Kuala Lumpur, Malaysia
Kuala Lumpur, Malaysia

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Gurpreet K.,Institute for Public Health | Tee G.H.,Institute for Public Health | Amal N.M.,Institute for Medical Research | Paramesarvathy R.,Kuala Lumpur City Hall | Karuthan C.,University of Malaya
Journal of Health, Population and Nutrition | Year: 2011

Acute diarrhoea is a major health problem in many parts of the world, contributing to about 1.8 million deaths globally. The objectives of the study were to assess the incidence, determinants, and severity of acute diarrhoea in the population. A nation-wide cross-sectional survey involving about 57,000 respondents was conducted via face-to-face interview among eligible respondents of all ages. An acute diarrhoeal episode was defined as having three or more episodes of loose stools in any 24-hour period within the past four weeks before the interview. The severity was measured by duration of acute diarrhoea and associated symptoms. The variables tested as determinants were age, sex, ethnicity, the highest educational level, total monthly household income, and locality. Univariate, bivariate and multivariate procedures meant for complex study design were used in the analyses. The four-week incidence of acute diarrhoea was 5% [95% confidence interval (CI) 4.8-5.2]. The incidence of acute diarrhoea among the estimated population was the highest among young adults aged, 20-29 years, Other Bumiputras (the pre-dominant ethnic group in East Malaysia), those with tertiary-level of education, those earning a monthly household income of less than RM 400, and rural dwellers. Only age, ethnicity, the highest level of education attained, and locality were significantly associated with acute diarrhoea in bivariate analysis. In multivariate analysis, these four variables were found to be the determinants of acute diarrhoea. Sex and monthly household income were excluded from the model. The mean duration of acute diarrhoea was 2.0 days (standard deviation 1.3). Forty-six percent of the respondents reported stomach cramps as an associated symptom. The findings revealed that acute diarrhoea is still a major public-health concern in Malaysia and grossly undernotified. There is a need for intensification of public-health intervention efforts to reduce the incidence of acute diarrhoea while improving surveillance and notification of the disease. © International Centre for Diarrhoeal Disease Research, Bangladesh.

Lim H.K.,Institute of Public Health | Ghazali S.M.,Institute for Medical Research | Kee C.C.,Institute for Medical Research | Lim K.K.,Institute of Public Health | And 7 more authors.
BMC Public Health | Year: 2013

Background: Three National Health and Morbidity Surveys (NHMSs) had been conducted in Malaysia in 10-year intervals from 1986-2006. Based on the latest NHMS survey in 2006, we describe the prevalence of smoking and identify the social and demographic factors associated with smoking among adult males in Malaysia. Methods. A cross-sectional study among 15,639 Malaysian adult males aged 18 years and above was conducted using proportional to size stratified sampling method. The socio-demographic variables examined were level of education, occupation, marital status, residential area, age group and monthly household income. Results: The prevalence of smoking among adult males in Malaysia was 46.5% (95% CI: 45.5-47.4%), which was 3% lower than a decade ago. Mean age of smoking initiation was 18.3 years, and mean number of cigarettes smoked daily was 11.3. Prevalence of smoking was highest among the Malays (55.9%) and those aged 21-30 years (59.3%). Smoking was significantly associated with level of education (no education OR 2.09 95% CI (1.67-2.60), primary school OR 1.95, 95% CI (1.65-2.30), secondary school OR 1.88, 95% CI (1.63-2.11), with tertiary education as the reference group). Marital status (divorce OR 1.67, 95% CI (1.22-2.28), with married as the reference group), ethnicity (Malay, OR 2.29, 95% CI (1.98-2.66; Chinese OR 1.23 95% CI (1.05-1.91), Other Bumis OR 1.75, 95% CI (1.46-2.10, others OR 1.48 95% CI (1.15-1.91), with Indian as the reference group), age group (18-20 years OR 2.36, 95% CI (1.90-2.94); 20-29 years OR 3.31, 95% CI 2.82-3.89; 31-40 years OR 2.85, 95% CI (2.47-3.28); 41-50 years OR 1.93, 95% CI (1.69-2.20); 51-60 years OR 1.32, 95% CI (1.15-1.51), with 60 year-old and above as the reference group) and residential area (rural OR 1.12, 95% CI (1.03-1.22)) urban as reference. Conclusion: The prevalence of smoking among Malaysian males remained high in spite of several population interventions over the past decade. Tobacco will likely remain a primary cause of premature mortality and morbidity in Malaysia. Continuous and more comprehensive anti-smoking policy measures are needed in order to further prevent the increasing prevalence of smoking among Malaysian men, particularly those who are younger, of Malay ethnicity, less educated, reside in rural residential area and with lower socio-economic status. © 2013 Lim et al.; licensee BioMed Central Ltd.

