Foreign workers in Malaysia are screened for certain infectious diseases prior to their entry to the country but some escape medical screening and others acquire infection during their stay in the country. The Faculty of Medicine, University of Malaya was commissioned to study the impact of foreign labour on the local health system and, as part of the investigations, 584 foreign workers attending local outpatient clinics were examined for serological evidence of syphilis, HIV infection, viral hepatitis B, C and E, as well as for enteric infections by Salmonella, Shigella and Vibrio cholerae. The results showed that apart from viral hepatitis E, the prevalence rates of the infections looked for were not notably higher than those for the general Malaysian population. The seroprevalence rates obtained were 2.6% for syphilis, 0.2% HIV infection, 3.8% viral hepatitis B, 1.0% viral hepatitis C, 14.4% viral hepatitis E. The detection of HEV IgM in 7.7% of the workers screened indicates that these infections could have been acquired during their stay in Malaysia.
MeSH terms: Hepatitis; Hepatitis B; Hepatitis C; HIV; Infection; Malaysia; Mass Screening; Salmonella; Shigella; Syphilis; Vibrio; Vibrio cholerae; HIV Infections; Prevalence; Hepatitis E
Malaysia has been swamped by migrant workers from nearby countries like Indonesia, Phillipine and also Bangladesh since 1980's. The main pulling forces which motivated them to migrate to Malaysia are better economy, political stability and religious freedom in Malaysia. Another way of classifying migration pattern is to divide it into push and pull migration or a combination of the two. Pull migrants are those who migrate to obtain better economic opportunity while push migrants are those who try to run away from being prosecuted or due to fear of political and religious suppression. Whatever the push and the pull factors, they are bound to encounter some acculturation challenges. This will inevitably produce certain psychological sequelae. Therefore, the main aim of this study is to determine the point prevalence of psychiatric morbidity experienced by the migrant population. The psychological impact of push and pull migrations is fundamentally distinct. There were significant numbers of migrants admitted to University Hospital psychiatric units who suffered from psychological distress and para suicide. The reasons for these problems are multi-faceted. Hence, another purpose of this study was to investigate factors which make them to be at risk of developing psychiatric morbidity. The findings of this study can be used as a basis for making recommendations to the government of the rationale to include psychological assessment as one of the important components in the pre-employment selection criteria.
The immigration of foreign workers has important public health implications because it is a potential route for disease transmission. New diseases may be introduced into the country and diseases which have been eradicated may re-emerge among the local population. The emergence of new diseases and re-emergence of previously eradicated diseases will have grave public health implications because the local population has no or decreased immunity against these diseases. The mobility of foreign workers withing the country sometimes makes it difficult for the health authorities to track the source of infection. Foreign workers who are carriers of diseases such as Hepatitis B and HIV (which have a window period) will test as negative and hence will not be detected during the pre-employment medical examination. Thus it is essential that these foreign workers undergo a full medical examination and screening withing 3 to 6 months after entry into Malaysia and annually throughout their employment period in Malaysia. The current physical examination and screening procedure does not guarantee that these workers are totally disease-free. Therefore, we need to re-look at the current examination content, criteria and procedures to rectify any deficiencies in the current system. The authorities need to devise a mechanism to ensure that foreign workers or their employers purchase a medical insurance so that the public sector health facilities and personnel are not overloaded and overworked. The authorities have already in place a mechanism to prevent medically UNFIT foreign workers from entering this country. However, it is the large number of undocumented and illegal foreign workers that pose a bigger threat to the wellbeing of the nation's health. As long as employers are willing to take a risk by employing illegal foreign workers, all the efforts that the government has undertaken to safeguard the nation's health will be rendered futile.
