MyMedR

A cross-sectional nutritional survey was carried out on 350 elderly Malays aged 60 and above from 11 randomly selected villages in a rural area on the East Coast of Malaysia. The findings indicated that the mean intakes of energy and all of the nutrients investigated were below the Malaysian Recommended Dietary Allowances, excepts for protein and vitamin C. Nutrients most likely to be inadequate were vitamin A, thiamine, riboflavin, niacin and calcium, with more than 50% of the subjects having estimated intakes of below 2/3 of the recommendations. However, vitamin A status was adequate, with only 2 subjects being biochemically deficient (plasma retinol < or = 0.7 mmol/l). Approximately a third of the subjects had hypoalbuminaemia (plasma albumin < 3.3 g/dl) and anaemia (Haemoglobin < 12 g/dl for men; < 13 g/dl for women). Riboflavin deficiency, as assessed by an erythrocyte glutathione reductase activation coefficient (EGRAC) of more than 1.35 was identified in 77% of the subjects. The prevalence of vitamin E deficiency (plasma a-tocopherol < or = 12 mmol/l) was 27%, with men being at a greater risk. In conclusion, the dietary intakes of these rural elderly Malays was inadequate. Over three quarters of the sample were biochemically deficient in riboflavin, the functional consequences of which need to be further investigated.

Matched MeSH terms: Rural Health*

Fulltext Antimicrobial stewardship in rural and remote primary health care: a narrative review

Yau JW, Thor SM, Tsai D, Speare T, Rissel C

Antimicrob Resist Infect Control, 2021 07 13;10(1):105.

PMID: 34256853 DOI: 10.1186/s13756-021-00964-1

BACKGROUND: Antimicrobial resistance is an emerging problem worldwide and poses a significant threat to human health. Antimicrobial stewardship programmes are being implemented in health systems globally, primarily in hospitals, to address the growing threat of antimicrobial resistance. Despite the significance of primary health care services in providing health care to communities, antimicrobial stewardship programmes are not well established in this sector, especially in rural and remote settings. This narrative review aims to identify in rural and remote primary health care settings the (1) correlation of antimicrobial resistance with antibiotic prescribing and volume of antibiotic use, (2) appropriateness of antimicrobial prescribing, (3) risk factors associated with inappropriate use/prescribing of antibiotics, and (4) effective antimicrobial stewardship strategies.

METHODS: The international literature was searched for English only articles between 2000 and 2020 using specified keywords. Seven electronic databases were searched: Scopus, Cochrane, Embase, CINAHL, PubMed, Ovid Medline and Ovid Emcare. Publication screening and analysis were conducted using Joanna Briggs Institute systematic review tools.

RESULTS: Fifty-one eligible articles were identified. Inappropriate and excessive antimicrobial prescribing and use directly led to increases in antimicrobial resistance. Increasing rurality of practice is associated with disproportionally higher rates of inappropriate prescribing compared to those in metropolitan areas. Physician knowledge, attitude and behaviour play important roles in mediating antimicrobial prescribing, with strong intrinsic and extrinsic influences including patient factors. Antimicrobial stewardship strategies in rural and remote primary health care settings focus on health care provider and patient education, clinician support systems, utility of antimicrobial resistance surveillance, and policy changes. Results of these interventions were generally positive with decreased antimicrobial resistance rates and improved appropriateness of antimicrobial prescribing.

CONCLUSIONS: Inappropriate prescribing and excessive use of antimicrobials are an important contributor to the increasing resistance towards antimicrobial agents particularly in rural and remote primary health care. Antimicrobial stewardship programmes in the form of education, clinical support, surveillance, and policies have been mostly successful in reducing prescribing rates and inappropriate prescriptions. The narrative review highlighted the need for longer interventions to assess changes in antimicrobial resistance rates. The review also identified a lack of differentiation between rural and remote contexts and Indigenous health was inadequately addressed. Future research should have a greater focus on effective interventional components and patient perspectives.

