Displaying publications 181 - 200 of 208 in total

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  1. Garba NN, Ramli AT, Saleh MA, Sanusi SM, Gabdo HT
    Isotopes Environ Health Stud, 2016 Jun;52(3):214-8.
    PMID: 26540360 DOI: 10.1080/10256016.2016.1095189
    Measurements of the environmental terrestrial gamma radiation dose rate (TGRD) in each district of Kelantan state, Malaysia, were carried out using a portable hand-held radiation survey meter and global positioning system. The measurements were done based on geology and soil types of the area. The mean TGRD was found to be 209 nGy h(-1). Few areas of relatively enhanced activity were observed in Pasir Mas, Tanah Merah and Jeli districts, which have a mean TGRD between 300 and 500 nGy h(-1). An isodose map of the area was produced using ArcGIS software version 9.3.
    Matched MeSH terms: Geographic Information Systems
  2. Tew MM, Hatah E, Arif F, Abdul Wahid MA, Makmor-Bakry M, Abdul Maulad KN
    J Pharm Policy Pract, 2021 Feb 24;14(1):24.
    PMID: 33627199 DOI: 10.1186/s40545-021-00308-9
    BACKGROUND: Minor ailments are defined as common, self-limiting, or uncomplicated conditions that may be diagnosed and managed without a medical intervention. Previous studies reported that pharmacists were able to help patients self-manage minor ailments that led to a reduction of health care burden in other facilities. Nevertheless, public access to community pharmacy and other health care facilities offering services for minor ailments has not yet been explored in Malaysia. Hence, this study aims to determine population access to the above-mentioned services.

    METHOD: According to the reported practice address in 2018, the spatial distribution of health care facilities was mapped and explored using the GIS mapping techniques. The density of health care facilities was analyzed using thematic maps with hot spot analysis. Population to facility ratio was calculated using the projection of the population growth based on 2010 census data, which was the latest available in the year of analysis.

    RESULTS: The study included geographical mapping of 7051 general practitioner clinics (GPC), 3084 community pharmacies (CP), 139 public general hospitals (GHs) and 990 public primary health clinics (PHC). The health care facilities were found to be highly dense in urban areas than in the rural ones. There were six districts that had no CP, 2 had no GPC, and 11 did not have both. The overall ratio of GPC, CP, GH, and PHC to the population was 1:4228, 1:10,200, 1:223,619 and 1:31,397, respectively. Should the coverage for minor ailment services in public health care clinics be extended to community pharmacies, the ratio of facilities to population for each district would be better with 1:4000-8000.

    CONCLUSIONS: The distribution of health care facilities for minor ailment management in Malaysia is relatively good. However, if the scheme for minor ailments were available to community pharmacies, then the patients' access to minor ailments services would be further improved.

