Validity of vision screening program conducted by preschool teachers: An interventional study

Background: Clear vision is crucial for effective learning among preschool children. Hence, early detection of vision impairment and prompt treatment are required to improve prognosis. Currently, limited information is available, and no program exists to screen for vision impairment among preschoolers in Bangladesh. This study aimed to validate the KieVision™ Preschool Vision Screening Kit, translated into the Bengali language, to improve vision impairment detection among preschool children. Methods: In this prospective case–control study, 60 preschool teachers from Chittagong were randomly selected. The study group was trained to conduct vision screening among preschool children using the translated kit, whereas the control group was trained using the Chittagong Eye Infirmary and Training Complex (CEITC) School Teachers’ Training Module. Fifteen preschool children aged 4–6 years were screened by each preschool teacher and again by the optometrist. Results: Sixty preschool teachers screened 900 children. The results showed a higher validity of vision screening findings by the preschool teachers in the study group (sensitivity, 68.00%; specificity, 92.75%) than in the control group (sensitivity 47.37%, specificity 70.39%). The level of agreement between the preschool teachers and optometrists was high for all tests (first-order agreement coefficient [AC1] ? 0.80 in the study group). The sensitivity and specificity of the visual acuity test for the study group were 59.65% and 94.15%, respectively, while in the control group it was 13.33% and 62.54%, respectively. A similar trend was noted in the general observation component and Hirschberg’s test. Conclusions: The Bengali Language KieVision™ Preschool Vision Screening Kit can be used effectively by preschool teachers in vision screening programs to improve the identification of vision impairment among preschool children in Bangladesh

Antenatal iron deficiency in an urban Malaysian population

Iron deficiency anemia is the most common form of anemia in pregnancy. The present study was carried out to determine the prevalence of antenatal anemia and iron deficiency in the Malaysian population and its correlation with socio-demographic and obstetric profile. It was a cross-sectional study conducted at an urban health clinic over a period of six months. A single blood sample was drawn from apparently healthy pregnant mothers at antenatal booking and sent for laboratory assessment of full blood count and serum ferritin as screening tools for anemia and iron status. SPSS version 19.0 was used for statistical analyses. The results showed that out of 250 subjects, 43.6% had anemia and 31.6% had iron deficiency. Whilst 47.7% of subjects with anemia were iron deficient, 19.1% of subjects without anemia were also iron deficient. Serum ferritin correlated negatively with period of gestation at booking (p<0.001), with 77.6% of these women not having prior iron supplements. Serum ferritin was also significantly lower among grandmultiparae (p=0.01). Iron deficiency was significantly (p=0.024) more common among Indians (42.5%) compared to Malays (33.5%) and Chinese (13.0%). In conclusion, continuation of the current practice of routine antenatal iron supplementation is still warranted and justifiable in Malaysia as there is high prevalence of iron deficiency in pregnancy not only in the presence of anemia but also in the presence of normal hemoglobin values

Exposure to Non-Ionizing Radiation and Childhood Cancer: A Meta-Analysis

Background: A slight increase in the childhood cancer trend has been observed for the past few decades. Non-ionizing radiation is one of the environmental factors linked to childhood cancers. This review is conducted to assess the association between non-ionizing radiation and childhood cancer based on all original studies to date. Methods: A systematic search was conducted on the titles and abstracts pertaining to non-ionizing radiation and childhood cancers using the PubMed, Scopus, SAGE and ScienceDirect databases from inception up to November 2018. Quality of each article was appraised using the Newcastle-Ottawa Scale, meta-analysis was performed with Review Manager, and fixed effects were used to estimate the pooled OR of the selected studies. Results: A total of 15 articles met all the selection criteria. Twelve articles were included in the meta-analysis. Pooled risk estimates of the 12 studies, obtained via fixed effects model, showed that children exposed to 0.2 µT or more of EMF non-ionizing radiation run 1.33 times higher risks of contracting childhood cancer compared to those with less than 0.2 µT exposure (95% CI: 1.10, 1.60). The studies were statistically homogeneous (chi-squared P=0.71, I2=0%), and there was no evidence of publication bias. Conclusion: It cannot be concluded that children exposed to non-ionizing radiation have higher risks of childhood cancer compared to those who were not exposed as claimed by the previous reviews. However, concerns about non-ionizing radiation exposure and childhood cancer should not be neglected

The association of knowledge, attitude and practice with 24 hours urinary sodium excretion among Malay healthcare staff in Malaysia

