Publications by authors named "Rafiza Shaharudin"

6 Publications

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Source of cigarettes among youth smokers in Malaysia: Findings from the tobacco and e-cigarette survey among Malaysian school adolescents (TECMA).

Tob Induc Dis 2018 5;16:51. Epub 2018 Nov 5.

Hospital Sultan Haji Ahmad Shah, Temerloh, Malaysia.

Introduction: Understanding how and where youth obtain tobacco products are major factors in the development of suitable intervention programs to reduce youth smoking. This study aimed to determine the source of cigarettes and the associated factors among Malaysian school adolescent smokers.

Methods: Our sample consisted of 1348 youth aged 10-17 years who were current smokers (having smoked at least once in the last 30 days). The source of cigarettes (commercial, over-the-counter purchases; or social, borrowing or obtaining from someone else) was the dependent variable, and multivariable logistic regression was employed to determine its association with independent variables (i.e. sociodemographics, smoking behavior, and knowledge of laws prohibiting sales of cigarettes to youth).

Results: Over half (54.3%) of current smokers obtained cigarettes from commercial sources, with a proportion nearly two times higher (84.2% vs 43.7%) among frequent smokers (i.e. those smoking more than 20 days per month) compared to less-frequent smokers, and among young males (56.5% vs 32.0%) compared young females. Multivariable logistic regression indicated that in urban areas, young females (AOR=12.5, 95% CI: 1.38-99.8) frequent smokers (AOR=4.41, 95% CI: 2.05-9.46), and those studying in lower (AOR=3.76, 95% CI: 1.41-10.02) and upper secondary (AOR=4.74, 95% CI: 1.72-13.06) school students were more likely to obtain cigarettes from a commercial source. On the other hand, in rural areas, only frequent smokers were more likely to get their cigarettes from commercial sources, whilst other variables were not significant.

Conclusions: The proportion of youth smokers who obtained cigarettes from commercial sources appeared to be high, suggesting that law enforcement and health promotion activities should be enhanced to reduce the rate of smoking among Malaysian youth.
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November 2018

Demographic, socio-economic and behavior as risk factors of tuberculosis in Malaysia: a systematic review of the literature.

Rev Environ Health 2018 Dec;33(4):407-421

Public Health Division, Selangor State Health Department, Shah Alam, Selangor, Malaysia.

Background Tuberculosis (TB) is making a comeback and has remained one of the main causes of mortality among the list of infectious diseases in Malaysia. Objective To evaluate the burden and demographic, socio-economic and behavior as risk factors of TB among communities in Malaysia. Method A comprehensive search of Scopus, Sciencedirect, PubMed, DOAJ, CINAHL Plus, MyJournal, BIREME, BMC Public Health, Medline, CAB, EMBASE (Excerpta Medica dataBASE), and Web of Science (WoS) was undertaken from the articles published from 1st January 2008 to 31st December 2017 using medical subject heading (MeSH) key terms. Results Of 717 papers screened, 31 eligible studies met our inclusion criteria. Gender, age, marriage status, ethnicity, area of living, being in prison and immigrant were evaluated as demographic factors, while educational level, occupation and household income were evaluated as socio-economic factors. For behavioral factors, smoking, drug abuse, alcohol consumption and other lifestyle practices were evaluated. However, not all the studies were statistically significantly associated with these risk factors. Studies on household income were few and too small to permit a conclusion. We also did not find any study that investigated TB infection among sex workers. Conclusion Immigrant in high density settings may increase the progression of disease infection in Malaysia. The risk factors for the development of TB, specifically in a high-risk population, should be targeted through the implementation of specialized interventions. Further research into the role of indoor and outdoor physical environments is required to better understand the association between the physical environment and the social environment with TB infection.
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December 2018


Southeast Asian J Trop Med Public Health 2016 Sep;47(5):951-6

Burkholderia pseudomallei is an important causative organism of fatal community bacteremia especially in Southeast Asia and northern Australia. Outbreaks of melioidosis have been reported post-floods and -typhoons. A cross sectional study was conducted in January 2015, following a major flood in Kelantan, Malaysia to detect presence of B. pseudomallei from soil. A total of 89 soil samples were cultured for B. pseudomallei on Ashdown agar. Putative colonies underwent further staining and biochemical testing prior to confirmation by PCR. Rate of detection was 1%, although low, it nevertheless indicated a risk for melioidosis among flood victims in Kelantan. Flood affected individuals should be made aware of symptoms of melioidosis and healthcare providers must have a high index of suspicion of patients presenting with fever. Such subjects should be screened for the possibility of melioidosis and given prompt treatment to avoid preventable death.
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September 2016

Fish consumption pattern among adults of different ethnics in Peninsular Malaysia.

Food Nutr Res 2016 16;60:32697. Epub 2016 Aug 16.

Ministry of Health Malaysia, Federal Government Administration Centre, Putrajaya, Malaysia.

Background: Understanding different patterns of fish consumption is an important component for risk assessment of contaminants in fish. A few studies on food consumption had been conducted in Malaysia, but none of them focused specifically on fish consumption. The objectives of this study were to document the meal pattern among three major ethnics in Malaysia with respect to fish/seafood consumption, identify most frequently consumed fish and cooking method, and examine the influence of demographic factors on pattern of fish consumption among study subjects.