    Matched MeSH terms: Geographic Information Systems
  3. Azlina Yahya, Osama Abdul Nasir
    Q Bulletin, 2019;1(28):36-44.
    MyJurnal
    Wastage due to unnecessary laboratory test requests is a major problem in government hospitals because they have cost implications. Although screening of infectious marker tests such as Human Immunodeficiency Virus (HIV), Hepatitis B surface Antigen (HBsAg), Hepatitis B antibody (AHBS) and Hepatitis C Virus (HCV)) before testing have been put in place, inappropriate tests were still being carried out in the Serology laboratory, which resulted in wasted human resources and reagents, increased workload and increased maintenance costs. Based on the verification studies using the Laboratory Information System (LIS), we observed only 70% of the tests followed the ordering guidelines or test specifications. Thus, we aim to increase the standard to more than 95% of the infectious marker test requests which were appropriate according to a few guidelines.
    A cross-sectional study was conducted for all infectious marker tests received at Serology Laboratory from January 2015 to June 2016 to verify the problem. A workplace audit and questionnaire survey on the staff were carried out to gain more information. Low level of knowledge, unavailability of standardised guidelines for quick and easy reference, lack of staff and inefficient work processes were among the main contributing factors. Empowering new staff to screen specimens, developing simple and informative screening guidelines, providing adequate trays and refrigerators for screening purposes and strengthening and developing a more effective process of care were the strategies taken during this study.
    The appropriate tests carried out from July to September 2015, October to December 2015, January to March 2016 and April to June 2016 were 99%, 98.80%, 99.50%, 98.90% respectively. During the same period, 711, 411, 710 and 768 tests were rejected. We monitored the performance and managed to achieve 100% appropriate testing for the period of July 2016 to June 2018 and an estimation of MYR 73,437.50 cost saving was achieve
    Matched MeSH terms: Clinical Laboratory Information Systems
  4. Nurul Salwana Abu Bakar, Jabrullah Abdul Hamid, Sharifah Zawani Syed Ahmad Yunus, Nurul Syarbani Eliana Musa, Roslinda Abu Sapian, Nur Hidayati Abdul Halim, et al.
    MyJurnal
    Introduction: Electronic medical records from hospital information system (HIS) offer a major potential for secondary data analysis which can improve the efficiency of healthcare delivery. This study describes an initiative to use HIS data to explore the level of diabetic care in patients with T2DM in a hospital-based outpatient clinic, the advantages and challenges in utilising HIS data. Methods: Patients age of 18 and above who received any diabetes medication in 2013 were retrospectively identified from HIS of Serdang Hospital. Demographic characteristics, anti-diabetic agent (ADA) dispensed, and glycaemic measures were quantified. Data was extracted using structured query lan- guage (SQL) and descriptive statistical analyses were conducted using Stata Version 12. Results: Prevalence of T2DM patients in the hospital was 7.5%. Male had slightly higher prevalence and patient at age of 61-70 years old. About 62% of patients were prescribed with metformin and 5% of newer combination of oral hypoglycemic agent. In pre- scribing pattern, stratification by age group, showed that patient age 41 to 70 years received mostly monotherapy, whilst 61.1% continue their regime for the year. Only 18% obtained good glycaemic control. Conclusion: Hospital Information system is a critical instrument in providing data as a platform in diabetic care in an outpatient care. Moving forward, steps to improve HIS should be taken to seize its potential as a tool to increase the efficiency of healthcare delivery.
    Matched MeSH terms: Hospital Information Systems
  5. Sulaiman MH, Aizuddin AN, Hod R, Puteh SEW
    Med J Malaysia, 2021 03;76(2):145-150.
    PMID: 33742620
    INTRODUCTION: Influenza outbreak causes high economic burden to Malaysia and other countries in South East Asia. Scientists have found a relatively new way to detect influenza outbreaks early thus reducing the burden of disease by early intervention. This new technology is a social network information system which uses Facebook or Twitter data to detect potential influenza cases. Such system is good to be developed by the Malaysian government as it can detect influenza outbreaks three weeks earlier than the normal pathway. However, to implement this we require good evidence that the development will be accepted by potential users.

    OBJECTIVE: This study was looking at the acceptance towards using social network information system among public health workers.

    MATERIALS AND METHOD: This study was done on 205 Malaysian One Health University Network (MyOHUN) members through email and physical survey.

    RESULTS: Results show that 62.4% public health workers accepted the use technology. The acceptance was shown to be associated with performance expectancy (p<0.05). However, unlike the very famous Unified Theory of Acceptance and Use of Technology (UTAUT) model, the acceptance of social network information system was not associated with effort expectancy, social factors, facilitating conditions and socio-demographic factors. Therefore, it is suggested that social network information system be developed by the authorities in Malaysia, and be developed in a way that the system could strongly increase performance in detection of outbreak earlier than the current normal pathways. As such the system to be accepted and used, it must be sensitive, specific and be able to detect influenza outbreak early CONCLUSION: The development of social network information system is feasible as it is highly accepted and it's potential to improve early detection of influenza outbreak.

