Displaying publications 21 - 40 of 62 in total

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  1. Human rotavirus infection in Malaysia. I. A hospital-based study of rotavirus in children with acute gastroenteritis
    Yap KL, Sabil D, Muthu PA
    J Trop Pediatr, 1984 06;30(3):131-5.
    PMID: 6737550 DOI: 10.1093/tropej/30.3.131
  2. Pediatric Rheumatic Heart Disease in a Middle-Income Country: A Population-Based Study
    Zahari N, Yeoh SL, Muniandy SR, Mat Bah MN
    J Trop Pediatr, 2022 Jan 07;68(1).
    PMID: 35084036 DOI: 10.1093/tropej/fmac005
    INTRODUCTION: Rheumatic heart disease (RHD), a debilitating complication from rheumatic fever, remains a problem in low- and middle-income countries. This study describes the incidence, prevalence, modifiable risk factors for severe RHD and immediate outcome of pediatric RHD.

    METHODS: This population-based and observational cohort study reviewed pediatric RHD patients (0-18 years) from the Sabah Pediatric Rheumatic Heart Registry from 2015 till 2018.

    RESULTS: A total of 188 RHD were reviewed with 120 new cases. The incidence of RHD is 2.19 [95% confidence interval (CI): 1.83-2.61] per 100 000 population, with a rising trend over time. Meanwhile, the prevalence of RHD was 13.78 (95% CI: 11.92-15.86) per 100 000 pediatric population. The majority of patients were from indigenous groups (59.0%), male (56.4%) with a mean age of 14.3 (3.31) years. About 77.9% had the lowest household income, and a significant proportion lived in overcrowded conditions. At diagnosis, 59% were diagnosed with severe RHD. There is heightened risk but no statistical significance between modifiable factors (low weight and height percentile at diagnosis, lowest income group, renting a house, overcrowding and healthcare access of more than 5 km) with severe RHD. Severe RHD is significantly associated with risk for intervention (p = 0.016). Sixteen (13.8%) patients required surgical intervention. About 97.6% of patients were on intramuscular benzathine penicillin G with 84.5% compliance.

    CONCLUSION: The rising prevalence and incidence of pediatric RHD in Sabah, with the most being severe RHD at diagnosis, necessitates the development of an echocardiographic screening and a comprehensive national disease program.

  3. Periventricular haemorrhage in very low birth weight Malaysian neonates
    Boo NY, Ong LC, Lye MS, Wong KP, Mastura M
    J Trop Pediatr, 1993 Aug;39(4):224-9.
    PMID: 8411316
    A prospective study was carried out to determine the incidence, clinical presentation, early outcome, and risk factors associated with periventricular haemorrhage (PVH) in 88 (84 per cent) of the 105 consecutive very low birth weight (VLBW) (< 1500 g) Malaysian neonates born in the Maternity Hospital, Kuala Lumpur. Based on the cranial ultrasound findings, PVH was detected in 86 of the 88 neonates (98 per cent, 95 per cent confidence intervals: 95 to 101). Seventeen (20 per cent) of them had grade I, 52 (61 per cent) had grade II, 7 (8 per cent) had grade III and 10 (12 per cent) had grade IV PVH. PVH was detected in all the affected neonates by the fifth day of life. Sixty-four neonates (74 per cent) were symptomatic when PVH was first detected. Shock (P < 0.01), pallor (P = 0.028), low haematocrit of less than 40 per cent (P < 0.01), convulsion (P < 0.001), and bulging of anterior fontanelle (P = 0.019) were significantly more common in the neonates with severe PVH (grades III or IV). Death occurred in 43/86 (50 per cent, 95 per cent confidence interval: 39-61 per cent) of the neonates with PVH before their first discharge from the hospital. Ventriculomegaly developed in 29/43 (67 per cent, 95 per cent confidence intervals: 54.4-81.4) of the survivors with PVH. Our study suggests that PVH is a common problem in the Malaysian VLBW neonates. To reduce the incidence and severity of this condition, prevention of preterm delivery and improvement in the basic facilities for neonatal care would help.
  4. Risk factors for developing neonatal septicaemia at a Malaysian hospital
    Wong NA, Hunt LP, Marlow N
    J Trop Pediatr, 1997 02;43(1):54-8.
