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  1. Knowledge and Confidence Level Among Emergency Healthcare Workers in Airway Management and Resuscitation of Suspected COVID-19 Patients: A Cross Sectional Study in Malaysia
    Abd Samat AH, Isa MH, Sabardin DM, Jamal SM, Jaafar MJ, Hamzah FA, et al.
    Ann Acad Med Singap, 2020 Sep;49(9):643-651.
    PMID: 33241252
    INTRODUCTION: This study aims to evaluate the knowledge and confidence of emergency healthcare workers (EHCW) in facing the COVID-19 pandemic.

    MATERIALS AND METHODS: A cross-sectional online study using a validated questionnaire was distributed to doctors (MD), assistant medical officers (AMO), and staff nurses (SN) at an urban tertiary Emergency Department. It comprised of 40 knowledge and 10 confidence-level questions related to resuscitation and airway management steps.

    RESULTS: A total of 135 from 167 eligible EHCW were enrolled. 68.9% (n = 93) had high knowledge while 53.3% (n = 72) possessed high confidence level. Overall knowledge mean score was 32.96/40 (SD = 3.63) between MD (33.88±3.09), AMO (32.28±4.03), and SN (32.00±3.60), P= 0.025. EHCWs with a length of service (LOS) between 4-10 years had the highest knowledge compared to those with LOS <4-year (33.71±3.39 versus 31.21±3.19 P = 0.002). Airway-related knowledge was significantly different between the designations and LOS (P = 0.002 and P = 0.003, respectively). Overall, EHCW confidence level against LOS showed significant difference [F (2, 132) = 5.46, P = 0.005] with longer LOS showing better confidence. MD showed the highest confidence compared to AMO and SN (3.67±0.69, 3.53±0.68, 3.26±0.64) P = 0.049. The majority EHCW were confident in performing high-quality chest-compression, and handling of Personal Protective Equipment but less than half were confident in resuscitating, leading the resuscitation, managing the airway or being successful in first intubation attempt.

    CONCLUSIONS: EHCW possessed good knowledge in airway and resuscitation of COVID-19 patients, but differed between designations and LOS. A longer LOS was associated with better confidence, but there were some aspects in airway management and resuscitation that needed improvement.

    Matched MeSH terms: Infection Control/methods*
  2. Clinical pairing revisited: a study at the University of Malaya, Malaysia
    Ahmad NA, Naimie Z, Lui JL, Aziz AA, Abdullah M, Abu Kasim NH, et al.
    J Dent Educ, 2012 Oct;76(10):1377-83.
    PMID: 23066138
    This study is part of ongoing educational research conducted by the Department of Conservative Dentistry, University of Malaya, Malaysia, to evaluate the perception of clinical pairing. A thirteen-question survey was distributed to 148 dental students after they had experienced four-handed dentistry. The objectives were to identify the advantages, disadvantages, and the acceptance of the implementation of clinical pairing from the students' point of view. The responses from the open-ended questions were categorized into six main themes (areas of interest): quality-related (Q), patient-related (PT), partner-related (P), lecturer-related (T), infection control (IC), and learning environment (L). Data analysis was done using SPSS version 18. Results indicated that the students perceived they possessed enough knowledge regarding clinical pairing. However, it was found that they still preferred to work independently as compared to working in pairs. The benefits of clinical pairing may not be viewed in the same vein by both dental students and teachers. The quality-related theme was perceived by students as the main advantage of clinical pairing, whilst the partner-related theme was perceived otherwise. The study also revealed that students may have some preconceived notions about pairing that may have impaired their acceptance. As a consequence, some reluctance was seen in their responses.
    Matched MeSH terms: Infection Control, Dental
  3. Isoniazid preventive therapy in correctional facilities: a systematic review
    Al-Darraji HA, Kamarulzaman A, Altice FL
    Int J Tuberc Lung Dis, 2012 Jul;16(7):871-9.
