Publications by authors named "Norazizah Ibrahim Wong"

11 Publications

  • Page 1 of 1

Abdominal obesity and its associated factors among older adults in Malaysia.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:68-72

Nutrition Division, Ministry of Health Malaysia, Putrajaya, Malaysia.

Aim: The rise in the prevalence of abdominal obesity (AO), in particular, has become a major concern as it contributes to diabetes, hypertension, high cholesterol, heart disease and certain types of cancer. The aim of this study is to determine the prevalence and associated factors of AO among older adults aged ≥60 years in Malaysia.

Methods: This was a nationwide cross-sectional study using two-stage stratified random sampling. In total, 3977 older adults aged ≥60 years were involved in this study. Socio-demography characteristics were obtained using self-administered questionnaire. AO was measured using waist circumference and classified according to the cut-off values of ≥90 cm for men and ≥80 cm for women based on the WHO recommendation. Descriptive and multiple logistic regression analysis using a complex sample design were performed for data analysis.

Results: Our findings showed that 2371 (67.3%) older adults had AO. Older adults who were from urban areas (69.7%), of women (78.4%), married (66.7%), with tertiary education (73.6%) and unemployed (70.9%) had the highest prevalence of AO. Those from urban areas (adjusted odds ratio [aOR] = 1.29), women (aOR = 3.12), unemployed (aOR = 1.14), diagnosed with hypertension (aOR = 1.56) and diabetes mellitus (aOR = 2.08) were also significantly associated with a higher risk of AO.

Conclusions: This study identified several risk factors that are associated with AO among older adults in Malaysia. Such information is important and needed to improve the healthcare system systematically, enable nutrition screening and appropriate intervention to combat the growing AO in Malaysia. Geriatr Gerontol Int 2020; 20: 68-72.
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http://dx.doi.org/10.1111/ggi.13962DOI Listing
December 2020

Factors contributing to food insecurity among older persons in Malaysia: Findings from the National Health and Morbidity Survey (NHMS) 2018.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:73-78

Sector of Biostatistics and Data Repository, National Institutes of Health, Selangor, Malaysia.

Aim: Older persons are vulnerable to food insecurity. Therefore, this study aimed to determine the prevalence of food insecurity and associated factors among older persons in Malaysia.

Methods: This is a cross-sectional study with two-stage stratified random sampling. In total, 3977 older persons participated in this study. Face-to-face interviews were conducted using a mobile device to obtain information about socio-demographic background, food insecurity, non-communicable diseases, social support and living arrangements. Descriptive and multiple complex sample logistic regression analyses were performed for data analysis.

Results: The overall prevalence of food insecurity among older persons was 10.4%. Older persons from rural areas with no or only primary and secondary education, income less than RM 2000 (USD 477.57), at risk of malnutrition and not receiving very high social support were more likely to be food-insecure.

Conclusion: Approximately, one-tenth of Malaysian older adults were classified as food-insecure; particularly those living in rural areas from lower socio-economic status, not receiving very high social support and malnourished were more likely to be at risk. A specific nutrition program, such as meals on wheels and food vouchers, should be targeted toward older persons who are at risk to improve their malnutrition status. Geriatr Gerontol Int 2020; 20: 73-78.
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http://dx.doi.org/10.1111/ggi.14006DOI Listing
December 2020

Elder abuse: Nationwide findings among community-dwelling Malaysian older persons.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:85-91

Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Aim: Elder abuse is a significant public health problem. This study aims to estimate its prevalence and associated factors, using representative national Malaysian data.

Methods: A nationwide population-based survey involving 3977 community-dwelling older persons aged ≥60 years was conducted via face-to-face interview, of whom 3466 older persons were eligible for screening using a locally validated tool. Elder abuse was defined as any one occurrence of neglect, financial, psychological, physical or sexual abuse perpetrated by someone in a position of trust that was experienced in the past 12 months.

