Background: The COMBI concept is a novel approach by the WHO to control communicable diseases which are influenced by community behaviour. The Ministry of Health is currently evaluating its use against dengue in selected areas throughout Malaysia. COMBI doctrine differs from previous dengue campaigns. It acknowledges that the factors contributing to dengue proliferation may differ between areas. Factors for a given area are analysed, then a single precise behavioural goal to overcome those problems is formulated. To inculcate this behavioural change, the target community is subjected to an intensive campaign using Integrated Marketing Communication techniques adapted from the advertisingindustry, particularly involving volunteers from the community itself.
Methodology: In Selangor the pilot project was implemented in Section 3 and Section 4 of Bandar Baru Bangi, in the district of Hulu Langat. Here, Aedes breeding was found to occur mainly in water containers of semi permanent nature (eg. ‘kolah’, aquatic plant jars, flower pot bases etc). A total of 172 volunteers were recruited to disperse the message of “Suluh – Suluh, Basuh - Basuh” whilst distributing leaflets and flashlights to 2666 homes. Residents were instructed to illuminate such water containers twice weekly and scrub any containers found to contain larvae. The program commenced on 23/5/2004 and lasted 16 weeks.
Results : During this period, the initial Aedes Index of 5 was reduced to 0.96 while combined cases of Dengue Fever / Dengue Haemorraghic Fever in Sections 3 and 4 reported to the Hulu Langat District Health Office also dropped to 1 (unconfirmed).
Conclusion : The COMBI approach in Hulu Langat successfully demonstrated that correct problem identification synergized with community engagement can potentially reduce Aedes proliferationand dengue morbidity.
Background: A cross sectional study was carried out to determine the prevalence of microbiological contamination in ready- to-eat food and factors affecting it in Melaka from February 2008 till May 2008 in collaboration with the Food Safety and Quality Unit and District Health Offices in Melaka Tengah, Alor Gajah and Jasin.
Methods: A purposive sampling of 101 food premises was carried out and 202 ready- to-eat food samples were collected and analysed microbiologically using standard methods. A total of 202 food handlers were randomly selected for questionnaire interview while rectal and nasal swabs were taken from them to determine their healthy carrier status of pathogenic food bacteria.
Results: Results showed that the overall prevalence of microbiological contamination in ready- to-eat food was 35.1%, while prevalence by type of food was 42.0% for main dishes and 9.8% for staple food. The majority of the contaminations were due to coliforms (14.9%), total plate counts (12.4%) and Staphylococcus aureus (3.5%). The mean score for food premise inspection was 77.21 ± 10.32 and the prevalence of healthy carrier status of pathogenic food bacteria among the food handlers was 15.8%. The level of food handling practices among food handlers was influenced by sex (p=0.012) and formal training on food handling courses (p=0.009). There was a significant negative correlation between age and level of food handling practices among the food handlers (r = -0.163; p = 0.02). Poor food handling practices (p=0.02) and poor hygiene status among the food handlers (p
Introduction: The purpose of this article is to review the definitions of food security and food insecurity as well as the concepts related to food security.
Methodology: This is a systematic review on a few papers, research, and articles according to studies and research by various organizations, experts, scholars on food security in developed and developing countries.
Result: The first definition of food security was given to reflect the comprehensive concerns on the availability of world food supplies. The definition was expanded to incorporate accessibility of food for all people at all times. Then, the complex definitions of food security incorporated food accessibility and availability as well as the quality of food intake. Latest definition integrates the social aspect of food that should be accessed in a socially acceptable way. Broad definition of food insecurity and several terms that closely related were also discovered. The four main concepts of food security from these definitions were identified; availability, accessibility, acceptability and adequacy. These concepts of food security are relevant to micro, meso and macro levels of social and administrative organizations. Conclusion: Understanding definitions and concepts of food security can assist researchers, policy makers and program implementers to conduct research that address the issues of food security.
Introduction: Back pain associated with sense of pain and less comfort in back part of the body especially at the lower back area. Back pain is an occupational health problem with significant impact to productivity of workers.
Methodology: A cross sectional study was conducted to study the prevalence of back pain towards individual, physical and psychosocial factors associated among body shop’s operators at national Automotive Manufacturers.
Result: A total of 32 operators were involved in this study. Nordic Musculoskeletal questionnaire has been used in this study and body position assessment was done by using Ovako Working Posture Analyzing System (OWAS) method. Study showed the prevalence of back pain among operators throughout their work and in the last 12 months was 93.8% and 87.5% respectively. There are significant association (p0.05) between prevalence of back pain with another individual, physical and psychosocial factor.
