Search

ABSTRACT: Objective: This study aims to investigate the association between smoking and the severity of COVID-19 infection during the initial wave of this pandemic in Malaysia. Methods: This is a multi-center observational study using secondary hospital data collected retrospectively from February 1, 2020, until May 30, 2020. Clinical records of all real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 cases with smoking status, co-morbidities, clinical features, and disease management were retrieved. Severity was assessed by the presence of complications and outcomes of COVID-19 infection. Logistic regression was used to determine the association between COVID-19 disease severity and smoking status. Results: A total of 5,889 COVID-19 cases were included in the analysis. Ever smokers had a higher risk of having COVID-19 complications, such as acute respiratory distress syndrome (odds ratio [OR] 1.69; 95% confidence interval [CI] 1.09-2.55), renal injury (OR 1.55; 95% CI 1.10-2.14), and acute liver injury (OR 1.33; 95% CI 1.01-1.74), compared with never smokers. However, in terms of disease outcomes, there were no differences between the two groups. Conclusion: Although no significant association was found in terms of disease outcomes, smoking is associated with a higher risk of having complications owing to COVID-19 infection.

Objectives To determine the longitudinal impact of elder financial and psychological abuse on risk of death among older Malaysians.Design 7-year prospective cohort study. Baseline data were collected in late 2013 and respondents were followed up in June 2020.Setting Kuala Pilah, Negeri Sembilan, Malaysia.Participants 1927 community-dwelling older adults aged 60 or older randomly sampled from the national census. Individuals with severe cognitive impairment were excluded.Outcome measure Mortality data were provided by the Malaysian National Registration Department and linked to respondents’ national identification numbers. Kaplan-Meier curves and Cox regression were used to examine victims’ survival periods and the impact of abuse on risk of death.Results Overall, 450 respondents (23.4%) died after 7 years. Among financial and psychological abuse victims, death percentage was 25.8% compared with 23.3% among those who did not experience these types of abuse. Kaplan-Meier curves showed shorter survival among abuse victims, but Cox regression found no significant impact of financial and psychological abuse on mortality risk (HR 1.05, 95% CI 0.78 to 1.41). Among all the variables studied, only cognitive impairment led to higher mortality risk (HR 1.32, 95% CI 1.03 to 1.69).Conclusion Our findings contradict prior empirical studies that supported the link between elder abuse and neglect (EAN) and mortality, even though we focused on two abuse subtypes. Results in this study are more in line with the recently emerging evidence that showed no association between EAN and mortality.

Our study aims to describe and determine factors associated with hospitalization among victims of elder abuse and neglect (EAN) in rural Malaysia. A cross sectional study based on the baseline data of the Malaysian Elder Mistreatment Project (MAESTRO) collected from November 2013 until July 2014 involving 1927 older adults in Kuala Pilah, Negeri Sembilan was conducted. EAN was determined using the modified Conflict Tactics Scale (CTS) and hospitalization rates were determined based on self-report. The prevalence of overall EAN was 8.1% (95%CI 6.9-9.3). Among male respondents, 9.5% revealed history of abuse and among female respondents, 7.2% reported experiencing EAN. The annual hospitalization rates per 100 persons within the past one year among EAN victims and non-victims were 18 per 100 persons (SD = 46.1) and 15 per 100 persons (SD = 64.1) respectively. Among respondents with history of EAN, 16.0% (n = 21) had been hospitalized in the past 12 months while among respondents with no EAN experience, 10.2% (n = 153) were hospitalized. Multivariable analyses using Poisson regression did not show any significant association between EAN and hospitalization. This could be due to the complex interactions between medical and social circumstances that play a role in hospital admissions, factors affecting the health care system, and access to health care among EAN victims.

Background and challenges to implementation Base on the Malaysian National Health Morbidity Survey in 2011, 48.6% of smokers have made quit attempt in the past 12 months but only 32.4% visited health care provider (HCP). One of the main challenges of getting professional advice in quitting is due to limited cessation services within public clinics and hospital. To overcome this and in line with Article 14 WHO Framework Convention on Tobacco Control (FCTC), Malaysia has developed a holistic and structured program under Malaysia Quit or mQuit services. Intervention or response The mQuit services was inaugurated on 27 th November 2015 through public-private partnership with the objective to make smoking cessation services accessible throughout the public and private sectors. The services were further enhanced with a quitline counselling system and a website to promote and facilitate registration of smokers to cessation program through www.jomquit.moh.gov.my. Both mQuit providers in public and private sectors have to fulfil standard criteria set by the Ministry of Health before accreditation given and the list is made available in the jomquit website. To date, 160 private HCP and 764 government health clinics and hospitals have become mQuit providers. Results and lessons learnt The number of registered patients have increased from 7757 in 2015 to 10791 in 2016. Since services start in private sector, the total number registered with private mQuit providers has increased from 10 patients in January 2017 to total of 394 patients until June 2017. The total number of registration through jomquit website was 420 patients. The implementation of the mQuit encountered a few challenges at first. Challenges and recommendations are discussed with all partners and remedial measures were applied to improve the services. Conclusions and key recommendations The mQuit services has increased accessibility to smoking cessation services in Malaysia.

OBJECTIVES:This study aims to describe the prevalence and transitions of frailty among rural-community dwelling older adults in Malaysia and to analyse factors associated with different states of frailty transition. Frailty was conceptualized using modified Fried phenotype from the Cardiovascular Health Study. DESIGN:This is a prospective longitudinal study with 12-months follow up among older adults in Malaysia. SETTING:Kuala Pilah, a district in Negeri Sembilan, which is one of the fourteen states in Malaysia. PARTICIPANTS:2,324 community-dwelling older Malaysians aged 60 years and older. RESULTS:The overall prevalence of frailty in this study was 9.4% (95% CI 7.8-11.2). The prevalence increased at least three-fold with every 10 years of age. This increase was seen higher in women compared to men. Being frail was significantly associated with older age, women, and respondents with a higher number of chronic diseases, poor cognitive function and low socioeconomic status (p