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Colorectal cancer is a major public health problem with significant number of cases and death in the population. This study aimed to determine the 5-year overall survival rate and the prognostic factors for colorectal cancer patients in Sabah.This was a retrospective cohort study conducted using secondary data from Malaysian National Cancer Registry (MNCR) database. A 5-year overall survival and the median survival time were determined with Kaplan-Meier survival curve. Cox regression analysis was done to determine the prognostic factors on survival.A total of 1,152 patients were included in this study. The majority of the patients had colon cancer and presented at late stage (stage III and IV) as compared to early stage (stage I and II). From the analysis, the 5-year overall survival for colorectal cancer was 23.2% (95% CI: 21.8, 24.6) and the median survival time was 16 months (95% CI: 14.3, 17.7). Higher survivals are seen in males (23.6%, 95% CI: 20.4, 24.7), aged 50-74 years old (24.2%, 95% CI: 22.4, 26.0), Chinese (25.5%, 95% CI: 23.0, 28.0), lived in Keningau (25.6%, 95% CI: 20.8, 30.4), colon as primary tumor site (24.5%, 95% CI: 22.5, 26.4), diagnosed with stage I (55.6%, 95% CI: 48.7, 62.5) and received surgery with chemotherapy or radiotherapy (31.3%, 95% CI: 27.8, 34.8). The significant prognostic factor was the stage at diagnosis. Patients with stage IV colorectal cancer (HR: 11.18; 95% CI: 3.48, 35.93) had eleven times risk of dying as compared to stage I.The survival rate for colorectal cancer patients in Sabah was comparatively lower than other states in Malaysia and in some Asian countries. Those patients who presented at later stage had poorer survival. Health promotion and community-based screening program should be emphasized in addition to encouraging early diagnosis to improve survival.

The World Health Organization (WHO) reported that Malaysia has the highest rate of obesity and overweight among Asian countries. There is an increasing trend in obesity from 11.9% (2015) to 14.8% (2019), according to the National Health and Morbidity Survey (NHMS). This study aimed to investigate the prevalence, bodyweight perception, and associated factors of overweight and obesity among rural communities in Northern Borneo. This cross-sectional study was conducted in one village in Northern Borneo. Adults from 18 to 69 years of age (n = 165) were included in the survey, and data were collected by interview or self-administered questionnaires. Measurements of weight and height were done for body-mass-index (BMI) calculation. The prevalence of overweight and obesity in the village was 71.5%. Kappa statistic indicated only a slight agreement between perceived and actual body weight status (k = 0.163, 95% CI = −0.156 to 0.482, p < 0.000). There were higher odds of being overweight and obese among the middle-aged group (35 – 55 years old) than the younger group (

SARS-CoV-2 virus created a huge health impact due to isolation, quarantine, or lockdown. University students also affected with the closure of institute and switch in teaching methods. The objective of this study is to explore the health-related lifestyle changes among university students during the implementation of movement control order. Secondly, we aimed to convoke suggestions and recommendations to promote healthy living amidst university students. This study implemented qualitative method via using a semi-structured interview. Three focus group discussions were conducted consisting of 12 participants recruited from snowball sampling method. Utilizing verbatim transcription approach, an inductive thematic point was sketch for data analysis. Seven male and five female students with a mean age of 20 ± 1.3 years (range 19-23) were recruited into this study. Four themes identified from the interview. Physical health influence by administrative roles to physically inactive and less sport activity. Secondly, mental health concern towards mixed emotions, coping strategy, psychological adjustment, and mental health issues. Variation and self-prepare food, food supply, dietary habit and dietary pattern contribute to changes in food intake. Student lifestyles modulate to sleep hygiene, alcohol consumption, online classes problem, individual factors, and other unhealthy activities. Some students experience no difference in the surrounding transformation. During the pandemic, students experienced health related-behavioural changes involving physical health, mental health, dietary and lifestyle. Even though some informants perceived no changes in certain aspect, they still experience health-related behavioural changes in other aspect linked to health.

