Current Issue - 2006, Volume 1 Number 2 & 3


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A cross-sectional survey conducted in 2001 among 4500 adolescent secondary students from 14 schools in Negeri Sembilan, Malaysia, revealed several important health issues that deserve the attention of primary care doctors and health policy planners.

Reprints request: Dr Lee Lai Kah,


Lee LK, Chen PCY, Wong KC, Jagmohni K. Smoking among secondary school students in Negeri Sembilan, Malaysia. Asia Pac J Public Health. 2005;17(2):130 [PubMed]

The prevalence of smoking among the students was 14.0%.  About a third of the students (37.8%) started smoking at 13 to 14 years of age.  The prevalence of smoking among the male students was higher (26.6%) compared to the female students (3.1%).  Adolescent smoking was associated with (1) socio-demographic factors (age, ethnicity, rural/urban status); (2) environmental factors (parental smoking, staying with parents); (3) behavioural factors (playing truant and risk-taking behaviours such as physical fighting, drug use, alcohol use, sexual activity, lack of seatbelt use, riding with a drunk driver); (4) lifestyle behaviours (being on diet and lack of exercise); (5) personal factors (feeling sad and suicidal behaviours). 

Chen PCY, Lee LK, Wong KC, Jagmohni K. Factors relating to adolescents suicidal behavior: a cross-sectional Malaysian school survey. J Adolesc Health. 2005;37(4):337 [PubMed]

Seven percent of the adolescent students had seriously considered attempting suicide.  Among the adolescents, 4.6% of them had attempted suicide at least once during the 12 months preceding the survey.  The female adolescents were more likely to put their suicidal thought into suicidal action than male adolescents.  Malay and Indian are more likely than Chinese in the aspect of ‘felt sad and hopeless’.  However, Malay adolescents had the lowest rate in attempting suicide.  Based on multiple logistic regression, factors significantly related to the urban adolescents suicide behavior are ‘felt sad or hopeless’,  ‘number of days felt unsafe to go to school’, ‘riding with a driver who had been drinking alcohol’, ‘physical fight’, and ‘number of days absent from school’.  On the other hand, factors relating to the rural adolescent suicide behavior are ‘felt sad or hopeless’, ‘physical fight’, ‘physical fight resulting in injury’, and ‘drive a vehicle after drinking alcohol’.

Lee LK, Chen PCY, Lee KK, Jagmohni K. Premarital sexual intercourse among adolescents in Malaysia: a cross-sectional Malaysian school survey. Singapore Med J. 2006;47(6):476-81 [PubMed]

The study showed that 5.4% of the total sample reported to have ever had sexual intercourse.  The proportion among males students who had ever had sex was higher (8.3%) compared with females students (2.9%).  The mean age at first sexual intercourse was 15 years.  One percent of students reported that they had been pregnant or had made someone else pregnant.  Adolescent sexual intercourse was significantly associated with (1) socio-demographic factors (age, gender); (2) environmental factors (staying with parents); (3) substance use (alcohol use, cigarette smoking, drug use) even after adjustment for demographic factors.  The survey showed that 20.8% of respondents had ever taken alcohol, 14.0% had smoked cigarettes and 2.5% had tried marijuana, 1.2% had tried ecstasy pills, 2.6% had tried glue sniffing, 0.7% had tried heroin and 0.7% had taken intravenous drugs into the body. 

Lee LK, Chen PCY, Lee KK, Jagmohni K. Menstruation among adolescent girls in Malaysia: a cross-sectional Malaysian school survey. Singapore Med J. 2006;47(10):899-74 [PubMed]

A cross sectional descriptive study was carried out among 2411 secondary school adolescent females in Negeri Sembilan.  Abnormal cycle length (menstrual cycle longer than 35 days or cycle length between 14 to 20 days or irregular pattern) was common and affected 37.2% of them.  Majority (74.6%) experienced premenstrual syndrome and 69.4% had dysmenorrhoea.  About 18% reported excessive menstrual loss (use 2 pads at a time to prevent blood from soaking through or confirmed by doctor to be anaemic due to heavy menstrual flow).  Only 11.1% of schoolgirls seek medical consultation for their menstrual disorders.  Mothers remained the most important source of information (80%).  Menstrual disorders were significantly more common in female adolescents who smoke and have suicidal behaviours (p<0.05).  Absenteeism was more common in those with increasing severity of dysmenorrhoea.