Cause-specific mortality estimates for Malaysia in 2013: Results from a national sample verification study using medical record review and verbal autopsy

Mortality indicators are essential for monitoring population health. Although Malaysia has a functional death registration system, the quality of information on causes of death still needs improvement, since approximately 30% of deaths are classified to poorly defined causes. This study was conducted to verify registered causes in a sample of deaths in 2013 and utilise the findings to estimate cause-specific mortality indicators for Malaysia in 2013.This study was funded by the Ministry of Health, Malaysi

Cross-cultural adaptation and validity of the patient rated michigan hand uutcome questionnaire in Bahasa Melayu for Malaysian patients

Background: The Michigan Hand Outcomes Questionnaire (MHQ) was designed in 1998 by Chung and colleagues at the University of Michigan in 1998. It is a hand-specific patient-rated outcome (PRO) instrument used to measure patients' outcome with conditions of, or injury to, the hand and/or wrist. This study is aimed at translating and cross-culturally adapting the MHQ into Bahasa Melayu (BM), examining the validity and reliability of the MHQ-BM version for our local population to be used as a patient-rated outcome measurement in Malaysian patients with hand injuries. Methods: This study was performed in two phases. Phase 1 involved the translation of the MHQ into BM using Beaton Protocol. In Phase 2, we administered the final version of the MHQ-BM in patients with hand and/or wrist injuries to test its stability (n = 50) and validity (n = 185). Results: The MHQ-BM showed good content and face validity. Cronbach α totalled 0.821 for the MHQ-BM. The Intra-class Correlation Coefficient (ICC) of the test-retest reliability for the six domains ranged from 0.960 to 0.984 with excellent correlation (ICC = 0.984) for the total score. The BM version of MHQ-BM showed excellent test-retest reliability. Conclusions: The MHQ-BM is well-translated and culturally well-adapted to maintain the reliability and content validity of the instrument (MHQ) at a conceptual level across Malaysia. We found the application and evaluation of the instrument to be feasible and understandable among patients with hand and/or wrist injuries in Malaysia

Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013

Background Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths for events that occur outside health facilities. This article reports the development of the VA methods and our principal finding from a validation study. Methods A cross sectional study on nationally representative sample deaths that occurred in Malaysia during 2013 was used. A VA questionnaire suitable for local use was developed. Trained field interviewers visited the family members of the deceased at their homes and conducted face to face interviews with the next of kin. Completed questionnaires were reviewed by trained physicians who assigned multiple and underlying causes. Reference diagnoses for validation were obtained from review of medical records (MR) available for a sample of the overall study deaths. Results Corresponding MR diagnosis with matched sample of the VA diagnosis were available in 2172 cases for the validation study. Sensitivity scores were good (>75%) for transport accidents and certain cancers. Moderate sensitivity (50% - 75%) was obtained for ischaemic heart disease (64%) and cerebrovascular disease (72%). The validation sample for deaths due to major causes such as ischaemic heart disease, pneumonia, breast cancer and transport accidents show low cause-specific mortality fraction (CSMF) changes. The scores obtained for the top 10 leading site-specific cancers ranged from average to good. Conclusion We can conclude that VA is suitable for implementation for deaths outside the health facilities in Malaysia. This would reduce ill-defined mortality causes in vital registration data, and yield more accurate national mortality statistics.This study was funded by the Ministry of Health, Malaysia

Factors associated with attendance to early childhood education programs in Malaysia: results from the national health and morbidity survey (Maternal and child health) 2016

The National Health and Morbidity Survey (NHMS) 2016 was a nationwide cross-sectional survey focusing on maternal and child health. This study aimed to identify the prevalence of, and factors associated with early childhood educational program (ECE) attendance among children aged three to five years in Malaysia. Attendance to ECE has been shown to enhance children’s development, yet there is no national information on ECE attendance in Malaysia, where attendance is not compulsory for children below five years. Parents were interviewed face-to-face utilising a validated questionnaire from the UNICEF Multiple Indicator Cluster Survey using mobile devices. Multivariate logistic regression analysis was performed to identify factors associated with ECE attendance. Half (53.4%) of children aged three to five years in Malaysia attend ECE. Older children aged four to five were six times more likely to attend ECE than children three to four years. Malaysian children of Chinese ethnicity were thrice as likely than ethnic Malays to attend ECE. Children with access to >3 children’s books were twice more likely to attend ECE than those who had access to <3 books. Unemployed mothers were less likely to send their children to ECE than mothers employed in civil service. More awareness on the importance and benefits of ECE attendance on children’s development is necessary so that younger children benefit from ECE

Practice of disciplinary methods and factors associated with belief for physical punishment among Malaysian parents: findings from NHMS 2016

The belief in the effectiveness of physical punishment is an important predictor for its use. The objectives of this study was to describe the factors associated with the belief for physical punishment toward children 1 to 5 years of age among Malaysian parents. Data was collected as part of the Malaysian National Health and Morbidity Survey (NHMS) 2016. The respondents were asked if they believed that physical punishment is needed to raise a child properly. A total of 60.0% of Malaysian parents believed in the need for physical punishment, with 54.3% practising it. Parents who believed in physical punishment had more than 2 times a higher likelihood of practising it (odds ratio 2.57) than those who did not. Parents need to be taught to respond positively to children’s behavior and anger management strategies in difficult parenting situations

