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Fulltext Impact of sandwiched strain periodic multilayer AlN/GaN on strain and crystalline quality of a-plane GaN

Kamarundzaman A, Abu Bakar AS, Azman A, Omar AZ, Talik NA, Supangat A, et al.

Sci Rep, 2021 May 06;11(1):9724.
PMID: 33958689 DOI: 10.1038/s41598-021-89201-8

We demonstrated high-quality single crystalline a-plane undoped-gallium nitride grown on a nonpatterned r-plane sapphire substrate via metal-organic chemical vapor deposition. The effect of four different numbers of sandwiched strain-periodic AlN/GaN multilayers on the strain state, crystal quality, optical and electrical properties was investigated. Field emission scanning electron microscopy and atomic force microscopy showed that the surface morphology was improved upon insertion of 120 pairs of AlN/GaN thin layers with a root-mean-square roughness of 2.15 nm. On-axis X-ray ω-scan rocking curves showed enhanced crystalline quality: the full width at half maximum decreased from 1224 to 756 arcsec along the [0001] direction and from 2628 to 1360 arcsec along the [1-100] direction for a-GaN grown with 120 pairs of AlN/GaN compared to a-GaN without AlN/GaN pairs. Reciprocal space mapping showed that a-plane GaN with a high number of AlN/GaN pairs exhibits near-relaxation strain states. Room-temperature photoluminescence spectra showed that the sample with the highest number of AlN/GaN pairs exhibited the lowest-intensity yellow and blue luminescence bands, indicating a reduction in defects and dislocations. The a-plane InGaN/GaN LEDs with 120 pairs of SSPM-L AlN/GaN exhibited a significant increase (~ 250%) in light output power compared to that of LEDs without SSPM-L AlN/GaN pairs.
Fulltext Author Correction: Impact of sandwiched strain periodic multilayer AlN/GaN on strain and crystalline quality of a-plane GaN

Kamarundzaman A, Abu Bakar AS, Azman A, Omar AZ, Talik NA, Supangat A, et al.

Sci Rep, 2021 Aug 11;11(1):16639.
PMID: 34381162 DOI: 10.1038/s41598-021-96016-0
Fulltext Detection of Moderate Traumatic Brain Injury from Resting-State Eye-Closed Electroencephalography

Lai CQ, Ibrahim H, Abd Hamid AI, Abdullah MZ, Azman A, Abdullah JM

Comput Intell Neurosci, 2020;2020:8923906.
PMID: 32256555 DOI: 10.1155/2020/8923906

Traumatic brain injury (TBI) is one of the injuries that can bring serious consequences if medical attention has been delayed. Commonly, analysis of computed tomography (CT) or magnetic resonance imaging (MRI) is required to determine the severity of a moderate TBI patient. However, due to the rising number of TBI patients these days, employing the CT scan or MRI scan to every potential patient is not only expensive, but also time consuming. Therefore, in this paper, we investigate the possibility of using electroencephalography (EEG) with computational intelligence as an alternative approach to detect the severity of moderate TBI patients. EEG procedure is much cheaper than CT or MRI. Although EEG does not have high spatial resolutions as compared with CT and MRI, it has high temporal resolutions. The analysis and prediction of moderate TBI from EEG using conventional computational intelligence approaches are tedious as they normally involve complex preprocessing, feature extraction, or feature selection of the signal. Thus, we propose an approach that uses convolutional neural network (CNN) to automatically classify healthy subjects and moderate TBI patients. The input to this computational intelligence system is the resting-state eye-closed EEG, without undergoing preprocessing and feature selection. The EEG dataset used includes 15 healthy volunteers and 15 moderate TBI patients, which is acquired at the Hospital Universiti Sains Malaysia, Kelantan, Malaysia. The performance of the proposed method has been compared with four other existing methods. With the average classification accuracy of 72.46%, the proposed method outperforms the other four methods. This result indicates that the proposed method has the potential to be used as a preliminary screening for moderate TBI, for selection of the patients for further diagnosis and treatment planning.
Fulltext Subperiosteal Drainage versus Subdural Drainage in the management of Chronic Subdural Hematoma (A Comparative Study)