Wan-Norafikah O.,University Technology of MARA | Wan-Norafikah O.,University of Malaya | Nazni W.A.,Institute for Medical Research IMR | Lee H.L.,Institute for Medical Research IMR | And 2 more authors.
Asian Biomedicine | Year: 2013

Background: Insects control using insecticides is used extensively and intensively in vector control programs in many countries including Malaysia. Because of this, mosquito species have been found to develop various levels of resistance towards these insecticides, leading to failure in vector control activities. Objectives: We determined permethrin resistance status in laboratory susceptible, permethrin-selected, and field strains of Aedes albopictus. Methods: The susceptibility status of laboratory susceptible strain, permethrin-selected strain, and four field strains of Aedes albopictus collected from Kuala Lumpur were determined using three standard laboratory tests, WHO larval bioassay, WHO adult mosquito bioassay, and microassay of mixed function oxidases (MFOs). Results: The LC50 values of permethrin-selected strain and field strains obtained from the WHO larval bioassay were almost two times higher (0.38-0.44 mg/L) than the LC50 value of the laboratory strain (0.20 mg/L). In the WHO adult bioassay, the susceptibility of permethrin-exposed of both permethrin-selected strain, and field strains (LT50 = 19.39 to 20.65 min) were reduced for 1.31 to 1.72 times after been exposed to the synergist, piperonyl butoxide (PBO) prior to permethrin. Complete mortalities were also recorded in both permethrin-exposed and PBO + permethrin-exposed Ae. albopictus of all strains, twenty-four hours post-exposure. For the MFOs enzyme microassay, a significant difference (p <0.05) in the mean absorbance of elevated oxidase activity at 630 nm was observed between all strains of both the non-exposed and PBO-exposed Ae. albopictus. Strong and significant positive correlations were also observed between LT50 values of permethrin-exposed and PBO + permethrinexposed with oxidase level in Ae. albopictus tested (r = 0.943; p <0.05). Conclusion: These results indicate the association of oxidase activity with permethrin resistance development in Ae. albopictus.

Wan-Norafikah O.,University Technology of MARA | Wan-Norafikah O.,University of Malaya | Nazni W.A.,Institute for Medical Research IMR | Lee H.L.,Institute for Medical Research IMR | And 2 more authors.
Saudi Journal of Biological Sciences | Year: 2013

The resistance status towards permethrin among the laboratory strain, the permethrin-selected strain and four field strains of Culex quinquefasciatus collected in Kuala Lumpur, Malaysia was determined using three standard laboratory methods: WHO larval bioassay, WHO adult bioassay and biochemical microplate assay. Cx. quinquefasciatus permethrin-selected strain larvae were the least susceptible to permethrin with a resistance ratio of 47.28-folds, whereas all field strain larvae of the same species were tolerant to permethrin with resistance ratios of more than 3-folds. In contrast, in adult stage, the permethrin exposed permethrin-selected strain (resistance ratio. = 1.27) was found to be more susceptible to permethrin than all permethrin-exposed field strains (resistance ratios. = 2.23-2.48). Complete mortalities for all strains of Cx. quinquefasciatus adults proved the effectiveness of the synergist; piperonyl butoxide (PBO). For the biochemical microplate assay, the reduction of the mean optical density of elevated oxidase activity of three field strains upon exposure to PBO confirmed the association between oxidase activity and permethrin tolerance. On the other hand, irregular patterns of the mean optical density of elevated oxidase activity in the laboratory strain, permethrin-selected strain and Jalan Fletcher strain illustrated the gene variation within these mosquito colonies as well as the involvement of other enzyme activities in the permethrin resistance occurred. © 2013.

Wan-Norafikah O.,Institute for Medical Research IMR | Wan-Norafikah O.,University of Malaya | Nazni W.A.,Institute for Medical Research IMR | Lee H.L.,Institute for Medical Research IMR | And 2 more authors.
Journal of Asia-Pacific Entomology | Year: 2010

Permethrin resistance status of a laboratory strain, a permethrin-selected strain and three field strains of Aedes aegypti collected in Kuala Lumpur, Malaysia were evaluated using three standard laboratory bioassays: WHO larval bioassay, WHO adult mosquito bioassay, and mixed function oxidase (MFO) enzyme microassay. The LC50 values of field strains from the WHO larval bioassay did not differ significantly. The highest LC50 value was from the Taman Melati field strain (0.39mg/L). The resistance ratio for the permethrin-selected strain and the field strains ranged from 1.86 fold to 5.57 fold. Pre-exposure to piperonyl butoxide (PBO) in the WHO adult bioassay and MFOs enzyme microassay reduced the LT50 values and reduced the mean optical density of elevated oxidase activity (0.28-0.42) at 630nm. The LC50 or LT50 values and the level of oxidases were significantly correlated (r=0.825; p<0.05). This study confirmed the presence of permethrin resistance in these mosquito populations. © 2010 Korean Society of Applied Entomology, Taiwan Entomological Society and Malaysian Plant Protection Society.

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