Publications by authors named "Hasimah Ismail"

12 Publications

  • Page 1 of 1

Prevalence and factors associated with falls among older persons in Malaysia.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:33-37

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia.

Aim: Falls are a common problem among older people, leading to major morbidity and increased mortality. The study aimed to determine the prevalence of falls among older persons in Malaysia and its associated factors.

Methods: Data were obtained from the National Health and Morbidity Survey 2018 (NHMS 2018), a cross-sectional study using stratified cluster sampling design. Older persons were defined as aged ≥60 years in this study. Descriptive and logistic regression analyses were conducted using SPSS version 25.0.

Results: Overall, 14.1% (95% confidence interval [CI]: 12.46, 15.84) of older persons reported having experienced at least one fall during the past 12 months. Univariate analyses revealed an association between the history of falls with not being employed (odds ratio [OR]: 1.35 [95% CI: 1.03, 1.77]), diabetes mellitus (OR: 1.65 [95% CI: 1.33, 2.04]), limitation in activities of daily living (ADL) (OR: 1.90 [95% CI: 1.43, 2.54]) or instrumental ADL (OR: 1.47 [95% CI: 1.16, 1.84]). Multiple logistic regression revealed that falls were positively associated with those who had diabetes mellitus (OR: 1.55 [95% CI: 1.23, 1.94]) and limitation in ADL (OR: 1.56 [95% CI: 1.14, 2.15]); 43.9% of falls occurred outdoors.

Conclusion: One in six older Malaysian people experience at least one fall over a 12-month period. Diabetes mellitus and limitation in ADL were the factors associated with falls among older persons. A comprehensive and targeted program designed to reduce risk of falls is urgently needed. Future research should identify suitable programs for our setting to reduce the potential society burden of falls in older Malaysians. Geriatr Gerontol Int 2020; 20: 33-37.
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http://dx.doi.org/10.1111/ggi.13980DOI Listing
December 2020

Self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:79-84

Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia.

Aim: The objective of this study is to determine the prevalence of self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia and their associated factors.

Methods: The study used data from the National Health and Morbidity Survey in 2018. It was a cross-sectional study with two-staged stratified cluster sampling design. In total, 3977 adults aged ≥60 years were selected for this study. Respondents were interviewed face to face using a structured questionnaire. Self-reported diabetes, hypertension or hypercholesterolemia was defined as having ever been told they have these diseases by a medical doctor or paramedic. Data were analyzed using SPSS version 25. The multiple logistic regression model was used to examine the factors associated with the prevalence of self-reporting.

Results: The prevalence of self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia were 27.7%, 51.1% and 41.8% respectively. Presence of other comorbidities and being obese showed higher odds for all three diseases. Indians, unemployed, inactive had higher odds for diabetes. Other Bumiputras, unemployed, non-smoker, obese and inactive had higher odds for hypertension. Non-smoker had higher odds for hypercholesterolemia.

Conclusions: Health promotion, vigilance, attention and services targeting on the associated factors should be strengthened for older persons in Malaysia to ensure healthy aging. Geriatr Gerontol Int 2020; 20: 79-84.
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http://dx.doi.org/10.1111/ggi.13968DOI Listing
December 2020

Association between functional limitations and depression among community-dwelling older adults in Malaysia.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:21-25

Faculty of Medicine & Health Sciences, University Putra Malaysia, Serdang, Malaysia.

Aim: This study aimed to assess the relationship between functional limitations and depression among community-dwelling older adults in Malaysia.

Methods: Data from a nation-wide community-based cross-sectional study were analyzed. This study was conducted using a two-stage stratified random sampling design. In total, 3772 older adults aged ≥60 years responded to the survey. Depression was identified using a validated Malay version of the Geriatric Depression Scale (M-GDS-14), with those scored ≥6 categorized as having depression. Functional limitations were assessed using both Barthel's Activities of Daily Living (ADL) and Lawton's Instrumental Activities of Daily Living (IADL). The relationship was determined by multivariate logistic regression, adjusted for other variables.