    PMID: 9078832 DOI: 10.1093/tropej/43.1.54
    A case-control study of antecedents of neonatal septicaemia was performed using 50 cases of neonatal septicaemia and 73 comparison infants from a Malaysian hospital nursery. Multivariate analysis indicated the following independent risk factors: maternal primiparity, pre-eclampsia, prolonged rupture of membranes, twin pregnancy, prematurity, assisted ventilation, umbilical catheterization, and formula feeding. Although the spectrum of causative organisms varied between our study and past studies from Western countries, the risk factors for developing neonatal septicaemia were strikingly similar. Therefore, preventative guidelines based on risk factors described in Western countries, should help reduce the incidence of neonatal septicaemia at this Malaysian hospital.
  5. Complications of bacteriologically confirmed typhoid fever in children
    Malik AS
    J Trop Pediatr, 2002 Apr;48(2):102-8.
    PMID: 12022423
    To find the incidence, markers and nature of complications of typhoid fever, we studied 102 children with cultures positive for Salmonella typhi in a cross-sectional study, prospectively, over a period of almost 5 years. All isolates were sensitive to commonly used antibiotics. One third of these children developed complications which included: anicteric hepatitis, bone marrow suppression, paralytic ileus, myocarditis, psychosis, cholecystitis, osteomyelitis, peritonitis, pneumonia, haemolysis, and syndrome of inappropriate release of antidiuretic hormone (SIADH). Twelve children developed multiple complications. If hepatitis is excluded from the complications, the rate of complications in bacteriologically confirmed cases of typhoid fever drops to 11 per cent. These complications were not related to: the age or sex of patients, duration of illness before admission, use of antibiotics before admission, nutritional status, level of 'O' or 'H' titre, presence of IgM or IgG antibodies, or treatment with chloramphenicol or ampicillin. Children with splenomegaly, thrombocytopenia or leukopenia were more likely to develop complications.
  6. Admission hypothermia among VLBW infants in Malaysian NICUs
    Boo NY, Guat-Sim Cheah I, Malaysian National Neonatal Registry
    J Trop Pediatr, 2013 Dec;59(6):447-52.
    PMID: 23774951 DOI: 10.1093/tropej/fmt051
    This study aimed to determine the prevalence of admission hypothermia (AH) among very-low-birth-weight (≤1500 g) infants in 32 Malaysian neonatal intensive care units (NICUs). This was a retrospective analysis of prospectively collected data of all very-low-birth-weight infants admitted and a questionnaire survey of the practice of AH prevention. Of the 3768 (99.8%) infants with admission temperature recorded, 64.8% (n = 2440) were hypothermic: 40.3% (n = 983) mildly (36.0-36.4°C), 58.5% (n = 1428) moderately (32.0-35.9°C) and 1.2% (n = 29) severely (<32.0°C). Mean ambient temperature of these NICUs was 22.8°C (SD = 2.7, n = 28) in labour rooms and 20.1°C (SD = 1.6, n = 30) in operation theatres. None of the NICUs practised complete care bundle against AH at birth (i.e. use of pre-warmed radiant warmer and cling wrap, ambient temperature of at least 25°C and use of pre-warmed transport incubator). Care bundle against neonatal hypothermia should be actively promoted in Malaysian labour rooms and operation theatres.
  7. Neural tube defects in Malaysia: data from the Malaysian National Neonatal Registry
    Boo NY, Cheah IG, Thong MK, Malaysian National Neonatal Registry
    J Trop Pediatr, 2013 Oct;59(5):338-42.
    PMID: 23583959 DOI: 10.1093/tropej/fmt026
    This study aimed to determine the prevalence and early outcome of neural tube defects (NTDs) in Malaysia. This prospective study included all neonates with NTDs (spina bifida, anencephaly, encephalocoele) born in 2009 in 32 Malaysian hospitals in the Malaysian National Neonatal Network. The prevalence of NTDs was 0.42 per 1000 live births, being highest among the indigenous people of Sarawak (1.09 per 1000 live births) and lowest among Malaysians of Chinese descent (0.09 per 1000 live births). The most common type of NTDs was anencephaly (0.19 per 1000 live births), followed by spina bifida (0.11 per 1000 live births) and encephalocoele (0.07 per 1000 live births). Majority of the infants with anencephaly (94.5%, n = 51), 45.8% (n = 11) with encephalocoele and 9.5% (n = 4) with spina bifida died. The median duration of hospital stay was 4 (range: 0-161) days.
