Displaying publications 1 - 20 of 95 in total

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  1. Zainul NH, Ma ZF, Besari A, Siti Asma H, Rahman RA, Collins DA, et al.
    Epidemiol Infect, 2017 Oct;145(14):3012-3019.
    PMID: 28891459 DOI: 10.1017/S0950268817002011
    Little is known about Clostridium difficile infection (CDI) in Asia. The aims of our study were to explore (i) the prevalence, risk factors and molecular epidemiology of CDI and colonization in a tertiary academic hospital in North-Eastern Peninsular Malaysia; (ii) the rate of carriage of C. difficile among the elderly in the region; (iii) the awareness level of this infection among the hospital staffs and students. For stool samples collected from hospital inpatients with diarrhea (n = 76) and healthy community members (n = 138), C. difficile antigen and toxins were tested by enzyme immunoassay. Stool samples were subsequently analyzed by culture and molecular detection of toxin genes, and PCR ribotyping of isolates. To examine awareness among hospital staff and students, participants were asked to complete a self-administered questionnaire. For the hospital and community studies, the prevalence of non-toxigenic C. difficile colonization was 16% and 2%, respectively. The prevalence of CDI among hospital inpatients with diarrhea was 13%. Out of 22 C. difficile strains from hospital inpatients, the toxigenic ribotypes 043 and 017 were most common (both 14%). In univariate analysis, C. difficile colonization in hospital inpatients was significantly associated with greater duration of hospitalization and use of penicillin (both P < 0·05). Absence of these factors was a possible reason for low colonization in the community. Only 3% of 154 respondents answered all questions correctly in the awareness survey. C. difficile colonization is prevalent in a Malaysian hospital setting but not in the elderly community with little or no contact with hospitals. Awareness of CDI is alarmingly poor.
  2. Zailani MAH, Sabudin RZAR, Rahman RA, Saiboon IM, Ismail A, Mahdy ZA
    Medicine (Baltimore), 2020 Sep 04;99(36):e21967.
    PMID: 32899033 DOI: 10.1097/MD.0000000000021967
    INTRODUCTION: Medical products transportation has become an important research topic requiring multidisciplinary collaboration among experts in medicine, engineering, and health economics. Current modes of transportation are unable to overcome the limited settings in maternal healthcare, particularly during the event of obstetric emergencies. The drone is a promising medical product aerial transportation (MedART) that holds an enormous potential for delivery of medical supplies in the healthcare system. We conducted a systematic review to examine scientific evidence of positive impact of drone transportation on maternal health.

    METHODS: The following electronic databases were searched from inception to July 2019: ScienceDirect, PubMed, and EMBASE. The report was made in accordance with the principles of PRISMA guidelines. The search terms used were related to drones including unmanned aerial vehicle (UAV) and unmanned aerial system (UAS), and related to obstetric/maternal including obstetric emergencies and postpartum hemorrhage. Studies were selected if the intervention used were drones, and if any direct or indirect maternal health indicators were reported. Meta-analysis was not done throughout the study in view of the anticipated heterogeneity of each study.

    RESULTS: Our initial search yielded a total of 244 relevant publications, from which 236 were carried forward for a title and abstract screening. After careful examination, only two were included for systematic synthesis. Among the reasons for exclusion were irrelevance to maternal health purpose, and irrelevance to drone applications in healthcare. An updated search yielded one additional study that was also included. Overall, two studies assessed drones for blood products delivery, and one study used drones to transport blood samples.

    CONCLUSION: A significant deficiency was found in the number of reported studies analyzing mode of medical products transportation and adaptation of drones in maternal healthcare. Future drone research framework should focus on maternal healthcare-specific drone applications in order to reap benefits in this area.

