Background: COVID-19 mortality is a public health issue in Malaysia and its contributing factors need to be addressed thoroughly. This study aimed to determine the risk factors for COVID-19 mortality in Besut region of Malaysia. Materials and Methods: A 1:5 case-control study between deceased and survived groups among COVID-19 patients was conducted in Besut district, Terengganu state from 1st October 2020 until 16th September 2021 based on retrospective record review. The inclusion criteria for cases were individuals with laboratory RT-PCR confirmed positive test for COVID-19 and died during COVID-19 care period. Descriptive statistics, simple and multiple logistic regression analyses were employed for statistical analysis. Result: There were 6464 COVID-19 cases in Besut district during the studied period. The proportion of COVID-19 mortality was 0.84%. Among the deceased group, majority of them were male (51.9%), symptomatic (87.0%), unvaccinated (94.4%); had COVID-19 of category 5 (31.5%) and comorbidity (81.5%). Multiple logistic regression revealed older age, stage 4 COVID-19, stage 5 COVID-19, symptomatic, cases with comorbidity and unvaccinated cases as the significant associated factors for COVID-19 mortality with adjusted odds ratio (AOR) of 1.07 (95%CI: 1.01, 1.10), p<0.001; AOR 92.61 (95%CI: 7.07, 1212.02), p=0.001; AOR 274.97 (95%CI: 25.27, 2991.74), p<0.001; AOR 8.83 (95%CI: 3.21, 24.28), p<0.001; AOR 46.72 (95%CI: 15.29, 142.70), p<0.001; and AOR 16.94 (95%CI: 6.34, 121.22), p=0.001, respectively. Conclusion: Advanced age, severe stages of COVID-19, symptomatic cases, cases with comorbidity and unvaccinated cases were the risk factors for COVID-19 mortality. Emphasis should be given to these factors to ensure timely control and treatment strategies.
Background: Malaysian National Health and Morbidity Survey 2019 illustrated the prevalence of current smoker was 21.3%. Out of current smokers, only about half of them made an attempt to quit smoking in the past 12 months and only 7.4% of the smokers had visited a healthcare provider for quit smoking advice. The “Quit Smoking Clinic” was established in Malaysia since 2000 to make smoking cessation service accessible for everyone. This study aims to determine the factors associated with successful quit smoking among smokers attending “Quit Smoking Clinic” in Besut District, Malaysia. Methods: A district-wide record review study using “Quit Smoking Clinic” record [BPKK/KBM(PKD)/3/2012 Amendment 2018] from seven health clinics was conducted. A logistic regression (LR) model was performed to assess the factors influencing successful quit smoking status. A success quit smoking status was defined as remaining abstinent from smoking behavior at six months of clinic follow-up. Result: A sample of 414 clients from seven health clinics in Besut were included, 14.3% of them had a success quit smoking status. In the final MLR model, factors influencing successful quit smoking were older age group 45 years old and above (Adj. OR 2.27; 95% CI: 1.22, 4.22, p-value=0.010), voluntary participation in the clinic (Adj. OR 1.86; 95% CI: 1.00, 3.45, p-value=0.049) and frequent visits to the clinic (Adj. OR 5.33; 95% CI: 2.88, 9.86, p-value<0.001). Conclusion: Recognition of these factors associated with the success of quit smoking status is beneficial to improve the service of “Quit Smoking Clinic” as well as to promote an accessible smoking cessation support for smokers in the district. Reinforcement of tobacco control policies in Malaysia is imperative to encourage more smokers to quit smoking in the country.
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