{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:36:27Z","timestamp":1787506587194,"version":"build-2736575974"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"UKMMC Fundamental Research Fund","award":["FF-318-2011"],"award-info":[{"award-number":["FF-318-2011"]}]},{"DOI":"10.13039\/501100011693","name":"Centre for Research and Instrumentation Management","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011693","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Health Qual Life Outcomes"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study investigates the health-related quality of life (HRQOL) of female patients with congenital adrenal hyperplasia (CAH) in Malaysia. The objectives were to attain socio-demographic and medical data on these Malaysian females with CAH and establish their health-related quality of life (HRQOL) in comparison to age matched diabetic controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted over 6 months in the two main tertiary centres for CAH patients in Malaysia. Participants including 59 female-raised CAH patients (mean age\u00a0\u00b1\u00a0SD\u2009=\u200916.3\u00a0\u00b1\u00a04.2\u2009years, range 10\u201328\u2009years) compared to 57 age-matched female diabetic patients (mean age\u00a0\u00b1\u00a0SD\u2009=\u200916.5\u00a0\u00b1\u00a03.4\u2009years, range 10\u201326\u2009years). Socio-demographic and medical profiles was obtained through semi-structured interviews. HRQOL of participants were evaluated utilising validated, Malay translated questionnaires which were age appropriate: Pediatric Quality of Life Inventory (PedsQL v4.0) scales for Child (8\u201312) and Adolescent (13\u201318) and Medical Outcome Survey 36-item Short Form version. These were then compared to the diabetic controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The CAH participants consisted of children (ages 10\u201312\u2009years,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912), adolescents (ages 13\u201317\u2009years,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929) and adults (\u2265 18\u2009years,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918). The majority were Malays (64.4%) and had salt-wasting CAH (67.8%). There were no significant differences between the total mean score of the HRQOL of the combined children and adolescents CAH group (total mean score\u00a0\u00b1\u00a0SD\u2009=\u200981.6\u00a0\u00b1\u00a017.9, 95% CI\u2009=\u200975.6\u201387.6) when compared to age-matched diabetic patients (total mean score\u00a0\u00b1\u00a0SD\u2009=\u200980.8\u00a0\u00b1\u00a011.0, 95% CI\u2009=\u200977.0\u201384.5,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.81, effect size\u2009=\u20090.05); no significant difference between the adult CAH and diabetic controls in the physical [median score (IQR) CAH vs diabetics; 49.3 (11.4) vs. 50.2 (6.1),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.60, effect size\u2009=\u20090.09] and the mental composite scores [median score (IQR) CAH vs. diabetics; 47.8 (14.1) vs. 50.0 (10.8),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.93, effect size\u2009=\u20090.01].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The HRQOL of the Malaysian CAH cohort were comparable to the diabetic controls.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12955-020-01515-9","type":"journal-article","created":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T05:04:36Z","timestamp":1596258276000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Health-related quality of life of female patients with congenital adrenal hyperplasia in Malaysia"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9463-8050","authenticated-orcid":false,"given":"Ani Amelia","family":"Zainuddin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia Regina","family":"Grover","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur Azurah","family":"Abdul Ghani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loo