Diabetes is a metabolic disorder, characterized by hyperglycemic state of the body. A silent killer, which can take the lives of victims if undiagnosed at the earliest stage. Prediabetes has become an important health concern across countries due to its huge potential for the development of diabetes and other complications. The objectives of this study were to determine the prevalence of prediabetes and diabetes and its associated factors among rural fishing communities in Penang, Malaysia. A cross-sectional study was conducted among fishing communities in Southwest District of Penang, Malaysia from August to November 2017. Blood sample (finger prick test) and physical examination were performed on sample of 168 participants consented in this study. Pre-validated Malay versions of International Physical Activity 7 (IPAQ-7) and Perceived Stress Scale (PSS) questionnaires were used to assess the level of physical activity and stress levels of the participants. Multinomial logistic regression models were fitted to identify factors associated with prediabetes and diabetes. The prevalence of diabetes and prediabetes were 19.6% (95% CI: 14.3, 26.4) and 10.12% (95% CI: 6.4, 15.7) respectively. The median physical activity (interquartile range) in MET-minutes per week for those with diabetes (1071.0 (2120.0)) and prediabetes (1314.0 (1710.0)) was generally lower as compared to non-diabetes. Majority reported moderate stress (57.3%) from PSS system. Abdominal obesity, family history of diabetes and being hypertensive were significant factors associated with diabetes; while older age, bigger waist circumference and self-perceived poor routine diet were factors associated with prediabetes. The screening for prediabetes in this population gives the opportunity to implement lifestyle interventions at the earliest possible, which could prevent the development of diabetes. The identification of diabetic individuals provides an opportunity to conduct health promotion and education to ensure good metabolic control and hence reduce the risks of complications.

Objective: Lifestyle-induced nasopharyngeal carcinoma is a serious but preventable risk factor. This study serves to develop and validate a questionnaire that aims to predict the health behavioural intention on smoking cessation in Sarawak, Malaysia using the Health Belief Model (HBM). Design: A cross-sectional study. Setting: Urban and suburban areas in Sarawak, Malaysia. Participants: The preliminary items of the instrument were developed after extensive literature review. The instrument was translated into the Malay language using the forward-backwards method before commencing with the content validity by a panel of 10 experts. Face validity was done both quantitatively and qualitatively by 10 smokers. The construct validity of the instrument was evaluated through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). A total of 100 smokers participated in phase 1 for EFA, while 171 smokers participated in phase 2 for CFA. Internal consistency was measured using Cronbach’s alpha coefficients to evaluate the reliability. Results: In the exploratory stage, the factor loading of each item remained within the acceptable threshold. The final revised CFA yielded appropriate fit of the seven-factor model with the following model fit indices: χ ² =641.705; df=500; p<0.001; comparative fit index=0.953; Tucker-Lewis Index=0.948; root mean square error of approximation=0.041. Satisfactory convergent validity and divergent validity were shown, with the exception of one pairwise construct. The internal reliability of these scales was above the desirable threshold, with Cronbach’s alpha coefficients ranging from 0.705 to 0.864 and 0.838 to 0.889 in phases 1 and 2, respectively. Conclusions: The study substantiated the instrument to be valid and reliable for predicting smokers’ health behavioural intention to reduce cancer risk. The instrument is made up of 34 items, categorised into two sections, six HBM constructs and health behavioural intention. The instrument can be utilised for other smoking cessation-related cancers in different at-risk populations.

Background Leptospirosis is a neglected zoonotic disease and often under-reported. Municipal waste collectors, engaging mainly migrant labour are at risk to leptospirosis due to their nature of work. The present study aimed to determine the knowledge, attitudes, and practices (KAP) of the multinational municipal waste collectors towards prevention of leptospirosis, and further identify factors associated with the KAP. Methods A cross-sectional study was conducted using face-to-face interview among 184 municipal waste collectors. They completed a questionnaire on sociodemographics and KAP towards leptospirosis. Multiple linear regression was performed to determine factors associated with KAP towards the leptospira infection. Results The majority of participants were Bangladeshi (75.0%) and Indonesian nationals (20.7%), with poor knowledge of leptospirosis (92.93%). The attitudes towards leptospirosis were moderate (59.78%) while preventive practices were good (74.46%). Indonesians had significantly better knowledge as compared to other nationals (p < 0.001) but had poor practices (p = 0.021). Workers with upper secondary school education had better attitudes (p = 0.026) and preventive practices scores (p = 0.045). Individual monthly income had inverse association with attitudes scores (p = 0.036). Conclusions Overall, the preventice practices among municipal waste workers was good due to relatively ethical work behaviours. However, they had poor knowledge on the cause, modes of transmission, symptoms and treatment of leptospirosis. The study suggests that targeted education to increase knowledge and systematic preventive measures to reduce contact with the infection are necessary for this occupation group.