Introduction: : Lymphatic filariasis is a public health problem in Malaysia. In sub-district Tangkarason, Beluran the nine rounds of Mass Drug Administration (MDA) do not seem to work in reducing the microfilaria (Mf) prevalence below the 2% threshold that the World Health Organization (WHO) recommends for stopping MDA. The study aims to identify possible factors contributing to the transmission of lymphatic filariasis in the area. Methods: A total of 244 individuals from seven high risk localities, whom between the age of 19 and 99-year-old, were interviewed and tested for lymphatic filariasis antibody. The associated factors were analyzed using Chi-square test (Fisher exact test where applicable) and odds ratio (OR), and adjusted odds ratio (AOR) was estimated using logistic regression. Re-sults: The median age was 40-year-old (interquartile range: 30-53). The prevalence of brugian filariasis in the studied population was 31.1% (95% CI 0.25, 0.37). Prevalence of brugian filarial infection is higher in males than in females (34.6% vs. 27.4%, P = 0.219); and in older adults (≥ 56-year-old) than in young-and-middle-aged adults (46.3% vs 26.8%, P = 0.006). The older group is 2.4 times at higher odd of contracting the disease than the younger adults (95% CI 1.26, 4.38; P = 0.007). The prevalence of brugian filarial infection is higher among those who never receive pro-phylaxis treatment compared to those who had received medications (48.5% vs 28.4%, p = 0.021). Those who had received prophylaxis treatment have about 60% reduction in odd of lymphatic filariasis infection (OR 0.42; 95% CI 0.20, 0.89; P = 0.023). The proportion of the studied population who has outdoor jobs is 52.9%. The prevalence of brugian filarial is higher in this group compared to those with indoor jobs (38.0% vs 23.5%, p = 0.015). The older age group was significantly associated with brugian filarial infection after adjusting for other factors (AOR 3.20; 95% CI 1.63, 6.32). Conclusion: The older adults (≥ 56-year-old), those who never involved in MDA and those with outdoor jobs are associated with lymphatic filariasis infection in Beluran.
MeSH terms: Adult; Aged; Aged, 80 and over; Animals; Antibodies; Elephantiasis, Filarial; Female; Malaysia; Male; Middle Aged; Public Health; World Health Organization; Prevalence; Chi-Square Distribution; Logistic Models; Odds Ratio; Young Adult
Introduction: Tuberculosis (TB) still remains a public health problem worldwide and the emergence of drug resistant TB (DR-TB) has worsened the situation as it is difficult and expensive to treat. The characterization of the genetic mutations underlying streptomycin resistance may be helpful in developing rapid detection methods which may guide clinicians in making therapeutic decisions. The aim of this study is to detect mutations causing streptomycin (STR) resistance in Mycobacterium tuberculosis isolates from Sabah. Methods: Susceptibility testing was carried out in MGIT system for 42 Mycobacterium tuberculosis clinical isolates. The drug resistant isolates were subject to whole genome sequencing and in-silico analysis was performed to detect the mutations in the sequence of the rpsL gene known to confer resistance to anti-tuberculous drugs. Results: Of the 42 positive isolates, 27 (64.3%) are shown to be susceptible towards first line drugs (FLDs) while 15 (35.7%) isolates were mono- and multiple resistant to the FLDs. Our findings reveal that the isolate 145 possess mutations at codon 43 within rpsL gene with amino acid change A to G (K43R). Conclusion: Findings from this study enable us to expand our knowledge of mutations causing drug resistance in Mycobacterium tuberculosis and the point mutations, which can be used as the potential marker for detection of drug resistant isolates.
