KNOWLEDGE, ATTITUDE, AND PRACTICES OF NON-COMMUNICABLE DISEASES: COMPARISON BETWEEN ORANG ASLI AND MALAY FROM RURAL AREA IN NEGERI SEMBILAN, MALAYSIA: A COMPARATIVE STUDY
DOI:
https://doi.org/10.37268/mjphm/vol.20/no.2/art.411Keywords:
knowledge, attitude, practices, non-communicable diseases, malay, Orang AsliAbstract
The study evaluates the prevalence, knowledge, attitude, and practices of non-communicable diseases (NCDs) among adult Orang Asli and Malay ethnicity in Negeri Sembilan, Malaysia. This cross-sectional study involving 634 respondents aged 18 years and above of Orang Asli (51.3%) and Malays (48.7%) from the rural villages. Structured interview questionnaire for disease history and KAP level conducted. Weight, height, waist circumference, blood pressure, and blood glucose levels then measured. Prevalence of NCDs was higher among Malays compared to Orang Asli with hypertension (35.0% vs 14.8%), hypercholesterolemia (31.1% vs 5.2%), and diabetes mellitus (16.2% vs 4.3%), respectively. Malays also had a higher percentage of being abdominal obese (70.6% vs 59.7%) and increased blood pressure (54.4% vs 29.8%). Multivariate analysis indicates hypercholesterolemia [OR=6.035 (95%CI: 3.150,11.561)], abdominal obesity [aOR= 1.807 (95%CI: 1.065, 3.067)], and increased in blood pressure [aOR= 2.359 (95%C1: 1.619,3.437)] have a significant relation with Malay ethnicity. For Orang Asli, 51.7% had poor knowledge, 72.3% had a good attitude, and 16.0% had a good practice. Knowledge and attitude scores were significantly less among Orang Asli with no significant difference for practice compared to the Malays. The prevalence of NCDs among the Malays is alarmingly high, with an increasing trend among Orang Asli, which needs immediate attention. The NCDs and obesity were significant among Malays but also showed a worrying trend in the Orang Asli as the good practice on a healthy life-style was low in both ethnicities. Thus, proper education and promotion regarding NCDs needed for diseases screening and prevention.
References
World Health Organization. Noncommunicable diseases country profiles 2018. Geneva, Switzerland: World Health Organization 2018.
World Health Organization. Noncommunicable diseases: the slow‑motion disaster. Geneva, Switzerland: World Health Organization 2017.
Institute for Public Health (IPH). National Health and Morbidity Survey 2015 (NHMS) Vol. II: Non-Communicable Diseases, Risk Factors & Other Health Problems. Kuala Lumpur: Ministry of Health Malaysia 2015.
Phua KL. The health of Malaysia's "Orang Asli" peoples: A review of the scientific evidence on nutritional outcome, parasite infestations, and discussion on implications for clinical practice. Malaysian Journal of Public Health Medicine. 2015;15(1):83-90.
Adrian Jinam T, Elvira Phipps M, Indran M, Rani Kuppusamy U, Ameen Mahmood A, Hong LC, et al. An update of the general health status in the indigenous populations of Malaysia. Ethn Health. 2008;13(3):277-87.
Ali O, Ismail S, Sugathan S, Soe MM, Ahmed W, Hayati A, et al. Determination of metabolic syndrome (MetS) among transitional community-comparison between Orang Asli and Malay rural area in Perak. 7th RRPG International Conference and Field Study in Malaysia 2016; UTM Skudai, Johor Bahru, Malaysia. p. 429-33.
Ahmad W, Sugathan S, Ismail S, Soe MM, Ali O. Cardiovascular risk factors in rural Malays and Aborigines in Perak, Malaysia; an alarming situation. Medical Forum Monthly. 2018;29(12):24-8.
Loef M, Walach H. The combined effects of healthy lifestyle behaviors on all-cause mortality: A systematic review and meta-analysis. Prev Med. 2012;55(3):163-70.
Forouzanfar MH, Afshin A, Alexander LT, Anderson HR, Bhutta ZA, Biryukov S, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1659-724.
Abdul-Razak S, Daher AM, Ramli AS, Ariffin F, Mazapuspavina MY, Ambigga KS, et al. Prevalence, awareness, treatment, control and socio demographic determinants of hypertension in Malaysian adults. BMC Public Health. 2016;16(1):351.
Buang NFB, Rahman NAA, Haque M. Knowledge, attitude and practice regarding hypertension among residents in a housing area in Selangor, Malaysia. Med Pharm Rep. 2019;92(2):145-52.
Ithnin M, Nor NAUM, Juliana N, Effendy NM, Sahar MA, Abdullah KHA, et al. Knowledge, attitude, and practice on Non-Communicable Diseases (NCDs) among the adult population in the urban area of Negeri Sembilan, Malaysia. International Journal of Research in Pharmaceutical Sciences. 2018;9(SPL 2):88-94.
Ahmad B, Khalid B, Quek K, Zaini A, Phipps ME. Knowledge of diabetes and lifestyle behaviour amongst indigenous population in Peninsular Malaysia. Medical Journal of Malaysia. 2013;68(4):309.
World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ. 2001;79(4):373-4.
Lwanga SK, Lemeshow S. Sample size determination in health studies: a practical manual. Geneva: World Health Organization; 1991.
Kalton G. Systematic Sampling. In: N. Balakrishnan TC, B. Everitt, W. Piegorsch, F. Ruggeri and J.L. Teugels, editor. Wiley StatsRef: Statistics Reference Online. New Jersey: John Wiley & Sons, Ltd.; 2017. p. 1-6.
George D, Mallery M. Using SPSS for Windows step by step: a simple guide and reference. Boston, MA: Allyn & Bacon; 2003.
