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Fulltext THE RELATIONSHIP BETWEEN GOVERNMENT EXPENDITURE ON SELECTED SECTORS TOWARDS ECONOMIC GROWTH IN MALAYSIA

NURUL FARHANA SENAWI, NOR FATIMAH CHE SULAIMAN, NOR FATIMAH CHE SULAIMAN

UMT Journal of Undergraduate Research, 2020;2(3):83-92.
MyJurnal

Government expenditure plays an important role in the country’s economic growth. Budget allocations through the annual budget presented have their strategies to ensure that the allocated budget can improve the growth and development in Malaysia and also can be enjoyed by all Malaysian. The government’s expenditure has contributed to the expansion of this country’s development from various sectors. However, there are various problems involving government expenditure such as low level of health, homeless poor people, weak public transportation and illegal immigrants. The purpose of this study is to examine the relationship between government expenditure on health, education, housing, transportation and defence sectors towards economic growth. The data used is secondary data from 1980-2017 for 38 years from the Department of Statistics, Malaysia and World Bank Data. The method used in this study is Descriptive Analysis and Autoregressive Distributed Lagged Model (ARDL). The result showed that economic growth and government expenditure on health, education, transportation, and defence has a long-run relationship. Therefore, the government should increase more expenditure on crucial sectors such as education, transportation, defence and health that will strengthen economic growth in the long run.

Matched MeSH terms: Health Services
Fulltext Healthcare Utilization and Knee Osteoarthritis Symptoms among Urban Older Malaysian

Kamsan SS, Singh DKA, Tan MP, Kumar S

Int J Environ Res Public Health, 2021 04 04;18(7).
PMID: 33916628 DOI: 10.3390/ijerph18073777

Knee osteoarthritis (OA) is a prevalent chronic disorder in the older population. While timely management is important to minimize the consequences of knee OA, information on the utilization of healthcare services among this population remains limited. Therefore, the objectives of this study were to determine the healthcare utilization and its associated factors in older persons with knee OA. Cross-sectional data from 1073 participants aged 60 years and above from the Malaysian Elders Longitudinal Research (MELoR) study were included. The utilization rate of healthcare services was quantified. Factors related to the utilization of healthcare services were determined using logistic regression analysis. Healthcare utilization among participants with knee OA was significantly higher than those without knee OA (p < 0.01). Outpatient usage was higher (p < 0.01) in comparison to inpatient and pharmacotherapy. Being married and having an income were significantly associated with seeking outpatient care (OR: 11.136, 95% CI: 1.73-52.82, p < 0.01) and pharmacotherapy (OR: 10.439, 95% CI: 1.187-91.812, p < 0.05), while females were less likely to utilize inpatient care services (OR: 0.126, 95% CI: 0.021-0.746, p < 0.05). The higher rate of healthcare utilization among older persons with knee OA indicates the increased healthcare needs of this population, who are commonly assumed to suffer from a benign disease.

Matched MeSH terms: Health Services
Fulltext Patients’ expectations and perceptions of services provided by primary health clinics in Kota Bharu, Kelantan, Malaysia

Ahmad Badruridzwanullah Zun, Mohd Ismail Ibrahim, Anees Abdul Hamid

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):225-230.
MyJurnal

Introduction: Primary health care plays an important role in healthcare systems. In Malaysia, One (1) Malaysia Clinic (now known as Community Clinic since 2018) was established in 2010 aims to increase healthcare services accessibility within the poor urban population. The aim was to look at the effectiveness of One (1) Malaysia Clinic as a new form of public primary health clinic by looking at expectations and perceptions of the quality of the provided services by the patients. Method: It applied a cross sectional study involving nine clinics in of the busiest district in Kelantan namely, Kota Bharu district. 386 respondents which were Malaysian citizen, 18 years old and above were involved in this study. The survey used Malay validated SERVQUAL questionnaire. The Service Quality (SQ) gap was calculated. Result: The empathy dimension obtained the highest expectation and perception score, while the tangi- ble dimension has the lowest expectation and perception score. In all SERVQUAL dimension, the expectations and perceptions of the service provided was significantly different with P < 0.001. The most critical dimension identified was tangible dimension as it has the largest negative SQ gap score. Conclusion: Negative gaps for all SERVQUAL dimensions and individual items indicated that provided services at One (1) Malaysia Clinic still could not fulfilled the patient’s expectation. A continuous improvement program is needed especially on tangible dimension in deliv- ering a quality healthcare services.

