Prevalence and predictors of low serum retinol and hypoalbuminaemia among children in rural Peninsular Malaysia

Vitamin A deficiency and malnutrition are still considered public health problems in rural areas of developing countries, including Malaysia. A cross-sectional exploration study was carried out on 281 Orang Asli (Aborigine) children aged between 2 and 15 years in Selangor, Malaysia. The overall prevalence of low serum retinol (<70 micromol/l) and hypoalbuminaemia (<35 g/l) were 25.2 and 7.8%, respectively. Univariate analysis showed that severe ascariasis, significant stunting and giardiasis were significantly associated with low concentration of serum retinol. As well as intestinal parasitic infections, low socio-economic status was a significant predictor of hypoalbuminaemia. Logistic regression analysis identified severe ascariasis and significant stunting as predictors of low serum retinol, while mixed intestinal parasitic infection and low household income were predictors of hypoalbuminaemia. In conclusion, control measures for intestinal parasitic infections should be included as one of the strategies for the prevention and control of malnutrition and vitamin A deficiency in this population.     

Rural health care in Malaysia

ABSTRACT:   Malaysia has a population of 21.2 million of which 44% resides in rural areas. A major priority of healthcare providers has been the enhancement of health of 'disadvantaged' rural communities particularly the rural poor, women, infants, children and the disabled. The Ministry of Health is the main healthcare provider for rural communities with general practitioners playing a complimentary role. With an extensive network of rural health clinics, rural residents today have access to modern healthcare with adequate referral facilities. Mobile teams, the flying doctor service and village health promoters provide healthcare to remote areas. The improvement in health status of the rural population using universal health status indicators has been remarkable. However, differentials in health status continue to exist between urban and rural populations. Malaysia's telemedicine project is seen as a means of achieving health for all rural people.     

Associations of serum aflatoxin B1-lysine adduct level with socio-demographic factors and aflatoxins intake from nuts and related nut products in Malaysia

Aflatoxins are one of the major risk factors in the multi-factorial etiology of human hepatocellular carcinoma. Therefore, the information on aflatoxins exposure is very important in the intervention planning in order to reduce the dietary intake of aflatoxins, especially among the children. This study investigated the relationship between aflatoxin B(1) (AFB(1)) lysine adduct levers in serum and socio-demographic factors and dietary intake of aflatoxins from nuts and nut products in Penang, Malaysia. A cross-sectional field study was conducted in five districts of Penang. A survey on socio-demographic characteristics was administered to 364 healthy adults from the three main ethnic groups (Malay, Chinese and Indian). A total of 170 blood samples were successfully collected and tested for the level of AFB(1)-lysine adduct. 97% of the samples contained AFB(1)-lysine adduct above the detection limit of 0.4 pg/mg albumin and ranged from 0.20 to 23.16 pg/mg albumin (mean±standard deviation=7.67±4.54 pg/mg albumin; median=7.12 pg/mg albumin). There was no significant association between AFB(1)-lysine adduct levels with gender, district, education level, household number and occupation when these socio-demographic characteristics were examined according to high or low levels of AFB(1)-lysine. However, participants in the age group of 31-50 years were 3.08 times more likely to have high AFB(1) levels compared to those aged between 18 and 30 years (P=0.026). Significant difference (P=0.000) was found among different ethnic groups. Chinese and Indian participants were 3.05 and 2.35 times more likely to have high AFB(1) levels than Malay. The result of AFB(1)-lysine adduct suggested that Penang adult population is likely to be exposed to AFB(1) but at a level of less than that needed to cause direct acute illness or death.     

Ethnicity and glycaemic control are major determinants of diabetic dyslipidaemia in Malaysia.