Results: The prevalence of depression was 11.5% (95% confidence interval [CI] 9.4, 13.4). Multiple logistic regression analysis found that older adults with limitations in ADL were 2.6 times more likely of having depression (adjusted odds ratio [aOR] 2.58, 95% CI 2.01, 3.32), while those with limitations in IADL the risk of having depression was almost doubled (aOR 1.68, 95% CI: 1.32, 2.14). Other significant factors were incontinence (aOR 3.33, 95% CI: 2.33, 4.74), chronic medical illness (aOR 1.44, 95% CI: 1.15, 1.81), current smoker (aOR 4.19, 95% CI: 1.69, 10.39), poor social support (aOR 4.30, 95% CI: 2.98, 6.20), do not have partner, ethnic minorities and low individual monthly income.

Conclusions: Older adults with functional limitation in both basic ADL and complex IADL are independently at higher risk of having depression. Geriatr Gerontol Int 2020; 20: 21-25.
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http://dx.doi.org/10.1111/ggi.14012DOI Listing
December 2020

Exposure to secondhand smoke among school-going adolescents in Malaysia: Findings from the tobacco and e-cigarettes survey among Malaysian adolescents (TECMA).

Tob Induc Dis 2020 20;18:96. Epub 2020 Nov 20.

Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia.

Introduction: Many studies have revealed that exposure to secondhand smoke (SHS) substantially increases the risk of smoking related diseases especially among the vulnerable groups, yet data on the location of SHS exposure among youth in Malaysia are still lacking. The study aims to describe the prevalence and factors associated with SHS exposure at home, outside the home, and inside the school among school-going adolescents in Malaysia.

Methods: We derived the data from the TECMA study, which used a cross-sectional study design and multi-stage sampling method to obtain a representative sample of school-going adolescents aged 11-19 years in Malaysia in 2016. Data were collected through a self-administered approach using a pre-validated standard questionnaire. Descriptive and multivariate analyses were used to analyze the data, and results are presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI).

Results: SHS exposure for the past seven days was higher outside the home (51.2%; 95% CI: 49.2-53.2) compared to at home (37.8%; 95% CI: 35.8-39.9) while 27.3% (95% CI: 25.1-29.5) of school-going adolescents reported exposure to SHS inside the school in the past one month. In the regression analyses, older adolescents, those of Malay and Bumiputra Sarawak ethnicities, adolescents from rural areas and current smokers had higher likelihood of exposure to SHS at home, outside home and inside the school. Our study also found that adolescents who were current smokers had higher odds of being exposed to SHS at home (AOR=2.87; 95% CI: 2.57-3.21), outside the home (AOR=3.46; 95% CI: 3.05-3.92) and in the school (AOR=2.25; 95% CI: 2.01-2.51).

Conclusions: Health promotion measures should target parents/guardians and household members to reduce SHS exposure among adolescents. In addition, smoke-free regulation should be fully enforced in school. Furthermore, more public places should be designated non-smoking areas to reduce SHS exposure and denormalize smoking behavior.
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http://dx.doi.org/10.18332/tid/128622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694740PMC
November 2020

Prevalence of chronic kidney disease and its associated factors in Malaysia; findings from a nationwide population-based cross-sectional study.

BMC Nephrol 2020 08 14;21(1):344. Epub 2020 Aug 14.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.

Background: The prevalence of chronic kidney disease (CKD) in Malaysia was 9.07% in 2011. We aim to determine the current CKD prevalence in Malaysia and its associated risk factors.

Methods: A population-based study was conducted on a total of 890 respondents who were representative of the adult population in Malaysia, i.e., aged ≥18 years old. Respondents were randomly selected using a stratified cluster method. The estimated glomerular filtration rate (eGFR) was estimated from calibrated serum creatinine using the CKD-EPI equation. CKD was defined as eGFR < 60 ml/min/1.73m or the presence of persistent albuminuria if eGFR ≥60 ml/min/1.73m.

