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Introduction: The rapid spread of the COVID-19 worldwide has led the World Health Organization (WHO) to declare COVID-19 outbreak as a pandemic on March 11, 2020. This study aims to determine the factors associated with asymptomatic COVID-19 patients in Petaling District, Selangor, Malaysia. Methods: Data on COVID-19 patients were extracted from the database of confirmed cases in Petaling District Health Office, Selangor, Malaysia from 3rd February 2020 to 30th April 2020. An asymptomatic laboratory-confirmed case is a person infected with COVID-19 who does not develop any symptoms. The study included socio-demographic variables, the detailed information on clinical manifestations and co-morbidity of the patients. Descriptive and multivariable logistic regression analyses were conducted to determine the factors associated with asymptomatic patients. Results: The overall COVID-19 patients in Petaling District were 434. Approximately 70% (N = 292) of the patients were symptomatic while 32.7% (N = 142) were asymptomatic. Multivariable logistic regression analyses revealed that factors significantly associated with asymptomatic patients were age below 40 years old (aOR: 1.79, 95% CI 1.11, 2.86), non-Malaysians (aOR: 3.22, 95% CI 1.44, 7.19) and local cases (aOR: 2.51, 95% CI 1.42, 4.42). Gender, ethnicity, co-morbidity and township were not significantly associated with asymptomatic patients. Conclusion: Approximately one-third of COVID-19 patients were asymptomatic and the risk factors identified were younger age, non-Malaysians and local cases. Rigorous epidemiological investigation and laboratory examinations are helpful in identifying COVID-19 cases among these group of people who are asymptomatic. Keywords: COVID-19 - asymptomatic - pandemic - Malaysia

Introduction: Internet usage has changed the way adolescents socialize. This study aims to determine the determinants of internet addiction among school-going adolescents in Malaysia. Methodology: 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. Results: 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. Conclusion: 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. Keywords: Internet addiction – public health – adolescents – NHMS - Malaysia

Background: A mandatory universal salt iodization (USI) has been implemented in Sarawak, Malaysia since 2008. Objectives: The aim of this study is to assess the current iodine status among school-aged children (SAC) and pregnant women (PW) after 10 years of USI implementation in Sarawak. Methods: This cross-sectional survey among school-aged children and pregnant women was conducted between July and October 2018 in Sarawak. The multistage proportionate to population size sampling technique was used to select 30 schools and 30 maternal and child health care clinics. A total of 1200 children aged 8 to 10 years and 750 first-trimester pregnant women were randomly selected to participate in the study. Iodine excretion level in urine was determined according to the World Health Organization classification. Results: A total of 988 children and 677 PW participated in the study with a response rate of 82.3% and 90.2%, respectively. The overall median urinary iodine concentration (UIC) level among the children was 126.0 μg/L (interquartile range [IQR], 71.0-200.9 μg/L) and classified as adequate iodine status. The median UIC among PW was 123.9 μg/L (IQR, 56.5-192.1μg/L) indicating inadequate iodine status. Conclusion: The present findings indicate that despite adequate iodine status in children, the majority of PW still showed inadequate iodine status. Thus, comprehensive monitoring of the iodine deficiency disorder problem among PW is warranted.

In 2016, the Ministry of Health (MOH) Malaysia has introduced a new programme to prevent and reduce the occurrence of non-communicable diseases (NCDs) as well as related risk factors in the work place environment known as KOSPEN Plus. This study aims to evaluate the awareness and perception of KOSPEN Plus programme after 3 years of implementation in MOH health facilities, government and private agencies in Malaysia. A cross sectional study design was employed in the study. All health facilities, government and private agencies which had implemented KOSPEN Plus programme between 2016 and 31 December 2018 in all states in Malaysia were invited to participate in the study. The computer assisted self-interview (CASI) using the pre-tested self-administered questionnaire in the electronic form was used. A total of 362 health facilities, government and private agencies which had implemented KOSPEN Plus programme was involved in this study. Overall, more than 80% of facilities/agencies in this study implemented six out of the eight scopes of KOSPEN Plus. The survey was planned with the goal of obtaining data to support the Ministry of Health in reviewing the present health activities related to workers health in Malaysia and make necessary improvement to the programme.

