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.
METHODS: Three areas of priority were identified as follows: staff safety, patient movement, and possible clinical scenarios based on simulation principles in health care education. Staff was rostered and rotated through stations for rapid-cycle deliberate practice to learn donning and doffing of personal protective equipment (PPE) and powered air-purifying respirator (PAPR). For difficult airway management, Peyton's 4 steps for skills training and Harden's Three Circle model formed the structure in teaching the core skills. Several clinical scenarios used system probing to elicit inadequacies followed by formal debriefing to facilitate reflection. Finally, evaluation was both immediate and delayed with an online survey after 1 month to examine 4 levels of reaction, learning, behavior, and impact based on the Kirkpatrick Model. Frequency and thematic analysis were then conducted on the quantitative and qualitative data, respectively.
RESULTS: A total of 15 of 16 (93%) consultants, 16 (100%) specialists, and 81 (100%) medical officers in the department completed training within 2 consecutive weeks. Reaction and part of the learning were relayed immediately to trainers during training. In total, 42 (39%) trained staff responded to the survey. All were satisfied and agreed on the relevance of training. A total of 41 respondents (98%; 95% confidence interval [CI], 87-99) answered 16 of 20 questions correctly on identifying aerosol-generating procedures (AGP), indications for PPE, planning and preparation for airway management to achieve adequate learning. About 43% (95% CI, 27-59) and 52% (95% CI, 36-68) recalled donning and doffing steps correctly. A total of 92 responses from 33 respondents were analyzed in the thematic analysis. All respondents reported at least 1 behavioral change in intended outcomes for hand hygiene practice (20%), appropriate use of PPE (27%), and airway management (10%). The emerging outcomes were vigilance, physical distancing, planning, and team communication. Finally, the impact of training led to the establishment of institutional guidelines followed by all personnel.
CONCLUSIONS: Simulation-based training was a useful preparation tool for small institutions with limited time, resources, and manpower in developing nations. These recommendations represent the training experience to address issues of "when" and "how" to initiate urgent "medical education" during an outbreak.
METHODS: This cross-sectional study recruited 553 parents of children aged 13-24 years in low-income community settings. The Parent-Child Conflict scale of the Parental Environment Questionnaire (PEQ) was used to measure parent-child conflict. Psychological distress was assessed using the Depression, Anxiety, and Stress Scale short form (DASS-21).
RESULTS: The study revealed a low level of parent-child conflict in the overall study population, with a median PEQ of 48.0 (interquartile range [IQR] 36 to 48). Concerning demographics, married parents reported a likelihood of having a higher level of parent-child conflict over 3 times higher than single parents (OR = 3.18 95%, CI 1.30-7.75). More parent-child conflicts were also found in parents aged 60-72 years old who were unemployed, retired, or housewives and from lower-income groups. In regard to lifestyle factors, a higher level of physical activity and having enough sleep were associated with lower levels of parent-child conflict. Only approximately 1% of the participants reported symptoms of depression, anxiety, or stress.
DISCUSSION: Low risk exists for parent-child conflict and psychological sequelae following the easing of the COVID-19 pandemic restrictions, which could be due to various support measures implemented by the government. Vulnerable parents identified as being at risk of parent-child conflict warrant attention in future advocacy efforts.
METHODS: This cross-sectional study aimed to determine factors associated with self-reported HH performance among nurses at Kelantan tertiary care hospitals. A sample of 438 registered nurses was selected through a stratified random sampling method. Self-reported HH performance was assessed using a validated WHO self-administered HH knowledge and perception questionnaire for healthcare workers.
RESULTS: A multiple linear regression analysis was performed to identify the predictors. The factors that significantly predicted self-reported HH performance among nurses included perception score (beta coefficient (β) = 0.260; 95% CI: 0.200, 0.417; p < 0.001), pediatric department (β = -0.104; 95% CI: -9.335, -2.467; p < 0.001), and orthopedic department (β = -5.957; 95% CI: -9.539, -0.720; p < 0.023), adjusted R2 = 0.102; p < 0.001. Nurses with a strong perception and belief in HH were more likely to have better HH performance. Compared to pediatric and orthopedic, surgical departments were associated with better self-reported HH performance.
CONCLUSIONS: This study showed the importance of factors that could improve the intervention's performance in HH strategy. Lack of perception and HH program intervention in departments engaged in patient care could lead to poor HH practices, thus increasing HCAIs and antimicrobial resistance (AMR).
METHODS: A total of doctors (39) and nurses (37) were recruited for an interventional study on the interprofessional learning approach on hospital acquired infection control. The participants responded to the University of West England Interprofessional (UWEIP) questionnaire at baseline consisting of four dimensions in IPL aspects; Self-assessment on communication and teamwork skills (CTW), interprofessional learning (IPL), interprofessional interaction (IPI), and interprofessional relationship (IPR). The Cronbach alpha value for the total questionnaire was established at 0.79.
RESULTS: The majority of doctors scored positive in CTW, IPL, IPR, and neutral in IPI. Nurses' also recorded the highest positive scores in CTW, IPL, and IPR, and neutral in IPI. Negative scores were found in CTW and IPI. A significant difference was revealed between doctors and nurses in IPL attitude; p = 0.024 and there was no significant difference in other dimensions (p > .05). Results also found a significant difference between participants' and non-participants of IPL training sessions; p = 0.009.
CONCLUSIONS: This study revealed the infusion of interprofessional learning training among the health professionals displayed better self-assessments, attitudes, and perceptions towards collaborative practices.
RESULTS: Five repatriation missions performed was led by the National Agency for Disaster Management (NADMA) with the Ministry of Health providing technical expertise. A total of 432 citizens were repatriated from the missions. The operations were divided into four phases: the pre-boarding screening phase, the boarding and in-flight phase, the reception phase and the quarantine phase. The commercial aircraft used were from two different commercial airlines. Each mission had flight crew members between 10 and 17 people. There were 82 positive cases detected among the repatriated citizens. There was a single positive case of a healthcare worker involved in the mission, based on the sample taken on arrival of the flight. There were no infections involving flight team members.
CONCLUSION: Medical flight crew must be familiar with aircraft fittings that differ from one commercial airline to another as it influences infection control practices. A clear understanding of socio-political situation of a country, transmission routes of a pathogen, disease presentation, and knowledge of aviation procedures, aircraft engineering and design is of great importance in preparing for such missions. Our approach of multidiscipline team involvement managed to allow us to provide and execute the operations successfully.
Methods: Nasopharyngeal swab and aspirate samples were collected prospectively from 199 patients who presented with ARTIs at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia during a 10-month period. The PCR assay was conducted in parallel with conventional culture and direct IF staining methods.
Results: The positive rate of the xTAG RVP Fast v2 assay (78.4%) in detecting respiratory viruses was higher than that of the viral isolation (7.5%) and direct IF (23.1%) methods. Using the xTAG RVP Fast v2 assay, human enterovirus/human rhinovirus (HEV/HRV) was the most frequently detected (46.2%). The xTAG RVP Fast v2 assay revealed mixed infection caused by two or three respiratory viruses in 40 specimens, and these were undetected by the viral isolation and direct IF methods.
Conclusion: The xTAG RVP Fast v2 assay was superior to conventional methods in the identification of common respiratory viruses, with higher sensitivity and shorter turnaround times for laboratory results.