Laboratory-bred females of Culex quinquefasciatus, Aedes aegypti and Aedes
albopictus from the insectarium, Unit of Medical Entomology, Institute for Medical Research
were used in the experiment. The late third stage of the F0 larvae which survived the high
selection pressure of malathion, permethrin and temephos were reared and colonies were
established from adults that emerged. Cx. quinquefasciatus larvae were subjected to selection
by malathion and permethrin for 40 generations, Ae.aegypti larvae to malathion, permethrin
and temephos for 32 generations and Ae.albopictus larvae were selected against malathion
and permethrin for 32 generations and 20 generations against temephos.. The rate of resistance
development was measured by LC50 value . Cx. quinquefasciatus larvae developed higher
resistance to malathion and permethrin compared to Ae.aegypti and Ae.albopictus. On the
whole, permethrin resistance developed at a faster rate than malathion and temephos.
MeSH terms: Temefos; Academies and Institutes; Aedes; Animals; Culex; Entomology; Female; Insecticide Resistance; Insecticides; Laboratories; Larva; Malathion; Permethrin; Biomedical Research
Ovi t rap survei l lance was conducted in two urban res ident ial areas (Taman
Samudera Timur and Taman Samudera Selatan) and in a settlement area (Kampung Banjar),
which is located 16 km from Kuala Lumpur city center, Malaysia. In Taman Samudera, dengue
cases were reported monthly in 2003/2004. Thus, a study was initiated to determine the
distribution and abundance of dengue vectors, Aedes aegypti and Ae. albopictus. The ovitrap
surveillance indicated that Ae. aegypti and Ae. albopictus were present both indoors and
outdoors. The residential sites had 73 – 79 % of the ovitraps with just Ae. aegypti population
and Kg. Banjar had 56 % of the ovitraps with just Ae. aegypti. In the indoor and outdoor of
t h e r e s i d e n t i a l a r e a s , t o g e t h e r wi t h t h e s e t t l eme n t a r e a , t h e A e . a e g y p t i d e n s i t y wa s significantly more than Ae. albopictus (p < 0.05) by 3 – 50 folds. There was no significant difference in the larval numbers of Ae. aegypti between indoors and outdoors (p > 0.05), thus
implicating that adult gravid female Ae. aegypti are present both indoors and outdoors and
they do oviposit indoors and outdoors. Ae. aegypti can be incriminated as the principal dengue
vector in the urban residential site, Taman Samudera and in the settlement area, Kg. Banjar.
House dust mites have lived in human contact from time immemorial. Human
dander or dead skin constitutes the major organic component of the house dust ecosystem.
Because the mites feed on dander, dust mites and human association will continue to co-exist
as part of our environment. Efficient house-keeping practice is the best form of control to
r e d u c e i n f e s t a t i o n . Howe v e r, s p e c i a l p r e c a u t i o n s a r e imp o r t a n t wh e n i n d i v i d u a l s a r e susceptible or sensitive to dust mites. House dust mites are responsible for causing asthma, rhinitis and contact dermatitis. The respiratory allergies are caused by the inhalation of dead
or live mites, their faecal matter or other byproducts. Immune factors are of paramount
importance in the development of dust related or mite induced respiratory diseases. House
dust mites were found in some 1,000 samples of dust taken from approximately 330 dwellings
in Peninsular Malaysia and Singapore. Mattresses, carpets, corners of a bedroom, and floor
beneath the bed are favourable dust mite habitats. The incriminating species based on studies
here and elsewhere, as well as many other species of dust mites of unknown etiological
importance are widely distributed in Malaysian homes. Density of dust mites in Malaysia and
Singapore is greater than in temperate countries. Prevention and control measures with
reference to subjects sensitive to dust mite allergies, including chemical control described in
studies conducted in Europe and America are discussed. However, a cost free and most
practical way to remove mites, their faecal matter and other products is to resort to sunning
the bedding and carpets to kill the living mites, and then beaten and brushed to remove the
dust and other components.