MeSH terms: Amino Acids; Codon; Drug Resistance; Malaysia; Mutation; Mycobacterium tuberculosis; Public Health; Streptomycin; Tuberculosis; Point Mutation; Tuberculosis, Multidrug-Resistant
Introduction: There has been a resurgence of vaccine-preventable diseases in Malaysia over the recent years. In overcoming this issue, parents as the main caregiver of their children play a major role, which is to protect their children against diseases via vaccinations. This study aimed to examine the parents’ vaccine knowledge, aware-ness, and hesitancy in relation to their children’s immunisation status and to determine the association between the parents’ vaccine knowledge, awareness, and hesitancy. Methods: A cross-sectional study with a sample size of 405 parents was conducted in the Sandakan health clinics from February 2018 to April 2018 by employing validated questionnaires adapted from two studies. Results: The median ± IQR of the total vaccine knowledge and awareness scores (ranging from 0-10) were 7.00±3.00 and 8.00±4.00, respectively. Meanwhile, the median ± IQR of the total vaccine hesitancy scores (ranging from 0-100) was 16.67±20.00, with only 27 (6.8%) parents being vaccine-hesitant (scores >50). Most of the children (n=376, 92.8%) were immunised in the study. It observed a significant association between the children’s immunisation status and the parents’ vaccine knowledge scores (p = 0.005). Nevertheless, the children’s immunisation status was not significantly associated with the parents’ vaccine awareness and hesitancy scores. The positive Spearman correlation value (r = 0.551) signified that the parents’ vaccine knowledge was posi-tively associated with their vaccine awareness. On the other hand, both the vaccine knowledge and awareness were negatively correlated to the vaccine hesitancy as indicated by the negative Spearman correlation value (r = -0.397 and r = -0.351 respectively). Conclusion: The study established that the parents with a better understanding about vaccinations were more likely to keep their children’s immunisation up-to-date. It was also revealed that improving the parents’ knowledge and raising their awareness about the importance of vaccination are vital in reducing their vaccine hesitancy.
Introduction: Childhood vaccination is proven as the most effective intervention to prevent and reduce children mortality caused by Vaccine Preventable Diseases (VPD). It is a major public health concern globally as there are still existences of vaccine incompletion. Despite good immunization coverage, outbreaks of VPD are still reported from time to time with serious implications. The aim of this study is to assess the association between maternal health literacy with completion of childhood vaccination. Methods: A cross- sectional study design was conducted among mothers with children aged 5 years and below using a face to face interview questionnaire. Data entered and analyzed using SPSS version 22. Chi square was used to look for association between two categorical data. Results:Majority of respondents were mother‘s aged 30’s, Malays (76.1 %), completed secondary education (74.8 %) un-employed (63.8 %).Study showed (98.99%) children completed vaccination however (1.01 %) had incomplete vac-cination. There was significant findings on association between maternal education and partner‘s education, main language, employment status and household income with health literacy. The mean health literacy score among the incomplete vaccination group was slightly lower (36.9) compared to the completed vaccination group (39.4). The problematic health literacy was seen at (17.4 %) and the sufficient health literacy was (82.6%). Conclusion: The finding indicated that there is an association between maternal education, partner‘s level of education with health literacy. The health literacy score among those who completed vaccination was slightly higher. Initiatives focusing on maternal health literacy could further improve vaccination completion among children.