Ling","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahmah","family":"Rasat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd. Rizal","family":"Abdul Manaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khadijah","family":"Shamsuddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaleha","family":"Abdullah Mahdy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,1]]},"reference":[{"key":"1515_CR1","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1056\/NEJMra021561","volume":"349","author":"PW Speiser","year":"2003","unstructured":"Speiser PW, White PC. Congenital adrenal hyperplasia. N Engl J Med. 2003;349:776\u201388.","journal-title":"N Engl J Med"},{"key":"1515_CR2","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s11154-007-9053-1","volume":"8","author":"FG Riepe","year":"2007","unstructured":"Riepe FG, Sippell WG. Recent advances in diagnosis, treatment, and outcome of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Rev Endocr Metab Disord. 2007;8:349\u201363.","journal-title":"Rev Endocr Metab Disord"},{"key":"1515_CR3","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.jpag.2012.08.004","volume":"26","author":"AA Zainuddin","year":"2013","unstructured":"Zainuddin AA, Grover SR, Shamsuddin K, Mahdy ZA. Research on quality of life in female patients with congenital adrenal hyperplasia and issues in developing nations. J Pediatr Adolesc Gynecol. 2013;26:296\u2013304.","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"1515_CR4","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1136\/bmj.38365.883843.79","volume":"330","author":"ML Cull","year":"2005","unstructured":"Cull ML. A support group's perspective. Bmj. 2005;330:341.","journal-title":"Bmj"},{"key":"1515_CR5","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1006\/hbeh.1996.0038","volume":"30","author":"KJ Zucker","year":"1996","unstructured":"Zucker KJ, Bradley SJ, Oliver G, Blake J, Fleming S, Hood J. Psychosexual development of women with congenital adrenal hyperplasia. Horm Behav. 1996;30:300\u201318.","journal-title":"Horm Behav"},{"key":"1515_CR6","doi-asserted-by":"publisher","first-page":"1844","DOI":"10.1210\/jcem.84.6.5718","volume":"84","author":"HF Meyer-Bahlburg","year":"1999","unstructured":"Meyer-Bahlburg HF. What causes low rates of child-bearing in congenital adrenal hyperplasia? J Clin Endocrinol Metab. 1999;84:1844\u20137.","journal-title":"J Clin Endocrinol Metab"},{"key":"1515_CR7","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1159\/000084093","volume":"8","author":"BJ Otten","year":"2005","unstructured":"Otten BJ, Stikkelbroeck MML, Claahsen-van der Grinten HL, Hermus A. Puberty and fertility in congenital adrenal hyperplasia. Endocr Dev. 2005;8:54\u201366.","journal-title":"Endocr Dev"},{"key":"1515_CR8","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1515\/JPEM.2006.19.10.1207","volume":"19","author":"KL Armstrong","year":"2006","unstructured":"Armstrong KL, Henderson C, Hoan NT, Warne GL. Living with congenital adrenal hyperplasia in Vietnam: a survey of parents. J Pediatr Endocrinol Metab. 2006;19:1207\u201323.","journal-title":"J Pediatr Endocrinol Metab"},{"key":"1515_CR9","first-page":"129","volume":"13","author":"OD Osifo","year":"2009","unstructured":"Osifo OD, Amusan TI. Female children with ambiguous genitalia in awareness-poor subregion. Afr J Reprod Health. 2009;13:129\u201336.","journal-title":"Afr J Reprod Health"},{"key":"1515_CR10","first-page":"509","volume":"54","author":"R Bhanji","year":"2004","unstructured":"Bhanji R, Khan AH, Balouch IL, Sabir S, Nazir Z, Billoo AG. Profile of children with congenital adrenal hyperplasia--a hospital study. J Pak Med Assoc. 2004;54:509\u201312.","journal-title":"J Pak Med Assoc"},{"key":"1515_CR11","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1097\/01.ten.0000081671.43801.57","volume":"13","author":"G Warne","year":"2003","unstructured":"Warne G. Ethical issues in gender assignment. Endocrinologist. 