Laboratory efficacy and residual activity of a water dispersible granule formulation
of Bacillus thuringiensis israelensis (Bti) at the dosages of 3000, 6000 and 15000 ITU/L were
conducted in this study. The study was conducted in two different size containers, earthen
jar (45 L) and glass jar (3 L) with or without daily replenishment of 6 L and 0.3 L of water in
the earthen and glass jars, respectively. Results indicate that for both earthen jar and glass
jar evaluations, Bti at the tested dosages, performed effectively against Aedes aegypti, giving
a minimum of 42 days effective killing activity. When the dosage was increased from 3000
ITU/L to 6000 ITU/L or 15000 ITU/L, the effective periods of the Bti increased by an additional
one to three weeks. The Bti water dispersible granule provided better larvicidal activity with
replenishment of water compared with non-replenishment of water especially for the higher
dosage (15000 ITU/L).
MeSH terms: Aedes; Animals; Bacillus thuringiensis; Glass; Mosquito Control; Pest Control, Biological; Water
Misuse of alcohol among adolescents, particularly schoolchildren has become one of the public health concerns in Malaysia due to its serious effects and an increased risk of alcohol related injuries, especially motor vehicle injuries. This is the most common type of youthful fatal injury in Malaysia. However the availability of data on the extent of alcohol abuse particularly among school children in this country is limited. Therefore, we conducted this study with the objectives of identifying the prevalence of alcohol drinking among school children in Kuala Lumpur, factors rekited to alcohol drinking among the adolescents and to assess health status of their parents through the presence of any related alcohol diseases and the habits of alcohol drinking among their parents.
In this baseline study a two stage stratified sampling design was used to recruit 8532 eligible students from the selected secondary schools in Kuala Lumpur. The prevalence of alcohol drinking was 9.0% (771 / 8532) . Significant factors identihed related to alcohol consumption were akoholic father (OR=1.29), akoholic mother (1 .55) ; elder siblings consume alcohol (2 .49) and the Chinese ethnic group (1 .55) . The study revealed that factors which signihcantly contributed to the habit of alcohol drinking were related to whether their parents consumed alcohol or not or either their eMer siblings were ako taking alcohol. Therefore, the, results from this study could be used as a baseline data to describe the level of alcohol consumption among adolescents particularly school children. Ehfective public health interventions that focus on the familial context of adolescents' drinking habits may be developed.
A study was conducted in Kelantan, Mabysia, in the year 2001 , to assess the typhoid reporting coverage and timeliness, and to estimate the annual incidence. Cases were persons given the diagnosis of typhoid clinically, and conhrmed cases are those with positive laboratory results. In all, 174/252 (69%) cases (95% CI = 63%-75%) were reported, ofwhich 89/131 (83%) within 7 days of diagnosis. The estimated annual typhoid incidence in Kelantan is 37/ 1 00,000.
MeSH terms: Health Personnel; Humans; Salmonella typhi; Social Work; Typhoid Fever; Typhoid-Paratyphoid Vaccines; Incidence
A cross·sectional study was done to determine the capacity of Public Health Inspectors in Selangor using a seh administered questionnaire and universal sampling, to determine the enforcement of public health legislation and its influencing factors. A total of 99 respondents from the District Health Offices and 100 respondents from the Local Health Departments participated. The level of enforcement is generally low in all the units except for the Food Unit and Sanitary and Hygiene Units. Factors influencing enforcement of Public Health Legislations are the unit where the respondents worlc and the length of service with the unit. Further analysis using multiple logistic regression, found that respondents from the Food Unit (OR ZZ; 95% C1: 7 .9-58.9 ) , being in the
U8 category (OR 5; 95% C1: l.4» 17.6), service offour years and above in the same unit (OR 6; 95% C1: 2.2»13.8) , received service rewards (OR 3; 95% C1 : 1.2· 6.9); low exposure to bribery (OR 46; 95% C1: 2.3·100.0) and offered bribes while on the field (OR 3; 95% C1: 1.02» 4.8) have higher kvel enforcement performance. Attention must be given to the enforcement organization with respect to duration of service, service awards and monitoring of bribes exposure to help develop the enforcement of public health legislations.
