Malaysian Population Research Articles

Sustainable food security in modern framework for optimal nutri-tional well-being of Malaysians

Food security is Malaysia’s second Sustainable Development Goal (SDG), which ensures access to nutritious food available for everyone in the country. In 2006, the Ministry of Health (MOH) launched NPANM II, the National Plan of Action for Nutrition of Malaysia, to handle food and nutrition issues. National surveys revealed that most Malaysians still cannot completely com-prehend and implement the Food Pyramid into practice. The Ministry intends to continue the programme through NPANM III to advance the population’s health and strengthen food and nutrition security. Therefore, this empirical study aims to develop inclusive, sustainable food security in a modern framework to identify possible reasons affecting nutritional well-being. In the data collection phase, a questionnaire survey is administered among 318 respondents from five states, i.e. Selangor, Pinang, Johor, Kuantan, and Melaka. The data collection process was taken over three months, from January to March 2023, and it ensured the rectification of miss-ing data. The results derived from the study would provide valuable insights to the policymakers towards identifying the most influential factors toward ensuring food security for enhancing the quality of health and well-being of the Malaysian population and have significant implications for achieving the objectives set under the NPANM III, 2016-2025.

Awareness of Microtakaful Development among Low-Income Earners in Malaysia

Malaysia is the third largest takaful market globally and the takaful sector in Malaysia shows sound growth in 2022. Takaful had a penetration rate of 20.1% in 2022, up from 18.6% the previous year. However, only 25% of adult employees in the low-income group have some form of life insurance or family takaful cover, in contrast with 59% of those who are employed in the overall population who have takaful or insurance protection. The Malaysian population can be classified into three income segments: the T20 group, the M40 group and the B40 group. This study will only focus on the B40 group with a median income of RM3,860. Microtakaful is a kind of takaful product entailed for addressing the financial needs of households with low incomes in times of significant expenses. The main objective of this study was to examine the factors influencing the awareness of microtakaful development among the low-income group (B40). This study examines the relationship between (i) income level (ii) knowledge, and (iii) loss of exposure to the awareness of microtakaful. Data was collected by distributing 320 questionnaires to the residents in (PPR) Kerinchi Lembah Pantai, Kuala Lumpur. Based on the findings, it can be concluded that the three independent variables, namely income level, knowledge, and loss exposures, have a strong positive relationship with microtakaful awareness. However, it is found that income level has the biggest impact on the awareness of microtakaful.

Trends in all-cause mortality among adults with diagnosed type 2 diabetes in West Malaysia: 2010 – 2019

AimsWe determined 10-year all-cause mortality trends in diagnosed type 2 diabetes (T2D) population in West Malaysia, a middle-income country in the Western-Pacific region. MethodsOne million T2D people aged 40–79 registered in the National Diabetes Registry (2009–2018) were linked to death records (censored on 31 December 2019). Standardized absolute mortality rates and standardized mortality ratios (SMRs) were estimated relative to the Malaysian general population, and standardized to the 2019 registry population with respect to sex, age group, and disease duration. ResultsOverall all-cause standardized mortality rates were unchanged in both sexes. Rates increased in males aged 40–49 (annual average percent change [AAPC]: 2.46 % [95 % CI 0.42 %, 4.55 %]) and 50–59 (AAPC: 1.91 % [95 % CI 0.73 %, 3.10 %]), and females aged 40–49 (AAPC: 3.39 % [95 % CI 1.32 %, 5.50 %]). In both sexes, rates increased among those with 1) > 15 years disease duration, 2) prior cardiovascular disease, and 3) Bumiputera (Malay/native) ethnicity. The overall SMR was 1.83 (95 % CI 1.80, 1.86) for males and 1.85 (95 % CI 1.82, 1.89) for females, being higher in younger age groups and showed an increasing trend in those with either > 15 years disease duration or prior cardiovascular disease. ConclusionsMortality trends worsened in certain T2D population in Malaysia.

First molecular detection of porcine circovirus type 4 (PCV4) in Malaysia.

