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Fulltext Avian influenza (H7N9) virus infection in Chinese tourist in Malaysia, 2014

William T, Thevarajah B, Lee SF, Suleiman M, Jeffree MS, Menon J, et al.

Emerg Infect Dis, 2015 Jan;21(1):142-5.
PMID: 25531078 DOI: 10.3201/eid2101.141092

Of the ≈400 cases of avian influenza (H7N9) diagnosed in China since 2003, the only travel-related cases have been in Hong Kong and Taiwan. Detection of a case in a Chinese tourist in Sabah, Malaysia, highlights the ease with which emerging viral respiratory infections can travel globally.
Fulltext Assessment of ergonomic risk level and working performance of pre-cast construction workers in Sabah

Muktar MZ, Shamsudin SB, Lukman KA, Jeffree MS

Malaysian Journal of Public Health Medicine, 2017;17(2):151-158.

A cross-sectional study was conducted on 116 male pre-cast construction workers in Sipitang, Sabah to evaluate the association between Ergonomic Risk Level exposure and their working performances for 6 months (June to November 2014). Initially, a structured interview using a modified-Standardized Nordic Questionnaire was conducted on each study subject to determine the prevalence of Musculoskeletal Disorders (MSDs). The results showed that 93 out of 116 subjects (80.17%) complained of experiencing ache, pain or body discomfort during and after work with high percentage of MSDs prevalence affecting the wrist (78.5%), shoulder (73.1%), and lower leg (71.0%) regions of the body. Pictures and videos of workers performing their routine tasks were analyzed using Rapid Entire Body Assessment (REBA) tool to generate individual Ergonomic Risk Level classification. The results showed that all subjects were exposed to Medium (56.90%), High (29.31%) and Very High (13.79%) level of Ergonomic Risk. Pearson Correlation and One-way ANOVA test was conducted to determine the association between Ergonomic Risk Level and the subjects’ individual working performances. The results indicated that there was a significant negative association between Ergonomic Risk Level and the workers' performances in terms of tendency to work overtime (p
Beriberi Outbreak Among Unauthorised Immigrants in a Detention Camp in Malaysia

Abdul Rahman S, Jeffree MS, Kamaludin F, Din IA, Yusof M, Ahmed K

J Immigr Minor Health, 2018 Oct;20(5):1294-1297.
PMID: 29159485 DOI: 10.1007/s10903-017-0674-5

In February 2012, a district health authority received three inmates with bilateral leg swelling and difficulty in breathing from a detention camp for unauthorized immigrants. A case control study was conducted. Fasting blood samples of case and control groups were collected according to instructions of the laboratory for determining thiamine level, and their 1 week dietary intake was analyzed. 9% (21/226) of inmates had bilateral leg swelling, and 75% (6/8) of them had low thiamine level (
Lower back pain and its association with whole-body vibration and manual materials handling among commercial drivers in Sabah

Awang Lukman K, Jeffree MS, Rampal KG

Int J Occup Saf Ergon, 2019 Mar;25(1):8-16.
PMID: 28978270 DOI: 10.1080/10803548.2017.1388571

A cross-sectional study was undertaken to determine the prevalence of lower back pain (LBP) and its association with whole-body vibration (WBV) and manual materials handling (MMH). We studied 110 commercial vehicle drivers using a self-administered questionnaire and the VI-400Pro human vibration monitor. Prevalence of LBP was 66.4%. The percentage of drivers who had frequent manual handling of heavy loads was 45.5% and those who handled heavy loads in awkward postures accounted for 86.4%. Daily vibration A(8) averaged on the z axis was 0.25 (0.06) m·s-2 and at vector sum was 0.29 (0.07) m·s-2. Daily vibration exposures on the z axis, frequent manual handling of heavy loads and awkward posture during MMH were significantly associated with LBP. Drivers who are exposed to WBV and frequently handle heavy loads manually and with awkward postures probably have more LBP than drivers who are exposed to only one of these risk factors.
Fulltext Norovirus outbreak among students of a boarding school in Kluang, Johor, Malaysia

Subahir MN, Jeffree MS, Hassan MR, Razak MFA, Mohamad SNG, Fong SY, et al.

