Citation: National Health Morbidity Survey 1986. Kuala Lumpur: Ministry of Health, Malaysia, 1987
Study name: National Health and Morbidity Survey (NHMS-1986)
National Health and Morbidity Survey (NHMS) was first initiated in 1986. Its objectives were to supplement existing data on the pattern of health problems, health needs and expenditure on health in the community to enable the Ministry of Health to review priorities and activities of programmes, plan future allocation of resources and evaluate the impact of strategies.
The scopes covered in the survey were morbidity rates, health service utilizations and their barriers, health expenditure and their sources, immunization coverage, acute respiratory illness, hypertension, angina, smoking, diabetes, astma and injuries. The survey only focused in Peninsular Malaysia with response rate in different modules ranging from 92 to 100%. The survey was spearheaded by the Institute for Public Health (IPH) and partially supported by the World Health Organisation (WHO) Grant.
The scopes covered in this survey were load of illness, health seeking behaviour, health care consumption cost, health related behaviours (exercise, breast-feeding practices, pap-smear examination, breast examination, smoking, alcohol consumption, obesity, adolescent risky behaviour: smoking, alcohol consumption, drug abuse, sexual practices), specific health problems (hypertension, ischaemic heart disease, diabetes mellitus, medically diagnosed cancer, injury, physical impairments, astman and acuter respiratory inflections), and blood cholesterol level. The response rate at Living Quarters (LQ) level was 86.9%.
Mass drug administration via 3 modes of delivery reduced the incidence and prevalence rates and intensity of Brugia malayi infection in 3 rural villages in the Bengkoka Peninsula, Sabah, in 1982-1983. A dosage of 6 mg diethylcarbamazine citrate (DEC-C)/kg body weight was administered either daily or weekly (total of 6 doses, 36 mg/kg body weight), and impact on B. malayi cases were comparable in the 3 villages. A total of 384 people participated in the DEC-C regimens, and all pregnant women and children under 2 years were excluded from the study. Bekessy's method of estimation of incidence and recovery rates was applied to data on B. malayi microfilaremia before drug administration. Treatment with DEC-C by any of the 3 modes of delivery drastically reduced the number of episodes of patent microfilaremia, incidence and prevalence, and median microfilarial density. Reduction was sustained for at least 18 to 24 months after treatment.
A study has been conducted on 198 employees of a steel-mill industry. These participants were examined for mucosal lesions in the oral cavity and including the commissures and vermillion borders of the lips. The prevalences of 16 types of lesions are reported.
The problem of diabetes is large unknown due to lack of good epidemiological studies. The author's own studies showed a prevalence rate, in the Malays, of less than 1.0% in remote rural areas, 3.9% in a village close to Kuala Lumpur, and 3.0% for Malays working in a railway yard in Kuala Lumpur. The prevalence rate for the Chinese was 4.9% in the same survey, and for the Indian it was 16.0%. A survey in GHKL showed that 17.9% of the patients admitted for a month period in 1986 were due to diabetes and its complications. Majority of diabetes in Malaysia are non-insulin-dependent type.
The prevalence of coinfection, superinfection and chronic infection with the hepatitis delta virus (HDV) was studied in 324 hepatitis B surface antigen (HBsAg)-positive Malaysians. Of these, 10.0% (5/50) had coinfection, 5.7% (11/194) had superinfection, but none of the 80 patients with chronic liver disease (CLD) or primary hepatocellular carcinoma (PHC) had chronic infection with HDV. The overall HDV infection was 4.9% (16/324). One of the coinfection cases acquired the HDV infection as early as 1982. HDV superinfection was detected mainly among IV drug abusers (20% or 7/35) and promiscuous males and females (13.6% or 3/22). They were all asymptomatic. Only 0.8% (1/125) apparently healthy blood donors was infected with HDV. None of the 12 multi-transfused patients examined were positive. Malaysia is the only Southeast Asian country examined so far in which HDV infection was detected. The reason could be that the IV drug abusers and the sexually promiscuous groups missed being examined in the other countries. Comparing the HDV infection rates in 4 categories of infected Malaysians (viz. acute hepatitis B patients, IV drug abusers, blood donors and CLD patients) with those of other countries, it was noted that the Malaysian rates were similar to the lowest in the range of prevalence rates of each category in the latter group. The rate of coinfection in a preliminary study in 1982-84 (9.0% or 1/11) was not very different from that obtained to date (10.0% or 5/50).(ABSTRACT TRUNCATED AT 250 WORDS)
A preliminary survey on sixty-nine 7 to 12 year old Temuan tribe school children living some 30 kilometers from Kuala Lumpur was conducted. The examinations were carried out using a chair-table set up with natural daylight as the source of light. The DMF index of klein, Palmer and Knutson was used to assess the dental caries status. In spite of low fluoride content in their water supply, the findings revealed a generally low prevalence of caries experience (DMFT 1.26). The highest DMFT was in the 11 year olds. The relationship between these findings and their possible causes are discussed.
The prevalence and symmetrical distribution of enamel defects were studied in 218 Malaysian school children aged 11-12 years old. The tooth prevalence of enamel defect was 40.3 per cent. The first permanent molars were the most severely affected, whereas the lower incisors were the least severely affected. Overall there was no sex difference. Distribution of symmetry was assessed between the right and left tooth pairs as well as for upper and lower teeth. A higher proportion of symmetry was observed for the right and left tooth pairs and the lingual surfaces showed a greater percentage of bilateral distribution.