Matched MeSH terms: Health Services
Fulltext The effectiveness of antenatal class towards improvement of knowledge among pregnant women in Hospital Chancellor Tuanku Muhriz (HCTM)

Rohani Mamat, Roziah Arabi, Hartini Jantan, Hanisah Zainal Abidin, Nor Azizah Ahmad, Shakinah Awang

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):60-0.
MyJurnal

Introduction: Antenatal knowledge is associated with positive outcome for pregnant women as it provides infor- mation to allow them to identify any problems during pregnancy. Studies have underlined the problems of the information overload is possible during an antenatal class, it is unclear to what extend information given during an- tenatal class are retain by mother, thus the need for this study. Methods: This is a quasi-pre-post experimental study involving 82 participants. Baseline pre and post knowledge on antenatal class was evaluated among respondents using validate questionnaires. T-test was used to determine the relationship between various socio-demographic factors and knowledge of respondents. Results: Chi-square test used to test pre and post knowledge score. There was a significant increase in the difference between before and after antenatal classes run against the knowledge. In addition, the study found no significant difference for participants who are professional and non-professional and level of education. Conclusion: This study concludes thatthe antenatal classes run in HCTM shows a positive im- pact in improving maternal care during pregnancy, childbirth and care after birth. It is best to suggest that to increase promotion and information regarding antenatal classes so that pregnant women and couple could attend and get the benefit from the class.

Matched MeSH terms: Maternal Health Services
Parents' and caregivers' satisfaction with community-based rehabilitation (CBR) services for children with disability in east coast states in Peninsular Malaysia

Hasan H, Abdul Aziz AF, Aljunid SM

Health Soc Care Community, 2021 01;29(1):215-226.
PMID: 33189086 DOI: 10.1111/hsc.13084

The Community-Based Rehabilitation (CBR) services under the Malaysian Ministry of Women, Family and Community Development have provided two types of services for disabled children: centre-based and home-based care since 1984. A cross-sectional study was conducted among parents and caregivers with children receiving treatment at CBRs on the east coast of Peninsular Malaysia, to determine the level of satisfaction with the services provided. Respondents were recruited via multi-staged sampling, and simple randomisation at CBR level. Respondents self-administered the Physical Therapy Satisfaction Questionnaire (PTSQ) and provided sociodemographic data. A total of 297 respondents were recruited and all the questionnaires were returned complete, making the response rate 100%. Total satisfaction scores and factors influencing respondents' satisfaction for both groups were analysed. The mean total satisfaction score for centre-based and home-based were 84.69 (SD = 10.01) and 75.30 (SD = 12.23; t = 7.160, p ≤ .001) respectively. Ninety-eight per cent of centre-based and 89% of home-based respondents were satisfied with the current services. There were significantly mean differences in the satisfaction level of respondents of different states respectively (Kelantan mean 84.92 10.83, Terengganu mean 77.49 11.16 and Pahang mean 77.47 12.93, p ≤ .001). Factors associated with satisfaction were education (p = .002), occupation (p = <0.001), monthly income (p = .001) and source of income (p = .001). In conclusion, majority of parents and caregivers were satisfied with current services provided at CBR and satisfaction with services was dependent on CBR centre location and education and financial earning capacity.

Matched MeSH terms: Community Health Services
Fulltext A fuzzy graph approach analysis for COVID-19 outbreak

Hassan N, Ahmad T, Ashaari A, Awang SR, Mamat SS, Wan Mohamad WM, et al.