MeSH terms: Humans; Malaysia; Transients and Migrants
Many nation states, including Malaysia are undergoing development and modernization while modernization brings tremendous achievements related to social and economic wellbeing, on the other hand, it also brings along with it the various untoward effects on the nation. One of the main factors which have an impact on modernization seems to be the rapid changes in the demographic pattern. In the initial stage of modernization, mass migration of rural populations to the urban areas, has been on going in Malaysia since the seventies. In the early nineties, the robust economic development in Malaysia necessitated the import of foreign labour from the neighbouring countries in order to provide cheap labour in the labour intensive industries. This demographic changes, internal and foreign migration, parallels the economic progress of the host countries. According to the latest report from the Immigration Department, there are more than 1.2 million registered foreign workers (up to January 1998) in Malaysia. This figure may exceed 2 million if we take into consideration the illegal immigrants and this is a big proportion (about 10%) of foreign workers in which has Malaysia's population of approxiamtely 20 million. The presence of such a big number of foreign workers during less than a decade is not merely an immigration issue, but it is a major concern for the nation especially with respect to health care, housing and education. As the immigrant community is highly dynamic, the emerging and re-emerging infectious diseases are a great concern for Malaysia especially in formulating health policies for Malaysia currently and in the future.
MeSH terms: Achievement; Hand; Health Policy; Housing; Industry; Malaysia; Rural Population
Many nation states, including Malaysia are undergoing development and modernization brings tremendous achievements related to social and economic well-being, on the other hand, it also brings along with it the various untoward effects on the nation. One of the main factors which have an impact on modernization, mass migration of rural populations to the urban areas, has been on going in Malaysia since the seventies. In the early nineties, the robust economic development in Malaysia necessitated the import of foreign labour from the neighbouring countries in order to provide cheap labour in the labour intensive industries. This demographic changes, internal and foreign migration, parallels the economic progress of the host countries. According to the latest report from the Immigration Department, there are more than 1.2 million registered foreign workers (up to January 1998) in Malaysia. This figure may exceed 2 million if we take into consideration the illegal immigrants and this is a big proportion (about 10%) of foreign workers in which has Malaysia’s population of approximately 20 million. The presence of such a big number of foreign workers during less than a decade is not merely an immigration issue, but it is major concern for the nation especially with respect to health care, housing and education. As the immigrant community is highly dynamic, the emerging and re-emerging infectious diseases are a great concern for Malaysia especially in formulating health policies for Malaysia currently and in the future.
MeSH terms: Humans; Infection; Malaysia; Transients and Migrants
About 27% of the eligible respondents reported having experienced some form of dental problems in the preceding one year prior to the interview. Female respondents (57.1%) were more likely to have encountered a dental problem as compared to male respondents (22.6%). Of the various nationalities, the Thais (60.7%) and the Pakistanis were the most and least likely respectively to have encountered a dental problem in the preceding one year. This pattern among the Thais was consistent for both the male (48.4%) and female (70.6%) population. Toothache (85.0%) was reportedly the most prevalent dental problems encountered regardless of gender and nationality, followed by sensitivity to hot and cold drinks (34.4%). About 1 in 4 subjects who had dental problem reported having bleeding gums. About 1 in 4 subjects who had dental problems had consulted the doctor or dentists regarding their problem and one more than one-half had self-medicated. Overall the majority (84.4%) of the respondents have never visited the dentists in Malaysia. Lack of perceived need was cited as the main reason for this.