The epidemic of Coronavirus Disease 2019 (Covid-19) in China and a number of countries had led to the Covid-19 pandemic declaration by WHO. The aim of this study is to assess the evidence and to report the effectiveness of Covid-19 containment and mitigation measures among the affected countries. A comprehensive search strategy was performed using the MESH terms of “Novel coronavirus,” “Novel coronavirus 2019”, “2019 nCoV”, “Covid-19”, “Wuhan coronavirus”, “SARS-CoV-2”, “Containment”, “Mitigation” and “Control”. After completion of the initial screening, 922 articles were excluded for the following reasons: the article did not meet the inclusion criteria (N = 862), the article was a duplicate (N = 60). The remaining 72 articles were screened at the full-text level. After full review for relevancy, 41 articles were excluded and a total of 31 articles were selected for scoping review. The two most successful countries that managed to control this pandemic were Hong Kong and South Korea. While, the United States of America (USA) and Brazil are the countries yet unable to significantly reduce the Covid-19 cases. The aggressiveness of government efforts and the compliance among the population are the main factors contributing to the effectiveness of the containment and mitigation measures implemented.

Background: Anaemia continues to be a global public health burden affecting all age groups, particularly children. Indigenous people, including the Orang Asli (OA) population in Malaysia, are at risk of anaemia due to the vast disparities in social determinants of health in their population compared to the non-indigenous population. Objectives: This review aimed to identify the prevalence and risk factors of anaemia among OA children in Malaysia and analyse the knowledge gaps. Methods: A systematic search was conducted in PubMed, Cochrane Library, Scopus and Google Scholar databases. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines. Results: This review identified six studies involving the participation of OA children from eight subtribes residing in Peninsular Malaysia. The overall prevalence of anaemia among OA children ranged from 21.6 to 80.0%, with iron deficiency anaemia prevalence at 34.0%. The risk factors of anaemia among OA children reported from one study in this review were being younger than ten years old children (AOR 2.11 (95% CI 1.23, 3.63)) and moderate to heavy Ascaris infections (AOR 2.05 (95% CI 1.12, 3.76)). There was no data from OA children from certain age groups and subtribes. Additionally, there is a paucity of data on risk factors for anaemia among OA children from the currently available evidence. Conclusion: The prevalence of anaemia among OA children poses a moderate to severe public health concern. Therefore, more comprehensive studies in the future are needed to address the gaps identified in this review, primarily regarding anaemia risk factors. This data would encourage policymakers in devising effective national prevention strategies to improve morbidity and mortality among OA children in the future.

Objective: This study aims to determine the prevalence of poor self-rated health (SRH) in Malaysia and its association with sociodemographic characteristics, lifestyle behavior, chronic diseases, depression, and functional limitations in activities of daily living (ADLs) among older persons. Design: Cross-sectional. Setting, participants, and outcome measures: We used data from the National Health and Morbidity Survey 2018, a nationwide community-based study. This study was conducted using a two-stage stratified cluster sampling design. Older persons were defined as persons aged 60 years and above. SRH was assessed using the question “How do you rate your general health?” and the answers were “very good”, “good”, “moderate”, “not good”, and “very bad”. SRH was then grouped into two categories; “Good” (very good and good) and “Poor” (moderate, not good, and very bad). Descriptive and logistic regression analyses were conducted using SPSS version 25.0. Results: The prevalence of poor SRH among older persons was 32.6%. Poor SRH was significantly related to physical inactivity, depression, and limitations in activities of daily living (ADLs). Multiple logistic regression revealed that poor SRH was positively associated with those who had depression (aOR 2.92, 95% CI:2.01,4.24), limitations in ADLs (aOR 1.82, 95% CI: 1.31, 2.54), low individual income (aOR 1.66, 95% CI:1.22, 2.26), physical inactivity (aOR 1.40, 95% CI:1.08, 1.82), and hypertension (aOR 1.23, 95% CI:1.02, 1.49). Conclusions: Older persons with depression, limitations in ADLs, low income, physical inactivity, and hypertension were significantly associated with poor SRH. These findings provide information to aid health personnel and policymakers in the development and implementation of health promotion and disease prevention programs, as well as adequate evidence in planning different levels of care for the older population.

