Introduction Healthy dietary practice is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing the rate of diabetes complication development. It is, therefore, important at all levels of diabetes prevention. The objective of this study was to determine the association of dietary practice with glycaemic control among Type 2 diabetes mellitus (T2DM) patients, who received treatment from an urban Health Clinic in Kuala Lumpur.
Methods A total of 307 patients with T2DM aged 18 years and above participated in this study. A pre-tested structured questionnaire with guided interview was used to collect information on socio-demographic, clinical and dietary practice. Anthropometric and biological measurements were also taken. Descriptive statistics and Chi-square were used in the data analysis. Good glycaemic control was defined as HbA1c level less than 6.5%.
Results The prevalence of good glycaemic control was only 27% (n=83). The highest percentage of good glycaemic control were among male patients (29.1%), aged 60 and above (33.3%), educational level of primary school (35.4%) and those with monthly income group between RM1001 to RM1500 (32.0%). About three quarter of T2DM patient (n=224) had poor control of HbA1c (≥6.5%). Age (p=0.045) and working status (p=0.039) had significant relationship with the level of HbA1c. Dietary practice showed no significant relationship with the HbA1c level.
Conclusions Effective interventional health education strategies are needed, focussing on modification of dietary behaviour in order to achieve glycaemic control among diabetic patients.
Study site: Klinik Kesihatan, Kuala Lumpur, Malaysia
Introduction Community-based health promotion programme has been recognised to reduce modifiable lifestyle risk behaviours for non-communicable diseases. The aim of this study was to evaluate the proportion of the awareness, knowledge and acceptance of a community-based intervention programme, “Komuniti Sihat, Pembina Negara“ (KOSPEN) (Healthy Community, Developed Nation). This cross-sectional study employed a two-stage proportionate sampling method to select a representative sample of communities in the Southern states of Peninsular Malaysia, Negeri Sembilan, Malacca, and Johor. Face-to-face interviews by trained research assistants using pre-validated questionnaires was the study tool applied. The study revealed that approximately two thirds of respondents were aware of the KOSPEN programme (65.5%) and almost half (45.4%) of them were involved in the health promotion activities, namely health screenings (84.8%), health talks (66.4%), and providing plain water in formal occasion (52.9%). About two thirds and one-quarter of them have a very good (73.4%) and good (24.1%) general view on this programme. Four out of ten respondents faced difficulties joining the activities. Lack of time (83.0%) was reported as the main barrier. The KOSPEN programme in overall was moderately accepted by the community. However, the need for future improvement has to be highlighted in order to enhance the involvement and participation of the communities.
Iodine deficiency is still prevalent worldwide and it is the main cause of goiter, thyroid dysfunction and mental retardation. The aim of the study was to determine the iodine status and goiter prevalence among the school children in Terengganu. The representative sample consists of 1163 primary school children aged 8-10 years old randomly selected from urban and rural schools in Terengganu using stratified systematic random sampling technique. Urinary iodine levels in spot urine were determined by in house modified micro-method while goiter assessment was carried out by palpation of thyroid gland. The status of iodine deficiency was determined by the median urinary iodine concentrations (UIC) and total goiter prevalence (TGP) in accordance with the WHO criteria. The result showed the median [inter-quartile range (IQR)] urinary iodine concentrations was 78.7µg/L (50.1µg/L -120.0µg/L) indicating the iodine intake was slightly lower than recommended range of 100 µg/L. The rural school children had a significantly lower Iodine levels (median UIC=72.4µg/L, IQR=46.7µg/L -113.0µg/L) than the urban school children (median UIC=87.7µg/L, IQR=54.5 µg/L - 127.5µg/L). The total goiter prevalence (TGP) was 5.7%. The prevalence of goiter was significantly higher in rural (TGP=6.9%) compared to urban areas (TGP=3.6%). The study revealed that school children in Terengganu showed mild iodine deficiency and the condition is more pronounced in children from rural areas. The findings emphasize the importance of intervention implementation, universal salt iodization to ensure sufficient intake of iodine among the Terengganu school children.