Results: About 9.0% of older persons in Malaysia have experienced elder abuse in the past 12 months, with neglect being the commonest type experienced (7.5%; 95% confidence interval [CI]: 5.54, 10.07). There is no significant difference by age group and geographical location. Males (adjusted odds ratio [aOR] 1.7; 95% CI: 1.06, 2.60), poorer social support (aOR 5.0; 95% CI: 2.25, 11.22), dependency in activities of daily living (aOR 2.1; 95% CI: 1.23, 3.44) and a previous history of abuse (aOR 10.1; 95% CI: 4.50, 22.86) show higher odds of experiencing elder abuse. Almost 5% of abused older persons reported experiencing multiple types of abuse. Reporting is low at 19.3% with none reporting to healthcare personnel.

Conclusions: The prevalence of elder abuse in this study is lower than global estimates, but similar to local studies. Preventive measures and programs are crucial to overcoming elder abuse and need to be carried out at multiple levels - the individual, community, healthcare and other stakeholders. Geriatr Gerontol Int 2020; 20: 85-91.
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http://dx.doi.org/10.1111/ggi.13989DOI Listing
December 2020

An overview of the methodology and general findings from the National Health and Morbidity Survey (NHMS) 2018: Older persons' health in Malaysia.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:7-15

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

Aim: This article describes the methodology of the 2018 Malaysian National Health and Morbidity Survey, and provides an overview of the sociodemographic details of the respondents and key findings on the health of older adults.

Methods: The survey included 3977 community-dwelling respondents, aged ≥60 years across Malaysia. Two-stage stratified random sampling with selection of enumeration blocks from both urban and rural areas ensured the findings were representative of the Malaysian older population.

Results: Complex sampling analyses ensured that findings on various geriatric syndromes, non-communicable diseases, nutritional status, functional status, social well-being and quality of life are representative of the Malaysian older population. Among the limitations are that the composition of older persons varied slightly from the general older population.

Conclusions: This article presents the methodology of the survey, and a baseline of the major health issues for older persons in Malaysia to provide clear guidance to researchers, program managers and policymakers to fully utilize the data from the Malaysian National Health and Morbidity Survey toward achieving healthy aging. The findings might stimulate more research on the health problems faced by older people to provide inputs for policymaking and program implementation. Geriatr Gerontol Int 2020; 20: 7-15.
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http://dx.doi.org/10.1111/ggi.14094DOI Listing
December 2020

Association of sociodemographic factors and self-perception of health status on oral health-related quality of life among the older persons in Malaysia.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:57-62

Biostatistics & Repository Data Sector, National Institutes of Health, Ministry of Health, Selangor, Malaysia.

Aim: This study aimed to evaluate the oral health-related quality of life (OHRQoL) among older persons in Malaysia and its associations with sociodemographic and self-perception towards general health as well as oral health.

Methods: A cross-sectional survey among community dwelling older persons utilizing stratified cluster sampling was conducted in 2018. Well-trained interviewers conducted a face-to-face interview with older persons aged ≥60 years to collect information on participants' sociodemographic characteristics, self-perception on general as well as oral health using the Geriatric Oral Health Assessment Index (GOHAI). Multivariate analysis of the data collected was performed using SPSS version 23.

Results: Overall, the GOHAI mean ± SD score for older persons in Malaysia was 51.83 ± 7.98, which was an average of fair mean (P < 0.001). Those with poor self-rated oral health (48.34 ± 8.96) or poor self-rated general health (47.13 ± 8.93) had poor mean OHRQoL (P < 0.001). Logistic regression analysis shows older persons who stay with spouse/partner (adjusted odds ratio [aOR]: 1.96 [1.66, 2.31]), no formal education (aOR: 1.84 [1.29, 2.61]) and self-perceived unhealthy oral health (aOR: 3.83 [3.19, 4.59]) were significantly associated with higher odds of having poor OHRQoL.

