CASES: In Malaysia, until end of February 2020, there were four COVID-19 paediatric cases with ages ranging from 20 months to 11 years. All four cases were likely to have contracted the virus in China. The children had no symptoms or mild flu-like illness. The cases were managed symptomatically. None required antiviral therapy.
DISCUSSION: There were 2 major issues regarding the care of infected children. Firstly, the quarantine of an infected child with a parent who tested negative was an ethical dilemma. Secondly, oropharyngeal and nasal swabs in children were at risk of false negative results. These issues have implications for infection control. Consequently, there is a need for clearer guidelines for child quarantine and testing methods in the management of COVID-19 in children.
METHODS: Specimens were further studied with universal and species-specific CoV and CCoV 1-step RT-PCR assays, and viral isolation was performed in A72 canine cells. Complete genome sequencing was conducted using the Sanger method.
RESULTS: Two of 8 specimens contained sufficient amounts of CCoVs as confirmed by less-sensitive single-step RT-PCR assays, and 1 specimen demonstrated cytopathic effects in A72 cells. Complete genome sequencing of the virus causing cytopathic effects identified it as a novel canine-feline recombinant alphacoronavirus (genotype II) that we named CCoV-human pneumonia (HuPn)-2018. Most of the CCoV-HuPn-2018 genome is more closely related to a CCoV TN-449, while its S gene shared significantly higher sequence identity with CCoV-UCD-1 (S1 domain) and a feline CoV WSU 79-1683 (S2 domain). CCoV-HuPn-2018 is unique for a 36-nucleotide (12-amino acid) deletion in the N protein and the presence of full-length and truncated 7b nonstructural protein, which may have clinical relevance.
CONCLUSIONS: This is the first report of a novel canine-feline recombinant alphacoronavirus isolated from a human patient with pneumonia. If confirmed as a pathogen, it may represent the eighth unique coronavirus known to cause disease in humans. Our findings underscore the public health threat of animal CoVs and a need to conduct better surveillance for them.
MATERIALS AND METHODS: A cross-sectional study through a purposive sampling method was employed, involving 142 caregivers of CWD at the selected CBR centre. Four CBR centres were selected in this study, which were located in the Kudat division of Sabah. The Malay version of the Modified Caregiver Strain Index Questionnaire (M-CSI-M) was used in this study to obtain information about the caregiver's strain.
RESULTS: Findings from this study revealed that most caregivers experienced moderate strain (72.5%). Some of the leading causes of their strain were upsetting CWD's behaviour (10.6%), financial strain (9.2%), and overwhelmed (9.2%). In addition, there were significant differences between caregiver strain and their level of education, income, and the types of their child's disabilities (p ≤ 0.05).
CONCLUSION: The well-being of the caregivers may significantly impact the effectiveness of rehabilitation for CWD, as caregivers are vital interdisciplinary team members.
RESULTS: We analyzed 1451 extant genomes, 189 AAs from India and Malaysia, and 43 ancient genomes from S&SEA. Population structure analysis reveals neither language nor geography appropriately correlates with genetic diversity. The inconsistency between "language and genetics" or "geography and genetics" can largely be attributed to ancient admixture with East Asian populations. We estimated a pre-Neolithic origin of AA language speakers, with shared ancestry between Indian and Malaysian populations until about 470 generations ago, contesting the existing model of Neolithic expansion of the AA culture. We observed a spatio-temporal transition in the genetic ancestry of SEA with genetic contribution from East Asia significantly increasing in the post-Neolithic period.
CONCLUSION: Our study shows that contrary to assumptions in many previous studies and despite having linguistic commonality, Indian AAs have a distinct genomic structure compared to Malaysian AAs. This linguistic-genetic discordance is reflective of the complex history of population migration and admixture shaping the genomic landscape of S&SEA. We postulate that pre-Neolithic ancestors of today's AAs were widespread in S&SEA, and the fragmentation and dissipation of the population have largely been a resultant of multiple migrations of East Asian farmers during the Neolithic period. It also highlights the resilience of AAs in continuing to speak their language in spite of checkered population distribution and possible dominance from other linguistic groups.