  8. The role of expressed breastmilk and continuous positive airway pressure as predictors of survival in extremely low birthweight infants
    Boo NY, Puah CH, Lye MS
    J Trop Pediatr, 2000 Feb;46(1):15-20.
    PMID: 10730035
    A case-control study was carried out on 152 extremely low birthweight (ELBW, < 1000 g) infants born consecutively in a large Malaysian maternity hospital during a 21-month period to determine the significant predictors associated with survival at discharge. Forty-nine (32.2 per cent) of these infants survived and 103 (67.8 per cent) died. The survivors weighed significantly heavier (mean = 888 g, SD = 99) than infants who died (mean = 763 g, SD = 131; p < 0.0001). They were also of higher gestational age (mean = 28.7 weeks, SD = 2.2) than those who died (mean = 26.7 weeks, SD = 2.5; p < 0.0001). Logistic regression analysis showed that, after controlling for various confounders, only three factors were significantly associated with the survival of these infants. These were: (1) increasing birthweight of the infants (with every gram increase in birthweight, adjusted odds ratio of survival was: 1.009; 95 per cent CI 1.004, 1.015; p = 0.0006); (2) given nasal continuous positive airway pressure for treatment of respiratory distress syndrome (adjusted odds ratio of survival: 4.2; 95 per cent CI 1.2, 14.0; p = 0.02); and (3) given expressed breastmilk (adjusted odds ratio of survival: 57.5; 95 per cent CI: 7, 474; p = 0.0002). Maternal illness, intrapartum problems, ethnicity, gestational age, use of antenatal steroid, modes of delivery, Apgar scores, congenital anomalies, respiratory distress syndrome, persistent ductus arteriosus, septicemia, necrotising enterocolitis, chronic lung disease, oxygen therapy, intermittent positive pressure ventilation, surfactant therapy, and blood transfusion were not significant factors associated with increased survival.
  9. Factors associated with clinically significant perinatal asphyxia in the Malaysian neonates: a case-control study
    Boo NY, Lye MS
    J Trop Pediatr, 1992 12;38(6):284-9.
    PMID: 1844086 DOI: 10.1093/tropej/38.6.284
    A 2-month prospective study was carried out in a Kuala Lumpur maternity hospital to determine the antenatal and intrapartum factors associated with perinatal asphyxia in the Malaysian neonates. The incidence of perinatal asphyxia was 18.7 per 1000 livebirths. Of the 75 asphyxiated neonates born during this period, 70 (93.3 per cent) were of term or post-term gestation. The incidence of perinatal asphyxia was more common in the neonates with one of the following characteristics: low birth weight (< 2500 g), breech delivery, or delivery by instrumentation or lower segment Caesarean section (P < 0.001). Conditional logistic regression analysis of the asphyxiated and the control neonates in a nested case-control study (after controlling for sex, race, birth weight, modes of delivery, and maternal gravida) showed that there were two associated factors which were of statistical significance. These were: small-for-gestation neonates and the presence of intrapartum problems. Our study suggests that to reduce the incidence of perinatal asphyxia, the common causes of small-for-gestation neonates and the common types of intrapartum problems should be identified to enable appropriate preventive measures to be carried out.
  10. Risk factors associated with feed intolerance in very low birthweight infants following initiation of enteral feeds during the first 72 hours of life
    Boo NY, Soon CC, Lye MS
    J Trop Pediatr, 2000 Oct;46(5):272-7.