Matched MeSH terms: Rural Health Services*

Fulltext Differences in public and private health services in a rural district of Malaysia.

Aljunid SM, Zwi AB

Med J Malaysia, 1996 Dec;51(4):426-36.

PMID: 10968029

A cross-sectional study, comparing the nature of services in 15 private clinics and 6 public health facilities, was undertaken in a rural district of Malaysia. Semi-structured interviews and observations using check-lists were employed. Public health facilities were run by younger doctors (mean age = 31.1 years), supported mostly by trained staff. The private clinics were run by older doctors (mean age = 41.2 years) who had served the district for much longer (8.9 years vs 1.5 years) but were supported by less well trained staff. The curative services were the main strength of the private clinics but their provision of preventive care was less comprehensive and of inferior quality. Private clinics were inclined to provide more expensive diagnostic services than the public facilities. 'Short hours' private clinics had very restricted opening hours and offered limited range of services.
Comment in: Hee HW. Differences in public and private health services in a rural district of Malaysia. Med J Malaysia. 1997 Sep;52(3):296-8

Matched MeSH terms: Rural Health*

Fulltext A prevalence survey of psychiatric morbidity in a rural Malaysian village: a preliminary report

Ramli H, Ohn K, Krishnaswamy S, Kasmini K, Hassan S

Singapore Med J, 1987 Dec;28(6):530-3.

PMID: 3441795

Matched MeSH terms: Rural Health*

Health problems of agricultural workers in Malaysia

Lim HH

Trop Geogr Med, 1983 Mar;35(1):83-9.

PMID: 6612777

The present paper reviews the health problems of rural agricultural workers in Malaysia. As is common with most developing countries, the agricultural sector forms the pillar of the national economy in Malaysia, the major products being rubber, palm oil, rice and timber. Most of the agricultural workers, who form the largest occupational group in the country, live in the rural areas under poor socioeconomic and environmental conditions. Their general health problems include large families, substandard housing, overcrowding, lack of piped water supply and sanitary excreta disposal, malnutrition and prevalent diseases such as cholera, typhoid, dysentery and parasitic infections. The specific occupational health problems include infectious diseases, agricultural accidents, pesticide poisonings, physical hazards, keratitis nummularis and snake-bites. The organization of agricultural health services in developing countries is also discussed.

Matched MeSH terms: Rural Health

Medical services of the Orang Asli (Aborigines) of West Malaysia

Tee OH

Med J Malaysia, 1975 Sep;30(1):30-37.

PMID: 1207529

Matched MeSH terms: Rural Health

Prescribing opportunities for pharmacists in rural areas

Ahmad A, Khan MU

Res Social Adm Pharm, 2016 04 23;12(5):811-2.

PMID: 27157865 DOI: 10.1016/j.sapharm.2016.04.003

Matched MeSH terms: Rural Health Services/legislation & jurisprudence; Rural Health Services/organization & administration*

Bird-related eye injuries

Shriwas SR

Trop Doct, 1993 Jul;23(3):140.

PMID: 8356755

Matched MeSH terms: Rural Health

Fulltext Latrine use in rural Sarawak, Malaysia

Kiyu A, Hardin S

Southeast Asian J. Trop. Med. Public Health, 1993 Mar;24(1):40-2.

PMID: 8362304

A cross-sectional survey covering 976 households in 41 rural villages covered by the Rural Health Improvement Scheme in Sarawak was carried out to determine the type of latrines they have and their usage of pourflush latrines. The survey was carried out by inspection and interview. Fifty-six percent of the households had pourflush latrines and upon inspection 91.3% of them showed signs of recent use. Based on the interview, ninety percent of the women responded that they always use the latrine for defecation. It was also reported that 86.5% of the husbands and 47.6% of the children below five years, always used the latrine for defecation. The most common reason for not using the latrine among adults was the lack of water to flush the latrines as well as not being home when the need arises. The reason for using the latrines were to keep the compound clean, convenience and health reasons. It is recommended that building latrines continue to be a prerequisite for getting water supply under the program and that non health-related reasons be emphasized in health education which aim to motivate people to build and use the latrines.