    Matched MeSH terms: Information Systems
  6. Zawiah Kassim, Norliza Mohd Nor, Ariffah Mokhtar, Suhaina Mohamad, Sarina Osman, Isqandar Adnan
    MyJurnal
    Introduction: Over three decades, patient-controlled epidural analgesia with a basal infusion
    regimen (PCEA+BI) has successfully improved labour analgesia quality due to its advantage
    in allowing self-titration by the parturients. Recently, a newer programmed intermittent epidural
    bolus with PCEA regimen (PIEB+PCEA) was suggested to improve the epidural spread of
    local anaesthetic hence resulted in better analgesia quality and higher maternal satisfaction.
    Methods: We conducted a one-year retrospective analysis of data from obstetric analgesia
    service record sheet and hospital information system comparing maternal satisfaction towards
    their labour analgesia quality, mode of delivery and neonatal Apgar scores between these two
    methods of epidural delivery techniques. A total of 343 parturients were recruited in this study
    (PCEA+BI n=171, PIEB+PCEA n=172). Results: There were no significant difference in
    maternal satisfaction between the two groups (P=0.398) with a higher percentage of excellent
    satisfaction were found in the PIEB+PCEA group (PIEB+PCEA 146/172 (84.9%) vs PCEA+BI
    138/171 (80.7%)). No significant difference in the mode of delivery (P=0.296). However, the
    PIEB+PCEA group shown a higher spontaneous vaginal delivery rate (PIEB+PCEA 87/172
    (50.6%) vs PCEA+BI 70/171 (40.9%) and lower Caesarean delivery rate (PIEB+PCEA 71/172
    (41.3%) vs PCEA+BI 87/171 (50.9%)). Despite statistically significant differences found in
    Apgar scores at 1 minute (P=0.036), there was no significant difference in the scores at 5
    minutes (P=0.107). Mean Apgar scores (SD) at 1 minute and 5 minutes for PIEB+ PCEA were
    7.77(0.85) and 8.91(0.55) respectively and for PCEA + basal infusion, the scores for 1 minute
    and 5 minutes were 7.92(0.39) and 8.98(0.19) respectively. Conclusion: PIEB with PCEA is
    a newer epidural delivery technique for labour analgesia which produces a comparable
    outcome to PCEA with basal infusion.
    Matched MeSH terms: Hospital Information Systems
  7. Chee Cheong K, Yoon Ling C, Kuang Hock L, Mohd Ghazali S, Chien Huey T, Che Ibrahim MK, et al.
    PMID: 30781699 DOI: 10.3390/ijerph16040593
    A growing number of fast-food outlets in close proximity to residential areas raises a question as to its impact on childhood overweight and obesity. This study aimed at determining the relationship between the availability of fast-food outlets that were in close proximity to residential areas and overweight among Malaysian children aged 5 to 18 years. Measurement data on the weight and height of 5544 children (2797 boys, 2747 girls) were obtained from the National Health and Morbidity Survey 2011. Overweight (including obesity) is defined as BMI-for-age z-score > +1 SD based on the WHO growth reference. Geographic information system geospatial analysis was performed to determine the number of fast-food outlets within 1000 m radius from the children's residential address. Multiple logistic regression was conducted to examine the association between the availability of fast-food outlets (none or more than one outlet) and overweight with adjustment for age, sex, ethnicity, monthly household income, parental educational level, residential area and supermarket density. Our results showed that the prevalence of overweight was 25.0% and there was a statistically significant association between the density of fast-food outlets and overweight (odds ratio: 1.23, 95% confidence interval: 1.03, 1.47). Our study suggested that the availability of fast-food outlets with close proximity in residential areas was significantly associated with being overweight among children. Limiting the number of fast-food outlets in residential areas could have a significant effect in reducing the prevalence of overweight among Malaysian children.
    Matched MeSH terms: Geographic Information Systems
  8. Herrera Amul GG
    J Stud Alcohol Drugs, 2020 11;81(6):697-709.
    PMID: 33308397
    OBJECTIVE: The expansion of transnational alcohol corporations (TACs) in Southeast Asia has been suggested as a possible contributor to increased alcohol advertising, promotion, and sponsorship (AAPS), which in turn may have contributed to increasing rates of alcohol consumption and alcohol-related problems. The aim of this scoping review is to document the growth of TACs in the region and to critically evaluate the development of alcohol policies to regulate AAPS in 10 Southeast Asian nations.