Conclusion: This study shows that back pain prevalence were influenced by types of activity and body posture during working at assembling division among workers. Attention should be given to ergonomics factors to prevent back pain incident among automotive industry assembly workers.
Background: This cross-sectional study aimed to investigate the prevalence of the caregiving burden among women who are caregivers to elderly with stroke and factors influencing it. Respondents identified through purposive sampling at the Universiti Malaya Medical Centre from October to December 2007.
Methods: Direct methods of data collection (clinical and housing) and indirect (postal) used a structured questionnaire distributed to the guards. Measurements taken include sociodemographic variables of patients and caregivers, the patient, the care, relationships with caregivers and patients with information about stroke. Zarit Burden Interview (ZBI) short version was used to measure the burden of care. Carers' Assessment of Managing Index (Cami) was used to assess coping strategies. A total of 96 respondents took part in this study.
Results: The study showed that prevalence of caregiving burden was 35.4%. Burden of care was found to have significant relationships with factors such as marital status, caregivers (p = 0.017), family income (p = 0040) and the patients (p = 0.000). Significant correlation obtained for the coping strategies with the burden (r =- 0228, p 0026).
Conclusion: The conclusion shows that policy makers and program managers should appreciate and assist caregivers in performing the role of care. Intervention programs should be designed to suit the needs of the heterogeneous guardian.
Background: Level of comfort in working environment can contribute to increase level of health, emotion during working, level of safety, quality and productivity of work. A study of physical factors (heat, noise and lighting) is important to determine the level of comfort during working. This study was carried out to study those physical factors upon comfort level during working among Casting Shop workers in a car manufacturing factory.
Methods: Instruments for the physical monitoring including Questemp°36 Thermal Environment Monitor, Sound Level Meter and Lux Meter were used at seven measured areas. The information about the level of comfort during working was collected using questionnaires among 65 respondents by random sampling method.
Results: Measured data showed there were four measured areas which Wet Bulb Globe Temperature indoor (WBGTi) value are above the standard limit recommended by ACGIH, three measured areas recorded noise level above the standard limit recommended by Factories and Machineries (Noise Exposure) 1989, while there was no measured area recorded lighting reading below the standard limit recommended by MS ISO 8995:2005. Result from questionnaire found that the majority of the workers did not feel comfortable towards the heat and noise level in their workplace while most of the respondents felt comfortable towards lighting level in their workplace. Mean of WBGTi reading and lighting reading have a significant difference (p
Introduction: The aim of this study was to assess the overall diet quality of husbands and wives in a selected urban area in Selangor.
Methodology: This cross-sectional study was carried out in Bandar Baru Bangi, Selangor among 150 married couples aged 20 and above, who voluntarily agreed to participate and were not practicing any special diet. Data were collected using a 2-day 24-Hour Dietary Recall and a Food Frequency Questionnaire (FFQ) to evaluate the quality of diet among husbands and wives using the Diet Quality Index Revised (DQI-R).
Result: Majority of husbands and wives in this study were in the middle-age group, had received tertiary education, had household monthly income of more than RM3, 500 and encompass household size of 3 to 5 persons. The mean DQI-R score for husbands (mean age= 43.33 + 11.16 years) and wives (mean age= 41.28 + 10.93 years) were 67.8 + 9.1 and 64.4 + 9.3 respectively and there was a significant different in scores between the husbands and wives (p < 0.001). In general, the diet quality of this study population was not satisfactory and that the diet quality of husbands was better compared to their wives.
Conclusion: This study gives an insight picture of husbands and wives’ quality of diet. It can be used as a guideline to improve health intervention programs in the future.
Introduction: Pre-pregnancy care is an important strategy in prevention of adverse maternal and fetal health as well as continuity of good child care. In multi-ethnicity country such as Malaysia there are many cultural, religion and beliefs related to certain life stages.
Methodology: A cross sectional study was conducted among the Indian ethnic group to assess the prevalence and factors associated with pre-pregnancy care. A study was conducted in Taman Manickavasangam Hulu Langat Selangor among the age group of 18-45 year old women.
Result: There were 90 respondents participated in self administered questionnaires. There were 65 respondents (72.2%) married, 24 (26.7%) single and one widow (1.1%). Using a scoring method of analysis (high and low) showed that 55 (61.1%) have high score in knowledge on pre-pregnancy care. The prevalence of pre-pregnancy care practice showed that 63 (70%) scored as high practice. Using correlation analysis showed that there was a significant association between the practice score and increasing age (P=0.03). However, only history of previous pregnancy showed a significant association with the pre-pregnancy care practice and no association found between the practice and knowledge score.
