ABSTRACTS FOR THE 1ST INTERNATIONAL BORNEO HEALTHCARE AND PUBLIC HEALTH CONFERENCE AND 4TH BORNEO TROPICAL MEDICINE AND INFECTIOUS DISEASE CONGRESS
Introduction: Gestational Diabetes Mellitus (GDM) imposes a risk for both mother and child. Worldwide, it was estimated that GDM affects 1% to 28% of antenatal mothers. Previous studies revealed that prevalence of GDM ranged from 18.3% and 24.9% in Malaysia. This study was conducted with the aim of determining the prevalence of GDM among pregnant women and their sociodemographic characteristics in Tuaran District, Sabah State, Malaysia.
Methods: A cross sectional study was done in four Maternal and Child Health (MCH) Clinics at Tuaran, Tamparuli, Tenghilan and Kiulu in Tuaran District which included all pregnant mothers at gestational period of 24 weeks and above who attended these clinics from May 2018 to June 2018. Convenient sampling method was used. Secondary data was obtained from antenatal book records and primary data was collected by interview method using pretest-ed questionnaire. A total of 195 pregnant women participated in the study.
Results: The overall GDM prevalence among pregnant women who attended MCH clinics for antenatal care in Tuaran District was 28.2%, (95% CI: 22.0%-35.1%, n=55). Distribution of GDM cases were 34.5%, 34.5%, 18.2% and 12.7% for MCH Tuaran, Teng-hilan, Tamparuli and Kiulu respectively. Sociodemographic characteristics showed that majority of GDM was less than 35 years old of age (63.6%), multipara (60%), Kadazan/Dusun ethnicity (58.2%), attained secondary schools’ education and above (91%) and earning > RM1000 per month (65.5%). Percentage according to potential risk factors were 25%, 21% and 20% for history of abortion, family history of diabetes mellitus and previous history of GDM respectively.
Conclusion: Prevalence of GDM among pregnant women in Tuaran District was quite alarming. Further studies should be conducted about GDM and its determining factors for effective planning in strengthening GDM prevention and control programs.
Tuberculosis (TB) is one of the main public health problems in Sabah; 30% of the total number of TB cases reported in Malaysia every year occur in Sabah. The average incidence of TB among health care workers over the past 5 years is 280.4 per 100,000 population (1, Annual Report of Sabah State TB Control Programme, 1998). At present, there are no specific measures for the prevention of TB transmission in health care facilities. A case-control study was conducted among health care workers in Sabah in 2000-2001. Cases were health care workers with TB diagnosed between January 1990 and June 2000. Controls were health care workers without TB and working in the same facility as cases during the disease episode. The study attempted to identify risk factors for TB among the study population. Data were collected through structured interviews and review of patients' records. The notification rate of TB among health care workers was significantly higher than that to the general population (Z=4.893, p<0.01). The average notification rate of TB among health care workers over the last 5 years was two times higher than in the general population (280.4/100,000 compared to 153.9/100,000). Regression results showed that ethnicity, designation, family contact and TB related knowledge did not significantly contribute to the risk of contracting TB in this study. However, after controlling for the above factors, age, gender, history of TB contact outside the workplace (other than family contact), duration of service and failure to use respiratory protection when performing high-risk procedures, were the main risk factors of TB among health care workers. This study succeeded in identifying some of the risk factors of TB among health care workers. We managed to include the large ratio of controls to case (3:1) and those cases spanned over a period of 10 years. However, the findings from the study have to be applied with caution due to the limitations of this study, which include recall bias, dropouts, and small sample size. Based on the study findings, we recommend that health care workers in the first 10 years of service should take extra precautions, such as using respiratory protection when performing procedures that are considered to be of high risk with respect to TB infection. They should also undergo TB screening at least once every 2 years and, if symptomatic, offered prophylactic treatment. The Respiratory Protection Programme should be fully implemented to help reduce the risk of TB among health care workers in Sabah.