Purpose University academicians are struggling to engage in teaching, supervision, research and publication. The purpose of this paper is to determine how academicians cope with the various burdens of academia work stressors to overcome burnout. Design/methodology/approach A cross-sectional study was conducted from January to July 2017. In total, 327 research university academicians were selected using a proportional stratified randomized sampling. Validated measures were used to collect data on perceived work stressors (teaching, research, interpersonal conflicts and career development), coping strategies (adaptive and maladaptive coping) and perceived burnout (emotional exhaustion (EE), depersonalization and personal accomplishment (PA)). The data were gathered via computer assisted self-interviewing (CASI). The research statistical model was tested by two-steps of assessment replicating covariance-based structural equation modeling (CB-SEM) with bootstrapping procedure to generalize the sample to the hypothesized model. Findings Overall data fit the hypothesized model well (CMIN/df=1.788, GFI=0.833, CFI=0.921, TLI=0.916, RMSEA=0.047) with various degree of explanatory value for EE, depersonalization and PA were 60, 49 and 22 percent, respectively. Academicians were resilient against the burden of teaching. However, they did adopt coping mechanisms to overcome research challenges and interpersonal conflicts. The effects of research and interpersonal conflicts on tri-dimensional burnout mediated by maladaptive coping (f2 effect size=0.37) had a larger effect than interpersonal conflicts toward burnout mediated by adaptive coping (f2 effect size=0.02). Practical implications Academicians adopt maladaptive coping for research and interpersonal conflicts to suppress burnout. An integrative approach at both organization and individual levels is crucial to enhance appropriate coping mechanism to curb with burnout among the academicians of a research university. Originality/value This is the first study in Malaysia which uniquely estimate the effects of academician’s work stressors toward burnout with introducing coping strategies as mediators toward work stressors and burnout relationship which has been analyzed via CB-SEM.

IntroductionThe rapid spread of the coronavirus disease (COVID-19) worldwide has led the World Health Organization (WHO) to declare COVID-19 outbreak as a pandemic on March 11, 2020. As of 17 April 2020, Malaysia has recorded 5,251 COVID-19 positive cases with 86 deaths, with the state of Selangor recorded the highest number of confirmed cases (1,338).There is increasing evidence that many patients with COVID-19 are asymptomatic or have only mild symptoms. Asymptomatic COVID-19 individuals have still the potential to infect others without ever knowing they are carrying and potentially spreading the virus, which could cause difficulties in COVID-19 prevention and control. Petaling district in Selangor was previously declared as COVID-19 red zone. Hence, this study aims to determine the factors associated with asymptomatic COVID-19 patients in the district of Petaling in Malaysia. MethodsStudy design: A cross-sectional study using secondary data • Data of laboratory-confirmed COVID-19 cases notified to the Petaling District Health Office, Selangor, Malaysia between 3 February 2020 and 30 April 2020 was obtained and analysed. • Ethical approval for this study was obtained from the Medical Research and Ethics Committee (MREC), Malaysia (NMRR-20-720-54598). • An asymptomatic laboratory-confirmed case is a person infected with COVID-19 who does not develop any symptoms. • Descriptive and multivariable logistic regression analyses were conducted using SPSS 23.0 to determine the factors associated with asymptomatic cases. Results[Refer to Poster]. Discussion / ConclusionApproximately one-third of COVID-19 patients in Petaling district were asymptomatic and the risk factors identified were younger age, non-Malaysians and local transmission. • Studies have shown that asymptomatic cases were more common in young and middle-aged individuals, suggesting that age and body condition may play an important role in the severity of COVID-19, possibly related to different immune responses and other potential pathogenesis.3 • Rigorous epidemiological investigation and laboratory examinations are helpful in identifying COVID-19 among these group of people who are asymptomatic. • Appropriate strategies, such as social distancing, wearing face masks in public, frequent hand washing should be strongly implemented to prevent disease transmission from asymptomatic individuals.

