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  1. Toyokawa H
    Hokenfu Zasshi, 1974 May;30(5):355-9.
    PMID: 4496068
    Matched MeSH terms: Public Health
  2. Toyokawa H
    Hokenfu Zasshi, 1974;30(6):415-9.
    PMID: 4498075
    Matched MeSH terms: Public Health Administration*
  3. Alabed AAA, Elengoe A, Anandan ES, Almahdi AY
    Z Gesundh Wiss, 2020 Oct 14.
    PMID: 33078089 DOI: 10.1007/s10389-020-01395-9
    Background: There is a major public health challenge threatening the world with the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in December 2019 from Wuhan, China.

    Objective: The aim of this study was to assess the knowledge, attitude and practice regarding COVID-19 and its transmission, causes and prevention among people living in Malaysia.

    Methods: A cross-sectional study was conducted among people living in Malaysia by using an online survey in March and April 2020.

    Results: Out of 520 respondents, the mean age was 36.9 ± 14.9, between 19 and 67 years with the majority being female. Most respondents had good knowledge, attitude and practice towards COVID-19 with mean ± sd 18.2 ± 1.7, 5.2 ± 1.1 and 4.1 ± 1.4, respectively. In addition, the majority had good knowledge regarding cause, mode of transmission, signs and symptoms, prevention and treatment and quarantine measures after answering 21 questions.

    Conclusion: To date, there is no specific treatment or vaccine for COVID-19, thus staying at home is the best preventive measure to curb the further growth of positive cases in the country. These findings could provide an insight in designing effective preparedness for future pandemic outbreaks.