Matched MeSH terms: Rural Health

Nursing overseas: tuberculosis in West Malaysia

Arokianathan A

Nurs Times, 1980 Feb 14;76(7):296-7.

PMID: 6899163

Matched MeSH terms: Rural Health

Maternal mortality amongst the rural Malays

Yusof K

Med J Malaysia, 1974 Mar;28(3):149-53.

PMID: 4278186

Matched MeSH terms: Rural Health

Haemoptysis as a presenting symptom in a rural area of Sabah

Barclay R

Med J Malaya, 1966 Dec;21(2):133-4.

PMID: 4227384

Matched MeSH terms: Rural Health

Fulltext Process evaluation of student health promotion programmes in rural Sabah

Naing Oo Tha, Mohd Yusof Ibrahim, Patricia Sator, Rajesh Kumar, D. Kamarudin D. Mudin, Mohd Saffree Jeffree

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):52-52.

MyJurnal

Introduction: The Faculty of Medicine & health sciences, UMS has implemented a co-curricular programme which is aimed to be improving rural health and reducing inequalities of health in Sabah. Groups of medical students are formed and distributed in various areas of rural remote areas in Sabah. Based on the observation and interview find-ings, each student group conducted health promotion activities with the limited resources. Various health problems were explored in different areas and different ethnic groups of Sabah and students conducted their health promotion activities .There are some questions “Are they effective, how it works in implementation?” Poor implementation can lead to errors in outcome of the programmes. In this paper we focus on process evaluation for measuring the degree to which Health promotion programmes were implemented as designed by using determinant framework (active implementation framework) and process evaluation tools in yearly health promotion programmes from 2009-2018.Methods: The study measures the implementation of programmes with active implementation framework (Explo-ration, Installation, Initial implementation, Full implementation) and process evaluation tools such as validation of implementation integrity using specification of intervention areas, making guidelines and manual for intervention protocol, competency of students and supervisors and fidelity monitoring. We used 7 components of process eval-uation particularly in context( Environmental influences), reach (Target participation), dose delivered (Lectures), dose received (learned by students with assessment methods), fidelity (Adherence to intervention delivery protocol), implementation (rating of execution and receipt of intervention) and recruitment (participant engagement). Results:It was found that fidelity, implementation strategies and some lessons learned after outreach programmes are impor-tantly influence in implementing the programmes. Conclusion: The study shows process evaluation strategies is ideal tool for conducting the rural outreach health promotion programme to reduce the errors and obstacles in implement-ing the programmes to maintain the better quality of the projects.

Matched MeSH terms: Rural Health

The developing countries and medical research

Nossal GJ

Med J Aust, 1978 Aug 12;2(4):152-4.

PMID: 723714

Matched MeSH terms: Rural Health

Serum vitamin A levels of two rural communities in Malaysia

NG TK, Chong YH

J Trop Pediatr Environ Child Health, 1977 Apr;23(2):91-3.

PMID: 585740

Matched MeSH terms: Rural Health

Distribution of Aedes aegypti (Linnaeus) and Aedes albopictus (Skuse) in small towns and villages of Penang Island, Malaysia--an ovitrap survey

Yap HH

Southeast Asian J. Trop. Med. Public Health, 1975 Dec;6(4):519-24.

PMID: 1226538

An ovitrap survey was carried out in April and May of 1975 at twenty-one locations scattered throughout Penang Island excluding the City of Georgetown. The results showed the ubiquitous presence of Ae. albopictus. Ae. aegypti was recorded only in Tanjung Tokong Lama, an area adjacent to the City of Georgetown. In the survey, Ae. albopictus females were found to prefer the outdoor ovitraps than indoor ones. The effectiveness of ovitrap in Aedes survey was discussed.

Matched MeSH terms: Rural Health

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