Conclusion: Prepregnancy care helps in screening risk factors of women before conception. This will help in prevention of adverse effect on maternal and foetal. Giving awareness on the importance of having prepregnancy care screening may help women to continue practicing good antenatal care.
Background: A randomised single blinded clinical trial comparing the effectiveness of two methods of cataract surgery with intraocular lens implantation: extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was carried out at Hospital Universiti Kebangsaan Malaysia (HUKM) between March 2000 and August 2001. Methods: The effectiveness of cataract surgery was assessed from the quality of life specifically for vision via Visual Function 14 (VF-14) preoperatively, one week, two months and six months after surgery. Results: The result showed that there was a significant increased in VF-14 scores after a week, two months and six months postoperation compared to the score before surgery for both techniques. However there was no significant difference in VF-14 scores when compared between ECCE and PEA. Conclusions: This study indicated that both techniques give equal benefit to cataract patients. Since effectiveness of cataract surgery with intraocular lens implantation is unrelated to operative procedures, less costly technique should be promoted.
Background: Safety and health audit study is a part of occupational safety and health risk assesment. Thus, student’s residential audit is important in order tu ensure the safety rules which implemented by the management is appropriate and follow the standard set forth. Furthermore, it also important to determine places, area or situation that might lead to hazard risk so that prevention step could be plan and implement.
Objective: This study was to determine the safety level of students residential in physical aspects.
Methods: Safety inspection or audit conducted is in accordance with criteria and indicators listed in the checklists that have been formed based on the audit forms from the Department of Safety and Health (DOSH), National Institute of Safety and health (NIOSH) and the Occupational Safety and Health Committee of UKMs (JKKP). Several indicators are also included in the audit form as to ensure it covers all the technical aspect and suited with the college conditions. The safety level for each of the blocks in KDO is categorized using points and percentage score obtained.
Results: Based on the overall score, the average safety score in percentage for areas in KDO are preceded by general office with score 85.5% followed by residential blocks with 71.5%, facilities with score 71.2% and administration block with 70.9%. The results of the study show that most of the areas are at least in a safe level.
Conclusion: Roles of employer and college administration, significant OSH programme and safety audit are important factors as to ensure the safety of student's residential college.
Introduction: Behavioural-based safety (BBS) programme is an accident prevention programme emphasized on the aspect of unsafe behaviour, which considerably new in Malaysia. The oil and gas industry is among the industries in Malaysia that has successfully implemented and sustaining the programme. The aim of this study is to measure and evaluate the effectiveness of BBS towards the safety performance in the oil and gas industry in Malaysia that certainly has owned an outstanding safety performance.
Methodology: A cross-sectional study using secondary data involving five indicators in the safety performance in the department of health, safety and environment (HSE) was performed at one of the oil and gas refinery companies in Malaysia. These indicators were chosen based on the frequency of its occurrence from January 2004 to December 2008.
Result: The results of the study show the presence of a significant difference in the incidence rates of near misses (p=0.008) and medical treatment cases (p=0.035) before and after the implementation of BBS and a very strong negative relationship (r=-0.885) between the incidence rates of near-misses and the rates of BBS observations done. However, analysis on unsafe behaviour does not show a significant reduction from 2006 to 2008. Instead, a significant reduction was seen on equipments failure from year 2006 to 2007 (p=0.021) and 2006 to 2008 (p=0.032).
Conclusion: The study has proven that the BBS is effective towards the reduction of the indicators in the safety performance, involving only the incidence rates of the nearmisses and the medical treatment cases. However, a very strong negative relationship only involves the incidence rate of near misses. A significant reduction was also seen on the occurrence of instrument failure, which is one of the root causes of near-misses. Although there is no significant reduction on thye unsafe behaviour, the reduction of equipment failure is expected to be related to the increase in the level of awareness and safe behaviour as a result of BBS implementation.
Introduction: To determine the effectiveness of the enhance enforcement programmes (The Ops) on the percentage of seatbelt wearing among front occupants in Malaysia.
Methodology: The roadside observations for measuring the seatbelt wearing among front occupant were conducted before, two weeks and six months after the Ops. The study was conducted in selected states representing four different zones (Northern, Southern, Eastern and Central zones) of Peninsular Malaysia.
Result: A total of 12,298 drivers and 11,212 front occupants were observed for their seatbelt wearing status through out the study. Percentage of seatbelt wearing among drivers and front passengers were increased from the baseline of 82.6 % and 74.4 % to 92 % (95 % CI: 91.2, 92.7) and 87.0 % (95 % CI: 85.9, 88.0) after two week, but declined to 85.7 % (95 % CI: 84.4, 86.8) and 76.8 % (95 % CI: 75.2, 78.3) after six months of the Ops respectively. Pre and post analysis revealed that after 2 weeks, the Ops were significantly effective in increasing the seatbelt wearing among front passengers and drivers with the RR (95 % CI) of 1.17 (1.14, 1.20) and 1.12 (1.10,1.13) respectively. However, after six months, the effectiveness of the Ops was reduced for both type of vehicle occupant.