    Matched MeSH terms: Public Health
  4. Michael JM, Hayakawa JM
    World Health Forum, 1994;15(3):282-3.
    PMID: 7945762
    In January 1984, the Asia-Pacific Academic Consortium for Public Health (APACPH) was established, bringing together 5 schools of public health with the objectives: to raise the quality of professional education in public health; to enhance the knowledge and skills of health workers through joint projects; to solve health problems through closer links with each other and with ministries of health; to increase opportunities for graduate students through curriculum development; and to make child survival a major priority. The Consortium now comprises 31 academic institutions or units in 16 countries, and is supported by UNICEF, The World Health Organization, the China Medical Board of New York, and the governments of Japan and Malaysia. During 1985-1992, it also received major support from the United States through the US Agency for International Development and the University of Hawaii. During the past 10 years, APACPH has carried out such activities as setting up a data bank on the programs of its members, assessing public health problems, designing new curriculum and systems for service delivery, facilitating information and faculty exchanges, and running workshops for academic administrators. It has also organized conferences on the impact of urbanization on health, aging, child survival, AIDS, and occupational health. Since 1987 it has published the Asia-Pacific Journal of Public Health, the only English language journal on public health issues in the Asia and Pacific region, which will feature work being done by non-English-speaking researchers. Emphasis in the coming years will be placed on setting common standards for teaching and research, so that members can make more use of each other's programs. It is hoped that membership of the Consortium will continue to expand. A particular concern will be to focus more resources on preventive care rather than curative.
    Matched MeSH terms: Schools, Public Health/organization & administration*
  5. Sinniah D, Rajeswari B, Harun F, Maniam CR
    World Health Forum, 1994;15(3):236-7.
    PMID: 7945748
    An outline is given of a simple cost-effective strategy aimed at the immunization of all children and pregnant women residing in the plantation sector of Malaysia. It is based on a partnership between government, nongovernmental organizations and the private sector, and is supported by UNICEF.
    PIP: A cost-effective strategy aimed at the immunization of all children and pregnant women residing in the plantation sector of Malaysia is outlined. It is based on a partnership between government, nongovernmental organizations and the private sector, and is supported by UNICEF. Over a million people reside on the Malaysian plantation estates: only 17% of the estates have their own hospitals; immunization services exist on only 1.5%; 40% of the estates are at least 5 kilometers from the nearest government health facility; and 64% lack transport for workers and their dependents to seek care away from the plantations. Two nongovernmental organizations, the Malaysian Paediatric Association and the Malaysian Society of Health, initiated discussions with the United Planting Association of Malaysia. A pilot study was undertaken by the groups on 6 estates in Selangor State, which included all the children at their first birthday. Tuberculosis, diphtheria/pertussis/tetanus, poliomyelitis, and measles immunization coverages were 88%, 44%, 59%, and 66%, respectively. The association of plantations accepted the organizations' proposals for all estates to: register all births; provide free transportation to government health clinics for the immunization of all eligible children and pregnant women; and enforce immunization schedules and record-keeping. The Ministry of Health agreed to provide free immunization of children and pregnant women; send mobile teams to estates that could assemble 20 or more eligible people for immunization; provide the estates with educational materials dealing with immunization; arrange that the maintenance of the cold chain be supervised by local medical officers of health; consider the training of estate hospital assistants with the help of the nongovernmental organizations. The total immunization plan was launched in September 1990. A manual was distributed to the estate managers, hospital assistants on the estates, and the medical officers who would implement and monitor the program. It is expected that total child immunization will be achieved in the foreseeable future in the estate sector.
    Matched MeSH terms: Public Health Administration*
  6. Golański J
    Wiad Lek, 1980 Jan 1;33(1):67-8.
    PMID: 7368743
    Matched MeSH terms: Public Health/trends*
  7. Lee S, Park H
    Water Sci Technol, 2010;61(12):3129-40.
    PMID: 20555209 DOI: 10.2166/wst.2010.454
    This study deals with the overcapacity problem of water treatment plants in Korea, and mainly discusses status, causes, and engineering options. To this end, we first statistically analyze the recent trend of demand, revealing that the demands of small- and mid-size systems are still increasing while that of large-size systems is now decreasing. Since the existing approach to plan capacity implicitly assumes that demand will increase at a regular rate, we estimate excess capacities and system utilizations of large-size systems. From these results it is found that the large-size systems are suffering from serious overcapacity, thus necessitating that engineers make very difficult decisions given that systems are still expanding the capacities of plants due to a lack of awareness of the current demand trend. For other systems where there is a better understanding of the transition of demand, planners have ceased to expand plants or have closed down relatively old plants in efforts to reduce O&M costs. To address this problem, quick recognition of the transition of demand is being highlighted by the concepts of integrated resources management and cybernetics. Therefore, we examined how quickly the new trend of the Seoul case could be precisely recognized and appropriately addressed. Using the Bayesian parameter estimation method, we found that a new trend can be recognized six years after the transition of demand.
    Matched MeSH terms: Public Health
  8. Hossain MS, Santhanam A, Nik Norulaini NA, Omar AK
    Waste Manag, 2011 Apr;31(4):754-66.
    PMID: 21186116 DOI: 10.1016/j.wasman.2010.11.008
    The management of clinical solid waste (CSW) continues to be a major challenge, particularly, in most healthcare facilities of the developing world. Poor conduct and inappropriate disposal methods exercised during handling and disposal of CSW is increasing significant health hazards and environmental pollution due to the infectious nature of the waste. This article summarises a literature review into existing CSW management practices in the healthcare centers. The information gathered in this paper has been derived from the desk study of open literature survey. Numerous researches have been conducted on the management of CSW. Although, significant steps have been taken on matters related to safe handling and disposal of the clinical waste, but improper management practice is evident from the point of initial collection to the final disposal. In most cases, the main reasons of the mismanagement of CSW are the lack of appropriate legislation, lack of specialized clinical staffs, lack of awareness and effective control. Furthermore, most of the healthcare centers of the developing world have faced financial difficulties and therefore looking for cost effective disposal methods of clinical waste. This paper emphasizes to continue the recycle-reuse program of CSW materials after sterilization by using supercritical fluid carbon dioxide (SF-CO2) sterilization technology at the point of initial collection. Emphasis is on the priority to inactivate the infectious micro-organisms in CSW. In that case, waste would not pose any threat to healthcare workers. The recycling-reuse program would be carried out successfully with the non-specialized clinical staffs. Therefore, the adoption of SF-CO2 sterilization technology in management of clinical solid waste can reduce exposure to infectious waste, decrease labor, lower costs, and yield better compliance with regulatory. Thus healthcare facilities can both save money and provide a safe environment for patients, healthcare staffs and clinical staffs.
    Matched MeSH terms: Public Health*
  9. Agamuthu P, Khidzir KM, Hamid FS
    Waste Manag Res, 2009 Oct;27(7):625-33.
    PMID: 19470545 DOI: 10.1177/0734242X09103191
    Drivers of sustainable waste management are defined as groups of related factors that influence the development (or lack thereof) of industry. There has been no attempt to reasonably list the drivers that influence sustainable waste management in Asia. In this review, four groups of drivers of sustainable waste management, specifically of Asia, are explained. The four groups of drivers consist of three human elements (human, economic and institutional) and the environment as a single driving group. Typically, the first three groups have been very influential, with the environment driver, noticeably, only considered when preceded by other groups of drivers. The interconnectedness of the drivers and neglect of the environment driver is discussed. It is concluded that while the essence of the four groups of drivers can be found all over Asia, each driving group must be investigated in a local context and all information combined to devise sustainable waste management policies or strategies.
    Matched MeSH terms: Public Health
  10. Zin T, Mudin KD, Myint T, Naing DKS, Sein T, Shamsul BS
    WHO South East Asia J Public Health, 2013 Jan-Mar;2(1):6-11.
    PMID: 28612817 DOI: 10.4103/2224-3151.115828
    BACKGROUND AND OBJECTIVES: Water and sanitation are major public health issues exacerbated by rapid population growth, limited resources, disasters and environmental depletion. This study was undertaken to study the influencing factors for household water quality improvement for reducing diarrhoea in resource-limited areas.