Chih AN, Hieng AW, Rahman NA, Abdullah JM

Malays J Med Sci, 2017 Mar;24(1):21-30.
PMID: 28381926 DOI: 10.21315/mjms2017.24.1.3

INTRODUCTION: Symptomatic chronic subdural hematomas (CSDH) remain one of the most frequent diagnoses in current neurosurgical practice. Burr-hole craniostomy with irrigation and placement of close-system drainage is the current recommended surgery for symptomatic CSDH. The aim of this study is to perform a direct comparison between two surgical techniques in the treatment of symptomatic CSDH, which have been proven in previous studies to be efficient. Our main objective was to compare the efficacy of placement of a subperiosteal drain (SPD) and a subdural drain (SDD) following single burr-hole craniostomy and irrigation, and to demonstrate any significant differences in terms of overall surgical complications, functional outcome at three months and mortality rate.
MATERIALS AND METHODS: The study was carried out in two local neurosurgical centres. The SPD group was performed in Hospital Umum Sarawak (HUS) and the SDD group was performed in Hospital Sultanah Aminah Johor Bahru (HSAJB), from 1 January 2012 till 30 January 2014 with a total of 30 patients in both treatment groups.
RESULTS: Overall, there were no statistically significant difference in terms of patient general characteristics, pre-operative and post-operative symptoms, Markwalder grades, post-operative hematoma volume and recurrence, mortality and functional outcome at discharge and at three month follow-up between both groups. Albeit not achieving statistical significance, we observed a lower rate of surgical complication especially for post-operative intracranial hematoma with placement of the SPD system.
CONCLUSIONS: Our study concludes that both treatment methods proved to be highly effective in the treatment of CSDH. However, with a lower overall surgical complication rate, treatment with single burr-hole craniostomy, irrigation and placement of the SPD system can be considered a treatment of choice for the management of symptomatic CSDH.
Fulltext Multi-level basis selection of wavelet packet decomposition tree for heart sound classification

Safara F, Doraisamy S, Azman A, Jantan A, Abdullah Ramaiah AR

Comput Biol Med, 2013 Oct;43(10):1407-14.
PMID: 24034732 DOI: 10.1016/j.compbiomed.2013.06.016

Wavelet packet transform decomposes a signal into a set of orthonormal bases (nodes) and provides opportunities to select an appropriate set of these bases for feature extraction. In this paper, multi-level basis selection (MLBS) is proposed to preserve the most informative bases of a wavelet packet decomposition tree through removing less informative bases by applying three exclusion criteria: frequency range, noise frequency, and energy threshold. MLBS achieved an accuracy of 97.56% for classifying normal heart sound, aortic stenosis, mitral regurgitation, and aortic regurgitation. MLBS is a promising basis selection to be suggested for signals with a small range of frequencies.
The global three: A Malaysian lens on the challenges and opportunities facing restorative justice planning and implementation

Mohammad T, Azman A, Anderstone B

Eval Program Plann, 2019 02;72:1-7.
PMID: 30245370 DOI: 10.1016/j.evalprogplan.2018.09.007

From the rise of restorative justice to evidence-based approaches to reducing recidivism, the intellectual landscape of criminal justice has seen considerable change in recent decades. The result is that an increasing number of countries have tackled the task of shifting preexisting political institutions to confirm with these new understandings. This is, of course, no easy feat. A great number of challenges confront willing policymakers, a reality that often puts philosophy at loggerheads with practicality. Moreover, the political process of change is subject to the influence of cultural and institutional norms. In this paper, we look at one particular case study - that of Malaysia's juvenile justice system - to understand the challenges faced in changing criminal justice policy. We identify three primary categories of challenges and elucidate their shape and impact through the Malaysian example. We also briefly analyze potential opportunities to mitigate and overcome these challenges. Furthermore, we also conclude with several implications for future research that we deem are important to be taken place. In sum, we argue that criminal justice reform must be undertaken with an eye toward important societal and institutional norms, each requiring thoughtful analysis of complex local cases.
Electrolyte profile of Malaysian mothers' milk

