Browsing by Author "LeeAnn Tan"
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- PublicationBeing Bullied Is Associated With Depression Among Malaysian Adolescents: Findings From a Cross-Sectional Study in Malaysia(2019)
;Mohamad Aznuddin Abd Razak ;Noor Ani Ahmad ;Fazly Azry Abd Aziz ;Rasidah Jamaluddin ;Sherina Mohd Sidik ;S. Maria Awaluddin ;Nurashikin Ibrahim ;LeeAnn TanRajini SooryanarayanaLimited evidence on the association of being bullied with depression among adolescents was found in Malaysia. This study aimed to determine the association of being bullied and depression among Malaysian school-going adolescents. Data from the National Health and Morbidity Survey 2017, a cross-sectional study conducted from March to May 2017, was analyzed using descriptive and multiple logistic regression analysis. A validated tool, the Depression, Anxiety, and Stress Scale-21 was used to categorize those with moderate or higher levels of depressive symptoms as having depression. A total of 27 399 school-going adolescents participated and 18.3% were found depressed. Adolescents of Indian ethnicity (adjusted odds ratio [aOR] = 2.02, P < .001), those with parents living apart (aOR = 1.41, P < .001), and those who were being bullied (aOR = 2.98, P < .001) were more likely to have depression. This study demonstrated the association between being bullied and having depression. Comprehensive preventive strategies should be implemented taking into consideration the findings from this study. - PublicationBody Weight, Body Weight Perception, and Bullying Among Adolescents in Malaysia(2019)
;Shubash Shander Ganapathy ;LeeAnn Tan ;Rajini Sooryanarayana ;Mohd Hazrin Hashim ;Thamil Arasu Saminathan ;Fazila Haryati Ahmad ;Ruhaya SallehNur Shahida Abdul AzizBody weight is a factor, with body weight perception a mediator, toward being a victim of bullying. This study aimed to explore the association between body weight, body weight perception, and bullying among students 13 to 17 years of age in Malaysia. Data were collected using a self-administered questionnaire. A 2-stage stratified cluster sampling design was used, and 212 schools across Malaysia were selected for this survey. Body weight was measured and body weight perception was the student’s reflection of their body weight. The prevalence of being bullied among adolescents in Malaysia was 16.2%. Being too thin or being obese increased the probability of being bullied. Students with a normal body mass index, but with a misperception of their body weight, also had increased odds of being bullied. Obesity prevention, together with instilling positive body weight perception, should be part of all programs directed toward tackling the problem of bullying. - PublicationBullying Victimization Among School-Going Adolescents in Malaysia: Prevalence and Associated Factors(2019)
;LeeAnn Tan ;Shubash Shander Ganapathy ;Rajini Sooryanarayana ;Mohd Hazrin Hasim ;Thamil Arasu Saminathan ;Mohamad Fuad Mohamad Anuar ;Fazila Haryati Ahmad ;Mohamad Aznuddin Abd RazakAzriman RosmanThis study aimed to assess the prevalence and factors associated with bullying victimization from a nationwide school-based survey among 27 458 students aged 13 to 17 years. The overall prevalence of having been bullied in the past 30 days was 16.2%; this decreased with age. Multivariate logistic regression analysis revealed that factors most strongly associated with bullying victimization were exposure to physical attacks (adjusted odds ratio [aOR] = 2.46, 95% confidence interval [CI] = 2.17-2.79), illicit drug use (aOR = 2.44, 95% CI = 1.78-3.34), involvement in physical fights (aOR = 1.97, 95% CI = 1.74-2.23), being younger than 14 years (aOR =1.95, 95% CI = 1.59-2.38), and having ever attempted suicide (aOR = 1.83, 95% CI = 1.51-2.21). Other significantly associated factors include loneliness, truancy, making suicidal plans, and symptoms of depression, anxiety, and stress. Exposure to bullying victimization can result in negative lifelong sequelae and important associated factors should be considered in planning effective school-based anti-bullying interventions. - PublicationEstimating the COVID-19 mortality burden over two full years of the pandemic in Malaysia(2022)