    MATERIALS AND METHODS: Data were collected from articles and reviews from relevant randomized controlled trials, new articles, systematic reviews and meta-analyses from PubMed, World Health Organization (WHO), United Nations Children's Fund (UNICEF) and WELL Resource Centre For Water, Sanitation And Environmental Health.

    DISCUSSION: Water quality on diarrhoea prevention could be affected by contamination during storage, collection and even at point-of-use. Point-of-use water treatment (household-based) is the most cost-effective method for prevention of diarrhoea. Chemical disinfection, filtration, thermal disinfection, solar disinfection and flocculation and disinfection are five most promising household water treatment methodologies for resource-limited areas.

    CONCLUSION: Promoting household water treatment is most essential for preventing diarrhoeal disease. In addition, the water should be of acceptable taste, appropriate for emergency and non-emergency use.
    Matched MeSH terms: Public Health
  11. Haregu T, Lim SC, Miranda M, Pham CT, Nguyen N, Suya I, et al.
    PMID: 37843178 DOI: 10.4103/WHO-SEAJPH.WHO-SEAJPH_140_22
    INTRODUCTION: The Better Health Program has been addressing key health system issues in the prevention and control of noncommunicable diseases (NCDs) in Malaysia, Thailand, Vietnam, and the Philippines. As the program comes to an end, the sustainability and scaling-up of issues have assumed importance.

    OBJECTIVES: The objective is to assess how well sustainability and scale-up strategies have been integrated into the design and implementation of a 3-year multicountry technical program; to explore enablers and barriers of sustainability and scaling up; and to identify practical strategies that can improve sustainability and scale-up of Better Health Program interventions.

    METHODS: We applied a staged approach to explore barriers and enablers and to identify practical strategies to improve sustainability and scale-up of four NCD interventions: community-based obesity prevention, front-of-pack labeling, local learning networks (LLNs), and NCD surveillance. We extracted evidence from peer-reviewed literature and local documents. We also conducted in-depth interviews with the implementation teams and key stakeholders. We conducted a thematic synthesis of the resulting information to identify practical strategies that improve sustainability and scale-up of the four interventions.

    RESULTS: Strong engagement of stakeholders at higher levels of the health system was identified as the main enabler, while limited funding and commitment from local governments were identified as a key barrier to sustainability and scale-up. Strengthening the social and institutional anchors of community health volunteers, enhancing evidence-based advocacy for front-of-pack labeling, trailblazing the LLN innovation, and securing the commitment of local governments in the implementation of NCD surveillance were among the key strategies for improving sustainability and scale-up of Better Health Program interventions in Malaysia, Thailand, Philippines, and Vietnam, respectively.

    CONCLUSIONS: This study identified practical strategies for improving sustainability and scale-up of NCD-related interventions. Implementation of the strategies that had high priority and feasibility will improve the sustainability of critical elements of the program in the respective countries.

