Associated factors of depression severity among school-going adolescents in Malaysia from national school based health survey 2012

Introduction: Depression is the single largest contributor to the global burden of disease. Depression was found as a common disorders among children lower than 18 years old. Objective: The objectives of this study are to estimate the prevalence of depression according to severity and to determine the factor associated with severity of depression among school-going adolescents in Malaysia. Method: Secondary data analysis from Malaysian National School Based Health Survey 2012 was conducted. From Mental Health Survey database, a total of 24,276 respondent have responded to depression module in DASS-21. While, the total number of respondent that responded to all module in Global School based Health Survey (GSHS) was 25,410. Finally after merged the database and taking consideration of inclusion and exclusion criteria of the study, a total of 21,764 school-going adolescents aged 12 to 18 years old were eligible in this study. No additional or further sampling was done on the obtained data which was taken with GSHS original sampling design scheme which engaged stratification and clustering. Socio demographics characteristics, substance use, health behaviour, home and environment and comorbidities factor were extracted from the database. Looking for depression severity, it was categorised as normal, mild, moderateand severe. Complex Sample ordinal logistic regression was used for analysis to quantify the odds ratio and 95 % confidence interval. Results: A total of 21,764 adolescents were included in the study with the mean (SD) age of 14.19 (1.47). The overall prevalence of depression symptoms was 33.2% (95% CI: 32.0, 34.4). The prevalence of mild, moderate and severe depression were 16.6% (95% CI: 16.08, 17.27), 12.8% (95% CI: 12.04, 13.53) and 3.8% (95% CI: 3.38, 4.22) respectively. In multivariable analysis, the higher odds of having more severe depression was observed among females (OR=1.32, 95% CI: 1.21, 1.43), Indian ethnicity (OR=1.73, 95% CI: 1.42, 2.10), those who smoke (OR=1.30, 95% CI: 1.15, 1.46), drink alcohol (OR=1.30, 95% CI: 1.14, 1.48), take drug (OR=1.81, 95% CI: 1.24, 2.65), involved in truancy (OR=1.31, 95% CI: 1.20, 1.43), those who have been bullied (OR=1.84, 95% CI: 1.68, 2.01), those who had suicidal ideation (OR=3.02, 95% CI: 2.56, 3.55), lack of parental bonding (OR=1.33, 95% CI: 1.22, 1.45), and lack of parental connectedness (OR=1.29, 95% CI: 1.19, 1.40). Conclusion: One third of adolescents were reported have symptoms of depression. The prevalence of depression by severity were higher in mild followed by moderate and severe depression. Complex Sample ordinal logistic regression analysis revealed that female, Indian ethnic, substance use risk factor, health behavior risk factor and home and school environment risk factor were likely to be associated in having more severe depression

Congenital Nasal Pyriform Aperture Stenosis as a rare manifestation of Trisome 8 Mosaicsm: a case report

Congenital Nasal Pyriform Aperture Stenosis (CNPAS) is an extremely rare cause of nasal airway obstruction. Clinically, it mimics choanal atresia in neonate. It needs to be differentiated because management differs from each. Pyriform aperture is located at the most anterior part of the nose and is always the narrowest region of the nasal cavity. Therefore, nasal obstruction can easily occur if there is slight decrease in its cross sectional area. CNPAS rarely presents alone. Usually, it arises together with a midline developmental defect such as holoprosencephaly or pituitary defect. We present the first ever reported case of CNPAS, in association with Trisomy 8 Mosaicsm (T8M)