Porcine circovirus type 4 (PCV4) is the newest member in the porcine circovirus family, first reported in 2020. To date, the presence of PCV4 has only been reported in China, South Korea and most recently in Thailand. Detection of PCV4 have been reported in various production stages of pigs from piglets, finishers to sows; associated with a myriad of clinical manifestations including porcine dermatitis and nephropathy syndrome (PDNS), postweaning multisystemic wasting syndrome (PMWS), respiratory, enteric and neurological diseases. While successful virus isolation and culture has yet to be reported, pathogenicity of PCV4 has been demonstrated through infectious clone studies. The objective of this study is to investigate the presence of PCV4 in Malaysian porcine population to update the epidemiology of porcine circoviruses in Malaysia. A total of 49 samples from commercial intensive pig farms, abattoir and wild boar population were subjected to conventional polymerase chain reaction assay to detect PCV4 capsid (cap) genome. Resulting cap nucleotide sequences were analyzed for maximum likelihood phylogeny relationship. Results revealed that PCV4 is present in Peninsular Malaysia at a molecular prevalence of 4.08% (2 / 49 samples). Both PCV4 positive samples originated from clinically healthy finishers. Malaysian PCV4 strains were classified as genotype PCV4b, and were found to be phylogenetically distinct from the China, South Korea and Thailand strains. With this latest update of the novel PCV4 in Malaysia, it is clear that more attention needs to be given to the investigation of novel porcine circoviruses (PCV) and management of PCV diseases.

Effectiveness of Ultrasound-guided versus Anatomical Landmark-guided Genicular Nerve Block to Treat Chronic Knee Osteoarthritis: A Retrospective Cohort Study.

There is limited data on the relative effectiveness of different techniques used for administering genicular nerve block (GNB) for pain management of chronic knee osteoarthritis (OA) in the Malaysian population. This study aims to determine and compare the effectiveness of GNB administered using two pain management techniques?"anatomical landmark-guided (ALG) and ultrasound-guided (USG)?"for chronic knee OA in this population. This retrospective cohort study included 40 patients with chronic knee OA who received GNB, 20 of whom underwent treatment with the USG technique and the other 20 with the ALG technique. Pain, stiffness, and functional limitation scores were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index Questionnaire (WOMAC) and Numeric Rating Scale (NRS-11) at baseline and post-treatment day one, three weeks, and six weeks. Both groups reported a significant reduction in WOMAC and NRS-11 scores as per their feedback on day one, three weeks, and six weeks post-treatment. Greater reductions in WOMAC and NRS-11 scores were reported by patients who received GNB via USG than by ALG technique, the difference achieving statistical significance at six weeks after treatment (p =0.026). GNB administration using USG and ALG techniques are both effective in significantly reducing pain, stiffness, and functional limitation in patients suffering from chronic knee OA. Among the two techniques, USG appears to be more effective. Nevertheless, GNB guided by ALG continues to be a viable treatment modality, especially in healthcare settings with limited to no USG facilities.

A Study on the Causes of Work Stress among Malaysia Civil Defense Force (MCDF) Personnel

Life in the modern world today is full of frustrations, demands and deadlines as stress has become a norm for many people. Since the harsh episode of the pandemic, stress is the normal physical response that disturbs our balance. Many experienced work-related ill health cases due to work-related stress, depression and anxiety. Therefore, work stress is inevitable. Work stress is increasing in Malaysia, especially since the pandemic and it continues to pose a major global health threat until now. Alarmingly, stress has become a modern epidemic and has influenced poor public health. Many past researches reviewed the prevalence of occupational stress and the causes of its prediction among the Malaysian population and found many occupational stress severe incidents. The Malaysian government mobilized the Malaysia Civil Defense Force (MCDF) for several responsibilities to save lives and properties. Based on the nature of MCDF work, stress is a major issue. There are many factors of stress; operational, organizational and lifestyle to name a few. Organizational stress highlights employees’ attachment to the organization, operational stress highlights employees' experience doing the work, and lifestyle stress highlights individual ways of living. Therefore, the researchers attempt to examine the relationships between operational, organizational and lifestyle factors and the most influencing factor that may cause stress among a population of 180 personnel of MCDF, while carrying out their work assignments in Klang Valley.

The prevalent factors of anxiety in women undergoing mammography.

