METHODS: Free vaccination was offered to school girls in secondary school (year seven) in Malaysia, which is usually at the age of 13 in the index year. All recipients of the HPV vaccine were identified through school enrolments obtained from education departments from each district in Malaysia. A total of 242,638 girls aged between 12 to 13 years studying in year seven were approached during the launch of the program in 2010. Approximately 230,000 girls in secondary schools were offered HPV vaccine per year by 646 school health teams throughout the country from 2010 to 2016.
RESULTS: Parental consent for their daughters to receive HPV vaccination at school was very high at 96-98% per year of the programme. Of those who provided consent, over 99% received the first dose each year and 98-99% completed the course per year. Estimated population coverage for the full vaccine course, considering also those not in school, is estimated at 83 to 91% per year. Rates of adverse events reports following HPV vaccination were low at around 2 per 100,000 and the majority was injection site reactions.
CONCLUSION: A multisectoral and integrated collaborative structure and process ensured that the Malaysia school-based HPV immunisation programme was successful and sustained through the programme design, planning, implementation and monitoring and evaluation. This is a critical factor contributing to the success and sustainability of the school-based HPV immunisation programme with very high coverage.
METHODS: This is a descriptive, retrospective, clinical study of surgeries performed between 2014 and 2016 at the Sarawak Heart Centre, Malaysia. Medical records of patients with primary and secondary exotropia were reviewed. The following factors that affected the surgical outcomes were collected: onset age of squint, age at the time of surgery, the interval between diagnosis and surgery, the type of exotropia, visual acuity, presence of amblyopia, previous patching, anisometropia, refractive error, type of surgery, preoperative and postoperative deviation, pre-existing ocular comorbidity and systemic illness.
RESULT: A total of 15 patients were studied with more than two thirds being females. Seven patients had primary exotropia while eight patients had secondary exotropia. Average interval between diagnosis and surgery was 1.3 years (±0.82) for primary exotropia and 1.2 years (±0.84) for secondary exotropia. Average pre-operative angle for primary exotropia was 50.57PD (±10.83) whereas secondary exotropia was 39.38PD (±8.63). Seven patients had successful surgical outcomes of within 10 prism dioptres, five for primary exotropia and two for secondary exotropia. The response to surgery was 3.0PD/mm (±0.59) for primary exotropia and 2.2PD/mm (±0.74) for secondary exotropia.
CONCLUSION: In our study, primary exotropia had larger preoperative angle than secondary exotropia. The response to surgery was positively correlated with the preoperative angle of deviation. Primary exotropia showed better surgical outcome.
STUDY DESIGN AND METHODS: This was a cross-sectional study conducted in Paediatric Nephrology Clinic, Hospital Selayang from November 2016 to November 2017. Seventy-eight parents were recruited based on universal sampling. Selfadministered questionnaire in Bahasa Malaysia and English was designed through focus group discussion with five subject matter experts and validated through content validity. Data was analysed using IBM SPSS Statistics 23.0.
RESULTS: Majority of parents or guardians (91%) were able to answer more than 50% of the questions correctly. Of these, 56% were able to answer more than 75% of the questions correctly. A 'cut-off' of 75% was defined as good knowledge. Parents of children with frequent relapses had higher parental knowledge and this was statistically significant (p=0.025).
CONCLUSION: Parental knowledge on nephrotic syndrome and disease relapse was still inadequate as only 56% parents had good knowledge. The main areas of deficit in parental knowledge were related to medications, infections, home urine dipstick monitoring, and recognition of warning signs during relapse.
METHODS: A total of 176 adolescents in selected urban areas in the states of Wilayah Persekutuan and Selangor were selected. The Suicide Ideation Scale (SIS) was used to measure the level of severity or tendency of suicidal ideation. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure the perceived social support received by the respondent while the Spiritual Wellbeing Scale (SWBS) was used to measure the religious wellbeing (RWB), the existential wellbeing (EWB) and the overall score of spiritual wellbeing (SWB).
RESULTS: The study found that both RWB and EWB showed significant negative correlation with suicidal ideation. Similarly, support from family and friends also showed a negative correlation with suicidal ideation. Further analysis using multiple regressions showed that RWB and SWB, and family support predict suicidal ideation in adolescents.
CONCLUSION: Spiritual wellbeing in combination with family support plays a major role in predicting suicidal ideation. Therefore, intervention for encompassing spirituality and family support may contribute to a more positive outcome in suicidal adolescents.
METHODS: To determine Zika virus (ZIKV) seroprevalence in Kuala Lumpur, Malaysia, 1085 serum samples from 2012, 2014-2015 and 2017 were screened for anti-ZIKV antibodies using a ZIKV NS1 blockade-of-binding assay. Reactive samples were confirmed using neutralization assays against ZIKV and the four dengue virus (DENV) serotypes. A sample was possible ZIKV seropositive with a ZIKV 50% neutralization (NT50) titre ≥20. A sample was probable ZIKV seropositive if, in addition, all DENV NT50 titres were <20 or the ZIKV NT50 titre was >4-fold greater than the highest DENV NT50 titre.