METHODS: A total of 152 respondents filled in a 76-item questionnaire based on the Health Belief Model. Articles on colorectal cancer in three English newspapers in Malaysia from 1 January to 30 June 2022 were analysed.
RESULT: A majority of the Malaysian respondents had low experiential knowledge of colorectal cancer, high perceived severity, low perceived susceptibility, and low to moderate susceptibility based on self-reported lifestyle and health conditions. The diet factor puts a majority of respondents at risk but smoking, alcohol drinking, and large intestine problems are risk factors for less than 10% of the group. The respondents believed in the benefits of seeking treatment but they were only marginally positive as to whether quitting smoking and losing weight could reduce colorectal cancer risk. They reported strong response efficacy and self-efficacy but the top barriers were lack of knowledge and cost. The strongest cue to action for their health protective intentions was news about colorectal cancer in newspapers, magazines, television and youtube. There were positive moderate correlations among perceived severity, benefits, response efficacy, self-efficacy, cues to action, and intention. Little salience was given to colorectal cancer in the three English newspapers based on the number of articles (N=10). The high frequency of information on severity, susceptibility, and benefits of lifestyle changes and screening in the newspaper articles are reflected in questionnaire results on better knowledge. Lack of information and cost prevented respondents from seeking screening or treatment, despite attempts by the newspaper articles to address barriers.
CONCLUSION: The study suggests a need to heighten cues to action in the mass media and social media by providing information on cost and practical details of colorectal cancer screening and benefits of diet-related risk factors.
METHODS: We conducted in-depth virtual interviews with pregnant women between February and April 2022. The interviews were recorded and transcribed, and data were analyzed by content analysis.
RESULTS: The majority of the participants demonstrated a commendable level of awareness regarding the signs and symptoms associated with ZIKV infection. They also exhibited a clear understanding of preventive measures, particularly emphasizing the importance of avoiding mosquito bites to minimize the risk of ZIKV transmission. However, a noteworthy gap in knowledge surfaced as a subset of participants remained uninformed about the potential for sexual transmission of ZIKV, which could lead to congenital ZIKV in pregnant women. Even among women who were cognizant of ZIKV and its potential negative health outcomes, associated with the infection, many of them did not perceive themselves to be at risk, mainly because ZIKV infection is infrequently discussed or heard of, leading to a sense of infections' rarity. While the adoption of preventive measures such as mosquito bite prevention during pregnancy was a common practice, however, prevention of sexually transmitted infections (STIs) including mosquito-borne diseases such as Zika is low. A minority of women express concerns about the sensitivity surrounding discussions and prevention of STIs within the context of marriage. Most of the participants were supportive of the provision of awareness of ZIKV infection in women during pregnancy and the involvement of men, especially in initiatives aimed at preventing transmission through sexual contact.
CONCLUSION: This study uncovered gaps in both knowledge and practices pertaining ZIKV infection among pregnant women in the aftermath of the ZIKV pandemic. The insights gleaned from our research are valuable for shaping future interventions geared towards preventing the resurgence or facilitating the sustainable eradication of ZIKV.
METHODS: A cross-sectional online survey was conducted from May to August 2022 with health practitioners commonly involved in obesity management in Peninsular Malaysia, including doctors in primary care, internal medicine and bariatric surgery, and allied health practitioners. The survey explored practitioners' perceptions, barriers and needs in managing obesity, and evaluated weight stigma using the Universal Measures of Bias - Fat (UMB Fat) questionnaire. Multiple linear regression analysis was used to identify demographic and clinical-related factors associated with higher negative judgment towards patients with obesity.
RESULTS: A total of 209 participants completed the survey (completion rate of 55.4%). The majority (n = 196, 94.3%) agreed that obesity is a chronic disease, perceived a responsibility to provide care (n = 176, 84.2%) and were motivated to help patients to lose weight (n = 160, 76.6%). However, only 22% (n = 46) thought their patients were motivated to lose weight. The most frequently reported barriers to obesity discussions were short consultation time, patients' lack of motivation, and having other, more important, concerns to discuss. Practitioners needed support with access to multi-disciplinary care, advanced obesity training, financing, comprehensive obesity management guidelines and access to obesity medications. The mean (SD) of the UMB Fat summary score was 2.99 (0.87), with the mean (SD) domain scores ranging between 2.21 and 4.36 (1.06 to 1.45). No demographic and clinical-related factors were significantly associated with negative judgment from the multiple linear regression analyses.