Conclusions: The estimated OHRQoL of older persons in Malaysia is rated as fair, with minimum association contributed by the sociodemographic factors, but with a significant influence by self-rated oral and general health. Self-perception of health can be used as a good indicator to estimate the OHRQoL. Geriatr Gerontol Int 2020; 20: 57-62.
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http://dx.doi.org/10.1111/ggi.13969DOI Listing
December 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

Association between long-term exposure to ambient air pollution and prevalence of diabetes mellitus among Malaysian adults.

Environ Health 2020 04 3;19(1):37. Epub 2020 Apr 3.

Department of Environment, Ministry of Energy, Technology, Science, Environment and Climate Change, 62662, Putrajaya, Malaysia.

Background: Malaysia has the highest rate of diabetes mellitus (DM) in the Southeast Asian region, and has ongoing air pollution and periodic haze exposure.

Methods: Diabetes data were derived from the Malaysian National Health and Morbidity Surveys conducted in 2006, 2011 and 2015. The air pollution data (NO, NO, SO, O and PM) were obtained from the Department of Environment Malaysia. Using multiple logistic and linear regression models, the association between long-term exposure to these pollutants and prevalence of diabetes among Malaysian adults was evaluated.

Results: The PM concentration decreased from 2006 to 2014, followed by an increase in 2015. Levels of NO decreased while O increased annually. The air pollutant levels based on individual modelled air pollution exposure as measured by the nearest monitoring station were higher than the annual averages of the five pollutants present in the ambient air. The prevalence of overall diabetes increased from 11.4% in 2006 to 21.2% in 2015. The prevalence of known diabetes, underdiagnosed diabetes, overweight and obesity also increased over these years. There were significant positive effect estimates of known diabetes at 1.125 (95% CI, 1.042, 1.213) for PM, 1.553 (95% CI, 1.328, 1.816) for O, 1.271 (95% CI, 1.088, 1.486) for SO, 1.124 (95% CI, 1.048, 1.207) for NO, and 1.087 (95% CI, 1.024, 1.153) for NO for NHMS 2006. The adjusted annual average levels of PM [1.187 (95% CI, 1.088, 1.294)], O [1.701 (95% CI, 1.387, 2.086)], NO [1.120 (95% CI, 1.026, 1.222)] and NO [1.110 (95% CI, 1.028, 1.199)] increased significantly from NHMS 2006 to NHMS 2011 for overall diabetes. This was followed by a significant decreasing trend from NHMS 2011 to 2015 [0.911 for NO, and 0.910 for NO].

Conclusion: The findings of this study suggest that long-term exposure to O is an important associated factor of underdiagnosed DM risk in Malaysia. PM, NO and NO may have mixed effect estimates towards the risk of DM, and their roles should be further investigated with other interaction models. Policy and intervention measures should be taken to reduce air pollution in Malaysia.
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http://dx.doi.org/10.1186/s12940-020-00579-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119016PMC
April 2020

Prevalence and Factors Associated With Oral and Hand Hygiene Practices Among Adolescents in Malaysia: Findings From the National Health and Morbidity Survey 2017.

Asia Pac J Public Health 2019 11 22;31(8_suppl):97S-104S. Epub 2019 Oct 22.

Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.

This cross-sectional national survey aimed to determine the prevalence of oral and hand hygiene practices as well as associations between sociodemographic characteristics and oral and hygiene practice among adolescents aged 13 to 17 years during the past 30 days. A validated self-administered bilingual questionnaire adapted from the Malaysian Global School Health Survey with computer-scanable answer sheets was distributed to 30 823 adolescents attending government secondary schools in Malaysia; and 89.2% responded to the questionnaire given. More than 80% (87.1%; 95% confidence interval [CI] = 86.24-87.96) of the adolescents reported that they had brushed their teeth at least twice daily and had always washed their hands after using the toilet (86.6%; 95% CI = 85.85-87.36). The odds of adolescents who brushed their teeth at least 2 times daily and washed their hands after using the toilet was significantly associated with sociodemographic characteristics. This study highlights the need to further improve the effectiveness of current oral health promotion programs with consideration for sociodemographic characteristics.
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http://dx.doi.org/10.1177/1010539519880998DOI Listing
November 2019

The Association of Internet Addiction and Perceived Parental Protective Factors Among Malaysian Adolescents.