Eric Chee How Tan,1,2 Richard Avoi,1 Fredie Robinson,1 Mohammad Saffree Jeffree,1 Syed Sharizman Syed Abdul Rahim,1 Mohd Yusof Ibrahim,1 Aza Sherin Mohd Yusuff,3 Khamisah Awang Lukman1,4 1Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia; 2Tawau Area Health Office, Ministry of Health Malaysia, Tawau, Sabah, Malaysia; 3Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia; 4Center for Occupational Safety & Health, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, MalaysiaCorrespondence: Khamisah Awang Lukman, Tel +60198337543, Email khamisah@ums.edu.myBackground: The double burden of malnutrition among children is an emerging public health problem, especially in developing countries. Eating behaviours have been hypothesised to contribute to both being underweight and overweight in children and adults. The objective of this study was to examine the association between the Child Eating Behaviour Questionnaire (CEBQ) subscale scores and body mass index (BMI) z-scores among Malaysian children under-5 years.Methods: This was a cross-sectional study conducted in 2020 by recruiting a sample of 500 children aged 24– 59 months old from clinics located in the interior districts of Sabah, Malaysia. The CEBQ was completed by the mothers on behalf of the child to assess their eating behaviour traits. The height and weight of the child were measured using standardised instrument. The BMI-for-age percentile, z-scores for BMI-for-age, height-for-age and weight-for-age were determined and classified using World Health Organization AnthroPlus software. The relationship between the CEBQ subscale scores and BMI z-scores were evaluated using multiple linear regression models adjusting for potential confounders.Results: The prevalence of underweight, stunting and wasting were 20.2%, 29.2% and 5.6%, respectively, whereas the prevalence of overweight and obese was 5.0%. There were significant positive association between Food responsiveness, Emotional overeating, Enjoyment of food with BMI z-scores (p< 0.05; unstandardised regression coefficient: 0.17 to 0.38). In contrast, there were significant negative association between Satiety responsiveness, Slowness of eating, Food fussiness with BMI z-scores (p< 0.01; unstandardised regression coefficient: − 0.35 to − 0.36).Conclusion: These findings show that specific eating behaviours can influence the growth of children under-5 years. Therefore, policymakers should formulate a nutrition policy that incorporates behavioural assessment and behavioural intervention in the prevention and management of malnutrition among children in Malaysia.Keywords: appetite, malnutrition, Child Eating Behaviour Questionnaire, body mass index

Background: Dengue fever infection has become a major public health concern in Malaysia with frequent epidemics occurring in urban areas. In Sabah, Dengue fever is among the 5 most reported communicable diseases and the district of Kota Kinabalu is among the top 3 districts with the highest number of dengue cases with 563 cases recorded in 2016. Aims and Methodolgy: This study aimed to determine the factors contributing or associated with dengue fever occurrence in Kota Kinabalu. A cross- sectional study was conducted among the primary health care clinic attendees in Kota Kinabalu. Data was collected via a set of structured questionnaires focusing on socio-demographic characteristic of participants, environmental characteristic of households, history of previous exposure to dengue fever, knowledge towards dengue fever and its vector, awareness on dengue fever and mosquito control and dengue fever prevention practices. Results and Recommendations: Among the 350 individual’s that participated in the interview, 53 were dengue fever cases. Subsequently, the prevalence of Dengue fever cases among the study population was calculated with prevalence in percentage concluded as 15.1%. Further analysis revealed that factors such as aged group by years, number of household occupants, staying at dengue outbreak areas, self – reported history of recent mosquito bites, indoor and outdoor storage of open water containers, installed house window screens, knowledge on dengue fever and its vector, practices of wearing protective clothing outdoor and usage of mosquito repellent ointment or creams showed significant association with dengue fever outcomes. However, further studies would need to be conducted to determine if these factors possess a higher threat or risk for dengue fever. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.878-886

Introduction: Plasmodium knowlesi (P.knowlesi) is a zoonotic malaria parasite, transmitted between non-human primate hosts by the Anopheles (An.) mosquitos, and causing spill-over infections in humans where the parasite, vector, host, and human converge. Methods: The search was done electronically to explore for appropriate papers via PubMed, and Science Direct for articles published up to March 2020, containing the words “factors associated” or “environmental factors” or “individual factors” or “ecological factors” and “P.knowlesi” and “human” including synonyms and Medical Subject Heading (MeSH) terms. A total of 27 articles from PubMed Databases and 18 articles from Science Direct were selected to be assessed for eligibility. Out of it, a total of 13 articles were selected to be analysed. Results: Host factors such as sex and age, as well as occupation as individual factors, while environmental factors such as rainfall and geographic elevation have some association with P.knowlesi infection in humans. This zoonotic malaria poses unique challenges that will need to be addressed if all forms of malaria are to be eliminated based on the sustainable development goal (SDG). Conclusion: This article highlights the importance of disease ecologies such as climate and landscape and human-environment interactions such as the land use patterns, such as agriculture or infrastructure activities) to reduce the further increase of cases and mortality globally due to P.knowlesi infection. This review focuses mainly on the host and environmental factors that influence P.knowlesi Malaria Infection in Humans.