Breast cancer is the most common cancer among women in Malaysia. Anxiety is one factor that deters women from participating in mammography. This study aimed to assess the anxiety level and its associated factors in women undergoing mammography. A three-month cross-sectional study was conducted using self-administered questionnaires, encompassing socio-demographic details, clinical characteristics, and the State-Trait Anxiety Inventory. The mean age of the participants was 57 years old (SD ±10.098). Repeat mammograms consisted of 48.8% of the participants. One-third (35.7%) of them had a history of breast disease. Most participants (84.5%) did not have a positive family history of breast cancer. The proportion of participants with moderate and high anxiety levels was 41.8%. The cause of anxiety was mainly due to the fear of the results (69%), while familiarity with the procedure reduced anxiety among respondents. Socio-demographic and clinical factors were not significantly associated with anxiety levels. However, a statistically significant positive correlation was found between state and trait anxiety scores (r = 0.568, p = 0.001, n = 213). The urban setting and absence of questions on the location of origin in the study may have excluded data from the rural population. This may have prevented a true representation of the Malaysian population. The findings suggest a better understanding of the procedures involved as well as the subsequent disease management would be beneficial in alleviating anxiety prior to, during, and post-mammogram.

Assessing the population’s correct knowledge of malaria in Malaysia: a vital component for malaria elimination certification

BackgroundMalaria remains a public health problem in Malaysia despite a decline in the number of cases in recent years. Public knowledge of malaria is essential to achieving and maintaining malaria elimination. Therefore, this survey assessed the prevalence of people who had ever heard of malaria, had correct knowledge of malaria transmission, symptoms, risk activities, and prevention measures in the Malaysian population, and identified the associated factors involved.MethodsThe data were obtained from the National Health and Morbidity Survey (NHMS) which was conducted from September to October 2020. A cross-sectional survey with five structured questionnaires using the method of computer-assisted telephone interviews (CATI) was used to collect data. The socio-demographic characteristics such as age, gender, ethnicity, nationality, marital status, educational level, and occupation were recorded. Data were analysed using STATA SE Version 16. Associations between variables were tested using chi-square and logistic regression, with the level of statistical significance set at p < 0.05.ResultsOut of 3085 respondents who participated in this survey, 2491 had ever heard of malaria with a prevalence of 76.1% (95% CI 70.5, 80.9). The prevalence of correct knowledge of malaria transmission was 53.9% (95% CI 50.2, 57.7), symptoms 24.1% (95% CI 21.2, 27.2), risk activities 34.0% (95% CI 29.3, 39.1) and prevention measures 59.7% (95% CI 55.5, 63.7). Multivariate analysis showed that age, ethnicity, and educational level were significantly associated with correct malaria transmission and risk activities. In addition, age and educational level were significantly associated with correct malaria symptoms. Subsequently, only the variable ethnicity showed a significant association with the correct malaria prevention measures.ConclusionIn general, the prevalence of ever heard of malaria was considered high since the survey was performed based on a non-specific malaria population. However, the prevalence of correct knowledge of malaria symptoms and risk activities were considered low. It is concluded that educational level is one of the major factors associated with correct malaria knowledge, along with age and ethnicity. Therefore, based on these findings, targeted intervention and innovation should be planned by malaria programme managers to sustain malaria elimination in Malaysia.

Creatinine clearance in selection of living kidney donor among the Malaysian population: is it safe?

BackgroundAssessment of donor renal function is made by the measurement of Glomerular Filtration Rate (GFR). Exogenous markers are preferred over creatinine clearance and are widely used for measuring GFR. However, they are difficult to obtain, costly and laborious. This is a study to look into the safety and accuracy of creatinine clearance for renal assessment among the living kidney donors in the Malaysian population.MethodsThis is a retrospective, single-centre study comprising 105 living kidney donor candidates from the year 2007 to 2020. By comparing against 51-Chromium ethylenediamine-tetraacetic acid (51Cr-EDTA), we analysed creatinine clearance for correlation, bias, precision and accuracy.ResultsThe study group had a mean age of 45.68 ± 10.97 years with a mean serum creatinine of 64.43 ± 17.68 µmol/L and a urine volume of 2.06 ± 0.83 L. Mean measured GFR from 51Cr-EDTA was 124.37 ± 26.83 ml/min/1.73m2 whereas mean creatinine clearance was 132.35 ± 38.18 ml/min/1.73m2. Creatinine clearance overestimated 51Cr-EDTA significantly with a correlation coefficient of 0.48 (p < 0.001) and an accuracy of 78.10% and 64.0% within 30% and 20% respectively of 51Cr-EDTA.ConclusionCreatinine clearance is an acceptable and affordable alternative for donor renal assessment in the absence of exogenous markers with an emphasis on adequate urine collection followed by using measured GFR in selected cases.