Results Phys, 2021 Jun;25:104267.
PMID: 33968605 DOI: 10.1016/j.rinp.2021.104267

Complex systems require rigorous analysis using effective method, in order to handle and interpret their information. Spectrum produced from Fourier transform infrared (FTIR) instrument is an example of a complex system, due to their overlapped bands and interactions within the spectrum. Thus, chemometrics techniques are required to further analyze the data, in particular, chemometrics fuzzy autocatalytic set (c-FACS). The c-FACS is initially used to analyze the FTIR spectra of gelatins. However, in this study, the c-FACS is generalized and implemented for analysis of Coronavirus disease 2019 (Covid-19), particularly, the pandemic outbreak in Malaysia. The daily Covid-19 cases in states in Malaysia are modeled and analyzed using c-FACS, to observe the trend and severity of the disease in Malaysia. As a result, the classification of severity of zones in Malaysia are identified. The obtained results offer descriptive insight for strategizing purposes in combating the Covid-19 outbreak in Malaysia.

Matched MeSH terms: Health Services
Mapping timely access to emergency and essential surgical services: The Malaysian experience

Hoh SM, Wahab MYA, Hisham AN, Guest GD, Watters DAK

ANZ J Surg, 2021 Jun 01.
PMID: 34075677 DOI: 10.1111/ans.16986

BACKGROUND: Surgical conditions form a significant proportion of the global burden of disease. Since the 2015 World Health Assembly resolution A68.15, there is recognition that the provision of essential surgical care is an integral part of universal access to health care. The Lancet Commission on Global Surgery proposed its first surgical indicator to measure a population's access to the Bellwether procedures (laparotomy, caesarean section and treatment of open fracture) within two hours. Bellwether access is a proxy for emergency and essential surgical care. This project aims to map essential surgical access to the Bellwether procedures in Malaysia.
METHODS: The location and capability of hospitals to perform the Bellwether procedures was obtained from the Ministry of Health (MoH) and MoH hospital specific websites. The Malaysian population data were retrieved from the national department of statistics. Times for patients to travel to hospital were calculated by combining manual contouring and geospatial mapping.
RESULTS: There were 49 Bellwether-capable MoH hospitals serving a national population of 32.5 million. Overall 94% of Malaysia's population have access to the Bellwethers within two hours. This coverage is universal in West (Peninsular) Malaysia, but there is only 73% coverage in East Malaysia, with 1.8 million residents of Sabah and Sarawak not having timely access. Malaysia's Bellwether capacity compares well with other countries in World Health Organisation's Western Pacific region.
CONCLUSION: There is good access to essential and emergency surgical services in Malaysia. The incomplete access for 1.8 million people in East Malaysia will inform national surgical planning.

Matched MeSH terms: Health Services Accessibility
Fulltext Estimation of Caffeine Content in Coffee of Malaysian Market Using Fourier Transform Infrared (FTIR) Spectroscopy

Francis Davin Nyoro, Siong Fong Sim, Amelia Laccy Jeffrey Kimura

Trends in Undergraduate Research, 2018;1(1):0-0.
MyJurnal

This study reports the caffeine content in seven locally available coffee. The caffeine was extracted with chloroform and analysed using Fourier Transform Infrared (FTIR). The method reports an average recovery of 101% with the limit of determination established at 0.1%. The absorption band at 1654 cm-1 was used to construct the calibration curve for quantification of caffeine where the regression was fitted with satisfactory linearity. An average of 0.55% of caffeine was detected in the seven coffee products with Arabica coffee demonstrating lower caffeine concentration. The study evidenced that caffeine content in coffee is determined by the coffee types. The caffeine content found in the local coffee products was relatively lower likely due to the solvent types, extraction procedure and analytical method used.