World Health Organization (WHO). Global recommendations on physical activity for health. Geneva, Switzerland: World Health Organization 2010.
Chan YY, Teh CH, Lim KK, Lim KH, Yeo PS, Kee CC, et al. Lifestyle, chronic diseases and self-rated health among Malaysian adults: results from the 2011 National Health and Morbidity Survey (NHMS). BMC Public Health. 2015;15(1):754.
World Health Organization, Western Pacific Regional Office, International Association for the Study of Obesity, International Obesity Task Force. The Asia-Pacific perspective: Redefining obesity and its treatment. Melbourne, Australia: Health Communications Australia 2000.
Janssen I, Katzmarzyk PT, Ross R. Body Mass Index, Waist Circumference, and Health Risk: Evidence in Support of Current National Institutes of Health Guidelines. Archives of Internal Medicine. 2002;162(18):2074-9.
Myers J. Exercise and Cardiovascular Health.Circulation. 2003;107(1):e2-e5.
Imai Y, Otsuka K, Kawano Y, Shimada K, Hayashi H, Tochikubo O, et al. Japanese Society of Hypertension (JSH) Guidelines for Self-Monitoring of Blood Pressure at Home. Hypertension Research. 2003;26(10):771-82.
Chan YH. Biostatistics 201: linear regression analysis. Singapore Medical Journal. 2004;45(2):55-61.
Thayer JD. Stepwise Regression as an Exploratory Data Analysis Procedure. Annual Meeting of the American Educational Research Association; 2002 1-5 April 2002; New Orleans, LA.
Suriah A, Zainorni M, Shafawi S, Suraya M, Zarina N, WA WZ, et al. Nutrient intake among elderly in southern Peninsular Malaysia. Malays J Nutr. 1996;2(1):11-9.
Tan K. Factors influencing physical inactivity among adults in Negeri Sembilan, Peninsular Malaysia. Med J Malays. 2019;74(5):389-93.
Seong AC, John CKM. A review of coronary artery disease research in Malaysia. Med J Malays 2016;71:42-57.
Burns-Cox C, Chong Y, Gillman R. Risk factors and the absence of coronary heart disease in aborigines in West Malaysia. British Heart Journal. 1972;34(9):953.
Ali O, Tan T, Sakinah O, Khalid B, Wu LL, Ng M. Prevalence of NIDDM and impaired glucose tolerance in aborigines and Malays in Malaysia and their relationship to sociodemographic, health, and nutritional factors. Diabetes Care. 1993;16(1):68-75.
Wong C, Faiz D, Safraa SD, Azim RRM, Zubaidah AS. Prevalence and Modifiable Risk Factors of Non-Communicable Diseases among Jakun Orang Asli at Tasik Chini, Pekan, Pahang. International Medical Journal of Malaysia. 2018;17(3):3-16.
Ali O, Shamsuddin Z, Khalid B. Socioeconomic, social behaviour and dietary patterns among Malaysian aborigines and rural native Malays. Med J Malays. 1991;46(3):222-9.
Lee LK, Paul CYC, Kam CW, Jagmohni K. Smoking among Secondary School Students in Negeri Sembilan, Malaysia. Asia Pac J Public Health. 2005;17(2):130-6.
Teh CH, Chan YY, Lim KH, Kee CC, Lim KK, Yeo PS, et al. Association of physical activity with blood pressure and blood glucose among Malaysian adults: a population-based study. BMC Public Health. 2015;15(1):1205.
Saimon R, Choo WY, Chang KH, Ng CJ, Bulgiba A. Physical Activity Among Adolescents in an East Malaysian Rural Indigenous Community:Exploring the Influence of Neighborhood Environmental Factors. Asia Pac J Public Health. 2015;27(8_suppl):33S-40S.
Yeates K, Lohfeld L, Sleeth J, Morales F, Rajkotia Y, Ogedegbe O. A global perspective on cardiovascular disease in vulnerable populations. Can J Cardiol. 2015;31(9):1081-93.
Ministry of Education. Malaysian Education Blueprint 2013–2025. Putrajaya, Malaysia: Ministry of Education 2013.
Haemamalar K, Zalilah MS, Neng Azhanie A. Nutritional Status of Orang Asli (Che Wong Tribe) Adults in Krau Wildlife Reserve, Pahang. Malays J Nutr. 2010;16(1):55-68.
Ahmad B, Khalid B, Quek K, Zaini A, Phipps ME. Knowledge of diabetes and lifestyle behaviour amongst indigenous population in Peninsular Malaysia. Med J Malays. 2013;68(4):309.
Nasr NA, Al-Mekhlafi HM, Ahmed A, Roslan MA, Bulgiba A. Towards an effective control programme of soil-transmitted helminth infections among Orang Asli in rural Malaysia. Part 2: Knowledge, attitude, and practices. Parasit Vectors. 2013;6(1):28.
Mustapha FI, Omar ZA, Mihat O, Md Noh K, Hassan N, Abu Bakar R, et al. Addressing non-communicable diseases in Malaysia: an integrative process of systems and community. BMC Public Health. 2014;14(2): S4.
Masron T, Masami F, Ismail N. Orang Asli in Peninsular Malaysia: population, spatial distribution and socio-economic condition. J Ritsumeikan Soc Sci Humanit. 2013;6:75-115.
Denscombe M. Communities of practice: A research paradigm for the mixed methods approach. J Mix Methods Res. 2008;2(3):270-83.
Yusof HM, Ching TS, Ibrahim R, Lola S. Anthropometric indices and life style practices of the indigenous Orang Asli adults in Lembah Belum, Grik of Peninsular Malaysia. Asia Pac J Clin Nutr. 2007;16(1):49-55.