Health care systems play a vital role in providing health services and in optimising the population’s health of each nation. The Malaysian health care system primarily consists of the public and private health services. One of the prominent private health care services offered in the General Practitioner’s (GP) Clinic. Despite the prominent role GPs play in the health care system in this country, little is known about their practices, the issues and challenges faced by GPs in this country. The objective of this study was to describe the current GP practice operations in Malaysia in terms of its general operations, financial expenditure and revenue, market competitiveness and laboratory services offered by the clinics.
Introduction It is well known that low back pain among working population is a global
problem throughout the world. However, the current situation of occupational
low back pain in Malaysia is still vague due to limited number of studies
conducted locally.
Objective A cross sectional study was conducted among three automotive industry
workers in Selangor, Malaysia from October 2010 to April 2011.
Methods This study aims to determine the prevalence and risk factors of low back pain
among automotive industry workers performing manual material handling
tasks using self-administered questionnaire survey.
Results A modified Standardised Nordic Questionnaire was used to assess low back
pain problem, to obtain personal and psychosocial risk factors information.
The prevalence of low back pain showed increment in the point prevalence of
57.9%, 49.5%, and 35.1 % for 12 months, one month, and of 7 days
respectively. Working hour, frequency of overtime, stress at work, work
pace, and faster movement were found to be significantly associated with the
12 months prevalence for low back pain.
Conclusions This finding indicates that psychosocial risk factors are associated to the
occurrence of low back pain.
Primary health care is an approach to health and a spectrum of services beyond the traditional health care system while primary care is just one element within PHC that focuses on health care services. The present status of PHC in Malaysia and the strides it has made in uplifting the health status of the nation is described. The challenges that the Malaysia health system are facing have necessitated a review of the structure of the whole health system and reforms in PHC will ensue in due course. The concept of 1Care, the proposed re-structuring of the health system, is discussed with emphasis on the reform in the PHC delivery system. The reforms are aimed at addressing three main concerns on seamless integration of care especially for the management of chronic diseases, ensuring universal coverage and responsiveness of the health system in the face of increasing client expectations and patient safety. The opportunity for macro reform to improve the health of Malaysians by developing a sustainable and high performing health care system is being seized by the Ministry of Health in 1Care. The micro reforms are discussed as regards to increasing access to services, development of primary health care teams to deliver comprehensive PHC, the application of ICT, the renewed emphasis on health promotion & prevention activities and a renewed focus on community empowerment and participation. Support in terms of human resource, governance & funding models, capacity building in monitoring & evaluation as well as change management to affect the reforms are identified. The paper concludes with lessons learnt from other countries and the importance of systemic reform for a well functioning health delivery system.
This study determines the association between osteoporosis knowledge, health belief and calcium intake behaviour among students in a medical sciences university.
Introduction Drug abuse has been a global threat not only in Malaysia but worldwide,
especially among adolescents. This is alarming issue had been a serious
public health problem worldwide. The aim of the study is to access the
knowledge and attitude on drug abuse among Pahang Matriculation students
in 2016.
Methods A cross¬-sectional study was conducted involving 217 matriculation
students. A self-determined questionnaire was distributed among the students
regarding knowledge and attitude about drugs.
Results The prevalence of good knowledge on drug abuse was (82.03%). The
prevalence of students’ attitude on drug abuse has higher number of good
attitude with the sum of 182 (83.9 %). Only gender showed a significant
association with students’ knowledge (P= 0.046).
Conclusion The knowledge, attitude, and practice of drug abuse among Pahang
Matriculation students are good.
Accepted 21 July 2011.
Introduction The extensive and intensive use of pesticides in agricultural practices has exposed farmers to various hazards resulting in varying degrees of health
outcomes.
Methods We conducted a cross-sectional study among paddy farmers in Sabak Bernam district, Malaysia. The objective of this study was to gather baseline information on chlorpyrifos blood level and its relationship with pesticides exposure symptoms.
Results We detected chlorpyrifos in farmers’ blood in 7 percent of the respondents, with mean 7.29 nanogram per millilitre blood (sd 5.84 nanogram per millilitre). The percentage of farmers who experienced at least one pesticide exposure symptoms was 75 percent. However, we found no significant association between chlorpyrifos blood level and its exposure symptoms. The farmers had low scores on safe practice of pesticide use even though they have high marks on knowledge and attitude. We found no significant association between the scores on knowledge, attitude and practice on pesticide use and the chlorpyrifos blood level.