  3. Yusoff FA, Rahman RA, May LH, Budart SB, Sulaiman LH
    Western Pac Surveill Response J, 2015 May 27;6(2):27-31.
    PMID: 26306213 DOI: 10.5365/WPSAR.2015.6.1.012
    In September 2012, 10 cases suspected to be hepatitis A were notified to the Manjung District Health Department. An investigation was conducted to identify the possible mode of transmission, source of the outbreak and to recommend prevention and control measures.
  4. Yip YS, Manas NHA, Jaafar NR, Rahman RA, Puspaningsih NNT, Illias RM
    Int J Biol Macromol, 2023 Jul 01;242(Pt 1):124675.
    PMID: 37127056 DOI: 10.1016/j.ijbiomac.2023.124675
    Maltooligosaccharides (MOS) are functional oligosaccharides that can be synthesized through enzymatic cascade reaction between cyclodextrin glucanotransferase (CGTase) and maltogenic amylase (Mag1) from Bacillus lehensis G1. To address the problems of low operational stability and non-reusability of free enzymes, both enzymes were co-immobilized as combined cross-linked enzyme aggregates (Combi-CLEAs-CM) with incorporation of bovine serum albumin (BSA) and Tween 80 (Combi-CLEAs-CM-add). Combi-CLEAs-CM and Combi-CLEAs-CM-add showed activity recoveries of 54.12 % and 69.44 %, respectively after optimization. Combi-CLEAs-CM-add showed higher thermal stability at higher temperatures (40 °C) with longer half-life (46.20 min) as compared to those of free enzymes (36.67 min) and Combi-CLEAs-CM (41.51 min). Both combi-CLEAs also exhibited higher pH stability over pH 5 to pH 9, and displayed excellent reusability with >50 % of initial activity retained after four cycles. The reduction in Km value of about 22.80 % and 1.76-fold increase in starch hydrolysis in comparison to Combi-CLEAs-CM attested the improvement of enzyme-substrate interaction by Tween 80 and pores formation by BSA in Combi-CLEAs-CM-add. The improved product specificity of Combi-CLEAs-CM-add also produced the highest yield of MOS (492 mg/g) after 3 h. Therefore, Combi-CLEAs-CM-add with ease of preparation, excellent reusability and high operational stability is believed to be highly efficacious biocatalyst for MOS production.
  5. Wu Y, Rahman RA, Yu Q
    Environ Monit Assess, 2022 Feb 08;194(3):154.
    PMID: 35132444 DOI: 10.1007/s10661-022-09817-9
    Sustainable agriculture is important for preserving environmental health and simultaneously gaining economic profits while maintaining social and economic equity. One way to evaluate sustainable agriculture is by studying agricultural eco-efficiency (AEE). Hence, this study constructed a data-driven method to evaluate and optimize AEE with the aim of providing a basis for improving the sustainable development of regional agriculture. Sixteen cities in Anhui Province, China, were considered in the study, and the variables used were agricultural resource inputs, environmental pollution, and agricultural economic development. Agricultural non-point source pollution (NPSP) emissions were considered the undesired output to build an AEE evaluation index system. Furthermore, a data envelopment analysis (DEA) model was established to analyse AEE from the static and dynamic perspectives. The spatial development and the temporal and spatial characteristics of AEE were also analysed. In addition, we applied a random effect (RE) panel Tobit model to quantitatively analyse the influencing factors of AEE from the input perspective and then proposed reasonable suggestions for improving the sustainable development of regional agriculture. Our findings show that the overall agricultural development in the 16 cities in Anhui Province has been continuously improving, even though there is an agglomeration of spatial development in some regions. In conclusion, this study provides suggestions and references for policy makers and agricultural practitioners regarding how to improve regional AEE and promote the sustainable development of the regional agricultural economy.
  6. Wahab F, Rahman RA, Yaacob LH, Noor NM, Draman N
    Korean J Fam Med, 2020 Sep;41(5):359-362.
    PMID: 32961047 DOI: 10.4082/kjfm.18.0181
    We report a case of steroid withdrawal syndrome in a 74-year-old woman who was suspected of having an occult exogenous Cushing's syndrome secondary to prolonged traditional complementary medicine use. She presented with non-specific symptoms of lethargy, malaise, and poor oral intake with weight loss for 1 month, and investigations showed suboptimal 9 AM cortisol level. She has responded well to steroid replacement.
  7. Tsyeng NK, Omar M, Rahman RA, Rahman SA
    BMJ, 2024 Jan 18;384:e077643.
    PMID: 38237943 DOI: 10.1136/bmj-2023-077643
  8. Tan HT, Rahman RA, Gan SH, Halim AS, Hassan SA, Sulaiman SA, et al.
    PMID: 19754926 DOI: 10.1186/1472-6882-9-34
    Antibiotic resistance of bacteria is on the rise, thus the discovery of alternative therapeutic agents is urgently needed. Honey possesses therapeutic potential, including wound healing properties and antimicrobial activity. Although the antimicrobial activity of honey has been effectively established against an extensive spectrum of microorganisms, it differs depending on the type of honey. To date, no extensive studies of the antibacterial properties of tualang (Koompassia excelsa) honey on wound and enteric microorganisms have been conducted. The objectives of this study were to conduct such studies and to compare the antibacterial activity of tualang honey with that of manuka honey.