Alaudeen S, Muslim N, Faridah K, Azman A, Arshat H

Malays J Reprod Health, 1988 Dec;6(2):102-7.
PMID: 12342169

PIP: The influence of socioeconomic status (ethnicity, income and parity) on electrolyte composition (sodium and potassium) in human milk is little known. We have thus quantitatively analyzed approximately 700 samples of milk (1-90 days postpartum) obtained from healthy Malaysian mothers' (Malay, Chinese and Indians) of full term infants. Results show that the mean concentration (mmol/l) of sodium is highest (48.2+or-1.7, Mean+or-SEM) in the Malaysian mothers' colostrum and this value decreased by 30% in their transitional milk and remained constant throughout subsequent days of lactation (mature milk). Ethnically, it is found that the level of sodium in colostrum of Malay and Chinese mothers were similar while the Indian mothers' colostrum showed apparently higher value (52.7+or-3.4 mmol/l) that is statistically insignificant. The transitional milk of all 3 ethnic groups studied exhibited similar levels of sodium. On subsequent days of lactation (mature milk) the Malay mothers exhibited lowest concentration (25.9+or-2.6 mmol/l) of sodium that is significantly (P0.05) different from that of Chinese and Indian mothers. Income and parity do not significantly affect the sodium level in Malaysian mothers' milk during all stages of lactation studied. The level of potassium, however did not change significantly with days of lactation. Like sodium, potassium too was not influenced by income and parity. (Author's).
Fulltext National HPV immunisation programme: knowledge and acceptance of mothers attending an obstetrics clinic at a teaching hospital, Kuala Lumpur

Ezat SW, Hod R, Mustafa J, Mohd Dali AZ, Sulaiman AS, Azman A

Asian Pac J Cancer Prev, 2013;14(5):2991-9.
PMID: 23803068

BACKGROUND: Introduction of the HPV vaccine is a forefront primary prevention method in reducing the incidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government has implemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted 13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV, HPV vaccine and National HPV (NHPV) immunisation programme since its' implementation. It also assessed acceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves.
MATERIALS AND METHODS: A cross sectional study was conducted on 155 respondents using self-administered questionnaires; conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur. Respondents were selected using a multistage sampling technique.
RESULTS: A response rate of 100% was obtained. Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2% for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regression analyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education was associated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPV immunisation programme; ethnicity (p=0.017), mothers' education (p=0.0005) and number of children (p=0.020). The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by for mothers themselves at 73.5%, and the least is for sons 62.6%.
CONCLUSIONS: This study found that the overall level of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and the National HPV immunisation programme should be provided to mothers in order to increase acceptance of the HPV vaccine which can reduce the disease burden in the future.
Study site: O&G clinic, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Analysis of examinations in curriculum review

Rotem A, Barrand J, Azman A

Med Educ, 1982 Jan;16(1):3-6.
PMID: 7057721

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.
Fulltext Arrangements of Resting State Electroencephalography as the Input to Convolutional Neural Network for Biometric Identification

Lai CQ, Ibrahim H, Abdullah MZ, Abdullah JM, Suandi SA, Azman A

Comput Intell Neurosci, 2019;2019:7895924.
PMID: 31281339 DOI: 10.1155/2019/7895924

Biometric is an important field that enables identification of an individual to access their sensitive information and asset. In recent years, electroencephalography- (EEG-) based biometrics have been popularly explored by researchers because EEG is able to distinct between two individuals. The literature reviews have shown that convolutional neural network (CNN) is one of the classification approaches that can avoid the complex stages of preprocessing, feature extraction, and feature selection. Therefore, CNN is suggested to be one of the efficient classifiers for biometric identification. Conventionally, input to CNN can be in image or matrix form. The objective of this paper is to explore the arrangement of EEG for CNN input to investigate the most suitable input arrangement of EEG towards the performance of EEG-based identification. EEG datasets that are used in this paper are resting state eyes open (REO) and resting state eyes close (REC) EEG. Six types of data arrangement are compared in this paper. They are matrix of amplitude versus time, matrix of energy versus time, matrix of amplitude versus time for rearranged channels, image of amplitude versus time, image of energy versus time, and image of amplitude versus time for rearranged channels. It was found that the matrix of amplitude versus time for each rearranged channels using the combination of REC and REO performed the best for biometric identification, achieving validation accuracy and test accuracy of 83.21% and 79.08%, respectively.
Fulltext Tuberculosis Treatment Outcome in Patients with TB-HIV Coinfection in Kuala Lumpur, Malaysia

