A study was carried out to identify some of the cultural factors in the epidemiology of filariasis in an endemic community in Malaysia. The viewpoint of the community, data an responses on knowledge of illness and filariasis, host related factors, health examination, vector study were analysed and discussed. The observations noted on cultural factors were: Occupational pattern: Different agricultural occupations seemed to related to transmission in terms of body exposure. Activities not related to production of crops: Play groups in late afternoon, bathing of household members near and after sunset, congregations at prayer houses very much exposed the population to mosquito bites in different degree in terms of length of time spent outside the house. Knowledge of filariasis: Filariasis was understood in terms of elephantiasis, the chronic stage of the disease. Other signs of disease-adenolymphangitis, red lines running down one or both legs and abscess were generally recognized but not often annonated with specific disease. Attitude toward disease: Filariasis was not seen as a health problem and the idea of filarial worms was still hard to believe. Knowledge on disease causation: Biological causes were generally recognized, though the idea of bacteria was not widespread.
The purpose of this paper is to compare two forms of treatment for heroin abusers in Malaysia--traditional medicine and institutional--and to evaluate which form of treatment the drug abusers consider more effective. The study involved interviewing 100 male drug abusers in Malaysia who had had treatment from an institution and from a traditional healer. The data revealed that traditional medicine was better for some abusers, but institutional treatment was better for others, depending upon an individual's own needs and personality. Advantages and disadvantages of both forms of treatment were given by those interviewed. The data can be used as guidelines for the development of a more flexible, individualized program within an institutional setting in Malaysia.
A study of food ideology and eating behavior in a Malay village demonstrates that the relationship between belief and action is complex and not always predictable. Over-reliance upon stated beliefs, and generalizations derived from particular ecological settings, have influenced investigators into making universal and logical statements about Malay eating behavior and its health consequences--a logic which, however, does not always jibe with reality. Food ideology, like any other portion of a belief system, is subject to innovation, interpretation and rationalization, and contains within it 'rules to break rules' which assure the continued integrity of the symbolic system by patterning what might otherwise be seen as rifts in its fabric. An understanding of eating behavior must be based both on a knowledge of the subsidiary, as well as primary, clauses of food ideology, and on direct observation of the behaviors elicited by these beliefs and modified by the setting, the situation and the individual.
A KAP study on dengue/dengue haemorrhagic fever (DF/DHF) was carried out in three areas in the Federal Territory. The three areas were selected based on their ethnic group composition and were Jinjang North (Chinese), Kampung Bahru (Malays) and Sentul (Indians). Houses were selected by a systematic sampling method and house-to-house interviews were carried out with a pre-tested, predesigned questionnaire. 546 (87.62%) of the households responded.
A study to identify the knowledge of infected and uninfected respondents on filariasis and epidemiologic factors in one endemic community in Malaysia to determine their role in the transmission and control of filariasis was carried out. The data were collected by non-participant observations and interviews using semi-structured schedules. The majority of respondents in both groups had knowledge of filariasis. There was no marked difference between male and female respondents, and similarly, there was fair distributions of knowledgeable respondents with and without some years of schooling. On filarial transmission, 9.2% of the infected said that filariasis was contacted through mosquito bites, while among the uninfected it was 7.4%. Within the infected, 14.8% thought that filarial worms entered the human body through the consumption of unhygenically prepared foods and drinks while, among the uninfected it was 20.4%. Both groups were aware of the presence of mosquitoes in their village. However, the majority did not associate this factor with host's susceptibility to filarial infections. Rather, they were of the opinion that personal hygiene and proper meals had something to do with filariasis. The findings showed there was general awareness of filariasis in the community which might indicate that the health campaigns had reached various levels of the population. Yet, they still lacked knowledge on disease transmission. Also, they did not make direct association between environment and exposure to mosquitoes bites though they were aware of their presence but which they regarded as not directly harmful to their health.
For any health education to succeed, the people's perception of the disease, their beliefs and cultural practices are of utmost importance as these have tremendous influence on their acceptance of new ideas. It is therefore essential to develop appropriate health education packages based on the understanding of the traditional and socio-cultural belief systems of the people. Thus on the basis of anthropological studies, health education packages were developed for the leprosy control programme in Sarawak, aimed at both adults and children. Newspaper articles, cartoon tape-slides, cartoon story books as well as posters were developed for both Chinese as well as other groups such as Malays, Ibans and Kayans. These were field tested and are now used in the Rejang Valley of Sarawak.
In 1984, in Sarawak, there were a total of 1,099 recorded cases of leprosy for a population of 1.3 million. However, for each case recorded, it is estimated that two others remain undiagnosed as a consequence of the stigmatization associated with leprosy. For the five year period, 1979-1983, an average of 29 new cases were detected each year of which 8.6 (30%) were deformed due to the late stages at which it was being reported. To increase the case-finding rate, human behavioural research was applied to the leprosy control programme so as to develop culture-specific health education packages aimed at self diagnosis and self referral in order to detect the large pool of undiagnosed cases hidden behind the veil of aversion, fear and ignorance. This was achieved through anthropological studies to identify how the various major ethnic groups perceived leprosy and their attitudes towards leprosy. Taking into account these findings, health education packages aimed at adults as well as children were developed for the Chinese as well as the non-Chinese, and consisted of newspaper articles, cartoon tape-slides, cartoon story books and posters.
Eleven maternal deaths were recorded in Hulu Terengganu between 1981-1985. This represents a high average maternal mortality rate of 1.4 per thousand deliveries annually over the five years. Nine of the 11 women were high priority pregnancies, but only three had hospital deliveries. The most common cause of death was post-partum haemorrhage (PPH), and PPH with a retained placenta. Hospital deliveries constitute only a low proportion of total deliveries in the district. In a survey of women with high priority pregnancies attending antenatal clinics in Hulu Terengganu, it was found that 79 (69%) out of 115 respondents were resistant to advice for hospital delivery. Grandmultiparae were a significant proportion of this group.