;LeeAnn Tan ;Shubash Shander Ganapathy ;Yee Mang Chan ;Nazirah Alias ;Nur Hamizah Nasaruddin ;Wan-Fei KhawAzahadi OmarMalaysia reported its first known local transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on 5 February 2020.1 On 17 March 2020, the first two deaths from coronavirus disease 2019 (COVID-19) in the country occurred—just a week after the World Health Organization (WHO) formally declared the growing outbreak a pandemic. Two years into the current pandemic, there have been over 32,000 deaths linked to COVID-19 in Malaysia over three major epidemic waves and a cumulative case count of over three million, making it one of the most affected countries in the Western Pacific region. Absolute death counts are often the metric of choice in official reports (and in accompanying graphics—often in large, bold numbers—circulated through social media or chat groups to be fixated upon by the populace) summaris ing the latest COVID-19 statistics. Burden of disease approaches, such as measuring years of life lost (YLL) owing to premature death from a disease, offer a more appropriate metric than number of deaths for measuring the mortality burden of a disease on a population and sub-populations by recognising that deaths at youn ger ages have a greater impact on population health. This study aims to estimate the burden of mortality from COVID-19 by calculating YLL to COVID-19 over two full years of the pandemic in Malaysia, to compare YLL rates across different states, and to compare the impact of mortality directly attributable to COVID-19 relative to deaths from other leading causes of disease and injury in the country in pre-pandemic times. - PublicationMalaysian burden of disease: years of life lost due to premature deaths(2023)
;Wan-Fei Khaw ;Yee Mang Chan ;Nur Hamizah Nasaruddin ;Nazirah Alias ;LeeAnn TanShubash Shander GanapathyBackground: In Malaysia, the previous mortality burden has been a significant concern, particularly due to the high prevalence of noncommunicable diseases (NCDs) as the leading cause of death. Estimates of mortality are key indicators for monitoring population health and determining priorities in health policies and health planning. The aim of this study was to estimate the disease burden attributed to 113 major diseases and injuries in Malaysia in 2018 using years of life lost (YLL) method. Methods: This study included all deaths that occurred in Malaysia in 2018. The YLL was derived by adding the number of deaths from 113 specific diseases and multiplying it by the remaining life expectancy for that age and sex group. Data on life expectancy and mortality were collected from the Department of Statistics Malaysia. Results: In 2018, there were 3.5 million YLL in Malaysia. Group II (NCDs) caused 72.2% of total YLL. Ischaemic heart disease was the leading cause of premature mortality among Malaysians (17.7%), followed by lower respiratory infections (9.7%), road traffic injuries (8.7%), cerebrovascular disease (stroke) (8.0%), and diabetes mellitus (3.9%). Conclusions: NCDs are a significant health concern in Malaysia and are the primary contributor to the overall burden of disease. These results are important in guiding the national health systems on how to design and implement effective interventions for NCDs, as well as how to prioritise and allocate healthcare resources. Key strategies to consider include implementing health promotion campaigns, adopting integrated care models, and implementing policy and regulatory measures. These approaches aim to enhance health outcomes and the managements of NCDs in Malaysia. - PublicationPrevalence and Factors Associated With Physical Abuse at Home Among School-Going Adolescents in Malaysia: A Population-Based Nationwide Study(2019)
;Thamil Arasu Saminathan ;Shubash Shander Ganapathy ;Rajini Sooryanarayana ;Mohd Hazrin bin Hasim ;Mohd Fuad Mohd Anuar ;Fazila Haryati Ahmad ;LeeAnn Tan ;S. Maria Awaluddin ;Tahir ArisAzriman RosmanWe assessed the current situation of physical abuse among adolescents at home in Malaysia. A total of 27 497 school-going adolescents answered a self-administered questionnaire during the Malaysian National Health and Morbidity Survey 2017. A complex sampling analysis was applied to identify factors associated with physical abuse among adolescents using multivariate logistic regression analysis. The prevalence of physical abuse at home among students was 11.8%. Our result shows that adolescents aged 13 years had significantly higher odds of such abuse, with odds decreasing as the adolescents age. Girls and adolescents from Indian ethnicity (minority ethnic group) had higher odds of such abuse. Other associated factors were mental health problems, substance abuse, and problems at school. Physical abuse among adolescents at home should be countered with appropriate measures. - PublicationPrevalence study of epilepsy in Malaysia(Elsevier, 2021-02)
