Background: This study aimed to estimate the prevalence of cardiovascular risk factors and its clustering. The findings are to help shape the Malaysian future healthcare planning for cardiovascular disease prevention and management. Methods: Data from a nationally representative cross-sectional survey was used. The survey was conducted via a face-to-face interview using a standardised questionnaire. A total of 37,906 eligible participants aged 18 years and older was identified, of whom 34,505 (91%) participated. Focus was on hypertension, hyperglycaemia (diabetes and impaired fasting glucose), hypercholesterolaemia and central obesity. Results: Overall, 63% (95% confidence limits 62, 65%) of the participants had at least one cardiovascular risk factor, 33% (32, 35%) had two or more and 14% (12, 15%) had three risk factors or more. The prevalence of hypertension, hyperglycaemia, hypercholesterolaemia and central obesity were 38%, 15%, 24% and 37%, respectively. Women were more likely to have a higher number of cardiovascular risk factors for most age groups; adjusted odds ratios ranging from 1.1 (0.91, 1.32) to 1.26 (1.12, 1.43) for the presence of one risk factor and 1.07 (0.91, 1.32) to 2.00 (1.78, 2.25) for two or more risk factors. Conclusions: Cardiovascular risk-factor clustering provides a clear impression of the true burden of cardiovascular disease risk in the population. Women displayed higher prevalence and a younger age shift in clustering was seen. These findings signal the presence of a cardiovascular epidemic in an upcoming middle-income country and provide evidence that drastic measures have to be taken to safeguard the health of the nation.

Introduction: Men having sex with men (MSM) have been one of the key populations to HIV problem and the trend is increasing globally including Malaysia. In Kuala Lumpur, number of positive HIV cases are attributable to MSM. This study aimed to describe the prevalence of HIV among MSM in Kuala Lumpur and the associated risk factors. Methodology: It was a cross-sectional study where hundred men were recruited using the respondent driven sample (RDS) technique in Kuala Lumpur. Participants were interviewed face to face and were screened for HIV with a rapid test kit at the end of the session. Results: The HIV prevalence among MSM were 22% and predominant among 20-29 years old. Majority of them were employed (86.4%) and all of them have completed at least secondary school (50%) and tertiary education (50%). 72.7% of the HIV positive participants have adequate knowledge on HIV based on scores of UNGASS questions. Conclusion: HIV among MSM are relatively high among young age indicates an early onset of risk exposure. This vulnerable population should be targeted for focused intervention strategies and programmes to decrease the risk of HIV infections among the MSM.

Background: Recent increases in cardiovascular risk-factor prevalences have led to new national policy recommendations of universal screening for primary prevention of cardiovascular disease in Malaysia. This study assessed whether the current national policy recommendation of universal screening was optimal, by comparing the effectiveness and impact of various cardiovascular screening strategies. Methods: Data from a national population based survey of 24 270 participants aged 30 to 74 was used. Five screening strategies were modelled for the overall population and by gender; universal and targeted screening (four age cut-off points). Screening strategies were assessed based on the ability to detect high cardiovascular risk populations (effectiveness), incremental effectiveness, impact on cardiovascular event prevention and cost of screening. Results: 26.7% (95% confidence limits 25.7, 27.7) were at high cardiovascular risk, men 34.7% (33.6, 35.8) and women 18.9% (17.8, 20). Universal screening identified all those at high-risk and resulted in one high-risk individual detected for every 3.7 people screened, with an estimated cost of USD60. However, universal screening resulted in screening an additional 7169 persons, with an incremental cost of USD115,033 for detection of one additional high risk individual in comparison to targeted screening of those aged ≥35 years. The cost, incremental cost and impact of detection of high-risk individuals were more for women than men for all screening strategies. The impact of screening women aged ≥45 years was similar to universal screening in men. Conclusions: Targeted gender- and age-specific screening strategies would ensure more optimal utilisation of scarce resources compared to the current policy recommendations of universal screening.