Psychosocial risk factors and cognitive decline in people living with HIV: results from the Malaysian HIV and aging (MHIVA) study

ABSTRACT HIV-associated mortality has improved with the advent of antiretroviral therapy, yet neurocognitive decline persists. We assessed the association between psychosocial risk factors and cognitive function among Malaysian PLWH. Data of virally suppressed PLWH (n = 331) on stable ART, from the Malaysian HIV and Aging study was assessed. Psychosocial factors were assessed using the Lubben Social Network Scale-6 (social isolation) and Depression Anxiety Stress Scale-21 (DASS-21). The Montreal Cognitive Assessment (MoCA) with normative standards for the Malaysian population was used to determine cognitive function. Linear and logistic regression were used to assess the associations between cognition, and psychosocial risk factors. Median age of participants was 43.8 years (IQR 37.7–51.0). Participants were predominantly male (82.8%), with secondary education or higher (85.2%). Participants were on ART for 5.7 years (IQR 3.0–9.7), with a mean MoCA score of 24.6 (±3.7). Social isolation was found in 34.6% of participants, and severe depression, severe stress, and severe anxiety in 10.6%, 15.4%, and 6.0% respectively. After adjusting for demographic, clinical, and HIV parameters, MoCA scores were significantly associated with severe stress (β = −0.11, p = 0.02) and having marginal friendship ties (β = −0.13, p = 0.03). Social isolation and severe stress are associated with neurocognitive impairment in PLWH.

Smoking status and its relationship with depression among the elderly population in Malaysia: Findings from the National Health and Morbidity Survey 2018.

Literature exploring smoking status and its association with depression among the elderly population using nationwide data in Malaysia is limited. Hence, a nationwide survey to determine the prevalence of smoking and depression among the elderly (aged ≥60 years) population was undertaken. This secondary dataset analysis used data from the National Health and Morbidity Survey (NHMS) 2018. Data from 3914 participants were collected on elderly health in the Malaysian population. Sociodemographic characteristics were recorded. Smoking status was grouped as current smokers, former smokers, and non-smokers. A validated Malay language version of the Geriatric Depression Scale (M-GDS-14) was used to screen for depression among the elderly. There was a significant association between smoking status with location, gender, employment status, marital status, ethnicity, education level, income, and depression. Current smokers are significantly higher in rural than urban areas. Among depressed participants, 65.7%, 17.1% and 17.2% were non-smokers, former smokers and current smokers, respectively. Multiple logistic regression showed that single (unmarried/separated/ divorced/widowed) participants were more likely to be depressed compared to married participants (AOR=1.68; 95% CI: 1.16-2.43). Whilst unemployed participants were more likely to be depressed than those who were employed (AOR=1.72; 95% CI: 1.22-2.44). Other Bumiputras were more likely to have depression compared to Malay, Chinese and Indian participants. Participants without formal education were more likely to be depressed compared to those having tertiary education. These participants have a 2-fold increased risk of depression (AOR=2.13; 95% CI: 1.02-4.45). Participants whose monthly salaries were <2000 MYR (AOR=3.67; 95% CI: 1.84-7.31) and 1000-1999 MYR (AOR=2.71; 95% CI: 1.23-5.94) were more likely to have depression compared with those who had received ≥3000 MYR. Ever smokers were more likely to be depressed than non-smokers (AOR=1.68; 95% CI: 1.23-2.29). Elderly Malaysians are indeed at risk of developing depression particularly if they had ever smoked. Public health awareness and campaigning are pertinent to disseminate these outcomes in order to spread the awareness associated with smoking-related depression.