    METHOD: National policies related to AAPS were reviewed using data from the Global Information System on Alcohol and Health, following the framework of the WHO Global Strategy to reduce the harmful use of alcohol. The policy review was supplemented with data from corporate annual reports, press releases, four databases of academic literature, market research from Euromonitor International, and news articles.

    RESULTS: Four TACs--Carlsberg, Diageo, Heineken, and San Miguel--have been expanding operations in Southeast Asia by setting up new breweries, acquiring local alcohol companies as subsidiaries, and entering into joint ventures. In contrast, policies for regulating AAPS vary across Southeast Asia and range from nonexistent to strong control of AAPS. There is strong control of AAPS in countries with existing legislation ranging from a complete ban (Brunei) to almost comprehensive bans (Indonesia, Myanmar, Laos) and partial bans (Thailand). Nonexistent to weak control of AAPS is observed in the Philippines, Singapore, Cambodia, Malaysia, and Vietnam, which mostly rely on voluntary regulation.

    CONCLUSIONS: The study's findings point to the growing power of TACs in the region and call for the need for stronger measures based on scientific evidence of effectiveness that are implemented without interference from commercial interests.

    Matched MeSH terms: Information Systems
  9. Rohani A, Nasir AA
    MyJurnal
    Four hundred and thirty five (435) cases 0f sexually transmitted infections (STIs) were notified from 20 (twenty) primary care clinics throughout Malaysia from June 1999 till September 2000 using the syndromic approach of STI management, adapted by the Ministry of Health based upon the criteria set by the World Health Organisation (WHO). Gonorrhoea was the most prevalent STI reported (30.34 %), followed by candidiasis (28.05%), syphilis (15.17%) and non-specific urethritis (NSU) — 14.02%) . As seen in most other parts of the world, the younger age groups (those between twenty and thirty nine years old) were found to be more commonly infected with STIs. Initial analysis shows that systematic data collection based on the syndromes and clear—case definitions (algorithms for the syndromic approach} need to be developed and added further to the current manual that is being developed for the health and medical staff at the operational it level. Exploration and expansion of behavioural surveillance research, management information systems of the syndromic approach, and development of new or additional strategies in the manual for the staff too, also need improvement. The Ministry of Health is also concerned about the quantity and quality of the available data based upon syndromic management of STI as compared to laboratory based criteria. Since this programme is very much client centered, the adoption of this approach generally might offer substantial improvements in the quality and effectiveness of STI care, either within the public or the private health care settings in Malaysia.
    Matched MeSH terms: Management Information Systems
  10. Mohd Said N, Othman J, Hairi F
    MyJurnal
    Malaysia's healthcare delivery system in Vision 2020 will be recognized as one of the world’s best. Putrajaya Health Clinic is our first paperless health clinic in Malaysia that incorporates the Health Information System (HIS). This system cuts across programmes and sections in the operational work process in the clinic with the ultimate aim of achieving a paperless status. This clinic provides a comprehensive health care service at the point of contact and focuses on wellness, clientfriendly, seamless and borderless care with e]§‘icient use of resources and towards high a quality of service. This health clinic which seesthe majority of the attendance being well persons, through the immunization programme, antenatal, postnatal, family planning, school health, and well clinics for child and adult, will continue to extend and further expand its services to include geriatric, ill mental, occupational and rehabilitative care. The e-government within Putrajaya will facilitate the use of an
    appointment system, which can be done through e—mail, fax, telephone or walk-in. Information and
    communication technology will also facilitate the promotion of health education for individuals and communities. To facilitate efective streaming or screening of clients/attendees, a simple triage system is introduced. Prompt, short and accurate is the rule for triaging, thus providing timely and ejfective care. New information and communication technologies will allow healthcare providers to adopt a more virtual, more integrated and more distributed approach in the delivery of health services. It was documented that the average contact time at the triage counter in Putrajaya Health Clinic was 1.16 minutes, i.e. the shortest among other services provided here.
    Matched MeSH terms: Health Information Systems
  11. Khodami S, Surif M, W O WM, Daryanabard R
    Mar Pollut Bull, 2017 Jan 15;114(1):615-622.
    PMID: 27887731 DOI: 10.1016/j.marpolbul.2016.09.038