MeSH terms: Adult; Child; Child, Preschool; Disease Outbreaks; Educational Status; Employment; Female; Humans; Language; Malaysia; Maternal Age; Mothers; Public Health; Surveys and Questionnaires; Vaccination; Vaccines; Child Mortality; Health Literacy
Introduction: Hypertension prevalence is increasing globally and has become a major issue of disease as it is a major cause for cerebrovascular, kidney and cardiovascular diseases. Even among treated patients, there is a dispropor-tional of blood pressure control causing a major public health challenge. This study is aimed to decide on the prev-alence of uncontrolled hypertension and its associated factors among hypertensive patient attending hypertension clinic at primary health clinics in Tuaran district. This study is justified by the fact that uncontrolled hypertension leads to high mortality, morbidity and even premature death. Methods: This study is a cross-sectional study among 460 hypertensive patients attending three primary health clinics in Tuaran district, Sabah. Data were collected using structured modified questionnaires through interviews, physical examinations and patient’s medical records. Types of data collected include socio-demography, lifestyle behavior, physical examination, co-morbidity status and med-ical adherence. Data analysis done using SPSS version 24.0. Results: Prevalence of uncontrolled hypertension was 45.9%. The study found that factors significantly associated with uncontrolled hypertension with p
MeSH terms: Blood Pressure; Blood Pressure Determination; Cardiovascular Diseases; Cross-Sectional Studies; Humans; Hypertension; Life Style; Malaysia; Medical Records; Morbidity; Public Health; Surveys and Questionnaires; Comorbidity; Prevalence; Mortality, Premature
Introduction: In recent years, the variation in total fertility rate (TFR) has sparked public interest for demographic concerns on the global population shift towards an older age structure. This study aims to investigate the determi-nants of total fertility rate among Brunei, Indonesia, Malaysia and Philippines East Asian Growth Area (BIMP-EAGA) region. Methods: Our empirical study consists of data collected from the United Nations Development Report of the UNDP, World Development Indicators (WDI) of the World Bank and World Health Organization (WHO) report 2018. We investigated the socio-economic determinants of fertility rate by analyzing a panel data set consisting of 28 years from 1990-2017 of the four countries. A statistical and econometric software EViews version 10 (HIS Global Inc., Irvine, CA, USA) were used to run a Pearson’s Correlation and a multiple regression analysis by panel least squares method. To investigate the determinants of TFR we have selected five socio- economic factors, these are- Infant mortality rate (IMR), Gross National Income Per Capita, PPP (GNI), Human Development Index (HDI), percentage of population living in urban areas (URB) and lastly Female Labor Force Participation Rate (FLP). Results:Pearson’s correlation showed that a statistically significant negative relationship exists between TFR and the 3 vari-ables- GNI, URB and HDI. A statistically strong positive relationship exists between IMR and TFR. However, our results from the empirical multiple regression model indicates that there is a statistically significant negative relation-ship exists between TFR and two of the independent variables GNI and FLP. Conclusion: The results of present study showed that an increase in the national income and female labor participation rate in the workforce could result in a decrease in total fertility rate. These findings may have implications for countries national policy for planning, development and resource allocation.
MeSH terms: Aged; Birth Rate; Brunei; Employment; Female; Fertility; Humans; Income; Indonesia; Infant; Infant Mortality; Malaysia; Philippines; Ships; United Nations; World Health Organization; Least-Squares Analysis; Resource Allocation
ABSTRACTS FOR THE 1ST INTERNATIONAL BORNEO HEALTHCARE AND PUBLIC HEALTH CONFERENCE AND 4TH BORNEO TROPICAL MEDICINE AND INFECTIOUS DISEASE CONGRESS. New Frontiers in Health: Expecting the Unexpected. Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia. 3rd-5th September 2019
Introduction: Rice is classified as waxy, very low, low, intermediate and high based on its amylose content (AC). Most people prefer to consume intermediate AC rice because of its texture which tends to appear in between low (moist and sticky) and high (dry and less tender). Although rice with high AC appears dry and less tender, it usually possesses a low glycemic index (GI) i.e. a slower increase in blood glucose level after the consumption of food. Consequently, people with diabetes are recommended to eat low and intermediate GI foods. Although, rice is generally categorised as a high GI staple food there are some exceptions to it. For example, the premium Basmati aromatic rice possesses a low GI and is recommended for diabetic patients. The study aimed to identify Sabah’s traditional rice germplasm with low GI via AC that may be used as a replacement to commercial rice varieties.
Methods: A total of 110 traditional rice samples were obtained from rice fields located in the Tuaran and Kota Belud districts of Sabah. The AC in each sample was determined via I:KI method (ISO AACC-6647).