Acceptance and effectiveness of the Healthier Choice Logo (HCL) among food industries in Malaysia

Introduction: The Healthier Choice Logo (HCL) was introduced in 2017 by the Ministry of Health Malaysia. This paper analysed acceptance of HCL, effectiveness of HCL in encouraging healthier product reformulation, and factors affecting reformulation among food industries. Methods: An online self-administered questionnaire consisting of four sections utilising multiple choice and 5-point Likert scale questions was distributed to food industries in Malaysia. Sample size calculation yielded 100 respondents. Results: Food industries had a higher acceptance of the processes and requirements involved in HCL implementation. HCL was highly effective in encouraging product reformulation among food industries in Malaysia. Meeting consumer demand, improving brand image, public health, more awareness around nutrition labelling, logo and national nutrition target, more technical knowledge and budget were found to motivate healthier product reformulation. However, product suitability, consumer acceptability, difficulties maintaining taste and shelf life, and limited budget were the challenges faced in product reformulation. There was no correlation between HCL acceptance and factors encouraging or inhibiting reformulation. Conclusion: These findings are expected to help relevant authorities or stakeholders make changes, if necessary, towards processes and requirements involved in HCL application to ensure wider HCL implementation. Future research should identify the relationship between HCL implementation and public health improvement among the Malaysian population.

The Unmet Needs of Caregiving Skills, Support, Emotions, and Finances of Stroke Caregivers: A Multicenter Study.

​​​​​​Background Informal stroke caregivers in Malaysia play an important role in supporting stroke survivors following acute care. Nevertheless, there is a lack of available data to inform the sufficiency of help and resources available to address the needs of local stroke caregivers. This study aimed to determine the unmet needs in caregiving skills, support, emotions, and finances as well as the associated factors of stroke caregivers in Malaysia. Methodology This multicenter, cross-sectional study used a self-administered survey developed and validated for the Malaysian population. It was prepared in paper-based and web-based formats, and it was distributed via direct contact with the respondents, post, and email. Respondents were recruited from different sites in Malaysia. In this study, unmet needs were defined as "help that was needed more or was not provided to assist caregivers and address their specific needs." This article only presents the quantitative data of this study. Data were analyzed using descriptive analysis and logistic regression to determine factors associated with unmet needs. Results Almost all study respondents (91%) reported having unmet needs. Unmet needs ranged from 1 to 10, while the mean unmet needs was 5. The highest unmet need was related to financial support (72.5%), followed by support from professionals to address their own needs (59.2%), skills to care for stroke survivors, i.e., skills in caring for stroke survivors with their daily activities (57.9%), and skills in supporting stroke survivors to perform rehabilitation at home (53.1%). The lowest unmet need was related to support in transporting stroke survivors from place to place (45.3%). Additionally, this study did not identify an association between the reported unmet needs and gender, age, ethnicity, duration of caregiving, and site of participation. Conclusions This study reported a range of unmet needs perceived by stroke caregivers in Malaysia. Further research is warranted to understand the gaps in supporting local stroke caregivers to inform future post-stroke support and services in the country.

Social Support among Older Persons and Its Association with Smoking: Findings from the National Health and Morbidity Survey 2018.

Globally, the average age of the world's population of older people continues to rise and having a good social support network becomes increasingly relevant with the aging populace. Overall, in Malaysia, social support prevalence was low among older persons. This study was conducted to determine the association between social support and smoking status among the older Malaysian population. Data were obtained from the National Health and Morbidity (NHMS) 2018 survey on the health of older Malaysian adults and analyzed. This cross-sectional population-based study used a two-stage stratified random sampling design. Sociodemographic characteristics, smoking status, and social support data were collected from respondents aged 60 years and more. A validated Malay language interviewer-administered questionnaire of 11-items, the Duke Social Support Index, was utilized to assess the social support status. A multivariable logistic regression analysis was used to assess the association of social support and smoking status among the respondents. The prevalence of good social support was significantly higher among the 60-69 years old (73.1%) compared to the ≥80 years old respondents (50%). Multivariate logistic regression analysis showed that respondents aged ≥80 years old were 1.7 times more likely to have poor social support compared to those aged 60-69 years. Respondents with no formal education were 1.93 times more likely to have poor social support compared to respondents who had tertiary education. Respondents with an income of <MYR 1000 were 1.94 times more likely to have poor social support compared to respondents with an income of >MYR 3000. Former smokers had good social support compared to current smokers (73.6% vs. 78.7%). For current smokers, they had poor social support, which is almost 1.42 times higher than that for non-smokers. There was poor social support among older people who were current smokers, had an increased age, had no formal education and had a low income. The findings obtained from this study could assist policymakers to develop relevant strategies at the national level to enhance the social support status among older smokers and aid in their smoking cessation efforts.

