Food poisoning is still a major problem in the state of Terengganu. The study was conducted during an episode of food poisoning outbreak which occurred in October, 1999, at Universiti Tekonologi Mara (UiTJ1rO, Dungun to determine the etiology, mode of transmission, source and the risk factors of the outbreak and hence to take appropriate remedial actions and preventive measures. A retrospective cohort study was conducted amongst 925 students using a standard questionnaire as well as environmental investigation and bacterial subtyping. All the samples were Malay females, age ranging jrom /9 — 22 years. It was found that majority ofthe victims (72 %) presented with abdominal cramp, 68.5% headache, 60.0% diarrhea, 55.2% fever, 45.0% nausea, 39.0% muscle
ache and 3]. 7% vomiting. The epidemic curve suggested of a common source of infection and the most probable food that has been contaminated was taken during lunch hour on October 20'I'1999, Statistical analysis showed that spices jiied chicken and "nasi minyak" were significantly associated with the illness (p < 0. 05). The most likely causative organism was Salmonella spp as supported by the clinical presentation and incubation period of the disease, identdication of contaminated food, bacterial subtyping result and environmental findings. Following the outbreaks, several remedial actions were taken including immediate close—up ofthe canteen for I4 days, treatment for the cases and health examination and typhoid immunization for all food handlers.
Cr0ss»sectional studies on lung functions of 100 smokers and 100 non-smokers was conducted among a university student population. The objectives of the studies were to determine the correlation between the lung functions with smoking frequency and duration among smokers as well as to compare the lung functions with non-smokers. The smokers’ mean age was 20.74 years, their smoking initiation age was 16.18 years, the smoking duration was 4.41 years and the smoking frequency was 8.72 cigarettes per day. Among smokers, signqicant inverse correlation was shown between FEV] predicted and the smoking frequency (number of cigarette per day) (ri-0.241, p=0.016). Multiple regression confirmed the relationship between FEV]% predicted with respondent’s age (p=0.013) and smoking frequency (p=0.002), FVC% predicted with age (p=0.005) and smoking frequency (p=0.009). The FEV;/FVC% predicted was signyicantly related to phlegm symptoms (p=0.03), while the FEFZ5.y5% predicted was signdicantly related to age (p=0.005), height (p=0.043) and smoking duration (p=0.046). The lung functions (FEV1% predicted, FVC% predicted and FEV]/FVC% predicted ) for smokers were not statistically dyferent from non-smokers. This study showed that the lung functions for the smokers were still quite normal due to their short smoking duration, their low number of cigarette smoked per day and their young age.
The aim of this study was to identify the problems of stress and health effect among the office computer users. A total of 41 office workers whose job required the use of computers. A set of constructed questionnaire were use to measure the work stress and health problems among workers. The data was analyzed by using of descriptive and inference statistic. The result showed that subjects who use computer for more than 2 hours would experienced work stress such as fatigue 29(70.7%), eye and visual symptoms such as blurring of vision 27(65.9%) and musculoskeletal pain at neck 32( 78.6%). However most of symptoms were moderate. There were a significant relationship between the time spent of using computer with problem of stress (r= 0.440, p<0.05) and eyes and visual problem (r=0.319, p<0.05). However there was no significant relationship between the work station design with stress, musculoskeletal, eye and visual problems. Therefore the longer time spent using computer will lead to health problems. Using the safety operating procedure will reduce the work stress problems.
Keys word: Work stress, health problems, computer users
Indicators, whether referred to as ecological, biological or environmental, help us in assessing environmental conditions. Hypothetically, joint influences are predicted of the parameters associated with the number of water-borne, food-borne and vector-borne cases in study areas. Regression analysis of the dependent variables in water—borne diseases such as Cholera, Typhoid, Dysentery and Hepatitis indicated that the total coly°orm, fecal colform, residual chlorine, mean monthly rainfall and temperature influence almost hay of the cases in the 3 District of Serernban. Thus, coordinated monitoring of physical, chemical and biological parameters is needed to continue to build databases and to develop models integrating environnrental and social conditions, consequences and costs.