Matched MeSH terms: Health Services
Relationship quality of health services with satisfaction of patients in H. Hanafie Muara Bungo Hospital in 2019

Zahlimar, Zuriati Z, Chiew L

Enferm Clin, 2020 06;30 Suppl 5:168-170.
PMID: 32713560 DOI: 10.1016/j.enfcli.2019.11.047

Hospitals as a place of health services are required to provide quality services. One of the determinants of the level of satisfaction of health services is health workers. The purpose of this study was to determine the relationship of health service quality with patient satisfaction at H. Hanafie Muara Bungo Hospital. This research is an analytic study using a cross-sectional study approach. The population in this study were all inpatients at H. Hanafie Muara Bungo Hospital. The sampling technique used an accidental sampling of 49 people. Data collection was done using questionnaires. Analysis of the data was done by univariate and bivariate analysis. The results showed there was a significant relationship between the reliability of officers, the responsiveness of officers, employee guarantees, the attention of health workers, and physical evidence of health services with the level of patient satisfaction at H. Hanafie Muara Bungo Hospital in 2019. Based on the results of the study, it was found that officer response, officer guarantee, officer attention, and physical evidence of service in the category of not qualified and there is a significant relationship with the level of patient satisfaction at H. Hanafie Muara Bungo Hospital in 2019.

Matched MeSH terms: Health Services
Fulltext Adolescent health services: do they address the needs of the adolescents - an experience in Barat Daya, Penang

Saraswathi, B.R.

Malaysian Journal of Public Health Medicine, 2004;4(1):59-65.
MyJurnal

A cross sectional study was carried amongst adolescent school children in Barat Daya, in 2000. This was to determine the characteristic features of adolescents in the district and to look into their sexual activities, substance use and psychosocial problems with the aim to plan an appropriate adolescent health program. Some 400 students from Form 2 and Form 4 were selected by purposive stratifed and systematic sampling. The study was carried out by trained nurses with an interview using a structured questionnaire. The majority of the respondents were Malays (78.8%) with a household income of less than RM2, 000.00 per if month. Family relations and parental influence were found to be strong. Mental health characteristics scored negatively significantly in this study and those particularly at risk were those who performed poorly in schools. Most claimed not to be involved in high risk behaviour though they knew of friends who did so. Adolescent health services in the district should take an integrated approach with other stakeholders. Health information should be easily available and focus should be given to poor achievers in school.

Matched MeSH terms: Adolescent Health Services
Fulltext Patterns and predictors of smoking cessation among smokers attending Smoking Cessation Clinics in Peninsular Malaysia

Wan Puteh SE, Selahuddeen AA, Aljunid SM, Zarihah Z

Malaysian Journal of Community Health, 2008;14(1):17-23.
MyJurnal

Introduction: This study seeks to identify the socio-demographic and behavioral characteristics of smokers (aged 18 and above), thus develop a predicting model for tobacco abstinence receiving cessation services for tobacco dependence at the Smoking Cessation Clinics (SCC) in government Primary Health Centers in Malaysia. These predictors would improve the effectiveness and efficiency of these clinics.
Methods : Smokers who sought smoking cessation therapy at the SCCs from 1st January 2004 to 31st
December 2004 were chosen randomly from clinic’s registries, and 254 smokers were recruited from 8 clinics chosen through stratified random sampling. Data analyses were performed with SPSS 12.0. 17.3% of smokers attending SCCs were able to quit smoking for at least six months.
Results : Factors significantly contributing to quitting success were elderly smokers (above 40 years old), smoked for more than 15 years, smoked less than ten sticks per day, had a previous history of quitting attempt, self referral to the clinic, high confidence level, attended SCC at least four times, each counseling session lasted for at least 30 minutes and were satisfied with the clinic service. In logistic regression model, smokers aged 40 years and above were 6.7 times more successful to quit, high level of confidence were nine times more successful, smoked more than ten sticks per day were ten times less successful, self referred smokers were ten times more successful and attending for at least 30 minutes counseling session were 12 times more successful.
Conclusion : This study concludes that more concerted effort is needed to approach various groups of target population and SCCs clinic services need to be improved.

