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  1. Isa SNI, Ishak I, Ab Rahman A, Mohd Saat NZ, Che Din N, Lubis SH, et al.
    Malays J Med Sci, 2021 Apr;28(2):128-141.
    PMID: 33958967 DOI: 10.21315/mjms2021.28.2.12
    BACKGROUND: Quality of life (QoL) is an important aspect of well-being for the caregivers of children with disability, making it a noteworthy outcome. Little is known about the challenges faced by the caregivers in Asian countries and its association to their QoL. The purpose of this study was to examine a model describing the relationship between sociodemographic and disability-related factors on caregivers' QoL, mediated by the caregivers' psychosocial factors such as perceived stress, coping skills, and social support.

    METHODS: A cross-sectional study was conducted involving caregivers of children with special needs in Kelantan, a state of Peninsular Malaysia. A total of 383 caregivers completed questionnaires measuring sociodemographics, disability-related factors, psychosocial factors and QoL outcome. Structural equation modelling was performed to examine the relations of the variables in the conceptual model.

    RESULTS: In the final model, childcare dependency, caregiver's age, financial support, negative perception of stress and maladaptive coping skills were significant predictors of QoL (R 2 = 0.65). Caregiver's age had a direct effect on QoL, while financial support had an indirect effect on QoL via negative perception of stress. Childcare dependency had direct and indirect effects on QoL via negative perception of stress. Higher perceived stress was associated with lower QoL directly and indirectly via maladaptive coping skills. The final model fitted the data well (root mean square error of approximation [RMSEA] = 0.046; CFI = 0.923; χ2/df = 1.798).

    CONCLUSION: Intervention strategies to improve the QoL of caregivers should target the family unit and take into account the factors of child's disability, demographic and caregiver's psychosocial status.

  2. Doglikuu BD, Abdulai A, Yaseri M, Shakibazadeh E, Djazayery A, Mirzaei K
    Malays J Med Sci, 2021 Apr;28(2):84-99.
    PMID: 33958963 DOI: 10.21315/mjms2021.28.2.8
    BACKGROUND: Diabetes mellitus (DM) is public health problem. Feeding-recommendations help persons with diabetes control glycaemia. The aim was to access the association between adherence to diabetics' feeding recommendation with glycaemic control and with malnutrition risk.

    METHODS: Cross-sectional study was conducted among 530 baseline normal weight (body mass index [BMI] 18.5 kg/m2-24.9 kg/m2) persons with type 2 diabetes (T2DM) in Brong Ahafo region of Ghana, from August 2018 to September 2019. Adherence to feeding recommendation was evaluated with perceived dietary adherence questionnaire (PDAQ). Malnutrition-risk was assessed using malnutrition universal screening tool. Multinomial logistics regression models were used to assess the association between adherence to diabetics' feeding recommendation with glycaemic control and with malnutrition risk.

    RESULTS: Participants were generally healthy. Weight (P = 0.011), total cholesterol (P = 0.003) and glycated haemoglobin (HbA1c)% (P < 0.001) were significant with adherence to diabetics feeding recommendation. Low adherence to diabetics' feeding recommendation (adjusted odds ratio [AOR] 2.56; 95% CI: 1.44, 4.56; P < 0.001), low adherence to fruit and vegetables (AOR 2.71; 95% CI: 1.48, 4.99; P < 0.001), low adherence to whole grain, beans, starchy-fruits and plantain (AOR 3.29; 95% CI: 1.81, 6.02; P < 0.001), and low adherence to foods prepared with walnut, canola, sunflower, cotton seed and fish oils (AOR 2.62; 95% CI: 1.49, 4.58; P < 0.001) were significant with poor glycaemic control. Furthermore, low adherence to food prepared with walnut, canola, sunflower, cotton seed, fish or soy oils (AOR 0.54; 95% CI: 0.31, 0.95; P = 0.034) and low adherence to fish and lean meat (AOR 2.09; 95% CI: 1.14, 3.86; P = 0.017) were significant with moderate malnutrition risk.

    CONCLUSION: This study demonstrates that poor adherence feeding recommendation could be related to glycaemic control and malnutrition risk.