A cross—sectional study conducted in the fasting month of Ramadan targeting muslim males assessed their religious beliefs in relation to smoking and their intentions t0 quit smoking in Ramadan. It was found that there law; is a strong association between their perceptions on the religious ruling of smoking as haram (prohibited) in relation to their smoking status. Among the non smokers and ex smokers, 87.8% and 73.6% respectively accept the ruling on smoking as prohibitea'(haram), while only 31.6% of smokers accept smoking as prohibited. Among the smokers, 97.7% smoke a lesser number of cigarettes during Ramadan, while 96.7% of them felt that it is easier to quit during the fasting month. The findings suggest that the religious department needs to provide more information and education to the Muslim population as to the reasons of the ruling on smoking as haram(prohibited) on religious grounds . It was also found that the majority felt it is easier to quit during quit smoking programmes can be emphasized and carried out on a bigger scale during fasting months in the future.
A cross sectional study to measure the prevalence of domestic violence and the factors associated with it among women who seek treatment at Hospital Pontian Out Patient Department was carried out in September 1998 until April 1999. The study sample was chosen through systematic random sampling. A total of 370 women between 15 to 49 years were selected and the response rate was 100%. The Results show the one year prevalence rate of domestic violence was 16.8% and life- long prevalence of domestic violence was 35.1%. Studies shows significant difference between the prevalence of domestic violence by age, marital and working status, age at marriage, knowledge, attitude and action to be taken toward domestic violence. Percent of victim is higher among women less than 20 year old, single, still schooling, negative attitude and action towards abuse and less knowledge of place for seeking help. Factor that contribute significantly toward domestic violence among single women is the lack of positive action in dealing with violence and among married women are early marriage(<25 year), lack of positive action in dealing with violence and lack of moral support from husband and family.
Key words: prevalence of domestic violence, mangsa keganasan, associated factors, contributing factors
Study site: Outpatient clinic, Hospital Pontian, Johor, Malaysia
A cross-sectional study was done to determine the prevalence of violence among 15-year-old adolescents and to identify associated protective or risk factors. The study involved 758 adolescents, 384 males and 3 74 females in the District of Kuala Terengganu and Besut, Terengganu. About 39.0% of adolescents under study were ever involved in violence. Percentage of girls were slightly higher 19.8% as compared to boys 19.2%. About 30% of the violent adolescents were from Kuala Terengganu and 9.1% from Besut. There was no significant relationship between violence and ethnic groups. Family total income above poverty line was significant protective towards violent behaviour < 0.01, OR 0.61, CI 0.45 - 0.82). Using univariate analysis, selected parental factors were protective against violence, such as good parental connection (p < 0.01), presence of parental regulation (p < 0.001), religious parents (p < 0.05) and parents who had dinner everyday with adolescents (p < 0.01, OR 0.59, CI 0.43 - 0.80). Adolescent who perceived to have interest in learning (p < 0.001, OR 0.32, CI 0.17 - 0.59) were less likely to involve in violence. Adolescent who felt well connected to their school (p < 0.01), and perceived themselves religious (P < 0.001) were more likely to be non-violent. Those who felt satisfied with day to day life were less likely to be involved in violence (p < 0.001, OR 0.52, CI 0.37 - 0.71). On the contrary, adolescents who ever had the feeling to run away from home (p < 0.001), had 3 times risk of violence, ever smoked cigarette had 2.4 times risk (p < 0.001, CI 1.55 - 3.69) ever been bullied by peers were 2.3 times risk (p < 0.001, CI 1.46 - 3.60) to violence. Same factors remained significant in multivariate analysis. Such factors were total family income below poverty line (p < 0.001, OR 1.82,CI 1.28 - 2.59), parental regulation (p < 0.05, OR 0.34, CI 0.13 - 0.89), had dinner every night and frequently (p < 0.01, OR 0. 62, CI 0.43 - 0.89), and adolescents' religiosity (p < 0.05, OR 0.81, CI 0.66 - 0.98) were protective, whereas ever· smoke cigarettes (12 < 0.01, OR 2.24,Cl 1.38 - 3.62), being bullied by peers (o < 0.01, OR 2. 09, C1 1.26 - 3.45), and frequently felt depressed previous one year (p < 0.001, OR 3.01,CI 1.79 - 5.07) were risk factors. The findings of the study will serve as baseline in planning adolescent health programme specifically to prevent violence behaviour from developing right from young, in the home and in the school environment.
