worker, but can also happen in overweight and obesity. The health practitioner in Indonesia pay less attention to anemia in overweight and obesity, because there is still paradigm that anemia is always associated with underweight. The aim of this pilot study is to know the prevalence of anemia and obesity among women worker at Cimahi, Indonesia Methods: The study was a descriptive design. Total subject were 257 women workers (mean age 31.5 y (SD 8.5 y) of garment and textile company in Cimahi, taken by purposive sampling. Anemia was examined by hemoglobin concentration and measured by Tallquist hemoglobin scale. To assess overweight and obesity, we used world health organization standard body mass index for Asian Results: This study shown the prevalence of anemia in women worker was 80.5% (mean Hb 10.8 g/dL (SD 1.3)). Prevalence of overweight and obesity were 54.5% (17.1% for overweight, 37.4% for obese). As many as 36 than 44 overweight participants had anemia (mean Hb 11.1 g/dL (SD 1.2)), and 82.3% of obesity participant also had anemia (mean Hb 10.6 g/dL (SD 1.2)). But this result only an early screening with Tallquist method, so this study will be continue with the better method for Hb examination. Conclusion: The prevalence of anemia in overweight and obesity women worker in Cimahi was high Keywords: anemia, obesity, women worker
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OP C2-1 PREVALENCE OF METABOLIC SYNDROME AND COMBAT RELATED AND PSYCHOLOGICAL RISK FACTORS AMONG MILITARY PERSONNEL AGED 30-55 YEARS IN SRI LANKA LIGHT INFANTRY REGIMENT OF SRILANKAN ARMY Chathurani Mekala Wickramaarachchi* Post Graduate Institute of Medicine, University of Colombo, Srilanka *For any correspondence: chathuwick@hotmail.com Introduction: Metabolic syndrome (MetS) is an emerging concern of public health importance. Its positive association with coronary vascular diseases, stroke and diabetes is evident. Military forces cannot escape from this epidemic wave of MetS, despite of their unique characteristics. There are no studies on military population to estimate the prevalence and correlates of MetS in Srilanka. The present study aims to evaluate the prevalence of MS among military personnel in Sri Lanka Light Infantry Regiment in Srilanka Army and investigates its relationships with combat related and psychological parameters. Methods: A population based cross sectional study was conducted in 2012 to obtain details on MetS and its associates. A nested case control study was done in the subsequent step in order to determine combat related and psychological risk factors. Mets was defined according to American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) definition. Data was collected using a pre-tested interviewer administered questionnaire on demographic and life style. 673 subjects (response rate of 98.7%) aged 30-55 years (mean 35.0 3.9) were screened with a physical examination and blood tests. Arterial blood pressure, weight, height, body mass index (BMI), waist circumference (WC) and hip circumference (HC), fasting blood glucose, lipid profile consisting of HDL and triglycerides were measured by standard methods. Results: The sample predominantly consisted of Sinhalese (97%), Buddhists (87.4%) and educated up to G.C.E. Ordinary level (74.6%). The results revealed the crude prevalence of MetS as 22.9% [95% CI=22.86-22.93]. Reduced HDL (100%), hypertension (83.1%) and elevated FBS (52.6%) were most common abnormalities among the participants. MetS was associated with younger age compared to advance age (X2=5.30, df =1, p=0.021); married males compared to others (unmarried, divorced and separated) (X2=19.29, df=1, p=0.001); Buddhists compared to those with other religions (X2= 6.815, df=1, p=0.009); brought up by single parent or other person during childhood comparison to both parents (X2=12.3, df = 1, p=0.001). MetS was found more in volunteer force compared to regular force military personnel (X2=15.0, df = 1, p=0.001). Mets was associated with family history of Dyslipidemia (X2 = 16.768, df =1, p=0.001 ) and family history of Diabetes mellitus (X2= 19.576, df =1, p=0.001). MetS was reported to be found more among participants with dyslipidemia (X2 = 11.77, df =1, p=0.001) ; alcohol consumers over participants who had never consumed alcohol during life time (X2= 4.976, df =1, p=0.026 ); less frequent alcohol consumption over more frequent alcohol consumers (X2 = 292.45, df = 1, p=0.001); participants who consume Arrack over participants who consume beer (X2 =154.2, df = 1, p=0.001); current smokers over never/ex smokers (X2 = 289.1, df = 1, p=0.001). Among current smokers who have started smoking at a younger age of less than 15 years had more prevalence of MetS than participants who have starts smoking at much later than 15 years of age (X2= 32.62, df =1, p=0.001); less frequent smokers than more frequent smokers (X2=70.2, df = 1, p=0.001). Among combat related risk factors for MetS, battle casualty showed 44.8 times (95%CI=25.5-78.6). Risk of development of MetS; advancing military service in years [OR=0.059 (95%CI=0.724-0.79] and advancing years of military service in operational areas [OR=0.059(95%CI=0.724-0.79] were found to be protective factors. Casualty was categorized as mild to severe and severe type of battle casualty had a risk of 94.6 times (95% CI=18.45-484.58) risk of developing MetS to mild to moderate type battle casualty. Army deserters showed 1.2 times (95% CI 1.1-1.3) of development of MetS.
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Among the selected psychological risk factors for MetS, Depression [OR=0.059 (95%CI=0.724-0.791]; PTSD [OR=65.39(95%CI=36.47-117.09]; Distress [OR=17.423 (95%CI=11.27-26.94] were found to be risk factors. Pessimism showed to be protective for Met S [OR=0.049 (95%CI=0.026-0.091)]. Binary logistic regression analysis was performed using the dichotomous variable MS (0 = absent, 1 = present). The independent co-variants were: depression, distress and severe type of battle casualty. Conclusion: Prevalence of MetS is comparatively high in this population. Psychological and combat related risk factors for MetS in military population needs further assessment and prompt and early management. Keywords: MetS, military, psychological OPC2-2 PREVALENCE OF OBSTRUCTIVE SLEEP APNOEA AMONG COMMERCIAL TRUCK DRIVERS IN MALAYSIA Wahida Ameer Batcha, Ilhamah Othman, Aimi Mohd Fahmi & Mohamad Suffian Ahmad* Vehicle Safety and Biomechanics Research Centre, Malaysian Institute of Road Safety Research (MIROS), Malaysia *For any correspondence: wahidameer@miros.gov.my Introduction: Obstructive Sleep Apnoea (OSA) has been recognized as one of the contributing factors that significantly increased the risk of road traffic accidents among drivers. In Malaysia, the prevalence of OSA among commercial truck drivers are still not known. Therefore, the aimed of this study was to identify the prevalence of OSA among commercial truck drivers in Malaysia. Methods: A cross sectional study was conducted over a three-month period in (2012). The population of this study was commercial truck drivers travelling within peninsular of Malaysia. Respondents were commercial truck drivers selected from a fleet company operated in Klang Valley. A validated Berlin questionnaire was used as screening tools to identify commercial truck drivers who were at risk of developing OSA. Results: A total of 130 commercial truck drivers participated in this study and were screened using Berlin questionnaire. All of the respondents were males, aged ranged from 22 to 70 years with an average of 38.9 (10.7) years old. The prevalence of OSA among commercial truck drivers were 14.6%. BMI (Mean = 30.6 SD 3.8, p< 0.001) and neck circumference (Mean = 40.9 SD 2.4, p< 0.001) were found to be statistically significant as associated risk factors for OSA. Conclusion: The prevalence of OSA among commercial truck drivers were relatively high in Malaysia, therefore early detection and treatment of OSA among commercial truck drivers are important preventive measures to take in reducing the risk of road traffic accidents among them. Keywords: Obstructive sleep apnoea, commercial truck driver, BMI OP C2-3 MUSCULOSKELETAL PROBLEMS AMONG AGRICULTURAL WORKERS IN FELDA SUNGAI KELAMAH, GEMAS, NEGERI SEMBILAN Mohd Dzulkhairi Mohd Rani*, Zairina A Rahman, Nooriah Mohamed Salleh & Mohd Yunus Abdullah Faculty of Medicine & Health Sciences, Universiti Sains Islam Malaysia, Malaysia *For any correspondence: drdzulkhairi@gmail.com Introduction: Agriculture tasks are highly physical demanding, strenuous and require extremely large energy in performing their tasks. Therefore, workrelated musculoskeletal problems (MSP) are inevitable consequences of agricultural labour. Thus, to ensure a stable and continuous production of the agriculture especially in the palm oil and rubber estates, MSP should be addressed properly. Methods: The objective of this study is to determine the prevalence of MSP and its association with sociodemographic profile, anthropometric factors, occupational factors and ergonomics, as well as the health seeking behaviours among agricultural workers in FELDA Sungai Kelamah, Gemas, Negeri Sembilan. A cross-sectional study was conducted among 168 adult rubber tappers and palm oil workers
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from FELDA Sungai Kelamah, Negeri Sembilan. Data was collected by using pre-tested, selfconstructed questionnaire which was modified from established Extended Nordic Musculoskeletal Questionnaire (NMQ-E) through face-to-face interview using validated questionnaire. Results: The prevalence of MSP was 55.4% with the most affected body part was lower back (33.7%), followed by knee (26.2%) and shoulder (25.0%). There was significant association between prevalence of MSP with BMI (p=0.050), working hours (p=0.034), working days per week (p=0.048), and numbers of trees worked per day (p=0.018). However, there was no significant association between prevalence of MSP with age (p=0.800), working years (p=0.844), working at trees posture (p=0.586), lifting posture (p=0.918), carrying posture (p=0.163) and occupation (p=0.869). Most respondents chose government clinics as their primary choice of treatment (44.64%). Conclusion: Slightly more than half of agricultural workers in FELDA Sg. Kelamah, Negeri Sembilan suffers from MSP with the commonest site was the lower back. Keywords: Musculoskeletal pain, FELDA Sg. Kelamah, lower back pain, rubber tappers, palm oil workers. OP C2-4 VALIDATING EFFORT OF AN OCCUPATIONAL BACK PAIN QUESTIONNAIRE WITH STANDARDS FROM A SOCIAL SECURITY ORGANIZATION BASED ON A HETEROGENOUSLY POPULATED DEVELOPING COUNTRY. Tam Jenn Zhueng1*, Mohd Idris Awang2, Noor Hassim Ismail1 & Sharifa Ezat Wan Puteh1
1.
*For any correspondence: tjz@ns.moh.gov.my Introduction: The BACKS questionnaire was a proposed Back Apparatus Collaboration between National University of Malaysia Medical Centre (UKMMC) with Malaysian Social Security Organization (SOCSO). It is designed to assist in the determination of occupational chronic back pain. At the same time, a confirmatory structural equation modeling was conducted to establish mediation properties of work relation between the hazards and outcomes of chronic back pain. Methods: Data was collected via cluster sampling from 2008 to 2010 SOCSO registry. Occupational chronic back pain was defined as minimal cumulative back pain for more than 2 weeks in the past year, Pain Visual Analog Score above 2 cm, Oswestry Disability Index of above 20% and BACKS score above 0.573 or percentage above 51.8% probability. The data is also used to test for confirmatory structural equation modeling. Results: According to the standards of the Medical Board, the BACKS Tool reported a sensitivity of 62.7%, specificity of 94.5%, positive- predictive value (PPV) of 92.9% and negative- predictive value (NPV) of 69.0% with moderate agreement as Kappa value was 0.56. Consistent with the exploratory phase, workplace conditions and employees preexisting medical health mediated occupational back pain to develop disability and monetary benefit relationships in a much more significant way. Conclusion: BACKS Tool served as a complementary assessment along with visits to the workplace that has its own advantages when one would conduct a self- administered assessment of their workplace. It provides a cost- effective adjunct to corporate bodies as the industrial world enters into the uncertain global recession. Keywords: Chronic low back pain; ergonomics; musculoskeletal; occupational; work- relatedness; employment
2.
Department of Community Health, UKM Medical Centre, Malaysia Department of Anthropology and Sociology, University of Malaya, Malaysia
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OP C2-5 KNOWLEDGE, ATTITUDE AND PRACTICE RELATED TO OCCUPATIONAL SAFETY AND HEALTH AMONG MEDICAL LABORATORY PERSONNEL IN HOSPITAL RAJA PERMAISURI BAINUN IPOH, MALAYSIA: AN INTERVENTION STUDY Suresh Narayanan1*, Anto Cordelia Tanislaus Antony Dhanapal2, Mohana Suppiah3, Norain Karim4 & Zuraida Mohamad5
1.
2.
3. 4.
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Department of Biomedical Science, Universiti Tunku Abdul Rahman, Malaysia Department of Chemical Science, Universiti Tunku Abdul Rahman, Malaysia Medical Oncology, Imperial College London Jabatan Patologi, Hospital Raja Permaisuri Bainun, Malaysia Jabatan Kesihatan Negeri Sembilan, Malaysia
*For any correspondence: smooper22@gmail.com Introduction: The diverse nature of a medical laboratory personnels work increases the risk of exposure to myriad of occupational hazards throughout their career. However, there are lack of focus-driven research done to evaluate the knowledge, attitude and practice (KAP) related to occupational safety and health (OSH) among medical laboratory personnel after implementation of mitigation actions. The objectives of this study were to compare the KAP level related to OSH among medical laboratory personnel in Hospital Raja Permaisuri Bainun (HRPB) before and after intervention programme. Methods: A three consecutive days of 'Health and Safety Campaign' was chosen as an intervention programme to be conducted among medical laboratory personnel. Their KAP level related to OSH were assessed before and after this intervention programme. Results: A total of 110 medical laboratory personnel from the Pathology Department of HRPB, Ipoh participated in this study. The data were analysis using Paired-t test to compare the mean score before and after intervention programme. The mean scores of KAP were classified into 'poor' (mean score of 0-
0.49), 'satisfactory' (mean score of 0.5-0.74) and 'good' (mean score of 0.75-1.00). Knowledge related to OSH was good where the mean score before intervention was 0.79 (SD 0.19) and after intervention was 0.85 (SD 0.12), t =-5.29 and p<0.05. However, knowledge related to biohazard, oxidizing hazard symbol and OSH legislation would still require further improvement. Attitude towards OSH was found to be good and remain unchanged where the mean score before intervention was 0.79 (SD 0.15) and after intervention was 0.7852 (SD 0.14), t=0.42 and p>0.05. Practice of OSH showed a satisfactory result where the mean score before intervention was 0.70 (SD0.24) and increased to 0.72 (SD0.20) after intervention although it was not statistical significance (t = -1.564; p>0.05). Conclusion: Although KAP related to OSH among medical laboratory personnel of HRPB were found to be mostly good before and after intervention, continuous education and training are important to fill in the gaps in KAP related to OSH. This will ensure a healthy and safe working ethos and environment among the employees thus increasing the productivity of the workforce. Keywords: Knowledge, attitude, practice, laboratory personnel, intervention OP C2-6 RELIGIOSITY, COPING AND POST TRAUMATIC STRESS DISORDER AMONG SURVIVORS OF THE 2009 PADANG EARTHQUAKE Rafidah Bahari1* & Norlaili Abdul Aziz2
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2.
Department of Psychiatry, Cyberjaya University College of Medical Sciences, Malaysia Department of Public Health, Cyberjaya University College of Medical Sciences, Malaysia
*For any correspondence: rafidahbahari@cybermed.edu.my Introduction: In September 2009, the town of Padang in Indonesia was shaken by an earthquake of a large magnitude leaving sheer destruction and killing countless lives. Following a disaster of such magnitude, post traumatic stress disorder (PTSD) is a
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common, but not inevitable consequence. Could coping styles and religiosity play a role? The objective is to examine the contribution of coping styles and religiosity on the development of PTSD. Methods: A cross sectional survey was carried out involving 44 students in a Malaysian university who were exposed to the event. PTSD was assessed using the Revised Impact of Event Scale (IES-R). The COPE questionnaire was used to measure coping mechanism utilised, while the Hatta Religiosity Scale (HRS96) was used to measure religiosity. Results: Even more than a year following the earthquake, 28% of the students were found to continue to experience PTSD symptoms. Among those with PTSD symptoms, the most common coping mechanisms employed were mental and behavioural disengagement. Interestingly, no difference was found between those with or without PTSD symptoms in terms of their Islamic knowledge and practices. However, there appears to be a significant correlation between Islamic practices and the use of behavioural disengagement as a coping mechanism. Conclusions: Untreated, the symptoms of PTSD persist even after a year. The practice of Islam is more important than knowledge, and poor practice seems to correlate with use of maladaptive coping. Keywords: Religiosity, coping, PTSD, earthquake OP C2-7 URTI OUTBREAK AT ISLAMIC RELIGIOUS SCHOOL HOSTEL, CHERAS, KUALA LUMPUR Haliza AM* & Asyraf Z Pejabat Kesihatan Cheras, Kuala Lumpur, Malaysia *For any correspondence: drhalizamanaf@wp.moh.gov.my Introduction: On 18 February 2013, there was a URTI outbreak at Islamic Religious School hostel, Cheras, Kuala Lumpur. 18 cases were reported on the same day. The number of cases increased rapidly up to 88 cases within few days. Nearly half of the cases (46.6% or 41 cases) stayed in an office lot turned into a hostel. They housed all the exam going students (Form 3 and 5). The rest are staying in two other hostels i.e Taman Maluri (11 students, 12.5%) and Taman Melati (34, 38.6%). Investigation was concentrated at the office turned hostel. Colonies of fungus were spotted at the building walls especially one of the dormitory on the 4th floor. It is suspected that the fungus was the cause of this outbreak. Cheras Health Office and KL Health Department collaborated with Institute of Medical Research (IMR) and Engineering Division, MOH in analyzing the situation especially the source of fungus. The aim of the study is to identify the cause and to prevent the outbreak from spreading. Methods: All data and information related to outbreak was collected and collated into Microsoft Excel 2010 and analyzed using Epi info 2004 3.4. Results: About 88 cases were identified by using active case detection (ACD) method. Five out of 88 cases had throat swab samples. The result showed three of the samples were Haemophilus Influenza positive. However, the air sampling by IMR to identify Haemophilus Influenza was negative. The samples taken by IMR showed there were present of fungus such as Aspergillus and Penicillium sp. Engineering Division, MOH found out that improper installation of air conditioner was the cause of the fungus spread. Conclusion: The present of fungus in the office turned hostel was due to improper installation of air conditioner that led to the outbreak. Office lot was unsuitable to be turned into a hostel as it could not support the capacity of students staying there and the amount of water arising from the laundry which increases the humidity in the area. Keywords: URTI outbreak, fungus, cause of the fungus spread
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OP C2-8 THE IMPACT OF WORK ENVIRONMENT ON NURSES COMPETENCIES Nor Aida M*, Krauss S.E., Mazanah M & Nik Hasnaa NM
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2.
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Cancer Resource and Education Center, Universiti Putra Malaysia, Malaysia Institute for Social Science Studies, Universiti Putra Malaysia, Malaysia Department of Human Resource Development, Razak School of Engineering and Advanced Technology Universiti Teknologi Malaysia, Malaysia
*For any correspondence: aidamaskor@gmail.com Introduction: The steady increase in cancer rates globally has led to greater interest in development of competent cancer care nurses. Competent nurses are important to ensure patients safety and positive health outcomes. Work environment can influence and empower nursing practice. Furthermore, work environment also contribute to excellent patient care. Although much research has been undertaken overseas to identify cancer care nurse competencies, a number gaps remain. The purpose of this study, therefore, was to determine the relationship between work environment and competency among cancer care nurses in Malaysia. Methods: A survey using purposive sampling technique was used to collect the data. A total of 845 cancer care nurses from selected public hospitals in Peninsular Malaysia participated in the study. The survey instrument was develop through a combination of extensive literature review, qualitative focus group data and related established instrument. For nursing competencies, three subscales were measured; (1) personal, (2) interpersonal, and (3) technical. To measure the nurses working environment, five subscales were included; (1) teamwork, (2) relationship with doctor, (3) relationship with supervisor, (5) nursing leadership, and (5) facilities control over practice. Descriptive statistics, Pearson Product-Moment Correlations and Multiple Regressions were used to analyse the data.
Results: The findings revealed a positive, significant relationship between work environment and competency of cancer care nurses (r = .607, p<0.01). This study shows that the work environment factors explain 46.5% of the competency of cancer care nurses. Regression analysis showed that teamwork ( = .362; p < .000), nurse-doctor relationship ( = .312; p < .000), and nurse-supervisor relationship ( = .083; p < .024) have contribution on nurses competencies. The main contributor is teamwork. Conclusion: In conclusion, work environment have a significant relationship with nurses competencies to provide an excellent patient care. Teamwork plays an important role in improving nurses competencies. It implies that the healthcare institution should provide a pleasant work environment to enhance nurses competencies. Keywords: cancer care nurse, competency, work environment OP C2-9 HOUSEWIVES IN SEPANG SELANGOR FAT OR FIT Sabariah AH*, Manan NA & Mohamad AR Cyberjaya of University College of Medical Sciences, Malaysia *For any correspondence: sabariah@cybermed.edu.my Introduction: Obesity increases the risk of many diseases. This study investigates differences and compares weight among housewives in rural and urban area of Sepang, Selangor. Methods: Cross-sectional studies were conducted in a village and housing estate areas in Sepang, Selangor with a sample of 196 in Kg Hulu Teris and 174 in Taman Mawar. A simple random sample of adults aged 18 years and above was selected. Data were collected by an interviewed questionnaire, physical measurements and blood collection. Result: Overall, 69% of housewives in rural and 72% in urban have at least overweight. However the rural-urban difference in waist circumference were greatest with 62% in urban has obese, whereas 100% in rural is normal. Urban housewives (86%) are
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more likely than rural housewives (76%) not having appropriate exercise. The reasons for not exercise are no time, lazy and lack of facilities. Conclusion: Though the data may not represent a larger population, it is crucial for this group of subjects to have their weight reduced by methods such as dietary control and physical exercise. Health education should also be targeted on this aspect. Keywords: housewives, fit, fat
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ORAL PRESENTATION: HEALTH MANAGEMENT / HEALTH PROMOTION
ORAL PRESENTATION HEALTH MANAGEMENT / HEALTH PROMOTION
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OP D1-1 COPING WITH DEATH: VARIATIONS BY GENDER AMONG VISITORS TO SEBERANG JAYA HOSPITAL, PENANG, WEST MALAYSIA Nur Atikah Mohamed Hussin* School of Social Sciences, Universiti Sains Malaysia, Malaysia *For any correspondence: temoseBest@yahoo.com Introduction: The aim for this study was to identify the loss of coping mechanisms among both genders. The death of the loved ones is one of the most stressful events which could happen to a person`s life. Methods: A convenience sample (N = 90: n Males = 45; n Female = 45) of visitors at Seberang Jaya Hospital, Pulau Pinang, Malaysia was interviewed. The Ways of Coping Questionnaire (WOC) were administered. The statistical program, SPSS (Statistical Programme for the Social Sciences) Student Version 17.0 (Field, 2003), was used to process the data collected from the participants. Results: Using the Mann Whitney test, it was found there is no significant difference between gender in choosing most of the coping mechanisms after the loss of their loved ones. However, there is a significant difference between gender in relation to self controlling and accepting responsibility coping mechanisms. Men scored higher for both coping mechanisms. The coping mechanisms chosen by both gender are influenced by religion, culture, education background, environment and relationship with the deceased. Conclusion: This study is a platform to a new dimension in social work field in order to understand how people cope with their loss and inspired future researches to create a service for each hospital to help families cope with their loss especially for violent death cases. Keywords: Death, coping with death, coping mechanisms, self controlling OP D1-2 HEALTH PROMOTION TARGETING MARGINALISED POPULATIONS Laurie Perkins* Suite 120, 193 Morayfield Rd, Morayfield 4506, QLD Australia *For any correspondence: lasmyth@hotmail.com Introduction: Community-based health promotion raises the level of social consciousness but how effective is it really? It often accentuates participant empowerment, creates multidisciplinary collaboration and capacity building. It stresses equity but is it really sustainable development? Methods: This presentation compares and contrasts 4 targeted collaborative health promotion programs conducted in Qld over the last 8 years. It demonstrates the strategies used and the difficulties faced to raise the level of awareness and understanding of living with a chronic illness. Results: The first of these is the Correctional Facilities Education Project which specifically targeted Blood Borne Virus Management within the prison system, the second project is the Youth detention Indigenous sexual health program, the third program is the Queensland Injectors health network outreach program which specifically targeted Injecting drug users with the aim to decrease BBV transmission and lastly the promotion of awareness of mental illness within the workplace. These four projects were coordinated by the same manager. The qualitative and quantitative data have positive and negative implications for community-based health promotion. Conclusion: The results show that the optimal standard for community-based health promotion depends on the setting and the circumstances. There is no magic bullet, one-size-fits-all or best standard. Health promotion is still a viable method of communicating a message to a marginalised population even when barriers are strategically placed to prevent it from occurring. Keywords: Marginalised population, communitybased health promotion, multidisciplinary collaboration
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OP D1-3 KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS ORGAN DONATION AMONG THE STUDENTS OF UNIVERSITI SAINS ISLAM MALAYSIA (USIM) Nazefah Abdul Hamid1*, Mohd Dzulkhairi Mohd Rani1, Marlini Muhamad1, Mohd Hairulhisyam Ngatiman1, Rosliza Ghazali1, Mustafa Afifi Ab. Halim2& Nooriah Mohamed Salleh1
1.
2.
Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Malaysia Faculty of Shariah and Law, Universiti Sains Islam Malaysia, Malaysia
a significant difference (p=0.013). The total practice score also showed a significant difference (p=0.011). Conclusion: The attitude towards organ donation is good amongst the students but in reality only 3 students have registered and donated their organs. It was also found out that there is a difference between mean of knowledge score between male and female. Hence, it is our responsibility to educate and promote organ donation amongst university students in Malaysia. Keywords: Knowledge, attitude, practice, organ donation, student OP D1-4 THE IMPACT OF MIGRAINE ON QUALITY OF LIFE IN FEMALES Munvar Miya Shaik1*, Norul Badriah Hassan2, Huay Lin Tan1, Shalini Bhaskar3& Siew Hua Gan1
1.
*For any correspondence: nazefah@usim.edu.my Introduction: Organ transplantation has become more realistic in the last recent years. In Malaysia, demand for organ and tissue transplantation is high. It is believed that the awareness to donate organs is based on good knowledge, attitude and practice amongst the public members. Hence, this study aims to determine knowledge, attitude and practice (KAP) and its association and correlation amongst USIMs students. Methods: A cross-sectional study with systematic random sampling conducted on 222 USIM students using self-administered and validated questionnaire. Results: There was no significant correlation between total knowledge and total attitude score (p=0.091, r=0.114), total knowledge and total practice score (p=0.666, r=0.029) and total attitude score and total practice score (p=0.001, r=0.213). There was a significant mean difference in the knowledge scores (p=0.048) between male and female students but not for attitude (p= 0.346) and practice (p=0.594). No correlation was found between total knowledge and total attitude (p=0.091) and knowledge and practice (p= 0.666). However, there was a correlation between attitude and practice score (p=0.001). Comparing the students from Faculty of Medicine and Health Sciences with Faculty of Shariah and Law, there is a significant difference in the mean age (p= 0.038). The total knowledge score for Year 1 and Year 6 students in the Faculty of Medicine and Health Sciences showed
2.
3.
Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Malaysia Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia Gleneagles Medical Centre, Malaysia
*For any correspondence: munvar.shaik@gmail.com Introduction: Despite advances in therapy, the prevalence of migraine has remained constant over the years. Health-related quality of life (QOL) is becoming an important outcome measure in the field of migraine. This study aimed to determine associations between migraine and QOL and to compare QOL between migraine and non-migraine controls in females. Methods: This hospital-based study was conducted in Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia, between January and May, 2013. Migraine was diagnosed at the Neurology Clinic as per criteria of the International Headache Society. A total of 100 female migraine cases and 100 nonmigraine female volunteers completed the World Health Organisation quality of life (WHOQOLBREF) questionnaire. Multiple logistic regression was used to determine association between migraine and QOL. Independent t-test and analysis of covariance (ANCOVA) were used to compare QOL
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between migraine and non-migraine controls in females. Results: The QOL scores has a significant linear association with migraine (p <0.001) and they decreased by 15% due to migraine headaches. Females with migraine had lower scores (83.43, p < 0.001) on WHOQOL-BREF compared with their non-migraine counterparts (91.90). After adjusting for age, income and years of education, QOL scores were still significantly lower (84.32, p<0.001), compared with their non-migraine controls (91.87). Conclusion: QOL score has linear association with migraine and females with migraine have significantly lower QOL compared with nonmigraine controls. Further studies are needed to determine the triggers for low QOL scores among the migraine subjects. Keywords: Migraine, quality of life, WHOQOLBREF, migraine headaches, females OP D1-5 THE EFFECTIVENESS OF DIETARY COUNSELING BY DIETITIAN ON KNOWLEDGE, ATTITUDE AND PRACTICE AND QUALITY OF LIFE OF DIABETIC PATIENTS IN KLINIK KESIHATAN BANDAR KUANTAN Nurfarhana Ezzaity Anuar1, Noraishah Mohamed Nor & Nor Azlina A.Rahman2*
1.
questionnaire were based on Likert scale. Only patients with no previous counseling by dietitian were recruited. Randomization could not be done because medical officers decided on the referral of patients to dietitian for dietary counseling. Patients in the intervention group were given at least two counseling sessions by dietitian while patients in the control group just continued with their usual followup with no counseling by dietitian. The dietary counseling given touched on diabetes itself and the different types of food that contain high refined sugar, also about carbohydrate counting in food and the importance of regular meals and exercise. Results: A total of 70 diabetic patients were recruited but only 63 of them completed this study (31 in intervention and 32 in control group). Based on the results of RM Anova, more improvement on the total score of KAP and QoL were seen in intervention as compared to control group, however the differences were not statistically significant (p-value of 0.938, 0.297, 0.278, 0.080, respectively). Conclusion: Even though not statically significant, but dietary counseling did show more improvement on diabetic patients KAP and QoL as compared to the control group. Keywords: Diabetes mellitus; dietary counseling; dietitian; KAP; QoL OP D1-6 PERCEPTION OF END USERS ON IKELAHIRAN IN SABAH STATE HEALTH DEPARTMENT Dhesi Baha Raja Selva Raja* & Cheah Whye Lian Department of Community Medicine & Public Health, Faculty of Medicine & Health Science, Universiti Malaysia Sarawak (UNIMAS), Malaysia *For any correspondence: dr.dhesi@gmail.com Introduction: I-Kelahiran (Inovasi Kelahiran) is a health informatics system that manages birth data. It was developed and implemented in June 2012 in Sabah to intervene birthing discrepancy, delayed reporting of high risk pregnancy and immunization coverage. Since its implementation, there has not been any formal evaluation on the acceptance of the system, particularly among the nurses who are the
2.
Department of Nutrition Sciences, International Islamic University Malaysia (IIUM), Malaysia Department of Biomedical Science, International Islamic University Malaysia (IIUM), Malaysia
*For any correspondence: nazara71@gmail.com Introduction: Dietary counseling is important for diabetic patients because diabetic control is very much related to the patients dietary intake and this can affect their knowledge, attitude and practice (KAP) and quality of life (QoL). The aim of this study was to assess the effect of dietary counseling by dietitian on KAP and QoL of diabetic patients in Klinik Kesihatan Bandar Kuantan. Methods: This quasi-experimental study assessed diabetic patients KAP and QoL, pre- and at least four weeks post-intervention, using an interviewguided questionnaire. The answers in the
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end user of this system. This study aims to assess the perception and acceptance of i-Kelahiran among the nurses in Sabah Health Department. Methods: It was a cross-sectional web-based study, conducted on February 2013 among nurses actively working with i-Kelahiran in 21 hospitals and 292 health clinics. A 12-items questionnaire based on perceived usefulness and perceived ease-of-use, adapted from technology acceptance model (TAM) was used for data collection. Data was analysed using SPSS version 21. Results: A total of 800 nurses participated in this study, with a mean age of 33.62 years (SD=8.060) and majority of them are community and staff nurses. About 63% of them are from primary health clinics and only 6.3% do not have any experience with computer. Mean score for both perceived usefulness 6.11 (SD=1.058) and perceived ease of use 6.14 (SD=0.952) were found to be high. Significant associations were found between perceived usefulness (p=0.001) and perceived ease of use (p=0.008) towards place of work. Significant higher score in perceived ease of use (p=0.033) and perceived usefulness (p=0.047) were found among nurses who have degree and higher qualification than those who have diploma. Conclusion: Though the study indicates that overall perceived usefulness and perceived ease of use were high, future study is needed to understand why higher qualification and place of work play an important role in determining technology acceptance behavior. Keywords: Reporting, pregnancy, health informatics system, delivery information system OP D1-7 EMBODYING KNOWLEDGE OF TEACHING PUBLIC HEALTH: QUALITATIVE STUDY Mzwandile Andi Mabhala* University of Chester, United Kingdom *For any correspondence: a.mabhala@chester.ac.uk Introduction: This research aimed to understand how public health nurse educators (PHNEs) professional knowledge could be conceptualised and to develop a substantive theory of their knowledge of teaching public health. Methods: The design of this study was influenced by constructivist grounded theory. The stages of data collection and analysis drew heavily on other variants of grounded theory. Semi-structured interviews (n=26) were used to collect data. Each interview was 60 to 90 minutes in length. Data collection and analysis occurred simultaneously. The grounded theory principles of constant comparative analysis and the iterative process of data collection and data analysis to build theory inductively. The setting for this study was the Faculty of Health and Social Care in one of the English universities. The participants were selected from the population of 98.6 full-time equivalent (FTE) nurse educators from the faculty. Theoretical sampling of participants with extensive knowledge and experience of public health, and of participants with extensive knowledge of curriculum planning and development was carried out. Results: Participants identified critical pedagogy as an appropriate pedagogical practice for embodying knowledge of public health. Conclusions: The analysis indicates that PHNEs are embodying knowledge for teaching through critical pedagogy, which involves them engaging in transformative, interpretive and integrative processes to refashion public health concepts; this requires PHNEs who possess a vision of what to teach, know how to teach, and are able to learn from experience. They believe in forms of teaching that achieve social transformation at individual, behavioural and societal levels, while also enabling learners to recognise their capacity to effect change. Keywords: Public Health Nurse Educators (PHNEs), full-time equivalent (FTE) nurse educators, embodying knowledge, critical pedagogy OP D1-8 FACTORS CONTRIBUTING TO THE DELAY OF TREATMENTS AMONG BREAST CANCER WOMEN IN UNIVERSITI KEBANGSAAN MALAYSIA MEDICAL CENTRE Raja Lexshimi RG* & Mohd Arif Atarhim Department of Nursing, UKM Medical Centre, Malaysia *For any correspondence: lex@ppukm.ukm.edu.my
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Introduction: Women with breast cancer in Universiti Kebangsaan Malaysia (UKMMC) were still found to delay their treatment after their diagnosis of breast cancer. This study aims to determine the factors contributing to the delay in treatment among women with breast cancer in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Methods: A total of 93 from 102 women who delayed for more than one month after their diagnosis were recruited into this cross-sectional study. Frequency and percentage used to analyze the data on identifying the factors contributing to the delay treatment. Chi square was used as the statistical test to identify the relationship between the factors and the delay treatment among breast cancer patient. Results: Data analysis revealed that occupational factors were found to have a significant association with delay of treatment among breast cancer patients (p <0.05). There were found to be no significant association between information received (p=0.184), perception of breast cancer illness (p= 0.499) and beliefs with alternative (p=0.107) and conventional treatment (p=0.056) with the delay treatment among breast cancer patient (p value > 0.05). In addition, there are other factors found to have also caused the delay in seeking breast cancer treatment, which consisted of patient factors (69.9%), healthcare factors (21.5%), and system factors (8.6%). Conclusion: Delay treatment still occurs nowadays even though the healthcare facilities have been improved and support from welfare enriched. The Breast Cancer team should take the necessary steps to prevent women with breast cancer from delaying conventional treatment by educating the women of the effects of traditional medicine and the proven evidence of conventional medicine and looking into other factors that could also likely cause the delay. Keywords: Breast cancer, delay in treatment, delay in conventional medicine OP D2-1 IMPROVEMENT OF AWARENESS, KNOWLEDGE AND ATTITUDES VIA INTERACTIVE ANIMATED EPILEPSY EDUCATION PROGRAMME (IAEEP) FOR CHILDREN WITH EPILEPSY
Pei Lin Lua1*, Neni Widiasmoro Selamat1, Jimmy Lee Kok Foo2 & Zariah Abd Aziz3
1.
2.
3.
Centre for Community Development and Quality of Life (CCDQ), Universiti Sultan Zainal Abidin, Malaysia Paediatric Department, Hospital Sultanah Nur Zahirah, Malaysia Neurology Department, Hospital Sultanah Nur Zahirah, Malaysia