Selimin DS, Ismail A, Ahmad N, Ismail R, Mohd Azman NF, Azman A

J Trop Med, 2021;2021:9923378.
PMID: 34194511 DOI: 10.1155/2021/9923378

Background: Tuberculosis (TB) is a serious health threat to people living with human immunodeficiency virus (HIV). This study aimed to identify the characteristics, unsuccessful TB treatment rate, and determinants of unsuccessful TB treatment outcome among patients with TB-HIV coinfection in Kuala Lumpur.
Methods: This was a cross-sectional study. The data of all patients with TB-HIV in the federal territory of Kuala Lumpur from 2013 to 2017 were collected and reviewed. The data were retrieved from the national database (TB Information System) at the Kuala Lumpur Health Department from 1 March 2018 to 31 May 2018.
Results: Out of 235 randomly selected patients with TB-HIV, TB treatment outcome was successful in 57.9% (cured and completed treatment) and unsuccessful in 42.1% (died, failed, or lost to follow-up). Patients who did not receive DOTS (directly observed treatment, short course) (adjusted odds ratio: 21.71; 95% confidence interval: 5.36-87.94) and those who received shorter treatment duration of <6 months (aOR: 34.54; 95% CI: 5.97-199.93) had higher odds for unsuccessful TB treatment outcome.
Conclusions: Nearly half of the patients with TB-HIV had unsuccessful TB treatment outcome. Therefore, it is important to ensure that such patients receive DOTS and continuous TB treatment of >6 months. It is crucial to strengthen and widen the coverage of DOTS, especially among high-risk groups, in healthcare settings. Strict follow-up by healthcare providers is needed for patients with TB-HIV to gain treatment adherence and for better rates of successful TB treatment.
Fulltext Lime juice as a dietary alternative to mist potassium citrate for urine alkalinisation: A prospective, cross-over clinical trial

Sivananthan K, Nagappan P, Md Mansor M, Abdullah U, Azman A

Malays Fam Physician, 2023;18:5.
PMID: 36992952 DOI: 10.51866/oa.216

INTRODUCTION: Urinary citrate is a potent inhibitor of urinary crystallization that is freely filtered in the proximal tubule of the kidney. We aimed to investigate the effect of citrate supplementation with fresh lime juice on the urinary pH and calcium excretion level among healthy individuals compared with that of mist potassium citrate.
METHOD: In this prospective, cross-over single-centre study, 50 healthy medical student volunteers were randomly allocated to two treatment arms. One arm was prescribed with potassium citrate, while the other arm received citrate supplementation with a home preparation of fresh lime juice. The urinary pH and calcium-to-creatinine ratio (uCa/uCr) were measured at baseline and after 7 days of treatment. This was followed by a washout period of 2 weeks, after which each participant crossed over to the other treatment arm, and the urinary measurements were repeated.
RESULTS: Potassium citrate significantly increased the urinary pH among all participants, while fresh lime juice did not. Both fresh lime juice and potassium citrate reduced the uCa/uCr, although this effect was not significant.
CONCLUSION: Fresh lime juice is not as effective as potassium citrate in improving the urinary pH and calcium excretion level of healthy individuals. Therefore, it should be used as an adjunct rather than an alternative to potassium citrate.
Violence and trauma encountered by Rohingya women fleeing to Malaysia: a qualitative study

Rajaratnam S, Azman A

Arch Womens Ment Health, 2023 Nov 25.
PMID: 38006427 DOI: 10.1007/s00737-023-01402-4