    Matched MeSH terms: Public Health*
  12. Mohd Hanafiah K, Ng C, Wan AM
    Viruses, 2021 06 03;13(6).
    PMID: 34204909 DOI: 10.3390/v13061058
    In an age of globalisation and hyperconnectivity, the COVID-19 pandemic has caused unprecedented and sustained impact worldwide. This article discusses issues related to (science) communication at different phases of the COVID-19 epidemic timeline. We consider the role of communication for prevention from the ecological perspective, taking into consideration that many emerging pathogens, including COVID-19, likely arise in part due to anthropogenic changes to natural environments. Communication forms part of the early response setting the scene for public buy-in of public health interventions at the start of an outbreak, as well as to maintain precautions over time. Finally, communication is a key element in increasing acceptance for new tools that require mass uptake to be effective, as seen with roll-out challenges for the COVID-19 vaccines, which faced heightened concerns of efficacy and safety while mired with rampant misinformation. Ultimately, strategies for prevention of viral epidemics such as COVID-19 must include communication strategies at the forefront to reduce the risk of the emergence of new diseases and enhance efforts to control their spread and burden. Despite key themes emerging, what constitutes effective communication strategies for different people and contexts needs to be investigated further.
    Matched MeSH terms: Public Health/education; Public Health/methods*
  13. Lin CN, Chan KR, Ooi EE, Chiou MT, Hoang M, Hsueh PR, et al.
    Viruses, 2021 07 30;13(8).
    PMID: 34452372 DOI: 10.3390/v13081507
    Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus in humans, has expanded globally over the past year. COVID-19 remains an important subject of intensive research owing to its huge impact on economic and public health globally. Based on historical archives, the first coronavirus-related disease recorded was possibly animal-related, a case of feline infectious peritonitis described as early as 1912. Despite over a century of documented coronaviruses in animals, the global animal industry still suffers from outbreaks. Knowledge and experience handling animal coronaviruses provide a valuable tool to complement our understanding of the ongoing COVID-19 pandemic. In this review, we present an overview of coronaviruses, clinical signs, COVID-19 in animals, genome organization and recombination, immunopathogenesis, transmission, viral shedding, diagnosis, treatment, and prevention. By drawing parallels between COVID-19 in animals and humans, we provide perspectives on the pathophysiological mechanisms by which coronaviruses cause diseases in both animals and humans, providing a critical basis for the development of effective vaccines and therapeutics against these deadly viruses.
    Matched MeSH terms: Public Health
  14. Sharma A, Ahmad Farouk I, Lal SK
    Viruses, 2021 Jan 29;13(2).
    PMID: 33572857 DOI: 10.3390/v13020202
    Three major outbreaks of the coronavirus, a zoonotic virus known to cause respiratory disease, have been reported since 2002, including SARS-CoV, MERS-CoV and the most recent 2019-nCoV, or more recently known as SARS-CoV-2. Bats are known to be the primary animal reservoir for coronaviruses. However, in the past few decades, the virus has been able to mutate and adapt to infect humans, resulting in an animal-to-human species barrier jump. The emergence of a novel coronavirus poses a serious global public health threat and possibly carries the potential of causing a major pandemic outbreak in the naïve human population. The recent outbreak of COVID-19, the disease caused by SARS-CoV-2, in Wuhan, Hubei Province, China has infected over 36.5 million individuals and claimed over one million lives worldwide, as of 8 October 2020. The novel virus is rapidly spreading across China and has been transmitted to 213 other countries/territories across the globe. Researchers have reported that the virus is constantly evolving and spreading through asymptomatic carriers, further suggesting a high global health threat. To this end, current up-to-date information on the coronavirus evolution and SARS-CoV-2 modes of transmission, detection techniques and current control and prevention strategies are summarized in this review.
    Matched MeSH terms: Public Health
  15. Assi MA, Hezmee MN, Haron AW, Sabri MY, Rajion MA
    Vet World, 2016 Jun;9(6):660-71.
    PMID: 27397992 DOI: 10.14202/vetworld.2016.660-671
    Lead, a chemical element in the carbon group with symbol Pb (from Latin: Plumbum, meaning "the liquid silver") and has an atomic number 82 in the periodic table. It was the first element that was characterized by its kind of toxicity. In animal systems, lead (Pb) has been incriminated in a wide spectrum of toxic effects and it is considered one of the persistent ubiquitous heavy metals. Being exposed to this metal could lead to the change of testicular functions in human beings as well as in the wildlife. The lead poising is a real threat to the public health, especially in the developing countries. Accordingly, great efforts on the part of the occupational and public health have been taken to curb the dangers of this metal. Hematopoietic, renal, reproductive, and central nervous system are among the parts of the human body and systems that are vulnerable toward the dangers following exposure to high level of Pb. In this review, we discussed the massive harmful impact that leads acetate toxicity has on the animals and the worrying fact that this harmful toxicant can be found quite easily in the environment and abundance. Highlighting its (Pb) effects on various organs in the biological systems, its economic, as well as scientific importance, with the view to educate the public/professionals who work in this area. In this study, we focus on the current studies and research related to lead toxicity in animals and also to a certain extent toward human as well.
    Matched MeSH terms: Public Health
  16. Jajere SM, Atsanda NN, Bitrus AA, Hamisu TM, Goni MD
    Vet World, 2018 May;11(5):598-605.
    PMID: 29915497 DOI: 10.14202/vetworld.2018.598-605
    Background and Aim: Bovine tuberculosis (bTB) still remains a major zoonotic bacterial disease affecting livestock and humans worldwide. The disease remains a poorly managed tropical disease in most developing countries of the world; where in addition to productivity losses and significance in international trade, it posed a major public health threat to both humans and animals. A retrospective study was designed to investigate the occurrence of bTB lesions at Bauchi municipal abattoir.