  3. Bachok N, Ghazali AK, Hami R
    Malays J Med Sci, 2021 Apr;28(2):106-118.
    PMID: 33958965 DOI: 10.21315/mjms2021.28.2.10
    BACKGROUND: Restricted movement and preventive actions have been introduced to break the chain of transmission of a new coronavirus. This study was conducted to determine the level of knowledge, awareness, attitude and preventive behaviour regarding the transmission of the COVID-19.

    METHODS: A cross-sectional study was conducted among Malaysians aged 20 years old and over, who had accessed the internet and used the WhatsApp application. The sampling method was a convenient snowball from 14 Malaysian states. This study was conducted online using questionnaires during the Movement Control Order due to the pandemic.

    RESULTS: Approximately 40.0%, 46.1% and 47.4% of 1,290 participants had a score above the median (good score) for preventive behaviour, attitude and knowledge, respectively. Age was significantly associated with poor knowledge (adjusted odds ratio [AOR] 0.98; 95% confidence interval [CI]: 0.97, 0.99; P = 0.026). Males (AOR 1.35; 95% CI: 1.05, 1.74; P = 0.021), Malays (AOR 1.41; 95% CI: 1.01, 1.98; P = 0.043) and Chinese (AOR 2.19; 95% CI: 1.17, 4.13; P = 0.015) were the associated factors for poor attitude. Chinese ethnicity was significantly associated with poor preventive behaviour (AOR 2.80; 95% CI: 1.39, 5.61; P = 0.004).

    CONCLUSION: The level of knowledge, attitude and practices were high except for a few questions. The young, males and Malay and Chinese individuals need health education.

  4. Hasbullah FY, Fong KY, Ismail A, Mitri J, Mohd Yusof BN
    Malays J Med Sci, 2021 Feb;28(1):75-86.
    PMID: 33679223 DOI: 10.21315/mjms2021.28.1.10
    BACKGROUND: Genetic factors increase the risk of type 2 diabetes mellitus (T2DM). Thus, family history status may be a useful public health tool for disease prevention. This study compared the nutritional status, knowledge level, and T2DM risk among young adults with and without a family history of diabetes in Malaysia.

    METHODS: A total of 288 university students aged 18 to 29 years participated in this comparative cross-sectional study. We assessed dietary intake, level of physical activity, knowledge of diabetes and T2DM risk.

    RESULTS: Respondents with a family history of diabetes had significantly higher weight (P = 0.003), body mass index (P < 0.001), waist circumference (P < 0.001), diabetes knowledge level (P < 0.005) and T2DM risk (P < 0.001). Ethnicity, fibre intake, T2DM risk score and knowledge about diabetes were significant contributors toward family history of diabetes (P = 0.025, 0.034, < 0.001 and 0.004, respectively).

    CONCLUSION: Young adults with a family history of diabetes had suboptimal nutritional status. Despite being more knowledgeable about diabetes, they did not practice a healthy lifestyle. Family history status can be used to screen young adults at the risk of developing T2DM for primary disease prevention.

