The results of this study indicate that the important viral agents associated with lower respiratory tract infections in young children are respiratory syncytial virus, rhinovirus, and parainfluenza virus, particularly in those under 2 years of age. This is in close agreement with studies done in temperate climates. Influenza A virus is seasonal and plays an important role in upper respiratory tract infections in older children.
Considerable attention has been paid to the correlation between high infant morbidity and mortality rates and the increased incidence of bottle feeding. The shift from prolonged breast feeding to a mixed regime or the exclusive use of sweetened condensed milk or infant formula has been related to the promotional activities of milk companies, and typically has been presented as a relatively recent development in Third World countries. However, the marketing of tinned and powdered milk only partially explains the increased use of these products. In colonial Malaya, condensed milk was marketed from the late 19th century. Infant formula was available from the turn of the century and was widely advertised, first in the English-language press and later also in the vernacular presses. At the same time, other social and cultural factors served to discourage breast feeding. There were changes in ideas regarding ideal body weight for both women and infants, and regarding infant care and diet; these ideas were presented in the mass media. In addition, maternal and child health clinics, established in the 1920s to reduce the high infant mortality rate, both propagated popular beliefs about infant weight and supplied milk and educated women to artificially feed their infants. Industry, the media, and health services all promoted, if not always intentionally, bottle feeding rather than breast feeding. Bottle feeding as an ideal, if not a reality, was thus well established before the intensive promotion of milk products by multinational corporations that followed the political independence of the colony.
A pilot, field investigation of the prevalence and treatment of alcoholism in Southeast Asia (Singapore, Indonesia, Malaysia, Burma, and Thailand) and conducted. The methodology combined an informant study, interviewing leading alcohol and drug abuse authorities; utilising existing data; and clinical and naturalistic observation. The effects of modernisation, multiracial culture, and the unilateral focus on opiates are discussed; recommendations on treatment, education, and research are presented.
The indirect hemagglutination test was used to measure malaria antibody levels in residents of an endemic area of Malaysia. Blood specimens were collected at 4-week intervals for a year. Seropositivity rates increased with age and number of episodes of malaria in young children. Although antibody levels were variable, titers tended to rise with parasitemia and fall in the absence of detected parasites. In general, the serologic indices tended to reflect the parasitologic findings.
A cohort of 62 persons living in a malaria-endemic area was examined by serology and by blood film 14 times over a 56-week period. Serologic responses (indirect hemagglutination test) of the group as a whole reflected the malaria transmission as determined by blood slide examination. The serologic responses of individuals showed titer changes that were not always consistent with blood slide results. The use of chloroquine may have modified the host's immune response.
This paper describes the analysis of the written professional examinations administered at the Medical School, Universiti Kebangsaan Malaysia (UKM), during the academic year 1979-80. It is a product of a collaborative activity involving medical teachers and two short-term consultants of the World Health Organization. The examination papers were analysed in order to identify content areas disproportionately emphasized in the examinations; to determine the quality and appropriateness of the examination items used; and to review the extent of continuity and integration across departments and courses. This paper is intended to introduce an approach to curriculum review which is based on analysis of the examination system. The procedures and sample outcomes are described and the implications for curriculum development and evaluation are discussed.
MeSH terms: Curriculum*; Education, Medical, Undergraduate; Malaysia
Over a five year period, 184 patients were treated for acute renal failure. Uraemia was usually treated by peritoneal dialysis, and haemodialysis was reserved for post surgical and hypercatabolic patients. The overall mortality was 33.2% and was highest among surgical patients. These results were similar to previous reports. Peritoneal dialysis was usually effective in controlling uraemia. Uncontrolled sepsis remains a major problem, and septicaemia and gastrointestinal bleeding were adverse factors affecting the outcome. The combination of septicaemia and gastrointestinal bleeding commonly led to a fatal outcome.
Adequately biopsied renal tissue received in the Department of Pathology, University Hospital, Kuala Lumpur from 1,000 consecutive Malaysian patients during an eleven year period between 1970 and 1981 was reviewed. The youngest patient was 6 days old and the oldest 80 years. Both sexes were equally represented. The majority of the patients were Chinese (71%) with Malays and Indians comprising most of the remainder. Over half the patients (50.4%) presented with the nephrotic syndrome. Other modes of presentation included systemic lupus erythematosus, proteinuria and haematuria separately or in combination and hypertension. Minimal change (25.7%) and proliferative glomerulonephritis (24.8%) were present in about equal numbers and together accounted for over half of the cases (50.5%). Lupus nephritis was the third most common diagnosis (18.4%). In addition, there were patients with focal glomerulonephritis (5.4%), membranous glomerulonephritis (5.5%), Berger's disease (5.8%), amyloidosis (0.6%) and end stage renal disease (4.0%).
Between January 1974 and June 1980, 85 cases of cryptococcosis were diagnosed in the University Hospital, Kuala Lumpur, Malaysia. The diagnosis was based on positive culture of the organism in 81 cases; the remaining four were diagnosed on histopathological findings. Cerebral cryptococcosis was the most common presentation and Chinese are particularly susceptible (72% of cases). The incidence of the disease is shown to be far greater than previously suspected. Association with compromised host status is uncommon (14%). The local literature is briefly reviewed and the findings discussed.