IntroductionMental health problem affected 20% of adolescents worldwide, most commonly depression or anxiety . This study aims to compare the prevalence of depression and factors related to depression among adolescents in Malaysia from two surveys. MethodologyA sub-analysis of data from two nationwide surveys using multistage cluster random sampling design was done among secondary school students aged 13-17 years in Malaysia from 234 (NHMS 2012) and 212 (NHMS 2017) randomly selected schools. We used a validated self-administrated bilingual Depression, Anxiety, Stress Scale (DASS-21) questionnaire to evaluate for depression. Descriptive analysis was applied using SPSS. ResultsThe prevalence of depression among adolescents was 17.7% (95% CI:16.71,18.67) in 2012 and slightly increased to 18.3% (95% CI:17.20,19.38) in 2017. The state with the highest prevalence of depression was Sarawak (20.9%) in the NHMS 2012 and Selangor (22.6%) in NHMS 2017. In 2012, the prevalence of depression was higher among females (18.5%) whereas in 2017, the prevalence was higher among males (18.9%). Table 1: Prevalence of Depression among adolescents by Sociodemographic in Malaysia. Discussion 1. The increasing number of ‘ever used drugs’ among adolescents from the two studies supported by Junette & Trishna (2011) found that the risk for depression may also increase by two - to threefold in the presence of comorbidities such as substance abuse and anxiety disorders. 2. This comparison of two studies showed quite similar findings as increasing trend of the prevalence of psychiatric morbidity among adolescents was from 13.0% in NHMS 1996, to 19.4% in 2006 and 20.0% in 2011. 3. A trend study in United States also reported that the prevalence rate of severe adolescent depression varied from 8.7% in 2005 to 11.3% in 2014. The trends remained significant after adjustment for substance use disorders and sociodemographic factors. 4.This comparison also showed the rates of prepubertal depression are similar for boys and girls; however, depression rates double in females after puberty. ConclusionThere was an increase in the prevalence of depression among adolescents in NHMS 2017 compared to the NHMS 2012. Depression remains a problem among adolescents especially those with risky behaviours. Intervention strategies should be targetted on adolescents with risky behaviours and those from broken family.

Introduction Erectile dysfunction (ED) is the inability to achieve or maintain an erection of the penis, which is important for satisfactory for sexual intercourse. Unhealthy lifestyles and non-communicable diseases (NCDs) are related to ED and need to be highlighted. This study aims to determine the prevalence of ED and its related risk factors including NCDs and Unhealthy lifestyles among adult men in Malaysia. MethodsThe data was based on Malaysia National Health and Morbidity Survey (NHMS) 2019; a cross-sectional study, with study sample randomly selected using a two-stage stratified sampling frame. Sexually active adult men (≥18 years old) completed the validated English and Malay versions of the 5-item International Index of Erectile Function (IIEF-5) questionnaire via self-administration. The IIEF scoring system was categorised into three categories; normal (22-25), symptomatic ED (17-21), and probable ED (5-16). Complex sample analysis was performed using SPSS v15. Results[Refer to Poster]. Conclusion Almost 3 out of 10 adults men diagnosed with NCDs were susceptible to probable ED. Unhealthy lifestyles as risk factors for probable ED also need to be highlighted. Thus, promotion of a healthy lifestyle is important in reducing the risk of ED among adult men.