Malaysian burden of disease: years of life lost due to premature deaths

Abstract Background In Malaysia, the previous mortality burden has been a significant concern, particularly due to the high prevalence of noncommunicable diseases (NCDs) as the leading cause of death. Estimates of mortality are key indicators for monitoring population health and determining priorities in health policies and health planning. The aim of this study was to estimate the disease burden attributed to 113 major diseases and injuries in Malaysia in 2018 using years of life lost (YLL) method. Methods This study included all deaths that occurred in Malaysia in 2018. The YLL was derived by adding the number of deaths from 113 specific diseases and multiplying it by the remaining life expectancy for that age and sex group. Data on life expectancy and mortality were collected from the Department of Statistics Malaysia. Results In 2018, there were 3.5 million YLL in Malaysia. Group II (NCDs) caused 72.2% of total YLL. Ischaemic heart disease was the leading cause of premature mortality among Malaysians (17.7%), followed by lower respiratory infections (9.7%), road traffic injuries (8.7%), cerebrovascular disease (stroke) (8.0%), and diabetes mellitus (3.9%). Conclusions NCDs are a significant health concern in Malaysia and are the primary contributor to the overall burden of disease. These results are important in guiding the national health systems on how to design and implement effective interventions for NCDs, as well as how to prioritise and allocate healthcare resources. Key strategies to consider include implementing health promotion campaigns, adopting integrated care models, and implementing policy and regulatory measures. These approaches aim to enhance health outcomes and the managements of NCDs in Malaysia

Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013

Abstract Background Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths for events that occur outside health facilities. This article reports the development of the VA methods and our principal finding from a validation study. Methods A cross sectional study on nationally representative sample deaths that occurred in Malaysia during 2013 was used. A VA questionnaire suitable for local use was developed. Trained field interviewers visited the family members of the deceased at their homes and conducted face to face interviews with the next of kin. Completed questionnaires were reviewed by trained physicians who assigned multiple and underlying causes. Reference diagnoses for validation were obtained from review of medical records (MR) available for a sample of the overall study deaths. Results Corresponding MR diagnosis with matched sample of the VA diagnosis were available in 2172 cases for the validation study. Sensitivity scores were good (>75%) for transport accidents and certain cancers. Moderate sensitivity (50% - 75%) was obtained for ischaemic heart disease (64%) and cerebrovascular disease (72%). The validation sample for deaths due to major causes such as ischaemic heart disease, pneumonia, breast cancer and transport accidents show low cause-specific mortality fraction (CSMF) changes. The scores obtained for the top 10 leading site-specific cancers ranged from average to good. Conclusion We can conclude that VA is suitable for implementation for deaths outside the health facilities in Malaysia. This would reduce ill-defined mortality causes in vital registration data, and yield more accurate national mortality statistics

Knowledge, perception and practice of infection control among Ministry of Health staff during COVID-19 outbreak in Malaysia

Coronavirus Disease 2019 (COVID-19) was declared as a pandemic in the middle of March as the disease is highly contagious and spread very quickly throughout the world. Understanding the knowledge and practice among healthcare staffs is also crucial especially among the frontlines staffs as they need to be able to protect themselves, and facilitate in educating their patients and public regarding disease prevention measures. The objective of this study is to assess knowledge, practice and perception on the effectiveness of the preventive measures taken by Ministry of Health (MOH) staffs to prevent transmission of the disease and measures they would take should they develop symptoms of the disease on COVID-19 disease. Methodology: We conducted a cross-sectional online survey from 30th March 2020 to 6th April 2020 among the Ministry of health staffs. 1719 staffs completed the survey. Results: The overall correct rate of knowledge was 46.6%. Most participants held good perceptions (range from 77.8% to 98.4%) and good practices (range from 88.8% to 99.7%) towards COVID-19 preventive measure. Meanwhile, the preventive measures practices if they develop symptoms of COVID-19 range from 89.8% to 99.7% and for the perception, it ranges from 85.5% to 98.9%. Conclusion: There are also still some lower components perceptions and practices than expected. Additional education intervention and campaigns are required to provide the Ministry of health staffs with adequate knowledge towards COVID-19 clinical presentation, general knowledge and transmission route of COVID-19, and to increase the perception and practice on some perceptions and practices of the preventive measures

Premature mortality among elderly in Malaysia, 2014

Introduction Substantial advances on the life expectancy have been achieved in Malaysia over the past few decades. It is essential that elderly lead a healthier old age which leans towards successful aging. Thus, this study describes the major causes of premature mortality among the elderly population in Malaysia, 2014. Methods The calculation of premature mortality in terms of Years of Life Lost (YLL) was based on the method used in the Global Burden of Disease (GBD) study. YLL is the mortality component determined by the age-sex specific number of deaths and life expectancy at the age of death. Mortality data was obtained from the Department of Statistics Malaysia. Elderly aged 60 years and above were included in this study. Results The major causes of premature mortality among elderly in Malaysia were Cardiovascular and Circulatory Diseases (39.0%); followed by Malignant Neoplasms (16.6%), Respiratory Diseases (9.8%), Respiratory Infections (9.2%) and Diabetes Mellitus (6.8%). Conclusions Awareness programme, early screening and help seeking among elderly should be a priority in planning health services to reduce the burden of Non-communicable diseases (NCD) among elderly