A study based on the WHO model of community-based rehabilitation in Guangzhou City, China, is described. Preliminary epidemiological data are reported, and compared with analogous data from Korea, Vietnam, Malaysia, Mexico, Indonesia, and Pakistan. Confidence levels for estimates of the prevalence of limb dysfunction, visual dysfunction, hearing and/or speech dysfunction, and mental retardation are also reported.
An investigation of the prevalence and distribution of hypodontia was carried out in Malaysian children between the ages of five to fifteen years. Hypodontia occurred in 2.8 per cent of these children. A greater number of females were found to have hypodontia, the ratio of affected females to males is 1.6:1. The teeth most frequently missing were the maxillary lateral incisors followed by the mandibular lateral incisors, then the mandibular second premolars. The aetiology of the condition is discussed. It is noteworthy that studies showing the lower second premolars to be most commonly missing have younger subjects. This suggests delayed development of these teeth in some individuals.
A total of 2,153 high vaginal swabs were processed for the presence of yeasts. The specimens were obtained from pregnant and non-pregnant Malaysian women with and without vaginitis. The yeast species most commonly isolated were Candida albicans, C. glabrata, C. famata and C. parapsilosis. C. albicans was isolated from 27% of pregnant women with vaginitis, 14% of pregnant women with no overt vaginitis, 15% of non-pregnant women with vaginitis, and 3% of non-pregnant women with no vaginitis. The significant difference of the isolation rates from women with and without vaginitis indicates that C. albicans is likely to be a vaginal pathogen.
PIP: Previous studies have shown the users of intrauterine devices have a 4.4 times greater risk of pelvic inflammatory disease. This present study intends to categorize the distribution of microbes in cultures from different types of extracted copper intrauterine devices (IUCDs). Bacteriological studies of aerobic and anaerobic organisms were performed on the extracted IUCDs of 522 IUCD users; 480 wearing a Multiload Cu 250, 15 wearing a Copper T, 22 Lippes Loop and 5 a Copper 7. Cultures were negative in 46 (8.8%) IUCD cultures where 43 were Multiloads, Copper T (1) and Lippes Loop (2). 91.2% yielded bacterial growth and the commonest organisms isolated were Staphylococcus species, (23%), E.coli (9.6%) and Staphylococcus aureus (4.0%. Candida albicans, E.coli and Staphylococcus sp. were commonly isolated from Multiload, Copper T, Lippes Loop and Copper 7. Beta-hemolytic streptococci, Staphylococcus aureus and Candida sp. were frequently recovered from Multiload, Copper T and Lippes Loop. Only Multiload cultures yielded Bacillus, Streptococcus viridans, Klebsiella, Proteus, Enterobacter, Citrobacter diversus, Citrobacter freundii, Moraxella, Pseudomonas and Acinetobacter. One woman with complaint of PID yielded E.coli in her IUCD culture.
A serosurvey of rubella antibody among nursing personnel was carried out. 452 blood samples were received from a total staff of 829. 65% was found to be immune by the radial haemolysis method. The highest immune rate was in the intensive care unit followed by maternity, paediatric and gynaecology wards. The lowest rate was in the ophthalmology ward. This study shows that there is lack of compliance among medical personnel and the high immune rate is compatible with the occupational risk of contact with rubella.
A survey was done to determine the prevalence of diabetes mellitus, hypertension and renal disease, as well as extent of diabetic control, amongst the workers of Malaysian Railways. The prevalence of diabetes was high at 6.6%, with 3.8% of these being insulin dependent diabetes. The highest prevalence was in Indians (16.0%) followed by Chinese (4.9%) and Malays (3.0%). Using HbA1 measurements, diabetic control was poor in 70.6% of the diabetics. Hypertension was found in 37% and proteinuria in 35%. Renal impairment was present in 30% of the diabetics. This survey shows that diabetes, hypertension and renal disease are high amongst the railway workers in Malaysia.
At the Faculties of Dentistry in Chiang Mai, Thailand (CM), and Kuala Lumpur, Malaysia (KL), 234 and 233 consecutive out-patients of mean ages 33.8 and 31.0 yr, respectively, were examined for the presence of oral mucosal lesions. Tobacco in some form was regularly used by 31.7% and 27.5% of the study populations in CM and KL, respectively. Cigarette smoking was the predominant habit. In CM three persons chewed betel quids and nine smoked banana leaf cigars daily. In addition, there were 24 habitual chewers of tea leaves (miang). In KL six persons chewed betel quids daily. In CM and KL three cases each (1.3%) of tobacco-associated leukoplakias were found. In KL an additional idiopathic leukoplakia was registered. One and three cases of betel related lesions were found in CM and KL, respectively. One case of a squamous cell carcinoma was found in a 45-yr-old Indian woman in KL who had been chewing betel with tobacco daily for many years. High prevalence figures were found for lichen planus, 3.8% in CM and 2.1% in KL, and an extremely high one, 48.3%, in CM for episodes of aphthous ulcers experienced during the last 2 yr. Comparatively low prevalence figures were found for herpes labialis. As could be expected melanin pigmentation was prevalent while only low figures were encountered for denture-related lesions and amalgam tattoos.
Over a 15-month period, 399 patients with dyspepsia were investigated for the presence of Campylobacter pylori infection. Half of the patients (50.6%) had Campylobacter organisms in the antrum of the stomach. C. pylori was found in 96.1% of patients with histological changes of chronic active gastritis in the antrum. Of patients with duodenal and gastric ulcers, 87.8% and 87.5%, respectively, had Campylobacter organisms, as did 39.3% of patients with non-ulcer dyspepsia. C. pylori infection was most commonly found in Chinese and Indians. Although the prevalence of infection appeared to increase with age, there was an equal distribution amongst the sexes.