*For any correspondence: peilinlua@unisza.edu.my Introduction: A new approach such as interactive animation in delivering effective education among children with epilepsy (CWE) is essential to improve their awareness, knowledge and attitudes (AKA). This prospective randomized interventional study aimed to assess the effectiveness of the Interactive Animated Epilepsy Education Programme (IAEEP) on AKA level. Methods: Eligible CWE from paediatric department of three general hospitals in Terengganu were randomized into control (CG) and intervention group (IG). CWE in CG were provided with printed epilepsy education programme while those in IG interacted with the IAEEP. AKA level was assessed using the Malay AKA For Paediatric at baseline, follow-up 1 (Day-1) and follow-up 2 (Day8). Descriptive statistics and non-parametric tests were employed (SPSS 20). Results: Thirty-two CWE (median age = 11.5 years; male = 50.0%; Malay = 87.5%; primary school = 53.1%) participated. CWE in CG did not show any significant changes in all domains. However, there were significant improvements for all domains over the time for IG [Awareness, X(2) = 30.154, P=0.001; Knowledge, X(2) = 31.388, P=0.001, Attitudes, X(2) = 30.720, P=0.001]. Subsequently, post-hoc analysis demonstrated that there were significant improvements between two time intervals for all domains [baseline vs. follow-up 1, P=0.001 and baseline vs. follow-up 2, P=0.001]. Conclusion: The potential of interactive animation as an effective educational tool to enhance CWE AKA has been preliminary shown. Keywords: Children with epilepsy, interactive, animated, education, awareness, knowledge, attitudes.
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OP D2-2 HAEMODIALYSIS IN JORDAN: SOCIODEMOGRAPHIC DATA, CLINICAL ANALYSIS AND PROJECTING BURDEN Emad Adel Shdaifat1* & Mohd Rizal Manaf 2
1.
Department of Technology Application & Human Resource Development, National Taiwan Normal University *For any correspondence: hsun520@gmail.com Introduction: Global climate change and environmental pollution have resulted in heat waves, COPD, and SARS, which affect the health of everyone. Determining the means to increase health adaptation ability to cope with these health threats is crucial. Unfortunately, the nature of health adaptation ability is not well understood. The purpose of this study was to construct a health adaptation model to understand the influence of health adaptation ability on a health promoting lifestyle. Methods: For data collection, this study developed a scale with which to designate the health adaptation model (HAM) of participants. Data statistical analysis was used with SEM. Results: The scale of average composite reliability was 0.82, (>0.7), indicating good internal consistency. Convergent validity was 0.60 (>0.5). The statistical power to be 0.84 with regard to the fit index of the model, the chi-squared value 2 (BollenStine calibrated p-value) was 64.27 (p=.999), which did not reach a level of significance. Other fitness indices such as GFI (0.97) and AGFI (0.91), NNFI (0.99), IFI (0.99), and CFI (0.99) exceeded 0.9 while RMEA (0.04) is less than 0.08 and SRMR (0.16) is less than 0.5, indicating that the health adaptation model provided a strong fit. Lastly, in relation to model effects, the path coefficients between the latent variables of the model ranged from 0.30 to 0.63, reaching a level of significance. Health awareness (0.69) had the most significant effect on a healthpromoting lifestyle. Conclusion: The health adaptation model was shown to possess strong reliability, validity and statistical power, demonstrating that it can be used to effectively measure individual health adaptability. The strong model fit also indicated that the model was consistent with observed data and can effectively explain the influence of health adaptability on a health-promoting lifestyle. Keywords: Health adaptation model, health adaptation ability, health promoting lifestyle
2.
Nursing Department, Faculty of Health Science, Universiti Teknologi MARA, Malaysia Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia
*For any correspondence: Emad_594@yahoo.com Introduction: Haemodialysis is a destructive medical, social and economic difficulty for patients and health care system. The purpose of the study was to explain the Socio-demographic characteristics of haemodialysis patients, their economic burden, besides the Projected cost in upcoming. Methods: A cross sectional research was performed in 2010 at Ministry of Health, Jordan. One hundred and thirty eight male and female patients with mean age 45 years were engaged in the study. Results: The total number of patients was 2890 and the prevalence was 473 per million populations. Approximately 68% of them not working and about 20% of patients were dialyzed 12 hours/week. The yearly cost per patient was USD 9976, and the cost per treatment was USD 72. Consequently, the nationwide burden of haemodialysis patients was USD 38.26 million annually and by 2028; the estimated burden of haemodialysis will be USD 147.65 million. Conclusion: focus on approaches and treatments to reduce the disease progress and to accelerate the set up of National Kidney Registry, which will be the precise and formal source of statistics of dialysis patients. Keywords: Haemodialysis, Socio-demographic Data, Projecting Burden OP D2-3 CONSTRUCTION OF HEALTH ADAPTATION MODEL Chih-Hsun Huang* & Chien Yu
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OP D2-4 CIVIL SERVANTS VALUATION OF CARIES PREVENTION PACKAGE Nurul Ashikin bt Husin* & Asma' bt Mohammed Department of Community Dentistry, Faculty of Dentistry, University of Malaya, Malaysia *For any correspondence: qew1202@gmail.com Introduction: Oral health needs among adults in Malaysia remain high. Among the oral diseases, caries prevalence is high (90.3% in 2000) and the caries severity increased with age. The complexities of treatment incur substantial cost. This paper attempts to measure the monetary value that people relate to primary caries prevention programme in Malaysia. The objectives were to determine the willingness to pay (WTP) value for primary caries prevention package and describe the factors influencing peoples preferences. Methods: A cross-sectional survey was conducted among civil servants working in six divisions under the Melaka State Health Department. The survey was conducted in the following manner: a) Face to face interview for hypothetical question using the Stated Preference technique (Contingent valuation method) to measure Willingness to pay (WTP) b) Selfadministered questionnaire to capture staffs details. All data were analysed using Statistical Package for the Social Science (SPSS) version 16.0. The test of significance was Mann-Whitney and Kruskal-Wallis. Results: A total of 188 civil servants participated. WTP for primary prevention was 40MYR (13USD). This amount was just a little more than one-third of the total floor price (105MYR) proposed by Malaysian Dental (MDA); which covered the price of consultation [25MYR (8USD)] and fluoride therapy [80MYR (26USD) and above]. Higher WTP value was observed among: female, Professional & Managerial group, those with no dependent family members, those with degree & higher qualifications, those in higher income group, those who able to own proxy assets, those who owned a medical insurance with dental benefits, those frequently did routine dental check-up and those preferred private dental facilities. Conclusion: The civil servants in this study valued the caries prevention however they are not ready to pay the actual consumption cost. Keywords: Willingness-to-pay, contingent valuation method, caries, fluoride OP D2-5 DESCRIBING THE PROPORTION AND CHARACTERISTICS OF UNPROTECTED POPULATION BY HEALTH ASSURANCE SCHEME IN PADANG CITY INDONESIA Ade Suzana*, Syed Aljunid & Amrizal M Nur United Nations University, International Institute for Global health (UNU-IIGH) *For any correspondence: adesuzana@gmail.com Introduction: The long-term treatment for NCDs forced households to expend expensive costs which may push the households toward poverty line. To protect the poor from catastrophic health expenses, Indonesian government is aiming at universal health coverage (UHC) on 2019 through social health insurance (SHI). This study is aimed to describe the proportion of health insurance coverage in Padang City, Indonesia and to find out the characteristic of this population. The result will be a valuable input for the government to plan SHI expansion and UHC achievement. Methods: A household survey is conducted with 961 samples of households in 9 sub-districts out of 11 sub-districts in Padang during February to April 2012. The sampling unit was households, derived by using universal sampling from 9 smallest administrative structure of Padang City called RT in each sub-districts which contains 40 to 120 households whereas those RT were chosen by multistage random method. Descriptive statistics was used to figure the proportion of the population who are not and covered by health assurance scheme whilst analytic statistics found the characteristic of the population. Results: The number of households that were protected by health insurance was 50.3%, with more than 50% of them were covered by subsidized scheme for the poor. Household characteristics which have significant differences (p value < 0.05) between
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the covered and uncovered households were age of the head of household, economic level of household, number of family members, occupation of the head of household and education attainment of the head of household. Conclusion: This study suggests that population characteristics which shall be considered by the government to achieve UHC is the lower health assurance protection among low economic level households, non-formal workers and low education attainment population. Furthermore, the evaluation of the impact of UHC especially toward NCDs treatment among the poor is needed. Keywords: Social Health Insurance (SHI), Universal Health Coverage (UHC), long-term treatment for NCDs OP D2-6 ILLNESS PERCEPTION AMONG HYPERTENSIVE PATIENTS ATTENDING POLYCLINICS IN KUCHING, SARAWAK Haironi Yusoff* & Rasidah Abd Wahap Department of Community Medicine & Public Health, Faculty of Medicine & Health Sciences, Universiti Malaysia Sarawak, Malaysia *For any correspondence: yhaironi@gmail.com Introduction: The prevalence of hypertension is increasing worldwide and knowledge on patients perception may have an impact in the compliance to treatment. Methods: In order to assess the perception of illness among hypertensive patients, a cross-sectional study was conducted among those attending the three main polyclinics in Kuching. A total of 150 hypertensive patients were randomly selected. A revised version of the Illness Perception Questionnaire for hypertension (IPQ-r) was used. The IPQ measures perception based on timeline, emotional control, consequences, personal control, treatment, cyclical nature of hypertension and identity. Only 100 patients completed and returned the questionnaires. Results: There were 59 females and 41 males. Of those, 30 were Malays, 42 Chinese and 28 comprised of other ethnic groups (Iban, Bidayuh, Melanau). The mean age was 58.29 years ( 10.03), and the mean duration of hypertension was 10.15 years (7.33). Most of the patients (97%) were on medication, with 43% on combined antihypertensive. Positive personal control was higher among females as compared to males (2 = 4.98, df = 1, p = 0.026), and was also higher among housewives as compared to other professions (2 = 14.02, df = 3, p = 0.003). The housewives were shown to be better able to identify their symptoms of hypertension (2 = 8.48, df = 3, p = 0.037). In addition, smokers were noted to have a lower positive personal control (2 = 4.44, df = 1, p = 0.035). For treatment, more males had a negative notion that they will be able to control their hypertension (2 = 5.25, df = 1, p = 0.022). In comparing the ethnic groups, the Chinese were more likely to perceive the chronicity of their condition as compared to other races (2 = 8.33, df = 2, p = 0.016). Conclusion: Results of this study may have implications on the compliance of patients to treatment and coping strategies in managing their hypertension. Keywords: Hypertension, illness perception, Illness Perception Questionnaire for hypertension (IPQ-r) OP D2-7 PROMOTING PRIMARY CARE SMOKING CESSATION SUPPORT WITH QUITLINE: THE EXPERIENCE OF SMOKE-FREE MELAKA PROJECT Noraryana Hassan1*, Ismail Ali1, Maizurah Omar2, Sulastri Samsudin2 &Haslina Hashim2
1. 2.
Melaka State Health Department, Malaysia Clearinghouse for Tobacco Control, National Poison Centre, University Sains Malaysia, Malaysia
*For any correspondence: noraryana@mlk.moho.gov.my Introduction: Cessation support and medication have been proven to increase the likelihood of smokers quitting successfully. Guidelines for the implementation of Article 14 in the WHO FCTC recognize that quitline is one of the key components of a system to help tobacco users quit. In 2011, the Quitline service has been piloted with the Smoke-free Melaka Project in collaboration with the Melaka State Health Department. To describe the
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characteristic of the Melaka residents who utilized the first telephone cessation service in Malaysia and evaluate its effectiveness. Methods: Since 1st January 2011 until 31 December 2012; all patients who visited the primary health care clinics received brief advice and were offered help to quit smoking. Those who wish to quit within a month were registered to the Quitline program. All clients were provided with scheduled motivational interviewing sessions within 1 month and followedup after 6 month Results: By the end of 2012, a total of 287 clients were registered. Melaka Quitline clients were mainly Malay, males, age 26 to 35 years, married, received secondary education, smoke at 20 cigarettes per day or less at the time of study and had tried quitting at least once in the past. Majority of clients smoked less than 31 years with the mean duration of 24 years. Almost half of the clients reported that they began smoking at the age of 13 17 years. The earliest initiation age was 5 years old. Out of the 287 registered clients, only 32% were successfully followed-up. At one month, 38% of them reported that they had not smoked a cigarette for the past 30 days, 51% had not smoked for the past 7 days and 19.6% successfully quit after 6 month. Conclusion: The smoke-free project with quitline can increase delivery of cessation support for primary care patients. Therefore, the data from both the Quitline services and quit clinics in Melaka should be integrated for a more efficient cessation program. Keywords: Primary care, smoking, cessation program, cigarette smoking, Quitline, quit clinics OP D2-8 MANAGED CARE: WHAT DO PRIVATE GENERAL PRACTITIONERS (GPS) THINK? Shamsinar Ibrahim*, Mohd Rizal Abd Manaf & Azimatun Noor Azimuddin Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: shamsinaribrahim05@gmail.com Introduction: Little research on managed care arrangement in local health industry even though it has penetrated the market many years ago. To date there is almost no comprehensive documentation that records whether managed care arrangement has either positive or negative experience on Private GPs. As the result, little was known about the private practitioners perception during their experienced working within managed care arrangement. Therefore, the goal of this study is to explore the private GPs perception towards the implementation of managed care and to provide empirical factors that might influence the perceptions. Methods: This study was a cross-sectional study participated by 157 GPs works within the vicinity of Kuala Lumpur and Putrajaya. Data collected were from August until November 2012. Thirty-three selfdeveloped questions asked were consisted of sociodemographic factors, GPs criteria factors, managed care issues factors and perception towards managed care arrangement. Results: The study shows age factor has an influenced to perception score. This differences was significantly proven t=2.009, p=0.04, which younger GPs have higher perception score than their counterparts. This study found no differences in any of GPs criteria factors and perception scores. Quality of care was spotted to have a fair correlation with perception score and this relationship is statistically significant r=0.39, p=0.00. Extended analysis of multivariate indicated race (B=0.158), GPs years of practice (B=-0.149), GPs clinic duration (B=0.168) and quality of care (B=0.436) as predictors succumb to 20% variance in perception score. Overall, majority of 102 GPs reported a negative, low perception towards managed care arrangement that is the finding consistent with previous studies Conclusion: The study describes the characteristics of private GPs and the perception they held on the issues involving managed care arrangement. The current perception of private GPs provides an important piece of the mosaic of evidence for health policy makers to seriously taken managed care arrangement into consideration and action. It could be utilized to access the magnitude of managed care problem, including populations, which are most vulnerable, the patients and the front-liner, the doctors. Further study is essential to acknowledge other area that related to managed care implementation. Keywords: Managed care, perception, private general practitioners, managed care organizations (MCOs).
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POSTER PRESENTATION: EPIDEMIOLOGY / STATISTICS
poster PRESENTATION EPIDEMIOLOGY & STATISTICS
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PP1 THE EFFECTIVENESS OF LIFESTYLE INTERVENTION AMONG PRE-DIABETES PATIENTS IN MELAKA, MALAYSIA Norma Sabtu1*, Nor Aryana Hassan2, Azmi Mohd Tamil1 & Zaleha Md Isa1
1.
2.
Department of Community Health, Faculty of Medicine, UKM Medical Centre (UKMMC), Malaysia Non-Communicable Disease Unit, State Health Department of Melaka, Malaysia
*For any correspondence: drnorm68@yahoo.com.my Introduction: The aim of this study is to evaluate the effectiveness of lifestyle intervention on physical (weight, body mass index (BMI), blood pressure, waist circumference) and biochemical (fasting blood sugar (FBS), 2 hours postprandial (2HPP), and lipid profile) parameters among individuals with prediabetes. Methods: This study involved 185 pre-diabetics patients from fourteen selected health clinics in Melaka. The patients were divided into three groups based on the intervention that they received the namely lifestyle intervention (n=62), pharmacological intervention (n=60), and a control group (n=63). Each clinic applied only one type of intervention. The control group received only the conventional education. The lifestyle intervention group underwent group and individual dietary counselling together with an exercise programme, and the pharmacological intervention group was given the oral Metformin (500 mg b.i.d). Results: Both blood glucose profiles included FBS and 2HPP with the mean difference of 0.24 0.94 mmol/L were significantly reduced in the lifestyle intervention group. Waist circumference and LDLcholesterol were significantly reduced while HDLcholesterol was significantly elevated in both lifestyle and pharmacological intervention groups. The greatest reduction of body weight and BMI were seen in pharmacological intervention group with the mean difference of 2.06 2.68 kg and 0.89 1.17 kg/m2 respectively as compared to the lifestyle intervention
and the control group with the mean difference of 1.49 2.98 kg, 0.46 2.02 kg/m2; 0.61 1.16 kg, 0.10 1.03 kg/m2 respectively. The lifestyle intervention showed significant reduction in weight (p=0.004), BMI (p=0.023) and waist circumference (p=0.005) as compared to the control group. As for multivariable analysis, the lifestyle intervention still had an effect on fasting blood sugar (FBS), 2 hours postprandial (2HPP), and body mass index (BMI) after all the baseline differences were controlled. The lifestyle intervention showed the greater decreased in FBS (0.279 mmol/L) than pharmacological intervention (0.245 mmol/L). Conclusion: Lifestyle intervention was effective in reducing blood sugar profile of pre-diabetic patients as compared to the pharmacological intervention and the control group. Keywords: Prevention T2DM, primary intervention, impaired glucose tolerance, pre diabetes. PP2 FACTORS ASSOCIATED WITH DIABETIC RETINOPATHY AMONG TYPE 2 DIABETES PATIENTS IN PAHANG Noor Azurah Wan Chik & Khalib Abdul Latiff* Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: noorazurah.wchik@gmail.com Introduction: Diabetic retinopathy (DR) has emerged as a leading complication of diabetes mellitus that is becoming an important public health concern. This study focused on the associated factors of the development of DR. Methods: This was a cross-sectional study using secondary data from the electronic National Diabetes Registry database. A total of 7 government health clinics in Temerloh, Pahang participated and contributed a total of 1201 patients from June 2011 until June 2012. Demographic data, treatment modalities, as well as various risk factors of DR were reported. Data were analysed using SPSS version 20. Independent associated risk factors were identified using multiple logistic regression analysis.
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Results: Prevalence of DR was 10.1%. DR was significantly associated with non-Malay ethnicities (p=0.003), a higher value of HbA1c (p=0.049), coexistence of hypertension (p=0.001), coexistence of dyslipidaemia (p=0.022) and insulin usage (p=0.005). Other variables consisting of age, gender, body mass index (BMI), blood pressure, cholesterol level, low density lipoprotein (LDL) cholesterol level, high density lipoprotein (HDL) cholesterol level and triglyceride (TG) level did not show any significant associations with DR. In multiple logistic regression analysis, there were strong significant associations between the development of DR and non-Malay ethnicities (OR = 1.764, 95% CI 1.166 2.670), insulin usage (OR = 2.035, 95% CI 1.361 3.042) and coexistence of hypertension (OR = 2.174, 95% CI 1.2753.707). Conclusion: There were statistically significant associations between retinopathy and non-Malay ethnicities, coexistence of hypertension and insulin usage. Monitoring and evaluation of these related factors will likely contribute to the prevention and treatment of DR in the future. Keywords: Diabetes mellitus, diabetic retinopathy, non-Malay ethnicities, coexistence of hypertension and insulin usage PP3 LESSON LEARNT IN CHOLERA OUTBREAK, BINTULU SARAWAK, 2012 Razitasham Safii1* & Azlee Ayub2
1.
acute gastroenteritis were positive for Vibrio cholera in Bintulu. Methods: Outbreak investigation started immediately with case investigation, contact tracing, rectal swab for all contact with presumptive treatment of doxycycline. Environmental assessment including the food outlet, food sampling, water and environmental sampling. Results: From a total of 111 confirmed cases, 63 (56.8%) were asymptomatic. The main symptoms were diarrhoea (87.2%), nausea and vomiting (46.8%) and abdominal pain (38.3%). Among the asymptomatic cases, 22 were food handlers. All were due to Ogawa serotype and only one Inaba. Food samples were positive for Staph.aereus, Salmonella and E coli but negative forVibrio cholera. Water samples were low in chlorine but negative for pathogenic organisms.It was a propagated source of infection. The genotyping was similar in all positive cases which indicate the same source but differed from Limbang outbreak. The presentation of positive cases was not typical. The presence of asymptomatic cases make outbreak control more difficult and presumptive treatment is vital to reduce the transmission.The source of infection was unknown but most probably from contaminated food by the asymptomatic food handler. Conclusion: Cholera in Sarawak is still a public health threat. Recurrent outbreak is possible if poor sanitation, poor water supply and poor food hygiene still exist. Keywords: Vibrio cholera, cholera outbreak, Sarawak PP4 WHO ARE AT RISK FOR DEPRESSION AMONG TYPE II DIABETICS? A STUDY IN KLANG VALLEY, MALAYSIA Gurpreet Kaur1*, Tee Guat Hiong1, Suthahar Ariaratnam2, Ambigga S Krishnapillai2 & Karuthan Chinna3
1.
2.
Communicable disease section, Sarawak Health Department, Malaysia Bintulu Divisional Health Office, Malaysia
*For any correspondence: razitasham@srwk.moh.gov.my Introduction: Sarawak was endemic for cholera since the Rajah Brookes Era. The presence of Vibrio cholera in the aquatic environment in Sarawak was well documented in 1998. However since 2000, no case of cholera reported until the outbreak in Limbang Division in 2011. On 14th July 2012, another outbreak was declared after a few cases of
2.
3.
Institute for Public Health, Ministry of Health, Malaysia Faculty of Medicine, UniversitiTeknologi MARA, Malaysia Department of Social and Preventive Medicine, University of Malaya, Malaysia
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*For any correspondence: dr.gurpreet@iku.moh.gov.my Introduction: Diabetes mellitus is a highly prevalent condition in Malaysia, increasing from 11.6% in 2006 to 15.2% in 2011 among individuals 18 years and above. Co-morbid depression in diabetics is associated with hyperglycaemia, diabetic complications and increased health care costs. This study describes the prevalence and predictors of depression in Type II diabetics attending government primary care facilities in the Klang Valley, Malaysia. Methods: The study was cross sectional in design and carried out in 12 randomly selected primary care government clinics in the Klang Valley, Malaysia in 2010. A total of 2508 eligible respondents 30 years and above gave written consent to participate in the study. The Depression, Anxiety and Stress Scale (DASS) 21 questionnaire was used to measure depression, anxiety and stress symptoms. The datawere analysed using the SPSS version 17 software using both descriptive and inferential statistics. Results: The overall prevalence of depression was 11.5%. In bivariate analysis, depression was found to be significantly associated with sex, ethnicity, educational level, monthly household income, and marital status, and current job status, duration of diabetes and family history of psychiatric illness. Using multiple logistic regression, females, Asian Indians, those who never or were previously married, family history of psychiatric illness, duration of diabetes of < 2 years and current alcohol drinkers was found to be significant predictors of depression Conclusion: The study showed a significant prevalence of depression among Type II diabetics. As part of a holistic approach in managing diabetes, screening for depression is recommended at regular intervals. Further research is also essential to identify effective depression intervention strategies at the primary care level. Keywords: Depression, prevalence, predictors, Type II diabetes, primary health care, Malaysia PP5 SELF-MONITORING OF BLOOD GLUCOSE LEVEL AND GLYCAEMIC CONTROL AMONG TYPE 2 DIABETES MELLITUS PATIENTS ATTENDING AN URBAN HEALTH CLINIC IN KUALALUMPUR Hasimah Ismail1*, Rashidah Ambak1, Tahir Aris1, Lim Kuang Kuay1, Lim Kuang Hock1 & Akmal Naziah2
1. 2.
Institute of Public Health, Malaysia Medical Development Division, Ministry of Health, Malaysia
*For any correspondence: hasimah.i@iku.moh.gov.my Introduction: Diabetes is a chronic disease that affects the well-being of human life due to the high morbidity and mortality and it is an epidemic in Malaysia. Self-monitoring of blood glucose (SMBG) provides immediate information on a persons glycaemic level and thus, could be an important guide for adjusting factors that affect glycaemic control. It is a timely basis monitoring compared to the HbA1c. To determine the prevalence of selfmonitoring of blood glucose and its association with glycaemic control among type 2 diabetes mellitus patients attending an urban health clinic in Kuala Lumpur Methods: A cross-sectional study was conducted among 307 patients diagnosed with type 2 diabetes mellitus aged 18 years and above. All respondents that meet the inclusion criteria were selected. Pretested structured questionnaires with guided interview were used to collect the data. Good glycaemic control was defined as HbA1c level <6.5%. Results: The study found that only 16.9% (n=52) of respondents performed self-monitoring blood glucose to control their diabetes. The majority is female (61.5%), aged 65 and above (40.4%), educational level of secondary school (63.5%), married (82.7%), Malay (78.8%) and RM 501 - RM 1000 of income (30.8%). Among them 94.0% monitored at least once per day and only 6.0% monitored at least twice per day. The study also showed that most of the
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respondents (82.7%) perform self-monitoring less than three times per week. However the majority of patients had HbA1c 6.5%, indicated a poor glycaemic control (n=42, 80.8%). Statistical analysis showed that there was no significant association between self-monitoring of blood glucose and reduction of HbA1c. Conclusion: Previous studies have shown monitoring of blood glucose give positive effect in controlling diabetes, but it was not found in this study. Further study with larger sample size and other factors associated with glycaemic control are needed to prove this. Keywords: Diabetes mellitus, glycaemic, clinic, urban PP6 PREVALENCE OF NON-COMMUNICABLE DISEASE AMONG RURAL POPULATION IN BATU PAHAT JOHOR Linayanti Rosli1*, Marina Mohd Said2 & Arbaiah Othman1
1. 2.
population. However the prevalence of obesity was higher among female (31.7%) as compared to male (24.2%). 7.9% percent were newly diagnosed or known case of diabetes, 22.3% were found to be hypertensive while 19.9% were smokers. Conclusion: High prevalence of overweight and obesity among the rural population requires an urgent intervention program focusing on physical activity and healthy diet to prevent obesity associated diseases. Keywords: Non communicable disease, rural population PP7 RISK FACTOR IDENTIFICATION FOR EXTRA PULMONARY TUBERCULOSIS IN KLANG DISTRICT: TWO YEAR RETROSPECTIVE STUDY Nirmalah Subramaniam*, Mohd Helmi Zakariah, Che Azlan Shah Shahari, Noriah Ismail & Noormala Zakaria Klang District Health Office, Malaysia *For any correspondence: drnimmi76@yahoo.com Introduction: Tuberculosis (TB) can affect almost any organ of the body and although the most common presentation is pulmonary, extra pulmonary disease is not rare. The proportion of extra pulmonary tuberculosis cases in the Klang District has increased from 12.1% of tuberculosis cases in 2011, to 14.3% cases in 2012. Hence the recognition and diagnosis of extra pulmonary lesion are likely to assume a greater importance in the foreseeable future. The aim of the study is to determine associations between the demographic, clinical, and lifestyle characteristics of patients with tuberculosis and the occurrence of extra pulmonary tuberculosis. Methods: A retrospective analysis was carried out on 1112 Tuberculosis (TB) patients, representing 147 EPTB and 965 PTB cases diagnosed in Klang District, from January 2011 to December 2012. Characteristics of demography, lifestyle and clinical features were obtained from TBIS records. Differences in categorical risk factors in extra pulmonary will be shown using Pearson's chi-square test. All risk factors of interest will be determined in
Batu Pahat Health Office, Malaysia Parit Raja Health Clinic, Malaysia
*For any correspondence: drlinayanti@yahoo.com.my Introduction: The rise of Non Communicable Disease (NCD) epidemics in rural population has important public health implications whereby early prevention will reduce mortality and morbidity from these diseases. This study aims to determine the prevalence of NCD among the rural population as part of the situational analysis for further intervention program. Methods: A cross sectional study was carried out in Jun 2012 in 7 rural areas in Batu Pahat Johor selected using stratified sampling. The living quarters in each rural area was selected via systematic sampling. Structured questionnaires with face to face interview, clinical examination and biochemical assessment were performed. A total of 2389 participants aged 18 and above were involved in the study. Results: 55.6% of the respondents were female and 89.9% were Malays. The prevalence of overweight was 34.3% while obesity accounts for 28.3% of the
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multiple logistic regression analysis and 95% confidence intervals to determine those risk factors associated with extra pulmonary tuberculosis. Results: Risk factors for EPTB vary. Age was associated with EPTB and the odds ratio of age group range from 3.24-4.83folds more common with age group of (<50 years). DM patients were an independent risk factor for EPTB in Klang District with an OR of 2.51 (CI 95% 1.15, 5.85). The most common site of EPTB was lymph node tuberculosis (1.8%), followed by osteoarticular tuberculosis (1.8%). In addition, milliary and meningeal tuberculosis each encountered (0.9%). Conclusion: This study contributes to a better understanding of the factors associated with EPTB. The identification of groups at higher risk may help in the early detection of cases. Keywords: Tuberculosis, extra pulmonary Tuberculosis, risk factor PP8 HUMAN BRUCELLOSIS: THE JERANTUT DISTRICT EXPERIENCE site visit to the farms, reviewing surveillance data on Brucellamelitensis screening of goat and sheep (2011-12) and interviewing patients, farm workers, family members and veterinary staff. The investigations at the farm were conducted by the Veterinary Department. The farm workers were also screened. All samples were tested for Brucella antibody by ELISA IgG and IgM tests. Results: The patient presented with arthralgia, myalgia, and severe lower back pain which later develops Caudal Equine Syndrome. He was treated as para-vertebral abscess (L4, L5) since May 2011. He consumes pasteurised goats milk as a regular basis but sometimes taking non pasteurised milk (Lyes farm). Three farms and four shops selling unpasteurized goat milk were identified. Twelve goats blood and eight milk samples for serology were taken however no IgM/IgGfor Brucella were detected. Three farmer blood samples and three milk samples from shops was found negative. All interviewed were well except Mr. Lyes wife and son that were admitted in 2010 for septicaemia and tested IgGBrucella positive. In 2011-12, 14 (0.3%) surveillance samples show IgM positive for Brucella. Conclusion: This is a first case of brucellosis in Jerantut and most likely caused from unpasteurised milk. Routine screening of livestock, followed by culling of all infected animals must be strictly implemented. Keywords: Brucellosis, non pasteurised goats milk, zoonosis PP9 PROGRESS OF JOURNEY TOWARDS MALARIA ELIMINATION IN SARAWAK Ooi Choo Huck*, Sarina Shuib, Jamilah Hashim, Jitos Gubes, Jurizam Saili, Mitchell Jahai & Mohd Faizal Ali Sarawak Health Department, Malaysia *For any correspondence: ooi.choo.huck@gmail.com Introduction: Malaria elimination aims at the sustainable interruption of local malaria transmission by mosquitoes despite a continued presence of malaria vector mosquitoes and importation of
FIRST
Wan Abdul Rahim B Wan Muhammad1*, Mohamed Sapian B Mohamed2 & Mohd Rahim B Sulong3
1. 2.
3.
Jerantut District Health Office, Malaysia CDC Unit Pahang State Health Department, Malaysia Rompin District Health Office, Malaysia
*For any correspondence: drwanabdrahim@phg.moh.gov.my Introduction: Brucellosis in human is rarely fatal and caused by Brucellaspp., a zoonosis that has been routinely screened among livestock in Malaysia. It can be encountered in ruminant animals. In April 2012, fifty seven years old Chinese man, mechanic from Jerantut was found positive for Brucellamelitensis in his blood culture. The investigation was conducted to describe the infection, to identify the source and to initiate control activities as well as preventive measures. Methods: This is a descriptive study. It was started with tracking the source of goats milk sold in Jerantut. Epidemiological investigations included a
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parasites from abroad through international travel and migration. Sarawak embarked on malaria elimination in 2011 and has set 2020 as its deadline for elimination of malaria transmission. Methods: A retrospective descriptive analysis was conducted on malaria epidemiology data routinely collected through the Sarawak State Health Department's Malaria Surveillance Information System between January 2010 and December 2012. Results: As for the locally transmitted P. falciparum infections in Sarawak, sixty-nine cases were reported in 2010 as compared to twelve cases in 2012 (reduction of 82.6%). There were fifty-four P. falciparum foci in 2010 as compared to seven foci in 2012 (reduction of 87.0%). There were four P. falciparum outbreaks in 2010 with four outbreak foci and ten cases in involved in the outbreaks as compared to two P. falciparum outbreaks (reduction of 50.0%) in 2012 with two outbreak foci (reduction of 50.0%) and eight cases (reduction of 20.0%) in involved in the outbreaks. In 2010, 2,132 locally transmitted P.vivax were reported as compared to 301 cases in 2012 (reduction of 85.5%). There were 302 P. vivax foci in 2010 as compared to ninety-nine foci in 2012 (reduction of 67.2%). There were fifty P. Vivax outbreaks in 2010 with forty-four outbreak foci and 1,420 cases in involved in the outbreaks as compared to fourteen P. vivax outbreaks (reduction of 72.0%) in 2012 with thirteen outbreak foci (reduction of 70.5%) and 111 cases (reduction of 92.2%) in involved in the outbreaks. Conclusion: Malaria Elimination activities in Sarawak have significantly reduced the incidence and outbreaks of locally transmitted P. falciparum and P. vivax from 2010 to 2012. Keywords: Malaria, Elimination, Sarawak, Epidemiology, Incidence, Plasmodium, vivax, falciparum PP10 LESSONS LEARNED FROM THE SPREAD OF INFLUENZA A IN A PRIVATE HOSPITAL IN PENANG Saraswathi Bina Rai1*, Vasantha Thiruvengadam2, Anand Sanmarkan2 & Hafiz Abdullah2
1. 2.
State Health Department, Penang, Malaysia Timur Laut District Health Office, Malaysia
*For any correspondence: binarai@yahoo.com Introduction: Surveillance for Influenza A (H1N1) in Malaysia has been in place since 2009. On 7th January, 2013 under the regular notification process, a case of Influenza A (H1N1) was notified to Timur Laut District Health Office from a private hospital in Penang. This was followed by 3 notifications amongst staff nurses in the same hospital on the 14th January, 2013. An investigation was carried out to assess the extent of the spread of the disease, to institute control measures and to identify weakness that allowed for this spread. Methods: Active case detection and interviews were conducted. A case was defined as any staff working in the hospital presenting with symptoms of influenza-like illness and tested positive for Influenza A. The process of barrier nursing and infected control in the affected wards was observed. All patients with influenza-like symptoms were tested for seasonal influenza A and Influenza A (H1N1) by real time PCR. Results: Out of the 750 staff in the hospital, 20 nurses and 4 other staff were infected with Influenza A. Out of this 11 were positive for Influenza A (H1N1). The initial cases were 3 staff nurses in the intensive and high dependency unit who had taken care of an influenza A (H1N1) patient prior to their illness. Inadequate barrier nursing, non-adherence to infection control and staff not being protected with the seasonal influenza vaccination resulted in the spread within the hospital. Control measures instituted and vaccination of staff helped to curb the outbreak. Conclusion: Private hospitals need to have a vaccination and a disinfection policy for their staff and administrators need to ensure that these are adhered to. Keywords: Influenza A (H1N1), hospital outbreak, control measure
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PP11 RELIABILITY OF KNOWLEDGE, ATTITUDE AND PRACTICES TOWARDS PREVENTION ON CNS TUBERCULOSIS AMONG HEALTH CARE WORKERS Farhanah Abd Wahab1*, Sarimah Abdullah1, Jafri Malin Abdullah2 & Wan Mohd Zahiruddin Wan Mohammad3
1.
2.
3.
Unit of Biostatistics, Universiti Sains Malaysia, Malaysia Department of Neuroscience, Universiti Sains Malaysia, Malaysia Department of Commmunity Medicine, Universiti Sains Malaysia, Malaysia
Cronbachs alpha coefficients were more than 0.7, these findings reinforced the reliability evidence of the knowledge, attitude and practice questionnaire. Conclusion: The study provides evidence that the knowledge, attitude and practice questionnaire have a good internal consistency reliability measure. It is reliable and sensitive to be applied to assess persons knowledge-attitude-practice towards CNS tuberculosis. Keywords: Tuberculosis, central nervous system, knowledge, attitude and practice, prevention PP12 PROGNOSTIC FACTORS CANCER IN MALAYSIA Norsaadah Bachok*
OF
BREAST
*For any correspondence: sarimah@kb.usm.my Introduction: Tuberculosis (TB) of the central nervous system (CNS) is a highly devastating form of tuberculosis and risk of transmission, particularly for health care workers is high. By having good knowledge, attitude and practice towards prevention of CNS TB is likely to reduce the chance of transmission among them. Objective: To assess the reliability of knowledge, attitude and practices towards prevention of CNS TB among health care workers. Methods: A cross-sectional study was done on 36 HCWs who worked as health care workers at neuromedical, neurosurgery and forensic unit in a tertiary hospital located in North-East Malaysia. A modified KAP questionnaire of TB was used to and reliability analysis was applied to assess the internal consistency reliability of the questionnaire. Results: The socio-demographic results of the total 36 respondents showed that the average age was 34 years old, majority in grade U29 and 30 of them came from neurology wards while the balance of the forensic unit. Reliability analysis showed that the total Cronbachs alpha value of knowledge, attitude and practice of CNS tuberculosis prevention among healthcare workers in a tertiary hospital located in North-East Malaysia was 0.841 which indicated a high level of internal consistency. The Cronbachs alpha values of KAP for CNS tuberculosis were 0.923 0.754 and 0.812 respectively. Since all the
Unit of Biostatistics & Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia *For any correspondence: norsaadah@kb.usm.my Introduction: Breast cancer is one of cancers that have a good prognosis if treated early. Identification of prognostic factors is very useful because it can be utilized in the management of breast cancer. This study was conducted to determine the prognostic factors that influence the mortality of breast cancer in Malaysia. Methods: This prospective study was conducted in five major hospitals in Malaysia. Confirmed breast cancer patients in year 2006-2008 were interviewed and the death status was checked in the year 2012 by the National Registration Department. The mean follow up time was 4.5 years. Kaplan Meier Survival and Cox Proportional Hazard Regression were used for data analysis. Results: In total, 328 respondents were included. The mean (standard deviation) age was 47.9 (9.4) years. Most respondents were of Malay ethnicity (79.9%), were married housewives (54.9%) with a median family income of RM1500 a month. Most respondents had ductal carcinoma (89.3%) and the stage distribution was as follows: 5.2% stage I, 38.7% stage II, 44.8% stage III and 11.3% stage IV. At the end of the study 109 (33.2%) died, 16 (4.9%) lost to follow up and the rest were alive. The