Introduction Erectile dysfunction (ED) is a prevalent problem across a variety of general male population. International Index of Erectile Function 5-item (IIEF-5) is a brief, validated, multidimensional tool to assess erectile function1. In a multicultural country like Malaysia, ED is a taboo topic to be discussed with and limited information regards to it. This study provides findings of ED using IIEF-5 as a screening tool in a community survey in Malaysia. Methods Data were obtained from the National Health and Morbidity Survey (NHMS) 2019, a cross-sectional study using a stratified cluster sampling design. A total of 2404 eligible respondents of sexually active adult men (≥18 years old) completed a self-administered IIEF-5 questionnaire. The International Index of Erectile Function (IIEF-15) consists of 15 variables was developed for determining the efficacy of treatment in controlled clinical trials1. The IIEF‐5 is the simplified version of IIEF-15,consists of five variables. Each variable rated 1-5, giving a total aggregate score of 25, with lower values representing a poorer sexual function. Analysis of variance (ANOVA) was performed using SPSS version 16. ResultsThe overall response rate was 98.6%. The overall composite mean score was 18.16(±4.12). The mean score of each variable were erection confidence (3.48 ±0.85), erection firmness (3.39 ±1.09), maintenance frequency (3.38 ±1.14), maintenance ability (4.27 ±1.05), and intercourse satisfaction variables (3.63 ±1.11). Population 60 years and above showed a significantly lowest mean score in the overall score(15.52 ±4.05), erection confidence (2.90 ±0.87), erection firmness (2.87 ±0.95), maintenance frequency (2.89 ±0.99), maintenance ability (3.75 ±1.20), and intercourse satisfaction variable (3.12 ±1.09). Mean score of all variables were also significantly lower among rural dwellers, low-income status and non-employed persons. Higher education and household income status had a higher mean score of all variables. ConclusionSexual function progressively declines in ageing men2. When the effects of ageing were correlated with the mean score in each variable, advanced ageing coincided with significantly lowest scores for all variables. Relationship of rural dwellers, low-income status and non-employed with erectile dysfunction had been observed in various study3,4,5. In addressing ED problems in Malaysia, fully understanding the IIEF-5 scoring pattern among Malaysian in community-based is essential. Findings of our study showed a risk stratification models of erectile dysfunction. A holistic strategy from policy maker directed towards targeted populations and healthcare services provider are important in promoting a healthy lifestyle and indirectly improving their sexual function.

IntroductionInternet usage has changed the way adolescents socialize. To date, the factors associated with internet addiction among Malaysian adolescents is still lacking. This study aims to determine the factors associated with internet addiction among school-going adolescents in Malaysia. Materials and MethodsThis study was a cross-sectional study involving 27,455 schoolgoing adolescents from 212 selected schools in Malaysia, as part of the 2017 National Health and Morbidity Survey (NHMS) that implemented a two-stage stratified cluster sampling design. Data collection was conducted from March till May 2017. A self-administered questionnaire was used to measure health risk behaviors among Malaysian adolescents. Results[Refer to Poster]. ConclusionOur results suggest that being a male, Chinese ethnicity, higher form level,feeling loneliness,unable to sleep due to worrying of something, insufficient parental supervision ➢ depression,anxiety, stress were positively associated with internet addiction among school-going adolescents. RecommendationParents should communicate and spend quality time with the adolescents at level best for better and sufficient parental supervision.