J Infect Dev Ctries, 2019 04 30;13(4):274-277.
PMID: 32045370 DOI: 10.3855/jidc.11199

INTRODUCTION: Norovirus (NoV) is a contagious virus causing acute gastroenteritis and is mainly responsible for diarrheal outbreak in closed settings. The aims of this study were to describe the epidemiological characteristic of an outbreak in a boarding school, to assess the extent of the outbreak and to implement appropriate control measures.
METHODOLOGY: A descriptive study was conducted to describe the epidemiological characteristics of the outbreak. Data on demographic details, onset of abdominal symptoms, food intake history and contact with ill person three days prior to illness were obtained.
RESULTS: Twelve fresh stool and 14 food samples were tested for NoV and enteric pathogens, respectively. Out of 745 students, 42 (5.6%) were infected during this outbreak. Predominant clinical features were diarrhea (76.1%), vomiting (71.4%) and abdominal pain (67%). Eight (67%) stool samples and six (43.9%)food samples were positive for NoV and total coliforms, respectively. The dissemination of the disease was due to poor hygiene practices among students. Quarantine was imposed until the last case on September 28, 2016. The outbreak was declared over on September 30, 2016.
CONCLUSIONS: A NoV outbreak was determined first time in Malaysia. Environmental assessment showed poor hygienic conditions in the school's kitchen. The number of infected students increased considerably despite the implementation of preventive and control measures. Quarantine was effective to stop the outbreak which is characteristics of NoV outbreak.
Fulltext Cholera outbreak by Sea Gypsies in Sabah, Malaysia: A challenge in North Borneo

Jikal M, Riduan T, Aarifin R, Jeffree MS, Ahmed K

Int J Infect Dis, 2019 Jun;83:83-85.
PMID: 30986543 DOI: 10.1016/j.ijid.2019.04.008

OBJECTIVES: In this study we investigated an outbreak of Vibrio cholera O1 Ogawa serotype, occurred during December 2014 in Kudat district, situated in Sabah state of the Malaysian part of Borneo.
METHODS: Active case detection and contact tracing were done at respective localities by house to house survey. Passive case detection was done among acute gastroenteritis patients attended at various health facilities. To determine the source, samples from food, water and environment were taken. A case control study was also done to determine the risk factors.
RESULTS: A total of 44 symptomatic and 34 asymptomatic cases from 19 localities were investigated. 39 cases were detected through passive case detection. Median age of cases was 23 years. All cases belonged to serogroup O1 and Ogawa serotype. The epidemiological investigation of time, place, and person identified that V. cholerae cross-transmission might have occurred in two fish markets and the fish-loading port. Circumstantial evidences indicated that cholera was possibly transmitted through contaminated sea foods.
CONCLUSIONS: We concluded that the life-style of Sea Gypsies is a challenge in cholera control; therefore vaccination might be an effective way to mitigate cholera in an outbreak prone area like Kudat.
Fulltext Evaluating the perception of farmers towards pesticides and the health effect of pesticides: A cross-sectional study in the oil palm plantations of Papar, Malaysia

Bin Sulaiman SK, Ibrahim Y, Jeffree MS

Interdiscip Toxicol, 2019 Sep;12(1):15-25.
PMID: 32189983 DOI: 10.2478/intox-2019-0003