Validating the Malaysian modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F): a cross-cultural adaptation

IntroductionThe Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) is a two-stage parent-reported tool for screening autism spectrum disorder (ASD). Early detection of ASD is highly associated with improved social communication and reduced restricted and repetitive behaviors associated with ASD. However, there is limited availability of ASD screening tools in Malaysia and there are no relevant validation studies published. The process of modifying a screening instrument to align with the cultural and linguistic characteristics of the target population is a crucial component in establishing the instrument's validity.MethodsTherefore, this study translates and culturally adapts the M-CHAT-R/F into Malay and verifies its psychometric properties among the Malaysian population. 500 Malaysian toddlers aged between 18 and 48 months were recruited from different settings. The parents of the toddlers were asked to complete the Malaysian M-CHAT-R/F. The reliability of the screening tool was verified using Cronbach's alpha.ResultsBy comparing the screening outcomes of the Malaysian M-CHAT-R/F and clinical evaluation results, the prevalence of ASD was determined as 6.6% in the sample. High values of sensitivity (96.6%) and specificity (93.2%) and a satisfactory positive predictive value (47.5%) supported the validity of the Malaysian M-CHAT-R/F. Furthermore, the receiver operating characteristic analysis yielded three as the optimal cut-off score of the Malaysian M-CHAT-R/F.DiscussionThese results suggest that the Malaysian M-CHAT-R/F is an effective screening tool reliable for use in clinical practice. Further investigation using a representative sample of the whole country is recommended given the high prevalence rate obtained in the current sample.

Measuring tooth size discrepancies using Bolton analysis: a comparative cross-sectional study among major ethnicity in Malaysia

BackgroundThe Bolton analysis is one of the commonly used tooth size analysis or diagnostic tools in deriving a treatment plan for orthodontic patients. Many studies have indicated and concluded that normal measurements for one group should not be considered normal for other ethnic groups. The aims and objectives of this study were to investigate the applicability of Bolton’s ratios in the orthodontic population of Malaysian main ethnics, Malay, Chinese, and Indians. Comparisons were made in terms of size and distribution of tooth size discrepancy in the Malaysian orthodontic population and the findings were converted in terms of millimeters.MethodsHundred fifty pre-orthodontic study casts comprised of 52 Malay, 54 Chinese, and 44 Indian patients were selected. Digital calipers (Fowler Pro-Max) linked to Hamilton Tooth Arch Software were used to measure the tooth width and ratios. Statistical analysis was carried out to test for gender differences (independent t-test), to identify the effects of malocclusion and ethnic groups (Two-way ANOVA), and to compare the means of the current study with Bolton’s standards (one sample t-test).ResultsThis study showed that there was no significant difference between the genders of the sample of each ethnicity. There was no correlation found between ethnic groups and malocclusion classes. There was a significant difference when comparing Bolton values with the Malay sample for both ratios. It was found that more Malay subjects presented with maxillary excess contrary to Chinese and Indians who presented more maxillary deficiency for the anterior and overall ratio.ConclusionThere was a significant difference found between the TSD of the three major ethnicities in Malaysia. The Bolton standards can be applied to Malaysian Chinese and Indians but not to Malays orthodontic populations for both anterior and overall ratios. Subsequently, a specific standard should be used for the Malays orthodontic population. It was found that more Malay subjects presented with maxillary excess contrary to Chinese and Indians who presented more maxillary deficiency for the anterior and overall ratio.

Factors Influencing TVET Choices among Secondary School Students in Kuching

TVET has not been well known among the Malaysian population. Participation in TVET has not yet been given a clear status. In Malaysia, TVET is currently not a popular option for higher education and is viewed negatively as it only serves dropouts. The majority of SPM graduates are still uncertain about which educational path they want to follow, and TVET is usually not their first choice. Given the recent surge in demand for skilled workers, this issue needs to be addressed. The aim of this study is therefore to investigate the perception of TVET among the genders and class streams of secondary school students. A quantitative descriptive study was conducted with 234 students from three different schools in the Kuching area who completed a questionnaire. The Statistical Package for Social Science (SPSS) was used to analyze the data. This finding implies that there is no statistically significant difference between male and female participants' overall impressions. As a result, the study indicates that there is insufficient data to establish the existence of a significant variation in overall perceptions across genders. According to the findings of the data analysis utilizing One-way ANOVA and post-hoc testing, there is no significant difference in overall perceptions amongst students from different class streams. To deepen students' interest in TVET, the government should continuously provide comprehensive information on TVET to students on a regular basis, helping them to make educated decisions regarding their tertiary education.