Results: We found that 46 (41.8%), 51 (46.4%), 7 (6.4%) and 6 (5.5%) Sabah’s traditional rice samples possess high, intermediate, low and very low AC, respectively. The intermediate AC type is predominant in Sabah’s traditional rice germplasm as it is the preferred rice texture by the general population. We have identified 46 rice germplasm with high AC type (i.e. with low GI value). The AC content in these is comparable to the Basmati rice and may be suitable candidates for diabetic patients.
Conclusion: The present study showed Sabah’s traditional rice germplasm has the potential to be promoted as a low GI rice cultivar based on AC for diabetic patients in order to prevent spikes in blood glucose levels while still enjoying the staple food
Introduction: Fewer men were engaged in taking responsibility of their own health. Previous evidence showed that the roles of masculinity, self-rated health status, social support and health literacy level affecting health seeking behaviour among men. However, there is still lack of evidence in Malaysia. The objective of this study was to deter-mine the factors influencing health seeking behaviours among male university students. Methods: This was a cross sectional study conducted in Universiti Malaysia Sarawak. Recommended sample size was 360 respondents. Out of eight faculties, using EXCEL randomization technique, first 4 faculties were selected. The selected faculties were Faculty of Business and Economics, Faculty of Social Sciences, Faculty of Engineering and Faculty of Language and Communication. Based on the name list given from each faculty, alternate names very selected to participate. Data was collected using self-administered questionnaire. Results: 354 male students participated in this study. Total of 259(73.2%) students were reported to have low overall health seeking behaviour. Chi-square analysis showed of all the variables, there was correlation between health literacy level (r = 0.149, n = 354, p
MeSH terms: Communication; Cross-Sectional Studies; Faculty; Humans; Language; Malaysia; Male; Surveys and Questionnaires; Random Allocation; Social Sciences; Students; Universities; Sample Size; Health Literacy
Introduction: Clinical wastes produced by health facilities were considered as scheduled waste listed in the First Scheduled of the Environmental Quality (Scheduled Waste) Regulation 1989. The management of clinical waste in all government hospitals in Sabah were outsourced to private concession company. Until now, there was no research being done in Sabah to evaluate it. Methods: This cross-sectional study was carried out on eight concessionaire com-panies located inside accredited non-specialist government hospitals in West Coast Division & Interior Division of Sabah. Data collected through Clinical Waste Management (CWM) Scores and Questionnaires. CWM scores adopt 5 elements of accreditation standard produced by Malaysian Society Quality in Health (MSQH). Questionnaires were used to collect concessionaire staff’s basic personal data, services and activities related to clinical wastes ac-cording to MSQH standard. Response from questionnaires were used to compare and support result gained from CWM scores. Descriptive analysis was used to analyze the data. Results: Two concessionaire companies got overall CWM scores ranging between 86% - 90%, while the other six companies were above 95%. It happened because both companies gained 81% and 73.3% on Policies and Procedures element. Result from questionnaires answered by 67 concessionaire staffs showed 98% of staffs had attended meeting, 97% had received an orientation, 97% had received training related to clinical wastes, 95% agreed that their work was monitored and no occupational disease and injury recorded between January to April 2019. These result correlate with CWM scores gained under Orga-nization Management element (99.6%), Human Resource Management element (90.1%), Facilities and equipment element (97%) and Safety & Quality Improvement element (100%). Conclusions: All concessionaire companies were implementing excellent clinical waste management in hospitals. CWM scores can be used to rank individual conces-sionaire company and provide pattern of uniformity or non-uniformity of the clinical waste management in Sabah.