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significant prognostic factors for breast cancer mortality were age < 40 years [HR 1.872; 95% CI: 1.129, 3.103; p value 0.015]; Malay ethnic [HR 2.296; 95% CI: 1.206, 4.371; p value 0.011]; less than secondary school education [HR 1.943; 95% CI: 1.270, 2.972; p value 0.002]; grade 2 histological type [HR 3.394; 95% CI: 1.518, 7.588; p value 0.003]; grade 3 histological type [HR 3.516; 95% CI: 1.561, 7.918; p value 0.002]; and stage 4 of disease [HR 5.768; 95% CI: 1.709, 19.461; p value 0.005]. Conclusions: Young age, Malay ethnic, low level of education, histological grade and disease staging are significant prognostic factors of breast cancer mortality in Malaysia. Keywords: Breast cancer, prognostic factors, breast cancer mortality PP13 THE EFFECT OF TREATMENT DELAY ON BREAST CANCER MORTALITY Norsaadah Bachok* Unit of Biostatistics & Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia *For any correspondence: norsaadah@kb.usm.my Introduction: Breast cancer is the commonest cancer in women worldwide. Delay in diagnosis and treatment of breast cancer is common in Malaysia. This study was conducted to confirm the effect of delay of treatment on the mortality of breast cancer. Methods: This prospective study was conducted in five major hospitals in Malaysia. Treatment delay was measured as the time the symptoms were first detected till the first treatment taken. Confirmed breast cancer patients in year 2006-2008 were interviewed and the death status was checked in the year 2012 by the National Registration Department. The mean follow up time was 4.5 years. Cox Proportional Hazard Regression was used for data analysis. In total, 328 respondents were included. Results: The mean (standard deviation) age was 47.9 (9.4) years. Most respondents were of Malay ethnicity (79.9%), were married housewives (54.9%) with a median family income of RM1500 a month. Most respondents had ductal carcinoma (89.3%) and the stage distribution was as follows: 5.2% stage I, 38.7% stage II, 44.8% stage III and 11.3% stage IV. The median (IQR) time from symptom detection to treatment was 6.8 (3.5, 15.4) months. At the end of the study, 109 (33.2%) had died, 16 (4.9%) lost to follow up and the rest were alive. The mean (95% CI) overall survival time was 6.1 (5.8, 6.4) years. Delay of treatment was not a prognostic factor for breast cancer mortality [HR 1.181; 95% CI: 0.722, 1.934; p value 0.508] when grade and ethnicity were controlled. Conclusions: Delay was not an important prognostic factor of breast cancer mortality. Other factors play more important roles in determining the mortality of breast cancer in Malaysia. Keywords: Breast cancer, prognostic factors, treatment delay, survival analysis PP14 A SERO-PREVALENCE STUDY OF HEPATITIS A INFECTION AMONG RESIDENTS IN KAMPUNG ORANG ASLI GAPAM, JASIN, MELAKA - A PRELIMINARY STUDY Noor Aizam Bin Mohd Said1*, Normadiah Jabar1, Ismail Ali2 & Intan Azura Mohd Din2
1. 2.
Jasin District Health Office, Malaysia Malacca State of Health Department, Malaysia
*For any correspondence: dr_aizam73@mlk.moh.gov.my Introduction: Hepatitis A virus (HAV) presents a significant problem for many aborigine communities as transmission is facilitated by environments with poor sanitation and inadequate water supply and is exacerbated by the overcrowding. In Melaka, there were no reported cases of Hepatitis A for the past five years. However in 2012, there were 2 outbreaks of Hepatitis A occur in 2 aborigines village in Melaka. This study was carried out to ascertain the prevalence and the socio-demographic features of the cases of Hepatitis A among residents in Kampung Orang Asli Gapam,Jasin, Melaka Methods: A seroprevalence study of HAV was conducted among residents who were eligible and
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given consent to participate in this study. Antibodies against HAV were measured and information regarding social-demographic and potential risk factors was collected through a face to face interview using a questionnaire. Results: Twenty- two samples of blood were analysed. Sixteen of the 22 respondents had antibodies against hepatitis A and this give the overall seroprevalence of Hepatitis A among residents in Kampung Orang Asli Gapam was 72.7%. Seroprevalence increased with increasing age: 33.3% at less than 20 years, 84.6% in 20-40 years and 100% at more than 40 years old and this was statistically significant. Conclusion: Our results indicate an epidemiological pattern of intermediate endemicity. Exposure to HAV at a later age may be associated with an increase in hepatitis A morbidity and a greater propensity for outbreaks. These data are important for creating new prevention measures, including vaccination policies, to prevent and control outbreaks of hepatitis A in Malaysia. Keywords: Seroprevalence, Hepatitis A, aborigines PP15 THE 2012 MEASLES OUTBREAK IN PETALING DISTRICT: HAVE WE DONE ENOUGH TO PREVENT IT? Mazliza bt Ramly*, Prema T. Rajendran & Kuhanesan Satiananden Petaling District Health Office, Malaysia *For any correspondence: drmazliza@wp.moh.gov.my Introduction: Measles elimination is a feasible target but requires vaccination coverage above 95% in all population groups and in all geographical areas. The introduction of measles, mumps and rubella vaccine (MMR) in the Malaysia Expanded Programme of Immunization (EPI) since 2002 has resulted in a substantial reduction in the incidence of all three diseases. Nonetheless, measles cases are still spreading in the Petaling Health District and have caused a large outbreak in the year 2012. We investigated a large measles outbreak that occurred in 2012 in Petaling Health District in order to describe the epidemic, the control measures and to evaluate the effectiveness of the measles immunization program. Methods: We reviewed national surveillance of measles confirmed cases, control measures activity and measles-mumps-rubella (MMR) vaccination coverage measles vaccine coverage data in the Petaling Health District for the year 2012. Results: In the year 2012, a total of 281 confirmed cases of measles with 24 clusters reported in the Petaling Health District. The highest incidences of measles were among children age 1-6 year old and infants 6-11 months old (83.3 and 46 cases per 1 million population respectively). During the mapping activities as part of the control measures in the year 2012, revealed that out of 25,344 children examined, only 84.01% (21,291) of them were immunized with MMR with almost 4.16% children had experienced miss opportunity for MMR vaccination. Immunization coverage in the Petaling Health District for the year 2012 is 93.1% for MCV1 (at age 12 months old) and 94% for MCV2 (at age 7 year old). In year 2012, 21.7% patients were considered missing an opportunity for measles vaccination (i.e. the patients were eligible for vaccination but unvaccinated). Conclusion: These results emphasize the need for improved strategies to reduce missed opportunities for vaccination and achieve high vaccination coverage nationwide in order to prevent large measles outbreaks Keywords: Measles, elimination, outbreak PP16 NEGATIVE LIFE EVENTS, ANXIETY AND STRESS
DEPRESSION,
Mariam Mohamad*, Zaliha Ismail, Nik Nairan Abdullah, Waqar Al-Kubaisy & Nor Aini Mohd Noor Faculty of Medicine, Universiti Teknologi MARA, Malaysia *For any correspondence: mariammd@salam.uitm.edu.my Introduction: Young adult college and university students are vulnerable groups for having depression, anxiety and stress (DAS) symptoms, which will
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affect their academic performance as well as social behaviour. This study aims to ascertain the prevalence of DAS symptoms and the negative life events experienced by this group of people to assist educational institutions in recognizing this problem. Methods: A cross-sectional study was undertaken in 2010-2011 involving attendees of randomly selected health clinics in Sabak Bernam, Hilir Perak and Gombak districts. Those who reported as students studying in colleges and university were included in this analysis. Data were collected using a questionnaire containing information on sociodemographic factors and the Bahasa Malaysia version of DASS-21 by trained interviewers or selfadministered. Results: A total of 219 college / university students with a mean age of 20.7 2.4 years old, and a majority (89.0%) were Malays were analysed. Almost 53% of them resided in the urban areas. The prevalence of depression, anxiety and stress symptoms were 26.0%, 44.3% and 16.4% respectively. The prevalence of negative life events occurred during the last one month before the interview was 26.5% of accidents, death among close family members (27.9%), emergency conditions (27.9%), serious illness (27.9%), work/study-related problems (52.1%), legal problem (14.6%) and marital problem (20.5%). Most of the negative life events have significant risk associations with DAS symptoms. Conclusion: Young college or university students have moderate to high prevalence of negative life events that contribute to depression, anxiety and stress symptoms. The educational institutions should be prepared with the supportive services to assist them in coping with the negative situations as well as recognizing depression, anxiety and stress symptoms early. Keywords: Negative life events, depression, anxiety, stress, college, university students PP17 GLYCEMIC CONTROL AND PREVALENCE OF DIABETIC COMPLICATIONS AND COMORBIDITIES AMONG DIABETIC PATIENTS IN KUANTAN Ahmad Zulfadli Mohamed Nor*, Sahrol Azmi Termizi & Amirullah Mohd Arshad Kuantan District Health Office, Malaysia *For any correspondence: drzulfadli@gmail.com Introduction: Co-morbid conditions are significantly frequent in diabetic patients. These conditions make it difficult to focus only on the diabetes since they influence diabetic management, either directly or indirectly. This study was done to determine the level of glycaemic control and the prevalence of diabetic complications and their concomitant morbidity among diabetic patients in Kuantan. Methods: This is a cross-sectional study done from January 2012 to December 2012. Samples were selected through simple random sampling from National Diabetic Registry (NDR). Data on demographics, level of HbA1c and complications/comorbidities were extracted and reviewed. Descriptive statistic and analysis of multi-factorial ANOVA were applied using SPSS 20.0. Results: Total of 2270 patients have been reviewed. The mean (SD) age was 58.4 (11.4) years old. The majority of the patients were Malays (79%) and has been diagnosed less than 5 years (49.1%). Overall mean HbA1c for diabetic patient in Kuantan was 8.46% (2.3%). Hypertension was found in 76.5% of diabetic patients, followed by dyslipidaemia (61.9%) and retinopathy (11.1%). Analysis of multi-factorial ANOVA showed an insignificant HbA1c level for all diabetic comorbidities except for retinopathy (F=5. 837, p =0.003). Conclusion: Based on this result, further strategies need to be strengthened and implemented to achieve good diabetic control. Comprehensive approach in managing diabetic patient with comorbidities is important to prevent further complication. Keywords: Diabetes, co-morbid conditions, diabetic patients
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PP18 KNOWLEDGE, ATTITUDE AND PREVENTIVE PRACTICES ON CNS TUBERCULOSIS CASES AMONG HEALTHCARE WORKERS Farhanah Abd Wahab1, Sarimah Abdullah1*, Jafri Malin Abdullah2 & Wan Mohd Zahiruddin Wan Mohammad3
1.
CNS tuberculosis while out of 32, 28 (87.5%) of them who had a poor attitude perceived insufficient level of knowledge. Conclusion: Despite of having a good knowledge and practice, the healthcare workers still perceived of insufficient level in preventing themselves from getting CNS tuberculosis. Keywords: Tuberculosis, central nervous system, health care workers (HCWs) PP19 INSULIN THERAPY REFUSAL AMONG TYPE II DIABETES MELLITUS PATIENTS IN KUBANG PASU DISTRICT KEDAH Tan WL*, Noor Liani H & SitiFairous A Kubang Pasu District, Kedah, Malaysia *For any correspondence: alextanwl@yahoo.com Introduction: Insulin therapy refusals among type II diabetic patients have always been an obstacle to commence insulin therapy in diabetic patients. Despite the demonstrated efficacy of insulin therapy, the initiation of therapy is still delayed in most of the patients. To determine the prevalence of insulin therapy refusal and factors causing insulin therapy refusal among type II diabetic patients in the Kubang Pasu district. Methods: A cross sectional study carried out at 7 public health clinics in the Kubang Pasu district from March 2012 until October 2012 using a newly developed questionnaire. Results: 461 patients participated in the study with response rate 100%. 74.2% of type II diabetic patients refused insulin therapy. The most agreed factors included lack of confidence in injecting insulin (85.4%), insulin causes life restrictiveness (72.2%) and misconception regarding insulin therapy causes renal failure and blindness (72.2%). Multiple logistic regression analysis revealed that insulin treated patients were found to have more acceptance toward insulin therapy compared to insulin nave patients (88.9% vs. 12.4%), (p-value <0.05, OR: 53.41, CI: 22.94-124.30).The patients who earned between RM 801 RM 3000 per month were more likely to accept insulin therapy as compared to those
2.
3.
Unit of Biostatistics, Universiti Sains Malaysia, Malaysia Department of Neuroscience, Universiti Sains Malaysia, Malaysia Department of Community Medicine, Universiti Sains Malaysia, Malaysia
*For any correspondence: sarimah@kb.usm.my Introduction: Central nervous system (CNS) tuberculosis is one of the tuberculous infections that carries a high mortality and distressing level of neurological morbidity. The objective is to determine the association between self-sufficient perception and the level of knowledge, attitude and practice towards CNS tuberculosis prevention among healthcare workers. Methods: A cross-sectional study was done on 62 health care workers (HCWs) who worked as a health care worker at neuro-medical ward, neuro-surgery ward, neuro-intensive care unit and forensic unit at Hospital Kuala Lumpur, a general hospital located on the west coast of Peninsular Malaysia. A selfadministered newly developed questionnaire was used to evaluate the self-sufficient perception. Results: The socio-demographic characteristics showed that the mean age was 33.9 (1.2) years old, 49 (79%) were female, 48 (77.4%) have diploma, 41 (66.1%) were in grade U29. Fifty-six (90.3%) of them came from neurological wards and have worked at least 9.6(1.1) years in service. Using a selfadministered questionnaire, the study showed that 58.1% and 59.7% of healthcare workers had good knowledge and practice respectively, while 51.6% of them had a poor attitude on CNS tuberculosis. There was a significant association between self-sufficient perception and level of attitude. Out of 30, 11 (36.7%) of health care workers who had a good attitude perceived sufficient level of knowledge on
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earned less than RM 800 per month (p=0.012, OR: 2.17, CI: 1.185-3.988). Conclusion: Insulin therapy refusal is common in the Kubang Pasu district. Most of the type II diabetic patients in Kubang Pasu were lack of confidence in insulin injection. Keywords: Insulin therapy refusal, insulin, Kedah, Malaysia PP20 OUTBREAK OF HUMAN ADENOVIRUS AMONG POLICE TRAINEES IN PORT DICKSON, 2011 LokmanR.1, Haslina H.2*, Muhammad Bazlan A.R.1
1. 2.
well. Prompt management and control measures have managed to contain the outbreak. Keywords: Human adenovirus, police training centre, outbreak PP21 EVIDENCEOF VARIABILITY OF BLOOD PRESSURE MEASURED ON BOTH ARMS IN FEMALE ADULTS, IN EASTERN KENYA Zipporah Bukania*, Moses Mwangi, Lydia Kaduka & Richard Mutisya Kenya Medical Research Institute, Kenya *For any correspondence: zbukania@gmail.com Introduction: Blood pressure is habitually measured on either arm depending on the setting. Our objective was to assess blood pressure in both arms and determine differences that could lead to undetected risk of hypertension measured on one arm only. Methods: Household cross-sectional survey was undertaken amongst 293 females participating in agricultural activities in Eastern Kenya. Six alternate arm blood pressure measurements were taken, three on each arm with 3 minutes rest between measurements. Main outcome measures were, mean inter-arm, intra-arm BP and age differences. Results: Marginal inter-arm differences were observed in mean systolic (left arm 123.3 13.2; right arm 124.412.5) and diastolic BP (left arm 76.29.1; right arm 75.48.9). BP taken on the right arm indicated a higher prevalence of pre-hypertension and hypertension (51.2% and 12.3% vs. left arm 47.8 and 10.6%; p<0.001). For every unit increase in right arm systolic BP value, there was a 0.91 increase in left arm systolic BP value (r=0.838, p<0.001). Statistically significant intra-arm differences (p<0.001) were observed between 1stvs. 2nd; 1st vs. 3rd mean left and right arm systolic and diastolic BP. Linear regression revealed 27% and 34% unexplained variability in systolic and diastolic BP respectively if taken on the right arm. The variance was higher in those aged between 30 and 39 years. Blood pressure measurements on both arms to identify variance between arms and ensure timely diagnosis of elevated blood pressure is important.
Rehemey
S.R.1&
Port Dickson District Health Office, Malaysia Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia
*For any correspondence: nurina08@hotmail.com Introduction: An outbreak of adenovirus took place in Police Training Centre Port Dickson in March 2011 which lasted for 34 days. We aimed to describe the epidemiological data of the outbreak and the control measures that were carried out. Methods: Basic information on the outbreak was recorded by using adapted influenza like illness investigation form. Investigation such as throat swab and culture were done at random. A retrospective cross-sectional study was conducted. Results: There were 848 police trainees and only 237 fulfilled the case definition criteria. The attack rate was 24%. Out of 237 trainees, 28 were hospitalized and 209 were admitted to an isolation room in the vicinity of the Training Centre. None of the trainees were admitted to the Intensive Care Unit. Random throat swab from 40 trainees revealed human adenovirus were isolated in 67.5% of the sample whereas influenza virus was responsible for the rest of the sample. Among control measures taken were screening of trainees body temperature, disinfection and health education. Conclusion: Human adenovirus has been associated with outbreaks in military recruits. It had caused similar presentation among the police trainees as
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Conclusion: Further studies are required to monitor the population blood pressure for long term risk differences between arms. Keywords: Blood pressure, inter arm, intra arm PP22 EFFECTS OF INHALED GINGER AROMATHERAPY ON DIETARY INTAKE, NAUSEA AND VOMITING AMONG BREAST CANCER CHEMOTHERAPY RECIPIENTS Pei Lin Lua1*, Noor Salihah Zakaria1 & Nik Mazlan Mamat2
1.
vs. 1296 276.76 kcal/day; p=0.747 and protein: 58.54 25.65 g/day vs. 58.34 43.36 g/day; p=0.978). The incidence of vomiting was also comparable in both groups. Although statistically insignificant due to limited sample, nausea severity was relatively lower during intervention with ginger EO than FO (p>0.05). Conclusion: These outcomes suggest the potential of aromatherapy in facilitating self-management of CINV among breast cancer patients, particularly with regard to reducing nausea severity. Keywords: Aromatherapy, breast cancer, chemotherapy PP23 PHYLOGENETIC ANALYSIS WOLBACHIA FOUND IN ALBOPICTUS FROM MALAYSIA
2.
Centre for Community Development and Quality of Life (CCDQ), Universiti Sultan Zainal Abidin, Malaysia Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM), Malaysia
OF AEDES
Sylvia Joanne1*, Indra Vythilingam1, Zulqarnain Mohamed2 & Sazaly Abu Bakar3
1.
*For any correspondence: peilinlua@unisza.edu.my Introduction: Aromatherapy is one the most popular modes of complementary therapy and is increasingly being used within the oncology setting. Methods: This single-blind, randomized, controlled, crossover study aimed to assess the efficacy of inhaled ginger aromatherapy on dietary intake, nausea, and vomiting after chemotherapy administration (delivered using a necklace). Breast cancer patients with at least two identical chemotherapy regimens were enrolled. Patients received single doses of ginger fragrance oil (FO) and three drops of ginger essential oil (EO) in an order dictated by the treatment group sequence. Doses were separated by a 14-day washout period. A special diary and 100mm visual analogue scale (VAS) were used to measure the incidence of vomiting and severity of nausea respectively. Dietary intake was assessed using 3-day food records. Descriptive statistics and parametric tests were employed using SPSS 16 whereas nutrient intakes were estimated using Nutritionist Pro. Results: Interim analysis of 32 participants (age=499.16 years; Malay=100%; on highly emetogenic chemotherapy = 84.4%) suggested that dietary intake of patients was comparable between ginger EO and FO (energy: 1289 257.57 kcal/day Department of Parasitology, University of Malaya, Malaysia Institute Biological Sciences, University of Malaya, Malaysia Department of Microbiology, University of Malaya, Malaysia
2.
3.
*For any correspondence: hermoine579@gmail.com Introduction: Wolbachia are intracellular bacteria which are maternally transmitted and found in most arthropods and nematodes. Wolbachiahas shown a wide range of reproductive phenotypes in their hosts. Aedesaegypti and Aedesalbopictus are the major vectors for dengue in Malaysia. They are lethal vectors which transmit deadly pathogens including Dengue Virus. Aedesalbopictus is found to be naturally infected singly and doubly with Wolbachiapipientis strains named wAlbA and wAlbB. Many studies have been done by incorporating the Wolbachia parasite into the Ae. aegypti mosquitoes. Several reproductive phenotypes have been observed such as male killing, parthenogenesis, feminization and cytoplasmic incompatibility (CI). The evolutionary relationships of different Wolbachia strains found in Ae. albopictus at different regions of Malaysia have not been
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resolved and the dynamics of distribution still remains unknown. Methods: To solve this issue, we have extracted DNA from 278 Ae. albopictus collected from 21 different locations in Malaysia. The samples were amplified using specific primers of the Wolbachia A and B super groups for the wsp gene to detect superinfections. Three superinfected samples from each region were purified and sequenced. Lastly, we aligned all sequences obtained with published sequences from other countries to establish the phylogenetic relationship on Wolbachia present in Malaysian Ae. albopictus. Results: The obtained sequences were highly variable and were able to resolve the phylogenetic relationship of Wolbachia in Malaysia. Analysis result showed 90.65% to be super infected with both wAlbA and wAlbB, 1.82% to be singly infected and 6.50% to be not infected. The phylogeny tree obtained showed that the wsp gene sequences of wAlbA are divided into 21 groups whereas 25 groups for wAlbB. Conclusion: Further alteration to the tree may occur when more samples are obtained from other regions in the future. Further studies to analyse the reproductive phenotype will be conducted in the future. Keywords: Phylogenetic analysis, Wolbachia, Aedesalbopictus PP24 THE ASSOCIATION BETWEEN SUPPLEMENT USED AND PREHYPERTENSION AMONG FIRST YEAR UNDERGRADUATE STUDENTS IN A GOVERNMENT UNIVERSITY, MALAYSIA Salmiah Md. Said*, Ahmed Dahiru Balami & Nor Afiah Mohd Zulkefli Department of Community Health, Universiti Putra Malaysia, Malaysia *For any correspondence: salmiah@medic.upm.edu.my Introduction: Pre-hypertension is associated with increased risk of hypertension, cardiovascular diseases and also cerebrovascular diseases. In Malaysia, the prevalence of pre-hypertension among adult age 18 and above was 37% which was higher than optimal blood pressure (32%). Supplement intake is thought to have an effect on lowering blood pressure. This study aims to determine the association between supplement used and prehypertension. Methods: A cross-sectional study was conducted among 495 first year undergraduate students from 5 faculties of a government university. Data collection used a questionnaire and was administrated by the subjects. Two sitting blood pressure measurements were taken from all subjects using sphygmomanometer mercury, 5 minutes apart after rest. Pre-hypertension was defined as the mean systolic blood pressure of 120 to 139mmHg, and/or mean diastolic blood pressure of 80 to 89 mmHg. A supplement used refers to any additional intake of herbs, vitamins or minerals. Data analyses used chisquare test and multivariate logistic regression. Results: The prevalence of pre-hypertension was 30.1% (46.8% male and 24.5% female). There was 23.6% of subjects reported using supplements (19.7% pre-hypertension and 33.3% normotensive). The prevalence of pre-hypertension was significantly lower among those using supplements than non-users (2=7. 94, p=0. 005). Those with supplement used was almost half times less likely to develop prehypertension than non-users (OR=0.45, 95%CI 0.270.78) after adjusting for gender, age and family history of hypertension. Conclusion: Supplement used may reduce the risk of pre-hypertension among this group. Keywords: Pre-hypertension, supplement use PP25 TUBERCULOSIS CASES IN DISTRICT, NEGERI SEMBILAN
SEREMBAN
Jenn Zhueng Tam1*, Shafizah Ahmad Shafei1, Suklvinder Singh1, Mohammed Paid Mohd Yusof3, Suk Chyn Gun2, Mustafa Bakri Adnan3, Sharifa Wan Ezat Wan Puteh1 & Noor Hassim Ismail1
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2.
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Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia Department of Internal Medicine, Tuanku Jaafar Hospital Seremban District Health Office, Ministry of Health
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Siti Nurbaya binti Abdul Aziz* & Azmi Mohd Tamil *For any correspondence: tjz@ns.moh.gov.my Introduction: The efforts in reducing the incidence of tuberculosis (TB) infection had always been challenging especially with the re- emergence of various threats from Human Immunodeficiency Virus (HIV) infecting with multi resistant TB strains to current anti- TB regime. Therefore, there is a tremendous need for epidemiological study to determine the distribution and patterns of TB in the Seremban district in terms of time, place and person. Observations from this study would entail appropriate suggestions to further strengthen the local anti- TB programme. Methods: A cross- sectional retrospective study was conducted from 10th October to 25th November 2011 to obtain secondary data from records kept at the Seremban District Health Office; Chest Clinic, Hospital Tuanku Jaafar; Seremban Health Clinic and other health clinic in the Seremban district for 5 years (2006- 2010). Data and records from line- listing, TBIS forms and medical records were collected and analysed using SPSS Version 18.0. Results: A total of 733 (70.9%) subjects was retrieved with the majority of the subjects from the age group of 20 years till 29 years (20.7%), men (66.7%), Malays (55.1%), non-working groups (31.8%) and from Seremban sub- district (36.7%). With this information, activity and the importance of effective contact screening was highlighted. Conclusion: Continuous training encompassing importance of adherence to anti- TB regime completion, disease burden, contact tracing, record keeping, health surveillance and personal protection among healthcare personnel should be regularly conducted. Only well- trained personnel could educate and counsel patients to change their behaviour and lifestyle to prevent TB. Keywords: Tuberculosis, public health surveillance, medical records PP26 FACTORS ASSOCIATED WITH MICROALBUMINURIA AMONG TYPE 2 DIABETIC PATIENTS IN A GOVERNMENT HEALTH CLINIC IN MELAKA Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: nurbayaaziz@yahoo.com Introduction: Diabetic nephropathy is the leading cause of end stage renal disease (ESRD) in Malaysia and accounts for 57% of ESRD requiring dialysis. Microalbuminuria is the earliest clinical evidence of diabetic nephropathy. The objective was to determine the prevalence of microalbuminuria and factors associated with it among type 2 diabetic patients (T2DM) in a government clinic in Melaka. Methods: The study design was a cross-sectional study. The study subjects were 2042 T2DM patients attending the clinic whose data was taken from the Diabetic Registryin Melaka State Health Department (Audit data from 05/08/2012 till 10/10/2012). Microalbuminuria is defined as urinary albumin of 20mg/L to 200mg/L in a first voided urine specimen. The independent variables analyzed in this study were age, gender, ethnicity, duration of diabetes, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), HbA1c, cholesterol and the use of angiotensinconverting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB). Results: The prevalence of microalbuminuria was 41.6%. The prevalence of microalbuminuria was higher among males at 45.6% (p=0.001), Malays at 47.4% (p<0.001), longer duration of diabetes (p=0.006), higher SBP (p=0.005), higher HbA1c (p<0.001) and higher cholesterol level (p=0.023). Further analysis using multiple logistic regression, indicated that all the above risk factors were still significant predictors of microalbuminuria, except for higher cholesterol level (r=51%). Conclusion: The prevalence of microalbuminuria in this study was relatively higher compared to other local studies due to the differences in population studied, microalbuminuria definition and method of microalbuminuria measurement. Systolic blood pressure and HbA1c level are factors that can predict development of microalbuminuria. Therefore more aggressive measures should be taken to reduce the development of microalbuminuria via strict
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management of the systolic blood pressure and HbA1c. Keywords: Microalbuminuria, type 2 diabetes (T2DM), prevalence, diabetic nephropathy. PP27 MODIFIABLE RISK FACTORS OF CARDIOVASCULAR DISEASE AMONG ADULTHOOD IN TANJUNG KARANG SELANGOR: A CROSS SECTIONAL STUDY Nurmawati Ahmad* & Aniza Ismail Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: drnurma@yahoo.com Introduction: Cardiovascular disease (CVD) was the second leading cause of death in Malaysia in 2006. Most of the risk factor is modifiable. This study aimed to measure the prevalence of modifiable cardiovascular risk factors and examine the association with the cardiovascular disease. Those risk factors are diabetes mellitus, hypertension, body mass index, abdominal obesity, smoking and psychosocial stress. Methods: A cross sectional study was carried out in Tanjung Karang Selangor from March 2011November 2011 on a total of 1488 rural population aged 18 and above selected via convenience random sampling. The survey was conducted via a face-toface interview using a standardised self-administered questionnaire. Results: Overall prevalence of modifiable risk factor were predominant compared non modifiable where diabetes mellitus ( 89.1%), hypertension (59.3%) and obesity (65.3% ).However the prevalence of other modifiable are relative low where abdominal obesity (47.6%) smoking ( 25%), and psychosocial stress (33.8%) respectively. Chi-square tests showed significant associations between cardiovascular disease and hypertension (P= 0.000) and diabetes mellitus (P = 0.005). Furthermore, there was association between the modifiable risk factor diabetes mellitus, hypertension and body mass index with cardiovascular disease. Respondent with underlying diabetes mellitus and hypertension were 4 times more likely to have cardiovascular disease and those who are obese had associated 2.5 risks towards cardiovascular disease. Conclusion: Therefore, all initiatives in community health intervention should be mobilized specifically on prevention and control of lifestyle-related risk factors Keywords: Cardiovascular disease, community intervention, modifiable risk factors PP28 THE PREVALENCE OF CONSTIPATION AMONG PSYCHIATRIC PATIENTS IN LONGSTAY CARE HOME IN HONGKONG: A SURVEY Li Mei Kuen*, Chow Uen Ching, Chow Uen Ue, Ho Yuen Kwan, Lam Ngan Mui, Lau Wing Ka, Leung Wing Yee, Li Kam Sim, Tai Hiu Yu, Wai Man Sum & Wan Shuk Han. Division of Nursing and Health Studies, The Open University of Hong Kong, China *For any correspondence: mkli@ouhk.edu.hk Introduction: Constipation is a common health problem with a prevalence of 14% in the general population in Hong Kong. Psychiatric patients belong to the high risk group of suffering from constipation as they are treated with antipsychotic medications which often lead to constipation. So far, there is scanty information on the prevalence of constipation among psychiatric patients in Hong Kong. This study aims to investigate the prevalence of constipation among psychiatric patients in long stay care home (LSCH) in Hong Kong. Methods: The study was a cross-sectional survey of psychiatric patients who were living in one of the five LSCHs in Hong Kong. The studied LSCH was the largest one with 425 residents. The patients were recruited for an interview if they were able to communicate with Cantonese and were mentally alert. Chinese Constipation Questionnaire was used to assess for the presence of constipation on a 5-point Likert scale ranging from 0 to 4 (6 items). Patients were diagnosed with constipation if the total scores were greater than five. Results: A total of 136 psychiatric patients were interviewed. 88 patients had their total scores greater
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than five (mean: 9.260.24; range: 614). The prevalence of constipation was reported to be 63.2%. The constipated patients were older (mean age: 62.210.8) than the non-constipated patients (mean age: 59.99.4). Conclusion: This study reveals the current situation on the problem of constipation among psychiatric patients in LSCH in Hong Kong for the health care team. Accordingly, relevant strategies can be formulated and implemented to tackle such problem. The present findings have limited generalization as only mentally alert patients from one LSCH were recruited. The actual prevalence rate is expected to be higher if all psychiatric patients were assessed. It is recommended to conduct a full scale survey of all psychiatric patients in LSCHs and using an objective outcome measure for assessing those patients who are not mentally alert. Keywords: Constipation, prevalence, psychiatric patients PP29 PREVALENCE OF HYPERTENSION AND ITS RISK FACTORS IN AN ORANG ASLI COMMUNITY IN PERAK, MALAYSIA K. K. Nyo*, Nagaraja Kumari N, Shakila S, J. R. Peela, J. Vejayan, Rakesh Rampal, Almas Khan, Ernest Chan Chit Chyn & Frances Kaviarasan
1.
2.
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Department of Community Medicine, Faculty of Medicine, Quest International University Perak, Malaysia Faculty of Medicine, Quest International University Perak, Malaysia Medical student, Faculty of Medicine, Quest International University Perak, Malaysia
*For any correspondence: kaykhine.nyo@qiup.edu.my Introduction: Hypertension is a silent killer and a global public health issue, which contributes to the burden of heart diseases, stroke, kidney failure and premature death and disability. WHO indicated that hypertension is the third most important contributor to the global disease burden. Hypertension is estimated to cause 4.5% of the global disease burden
in developing and developed countries. The complications of hypertension account for 9.4 million deaths worldwide every year. The increasing trend of non-communicable diseases (NCD) among Orang Asli community became a growing public health concern for the health status of aboriginal groups in Malaysia. The prevalence of hypertension among the Orang Asli community was 30.8% which is lower than the 3rd National Health and Morbidity Survey (NHMS III: 32.2% of Malaysians aged 18 years and above). There are many risk factors for the development of hypertension including: consumption of salty and fatty food, and not eating enough fruit and vegetables, alcohol abuse, physical inactivity and lack of exercise, etc. Methods: The objectives of the study are to determine the prevalence of Hypertension and to identify its risk factors among Orang Asli villagers in Perak. A cross-sectional study was conducted among consenting villagers aged 18 years and above. Blood pressure was measured by a standardized method by using a manual sphygmomanometer. A validatedquestionnaire based survey was conducted to study the demography and to identify the risk factors of hypertension. Results: Of the 103 villagers screened. 68% were females and 32% were males. Hypertension and obesity (BMI 27.5 kg/m2) were identified in 50 villagers; the point prevalence was 48.5%. 62% of those found with hypertension were undiagnosed earlier and 38% of those who were diagnosed in less than one year. 74% of those diagnosed were under medications. 48% of the villagers had a primary level of education. 49% were in the low-income group and 87% had a family history of hypertension. The most associated risk factors were the daily high consumption of fatty food (61%) and salty food (70%), and physical inactivity (40%). Only a few are found to consume alcohol and cigarettes. Diabetes cases were not reported. Dietary assessment showed a higher consumption of salted dry fish and other fish products (49%) daily. Only 16% of villagers consumed fruits and vegetables daily. 40% of respondents never consumed meat and meat products, 33% never consumed milk and milk products and 40% never consumed cereals and cereal products. Age (p<0.01), education level (p<0.05), occupation (p<0.05) and BMI (p<0.01) were the important risk
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factors associated with the prevalence of hypertension among Orang Asli villagers. These risk factors were comparable to those reported in the NHSM III. Other risk factors of hypertension such as family history, high consumption of salty and fatty food, unbalanced diet and physical inactivity were identified among the villagers. Conclusion: A comprehensive health promotion program should include a dietary and lifestyle modification advice to consume less salt, more fruits and vegetables, to maintain a healthy body weight and to practice daily physical activities, backed up with a health education program to increase awareness of the adverse outcomes of hypertension among the Orang Asli community. Along with the concept of 1 Care for 1 Malaysia, health promotion and health education programs for prevention of noncommunicable diseases should be reachable to the indigenous minority groups like Orang Asli community in Perak State. Keywords: Hypertension, risk factors, Orang Asli, Perak PP30 ASSESSMENT OF PHYSICAL INACTIVITY AND ASSOCIATED BARRIERS AMONG THE TYPE 2 DIABETES MELLITUS PATIENTS IN THE UKMMC PRIMARY CLINIC Siti Norbayah Yusof* & Azmawati Mohammed Nawi Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: rabiatuladawiya@yahoo.com Introduction: The prevalence of Type 2 Diabetes Mellitus (T2DM) is increasing globally, including in Malaysia and has a devastating effect. Despite health care effort, only 22.5 percent of the patients in Malaysia are well controlled in 2011. Physical inactivity has been proven as another important aspect that need action as it results in poor glycaemic control. Methods: This was a cross-sectional study using an interview guided questionnaire among 121 T2DM patients in a university primary clinic done between March to May 2013. The objectives were to assess the prevalence of physical inactivity and determine the barrier factors leading to it among T2DM patients. Results: The study found among the study population 55% were physically inactive; mean age of 56.2 (8.48) years; 76% had low education; 55.4% had low income, 76% with poor glycaemic control and mean duration of illness of 7.8 (6.87) years. Factors significantly associated with physically inactivity were presence of complication (2 = 5.89; p=0.015) and barrier domains of Health Status (t=5.88, p<0.001), Availability (t=3.45, p<0.001), Time (t=3.57, p<0.001) and Pain/Injury (t=3.64, p<0.001). Using multiple logistic regression, barrier domains of Health Status (Adjusted OR: 1.58, confidence interval 95% (CI 95%): 1.31-1.92, p<0.001) and Time (adjusted OR: 1.27, CI 95%: 1.12-1.45, p<0.001) were associated with higher odds for physical inactivity. Conclusion: Policy on facility availability and strengthening the role of Health Care Providers in providing individually catered problem solving on physical inactivity involving time management, various ways to be physically active and better complication management among the T2DM patients are thus warranted. Keywords: Type 2 diabetes, physical activity, barriers, health status, time PP31 OBESITY RELATED HYPERTENSION GENDER SPECIFIC ANALYSIS AMONG ADULTS IN TANJUNG KARANG, SELANGOR Juhaida Mohd Noor* & Aniza Ismail Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: juhaidamohdnoor@yahoo.com Introduction: Obesity is a major health concern and the growing rates raise important issues specific to the concurrent rise of the related diseases especially hypertension. This study aimed to determine the relationship between hypertension and obesity based on body mass index and waist circumference besides