Results: Our study shows that the prevalence of CKD in Malaysia was 15.48% (95% CI: 12.30, 19.31) in 2018, an increase compared to the year 2011 when the prevalence of CKD was 9.07%. An estimated 3.85% had stage 1 CKD, 4.82% had stage 2 CKD, and 6.48% had stage 3 CKD, while 0.33% had stage 4-5 CKD. Hypertension (aOR 3.72), diabetes mellitus (aOR 3.32), increasing BMI (aOR 1.06), and increasing age (aOR 1.06) were significantly associated with CKD.

Conclusion: Our study has shown that CKD has become one of the leading public health issues in Malaysia. Thus, there is an urgent need to screen for CKD and prevent its progression, associated morbidity, and mortality at the national level.
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http://dx.doi.org/10.1186/s12882-020-01966-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427283PMC
August 2020

A systematic review protocol on small/kiddie cigarette packaging size and its impact on smoking.

Syst Rev 2020 01 13;9(1):13. Epub 2020 Jan 13.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia.

Background: Small/kiddie cigarette packs consist of less than 20 cigarette sticks. Kiddie packs were recently proposed to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. By reintroducing kiddie packs, cigarettes will inevitably be more affordable and this would appeal to lower-income consumers especially teens. In this systematic review, we aimed to identify the impact of kiddie packs on smoking, specifically on smoking initiation, the urge/tendency to buy cigarettes and attempts to reduce cigarette consumption.

Methods: This systematic review will be based on the review of original articles on the impact of kiddie packs on smoking. There is no restriction on the publication dates. The Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Web of Science and Scopus will be searched to retrieve potential original articles. Additional records identified through other sources: Google Scholar, as well as Journal of Substance Use and Tobacco Control, are also to be searched. These will include original articles in any language which included all study designs (randomised controlled trials, quasi experimental and experimental studies, observational cross-sectional and cohort studies) comparing kiddie packs with regular cigarette packs. The primary outcomes of interest will be initiation of smoking and urge/tendency to buy cigarettes in the general population and attempts to reduce cigarette consumption among current smokers. Secondary outcomes will be the prevalence of smoking using kiddie packs among the current smokers.

Discussion: This systematic review will provide evidence to support the impact of kiddie packs on smoking in terms of smoking initiation, smoking prevalence, urge/tendency to purchase cigarettes and attempts to reduce cigarette consumption. The findings from this review could be helpful to policymakers in regulating kiddie packs to control the consumption of tobacco.

Systematic Review Registration: PROSPERO CRD42018102325.
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http://dx.doi.org/10.1186/s13643-019-1263-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6958659PMC
January 2020

Factors Associated With E-Cigarette Usage and the Reasons for Initiation Among Malaysian Adolescents.

Asia Pac J Public Health 2019 10 14;31(7_suppl):44S-52S. Epub 2019 Sep 14.

Institute for Public Health, Ministry of Health, Malaysia.

Electronic cigarettes (e-cigarettes) are handheld devices that deliver an aerosol by heating a solution made up of propylene glycol and/or glycerol with or without flavoring agents and nicotine. This nationwide cross-sectional survey examined factors associated with e-cigarette usage and reasons for its initiation among 13 162 Malaysian adolescents. Data from TECMA (Tobacco and E-Cigarette Survey among Malaysian Adolescents) were used. Nine percent of adolescents had used e-cigarettes in the past month. Males (adjusted odds ratio [aOR] = 4.08; 95% confidence interval [CI] = 3.36-4.95), 16 to 19 year olds (aOR = 2.64; 95% CI = 2.13-3.26), Malays (aOR = 2.25; 95% CI = 1.79-2.83), Sabah and Sarawak Bumiputeras (aOR = 2.25; 95% CI = 1.61-3.15), and cigarette smokers (aOR = 13.16; 95% CI = 11.14-15.54) were more likely to use e-cigarettes. Three main reasons for e-cigarette initiation among adolescents were its taste and smell, experimentation, and popularity. Sale of e-cigarettes with or without nicotine to people aged younger than 18 years should be banned. Flavored e-cigarettes should also be banned since there is evidence suggesting increased appeal among the younger generation.
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http://dx.doi.org/10.1177/1010539519870663DOI Listing
October 2019