Undernutrition is the result of complex interplay of factors such as household food security, childcare, feeding practices, nutrition and sanitation. Therefore, this study aimed to determine the prevalence of stunting, wasting, underweight based on WHO child growth standards 2006 and undernutrition based on Composite Index Anthropometric Failure (CIAF) and its association with the biological, behavioural, socio-economic and physical environment factors among children under-5 years. This was a cross sectional study involving children aged between 6 and 59 months recruited through stratified random sampling from the Tenom district. Sociodemographic background was obtained from mothers via a questionnaire. Height and weight measurements were measured using standardised instrument. The height-for-age, weight-for-age and BMI-for-age were classified according to the WHO Child Growth Standard 2006. Bivariate analysis and multivariate logistic regression analysis were conducted. The prevalence of undernutrition based on CIAF was 42.3%, underweight 34.7%, stunting 33.3% and wasting 10.0%. After adjusting for all confounders, childhood undernutrition was significantly associated with unimproved sanitation (adjusted OR 2.98, 95% CI: 1.082 to 8.225) and frequent illness (adjusted OR 2.07, 95% CI: 1.015 to 3.274). These findings support the association of biological and physical environmental factors with the nutritional status of children under-5 years old.

Introduction Worldwide, the gap between organ supply and demand has widened over the years. Malaysia has one of the lowest deceased organ donation rates. Success rate of organ or tissue procurement depends on not only the approach rate by health care providers but also the awareness among the public, whereby it can be a platform for family initiation of organ donation. The purpose of this study is to assess the knowledge of and determine the factors influencing attitude toward organ and tissue donation among patients in a primary clinic. Methods A cross-sectional analytical study was carried out. Self-administered questionnaires were given to 400 patients who registered at an outpatient clinic in April 2018. Convenience sampling was applied. Results Monthly income, education level, occupation, and knowledge level are significantly associated with attitude of the respondents toward organ and tissue donation. Occupation influenced attitude toward organ donation. Knowledge of organ donation and brain death both significantly affected attitude toward organ donation. Conclusion The greater the knowledge of organ donation and brain death, the more positive impression or attitude toward organ donation. Education level and income are the main predictors that influence attitude toward organ donation. Hence, it is important for public health units to promote and deliver public education on organ donation, change public misconceptions, and work parallel with hospitals to increase organ donation rates in Sabah.

Background Occupational injuries are among the most important workplace issues. This study aims to determine the safety climate and prevalence of occupational injuries in the small-scale manufacturing industry. Methods A cross-sectional study with ten small scale manufacturers participated accounting for a total of 300 respondents. Data were collected from July to August 2020 using the NOSACQ-50 questionnaire. Results The prevalence of occupational injury for the past 12 months was at 18%. The most often injured body parts were hands and legs while among the most common injury types were open wound, burns and bleeding. The mean NOSACQ-50 scores for all dimensions are good. The associated factors are working hours per week, and compliance to SOP. There are differences in the mean scores of NOSACQ-50 between injured and non-injured workers across all dimensions. Conclusion The safety climate among manufacturing industry employees is at a good level, while the prevalence of occupational injury is relatively low., Highlights • Occupational injury is a global issue causing permanent disabilities as well as mortality including in Malaysia. • The prevalence of occupational injury in a small scale manufacturing industry is relatively low. • Safe behaviour in the work practice, and following designed SOP to prevent accident, can reduce the possibility of injury.

Stress is accepted as the accumulation of unpleasant state of physical, mental and emotion on a person. Medical education has been known as one of the most stressful academic curriculum. Hence, medical students may subjected to multiple psychological changes and challenges throughout the years of medical education. The aim of this study was to determine the prevalence of stress and its associated factors among medical students. This cross sectional study was conducted from April to May 2018 in medical school in Sabah. It involved 396 medical students through universal sampling. Self-administered questionnaires were used as an instrument for data collection. The questionnaires included were Sociodemographic Questionnaire, Depression, Anxiety and Stress Scales 21 (DASS-21) and Medical Student Stressors Questionnaire (MSSQ). Bivariate analysis (Chi Square test, Fisher’s Exact Test, Independent T test and Man-Whitney U test) were used to analyse the association. The response rate was 90.2%. The prevalence of stress among medical students were 33.3%. Significant associated factors include financial support inadequacy (p=0.010) and all categories of medical student stressors. The mean score of the academic related stressors was found to be at 2.117 (±0.758) which was the highest mean score among medical student stressors assessed by MSSQ. The result of this study can be used as a basis for implementation of preventive measures such as provision of comprehensive, integrated and responsive mental health care services in university-based settings.