    PMID: 22410101 DOI: 10.5588/ijtld.11.0447
    Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide and the main cause of death in correctional facilities in middle- and low-income countries. Due to the closed environment and the concentration of individuals with TB-related risk factors, effective measures are required to control TB in such settings. Isoniazid preventive therapy (IPT) represents an effective and cost-effective measure. Despite international recommendations that IPT be integral to TB control, it is seldom deployed. A systematic review of interventions used to assess IPT initiation and completion in correctional facilities was conducted using published studies from two biomedical databases and relevant keywords. Additional references were reviewed, resulting in 18 eligible studies. Most (72%) studies were conducted in the United States and in jail settings (60%), with the main objective of improving completion rates inside the facility or after release. Studies that provided data about initiation and completion rates showed poor success in correctional facilities. Adverse consequences and treatment interruption ranged from 1% to 55% (median 5%) in reported studies; hepatotoxicity was the most prevalent adverse reaction. Despite its accelerating effect on the development of active TB, information on human immunodeficiency virus (HIV) status was provided in only half of the studies. Among the four studies where IPT effectiveness was assessed, the results mirror those described in community settings. Future studies require thorough assessments of IPT initiation and completion rates and adverse effects, particularly in low- and middle-income countries and where comorbid viral hepatitis may contribute significantly to outcomes, and in settings where TB and HIV are more endemic.
    Matched MeSH terms: Infection Control/methods*
  4. Fulltext Narrative Review of Infection Control Knowledge and Attitude among Healthcare Workers
    AlJohani A, Karuppiah K, Al Mutairi A, Al Mutair A
    J Epidemiol Glob Health, 2021 03;11(1):20-25.
    PMID: 33605115 DOI: 10.2991/jegh.k.201101.001
    BACKGROUND: Infection is one of the major threats to Healthcare Workers (HCW) worldwide. It exposes HCW to more than 20 kinds of blood-borne pathogen infections, especially the most severe cases, namely Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV). The impact of infection about HCWs' health, clinical burden, national economic burden, and humanistic burden suggests the importance of further investigation and discussion on this topic.

    AIMS: This paper aimed to discuss literature on infection control knowledge and attitudes among HCWs and potential factors contributing to infection control.

    METHOD: For this narrative review Proquest, Medline, and Up To Date have been utilized to search articles about infection control knowledge and attitudes among healthcare workers and potential factors contributing to infection control. The search was narrowed to article between 2000 and 2018. A total of 400 materials were initially identified to be potentially relevant for the review. A total of 28 articles were included, and they were found to match the inclusion criteria.

    RESULTS: Results from the reviewed studies showed that there was a high-level knowledge in terms of precautionary measures and compliance with needle safety precautions while staff attitude achieved above average. Weak positive correlation was found between staff attitude and precautionary measures, while moderate positive correlation was found between precautionary measures and compliance with needle safety precautions. Only precautionary measures were found to significantly influence compliance with needle safety precautions, in which higher precautionary measures, resulted in higher compliance with needle safety precautions.

    Matched MeSH terms: Infection Control*
  5. Fulltext The forgotten sub-regional COVID-19 response layer. The case of the WHO Eastern Mediterranean Region
    Ali Maher O, Elamein Boshara MA, Pichierri G, Cegolon L, Panu Napodano CM, Murgia P, et al.
    J Infect Dev Ctries, 2021 04 30;15(4):478-479.
    PMID: 33956646 DOI: 10.3855/jidc.14057
    The response to the COVID-19 pandemic have been driven by epidemiology, health system characteristics and control measures in form of social/physical distancing. Guidance, information and best practices have been characterized by territorial thinking with concentration on national health system and social contexts. Information was to a large extent provided from global entities such as the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and others. This bipolar response mechanism came to the detriment of regional and sub-regional levels. The development of the global pandemic was evaluated in terms of the performance of single countries without trying to reflect on possible regional or sub-regional results of similar characteristics in health system and social contexts. To have a clearer view of the issue of sub-regional similarities, we examined the WHO, Eastern Mediterranean Region. When examining the development of confirmed cases for countries in the region, we identified four different sub-groups similar in the development of the pandemic and the social distancing measure implemented. Despite the complicated situation, these groups gave space for thinking outside the box of traditional outbreaks or pandemic response. We think that this sub-regional approach could be very effective in addressing more characteristics and not geographically based analysis. Furthermore, this can be an area of additional conceptual approaches, modelling and concrete platforms for information and lessons learned exchange.
    Matched MeSH terms: Infection Control/methods*
  6. Fulltext Assessment of infection control among health care workers in healthcare centers Sana'a, Yemen : a cross-sectional study
    Ameen Saleh Saleh Sherah, Mohd Hasni Jaafar
    Int J Public Health Res, 2015;5(2):597-605.
