METHODOLOGY: A total of nine focus group discussions with 56 farmworkers across eight animal farms in Peninsular Malaysia were conducted between August and October 2013.
RESULTS: Farmworkers explained their experience of tick bites, but no one reported TBDs. Many farmworkers indicated that they did not seek any medical treatment. There was a misconception that ticks are solely pathogenic to farm animals. Farmworkers perceived low severity and susceptibility of tick bites, and low self-efficacy of tick bite prevention, however, a group also perceived susceptibility to getting tick bites due to the characteristics of their job. Barriers for prevention were related to the perception and knowledge towards ticks. Farmworkers requested information about TBDs.
CONCLUSIONS: This study of farmworkers identified gaps in the knowledge of TBDs, barriers of the tick bite preventive measures and information needs. These findings suggest a need for education programs to improve the knowledge of ticks and TBDs, change health beliefs and address the barriers of tick bite preventive measures.
METHODOLOGY: A descriptive study was conducted to describe the epidemiological characteristics of the outbreak. Data on demographic details, onset of abdominal symptoms, food intake history and contact with ill person three days prior to illness were obtained.
RESULTS: Twelve fresh stool and 14 food samples were tested for NoV and enteric pathogens, respectively. Out of 745 students, 42 (5.6%) were infected during this outbreak. Predominant clinical features were diarrhea (76.1%), vomiting (71.4%) and abdominal pain (67%). Eight (67%) stool samples and six (43.9%)food samples were positive for NoV and total coliforms, respectively. The dissemination of the disease was due to poor hygiene practices among students. Quarantine was imposed until the last case on September 28, 2016. The outbreak was declared over on September 30, 2016.
CONCLUSIONS: A NoV outbreak was determined first time in Malaysia. Environmental assessment showed poor hygienic conditions in the school's kitchen. The number of infected students increased considerably despite the implementation of preventive and control measures. Quarantine was effective to stop the outbreak which is characteristics of NoV outbreak.
METHODOLOGY: A total of 16 OA villages distributed across 8 states in Peninsular Malaysia participated in this study. Sera obtained from 904 OA volunteers were screened for anti-B. burgdorferi IgG antibodies. ELISA results obtained and demographic information collected were analysed to identify possible variables associated with seroprevalence.
RESULTS: A total of 73 (8.1%) OA tested positive for anti-B. burgdorferi IgG antibodies. Among all the variables examined, village of residence (p = 0.045) was the only significant predictor for seropositivity. High (> 10.0%) prevalence was associated with three OA villages. Those living in one particular village were 1.65 times more likely to be seropositive as compared to other OA villages. Age, gender, marital status, household size, level of education, monthly household income and occupation were not significant predictors for seropositivity.
CONCLUSION: Results of the present study support earlier findings that B. burgdorferi infection among Malaysians is currently under-recognized. Further studies will be needed at these locations to confirm the presence of Lyme disease among these populations.
METHODOLOGY: We conducted a cross-sectional study using a validated self-administered questionnaire among tuberculosis patients attending primary care clinics in Johor Bahru district. A total of 208 tuberculosis patients were enrolled in this study through convenience sampling. We assessed the general knowledge, transmission, causes, and prevention of tuberculosis, where higher scores indicated better knowledge. For the perception of treatment, a higher mean score indicated a more negative perception.
RESULTS: The mean score for knowledge on tuberculosis was 54.33 ± 12.78, ranging from 25 to 88.9%. The mean score for perception was 2.75±0.52, ranging from 2.15-3.39. We found that although 88.9% of respondents knew a person could be infected with TB through inhalation of tuberculosis bacilli, a majority believed that smoking (68.2%), sharing food (69.2%), and eating from the same plate (66.8%) are causes of tuberculosis. Moreover, there was still a negative perception regarding the treatment of tuberculosis with the highest mean score for the statement 'I am afraid if I am told I am tuberculosis positive'.
CONCLUSIONS: We found that there were gaps in knowledge among tuberculosis patients. Intermittent counseling during the treatment re-enforces the knowledge of tuberculosis. An updated standardized counseling sheet of tuberculosis Health Education should be included along with staff training to update their knowledge as part of their important role in health education in tuberculosis prevention.
METHODOLOGY: A total of 571 healthcare workers at COVID-19 and non-COVID-19 wards as well as the emergency department and laboratory staff at COVID-19 testing labs were recruited. The presence of novel human coronavirus (SARS-CoV-2) and IgM/IgG antibodies were confirmed in all healthcare workers. The healthcare workers responded to an online Google Forms questionnaire that evaluates demographic information and comorbidities, exposure and adherence to infection prevention and control measures against COVID-19. Descriptive analysis was performed using Statistical Package for the Social Sciences 24.0.