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of relevant socio-demographic factors, according to the gender specific analysis. Methods: This cross-sectional study was conducted among communities in TanjungKarang, Selangor in 2009 and included a total of 439 male and 668 female respondents. Data was collected by interview-guided questionnaire and anthropometric measurements. SPSS version 21.0 was used for analysis of the relationship between socio-demographic factors, smoking, body mass index and waist circumference with hypertension. Finally logistic regression analysis was used to assess the predictors of hypertension according to gender. Results: The prevalence of hypertension was 25.5% in males and 23.1% in females, giving a total of 24%. Significantly higher prevalence of hypertension was found in overweight and obese categories (40.6% and 54.1% in overall; 42.2% and 60.5% in males; 39.5% and 48.9% in females). Those with abdominal obesity also had significantly greater risk of having hypertension (35.7% in overall, 41.6% in males and 33.2% in females). The logistic regression indicated the significant factors that contribute to the hypertension for overall respondents were age, BMI and abdominal obesity and similarly with female group, whereas age and BMI only for the male group. Conclusion: Obesity and abdominal obesity are significantly important predictors of hypertension, both in females but BMI obesity only in males. Effective weight management strategies targeting obese people and abdominally obese women should be implemented in order to prevent hypertension and related cardiovascular diseases. Keywords: Obesity, hypertension, gender-specific analysis, body mass index, waist circumference PP32 COMPARISON OF RISK FACTOR OF CARDIOVASCULAR DISEASE BETWEEN URBAN AND RURAL AREAS IN SELANGOR, MALAYSIA Noor Hassim I, Khairul Hazdi Y*, Arma Noor, Mohd Hasni J, Azmi M.T, Zaleha M.I & Azman A Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: hazdi@ppukm.ukm.edu.my Introduction: A comparative cohort study of the health risks of the population age 35 to 75 years in urban and rural area are conducted in January 2009 to December 2020. The objective of the study is to compare risk factor of cardio vascular disease between urban and rural areas in Selangor, Malaysia. Methods: This is a cross-sectional study, randomly chosen involved 8467 adult aged 31 years and above from urban and rural population in Selangor. Urban areas selected were Cheras and Ampang and rural area were Tanjong Karang, Kuala Selangor, Sabak Bernam, Felda Sungai Tengi, Felda Soeharto and Felda Gedangsa in Selangor, Malaysia. Individual characteristics including demographic and socioeconomic factors were recorded on the census forms. Socio-demographic pattern and prevalence of chronic disease, cancer and infectious disease were compared between urban and rural by using chi-square analysis. Results: The study shows that in rural, there are more elderly (>50 years old) (52.3%), lower education level (94.7%) and not working (58%), with higher prevalence of chronic heart disease (2.1%) and heart failure (2.1%). Meanwhile, the prevalence of type II diabetes in urban is 19.6%, which is higher compare to rural. There were significant (P<0.05) Urban and rural between employment status, age > 50 years old, marital status, type II diabetes, chronic heart disease and heart failure. Conclusion: Urban areas appear less healthy than the rural areas among younger age group (31-50 yearold) and the association with type II diabetes suggests that lifestyle may be factor. Rural area however, have higher non working rate amongst elderly (>50 yearold), probably due to migration after pension from urban to rural. Diabetes mellitus type II was significantly higher in urban area but heart failure was higher in rural. Other studied disease did not show significant different between urban and rural. Keywords: Urban-rural health, diabetes, chronic heart disease
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PP33 AN ASSOCIATION BETWEEN OBESITY LEVEL AND DEPRESSION AMONG THE MALAYSIAN WORKING POPULATION Santhna Letchmi Panduragan*, Ang Ciau Wooi, Norizan Min, Nooraishah Saadon, Ruban Dalayan & Ho Siew Eng Department of Nursing, UKM Medical Centre, Faculty of Medicine, Malaysia *For any correspondence: santhna@ppukm.ukm.edu.my Introduction: Obesity is becoming a major health issue in Malaysia. It not only causes a lot of medical problems but also leads to emotional disturbances. Studies have suggested that some degree of depression is prevalent among obese people but the results usually vary. The objective of the present study was to assess the relationship between obesity and depression. Methods: A quantitative, cross-sectional study was conducted using a convenient sampling. Respondents who fulfilled the criteria such as the Malaysian working population with a body mass index (BMI) of 30 and above, were randomly selected. A structured questionnaire that consisted of five sections was used to collect data. Results: A total of 60 people participated in the study and the data was analysed using SPSS version 20. The results of the study revealed that the prevalence of depression among the respondents was 23.33%. There was no significant difference in terms of depression between obese male and female (X2= 0.3568, p=0.059). There was association between depression and active measures taken to reduce weight (X2=5.963, p=0.015). Conclusion: The study revealed that not all obese people are depressed. However, it is important that obese people with depression seek immediate medical help to prevent further detriment to their health. Public awareness of obesity and depression is important because early detection can prevent unwanted negative outcome in the Malaysian population. Keywords: Obesity, depression, Malaysian, working population PP34 PLASMODIUM KNOWLESI IN PAHANG MALAYSIA. ARE WE EXPERIENCE ENOUGH TO DIAGNOSE BY MICROSCOPIC EXAMINATION? Abu Hassan Shaari Abd Kadir1*, Masran Muhamad1, Rosli Ismail2 , Rahimi Hassan3, Azuwa Ariff4 & Rafidah Abd Latiff5
1.
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3.
4.
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Unit Kawalan Penyakit Bawaan Vektor, Kuantan, Malaysia Bentong Health District Office, Pahang, Malaysia Kuala Lipis Health District Office, Pahang, Malaysia Temerloh Health District Office, Pahang, Malaysia Raub Health District Office, Pahang, Malaysia
*For any correspondence: drabuhassan@phg.moh.gov,my Introduction: Correct diagnosis of plasmodium species infection is crucial for effective treatment and surveillance of malaria eradication programme. In areas where Plasmodium knowlesi and others plasmodium species commonly occurs misdiagnosis by microscopy had been reported. Methods: This cross sectional study in state of Pahang, Malaysia from 1 June 2012 until 31 Mach 2013 evaluated the accuracy of microscopic examination at district, state and national laboratory. A total of 108 malaria cases with PCR-confirmed Plasmodium species infection were enrolled including 69 Plasmodium knowlesi, 30 Plasmodium vivax, 3 mixed infection Plasmodium Vivax/Plasmodium knowlesi, 1 mixed infection Plasmodium falciparum/Plasmodium knowlesi and 4 negative Plasmodium. Results: The incidence rate IR of Plasmodium species infection was 6.8 per 100,000 populations and the IR of Plasmodium knowlesi mono-infection was 4.3 per 100,000 populations and it was the highest among the species. The distribution of the case of Plasmodium knowlesi mono-infection were highest among male gender (82.4%), Malay ethnic
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group (57.9%) and foreigner (20.9%),young adult age group 10- 50 years old (64.9%),Living in village and temporary workers house (84.0%) and 70.9% of the infection occurred in village and jungle .The accuracy of microscopic examination at district laboratory were 92.7% for P.knowlesi,83.3% for P.Vivax, 40.0% for P.falciparum, 0.0% for negative plasmodium sp. And 0.0% for mixed infection whereas at state laboratory were 85.9% for P.knowlesi, 96.2% for P.vivax, 60.0% for P.falciparum, 0.0% for negative plasmodium and 0.0% for mixed infection and at National research laboratory were 2.8% for P.knowlesi, 100% for P.vivax, 100% for P.faciparum, 50.0% for negative plasmodium and 0.0% for mixed infection. Conclusion: The accuracy of diagnosis of Plasmodium knowlesi by microscopic examination varies from 2.8% to 92.7%. It was highest at district level where treatment of the case was critical for its outcome and its lowest at national research laboratory. For others species of P.falciparum and P.vivax it was highest at national research laboratory and lowest at district laboratory and it has potentially lead to inappropriate treatment. The limitation of microscopic examination to differentiate the plasmodium species may require PCR diagnostic test for correct diagnosis and appropriate treatment. Keywords: Plasmodium knowlesi, microscopic examination, PCR-Polymerase chain reaction PP35 MUSHROOM POISONING: A CASE REPORT FROM SARATOK Johny Anak Kelak1* & Aren Sinedeh Anak Lemin2
1. 2.
Introduction: There are many thousand of mushroom species in the world, some are edible and some are poisonous due to containing significant toxins. Mushroom poisoning usually results from ingestion of mild mushrooms due to misidentification of a toxic mushroom as an edible species. Methods: The paper describes 3 outbreaks of 3 differences locality within a year of 2011 in Saratok. Results: Our report have 7 cases of mushroom poisoning with Amanita species and 2 cases with Russula species. All patients were presented with gastrointestinal symptoms including vomiting and diarrhoea. Some of them presented with Central Nervous System symptoms like dizziness, body weakness and semi-paralysis. Conclusion: In view of this fungus is likely to be confused with edible mushrooms, it is important to educate people about the dangers involved. Aiming at primary prevention, the government should establish regional toxicology centers which would impart public education on recognition of toxic mushrooms. Keywords: mushroom poisoning, toxic mushroom, edible mushroom
Health District Office Saratok, Malaysia Health Division Office Betong, Malaysia
*For any correspondence: jc_johnclark2000@yahoo.com
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POSTER PRESENTATION: FAMILY HEALTH / NUTRITION / SOCIAL WORK
poster PRESENTATION FAMILY HEALTH / NUTRITION / SOCIAL WORK
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PP36 A CROSS-SECTIONAL STUDY ON KNOWLEDGE AND RISK FACTOR FOR OSTEOPOROSIS AMONG FINAL YEAR FEMALE STUDENTS IN FACULTY OF SCIENCE, UNIVERSITI TUNKU ABDUL RAHMAN, (UTAR) KAMPAR CAMPUS Kavitha Subramaniam, Chan Annaletchumy Loganathan* Wei Lian & PP37 HEALTH SCREENING UTILIZATION AND ITS INFLUENCING FACTORS AMONG WOMEN UKM STAFF IN YEAR 2012 Aniza Ismail1*, Siti Fatimah Abd Ghaffar1, Khadijah Shamsuddin1 & Zailliza Suli2
1.
2.
Universiti Tunku Abdul Rahman, Malaysia *For any correspondence: kavithas@utar.edu.my
Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Malaysia State Health Department, Negeri Sembilan, Malaysia
*For any correspondence: draniza@gmail.com Introduction: Osteoporosis is a major cause of mortality and morbidity especially amongst women in post-menopausal age. It is preventive measures should be taken decades before women experience menopause, ideally in teenage years. The aim of this study is to evaluate the knowledge on osteoporosis, presence of its risk factors, and practice of preventive measures among female university students. Methods: A survey was conducted among female science students in final year. All final year female students majoring in Biology based courses were eligible. Students were met in the class room and requested to fill up the questionnaires to upon consent. A self-designed questionnaire and food frequency questionnaire were used were used to collect information. Results: A total of 133 female students responded. Majority of the respondents were Chinese and were aged between 121-22 years old. Most respondents (85%) defined osteoporosis, correctly. The level of knowledge on its risk factors varied. Practice of preventive measure for osteoporosis was poor, even amongst the students with family history of osteoporosis. Twenty five percent of students consumed recommended amount of calcium weekly. Conclusion: Practice of preventive measure for osteoporosis was poor among the respondents. Students should be educated on the importance of practicing healthy lifestyle. Keywords: Risk factor of osteoporosis, postmenopausal age, women Introduction: The main objective of this study was to reanalyse and compare the changes in health screening utilization with a previous study done in 2001 and its influencing factors. Methods: This study was a cross-sectional study conducted on women UKM staff aged between 18 and 55, from July-October in 2012. A total of 234 respondents were selected by using stratified random sampling method. Information was gathered through self-administered questionnaire, distributed at Bangi main campus, Kuala Lumpur health campus and UKMMC. Data was analyzed by using SPSS version 17.0. Results: The most common general health screening utilized by respondents was blood pressure measurement (85.9%) whilst Pap smear test were the most common reproductive health screening utilized by respondents (64.5%). Utilization levels for these health screening were higher compared to previous study. Regression analysis showed that factors associated with blood pressure measurement utilization were age (OR 2.7, CI 95% 1.2, 6.3), family history of general health problems (OR 3.4, CI 95% 1.5, 7.6), and health staff influence (OR 5.2, CI 95% 1.1, 25.5). Influencing factors for Pap smear test utilization were marital status (OR 62.8, CI 95% 7.2, 546.4), general health problems (OR 2.3, CI 95% 1.2, 4.5) family planning practice (OR 6.9, CI 95% 3.0, 16.5) and self-interest (OR 3.3, CI 95%, 1.3, 8.6). Conclusions: The most important significant factor in this study was health staff influence, which was not statistically significant in previous study. UKM
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should monitor utilization of health screening among women staff and optimize health staff role. Keywords: Health Services Utilization, Women Staff, Pap smear, Blood Pressure Measurement PP38 FACTORS INFLUENCING PSYCHOSOCIAL EFFECTS ON THALASSEMIA PATIENTS Azimatun Noor A* & Zunianfih S Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Malaysia *For any correspondence: azimatunnoor@gmail.com Introduction: This study measured the level of psychosocial effects faced by thalassemia major patients seeking treatment at Likas Women and Children Hospital and Keningau Hospital, as well as the influencing factors. Methods: A cross sectional study involving 161 children with thalassemia major was conducted from February to April 2013. The PedsQL 4.0 Generic and Social Support Questionnaire were used to assess the psychosocial effects in patients with thalassemia major. Results: Results showed that the overall mean psychosocial effects score was 68.50 (sd= 15.18) and the mean psychosocial effect score of school function was the lowest score among all the domains (58.3817.82). Statistical analysis showed that only gender had a significant relationship with psychosocial effect of emotional function. Social support from parents, friends, classmates and teachers was the most influential factor that affected the whole psychosocial effects. Other factors such as age, ethnicity, religion, parental income, education level and frequency of blood transfusion were not significantly related with the overall psychosocial effects among these patients. Multivariate analysis revealed that social support from friends was the major contributing factor affecting the overall psychosocial effects of thalassemia major patients. Conclusion: The findings of this study hopefully will help the relevant authorities be more sensitive when dealing with thalassemia patients by providing more psychosocial support programs to ensure that these patients are able to carry out their social function as normal individuals. To provide more effective aids, medical social workers should seriously consider the identified factors that influence pyschosocial effects on thalassemia patient. Keywords: Psychosocial effects, factors, children, thalassemia PP39 IODINE NUTRITIONAL STATUS OF SCHOOL CHILDREN IN RURAL SARAWAK Lim Kuang Kuay*, Chan Ying Ying, Ahmad Ali Zainuddin, Teh Chien Huey & Hasimah Ismail Institute for Public Health, Ministry of Health, Malaysia *For any correspondence: limkk@iku.moh.gov.my Introduction: Geographically, population in the interior of Sarawak are prone to iodine deficiency owing to the predominantly mountainous terrain and heavy rainfall. The aim of this study was to assess the status of iodine deficiency disorders (IDD) among school children in rural Sarawak. Methods: A cross-sectional study was conducted in 15 primary schools in rural Sarawak from April to July 2008. The probability proportionate to size (PPS) sampling was used to randomly select 600 school children aged 8-10 years. The selected schools and school children were the sub-sample population of the state wide IDD survey 2008. The iodine content of urinary samples was measured by in house modified micro-method and the prevalence of IDD was determined according to WHO criteria. Results: Of the 15 schools, 7 schools (47%) were categorised as iodine sufficient, another 7 schools (47%) were mildly deficient and one school was moderately deficient with median urinary iodine concentration (UIC) of 39.9g/L. The overall median UIC among rural school children (n=569) was 91.9g/L, indicating mild iodine deficiency. In addition, the proportion of urinary samples with iodine content below 100 g/L (iodine insufficiency) was about 55%. Conclusion: The present study confirms the occurrence of mild to moderate IDD among school children in rural Sarawak, with approximately 50% of the schools and school children at risk of IDD. The
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introduction of universal salt iodisation in July 2008 (after this survey) in the state will help to eliminate problems of IDD in rural communities in Sarawak. Keywords: Iodine deficiency disorders, school children, median urinary iodine concentration, iodised salt, Sarawak PP40 UNDERWEIGHT AND OVERWEIGHT AMONG 10-YEAR OLD SCHOOL CHILDREN Norsaadah Bachok* & Aniza Abd Aziz Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia *For any correspondence: norsaadah@kb.usm.my *For any correspondence: kusote@gmail.com Introduction: Underweight and overweight are jointly causing problems in developing countries. The objective of this study was to determine the prevalence of underweight and overweight in 10-year old school children. Methods: This was a cross-sectional study conducted in a district of Malaysia. Four schools in a district were randomly selected and all 10-year old pupils were included. All pupils were subjected to anthropometrics measurement. Their body mass index and percentile were calculated. Results: A total of 364 pupils were involved in this study and all pupils were Malays. The prevalence of BMI above the 95th percentile ranged between 4.9 to 19.8%. BMI less than the 5th percentile ranged between 17.8 to 35.5%. There was significantly higher percentage of overweight in urban schools and underweight in rural schools (p=0.018). Children from urban area [OR 2.29; 95% CI 1.24, 4.23], having overweight father [OR 2.28; 95% CI 1.25, 4.15], overweight siblings [OR 2.25; 95% CI 1.11, 4.54) and weight affected activity [OR (2.06; 95% CI 1.11, 3.84) were at higher odds of overweight. Otherwise, significant factors associated with underweight were more number of siblings [OR 1.19; 95% CI 1.01, 1.41], sequent in sibling [OR 0.82; 95% CI 0.69, 0.97] and walking to school [OR 2.14; 95% CI 1.01, 4.55). Introduction: Despite the debates of the benefits of continuing mammography screening among elderly women, studies in Malaysia have shown that the prevalence of breast examination declines after age 45 years and for mammogram per se, the prevalence of examination increases until age of 64. This study aims to determine the prevalence of mammogram screening among elderly women in Hulu Langat, Selangor and its relationship with factors such as demographic factors, family history of breast cancer, perceived health status, perceived general psychological factor and lifestyle factors. Methods: Data used were from a cross sectional study of health status of communities in Hulu Langat area by the Department of Community Health, Universiti Kebangsaan Malaysia carried out from the year 1998 till 2002. However this paper focused on the database involving elderly women age 60 and above. Results: The sample population was 652. The mean (standard deviation) age was 67.17 (5.995). Only 8.3% of the elderly women claimed to ever had mammogram screening done. Hence, the prevalence of mammogram screening is still low among elderly women in Hulu Langat. Having family history of breast cancer (p < 0.001) and perceived positive psychological status (p=0.003) had shown significant associations with mammogram screening among them. Conclusion: There was a reverse trend of underweight and overweight of 10-year old according to the locality of schools. This indicates the influence of urbanisation on the nutritional intake of children. Keywords: Underweight, overweight, school children PP41 DO ELDERLY WOMEN IN MALAYSIA GO FOR MAMMOGRAM SCREENING? Rahmah MA1*, Aniza I 2& Che Engku Nor Bahiyah CEM2
1. 2.
Universiti Sultan Zainal Abidin, Malaysia Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
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Conclusion: It is therefore important for researcher to further look into the reasons behind this and qualitative exploration is highly recommended. Keywords: Mammogram screening, elderly, Malaysia. PP42 CHRONIC PAIN AND PATTERN OF HEALTH CARE UTILIZATION AMONG MALAYSIAN ELDERLY POPULATION Lily Rafidah Binti Mohamed Zaki1* & Noran Naqiah Hairi2
1.
facilities. Presence of interference as well as its level of interference did not significantly associate with frequency of hospitalization. However, we found that higher level of interference reduced the frequency of visits to ambulatory facilities, which is not consistent with findings from developed countries. Conclusion: Chronic pain is a prevalent health problem among the elderly in Malaysia and is associated with higher frequency of hospitalization. All healthcare providers must be prepared to fulfill these needs. Keywords: Chronic pain, health care utilization, hospitalization, elderly, Malaysia PP43 INFANT FEEDING ATTITUDE MALAYSIAN MOTHERS
2.
Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia JCUM, Centre for Clinical Epidemiology and Evidence-Based Medicine, Faculty of Medicine, University of Malaya, Malaysia
AMONG
Tuty Aridzan Irdawati Mohsinon* & Wong Yut Lin Department of Social & Preventive Medicine, University of Malaya, Malaysia *For any correspondence: tutynim4@yahoo.com Introduction: Every child needed sufficient nutrition for their healthy growth and development. Exclusive breastfeeding was the most effective nutrition to reduce child morbidity and mortality. In Malaysia, only 14.5% mothers were breastfeeding exclusively at 6 months during national survey 2006.The Iowa Infant Feeding Attitude Scale (IIFAS) was a measure of attitudes towards infant feeding. The aim of this study was to translate and validate a Malay version of IIFAS and to determine the infant feeding attitudes among Malaysian mothers. Methods: This is a cross sectional study. Three hundred mothers at 36 weeks pregnancy were asked to respond to all 17 IIFAS items with a 5 point Likert scale. Total attitude scores range from 17 to 85 with higher scores reflecting a preference to breastfeeding. The IIFAS was translated into Malay language via forward and backward translation process. The Malay version IIFAS was pre-tested with 6 mothers and a focus group discussion was done to review the understanding of the questionnaire. A pilot study was done on 30 mothers. Results: The mean IIFAS score was 61.39 and 36.7% of mothers strongly agreed on item stating
*For any correspondence: drlilyrafidah@siswa.um.edu.my Introduction: Little is known about the prevalence of chronic pain among elderly in Malaysia as well as its influence on our healthcare services. Data on health service utilization helps to estimate future demands of health services among elderly. The aim of the study was to report chronic pain prevalence among Malaysian elderly and examine whether chronic pain influence healthcare usage. Methods: This was a sub-population analysis of the elderly sample from the Third National Health and Morbidity Survey 2006. All statistical analysis was performed using STATA version 8.0. Results: Prevalence of chronic pain among Malaysian elderly was 15.2% (95%CI: 14.5, 16.8) double the overall prevalence among general population (7.1%). Prevalence of chronic pain increased with advancing age, and the highest prevalence was seen among the old-old group category (21.5%). Across both age groups, chronic pain was more prevalent among females, Indian ethnicity, widows/widowers, rural residency and those with no education background. We found that chronic pain alone increased frequency of hospitalization but not on visits to ambulatory
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Nutritional benefits of breast milk last only until the baby weaned from breast milk. Of these mothers, 33.3% agreed with the item which stated Breastfed babies are more likely to be overfed than formula fed babies and 50% of mothers strongly agreed on item stating Mother who occasionally drinks alcohol should not breastfeed her baby. The Malay version IIFAS had moderate internal consistency with a Cronbachs alpha of 0.682. Conclusion: Mothers in this study had neutral breastfeeding attitude, and were not positive on both breastfeeding and formula feeding. These mothers still had poor knowledge of certain aspects of breastfeeding. Breastfeeding education to mothers during antenatal is very important. The Malay version IIFAS was a reliable and valid instrument to measure the infant feeding attitudes in these populations. Keywords: Breastfeeding, infant feeding attitude, Malay version IIFAS PP44 PSYCHOSOCIAL LOSS, SOCIAL SUPPORT AND POST-TRAUMATIC STRESS DISORDER AMONG ADOLESCENTS AFTER EARTHQUAKE IN PADANG WEST SUMATERA Firdawati* & Rosnah Sutan Department of Community Health, Universiti Kebangsaan Malaysia, Medical Centre, Malaysia *For any correspondence: firdawati_2001@yahoo.com Introduction: This study is to examine the level of trauma, psychosocial loss and Post-traumatic Stress Disorder (PTSD) among adolescents as impacts of the 30th September 2009 earthquake in Padang West Sumatera, 32 months after the disaster. Methods: The total respondents were 600 adolescents (12-18 years old) who were exposed to the earthquake. They were recruited from junior and senior high schools affected by the earthquake. Samples were chosen based on the level of destroyed school buildings. Participants were assessed for PTSD symptoms using the University of California Los Angeles Reaction Index (UCLA-RI). Perception of trauma and psycho-social loss were assessed using a modified questionnaire from Giannopoulou (Cronbach coefficient; 0.65 - 0.75). Measurement of perception of social support was based on questionnaire modified from the Multi Dimensional Scale of Perceived Social Support (MSPSS) which had been validated by Bruwer (Cronbach coefficients; 0.86 - 0.90 and constructs reliability>0.7). Results: Results showed that the prevalence of PTSD was 39.3%, with high exposed trauma (39.7%), high psycho-social loss (64.2%) and high social support (49%). Earthquake exposed trauma and psycho-social loss were significantly predictors of PTSD symptoms. The high level of trauma and psychosocial loss affected more PTSD symptoms (p<0.05) as risk factors. On the other hand, high social support significantly contributed toward the lower PTSD symptoms (p<0.05), acting as a buffer factor. Conclusion: The government should improve ongoing recovery and reconstruction programs especially in the junior and senior high schools. Keywords: PTSD, adolescents, earthquake, psychosocial loss, social support, trauma PP45 PREDICTOR OF FALLS AMONG OLDER PERSONS LIVING NEARBY RURAL CLINICS IN LIMBANG DISTRICT, SARAWAK Teh Jo Hun* Universiti Malaysia Sarawak (UNIMAS), Malaysia *For any correspondence: johunteh@gmail.com Introduction: Ageing leads to an inevitable increase in degenerative and age related diseases. Degenerative changes due to ageing leads to reduced adaptability to sudden changes in environment or body position and this results in loss of balance and falls. Falls among the older persons is common and often result in serious morbidity and mortality. Methods: This study assessed the association between falls and socio-demographic factors, extrinsic risk factors, intrinsic risk factors, functional status, and determined predictors of falls in this study population. A total of 187 community dwelling older persons were selected by systematic random
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sampling of five villages within all the rural government health clinic operational areas in Limbang district, Sarawak. This survey was carried out from November 2010 to February 2011 using face to face interviews. A questionnaire was developed that contained sections on sociodemographic variables and environmental fall risk factors, including falls and circumstances of falls, medical conditions and prescribed medications. Functional status assessment was carried out using a ten-item modified Barthel Index. Information on medical conditions and prescribed medications were obtained from home-based medical record or direct assessment by a trained healthcare worker. Data was analysed using descriptive statistics, Chi-square test for association between falls and risk factors and finally multiple logistic regression for predictors of falls. Results: The rate of falls was 30.5% and majority (96.5%) of fallers had no injury. Most falls (84.2%) occurred during the day and 63.2% occurred outside the house. The main reason for falls was due to slips (73.7%) and trips (17.5%), and the remaining due to dizziness. Falls occurred almost equally among the age groups, males and females, those married and those without spouses, the ethnic groups, different education levels, various income groups, and those staying alone or with extended family. Conclusion: There was significant association between falls and functional status, arthritis, asthma or chronic obstructive pulmonary disease, visual impairment and urinary incontinence. However, functional status was the only predictor of falls among the study population. Keywords: Falls, elderly, geriatric, Sarawak, factors, rural, primary care, functional status. PP46 CULTURAL PRACTICE AMONGST YEMENI PARENTS AND ITS RELATION TO UNINTENTIONAL HOME CHILD INJURY Al-abed Ali Ahmed Al-abed1* & Syed Mohamed Aljunid2
1.
2.
Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Malaysia United Nations University-International Institute for Global Health (UNU-IIGH)
*For any correspondence: abed11k@gmail.com Introduction: Unintentional injuries are important medical problems leading to death and disability among children in both developed and developing countries. Most of these of injuries occurred at home due to many factors related to family, housing condition, child, knowledge on child injury prevention and cultural factors. Chewing khat by parents and other family factors are common problems found amongst Yemenis. The goal of this study is to identify the potential risk factors for having unintentional childhood injury at home in the Yemeni society. Methods: A case control study was conducted in 2012 using a structured face to face interview. Six hundred ninety two parents or main carers of children who attended the emergency and medical ward from six major hospitals (3 public & 3 private) in Sanaa, Yemen were recruited. Factors studied included demographic and socio-economic factors, family structure, and social and cultural practices. Descriptive and statistical analyses were run using SPSS version 20. Results: There were 20 variables related to sociodemographic, home, family and cultural practices factors which were statistically significant with child injury (P< 0.05). After controlling for the confounders using multivariate analysis, only some factors predict the unintentional child home injury. The most important factors were younger maternal age (OR= 0.87, 95% CI 0.84-0.90, P< 0.001), mothers primary, secondary or graduate education (OR= 0.36, 95% CI 0.21-0.66, P= 0.001; OR= 0.23, 95% CI 0.14-0.37, P< 0.001; and OR= 0.29, 95% CI 0.13-0.65, P= 0.003) respectively, fathers employment (OR= 2.69, 95% CI 1.68-4.29, P< 0.001), mothers employment (OR= 3.56, 95% CI 2.25-5.65, P< 0.001), having safe kitchen cabinet (OR= 2.82, 95% CI 1.97-4.04, P< 0.001), living with large families (OR= 1.32, 95% CI 1.22-1.44, P< 0.001) and parental khat chewing (OR= 2.01, 95% CI 1.40-2.89, P< 0.001).
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Conclusion: Some factors related to Yemeni families and their cultural practices have an association with child injury at home. Yemeni cultural practice of chewing khat has twice the risk of child home injury. This should be informed to the public to stop this practice. Government needs to state a policy to prevent this cultural practice among parents. Keywords: Unintentional injury, home injury, children, risk factors, chewing khat, family factors PP47 QUALITY OF LIFE AND ITS ASSOCIATED FACTORS AMONG YOUNG ADULTS IN RURAL AREAS OF HULU LANGAT DISTRICT, SELANGOR Madihah Mustafa* & Norfazilah Ahmad Department of Community Health, Universiti Kebangsaan Malaysa Medical Centre, Malaysia *For any correspondence: madihahmustafa@gmail.com Introduction: Measuring quality of life (QOL) is very important to assess the completeness of health of a person, as well as the need to improve the QOL by identifying the factors affecting it. This study aims to measure the QOL among young adults in rural areas of Hulu Langat district, Selangor, and determine the factors that are associated with the QOL scores. Methods: A cross-sectional study was conducted to measure the QOL and determine its associated factors among young adults aged 18 to 39 years living in rural areas of Hulu Langat district, Selangor. A total of 308 respondents selected through simple random sampling, participated and completed this study. Validated Malay version of WHOQOL-BREF questionnaire which generated four domain scores of physical health, psychological health, social relationship and environmental QOL was used to measure QOL of the respondents. Results: Overall QOL score was 65.10 (17.92), while physical health domain score was 58.23 (11.00), psychological health domain score was 60.67 (11.88), social relationship domain score was 67.07 (18.87) and environmental QOL domain score was 64.88 (12.83). Indians and married young adults were found to have higher QOL scores. Being unemployed, and having chronic diseases and mental health distress were found to lower the QOL score. Conclusion: Improving QOL of young adults who are unemployed, having chronic diseases and mental health distress is needed. Unemployed young adults should be empowered by identifying their concerns and creating and strengthening personal development in relation to work or education. More equity in health should also be ensured to help those with chronic diseases and mental health distress. Keywords: Quality of life, associated factors, young adults, rural areas, Selangor, WHO-QOL BREF PP48 THE EFFECT OF WORK-FAMILY CONFLICT ON PSYCHOLOGICAL DISTRESS AMONG MARRIED WORKING WOMEN IN MALAYSIA Sanaz Aazami1*, Syaqirah Akmal1, Rahmah Mohd Amin2 & Khadijah Shamsuddin1
1.
2.
Department of Community Health, University Kebangsaan Malaysia Medical Centre, Malaysia Universiti Sultan Zainal Abidin, Malaysia
*For any correspondence:kshams57@yahoo.com Introduction: Work-Family conflict is a form of inter-role conflict in which responsibilities and obligations from work and family domain are mutually incompatible. It is recognized as bidirectional in nature and can be categorized as work interference into family (WIF) and family interference into work (FIW). Greater level of WIF and FIW has been linked to higher psychological distress. Methods: The enclosed study is part of a larger cross-sectional research which analysed 325 married working women with at least one child. The respondents were Malaysian female workers from randomly selected government agencies in the state of Selangor and Kuala Lumpur. Data was collected using self-administrated questionnaire which includes socio-demographic information, work-family conflict measurement and measures of psychological distress from the General Health Questionnaire (GHQ). Socio-demographic variables include age, education, income, working hours per week, work experience
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and number of children. Work-family conflict was measured using a 22-item instrument with Likert type scale ranging from 1=strongly disagree to 5=strongly agree. WIF and FIW scores can range from 11 to 55 with the higher score indicating higher level of conflict. The GHQ was a 12-item Likert type instrument with total scores of 0 to 36 where higher GHQ scores indicate higher level of psychological distress. Results: Mean age of the 325 respondents was 36.1 9.2 year and their average income was RM 2,766 2539 monthly. A third (34.5%) of them had at least bachelor degree. Women in this study had on average 2.3 1.3 children. On average, they worked 42.6 5.3 hours per week and they had worked for11.9 9.7 years. Mean total score for WIF, FIW and GHQ was 28.5 7.1, 24.5 5.6 and 9.7 4.1 respectively. The Pearson bivariate correlation showed that psychological distress is significantly and positively related to WIF (r=0.31 p=0.00) and FIW (r=0.30 p=0.00). After controlling for the effect of sociodemographic factors, linear regression analysis showed that WIF (b=0.23 p=0.008) and FIW (b=0.17 p=0.000) are predictors of psychological distress. Conclusion: This study showed that work-family conflict can predict psychological distress among working women but, WIF seems to have a stronger relation with psychological distress than FIW. The traditional gender attitude towards domestic responsibilities could result in higher level of WIF and consequently poorer mental health. The findings support the moves toward more family-friendly policies in the workplace to reduce womens psychological stress through reduction of work family conflict. Keywords: Work-family conflict, married women, psychological, stress PP49 CHILDHOOD INJURY PRONENESS: PERCEPTION OF URBAN MOTHERS ATTENDING MATERNAL AND CHILD HEALTH CLINICS IN KUALA LUMPUR. Nadeeya Ayn Umaisara Mohd Nor1,2*, Khadijah Shamsuddin1, Rosnah Sutan1 & Zairina Abdul Rahman1
1.
2.
Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Malaysia Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Malaysia
*For any correspondence:kshams57@yahoo.com Introduction: Unintentional injury in children can be precipitated by their injury-prone behaviours. Mothers perception of her childs injury proneness may help in injury prevention. The objective is to determine urban mothers perception of their young children injury proneness and its associated factors. Methods: A cross sectional study was carried out among mothers who attended the Maternal and Child Health Clinics in Kuala Lumpur from February 2013 to June 2013. Two hundred mothers with children aged 1 to 4 years were approached randomly to participate in the study. A validated, self administered questionnaire containing the Injury Behaviours Checklist, a 24-item inventory was used to ascertain the childs injury proneness. Total scores can range from 0 to 96, with higher scores indicating higher perceived injury proneness. Results: Preliminary analysis of 200 shows the majority of mothers were Malays (88.5%), married (98.0%), working (61.0%), have had tertiary level of education (47.5%) and their mean age was 30.32 (4.67) years. Most mothers stayed in nuclear family (70.0%) with more than 1 child (56.5%). Of these mothers 79.0% had one child aged 1 to 4 years, and 64.5% required helper in taking care of their child. The mean time spent with their children was 10.6(7.0) hours daily. The average score on mothers perception of their childs injury proneness was 20.12 (10.29). Significant factors that were associated with mothers perception of their children injury proneness were mothers level of education (p= 0.034), childs gender (p= 0.000) and childs history of recent injury (p= 0.001). Conclusion: Based on crude analysis, this study found that mothers perception on child injury proneness was associated with tertiary level of education, having a son and history of recent child injury. These can be further analyzed by the childs age, and using adjusted analysis and subsequent results be used for planning and developing public health intervention to prevent childhood injury. Keywords: Injury proneness, urban mothers, children under five years, mothers perception