    Materials and Methods: The study utilized abattoir records spanning a period of 10 years (2004-2013). The records indicated that a total of 1,08,638 heads of cattle comprising n = 56,070 males and n = 52,570 females were slaughtered at the municipal abattoir during the study period.

    Result: Of these heads, n = 1230 (1.13%) (95% confidence interval [CI]: 1.07, 1.19) had tuberculous lesions. The annual occurrence during the study period varied significantly (p<0.001) from 0.53% (95% CI: 0.40, 0.67) to 1.87% (95% CI: 1.66, 2.10) in 2010 and 2012, respectively. Females had a significantly higher (p<0.001) prevalence of 2.10% (95% CI: 1.98, 2.23) compared with the males 0.23% (95% CI: 0.19, 0.27). The distribution of suspected gross bTB lesions in different organs showed 11.87% in the lungs, 5.93% in the liver, 1.14% in the heart, and 0.49% accounted for generalized bTB. However, none was observed on the lymph nodes and intestines.

    Conclusion: It can be concluded that bTB persists in Bauchi State with annual variations during the study period. This study highlights the importance of meat inspection as an important tool for detecting the presence of bTB lesions.

    Matched MeSH terms: Public Health
  17. Lee KKC, Chia Wu DB, Topachevskyi O, Delgleize E, DeAntonio R
    Value Health Reg Issues, 2013 May;2(1):64-74.
    PMID: 29702855 DOI: 10.1016/j.vhri.2013.01.012
    BACKGROUND: Pneumococcal universal vaccination in Hong Kong was introduced in 2009.

    OBJECTIVES: We assessed the health and economic impact of the 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PCV-10) compared with the current 13-valent pneumococcal conjugate vaccine (PCV-13) recommended for Hong Kong in 2011, providing new elements to be considered by public health authorities in the future decision-making process for pneumococcal vaccines in this country.

    METHODS: An analytical model was used to estimate the annual economic and health outcomes of invasive pneumococcal disease (IPD), community-acquired pneumonia, and acute otitis media (AOM), including nontypeable H. influenzae-related AOM, for a birth cohort in Hong Kong from the payer perspective with a 10-year horizon. Clinical impact including morbidity-mortality, quality-adjusted life-years (QALYs), incremental costs, and cost-effectiveness comparing PCV-10 and PCV-13 were estimated. Probabilistic sensitivity analyses by using alternate scenarios were performed.

    RESULTS: Model projections indicate that PCV-13 and PCV-10 have approximately equivalent impact on the prevention of deaths caused by IPD and pneumonia. PCV-13 is projected to prevent 6 additional cases of IPD, whereas PCV-10 is projected to prevent 13,229 additional AOM cases and 101 additional QALYs. For the base case, PCV-10 vaccination is estimated to save 44.6 million Hong Kong dollars (34.1 million Hong Kong dollars discounted). Sensitivity analysis indicated that PCV-10 would generate more QALYs and save costs as compared with PCV-13.

    CONCLUSIONS: Universal infant vaccination with new available pneumococcal vaccines is expected to generate a significant additional impact on reducing the burden of pneumococcal diseases in Hong Kong. PCV-10 vaccination would be potentially a cost-saving strategy compared with PCV-13 vaccination, generating better cost offsets and higher QALY gains.