RESULTS: Three healthcare workers (0.5%) tested positive for SARS-CoV-2, while the remaining 568 (99.5%) were negative. All were negative for IgM and IgG antibodies during recruitment (day 1) and follow-up (day 15). More than 90% of the healthcare workers followed infection prevention and control practices recommendations regardless of whether they have been exposed to occupational risk for COVID-19.
CONCLUSIONS: The healthcare workers' high level of adherence to infection prevention practices at this hospital helped reduce and minimize their occupational exposure to COVID-19.
METHODOLOGY: A cross-sectional study involving 149 healthy adult volunteers from Tanjung Sepat was performed soon after the outbreak had subsided. All the participants donated blood samples and completed the questionnaires. Laboratory detection of anti-CHIKV IgM and IgG antibodies was performed using enzyme-linked immunoassays (ELISA). Risk factors associated with chikungunya seropositivity were determined using logistic regression.
RESULTS: The majority (72.5%, n = 108) of the study participants tested positive for CHIKV antibodies. Only 8.3% (n = 9) of the participants out of all the seropositive volunteers had an asymptomatic infection. Participants who resided with a febrile (p < 0.05, Exp(B) = 2.2, confidence interval [CI] 1.3-3.6) or a CHIKV-diagnosed person (p < 0.05, Exp(B) = 2.1, CI 1.2-3.6) in the same household were found likely to be tested positive for CHIKV antibodies.
CONCLUSIONS: Findings from the study support that asymptomatic CHIKV infections and indoor transmission occurred during the outbreak. Hence, widespread community testing and indoor use of mosquito repellent are among the possible measures that can be implemented to reduce CHIKV transmission during an outbreak.
METHODOLOGY: A systematic literature search was conducted on PubMed, Cochrane library, World Health Organization database-Index Medicus for South-East Asia Region (WHO-IMSEAR), and Google Scholar databases. The search period was from 1st January 1990 until 12th May 2022. The prevalence of HAIs and subgroups were calculated using MetaXL software.
RESULTS: The database search retrieved 3879 non-duplicate articles. After applying exclusion criteria, 31 articles with a total number of 47666 subjects were included and a total of 7658 cases of HAIs were recorded. The overall prevalence of HAIs in Southeast Asia was 21.6 % (95% CI: 15.5 - 29.1%) with heterogeneity statistics of I2 = 100%. Indonesia had the highest prevalence rate of 30.4% whereas Singapore had the lowest prevalence rate at 8.4%.
CONCLUSIONS: This study revealed that the overall prevalence of HAIs was relatively high and the prevalence rate of each country was associated with socioeconomic status. Measures should be taken to examine and control the rates of HAIs in countries with high HAI prevalence.
METHODOLOGY: A prospective hospital-wide point prevalence survey was carried out by a multidisciplinary team in April 2019 at the University Malaya Medical Centre (UMMC) and the Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia. Data was collected from the patient's electronic medical records and recorded using the Hospital National Antimicrobial Prescribing Survey toolkit developed by the National Centre for Antimicrobial Stewardship, Australia.
RESULTS: The appropriateness of prescriptions was 60.1% (UMMC) and 67% (HCTM), with no significant difference between the two hospitals. Compliance with guidelines was 60.0% (UMMC) and 61.5% (HCTM). Amoxicillin-clavulanic acid was the most commonly prescribed antimicrobial (UMMC = 16.9%; HCTM = 11.9%).
CONCLUSIONS: The appropriateness of antimicrobial prescribing in medical wards, compliance with guidelines, and prescribing patterns were similar between the two hospitals in Malaysia. The survey identified several areas of prescribing that would need targeted AMS interventions.
METHODOLOGY: A retrospective cross-sectional study was employed to identify patients with positive AR bacteria between March 2019 and March 2022. The bacterial isolates and patients' data were identified from laboratory and medical records departments retrospectively. Binary logistic regression analysis was performed to identify the factors associated with AR and deaths. Multinominal logistic regression was applied to confirm the factors associated with AR classification.