Rohingya women are doubly marginalized owing to their ethnicity and gender. Therefore, this study aims to describe the unique experiences of violence faced by Rohingya women who fled Myanmar and Bangladesh to seek asylum in Malaysia before, during, and after their transit. Primary data were collected from 33 participants comprising Rohingya women refugees and asylum seekers, medical social workers, medical officials, volunteer workers/activists, refugee organization officers, and a mental health care provider. Thematic analysis was used to identify the patterns in and relationships between the concepts in the collected data. Rohingya women were exposed to various forms of violence and trauma by various groups of men, including those from their own community, throughout their journey to and in Malaysia. The lack of recognition of refugees and asylum seekers in Malaysia prevents them from having mainstream or legal access to jobs, education, and healthcare, and this predicament compounds their suffering from violence, especially for women and girls. Rohingya women and girls in Malaysia need better access to healthcare, resources, and support to identify and address violence, which has a significant impact on their health.
Fulltext Psychosocial stress and trauma during the COVID-19 pandemic: Evidence from Bangladesh

Hossain MI, Mehedi N, Ahmad I, Ali I, Azman A

Asian Soc Work Policy Rev, 2021 Jun;15(2):145-159.
PMID: 35655964 DOI: 10.1111/aswp.12227

The COVID-19 outbreak has become a global health crisis affecting both the physical and mental health of people across the world. Likewise, the people of Bangladesh are going through a menacing mental health catastrophe with the outbreak of coronavirus that resulting in stress and trauma. Hence, this situation is altering people's lifestyles and generating complexities in psychological well-being. The study was based on the review of published articles and media reports related to stress and trauma during the COVID-19 pandemic in Bangladesh. A total of 10 peer-reviewed articles and 45 newspaper reports were included following an extensive literature search. The contents were searched on Google, Google Scholar, PubMed, local online newspapers, social networking sites, and different webpages and published articles in different journals on COVID-19 from March 5 to October 25, 2020. The review study finds that the mental health of people in Bangladesh has severely been affected by the outbreak of coronavirus. All of the government, voluntary, and civil organizations need to give further emphasis on psychosocial and bereavement counseling in order to support those experiencing mental shocks resulting from the COVID-19 crisis. There is the need to strengthen more consultative and collaborative efforts from all public health experts, social workers, psychologists, and policymakers in doing so. Social workers in this context will be able to make meaningful contributions in supporting those affected people to better adjust to the challenging situation.
Fulltext Social assistance programs during the COVID-19 pandemic in Bangladesh: Does faith-based approach matters?

Salahuddin AFM, Hossain MI, Ali I, Azman A

Asian Soc Work Policy Rev, 2022 Jun 25.
PMID: 35942155 DOI: 10.1111/aswp.12261

This paper aimed to examine the role of faith-based organizations (FBOs) in the distribution of social assistance (SA) during the COVID-19 pandemic in Bangladesh. The paper adopts a qualitative case-study approach to explore the best practices in the distribution of SA by five (5) organizations including FBOs, governmental organizations (GOs), Non-governmental organizations (NGOs), political groups, and private voluntary groups. In this study, 14 beneficiaries of SA were selected by stratified proportionate random sampling method, and five (5) key personnel were selected purposively based on their experiences in the management of SA distribution. The study found that "no-move, no touch" approach followed by FBOs is more likely to establish human rights and social justice and reduce the transmission of diseases. In contrast to the modern idea, which undermines the faith-based charity, the study proved that faith-based charity is gaining attraction as an effective approach combating global pandemic. The findings of this paper will be useful for policymakers, voluntary service workers, GO, and NGO workers to ensure the distribution of SA in a more productive and disciplined way during and after an emergency like the COVID-19 pandemic.
Fulltext Cost analysis of cataract surgery with intraocular lens implantation: a single blind randomised clinical trial comparing extracapsular cataract extraction and phacoemulsification

Rizal AM, Aljunid SM, Normalina M, Hanom AF, Chuah KL, Suzainah Y, et al.