Anxiety and its associated factors among school-going adolescents in Malaysia

Many mental health disorders have onset during adolescence. To date, the data on the correlates of anxiety is still lacking. Therefore, this study is crucial to determine the factors associated with anxiety among school-going adolescents in Malaysia. Methods This study was based on 26,892 school-going adolescents from 212 selected schools in Malaysia. Anxiety was measured using Depression Anxiety and Stress Scale (DASS-21). Associations between anxiety, sociodemographic characteristics and variables of interest were examined using multivariable logistic regression. Results Overall, 10,540 (39.7%) school-going adolescents had anxiety. Anxiety was positively associated with female (odds ratio, OR [95% confidence interval, CI] = 1.30 [1.19,1.42]) compared to male counterpart, feeling loneliness (1.78 [1.54,2.05]) compared to not lonely, unable to sleep due to worry of something (1.79 [1.56,2.05]) compared to able to sleep, being bullied (1.66 [1.48,1.87]) compared to not being bullied, physical abuse (1.33 [1.18,1.49]) compared to no physical abuse, verbal abuse (1.47 [1.35,1.59]) compared to no verbal abuse, current drinker (1.23 [1.06,1.43]) compared to not current drinker, current drug use (1.84 [1.43,2.35]) compared to not current drug use, ever had sex (1.17 [1.01,1.36]) compared to never had sex, physically inactive (1.16 [1.06,1.26]) compared to physically active and internet addiction (2.59 [2.37,2.83]) compared to no internet addiction. Chinese ethnic (0.68 [0.50,0.93]) compared to other ethnic, and Form 2 (0.78 [0.69,0.89]) and Form 3 (0.73 [0.65,0.82]) students compared to Form 1 students, were protective of anxiety. Conclusions Prevention and intervention programs for these “at-risk” adolescents should be planned holistically towards reducing the risk factors

Internet addiction and its associated factors among school-going adolescents in Malaysia

Internet usage has changed the way adolescents socialize. This study aims to determine the determinants of internet addiction among school-going adolescents in Malaysia. This study was a cross-sectional study involving 27,455 school-going adolescents from 212 selected schools in Malaysia, as part of the 2017 National Health and Morbidity Survey that implemented a two-stage stratified cluster sampling design. Data collection via a self-administered questionnaire was conducted from March till May 2017. Overall, 8,049 (29.0%) school-going adolescents had internet addiction. Internet addiction was positively associated with male (odds ratio, OR [95% confidence interval, CI] = 1.20 [1.08,1.34]) compared to female, Chinese ethnicity (1.67 [1.12,2.48]) compared to other ethnicity, feeling loneliness (1.37 [1.20,1.57]) compared to never feel lonely, unable to sleep due to worrying of something (1.40 [1.17,1.67]) compared to able to sleep, insufficient parental supervision (1.30 [1.14,1.48]) compared to sufficient parental supervision, depression (1.67 [1.48,1.89]) compared to no depression, anxiety (2.12 [1.95,2.30]) compared to no anxiety and stress (2.26 [1.96,2.61]) compared to no stress. The odds of having internet addiction increase from Form 2 (1.51 [1.28,1.78]), Form 3 (2.37 [2.01,2.80]), Form 4 (2.60 [1.76,3.85]) to Form 5 adolescents (2.96 [1.98,4.41]) compared to Form 1 adolescents. Our results suggest that being a male, of Chinese ethnicity, higher form level, feeling loneliness, unable to sleep due to worrying of something, insufficient parental supervision, depression, anxiety and stress were positively associated with internet addiction among school-going adolescents

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

Associations between the COVID-19 pandemic and women’s fertility intentions: a multi-country, cross-sectional (I-SHARE) study

Introduction The COVID-19 pandemic, together with the subsequent social distancing measures, could lead to shifts in family and fertility planning. This study aimed to explore the associations between the COVID-19 pandemic and changes in fertility intentions among an international sample of reproductive-aged women. Methods A multi-country, cross-sectional study based on data from 10 672 women aged 18–49 years who participated in the International Sexual Health And REproductive Health (I-SHARE) study, which organised an international online survey between July 2020 and February 2021. Factors associated with changes in fertility intentions were explored using multinomial probit regression models. Cluster-robust standard errors were used to calculate model parameters. Results Of 10 672 included reproductive-aged women, 14.4% reported changing their fertility intentions due to the pandemic, with 10.2% postponement and 4.2% acceleration. Women who had ever been isolated/quarantined were more likely to postpone their fertility intentions (adjusted odds ratio (AOR)=1.41; 95% CI 1.18 to 1.69) compared with those who had not; women who lived with a steady partner were more likely to want children sooner (AOR=1.57; 95% CI 1.10 to 2.23) compared with those who did not; and those who reported a higher frequency of getting angry, feeling frustrated, or worrying about their finances were more likely to postpone their fertility intentions. The main findings were robust in the sensitivity analyses. Conclusions Most women who changed fertility intentions because of the pandemic have postponed intentions to expand their families. The pandemic-induced exposures were associated with these postponements

Reliability and Validity of the Physical Activity Questionnaire for Older Children (PAQ-C) In Malay Language