IntroductionIn December 2019, an epidemic of Coronavirus Disease 2019 (Covid-19) began in China and the number of countries infected by the virus has continued to rise. This phenomenon has led WHO to declare Covid-19 as pandemic on March 11, 2020, and has urged all affected countries to take urgent and aggressive action to control this pandemic. Most of the countries affected by the Covid-19 pandemic were recommended to adopt the containment and mitigation measures in order to control the disease from spreading. Briefly, the containment measures aimed at preventing the disease from taking hold, encompassing early detection, isolation, and care of people already infected, with careful tracing and screening of their contacts. While, mitigation measures aimed at reducing the impact and its incidence, as well as disruptions to economic, political, and social systems, encompassing social distancing strategies such as the cancellation of conferences and other large gatherings, reducing non-essential use of public transport, and closure of schools. ObjectiveThe aim of this study is to determine the control methods used in containment and mitigation of the Covid-19 virus from the affected countries and to ascertain what are the best methods in Covid-19 transmission control. MethodologyIn our study, a scoping review approach in searching, screening, reviewing and data extraction was applied based on framework by Arksey and O’Malley. A comprehensive search strategy was performed, which included published scientific journals, unpublished work, grey literature using the MESH terms of “Novel coronavirus,” “Novel coronavirus 2019”, “2019 nCoV”, “Covid-19”, “Wuhan coronavirus”, “SARS-CoV-2”, “Containment”, “Mitigation” and “Control”. Two reviewers independently screened all references from the articles search and then reached consensus on which met the eligibility criteria. Two reviewers independently screened all references from the articles search and then reached consensus on which met the eligibility criteria. Non-English language articles were excluded as the translation was not practical. Data from the articles were extracted and summarized on a standardized form with the data reviewed by both authors. ResultsA total of 996 sources of evidence identified from the literature search and grey literature hand search were included in the review, representing the types of containment and mitigation from four regions; i. Western Pacific and South East Asia, ii. European, iii. Eastern Mediterranean, and iv. The Americas. After completion of the initial screening, 922 articles were excluded for the following reasons: the article did not meet the inclusion criteria (N = 862), the article was a duplicate (N = 60). The remaining 72 articles were screened at the full-text level. After full review for relevancy, 41 articles were excluded and a total of 31 articles were selected for scoping review (Figure 1;).After more than one month of the containment and mitigation control measures taken, most of the countries managed to reduce the Covid-19 cases from spreading in the communities [45]. However, the two most successful countries that managed to control this pandemic were Hong Kong and South Korea. While, the United States of America (USA) and Brazil are the countries yet unable to significantly reduce the Covid-19 cases (Table 1). ConclusionThis review revealed all countries affected by the Covid-19 had implemented multiple containment and mitigation measures to reduce the impact of the disease. Thus, making it difficult to measure the effectiveness of each individual method. A combination of multiple control measures is necessary, since this could increase the success in reducing the transmission of the Covid-19 disease. In addition, the aggressiveness of government efforts and the compliance among the population are the main factors for the effectiveness of the containment and mitigation measures implemented. Lastly, the efforts should be directed at the creation of standard guidelines to improve the containment and mitigation efforts, considering the characteristics of the virus and community acceptance.

IntroductionIn an ageing society, falls is a serious issue that contributes to morbidity and mortality. Additional health problem such as urinary incontinence could further increase risks. Urinary incontinence could present in the form of stress, urge incontinence or mixed. Previous studies have demonstrated the link between urinary incontinence and falls. This sub-study aims to demonstrate the prevalence of falls among older women in Malaysia and its association with urinary incontinence. MethodologyData was obtained from the National Health and Morbidity Survey (NHMS) 2018, a cross-sectional survey focusing on elderly health in the population. Secondary data obtained were for women aged ≧60 years old (n=). Information on socio-demography and falls history were obtained from face-to-face interview. Urinary incontinence was measured using a validated tool, Questionnaire for Urinary Incontinence Diagnosis (QUID) which could assess stress and urge incontinence. Descriptive and logistic regression complex sampling analysis was done using SPSS version 22. ResultsThe prevalence of having at least 1 fall episode in the past 12 months at the date of interview among women aged 60 and above was 14.7% in Malaysia. Those aged >80 years old, from urban area, unemployed and with a spouse have higher prevalence of falls compared to their counterparts. The prevalence of falls among women with urinary incontinence was 24.3%; higher for stress incontinence (33.5%) compared to urge incontinence (20.1%). Older women with urinary incontinence have almost 2 times odds of falling [OR 1.98 (95% CI: 1.3, 3.0). Those with stress incontinence 3 times odds of falling [OR 3.09 (95% CI: 2.0,5.0)] as to urge incontinence [OR 1.48(95% CI: 0.52,4.19)]. Multiple logistic regression revealed that urinary incontinence were positively associated with those who had stress urinary incontinence [aOR 1.51 (95%CI: 1.03,2.04)] Discussion / ConclusionPrevalence of falls increases with age which is consistent with previous studies. The finding that urinary incontinence is associated with falls was similar to studies done in England, Australia, Japan and the United States. This could be due to the need to rush to the bathroom due to incontinence. Another study suggested that the discomfort and anxiety associated with it which could interfere with balance leading to falls. Urinary incontinence should be considered as a risk factor for falls especially in women. Likely due to the small sample size, significant associations when multiple factors were considered were unable to be demonstrated. Further studies should be done in the future with larger sample size to explore the association in order to determine the necessity and suitable early preventive strategies.