    MyJurnal
    Introduction An Analysis of a Survey Questionnaire on health care workers’ knowledge and practices regarding of infection control and complains them to apply universal precautions. Health care workers are at substantial risk of acquiring blood borne pathogen infections through exposure to blood or other products of patients. To assess of infection control among health care workers in Sana'a healthcare centers, Yemen.
    Methods A cross-sectional study was conducted in the health center to assess knowledge and practices regarding of infection control among 237 health workers in Sana,a city. A structured self-administered questionnaires were used and data was analyzed using SPSS version 20 and the associations were tested with chi-square, with p-value of < 0.05.
    Results The health care workers in public centers ware (51.1%) and (48.9%) of them works in private centers. One hundred and seventeen (49.4%) respondents had poor infection control knowledge, 113 (43.5%) had fair knowledge, and 17 (7.2%) had good knowledge. The knowledge was significantly associated with type of center (P < 0.018), such that the public center had the highest proportion with poor knowledge. And nurses and midwife having the highest proportion with fair knowledge of infection control. Eight (3.4%) respondents had a poor practice of universal precautions, 93 (39.2%) had fair practice, and 136 (57.4%) good practice. The practice was significantly associated with the profession, level of education and work experience (P < 0.001), (P < 0.006), (P < 0.001) respectively, and nurses and midwives as the profession with the highest proportion with good practice.
    Conclusion We conclude that the practices and knowledge of universal precautions were low and that's need for intensive programmes to educate health care workers on various aspects of standard precautions and infection control programmes and policies.
    Matched MeSH terms: Infection Control*
  7. Fulltext Development of conventional and real-time multiplex PCR assays for the detection of nosocomial pathogens
    Anbazhagan D, Mui WS, Mansor M, Yan GO, Yusof MY, Sekaran SD
    Braz J Microbiol, 2011 Apr;42(2):448-58.
    PMID: 24031653 DOI: 10.1590/S1517-83822011000200006
    Nosocomial infections are major clinical threats to hospitalised patients and represent an important source of morbidity and mortality. It is necessary to develop rapid detection assays of nosocomial pathogens for better prognosis and initiation of antimicrobial therapy in patients. In this study, we present the development of molecular methods for the detection of six common nosocomial pathogens including Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter spp. Conventional multiplex PCR and SYBR Green based real time PCR assays were performed using genus and species specific primers. Blind testing with 300 clinical samples was also carried out. The two assays were found to be sensitive and specific. Eubacterial PCR assay exhibited positive results for 46 clinical isolates from which 43 samples were detected by real time PCR assay. The sensitivity of the assay is about 93.7% in blind test isolates. The PCR results were reconfirmed using the conventional culture method. This assay has the potential to be a rapid, accurate and highly sensitive molecular diagnostic tool for simultaneous detection of Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter spp. This assay has the potential to detect nosocomial pathogens within 5 to 6 hours, helping to initiate infection control measures and appropriate treatment in paediatric and elderly (old aged) patients, pre-and post surgery patients and organ transplant patients and thus reduces their hospitalization duration.
    Matched MeSH terms: Infection Control
  8. Fulltext Electrospun Azithromycin-Laden Gelatin Methacryloyl Fibers for Endodontic Infection Control
    Ayoub AA, Mahmoud AH, Ribeiro JS, Daghrery A, Xu J, Fenno JC, et al.
    Int J Mol Sci, 2022 Nov 09;23(22).
    PMID: 36430238 DOI: 10.3390/ijms232213761
    This study was aimed at engineering photocrosslinkable azithromycin (AZ)-laden gelatin methacryloyl fibers via electrospinning to serve as a localized and biodegradable drug delivery system for endodontic infection control. AZ at three distinct amounts was mixed with solubilized gelatin methacryloyl and the photoinitiator to obtain the following fibers: GelMA+5%AZ, GelMA+10%AZ, and GelMA+15%AZ. Fiber morphology, diameter, AZ incorporation, mechanical properties, degradation profile, and antimicrobial action against Aggregatibacter actinomycetemcomitans and Actinomyces naeslundii were also studied. In vitro compatibility with human-derived dental pulp stem cells and inflammatory response in vivo using a subcutaneous rat model were also determined. A bead-free fibrous microstructure with interconnected pores was observed for all groups. GelMA and GelMA+10%AZ had the highest fiber diameter means. The tensile strength of the GelMA-based fibers was reduced upon AZ addition. A similar pattern was observed for the degradation profile in vitro. GelMA+15%AZ fibers led to the highest bacterial inhibition. The presence of AZ, regardless of the concentration, did not pose significant toxicity. In vivo findings indicated higher blood vessel formation, mild inflammation, and mature and thick well-oriented collagen fibers interweaving with the engineered fibers. Altogether, AZ-laden photocrosslinkable GelMA fibers had adequate mechanical and degradation properties, with 15%AZ displaying significant antimicrobial activity without compromising biocompatibility.