One (1) anti-Blastocystis serum from a monkey naturally infected with isolate M12 and four (4) hyperimmune sera raised in inbred Balb/c mice against crude antigens of two Blastocystis isolates (C and KPI). one each of Entamoeba histolytica (HK9) and Giardia lamblia (7404) were used to react with several homologous and heterologous Blastocystis isolates, E. histofytica, G. lambfia, Endolimax nana and Bac-4 (Escherichia coli isolated from culture medium of a B. hominis isolate KPl). All anti-Blastocystis sera did not show cross-reactivity with E. histolytica and G. lamblia by western blotting. Similarly, anti-E. histolytica and anti-G. lamblia sera also did not react against all Blastocystis isolates tested, even though these three protozoa are known to produce diarrhoea in humans. Polyclonal sera raised against antigen prepared from xenic culture of Blastocystis produced a smear reaction on the immunoblot, while antibodies raised against antigens prepared from axenic culture (isolate C) gave prominent reaction bands. This may be due to the purity of the immunogen used in inducing the immune response. The cross-reactions of sera from mice immunised with the xenic B. hominis isolates may also due to antibodies against E. coli. Anti-Blastocystis serum from monkey's with natural infection showed several prominent reaction bands together with a smear at above 40 kD were most probably induced by the excretory-secretory antigens of the parasite. A variety of reaction patterns were obtained with these anti-sera and the antigens from different Blastocystis isolates. These may be reflects from differences in antigenic components from various strains of this parasite. KEYWORDS: lJIastocysfis, polycional antibodies, immunoblot, experimental animals
Osteoarthritis is the most common joint disorder in the human population. It is characterized by the destruction of articular cartilage and the overgrowth of marginal and subchondral bone. The commonest weight bearing joint affected is that of the knee, affecting over one third of people over Ihe age of 65 years. This article reviews the recent principles of non surgical management of osteoarthritis. This is divided into non drug management such as primary prevention, physiotherapy, occupational therapy and patient education. Drug management will include the use of different types of analgesics. viscosupplementation as well as joint injection. KEY WORDS: Osteoarthritis, management
This study is to examine the use of a Rapid Troponin T test in patients attending the Emergency Room with complaints of chest pain. The results show a strong correlation between time to positive developmentaf the Rapid Trapanin T lest to ELISA Trapanin T. These results indicate the use of a simple to perform bedside assay of Rapid Trapanin T may be used in early risk stratification of patients presenting wilh acute coronary syndromes. KEYWORDS: Rapid Trapanin T, acule coronary syndromes, risk stratification.
This paper attempts to examine the socio-demographic profile of the respondents in Migrant Health studies. It was based on questionnaire survey among 820 respondents from the Klang Valley and the State of Kelantan from 6th January 1998 to 14th January 1999. Majority of the respondents (47.9%) were from Bangladesh, followed by Indonesia (14.8%), Thailand (13.7%), Myanmar (20.4%), Pakistan (9.9%) and Others (1.3%). The male to female ratio is 7:1. He age of respondents ranged from 18 to 69 years with a mean of 30.5 years. More than 70% of them are adults (25-44 years). Females were older than males (mean age of 33.8 years and 30.5 years respectively). Majority of the respondents were married (females 75.8% and males 52.6%), 93.7 were Muslims. About 87.4% of them had some formal education. Majority of the foreign workers were employed as factory workers (35.7%), followed by construction workers (18.3%), agricultural workers (33.6%), service workers (13.3%) and self-employed (11%). Nevertheless, the profile of these responding do not conform to the national profile.
MeSH terms: Humans; Malaysia; Transients and Migrants
Many studies have shown that failure in the control of hypertension with oral antihypertensives could be associated with noncompliance. The present study was conducted to assess the compliance rate to antihypertensive therapies and also to determine factors related to any noncompliance. The study was conducted in a teaching hospital in Kuala Lumpur. Data was collected from patients' medical records and via personal interview using a structured questionnaire. Out of a total of 175 respondents recruited in the study, 49.1% missed at least a dose of their antihypertensive agents during a one·month period. The most common reason given by respondents who were not compliant to their antihypertensive therapies was forgetfulness (91.8%), followed by too busy (20.0%) and insufficient medication supplied to them (18.8%). None of the factors analysed, including the demography of the respondents, their knowledge about hypertension and the types of antihypertensive therapies they were on, had any statistically significant influence on the compliance behaviour of the respondents to their antihypertensive therapies. However, more than 80% of the respondents kept their appointment to see their doctor and only this factor appeared to be related to the medication compliance behaviour although it still did not reach any statistical significance. KEYWORDS: Compliance, antihypertensive agent, blood pressure, knowledge
The aim of this study was to determine the prevalence and extent of diseases present among migrant workers. A total of 809 migrant workers were examined. The mean BMI (Body Mass Index) was 22.3 kg/m2. Only 4.9% of the respondents had blood pressure greater than 140/90 mmHg. Generally the migrant workers examined were healthy, except for subjects with abnormal eosinophilia coutns, which may indicate occult parasitic infestation. Non-communicable disease in particular hypertension and diabetes mellitus are not major problems among migrant workers. Perhaps the target to aim at are the illegal migrant workers where more illness could be detected.