Introduction: Malaysia participated in the second phase of the Global Adult Tobacco Survey (GATS) in 2011. GATS, a new component of the Global Tobacco Surveillance System, is a nationally representative household survey of adults 15 years old or above. The objectives of GATS Malaysia were to (i) systematically monitor tobacco use among adults and track key indicators of tobacco control and (ii) track the implementation of some of the Framework Convention of Tobacco Control (FCTC)-recommended demand related policies. Methods: GATS Malaysia 2011 was a nationwide cross-sectional survey using multi stage stratified sampling to select 5112 nationally representative households. One individual aged 15 years or older was randomly chosen from each selected household and interviewed using handheld device. GATS Core Questionnaire with optional questions was pre-tested and uploaded into handheld devices after repeated quality control processes. Data collectors were trained through a centralized training. Manuals and picture book were prepared to aid in the training of data collectors and during data collection. Field-level data were aggregated on a daily basis and analysed twice a week. Quality controls were instituted to ensure collection of high quality data. Sample weighting and analysis were conducted with the assistance of researchers from the Centers for Disease Control and Prevention, Atlanta, USA. Results: GATS Malaysia received a total response rate of 85.3% from 5112 adults surveyed. Majority of the respondents were 25-44 years old and Malays. Conclusions The robust methodology used in the GATS Malaysia provides national estimates for tobacco used classified by socio-demographic characteristics and reliable data on various dimensions of tobacco control.

This study was to determine the prevalence and socio-demographic associated factors for serious injury among adolescents in Malaysia. The study used data from the Malaysian Global School-based Health Survey which was conducted in 2012. Logistic regression analysis was used to establish associations. Of the 25,507 respondents, 34.9% (42.1% males and 27.8% females) reported having been in a serious injury. Compared to participants who were not bullied, those who reported being bullied were more likely to have sustained serious injury (aOR = 2.2; 95% CI [1.95 - 2.48]). Adolescents who were involved in physical fighting were 57.5% (aOR = 2.75; 95% CI [2.53 - 2.99]) and more likely to have sustained serious injury compared to those who were not involved in the fighting. Meanwhile, adolescents who used substances were 52.3% (aOR = 1.68 [1.52 - 1.85]) and more likely to have sustained serious injury compared to those who did not use substances. Serious injury is frequent among adolescents in Malaysia. Based on studies by Harel, suggestion where reduction of substance use and bullying may be assessed if they have an impact in reducing serious injury among adolescents. Furthermore, educational programmes that focus on the underlying causes and determinants of injury provide an effective and efficient method of injury prevention.

Dengue is a major vector-borne disease caused by any one of four closely related dengue viruses. The viruses are transmitted to humans by the bite of an infected mosquito (Aedes aegypti or Aedes albopictus). The study was conducted in the Seksyen 7, Shah Alam where there is a marked increase of dengue cases evidenced during the last few years. This study aimed to establish spatial density of dengue incidence in Seksyen 7, Shah Alam using Geographical Information System (GIS) and spatial statistical tools. Methodology: We analysed 23 ovitrap index and 2389 dengue cases from 2013 to 2014. Data were collected from Petaling District Health Office and Shah Alam City Council. Spatial statistical tools were used to show spatial correlation of dengue cases and kernel density was implemented to identify dengue hotspot localities. Results: The result showed that dengue cases were spatially random (p<0.001) by using spatial autocorrelation analysis. Average Nearest Neighbour analysis showed that dengue cases were highly clustered and occurred at an average distance of 219.2 meters. Location especially residential areas had been identified as hotspot by using kernel density estimation analysis. Discussion and Conclusion: Our results showed that GIS and spatial statistical tools could be an effective mean to establish spatial density of dengue. Mapping of dengue cases would serve as guidance for stakeholders to identify source of outbreaks. It will generate more hypotheses and further investigations. Understanding the spatial of Aedes index and its impact on human health, particularly outbreaks of dengue is important in controlling the transmissions of the disease.