    Matched MeSH terms: Infection Control
  9. Fulltext Incidence of phlebitis among adult patients with peripheral intravenous catheter in an east coast hospital Malaysia
    Azlina Daud, Fatimah Mohamad, Siti Noorkhairina Sowtali
    International Journal of Care Scholars, 2018;1(2):5-8.
    MyJurnal
    Objective: This study aims to determine the incidence rate of phlebitis among patients with peripheral intravenous catheter. Methods: An observational study was conducted in one of the hospitals in East Coast Malaysia. There were 321 data collected among patients who had peripheral intravenous catheter in medical, gynecology and orthopedic wards. The incidence of phlebitis was evaluated using modified Visual Infusion Phlebitis score checklist. Results: The incidence of phlebitis, was found out to be 36.1% (n=116/321). Most patients who developed phlebitis had visual infusion phlebitis, with a score of two (34.9%) and the rest developed phlebitis with a score of three (1.2%). Conclusion: This high incidence of phlebitis indicated a worrying outcome. Therefore, the study findings suggested that a specific guideline on post insertion management of peripheral intravenous catheter should be revised which may help in reducing more incidence of phlebitis, subsequently reduce infection in ward, and provide more safety environment in hospital and reducing cost in managing infection control.
    Matched MeSH terms: Infection Control
  10. Six year trend of neonatal septicaemia in a large Malaysian maternity hospital
    Boo NY, Chor CY
    J Paediatr Child Health, 1994 Feb;30(1):23-7.
    PMID: 8148183
    A study carried out in the Maternity Hospital, Kuala Lumpur over a 6 year period from 1986 to 1991, showed that the annual rates of septicaemia ranged from 5.2 to 10.2/100 admissions. Septicaemia accounted for between 11.0 to 30.4% of all neonatal deaths. The case fatality ratios ranged from 23.0 to 52.2%, being highest in 1989 when basic facilities were compromised. Low birthweight neonates accounted for 55.5% of those with septicaemia. The most common causative organisms were Staphylococcus epidermidis and Staphylococcus aureus in 1986 and 1987, but from 1988 Klebsiella species became the most common. More than 50% of neonatal septicaemia occurred after the age of 2 days. The results of the study demonstrated the dynamism of infection control: when control measures introduced earlier were not sustained, outbreaks of nosocomial infection recurred or worsened.
    Matched MeSH terms: Infection Control
  11. A case-control study of risk factors associated with rectal colonization of extended-spectrum beta-lactamase producing Klebsiella sp. in newborn infants
    Boo NY, Ng SF, Lim VK
    J Hosp Infect, 2005 Sep;61(1):68-74.
    PMID: 15953660
    To determine the risk factors for rectal colonization by extended-spectrum beta-lactamase (ESBL) Klebsiella sp. in 368 newborns admitted consecutively to a neonatal intensive care unit over six months, rectal swabs were cultured on admission and weekly until discharge. Eighty infants (21.7%) had ESBL Klebsiella sp. cultured from their rectal swabs. Eighty controls were selected at random from infants with negative cultures admitted within the 14-day period prior to the detection of ESBL Klebsiella sp. in the cases. Cases had significantly lower birth weight, gestational age, earlier age of admission, longer hospital stay, and higher proportions of congenital malformations, early-onset pneumonia and respiratory distress syndrome compared with controls. Significantly more cases received mechanical ventilation, nasal continuous positive airway pressure support, total parenteral nutrition, umbilical vascular catheterization, arterial line insertion, urinary bladder catheterization, and prior treatment with antibiotics. However, stepwise logistic regression analysis showed that only two independent risk factors were significantly associated with ESBL rectal colonization: duration of hospital stay [adjusted odds ratio (OR): 1.3; 95% confidence intervals (CI): 1.2, 1.4; P<0.0001) and early-onset pneumonia (adjusted OR: 8.3; 95% CI: 1.6, 43.4; P=0.01).
    Matched MeSH terms: Infection Control/methods
  12. The Changing Landscape of Alcohol Use and Alcohol Use Disorder During the COVID-19 Pandemic - Perspectives of Early Career Professionals in 16 Countries
    Calvey T, Scheibein F, Saad NA, Shirasaka T, Dannatt L, Stowe MJ, et al.