  5. Shakeel S, Ahmad Hassali MA
    Malays J Med Sci, 2021 Feb;28(1):109-116.
    PMID: 33679227 DOI: 10.21315/mjms2021.28.1.14
    With the continuation of the second wave of a novel coronavirus disease (COVID-19), which is likely to be even more devastating, there are several associated health problems. COVID-19 is usually mild and non-fatal in children. However, in rare cases, children could severely be affected, and clinical manifestations may differ from adults. A multisystem inflammatory syndrome in children (MIS-C) is a rare but serious complication associated with COVID-19, initiated by an overactive immune response in kids that usually hits weeks after exposure to the COVID-19. MIS-C is a disorder in which inflammation could occur in different parts of the body. The disease puts pressure on the heart, as blood vessels leading towards the heart get inflamed and incapable of carrying adequate blood, hence producing cardiac complications in children hospitalised with MIS-C. The problem seems to be associated with COVID-19 in children; however, the association between MIS-C and COVID-19 is still unidentified. There is very little understanding of what triggers the MIS-C, which necessitates a rigorous mapping of the disease and associated risk elements for better disease management and navigating through this crisis.
  6. Gill MS
    Malays J Med Sci, 2021 Apr;28(2):171-176.
    PMID: 33958971 DOI: 10.21315/mjms2021.28.2.16
    Pharmacy practice is the discipline concerning the roles of pharmacists in the healthcare setting. Healthcare in Malaysia encompasses numerous sectors, such as academics, community, enforcement, hospital, industrial, jurisprudence, military, regulatory and research and development. In addressing the crisis brought on by the coronavirus disease 2019 (COVID-19) pandemic, pharmacists and technicians have been highly involved in the delivery of healthcare services. Malaysia has a distinct two-tier healthcare system and within this context, it is essential to integrate services during a crisis to maximise the available but limited medical resources. Often, the focus is on realistic and logical public-private partnerships. However, integrating different ministries offering healthcare facilities is also important and inter-agency pharmacy practice coordination must be optimised. The Malaysian Armed Forces Health Services can be primed to enhance the nation's healthcare capacity and capability. As the COVID-19 pandemic continues to grip the nation and cause an unprecedented number of Malaysians to become very ill, pharmacists must be resilient in leading, adapting and integrating well-rounded strategies in their respective fields to ensure good pharmacy practice.
  7. Gupta R, Choudhari OK, Mishra H, Ojha UC
    Malays J Med Sci, 2021 Feb;28(1):9-14.
    PMID: 33679215 DOI: 10.21315/mjms2021.28.1.2
    The coronavirus disease 2019 (COVID-19) pandemic is an evolving condition in the absence of established treatment and vaccines. The few autopsy studies on COVID-19 patients suggested the presence of pulmonary microvascular thrombosis. Hence, it is imperative to understand the pathobiology of thrombus formation and speculate the therapeutic goals in combating COVID-19. This paper focuses on a holistic approach by integrating the previous concepts and current concepts of thrombosis to better understand the pathogenesis of thrombosis.
  8. Arung ET, Ramadhan R, Mandzilkh LD, Santoso PA, Matsumoto M, Nagata M, et al.
    Malays J Med Sci, 2022 Oct;29(5):146-153.
    PMID: 36474534 DOI: 10.21315/mjms2022.29.5.15
    The broader objective of this study is to identify natural materials that might inhibit the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We have focused on stingless bee honey, which has a unique taste that is both sweet and sour and sometimes bitter. We screened 12 samples of honey from 11 species of stingless bees using an angiotensin-converting enzyme 2 (ACE2)-spike protein-binding assay and phytochemical analysis. Ten of the samples showed inhibition above 50% in this assay system. Most of the honey contained tannins, alkaloids, flavonoids, triterpenoids, carotenoids and carbohydrates. Our findings in this in vitro study showed that honey from stingless bees may have a potent effect against SARS-CoV-2 infection by inhibiting the ACE2-spike protein-binding.
  9. Aminuddin F, Bahari MS, Mohd Nor Sham Kunusagaran MSJ, Zaimi NA, Shahari MR, Mohd Hassan NZA
    Malays J Med Sci, 2022 Oct;29(5):93-104.
    PMID: 36474536 DOI: 10.21315/mjms2022.29.5.10
    BACKGROUND: Postnatal care (PNC) in Malaysia is believed to have played a role in reducing maternal and child mortality. A pilot study was thereby conducted to estimate the cost of PNC in public primary care facilities in Negeri Sembilan from the perspective of healthcare providers.

    METHODS: This study employed a cross-sectional design that involved six public primary care facilities in Negeri Sembilan, Malaysia. The PNC-related costs data were collected between May and July 2017, utilising cost data for the year 2016 and involving 287 eligible mothers. The PNC costs were calculated using mixed top-down and activity-based costing (ABC) approaches.

    RESULTS: The mean cost of PNC per patient was RM165.65 (median, RM167.12). Personnel cost was the main cost driver for PNC, which accounted for the most significant proportion of the total cost at 94.2%. Education level, type of health facilities and postnatal visits were positively associated with the total PNC cost.

    CONCLUSION: This study highlighted the average cost of PNC in the public primary care facilities in Negeri Sembilan. The cost of PNC was revealed to be primarily driven by personnel cost. The findings of this pilot study could add to the evidence base of PNC and serve as a vital reference for improving future estimates to better allocate scarce resources.