Risk Factors for Illicit Drug Use Among Malaysian Male Adolescents.

Asia Pac J Public Health 2019 11 26;31(8_suppl):48S-56S. Epub 2019 Jul 26.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia.

This study was carried out to determine the prevalence of illicit drug use and its associated factors among male adolescents in Malaysia. Data of 13 135 adolescents were extracted from the National Health and Morbidity Survey 2017, a cross-sectional survey among school-going adolescents in Malaysia aged between 13 and 17 years, using a 2-stage stratified cluster sampling. A complex sample design analysis and multiple logistic regression analysis were applied. The overall prevalence of lifetime illicit drug use among male adolescents was 6.6%. The multivariable model showed that illicit drug use among male adolescents were associated with younger age, rural school area, marital status of parent, current smoker, ever having sex, truancy, involved in physical fight, and lack of peer support. The findings from this study can assist community and relevant authorities in their efforts to combat illicit drug usage among adolescents using intervention programs that diminishes risk factors and enhances the protective factors.
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http://dx.doi.org/10.1177/1010539519865053DOI Listing
November 2019

Cessation of E-Cigarette Use Among Adolescents and Its Associated Factors.

Asia Pac J Public Health 2019 10 12;31(7_suppl):53S-60S. Epub 2019 Jun 12.

Institute for Public Health, Ministry of Health Malaysia.

We assessed the prevalence of cessation of e-cigarette and its associated factors among adolescents in Malaysia. This study analyzed data from the Tobacco and E-Cigarette Survey among Malaysian Adolescent (TECMA) in 2016, a cross-sectional study with 2-stage stratification cluster sampling. A total of 14 832 school-going adolescents aged 10 to 19 years participated in this survey. A complex sampling design and multiple logistic regression analysis were applied. Nearly half of the adolescents (49.9%; 95% confidence interval [CI] = 44.9-55.0) who had ever used e-cigarette ceased the usage. Based on multivariate analysis, adolescents were more likely to quit e-cigarette because they could not afford the e-cigarette (adjusted odds ratio [aOR] = 2.39, 95% CI = 1.78-3.20), if they are aged 13 year and older (aOR = 1.80, 95% CI = 1.25-2.61), and those who claimed their e-cigarette does not contain nicotine (aOR = 1.35, 95% CI = 1.03-1.78). E-cigarette prevention efforts among adolescents could consider the cessation factors described in this study.
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http://dx.doi.org/10.1177/1010539519854873DOI Listing
October 2019

Iodine status among pregnant women in rural Sabah, Malaysia.

Asia Pac J Clin Nutr 2017;26(5):861-866

School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.

Background And Objectives: In 2000, legislation on mandatory universal salt iodisation was enacted in Sabah, Malaysia, to reduce the incidence of iodine deficiency disorders among its population. To evaluate the iodine levels among pregnant women from selected rural divisions in Sabah 13 years after the enactment of the universal salt iodisation programme.

Methods And Study Design: This cross-sectional study was conducted from 1 May to 30 June, 2013, in three rural divisions of Sabah (the Interior, the West Coast, and Kudat). Data regarding domestic iodised salt use and iodine-containing supplement consumption were obtained from respondents through face-to-face interviews; goitre enlargement was examined through palpation and graded according to the World Health Organization classification. Spot urine samples were also obtained to assess urinary iodine levels by using an in-house modified micromethod.