    PMID: 11077935 DOI: 10.1093/tropej/46.5.272
    An observational study was carried out in the Kuala Lumpur Maternity Hospital to determine the risk factors associated with feed intolerance in very low birthweight (VLBW, <1501 g) infants given intermittent 3-hourly enteral feeds within 72h after birth. Feed intolerance developed in 85 (64.4 per cent) of 132 infants. Logistic regression analysis showed that the only significant risk factor associated with feed intolerance was the age when the first feed was commenced. For each hour delay in the age of the infants when the first feed was given, the adjusted odds ratios of feed intolerance was 1.03 (95 per cent confidence intervals: 1.01-1.05; p = 0.01). Other factors (modes of delivery, Apgar score at 1 min, sex, ethnicity, history of resuscitation at birth, birthweight, gestation, multiple pregnancy, perinatal asphyxia, types of milk, hypothermia before first feed, hypotension before first feed, respiratory distress syndrome, patent ductus arteriosus, septicaemia, theophylline therapy, indomethacin therapy, ventilatory support, continuous positive airway pressure, umbilical catheterization, and surfactant therapy) were not significantly associated with feed intolerance. Our study suggests that to promote tolerance of enteral feeds in VLBW infants, intermittent orogastric feeds should be commenced as soon as possible during the first 72 h of life.
  11. Severe bronchiolitis in Malaysian children
    Chan PW, Goh AY, Lum LC
    J Trop Pediatr, 2000 Aug;46(4):234-6.
    PMID: 10996986
    Twenty-two (42 per cent) out of 52 patients admitted with severe bronchiolitis to our Paediatric Intensive Care Unit required ventilation. Risk factors associated with ventilation included a younger mean age, female sex, low birthweight, failure to thrive and the presence of an underlying illness. Ventilated patients were also more likely to have a higher respiratory distress assessment index (RDAI) score, pneumonic infiltration on chest X-ray, lower serum sodium and a positive respiratory syncytial virus isolation in the tracheal secretion.
  12. Antibiotic susceptibility and serotype distribution of Streptococcus pneumoniae in Malaysian children
    Cheong YM, Jegathesan M, Henrichsen J, Wong YH, Ng AJ, Louis A
    J Trop Pediatr, 1988 08;34(4):182-5.
    PMID: 3172328 DOI: 10.1093/tropej/34.4.182
  13. Cure of beta-thalassaemia major by umbilical cord blood transplantation--a case report of Malaysia's first cord blood transplantation
    Chan LL, Lin HP
    J Trop Pediatr, 1999 Aug;45(4):243-5.
    PMID: 10467839
    A 25-month-old boy with beta-thalassaemia major was presented with an opportunity for umbilical cord blood transplantation when his unborn sibling was diagnosed in utero to be a beta-thalassaemia carrier and also human leucocyte antigen compatible. A barely adequate amount of cord blood was collected at the birth of his sibling and infused into the patient after appropriate chemo-conditioning. Engraftment occurred without major complications. The subject is now alive and well 9 months post-transplant, thus marking our first success in umbilical cord blood transplantation.
  14. Breastfeeding at 6 weeks and predictive factors
    Chye JK, Zain Z, Lim WL, Lim CT
    J Trop Pediatr, 1997 10;43(5):287-92.
    PMID: 9364127 DOI: 10.1093/tropej/43.5.287
    Despite the numerous changes made in accordance with the Baby Friendly Hospital Initiative at the University Hospital, Kuala Lumpur, the low rates of breastfeeding have persisted. This study aims to examine the current trend in infant feeding, and the influences of some perinatal and sociodemographic factors on breastfeeding. Five-hundred mothers with singleton pregnancies and healthy infants were interviewed at 6 weeks post-partum. Only 124 (25 per cent) mothers were practising exclusive breastfeeding (EBF), and 132 (26 per cent) mothers were using exclusive infant formula feeding (EIF). On logistic regression analyses, mothers who followed EBF were more likely to have had antenatal plans to breastfeed (Odds ratio 2.44, 95 per cent confidence interval 1.75-3.45), not in paid employment post-natally (OR 1.76, 95 per cent CI 1.31-2.36), of older age group (> 27 years) (OR 1.48, 95 per cent CI 1.13-1.93), had female infants (OR 1.38, 95 per cent CI 1.05-1.80) and of Indian ethnicity (compared to Chinese) (OR 3.87, 95 per cent CI 2.16-6.89). Breastfeeding difficulties were associated with decreased odds of EBF (OR 0.21, 95 per cent CI 0.13-0.34). Parental education, fathers' ages and incomes, primigravida status, Caesarean section, present of episiotomy, late first breastfeed, phototherapy, and length of hospital stay were not significant predictors of failure of EBF. In comparison, predictive factors for increased use of EIF were mothers who have had breastfeeding difficulties, < or = 9 years of schooling, and of Chinese descent. In conclusions, the overall rate of EBF by 6 weeks of age in infants born in this urban hospital had remained poor. The adverse factors for EBF identified in this study warrant further in-depth studies to determine effective ways of improving EBF rates.