Agriculture is an important occupation in Malaysia that generates a major portion of the national revenue. Similar to the rest of the world, pesticides are used to boost agricultural production in Malaysian farms. However, chemical pesticides are associated with human health hazard and are not environment-friendly as they persist in nature for long periods of time. Therefore, pesticide use should be reduced and farmers should be trained on correct and/or alternative ways of pesticide use. In this cross-sectional study, we surveyed 19 palm oil plantations in the Sabah district of Malaysia and evaluated the perception of the workers towards pesticide use and awareness regarding the health effects post-pesticide exposure. Analysis of the survey shows that most of the workers among the 270 respondents were 30-year-old males with average education, and belonged to the low income group. Majority opined that they were aware of the health hazards of pesticide use and suffered from symptoms (with mean duration of three days) such as vomiting, diarrhea, skin irritation, and dizziness. Surprisingly, the opinion was almost equally divided on whether they perceived pesticides to be the cause of their health problems, and a major percentage did not avail medical help. Most of the workers responded that they did not receive any training in pesticide handling and used partial personal protective equipment (glasses, hats, shirt, and gloves) during working hours. Interestingly, a large percentage responded that they would not read the safety material even if it was provided. These observations clearly highlight the urgency of improving the awareness, education, and attitude of these plantation workers towards the short- and long-term effects of pesticide use. They should also be educated about alternative and eco-friendly ways of farming. Finally, the plantation management should intervene and proactively advocate the use of safe farming practices.
Fulltext Editorial: Can the Health Implications of Land-use Change Drive Sustainability?

Ahmed K, Jeffree MS, Hughes T, Daszak P

Ecohealth, 2019 12;16(4):585-586.
PMID: 31811598 DOI: 10.1007/s10393-019-01462-y
Factors Influencing Attitude Toward Organ and Tissue Donation Among Patients in Primary Clinic, Sabah, Malaysia

Lim KJ, Cheng TTJ, Jeffree MS, Hayati F, Cheah PK, Nee KO, et al.

Transplant Proc, 2020 Apr;52(3):680-686.
PMID: 32146022 DOI: 10.1016/j.transproceed.2020.01.007

INTRODUCTION: Worldwide, the gap between organ supply and demand has widened over the years. Malaysia has one of the lowest deceased organ donation rates. Success rate of organ or tissue procurement depends on not only the approach rate by health care providers but also the awareness among the public, whereby it can be a platform for family initiation of organ donation. The purpose of this study is to assess the knowledge of and determine the factors influencing attitude toward organ and tissue donation among patients in a primary clinic.
METHODS: A cross-sectional analytical study was carried out. Self-administered questionnaires were given to 400 patients who registered at an outpatient clinic in April 2018. Convenience sampling was applied.
RESULTS: Monthly income, education level, occupation, and knowledge level are significantly associated with attitude of the respondents toward organ and tissue donation. Occupation influenced attitude toward organ donation. Knowledge of organ donation and brain death both significantly affected attitude toward organ donation.
CONCLUSION: The greater the knowledge of organ donation and brain death, the more positive impression or attitude toward organ donation. Education level and income are the main predictors that influence attitude toward organ donation. Hence, it is important for public health units to promote and deliver public education on organ donation, change public misconceptions, and work parallel with hospitals to increase organ donation rates in Sabah.
Fulltext An outbreak of gastroenteritis by emerging norovirus GII.2[P16] in a kindergarten in Kota Kinabalu, Malaysian Borneo

Ahmed K, Dony JJF, Mori D, Haw LY, Giloi N, Jeffree MS, et al.