MeSH terms: Attention; Awards and Prizes; Cross-Sectional Studies; Hygiene; Organizations; Public Health; Surveys and Questionnaires; Reward; Logistic Models
A cross sectional study was conducted to determine the perception of Hospital Directors in performing clinical duties. This was done through a postal survey which was conducted covering all public hospitals in Malaysia. The majority of Hospital Directors had read the circular at the time of the study and agreed to do clinical work besides managerial duties. Before the issuance of the directive, the majority of those directors were already doing some clinical work. However they disagreed that by doing clinical work they could help overcome the problem of shortage of doctors. They agreed that the duration of 10 hours per week is suitable to do clinical duties. In term of confidence in giving curative treatment, the Hospital Directors especially those from district hospitals without specialists were confident in giving curative care to individuals. As for the clinicians, the majority felt that the implementation of the directive for Hospital Directors to do clinical work will not disrupt the clinicians' routine duties.
Study site: University Malaya, Universiti Kebangsaan Malaysia; Hospital Kuala Lumpur, Malaysia
Cancer of uterine cervix is one of the most common cancers among women worldwide, second only to breast cancer in incidence and mortality. Industrialized countries have dramatically reduced the incidence of mortality from cervical cancer in the last 50 years through aggressive screening programs utilizing pelvic examinations and Papanicolaou (pap) smears. The main objective of the study was to determine the relationship between socio-demography, knowledge, attitude and practice regarding pap smear screening among female patients in Hospital Teluk Intan. There was statistically significant association between level of knowledge and practice (p
MeSH terms: Uterine Cervical Neoplasms; Female; Hospitals, District; Humans; Health Knowledge, Attitudes, Practice; Malaysia; Mass Screening; Vaginal Smears; Incidence; Developed Countries; Gynecological Examination; Papanicolaou Test
Iodine is an essential micronutrient for normal physical and mental development. Iodine deficiency is endemic in 130 countries worldwide, including Malaysia. This is a cross-sectional study done to determine the prevalence and risk factors of iodine dejiciency among 342 rural mothers attending antenatal clinics in Bachok, Kelantan. A self-adrninistered questionnaire on the knowledge, attitudes, practices and other risk factors relating to iodine deficiency was done. Physical examination for thyroid enlargement was carried out and urine samples were taken for urine iodine determination. The prevalence of iodine deficiency based on urine iodine Q level of less than 100 mcg/l was 63.0 % (95% CI: 57.8, 68.2). The mean urinary iodine level was 87.3 mcg/l with a median of 78.0 mcg/l. However, the goiter prevalence was only 9.4%. The total mean scores of knowledge, attitudes and practices were generally low at 58.6 (SD 7.9), 52.9 (SD 7.9) and 42.9 (SD 10.9) respectively. Logistic regression analysis found that a smoking husband is a risk for iodine deficiency (OR=2.0). In conclusion, iodine deficiency disorders among rural antenatal mothers were still prevalent in Bachok. Their level of knowledge on the causes, effects, prevention and clinical presentations of Q iodine deficiency disorders were poor. In addition, having a husband who is a smoker increases the risk of the antenatal mothers developing iodine denciency.
Study site: Antenatal clinic (klinik kesihatan), Bachok, Kelantan, Malaysia
Kajian sero»prevalens dijalankan untuk menentukan prevalens kes Hepatitis A dan ciri-ciri demografinya di Kampung Pangsoon, Kampung Padang dan Kampung Lubuk Kelubi, di Mukim Hulu Langat, pada 15 dan 16 Mac 2003. Sebanyak 1643 sampel telah diperiksa dan didapati 995 kes (60.6%) telah terdeclah tehadap jangkitan Hepatitis A iaitu sebanyak 327 kes di Kampung Pangsoon, 400 kes, Kampung Padang dan 268 kes di Kampung Lubuk Kelubi. Majoriti kes adalah perempuan 545 kes (54 .7%), etnik Melayu 752 kes (75 .6%) , berusia kurang daripada 40 tahun (65%) dengan min umurnya 25 .4 tahun ( SP 1 9) dan tahap pendidikan di peringkat sekolah rendah. Kes di kalangan Orang Asli pula sebanyak 231 kes (23 .2%) . Lebih kurartg 40.3% kes telah bekerja, dengan pendapatan kurang daripada RM1000 sebulan. Majoriti kes mempunyai tandas sempurna 92Z( 95.4% ), sistem air limbah 846( 91 .2%), bekalan air seharrtat 930(96.4%) dan sistem lubang sampah 426( 44.6%) . Terdapat perbezaan yang bererti (p
Health traditionally has been compared using mortality and morbidity and in recent years health related instruments have been utilized along to complement those measures. Health related quality oflife instruments are important because they provide patient's opinion and decision of management and for monitoring and evaluating health status. The quality of life instruments such as health related quality of life questionnaires are increasingly being used and these questionnaires are classified into disease specific and generic questionnaires. They require proper assessment using psychometric analysis of reliability and validity, For reliability, the two common analyses are the test-retest and internal consistency and for validity, it requires the assessment of content validity and analyses of construct validity and criterion validity. Reliable and valid quality of lhfe questionnaires provide consistent and accurate information. The purpose of this paper is to provide crucial assessment and analyses of the reliability and validity of health related quality of life questionnaires.