Matched MeSH terms: Health Services Needs and Demand
Fulltext Traditional healers are causing treatment delay among patients with psychosis in Hospital Kuala Lumpur: fact or fallacy?

Marhani Midin, Salina Abdul Aziz, Phang, Cheng-Kar

ASEAN Journal of Psychiatry, 2010;11(2):206-215.
MyJurnal

Objective: Mental health services in Malaysia often face competition from traditional healers especially among patients with psychosis. The objective of the study is to determine whether patients who sought help earlier from traditional healers had longer duration of untreated psychosis (DUP), and more adverse experiences in pathways to psychiatric care. Methods: This is a hospital-based cross-sectional study of 50 inpatients with first-episode
psychosis in Hospital Kuala Lumpur. Structured Clinical Interview for DSM-IV (Diagnostic and statistical manual, 4th edition) Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Onset of psychosis was defined as any one positive symptom with a score of >3 on the Positive and Negative Syndrome Scale (PANSS). Socio-demographic
data, information on pathways and treatment delaying factors were determined through face-to-face interview and semi-structured questionnaire. Results: Fifty-four percent of the patients had at least one contact with traditional healers prior to consulting psychiatric service, and it was the most popular first point of non-psychiatric help-seeking contact
(48%). Contact with traditional healers was not associated with age, gender, ethnic, education level, longer DUP or treatment delay, and admissions with violent behaviour or police assistance. Of those who had sought help from traditional healers, one third were recommended by at least one of their traditional healers to seek medical help. Conclusion:
Consultation involving traditional healers was a popular choice, and not associated with treatment delay. Traditional healers in an urban setting may be potential collaborators in managing patients with first-episode psychosis. Future research should explore the frontiers of such collaborative work.

Matched MeSH terms: Mental Health Services
Fulltext Outbreak management during the worst flood disaster of 2006–2007 in Johore, Malaysia

Arbaiah, O., Badrul, H.A.S., Marzukhi, M.I., Mohd Yusof, Badaruddin, M., Mohd Adam

Malaysian Journal of Community Health, 2009;15(3):111-118.
MyJurnal

Outbreak management in disaster has to be planned and implemented prior to, during and after the disaster is over. The risk of outbreaks following disaster is related to the size, health status and living conditions of the displaced population. The risk is increased due standing water in floods for vector borne diseases, overcrowding, inadequate water and sanitation and poor access to health care. The 2006-2007 flood in Johore resulted in 2 episodes of food poisoning and an outbreak of coxsackie A24 acute haemorrhagic conjunctivitis. Only 19,667 (12.5%) of the 157,018 displaced persons suffered from communicable diseases which comprised of acute respiratory disease 7361(28%), skin infection 4241(19%), acute gastroenteritis 1872(8%) and conjunctivitis 589 (2%). The routine disease surveillance and environmental control were enhanced to cover the relief centers and flood areas. Risk assessment of communicable disease carried out resulted in prompt control measures and good coverage of preventive activities. In conclusion the Johore State Health Department has successfully manage the outbreaks during the major flood.

Matched MeSH terms: Health Services Accessibility
Fulltext Influence of immunology knowledge on healthcare and healthy lifestyle