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PP50 UNMET NEED FOR INFERTILITY CARE AMONG WOMEN WORKING IN MALAYSIAN PUBLIC SERVICES Syaqirah Akmal*, Khadijah Shamsuddin, Sharifa Ezat Wan Puteh & Sanaz Aazami Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Malaysia *For any correspondence:kshams57@yahoo.com Introduction: Unmet need for infertility care is defined as non-utilisation of infertility care among married women who have been trying to conceive for more than 1 year. To date, there is little information on unmet need for infertility care and its predictors among Malaysian women. The objective is to determine the predictors of unmet need for infertility care among Malaysian working women. Methods: The study was a cross sectional survey of women working in public services in the Klang Valley area. Data was collected from women selected through multistage sampling using validated, selfadministered questionnaire. Results: A total of 407 married women participated in this study. Their mean age was 33.55 +8.73 years, the majority (93.6%) was Malays and the median duration of working in public services was 7 years (IQR 8 years). Forty seven (11.5%) women reported trying to conceive in the last one year and 38.3 % had unmet need for infertility care. Of these women, half of them utilised informal care while the other half did not seek care at all. We found that not having own transport was the most important predictor of unmet need for infertility care (OR= 3.5; 95% CI: 1.37, 9.15). Other predictors include being physically or psychologically stressed by the workplace (OR = 1.8; 95% CI: 1.09, 3.10), lacking regular health provider (OR = 1.6; 95% CI: 1.01, 2.71) and unavailability of health services (OR = 1.1; 95% CI: 1.01, 1.13). Conclusions: In meeting the need for infertility care among working women in Malaysia, we could primarily encourage financial empowerment, reduce physical and psychological stress in the work place, ensuring availability of regular health providers and good health services. Keywords: Unmet need, infertility care, working women, availability of health services, physical stress, psychological stress, Malaysian public service PP51 PREDICTING LOW BIRTH WEIGHT INFANTS IN UKM MEDICAL CENTRE: A MATCHED CASE CONTROL STUDY Mazlina Mokhtar*, Aimi Nazri Mahat, Rosnah Sutan & Azmi Mohd Tamil Department of Community Health, UKM Medical Centre, Malaysia *For any correspondence: aimi_nazri@yahoo.com Introduction: Low birth weight (LBW) is a well known factor associated with neonatal mortality and had contributes to a range of poor health outcomes. Thus, the objective of this study was to identify the factors associated with LBW infants in UKM Medical Centre, Kuala Lumpur, Malaysia. Methods: This matched case control study was conducted at UKM Medical Centre. Data of deliveries were obtained from Total Hospital Information System and medical records. All registered deliveries from January June 2012 were used as sample populations. There were 180 pairs of cases and controls with matched 1:1 on babies gender. Fourteen variables were analyzed; Maternal age, Ethnicity, Gravida, Parity, Gestational Age, Maternal booking weight, height and BMI, History of LBW infants, Inter-pregnancy Interval, booking Haemoglobin levels, Hypertension, Diabetes Mellitus and Type of Delivery. Analysis was done using SPSS version 20. Results: Younger mother (t=6.947, p<0.001), lower booking BMI (t=3.067, p=0.002), prematurity (t=12.324, p<0.001), history of LBW infants (OR=3.0, p=0.001), LSCS (OR=0.06, p=0.001) and having hypertension (OR=3.1, p=0.008) were found significant in bivariate analysis. Multivariable conditional logistic regression identified younger maternal age (AOR=2.9, 95% CI=1.86-4.51, p<0.001), previous history of LBW infants (AOR=3.7, 95% CI=1.03-13.58, p=0.045), prematurity (AOR=2.4, 95% CI=1.79-3.26, p<0.001), and having hypertension (AOR=4.5, 95% CI=1.06-
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19.22, p=0.041) as significant factors associated with LBW infants in UKM Medical Center. Conclusion: Younger maternal age, history of LBW infants, prematurity and hypertension has been recognized as predictors of LBW infants. The importance of pre pregnancy screening, early antenatal booking and proper identification of high risk mother need to be strengthen and enforce in effort to reduce incidence of LBW infants. Keywords: Low birth weight, maternal factors, matched case control PP52 POSTPARTUM DEPRESSION AMONG MOTHERS IN KOTA KINABALU, SABAH Aza Sherin1*, Colin Binns2 & Andy Lee2
1.
2.
School of Medicine, University Malaysia Sabah, Malaysia School of Public Health and Curtin Health Innovations Research Institute, Curtin University, Australia
depression. The risk factors associated with antenatal depression included low family household income, on family planning, unhappy with the pregnancy, unplanned pregnancy and worry during pregnancy. Risk factors-associated with postpartum depression include antenatal depression, low family household income, not receiving husbands help in taking care of baby, having problems most of the time and have problems with childcare during confinements. Conclusion: In conclusion, this study offers important insights in the risk factors for antenatal depression among women in Malaysia. It is suggested that screening and treatment should be targeted on women who are exposed to these risk factors in the early stage of pregnancy to avoid the risk of developing depression during pregnancy and also in the postpartum period. Keywords: antenatal depression, postpartum depression, risk factors, prevalence, Sabah. PP53 FACTORS ASSOCIATED WITH NONEXCLUSIVE BREASTFEEDING IN GOVERNMENT HEALTH CLINICS BATU PAHAT, JOHOR Rahmat Dapari* & Shamsul Azhar Shah Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: rahmat_09h@yahoo.com Introduction: Exclusive breastfeeding is accepted as global health policies to ensure the infant receive the optimum nutritional benefit of breastfeeding from first hour of life until six months old. However, Malaysia remains the country with the lowest prevalence of exclusive breastfeeding compared to other countries in the Southeast Asian region. Thus, it is important for health care provider to evaluate the factors that may influence exclusive breastfeeding practice. The aim of this study is to determine the prevalence of non-exclusive breastfeeding and its associated factors in Batu Pahat, Johor. Methods: This was a cross-sectional study involving 354 mothers with infants from six months to one year
*For any correspondence: azashern@ums.edu.my Introduction: This study aimed to identify the prevalence and risk factors associated with depression among mothers in the antenatal period and during the first 6 months after childbirth. Methods: This is a prospective study of a cohort of 2072 women who were recruited at their antenatal visit at five Maternal and Child Health Clinics in the district of Kota Kinabalu. After birth the mothers were followed up with a sample of 1598 at 1 month, 1326 at 3 months and 1184 at 6 months postpartum visits. Results: A total of 924 mothers attended all the four interviews. Using the Edinburgh Postnatal Depression Scale, the prevalence of antenatal depression (i.e. a score 12) was 13.8% while the prevalence of postpartum depression was 7.6%, 7.2% and 8% at 1 month, 3 months and 6 months respectively. Multivariate analysis involved the Multivariate Logistic Regression Analysis, Generalised Logistic Estimating Equation Analysis and the Cox Proportional Hazard Analysis. Antenatal depression was a strong risk factor for postpartum
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old attending government maternal and child health clinics in Batu Pahat, Johor. Data on maternal and infant factors were collected from the antenatal and postnatal record book between 28 and 29 March 2013 in selected health clinics. Results: The prevalence of non-exclusive breastfeeding was 40.4%. The mean maternal age was 29.67 (5.65) years. In bivariate analysis, factors significantly associated with non-exclusive breastfeeding were maternal age, ethnicity, BMI, occupational status, type of employer, parity, last child birth, place of delivery, mode of delivery, infant gender, infant weight and infant gestation age at birth. However, in multivariate analysis, only maternal age, ethnicity, occupational status, BMI, place of delivery and infant gestation age were found to be significant associated with non-exclusive breastfeeding. Conclusions: Implementation of any intervention program related to education and promotion of exclusive breastfeeding should be focus on those who are at increased risk of non-exclusive breastfeeding in order to improve exclusive breastfeeding practice. Keywords: non-exclusive breastfeeding, risk factors, occupational status, six months. PP54 ASSOCIATION BETWEEN NUTRITIONAL STATUS AND NUMBER OF TEETH IN AN OLDER POPULATION IN KUALA PILAH, NEGERI SEMBILAN Tanti Irawati Rosli1*, Rahimah Abd Kadir2, Tengku Aizan Abd Hamid3 & Zaiton Yassin4
1.
*For any correspondence: tantiir@hotmail.com Introduction: Compromised dentition can reduce masticatory efficiency in older adults. This may result in avoidance or modifications in food choices and thereby lead to impaired nutritional status. This study was to determine the association between number of teeth and nutritional status in older adults in Kuala Pilah, Negeri Sembilan. Methods: A cross-sectional study was carried out on 495 older adults aged 50 years and above from 10 randomly selected villages in district of Kuala Pilah. Respondents were interviewed using a structured questionnaire to collect information on their demographic characteristics. Total number of teeth was determine through oral assessment, followed by a physical examination to measure height and weight to calculate the body mass index (BMI) of respondents. Results: The response rate was 97.4%. More than half of the respondents were female (56.4%). The percentage of respondents who was normal, underweight, overweight and obese was 32.2, 4.6, 43.0 and 20.2% respectively. The proportion of edentulism was 16% and majority of the older adults had less than 20 teeth (70%) and less than 5 posterior occluding pairs of teeth (88%). The percentage of underweight respondents who were edentulous and had less than 20 teeth was 29.4% and 88.2% respectively. The percentage of overweight and obese respondents who were edentulous and had less than 20 teeth was 12.8% and 65.5% respectively. Conclusion: Number of teeth is significantly associated with being overweight and obese, but not being underweight, among older adults in Kuala Pilah. Keywords: nutritional status, number of teeth, compromised dentition
2.
3.
4.
Faculty of Dentistry, Universiti Kebangsaan Malaysia, Malaysia Faculty of Dentistry, Lincoln University College, Malaysia Institute of Gerontology, Universiti Putra Malaysia, Malaysia Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Malaysia
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PP55 PRELIMINARY STUDY: KNOWLEDGE, ATTITUDE AND PRACTICE ON NUTRITION AMONG CHILDREN IN TWO SELECTED ORPHANAGES AND ITS RELATIONSHIP WITH BMI Wan Noraini Wan Sulaiman*, Mohd Dzulkhairi Mohd Rani, Nazefah Abdul Hamid, Syimir Shaziman, Marlini Muhammad & Ku Mastura Ku Mohd Noor Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Malaysia *For any correspondence: nur_ikram29@yahoo.com Introduction: Knowledge regarding nutrition may influence good dietary practice among children. It has been reported that children living in orphanages are found to be undernourished than non-orphans. This study aims to determine the knowledge, attitude and practice (KAP) on nutrition, to determine the body mass index (BMI) and the correlation between the nutrition knowledge and BMI of children from 2 orphanages. Methods: A cross sectional study was conducted among 30 children aged 7 to 17 years from 2 selected orphanages. Their BMI were measured and KAP regarding nutrition was obtained using validated questionnaire via face to face interview. Results: Male and female respondents were equal in number. Their overall mean age was 12.3 years (SD=2.31). Mean BMI of the children was 20.03 (SD=5.08). 56.7 % of children had normal BMI, 26.7% were overweight, 13.3% were obese, and only 3.3% were underweight. KAP results showed 80% of the children knew about balanced diet; 70% claimed to eat vegetables and fruits everyday. 80% of them knew that junk food contains additives and colourings. However, only 40 % stated that they are willing to stop eating junk food. 66.7% knew drinking sweet drinks might lead to obesity and only 43.3% claimed to drink sweet drinks regularly. The total knowledge score (TKS) and total attitude score (TAS) with the childrens BMI showed no significant correlation (p=0.551, r=0.113), and (p=0.406, r=0.158) respectively. However, there was significant correlation between their total practice score (TPS) and BMI (p=0.013, r= -0.449). Conclusions: Overall, more than half of the orphans in this study have normal BMI. However, there is still a concern on those who were overweight and obese. TKS about nutrition among them was good. Despite of that, by just educating the children about nutrition may not be sufficient enough as nutritional practice associates more to the children's BMI. Keywords: KAP, nutrition, BMI, orphanage
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POSTER PRESENTATION: OCCUPATIONAL HEALTH
poster PRESENTATION OCCUPATIONAL HEALTH
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PP56 JOB SATISFACTION AMONG LIBYAN GENERAL PHYSICIANS IN PUBLIC SECTOR Mohamed Sryh1* & Azimatun Noor Aizuddin2
1.
PP57 PREVALENCE OF LOW BACK PAIN AND ITS ASSOCIATED RISK FACTORS AMONG SEMICONDUCTOR INDUSTRY WORKERS IN MALACCA Norfazilah Ahmad* & Ahmad Faizal Zuli Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: ah.fazilah@gmail.com Introduction: A cross sectional study was conducted to determine the prevalence of low back pain and its associated risk factors among semiconductor industry workers in Malacca. Methods: The study involved 295 respondents who were selected through convenient sampling. The respondents comprised of workers from four semiconductor companies located in the Batu Berendam Free Trade Zone, Melaka who gave their written consent to participate in the study. Data collection was through self-administered questionnaire and anthropometric (height and weight) measurement. Individual and sociodemographic, physical and psychosocial risk factors were studied. Results: This study found that the 12-month prevalence of low back pain among the semiconductor workers was 40.0%, behind shoulder pain (60.0%), upper back pain (57.3%) and neck pain (56.6%) and comparable to pain in the hand/wrist (39.7%). None of the individual and sociodemographic factors studied showed significant relationship with low back pain. Multiple logistic regression analysis revealed that for physical risk factors; non-neutral body position (aOR 2.4, 95% CI 1.13, 4.43), lifting heavy objects (aOR 2.0, 95% CI 1.16, 3.28) and for psychosocial risk factors; high psychological job demand (aOR 2.1, 95% CI 1.20, 3.77) were significantly associated with low back pain. Conclusion: The prevalence of low back pain was high and certain physical risk factors and high psychological job demand explained up to 10.4% of low back pain in this working population. Keywords: Low back pain, prevalence, risk factors, semiconductor industry
2.
Community Health Department, Faculty of Medicine, Elmergib University Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia
*For any correspondence: mss99044@yahoo.com Introduction: The aim of the study is to determine the level of job satisfaction among the Libyan general physicians and to determine the influence of demographic characteristics and job characteristics on job satisfaction among Libyan GPs. Methods: This cross sectional study was conducted in Libyan major public referral hospitals where subjects were Libyan general physician who carried a bachelor degree in medicine and general surgery and who had a regular job in one of the Libyan major hospitals. Data collection was through selfadministered questionnaire. Results: Random sample of general physicians (215) were selected where 64.2% of the respondents were males and 35.8% were females. 80.5% of the respondents were singles and 19.5% were married. Their mean hours of work per week were 49.93 hours and the average monthly salary was 738.39 L.D. Subjects had an average level of satisfaction in all of the domains. Conclusion: The study results revealed that Libyan general physicians working at the public sector hospitals had an average level of job satisfaction as shown on the total score. There were significant associations between gender, marital status, and experience with job satisfaction among the Libyan general physicians working at the public sector hospitals. There were no significant association between monthly salary and job satisfaction. There was a strong significant association between working hours and job satisfaction but there were weak associations between type of department, hospital and job satisfaction among the Libyan general physicians working at the public sector hospitals. Keywords: Job satisfaction, general physician, satisfaction scoring
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PP58 HEALTH EFFECTS AMONG ON CALL DOCTORS IN UNIVERSITI KEBANGSAAN MALAYSIA MEDICAL CENTRE Azimatun Noor A* & Nurul Syahira ML Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: azimatunnoor@gmail.com Introduction: Doctor's skills and services are always needed regardless of time. Therefore, most doctors are required to work on call. Methods: A cross-sectional study was conducted in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) to determine the health effects among on call doctors. 227 Personal Stress Inventory questionnaires were distributed to on call doctors in all departments of UKMMC. Response rate was 100%. Results: The findings showed that the mean age of respondents was 31.4 years (SD 3.46). Majority of respondents participated were Malay, female, married; medical officer with the mean years in service was 5.4 years (SD 2.97). The mean income of respondent was RM 5645.85 (SD 2337.99) and the mean frequency of on call is 2 times (SD 0.65) a week. Results of this study showed that the highest prevalence of health effects among on call doctors was stress (49.3%) and the lowest was sleep disturbance (20.7%). Results showed that age and marital status were among the factors contributing significantly to musculoskeletal disorder, fatigue and sleep disturbance. In addition, it was found that marital status had significant association with gastrointestinal disorder and other physical system, while gender and income had significant association with stress. Sharps injuries and needle stick injuries were significantly influenced by job category. Frequency of on call was significant associated with gastrointestinal problem, stress and sharps injuries and needle stick injuries. Multiple logistic regression analysis revealed significant association between marital status and musculoskeletal disorder, gastrointestinal disorder, other physical systems, fatigue, and sleep disturbance, gender and stress, and work category with sharps injuries and needle stick injuries. Conclusion: In conclusion, this study found that the health effects among on call doctors were musculoskeletal disorder, gastrointestinal disorder, other physical system, fatigue, sleep disturbance and sharps injuries and needle stick injuries. Several factors affect on call doctors health such as age, gender, marital status, income, work category and frequency of on call. Keywords: On call doctors, fatigue and stress, job category PP59 EXPOSURE TO PM2.5 AND CARBON BLACK AND ITS RELATIONSHIP WITH RESPIRATORY HEALTH AMONG WORKERS AT THE PRINTING INDUSTRY IN SELANGOR Nurfatin Athirah Malik, Emilia Zainal Abidin* & Irniza Rasdi Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia *For any correspondence: emiliazainal@gmail.com Introduction: Carbon black is widely used in the industrial sectors in the manufacturing of car tires, resins, plastic materials, inks, varnishes and coloring agents. Workers who are exposed to carbon black in their daily tasks in the printing industries are at risk for adverse respiratory health effects. The aim of this study was to determine the level of carbon black and PM2.5 exposure levels of workers in a printing industry in Selangor. This study has also aimed to assess the respiratory health of the workers and how the exposure to PM2.5 is associated with their respiratory health. Methods: This is a cross-sectional study among 105 workers in a printing factory in Selangor. The workers were given a self-administered questionnaire consisting of questions on respiratory symptoms, background information and other relevant information. The workers performed a spirometer test to assess their lung function. Respiratory health
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symptoms were assessed using a standard questionnaire from the American Thoracic Society. The environmental monitoring for PM2.5 was performed using TSI SIDEPAK AM510 Aerosol Monitor and carbon black was measured via Gillian air sampling pump with a PVC filter. Results: There were 60 and 45 workers involved in this study as the exposed and unexposed group respectively. The level of carbon black was 0.49 mg/m3 which did not exceed the 8-hour Total Weighted Average (3.5 mg/m3). The 24-hour PM2.5 for the exposed areas was almost 4-fold higher than the unexposed area (49.01 and 12.76 g/m3 respectively). There were no significant differences between the lung function parameters and reported respiratory symptoms. Conclusion: The workers are exposed to carbon black at levels not exceeding the standards but are exposed to high concentrations of respirable dust. It is suggested that the engineering controls such as local exhaust ventilation be installed to reduce the amount of respirable dusts exposures. Keywords: Carbon black, Respiratory system, Spirometer test, PM2.5 PP60 DETERMINANTS OF RETURN TO WORK AMONG WORKERS WITH OCCUPATIONAL INJURIES IN MALAYSIA Erlendawati Binti Mohd Anuar*, Azlan Bin Darus & Choo Wan Yuen Department of Social and Preventive Medicine, University of Malaya, Malaysia *For any correspondence: dr_erlendawati@yahoo.com Introduction: Disability associated with occupational injury can cause a serious direct and indirect cost, not only to the employees, but will also affect other stakeholders, namely the employers, the social security organization, the insurance company and the health care providers. Although numerous literature have identified factors of return to work, but limited literatures has been published that look into developing instrumentation to predict return to work duration, and in addition, looking into the Asian population, mainly the Malaysian population. The aim of this study is to predict factors and duration (in days) that are associated with return to work. This is a retrospective cohort study. The subjects is the secondary data of workers insured under Social Security Organization Malaysia (SOCSO) between 2008 until 2010 Methods: A negative binomial regression modelling techniques was used to develop the risk score. This tool consists of thirteen main preliminary variables : age, gender, ethnic, salary, working experience, types of industry, types of work, nature of injury, site of injury, history of previous injury, history of hospitalization and receipt of compensation payment (permanent disablement and temporary disablement benefit). Results: Age, occupation, in (Dept of Social and Preventive Medicine, UM) dustry, site of injury, nature of injury, hospitalization, permanent disability benefit received, payment of temporary disablement benefit claim were variables to be considered in the final model. Conclusion: Prediction of duration and factors of return to work involves a multi-dimensional issues and organization like the workers health, the employer or workplace, and the insurance or social security board. Keywords: Prediction, return to work, occupational injury PP61 THE RELATIONSHIP BETWEEN SHIFT WORK AND JOB STRESS IN PLUMBON INTERNATIONAL TEXTILE FACTORY, CIREBON, INDONESIA Jaenudin* & Irfan A. R Public Health Program, Mahardika College of Health Sciences, Cirebon, Indonesia *For any correspondence: skm_jays@yahoo.com Introduction: Job stress is a form of emotional and physiological reaction towards stressor at workplace. Job stressor can be in the form of certain aspects of the job task, the work environment that are detrimental to health and shift work. Studies conducted in the United States indicate that
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approximately 60-70% of workers with shift work had occupational health problems. The aim of this study was to determine the relationship between shift work and job stress among production workers in Plumbon International Textile Factory Cirebon Indonesia Methods: This was a cross-sectional study among 72 workers in a Plumbon International Textile Factory. Data were collected directly from the production workers using self-administered questionnaires. Results: A total of 15 people (62.5%) have moderate level of job stress as results of working in morning shift, 8 people (33.3%) have low level of job stress working in daylight shift and 13 people (54.2%) have moderate level of job stress working in night shift. There was a significant association between shift works with job stress Conclusion: Majority of the workers had moderate level of job stress as results of working in morning shift. To reduce job stress, we recommend that the workers are prepared emotional and physical before start working. Keywords: Shift Work, job stress, textile factory PP62 TEST ANXIETY AND ITS RELATED FACTORS AMONG MEDICAL STUDENTS, SHAHREKORD, IRAN Lotfizadeh Masoud* & Ghafari Mahin Department of Community Health, Shahrekord University of Medical Sciences, Shahrekord, Iran *For any correspondence: masoud_lotfizadeh@yahoo.com Introduction: One of the factors that influence students performances and educational progress is test anxiety. The following study considers the spreading of test anxiety and its related factors among medical students at Shahrekord University Medical Sciences. Methods: This cross sectional study was conducted among the medical students in the 1st semester of the year 2012-2013 at Shahrekord University Medical Sciences. 144 respondents were selected randomly to participate in this study. Sarason test anxiety questionnaires (TAQ) which consists of 25 questions were used in this study. The anxiety levels were classified according to the total score where a score of less than 12 = no anxiety, 13-37 = mild, 38-62 = moderate and more than 63 = severe anxiety. The SPSS (18) and relevant statistics tests were used for analyzing the data. Results: The respond rate for this study was 95.0%. 73.6% (106) of the respondents were females and 26.4% (38) were males. The mean age of the students was 212.9 (21.62.3 for female and 21.64.2 for male). 86.8% of the respondents were single and had monetary dependence to their families, 96.5% had no past medical history and 55.6% were native. 72.0% of the respondents had little or mild while 28% had severe anxiety. The mean score of the students test anxiety was 37.84.6 (38.14.8 for female and 373.8 for male). There were significant relationship between test anxiety and marital status, major, and employment. Conclusion: The findings emphasized on the necessary programs for reinforcing and improving the quality of training consultation and some other aspects. Keywords: Anxiety, test, medical students, shahrekord PP63 RELIABILITY AND VALIDITY OF JOB CONTENT QUESTIONNAIRE AMONG RESEARCH LABORATORY STAFFS Nehzat Fadaei*, Huda Zainuddin & Syed Tajuddin Syed Hassan Department of Community health, Universiti Putra Malaysia, Malaysia *For any correspondence: nefa.otr@gmail.com Introduction: Job Content Questionnaire (JCQ) is an instrument popularly used to assess job strain. Studies have been done among different jobs such as secondary teacher schools, office workers, and automotive assembly workers to assess the reliability and validity of JCQ. Methods: This is a cross - sectional study among 258 research laboratory staff in Universiti Putra Malaysia (UPM). Five scales of JCQ (validated Malay
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version); decision latitude, psychological job demands, physical job demands, social support, and job dissatisfaction were assessed. Results: Cronbachs alpha coefficient for all scales were acceptable, where decision latitude was .70, psychological job demands (.72), physical job demands (.75), social support (.86) and job dissatisfaction (.81). Exploratory factor analysis done to assess construct validity was able to explain the two dimensional Karaseks job strain model. Conclusion: In addition, the results of this research suggest that the JCQ scales were reliable and valid for examining job strain among research laboratory staffs. Keywords: job strain, laboratory staff, reliability, validity.
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POSTER PRESENTATION: ENVIRONMENTAL HEALTH
poster PRESENTATION ENVIRONMENTAL HEALTH
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PP64 AIR QUALITY STUDY IN PETALING JAYA, SELANGOR Jeffry S1*, Normah A2 & Azmawati MN3
1.
PP65 INJURY AND RISK REDUCTION PRACTICES OF ROAD TRAFFIC ACCIDENTS Magesiwaran M, Nor Haniza Z*, Aisah M, Vinoth Viknesh M & Roslinah A Institute for Health Management, Ministry of Health Malaysia, Malaysia *For any correspondence: drnorhaniza_zakaria@moh.gov.my Introduction: World Health Organisation (2002) estimated 1.2 million people died as the result of road traffic collisions. This gives an average of 3,242 people being killed on the worlds roads daily. Road traffic injuries were the 11th leading cause of death worldwide and accounted for 2.1% of all deaths globally. In Malaysia, road traffic injuries were the commonest cause contributing up to 60.0% of total burden of unintentional injuries. In order to develop effective preventive strategies, more information needed such as a number of and types of injuries and the circumstances in which the injury occurred as it will indicate the seriousness of the problem and preventative measures that are needed most. The objectives of the study are to determine the incidence rate of road traffic injuries and to assess the magnitude of risk reduction practices in populations. Methods: A two stage stratified sampling design with proportionate allocation was adopted in this National Health and Morbidity Survey (NHMS) III. The first stage sampling unit was the Enumeration Blocks (EB), comprised of 8 sampled Living Quarters (LQ). The EBs was geographically contiguous areas of land with identifiable boundaries. Each contains about 80-120 LQs with about 600 persons. The EBs in the sampling frame was also classified into urban and rural areas. Data was collected using face to face and self-administered questionnaires. Data analysis was done by Microsoft Excel, SPSS and STATA. Results: A total of 55,774 (98.4%) out of 56,710 samples responded to the injury and risk reduction questionnaire. The incidence rate for injuries on the road was 4.4% (n=2,423). The incidence rate was significantly higher among those aged between 15 to 24 years old (11.1%), males (6.4%), Indians (6.1%),
2.
3.
Engineering Unit, Selangor State Health Department, Malaysia Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Malaysia Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia
* For any correspondence: atienawi@yahoo.com Introduction: During the last two decades there has been increasing concern within the scientific community over the effects of air quality on health. Methods: This cross-sectional study was conducted to determine the air quality based on concentrations of particulate matter diameter of 10 micrometers (PM10), particulate matter diameter of 2.5 micrometers (PM2.5), carbon dioxide (CO), nitrogen oxide (NO), sulphur dioxide (SO2) and surface level ozone (O3) in industrial, commercial and residential areas in Petaling Jaya. Dust mate Fume and Particle Detector, Multilog 2000 and Ozone Analyzer has been used during the sampling activities. Five sampling points were selected according to the type of study in with the study was conducted from July until September 2009. Results: This study found that the concentrations of particulate matters were above the Recommended Malaysian Air Quality Guidelines (RMAQG), especially in the industrial areas. Kruskal-Wallis test showed significant differences for PM10 and PM2.5 between the sampling stations. Spearman correlation tests show a low relationship between the PM2.5 and NO (r = 0.24; p = 0.003), moderate relationship between PM10 and PM2.5 (r = 0.35; p <0.001) and strong relationship between NO with O3 (r = 0.78; p <0.001). Conclusion: A high concentration of particulate matters can contribute to health problems to humans if the exposure continues for a long period. Keywords: Air quality, PM10, PM2.5
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not married (10.1%) and had secondary education (5.9%). Generally, the incidence rate of injuries on the road declined with increasing personal and household incomes. The injury incidence rate was significantly higher among those living in rural areas (4.8%) compared to urban dwellers (4.1%). Malaysians had significantly higher incidence rate injuries on the road (4.5%) compared to nonMalaysian (1.2%). Nearly 20.0 30.0% of respondents admitted being exposed to first aid and cardiopulmonary resuscitation and only slightly more than half of the motorist wore the helmet correctly all the time. Conclusion: Further studies are urgently needed to be conducted to identify reasons and management for the risk behaving behaviour in order to reduce the incidence rate of road traffic accidents in Malaysia. Keywords: Road traffic accidents, incidence rate, injuries, risk reduction practices PP66 INJURIES AT RECREATIONAL AREAS AND RISK REDUCTION PRACTICES Mohd Fairuz AR, Norrina J, Sumithra N, Shahrul Nizam A & Noriah B* Institute for Health Management, Ministry of Health Malaysia, Malaysia *For any correspondence: drnoriahbidin@ipk.moh.gov.my Introduction: Injuries, either unintentional or intentional are a major public health problem. Studies on injuries have shown that the events are predictable and controllable, and they can be prevented through human effort. Injuries can occur anywhere including at recreational areas. The purpose of the study is to determine the incidence rate of injuries at recreational areas and to assess the magnitude of risk reduction practices among the population. Methods: A two stage stratified sampling design with proportionate allocation was adopted in this National Health and Morbidity Survey (NHMS) III. The first stage sampling unit was the Enumeration Blocks (EB), comprised of 8 sampled Living Quarters (LQ). The EBs was geographically contiguous areas of land with identifiable boundaries. Each contains about 80-120 LQs with about 600 persons. The EBs in the sampling frame was also classified into urban and rural areas. Validated selfadministered questionnaires and interviews were used to obtain data about personal and household information. Data were analyzed by SPSS and STATA. Results: A total of 55,774 (98.4%) out of 56,710 samples responded to the injury and risk reduction questionnaires of which 55,141 respondents completed the questionnaire on recreational injury. The overall incidence rate was 1.7% (n=960), higher among 15 to 24 years of age (4.0%) and males (2.9%). Majority of the recreational injuries occurred at playground areas (61.7%), followed by sport facilities (16.9%) and recreational parks (10.6%). The most common type of recreational injuries was fallen (91.3%). The injuries resulted in inability to go to workplace, school or play (21.0%) and 5.8% required hospital admission for at least one night. Exposure to first aid was reported by 25.6% of the respondents while exposure to cardio-pulmonary resuscitation (CPR) was only 19.0%. Conclusion: In this NHMS III study, the incidence of recreational injuries was found to be the lowest among the other five types of injuries studied (workplace, school, home and road). The riskreduction practices (CPR and first aid) were also noted to be low. Therefore, there is a need to increase the awareness about the potential injuries and risk reduction practices. Keywords: Recreational areas, incidence rate, injuries, rate reduction practices PP67 INJURIES AT HOME AND RISK REDUCTION PRACTICES Melvyn CYC, Eliana M*, Nabilah H & Mohd Idris O Institute for Health Management, Ministry of Health Malaysia, Malaysia * For any correspondence: eliana@ipk.moh.gov.my Introduction: Accidents are unfortunate events occurred as a result of the interaction between the agent (hazard), the host (man) and the environment (physical and psychosocial). Home is a place where
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people seek shelter, and it is supposedly to be a safe place. Nevertheless, injuries at home do occur especially among the children and elderly. The purpose of this study is to determine the incidence rate of injuries at home and to assess the magnitude of risk reduction practices among the population. Methods: This is part of National Health and Morbidity Survey (NHMS) III whereby a two stage stratified sampling design with proportionate allocation was adopted. Validated self-administered questionnaires and interviews were used to obtain data about personal and household information. Data were analyzed by SPSS and STATA. Results: The response rate of this study was 98.4% (55,774/56,710), and the overall incidence rate of home injury was 6.5% (3,742/55,593). The highest incidence of injury was among the age group of 0-4 years old (11.8%), and the lowest was between 45-54 years old (3.7%). The incidence rate among those in the age group of 65 years and above was 6.0%. Other Bumiputras recorded the highest incidence rate (10.7%) followed by Indians (6.9%). The injury rate was significantly higher among those in the rural areas (7.4%), and the main cause of injuries was due to fall (63.4%) followed by cut (19.9%), fire (4.3%) and struck by object (3.9%). The injuries were most commonly occurred in gardens (28.0%) followed by kitchen (24.9%), living room (14.7%), bathroom (7.5%) and stairs (7.2%). About 16.7% resulted in inability to go to school, work or play and about 4.9% required hospital admission for at least one night. It was noted that exposure to both first aid and cardiopulmonary resuscitation increased significantly with the level of education, highest among an age group of 18-24 years old, and those who have higher personal and household income. Conclusion: This study showed that there was an increase from 2.5% to 6.5% in the incidence rate of home injuries as compared to NHMS II. Therefore, there is a need to create the awareness on home safety to reduce accidents and identify the risk factors for home injuries. Keywords: Home injuries, incidence rate, risk reduction practices PP68 INJURIES AT SCHOOL Mu'izuddin S, Nik Nur Eliza M, Nor Filzatun B, Chang NK* & Roslinah A Institute for Health Management, Ministry of Health Malaysia, Malaysia *For any correspondence: jason_chang@ipk.moh.gov.my Introduction: Intentional injuries at schools have been identified as a significant public health problem. Schools are regarded as a learning center. However, schools also have been reported to be the most common place of injury among pupils. A major barrier against the development of the injury prevention programme has been the lack of national data on the circumstances of injuries at school. The purpose of this study is to determine the incidence rate of injuries at school, causes and associated risk factors. Methods: This study is part of the National Health and Morbidity Survey (NHMS) III whereby a two stage stratified sampling design with proportionate allocation was adopted. The first stage sampling unit was the Enumeration Blocks (EB), comprised of 8 sampled Living Quarters (LQ). The EBs was geographically contiguous areas of land with identifiable boundaries. Each contains about 80-120 LQs with about 600 persons. The EBs in the sampling frame was also classified into urban and rural areas. Validated self-administered questionnaires and interviews were used to obtain data about personal and household information. Data were analyzed by SPSS and STATA. Results: The response rate of this study was 98.4% (55,774/56,710). The overall incidence rate of injury at school was 7.0% (900/13,928). It was found to be highest among the age group of 15 to 17 years (8.5%), males (8.0%), residing in the urban areas (7.7%), and among o Bumiputras (9.1%). Majorities of the injuries were unintentional or accidental (79.8%), 16.2% were caused by someone else, and 4.0% were self-inflicted. Conclusion: The incidence of injuries at school was the highest as compared to other injuries (workplace, recreational areas, road traffic and home). However,
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further studies are required to ascertain nature of injuries to address the issues in order to provide a safe school environment. Keywords: Injuries at school, injuries, incidence rate, risk reduction PP69 FOOD HANDLER'S PERSONAL HYGIENE IN UNIVERSITI KEBANGSAAN MALAYSIA CAFETERIA Nurul'Izzah Ismail1*, Hasnah Haron1, Zurina Mahadi2 & Hukil Sino1
1.
2.
Faculty of Health Sciences, Kebangsaan Malaysia, Malaysia Center for General Study, Kebangsaan Malaysia, Malaysia
Universiti Universiti
agreed with the periodic health examination for food handlers, and 58% agreed with the need to comply with the optimum storage temperature. The statistical analysis shows that there was a significant relationship between job specification and typhoid vaccination (H=11.396, p=0.22), knowledge and attitude (2=6.542, p=0.01, =0.32), attitude and practice (2=9.788, p=0.02, = 0.391) and, between citizenship and attitude (2=5.486, p=0.02, = 0.293). Conclusion: In conclusion, every respondent does have good knowledge and practice in hygiene despite their negative attitude towards it. This study suggests the entrepreneur to realise the importance of their employees getting typhoid vaccination and basic food handlers courses to ensure food hygiene and safety. Keywords: Food handlers, knowledge, attitude, practice PP70 HEALTH RISKS FROM CADMIUM EXPOSURE VIA CONSUMPTION OF FOOD CROPS AT INTENSIVELY FARMED AREA, CAMERON HIGHLANDS Sharifah Norkhadijah Syed Ismail*, Raagheni M & Sarva Mangala Praveena Department of Environmental and Occupational Health, Universiti Putra Malaysia, Malaysia *For any correspondence: norkhadijah@medic.upm.edu.my Introduction: Cadmium (Cd) is ubiquitous in environment and is widely present in phosphate rock deposits of sedimentary origin and may enter the food chain through intense application of phosphate fertilizers to agricultural crops. A cross-sectional study was conducted at Kuala Terla and Blue Valley farming villages, Cameron Highlands to determine cadmium concentration in vegetables and soil and to determine the health risks among respondents. Methods: A total of 87 respondents were selected based on inclusive and exclusive criteria. A set of pre-tested questionnaires utilized to obtain sociodemographic information and to predict health risks faced by the respondents based on their vegetable ingestion rate. The Average Daily Dose (ADD) and
*For any correspondence: ismail_nurulizzah@yahoo.com Introduction: This study aims to identify the contributing factors to food handlers hygiene by looking into their knowledge, attitudes and practices. Methods: A survey was conducted among UKM cafeterias food handlers involving 64 respondents under various job specifications, including the entrepreneurs, chefs, drinks brewers, waiters or waitress, and cleaners. 56.3% of the respondents are Malaysian. 82.8% of the respondents have been vaccinated, but only 57.8% have attended food handlers basic courses. Results: The findings show that the level of respondents knowledge on hygiene (73.4%) was high but their level of knowledge on the crosscontamination pathway (30.5%), optimum storage temperatures (43.3%) and knowledge on HACCP (71.9%) was low. In general, the respondents do practice hygiene (79.7%) but occasionally conduct improper practices, including drying their hands on apron (39.1%) and wearing dark-colored cloth to reduce the visibility of their unhygienic appearance (39.1%). Despite having a good knowledge in hygiene, the attitude of 62.5% respondents towards hygiene was negative. This is evident when only 48.5% agreed to wash their hands after they went to the washroom. It is also evident that just 31.3%