Asia Pac J Public Health 2019 11 15;31(8_suppl):57S-64S. Epub 2019 Sep 15.

Family Health and Development Division, Ministry of Health Malaysia, Federal Government Administration Centre, Putrajaya, Malaysia.

Parental protective factors do play an important role in preventing Internet addiction. A self-administered questionnaire was used to measure health risk behaviors among Malaysian adolescents. The prevalence of Internet addiction was significantly higher among adolescents with perceived lack of parental supervision (30.1% [95% confidence interval (CI) = 28.7-31.4]) and lack of parental connectedness (30.1% [95% CI = 28.5-31.7]), compared with their counterparts. Adolescents who perceived a lack of parental supervision, respect for privacy, connectedness, and bonding were more likely to have Internet addiction: (adjusted odds ratio [aOR] = 1.39; 95% CI = 1.27-1.52), (aOR = 1.23; 95% CI = 1.16-1.31), (aOR = 1.09; 95% CI = 1.02-1.16), (aOR = 1.06; 95% CI = 1.00-1.12), respectively. Among girls, Internet addiction was associated with those who perceived lack in all 4 parental factors, while among boys, those who perceived lack of parental supervision and respect for privacy were more prone to Internet addiction.
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http://dx.doi.org/10.1177/1010539519872642DOI Listing
November 2019

Methodology and Representativeness of the Adolescent Health Survey 2017 in Malaysia.

Asia Pac J Public Health 2019 11 21;31(8_suppl):8S-17S. Epub 2019 Jun 21.

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

Health risk behaviors and mental health problems are associated with morbidity and premature mortality among adolescents. Understanding the magnitude of the problem may improve adolescent health status. The Adolescent Health Survey was conducted to collect data on health risk behaviors among Malaysian school-going adolescents using self-administered questionnaires. A 2-stage stratified cluster sampling design was used and samplings weights were calculated to ensure representativeness to the general population. A total of 27 497 out of 30 823 school-going adolescents completed the questionnaires, yielded an 89.2% overall response rate. The methodology was robust to ensure valid estimation on the prevalence of health problems among Malaysian school-going adolescents.
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http://dx.doi.org/10.1177/1010539519854884DOI Listing
November 2019

Prevalence and determinants of disability among adults in Malaysia: results from the National Health and Morbidity Survey (NHMS) 2015.

BMC Public Health 2017 09 29;17(1):756. Epub 2017 Sep 29.

Centre for Family Health Research, Institute for Public Health, Ministry of Health, Jln Bangsar, 50590, Kuala Lumpur, Malaysia.

Background: Reliable national data on disability which is internationally comparable is needed in Malaysia. This study aims to examine the prevalence of disability among adults in Malaysia and its determinants, particularly the socioeconomic factors and comorbidities.

Methods: This study was based on the disability module, which is part of the National Health and Morbidity Survey 2015. This survey was implemented using a multi-stage stratified sampling design. A locally validated Washington Group questionnaire was used to collect data on disability.

Results: Based on the definition of having at least one domain scored "a lot of difficulty or unable to do at all" or at least "some difficulty" scored in two domains, the prevalence of disability among adults in Malaysia was 11.8% (95% CI: 11.15, 12.53). Logistic regression analysis performed showed that population at risk of having disability in Malaysia were those of older people, ethnic minority, low level of education, single, obese, physically inactive and having mental health problems. Among older people, disability was significantly higher among those with no formal education, having mental health problems and physically inactive.

Conclusions: The prevalence of disability among adults in Malaysia is comparable to WHO estimates and most developing countries. Planning for healthcare services should consider at-risk population, particularly older people and those from disadvantaged background to ensure equity healthcare.
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http://dx.doi.org/10.1186/s12889-017-4793-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622591PMC
September 2017