    J Addict Med, 2020 12;14(6):e284-e286.
    PMID: 32909983 DOI: 10.1097/ADM.0000000000000735
    : Alcohol use is a major risk factor for infectious disease and reduction of harms associated with alcohol consumption are essential during times of humanitarian crises, such as the COVID-19 pandemic. As a network of early career professionals working in the area of addiction medicine, we provide our views with regards to national actions related to reducing alcohol-related harm and providing care for people with alcohol use disorder during COVID-19. We believe that COVID-19 related measures have affected alcohol consumption in the majority of countries represented in this commentary. Examples of these changes include changes in alcohol consumption patterns, increases in cases of alcohol withdrawal syndrome, disruptions in access to medical care for alcohol use disorder and increases in illegal production of alcohol. Our members urge that treatment for acute and severe conditions due to substance use should be considered as essential services in times of humanitarian crises like COVID-19.
    Matched MeSH terms: Infection Control
  13. Fulltext Evaluation of the bacteriological contamination of a closed feeding system for enteral nutrition
    Chan L, Yasmin AH, Ngeow YF, Ong GS
    Med J Malaysia, 1994 Mar;49(1):62-7.
    PMID: 8057993
    A closed enteral delivery system consisting of a cardboard tetrapack containing the sterile ready-to-use liquid feed and an independent sterile administration set, has been devised. We found bacterial contamination within 24 hours in this system in patients on ventilatory support in intensive care. This emphasises the need for meticulous care in handling enteral feeding systems to prevent environmental contamination.
    Matched MeSH terms: Infection Control/methods
  14. Fulltext Use of negative pressure individual isolation system for CT scan of patients with suspected COVID-19
    Cheah PK, Krisnan T, Abdul Kadir MH, Steven EM
    Emerg Med J, 2020 Aug;37(8):467.
    PMID: 32546476 DOI: 10.1136/emermed-2020-209851
    Matched MeSH terms: Infection Control/instrumentation; Infection Control/methods*
  15. Indigenous concepts of causation and methods of prevention of childhood diseases in a rural Malay community
    Chen PC
    J Trop Pediatr (1967), 1970 Jun;16(2):33-42.
    PMID: 5005749
    Matched MeSH terms: Infection Control*
  16. Fulltext Methicillin-resistant Staphylococcus aureus (mrsa) in a Malaysian hospital
    Cheong I, Tan SC, Wong YH, Zainudin BM, Rahman MZ
    Med J Malaysia, 1994 Mar;49(1):24-8.
    PMID: 8057986
    Between August 1990 to November 1991, 905 of 2583 (35.4%) isolates of Staphylococcus aureus were found to be methicillin-resistant in a general hospital in Malaysia. A detailed study of 539 of these isolates showed a high prevalence of methicillin resistant Staphylococcus aureus (MRSA) in the surgical/orthopaedic wards, paediatric wards and the special care unit. The yield of MRSA was highest from wounds/ulcers/skin swabs accounting for 64.2 per cent followed by 6.9 per cent in blood cultures. Vancomycin remains the drug of choice with no resistance detected. The resistance to ciprofloxacin was 6.7 per cent, rifampicin 4.5 per cent and fusidic acid 2.0 per cent. Most isolates were resistant to aminoglycosides. In view of the high prevalence of MRSA in this hospital, the authorities must introduce more effective measures to control its spread as a nosocomial pathogen. Otherwise it may seriously disrupt the efficient delivery of health care services in the country.
    Matched MeSH terms: Infection Control
  17. Fulltext Establishment of a hospital-based health care workers surveillance programme to keep them safe during the COVID-19 pandemic
    Chong DW, Jayaraj VJ, Rampal S, Said MA, Farid NDN, Zaki RA, et al.
    J Glob Health, 2020 Dec;10(2):0203100.
    PMID: 33304566 DOI: 10.7189/jogh.10.0203100
    Matched MeSH terms: Infection Control/organization & administration*
  18. Effect of various infection-control methods for light-cure units on the cure of composite resins
    Chong SL, Lam YK, Lee FK, Ramalingam L, Yeo AC, Lim CC
    Oper Dent, 1998 Mar-Apr;23(3):150-4.