The relationship between dust exposure and lung function were investigated in a cross-sectional study of 70 male quarry workers. The investigation included spirometric testing and detailed personal interviews using a structured questionnaire adapted from British Medical Research Council questionnaire on respiratory symptoms. Respiratory symptoms commonly reported by the male workers were shortness of breath (42.9%), chest tightness (37.1 %}, morning phlegm (20.0%) and morning cough (0.8%}. Prevalence of respiratory symptoms was greater in current smokers. Age and duration of employment also had significant relationship with chest tightness. Both FEV, and FVC of these workers were significantly reduced when compared to healthy population. Smoking status, age, and duration of employment were also associated with reduced pulmonary function (p<0.01).
Key words: respiratory symptoms, lung function and quarry workers
The status ofhve l1eavy metals: cadmium, lead copper, zinc and mercury were determined in seafood and its products imported_ti·om Thailand via Bukit Kayu Hiram, Kedah, Flame Atomic Absorption Spectrophotometer was used to determine the level of these heary metals except for mercury, where the cold vapor technique was used, Randomized sampling was done according to a predetermined sampling plan based on the previous years consignments. Data collected were compared with the maximum permitted level of -metal contaminants in fish and fish products- ofthe Fourteenth Schedule (Regulation 38) of Food Act I983 and Food Regulations I 985 to ascertain compliance. lt was noted form this study, that the level of metals detected in seafood and its products had a very wide range, The levels detected for cadmium was at a range of 0. 00] - 3.9/2, 0.07 — 0.29, 0,04 - 4,4 mg/kg in fish, shellfish and cuttlefish respectivelv. In general, cadmium level in some samples was notably higher particularly in shellfish. All samples had lead level less than the permitted value except for fish where the highest value detected was 3.28 mg/kg. The level of copper and zinc was higher than the permitted value in octopus, prawn and crab, Mercury level in all samples analvzed was found to be below the detection level. As for fish samples, zinc level was found to be higher whereas copper was within the limit. However, it was also noted that the level of all the heavy metals in jiozen jish was within the permitted limit.
The objective of this study was t0 determine the relationship between scores on McCarthy Scales of Children's Abilities (MSCA) and academic peU’ormance of school children. A total ofI12first and second graders aged 6 to 8 I/2 years old hom two primary schools in Kuala Lumpur, Malaysia were selected as subjects for this study. This selection was based on a random sampling stratyied proportionalhr according to school and sex. The MSCA was administered to 59 male and 53 female students. The test battery was translated from English to Malay and adapted to suit the local situation. Academic performance was measured using the mean percent of the total score on all the subjects (English, Malay, Mathematics and Islamic Religion) in the jinal examinations at the end of the year. T—test results indicated no signdicant dfference between MSCA scores and academic scores of maleandkmale students. The results revealed that all the scores on the MSCA and the General Cognitive Index were signyicantbr correlated with academic pejormance, The General Cognitive Index accounted for [0.4% ofthe variation in academic performance. T he findings appear to support that intelligence scores may be used to predict children 's academic performance in the early years of primary education.
We do not know how medical doctors perceive the risk of cancer as a cause of death. Medical doctors provide advice and information on health risks to the general public. How they perceive these risks influences the way they behave towards these risks and the way they will communicate these risks. We would like to ascertain how medical students perceive cancer as a health risk. This will hehv us determine misperceptions among medical students that need to be addressed before they practice medicine. A cross-sectional study was conducted among
all UPM medical students (2000-2001) using sefadministered questionnaires. A total of 339 (88.3%) students responded to the questionnaires. The internal consistency of items was good (Cronbach Alpha >0,7). Cancer was perceived as the 3rd leading risk of death after motor vehicle accidents (I") and heart diseases/cardiovascular disorders (2"d ). The breast was perceived as the organ with the highest risk of developing cancer. Smoking was perceived to be the leading risk factor for developing cancer. There is a dpjference in risk perception of diseases, cancer target organs and cancer risk factors based on gender and ethnicity. There was moderate to fair correlation ( r = 0.41-0.57) between perception of risks of death, cancer target organs and risks factors of cancer (p
Accidental poisoning in children is a preventable condition. It is a problem mainly in children aged 1 to 4 years. This is a descriptive study of accidental poisoning in children below 12 years old admitted to Hospital Seremban from October 15, 1994 to October 14, 1995. A major cause of household accidental poisoning was kerosene ingestion (25%) followed by ingestion of medications (22%), liniment methyl salicylate (12 %), mothballs (12%) and hypochlorinate solution (9%). There was a higher incidence of poisoning in males (50.8%), among Indians (41.2%) and in children from lower social classes (67%). A greater proportion of the accident occurred when the child was taken care by the parents (53 %) and in the house (80%). Most of the poison was ingested from its original package (81%). The immediate action taken was sending the child to the hospital (75%) without carrying out other actions such as washing the child’s mouth. The delay of sending the child to hospital was due to husband not at home (57%). Most of the cases (72.1 %) were discharged well within 1-2 days following admission.