Sci Rep, 2020 04 28;10(1):7137.
PMID: 32346119 DOI: 10.1038/s41598-020-64148-4

Outbreaks of diarrhea in kindergartens are underreported and frequently go unnoticed in developing countries. To better understand the etiology this study was performed during an outbreak of diarrhea in a kindergarten in Sabah, Malaysia. Outbreak investigation was performed according to the standard procedures. In this outbreak a total of 34 (36.5%) children and 4 (30.8%) teachers suffered from gastroenteritis. Stool samples from seven children and 13 teachers were tested for rotavirus and norovirus. During the investigation stool samples were collected and sent in cold chain to the laboratory. The samples were subjected to rotavirus enzyme linked immunosorbent assay, and reverse transcription PCR for norovirus. All samples were negative for rotavirus but positive for norovirus. To determine the genogroup and genotype of norovirus, nucleotide sequencing of the amplicons was performed. All norovirus from the outbreak was of genotype GII.2[16]. To determine the relatedness of the strains phylogenetic analysis was done using neighbor-joining method. Phylogenetically these strains were highly related to GII.2[P16] noroviruses from China and Japan. This study provided evidence that a diarrheal outbreak in a kindergarten was caused by GII.2[P16] norovirus which is an emerging strain in East Asia and Europe.
Fulltext A training module to empower marginalised Northern Borneo islanders for tuberculosis control

Jeffree MS, Ahmedy F, Ibrahim MY, Awang Lukman K, Ahmed K, Giloi N, et al.

J Public Health Res, 2020 Jul 28;9(3):1757.
PMID: 33117755 DOI: 10.4081/jphr.2020.1757

Empowering marginalised urban islanders with limited health accessibility through knowledge transfer program for controlling pulmonary tuberculosis (PTB) requires a specific training module. The study was aimed to develop this training module by adapting and modifying the IMCI (Integrated Management of Childhood Illness) framework. Structuring the content for the knowledge and skills for PTB control in the module was based on the National Strategic Plan for Tuberculosis Control 2016-2020. A total of five knowledge and skills were structured: i) PTB disease and diagnosis, ii) PTB treatment, iii) preventive PTB measures, iv) prevention of malnutrition, and v) psychosocial discrimination. The IMCI framework was modified through 3 ways: i) identifying signs and symptoms of PTB, ii) emphasising the IMCI's 5 steps of integrated management: assess, diagnose, treat, counsel and detect, and iii) counseling on BCG immunisation, malnutrition, environmental modifications and stigma on PTB.
Fulltext Nineteen Years of Japanese Encephalitis Surveillance in Sabah, Malaysian Borneo

Montini Maluda MC, Jelip J, Ibrahim MY, Suleiman M, Jeffree MS, Binti Aziz AF, et al.

Am J Trop Med Hyg, 2020 08;103(2):864-868.
PMID: 32524958 DOI: 10.4269/ajtmh.19-0928

Japanese encephalitis (JE) is endemic in Malaysia. Although JE vaccination is practiced in the neighboring state of Sarawak for a long time, little is known about JE in Sabah state in Borneo. As a result, informed policy formulation for JE in Sabah has not been accomplished. In the present study, we have analyzed JE cases that have been reported to the Sabah State Health Department from 2000 to 2018. A total of 92 JE cases were reported during 19 years, and three-fourths of the cases were attributed to children. The estimated mean incidence for JE cases is 0.161/100,000 population. Japanese encephalitis was predominant in Sabah during June, July, and August, peaking in July. In most cases, pigs were absent within a 400-m radius of the place of residence. We could not establish any relationship between the mapping of JE cases and the number of piggeries in each district. We could not establish a relationship between average rainfall and JE cases, either. We propose the cases reported are possibly showing the tip of an iceberg and continuous surveillance is needed, as JE is a public health challenge in Sabah.
Fulltext SARS-CoV-2 infection of the nervous system: A review of the literature on neurological involvement in novel coronavirus disease-(COVID-19)

Payus AO, Liew Sat Lin C, Mohd Noh M, Jeffree MS, Ali RA

Bosn J Basic Med Sci, 2020 Aug 03;20(3):283-292.
PMID: 32530389 DOI: 10.17305/bjbms.2020.4860