Conclusions The presence of pesticide exposure symptoms proved that most of the farmers were exposed to hazardous effects of pesticides. Specific trainings on safe use and handling of pesticides should be given on regular basis to these farmers to ensure they are protected from hazardous effects of pesticides exposure.
Introduction An Analysis of a Survey Questionnaire on health care workers’ knowledge and practices regarding of infection control and complains them to apply universal precautions. Health care workers are at substantial risk of acquiring blood borne pathogen infections through exposure to blood or other products of patients. To assess of infection control among health care workers in Sana'a healthcare centers, Yemen.
Methods A cross-sectional study was conducted in the health center to assess knowledge and practices regarding of infection control among 237 health workers in Sana,a city. A structured self-administered questionnaires were used and data was analyzed using SPSS version 20 and the associations were tested with chi-square, with p-value of < 0.05.
Results The health care workers in public centers ware (51.1%) and (48.9%) of them works in private centers. One hundred and seventeen (49.4%) respondents had poor infection control knowledge, 113 (43.5%) had fair knowledge, and 17 (7.2%) had good knowledge. The knowledge was significantly associated with type of center (P < 0.018), such that the public center had the highest proportion with poor knowledge. And nurses and midwife having the highest proportion with fair knowledge of infection control. Eight (3.4%) respondents had a poor practice of universal precautions, 93 (39.2%) had fair practice, and 136 (57.4%) good practice. The practice was significantly associated with the profession, level of education and work experience (P < 0.001), (P < 0.006), (P < 0.001) respectively, and nurses and midwives as the profession with the highest proportion with good practice.
Conclusion We conclude that the practices and knowledge of universal precautions were low and that's need for intensive programmes to educate health care workers on various aspects of standard precautions and infection control programmes and policies.
Introduction Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. A physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. This paper presents some information regarding medical ethics, including the values and principles of ethical conduct. Later the requirements of consent form is presented to guide the researchers before conducting a study.
Introduction Pneumococcal disease causes considerable morbidity and mortality,
including among adults. Adult pneumococcal vaccines help to prevent these
burdens, yet, they are underutilized. Our objective is to systematically collect
and summarize the available evidence on the potential factors that lead to
pneumococcal vaccination acceptance among of adult community.
Methods A systematic literature search was conducted involving studies published
from January 1999 to December 2015. The studies were identified by
searching electronic resources (PubMed/MEDLINE and Pro Quest database)
and manual searches of references. The keywords “vaccine/ immunization”,
“uptake/ coverage”, “determinant/ factor”, and “Streptococcus pneumoniae/
pneumococcus/ pneumococcal” were used. Final studies result and data were
reviewed by two independent authors. Disagreement was resolved through
discussion and consensus.
Results A total of 171 studies were identified, only 17 studies were included in final
discussion with 10 domains identified in the paper. 7 studies (41%) had
reported that the provider domain, patients’ perception and
socio-demographic factor have had the most effect on the pneumococcal
vaccination acceptance rate. In addition, only 18% (3) of reviewed papers had
highlighted that socio-economic was a factor influenced the pneumococcal
vaccination acceptance while 24% (4 studies) were attributed to the comorbid
domains.
Conclusions Healthcare provider and patients’ perception about pneumococcal vaccination
for adult population are significant domains which influence the acceptance
towards vaccination. Strong recommendations from healthcare provider for
pneumococcal vaccination would be an important step to increase vaccination
acceptance among the population.
Introduction Strongyloides stercoralis is an intestinal helminth that infects humans
through contact with soil containing the larvae.
Methods A systematic search was performed for relevant titles, abstract and keywords
in database from Cochrane Library, PLOS One, PubMed and several other
sources in October 2017 based on PICO strategy. Out of 511 papers that were
evaluated for possible inclusion, final assessment for eligibility has yielded a
total of 17 papers to be included which were found suitable for analysis
covering period from 2012 till 2016.
