BackgroundChildhood malnutrition is a multi-dimensional problem. An increase in household income is not sufficient to reduce childhood malnutrition if children are deprived of food security, education, access to water, sanitation and health services. The aim of this study is to identify the characteristics of malnourished children below five years of age and to ascertain the risk factors of childhood malnutrition in a state in Malaysia.MethodsA case control study was conducted in the maternal and child health clinics in five districts of Terengganu, Malaysia from April to August 2012. Case was a child with moderate to severe malnutrition with z-scores < −2SD from the median of WHO reference. Control was a child without malnutrition with z-scores between -2SD and +2SD and the age matched with case’s. Face to face interviews with the respective child’s mother and measurements of the respective child’s weight and height were carried out. Information on socio-economic characteristics, household food security status, child’s dietary intake, caregivers’ practices and resources were enquired. Univariate and multivariate logistic regression analyses were conducted. Crude odds ratio and adjusted odds ratio with 95% confidence interval were calculated.ResultsA total of 274 children with 137 cases and 137 controls were recruited. All respondents were Malays. Among the cases, a larger proportion of them was female and originated from low income families. After adjusting all confounders, childhood malnutrition was significantly associated with number of children (aOR: 5.86, 95% CI: 1.96, 17.55), child hunger (aOR: 16.38, 95% CI: 1.34,199.72), dietary energy intake (aOR: 0.99, 95% CI: 0.98, 0.99), protein intake (aOR: 1.06, 95% CI: 1.01, 1.12), vitamin A intake (aOR: 0.999, 95% CI: 0.997, 1.00), low birth weight (aOR: 6.83, 95% CI: 1.62, 28.89), frequent illness (aOR: 2.79, 95% CI: 1.06, 7.31), and history of worm infection (aOR: 3.48, 95% CI: 1.25, 9.70).ConclusionsLower socio-economic status, household food insecurity, and poor child caring practices were associated with childhood malnutrition. Besides implementation of programmes focusing on poverty reduction, community based nutrition and hygiene education with extensive family planning and de-worming programmes should be intensified to improve both mother and children’s nutritional status.

Background Apart from maximizing functional abilities and independence after stroke, improving overall health-related quality of life (HRQoL) should also become part of the stroke treatment and rehabilitation process goals. This study aimed to assess the HRQoL profiles and explore the dimension-specific associated factors of HRQoL among stroke survivors. Methods This was a cross-sectional study of stroke survivors attending post-stroke care clinics in three public hospitals in the states of Pahang and Terengganu, Malaysia. The HRQoL was assessed by EuroQol-5 dimension-5 levels. Data on socio-demographic, clinical profiles, malnutrition risk, and physical activity level were collected through an interviewer-administered survey. Descriptive analyses for HRQoL profiles and multiple logistic regression analyses for its associated factors were performed. Crude and adjusted odds ratios were reported. Results A total of 366 stroke survivors were recruited with a mean age of 59 ± 11 years. The most -commonly reported health problems were mobility (85%), followed by usual activities (82%), pain/discomfort (63%), anxiety/depression (51%) and self-care (41%). The mean of the EQ visual analogue scale and the median of the EQ5D summary index was reported at 60.3 ± 14.2 and 0.67 ± 0.37, respectively. Malnutrition risk (mobility, usual activities, and self-care), wheelchair users (self-care and usual activities), speech impairment (usual activities and pain/discomfort), number of stroke episodes (self-care and pain/discomfort), body mass index, physical activity level and types of strokes (usual activities), age and use of a proxy (anxiety/depression), working and smoking status (mobility), were factors associated with either single or multiple dimensions of HRQoL. Conclusion Routine malnutrition screening, tailored program for speech therapy, prevention of recurrent stroke, and physical activity promotion should be addressed and further reinforced in current rehabilitation interventions to improve the HRQoL among stroke survivors in Malaysia.