A survey of 308,101 schoolchildren conducted in 10 of 11 states in Peninsular Malaysia revealed that 10.7% have Pediculus humanus capitis infestation. The results of treatment with 1%, 2% and 5% DDT in coconut oil in 374 cases reveal cure rates of 3.5%, 15.8% and 51.3%, respectively, suggesting that the head louse has probably developed resistance to this insecticide in Malaysia.
This paper provides an empirical analysis of the determinants of the demand for medical services in Peninsular Malaysia. After elaborating a theoretical model of household demand for medical care in Section II an econometric model is specified and estimated in Sections III, IV, and V. The results indicate that total medical demand, as measured by the absolute volume of outpatient and inpatient consumption, is highly inelastic to the cash price and to the cost in time of utilization. Total medical demand is also inelastic with respect to income. Yet consumers are clearly responsive to the relative prices of alternative sources of medical care. Consumers are also sensitive to the way in which the time of utilization is spent, with high travel and treatment time causing reduced demand for services.
MeSH terms: Costs and Cost Analysis; Delivery of Health Care*; Health Services Needs and Demand/economics*; Health Services Research/economics*; Humans; Income; Malaysia; Models, Theoretical*
Malays, Chinese, and Indians from Peninsular Malaysia; Ibans and Bidayuh from Sarawak State; Kadazans from Sabah State, Northern Borneo; and Bataks, Minangkabau, and Javanese from North Sumatra, Indonesia, were subtyped for transferrin C by polyacrylamide gel isoelectric focusing. All nine populations studied are polymorphic for two alleles, TfCl and TfC2, TfC3 was polymorphic in six populations and present as a rare variant in the other three. The frequency of TfC1 ranged from 0.855 in Bidayuh to 0.711 in Javanese, that of TfC2 from 0.231 in Indians to 0.113 in Bidayuh, and that of TfC3 from 0.030 in Javanese and Chinese to 0.008 in Bidayuh. TfDchi is polymorphic in all the populations that we studied except in Minangkabau, in whom it is present as a rare variant, and in Indians, in whom it is absent.
This paper describes a rehabilitation programme for male chronic mental patients, with the aim of reintegrating them into the community. Since in Malaysia about 50% of the work force are stilling earning their living in the agricultural sector, the programme concentrates on training in farming and animal rearing. Since the patients are very institutionalised, resocialisation training is also provided that involves learning to communicate, to mix with others, to know how to use money, to make one's own demands, and to cope with more personal freedom. When a patient is trained well enough to be employed outside, a job is found for him that provides food, lodging and payment. After discharge from the hospital, he is regularly followed up by the social worker.
MeSH terms: Agriculture; Behavior Therapy/methods; Mental Disorders/psychology; Mental Disorders/rehabilitation*; Ethnic Groups/psychology*; Humans; Length of Stay; Malaysia; Middle Aged; Public Opinion; Rehabilitation, Vocational/psychology; Social Adjustment*
The health of a population and the development of health services in a country at a particular time in history are directly linked to the socioeconomic system. This paper discusses health and health services in Malay Peninsula during the time that it was a British colony. Economic production under British colonialism, which is basically a capitalist system, is organized primarily for the purpose of realizing profits. The health of the population is in direct conflict with and generally subordinated to this main objective. The pattern of health that emerges reflects this general framework. Moreover, health services under the colonialist system are developed primarily to serve the economic interests of the colonialists. Hence, the structure of health services is biased toward curative medicine and centered mainly in the urban areas.
MeSH terms: Communicable Diseases/epidemiology; Health*; Health Services Administration*; Health Status*; Hospitalization; Humans; Indonesia; Nutrition Disorders/epidemiology; Political Systems*; Public Health Administration*; Respiratory Tract Diseases/epidemiology; Social Control, Formal; Socioeconomic Factors
One hundred and forty-eight patients over the age of 12 years seen from July 1972 through December 1980 were accepted for this review of minimal change glomerular disease (MCGD). The diagnosis was based on a typical clinical presentation, and renal biopsy findings. MCGD forms 43.5 per cent of our patients with idiopathic nephrotic syndrome. The patients were predominantly young adults (82 per cent) and the onset of nephrotic syndrome (NS) occurred below the age of 30 years. Most patients had severe oedema and hypoalbuminaemia. Few patients recovered spontaneously. One hundred and thirty patients were given long-term alternate-day steroid (LASt) therapy. Four had cyclophosphamide alone, 21 patients had cyclophosphamide after a trial of LASt. Eighty-four patients (62.7 per cent) were initial responders: 17 of these after cyclophosphamide, 26 (19.4 per cent) were initial non-responders: five cyclophosphamide, 19 were late responders. Nine patients were partial responders, six were non-responders and one went into renal failure. Forty-one patients defaulted, emigrated or were seen only locally at the time of study. Ninety-nine patients were followed for three to 102 months (mean 23 . 3 months). Thirty-seven patients were followed for 36 to 102 months. Relapses were infrequent but occurred as late as 60 months.
The history of efforts to establish a cancer registry in Malaysia since 1961 is reviewed. In 1980, the staff of the Institute for Medical Research in Kuala Lumpur was authorized to develop an official registry that would combine the resources of the various university faculties, the hospitals, research institutes, and the Cancer Society. Special registries operate for oral precancerous conditions and for nasopharyngeal carcinoma (NPC). The topics of recent epidemiological studies include: a review of all cancers diagnosed at the University Hospital during 1972-74, the association of Epstein-Barr virus and NPC, social and environmental factors associated with NPC, oral cancers, and childhood cancers.