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.

Aim: This study aimed to assess the relationship between functional limitations and depression among community‐dwelling older adults in Malaysia. Methods: Data from a nation‐wide community‐based cross‐sectional study were analyzed. This study was conducted using a two‐stage stratified random sampling design. In total, 3772 older adults aged ≥60 years responded to the survey. Depression was identified using a validated Malay version of the Geriatric Depression Scale (M‐GDS‐14), with those scored ≥6 categorized as having depression. Functional limitations were assessed using both Barthel's Activities of Daily Living (ADL) and Lawton's Instrumental Activities of Daily Living (IADL). The relationship was determined by multivariate logistic regression, adjusted for other variables. Results: The prevalence of depression was 11.5% (95% confidence interval [CI] 9.4, 13.4). Multiple logistic regression analysis found that older adults with limitations in ADL were 2.6 times more likely of having depression (adjusted odds ratio [aOR] 2.58, 95% CI 2.01, 3.32), while those with limitations in IADL the risk of having depression was almost doubled (aOR 1.68, 95% CI: 1.32, 2.14). Other significant factors were incontinence (aOR 3.33, 95% CI: 2.33, 4.74), chronic medical illness (aOR 1.44, 95% CI: 1.15, 1.81), current smoker (aOR 4.19, 95% CI: 1.69, 10.39), poor social support (aOR 4.30, 95% CI: 2.98, 6.20), do not have partner, ethnic minorities and low individual monthly income. Conclusions: Older adults with functional limitation in both basic ADL and complex IADL are independently at higher risk of having depression. Geriatr Gerontol Int 2020; 20: 21–25.

Background: Iodine deficiency disorder (IDD) is a public health issue in Sarawak. This study aimed to determine the present status of IDD among first trimester pregnant women in Sarawak after a decade of implementation of USI. Materials and Methods: A cross-sectional study of IDD involved 30 Maternal and Child Health Clinics throughout Sarawak with 750 pregnant women in the selected clinics were randomly selected via systematic sampling. Socio-demographic data, urinary iodine sample, thyroid size examination, and household salt were also collected. Further associations and odds were analysed using Krusskal-Wallis, Chi square and Logistic regression. Result: The prevalence of goiter rate (TGR) was found to be 1.0% (n=10). The median urinary iodine concentration (UIC) for Sarawak was 123.9μg/L (IQR 56.5-192.1μg/L) which indicates an iodine deficiency. Median UIC for both Sri Aman and Mukah had achieved adequacy of iodine intake which were 150.7 (IQR 128.2-235.8) and 170.2 (IQR 119.1-264.7) respectively. Sarawak divisions and ethnicity were found significant association with UIC. Conclusion: USI programme should be continue as has improved IDD in Sarawak despite majority of pregnant women in Sarawak still having iodine insufficiency. Programme manager should anticipate to location who has UIC lower than <100 μg/L.

Introduction: Iodine deficiency disorders (IDD) among Sarawakian school children has been highlighted as substantial public health problem. It has mandated universal salt iodization (USI) implemention in Sarawak started since 2008. This paper describes the approach in methodology of Sarawak IDD Survey 2018 which aimed to determine the current status of IDD among school children in Sarawak after 10 years of USI implementation. Method: The IDD survey was conducted between July and September 2018 involving all 12 divisions in Sarawak. 30 schools were selected via multistage proportionate-to-population size sampling technique and 1200 school children were randomly selected via systematic sampling. Results: All selected schools participated in the survey, which resulted in a 100% school’s response rate. A total of 988 school children participated in the survey, with overall response rates of 82.3%. Conclusion: The present study findings will highlight the impact of mandatory USI towards the iodine level among school children in Sarawak.

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.

Background: Reliable national data on disability which is internationally comparable is needed in Malaysia. This study aims to examine the prevalence of disability among adults in Malaysia and its determinants, particularly the socioeconomic factors and comorbidities. Methods: This study was based on the disability module, which is part of the National Health and Morbidity Survey 2015. This survey was implemented using a multi-stage stratified sampling design. A locally validated Washington Group questionnaire was used to collect data on disability. Results: Based on the definition of having at least one domain scored "a lot of difficulty or unable to do at all" or at least “some difficulty” scored in two domains, the prevalence of disability among adults in Malaysia was 11.8% (95% CI: 11.15, 12.53). Logistic regression analysis performed showed that population at risk of having disability in Malaysia were those of older people, ethnic minority, low level of education, single, obese, physically inactive and having mental health problems. Among older people, disability was significantly higher among those with no formal education, having mental health problems and physically inactive. Conclusions: The prevalence of disability among adults in Malaysia is comparable to WHO estimates and most developing countries. Planning for healthcare services should consider at-risk population, particularly older people and those from disadvantaged background to ensure equity healthcare.

Aim: An aging population is a potential burden for unprepared developing countries. Malaysia is foreseen to be an aging country by 2035. Thus, this study aimed to determine the prevalence and factors associated with hearing disability among older persons in Malaysia. Methods: Data from a nationwide survey implemented using a stratified cluster sampling design were analyzed. This study was carried out through face‐to‐face interviews and guided questionnaires. The questions were based on the Washington Group of Disability (WG) questionnaires, which produce multiple disability identifiers. Hearing disability is defined as at least one domain or question out of four questions coded as “A lot of difficulty” or “Cannot hear at all”. Results: The prevalence of hearing disability among older persons aged ≥60 years was 6.4% (95% CI 5.0–8.3), whereas 1.5% (95% CI 0.90, 2.50) older persons were reported to be using a hearing aid. The determinants of hearing disability are being male (aOR 2.67, 95% CI 1.94–3.66), being unemployed (retired, homemaker, unemployed; aOR 1.86, 95% CI 1.86–4.14) and had no formal education (aOR 18.25, 95% CI 4.18–79.55). Conclusions: Promoting healthy aging is important and crucial for Malaysia, in preparation toward an aging nation, as it could reduce the country's financial burden in the long term. Health‐related agencies should promote health awareness and treatment centers in relation to hearing disability among older persons, as they should be educated and informed about healthcare choices availability, which is aligned with the Global Disability Action Plan 2014–2021. Geriatr Gerontol Int 2020; 20: 43–48.

Parental protective factors do play an important role in preventing Internet addiction. A self-administered questionnaire was used to measure health risk behaviors among Malaysian adolescents. The prevalence of Internet addiction was significantly higher among adolescents with perceived lack of parental supervision (30.1% [95% confidence interval (CI) = 28.7-31.4]) and lack of parental connectedness (30.1% [95% CI = 28.5-31.7]), compared with their counterparts. Adolescents who perceived a lack of parental supervision, respect for privacy, connectedness, and bonding were more likely to have Internet addiction: (adjusted odds ratio [aOR] = 1.39; 95% CI = 1.27-1.52), (aOR = 1.23; 95% CI = 1.16-1.31), (aOR = 1.09; 95% CI = 1.02-1.16), (aOR = 1.06; 95% CI = 1.00-1.12), respectively. Among girls, Internet addiction was associated with those who perceived lack in all 4 parental factors, while among boys, those who perceived lack of parental supervision and respect for privacy were more prone to Internet addiction.