  10. Ishak B, Azizan ANA, Mariappan V
    Malays J Med Sci, 2022 Oct;29(5):126-132.
    PMID: 36474533 DOI: 10.21315/mjms2022.29.5.13
    BACKGROUND: Many factors determine the success of wearing contact lens, including knowledge and compliance towards lens care. This study aimed to evaluate the level of knowledge and compliance between two groups of adult contact lens wearers in Kuala Lumpur, Malaysia.

    METHODS: A total of 60 participants aged 18-30 years old volunteered to participate in this study (30 participants prescribed contact lenses at the Universiti Kebangsaan Malaysia [UKM] optometry clinic and 30 participants fitted at private practices). Participants were interviewed using a structured questionnaire consisting of nine questions on basic knowledge related to lens wear and 13 questions on compliance, categorised into questions on the cleaning process, disinfection, accessories care and replacement schedule.

    RESULTS: All participants wore disposable contact lens 53.3% (n = 32) participants preferred using monthly disposable lenses. Both groups had the same level of knowledge, except knowledge of the effects of makeup (P < 0.000) and duration of the solution used for cleaning (P < 0.010), showing lack of knowledge on contact lenses among participants in private practices group. There were no significant differences between the groups in terms of the level of compliance with the cleaning process (P = 0.830), disinfection (P = 0.725), accessories care (P = 0.865) and replacement schedule (P = 0.699).

    CONCLUSION: Participants from UKM optometry clinic had better knowledge on wearing contact lens; moreover, both groups had good compliance towards lens care. Contact lens practitioners should provide all the necessary information to contact lens wearers so that they are equipped to handle contact lenses correctly, which would minimise the risk of eye complications.

  11. Ueda M, Yoshida M, Yamashita E, Bhandari D, Endo M, Ozaki A
    Malays J Med Sci, 2022 Oct;29(5):154-158.
    PMID: 36474538 DOI: 10.21315/mjms2022.29.5.16
    Previous laboratory studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) revealed that the stability of the virus in the air or on surfaces is sensitive to seasonally relevant environmental conditions. However, the seasonality of the virus in the real world remains unclear because each country adopted various infection control policies. Therefore, we investigated peak dates with regard to new confirmed cases of coronavirus disease 2019 (COVID-19) and an association of these dates with the timing of the lockdown among G20 countries that have four seasons from 1 June 2020 to 18 February 2021. As a result, countries in both hemispheres experienced seasonal peaks in the number of COVID-19 cases both in the middle of warm and cold seasons. In addition, there were no apparent relationships between the peak date and periods with stringent measures. Our study demonstrated that SARS-CoV-2 causes seasonal outbreaks in the winter and possibly summer and thus, countries might need to consider measures to prepare for resurgence of the virus in the middle of 2021.
  12. Al-Ani AHHDA, Othman N, Hassali MA, Ibrahim B
    Malays J Med Sci, 2022 Oct;29(5):17-23.
    PMID: 36474531 DOI: 10.21315/mjms2022.29.5.3
    Sepsis is a medical emergency that involves a systemic immunological response due to an infection, resulting in the end-stage-organs malfunction and death. It is associated with high mortality rate despite a better understanding of the disease pathology and the mechanism involved. This review was designed to summarise the available evidences regarding the adequacy of the empiric antimicrobial therapy (EAMT), its predictors and its impact on the outcomes in intensive care unit (ICU) sepsis patients. Providing an adequate EAMT is considered one of the cornerstones of sepsis management as it has been found to be associated with better survival and is a good predictor for shorter ICU-length-of-stay. In contrast, inadequate EAMT in sepsis patients is associated with poor clinical outcomes including increased mortality and prolonged hospital stay. Evidence from this review suggest that it is important to identify determinants of inadequate EAMT to optimise the antimicrobial therapy provided to sepsis patients. Predictors of inadequate EAMT included co-morbidities (cancer), source and type of infection, higher Acute Physiology and Chronic Health Evaluation (APACHI-II) score and long hospital stay prior to the infection. As EAMT is considered as one of the effective treatment strategies to prevent sepsis associated death, healthcare providers should ensure the adequate antimicrobial therapy is provided for sepsis patients to improve and optimise their management.
  13. Shamsuddin AS, Mohd Abu Bakar WA, Syed Ismail SN, Jaafar NH, Mohd Yassin W, Norhizat M
    Malays J Med Sci, 2022 Oct;29(5):24-38.
    PMID: 36474532 DOI: 10.21315/mjms2022.29.5.4
    Approximately 230 million children under 5 years old of age suffer from malnutrition and over half of the children below 5 years old deaths are due to malnutrition nowadays. To gain a better understanding of this problem, the application of spatial analysis has risen exponentially in recent years. In this review, the present state of information on the use of spatial analysis in childhood malnutrition studies was evaluated using four databases of digital scientific journals: ScienceDirect, Scopus, PubMed and CINAHL. We chose 2,278 articles from the search results and a total of 27 articles met our criteria for review. The following information was extracted from each article: objective of study, study area, types of malnutrition, subject, data sources, computer software packages, spatial analysis and factors associated with childhood malnutrition. A total of 10 spatial analysis methods were reported in the reviewed articles and the Bayesian geoadditive regression model was the most common method applied in childhood malnutrition studies. This review highlights the importance of the application of spatial analysis in determining the geographic distribution of malnutrition cases, hotspot areas and risk factors correlated with childhood malnutrition. It also provides implications for strategic initiatives to eradicate all forms of malnutrition.
  14. Chainchel Singh MK, Mohd Noor MH, Ibrahim MA, Siew SF, Lai PS
    Malays J Med Sci, 2022 Oct;29(5):83-92.
    PMID: 36474535 DOI: 10.21315/mjms2022.29.5.9
    BACKGROUND: COVID-19 was declared a pandemic by the World Health Organization (WHO). COVID-19 is highly contagious, making it a threat to healthcare workers, including those working in mortuaries. Therefore, it is important to determine if the cause of death (COD) could be identified using limited autopsy, diagnostic tests and post-mortem imaging modalities instead of full autopsy. This study aims to examine the effectiveness of post-mortem imaging, specifically post-mortem computed tomography (PMCT) at determining the COD during a pandemic.