SOCIODEMOGRAPHIC FACTORS ASSOCIATED WITH CONSUMPTION AND EXPENDITURE ON VITAMIN SUPPLEMENTS AMONG YOUTH IN MALAYSIA

Consumption of vitamins can lower the risks of various noncommunicable diseases (NCDs). Nevertheless, only a small proportionof adults in Malaysia consume vitamin supplements, and this may contribute to the increase in the prevalence of NCDs across the country. Despite the high prevalence of NCDs and low consumption of vitamin supplements, there is insufficient research that assess individuals’ use and expenditure on vitamin supplements. The objective of the present study is to examine the effects of sociodemographic factors on vitamin supplement spending among youth in Malaysia. The primary survey data were collected using convenient sampling (n = 482). In addition to one-way analysis of variance (ANOVA), a lognormal hurdle model was used to explore factors affecting consumption and amount decisions of vitamin supplements. Results of the present study showed that higher-income and less-educated individuals spent more on vitamin supplements compared to lower-income and welleducated individuals. Expenditure on vitamin supplements was higher among Chinese than Malays. Being male and married increased the likelihood of consuming vitamin supplements. In conclusion, sociodemographic factors play an important role in determining consumption and expenditure on vitamin supplements. With the present study’s findings, policymakers could better understand which cohorts of the Malaysian population to be focused on. Therefore, a more effective policy directed towards promoting the use of vitamin supplements can be formulated.

Evaluation of 2 Artificial Intelligence Software for Chest X-Ray Screening and Pulmonary Tuberculosis Diagnosis: Protocol for a Retrospective Case-Control Study.

According to the World Bank, Malaysia reported an estimated 97 tuberculosis cases per 100,000 people in 2021. Chest x-ray (CXR) remains the best conventional method for the early detection of pulmonary tuberculosis (PTB) infection. The intervention of artificial intelligence (AI) in PTB diagnosis could efficiently aid human interpreters and reduce health professionals' work burden. To date, no AI studies have been evaluated in Malaysia. This study aims to evaluate the performance of Putralytica and Qure.ai software for CXR screening and PTB diagnosis among the Malaysian population. We will conduct a retrospective case-control study at the Respiratory Medicine Institute, National Cancer Institute, and Sungai Buloh Health Clinic. A total of 1500 CXR images of patients who completed treatments or check-ups will be selected and categorized into three groups: (1) abnormal PTB cases, (2) abnormal non-PTB cases, and (3) normal cases. These CXR images, along with their clinical findings, will be the reference standard in this study. All patient data, including sociodemographic characteristics and clinical history, will be collected prior to screening via Putralytica and Qure.ai software and readers' interpretation, which are the index tests for this study. Interpretation from all 3 index tests will be compared with the reference standard, and significant statistical analysis will be computed. Data collection is expected to commence in August 2023. It is anticipated that 1 year will be needed to conduct the study. This study will measure the accuracy of Putralytica and Qure.ai software and whether their findings will concur with readers' interpretation and the reference standard, thus providing evidence toward the effectiveness of implementing AI in the medical setting. PRR1-10.2196/36121.

Estimating Disability-Free Life Expectancy of Malaysian Population Using the Sullivan's Approach

As we age, the chances of becoming disabled tend to increase due to an accumulation of health risks from a lifetime of illness, injury, and disability. This research examines the increasing life expectancy of the Malaysian population in relation to their disability status from 2015 to 2019. Disability-free life expectancy (DFLE) was computed using the Sullivan's approach; subsequently, compression or expansion of disability over the two observation years, 2015 and 2019, were analysed. Malaysian disability prevalence rates by age groups for 2015 and 2019 were used to execute this research. In addition, the respective mortality rates by age were gathered from the Department of Statistics of Malaysia. Results showed that, as life expectancy increases, the number of years lived without a disability would rise significantly while the anticipated number of years with a disability will be concurrently declining, suggesting evidence of disability compression. It was also observed that the median age at which the number of years spent with a disability higher than without a disability was 55 in 2015, then delayed to 67.5 in 2019. This study informs medical practitioners and health policymakers about the average lifespan of Malaysians without disabilities, which can indicate the population's general health status.