Introduction: Interprofessional scientific communication skills are an essential part of the medical profession. Mul-tiple research suggests poor interprofessional communication has direct correlations with poor patient outcomes. As part of the inaugural Multiple Mini Interview (MMI) at Universiti Malaysia Sabah, a 5-minute station on science com-munication was introduced, assessed on three domains – logical thinking, communication skills, and general impres-sion. This station featured a panicky nurse calling a doctor to get them to calculate doses of a medication, using only upper primary school-level arithmetic and knowledge of ratios. Methods: 255 candidates, grouped into 3 separate geographical groups – Klang Valley, non-Klang Valley, and Borneo – participated in the MMI featuring a science communication station. Candidates were graded in the abovementioned three domains, and correlations were cal-culated between scores and various sociodemographic factors, with an objective written basic science test, and with overall scores. Also, quantitative analysis was done of the “red flag” comments for candidates deemed unsuitable for the practise of medicine. Results: The average scores for West Malaysia for logical thinking scores were higher than Borneo, with non-Klang Valley scores (4.1) significantly higher than Klang Valley (3.6). Communication scores were also significantly lower in Borneo compared to West Malaysia. General impression scores hence also showed a dis-crepancy between West Malaysian and Bornean scores. There were a total of 8 red flags, with reasons ranging from gross miscalculation with misplaced confidence, to nervous breakdowns while performing calculations. Conclusion: The present study showed that there is a distinct separation of science communication scores between geographic re-gions. Also it illustrates the yawning gap between academic knowledge and “translational” scientific knowledge. The results illustrate the need for medical curricula to boost resilience and translational computational skills in medical graduates who will be working in environments that demand usual abilities under unusual and trying circumstances.
Introduction: Illegal immigrants refer to the migration of people into a country in ways that violates its immigra-tion laws. A stateless person is a person who is not considered as a national by any state under the operation of its law. Interestingly, many who are stateless have never even crossed an international border. The term illegal is very loosely used in places like Sabah where it is interchanged with statelessness. As of 13 November 2018, it was estimated that there are about 12 million stateless people in the world. This review seeks to understand the current demographic situation in Sabah along with the public health repercussions of this demographic change and also to look into the success stories from around the world along with the recommendations from United Nation in solving this matter. Methods: The method used is reviewing of literature of previous studies conducted on statelessness and illegals. Local as well as international studies were reviewed. The data base used was ProQuest. Results: This review identified that one third of Sabah’s population consists of non-locals and in the past 27 years, about half a million illegal immigrants have been deported from Sabah. These numbers pose major public health repercussions from the economic, crime and health point of view. The way forward involves incorporating the United Nation Action plan with the local requirements and settings. Despite challenges, Sabah is trying its best to curb this issue and the Public health repercussions through various initiatives. We have also identified that more public health actions can be taken to reduce the negative effects. Conclusion: Dealing with the stateless and illegals is a delicate matter and there is no one way to solve it. Every country and every state are unique therefore the methods used must be tailor made. This is not something that can be solved within a short period of time and therefore persistence and perseverance is very much needed to tackle this global issue.
MeSH terms: Undocumented Immigrants; Crime; Demography; Health Services; Humans; Malaysia; Public Health; Publications; United Nations