2003;13:182\u20136.","journal-title":"Endocrinologist"},{"key":"1515_CR12","first-page":"60","volume":"10","author":"CI Hasanah","year":"2003","unstructured":"Hasanah CI. Approaches and methodological as well as interpretative issues in quality of life research in Malaysia. Malays J Med Sci. 2003;10:60\u20135.","journal-title":"Malays J Med Sci"},{"key":"1515_CR13","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1097\/00005650-200108000-00006","volume":"39","author":"JW Varni","year":"2001","unstructured":"Varni JW, Seid M, Kurtin PS. PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Med Care. 2001;39:800\u201312.","journal-title":"Med Care"},{"key":"1515_CR14","first-page":"1","volume":"1","author":"A Ismail","year":"2010","unstructured":"Ismail A, Campbell M. Measuring the Health Related Quality of Life of Malaysian Children with Thalassaemia: Reliability and Validity of PedsQL 4.0 Generic Score and SF36v2. J Stat Model Analytics. 2010;1:1\u201328.","journal-title":"J Stat Model Analytics"},{"key":"1515_CR15","first-page":"694","volume":"58","author":"AB Azman","year":"2003","unstructured":"Azman AB, Sararaks S, Rugayah B, Low LL, Azian AA, Geeta S, Tiew CT. Quality of life of the Malaysian general population: results from a postal survey using the SF-36. Med J Malaysia. 2003;58:694\u2013711.","journal-title":"Med J Malaysia"},{"issue":"Suppl 1","key":"1515_CR16","doi-asserted-by":"publisher","first-page":"S44","DOI":"10.1007\/s00586-005-1046-8","volume":"15","author":"G Nemeth","year":"2006","unstructured":"Nemeth G. Health related quality of life outcome instruments. Eur Spine J. 2006;15(Suppl 1):S44\u201351.","journal-title":"Eur Spine J"},{"key":"1515_CR17","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1093\/jpepsy\/jsp004","volume":"34","author":"JA Durlak","year":"2009","unstructured":"Durlak JA. How to select, calculate, and interpret effect sizes. J Pediatr Psychol. 2009;34:917\u201328.","journal-title":"J Pediatr Psychol"},{"key":"1515_CR18","doi-asserted-by":"crossref","unstructured":"Cohen J. Statistical power analysis for the behavioral sciences. 2nd Ed. Hillsdale: Lawrence Eribaum Associates; 2013.","DOI":"10.4324\/9780203771587"},{"key":"1515_CR19","volume-title":"Press Release: Current Population Estimates, Malaysia, 2017\u20132018","author":"Department of Statistics Malaysia","year":"2018","unstructured":"Department of Statistics Malaysia: Press Release: Current Population Estimates, Malaysia, 2017\u20132018. 2018."},{"key":"1515_CR20","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.1210\/jc.2013-3326","volume":"99","author":"A Strandqvist","year":"2014","unstructured":"Strandqvist A, Falhammar H, Lichtenstein P, Hirschberg AL, Wedell A, Norrby C, Nordenskjold A, Frisen L, Nordenstrom A. Suboptimal psychosocial outcomes in patients with congenital adrenal hyperplasia: epidemiological studies in a nonbiased national cohort in Sweden. J Clin Endocrinol Metab. 2014;99:1425\u201332.","journal-title":"J Clin Endocrinol Metab"},{"key":"1515_CR21","doi-asserted-by":"publisher","first-page":"5110","DOI":"10.1210\/jc.2010-0917","volume":"95","author":"W Arlt","year":"2010","unstructured":"Arlt W, Willis DS, Wild SH, Krone N, Doherty EJ, Hahner S, Han TS, Carroll PV, Conway GS, Rees DA, et al. Health status of adults with congenital adrenal hyperplasia: a cohort study of 203 patients. J Clin Endocrinol Metab. 2010;95:5110\u201321.","journal-title":"J Clin Endocrinol Metab"},{"key":"1515_CR22","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1097\/MOP.0b013e32834810a4","volume":"23","author":"A Nordenstrom","year":"2011","unstructured":"Nordenstrom A. Adult women with 21-hydroxylase deficient congenital adrenal hyperplasia, surgical and psychological aspects. Curr Opin Pediatr. 2011;23:436\u201342.","journal-title":"Curr Opin Pediatr"},{"key":"1515_CR23","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1530\/EJE-10-0284","volume":"163","author":"I Nermoen","year":"2010","unstructured":"Nermoen I, Husebye ES, Svartberg J, Lovas K. Subjective health status in men and women with congenital adrenal hyperplasia: a population-based survey in Norway. Eur J Endocrinol. 