RESULTS: AR Gram-negative bacteria decreased during and after the pandemic. However, S. aureus showed a negligible increase in resistance rate after pandemic, while E. faecium, recorded a higher-than-average resistance rate during the pandemic. The prevalence of pan drug resistance (PDR) during the pandemic (85.7%) was higher than before (0%) and after (14.3%), p = 0.001. The length of stay and time were significant predictors for AR classification. The odds of multi drug resistance (MDR) development to PDR during the pandemic were 6 times higher than before and after (OR = 6.133, CI =, p = 0.020). Age, nationality, COVID-19 infection, smoking, liver disease, and type and number of bacteria were associated with death of patients with positive AR.
CONCLUSIONS: Further studies are recommended to explore the prevalence of PDR and to justify the increased rates of E. faecium AR during the COVID-19 pandemic.
METHODOLOGY: The Hexarotor Agro Drone (Polardrone Sdn Bhd, Malaysia) was used to carry out larviciding using Vectobac® manufactured by Valent BioSciences LLC, Libertyville, USA. The drone flew at a height of 10 feet and at a speed of 5 m/s. A total of 32 items with 10 larvae in each item were placed to test the effectiveness of larviciding using UAV.
RESULTS: Out of 32 items used, 4 containers had a 100% larva mortality (13.3% mortality). The drone was not able to reach the designated spraying route that had been pre-programmed. This was due to interference with the electromagnetic waves emitted from the home satellite dishes, that were in front of the houses along the route.
CONCLUSIONS: This trial showed that UAVs will be more suitable for use in larviciding in an open area without electromagnetic disturbances from electric house poles and satellite TV dishes that are commonly present in urban areas.
METHODOLOGY: A single-center cohort study was performed at Indus Hospital and Health Network, Karachi, Pakistan, between April 1, 2021, and October 31, 2021. This study included 333 hospitalized hypertensive COVID-19 patients and evaluated their clinical characteristics and survival outcomes. A multivariate logistic regression model was applied in IBM SPSS 27.0 to determine the predictors of mortality.
RESULTS: The majority of patients were females (54.7%), the median age was 62 [55-70] years, with co-existing diabetes (56.5%) and severely ill (52.6%). The independent predictors of mortality identified were age ≥ 65 years (aOR 20.89, 95% CI, 5.81-75.15; p < 0.001), pulse rate (aOR 1.03, 95% CI 1.01-1.63; p = 0.006), serum creatinine (aOR 1.34, 95% CI 1.11-1.63; p = 0.002), use of antibiotics (aOR 3.40, 95% CI 1.29-8.98; p = 0.014)), corticosteroid (aOR 49.68, 95% CI 1.83-1350.31; p = 0.020), and who needed high flow oxygen supply (aOR 13.08, 95% CI 1.70-100.54; p < 0.001), non-invasive mechanical ventilation (aOR 229.01, 95% CI 29.30-1789.71; p < 0.001) and invasive mechanical ventilation (aOR 379.54, 95% CI 36.60-3935.87; p < 0.001).
CONCLUSIONS: Our study suggests that older age, elevated pulse rate, serum creatinine, use of antibiotics and corticosteroids, and the need for mechanical ventilation predict mortality among hypertensive COVID-19.
METHODOLOGY: Records of patients diagnosed with tuberculosis from 1st January 2018 to 30th September 2019 were retrieved. Sociodemographic and clinical data were extracted. Treatment outcomes and all-cause mortality were recorded at 1 year after diagnosis. Univariate, multivariate, and stepwise regression were used to determine the factors associated with all-cause mortality.
RESULTS: Four-hundred and seventy-one patients were reviewed. The mean age was 46.6 ± 19.7 years. The all-cause mortality rate at one year of diagnosis was 15.3%. Factors identified were age [aOR 1.026 (95% CI: 1.004-1.049)], chronic kidney disease [aOR 3.269 (1.508-7.088)], HIV positive status [aOR 4.743 (1.505-14.953)], active cancer [aOR 5.758 (1.605-20.652)], liver disease [aOR 6.220 (1.028-37.621)], and moderate to advanced chest X-ray findings [aOR 3.851 (1.033-14.354)].
CONCLUSIONS: On average, one in seven patients diagnosed with TB died within a year in a Malaysian tertiary hospital. Identification of this vulnerable group using the associated factors found in this study may help to reduce the risk of mortality through early intervention strategies.
METHODOLOGY: A mutlinational study was conducted from April-June 2020 involving researchers from 12 countries (Japan, Austria, U.S., Taiwan, India, Sudan, Indonesia, Malaysia, Philippines, Myanmar, Vietnam and Thailand). Steps in this research consisted of carrying out open-ended questionnaires, qualitative analyses in NVivo, and a multinational meeting to reflect, exchange, and validate results. Lastly, a commuinty response model was synthesized from multinational experiences.