Abu Kassim NL, Saleh Huddin AB, Daoud JI, Rahman MT

PLoS One, 2016;11(7):e0159767.
PMID: 27467083 DOI: 10.1371/journal.pone.0159767

Completing a course in Immunology is expected to improve health care knowledge (HCK), which in turn is anticipated to influence a healthy lifestyle (HLS), controlled use of health care services (HCS) and an awareness of emerging health care concerns (HCC). This cross-sectional study was designed to determine whether these interrelationships are empirically supported. Participants involved in this study were government servants from two ministries in Malaysia (n = 356) and university students from a local university (n = 147). Participants were selected using the non-random purposive sampling method. Data were collected using a self-developed questionnaire, which had been validated in a pilot study involving similar subjects. The questionnaire items were analyzed using Rasch analysis, SPSS version 21 and AMOS version 22. Results have shown that participants who followed a course in Immunology (CoI) had a higher primary HCK (Mean = 0.69 logit, SD = 1.29 logits) compared with those who had not (Mean = -0.27logit, SD = 1.26 logits). Overall, there were significant correlations among the HLS, the awareness of emerging HCC, and the controlled use of HCS (p <0.001). However, no significant correlations were observed between primary HCK and the other variables. However, significant positive correlation was observed between primary HCK and controlled use of HCS for the group without CoI. Path analysis showed that the awareness of emerging HCC exerted a positive influence on controlled use of HCS (β = 0.156, p < .001) and on HLS (β = 0.224, p < .001). These findings suggest that having CoI helps increase primary HCK which influences controlled use of HCS but does not necessarily influence HLS. Hence, introducing Immunology at various levels of education and increasing the public awareness of emerging HCC might help to improve population health en masse. In addition, further investigations on the factors affecting HLS is required to provide a better understanding on the relationship between primary HCK and HLS.

Matched MeSH terms: Health Services
Fulltext Contributory factors to the smoking of Shisha among teenagers in the Perak city of Ipoh: a preliminary qualitative survey

Khor, Poh Yen, Norshidah Harun, Fazreenizam Ishak, Nur Aimy Iryany Mohd Anuar, Noraini Abdul Karim, Aqirah Azman, et al.

Int J Public Health Res, 2012;2(1):80-84.
MyJurnal

Accepted 13 January 2012.
Introduction The purpose of this study is to explore the reasons of Shisha smoking among teenagers in Ipoh, Perak.
Methods Data was collected using in-depth face to face interview. Purposive convenient sampling was used to select volunteer respondents from one of the Shisha restaurant located at Ipoh. The interviews were conducted for 15-20 minutes, recorded using video tape. The data obtained was transcribed and coded for the purpose of thematic analysis.
Results All respondents were influenced by peers in their first attempt in Shisha smoking. Other reasons attracting them to continue smoking Shisha include appealing smell and the flavoured taste of Shisha, easy to access, perceived that Shisha was not addictive and its’ cheaper price. In terms of perception on health risk, all respondents believed that Shisha was less harmful compared to cigarette smoking.
Conclusions More educational programme, health talk about risk of Shisha should be developed and conducted to rectify the misconception about health risk of Shisha smoking. The target population should be focus on male teenagers who smoke Shisha in order to control the widespread Shisha smoking in Malaysia.

Matched MeSH terms: Health Services Needs and Demand
Consumer quality use of medicines: An important element in public health

Hassali MA, Al-Tamimi SK, Dawood OT

Res Social Adm Pharm, 2016 07 14;13(1):261-265.
PMID: 27496382 DOI: 10.1016/j.sapharm.2016.06.011
Matched MeSH terms: Health Services Accessibility
Fulltext Perception of individuals in farming sector towards health care services in the implementation of the new national health financing scheme

Azimatun Noor, A., Mohd Rizal, A.M., Rozital, H., Aljunid, S.M.

Malaysian Journal of Community Health, 2009;15(1):16-20.
MyJurnal

Introduction : Limited access to health services, variations in quality of health care and pressure to contain escalation of health care cost are problems in health care systems that are faced by all the societies in the world especially in developing countries. There is an urgent need to conduct a study to assess perception of individual towards health care services in the new planned National Healthcare Financing Scheme.
Objective : The study objective is to examine the perception towards health care services among the farming community and to assess the willingness to contribute to The New National Health Financing Scheme.
Methods : A cross sectional study involving farmers in the state of Selangor in Peninsular Malaysia was conducted. A total of 400 farmers as the household head were selected using multistage random sampling method.
Results : The respondents’ mean score of perception towards public healthcare services were higher than the respondents’ mean score of perceptions towards private healthcare services except for accessibility and convenience aspects. There was no association between willingness to contribute to The New National Healthcare Financing Scheme and perception towards public healthcare services but there was association between willingness to contribute to The New National Healthcare Financing Scheme and perception towards private healthcare services.
Conclusion : Perception towards healthcare services is an important element in the implementation of The New National Healthcare Financing Scheme as it will determine the willingness of an individual to contribute to it.