  9. Tan CYM, Rahman RA, Lee YS
    PMID: 38236568 DOI: 10.1007/s11356-024-31923-z
    Many reported cases of occupants in modern office buildings suffer from severe health risks, negative impacts on well-being, and productivity loss. Existing building standards often prioritize energy performance and green environments over human sustainability. Moreover, office buildings have a distinct group of occupants that require extra attention. Hence, the study aims to develop a WELL building model specifically for office buildings to support occupants' well-being, health, and productivity (i.e., WELL). To achieve that objective, this study developed a list of physical indoor building features through a systematic literature review and semi-structured interviews. Then, the features were inserted into a survey and sent to office building occupants and built environment professionals. The collected data was analyzed using the analytic hierarchy process (AHP) and confirmatory factor analysis (CFA). The findings suggest twelve new features applicable for supporting WELL in office buildings: workspace privacy, sufficient space, office layout, cleanliness, efficiency in building services, individual control, building automation system, Information Technology (IT) infrastructure, Wireless Fidelity (WiFi) risk, security system, safety at parking lots, and safe design. Also, three new concepts for supporting WELL in office buildings were established: office space, building services and maintenance, and smart systems. The new concepts and features lay a foundation for designing office buildings that comprehensively target occupants' WELL. Finally, this study is unique as it accentuates the development of a WELL building model specifically for office buildings.
  10. Tamizi NAMA, Rahim SZA, Abdellah AE, Abdullah MMAB, Nabiałek M, Wysłocki JJ, et al.
    Materials (Basel), 2021 Mar 15;14(6).
    PMID: 33804036 DOI: 10.3390/ma14061416
    Many studies have been done using recycled waste materials to minimise environmental problems. It is a great opportunity to explore mechanical recycling and the use of recycled and virgin blend as a material to produce new products with minimum defects. In this study, appropriate processing parameters were considered to mould the front panel housing part using R0% (virgin), R30% (30% virgin: 70% recycled), R40% (40% virgin: 60% recycled) and R50% (50% virgin: 50% recycled) of Polycarbonate (PC). The manufacturing ability and quality during preliminary stage can be predicted through simulation analysis using Autodesk Moldflow Insight 2012 software. The recommended processing parameters and values of warpage in x and y directions can also be obtained using this software. No value of warpage was obtained from simulation studies for x direction on the front panel housing. Therefore, this study only focused on reducing the warpage in the y direction. Response Surface Methodology (RSM) and Genetic Algorithm (GA) optimisation methods were used to find the optimal processing parameters. As the results, the optimal ratio of recycled PC material was found to be R30%, followed by R40% and R50% materials using RSM and GA methods as compared to the average value of warpage on the moulded part using R0%. The most influential processing parameter that contributed to warpage defect was packing pressure for all materials used in this study.
  11. Sulaiman AS, Ahmad S, Ismail NA, Rahman RA, Jamil MA, Mohd Dali AZ
    Saudi Med J, 2013 Aug;34(8):819-23.
    PMID: 23974453
    To evaluate the prevalence of obstetrical anal sphincter injuries (OASIS), which include third and fourth degree perineal tears in primigravida in routine versus selective mediolateral episiotomy. Secondly, to determine the rate of episiotomy in local settings.
  12. Singh R, Tan SG, Panandam JM, Rahman RA, Ooi LC, Low ET, et al.
    BMC Plant Biol, 2009;9:114.
    PMID: 19706196 DOI: 10.1186/1471-2229-9-114
    Marker Assisted Selection (MAS) is well suited to a perennial crop like oil palm, in which the economic products are not produced until several years after planting. The use of DNA markers for selection in such crops can greatly reduce the number of breeding cycles needed. With the use of DNA markers, informed decisions can be made at the nursery stage, regarding which individuals should be retained as breeding stock, which are satisfactory for agricultural production, and which should be culled. The trait associated with oil quality, measured in terms of its fatty acid composition, is an important agronomic trait that can eventually be tracked using molecular markers. This will speed up the production of new and improved oil palm planting materials.
  13. Singh J, Rahman RA, Rajion ZA, Abdullah J, Mohamad I
    J Craniofac Surg, 2017 Jan;28(1):e64-e70.
    PMID: 27922969 DOI: 10.1097/SCS.0000000000003218
    INTRODUCTION: The human orbit is a complex anatomic region, which plays predominant role in the evaluation of craniofacial complex. A thorough understanding of the relationship of the distance from orbital rim to the important vital structures of the orbital apex is required for the surgeon to perform safe and effective surgery.