The novel coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is believed to have emerged from an animal source and has been spreading rapidly among humans. Recent evidence shows that SARS-CoV-2 exhibits neurotropic properties and causes neurological diseases. Here, we review the literature on neurological involvement in SARS-CoV-2 infections and the possible mechanisms of invasion of the nervous system by this virus, to provide a summary and critical analysis of the early reporting of neurological involvement in COVID-19. An exhaustive search of scientific articles on neurological involvement in COVID-19 was performed in the Web of Science, Scopus, Medline/PubMed, and several other databases. Nineteen relevant articles that had been published or were in preprint were carefully selected according to the inclusion and exclusion criteria. Based on our research, we found that patients with COVID-19 can present with neurological symptoms that can be broadly divided into central nervous system involvement, such as headache, dizziness, altered mental state, and disorientation, and peripheral nervous system involvement, such as anosmia and hypogeusia. Most of these patients are in the older age group and exhibit comorbidities, especially hypertension, and severe infection. In extreme presentations of COVID-19, some patients exhibit seizures, stroke, flaccid paraparesis, corticospinal weakness, and even coma. Moreover, the neurological man-ifestations can occur independently of the respiratory system. In conclusion, SARS-CoV-2 infection can cause multiple neurological syndromes in a more complex presentation. Therefore, this review elucidated the involvement of the nervous system in SARS-CoV-2 infection and will hopefully help improve the management of COVID-19.
Fulltext A University-Wide Preparedness Effort in the Alert Phase of COVID-19 Incorporating Community Mental Health and Task-Shifting Strategies: Experience from a Bornean Institute of Higher Learning

Mukhsam MH, Jeffree MS, Pang NTP, Syed Abdul Rahim SS, Omar A, Abdullah MS, et al.

Am J Trop Med Hyg, 2020 Sep;103(3):1201-1203.
PMID: 32705977 DOI: 10.4269/ajtmh.20-0458

The COVID-19 pandemic caught the world by surprise, causing millions of confirmed cases and hundreds of thousands of deaths. Hence, the Malaysian government announced a Movement Control Order at the start of the containment phase to flatten the epidemiological curve. Universiti Malaysia Sabah (UMS), a public university in Borneo, was accelerated into alert phase because of high risk of case importation from more than 400 China incoming undergraduates. Measures to mitigate the potential COVID-19 outbreaks in its population were taken by using conventional public health measures with special attention to task-shifting and widespread community mental health interventions. A Preparedness and Response Centre was established to overseer the mitigating measures happening inside the university. Measures taken included empowerment of frontline staff, strengthening of restrictions, strengthening university health center, vigorous contact tracing, widespread health education, maintaining cultural sensitivity, and establishment of early standard operating procedures and university continuity plans. Hence, UMS was able to ensure no importation of cases into its campus during both acute and containment phases at the nationwide level.
Fulltext Exposure risk assessment of the municipal waste collection activities during COVID-19 pandemic

Salvaraji L, Jeffree MS, Avoi R, Atil A, Mohd Akhir H, Shamsudin SBB, et al.

J Public Health Res, 2020 Oct 14;9(4):1994.
PMID: 33312989 DOI: 10.4081/jphr.2020.1994

An increasing amount of waste concurrently further extends the risk of exposure to hazardous material among waste collectors. In light of the COVID-19 crisis, municipal waste collectors are one of the most at-risk groups of SARS-Cov-2 exposure. Risk assessment included hazard identification, evaluation of existing control level at the workplace, estimation of likelihood and severity of hazard, risk determination, and control measure recommendations. Five waste collection activities were identified and reviewed. High-risk exposure includes collection of garbage, mechanical manipulation of compactor lorries and unloading of garbage at the disposal site. There is poor practice of personal hygiene and unestablished continuous monitoring of personal protective equipment supplies. The preventive measures in the waste collection industry are influenced by several factors. Until the preventive measures are adopted into practice and adapted according to each company's requirements, biological agents continue to be risk factor to the health workers.
Fulltext High incidence of asymptomatic leptospirosis among urban sanitation workers from Kota Kinabalu, Sabah, Malaysian Borneo

Jeffree MS, Mori D, Yusof NA, Atil AB, Lukman KA, Othman R, et al.