Results: In total, 534 pregnant women participated. The prevalence of goitre was 1.0% (n=5), noted only in the West Coast and Kudat divisions. Although all pregnant women consumed iodised salt, overall median urinary iodine concentration was only 106 μg/L, indicating insufficient iodine intake, with nearly two-thirds of the women (60%) having a median urinary iodine concentrations of <150 μg/L.

Conclusions: Pregnant women from the rural divisions in Sabah still exhibit iodine deficiency disorder despite the mandatory universal salt iodisation programme. Iodine supplementation programmes targeting pregnant women are warranted.
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http://dx.doi.org/10.6133/apjcn.092016.06DOI Listing
August 2019

Smoking among Secondary School Students in Kota Tinggi, Johor, Malaysia--Findings from a Cross-Sectional Study.

Asian Pac J Cancer Prev 2015 ;16(11):4563-70

Institute of Public Health, Kuala Lumpur, Malaysia E-mail :

Background: Smoking is a learnt behavior during adolescence and understanding the factor/s associated with smoking will assist in identifying suitable measures in combating the rising prevalence of smoking among adolescents. This research aimed to identify the factor/s associated with smoking among form four students in Kota Tinggi, Johor. Multistage sampling was used to select a representative sample of students in 2008 and data were collected using a self-administered validated questionnaire. This study revealed that the overall smoking prevalence was 19.0% with a significantly higher proportion of male smokers (35.8%) as compared to females (3.15%). Adolescents who were male (aOR 6.6, 95%CI 2.61-16.4), those who had peer/s who smoked (aOR 4.03, 95% CI 1.31-12.4), and those who studied in rural areas and Felda Settlements ( aOR 4.59, 95 CI 1.11-18.0; aOR 9.42, 95%CI 3.91-29.1) were more likely to smoke in the past one week. On the other hand, adolescents with better knowledge on the hazards of smoking and negative attitudes towards smoking were less likely to smoke (aOR 0.51, 95%CI 0.37-0.72; aOR 0.67, 95%CI 0.46-0.99). Future promotional and interventional programmes on smoking should be considered and the above identified risk factors integrated to reduce smoking prevalence among students of school-going ages in Kota Tinggi. Johor.
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http://dx.doi.org/10.7314/apjcp.2015.16.11.4563DOI Listing
March 2016

Sexual activity among Malaysian school-going adolescents: what are the risk and protective factors?

Asia Pac J Public Health 2014 Sep 28;26(5 Suppl):44S-52S. Epub 2014 Jul 28.

Family Health and Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia.

This study aimed to identify risk and protective factors associated with sexual activity among Malaysian adolescents. Data from the World Health Organization Global School-based Student Health Survey 2012 were analyzed. A total of 23 645 students aged 12 to 17 years responded using self-administered validated questionnaire. The overall prevalence of reported ever-had sex was 8.3%. Logistic regression analysis revealed that ever-had sex was positively significantly associated with ever-used drugs (adjusted odds ratio [aOR] = 7.71; 95% confidence interval [CI] = 6.51-9.13), and to a lesser extent, ever-smoked (aOR = 1.83; 95% CI = 1.62-2.07) and ever-consumed alcohol (aOR = 1.33; 95% CI = 1.15-2.53). Protective factors against ever-had sex were having a close friend (aOR = 0.63; 95% CI = 0.50-0.81), parental bonding (aOR = 0.72; 95% CI = 0.65-0.81), supportive peers (aOR = 0.77; 95% CI = 0.69-0.86), and parental connectedness (aOR = 0.88; 95% CI = 0.78-0.99). Although the prevalence of sexual activity among school-going adolescents in Malaysia is relatively low, identifying the risk and protective factors is crucial toward developing an integrated multiple approach to preventing sexual-related problems.
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http://dx.doi.org/10.1177/1010539514544700DOI Listing
September 2014