    OBJECTIVES: To evaluate and compare the depth and distances from various points of the orbital rim to the fissures and foramina of the orbital apex between genders in the local population.

    METHODOLOGY: Linear measurements were conducted on 60 orbits from 30 patients who had undergone head computed tomography scan. These measurements were done utilizing the multiplanar reconstruction modes on computed tomography images with minimum slice thickness of 1 mm.

    RESULTS: Males have statistically significant larger orbits than females with higher mean measurements in all parameters, except for the distance from posterior ethmoidal foramen to the optic canal which was the same. However, there were no significant differences in all parameters between the right and left orbits.

    CONCLUSION: This study provides the absolute limit of safe internal orbital dissection in respect to the local population. Despite males having larger orbits than females, it is clinically negligible.

  14. Shameli K, Ahmad MB, Yunus WM, Ibrahim NA, Rahman RA, Jokar M, et al.
    Int J Nanomedicine, 2010 Sep 07;5:573-9.
    PMID: 20856832
    In this study, antibacterial characteristic of silver/poly (lactic acid) nanocomposite (Ag/PLA-NC) films was investigated, while silver nanoparticles (Ag-NPs) were synthesized into biodegradable PLA via chemical reduction method in diphase solvent. Silver nitrate and sodium borohydride were respectively used as a silver precursor and reducing agent in the PLA, which acted as a polymeric matrix and stabilizer. Meanwhile, the properties of Ag/PLA-NCs were studied as a function of the Ag-NP weight percentages (8, 16, and 32 wt% respectively), in relation to the use of PLA. The morphology of the Ag/PLA-NC films and the distribution of the Ag-NPs were also characterized. The silver ions released from the Ag/PLA-NC films and their antibacterial activities were scrutinized. The antibacterial activities of the Ag/PLA-NC films were examined against Gram-negative bacteria (Escherichia coli and Vibrio parahaemolyticus) and Gram-positive bacteria (Staphylococcus aureus) by diffusion method using Muller-Hinton agar. The results indicated that Ag/PLA-NC films possessed a strong antibacterial activity with the increase in the percentage of Ag-NPs in the PLA. Thus, Ag/PLA-NC films can be used as an antibacterial scaffold for tissue engineering and medical application.
  15. Shahmohammadi HR, Bakar J, Rahman RA, Adzhan NM
    J Food Sci, 2014 Feb;79(2):E178-83.
    PMID: 24410375 DOI: 10.1111/1750-3841.12324
    To improve textural attributes of puffed corn-fish snack, the effects of 1%, 1.5%, and 2% of calcium carbonate, magnesium silicate (talc), sodium bicarbonate as well as 5% and 10% of wheat bran (as the nucleating materials) on textural attributes were studied. Sensory evaluation, bulk density, expansion ratio, maximum force, and count peaks were measured using the Kramer test. The results showed that all of the additives except bran significantly enhanced the texture. Among them, talc at 0.5% was the best to enhance the density and expansion ratio. Effects of using 0.5% talc on puffed corn-fish snack microstructure were studied using scanning electron microscopy. The average cell diameter of 109 ± 48 μm and cell numbers per square centimeter of 67.4 for talc-treated products were obtained, while for nontalc-treated extrudates, average cell diameter of 798 ± 361 μm and cell numbers per square centimeter of 13.9 were found. Incorporation of 0.5% w/w of magnesium silicate reduced (7-fold) the average cell diameter while increased (4-fold) the cell number.
  16. Shaharir SS, Maulana SA, Shahril NS, Mohd R, Mustafar R, Said MSM, et al.
    Lupus, 2020 Sep;29(10):1305-1313.
    PMID: 32660312 DOI: 10.1177/0961203320938871
    BACKGROUND: Despite the improvement in the live birth rate among patients with systemic lupus erythematosus (SLE), they are still at an increased risk of adverse pregnancy outcomes (APOs).