Sci Rep, 2020 11 10;10(1):19442.
PMID: 33173153 DOI: 10.1038/s41598-020-76595-0

Leptospirosis is a public health challenge in Sabah State of Malaysian Borneo. Rapid urbanization, rural-to-urban migration, and undocumented immigration in Sabah have increased the pressure on the urban garbage disposal system. Rodents and other small animals thrive under these conditions. We hypothesized that urban sanitation workers would be at risk of developing leptospirosis. In total, 303 urban sanitation workers with a mean age of 42.6 years were enrolled in this study. The serum samples collected from these workers were subjected to the microscopic agglutination test (MAT), PCR and nucleotide sequencing of the amplicons to confirm the presence of Leptospira. The phylogenetic analysis using the neighbor joining method was performed to assess whether they were pathogenic. In this study 43.8% (133/303) of the samples were MAT-seropositive and among them, 29 (21.8%) were positive by PCR. Nucleotide sequencing of the amplicons confirmed the presence of Leptospira. Phylogenetic analysis showed that our strains belonged to the pathogenic group of Leptospira. A high proportion of urban sanitation workers were seropositive for leptospirosis, and a considerable number were PCR positive for Leptospira, thereby indicating asymptomatic infections. Further research is needed to confirm whether this is a transient phenomenon or antibiotic therapy is required.
Fulltext Respiratory Symptoms Among Domestic Waste Collectors

Salvaraji L, Jeffree MS, Avoi R, Akhir HM, Rahim SSSA, Lukman KA

Medeni Med J, 2020;35(4):304-309.
PMID: 33717622 DOI: 10.5222/MMJ.2020.82246

Objective: Increasing amount of waste concurrently increases the risk of exposure to hazardous materials among waste collectors. Vigorous exertion in the field intensifies the abundance of contaminated inspirable droplets. If left undetected and untreated, it may provoke significant pernicious health effects and redundant burdens to employees and employers. The purpose of this study is to determine the prevalence of respiratory symptoms and their associated factors among domestic waste collectors.
Method: A cross-sectional study was conducted in Kota Kinabalu, Sabah between January and April 2020. Data were collected using a validated questionnaire which encompasses details about sociodemographic, health status, environment, and employment characteristics.
Results: A total of 290 waste collectors with a mean age of 40 (±9) years old were participated in the study. Most of them were from Kadazan-Dusun-Murut ethnic origin with educational background till secondary school. The average monthly income of the workers was USD 298.45 (±171.9) per month, and they had been in service for 11 (±9.04) years. Respiratory symptoms were seen in 21% of the workers. The identified significant risk factors were determined as underlying chronic diseases (OR=2.34; 95% CI=1.054, 5.219) and contact with pets (OR=1.87; 95% CI=1.004, 3.288).
Conclusion: Respiratory symptoms are prevalent amidst domestic waste collectors and related to their health and field activities.
Fulltext A Review on Oxidative Stress, Diabetic Complications, and the Roles of Honey Polyphenols

Pasupuleti VR, Arigela CS, Gan SH, Salam SKN, Krishnan KT, Rahman NA, et al.

Oxid Med Cell Longev, 2020;2020:8878172.
PMID: 33299532 DOI: 10.1155/2020/8878172