Background: Screening for sarcopenia in the stroke population is an emerging concept in research and clinical practice. Therefore, this cross-sectional study aimed to assess the prevalence of possible sarcopenia and its associated factors among older stroke survivors who visited the neurology and rehabilitation departments of three public hospitals in Malaysia. Methods: We acquired data on sociodemographic characteristics, clinical profiles, malnutrition risk, dietary intake, physical activity level, and health-related quality of life. Possible sarcopenia was diagnosed in individuals with decreased calf circumference and low handgrip strength, as proposed by the Asia Working Group for Sarcopenia (2019). Finally, we performed descriptive analysis and binary logistic regression. Results: Among 196 older adults with stroke (mean± standard deviation of age: 67.60 ± 5.70 years), 42.3% had possible sarcopenia, with a higher prevalence in the more advanced age group (≥70 years). In univariable analysis, possible sarcopenia was significantly associated with anthropometric indices, malnutrition risk, nutrient intake, physical activity level, and health-related quality of life. In multivariable analysis, body mass index (adjusted odds ratio [AOR]=0.57; 95% confidence interval [CI], 0.43–0.75) was the only factor associated with possible sarcopenia among individuals aged ≥70 years. Recurrent stroke (AOR=3.48; 95% CI, 1.02–11.92), body mass index (AOR=0.64; 95% CI, 0.54–0.76), and EQ-5D index (AOR=0.15; 95% CI, 0.03–0.78) were significantly associated with possible sarcopenia in the 60–69-year age group.Conclusion: The prevalence of possible sarcopenia among community-dwelling older stroke survivors was high. Therefore, we recommend routine screening for possible sarcopenia to ensure early nutritional and exercise intervention.

Background The present study examined the prevalence and predictors of malnutrition risk among post-stroke patients. Methods Post-stroke patients who attended the outpatient clinics in three hospitals of Peninsular Malaysia were enrolled in the study. The risk of malnutrition was assessed using the Malnutrition Risk Screening Tool-Hospital. Data including demographic characteristics, clinical profiles, dietary nutrients intake, body mass index (BMI) and hand grip strength were collected during the survey. The crude odds ratio (OR) and adjusted odds ratio (AOR) were reported for univariate and multivariate logistic regression analyses, respectively. Results Among 398 patients included in the study, 40% were classified as high-risk for malnutrition. In the multivariable logistic regression, tube feeding (AOR: 13.16, 95% confidence interval [CI]: 3.22–53.77), loss of appetite (AOR: 8.15, 95% CI: 4.71–14.12), unemployment (AOR: 4.26, 95% CI: 1.64–11.12), wheelchair-bound (AOR: 2.23, 95% CI: 1.22–4.09) and BMI (AOR: 0.87, 95% CI: 0.82–0.93) were found to be significant predictors of malnutrition risk among stroke patients. Conclusion The risk of malnutrition is highly prevalent among post-stroke patients. Routine nutritional screening, identification of risk factors, and continuous monitoring of dietary intake and nutritional status are highly recommended even after the stroke patient is discharged.

INTRODUCTION: Control of modifiable risk factors is important in recurrent stroke prevention strategies. This study aimed to determine the control of blood pressure and other cardiovascular risk profiles among poststroke patients. Factors associated with uncontrolled blood pressure were also determined. MATERIAL AND METHODS: A cross-sectional study was conducted in the outpatient clinics of three hospitals located in the East Coast region of Peninsular Malaysia from May to August 2019. Information on socio-demographic characteristics, clinical profiles, and lifestyle practices were acquired. Univariate and multivariate logistic regression analyses were carried out. Crude odds ratio and adjusted odds ratio (aOR) were reported. RESULTS: From a total of 398 stroke patients, majority of the respondents were elderly with first-ever stroke, ischaemic type, and duration of stroke less than 24 months. Uncontrolled blood pressure (52%), overweight and obesity (65%), abdominal obesity (54%), and low physical activity level (65%) were common among the patients. Patients with hypertension (aOR= 3.11, 95% CI: 1.38, 6.99), diabetes mellitus (aOR 1.57, 95% CI: 1.03, 2.38), not taking prescribed medication every day (aOR 2.28, 95% CI: 1.29, 4.01), overweight (aOR 1.75, 95% CI:1.02, 2.99), obesity (aOR 1.99, 95% CI: 1.12, 3.53), and low physical activity level (aOR 2.10, 95% CI: 1.35, 3.27) were at a higher risk of having uncontrolled blood pressure. CONCLUSION: Uncontrolled blood pressure and other major cardiovascular risk factors were highly prevalent among poststroke patients. Increased efforts must be made to optimise the risk profiles management of these high-risk patients to prevent recurrent vascular events in the future.