Introduction: Needlestick injuries (NSIs) are common occupational hazards against healthcare workers (HCWs). NSIs led to serious economic burden as there were high costs forhealth system and the society, as well as the psycholog-ical impact on exposed workers post injury. Methods: A retrospective cohort study was conducted to determine the incidence, contributing factors of NSIs and to estimate the cost of PEM in Sabah’s tertiary hospitals. Descriptive statis-tics were used to analyse and describe the trends of NSIs. Chi-Square test was performed to determine the association between variables, relative risk was calculated. Results: 145 cases out of 7075 employees were reported from 2017 to 2018. Results in this study showed that the highest incidence of NSIs was 2.4/100 employees in Hospital Queen Elizabeth. 1.1/100 employees in 2018, which was higher compared to year 2017. Most common among younger age group between 20-29 years old, among doctors, with median working experience of 2 years. NSIs occurred com-monly at the wards, during blood taking, disposal of devices and common device used were hypodermic needles. There was a lack of awareness on NSI precaution guidelines among the doctors (χ2=19.304, df=1, p=
MeSH terms: Adult; Health Personnel; Humans; Malaysia; Needles; Physicians; Retrospective Studies; Risk; Societies; Incidence; Chi-Square Distribution; Needlestick Injuries; Cost of Illness; Tics; Young Adult; Tertiary Care Centers
Introduction: Early childhood development (ECD) refers to cognitive, emotional and social development of young children. First three years of life are very crucial for ECD because during this time, brain grows fastest and is most responsive and receptive. Plenty of new connections (synapses) are formed in brain so that children acquire 85% of adult’s brain volume by this age. Proper nutrition and positive stimulation are essential during this time. Play positively stimulates the brain and helps to create more, healthy inter-neuronal connections. The objective of this review was to make a constellation of research works and explore to learn the concept of ECD and its relationship with play. Methods: An extensive literature search was done using the key words: ‘early childhood development and play’; ‘play and brain development in children’; ‘neuroplasticity and play’; ‘how do children learn’; ‘synaptic connections and early childhood development’; and ‘can play make children intelligent’. The databases explored for the resources included Medline (PubMed), PsycINFO, Teacher Reference Center, Child Encyclopedia, Health & Education Advice & Resource Team (HEART) database, Catholic Relief Services database, UNICEF & World Bank databases, and Cochrane review. Results: The result of the review work showed that play has a temporal and linear relationship with cognitive and social development among preschool children. Conclusion: In this era of screen addiction, parents spend free time in social media and the kids playing or watching video games. It is contextual to propagate the concept of ECD and raise the awareness so that parents are motivated to spend more time playing with their children. No investment in human capital can be worth more than this.
MeSH terms: Brain; Catholicism; Child; Child, Preschool; Cognition; Humans; Neuronal Plasticity; Parents; Social Change; Synapses; United Nations; MEDLINE; Video Games; PubMed; Social Media
Introduction:Diabetes is high in the agenda of public health issues with significant prevalence of diabetic-related amputations. Prosthetic restoration post-amputation is imperative to reduce disability, but its success is influenced by several factors. This study analysed the practice, and the determining factors affecting prosthetic restoration among major lower limb amputees with diabetes in Sabah. Methods: Retrospective cross-sectional study among 65 major lower limb amputees with diabetes referred for rehabilitation medicine services at Queen Elizabeth Hospital from 1st January 2015 to 31st December 2017. Demographics data, pre-morbid diseases, levels of amputation and prac-tice on prosthetic restoration (suitability for restoration, duration from prosthetic application to restoration, funding issue) are primary evaluated factors. Results: Forty-nine, fifteen and one amputees had below knee amputation, above knee amputation and hip disarticulation respectively. Forty-three amputees (66.2%) were deemed suitable for prosthetic restoration but only 27 were prosthetically restored, with mean duration from prosthetic application to res-toration of 5.92±2.189 months. Having additional pre-morbid diseases did not reduced the likelihood of suitability for prosthetic restoration compared to those only with diabetes (p=0.082). Funding issue is the key factor affecting prosthetic restoration with higher likelihood for restoration among those eligible through governmental agencies funding (p=0.027). Conclusion: In Sabah, low rate of suitability for prosthetic restoration is observed among major lower limb amputees with diabetes. A larger study is warranted to investigate causes of such low rate of suitability for prosthetic restoration among this specific population in the effort to reduce public health burden from major lower limb amputation-related disability.
