Theses (MSc. Public Health)

Introduction: Insomnia is a sleep disorder that affects the ability to fall asleep, stay asleep, or achieve restorative sleep. The impact of insomnia can be addressed by various sleep habits. The objectives of this study were to analyze the prevalence and behavioral factors of insomnia and the association between sleep hygiene and insomnia. Methods: A cross-sectional study was carried out among 384 Taman Beringin, Jinjang Utara residents. There are around 8,000 flats and 2,000 terrace houses in Taman Beringin. The survey, comprising insomnia and sleep hygiene questionnaires, was administered to the participant to assess behavioral factors and their related associations with sleep hygiene and insomnia. Result: Among the respondents, the majority (44.0%) experienced no insomnia, with 39.6% falling into the “Subthreshold” category. “Moderate” insomnia affected 14.3% of respondents, indicating a significant impact on insomnia, while “Severe” insomnia was least prevalent at 2.1%. Conclusion: The study revealed a significant association between behavioral factors and sleep hygiene and insomnia. Further research is needed to identify other factors that could strengthen the study’s effectiveness. Keywords: Insomnia, sleep hygiene, prevalence, associations, behavioral factors.

Introduction: The high burden of paediatric pneumonia warrants investigation on its occurrence and risk factors, particularly among children aged five years old and below. Objectives: To determine the a) risk factors associated with paediatric pneumonia, b) occurrence of PCR positivity, c) sensitivity and specificity of pneumococcal urinary antigen test (UAT) in detecting pneumococcal pneumonia and d) colonisers among children aged five years and below in east-coast of Peninsular Malaysia. Methods: This case-control study was conducted over two years at the east-coast of Peninsular Malaysia. Cases were hospitalised children ≤5 years old with clinical and radiological diagnosis by sentinel site paediatrician while controls were children without any features suggestive of pneumonia. Nasopharyngeal swab for polymerase chain reaction (PCR) and urine samples for pneumococcal UAT were collected within 24 hours of admission. Results: Six hundred children, with mean age of 20.99 ± 15.35 months for cases and 21.57 ± 16.96 months for controls, were included in the study. Regression analysis revealed factors associated with pneumococcal pneumonia are children living in household of 3-5 occupants (OR, 1.821; 95%, CI 1.191-2.787, p=0.006), unknown history of hospitalisation (OR, 1.672; 95%, CI 1.034-2.703, p=0.036), and underaged children for vaccination up-to-age (UTA) (OR, 1.552; 95%, CI 1.013-2.378, p=0.044) were found to be significant factors among subjects. PCR testing revealed a positivity rate of 13.5% (n=81) among cases and 5.2% (n=31) among controls, accounting 18.7% (n=112) of all subjects. Additionally, UAT testing showed positivity rate of 8.7% (n=52) cases and 6.8% (n=41) controls, comprising 15.5% (n=93) of the subjects. The sensitivity and specificity of UAT were 38.4% and 89.8% respectively with positive predictive value (PPV) of 46.2% and negative predictive value (NPV) of 86.4%. UAT sensitivity and specificity among cases were 37% and 90% respectively while PPV of 57.7% and NPV of 79.4%. UAT sensitivity and specificity among controls were 41.9% and 89.6% respectively while PPV of 31.7% and NPV of 93.1%. Conclusion: Emphasise on risk factor prevention should be the preference over clinical management. Surveillance on local aetiology is essential. UAT was found to be an unsuitable rapid tool in diagnosing pneumococcal pneumonia nor detecting colonisers in paediatrics. Thus, research focus on higher valency vaccines production and invention of simpler, rapid, and non-invasive diagnostic method to reduce disease burden and improve disease prognosis.