Introduction: Physical activity assessment in children is the first step in assessing the relationship between activity and health, as well as the determinants of childhood physical activity and changes in activity level.Physical Activity Questionnaire for Older Children (PAQ-C) is self- administered questionnaire to assess physical activity among older children. The objective of this study was to determine the validity and reliability of Physical Activity Questionnaire for Older Children in Malay language PAQ-C (M). Methods: The validation study was done among 73 students aged 10 to 17 years old. The PAQ-C was translated into Malay language using forward and backward translation. The evaluation of the psychometric properties included internal consistency, test-retest reliability and criterion validity. Reliability of PAQ-C (M) was determined using Cronbach alpha and intra-class correlation coefficient (ICC). The PAQ-C (M) was administered twice in one week interval to assess test-retest reliability. Criterion validity was assessed between PAQ-C (M) and 3 Day Physical Activity Recall (3DPAR). Results: The internal consistency of PAQ-C (M) assessment calculated in this study was α = 0.75 and α = 0.77 for assessments one and two, respectively. The ICC between individual items of PAQ-C (M) was 0.59 to 0.91, indicating moderate to good correlation. The Spearmen correlation coefficient between PAQ-C (M) and 3DPARwas acceptable (r=0.60, p<0.01). Conclusions: In conclusion, the findings of this study suggest that the PAQ-C (M) has moderate to good reliability and validity in assessing physical activity among older children and adolescents. Future validation of PAQ-C (M) against different measures such as accelerometer is recommended

Factors Associated with Mental Health Problems among Malaysian Children: A Large Population-Based Study

Mental health problems are a major public health issue, particularly among children. They impair children’s development, academic achievement, and ability to live a productive life. The present study aimed to determine the prevalence and factors associated with mental health problems among children aged 5 to 15 years old in Malaysia. Data from the National Health and Morbidity Survey (NHMS) 2015 were analyzed. A validated Strengths and Difficulties Questionnaire (SDQ) was used. The overall prevalence of mental health problems among children in Malaysia was 11.1%. Multiple logistic regression analysis revealed that for every year increment in age, mental health problems decreased by 5%. Further analysis found that children who had fathers with a non-formal education and worked in the private sector, had parents who were widowed or divorced, and had either parent with mental health problems were more likely to have mental health problems themselves. Children from the lower socioeconomic group and who had either parent with mental health problems had higher odds of having mental health problems in Malaysia

Vision and Hearing Impairments Affecting Activities of Daily Living among Malaysian Older Adults by Gender

Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p &lt; 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults’ level of independence

Factors associated with the severity of hypertension among Malaysian adults.

High blood pressure is a worldwide problem and major global health burden. Whether alone or combined with other metabolic diseases, high blood pressure increases the risk of cardiovascular disease. This study is a secondary data analysis from the National Health and Morbidity Survey 2015, a population-based study that was conducted nationwide in Malaysia using a multi-stage stratified cluster sampling design. A total of 15,738 adults ≥18-years-old were recruited into the study, which reports the prevalence of hypertension stages among adults in Malaysia using the JNC7 criteria and determinants of its severity. The overall prevalence of raised blood pressure was 66.8%, with 45.8% having prehypertension, 15.1% having Stage 1 hypertension, and 5.9% having Stage 2 hypertension. In the multivariate analysis, a higher likelihood of having prehypertension was observed among respondents with advancing age, males (OR = 2.74, 95% CI: 2.41-3.12), Malay ethnicity (OR = 1.21, 95% CI: 1.02-1.44), lower socioeconomic status, and excessive weight. The factors associated with clinical hypertension (Stages 1 and 2) were older age, rural residency (Stage 1 OR = 1.22, Stage 2 OR = 1.28), Malay ethnicity (Stage 2 OR = 1.64), diabetes (Stage 2 OR = 1.47), hypercholesterolemia (Stage 1 OR = 1.34, Stage 2 OR = 1.82), being overweight (Stage 1 OR = 2.86, Stage 2 OR = 3.44), obesity (Stage 1 OR = 9.01, Stage 2 OR = 13.72), and lower socioeconomic status. Almost 70% of Malaysian adults are at a risk of elevated blood pressure. The highest prevalence was in the prehypertension group, which clearly predicts a future incurable burden of the disease. Public health awareness, campaigns through mass and social media, and intervention in the work place should be a priority to control this epidemic