Study site: Maternal Child Health Centre (Klinik Kesihatan), Hulu Terengganu, Malaysia
A study in Sarawak, Malaysia, revealed diverse opinions, prejudices and degrees of knowledge about leprosy among various ethnic groups. The information gathered was used as the base on which a health education package relating to the disease was established. It is intended that this will lead to the early detection and treatment of a higher proportion of cases than has previosly been possible
The present study analysed the records of 342 elderly subjects aged 55 years and above of different ethnic groups to ascertain the types and level of their unperceived dental needs. The overall percentage of unperceived needs was highest among the Malays (96.1% or 74/77 subjects) and among the men (88.5% or 139/157 subjects). The unperceived need for prosthetic treatment was highest among the Malays and Chinese as well as among women, whereas the unperceived need for treatment for periodontal disease was highest among the Indians. The data for unperceived needs for prosthetic treatment as well as for treatment for caries and periodontal disease were somewhat similar among men. Within each ethnic group, variations among sex in the unperceived needs for the various dental symptoms were also noticeable. Further research is indicated to ascertain the role of traditional and cultural concepts and dogmas in determining the importance attached to the various dental health symptoms within each ethnic group.
The aim of this study is to determine the social impact of oral and facial pain in a sample involving an industrial population. Out of a total of 355 subjects interviewed, nearly one-half claimed to have oral and facial pain in the previous one month prior to the survey. The most common type of pain was that related to hot or cold fluids or sweet things followed by toothache. On the average, the pain lasted for 4.2 days (SD = 4.9) per person in the past one-month. About one in five persons with pain reported that it was severe enough to disrupt sleep. About one in ten persons reporting pain had to take sick leave because of the pain. However, only one in four persons with pain consulted a doctor or dentist. More than one-third tried to cope with the pain and did nothing while the rest tried various means of self-cure. It is therefore postulated that in this population, pain per se is a poor predictor of utilisation of dental services. Further research into pain coping behaviour and how this affects of pattern of utilisation of dental services is indicated in order to formulate a strategy to encourage the habit of seeking prompt dental care by the target population.
This study evaluates the level of dental knowledge among 328 antenatal mothers from different ethnic groups and ascertains the importance of the various sources of dental information. The mothers were interviewed based on a structured questionnaire. Most mothers knew about the number of sets of teeth they possessed throughout their life. This was most evident among the Chinese and least among the Malays. Only 42.7% of the mothers interviewed were positive about the preservation of their teeth throughout life. This belief was highest among the Chinese followed by the Indians. However about 40% of the Chinese believed that tooth decay is hereditary. Generally the principal sources of dental information cited by most mothers were television or radio followed by dentists, school and family. This order of importance was similarly observed among the Malays and Chinese. However, among Indians, family members represent the second most important source of dental information. The implications of these findings are discussed.
Knowledge of prevention can influence preventive dental behaviours. This study surveyed knowledge and preventive dental behaviours on the prevention of dental caries and gum disease among the adult population of the three major racial groups in Singapore. Respondents were asked to rate the importance of several preventive measures against dental caries and gum disease. Questions were also fielded on dental behaviours such as preventive visits to the dentist, toothbrushing and flossing. Results showed that there was a general lack of appreciation for the use of flossing, dental sealants and fluoride supplements. Although a majority of respondents thought that regular dental checkups would be essential for prevention, the proportion who actually saw the dentist for preventive care was significantly lower. Respondents provided inappropriate reasons for brushing their teeth. Differences in both preventive knowledge and preventive dental behaviours among racial groups were evident although these were attributed to differences in education and exposure to product information rather than to racial or cultural factors.
Studies on the social and behavioral aspects of filariasis transmission were conducted in the transmigration area of Kumpeh, in the province of Jambi, Sumatra, Indonesia. Three methods were used in the study namely, interview, participation observation and focus group discussion. A total of 266 respondents (136 males and 130 females) were interviewed. The results of the study showed the most of the transmigrants were not familiar with the word "filariasis". They were more used to the name of "penyakit kaki gajah" or "elephant's leg" disease or "untut". The word "untut" is similar to what people of Selangor, Malaysia call this disease. The community attitude towards control efforts against filariasis was positive, as evidenced by their readiness in being bled and their readiness to help change the environment which serves as mosquito breeding places. Usually the transmigrants live in the "ladang" or dry farming area for 3-4 months to protect their crops from damages by pests. This habit was rather negative, because in their "ladangs" they exposed themselves to high risk of mosquito bites and thus to filariasis infection.
A cross-sectional survey of 568 married women aged 21-65 years in the Pasir Panjang Constituency was conducted to determine the prevalence of cervical cancer screening in the community and the factors affecting acceptance of this screening test. Results show that 309 (54.4%) of the respondents had ever had a Pap smear. The women who reported having had a smear were more likely to be below 45 years of age (prevalence ratio 1.47, 95% confidence interval 1.15 to 1.88), Chinese and of a higher socioeconomic status (1.68, 1.33 to 2.12). They were also more likely to have married at a later age (1.68, 1.21 to 2.31) than women who had not had a smear. Age and socioeconomic status remained independent predictors on multivariate analysis. The findings suggest that an important task of public health practitioners is to increase the uptake of screening among older and socially disadvantaged women who are known to be at the highest risk of cervical cancer. In addition, strategies to encourage younger women to continue regular attendance at screening clinics beyond their childbearing years will be important for the future.