Introduction : According to the World Health Organization(WHO), mental health issues are surging throughout the world with 13% increase, predominantly caused by demographic shifts. Migrant workers face a variety of vulnerabilities that increase their risk of poor mental health. The objective of this study is to determine the level of knowledge, help-seeking behaviour and stigma towards mental health among Myanmar migrant workers as well as the correlation between sociodemographic factors, previous mental health experience, social support and the level of mental health literacy. Methods : A cross-sectional study design will be employed for this research. A convenience sampling will be utilized on selected clusters of Myanmar migrant workers population within Klang Valley. Results : The study drew a total of 395 qualified participants. The majority of respondents were between the ages of 18 and 32, male, Buddhist who had completed secondary level of education with a monthly family income of Rm1000 to Rm3000. The overall mean (SD) mental health literacy score was low 94.43 (9.563) and substantially related to gender, income and visit to mental health practitioner (p>0.05). Multiple linear regression model demonstrated that education level and past experience in visiting mental health practitioner were associated with mental health literacy (p>0.05). Conclusion : Overall mental health literacy levels were low and varied across sociodemographic categories. However, it was observed that attitudes that promote the recognition or appropriate help-seeking behaviour was high while knowledge of self-treatment was low among the respondents. Thus, addressing mental health literacy factors is a step towards developing a vulnerable demographic group with appropriate MHL, allowing them to maintain and preserve a good state of mental wellness. Further study on mental health literacy and its correlation with mental health outcome among Myanmar migrant workers would be beneficial in order to gain a better understanding of psychological difficulties and their influence on overall health.

Background: The relationship between spirituality and stress has been documented in the literature. This study aimed to determine the relationship between spirituality and stress and other associated factors among non-governmental organizations in Malaysia. Method: A cross-sectional study was conducted of 241 personnel from non-governmental organizations registered with the National Coalition for Mental Wellbeing (NCMW). The participants, including NGO employees, completed a self-administered online questionnaire. The survey included questions about sociodemographic and job-related factors. Stress levels were evaluated using the Perceived Stress Scale 10 (PSS-10) Questionnaire. Together, spiritual well-being was evaluated through 10 items from the Existential Well-Being Scale (EWB) incorporated within the Spiritual Well-Being Scale (SWBS). Results: The study found that a majority of NGOs (68.9%) reported moderate stress, with 18.1% experiencing low stress and 13.2% facing high perceived stress. Significant predictors of stress included age (P = 0.007), spirituality (P = 0.000), income satisfaction (P = 0.048), job satisfaction (P = 0.005), marital status (P = 0.026), and living status (P = 0.010). Conclusion: Contributors to stress among NGOs include age, spirituality, income satisfaction, job satisfaction, marital status and living status. Higher spirituality, linked to a connection with a higher power, reduces stress. Further studies are required to explore spirituality's role and manifestation. Keywords: Spirituality, Stress, NGOs, Malaysia, Spiritual Well-Being Scale (SWBS), and Perceived Stress Scale (PSS).

Objectives: This dissertation studied the time trends and distribution of fatal and non-fatal childhood drowning in Malaysia by demographic and spatial factors between 2000 and 2022. The difference in annual incidence between 2000-2011 and 2012-2022 was also identified. Methods: The drowning data reported to the national Health Informatics Centre (HIC) for 18 years old and below, from hospitalised cases of child drowning incidents and drowning deaths, were analysed. Data from the Department of Statistics Malaysia (DOSM) were also retrieved. These data were then used to calculate annual incidence, annual rates of change in drowning, and case fatality rates. Also, binary logistic regression analyses identified the socio-demographic and spatial factors associated with drowning. The outcome or the dependent variables were fatal and non-fatal, while age, year, sex, race, and region acted as independent variables. Results: A total of 4,191 reports of childhood drowning incidents and 155 drowning fatalities were reported to HIC. Drowning incidence rate was higher in 2000-2011 (IR 21.83) than in 2012-2022 (IR 17.65). Drowning incidence were significantly higher among the aged 0-4 years, boys, Bumiputera, and children living in urban areas (p<0.001). In contrast, the case fatality rate was higher in 2012-2022 (CFR 4.88) than in 2000-2011 (CFR 2.75). Children aged 0-9 years (p<0.001), children living in the Klang Valley region (p=0.049), and urban areas (p=0.034) were significant in fatal drowning. The time trends analysis for annual rates of change increased by 0.0001 for drowning incidents and 0.0003 for drowning fatalities. The east coast region significantly demonstrates 2.19 times (95% CI 1.03-4.65) higher than other regions (p=0.0041). Conclusions: This study provided more detail analyses of available childhood drowning data. The null hypothesis was rejected as there was a difference of drowning incidents in 2000-2011 and 2012-2022. The findings also suggested that preventive measures should be targeted towards children aged 0-9 years, boys, and children living in urban areas.