    This study aimed to evaluate the spatial and temporal distribution of heavy metals (Cd, Cr, Cu, Co, Fe, Pb, Ni, V, and Zn) in the sediments of Bayan Lepas Free Industrial Zone of Penang, Malaysia. Ten sampling stations were selected and sediment samples were collected during low tide (2012-2013). Metals were analyzed and the spatial distribution of metals were evaluated based on GIS mapping. According to interim sediment quality guidelines (ISQG), metal contents ranged from below low level to above high level at different stations. Based on the geoaccumulation index (Igeo) of sediment, sampling stations were categorized from unpolluted to strongly polluted. The enrichment factor (EF) of metals in the sediment varied between no enrichment to extremely high enrichment. The potential ecological risk index (RI) indicated Bayan Lepas FIZ was at low risk.
    Matched MeSH terms: Geographic Information Systems
  12. Samsudin IN, Md Saleh R, Thambiah SC, Mohamad Amir Hamzah AS, Wan Khalik WNF, George E
    MyJurnal
    Background: Diabetic retinopathy (DR) is a microvascular complication of diabetes, which is a cause of visual impairment and blindness. Its development and progression have been linked to dyslipidaemia, although the link remains inconclusive.
    Aim: This study aimed to determine the prevalence of dyslipidaemia among type 2 diabetic patients with DR in a tertiary setting and to determine the association between dyslipidaemia and DR severity.
    Materials and methods: This was a cross sectional study using retrospective data of type 2 diabetic patients attending the opthalmology clinic of a tertiary centre from January 2007 to June 2014. Results of their fasting lipid profile and clinical data were retrieved from the hospital information system.
    Results: A total of 178 patient’s data were collected. 120 (n=67.4%) patients had non-proliferative diabetic retinopathy (NDPR) with moderate NPDR being the most prevalent. Dyslipidaemia was noted in 151 (84.8%) of the patients. Patients had a combination of more than one abnormality in the lipid profile with increased LDL-cholesterol being the main abnormality. Dyslipidaemia was however, not significantly associated with DR severity.
    Conclusion: Dyslipidaemia was highly prevalent in DR patients. The dyslipidaemia was however not associated with severity of DR.
    Study site: Ophthalmology clinic, Hospital (?name), Malaysia
    Matched MeSH terms: Hospital Information Systems
  13. Rizeei HM, Azeez OS, Pradhan B, Khamees HH
    Environ Monit Assess, 2018 Oct 04;190(11):633.
    PMID: 30288624 DOI: 10.1007/s10661-018-7013-8
    Groundwater hazard assessments involve many activities dealing with the impacts of pollution on groundwater, such as human health studies and environment modelling. Nitrate contamination is considered a hazard to human health, environment and ecosystem. In groundwater management, the hazard should be assessed before any action can be taken, particularly for groundwater pollution and water quality. Thus, pollution due to the presence of nitrate poses considerable hazard to drinking water, and excessive nutrient loads deteriorate the ecosystem. The parametric IPNOA model is one of the well-known methods used for evaluating nitrate content. However, it cannot predict the effect of soil and land use/land cover (LULC) types on calculations relying on parametric well samples. Therefore, in this study, the parametric model was trained and integrated with the multivariate data-driven model with different levels of information to assess groundwater nitrate contamination in Saladin, Iraq. The IPNOA model was developed with 185 different well samples and contributing parameters. Then, the IPNOA model was integrated with the logistic regression (LR) model to predict the nitrate contamination levels. Geographic information system techniques were also used to assess the spatial prediction of nitrate contamination. High-resolution SPOT-5 satellite images with 5 m spatial resolution were processed by object-based image analysis and support vector machine algorithm to extract LULC. Mapping of potential areas of nitrate contamination was examined using receiver operating characteristic assessment. Results indicated that the optimised LR-IPNOA model was more accurate in determining and analysing the nitrate hazard concentration than the standalone IPNOA model. This method can be easily replicated in other areas that have similar climatic condition. Therefore, stakeholders in planning and environmental decision makers could benefit immensely from the proposed method of this research, which can be potentially used for a sustainable management of urban, industrialised and agricultural sectors.
    Matched MeSH terms: Geographic Information Systems
  14. Khormi HM, Kumar L
    Geospat Health, 2016 11 21;11(3):416.
    PMID: 27903054 DOI: 10.4081/gh.2016.416