Introduction: Chemical pesticide is commonly used among vegetable family farmers in Sabah. There is no system to monitor adverse health effects. This study is to determine the blood cholinesterase activity and associated factors among vegetable family farmers. Methods: A cross sectional study has involved 163 farmers aged 18-60 years old. Validated questionnaire was used to assess the associated factors. Lovibond AF267 Cholinesterase Kit was used to determine the blood cholinesterase activity. Chi square test was used to determine the association between blood cholinesterase activity and socio demographic factors and work practices. Results: Approximately 23.3% of study sample had low blood cholinesterase activity. There were significant associations between low blood cholinesterase activity with older age group (p
Introduction: Kidney transplantation (KT) is the preferred end-stage renal disease (ESRD) treatment because it pro-vides a better survival rate, quality of life as well as a cheaper alternative. However, Malaysia’s KT rates is consis-tently low considering that ESRD rates have been increasing exponentially. With only four hospitals performing KT, there’s a gap to indicate a lack of evaluation in KT system of Malaysia. Qualitative study was undertaken to explore and describe the barriers and solutions improve the rates and service of KT in Malaysia. Methods: Semi-structured interviews adopted as qualitative methodological approach to explore current KT policy and service in Malaysia be-tween March – May 2018 in Kuala Lumpur. Eight key-informants selected using stakeholder analysis and informed consent were obtained. Interviews were digitally audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Barriers and solutions of Malaysia’s KT are the results of complex interplay of personal, cultural, and environmental factors that can be categorized and described using the five levels of influence conceptualized by the socio-ecological model (SEM). Guidance for developing culturally appropriate and sensitive interventional strategies was elicited from the key informants’ experiences to improve KT rate and services in Malaysia. Conclusion:Malaysia is experiencing very low rate of KT compared to other countries. The use of SEM provided a framework to foster a better understanding of current practice, barriers and solutions to KT in Malaysia. Implications of these find-ings could prompt policy change for better KT service delivery model. Further stakeholder engagement and evalua-tion is required to align best practices to improve KT rates and service in Malaysia that is comparable to high-income countries.
MeSH terms: Informed Consent; Kidney Failure, Chronic; Malaysia; Polysorbates; Quality of Life; Survival Rate; Kidney Transplantation; Developed Countries; Qualitative Research
Introduction: The Environment of Care (EoC) is less being the highlight as one of the important components in hospi-tal administration. The EoC is the interface between the patient and the organisation and it provides both a practical and safe area in which to provide patient care. The study aims to determine the correlation between the environment of care, patient satisfaction and willingness to recommend. Methods: This was a cross-sectional study conducted in one of the teaching hospitals in Malaysia. A Malay validated Hospital Consumer Assessment of Healthcare Provider and System (HCAHPS) questionnaire was used. The multistage sampling was applied. 13 wards represent medical, surgical and O&G based wards were selected randomly. Systematic random sampling method was used for pa-tient selection. Number of samples for each ward was calculated proportionately based on the average number of discharge patient monthly. The global rating item in HCAHPS was used to determine satisfaction level. Data was collected and analysed using SPSS version 22.0. Results: 547 respondents were involved in the study with 61.6% of them were female. Majority of respondents were young adult less than 60 years old. 36.9% of the respondents had positive experience with cleanliness of the ward meanwhile 26.7% had positive experience with quietness of the ward. 57.6% of the respondents were satisfied with the services and 64.5% were willing to recommend the hos-pital to others. There was a significant correlation between environment of care, satisfaction level and willingness to recommend. Conclusion: The healthcare facility needs to concentrate on creating a positive experience on EoC component as this can influence satisfaction level and willingness to recommend the hospital.
MeSH terms: Cross-Sectional Studies; Female; Patient Care; Health Personnel; Hospitals, Teaching; Humans; Malaysia; Middle Aged; Patient Discharge; Personal Satisfaction; Surveys and Questionnaires; Patient Satisfaction; Young Adult
Introduction: Dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) are Arboviruses that are transmitted by the same vector, Aedes aegypti. Dengue has become a global problem since the Second World War and is common in more than 110 countries. In Malaysia, dengue is a major disease burden as total economic costs to the country as a result of dengue is close to RM1.05 billion in 2010 and estimated to rise to 1.3 billion by 2020. Apart from Dengue, Zika and Chikungunya are the other important mosquito borne diseases in Malaysia. The aim of this study was to develop a multiplex real-time assay for simultaneous detection of DENV, ZIKV and CHIKV in clinical specimens. Methods: The published singleplex protocols were used with key modifications to implement a triplex assay. A one-step multiplex real-time RT-PCR assay was developed that can simultaneously detect RNA of DENV, ZIKV and CHIKV with good performance for a routine diagnostic use. The assay was evaluated for inter- and intra-reproducibility by mean CT value. The diagnostic sensitivity was tested with 135 archived samples which had been defined positive or negative by routine singleplex assays. Whole blood, plasma and urines were used in this study. Results: Intra- and inter-reproducibility and sensitivity varied from 0.10% to 4.73% and from 0.45% to 5.98% for each virus respectively. The specificity of detection was 100%. The multiplex real-time RT-PCR assay showed concordance with test results performed by routine singleplex assays. No cross reaction was observed for any of the clinical samples. Conclusion: The development of a rapid, sensitive and specific molecular assay for DENV, ZIKV and CHIKV infections will produce a greater diagnostic capacity in our laboratory. This multiplex approach is cost effective and robust with the concurrent detection of 3 viruses of public health concern.