;Si-Lei Fong ;Kheng-Seang Lim ;LeeAnn Tan ;Nabilah Hanis Zainuddin ;Jun-Hui Ho ;Zhi-Jien Chia ;Wan-Yuen Choo ;Santhi Datuk Puvanarajah ;Suganthi Chinnasami ;Sow-Kuan Tee ;Azman Ali Raymond ;Wan-Chung LawChong-Tin TanIntroduction: The lifetime prevalence of epilepsy varies greatly from 1.5–14.0 per 1000 persons among the Asian countries. We aim to study the prevalence of epilepsy in Malaysia to have a better insight into the burden of disease in the country. Methods: A population-based door-to-door survey was carried out throughout the country, using questionnaire for brief screening in ascertainment of epilepsy, using a questionnaire and its validated multilingual versions. Respondents who were screened positive underwent second-stage diagnostic phone interview by neurologists/ research assistants. Results: A total 16, 686 respondents participated in the survey and 646 (3.8 %) respondents were screened positive during the first stage interview. A total of 185 consented for second stage diagnostic interview and 118 (63.8 %) respondents were contacted successfully for the second stage diagnostic phone interview, of which 17 (14.4 %) respondents were diagnosed to have epilepsy. An additional 68 (57.6 %) respondents had febrile seizures only. After applying a weighting factor to each respondent to adjust for non-response and for the varying probabilities of selection, the adjusted lifetime epilepsy prevalence was 7.8 in 1000 population, and the adjusted prevalence for active epilepsy was 4.2 in 1000 population in Malaysia. Conclusion: The prevalence of lifetime epilepsy in Malaysia is 7.8 per 1000 persons. - PublicationSocio‑demographic factors and healthy lifestyle behaviours among Malaysian adults: National Health and Morbidity Survey 2019(Nature Portfolio, 2022-10-04)
;Wan-Fei Khaw ;Nur Hamizah Nasaruddin ;Nazirah Alias ;Yee Mang Chan ;LeeAnn Tan ;Siew Man Cheong ;Shubash Shander Ganapathy ;Muhammad Fadhli Mohd YusoffHeng Yaw YongThis study aimed to investigate the association between socio-demographic factors and designated healthy lifestyle behaviours in a nationally-representative sample of Malaysian adults aged 18 years and above. Secondary data involving 7388 participants aged 18–96 years from the National Health and Morbidity Survey 2019, a national cross-sectional survey, was used in this study. A healthy lifestyle score (0–5 points) was calculated based on five modifiable lifestyle factors: non-smoker, body mass index < 25 kg/m2, physically active, moderate (or less) alcohol intake, and daily consumption of ≥ 5 servings of fruits and vegetables. Associations between socio-demographic factors and healthy lifestyle behaviours were examined using multinomial logistic regression adjusted for sampling design. About 30.6% of the participants met at least four out of the five healthy lifestyle factors. In multinomial model, subjects who were female (aOR = 3.26, 95%CI = 2.58, 4.12), of Chinese (aOR = 2.31, 95%CI = 1.62, 3.30 or other ethnicity (aOR = 1.44, 95%CI = 1.05, 1.98), and aged 18–30 years (aOR = 1.74, 95% CI = 1.12, 2.71) showed significant association with achieving healthy lifestyle compared to male, Malay and ≥ 61 years old as reference categories. Our results indicated that gender, age and ethnicity associated with healthy lifestyle behaviours. Information on the influence of socio-demographic factors on the prevalence of healthy lifestyles will facilitate the development of effective intervention strategies to improve the adaptation of healthy lifestyle practices. - PublicationSuicide attempt among Malaysian school‑going adolescents: relationship with bullying(2023)
;Siaw Hun Liew ;Mohamad Aznuddin Abd Razak ;Mohd Shaiful Azlan Kassim ;Noor Ani AhmadLeeAnn TanBackground: According to World Health Organization (WHO), the fourth leading cause of death among adolescents aged 15 -19 years is suicide. The National Health and Morbidity Survey (NHMS) 2017 reported that suicidal attempts among school adolescents increased from 6.8%—6.9% as compared to NHMS 2012. Suicide attempts can cause significant negative impacts on health, social and economic status. Bullying is one of the factors for adolescent suicide attempts, and its relationship to suicidality in adolescents has been shown in numerous research. Objectives: This study examined the relationship between suicide attempts and bullying among school adolescents in Malaysia. Methods: Data from the Malaysia NHMS 2017, a nationwide study that adopted a two-stage cluster sampling design, were analysed. The survey used a self-administered questionnaire in bilingual language adapted from GSHS developed by WHO. Participants were secondary school students aged 13 -17 in all states. Descriptive and multiple logistic