INTRODUCTION: Previous evidence has suggested a relationship between male self-reported body size and the risk of developing prostate cancer. In this UK-wide case-control study, we have explored the possible association of prostate cancer risk with male self-reported body size. We also investigated body shape as a surrogate marker for fat deposition around the body. As obesity and excessive adiposity have been linked with increased risk for developing a number of different cancers, further investigation of self-reported body size and shape and their potential relationship with prostate cancer was considered to be appropriate.OBJECTIVE: The study objective was to investigate whether underlying associations exist between prostate cancer risk and male self-reported body size and shape.METHODS: Data were collected from a large case-control study of men (1928 cases and 2043 controls) using self-administered questionnaires. Data from self-reported pictograms of perceived body size relating to three decades of life (20's, 30's and 40's) were recorded and analysed, including the pattern of change. The associations of self-identified body shape with prostate cancer risk were also explored.RESULTS: Self-reported body size for men in their 20's, 30's and 40's did not appear to be associated with prostate cancer risk. More than half of the subjects reported an increase in self-reported body size throughout these three decades of life. Furthermore, no association was observed between self-reported body size changes and prostate cancer risk. Using 'symmetrical' body shape as a reference group, subjects with an 'apple' shape showed a significant 27% reduction in risk (Odds ratio = 0.73, 95% C.I. 0.57-0.92).CONCLUSIONS: Change in self-reported body size throughout early to mid-adulthood in males is not a significant risk factor for the development of prostate cancer. Body shape indicative of body fat distribution suggested that an 'apple' body shape was protective and inversely associated with prostate cancer risk when compared with 'symmetrical' shape. Further studies which investigate prostate cancer risk and possible relationships with genetic factors known to influence body shape may shed further light on any underlying associations.

Smoking cessation is a major public health goal today as smoking has threatened the safety, health, and lives of millions of people in the global community. Therefore, the purpose of this study is to identify the role of biopsychosocial and spiritual factors towards the readiness to quit smoking and smoking cessation. The results of the study found that smoking behaviour adversely affects not only the biological aspects but also the psychological, social, and spiritual aspects. Apart from that, this study also found that the biological, psychological, social, and spiritual aspects also play an important role in determining the motivation of smokers to quit smoking holistically. Therefore, research and empirical evidence on the biopsychosocial and spiritual aspects are needed to help healthcare teams to identify the barriers and motivating factors to quit smoking.

Aging population will be an inevitable phenomenon around the globe. This study aimed to assess the quality of life and its associated factors among the elderly population in rural areas of Kudat, Sabah. A community based cross-sectional study was conducted among elderly aged 60 and above living in Tambuluran Area of Kudat. Quality of life was assessed using WHOQOL-BREF questionnaires. Socio-demographic data of the elderly, perceived morbidities and utilization of health services were collected. Independent sample t-test was used for data analysis. A total of 165 respondents participated in this study with a mean age of 71.42±6.50. The mean WHOQOL-BREF score was 65.20 ±11.49. Mean scores for physical and psychological domains were lower than average. Age, marital status, educational level and perceived morbidity were associated significantly with QOL. In conclusion, QOL was generally average among elderly in rural areas of Kudat. Therefore, interventions should place emphasis on physical and psychological aspects of life among these aged population.

Ageing is a global phenomenon. In Malaysia, a projected model estimated that the number of elderly would be 3.4 million in 2020 which is more than 10% of the population. A cross-sectional study targeted the elderly population of three villages in rural Sabah, Malaysia aimed to investigate the health-related quality of life, comorbidity, and the socio-demographic profile amongst the elderly in the community. Participants (60 years and above) were selected for face-to-face interviews using health-related quality of life questionnaires (SF-36). SPSS 21 was used for statistical analyses. Results showed that mean (sd) of age; 67.71 (6.95) years. Five common co-morbidities were hypertension (67%), bone and joint pain (63%), gastric pain (67%), poor vision (58%), and hearing problems (33%). The highest HRQoL score was social functioning (67.96) whereas the lowest HRQoL score is role limitation due to emotional problems (30.54). There is a significant relationship between HRQoL domains and socio-demographic factors (gender, marital status, membership in association), and health condition (co-morbidities and access to healthcare, bone and joint pain or arthritis and treatment, hearing impairment and treatment) which indicated need for health and social support like participating in association and access to health care for rural elderly in future programme. We recommend a further study to compare elderly HRQoL in rural, urban and institutional settings for future health-care planning.South East Asia Journal of Public Health Vol.5(2) 2015: 35-42

Covid-19 The first case of COVID-19 in Malaysia was detected on 24 January 2020.1 As of 10 September 2020, when this editorial article is written, the total cases have increased to 9,628 cases, with active cases of 333 are being isolated and undergoing treatment, while 9,167 cases achieved recovery.2 The number of deaths in Malaysia due to COVID-19 is 128 people. Within the past few months, there has been increased in the number of clusters of infection in some states including Sabah. The number of cases in Sabah is currently at 592 cases.Healthcare Management in Sabah.