Conclusion: This study sheds light on the importance of the enhance enforcement programme for increasing the seatbelt wearing in Malaysia. However, in order to give more impact on seatbelt wearing, the strategy and the frequency of the enhance enforcement programme in Malaysia may need to be revised.
Introduction: Relatives play an important role in patient care - not only providing social support but also help to complement the existing care. They must be empowered with relevant knowledge and skills of patient care including motivating patient towards immediate healing and acceptance of his fate. Although these are various approaches, the media is regarded as the most effective method in educating the family or the relatives. This paper highlights the significant role of the media as an educational tool to mobilize patient’s relatives in total patient care.
Methodology: This is a review conducted on reports, observations and feedbacks gathered from various sources involved in patient education in hospital setting. It was endorsed by a series of in-depth expert forum under patient education module.
Results: Relative empowerment has been identified to be as an important role and yet it is not fully utilized. The manpower resources are so scarce and crucial in patient as well as relative education. The media is the only alternative educational tool that could compliment the educational needs. Of all potential media available in the market we have recognized at least four types of media that can be optimally resourced and used. Through manipulation of its content and making it interactive, the role of media seemed to be extremely effective in patient management that include relatives.
Conclusion: The role of media in relative’s education in support of patient care is undeniable. The media with the most potential should be identified and the management of its content to be enhanced. It must be incorporated with an interactive approach in order to have more self-involvement and undersatanding of its content.
Introduction: In view of high healthcare expenditure, Malaysia also faces problems in healthcare financing. The policy option is to establish a national health financing scheme. However, it is a problem to develop mechanisms to cover social insurance package to more than one third of the population working in informal sector such as farmers. Therefore, there is an urgent need to assess the ability and willingness of the farming community. The main objective was to study the ability and willingness in the farming community to contribute to national healthcare financing scheme.
Methodology: This a cross sectional study involved 400 farmers in Selangor. A total of 92.3% farmers were able to pay for the healthcare.
Results: Willingness to contribute to The national healthcare financing scheme were RM2.00 per month.
Conclusion: The education level influenced the ability to pay while the educational level and per capita income influenced willingness to pay.
Background: Without any doubt, the combo of user ID and password are the most used authentication method in the computing and internet environment. However, due to the enormous number of accounts that require password authentication, users tend to develop bad habits in their password practices which in turn will put their account security at risk. With the increasing use of computing in health-care settings and the use of EMR in hospitals, such practices are a cause for concern.
Methods: This is a cross-sectional study using self-administered questionnaires, investigating the practice of the respondents in keeping their passwords secure. Respondents in this survey are the undergraduate students of Faculty of Medicine, Universiti Kebangsaan Malaysia.
Results: Among the findings are that 87.4% of the respondents used the same password for more than one account. If a user used the same password for several accounts, it might trigger a domino effect if any of the account passwords were compromised. A total of 98.9% of the respondents memorised their password only in their mind, without writing down the password anywhere. This may lead to using easily guessable passwords which may introduce additional security risk to their accounts. The majority of the respondents (96.6%) never or rarely change their passwords. The study also showed that 82.7% of the respondents used passwords which are 6-8 characters in length. Longer passwords are usually safer but harder to remember. The questionnaire also explored the users’ password combination style, whether they used numbers only or combination of numbers and alphabets or some other pattern. A total of 39.1% used letters only but 27.6% used combination of numbers only which is less secure. About 77% of the respondents used personal information such as their birthday date or a person’s name as part of their password.
Conclusions: This habit may make their password guessable to people who are close to them. In conclusion, most medical students are not practising safe password conduct and they should be educated on this. If not, patients’ data confidentiality may be compromised in the future due to such practices.
Introduction : Globalization has made health tourism possible and continues to flourish. For participating countries, this new industry rakes in billions of dollars a year, and is worth focusing on and being developed.
Objective : This write up aims to find out the history and success of health tourism in countries around the world, study the scenario in Malaysia and propose strategies which could make Malaysia prosper with this multibillion dollar industry.
Methodology: The methodology applied was compilation, data review and comparison from annual report, action plan report and articles.