MeSH terms: Health Status; Humans; Morbidity; Psychometrics; Quality of Life; Surveys and Questionnaires; Reproducibility of Results
Kajian kuasbeksperimental telah di lakukan di tiga buah penempatan pembangunan tanah di negeri Johor, Pahang dan Perak, Semenanjung Malaysia daripada Januari 2003 sehingga Disember 2003 untuk menilai keberkesanan satu program intervensi yang komprehensif dalam mengurangkan tingkahlaku berisiko dikalangan remaja. Tiga buah sekolah yang diberi intervensi (disebut sebagai sekolah kes) dan tiga buah lagi sekolah tidak diberi sebarang intervensi (sekolah kawalan) telah dipilih untuk ketiga»tiga kawasan penempatan pembangunan tanah tersebut. Data pra»intervensi dan pos-intervensi telah diambil daripada setiap remaja tingkatan satu yang menjadi sampel kajian. Walaupun terdapat peningkatan signifikan dalam peratusan remaja yang bertingkahlaku berisiko pos-intervensi, namun peningkatan tersebut adalah lebih tinggi (32 .2%) di sekolah kawalan berbanding
Y sekolah kes (29.2%). Penurunan yang signifikan dikalangan mereka yang telah dikenalpasti sebagai bertingkahlaku berisiko semasa pra»intervensi berlaku cli sekolah kes (25.8%) dan juga kawalan (32.6%). Kajian ini telah menunjukkan kepentingan program interventif remaja yang bukan sahaja boleh mengurangkan bilangan remaja yang bertingkahlaku berisiko malah mencegah
sebahagian besar remaja daripada bertingkahlaku berisiko.
MeSH terms: Animals; Drugs, Chinese Herbal; Malaysia; Panthera; Gastropoda
On December 26, 2004, an earthquake triggered a devastating tsunami that caused death and destruction in twelve countries including India, Indonesia, Malaysia, Maldives, Seychelles, Somalia, Sri Lanka and Thailand. One of the authors was a volunteer with FELDA WAJA AMAN MALAYSIA medical relief team that served the Aceh victims from 16th February to 24th February 2005 (8 weeks post tsunami). A study to determine the pattern of health ailments was conducted among children aged 18 years and below based at Seuneubok Camp, 30 km from Banda Aceh. All respondents were from Pulau Aceh and the total number of children seen and examined was 60. About 18% had lost their fathers, 10 % had lost their mothers and 27% had lost one or more of their siblings. 77% suffered some form of health ailments. The common health ailments were diarrhea (61%), respiratory complaints (59%) and fever (20%). About 38 % of preschoolers had loss of appetite and 28% had sleep disturbances. About 35% of the elementary school children suffered from sleep disturbances, 29% of the young adolescents suffered from headaches and 24% had sleep disturbances. Nearly a quarter (24%) of all the children felt fearful and anxious about the disaster. Nevertheless, 56% of the respondents wanted to return back to Pulau Aceh, although 14 % did not want to go back. Interestingly, 73% of the children voiced their gratitude to God for having been saved from death.