Introduction The most effective and affordable public health strategy to prevent hypertension, stroke and renal disease is by reducing daily salt consumption. Therefore, this study aims to determine the association of knowledge, attitude and practice on salt diet intake and to identify foods contributing to high sodium intake. Methods Secondary data analysis was performed on MySalt 2016 data. It was conducted from November 2015 until January 2016 which involving Ministry of Health Staff worked at 16 study sites in Malaysia. Salt intake was measured using 24 hours urinary sodium excretion. Food frequency questionnaire was used to determine the sodium sources. Knowledge, attitude and practice of salt intake were assessed using a validated questionnaire adapted from WHO. Demographic data and anthropometric measures also were collected. Sodium levels of more than 2400mg/day was categorised as high sodium intake. Data were analysed using SPSS software version 21. Results The mean sodium intake estimated by 24 hours urinary sodium excretion was 2853.23 + 1275.8 mg/day. Food groups namely rice/noodles (33.8%), sauces/seasoning (20.6%), meat and poultry (12.6%) and fish/seafoods (9.3%) were the major contributors of dietary sodium. In multiple logistic regression analysis, being a male (aOR=2.83, 95% CI 2.02 – 3.96) and obese (aOR=6.78, 95% CI 1.98 – 23.18) were significantly associated with high urinary sodium excretions. In addition, those who were unsure that high salt intake can cause hypertension (aOR=1.24, 95% CI 0.65 – 2.36), those who think that they consumed too much salt (aOR=2.10, 95% CI 1.13 – 3.87) and those who only use salt rather than other spices for cooking (aOR=2.07, 95% CI 1.29 – 3.30) were significantly associated with high urinary sodium excretion. Conclusions This study showed that the main sources of sodium among Malay healthcare staff is cooked food. Poor knowledge and practice towards reducing salt consumption among them contributes to the high sodium consumption. The practice of healthy eating among them together with continuous awareness campaign is essential in order to educate them to minimize sodium consumption and to practice healthy eating

Predictors of Detected Organophosphorus Pesticides Among Orang Asli Children Living in Malaysia

BackgroundIncreasing use of pesticides in agriculture to control pest may result in permanent damage to the environment and consequently cause harmful health problems especially among infant and children. Due to pesticide's natural toxicity and its widespread use, it causes a serious threat to public health especially to this vulnerable group.ObjectiveThe purpose of this study was to determine the organophosphorus pesticide urinary metabolite levels and its predictors among Orang Asli children of the Mah Meri tribe living in an agricultural island in Kuala Langat, Selangor.MethodsData collection was carried out at an island in Kuala Langat, Selangor, where a total of 180 Orang Asli children of the Mah Meri tribe voluntarily participated in the study. Data were collected via a validated, modified questionnaire. Urinary organophosphate metabolites, namely dimethylphosphate, diethylphosphate, dimethylthiophosphate, dimethyldithiophosphate, diethylthiophosphate, and diethyldithiophosphate were measured to assess organophosphate pesticide exposure in children.FindingsEighty-four (46.7%) of the respondents were positive for urine dialkyl phosphate metabolites. In multivariable analysis, children who frequently consumed apples had 4 times higher risk of pesticide detection than those who consumed apple less frequently. In addition, those who frequently ate cucumbers had 4 times higher risk for pesticide detection than those who ate cucumbers less frequently. Children with a father whose occupation involved high exposure to pesticides (agriculture) had 3 times higher risk of pesticide detection than those with a father in a low-risk occupation (nonagriculture).ConclusionsAlmost half of the children (46.7%) in the study area tested positive for urinary dialkyl phosphate metabolite levels. Most of the metabolite levels were equal to or higher than that reported in other previous studies. Major factors associated with pesticide detection in children in this study were frequent intake of apple and cucumber and fathers who are working in an agricultural area

Remediation technology inventions for soil and groundwater contamination

The reducing quality of groundwater resulted from accidental wastes compounded with soil leaching has become the topmost health concerns. Groundwater plays an important role in provisioning central source of drinking water to humanpopulation. The extensive contamination of ground water urges for remedial actions by many to control the damage. This narrative review will attempt to present the current state of remediation technologies for soil and groundwater contamination implemented to prevent further damage to the biodiversity of surrounding ecosystem. Components of each in-situ and ex-situ technologies were examined in detail to suit the characteristics of contamination site. The discoveries of reliable in-situ remediation technology of removing contaminants are another milestone for green environment sustainability. Therefore, adequate knowledge on characteristics of contamination site, understanding of groundwater flow conditions, site assessments and contaminant transport activities are crucial for future planning remediation technologies

Development and validation of a questionnaire to predict intention to comply to iron supplement during pregnancy

The World Health Organisation (WHO) has recommended iron supplementation to overcomeanaemia in pregnancy. In Malaysia, about half of pregnant women with anaemia do notcomply to iron supplement. The purpose of this study is to develop and validate aquestionnaire that assesses the attitude towards iron supplementation and later to predictintention to comply with daily iron supplement among pregnant women. Based on theguidelines for construction of the Theory of Planned Behaviour questionnaire, 18 items werecreated initially by using the findings from an open-ended questionnaire survey, literaturereviews and experts’ opinion. From content validity by 3 experts, 15 items with contentvalidity ratio (CVR) of ≥0.99 were retained. From a pilot test for exploratory factor analysis(EFA), total of 12 items were retained, and classified into 3 components and termed as“Attitudes”, “Subjective Norms” and “Perceived Behaviour Control”. Cronbach Alpha for the12 items was 0.814, and for each component were 0.844, 0.813 and 0.901 respectively, whichindicates acceptable internal consistency. During the Confirmatory Factor Analysis (CFA), afinal 10 items were retained. The construct validity was good where the Fitness Index haveachieved the threshold i.e. p-value &gt;0.05, RMSEA &lt;0.08, CFI &gt;0.90 and the ChiSq/df ratio&lt;3.00. The convergent validity and composite reliability were good i.e. Average VarianceExtracted (AVE) ≥0.50, and Composite Reliability (CR) ≥0.60 respectively. As a conclusion,the validation of this newly developed questionnaire has shown promising result andpotentially reliable in predicting compliance to iron supplement among pregnant womenspecifically in Malaysia