IntroductionAcute myeloid leukaemia (AML) is a type of cancer in which the bone marrow makes abnormal myeloblasts (a type of white blood cell), red blood cells or platelets. Gemtuzumab ozogamicin (GO) holds promise as a new agent that also could be efficacious in newly diagnosed AML with acceptable toxicity. This paper describes the design of a protocol to conduct a systematic review of published studies assessing GO for the treatment of AML.Method and analysisWe will conduct a systematic review of randomised controlled trials that investigate the effect and safety of GO for the treatment of patients with AML. We will search for any eligible articles from selected electronic databases. We will follow the Preferred Reporting Items for Systematic reviews and Meta-Analysis for study selection and reporting. We will use The Cochrane Handbook for Systematic Reviews of Interventions and Meta-Analysis as guidance to select eligible studies. All data will be extracted using a standardised data extraction form.Ethics and disseminationThere was no patient involved in this study, therefore no ethical consideration is needed. The findings of this study will be disseminated in a peer-reviewed journal and any relevant conference presentation.PROSPERO registration numberCRD42019123286.

Aims As the Malaysian population is aging rapidly, there is an urgent need for an effective management plan for healthy aging, to extend life expectancy and to improve quality of life (QoL). Urinary incontinence (UI), which is common in older persons, is often linked to reduced QoL. This study aimed to determine the effects of UI on QoL among older persons in Malaysia. Methods This study was based on data obtained from 3716 Malaysians aged ≥60 years as part of the National Health and Morbidity Survey (NHMS) 2018. QoL was measured using the Control, Autonomy, Self-realization and Pleasure 19-item (CASP-19) questionnaire. UI was measured using the Questionnaire Urinary Incontinence Diagnosis (QUID) score. Association between UI and QoL were examined using linear regression analysis, after controlling socio-demographic variables and comorbidities. Results Overall, the prevalence of UI was 5.2%. By subtypes, the prevalence of stress UI and urge UI were both 2.0%, while that of mixed UI was 1.3%. The UI group rated their lives more negatively in all four domains of QoL compared with non-UI group. Those who were incontinent had lower standardized scores on control and autonomy domains of CASP-19 as well as total score. Results from linear regression analysis indicated that UI had a significantly negative impact on control and autonomy domains of QoL after controlling for socio-demographic factors and comorbidities. Conclusion UI contributes to a significant reduction on QoL of older persons. Healthcare providers need to be sensitive in evaluating and discussing UI, particularly with their older patients. Geriatr Gerontol Int 2020; 20: 38-42.