2010;163:453\u20139.","journal-title":"Eur J Endocrinol"},{"key":"1515_CR24","first-page":"108","volume":"55","author":"LM Ding","year":"2000","unstructured":"Lim TO, Ding LM, Zaki M, Suleiman AB, Fatimah S, Siti S, Tahir A, Maimunah AH. Distribution of body weight, height and body mass index in a national sample of Malaysian adults. Med J Malaysia. 2000;55:108\u201328.","journal-title":"Med J Malaysia"},{"key":"1515_CR25","doi-asserted-by":"publisher","first-page":"4161","DOI":"10.1210\/jc.2009-2616","volume":"95","author":"K Muthusamy","year":"2010","unstructured":"Muthusamy K, Elamin MB, Smushkin G, Murad MH, Lampropulos JF, Elamin KB, Abu Elnour NO, Gallegos-Orozco JF, Fatourechi MM, Agrwal N, et al. Clinical review: adult height in patients with congenital adrenal hyperplasia: a systematic review and metaanalysis. J Clin Endocrinol Metab. 2010;95:4161\u201372.","journal-title":"J Clin Endocrinol Metab"},{"key":"1515_CR26","doi-asserted-by":"publisher","first-page":"4429","DOI":"10.1210\/jc.2012-2102","volume":"97","author":"GP Finkielstain","year":"2012","unstructured":"Finkielstain GP, Kim MS, Sinaii N, Nishitani M, Van Ryzin C, Hill SC, Reynolds JC, Hanna RM, Merke DP. Clinical characteristics of a cohort of 244 patients with congenital adrenal hyperplasia. J Clin Endocrinol Metab. 2012;97:4429\u201338.","journal-title":"J Clin Endocrinol Metab"},{"key":"1515_CR27","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1530\/EJE-10-0877","volume":"164","author":"H Falhammar","year":"2011","unstructured":"Falhammar H, Filipsson Nystrom H, Wedell A, Thoren M. Cardiovascular risk, metabolic profile, and body composition in adult males with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Eur J Endocrinol. 2011;164:285\u201393.","journal-title":"Eur J Endocrinol"},{"key":"1515_CR28","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1210\/jc.2006-1350","volume":"92","author":"H Falhammar","year":"2007","unstructured":"Falhammar H, Filipsson H, Holmdahl G, Janson PO, Nordenskjold A, Hagenfeldt K, Thoren M. Metabolic profile and body composition in adult women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J Clin Endocrinol Metab. 2007;92:110\u20136.","journal-title":"J Clin Endocrinol Metab"},{"key":"1515_CR29","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1111\/j.1651-2227.2000.tb01213.x","volume":"89","author":"J Jaaskelainen","year":"2000","unstructured":"Jaaskelainen J, Voutilainen R. Long-term outcome of classical 21-hydroxylase deficiency: diagnosis, complications and quality of life. Acta Paediatr. 2000;89:183\u20137.","journal-title":"Acta Paediatr"},{"key":"1515_CR30","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1111\/j.1365-2265.2010.03920.x","volume":"74","author":"N Reisch","year":"2011","unstructured":"Reisch N, Hahner S, Bleicken B, Flade L, Pedrosa Gil F, Loeffler M, Ventz M, Hinz A, Beuschlein F, Allolio B, et al. Quality of life is less impaired in adults with congenital adrenal hyperplasia because of 21-hydroxylase deficiency than in patients with primary adrenal insufficiency. Clin Endocrinol. 2011;74:166\u201373.","journal-title":"Clin Endocrinol"},{"key":"1515_CR31","doi-asserted-by":"publisher","first-page":"3432","DOI":"10.1210\/jc.2009-0636","volume":"94","author":"L Frisen","year":"2009","unstructured":"Frisen L, Nordenstrom A, Falhammar H, Filipsson H, Holmdahl G, Janson PO, Thoren M, Hagenfeldt K, Moller A, Nordenskjold A. Gender role behavior, sexuality, and psychosocial adaptation in women with congenital adrenal hyperplasia due to CYP21A2 deficiency. J Clin Endocrinol Metab. 2009;94:3432\u20139.","journal-title":"J Clin Endocrinol Metab"},{"key":"1515_CR32","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1007\/BF02276713","volume":"154","author":"U Kuhnle","year":"1995","unstructured":"Kuhnle U, Bullinger M, Schwarz HP. The quality of life in adult female patients with congenital adrenal hyperplasia: a comprehensive study of the impact of genital malformations and chronic disease on female patients life. Eur J Pediatr. 