MeSH terms: Zika Virus Infection; Zika Virus; Aedes; Animals; Arboviruses; Chikungunya virus; Cost-Benefit Analysis; Malaysia; Public Health; RNA; Reproducibility of Results; Reverse Transcriptase Polymerase Chain Reaction; World War II; Multiplex Polymerase Chain Reaction; Chikungunya Fever; Mosquito Vectors
Introduction: Food poisoning usually occurs with the consumption of contaminated food. Some related factors are unsafe water supply, poor sanitation, unhygienic waste disposal and unhygienic practices or poor personal hygiene by food handlers. The purpose of this study is to describe the spatial epidemiology of food poisoning cases in the four districts of Sabah. Methods: This review consists of all food poisoning cases reported from 2011 to 2014 from Kota Kinabalu, Penampang, Putatan and Papar, Sabah. The coordinates used for locations of cases are based on home addresses. Tools such as SPSS v20, ArcGIS v10 and CrimeStat IV were used for data analysis and mapping. Results: A total of 1,787 cases of food poisoning were reported during this review period. In 2011, only Kota Kinabalu and Pa-par illustrated significant food poisoning clusters. Meanwhile, in the year 2012 to 2014, Kota Kinabalu, Penampang and Putatan had clustering of cases. Analysis of nearest neighbour hierarchical clustering analysis showed 32 food poisoning clusters. There were 4 food poisoning points at 500 meters radius around a market place, 2 food poisoning points near a sewage plant and 1 food poisoning point near a water treatment plant. No cases were near a municipal landfill. For rivers and coastline, there were 37 points of food poisoning cases in the proximity of 500 meters. Con-clusion: Food poisoning usually occurs in clusters with possible associated environmental factors.
Introduction: Zika infection was declared as Public Health Emergency of International Concern since year 2015. Despite of no new reported case via National Surveillance System for flavivirus, an underestimated seroprevalence might occur as the country contributes to the Asian lineage of the virus. Methods: Systematic literature search using PICO framework and PRISMA checklist across four databases for articles published from year 2013-2018 yielded 189 results, 37 articles accepted by titles following criteria were subjected to abstract screening, leaving 8 articles with clear risk proceed to full text analysis using Cochrane checklist and GRADE assessment. Results: There were four high quality articles and four low quality articles based on biases in studies. Blood product management and vac-cination are strategies strongly recommended to be implemented as Zika response while vector control and family planning are public health measures to be proposed as policy if feasible. Successful factors to improve Zika surveil-lance and management includes developing algorithm for blood product management, anti-Zika vaccine research, algorithm for new-born screening, participation of policy makers, healthcare capacity building, raising healthcare and public awareness on the infection, international funding, utilization of technology in data management and bio-logical control of vector. Conclusion: Implementation of Zika response as policy is timely, should be evidence-based and follow guidelines from WHO / CDC / FDA US after cost-effectiveness evaluation for Malaysia setting.
MeSH terms: Zika Virus Infection; Zika Virus; Animals; Cost-Benefit Analysis; Disease Vectors; Emergencies; Family Planning Services; Flavivirus; Humans; Malaysia; Public Health; United States; Seroepidemiologic Studies; Checklist; Capacity Building