Background The obesity rate in Malaysia is the highest in Asia. Half its population is obese or overweight. The present study aims to determine the effects of lifestyle intervention on weight loss and blood pressure among Malaysian overweight and obese housewives in Klang Valley. Methods A quasi-experimental study with 328 obese and overweight low socio- economic status housewives aged 18-59 years old who met the screening criteria participated in the study. They were recruited into an intervention group (N = 169) or control group (N = 159). The intervention group received a lifestyle intervention consisting of a diet, physical activity and self-monitoring behavior package. The control group (delayed intervention group) received a women's health seminar package. Both groups were followed up for six months. Weight, body mass index (BMI), and blood pressure were evaluated both pre- and post-intervention. Results A total of 124 participants from the intervention group and 93 participants from the control group completed the study. Mean weight loss was 1.13 ± 2.70 kg (P < 0.05) in the intervention group and 0.97 ± 2.60 kg (P < 0.05) in the control group. Systolic blood pressure (SBP) reductions in the intervention group were 5.84 ± 18.10 mmHg (P < 0.05). The control group showed reduction in SBP 6.04 ± 14.52 mmHg (P < 0.05). Both group had non-significant DBP reduction. Multivariate analysis via General Linear Model Repeated Measures observed no significant differences in terms of parameter changes with time in both groups for all parameters. Conclusions The results indicate that the lifestyle interventions in this study resulted in modest weight loss and thus decreased BMI and blood pressure (SBP) within six months of intervention.

Previous findings from a state-wide Iodine Deficiency Disorders (IDD) study among pregnant women (PW) in Sarawak indicated that PW are at risk of IDD and further study is needed. This paper describes the methodology used in conducting this study on assessment of risk of iodine deficiency among pregnant women in Sarawak, Malaysia. Thirty maternal child health care clinics (MCHCs) were selected using probability proportional to population size (PPS) sampling technique. The PW sample size was calculated based on 95% confidence interval (CI), relative precision of 5%, design effect of 2, anticipated IDD prevalence of 65.0% and non-response rate of 20%. Thus, the total sample size required was 750 (25 respondents per selected MCHC). The WHO Expanded Programme on Immunization (EPI) surveys approach was used to randomly select the first respondent and subsequent respondents were chosen until the required number of PW was met. The required data were obtained through: face-to-face interviews (socio-demographic and food frequency questionnaire), clinical assessments (thyroid size, and hyper/hypothyroidism) and biochemical analysis (urine and blood serum). A total of 677 PW responded in the study with a response rate of 90.2%. Majority of the PW were at second gravida, aged 25-29 years old and of Malay ethnicity. The methodology used in this study was based on international guidelines which may provide state’s estimates. All the necessary steps were taken into consideration to ensure valid and reliable findings on current iodine status among PW.

The co-occurrence of multiple modifiable risk factors increases the risk of cardiovascular disease (CVD) morbidity or mortality. This study examines the prevalence and clustering of self-reported modifiable CVD risk factors among older adults in Malaysia. A total of 7117 adults aged ≥50 years participated in the National Health and Morbidity Survey (NHMS) 2018: Elderly Health, a community-based cross-sectional survey. Data were collected using a standardized structured questionnaire. Multivariable logistic regression was used to determine the factors associated with the clustering of self-reported modifiable CVD risk factors. The prevalence of self-reported diabetes, hypertension, hypercholesterolemia, overweight/obesity, and current smoking was 23.3%, 42.2%, 35.6%, 58.4%, and 17.5%, respectively. Overall, the prevalence of clustering of ≥1, ≥2, and ≥3 modifiable CVD risk factors was 83.3%, 75.4%, and 62.6%, respectively. Multivariable logistic regression analysis showed that men, 60–69 age group, urban dwellers, having no formal education, unemployed/retirees/homemakers, and being physically inactive were independently associated with self-reported modifiable CVD risk factors clustering. There are also ethnic differences in self-reported modifiable CVD risk factors clustering. Our findings underscore the necessity of targeted interventions and integrated strategies for early detection and treatment of modifiable CVD risk factors among older adults, considering age, sex, ethnicity, and socioeconomic status.