    Matched MeSH terms: Public Health
  18. Lam SK, Burke D, Capeding MR, Chong CK, Coudeville L, Farrar J, et al.
    Vaccine, 2011 Nov 28;29(51):9417-22.
    PMID: 21864627 DOI: 10.1016/j.vaccine.2011.08.047
    Infection with dengue virus is a major public health problem in the Asia-Pacific region and throughout tropical and sub-tropical regions of the world. Vaccination represents a major opportunity to control dengue and several candidate vaccines are in development. Experts in dengue and in vaccine introduction gathered for a two day meeting during which they examined the challenges inherent to the introduction of a dengue vaccine into the national immunisation programmes of countries of the Asia-Pacific. The aim was to develop a series of recommendations to reduce the delay between vaccine licensure and vaccine introduction. Major recommendations arising from the meeting included: ascertaining and publicising the full burden and cost of dengue; changing the perception of dengue in non-endemic countries to help generate global support for dengue vaccination; ensuring high quality active surveillance systems and diagnostics; and identifying sustainable sources of funding, both to support vaccine introduction and to maintain the vaccination programme. The attendees at the meeting were in agreement that with the introduction of an effective vaccine, dengue is a disease that could be controlled, and that in order to ensure a vaccine is introduced as rapidly as possible, there is a need to start preparing now.
    Matched MeSH terms: Public Health
  19. Stanis CS, Song BK, Chua TH, Lau YL, Jelip J
    Turk J Med Sci, 2016 Jan 05;46(1):207-18.
    PMID: 27511356 DOI: 10.3906/sag-1411-114
    BACKGROUND/AIM: Malaria is a major public health problem, especially in the Southeast Asia region, caused by 5 species of Plasmodium (P. falciparum, P. vivax, P. malariae, P. ovale, and P. knowlesi). The aim of this study was to compare parasite species identification methods using the new multiplex polymerase chain reaction (PCR) against nested PCR and microscopy.

    MATERIALS AND METHODS: Blood samples on filter papers were subject to conventional PCR methods using primers designed by us in multiplex PCR and previously designed primers of nested PCR. Both sets of results were compared with microscopic identification.

    RESULTS: Of the 129 samples identified as malaria-positive by microscopy, 15 samples were positive for P. falciparum, 14 for P. vivax, 6 for P. knowlesi, 72 for P. malariae, and 2 for mixed infection of P. falciparum/P. malariae. Both multiplex and nested PCR identified 12 P. falciparum single infections. For P. vivax, 9 were identified by multiplex and 12 by nested PCR. For 72 P. malariae cases, multiplex PCR identified 58 as P. knowlesi and 10 as P. malariae compared to nested PCR, which identified 59 as P. knowlesi and 7 as P. malariae.

    CONCLUSION: Multiplex PCR could be used as alternative molecular diagnosis for the identification of all Plasmodium species as it requires a shorter time to screen a large number of samples.

    Matched MeSH terms: Public Health
  20. Al-Darraji HA, Altice FL, Kamarulzaman A
    Trop Med Int Health, 2016 Aug;21(8):1049-1058.
    PMID: 27197601 DOI: 10.1111/tmi.12726
    OBJECTIVES: To investigate the prevalence of previously undiagnosed active tuberculosis (TB) cases among prisoners in Malaysia's largest prison using an intensified TB case-finding strategy.

    METHODS: From October 2012 to May 2013, prisoners housed in two distinct units (HIV-negative and HIV-positive) were approached to participate in the TB screening study. Consenting prisoners submitted two sputum samples that were examined using GeneXpert MTB/RIF, smear microscopy and liquid culture. Socio-demographic and clinical information was collected and correlates of active TB, defined as having either a positive GeneXpert MTB/RIF or culture results, were assessed using regression analyses.

    RESULTS: Among the total of 559 prisoners, 442 (79.1%) had complete data; 28.7% were HIV-infected, 80.8% were men and the average age was 36.4 (SD 9.8) years. Overall, 34 (7.7%) had previously undiagnosed active TB, of whom 64.7% were unable to complete their TB treatment in prison due to insufficient time (<6 months) remaining in prison. Previously undiagnosed active TB was independently associated with older age groups (AOR 11.44 and 6.06 for age ≥ 50 and age 40-49 years, respectively) and with higher levels of immunosuppression (CD4 < 200 cells/ml) in HIV-infected prisoners (AOR 3.07, 95% CI 1.03-9.17).

    CONCLUSIONS: The high prevalence of previously undiagnosed active TB in this prison highlights the inadequate performance of internationally recommended case-finding strategies and suggests that passive case-finding policies should be abandoned, especially in prison settings where HIV infection is prevalent. Moreover, partnerships between criminal justice and public health treatment systems are crucial to continue TB treatment after release.

    Matched MeSH terms: Public Health
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