Methods: A cross-sectional survey was conducted between February 2008 and May 2009 to investigate patterns of fish consumption among Malaysian adults in Peninsular Malaysia. Adults aged 18 years and above were randomly selected and fish consumption data were collected using a 3-day prospective food diary.

Results: A total of 2,675 subjects, comprising male (44.2%) and female (55.7%) participants from major ethnics (Malays, 76.9%; Chinese, 14.7%; Indians, 8.3%) with a mean age of 43.4±16.2 years, were involved in this study. The results revealed 10 most frequently consumed marine fish in descending order: Indian mackerel, anchovy, yellowtail and yellow-stripe scads, tuna, sardines, torpedo scad, Indian and short-fin scads, pomfret, red snapper, and king mackerel. Prawn and squid were also among the most preferred seafood by study subjects. The most frequently consumed freshwater fish were freshwater catfish and snakehead. The most preferred cooking style by Malaysians was deep-fried fish, followed by fish cooked in thick and/or thin chili gravy, fish curry, and fish cooked with coconut milk mixed with other spices and flavorings. Overall, Malaysians consumed 168 g/day fish, with Malay ethnics' (175±143 g/day) consumption of fish significantly (p<0.001) higher compared with the other two ethnic groups (Chinese=152±133 g/day, Indians=136±141 g/day).

Conclusion: Fish consumption was significantly associated with ethnicity, age, marital status, residential area, and years of education of adults in Peninsular Malaysia, and the data collected are beneficial for the purpose of health risk assessment on the intake of contaminants through fish/seafood consumption.
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August 2016

Workplace injuries and risk reduction practices in Malaysia.

Int J Occup Environ Health 2012 Oct-Dec;18(4):299-306

Institute for Health Management, Kuala Lumpur, Malaysia.

Introduction: This study on workplace injuries and risk reduction practices was part of the Malaysia National Health Morbidity Survey III (NHMS III) conducted in 2006.

Methods: This cross-sectional population-based survey was conducted to determine the incidence of workplaces injuries and assess the magnitude of some important risk reduction practices among workers. Data were gathered through face-to-face household interviews using a pre-coded questionnaire.

Results: Of the 22 880 eligible respondents, 88·2% (20 180) responded. The incidence rate for injuries at the workplace was 4·9 per 100 (95% CI: 4·6-5·2). The overall proportion of workers who had received occupational safety and health (OSH) training before or within 1 month of starting work was 33·6%. Among respondents who perceived that personal protective equipment (PPE) was required at their workplace, only 38·9% (95% CI: 37·8-39·4) were provided with it by their employers.

Discussion: Further studies are urgently needed to identify reasons for and management of the low uptake of risk reduction practices. This issue needs to be addressed to ensure the safety and health of our working population.
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July 2013

Prevalence and risk factors of latent tuberculosis infection among health care workers in Malaysia.

BMC Infect Dis 2011 Jan 18;11:19. Epub 2011 Jan 18.

Institute for Medical Research, Environmental Health Research Centre, Occupational Health Unit, Jalan Pahang, 50588 Kuala Lumpur, Malaysia.

Background: Health care workers are exposed to patients with tuberculosis and are at risk of nosocomial infection. The aim of this study was to determine the prevalence and factors associated with latent tuberculosis infection among health care workers in Malaysia and also to evaluate the agreement between Quantiferon TB Gold in tube test with Tuberculin Skin Test.

Methods: A cross sectional study was conducted at four randomly selected hospitals in the Klang Valley from December 2008 to May 2009. Self administered questionnaire was used to obtain information on health care workers and possible risk factors. The response rate for this study was 90.8% with 954 respondents completed the questionnaire and were tested with Quantiferon TB Gold in tube for latent tuberculosis infection. Agreement between Quantiferon TB Gold in tube and Tuberculin Skin Test was assessed among 95 health care workers who consented to undergo both tests.

Results: The overall prevalence of latent tuberculosis infection among health care workers was 10.6% (CI: 8.6%; 12.6%). Factors significantly associated with latent tuberculosis infection were aged 35 years and older [9.49 (CI: 2.22; 40.50)], history of living in the same house with close family members or friends who had active tuberculosis [8.69 (CI: 3.00; 25.18)], worked as a nurse [4.65 (CI: 1.10; 19.65)] and being male [3.70 (CI: 1.36; 10.02)]. Agreement between Quantiferon TB Gold in tube test and tuberculin skin test at cut-off points of 10 mm and 15 mm was 50.5% and 82.1% respectively. However, Kappa-agreement was poor for both cut-off points.

Conclusion: The prevalence of latent tuberculosis infection in Malaysia was relatively low for an intermediate TB burden country. We could not comment on the occupational risk of latent tuberculosis infection among health care worker compared to the general population as there were no prevalence data available for latent tuberculosis infection in the general population. Kappa agreement between Quantiferon TB gold in-tube and tuberculin skin test was poor.
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January 2011