regression analyses were performed using IBM SPSS version 28. Results: A total of 27,497 school adolescents participated in the study. Results showed that 6.9% of school adolescents had attempted suicide. There was 16.2% of adolescents being bullied. Multiple logistic regression revealed that students who were bullied were more likely to have suicide attempts (aOR 4.827, 95% CI: 4.143, 5.624) P0.001. Discussion/conclusion: This study revealed that bullying is associated with suicide attempts among school adolescents in Malaysia. The respective authority should consider and plan effective measures to curb bullying among school adolescents. - PublicationThe burden of premature mortality among older adults: a population-based study in Malaysia(BMC, 2022)
;Yee Mang Chan ;Shubash Shander Ganapathy ;LeeAnn Tan ;Nazirah Alias ;Nur Hamizah NasaruddinWan-Fei KhawBackground: The populations of many countries—including Malaysia—are rapidly growing older, causing a shift in leading causes of disease and death. In such rapidly ageing populations, it is critical to monitor trends in burden of disease and health of older adults by identifying the leading causes of premature mortality and measuring years of life lost (YLL) to these. The objective of this study, therefore, is to describe the burden (quantified by YLL) associated with major causes of premature mortality among older adults in Malaysia in 2019. Methods: All deaths that occurred in older adults aged 60 and above in Malaysia in the year 2019 were included in this study. YLL was calculated by summing the number of deaths for the disease category at 5-year age intervals, multiplied by the remaining life expectancy for the specific age and sex group. Both life expectancy and mortality data were obtained from the Department of Statistics Malaysia. Results: In 2019, older adults accounted for 67.4% of total deaths in Malaysia (117,102 out of 173,746). The total number of YLL among older adults in Malaysia in 2019 was estimated at 1.36 million YLL, accounting for 39.6% of the total YLL (3.44 million) lost to all premature deaths in that year. The major causes of premature mortality among older adults were ischaemic heart disease (29.5%) followed by cerebrovascular disease (stroke) (20.8%), lower respiratory infections (15.9%), diabetes mellitus (8.1%) and trachea, bronchus and lung cancers (5.0%). Conclusions: Non-communicable diseases (NCD) remained the largest contributor to premature mortality among older adults in Malaysia. Implementation of population-level NCD health promotion programmes, screening programmes among high-risk groups and holistic intervention programmes among populations living with NCD are critical in reducing the overall burden of premature mortality - PublicationWhat's on YouTube? A Case Study on Food and Beverage Advertising in Videos Targeted at Children on Social Media(2018)
;LeeAnn Tan ;See Hoe Ng ;Azahadi OmarTilakavati KarupaiahBackground: Unhealthy food marketing to children is a key risk factor for childhood obesity. Online video platforms have surpassed television as the primary choice for screen viewing among children but the extent of food marketing through such media is relatively unknown. We aimed to examine food and beverage advertisements (ads) encountered in YouTube videos targeting children in Malaysia. Methods: The social media analytics site SocialBlade.com was used to identify the most popular YouTube videos (n = 250) targeting children. Ads encountered while viewing these videos were recorded and analyzed for type of product promoted and ad format (video vs. overlay). Food and beverage ads were further coded based on food category and persuasive marketing techniques used. Results: In total 187 ads were encountered in sampled videos. Food and beverage ads were the most common at 38% (n=71), among which 56.3% (n = 40) promoted noncore foods. Ads for noncore foods were more commonly delivered as video rather than overlay ads. Among ads promoting noncore foods, the most commonly employed persuasive marketing techniques found were taste appeal (42.3%), uniqueness/novelty (32.4%), the use of animation (22.5%), fun appeal (22.5%), use of promotional characters (15.5%), price (12.7%), and health and nutrition benefits (8.5%). Conclusions: Similar to television, unhealthy food ads predominate in content aimed toward children on YouTube. Policies regulating food marketing to children need to be extended to cover online content in line with a rapidly-evolving digital media environment. Service providers of social media can play a part in limiting unhealthy food advertising to children.