CONCLUSION: Practitioners in this study considered obesity a chronic disease. While they had the motivation and capacity to engage in obesity management, physical and social opportunities were the reasons for not discussing obesity with their patients. Practitioners needed more support to enhance their capability and opportunity to engage with obesity management. Weight stigma in healthcare settings in Malaysia should be addressed, given the possibility of hindering weight discussions with patients.
METHODS: Using a cross-sectional survey that was conducted online, a convenience sample of 319 Malaysians aged 18-30years (M =23.05, s.d.=2.55) reported their attitudes and behaviours related to pornography consumption, including the degree of problematic consumption, and completed measures of sexual health. These included sexual satisfaction, awareness of sexual feelings, sexual self-reflection, sexual assertiveness, embarrassment during partnered sex, and genital image. To capture pornography genre preferences, participants also reported the keywords that they typically use to search for pornography. These open-ended responses were thematically coded.
RESULTS: Between 60 and 70% of participants reported positive attitudes toward pornography and 81.2% (N =259) reported lifetime intentional exposure to pornography. Gender differences were present in pornography consumption attitudes, motivations, preferences, and behaviours. Problematic pornography consumption, and not consumption frequency, was associated with poorer sexual satisfaction. Among women and not men, more frequent consumption was associated with more sexual self-reflection and positive feelings about their genitals. Sexual embarrassment was higher among women who consume pornography more problematically and among men who consumed pornography more frequently.
CONCLUSIONS: Pornography consumption attitudes and behaviours appear rather universal. However, the benefits of pornography consumption frequency and disadvantages associated with problematic consumption appear to be more relevant for women's than men's sexual health, specifically sexual self-reflection, genital image, and sexual embarrassment.
METHODOLOGY: Using the newly developed PID Life Index software, the index of implementation of principles of care in the management of PIDs patients involving the six participating SEA countries (Cambodia, Indonesia, Malaysia, Vietnam, Thailand, and Philippines) were extracted. For each of the six separate principles, the index from the six countries will be compared and presented based on the calculated index.
RESULTS: Comparative analysis of the six principles of care of PID in the SEA countries showed low diagnostic rate with minimal availability of diagnostic tests options. Generally, almost all SEA countries provide curative treatments, vaccines, and anti-infectious therapies although the reimbursement scheme varied in relieving patients' financial burden. We also highlighted the active involvement of patient organizations in SEA, with main areas of work focused on advocacy and increasing awareness among public and healthcare professionals.
DISCUSSION AND CONCLUSION: It is applaudable that the SEA continent is gradually strengthening its work in management of PID, especially in Thailand and Vietnam. However, more emphasis must be placed among stakeholders in SEA countries towards successful implementation of the PoC for a holistic management of PID patients.
MATERIALS AND METHODS: A cross-sectional study was conducted in Luyang Health Clinic from 1st June 2020 to 3rd September 2020. A self-interviewed questionnaire comprises of three sections; sociodemographic, Wake Forest Physician Trust Scale (WFS) and Adherence to Refills and Medications Scale (ARMS) was completed by 281 respondents. Glycaemic control is based on the latest Hba1c profile of the respondents. Descriptive and nonparametric bivariate analysis were performed using IBM SPSS version 26.
RESULTS: The median (IQR) level of trust in physician was 43(8) out of a possible score range of 10 to 50. Trust in physician was correlated with treatment adherence (r=-0.12, p=0.048). There was no significant association between trust in physician with sociodemographic factors, which include age (p=0.33), gender (p=0.46), ethnicity (p=0.70), education level (p=0.50), and household income (p=0.37). Similarly, there was no significant association between the level of trust in physician with glycaemic control (p=0.709).
CONCLUSION: In conclusion, trust in physician was associated with treatment adherence but not with glycaemic control. In our local context, the glycaemic control could be due to other factors. Further studies should include a multicentre population to assess other potential factors that could contribute to glycaemic control.