Med J Malaysia, 2003 Aug;58(3):380-6.
PMID: 14750378

A randomised single blinded clinical trial to compare the cost of cataract surgery between extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM) between March and December 2000. A total of 60 patients were included in this study. The cost of a cataract surgery incurred by hospital, patients and households up to two months after discharge were included. The costs of training, loss of patients' income after discharge and intangible costs were excluded. Results showed that the average cost for one ECCE operation is RM1,664.46 (RM1,233.04-RM2,377.64) and for PEA is RM1,978.00 (RM1,557.87-RM3,334.50). During this short period of follow up, it can be concluded that ECCE is significantly cheaper than PEA by an average difference of RM 313.54 per patient (p < 0.001). Cost of equipment and low frequency of PEA technique done in HUKM were the two main reasons for the high unit cost of PEA as compared to ECCE.
Assessment of knowledge, attitude and practice of food allergies among food handlers in the state of Penang, Malaysia

Shafie AA, Azman AW

Public Health, 2015 Sep;129(9):1278-84.
PMID: 25931434 DOI: 10.1016/j.puhe.2015.03.016

Food handler's knowledge, attitude and practice regarding food allergies are important to prevent debilitating and sometimes fatal reactions. This study aimed to assess their food allergy knowledge, attitude and practice, which could help to maintain the safety and hygiene of food consumed by the public.
The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?

De Simone B, Abu-Zidan FM, Chouillard E, Di Saverio S, Sartelli M, Podda M, et al.

World J Emerg Surg, 2022 Dec 16;17(1):61.
PMID: 36527038 DOI: 10.1186/s13017-022-00466-4

BACKGROUND: The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not.
METHODS: Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not.
RESULTS: A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p
Progressive ataxia, ophthalmoparesis, and hypogonadotropic hypogonadism in a family with a novel variant in the KIFBP gene

Ooi JCE, Azman A, Chan MY, Toh ESY, Seo GH, Kim JH, et al.

Clin Genet, 2024 Feb;105(2):228-230.
PMID: 37903629 DOI: 10.1111/cge.14448

A novel homozygous variant in KIFBP was identified in a consanguineous family with four sibs affected by Goldberg-Sphrintzen Syndrome (GOSHS). We report for the first time, early-adulthood-onset progressive ataxia, opthalmoparesis, and hypogonadotropic hypogonadism in GOSHS.
Fulltext Diagnostic accuracy of fresh drooled saliva for SARS-CoV-2 in travelers

Mohd Thabit AA, Peariasamy KM, Kuan PX, Fern Ying DK, Nheu N, Cyncynatus C, et al.

Travel Med Infect Dis, 2021;43:102144.
PMID: 34302954 DOI: 10.1016/j.tmaid.2021.102144

BACKGROUND: The standard for SARS-CoV-2 diagnosis is RT-PCR from nasopharyngeal or oropharyngeal swabs. Major airports require COVID-19 screening, and saliva has the potential as a substitute specimen for SARS-CoV-2 diagnosis. We investigated the utility of fresh drooled saliva against NPS for COVID-19 screening of travelers.
METHODS: We recruited 81 travelers and 15 non-travelers (including ten controls) prospectively within a mean of 3·22 days of RT-PCR confirmed COVID-19. Each study participant provided 2 mls of early morning fresh drooled whole saliva separately into a sterile plastic container and GeneFiX™ saliva collection kit. The saliva specimens were processed within 4 h and tested for SARS-CoV-2 genes (E, RdRP, and N2) and the results compared to paired NPS RT-PCR for diagnostic accuracy.
RESULTS: Majority of travellers were asymptomatic (75·0%) with a mean age of 34·26 years. 77 travelers were RT-PCR positive at the time of hospitalization whilst three travelers had positive contacts. In this group, the detection rate for SARS-CoV-2 with NPS, whole saliva, and GeneFiX™ were comparable (89·3%, 50/56; 87·8%, 43/49; 89·6%, 43/48). Both saliva collection methods were in good agreement (Kappa = 0·69). There was no statistical difference between the detection rates of saliva and NPS (p > 0·05). Detection was highest for the N2 gene whilst the E gene provided the highest viral load (mean = 27·96 to 30·10, SD = 3·14 to 3·85). Saliva specimens have high sensitivity (80·4%) and specificity (90·0%) with a high positive predictive value of 91·8% for SARS-CoV-2 diagnosis.
CONCLUSION: Saliva for SARS-CoV-2 screening is a simple accurate technique comparable with NPS RT-PCR.

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