MeSH terms: Adolescent; Amantadine; Appetite; Child; Diarrhea; Disasters; Fathers; Headache; Humans; India; Indian Ocean Islands; Indonesia; Malaysia; Mothers; Surveys and Questionnaires; Seychelles; Sleep Wake Disorders; Somalia; Sri Lanka; Thailand; Volunteers; Precipitating Factors; Siblings; Earthquakes; Tsunamis
Prevention of needle stick injuries (NSI) remained a challenge to the health care workers throughout the world. In Malaysia, efforts to prevent NSI among health care workers has been one ofthe emphases as these injuries may cause serious and potential fatal infections such as Hepatitis B, Hepatitis C and HIV. This retrospective cohort study was done to determine factors related to prevalence of NSI among health care workers in government health facilities in Negeri Sembilan that were reported from 2001 until 2003. There were 101 cases of NSI reported affecting various categories of health staff and also paramedical trainees and medical students. The NSI occurs mostly in females (72.35%), age 30 years or less (73.2%), and trainees of medical or paramedical courses (45.4%). Other characteristics found are as follows: cases had attended SP courses (60.4%) , had less than 5 years in service (78.1%) and mostly never had NSI before (93.1%), However 84.2% of N SI among the respondents that have good and very good knowledge levels on NSI prevention. It is recommended that follow-up or audit on the practice of the Standard Precautions (SP) should be implemented following the training of staff. It is also important that medical trainees or paramedical students be adequately trained on SP before entering the clinical environment.
MeSH terms: Female; Follow-Up Studies; Government; Health Facilities; Health Personnel; Hepatitis B; Hepatitis C; Malaysia; Surveys and Questionnaires; Retrospective Studies; Students, Medical; Cohort Studies; HIV Infections; Prevalence; Needlestick Injuries
The objective of this study was to evaluate compliance :0 the cliencs’ charter in a dental clinic and factors that may afect the updating of the charter. Our clients’ charter states that registration time is within IO minutes and waiting-mom time before being seen by the dentist is within 30 minutes. Convenience sampling was carried our over two weeks. Only patients above 12 years treated by dental officers were included. Data recorded included registration and wrziting-room time, treatment time, punctualiry afpaniems and workload of ajcicers. There were a total of 532 patients (407 walk»in/outpatients, 125 appointments). Results show that the mean waiting-mom time for all paticnm was nor compliant to the clients' charter (42.7 x 23.8 min for walking flll 44.9 : 32.7 min for appointments). Only 33% were seen within 30 min whilst about 23% waited for more than 60 minutes. All The mean registration time (17.9 1- 12.8 min) was ncmcomplianr everyday except on Thursdays where there were very few patients. Waiting time for elderly patients was not statistically significant from the younger patients. About 36% of appointment ariems were seen within 30 minutes; althou h hal 0 them were late, Exmzctivns, dentures and examination and diagnosis took the shortest time wrzh about 88%, 91% and 98% completed within 30 minutes respectwely. There was variable individual speed and number of patients managed by different operators, although the majority was flrsnyear dental officers. Factors that may contribute waiting time included number of patients per day, operator and punctualizy of patients.
Peningkatan mutu penjagaan kesihatan menyaksikan peningkatan populasi wargatua di Malaysia. Antara gejab yang menjejaskan taraf kesihatan wargatua adalah rnorbiditi akibat amalan merokok. Meskipun pelbagai kajian tentang merokok telah dijalankan di negara ini, namun ttclak banyak yang berkaitan dengan amalan merokok di kalangan wargatua di Malaysia. Perbezaan faktor sosio ekonomi dan pengetahuan tentang amalan merolook di kalangan 850 responden lelaki berusia 60 tahun dan ke atas yang mengambil bahagian di dalam kajian peringkat kebangsaan sempena Kempen Cara Hidup Sihat 2002 dikaji. Maklumat tentang status merokok, pengetahuan dan sikap diperolehi melalui temubual bersemuka menggunakan borang soal selidik berstruktur. Prevalen merokok di kalangan responden adalah 39.2%. Prevalen diclapati paling tinggi di kalangan golongan bertaraf sosio ekonomirendah. Pengetahuan tentang bahaya amalan merokok berbeza mengikut status perokok. Perokok mempunyai pengetahuan yang lebih rendah, sikap yang lebih negatif tentang amalan merokok serta tanggapan risiko penyakit akibat amalan merokok yang lebih rentlah berbanding dengan bekas perokok dan yang tidak pemah rnerokok. Amalan merokok merupakan masalah yang masih membelenggu wargatua lelaki di negara ini. Prevalen merokok di kalangan wargatua Malaysia pada kadar 39 .2% adalah birth tinggi jikidibandingkanhdengan Amerika Syarikat (12%) dan China (26%). Program anti merokok yang mementingkan peningkatan pengetahuan dan sokongan kepada mereka yang ingin berhenti merokok dasar wargatua. Ini untuk meningkatkan kualiti kehidupan wargatua dengan mencegah penyakit kronik berkaitan dengan merokok.