    OBJECTIVE: To determine the prevalence and factors associated with APOs in the multi-ethnic SLE populations in Malaysia.Methodology: This was a retrospective review of the consecutive SLE patients who attended the outpatient clinic in two major rheumatology centres from January 2016 until December 2019 with complete pre-pregnancy, antenatal and intra-partum records. APOs include pregnancy loss, prematurity, pre-eclampsia, intra-uterine growth restriction (IUGR) and maternal death. Univariate and multivariable logistic regression with generalised estimating equation (GEE) analyses were performed to determine the factors associated with APOs.

    RESULTS: A total of 153 patients with 240 pregnancies were included and the majority of the patients were Malay (69.9%), followed by Chinese (24.2%) and Indian (5.9%). The prevalence of APOs was 61.7% with the commonest complication being prematurity (28.3%), followed by pregnancy loss (24.6%) and pre-eclampsia (21.8%). Logistic regression model-based GEE analysis revealed that the independent predictors of APOs were active haematological system during pregnancy, pre-pregnancy active disease, Indian patients and positive lupus anticoagulant. Hydroxychloroquine use was associated with lower APOs including pre-eclampsia, prematurity and IUGR in the univariate analyses but it was no longer significant in the GEE analysis.

    CONCLUSION: The prevalence of APOs was high particularly among the Indian patients. Positive lupus anticoagulant and pre-pregnancy active disease were the factors strongly associated with APOs in our multi-ethnic cohort. Hydroxychloroquine may protect against APOs but further larger studies are needed to confirm this.

  17. Shah NN, Rahman RA, Hashim DM
    J Food Sci Technol, 2015 Mar;52(3):1525-33.
    PMID: 25745221 DOI: 10.1007/s13197-013-1111-y
    Ozone dose from 0.1 to 0.4 ppm has been proven to be effective in lowering Bacillus cereus count in uncooked and cooked rice. However, it induces physicochemical changes in raw white rice. Physicochemical tests were done to see the effect of ozone treatment towards moisture content, pH, color, hardness of uncooked rice, adhesiveness and hardness of cooked rice, cooking quality and total solids. Results have shown that moisture content, adhesiveness and hardness of cooked rice and uncooked rice have not undergone any significant changes (P > 0.05) in comparison with controlled rice sample. Meanwhile, color (L* and b* value), pH, total solids and cooking quality results have shown significant changes (P 
  18. Shah NN, Rahman RA, Shamsuddin R, Adzahan NM
    J Food Sci Technol, 2015 Aug;52(8):5057-65.
    PMID: 26243926 DOI: 10.1007/s13197-014-1554-9
    The purpose of this study is to investigate the changes occured on phenolic compounds between two Malaysian varieties of pummelo fruit juice: Ledang (PO55) and Tambun (PO52) post-enzymatic clarification. The changes in polyphenols composition were monitored using High Performance Liquid Chromatography Diode Array Detection and Folin Ciocalteu's method. Clarification treatment of pummelo fruit juice with a commercial pectinase was optimized based on incubation temperature, time and enzyme concentration. Both varieties of pummelo fruit juice were treated with different optimized variables which produced the highest clarities with the least effect to the juice physical quality. Tambun variety was found to have significantly more total phenolic compounds (p <0.05) in comparison to Ledang variety, possibly due to the amount of naringin. Three types of hydroxycinnamic acids (chlorogenic, caffeic and coumaric acid) and three compounds of flavanones (naringin, hesperidin and narirutin) were found in both fruit juices, where naringin and chlorogenic acid were the major contributor to the total phenolic content. Naringin, which gave out bitter aftertaste to the juice, was found to decrease, 1.6 and 0.59 % reduction in Ledang and Tambun respectively, post-enzymatic treatment. The decrease in naringin, albeit nominal, could be a potential benefit to the juice production in reducing the bitterness of the juice. Post-enzymatic analysis furthermore resulted in no significance differences (p <0.05) on the total phenolic compounds of both varieties. This study in summary provides a compositional database for Malaysian pummelo fruit juice of various phenolic compounds, which can provide useful information for evaluating the authenticity and the health benefits from the juice.
  19. Shafei H, Rahman RA, Lee YS
    Environ Sci Pollut Res Int, 2024 Feb;31(10):14858-14893.
    PMID: 38285259 DOI: 10.1007/s11356-024-31862-9
    This study aims to compare the impact of Construction 4.0 technologies on different organizational core values, focusing on sustainability and resiliency, well-being, productivity, safety, and integrity. To achieve that aim, the study objectives are the following: (i) identify the critical Construction 4.0 technologies between core values; (ii) appraise overlapping critical Construction 4.0 technologies between core values; (iii) examine the ranking performance of Construction 4.0 technologies between core values; and (iv) analyze the interrelationships between Construction 4.0 technologies and core values. First, twelve Construction 4.0 technologies were identified from a national strategic plan. Then, the fuzzy technique for order of preference by similarity to ideal solution (TOPSIS) that incorporates subjective and objective weights was used to evaluate the impact of the Construction 4.0 technologies on the five core values. Finally, the collected data was analyzed using the following techniques: fuzzy TOPSIS, normalization, overlap analysis, agreement analysis, sensitivity analysis, ranking comparison, and Spearman correlation. The study findings reveal four critical Construction 4.0 technologies that enhance all five core values: building information modeling (BIM), Internet of Things (IoT), big data and predictive analytics, and autonomous construction. Also, there is a high agreement on the Construction 4.0 technologies that enhance well-being and productivity. Lastly, artificial intelligence (AI) has the highest number of very strong relationships among the core values. The originality of this paper lies in its comprehensive comparison of the impact of Construction 4.0 technologies on multiple organizational core values. The study findings provide valuable insights in making strategic decisions in adopting Construction 4.0 technologies.
  20. Senin A, Noordin NM, Sani JAM, Mahat D, Donadel M, Scobie HM, et al.
    PLoS One, 2024;19(3):e0298730.
    PMID: 38483868 DOI: 10.1371/journal.pone.0298730
    INTRODUCTION: A lateral flow rapid diagnostic test (RDT) enables detection of measles specific immunoglobulin M (IgM) antibody in serum, capillary blood, and oral fluid with accuracy consistent with enzyme immunoassay (EIA). The objectives of the study were: 1) to assess measles RDT inter-reader agreement between two clinic staff; 2) to assess the sensitivity and specificity of the measles RDT relative to standard surveillance testing in a low transmission setting; 3) to evaluate the knowledge, attitudes, and practices of staff in clinics using the RDT; and 4) to assess the impact of RDT testing on the measles public health response in Malaysia.