Result : In the ASEAN region, Malaysia is making a mark in the health tourism industry, thanks to the availability of medical and technical expertise, political and economical stability, high quality infrastructure, and scenic beauty of the land. Nonetheless, despite all these, Malaysia has yet to be at par with her neighbours- Thailand, Singapore and India, in terms of the number of foreign patients and the revenue gained from this industry. Thus there is a serious and urgent need to conduct research to analyze the current situation and future prospects of health tourism in Malaysia. This industry is open to all countries around the world. It is those countries that can continually analyze and adapt that will prosper in the emerging medical tourism industry. Some of the key issues which need to be addressed are those of promotion, finding the niche market, branding, legislations, immigration and quality of healthcare. In addition to these, matters regarding human resource, particularly that of internal brain-drain, need to be looked into.
Conclusion : Malaysia has great potential of becoming the giant of the health tourism industry provided appropriate and timely actions are taken towards achieving it. The negative impact must not be ignored or overlooked; instead it must be thoroughly studied and rectified.
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.
Background: Social misconduct amongst adolescents is a worrying and ever growing problem in Malaysia, despite efforts taken to overcome it.
Methods : A cross sectional study was conducted among secondary school students in Melaka Tengah District to measure the prevalence and determine the factors associated with social misconduct amongst adolescents. A total of 414 form four students were recruited by systematic random sampling fulfilling the study criteria between Jun to September 2008, from eight randomly selected secondary schools in the district. Data were collected using a structured self-administered questionnaire and analyzed using SPSS software version 12.0. Socio-demographic, housing and family factors in relation with social misconduct were studied.
Results : The prevalence of the social misconduct in this study was 70.5%. The most prevalent misconduct includes loitering (37.4%), truancy (30.0%), watching pornographic films (28.7%), and involved in pre-sexual activities (23.7%). The factors that showed significant association with social misconduct were sex and race.
Conclusion : The prevalence of social misconduct is high among adolescent and males as well as Malays are at higher risk. Activities planned for adolescents should be stressed on the danger and effects of social misconduct and be more focused towards male and Malay adolescents.
Aims : The review was to determine the prevalence of needlestick injury especially among health care personnel and to determine the score of knowledge and compliance to the Standard Universal Precaution.
Method : Twelve theses were reviewed from year 1996 to 2007 of Master in Community Health Science, Master in Community Health and Postgraduate Diploma in Occupational Health of Community Health Department Universiti Kebangsaan Malaysia Medical Center involving of 1645 respondents of health care personnel, support staff and student of nursing and medical. Eleven studies were cross sectional design and only one study was retrospective.
Results : Respondents were dominated by female (74.6%) and Malay ethnicity (65%), as young as 19 years old to 56 years old of age. Majority had received Hepatitis B vaccination (79.4%) but only 37.1% had completed the 3 doses regime. The incidence of episodes of needle stick injury among health care personnel was double (53.7%) compared to final year medical students (20.9%). Needle stick injuries did not occur at random as there were a few health care personnel injured repeatedly. Those who had higher mean or median score for compliance to Standard Universal Precaution were non case of needlestick injury. Work practices had been highlighted in few studies of being risk factors for needlestick injury such as blood withdrawing related activities. Other risk factors were job category, predictive factor for compliance to Standard Universal Precaution, risk perception and training.
Conclusion : Even though the review could not extrapolated to general population of healthcare personnel but it gave some illustrated pictures to what had happened in small clustered locations. Episodes of needle stick injury was 53.7% for past 12 years, it was double in comparison to final year medical students in year 2001. 13.2% were injured repeatedly. The score of knowledge was more the 50% of range but compliance to Standard Precaution made differences in being cases or non cases among respondents. The seroconversion status till date was unknown.
Background : Family planning is a method to control family size and to increase the intervals between chidbirths using multiple methods of contraceptives.
Objectives : This study aims to determine the pravelance of family planning practice among married women (wife less than 55 years old) and its related factors and also to determine the husbands knowledge on family planning and their support.
Methodology : This is a cross sectional study done through direct interviews amongst 118 married couples in Kampung Sesapan Batu Mingkabau, Hulu Langat Selangor.
Results : On family planning practise, 43.2% of couples is currently practising, 22.0% have practiced but stopped and 34.8% have never used any types of family planning methods. As high as 75% of wives received support from their husband to pratice family planning. There is a significant association between family planning practice and wife’s age, husband’s age, wife’s occupation, wife’s education, wife’s knowledge and husband’s support. Husband’s knowledge , number of live children and husband’s education have no significant assocation in influencing family planning practice.
Conclusion : To achieve better knowledge and family planning practises, husband’s involvement and support must be encouraged to ensure the correct informations and support are delivered to both couples. Approach through husbands is regarded as one of the key factors to the success of rural women family planning practice.