RESULTS: Effective communication is key in promoting collective action for preventing virus transmission. Health literacy, habits and social norms in different populations are core components of public health interventions. To enable people to stay home while sustaining livelihoods, economic and social support are essential. Countries could benefit from previous pandemic experience in their community response. Whilst contact tracing and isolation are crucial intervention components, issues of privacy and human rights need to be considered.
CONCLUSIONS: Understanding community responses to containment policies will help in ending current and future pandemics in the world.
METHODOLOGY: We report a case of a 43-year-old man who was admitted to our hospital for further management of severe coronavirus disease 2019 (COVID-19) pneumonia. During his stay in the ward, he received systemic corticosteroids for a total duration of 32 days. A broad-spectrum antibiotic (piperacillin-tazobactam) was also given due to copious amounts of tracheostomy secretions.
RESULTS: The patient's fever recurred following an afebrile interval of 11 days, and C. tropicalis was cultured from his blood. The yeast was highly resistant to fluconazole and voriconazole but remained susceptible to echinocandins. Unfortunately, the patient was unable to receive any echinocandin and eventually succumbed to candidemia.
CONCLUSIONS: Multilocus sequence typing was used to characterize C. tropicalis as a novel diploid sequence type (i.e., 1515) that has not been previously reported.
METHODOLOGY: We conducted a population-based, matched case-control study in Malaysia to estimate the marginal vaccine effectiveness (mVE) of homologous and heterologous BNT162b2 and CoronaVac booster vaccination against COVID-19 related intensive care unit (ICU) admission and death in Delta-predominant and Omicron-predominant periods.
RESULTS: Receipt of a booster vaccination - either homologous or heterologous for CoronaVac, and homologous for BNT162b2 - demonstrated mVE estimates of at least 70% against ICU admission and at least 80% against death, compared to BNT162b2 primary vaccination, in both periods. Overall, the mVE estimates were 10-20 percentage points lower in the Omicron-predominant period than in the Delta-predominant period.
CONCLUSIONS: Our study reaffirms that the administration of booster vaccination increases protection against severe COVID-19 outcomes for BNT162b2 and CoronaVac primary vaccination recipients.
METHODOLOGY: A qualitative, semi-structured interview, followed by a quantitative, questionnaire-based study, was carried out at the Shifa International Hospital (SIH; Islamabad, Pakistan). Discharge summaries of patients aged ≥ 60 years were collected to assess the prevalence of polypharmacy at SIH.
RESULTS: Discharge summaries of n = 350 patients were collected; 60.2% (n = 211) had comorbid conditions, and the co-occurrence of diabetes and hypertension were the most common. 37.8% (n = 132) were taking 8 or more medications. Eight (n = 8) hospital pharmacists participated in the qualitative study, and 4 major themes were identified in their perceptions regarding prescribing cascades. Fifty-two (n = 52) pharmacists were recruited in the quantitative phase. 86.5% (n = 45) of the participants reported long standing illness/chronic conditions; 67.3% (n = 35) noted the presence of comorbidities as a high risk, while 90.3% (n = 47) noted multiple prescribers, and 75.0% (n = 39) identified the ageing population as important risks factors for polypharmacy.
CONCLUSIONS: The current research may inform the role and responsibilities of hospital pharmacists in outpatient and inpatient departments, and in interprofessional care teams, in preventing and minimizing prescribing cascades.
METHODOLOGY: A systematic search was conducted on October 1, 2022, on PubMed, Scopus, Google, and the British Broadcasting Corporation (BBC) News's official website to identify COVID-19 apps available in Vietnam. The apps were evaluated through user reviews and content analysis of their specific features and drawbacks.
RESULTS: Thirty Vietnam-based COVID-19 mobile apps were identified on the Apple and Google Play Store. Their functions were recorded and analyzed using a dedicated tool for appraising mobile applications. Although useful, many specific COVID-19 features were dispersed and duplicated between the apps. The most comprehensive apps still lack important functionalities, such as vaccination information. The most serious user concerns were privacy breaches during data recording and storage, technical issues, and non-user-friendly interfaces.
CONCLUSIONS: The panorama of current COVID-19 apps in Vietnam is complex and includes many apps. Their overlap in features and functions could create a dispersion of mobile users that could undermine the apps' usefulness and effectiveness in combating the pandemic in Vietnam. An app that integrates the most useful features and addresses the main issues could facilitate user experience and usage uptake.