Supplemental Digital Content is available in the text, Background: The recent controversy about using mammography to screen for breast cancer based on randomized controlled trials over 3 decades in Western countries has not only eclipsed the paradigm of evidence-based medicine, but also puts health decision-makers in countries where breast cancer screening is still being considered in a dilemma to adopt or abandon such a well-established screening modality. Methods: We reanalyzed the empirical data from the Health Insurance Plan trial in 1963 to the UK age trial in 1991 and their follow-up data published until 2015. We first performed Bayesian conjugated meta-analyses on the heterogeneity of attendance rate, sensitivity, and over-detection and their impacts on advanced stage breast cancer and death from breast cancer across trials using Bayesian Poisson fixed- and random-effect regression model. Bayesian meta-analysis of causal model was then developed to assess a cascade of causal relationships regarding the impact of both attendance and sensitivity on 2 main outcomes. Results: The causes of heterogeneity responsible for the disparities across the trials were clearly manifested in 3 components. The attendance rate ranged from 61.3% to 90.4%. The sensitivity estimates show substantial variation from 57.26% to 87.97% but improved with time from 64% in 1963 to 82% in 1980 when Bayesian conjugated meta-analysis was conducted in chronological order. The percentage of over-detection shows a wide range from 0% to 28%, adjusting for long lead-time. The impacts of the attendance rate and sensitivity on the 2 main outcomes were statistically significant. Causal inference made by linking these causal relationships with emphasis on the heterogeneity of the attendance rate and sensitivity accounted for the variation in the reduction of advanced breast cancer (none-30%) and of mortality (none-31%). We estimated a 33% (95% CI: 24–42%) and 13% (95% CI: 6–20%) breast cancer mortality reduction for the best scenario (90% attendance rate and 95% sensitivity) and the poor scenario (30% attendance rate and 55% sensitivity), respectively. Conclusion: Elucidating the scenarios from high to low performance and learning from the experiences of these trials helps screening policy-makers contemplate on how to avoid errors made in ineffective studies and emulate the effective studies to save women lives.

Introduction In the UK, approximately 11% of newly registered PrCa cases are under the age of 60 years. The unequal incidence across different countries suggests that modifiable factors, such as dietary intake of omega 3 polyunsaturated fatty acids (PUFAs) may be important. Methods Data were analysed on 805 cases and 1283 controls of age Results For the highest compared with the lowest quartile of intake, total omega 3 dietary intake (OR=0.68, 95% CI 0.40 to 1.15, p=0.14), DHA (OR=0.71, 95% CI 0.48 to 1.05, p=0.09) and EPA (OR=0.72, 95% CI 0.46 to 1.14, p=0.16), all showed non-significant trends with decreased PrCa risk. However, increased supplement dosage of DHA and EPA both showed significant, protective dose-response relationships (p for trends=0.04). Conclusion This study of early onset prostate cancer has shown protective trends for supplement intakes of DHA and EPA which if confirmed in other studies could have implications for prevention.

Background: Prostate cancer is the most common cancer among males in the UK and in 2007 accounted for almost a quarter of all male cancers diagnosed. Previous studies have shown some associations between body size/obesity and prostate cancer risk. However body fat distribution in terms of perceived “body shape” and its association with prostate cancer risk has never been described. Methods: In the UK data from 1343 cases and 817 controls with age ranged between 38 and 85, with mean age 62.4 (SD 6.2) were collected between 2007 -2009 as part of the UKGPCS Prostate Cancer Study. The data on subjects’ body fat distribution type including “apple” (body fat mostly around the waist and upper trunk), “pear” (body fat around hips), “oval” (body fat generalised on whole body) and “symmetrical” were obtained through self report diagrams in questionnaires after consent from the subjects. Unconditional logistic regression analysis, with adjustment for age, education, ethnic, family history and lifetime body shape size as potential confounders, were carried out to obtain odds ratios and confidence intervals for different types of body fat distribution to assess their possible association with risk of prostate cancer. Results: A “symmetrical” body shape was used as the reference category. Subjects with an “apple” shape were at a significantly 30% reduced risk (adjusted OR 0.70 with 95% CI: 0.55-0.89). Subjects with an “oval” or “pear” shapes did not show any statistically significant association. Conclusion: An “apple” body fat distribution was associated with reduced prostate cancer risk when compared to symmetrical shape. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 642. doi:1538-7445.AM2012-642