Matched MeSH terms: Health Services
Fulltext Managing ‘schizophrenia in the midst of schizophrenia’- the role of assertive community treatment

Ahmad Nabil, M.R., Marhani, M., Azlin, B.

Medicine & Health, 2014;9(2):139-142.
MyJurnal

This case report emphasizes the role of Assertive Community Treatment (ACT) in managing a family with four members suffering from mental illness, mainly schizophrenia. We report a case of middle-aged lady who was diagnosed with treatment resistant schizophrenia (TRS) living with two other family members with the same illness and their carer who developed major depression from shouldering the burden of caring for mentally ill family members. ACT, through its holistic approach, proved to have reduced hospitalizations and improve symptom control and quality of life in this family.

Matched MeSH terms: Community Mental Health Services
Fulltext Research and health policy

Suleiman AB

International e-Journal of Science, Medicine & Education, 2013;7(11):2-6.
MyJurnal

Healthcare investment is critically important for the health and well-being of the population, and different health systems are developed to meet the needs and priorities of each country. What has become clear has been that despite major advances in medicine, science and technology, there are major issues related to access and equity as well as quality and patient safety in healthcare services. The issue of patient safety was highlighted by the reports of the Institute of Medicine, USA1,2 and this had received worldwide attention. It is also an irony that despite being in an age of major advances in medicine, science and technology, with the acceptance of evidence-based medicine, so much of medicine and healthcare delivered is of little or no proven value. This poses a major challenge on health policy, and on how this can be addressed in any health reform process that focuses on improving access, equity, efficiency and effectiveness in healthcare services.

Matched MeSH terms: Health Services
The prevalence of cardiac murmurs amongst standard one schoolchildren in the district of Gombak

Yong, J.F., Zulkifli, H.I., Che' Zuraifah, A.Z.

Malaysian Journal of Child Health, 1998;10(1):28-33.
MyJurnal

Background - Cardiac mumurs are common in childhood and are often innocent in nature. With careful examination, most innocent murmurs can be reliably diagnosed by a paediatric cardiologist, thus obviating the need for further investigations.

Aim - To look at the prevalence of cardiac murmurs amongst standard one schoolchildren in an urban setting, and calculate the sensitivity, specificity, positive and negative predictive values of clinical diagnosis in differentiating innocent from pathological murmurs.

Methods - One thousand three hundred and fourteen students from 7 primary schools in the district of Gombak were examined during a routine school health examination. Those who were found to have murmurs were referred for echocardiography. A diagnosis was made at the time of clinical examination and following echocardiography. Children with median sternotomy, lateral or posterior thoracotomy scars or those with previously diagnosed cardiac lesions were excludedfrom the study.

Results - Thirty six children were referred for echocardiography out of which 2 were confirmed to have underlying cardiac disease on echocardiography. The prevalence of previously undiagnosed cardiac mumurs in this study was 3%. The sensitivity of clinical examination in diagnosing pathological murmurs was 100% while the specificity was 75%. Positive predictive value was 25% and negative predictive value was 100%. Forty three percent of the students who underwent echocardiography were found to have trivial pulmonary regurgitatibn on Doppler echocardiography.

Conclusion - The prevalence of previously undiagnosed cardiac murmurs is low in this study. This may be due to the fact that they are detected and treated at an earlier age. There is need to conduct a similar study in a rural setting to compare the results.

Matched MeSH terms: School Health Services

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