  15. Post-transfusion hypertension and seizure in congenital hemolytic anemia: a case report and literature review
    Ngim CF, Ng CS, Lai NM
    J Trop Pediatr, 2014 Jun;60(3):253-6.
    PMID: 24473404 DOI: 10.1093/tropej/fmu003
    A rare syndrome of hypertension, seizures and intracranial bleed has been reported among patients with congenital hemolytic anemia who underwent multiple blood transfusions. We report this syndrome in a 12-year-old Malay girl with hemoglobin E-beta-thalassemia, who underwent intensive transfusion and subsequently had headache, visual loss, severe hypertension and seizures. A comprehensive literature review revealed 30 patients with this syndrome, of whom 15 had intracranial bleed and 12 among these 15 died. A less-intensive transfusion regimen among patients with chronic hemolytic anemia and prompt detection and management of hypertension may prevent this potentially fatal syndrome.
  16. Acute respiratory tract infection: a community-based intervention study in Malaysia
    Lye MS, Nair RC, Choo KE, Kaur H, Lai KP
    J Trop Pediatr, 1996 06;42(3):138-43.
    PMID: 8699578 DOI: 10.1093/tropej/42.3.138
    A community-based intervention trial was conducted in Kelantan, Malaysia with the aim of reducing severe acute respiratory tract (ARI) infection in children. Interventions included health education of mothers on childhood pneumonia and training of health staff on case management. In a house-to-house survey 1382 and 1107 children less than 5 years of age in the intervention and control areas, respectively, were followed up every 2 weeks over a 62-week period. The reduction in the incidence of severe ARI cases in the intervention area was significantly greater than in the control area (P < 0.05). The ARI mortality rates were low in both the intervention and control areas ( < 0.1%). Our results indicate that with relatively inexpensive methods and simple interventions, reduction of severe ARI may be effectively achieved. This has important implications for an ARI control programme in Malaysia and other developing countries.
  17. Breast feeding among the Chinese in four countries
    Koh TH
    J Trop Pediatr, 1981 04;27(2):88-91.
    PMID: 7230315 DOI: 10.1093/tropej/27.2.88
  18. Knowledge, attitude and concerns among urban Malaysian parents of bedwetting children
    Kanaheswari Y
    J Trop Pediatr, 2011 Apr;57(2):141.
    PMID: 20584719 DOI: 10.1093/tropej/fmq051
  19. Measuring the Daily Activity of Lying Down, Sitting, Standing and Stepping of Obese Children Using the ActivPALTM Activity Monitor
    Wafa SW, Aziz NN, Shahril MR, Halib H, Rahim M, Janssen X
    J Trop Pediatr, 2017 04 01;63(2):98-103.
    PMID: 27539845 DOI: 10.1093/tropej/fmw052
    This study describes the patterns of objectively measured sitting, standing and stepping in obese children using the activPALTM and highlights possible differences in sedentary levels and patterns during weekdays and weekends. Sixty-five obese children, aged 9-11 years, were recruited from primary schools in Terengganu, Malaysia. Sitting, standing and stepping were objectively measured using an activPALTM accelerometer over a period of 4-7 days. Obese children spent an average of 69.6% of their day sitting/lying, 19.1% standing and 11.3% stepping. Weekdays and weekends differed significantly in total time spent sitting/lying, standing, stepping, step count, number of sedentary bouts and length of sedentary bouts (p < 0.05, respectively). Obese children spent a large proportion of their time sedentarily, and they spent more time sedentarily during weekends compared with weekdays. This study on sedentary behaviour patterns presents valuable information for designing and implementing strategies to decrease sedentary time among obese children, particularly during weekends.
  20. Growth pattern of urban Malaysian infants
    Hashim Z
    J Trop Pediatr, 1992 Aug;38(4):204-5.
    PMID: 1527822
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