Results A major challenge of giving an overview of prevalence data for S. stercoralis
lies in the low sensitivity of diagnostic method used which resulted in very
low prevalence in certain countries. Cambodia and Laos presented with high
prevalence ranging from 17.4% to 45.9% by using high sensitivity of
diagnostic methods. The current prevalence situation of S. stercoralis in
Southeast Asia still have wide gaps remains due to several reasons.
Conclusions The information we have today only scratches the surface which cannot truly
reflect the true burden of S. stercoralis in Southeast Asia The main risk factor
is personal hygiene practices especially amongst males.
Introduction Low bone mineral density is a significant problem in children with Thalassemia which may lead to increased risk for fragility fractures and suboptimal peak bone mass. This cross-sectional study was conducted to
determine the bone health status of Thalassemia children Universiti Kebangsaan Malaysia Medical Centre and Paediatrics Insititute Kuala Lumpur Hospital.
Methods A total of 81 respondents diagnosed with transfusion dependant beta Thalassemia (41 boys and 40 girls) aged between 7 to 19 years old completed the study. The data collected were demographic information, anthropometric measurements, dairy frequency questionnaires, dietary habits of the respondents and their parents, dietary intakes and bone densitometry using Ultrasound Bone Densitometer.
Results For Quantitative Ultrasound (QUS) parameters, T-score of 9.8% participants were lower than -1.0 and 30.9% of the participants had lower Speed of Sound (SOS) than healthy SOS. This study showed there was no difference in bone density by sex (p>0.05). The median bone density of boys was 1616.00 m/sec (IQR= 39.00) and girls’ was 1579.00 m/ sec (IQR= 116.00). SOS was not increased with age, height and weight; but girls’ Body Mass Index (BMI). Malay children had significantly higher SOS than non-Malay children.
Conclusions This study highlights a need of proper intervention for the high risk group to achieve optimal bone health.
Study site: inpatient or outpatient, Institut Pediatrik (Hospital Kuala Lumpur), Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Introduction More school children were referred for learning difficutly (LD), especially after the introduction of LINUS sccreening programme by Ministry of Education Malaysia.
Aims To study the clinical diagnosis and non-verbal ability of primary-one school children with LD after paediatric assessment, as well as associated behavioural issues and socio-economincal background.
Methods Assessment findings by Paediatricians and Naglieri Non-Verbal Ability Test®(NNAT®) results of all primary-one school children referred in year 2010 with LD were studied retrospectively.
Results Ninety-three children were included (62.4% male), and 72.0% of them failed the LINUS screening programme. The commonest diagnoses were Borderline Intellectual Disability (ID, 37.6%) and Mild ID (19.4%). Other diagnoses included Attention Deficit Hyperactive Disorder (ADHD, 11.8%), Specific Learning Disability (SLD, 10.8%), Autistic Spectrum Disorder (n = 5) and Severe Language Disorder (n = 3). Mean NNAT scores were 84.6 ± 11.8 (n = 85), of which 9.4% children scored less than 70 (
In July 2010 Universiti Kebangsaan Malaysia (UKM) and Niigata University (NU) signed a memorandum of agreement to continue collaboration in joint planning and implementation of education, research and practice services in the field of medicine.This collaboration is also a good opportunity for Doctor of Public Health (DRPH) postgraduate candidates to gain experience on the practice of public health in handling public health issues, planning the healthcare facilities, delivering a quality public health services, enforcing public health policies/regulations and finally learn about the health systems in general at other countries especially from developed country like Japan. Experiencing Health Care and Culture in Niigata, Japan.
Breastfeeding is almost universal, but there are many barriers for proper breast feeding practices. Inadequate knowledge, or inappropriate practice, of breastfeeding may lead to undesirable consequences. The aim of this study was to assess breastfeeding knowledge, and practice among mothers in Arma’a district Shabwah governorate and identify factors that may affect breastfeeding practice in the study population.
Introduction A study was conducted to determine the level of mothers' perception on children with cleft deformity and its associated factors
Methods This was a cross sectional study involving 110 mothers with children attending the Plastic And Reconstructive Surgery Clinic. Data was gathered from a face to face interview based on a questionnaire that assesses the level of perception and its associated factors. The level of perception was evaluated from a scoring method and divided into four domains namely psychosocial, care management, treatment and education.