Malnutrition among 3 to 5 Years Old Children in Baghdad City, Iraq: A Cross-sectional Study

The unstable geopolitical situation in Iraq since 2003 still affects the health of people, especially children. Several factors may indirectly affect a child\u2019s nutritional status. The main aim of this study was to identify factors contributing to malnutrition among 3 to 5 years old children in Baghdad city, Iraq. Two hundred twenty children aged 3 to 5 years were chosen randomly from four kindergartens in Baghdad city according to the cross-sectional design. The nutritional status of the children was assessed using a weight-for-age z-score based on the World Health Organization 2007 cutoff points, in which any child with a z-score of &lt;-2 is considered to be malnourished. The overall prevalence rate of underweight children was 18.2%. There was no significant difference in the prevalence rate between males and females (p=0.797). However, the percentage of underweight children was slightly higher among females (18.9%) compared to males (17.6%). There was no association between parents\u2019 educational level or employment status and childhood malnutrition. There was no association between a family\u2019s movement from their house and childhood malnutrition (p=0.322). Living in an unsafe neighbourhood and having a family member killed during the past five years were significantly associated with childhood malnutrition (p=0.016 and 0.018 respectively). Childhood malnutrition is still a public-health concern in Baghdad city, especially after the war of 2003. Malnutrition is significantly associated with living in unsafe neighbourhoods and at least one family member having been killed during the past five years

Reliability of a Bahasa Melayu language version of the MOS 36-item short-form health survey (SF-36) in patients with low vision

Background: The MOS 36-Item Short-Form Health Survey (SF-36) Bahasa Melayu language version is widely used to determine the health outcomes in Malaysia. Low vision is a condition where vision cannot be restored and vision rehabilitation is required to overcome the challenges it imposes. The SF-36 Bahasa Melayu language version can be used to measure the health outcomes among low-vision patients. However, little information is available among low-vision patients. This study aimed to assess the reliability of the SF-36 Bahasa Melayu language version among low-vision patients. Methods: Fifty low-vision patients aged 14 to 74 years (mean ± standard deviation: 44.58 ± 18.70 years) were randomly selected. All low-vision patients were interviewed twice by the same interviewer with a 2-weeks interval. Results: The SF-36 Bahasa Melayu language version showed acceptable and good Cronbach’s alpha values of 0.68, 0.67, 0.76, 0.72, 0.73, 0.75, 0.72, 0.73 for physical function, role-physical, body pain, general health, vitality, social functioning, role-emotion, and mental health, respectively, in the first interview. The second interview also revealed similar Cronbach’s alpha values. The SF-36 Bahasa Melayu language version also showed a good repeatability between the first interview and the second interview, with Pearson’s correlation coefficients ranging from 0.6 to 0.9. Conclusions: From this study, it can be concluded that the SF-36 Bahasa Melayu language version is reliable and repeatable. It is a useful tool to measure health outcomes among Malaysian low-vision patients. However, a future study of low-vision patients from the rural population and age groups representing the youth, working adults, and older individuals is necessary to obtain better outcomes of SF-36 in Bahasa Melayu language-based information on the health status of low-vision patients

Indoor Particulate Matters, Microbial Count Assessments, and Wheezing Symptoms among Toddlers in Urban Day Care Centers in the District of Seremban, Malaysia

Introduction: Indoor air quality in day care centers (DCCs) is an emerging research topic nowadays. Indoor air pollutants such as particulate matter (PM) and microbes have been linked to respiratory health effects in children, particularly asthma-related symptoms such as night coughs and wheezing due to early exposure to indoor air contaminants. Objective: The aim of this study was to determine the association between wheezing symptoms among toddlers attending DCCs and indoor particulate matter, PM10, PM2.5, and microbial count level in urban DCCs in the District of Seremban, Malaysia. Methods: Data collection was carried out at 10 DCCs located in the urban area of Seremban. Modified validated questionnaires were distributed to parents to obtain their children’s health symptoms. The parameters measured were indoor PM2.5, PM10, carbon monoxide, total bacteria count, total fungus count, temperature, air velocity, and relative humidity using the National Institute for Occupational Safety and Health analytical method. Results: All 10 DCCs investigated had at least one indoor air quality parameter exceeding the acceptable level of standard guidelines. The prevalence of toddlers having wheezing symptoms was 18.9%. There was a significant different in mean concentration of PM2.5 and total bacteria count between those with and those without wheezing symptoms ('P' = 0.02, 'P' = 0.006). Conclusions: Urban DCCs are exposed to many air pollutants that may enter their buildings from various adjacent sources. The particle concentrations and presence of microbes in DCCs might increase the risk of exposed children for respiratory diseases, particularly asthma, in their later life