    We used the Model for Interdisciplinary Research on Climate-H climate model with the A2 Special Report on Emissions Scenarios for the years 2050 and 2100 and CLIMEX software for projections to illustrate the potential impact of climate change on the spatial distributions of malaria in China, India, Indochina, Indonesia, and The Philippines based on climate variables such as temperature, moisture, heat, cold and dryness. The model was calibrated using data from several knowledge domains, including geographical distribution records. The areas in which malaria has currently been detected are consistent with those showing high values of the ecoclimatic index in the CLIMEX model. The match between prediction and reality was found to be high. More than 90% of the observed malaria distribution points were associated with the currently known suitable climate conditions. Climate suitability for malaria is projected to decrease in India, southern Myanmar, southern Thailand, eastern Borneo, and the region bordering Cambodia, Malaysia and the Indonesian islands, while it is expected to increase in southern and south-eastern China and Taiwan. The climatic models for Anopheles mosquitoes presented here should be useful for malaria control, monitoring, and management, particularly considering these future climate scenarios.
    Matched MeSH terms: Geographic Information Systems
  15. Golkarian A, Naghibi SA, Kalantar B, Pradhan B
    Environ Monit Assess, 2018 Feb 17;190(3):149.
    PMID: 29455381 DOI: 10.1007/s10661-018-6507-8
    Ever increasing demand for water resources for different purposes makes it essential to have better understanding and knowledge about water resources. As known, groundwater resources are one of the main water resources especially in countries with arid climatic condition. Thus, this study seeks to provide groundwater potential maps (GPMs) employing new algorithms. Accordingly, this study aims to validate the performance of C5.0, random forest (RF), and multivariate adaptive regression splines (MARS) algorithms for generating GPMs in the eastern part of Mashhad Plain, Iran. For this purpose, a dataset was produced consisting of spring locations as indicator and groundwater-conditioning factors (GCFs) as input. In this research, 13 GCFs were selected including altitude, slope aspect, slope angle, plan curvature, profile curvature, topographic wetness index (TWI), slope length, distance from rivers and faults, rivers and faults density, land use, and lithology. The mentioned dataset was divided into two classes of training and validation with 70 and 30% of the springs, respectively. Then, C5.0, RF, and MARS algorithms were employed using R statistical software, and the final values were transformed into GPMs. Finally, two evaluation criteria including Kappa and area under receiver operating characteristics curve (AUC-ROC) were calculated. According to the findings of this research, MARS had the best performance with AUC-ROC of 84.2%, followed by RF and C5.0 algorithms with AUC-ROC values of 79.7 and 77.3%, respectively. The results indicated that AUC-ROC values for the employed models are more than 70% which shows their acceptable performance. As a conclusion, the produced methodology could be used in other geographical areas. GPMs could be used by water resource managers and related organizations to accelerate and facilitate water resource exploitation.
    Matched MeSH terms: Geographic Information Systems
  16. Kura NU, Ramli MF, Ibrahim S, Sulaiman WN, Aris AZ
    Environ Sci Pollut Res Int, 2014;21(11):7047-64.
    PMID: 24532282 DOI: 10.1007/s11356-014-2598-0
    In this study, geophysics, geochemistry, and geostatistical techniques were integrated to assess seawater intrusion in Kapas Island due to its geological complexity and multiple contamination sources. Five resistivity profiles were measured using an electric resistivity technique. The results reveal very low resistivity <1 Ωm, suggesting either marine clay deposit or seawater intrusion or both along the majority of the resistivity images. As a result, geochemistry was further employed to verify the resistivity evidence. The Chadha and Stiff diagrams classify the island groundwater into Ca-HCO3, Ca-Na-HCO3, Na-HCO3, and Na-Cl water types, with Ca-HCO3 as the dominant. The Mg(2+)/Mg(2+)+Ca(2+), HCO3 (-)/anion, Cl(-)/HCO3 (-), Na(+)/Cl(-), and SO4 (2-)/Cl(-) ratios show that some sampling sites are affected by seawater intrusion; these sampling sites fall within the same areas that show low-resistivity values. The resulting ratios and resistivity values were then used in the geographical information system (GIS) environment to create the geostatistical map of individual indicators. These maps were then overlaid to create the final map showing seawater-affected areas. The final map successfully delineates the area that is actually undergoing seawater intrusion. The proposed technique is not area specific, and hence, it can work in any place with similar completed characteristics or under the influence of multiple contaminants so as to distinguish the area that is truly affected by any targeted pollutants from the rest. This information would provide managers and policy makers with the knowledge of the current situation and will serve as a guide and standard in water research for sustainable management plan.
    Matched MeSH terms: Geographic Information Systems
  17. Choon SE, Wright AK, Griffiths CEM, Wong KW, Tey KE, Lim YT, et al.
    Br J Dermatol, 2023 Sep 15;189(4):410-418.
    PMID: 37162007 DOI: 10.1093/bjd/ljad158
    BACKGROUND: There is limited understanding of the epidemiology of generalized pustular psoriasis (GPP) internationally, with no population-based estimates of GPP in South East Asia.

