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P23 The health of malaysia’s adolescents: findings from the global burden of disease 2017 study
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  1. S Abdul-Razak1,
  2. SM Sawyer2,3,4,
  3. GC Patton2,3,4,
  4. K Cini2,
  5. NA Ahmad5,
  6. AH Mokdad6,
  7. PS Azzopardi2,3,7
  1. 1Department of Primary Care Medicine, Universiti Teknologi MARA, Selangor, Malaysia
  2. 2Centre for Adolescent Health, Royal Children’s Hospital and Murdoch Children’s Research Institute, Parkville, Victoria, Australia
  3. 3Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
  4. 4Nossal Institute,School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
  5. 5Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
  6. 6Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
  7. 7Burnet Institute, Melbourne, Australia

Abstract

Aim The epidemiological transition has resulted in a large population of adolescents in Malaysia, whose health burden is poorly described. We set out to provide a comprehensive profile of health in Malaysian adolescents to illustrate important targets for health actions.

Methods A conceptual framework for reporting health and wellbeing of Malaysian adolescents was defined to measure health outcomes, health risks and sociocultural determinants. Data from the Global Burden of Disease 2017 study were used to analyse mortality (all-cause and cause-specific mortality), morbidity, total disease burden and selected health risks and determinants for 10-24-year-old Malaysians, by three age groups (10–14, 15–19 and 20–24 years) and sex, from 1990 to 2017.

Results While the total disease burden decreased, most of this decrease was due to mortality, with morbidity mostly unchanged for all age groups and sexes between 1990 and 2017. Most of the reductions in disability-adjusted life years (DALYs) appear driven by a reduction of mortality from vaccine preventable diseases and maternal causes, across all age groups. Communicable diseases remain most prevalent in the 10–14-year-olds and some causes (e.g. diarrheal diseases, dietary iron deficiency) have increased by 2017. Morbidity from non-communicable diseases (NCDs) continued to be high in 2017. By 2017, mental disorders (e.g. anxiety, depression, conduct disorders) and chronic physical disorders (e.g. migraine, low back pain) were important contributors of morbidity for all adolescents. Motor-vehicle accidents were the principal cause of death in 15–19 and 20–24-year-olds of both sexes, while drowning and lower respiratory infections were the leading causes of death in 10–14-year-old males and females, respectively. The prevalence of male tobacco smoking had changed little across all groups, highest for males aged 20-24 years at 49.4% in 1990 and 44.4% in 2017. In contrast, rates of overweight and obesity had tripled in females and quintupled in males. Rates of youth not in education, employment and training rates had decreased, while adolescent fertility rate has halved from 1990.

Conclusion These data highlight that adolescent specific interventions are inadequate and health actions are required to address the disease burden from NCDs, injuries, some communicable diseases and obesity, which in addition to the health sector, will require multisector actions.

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