1995;154:708\u201316.","journal-title":"Eur J Pediatr"},{"key":"1515_CR33","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/1687-9856-2012-2","volume":"2012","author":"SA Sanches","year":"2012","unstructured":"Sanches SA, Wiegers TA, Otten BJ, Claahsen-van der Grinten HL. Physical, social and societal functioning of children with congenital adrenal hyperplasia (CAH) and their parents, in a Dutch population. Int J Pediatr Endocrinol. 2012;2012:2.","journal-title":"Int J Pediatr Endocrinol"},{"key":"1515_CR34","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s12955-014-0107-2","volume":"12","author":"DL Gilban","year":"2014","unstructured":"Gilban DL, Alves Junior PA, Beserra IC. Health related quality of life of children and adolescents with congenital adrenal hyperplasia in Brazil. Health Qual Life Outcomes. 2014;12:107.","journal-title":"Health Qual Life Outcomes"},{"key":"1515_CR35","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1016\/j.jclinepi.2009.01.023","volume":"62","author":"T van Rijn","year":"2009","unstructured":"van Rijn T. A physiatrist's view of response shift. J Clin Epidemiol. 2009;62:1191\u20135.","journal-title":"J Clin Epidemiol"},{"key":"1515_CR36","doi-asserted-by":"publisher","first-page":"e804","DOI":"10.1542\/peds.2006-3272","volume":"120","author":"M White-Koning","year":"2007","unstructured":"White-Koning M, Arnaud C, Dickinson HO, Thyen U, Beckung E, Fauconnier J, McManus V, Michelsen SI, Parkes J, Parkinson K, et al. Determinants of child-parent agreement in quality-of-life reports: a European study of children with cerebral palsy. Pediatrics. 2007;120:e804\u201314.","journal-title":"Pediatrics"},{"key":"1515_CR37","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1210\/jc.2007-0556","volume":"93","author":"A Nordenskjold","year":"2008","unstructured":"Nordenskjold A, Holmdahl G, Frisen L, Falhammar H, Filipsson H, Thoren M, Janson PO, Hagenfeldt K. Type of mutation and surgical procedure affect long-term quality of life for women with congenital adrenal hyperplasia. J Clin Endocrinol Metab. 2008;93:380\u20136.","journal-title":"J Clin Endocrinol Metab"},{"key":"1515_CR38","volume-title":"Malaysian Population and Family Survey","author":"Board TNPaFD","year":"2004","unstructured":"Board TNPaFD. Malaysian Population and Family Survey. Kuala Lumpur: National Population and Family Development Board (NPFDB); 2004."}],"container-title":["Health and Quality of Life Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12955-020-01515-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12955-020-01515-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12955-020-01515-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T19:16:55Z","timestamp":1627759015000},"score":1,"resource":{"primary":{"URL":"https:\/\/hqlo.biomedcentral.com\/articles\/10.1186\/s12955-020-01515-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,1]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1515"],"URL":"https:\/\/doi.org\/10.1186\/s12955-020-01515-9","relation":{},"ISSN":["1477-7525"],"issn-type":[{"value":"1477-7525","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,1]]},"assertion":[{"value":"2 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 August 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by research committees of the respective medical centres (UKM Medical Research and Ethics Committee, Approval Reference FF-318-2011 and UMMC Medical Ethics Committee, Approval Reference 859.11). Informed consent was obtained from those who agreed to participate. For the participants who are <\u200918\u2009years old, the informed consent was obtained from their parent or legal guardian in addition to the verbal consent obtained from the young person.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"258"}}