Association between Comorbidities and Selected Sociodemographic Factors with Complications of Diabetes: Results from the National Diabetic Registry Malaysia

Background: This study aims to determine the hazard ratio of having any complication from diabetes mellitus, and the associations between comorbidities and risk of having any complications from diabetes mellitus among diabetic patients who have attended government primary care clinics. Methods: Secondary data were retrieved from the Malaysian National Diabetic Registry which included all patients who received care. The data from the study on the socio-demographic, diabetes complications, clinical and treatment characteristics were analyzed using descriptive statistics. Cox regression was performed to estimate the hazard ratio for comorbidities, tobacco use, duration of diabetes and socio-demography characteristics upon time to diabetic complications. Results: Adjusted for other covariates, increase number of comorbidities contributed the highest hazard ratio risk: 1 comorbid (aHR: 2.47, 95% CI: 2.39, 2.55), 2 comorbidities (aHR: 4.34, 95% CI: 4.22, 4.47), 3 comorbidities (aHR: 6.56, 95% CI: 6.31, 6.81) and 4 comorbidities (aHR: 9.13, 95% CI: 8.20, 10.17). Other factors: age > 40 years (8%) Malays (27%) and smokers (10%) have hazard risks to develop diabetic complications. Conclusions: Increase in number of comorbidities will increase the risk of getting diabetes complications. Other factors such as age, gender, race, smoking status and duration of diabetes are also noted to contribute to increase risk for diabetes complications.

Health Facilities Affected by Flood Simulation to a District in Malaysia

Objective: The Ministry of Health Malaysia is developing a GIS database of health facilities in the country with the main aim to assist in the planning and development of the services, and in allocation of resources. Methodology: Apart from coordinates of the facilities, other digital information such as states and districts boundaries, main road networks and river were obtained from MacGDI, a centre responsible to manage geospatial data infrastructure in Malaysia. In assisting the Ministry of Health in its planning, one of the analyses that were conducted was a flood simulation analysis in a district in a coastal area of Peninsular Malaysia. This was done following a possibility that a tropical storm “Sonamu” would happen in that area. The objective was to identify health facilities that would be affected if a flood were to happen in the district and finally to assist the Ministry of Health in their emergency plan. Data on contour was obtain from a relevant government agency and was also mapped digitally. Results: The results were showing that with one metre depth of flood, more than half of the facilities would be affected and about two third of the facilities would be affected if the flood level rises to 2.5 metres. Conclusion: Application of GIS is very useful for the health sector in planning of facing an environmental related disaster.