Several studies had shown that the problem of plate waste in hospitals ranged from 17% to 67%. This study aimed to determine the extent of plate waste in a district government hospital, the type of food item wasted and the factors contributing to food waste. A oross»sectional study was conducted in a district hospital, involving four third class wards. A total of 300 patients were included in the study. A plate waste was dehned as the proportion of edible portion of food served that was discarded by patients. The serving size was established by weighing each food item served over breakfast, lunch and dinner on a seven·day rotation menu, using the procedure recommended by the National Food Service Management, During the study period, the left over from each patient’s plate was weighed for all meals. The plate waste for each patient was determined by dividing the total weight of the left over with the average serving weight for the same serving in the same ward. Each patient was also given a self-administered questionnaire to obtain information on reasons or not consuming the ood items served. The overall mean ercentage plate waste of all food served in the four wards was 42.6%. Plate wastage occurred most at dinner (53.2%) and least at breakfast (31 .3%). Vegetables were the most wasted food items. Females wasted significantly higher than males for all meals. Food taste, portion size, appetite and staff service efficiency were factors found signihcantly contributing to plate waste. With almost half of the food served was wasted, hospital management need to direct more attention towards addressing the problem of plate waste since it has both nutritional and cost implications.
This survey was done to determine the knowledge, attitude and practice of preventive measures concerning Severe Acute Respiratory Syndrome (SARS) among Alor Gajah town community. The purpose of this study was to determine the knowledge level of SARS, to know their attitude towards SARS and health information provided, to know which sources that provide the best infomation about SARS and to identify the expectations and preferences of population on gaining health infomation. A cross-sectional study involving respondents age 18 and above staying in Alor Gajah town was done. The respondents were assessed using questionnaires comprising of 25 questions. A total 180 respondents had answered the questionnaire. All of them were aware of SARS with 93 .3% with high scores in the knowledge level. Furthermore, 9l .7% of respondents had high scores in their attitude towards SARS. About 98.9% of respondent got their information regarding SARS from television, and 83.9% of them believed the information given. Firty four percent choose television as the best method to convey information concerning SARS or other new emerging diseases. The knowledge and attitude of the respondents concerning SARS were good.
MeSH terms: Attitude; Awareness; Cross-Sectional Studies; Malaysia; Surveys and Questionnaires; Residence Characteristics; Television; Severe Acute Respiratory Syndrome
A cross»sectional study was undertaken between April 2005 to _1 uly 2005 to determine the extent of the health problems experienced by individuals involved in the December 2004 tsunami wave disaster in the Northeast District of Penang, Malaysia. The overall health status of the respondents were evaluated using the Short Form 36 (SF-36) questionnaire. Out of 171 respondents, 160(93 .6%) were Malays, 8(4.7%) were Chinese and 3(1.8%) were Indians. The mean age ofrespondents was 45.4 years, 15.9 years. Ninety-four of the respondents were males (55.0%) while 7 7(45.0%) were females. The overall mean physical component score was significantly lower (66.9:23 .O) amongst respondents with low education level compared with those with high education level (76.3:19.1, p=0.004). This mean score was also significantly much lower ( 68.7:22 .3) amongst those who are married compared to those who were not married (79.8:1 7.4, p=0.003) . The overall mental health score was significantly much higher (78.8:14.6) amongst those who were not married compared to those who were married (68.5:19.2, p=0.001). The overall mental health score was also significantly higher amongst those in the younger age»group (62.3:16.1) compared to those in the older age»group (72.4:18.9, p=0.005). Based on the scores obtained on the Physical Health and Mental Health dimensions of the SF-36 questionnaire, it can be concluded that the health of victims with low education, elderly and those who were married were more adversely affected than others. Therefore, it is vital that medical as well as psychological attention should be channeled to these risk groups who responded more adversely to disasters.
MeSH terms: Aged; Attention; Cross-Sectional Studies; Disasters; Female; Health Status; Humans; Malaysia; Male; Marriage; Mental Health; Surveys and Questionnaires; Tsunamis