AIMS: To define the prevalence of dyslipidaemia in young diabetic patients in Peninsular Malaysia and the contributory factors of dyslipidaemia in these subjects. METHODS: This is a cross-sectional study involving 848 young diabetic patients from seven different centres, with representation from the three main ethnic groups. Clinical history and physical examination was done and blood taken for HbA1c, fasting glucose, total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol and triglycerides. RESULTS: The overall lipids were suboptimal, worse in Type 2 diabetes mellitus (DM) patients compared with Type 1 DM patients. Of the Type 2 patients, 73.2% had total cholesterol > 5.20 mmol/l, 90.9% had LDL-cholesterol > 2.60 mmol/l, 52.6% had HDL-cholesterol < 1.15 mmol/l and 27.3% had serum triglycerides > 2.30 mmol/l. There were ethnic differences in the lipid levels with the Malays having the highest total cholesterol (mean 6.19 mmol/l), and the highest LDL-cholesterol (mean 4.16 mmol/l), while the Chinese had the highest HDL-cholesterol (geometric mean 1.24 mmol/l). Ethnicity was an important determinant of total, LDL- and HDL-cholesterol in Type 2 DM, and LDL- and HDL-cholesterol and triglycerides in Type 1 DM. Glycaemic control was an important determinant of total, LDL-cholesterol and triglycerides in both Type 1 and Type 2 DM. Waist-hip ratio (WHR) was an important determinant of HDL-cholesterol and triglycerides in both types of DM. Gender was an important determinant of HDL-cholesterol in Type 2 DM, but not in Type 1 DM. Socioeconomic factors and diabetes care facilities did not have any effect on the dyslipidaemia. CONCLUSIONS: The prevalence of dyslipidaemia was high especially in Type 2 DM patients. Ethnicity, glycaemic control, WHR, and gender were important determinants of dyslipidaemia in young diabetic patients. Diabet. Med. 18, 501-508 (2001)     

Sexual issues: let's hear it from the Malaysian boys

Background

This paper explored adolescents’ sexuality with specific reference to their attitudes towards sex, safe sex, their risk-handling skills, sources of sexual information and how this information influenced their knowledge and attitudes.

Methods

This qualitative study utilized focus group methodology. Four focus groups were conducted, involving a total of 31 Malaysian adolescent boys aged between 13 and 17 years.

Results

Findings from the focus groups revealed that the concept of sex was seen within the context of marriage and sex was also viewed as synonymous with love. All the participants denied having sex. The reasons for having sex were: ‘to have fun’, ‘part of natural urge’, curiosity, tension and pressure from family, schoolwork and being away from family. Procreation and the expression of love were also noted as reasons why people have sex. Masturbation was fairly well known among the boys but was felt to have negative consequences on one's health. There was a general lack of awareness on the issue of wet dreams. There were mixed feelings with regards to sexual abstinence before marriage. Knowledge on safe sex was still vague. The boys also perceived themselves to be at risk of HIV infection, but lacked the skills for handling this issue. Sources of sexual information were mainly from male friends or through the mass media. None of their parents talked to them about sexual matters.

Conclusions

Level of awareness and knowledge on sexual issues is still lacking. Misconceptions still prevail. Sex education and research in this area is warranted.     

Is a symmetrical face really attractive?

Facial symmetry plays an important role in facial attractiveness and is one of the major criteria used to determine attractiveness in humans. In craniomaxillofacial surgery, facial symmetry is one of the main considerations. The aim of this study was to determine anthropometric measurements quantitatively and investigate the relationship between facial symmetry and attractiveness in a local Malay population. The study included 30 photographed Malay individuals and 100 photograph assessors, all aged between 18 and 26 years. The assessors indicated their preferences regarding the more attractive face on original and manipulated (symmetrical face) photographs. None of the photographed subjects had a perfectly symmetrical face (asymmetry index (AI) of 0%); 33.3% of the photographed subjects had an AI in the range of 1.6–2.0%. The majority of assessors chose the manipulated symmetrical face as the most attractive (manipulated photograph selected in 91.2% of cases). As facial symmetry is considered a critical factor in attractiveness, it is beneficial to consider balance and symmetry prior to facial reconstruction. The AI values found in this study may be useful as guidance to determine the normal minimum balance of facial symmetry. No AI values indicating perfect symmetry were observed for the unedited facial anthropometric measurements. However, the projection of a perfectly symmetrical face does influence the perception of facial attractiveness.