Although only 6.3% of the 221 respondents in this crass-sectional study stated outright that the hospital food served to them was not good, a high proportion of respondents ( 62.0%) supplemented ltaspimlfoad with outside food. When the reasons for supplementation were considered, it is likely that 53.8% ( $5.5%; 95% CI ) of the patients in this study were dissatisfied with hospimlfoudfar some reasons or when particularly with regards t0 variety, attractiveness and sewing lime. The pl‘0]701’l‘i011 of respondents wha were dissatisfied with hospital faud was significantly higher (p
Health impact related to smoking is a critical public health predicament especially in pregnancy. However there is not much data available to describe the magnitude of the problem. Hence this study was conducted to determine the prevalence of smoking and its socioeconomic factors among antenatal mother and their opinion related to tobacco control measures. A cross sectional study was carried out involving newly registered antenatal mothers attending all government health clinics in Penang. Prevalence of ever smoking among antenatal mother is 1.4%, of which 42.4% is still smoking at first antenatal visit. It was found that single mothers are more likely to smoke (OR, 14.23: C12.52-53.27). It was also noted that spouse smoking (OR, 5,14: CI 1.95-17.09), primigravida (OR, 2.7: C1 1.3-5.62), age group less than 30 years old (OR, 2.41; CI 1.03-6.09) and living in urban area (OR, 2.33; CI 1.01 — 6.47) have a higher risk to indulge in smoking behaviour. Muslim OR 0.29; C1 0.14 - 0.60) and Malay (OR 0.22; CI 0.10 - 0.47) pregnant mothers are noted to be less likely to smoke as compared to non Muslim and non Malay. More than 85% of them agreed with the tobacco control measures regardless of their smoking status. Most of respondents agreed the influential people in community L;11T · such as medical personnel, teachers and parents should not smoke.
Influenza has always been wrongly perceived as a minor disease which is no dwerent than common cold. Influenza affecting all age groups cause a considerable morbidity and mortality although the data are not well established in Asia Pacwc. In the United States, it claims similar order of mortality as that due to car accidents. Inflluenza A and B can cause epidemic human disease. New Influenza virus variants develop frequently due to antigenic dry?. The rapid evolution of both influenza A and B virus is responsible for annual influenza epidemics in humans. Although in Malaysia, Influenza Surveillance began in 1954, the disease awareness is still low. It is
prudent to continue the surveillance throughout in order to monitor the seasonal trend, circulating strain as well to prepare us from an epidemic or pandemic. Institute for Medical Research, being the sole WHO National Reference lab in this country committed in improving the Influenza Surveillance which will involve all the states in Malaysia in the near future.
Water filters are being increasingly promoted and used in the home. There are many types of commercial water jilters available for domestic use but almost all of them employ a physical filter media and an activated substance. The study showed that water filters effectively removed suspended solids and residual chlorine. However, as far as removing colhform bacteria is concerned, in ZZ .5% of the cases, bacteria were in fact introduced into the water. And in 20% ofthe cases, the amount of bacteria introduced was “too numerous to count (TNTC)". Furthermore, water hlters can lose their ability to filter bacteria without losing their ability to filter suspended solids and residual chlorine. This highlights the necessity of some authorized body looking into the claims made by these water filter manufacturers and impose certain standards to ensure that at the very least, the water quality ofthe hltered water is not worse than the unfiltered water.
Upper respiratory tract infections (URTI) are the most common diseases treated in the primary health care centres in Kinta District, Perak. Thus, aretrospectiire study was undertaken to examine the documentation of the presentation of patients diagnosed with URTI and their antibiotic treatment at two health care centres in Kinta district, The randomly selected case notes of 700 patients documented the following symptoms, fever (43 .29%) , cough (68.14%) , no cough (24.43%), nasal symptoms (35 .29%) , sore throat (46.00%), headache (13 .57%) , bodyache (3 .57%) , earache (1 .86%) and gastrointestinal symptom (0, 14%) . Analysis of results using 'sore throat score' and isuggested appropriate management’ adopted from a study by Wawen et al. revealed poor correlation between diagnosis of URTI and the need for antibiotic therapy. Therefore, a clinical score for patients with sore throat can be introduced to overcome inappropriate prescription of antibiotics.