    OBJECTIVES: To determine the incidence and prevalence of GPP in the Malaysian population and characterize its flares and trigger factors.

    METHODS: We conducted a population-based cohort study using the Teleprimary Care database between January 2010 and December 2020. We identified 230 dermatologist-confirmed GPP cases using International Classification of Diseases, 10th revision, diagnostic codes. Annual prevalence and incidence rates were stratified by age, sex and ethnicity. We compared data regarding flares and trigger factors for patients with GPP who had associated psoriasis vulgaris (PV) with those who did not have associated PV.

    RESULTS: The prevalence of GPP was 198 per million (267 women, 127 men) and incidence was 27.2 per million person-years [95% confidence interval (CI) 22.8-31.6]; 35.3 (28.4-42.2) per million person-years for women and 18.3 (13.1-23.5) per million person-years for men. Rates were higher in Chinese individuals [prevalence 271 per million; incidence 41.6 per million person-years (28.9-54.3)] than in the Malay population [prevalence 186; incidence 24.6 (19.4-29.7)] or the Indian ethnic group [prevalence 179; incidence 25.0 (13.8-36.3)]. Annual prevalence was consistently higher in women than in men and highest among the Chinese population, followed by the Indian and Malay populations. Overall, 67% of patients with GPP had associated PV. The prevalence and incidence of GPP without PV were lower than GPP with PV at 66 vs. 132 per million and 19.3 (95% CI 15.6-23.0) vs. 8.0 (95% CI 5.6-10.3) per million person-years, respectively. The mean age at GPP onset was 42.7 years (SD 18.4). A bimodal trend in the age of GPP onset was observed, with first and second peaks at age 20-29 years and age 50-59 years, respectively. Disease onset was significantly earlier in patients with GPP without PV than in those with PV [mean age 37.5 years (SD 20.7) vs. 44.9 years (SD 17.0), P = 0.026]. Flares occurred more frequently in patients without PV than in those with PV [mean number of flares per patient per year was 1.35 (SD 0.77) vs. 1.25 (SD 0.58), P = 0.039]. Common triggers of flares in patients with GPP who did not have PV were infections, pregnancy, menstruation and stress, whereas withdrawal of therapy, particularly systemic corticosteroids, was a more frequent trigger in patients with GPP who also had PV.