    PMID: 9656927
    This study (1) compared the curing-light intensity with various barrier infection-control methods used to prevent cross contamination, (2) compared the Knoop hardness value of cured composite resin when various barrier control methods were used, and (3) correlated the hardness of the composite resin with the light-intensity output when different infection-control methods were used. The light-cure unit tips were covered with barriers, such as cellophane wrap, plastic gloves, Steri-shields, and finger cots. The control group had no barrier. Composite resins were then cured for each of the five groups, and their Knoop hardness values recorded. The results showed that there was significant statistical difference in the light-intensity output among the five groups. However, there was no significant statistical difference in the Knoop hardness values among any of the groups. There was also no correlation between the Knoop hardness value of the composite resin with the light-intensity output and the different infection-control methods. Therefore, any of the five infection-control methods could be used as barriers for preventing cross-contamination of the light-cure unit tip, for the light-intensity output for all five groups exceeded the recommended value of 300 W/m2. However, to allow a greater margin of error in clinical situations, the authors recommend that the plastic glove or the cellophane wrap be used to wrap the light-cure tip, since these barriers allowed the highest light-intensity output.
    Matched MeSH terms: Infection Control, Dental/methods*
  19. Drive-through transcutaneous bilirubin screening for neonatal jaundice: A safe and efficient system during the COVID-19 pandemic
    Chua BS, Song LH, Chang CT, Lim XJ, Nachiappan J
    J Paediatr Child Health, 2021 01;57(1):12-14.
    PMID: 33078471 DOI: 10.1111/jpc.15226
    The coronavirus disease 2019 (COVID-19) cases was on an increasing trend, including in Malaysia. The Malaysian Ministry of Health had implemented a range of measures, such as the use of masks and social distancing, to reduce the risk of transmission. Traditionally, newborns are evaluated for neonatal jaundice using visual assessment, a capillary heel prick and serum bilirubin (SB) sampling in primary health-care clinics. This approach requires the physical presence of both parents and their newborns in the primary health-care clinics, causing crowding and increasing the risk of COVID-19 infections. To alleviate crowding, we implemented the transcutaneous bilirubin drive-through (DT) service, which is an established, non-invasive, painless and rapid method to determine the bilirubin levels. Throughout the screening, both parents and baby will be confined to their car. A total of 1842 babies were screened in our DT setting from April to July 2020. Of the total babies, 298 (16.1%) required venesection for SB measurement and 85 required admission for phototherapy. None with severe jaundice were missed since the implementation of this service. The average test duration per neonate was less than 5 min, while conventional venous bilirubin laboratory testing required an average of 1.5 h per neonate. The cost of the SB laboratory test and consumables was approximately USD 5 per test, with an estimated cost savings of USD 7720. DT screening may be introduced in health-care settings to reduce crowding and eliminate the need of painful blood sampling in newborns.
    Matched MeSH terms: Infection Control/methods*; Infection Control/organization & administration
  20. Fulltext Risk factors, prevention and communication strategy during Nipah virus outbreak in Malaysia
    Chua KB
    Malays J Pathol, 2010 Dec;32(2):75-80.
    PMID: 21329177 MyJurnal
    An outbreak of acute febrile encephalitis affecting pig-farm workers and owners was recognized in peninsular Malaysia as early as September 1998. The outbreak was initially thought to be due to Japanese encephalitis (JE) virus and thus very intensive prevention, control and communication strategies directed at JE virus were undertaken by the Ministry of Health and Ministry of Agriculture of Malaysia. There was an immediate change in the prevention, control and communication strategies with focus and strategies on infected pigs as the source of infections for humans and other animals following the discovery of Nipah virus. Information and understanding the risks of Nipah virus infections and modes of transmission strengthened the directions of prevention, control and communication strategies. A number of epidemiological surveillances and field investigations which were broadly divided into 3 groups covering human health sector, animal health sector and reservoir hosts were carried out as forms of risk assessment to determine and assess the factors and degree of risk of infections by the virus. Data showed that there was significant association between Nipah virus infection and performing activities involving close contact with pigs, such as processing of piglets, administering injection or medication to pigs, assisting in the birth of piglets, assisting in pig breeding, and handling of dead pigs in the affected farms. A complex process of anthropogenic driven deforestation, climatic changes brought on by El Niño-related drought, forest fire and severe haze, and ecological factors of mixed agro-pig farming practices and design of pig-sties led to the spillovers of the virus from its wildlife reservoir into pig population.
    Matched MeSH terms: Infection Control/methods*
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