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Target Hazard Quotient (THQ) were determined in this study. Convenient sampling method was employed to obtain 15 paired soil and vegetable samples. Cadmium concentration in the samples was determined through acid digestion prior analysis using Flame Atomic Absorption Spectrophotometer (FAAS). Results: The mean concentration of Cd in vegetable samples were 0.13mg/kg (SD 0.082), within the acceptable range specified by Malaysian Food Act 1985 (1mg/kg). For soil samples, the mean concentration of Cd was 2.78mg/kg (SD 2.83). Eight out of 11 soil samples exceeded the permissible limit of Cd outlined by The Dutch Standard (1mg/kg). The findings on THQ demonstrated that all the respondents are within the acceptable noncarcinogenic health risk. The results also exhibit that there was no correlation between cadmium in soils and vegetables. Conclusion: There were unlikely potential adverse health impacts arising from Cd through vegetable's consumption in this study. Respondents were advised to have a medical check-up in order to determine Cd body burden thus eliminating the risks of acquiring cadmium-related diseases. Keywords: Cadmium, vegetables, soil PP71 BLASTOCYSTIS INFECTION IN MALAYSIA: EVIDENCE OF WATERBORNE AND HUMANTO-HUMAN TRANSMISSIONS AMONG THE PROTO-MALAY, NEGRITO AND SENOI TRIBES OF ORANG ASLI Tengku Shahrul Anuar1*, Norhayati Moktar1, Siti Nor Azreen1, Fatmah Md Salleh1, Mohamed Kamel1 & Abdul Ghani2
1.
2.
Department of Parasitology & Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia Programme of Biomedical Sciences, School of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
Introduction: Blastocystis has been described as the most common intestinal parasite in humans and has an increased impact on public health. However, the transmission of this parasite has not been conclusively determined. To contribute to a better comprehension of the epidemiology of this infection, a cross-sectional survey aimed at providing the first documented data on the prevalence and risk factors associated with Blastocystis infection was carried out among three Orang Asli tribes in selected villages at Negeri Sembilan, Perak and Pahang. Methods: Faecal samples were examined by formalin-ether sedimentation and trichrome staining techniques. Results: Of 500 individuals, 20.4% (n=102) were detected positive for Blastocystis. A total of 13.3% (20/150) of Proto-Malays, 21.6% (30/139) of Negritos and 24.7% (52/211) of Senois were positive for Blastocystis, respectively. The positive cases showed an inverse relationship with age, and most of them were individuals less than 15 years old. Multivariate analysis confirmed that drinking untreated water, and the presences of other family members positive with Blastocystis were significant risk factors of infection among the three tribes, and overall population studied. Conclusion: Essentially, the findings highlighted that Blastocystis infection is prevalent among Orang Asli in Malaysia. Further studies using molecular approaches to distinguish the subtype of Blastocystis are needed. The present study also revealed that this infection may be transmitted through waterborne and human-to-human contact. Therefore, interventions with the provision of clean water supply for the communities and health education, especially to the parents are urgently required. Keywords: Blastocystis, waterborne, Orang Asli.
*For any correspondence: syahbasree@yahoo.com
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PP72 EVALUATION OF SERUM ZINC, COPPER AND MAGNESIUM LEVELS IN BETA THALASSEMIA MAJOR PATIENTS IN KOTA KINABALU, SABAH, MALAYSIA Shazia Qaiser1*, Mohammad Zahirul Hoque1, Mohammad Iqbal2 & D Kamarudin D Mudin1
1.
2.
School of Medicine, Universiti Malaysia Sabah (UMS), Malaysia Biotechnology Research Institute, Universiti Malaysia Sabah (UMS), Malaysia
*For any correspondence: qshazia@ums.edu.my Introduction: Beta thalassemia is one of the most common inherited single gene disorder caused by several different mutations in the beta globin chain. Beta thalassemia major is a severe form of beta thalassaemia resulting from homozygosity or compound heterozygosity. Repeated blood transfusions are required in beta thalassemia major which may cause per oxidative tissue injury by secondary iron overload leading to oxidative stress. Zinc, copper and magnesium are essential trace elements which are considered as important micronutrient for human body.The purpose of this study is to determine serum concentrations of Zinc, Copper and Magnesium in relation to oxidative stress among beta thalassemia major patients. Methods: This study was conducted among one hundred randomly selected beta thalassemia major patients aged between 14- 35 years. These patients were on regular blood transfusions and on chelation therapy at Thalassemia centre in Queen Elizabeth Hospital, Kota kinabalu, Sabah, Malaysia.One hundred age and sex matched non-thalassemic individuals served as healthy controls. Serum concentrations Zinc, Copper and Magnesium were estimated using Atomic Absorption Spectrophotometer (AAS) technique according to the manufacturers protocol (Perkin Elmer, USA). The mean, standard deviation, correlation coefficient and t-test were used. P-values<0.05 were considered statistically significant.
Results: In Thalassemia patients, the serum concentration of Zinc, Cu and Mg were found to be 0.62 0.12(mg/L), 0.96 0.19 (mg/L) and 8.86 0.23(mg/L) while in non thalassaemic healthy controls these were 0.83 0.13(mg/L), 1.00 0.16(mg/L) and 12.970.27 (mg/L) respectively. The results show significantly low serum concentrations of Zinc and Magnesium (p<0.01) in thalassemic patients as compared to healthy controls but there is no significant difference of serum Copper concentration found among the two groups. Conclusion: Trace elements are essential for vital body functions. This study revealed significant decrease in serum concentrations of Zn and Mg but no significant change in serum Cu concentrations in beta thalassemia major patients as compared to their healthy counterparts. Selective administration of trace elements like Zinc and Magnesium in beta thalassemia major patients might be helpful in reducing the extent of damage caused by oxidative stress but this still needs further evaluation. Keywords: Beta-thalassemia, zinc, copper, magnesium.
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POSTER PRESENTATION: HEALTH MANAGEMENT
poster PRESENTATION HEALTH MANAGEMENT
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PP73 IMPLEMENTATION OF CLINICAL PATHWAY IN TERTIARY HOSPITAL IN MALAYSIA: MEASURING KNOWLEDGE AND PRACTICE ON CLINICAL PATHWAYS AMONG HEALTHCARE PROFESSIONALS Aniza Ismail1*, Haris Cendera Khazaani Osman1 & Saperi Sulong2
1.
Conclusions: In general, majority of respondents in UKMMC have highly practice the CP and half of them have high level of knowledge on clinical pathways. Keywords: Knowledge, practice, clinical pathway, UKMMC PP74 A CROSS SECTIONAL STUDY ON PATIENT SATISFACTION AMONG OUTPATIENTS AT UNIVERSITY KEBANGSAAN MALAYSIA MEDICAL CENTRE (UKMMC) Aniza Ismail*, Hashimah Razali & Ahmad Taufik Jamil Department of Community Health, UKM Medical Centre, Malaysia *For any correspondence: draniza@gmail.com Introduction: Patient satisfaction is important in ensuring service quality in hospitals and used as an indicator of quality care to determine the continuity and treatment outcome. The main objective of the study is to measure the level of patient satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC) and its contribution factors. Methods: A cross-sectional study was conducted among 520 patients attending the outpatient departments in four clinics namely Surgery, Orthopaedic, Obstetrics and Gynaecology as well as Medical starting from September 2012 until November 2012. Systematic sampling method was used in patient selection based on the list of patient appointments. The level of patient satisfaction was measured using the PSQIII domain. Results: Majority of the respondents were Malay 381 (73.3%), age group >33 years old 326 (62.7%), female 348 (66.9%), and were married 437 (84.0%). Overall, the study finding revealed almost half of the respondents were satisfied with the service provided (41.0%), while the others were not satisfied (59.0%). Based on the domain studied, the level of satisfaction varies widely especially interpersonal relationships domain, 75.8% patients were found satisfied followed by the registration process (73.8%), technical quality (71.3%), communication (66.7%), physical facilities (64.6%), accessibility (60.2%), and
2.
Department of Community Health, Medical Centre, Malaysia Department of Health Information Medical Centre, Malaysia
UKM UKM
*For any correspondence: draniza@gmail.com Introduction: The clinical pathway (CP) is a document or tool that improved the quality of care of patients, enhanced the multidisciplinary approach to a patients care and improved the preparation for discharge. The CP is implemented at University Kebangsaan Malaysia Medical Centre (UKMMC). The objectives of the study were to measure the knowledge and practice on CP among the health care professionals and its determining factors. Methods: A cross sectional study was conducted at University Kebangsaan Malaysia Medical Centre (UKMMC) with 127 respondents was selected using universal sampling method based on inclusion and exclusion criteria. A self developed questionnaire by the researchers with the reliability (reliability) tested was used to collect the data. Data was analyzed using Chi Square and Logistics Regression with SPSS version 19.0. Variables analyzed include sociodemographic, socio-economic and organizational factors. Results: Predominant respondents was female (77.2%), aged between 32 to 45 years (51.2%), working as nurses (71.7%) and with working experience of six (6) years and above . 52% of respondent have high level of knowledge and 70.1% of them practiced clinical pathways. The position and working experience as the predictor of respondents knowledge on the clinical pathways and position as the predictor factor in practice of clinical pathways in UKMMC.
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financial cost treatments (47.3%). It was also found that the frequency of patients visits has significant association with the level of satisfaction (p<0.05). Race and frequency of patients visits were the predictors of patient satisfaction level. Conclusion: The study showed high patient satisfaction with respect to interpersonal relationships domain compared to other domains. Meanwhile, the level of patient satisfaction was moderated on financial costs treatment domain. Therefore, the service provider should pay more attention to cost of treatment in order to ensure an increase in patient satisfaction levels. Keywords: Patient satisfaction, outpatient clinics, quality, service PP75 PROVIDING AND MAXIMIZING ACCESS TO HEALTHCARE: INTRODUCTION OF HPV VACCINATION IN MALAYSIA Saidatul Norbaya Buang1*, Rohani Jahis2, Norsaleha Ibrahim Thambi2, Majdah Mohammad1, Rohana Ismail1, Azila Azmi3, Tan Phaik Sim1 & Mohd Shahriel Mad Noh1
1.
in implementing the School-based HPV vaccination program and vaccine delivery, usage and storage. Results: Within 12 months, the programme covered 2,985 public and private secondary schools in 15 states in Malaysia. 95.6% from a total of 242,638 Form 1 girls, in the first cohort who were entitled to be vaccinated gave their consent to the vaccination. The outcome for this first cohort was more than encouraging, with coverage for the first, second and the third dose was 99.8%, 99% and 95.8%, respectively. The overall completion rate for 3 doses of HPV vaccination was 97.9 % Conclusion: The strong political will and commitment provided the solid support for the sustainability of this initiative. Keywords: HPV vaccination, school based PP76 PATIENT SATISFACTION: INDEPENDENT PERSPECTIVE
AN
Noriah B, Nabilah H*, Mohd Idris O, Aisah M, Eliana M, Nor Filzatun B & Roslinah A Institute for Health Management, Ministry of Health Malaysia, Malaysia *For any correspondence: nabilah.h@ipk.moh.gov.my Introduction: Several studies on patient satisfaction in Ministry of Health (MOH) hospitals had been conducted by the Institute for Health Management (IHM) since 2004. In all studies, patient satisfaction has been found to be good. However, such survey had never been conducted by an independent body, which was important to reduce bias in reporting. This study was commissioned by MOH top management to an independent consultant to ascertain the level of patient satisfaction in the hospitals in Klang Valley. Methods: This cross sectional study was conducted in two hospitals in Klang Valley, namely Hospital A and Hospital B which involved the disciplines of Medical, Surgery, Orthopaedic, Obstetrics & Gynaecology and Paediatric. By random sampling, total of 639 inpatients from both hospitals were interviewed using structured questionnaire. The questionnaire consisted of 30 questions, divided to multiple questions to measure the nine dimensions
2.
3.
Family Health Development Division, Ministry of Health, Malaysia Disease Control Division, Ministry of Health, Malaysia Health Education Division, Ministry of Health, Malaysia
*For any correspondence: s.norbaya@moh.gov.my Introduction: Cervical cancer is the third most common cancer in women in Malaysia after breast and colorectal cancers. Delay in seeking treatment contributed to the mortality and exorbitant medical cost. With the introduction of the new HPV vaccine, an opportunity opens for Malaysia to launch a new approach in the prevention of cervical cancer through a School-based Methods: In executing this new initiative, the MOH engaged various relevant stakeholders in the planning process and the implementation of the school-based HPV vaccination. Key strategy was the development of a standardized work process to facilitate the staffs
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of SERVQUAL KKM; Tangible, Reliable, Responsiveness, Assurance, Empathy, Outcome, Caring, Teamwork and Professionalism and a single question to measure overall patient satisfaction. Caring, Teamwork and Professionalism would provide as a measurement of Corporate Culture in KKM. Results: The levels of satisfaction based on single question and multiple questions were 84.2% and 84.6% respectively. The highest dimension was Reliable (88.7%) followed by Assurance (86.4%), Empathy (83.0%), Tangible (80.5%) and Responsiveness (79.0%). For Corporate Culture dimensions, Teamwork scored the highest (88.9%), followed by Professionalism (85.2%), while Caring scored the lowest (82.6%). Conclusion: Both studies reported that the level of patient satisfaction was good (>80.0%). This finding does not differ much from those obtained by IHM. However, continuous support from top level management is needed for further improvement. Nevertheless, individual hospitals should be more innovative to increase the patient satisfaction. Keywords: Satisfaction, in patient, independent PP77 HEALTHCARE UTILIZATION PATTERN AND WILLINGNESS TO PAY AMONG MALAYSIAN HOUSEHOLD: RESULTS FROM THE THIRD NATIONAL HEALTH MORBIDITY SURVEY (NHMS III) 2006 Zaleha Md Nor* & Azimatun Noor Aizuddin Department of Community Health, UKM Medical Centre, Malaysia *For any correspondence: zalehamdnor@yahoo.com.my Introduction: There are lots of changes have been done in healthcare system, in order to achieve good healthcare coverage all over Malaysia with taking into consideration of the changes of the disease burden and improvement of the technology. The objective of this study is to determine the pattern of healthcare utilization and assessing the willingness to pay among the Malaysian household. It also determined the associating factors that influencing the utilization of the healthcare services and identifies the barriers toward seeking healthcare. Methods: Using data derived from the third National Health Morbidity Survey (NHMS III) 2006, information on utilization of healthcare and willingness to pay for healthcare were analysed. Results: From 56710 eligible respondents, 55824 (98.4%) participated in the study. Prevalence of seeking healthcare is 58.1% from total that report having recent illness. Most of the respondents seek healthcare to the ambulatory facilities which is 68.9% (CI: 67.470.4). In the utilization of out-patient, respondent significantly chose for private healthcare facilities exception for the elderly who (61.5%) preferred public sector for out-patient care. As per hospitalization, respondent significantly chose for public healthcare with higher prevalence among the young age group, Malay, primary education level and low income group. The barrier that had been identified is significantly because they perceive as mild illness. In both overall care and visit to private outpatient care, the willing ness to pay is positively associated with the respondent socioeconomic level. Conclusion: By using the pattern on utilization of health facilities by different socio-economic groups, the results will help the Ministry of Health Malaysia to enhance the existing health programmes in the country. Keywords: Healthcare utilization, public healthcare, private healthcare, willingness to pay, NHMS III. PP78 COST ANALYSIS OF CONTRACEPTIVE PILLS COMPARED TO IMPLANON: FROM MALAYSIAN EXPERIENCE Rizal AM1, Nasaruddin M2*, Rosilawati AR1, Noraliza R1, Artim AR1, Asmah J1, Huzaimah H1 & Aniza I1
1.
2.
Department of Community Health, UKM Medical Centre, Malaysia Clinical Training Centre, Faculty of Medicine, Universiti Teknologi MARA, Malaysia
*For any correspondence: nasaruddin1981@yahoo.com
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Introduction: In 2002, the Ministry of Health provided 75.8% of the family planning services, nongovernment agencies provided 15.1%, and other agencies provided the remaining percentage (MOH 2002). Women consenting to family planning programs in Malaysia used birth control pills, condoms, sterilization and intrauterine devices. The objective of this study is to assess the cost-analysis of Contraceptive Pills compared to Implanon in Malaysia from providers perspective within 3 years duration. Methods: This was a retrospective study of patients record who underwent Family Planning Programme at Lembaga Penduduk dan Pembangunan Keluarga Negara in Year 2009. The costs were calculated merely on providers point of view and further classified into capital costs and recurrent costs. Cost analysis was done using Microsoft Excel 2010. Results: In order to serve about 64,475 patients for Contraceptive Pills and 513 patients for Implanon procedure (based on prevalence in Year 2009), the results showed that the Capital Cost (Building, Furniture and Equipments) was about RM 7,357.21 and RM 23, 845.89 of the Recurrent Cost (Staff Cost). However, Recurrent Cost (Non-Staff Cost) was higher in Contraceptive Pills usage. The cost for implementation of Implanon procedure was about RM 148.38/patient/year compared with Contraceptive Pills usage which was about RM 163.03/patient/year. Conclusion: Contraceptive awareness and preventing unintended pregnancy especially in women high risk for pregnancy are keys to success in family planning program. Hence, National Implanon Program for women with unmet needs should be implemented as primary contraceptive choice in Primary Health Clinics in Malaysia. Keywords: Cost analysis, contraceptive pills, implanon, family planning. PP79 STUDY OF THE KNOWLEDGE, ATTITUDE AND PRACTICE BETWEEN THE MOTHERS/CARETAKERS OF THE RECIPIENTS AND NON-RECIPIENTS OF THE REHABILITATION PROGRAM FOR UNDERNOURISHED CHILDREN REGARDING CHILD NUTRITION IN KUCHING DIVISION, SARAWAK Haseanti Hussein*, Zainab Tambi & Md Mizanur Rahman Department of Community Medicine and Public Health, Universiti Malaysia Sarawak, Malaysia *For any correspondence: drhaseanti@gmail.com Introduction: The main macronutrient deficiency problem among Malaysian children is protein and energy malnutrition, resulting in children being underweight for their age. The Rehabilitation Program for Undernourished Children (Program Pemulihan Kanak-Kanak Kekurangan Zat Makanan, PPKZM) is the government's efforts to improve health and nutritional status of children less than six years. Since 1989, children who met the eligibility criteria were given food aid to help them obtain a balanced and nutritious food, in order to achieve optimal physical and mental development. The children involved were given treatment, if suffering from any illness, immunization, health education and health care and monitoring care. Methods: A cross-sectional study was done by doing a survey among the mothers/caretakers of recipients and non-recipients of the PPKZM program to assess their knowledge, attitude and practice on child nutrition. This was performed in the Kuching division, Sarawak. A sample of 153 respondents was selected via purposive sampling. A knowledge, attitude and practice regarding child nutrition questionnaire was used for mothers/caretakers of both recipients and non-recipients of the PPKZM program to assess their knowledge, attitude and practice regarding child nutrition. Results: Majority of the respondents was in the 3034 years age group, Bidayuhs, Christians, attended until secondary school, housewives, had family size of 3-4 persons and less than 3 children. Majority of the respondents had good knowledge, attitude and practice regarding child nutrition. There were no statistically significant differences in knowledge and practice between the mothers/caretakers of the PPKZM recipients and non-recipients but there was a statistically significant difference in attitude between them. Conclusion: The PPKZM program was found to have positive results and beneficial. So, the program should be continued.
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Keywords: Knowledge, attitude, practice, child nutrition PP80 FACTORS INFLUENCING SUPPORT FOR NATIONAL HEALTH INSURANCE AMONG PATIENTS ATTENDING URBAN SPECIALIST CLINICS IN MALAYSIA Sharifa Ezat Alkaff1*, Yasmin Almualm1, Syed Aljunid2 & Syed Sagoff Alsagoff 3
1.
2.
3.
Department of Community Health, UKM Medical Centre, Malaysia United Nations University- International Institute for Global Health (UNU-IIGH) Faculty of Law, Universiti Kebangsaan Malaysia, Malaysia
*For any correspondence: sh_ezat@yahoo.com Introduction: In response to the ever rising cost of healthcare expenditure, the Ministry of Health in tandem with the Malaysia National Plan and WHO Resolution in improving accessibility and affordability of quality healthcare services has proposed a National Health Insurance (NHI) Scheme. A National Health Financing Authority (NHFA) will be empowered to manage the NHI. A National Health Fund that will be set up under this program will cover treatment and illnesses that are listed in the Essential Health Benefit Package. The government will be a major contributor while Malaysian working for the government, private sector and self-employed will have to contribute accordingly. The objective of this study is to determine the level of support among patients attending specialist clinics at UKMMC towards the proposed NHI in Malaysia and its influencing factors. Methods: This is a cross sectional study carried out from July until October 2012 at the specialist clinics at UKMMC. 260 patients were selected using multistage sampling method. Each respondent was personally interviewed using a newly developed questionnaire that has been validated by experts in health management and health economics. The questionnaire consisted of five sections addressing factors under study: (a) socio-economic and
demographic factors; (b) knowledge on NHI; ownership of private health insurance; (d) premiums respondents are willing to pay to join NHI; and (e) support for National Health Insurance Scheme. Research data were analyzed using SPSS version 19.0. Results: 71.2% of respondents supported National Health Insurance Scheme. 57.2% of respondents are willing to pay up to RM240 per year to join the NHI and 76.6% of respondents thought that enrolment in NHI should be made compulsory. Knowledge had a positive influence on respondents support towards NHI with Odd Ratio of 3.398 and a 95.0% Confidence Interval of 1.360-8.485. Conclusion: The study shows high support towards the proposed NHI Scheme among malaysian patients attending specialist clinics at UKMMC. NHI when implemented can raise funds for health care financing, increase access to health services and achieve the desired health status. This is in tandem with WHO resolution to achieve Universal Health Coverage as well as the concept behind 1 Care for 1 Malaysia. More efforts should be taken to promote the scheme and educate the public through media, campaigns and seminars. Due considerations should be given to the amount of premiums set to join the Scheme as well as the services covered. Keywords: National Health Insurance (NHI), National Health Financing Authority (NHFA), Social Health Insurance (SHI), Knowledge PP81 HOME CARE SERVICE PROVIDED BY UNIVERSITI KEBANGSAAN MALAYSIA MEDICAL CENTRE Fuziah Hamid, Wan Fatimah Wan Daud, Jamilah Fakir Mohamad, Roslina Rasip, Masrifah Zakaria. J. Sanarina Abd Jabbar, Roslizaton Che Mamat, Zurina Mohd Saleh & Ho Siew Eng* Department of Nursing, UKM Medical Centre, Faculty of Medicine, Malaysia *For any correspondence: ho@ppukm.ukm.edu.my Introduction: Home care service was established on 29th June 1998 at Universiti Kebangsaan Malaysia Medical Centre. We focus on rendering patient best
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recovery following discharge from the hospital. It is a unit that delivers an excellent continuity of nursing care in the comfort of patients own home. Methods: Nursing audit was out carried from January 2012 to December 2012.The objectives of the home care service are 1) to reduce high cost associated to long term hospitalization with early discharge planning; 2) to provide effective and continuous supervision of care such as wound care, insertion/change of urethral catheter, insertion/change of nasogastric tube, supervision of enteral feeding, health education for patients and caregivers, and basic physiotherapy and 3) to provide a platform for caregivers/family members involvement and participation in the provision of care. We also include pain management through nursing intervention and non-invasive interventions to the patients/carers during the visit. Criteria of recruitment; the patient must be discharged and referred to home care service unit of UKMMC. Patients address should be contactable by telephone. All cases requiring home care service need to be referred by the attending physician of the patient. References should be made prior to patients discharge from hospital with an appointment at the clinic and a summary of the records. Results: A total number of patients were 2921, 150 patients were discharged and 57 patients expired. The nursing audit reported a reduction in readmission of patients by three percent. The findings indicated 1925 patients required simple dressing; 686 patients requested insertion/change of nasogastric tube and supervision; and insertion/change of urethral catheter consisted of 281 patients. This would be further explained in graph and tables. Conclusion: This program has created awareness among the public and more patients are requesting for this service. The coverage of this service is only nine kilometres from the hospital, eventually we hope to cover distance areas around Cheras community, Kuala Lumpur. Keywords: Home care, services, patients, readmission PP82 THE WILLINGNESS TO PAY FOR DRUGS AMONG STATE POPULATION IN MALAYSIA Siti Nurul Akma Ahmad1, Sharifa Ezat Wan Puteh1*, Azimatun Noor Aizuddin1, Ramli Zainal2 & Ruhaini Ismail3
1.
2.
3.
Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia Institute for Health Systems Research, National Institutes of Health, Malaysia Health District Office, Sepang, Malaysia
*For any correspondence: nurulakma08@yahoo.com Introduction: Escalating of healthcare cost is a global healthcare challenges in most of the countries. Inline with the increasing of disease prevalence, there will be escalating of drugs expenditures. In Malaysia, the national drug expenditure has seen an increase where the Malaysia Ministry of Health allocated up to RM 1.402 billion in 2009 for the drug expenditure. Since Malaysia has no social health insurance scheme, most of these expenditures are still highly subsidized by the government. Thus, Malaysia is approaching towards increasing demands to control the rising of health care costs in order to guarantee the capability of upcoming health care financial support in the future. Therefore, this study was conducted to measure patients willingness to pay for drugs among state population in Malaysia. Methods: A cross-sectional study was conducted at selected health clinic and the collection of data was conducted in August 2012.The face-to-face questionnaires were distributed to 324 sampled respondents. Results: Majority of the respondents 234 (72.2%) were disagree or not willing to pay for the drug charges. Among those who are willing to pay, the overall willingness to pay for drugs for both chronic and acute diseases has an equal median of RM10. Conclusion: In a nutshell, the results indicate that patient have low willingness to pay for drugs of chronic disease and acute disease. In addition, most of our citizens are in a comfort zone of highly subsidize of health services thus were not ready to change this norm from having free services to paid drugs charges. Keywords: Willingness-to-pay, drugs expenditure
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PP83 THE INFLUENCE OF CULTURAL BELIEFS ON THE UTILISATION OF REHABILITATION SERVICES IN A RURAL COMMUNITY IN SOUTH AFRICA Liezel Wegner* & Anthea Rhoda Department of Physiotherapy, University of the Western Cape, South Africa *For any correspondence: liwegner@uwc.ac.za Introduction: Cultural beliefs have influenced the way in which disability is viewed by certain societies. These cultural beliefs have known to impact the utilization of rehabilitation or health care services by people with disabilities. The aim of the study was therefore to explore the influence of cultural beliefs on the utilisation of rehabilitation services in a rural district in South Africa from the therapists perspectives. Methods: The study used five focus group discussions (FGDs) as a tool for data collection, and included 17 participants. The participants were conveniently selected based on the fact that they were employed at a rural hospital. The qualitative data obtained from the FGDs were analysed using a thematic approach and peer reviewed to ensure trustworthiness. Results: The main finding of this study was that cultural perceptions regarding the aetiology of disability and disease often prevent persons with disabilities from utilising rehabilitation services. Conclusion: These findings also provides insights into the personal challenges influencing the use of rehabilitation services which can be valuable to inform health care providers working in a rural South African context as well as to plan appropriate education and health-awareness campaigns. Keywords: rural, cultural influence, rehabilitation PP84 PHYSICIAN ATTRIBUTES BOOSTING SATISFACTION AND ENCOURAGING UTILIZATION OF PRIMARY CARE BY PATIENTS WITH CHRONIC DISEASE Abdalla Abdelwahid Saeed* Department of Community Medicine, Faculty of Medicine, KSAU-HS, Riyadh, Saudi Arabia *For any correspondence: aasaeed@kfmc.med.sa / saeed.abdalla@gmail.com Introduction: The assessment of consumers satisfaction with physician services and characteristics of physicians encouraging utilization of Primary Care by patients with chronic diseases Methods: Adult Saudi consumers visiting 15 randomly selected PHCCs in Riyadh completed a self administered pilot tested questionnaire measuring consumers satisfaction with physician services and physician characteristics boosting satisfaction and utilization of primary health services including chronic diseases all rated on a Likert type scale of 1 5 points, Results: Higher satisfaction was for physician communication skills and responding positively to consumers requests. Consumers were least satisfied with health education messages of physicians. To boost both satisfaction and utilization chronic disease patients preferred consulting the same physician of similar gender, Moslem, experienced and Arabic speaking physician Conclusion: Many physician attributes showed high satisfaction levels but certain service areas showed low satisfaction. Choosing Physician of same gender, religion and language will boost both satisfaction and utilization of patients with chronic diseases in Primary Care settings Keywords: Primary care, satisfaction, utilization, chronic disease, Riyadh
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PP85 HIV/AIDS-RELATED KNOWLEDGE AND ATTITUDES OF HIV-INFECTED PATIENTS AND THEIR CAREGIVERS IN TERENGGANU Norhayati Mustapha1*, Pei Lin Lua 1 & Ahmad Kashfi Abdul Rahman2
1.
2.
Centre For Community Development And Quality of Life (CCDQ), Universiti Sultan Zainal Abidin (UniSZA), Kampus Kota, Kuala Terengganu, Malaysia Infectious Disease Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia
knowledgeable (p<0.05) whereas other demographic variables were insignificant in relation to knowledge and attitudes. Conclusion: In view of such findings, demographic characteristics seemed to influence knowledge and attitudes towards HIV/AIDS among both HIVinfected patients and their caregivers. Keywords: HIV/AIDS, knowledge, attitudes, antiretroviral therapy PP86 TO STUDY THE EFFECTIVENESS OF DIABETIC REVIEW TEAM IN MANAGING PATIENTS WITH UNCONTROLLED TYPE 2 DIABETES MELLITUS IN A PRIMARY CARE CLINIC Tan Wee Yong* & Wan Fadhilah Binti Wan Ismail Mahmoodiah Health Centre Johor Bahru, Malaysia *For any correspondence: tan_wee_yong@hotmail.com Introduction: Type 2 Diabetes Mellitus (T2DM) is an important public health problem worldwide, particularly in Malaysia, where its prevalence rate has risen much faster then expected, almost doubling in magnitude over the 2 last decades. Multifaceted professional intervention and organisational interventions has been shown could lead to improve care for patients with diabetes. The objective is to assess the impact of intervention done by Diabetic review team to improve patients outcome which include metabolic control of patient with uncontrolled type 2 diabetes mellitus and to improve future practice on Diabetic review team program provided by a health clinic in keeping with evidence based medicine Methods: This cross sectional trial was designed to test whether a multifaceted intervention done for uncontrolled diabetic patients would improve outcome. About 20 case notes of patients were selected from the diabetic clinic with HbA1c of >11% and multifaceted intervention done. Other baseline data such as BMI, BP, Fasting Lipid Profile were measured and the tests were repeated after at least a year post intervention.
*For any correspondence: yatt82@yahoo.com Introduction: Knowledge could undeniably promote adherence to treatment regimen and prevent the transmission of the disease. This preliminary investigation intended to assess the knowledge and attitudes towards HIV/AIDS and antiretroviral therapy (ARV) among HIV-infected patients and their caregivers based on demographic traits. Methods: A prospective, cross-sectional study was carried out among HIV-infected patients and their respective caregivers in Hospital Sultanah Nur Zahirah Kuala Terengganu. Upon written consents, included patients and caregivers completed the Malay Knowledge and Attitudes Regarding HIV/AIDS and Antiretroviral Therapy in People Living with HIV/AIDS (PLWHA) and Malay Knowledge, Attitudes and Practices Regarding HIV/AIDS and Antiretroviral Therapy in Caregivers respectively. Data was analysed using SPSS 17 employing descriptive and non-parametric statistical methods. Results: A total of forty-two Malay Muslim HIVinfected patients (median age = 37.0 years, male = 54.5%, married = 50.0%) and caregivers were enrolled (median age = 41.0 years, female = 61.9%, married = 71.4%). Those who did not disclose their HIV diagnosis and were married possessed significantly better knowledge on HIV/AIDS (p<0.05). Additionally, females and non exintravenous drug users significantly showed positive attitudes towards HIV/AIDS compared to their counterparts (p<0.05). For caregivers, younger respondents (age <40 years) were significantly more
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Results: The age ranges of patient were between 41 to 74 years old. Majority of patients were female (65.0%), having hypertension (85.0%) and dyslipidemia (90.0%). The mean pre-intervention HbA1c were 12.4% and the post-intervention HbA1c were 10.0%. Other metabolic outcome such as BMI, BP and lipid profile will be discussed. Conclusions: Dedicated diabetic team in primary health care clinic can improve patients outcome provided that healthcare providers were given appropriate training and support. Keywords: Type 2 Diabetes Mellitus (T2DM), primary care clinic, multifaceted intervention PP87 AN INNOVATIVE APPROACH TO IMPROVING OUTCOMES IN NCD-RELATED COMPLICATIONS: STROKE AND DIABETIC FOOT ULCER Mathavan G1, Teo SW1, Seo ST1, Selvarajah N1, Khong KC2 , Choo SB2, Salleh H2, Katiman HH3 & Chandrasegaram PD1*
1.
2.
3.
Department of Orthopaedics, Hospital Port Dickson, Malaysia Department of Pharmacy, Hospital Port Dickson, Malaysia Department of Microbiology, Hospital Port Dickson, Malaysia
*For any correspondence: pdev_2406@hotmail.com Introduction: Complex wounds, common in bed sores and DFU, are mainly managed in district hospitals by Ward Nurses. They are technically difficult to dress and have higher potential to breach the aseptic fields constructed during bedside aseptic no touch technique dressing (ANTT).
Methods: A non-randomised pre- and postintervention study design was used. All complex wounds were managed by Orthopaedic MOs in the Operating Theatre using saline irrigation. Outcomes were measured and analysed using a mixed-methods format with key informant interviews, hospital Audit records and SPSS program. Wound cross-infection was assessed by culture counts, organism prevalence and sensitivity pattern. Antibiotic utilization by defined daily dose (DDD) per 100 patient days. Results: Qualitative Assessment-Ward Nurses were fatigued, demoralised and unmotivated but reported becoming empowered, motivated and emphathetic after the intervention. Patients complained of pain, poor odour control and frequently defaulted followup but after the intervention they felt their dignity restored, felt consulted and became more participative. Quantitative Assessment-SPSS using paired t-tests showed statistical significance between preand post-intervention culture counts. All other criteria also markedly improved. Culture counts reduced from 65 to 47 (p = 0.035), organism prevalence types reduced from 6 to 2 and sensitivity patterns showed MRO was no longer present. Utilization of Cefuroxime reduced from 44.16 to 23.50 DDDs (46.78%), of Ceftazidime from 17.23 to 6.04 DDS (68.5%) and of Ciprofloxacin from 23.71 to 1.55 DDDs (93.46%). Conclusion: Complex wounds were opened, treated and sealed in a sterile environment. The need for ANTT was eliminated. Increased Ward Nurse morale and improved wound outcomes were achieved using low-cost wound dressings. Efficient overall antibiotic usage resulted. Simple work process changes can yield outstanding, efficient outcomes. The role of the district hospital is thus to strengthen primary health care. Keywords: complex wounds, OT wound care, NCDs, bed-sores, DFU
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POSTER PRESENTATION: HEALTH PROMOTION
poster PRESENTATION
HEALTH PROMOTION
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PP88 FACTORS INFLUENCING SMOKING INITIATION AMONG THE SECONDARY SCHOOL STUDENTS IN BANGLADESH: A CROSS SECTIONAL STUDY Md Mizanur Rahman1, 2, 3*
1.
2.
3.
Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), Malaysia Department of Occupation and Environmental Health, National Institute of Preventive and Social Medicine (NIPSOM), Mohakhali, Bangladesh Malaria Control Program, Directorate General of Health Services (DGHS), Dhaka, Bangladesh
initiation (p<0.05). Parental smoking, type of schools appeared as significant factors for smoking initiation by bi-variate analysis, but regression analysis did not significantly influence (p>0.05). Conclusion: Nicotine addiction is a big threat among the children. Comprehensive anti-tobacco campaign should be intensified through interactive programme with teachers, students and parents. Keywords: Bangladesh, secondary school students, smoking initiation PP89 COMMUNITY ATTITUTE TOWARDS MENTALLY ILL PATIENTS AND ASSOCIATED FACTORS: A STUDY IN TAMPOI, JOHOR Norfazilah Ahmad*, Siti Zubaidah Semail & Azmawati Mohammed Nawi Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: ah.fazilah@gmail.com Introduction: The attitude shown by community towards the mentally ill can have implications for recovery. To gather robust evidence regarding community attitudes towards people with mental illness, a data collection is required. Methods: A cross sectional study was conducted to examine the community attitude towards the mentally ill and its associated factors in among 347 respondents in Tampoi, Johor from June 2012 to June 2013. A set of self administered questionnaire was used to collect data on socio-demograhic and socioeconomic of the respondents, public attitudes towards the mental patient using Community Attitudes towards the Mentally Ill (CAMI) questionnaire, publics knowledge of mental health using Mental Health Questionnaire, media influence and history or experience with mental patient. Results: Result showed that the community in Tampoi, Johor had a positive attitude towards mental patient. Benevolence attitude which represents positive attitude have the highest mean score 37.13 (4.18). Social Restrictiveness attitude which represents negative attitude have the lowest score 25.42 (4.82). Univariate analysis indicated that