Despite the availability of various antidiabetic drugs, diabetes mellitus (DM) remains one of the world's most prevalent chronic diseases and is a global burden. Hyperglycaemia, a characteristic of type 2 diabetes mellitus (T2DM), substantially leads to the generation of reactive oxygen species (ROS), triggering oxidative stress as well as numerous cellular and molecular modifications such as mitochondrial dysfunction affecting normal physiological functions in the body. In mitochondrial-mediated processes, oxidative pathways play an important role, although the responsible molecular mechanisms remain unclear. The impaired mitochondrial function is evidenced by insulin insensitivity in various cell types. In addition, the roles of master antioxidant pathway nuclear factor erythroid 2-related factor 2 (Nrf2)/Kelch-like ECH-associated protein 1 (Keap1)/antioxidant response elements (ARE) are being deciphered to explain various molecular pathways involved in diabetes. Dietary factors are known to influence diabetes, and many natural dietary factors have been studied to improve diabetes. Honey is primarily rich in carbohydrates and is also abundant in flavonoids and phenolic acids; thus, it is a promising therapeutic antioxidant for various disorders. Various research has indicated that honey has strong wound-healing properties and has antibacterial, anti-inflammatory, antifungal, and antiviral effects; thus, it is a promising antidiabetic agent. The potential antidiabetic mechanisms of honey were proposed based on its major constituents. This review focuses on the various prospects of using honey as an antidiabetic agent and the potential insights.
Fulltext Knowledge, attitude and practice on diabetic wound care management among healthcare professionals and impact from a short course training in Sabah, Borneo

Bondi ME, Rahim SSSA, Avoi R, Hayati F, Ahmedy F, Omar A, et al.

Medeni Med J, 2020;35(3):188-194.
PMID: 33110670 DOI: 10.5222/MMJ.2020.02929

Objective: Healthcare professionals with an advanced level of knowledge and skills on diabetic wound care management are needed to effectively manage complex wounds. This study aimed to determine the effects of an educational intervention to enhance the management of wound care among healthcare professionals.

Method: This study was part of a quasi-experimental pre-post research design where 82 healthcare professionals were recruited and assigned to intervention and control groups. The participants in the intervention group attended two days of educational intervention training on diabetic wound care management, while there was no intervention in the control group. A questionnaire on knowledge, attitude, and practice was applied before and one-month post-intervention to both groups.

Results: Pre-test resulted in a low level of knowledge 72.1% and 74.4%, negative level of attitude 67.4% and 66.7%, and a moderate level of practice 79.1% and 76.9% in both intervention and control groups respectively. Post-test resulted in increasing levels of knowledge (76.7%), positive attitude (100%), and practice (76.7%) in the intervention group. At the same time, there was no significant change in the control group. Repeated Measure ANOVA for within-subject and between-subject effects resulted in a statistically significant p-value of 0.001 for knowledge, attitude, and practice after the educational intervention.

Conclusion: Health professionals have only a moderate level of knowledge on diabetic wound care management. It is important to improve this level by specific trainings and by using a good training module.
Fulltext Nutraceutical Use among Patients with Chronic Disease Attending Outpatient Clinics in a Tertiary Hospital

Mahmood NA, Hassan MR, Ahmad S, Mohd Nawi H, Pang NTP, Syed Abdul Rahim SS, et al.

Evid Based Complement Alternat Med, 2020;2020:9814815.
PMID: 33224262 DOI: 10.1155/2020/9814815

Food-drug interphase products, referring to nutraceuticals in this study, are a category of health products containing a combination of food ingredients with active substances for oral consumption. Many of these products are marketed as an alternative to prescription medicine to treat various ailments despite the lack of scientific evidence, influencing patients with chronic diseases to consume nutraceutical products. This study aimed to determine the prevalence and factors associated with knowledge, attitude, and practice of nutraceutical use among patients with chronic disease attending to the outpatient clinic. This is a cross-sectional study involving patients with chronic disease at the outpatient specialist clinic. Samples were recruited from the outpatient clinic using convenience sampling. Data was collected using a self-administered questionnaire, which was self-constructed and validated. We found that the use of nutraceuticals was prevalent among 17.9% of respondents. More than half (60.9%) of the respondents have poor knowledge of nutraceutical and 53.1% of respondents have a positive attitude towards nutraceutical. Gender and morbidities were the factors associated with the practice of nutraceutical usage. Female patients are more likely to have increased use of nutraceutical than male patients and patients with multiple morbidities have higher odds of using nutraceutical than patients with single morbidities. There is a high number of patients who consume nutraceutical products and public knowledge of nutraceutical needs to be improved further. The government should develop appropriate regulation and monitoring of nutraceutical products.

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