    MATERIALS AND METHODS: The clinic-based prospective evaluation included all suspected measles cases captured by routine measles surveillance at 34 purposely selected clinics in 15 health districts in Malaysia between September 2019 and June 2020, following day-long regional trainings on RDT use. Following informed consent, four specimens were collected from each suspected case, including those routinely collected for standard surveillance [serum for EIA and throat swabs for quantitative reverse transcriptase polymerase chain reaction (RT-qPCR)] together with capillary blood and oral fluid tested with RDTs during the study. RDT impact was evaluated by comparing the rapidity of measles public health response between the pre-RDT implementation (December 2018 to August 2019) and RDT implementation periods (September 2019 to June 2020). To assess knowledge, attitudes, and practices of RDT use, staff involved in the public health management of measles at the selected sites were surveyed.

    RESULTS: Among the 436 suspect cases, agreement of direct visual readings of measles RDT devices between two health clinic staff was 99% for capillary blood (k = 0.94) and 97% for oral fluid (k = 0.90) specimens. Of the total, 45 (10%) were positive by measles IgM EIA (n = 44, including five also positive by RT-qPCR) or RT-qPCR only (n = 1), and 38 were positive by RDT (using either capillary blood or oral fluid). Using measles IgM EIA or RT-qPCR as reference, RDT sensitivity using capillary blood was 43% (95% CI: 30%-58%) and specificity was 98% (95% CI: 96%-99%); using oral fluid, sensitivity (26%, 95% CI: 15%-40%) and specificity (97%, 95% CI: 94%-98%) were lower. Nine months after training, RDT knowledge was high among staff involved with the public health management of measles (average quiz score of 80%) and was highest among those who received formal training (88%), followed by those trained during supervisory visits (83%). During the RDT implementation period, the number of days from case confirmation until initiation of public response decreased by about 5 days.

    CONCLUSION: The measles IgM RDT shows >95% inter-reader agreement, high retention of RDT knowledge, and a more rapid public health response. However, despite ≥95% RDT specificity using capillary blood or oral fluid, RDT sensitivity was <45%. Higher-powered studies using highly specific IgM assays and systematic RT-qPCR for case confirmation are needed to establish the role of RDT in measles elimination settings.

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