*For any correspondence: rmmizanur@fmhs.unimas.my ; aniqm@hotmail.com Introduction: Smoking among school children is becoming a serious problem in developing countries including Bangladesh. The early initiation of smoking needs urgent intervention to protect this vulnerable group and preventing them to be addicted. This study aims to determine the age at initiation of smoking and factors affecting it. Methods: A two-stage cluster sampling was used with a selection of schools on probability proportional to enrolment size followed by stratified random sampling at government and private schools and then a random start in classes of VIII, IX and X of each school targeting the students aged 13 years and above. Data was collected from secondary school students using self-administered structured questionnaire. All analyses were performed with SPSS version 20.0. Missing value was treated by multiple imputations. Results: A total of 6877 data were analysed in which 84.7% were non-smoker, 9.5% were ever smoker and 5.8% were current smokers. Among the ever smoker (n=837), 38% were current smokers, 56.5% former and 5.5% were recent quitters. The mean (SD) age at initiation of smoking was 10.9 (0.2) years. Multinomial regression analysis revealed that class grade, peer pressure and offered free cigarette appeared to be significant predictors for smoking
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ethnicity religion, education level, income, history or experience with mental patient and knowledge of mental health have a significant association with community attitudes towards the mental patient. Conclusion: These findings are expected to help the related parties in conducting various comprehensive and holistic programs or campaign. Medical social worker especially, should be more sensitive to the community attitude toward the mentally ill patient so that they could recognize the associated factors on negative attitudes and prevent them. Keywords: Mentally ill, community, attitude PP90 SMOKING BEHAVIOURS AND ATTITUDES TOWARD TOBACCO CONTROL AMONG ASSISTANT ENVIRONMENTAL HEALTH OFFICER TRAINEES IN MALAYSIA Tee Guat Hiong1*, Gurpreet Kaur1, Noran N Hairi2, Zarihah Zain3 & Fadzilah Kamaludin4
1.
2.
3.
4.
Institute for Public Health, Ministry of Health, Malaysia Julius Centre University of Malaya & Department of Social & Preventive Medicine, University of Malaya, Malaysia Department of Public Health, Lincoln University College, Malaysia Disease Control Division, Ministry of Health, Malaysia
Results: The study received a response rate of 96.5%. The mean age of the AEHO trainees was 21.432.43 years, 66.9% were males and 74.2% were Malays. Overall, 10.8% of the AEHO trainees were current smokers and 14.3% of the tutors were currently smoking. Current smokers was positively associated with male gender (OR 1.19, 95% CI: 1.131.26), age <20 years (OR 2.58, 95% CI: 1.19-5.67) and having friends who smoked (OR 1.13, 95% CI: 1.08-1.17). Almost 30% of the trainees did not know it is the duty of AEHOs to counsel smokers to stop smoking, but 91% agreed they should not smoke before advising others not to smoke. Majority of the trainees (>75%) agreed to tobacco control regulations and laws to reduce smoking prevalence. Conclusion: Future AEHO had positive attitudes toward tobacco regulations and laws on tobacco use but lacked understanding in their responsibilities in tobacco control measures. Attention should be given to instill the right knowledge and attitude in tobacco control through proper effective enforcement of smoke free areas in the College and other relevant locations. Every tutor has the responsibility as role model for trainees to emulate and should always be ready to assist them to maintain or change to be nonsmokers. Keywords: Smoking, Assistant Environmental Health Assistants, tobacco control measures, attitudes PP91 STUDY ON KNOWLEDGE, ATTITUDES AND BELIEFS RELATED TO HIV/AIDS AMONG SECONDARY SCHOOL STUDENTS IN BATU PAHAT DISTRICT 2013 Zuraini bt Ahmad1*, Marina bt Mohd Said1, Linayant bt Rosli2& Arbaiah bt Othman2
1. 2.
*For any correspondence: ghiong88@yahoo.com Introduction: Assistant Environmental Health Officers (AEHO) are among the health care providers who act as enforcers, educators and trusted role models to the public. This paper aims to determine the smoking behaviour and attitudes toward tobacco control among the AEHO trainees. Methods: A cross-sectional survey of 360 AEHO trainees at the College of Allied Health Sciences was conducted using a pre-tested questionnaire based on the questionnaire for health professionals by the WHO and the International Union against Cancer, American Cancer Society. The Statistical Package for the Social Science; Version 16 was used for data analysis.
Klinik Kesihatan Batu Pahat, Johor, Malaysia Pejabat Kesihatan Batu Pahat, Johor, Malaysia
*For any correspondence: zurainia_dr@yahoo.com.my Introduction: An estimated 11.8 million young people aged 15-24 are living with HIV/AIDS worldwide.They are vulnerable to HIV infection because of risky sexual behavior & substance use. To
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determine the knowledge, attitudes and risk behavior related to HIV/AIDS among secondary school students in Batu Pahat district. Methods: This cross sectional study was conducted among form one students, from five randomly selected secondary schools between January to March 2013. Data was collected using a standardized pre-tested self-administrated questionnaire and analyzed using SPSS version 15. Results: 1157 respondents were participated in the survey. Majority were male (51.2%) & Malays (79.4%). The overall knowledge about HIV/AIDS transmission and prevention was low. The mean knowledge score was 16.76 (95% CI=16.55-16.97). Female had better knowledge than male (p<0.05). The respondents have misconception that HIV infected person wont appear physically healthy (80.4%) & having sex with an infected partner wont transmit the HIV (63.4%). Sharing food (25.5%) and mosquito bites (25.2%) were incorrectly identified as routes of transmission. Television is the most important sources of information about HIV/AIDS (73.8%). The overall attitudes were poor. The mean attitude score was 39.78 (95% CI = 39.43-40.14). Differences of mean attitude score were very small among gender, male 40.32 (95% CI=39.8-40.83) & females 39.23 (95% CI=38.76-39.7); and school categories, urban 41.16 (95% CI=40.67-41.65) & rural 38.5(95% CI=38.03-38.98). 20 (1.7%) students have had already experienced sexual intercourse. It was higher among Malay male, from rural school (p<0.05). Conclusions: Level of knowledge related to HIV/AIDS among students was low. Attitude on prevention of HIV & people living with HIV/AIDS were unsatisfactory. Therefore, a comprehensive HIV/AIDS education with promotion of safe sexual behavior is needed to decrease the disease transmission. Keywords: Knowledge, attitude, HIV/AIDS PP92 FROM TORMENT TO FREEDOM Laurie Perkins* Suite 120, 193 Morayfield Rd, Morayfield 4506, QLD Australia *For any correspondence: lasmyth@hotmail.com Introduction: Even though there are laws and government initiatives surrounding Blood Borne Viruses, discrimination and stigma still prevails against people living with an infectious disease. Methods: This presentation will take the audience on a very personal journey as the presenter talks candidly about her own personal experience navigating through the mind field of emotions as she attempts to understand and come to terms with her initial diagnosis of Hepatitis C and its links to her forgotten past. Results: It will focus on the positive and negative interactions with the health care professionals that provided care for her during her 2 treatment regimes. This presentation will provide a first hand account of how individuals feel from diagnosis beyond treatment. Conclusion: It will offer some simple yet effective strategies to create and inclusive and supporting environment when assisting people living with any chronic illness. Keywords: Hepatitis C, Blood Borne Viruses, diagnosis, treatment PP93 INTERACTIVE ANIMATED EPILEPSY EDUCATION PROGRAMME (IAEEP) FOR CHILDREN WITH EPILEPSY: DEVELOPMENT AND EVALUATION Pei Lin Lua1*, Neni Widiasmoro Selamat1, Jimmy Lee Kok Foo2 & Zariah Abd Aziz2
1.
2.
Centre for Community Development and Quality of Life (CCDQ), Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Malaysia Hospital Sultanah Nur Zahirah (HSNZ), Malaysia
*For any correspondence: peilinlua@unisza.edu.my Introduction: An effective education programme which could secure interest and simultaneously improve awareness, knowledge and attitudes (AKA) is essential in enhancing children with epilepsy (CWE)s well-being and health outcomes. This study aimed to describe the development of a new
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Interactive Animated Epilepsy Education Programme (IAEEP) for children and to assess its feasibility, acceptability and practicality. Methods: The IAEEP was developed by an interdisciplinary group of neurologist, pediatrician, pharmacist, biomedical scientist and educators which was based on two established epilepsy education programmes: the educational program for patients with epilepsy and their relatives (MOSES) and the modular educational program for children with epilepsy and their parents (FAMOSES). CWE were initially introduced to the IAEEP and were requested to complete an evaluation form assessing its feasibility, acceptability and practicality. Descriptive statistics were employed for data analyses (SPSS 20). Results: Sixteen CWE from paediatric department of three general hospitals in Terengganu (median age = 13.0; male = 56.2%; Malay = 81.2%; secondary school = 56.2%) and their corresponding parents were recruited. Each CWE owned at least a computer/notebook/tablet (100%). The cost of distribution of IAEEP (in compact disc form) among CWE was estimated at about MYR 17.99/USD 5.90 per CWE. The average time required to complete the programme was 23.5 minutes (SD = 1.9, range 20-26 minutes). The programme was 100% acceptable and received full support from both CWE and their parents (100%). Conclusion: The favorable findings from this study add to the growing evidence suggesting that investment in interactive and animated education programme would be both feasible, well-received by patients and could be a potentially valuable approach to increase access and effectiveness of epilepsy care especially among CWE. Keywords: Children, epilepsy, interactive animation PP94 HYGIENE PRACTICES AMONG SEMAQ BERI AND BATEK ORANG ASLI IN TERENGGANU AND KELANTAN Pei Lin Lua1*, Aryati Ahmad1, Ramle Abdullah2, Sahar Sadi Hashim2, Nor Shahirah Mansor1 & Mohamad Asmawi Ibrahim2
1. 2.
Faculty of Islamic Contemporary Studies, Universiti Sultan Zainal Abidin, Malaysia
*For any correspondence: peilinlua@unisza.edu.my Introduction: Despite the governments modernisation efforts, Orang Asli communities are still very dependent upon their natural environment for food, health and hygiene practices. Methods: Our cross-sectional study intended to explore basic hygiene practices among the Semaq Beri and Batek Orang Asli in Terengganu and Kelantan respectively. Adult respondents were identified, observed and semi-structurally interviewed during a research visit. Besides demographic background, questions on their general health status and daily hygiene practices were asked tooth-brushing, bathing, face-washing, handwashing and usage of soap. The frequency of each habit, their corresponding evidence (if any) and their physical clothing were also documented. Data was presented descriptively and non-parametric tests were employed (SPSS 16). Results: Twenty-three respondents who were all selfemployed were recruited (Batek = 12; male =18; age = 38 18; family members = 5 3). All but one respondents declared that they were healthy. Sixtyfive percent admitted to daily tooth-brushing (mean = 1) , 95.7% claimed to bathe daily (mean = 3) while 87.0% had used soap (mean = 3). In terms of faceand hand-washing practices (before or after food and after answering natures call), all responded positively. The respondents were also fully-clothed and wore proper footwear although several children were seen unclothed. These hygiene practices were also not significantly different between the two cohorts (p > 0.05). Nonetheless, a few self-reported practices (particularly tooth-brushing and bathing) could not be 100% reliable as they did not correspond to the observational records and hard evidence. Conclusion: The overall hygiene practices among the Orang Asli are still unsatisfactory. Integration into modern living may help reduce reliance on the natural environment, thereby enhancing cleanliness level and health in general. Keywords: Hygiene practices, Orang Asli, natural environment
Centre for Community Development and Quality of Life (CCDQ), Universiti Sultan Zainal Abidin, Malaysia
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PP95 BELIEFS ON THE BEHAVIOUR OF EXCLUSIVE BREASTFEEDING FOR SIX MONTHS AMONG WOMEN IN KELANTAN, MALAYSIA Tengku Alina Tengku Ismail1*, Wan Manan Wan Muda2 & Mohd Isa Bakar2
1.
2.
Department of Community Medicine, Universiti Sains Malaysia, Malaysia School of Health Sciences, Universiti Sains Malaysia, Malaysia
exclusive breastfeeding for six months. The behaviour was believed as not feasible and impossible. They were less concern or had misconception on the influence of the behaviour on their body weight and beauty. Conclusion: The beliefs identified from this study can be targeted as the focus of intervention. Providing correct information to the women and their important referents may help to improve exclusive breastfeeding behaviour. Keywords: Exclusive breastfeeding, Theory of Planned Behaviour, focus group discussion, beliefs PP96 EFFECTIVENESS OF A HEALTH PROMOTION APPROACH IN REDUCING OVER WEIGHT AMONG ADULTS IN KUNCHIKULAMA VILLAGE OF MIHINTALE MOH AREA, SRI LANKA B.L.G.Upuli Bhagya*, Y.Sivakumar, C.M.Punchihewa, T.M.I Lakmali, R.G.Isanka Jayathilake, Hirani kumarathunga, Duminda Guruge & Manoj Fernando Department of Applied Sciences, Health Promotion Unit, Rajarat University, Sri Lanka *For any correspondence: upuli.bhagya@yahoo.com Introduction: Non Communicable Diseases (NCD) is a common social issue nowadays. Over-weight is a major determinant factor of non-communicable diseases among Sri Lankans. 32.5% of Kunchikulama villagers identified as over-weight people. Food habits, lack of exercises, knowledge, food preference and food preparation, income and availability were the identified determinants. Health promotion is a process of enabling people to increase control over, and to improve their health by addressing determinants is a tool that can be used to address determinants of NCDs. The aim of this study was to reduce over weight among adults of Kunchikulama within12 months using a health promotion approach. Methods: The target group was adult above 18 in Kunchikulama. Initially the risk group was identified by the health camp was held in the preschool. Two groups created via the risk group.
*For any correspondence: dralina@kb.usm.my Introduction: Exclusive breastfeeding may lead to maternal postpartum weight loss and reduction in childhood obesity. Many women breastfeed their infants but exclusive breastfeeding is not common. This study aimed to explore beliefs under the framework of the Theory of Planned Behaviour in relation to the behaviour of practising exclusive breastfeeding for six months among women in Kelantan. Methods: A qualitative study using focus group discussions was conducted from June to August 2011, among pregnant women attending governmental health clinics in Pasir Mas, Kelantan. They were recruited through a stratified purposive sampling. An interview guide was developed to assess the behavioural belief, normative belief and control belief. They were the beliefs on the advantages and disadvantages of practising exclusive breastfeeding for six months, the important people whom the participants believed would support or oppose them and whom they themselves practised or did not practice, and the factors that they believed would facilitate or inhibit the behaviour. The discussions were audio-recorded and transcribed verbatim. Thematic analysis was conducted to identify the codes and themes in relation to exclusive breastfeeding for six months. Results: A total of 28 pregnant women participated in four focus group discussions. Five themes were identified. The first three themes reflected the three beliefs in the Theory of Planned Behaviour. The two newly identified themes were giving water to infants in the first six months of life and feasibility of
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Then determinants of overweight were identified via focus group discussions and in-depth interviews. BMI was measured once a month and salt, sugar and oil consumption also controlled by daily measuring. After introducing the physical exercise program, all group members together continue it once fortnight. They also involved in games with childrens health promotion committee as family based approach once a month. Finally the food chart was introduced. Results: A total of four respondents have come to the proper BMI range out of 15 and five who have not gained the normal range but have reduced their over BMI level in considerable amounts while another five have reduced their weight in small amounts. The reduced over weight among adults of Kunchikulama is 9%. Conclusion: The change in the knowledge, attitudes and behaviors of people can be considered as outcome of participatory health promotion interventions done with adults was effective and satisfactory to reduce the overweight of adults in Kunchikulama. Keywords: Over- weight, Body Mass Index, intervention PP97 AN INVESTIGATION OF THE CHARACTERISTICS OF HEALTH ADAPTION RISK GROUP Chih-Hsun Huang* & Chien Yu Department of Technology Application & Human Resource Development, National Taiwan Normal University, Taipei, Taiwan, R.O.C *For any correspondence: hsun520@gmail.com Introduction: This study aimed to investigate the characteristics of health adaption risk group. The characteristics include demographic and the selection of health information channels. Methods: A sample survey for adults over the age of 25 in Tainan, Taiwan with Health Adaption Scale. Data analyzed by structural equation and simple Logistic regression to establish health adaption system model and filter health adaptation risk group. Results: The low education, elder, no job and living alone is higher probability to be health adaption risk group. They used less time and channels on health information channels. They prefer passive entertainment and informal-interpersonal channels to get health information. Conclusion: Health adaption system model is a viable model to explain health with good reliability and validity. The health adaption risk group has at least population of 37.8 thousand on Taiwan by conservative estimate and they will increase by three times at 2050 with the elder population growth in the future. It is necessary to strengthen the health adaption ability of health adaption risk group to reduce the probability of occurrence of chronic diseases and reduce the social burden. Keywords: Health adaptation, health information, health promotion lifestyle PP98 THE EFFECTIVENESS OF AUDIOVISUAL MEDIA IN HEALTH EDUCATION OF PERSONAL HYGIENE TOWARD THE KNOWLEDGE AND THE STUDENT ATTITUDE IN SD NEGERI PUSMALANG, WUKIRSARI, CANGKRINGAN, SLEMAN, YOGYAKARTA Linda Setiyowati* & Mubasysyir Hasanbasri School of Public Health, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia *For any correspondence: lindasetiyowati@gmail.com Introduction: Lack of knowledge and attitudes among primary student on personal hygiene reflects the personal hygiene in everyday life. The school has never carried out any counseling or other health education on personal hygiene to enhance primary students awareness. The objective of the study was to determine the effect of health education with audiovisual media in increasing the knowledge and attitudes on personal hygiene. Methods: This is a pre-experimental study with a one group pretest-posttest. Respondents data were collected using a questionnaire before the intervention (pretest) and after the intervention (posttest).
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Result: Overview of knowledge and attitudes of respondents in health education about personal hygiene before and after treatment gained a mean of 44.00 at pretest for knowledge. These result increased to 51.43 at posttest. The same is obtained in attitude. At pretest obtained a value of 46.89 and posttest value obtained 58.00. While the analysis of knowledge on health education with audiovisual media the post test was 51.43. As for the attitudes was found in the pretest mean was 46.89 and 58.00 for the posttest. Both results were significant difference. Conclusion: There is an impact of giving health education on personal hygiene through the audiovisual media to increase primary students knowledge and attitudes. Keywords: Knowledge, attitude, Personal Hygiene Audiovisual PP99 SOCIODEMOGRAPHIC RELATIONSHIP WITH LEISURE TIME ACTIVITIES AMONG THE LOCAL COMMUNITY OF FELDA GEDANGSA Rizam A.R, Khairul Hazdi Y*, Faiz D, Sazman W, Hairol M.I, Noorasma Husna M.H, Mohd Firdaus H, Mohammad Fuad M.A, Azman A & Noor Hassim I Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: hazdi@ppukm.ukm.edu.my Introduction: Leisure activities should be filled up wisely as it has beneficial impacts in improving the quality of life. The objective of the study was to identify socio-demographic relationship with leisure activities in the community of Felda Gedangsa in Kuala Kubu Bharu, Selangor, which was carried out in March2013. Methods: Questionnaires on leisure activities was adapted to the Malaysian culture containing 25 activities and categorized into 4groups; recreational activities (physical), cognitive, social and productive. Survey was conducted face to face. Chi-square test was used to examine the relationship between leisure time activities and the factors studied. Results: A total of 168 respondents aged 18 to 84 years (mean age 5514.76) were surveyed. Activities performed each day were watching television (74.4%), reading (57.1%), decorating, tidying the house or surrounding area (51.2%) and spending time with their children and grandchildren (46.4%). This study showed female has the highest productive activities (33.3%), respondents with secondary education and above has highest physical activities (7.1%) and cognitive (15.3%), working respondents with recreation (1.0%), productive (30.0%) and cognitive (2.0%). The age group above 60 years do not engage in physical activities or cognition; they are more focused on social activities (38.4%) and productive (20.5%). Conclusion: Overall, the community performs minimal physical activities and cognitive during their leisure time. Keywords: Leisure time activity, local community, sociodemographic PP100 SPIRITUALITY AND MENTAL ADJUSTMENT AMONG BREAST CANCER WOMEN IN UNIVERSITI KEBANGSAAN MALAYSIA MEDICAL CENTRE Raja Lexshimi RG1*, Sharifah Ezat2, Mohd Fahmi Elias3, Lee Siew Choo3, Nor Suhana Hassan3& Nor Hazirah Hamzah3
1.
2.
3.
Department of Nursing, UKM Medical Centre, Malaysia Department of Community Health, UKM Medical Centre, Malaysia Department of Medicine, UKM Medical Centre, Malaysia
*For any correspondence: lex@ppukm.ukm.edu.my Introduction: Studies have shown that a diagnosis of breast cancer can cause distress to every woman. Spirituality has been shown to play an important role in coping with distress. Methods: A cross sectional study was conducted to assess spirituality and mental adjustment on 216 women with breast cancer in Universiti Kebangsaan Malaysia Medical Centre. The Functional
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Assessment of Chronic Illness Therapy-Spiritual Well-Being (Facet-Sp) was used to assess the spiritual well-being while mental adjustment to cancer (MAC) Scale was used to assess the mental adjustment of respondents. Results: In relation to mental adjustment, there was a significant positive correlation between spiritual well-being and fighting spirit (r=0.668) and negative correlation between spiritual well-being and helplessness (r=0.690), anxious preoccupation (r=0.277) and avoidance (r=0.235). There was no significant relationship between spiritual well-being and race (p=0.000, religion (p=0.000, academic qualification (p=0.004) and type of surgery (p=0.016). There was a significant relationship between fighting spirit and race (p=0.000), religion (p=0.000) and academic qualification (p=0.003). Results also revealed a significant relationship between avoidant and race (p=0.007) and academic qualification (p=0.005). Conclusion: This study concludes that patients are to be treated holistically rather than treating the breast cancer only. Higher spirituality level contributes to better coping strategy towards the disease by the patient then improving the disease outcome. Keywords: Breast cancer, spirituality and mental adjustment, women PP101 KANHELPLINE Othman Omar*, Nor Aida Maskor, Mazanah Muhamad & Rosemary S. Caffarella
1.
2.
Cancer Resource and Education Center (CaRE), Universiti Putra Malaysia, Malaysia Cornell University, Ithaca NY
*For any correspondence: othman.dr@gmail.com
Introduction: Cancer Resource and Education Center (CaRE) is a centre that provides education, information and support to those affected by cancer in Malaysia. CaRE used multipoint access to information and support such as education and awareness program, website, social media, books, resource centre and toll free call center. CaRE initiated KanHelpLine in 2009 with the support from Cancer Council Australia and Telekom Malaysia. KanHelpLine is a communication channel to facilitate those affected by cancer to seek information and support via toll free line. Methods: This paper deliberates an exploratory study on KanHelpLine and focus on pattern of its calls from January to December 2012. A qualified nurse responded to callers and recorded the details into CaRE database. The data included; (1) callers profile, (2) callers category, and (3) information sought. Results: A total of 114 calls were received by KanHelpLine in 2012. Majority callers were female. Most callers were from the public (46%), followed by cancer patients (23%), immediate family members (15%), workplaces (10%), extended friends and family (5%), and health professional (1%). The data showed that majority callers sought information about; cancer type (59%), hospital and clinic directory (11%), support group (7%), peer support (4%), publication (2%), counseling (2%) and others (15%). Callers received information (verbal and written), and CaRE book publication as requested. They were also referred to peer support group or other resources when needed. The call pattern shows that female and public are KanHelpLines main information and support seekers. Most called to ask questions on cancer (disease management). Conclusion: The analysis suggests that the public and those affected by cancer seek information on cancer when such service is provided to seek information and support to clarify their issues. The observation provides insights towards improvement of KanHelpLine. Keywords: cancer call center Malaysia, cancer information and support system
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PP102 CLINICAL VALIDATION STUDIES OF A NOVEL SELF-ADMINISTERED CERVICAL SMEAR KIT CERVISAFE, FOR EARLY CERVICAL CANCER SCREENING AND SEXUALLY TRANSMITTED INFECTION DETECTION Latifah A. Latiff 1*, Wong Yong Wee2 & Sabariah Abd.Rahman3
1. 2. 3.
Universiti Putra Malaysia, Selangor, Malaysia DRC Research Centre M Sdn. Bhd., Malaysia Universiti Teknologi MARA, Malaysia
Result also showed the ability of endocervical cells collection in specimen collected by CERVISAFE (46.1%) and cytobrush (74.8%). CERVISAFE was shown to be as good as cytobrush in HPV DNA detection. Cervisafe can perform as good as cytobrush for HPV DNA genotyping and cytology. Conclusion: CERVISAFE can be used as an option to conventional Pap smear by women at their convenience and can encourage women who are facing difficulty perform cervical cancer screening by healthcare provider. Keywords: cervical cancer, Human Papilloma Virus (HPV), Pap smear, cytobrush, Cervisafe PP103 WHAT MOTIVATE CANCER CARE VOLUNTEERS? Mazanah Muhamad1, Nor Wahiza Abdul Wahat2, Rahimah Ibrahim3, Kauthar Mohamad Kamaludin4 & Nor Aini Mohamed1*
1.
*For any correspondence: noraini.ain@gmail.com Introduction: The acceptance of Papanicolaou (Pap) test for screening of early cervical cancer and Human Papilloma Virus (HPV) infection is still low in Malaysia. It was estimated that only about 6% of women in Malaysia are screened .The aim of this study was to evaluate and compare cervical cell collection ability of CERVISAFE performed by the women as compared to the conventional sampling by using cytobrush performed by clinician or caregiver. Methods: This study was performed based on convenient sampling method amongst women who participated voluntarily in health campaigns in Selangor, Johor and Melaka from July 2012 till April 2013. Cervical specimens were collected from these recruited participants by two different methods using Cytobrush and CERVISAFE, in the same day. Participants were randomly divided into two groups A & B. GROUP A will perform CERVISAFE sampling first before proceed with cervical sampling collected using cytobrush and GROUP B will perform cervical sampling collected using cytobrush first before sampling by CERVISAFE. The specimens from both groups were analyzed blindly by a cyto-screener and results were compared for cytological changes and HPV genotypes. Results: A total of 266 subjects (mean age of 40.89 10.77 years) participated in this study. From the analysis we found that CERVISAFE can perform as good as cytobrush because there was no significant difference in cell adequacy and microscopic interpretation between two devices (p = 0.135).
2.
3.
4.
Cancer Resource & Education Center, Universiti Putra Malaysia, Malaysia Institute for Social Science Studies, Universiti Putra Malaysia, Malaysia Faculty of Human Ecology, Universiti Putra Malaysia, Malaysia Faculty of Educational Studies, Universiti Putra Malaysia, Malaysia
*For any correspondence: noraini.ain@gmail.com Introduction: Cancer is a major disease killer. There is a limited resource available for those affected by cancer. The cancer burden calls for volunteer participation. Volunteers spend a lot of time for others without remuneration. This kind of work does not always attract people. Why then people volunteer? According to Clary et al. (1998) and Clary and Synder (1999). The purpose of the study was to identify motives for volunteering in cancer care. Methods: The instrument was custom developed by reviewing the literature and finding from 3 focus group discussions on cancer care volunteers. The questionnaire was administered to 144 cancer care volunteers from various cancer support groups in Klang Valley.
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Results: The findings indicated that among the ten motivational factors, the highest mean score was value (4.3819). This was followed by understanding (4.3426), reciprocity (4.2917), social (4.1505), esteem/enhancement (4.1157), protective (4.0972), religion (3.7639), and career (3.2899). The study result also showed that motive is significantly related to commitment (r = .259, p<.05). Conclusion: Thus, it can be concluded that, (1) cancer care volunteers are intrinsically motivated, and (2) motivated volunteers are more committed towards volunteerism. To promote volunteerism for cancer care it is suggested that volunteer support organizations takes consideration of volunteers perceived benefits. Keywords: cancer care volunteers, cancer, motivational factors PP104 UPM-COMMUNITY ENGAGEMENT INITIATIVE: THE CASE OF CANCER EDUCATION PROGRAM Mazanah Muhamad, Othman Omar & Nurfaizah Saibul* Cancer Resource & Education Center (CaRE), Universiti Putra Malaysia, Malaysia *For any correspondence: nurfaizah.care@gmail.com Introduction: Cancer survival is a challenging journey. Evidences suggested that cancer survivorship needs both medical intervention and supportive care to live with, through and beyond cancer (Jabson et al., 2010; Radhakrishnan et al., 2010). Cancer Resource & Education Center (CaRE), a center of Excellence for Universiti Putra Malaysia, was set up in 2003 in collaboration with Cornell University, USA with goals to develop and provide evidence based cancer information, education and support to those affected by cancer. CaRE is also developed to extend the role of the university beyond research and teaching to benefit the community. This paper deliberates on the implementation of cancer education program as one of UPM-community engagement initiatives. Methods: Monthly face to face cancer education program is organized based on community needs and feedback to educate participants on cancer treatment and supportive care including; 1) Lifestyle, 2) Spiritual, 3) Social, 4) Motivation and 5) Volunteer development. This program is publicized to public particularly among cancer survivors and cancer stakeholders through multi channels including mail, email, mass media and social media. Each program is conducted for duration of 2 hours and is evaluated by using an evaluation form. Results: From 2009 until May 2013, a total of 51 cancer education programs had been organized with 7,037 participations. In 2013, customers expressed satisfaction to the program as evidenced by mean score of 4.2/ 5.0. The continuous participation and demand from customers suggest that cancer education program is relevant. This program is sustained through support and collaboration with local institutional and health care providers. Conclusion: The program may serve as guidance and module for participants to disseminate the information to others in the community. The program also illustrates how a university engages community for the good of mankind. Keywords: CaRE, cancer education program, UPMCommunity engagement PP105 IMPROVED EXERCISE TOLERENCE AND HEALTH RELATED QUALITY OF LIFE OF COPD PATIENTS UNDERGOING PULMONARY REHABILITATION PROGRAMME Zaleha Md Isa* & Ayiesah Department of Community Health, Faculty of Medicine, UKM Medical Centre, Malaysia *For any correspondence: zms@ppukm.ukm.edu.my Introduction: The objective is to determined effectiveness of a comprehensive pulmonary rehabilitation program on exercise tolerance and health-related quality of life (HRQoL) among chronic obstructive pulmonary disease patients.
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Methods: This is a quasi experimental parallel-group study involving 66 COPD patients undertaking a pulmonary rehabilitation programme with a controlled group in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and Institute Respiratory Medicine (IPR). The mean age for the control group in IPR was younger (n=18, 58.78 11.60) than those in PPUKM (n=16, 62.94 11.71) but the intervention group from IPR (n=18, 63.89 10.73) were older than those from PPUKM (n=14, 62.71 7.98). The outcome measures used were 6 Minutes Walking test (6-MWT), Medical Research Counsil (MRC) dypsnoea scale carried out at baseline and at the end of 8 weeks. Results: Findings showed improvement in 6MWT among intervention groups from both hospitals with mean difference of 60m (p<0.001) among patients in PPUKM and 46.78m (p=0.001) from IPR with no improvement in control group (p>0.05) from either hospitals. Modified Borg score (PPUKM: p<0.001) improved in both intervention groups but none in the control group. Similarly, significant improvement was observed in domains of SQRQ (p<0.001) for patients undergoing intervention group from both hospitals. The quality of life of COPD patients for all subscales in SGRQ (p>0.05) were better improved than those from IPR. Conclusions: The comprehensive pulmonary rehabilitation programme significantly improved exercise tolerance and health-related quality of life of COPD patients undergoing pulmonary rehabilitation programmme. Keywords: exercise, quality of life of COPD patients, pulmonary rehabilitation programme PP106 AN OPINION SURVEY IN EASTERN GHANA: HEALTH BEHAVIOURS AND KNOWLEDGE OF DIABETES IN DIAGNOSED DIABETES MELLITUS TYPE 2 PATIENTS Gemma Buston* *For any correspondence: drsaadalezzi@gmail.com University of Birmingham Medical School, United Kingdom *For any correspondence: gcb916@bham.ac.uk Introduction: An expectation specific version of the QUOTE questionnaire was developed to measure the patients perspective on part of the healthcare providers. Introduction: As the countries of Sub-Saharan Africa become more developed and more educated, death from communicable diseases is decreasing, whilst a diagnosis of a non-communicable disease (NCD) such as diabetes mellitus type 2 (DM2) is becoming much more commonplace. This opinion survey at Asesewa Government Hospital, Ghana, aims to assess the knowledge of risk factors and complications of DM2, and attitudes towards DM2, in patients who have already received a diagnosis of the disease. Methods: A 17-part questionnaire will be handed to diagnosed DM2 patients in an opportunistic manner in outpatient clinics and on hospital wards. Where patients are unable to answer the questionnaire due to literacy constraints, a structured interview will be conducted. If patients are willing to discuss their views further, semi-structured interviews will be conducted to determine common themes in attitudes towards the disease. Results: This study will be conducted from 20th May to 3rd June 2013 Conclusion: Results and conclusion will follow in due course. Keywords: Ghana, diabetes mellitus type 2, opinion survey PP107 DEVELOPMENT OF VALID AND RELIABLE QUESTIONNAIRE Saad Ahmed Ali Jadoo1, 2*, Ammar Jawdat2, Mustafa Ali Mustafa Alabbasi3, Al-Abed Ali Ahmed Al-Abed1, 2 & Namaitijiang Maimaiti1
1.
2.
3.
International Institute for Global Health (UNUIIGH), United Nation University Department of Community Health, National University of Malaysia Department of Community Medicine, Tikrit University
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Methods: The consistency and validity of the questionnaire was assessed. Extensive literature review and focus group discussions were used to select aspects for inclusion in the questionnaire that are important to patients. Item and factor analysis and reliability analysis were performed to test the internal consistency and validity of the questionnaire. Sixteen items were used in the QUOTE- Expectation questionnaire. Results: Factors analysis showed that the scale items were loaded on three distinct factors with eiginvalues more than 1 were obtained. The overall explained variance of scale was 84.28% of the total variance. The internal consistency of the total questionnaire was good (Cronbachs alpha >0.90). Testretest reliability was used to check the stability. Pearson correlation coefficient between the two assessments was high (r= 0, 967 p> 0.001). Conclusion: The QUOTE- expectation questionnaire has proved likely to be a valid and reliable tool that could be used to measure patient's expectation on part of the healthcare providers. Keywords: Expectation, QUOTE, Healthcare Provider, Skills, Communication PP108 CARDIOVASCULAR RISK FACTORS: DO WE FIT TO BE THE ROLE MODEL? P Hafizah , A R Siti Zubaidah , Z Nur Aiza & M Fadilla Norli1*
1. 2. 1 1 2
pressure and 4.0 percent for diastolic blood pressure, 19.0 percent has raised fasting blood sugar while 22.0 percent has raised total cholesterol level. In addition, approximately 64.0 percent female and 30.0 percent male respondents has central obesity. Chi-square test showed significant association between systolic blood pressure and gender (p=0.012) as well as age group (p=0.003) and BMI with age group (p=0.025). Even though this study does not represent the cardiovascular risk factors of the entire healthcare workers in Pahang, nevertheless, findings did highlighted the need in managing overweight and obesity as well as central obesity problems among PKD Pekan healthcare workers. Conclusion: Therefore, this study showed that healthcare workers are far from fit to be the role model for public in term of cardiovascular risk factors. Keywords: prevalence, cardiovascular, risk factor, healthcare workers, Pahang PP109 VALIDITY OF THE MALAY VERSION OF THE REVISED ILLNESS PERCEPTION QUESTIONNAIRE Rasidah Abd Wahab* & Haironi Yusoff Medical Education Unit, Faculty of Medicine & Health Sciences, Universiti Malaysia Sarawak, Malaysia *For any correspondence: awrasida@fmhs.unimas.my Introduction: Illness perception represents the patients experience of the illness and is reflected as either transient or long term. It has been increasingly linked to various coping procedures, action plan and outcome of illness. Methods: Although the Illness Perception Questionnaire (IPQ) is commonly used in assessing the patients view of their illness, its use in the Malaysian context using Bahasa Malaysia has been limited. Hence, a cross sectional study is conducted to validate the Malay version of the revised IPQ, which was administered to 100 randomly selected
Pekan Health District Office, Pahang, Malaysia Unit Kesihatan Pekerjaan, Jabatan Kesihatan Negeri Pahang, Pahang.
*For any correspondence: fadilla_norli@yahoo.com Introduction: Healthcare workers are among the main contributors of workforce in Malaysia. The purpose of this study is to determine the prevalence of cardiovascular risk factors among the healthcare workers in PKD Pekan. Methods: this is a cross sectional study on 100 healthcare workers. Results: Prevalence of overweight and obesity were 36.0 and 17.0 percent respectively. Blood pressure at hypertensive level were 6.0 percent for systolic blood
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hypertensive patients attending the three main polyclinics in Kuching, Sarawak Results: The overall internal consistency of the revised IPQ was satisfactory, with a Cronbachs alpha of between 0.815-0.904 for perception scale and between 0.76-0.794 for identity scale. Factorial analysis of the 7 subscales also showed an acceptable internal consistency with a Cronbachs alpha of 0.702. Of these subscales, emotional control showed the lowest alpha value of 0.589. There was a significant correlation between the 7 subscales. However, a negative correlation was noted between identity and treatment, and identity and personal control. Conclusion: The reliability of the Malay version of the IPQ is comparable to the English version (Cronbachs alpha = 0.75-089). This ensures that it is a valid instrument that can be used to measure illness perception of hypertension in the Malaysian context. Keywords: Illness perception questionnaire, validity, reliability, internal consistency, Cronbachs alpha
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Prevalence of Hypertension and Its Risk Factors in An Orang Asli Community in Perak, Malaysia