RESULTS: We found low rates of possible ZIKV seropositivity (3.3% [95% confidence interval {CI} 2.4 to 4.6]) and probable ZIKV seropositivity (0.6% [95% CI 0.3 to 1.4]). Possible ZIKV seropositivity was independently associated with increasing age (odds ratio [OR] 1.04 [95% CI 1.02 to 1.06], p<0.0001) and male gender (OR 3.5 [95% CI 1.5 to 8.6], p=0.005).
CONCLUSIONS: The low ZIKV seroprevalence rate, a proxy for population immunity, does not explain the low incidence of Zika in dengue-hyperendemic Kuala Lumpur. Other factors, such as the possible protective effects of pre-existing flavivirus antibodies or reduced transmission by local mosquito vectors, should be explored. Kuala Lumpur is at high risk of a large-scale Zika epidemic.
OBJECTIVE: To evaluate and compare the treatment effect of Reverse Twin-Block (RTB) and Reverse Pull Face Mask (RPFM) on Pharyngeal Airway Space (PAS) in early and late mixed dentition Class III samples.
METHODS: Ninety-five mixed dentition Malay children with Class III malocclusion were included in this study. Data consists of 190 pre- and post-treatment lateral cephalograms of early (8-9 years) and late (10-11 years) mixed dentition Class III samples. forty-nine samples were under RTB and forty-six samples were under RPFM. Treatment changes were evaluated by McNamara airway analysis and changes in tongue and hyoid bone position.
RESULTS: Both upper and lower pharyngeal airway width were increased after treatment with RTB and RPFM ruling out the chance of airway constriction. There was also posterior positioning of the tongue and hyoid bone indicating mandibular retrusion. No significant treatment changes were found on the Pharyngeal Airway Space by the factor age, gender or type of appliance.
CONCLUSIONS: Both RTB and RPFM increased the Pharyngeal Airway Space and produced similar treatment effect. As age does not affect the treatment outcome significantly, treatment can be delayed until late mixed dentition stage.
METHODS: Data was collected from 380 randomly selected antenatal care attendees of a hospital in Maiduguri, using structured questionnaires. This data was then used to test the Information-Motivation-Behavioural Skills (IMB) model, for model fit, and interrelations among the constructs, using the structural equation modelling analysis with Smart-PLS.
RESULTS: Information and motivation were significantly related to behavioural skills (r = 0.29, p
MATERIALS AND METHODS: A study was conducted to analyze data on the utilization of T&CM services within public hospitals. Secondary data on 822 patients' satisfaction with services offered at 15 T&CM units was analyzed to examine the overall levels of satisfaction with T&CM services in public hospitals in Malaysia.
RESULTS: Overall, 99.4% of patients were satisfied with T&CM services and most patients (91.8%) felt that T&CM treatment positively impacted their health. Overall satisfaction was not affected by lower levels of satisfaction with subcategories of service, such as the number of treatment sessions received (90.7% satisfied), date to the next appointment (90.7% satisfied), and the absence of adverse effects of treatment received (87.1% satisfied). There were no significant associations between the socioeconomic status of the respondents and the level of satisfaction reported; however, respondents with a monthly salary of Ringgit Malaysia (RM) 1000 to RM 3000 were more than twice as likely to be strongly satisfied with services received (adjusted odds ratios [AOR]: 2.12, 95% CI: 1.19-3.78).
CONCLUSION: This study revealed a high level of satisfaction among patients who had received T&CM treatment at public hospitals in Malaysia. High satisfaction with T&CM treatment validates the integrative management approach adopted in patient care within the public hospitals in Malaysia.
METHODS: This was a prospective multicenter study conducted in Sindh. Children aged ≤14 years enrolled from June to November 2016 were included. A structured data collection tool was used to gather information with respect to patients' socio-demographic, clinical and microbiological data. Additionally, to collect the information related to socio-economic and education level of caregivers, validated questionnaire was administered to the caregivers. Treatment outcomes were assessed according to the World Health Organization (WHO) guidelines. The relationship of unsuccessful treatment outcome with socio-demographic and clinical attributes of TB patients was analyzed using logistic regression model.
RESULTS: Childhood TB represented 19.3% (508/2634) of all TB cases in selected hospitals. Of these, 268/508 (52.8%) were females and one third of the children were aged ≤2 years (34.3%). In multivariate analysis, pulmonary smear positive TB (PTB+) (AOR = 5.910, 95%CI = 1.64-21.29), those with adverse drug reactions (AOR = 11.601, 95%CI = 4.06-33.12) and those who had known TB contacts (AOR = 3.128, 95%CI = 1.21-8.06) showed statistically significant association with unsuccessful treatment outcomes.
CONCLUSIONS: The high proportion of childhood TB cases (19.3%) demonstrates the continuation of TB transmission in the study setting. Furthermore, an increased focus on PTB+ patients, those with adverse drug reactions and household contact with TB is warranted.