Results The level of perception was high in all four domains ranged from 62% for treatment and 80% for education. Factors that were significantly associated with the level of perception were ethnicity, religion, type of cleft deformity and level of information.
Conclusions Information regarding cleft deformity must be tailored toward mothers’ personal characteristics and type of cleft deformity to improve mothers' perception on this problem.
Study site: Plastic And Reconstructive Surgery Clinic, Hospital Kuala Lumpur, Malaysia
Dengue fever is an illness by arthropod-borne viral disease that become known pandemic to the most tropical countries. In 2014, Malaysia reported 108 698 cases of dengue fever with 215 deaths which increased tremendously compared to 49 335 cases with 112 deaths in 2008 and 30 110 cases with 69 deaths in 2009. This study aimed to identify the best method in determining dengue outbreak threshold for Negeri Sembilan and hopefully these methods can be standardized as it can help to send uniform messages to inform the general public and make the outbreak analysis comparable within and between countries. Methodology : Using retrospective Negeri Sembilan country dataset from 1st epid week of 2011 till the 52nd epid week of 2016. The data were split into two periods: 1) a 3-year historic period (2011–2013), used to calibrate and parameterise the model, and a 1-year evaluation period (2014); 2) a 2-year historic period (2014–2016), used to calibrate and parameterise the model, and a 1-year evaluation period (2016), used to test the model. E-dengue is a registration system for confirm case dengue by Ministry of Health. Data include details of cases, district locality, records on the outbreak and epidemiological week (Sunday to Saturday). The variables were captured using the Excel spreadsheet. Analysis method included endemic channel method, moving average or deviation bar chart and recent mean. Result: Seremban as big district and facing with heavy dengue cases, all three methods (endemic curve, current mean and moving mean) showed promising results. Meanwhile comparing with small district of Port Dickson and Tampin with fewer dengue cases and outbreak recorded, the suitable method is by using endemic channel for epidemic threshold. Conclusion: Simpler methods such as the endemic channel, recent mean and moving mean may be more appropriate in urban district. Whereas in rural or district with minimal dengue cases, Endemic Channel would be the most suitable method for epidemic threshold. However, both methods require a consistent updated graph threshold as time progress.
Introduction Hepatitis C Virus (HCV) recently was identified as a major cause of post transfusion hepatitis world wide. To evaluate the role of blood transfusion on the prevalence of HCV infection, by testing antibody and RNA as well as the genotypes of HCV .Also to detect if Blood transfusion acts as unconfounding risk factor for HCV infection.
Methods Sera from 3491 pregnant women were investigated for the presence of HCV antibodies (anti-HCV) by using third generation enzyme immunoassay (EIA-3) as screening test, followed by immunoblot assay (Lia Tek-III). In addition 94 sera of studied women were subjected to molecular analysis (at laboratories of Sorin BioMedica - Italy) for the detection of viral RNA and genotypes of HCV. Using RT-PCR & DNA Enzyme immunoassay (DEIA) method.
Results Our study revealed, that seroprevalence rate of HCV specific Ab & RNA were significantly higher (16.32 %, 80% respectively) among women with a history of blood transfusion, compared to those (2.53%, 56.5%) with no such history P=0.0001, P=0.01. And there is a significant direct linear correlation between number of blood transfused and the seropositive rate of anti-HCV (r=0.7, p=0.046). Based on multivariate analysis, interestingly, this study confirmed that, blood transfusion significantly acting as unconfounding risk factor for acquiring HCV infection (Adjusted OR=1.938,95% C.I=1.646-2.28). And the risk of exposure is increases with increased number of blood transfused. Although, we found no significant association between, HCV genotypic distribution and history of blood transfusion. However, high proportion of women with a history of blood transfusion were harboring HCV genotype -4 or 1b, 50%,40%, resepctively.
Conclusions Our study shows, evidence that, blood transfusion acts as unconfounding risk factor for acquiring and in a mode of transmission of HCV infection. Therefore strict screening of blood donor for HCV-Abs and / or RNA is highly recommended.