    CONCLUSIONS: Our findings contribute to the global mapping of GPP, which will help inform the management of this rare condition.

    Matched MeSH terms: Information Systems
  18. Dickin SK, Schuster-Wallace CJ, Elliott SJ
    PLoS One, 2013;8(5):e63584.
    PMID: 23667642 DOI: 10.1371/journal.pone.0063584
    The Water-associated Disease Index (WADI) was developed to identify and visualize vulnerability to different water-associated diseases by integrating a range of social and biophysical determinants in map format. In this study vulnerability is used to encompass conditions of exposure, susceptibility, and differential coping capacity to a water-associated health hazard. By assessing these conditions, the tool is designed to provide stakeholders with an integrated and long-term understanding of subnational vulnerabilities to water-associated disease and contribute to intervention strategies to reduce the burden of illness. The objective of this paper is to describe and validate the WADI tool by applying it to dengue. A systemic ecohealth framework that considers links between people, the environment and health was applied to identify secondary datasets, populating the index with components including climate conditions, land cover, education status and water use practices. Data were aggregated to create composite indicators of exposure and of susceptibility in a Geographic Information System (GIS). These indicators were weighted by their contribution to dengue vulnerability, and the output consisted of an overall index visualized in map format. The WADI was validated in this Malaysia case study, demonstrating a significant association with dengue rates at a sub-national level, and illustrating a range of factors that drive vulnerability to the disease within the country. The index output indicated high vulnerability to dengue in urban areas, especially in the capital Kuala Lumpur and surrounding region. However, in other regions, vulnerability to dengue varied throughout the year due to the influence of seasonal climate conditions, such as monsoon patterns. The WADI tool complements early warning models for water-associated disease by providing upstream information for planning prevention and control approaches, which increasingly require a comprehensive and geographically broad understanding of vulnerability for implementation.
    Matched MeSH terms: Geographic Information Systems
  19. Aziz S, Aidil RM, Nisfariza MN, Ngui R, Lim YA, Yusoff WS, et al.
    J Vector Borne Dis, 2014 Jun;51(2):91-6.
    PMID: 24947215
    Dengue fever (DF) is a major vector-borne disease in Malaysia. The incidences of DF in Malaysia are caused by viruses transmitted through the bites of infected female Aedes albopictus and Ae. aegypti mosquitoes. This study aims to establish the spatial density of mosquito population or breteau index (BI) in the areas of Kuala Lumpur using geographic information system (GIS), remote sensing (RS) and spatial statistical tools.
    Matched MeSH terms: Geographic Information Systems
  20. Chua SS, Tea MH, Rahman MH
    J Clin Pharm Ther, 2009 Apr;34(2):215-23.
    PMID: 19250142 DOI: 10.1111/j.1365-2710.2008.00997.x
    Drug administration errors were the second most frequent type of medication errors, after prescribing errors but the latter were often intercepted hence, administration errors were more probably to reach the patients. Therefore, this study was conducted to determine the frequency and types of drug administration errors in a Malaysian hospital ward.
    Matched MeSH terms: Hospital Information Systems
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