Klinik Kesihatan Gopeng, Klinik Kesihatan Malim Nawar, Kinta district, Perak, Malaysia
This is a cross»sectional study to determine the nutritional status of Malay children aged 6 to 10 years in Kampongknderam Hilir. A cross sectional study design was used.All households were included in the study. All the 218 Malaysian children aged 6 to 10 years in Kamponglenderam Hilir were included in the study. A pre-tested structured questionnaire was used to collect the data.
Data were analyzed by using Statistical Package of Social Sciences (SPSS) version 10. The minority of the chihlren were within normal range for weight·for-age, normal height for age status and weight for height status. However in small proportion of children, there was a persistence of protein·energy malnutrition problems. Overall 11% were underweight. There was no significant difference in the prevalence ofunderweight between males and females. The prevalence of overweight and stunting was 5 .3% and 11 .5%. There was no significant difference in the prevalence of sturtting in male compared to females. Although stunting was prevalent in all age groups (4.4% to 19.6%) a significant higher prevalence was observed in the age group 9 - 9.9 years compared to other age groups (p< 0.05). Wasting was present in 7.6% of the respondents. The 6 - 6.9 years age group had the highest wasting prevalence compared to other age groups. The prevalence of wasting was significantly higher in males. ln conclusion the overall nutritional status of children aged 6 to 10 years old in Kampong]enderam Hilir was satnfactory. However, there was still malnutrition in a small proportion of chihlren. Underweight, stunting and overweight were seen in all age groups. As such there is a need to identify these chiMren and improve their nutritional status.
A diarrhoea outbreak had occurred among neonates delivered in a private hospital in Kedah from 15 August to 8 September 2002 involving 27 (55.1%) cases out of a total of 49 deliveries. Thirteen of them (48.1%) were admitted to either government or private hospitals for treatnzent while fourteen of them (51.9%) were managed at home. The main presenting feature was frequent yellowish to greenish watery stool not associated with vomitting. Investigations include active case finding, environmental inspection, sampling of stool specimens, identifying causative agents and identuying human carriers. All the diarrhoea eases (100%) were noted to have received infant formula feeding while in the private hospital. Staphylococcus aureus was isolated hom the milk scoop which was used for milk preparation. Nasal swabs of four (50%) nursing personnel were also positive for Staphylococcus aureus. One of them was positive for methycilline resistant Staphylococcus aureus (MRSA). The milk and water samples showed no signuicant bacterial contamination. Stool samples of these cases were negative for Rotavirus, Vibrio sp., Salmonella sp., Shigella sp. and Entamoeba coli. This outbreak of diarrhoea was noted to have a strong association with infant formula feeding in the hospital. Breastfeeding should be continuously promoted. Baby friendly hospital initiatives in private hospital settings need to be initiated.
The aim of this study is to describe the epidemiological features of HFMD outbreak in the Hulu Langat District in 2000. Until November 2000, a total of 60 cases were reported and the worst ever reported to the previous years. The mean age of patients was 3.9; 5.8 years with majority of the cases aged between 1 to 4 years old (53.8 per 100,000 of population), male gender (8.3 per 100,000 of populations), and were of Chinese (12.2 per 11 100,000 of populations) and Malay ethnicity (7.2 per 100.000 of populations). All cases were uncomplicated cases and were diagnosed clinically. Most of the notified cases were front the government facilities, which are 44 cases (73.3%). Thirty-five (35) cases (58.4%) were treated as outpatient and 25 cases (41.6%) as in patients (p>0,05). Only 7 cases (11.7%) have history of contact with HFMD patients. The notified cases were mainly from the densely populated areas which were Cheras, Kajang and Ampang. No differences were noted between HFMD cases which have been breasfed for less than 6 month or more, and twenty nine (29) cases (48.3 %) had completed the immunization schedule. In conclusion, the recent emergence of HFMD brings a new challenge, which have to be faced in the prevention and surveillance activities of public health problems in the district.
Study site: Notified cases from Klinik Kesihatan, hospital, private clinics, Ulu Langat, Selangor, Malaysia