MeSH terms: Blood Pressure; Cross-Sectional Studies; Diabetes Mellitus; Eosinophilia; Hypertension; Malaysia; Physical Examination; Primary Health Care; Body Mass Index; Prevalence
A case of an unusual foreign body aspiration in a child was managed T&ently. The mainstay in treahnen! is urgent extraction of the aspirated foreign body via a bronchoscope under general anaesthesia. A thoracotomy may sometimes be required when endoscopic retrieval fails, as illustrated by this case. She had an increased hospital Slay of 16 days, was ventilated for 8 days and her most serious complication was septic shock from which she recovered. KEYWORDS: Foreign body aspiration, children.
A survey was done to assess the chest radiographs of a selected group of immigrants. The objective is to ascertain the rpesence of abnormalities especially the presence of tuberculosis. Five hundred and eleven (511) chest radiographs (PA view) were evaluated. majority of the chest radiographs were normal, except for 2 cases of hilar lymphadenopathy, 4 cases of scoliosis and cervical rib, an old case of fracture of the clavicle and a case of cardiomegaly. Only 2 cases of TB were detected.
A pilot study on 250 foreign workers was undertaken during a 7 month period beginning December 1996. The study subjects were mainly males (88.8%). They were selected using non-probability sampling from two sources, that is, from University of Malaya Medical Centre (72.8%) and the PEREMBA group (27.2%). The study was clinic-based. Face-to-face interviews (using a structured questionnaires) were carried out to obtain socio-demographic, environmental, health and morbidity data. Physical examinations were also performed on the same day of the interview. Subjects were also required to give their stools, venous blood and urine specimens for microbiological, parasitological and clinical laboratory investigations. Chest X-Ray was done on all subjects. The other investigators had already reported findings on the various specific areas of their study. In this part of the report attempt was made to relate the infectious diseases to some of the socio-demographic and environmental variables on the 112 Indonesians and 133 Bangladeshi workers. Some aspects of health seeking behaviour of these foreign workers were also presented. Most of the Indonesian workers (84%) were from East Java, Jambi in the Sumatra, while majority of the Bangladeshis were from two neighboring administrative districts of Dhaka and Chittagong. The majority of the Indonesians (50.0%) were working in the service industry, while 53.5% Bangladeshis were in the manufacturing. One-fifth of the workers lived in squatter areas and nearly half of them were working in the service industry. About 70% of the workers had at least one infection. The proportion was slightly higher among the Indonesians (72.3%) compared to the Bangladeshis (67.7%). It is of interest to point out that 40% had multiple infections. Thirteen had five or more infections (details for the two of the thirteen cases are presented as case studies). However, the findings did not indicate any association between sanitation and infections. The Indonesian workers carried a higher risk of transmitting the diseases (33.9%) compared to 19.5% among the Bangladeshi workers. Those working in the construction industry were at a higher risk of transmitting the diseases compared to other industries. Slightly more than half of the workers experienced some form of minor illness or injury during the two week period preceding the interview. Majority sought private care (43.1%), while 42.3% either self-medicate or doing nothing at all. Nearly two-thirds paid out of their own pocket. Among the employers, those in the construction sector made negligible contribution (2.9%) to the payment. It is interesting to find that 41.0% of the workers took some form of health supplements, and the majority (48.4%) got it from the pharmacy or traditional sources. Nearly all (88.5%) paid on their own for their health supplements. The findings from this pilot project need to be interpreted with some caution. However, it appears that the foreign workers do have a considerable amount of health problems. If these are not addressed quickly it may endanger the health of the nation, while we readily acknowledge their contribution towards our national development.
MeSH terms: Humans; Malaysia; Pilot Projects; Transients and Migrants