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Prevalence of Hypertension and Its Risk Factors in An Orang Asli Community in Perak, Malaysia

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PROGRAMME AND ABSTRACT

28 29 AUGUST 2013 RIVERSIDE MAJESTIC HOTEL KUCHING, SARAWAK

United Nations University International Institute for Global Health (UNU-IIGH)

Sarawak State Health Department

Sarawak Nursing Professional Association (SNPA)

In Collaboration with: Universiti Malaysia Sarawak (UNIMAS)

Supported by: Sarawak Convention Bureau

SCIENTIFIC / SYMPOSIUM SPEAKERS / PROCEEDING COMMITTEE 2013

xix xix xix xxiii xxv xxvii xxix

xxxi xxxiv xxxvi xxxvii xxxviii xxxix 1-138

Assalamualaikum Warahmatullahi Wabarakatuh and Salam Sejahtera

SCIENTIFIC Chairman Members

Assoc. Prof. Dr. Azmi Mohd Tamil

TIME 9.00am 4.00pm

Room: Lady Suite (3rd Floor)

OPENING CEREMONY PROGRAMme

TIME 10.15am-10.30am 10.30am 10.35am 10.35am-10.40am

Conference schedule recommence

TIME 8.00am 9.00am 9.00am 9.45am

11.45am 12.20pm SYMP1-1

12.20pm 12.55pm SYMP1-2

12.55pm 1.30pm SYMP1-3

12.20pm 12.55pm SYMP2-2

12.50pm 1.30pm SYMP2-3

1.30pm - 2.30pm 2.30pm - 4.30pm

3.10pm-3.50pm SYMP3-2 3.50pm-4.30pm SYMP3-3

TIME 8.30am 9.15am

SCIENTIFIC PAPER 1 PRESENTATION 4 CONCURRENT SESSIONS

SYMPOSIUM 5 & 6 (CONCURRENT)

11.25am 12.05pm SYMP5-2

12.05pm 12.45pm SYMP5-3

11.15am 11.45am SYMP6-2

11.45am 12.15pm SYMP6-3

12.15pm - 12.45pm SYMP6-4

12.45pm - 2.00pm 2.00pm - 3.00pm

3.00pm 3.40pm SYMP7-1

3.40pm 4.20pm SYMP7-2

4.20pm 5.00pm SYMP7-3

3.40pm 4.20pm SYMP8-2

4.20pm 5.00pm SYMP8-3

SCIENTIFIC PAPER PRESENTATION Epidemiology / Statistics (Session A1)

Epidemiology / Statistics (Session A2)

Family Health / Nutrition / Social Work (Session B1)

Family Health / Nutrition / Social Work (Session B2)

Occupational Health / Environmental Health (Session C1)

Occupational Health / Environmental Health (Session C2)

Health Management / Health Promotion (Session D1)

Health Management / Health Promotion (Session D2)

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

ORAL PRESENTATION EPIDEMIOLOGY & STATISTICS

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

*For any correspondence: drnizamb@yahoo.co.uk

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

ORAL PRESENTATION: EPIDEMIOLOGY / STATISTICS

ORAL PRESENTATION: FAMILY HEALTH / NUTRITION / SOCIAL WORK

ORAL PRESENTATION FAMILY HEALTH / NUTRITION / SOCIAL WORK