    METHODS: This cross-sectional study included 172 subjects with suspected or unknown COVID-19 status brought in dead to the institute's mortuary during the pandemic in Malaysia. PMCT images reported by forensic radiologists and their agreement with conventional autopsy findings by forensic pathologists regarding COD were analysed to look at the effectiveness of PMCT in determining COD during a pandemic.

    RESULTS: Analysis showed that 78.7% (133) of cases reported by forensic radiologists concurred with the COD certified by forensic pathologists. Of these cases, 85 (63.9%) had undergone only external examination and real-time reverse transcriptase polymerase chain reaction (rRT-PCR) COVID-19 testing, meaning that imaging was the sole method used to determine the COD besides history from available medical records and the investigating police officer.

    CONCLUSION: PMCT can be used as a complement to medicolegal autopsies in pandemic contexts, as it provides significant information on the possible COD without jeopardising the safety of mortuary health care workers.

  15. Mohamed Z, Jit Singh GK, Dediwadon NS, Mohamad Saleh NA, Jupri NN, Ganesan Y
    Malays J Med Sci, 2022 Oct;29(5):117-125.
    PMID: 36474539 DOI: 10.21315/mjms2022.29.5.12
    BACKGROUND: Stress related to nursing education and clinical placement encounters by students since the beginning of their nursing course has been an issue of concern. This study aims to examine the prevalence of adult personality traits and their relationship with stress levels, coping mechanisms and academic performance among nursing students.

    METHODS: This cross-sectional study was conducted among 92 nursing students at Universiti Kebangsaan Malaysia (UKM). The Big Five Inventory (BFI), Student Nurse Stress Index and Brief COPE instruments were used to measure the respondents' personality traits, stress level and coping mechanisms, respectively. Data were analysed using IBM SPSS version 26.

    RESULTS: The most prevalent personality trait of the students was openness (mean = 33.58). Conscientiousness (r = -0.226, P = 0.030) and neuroticism (r = 0.326, P = 0.002) are significantly related to stress level. Extraversion (r = 0.219, P = 0.036), conscientiousness (r = 0.206, P = 0.049) and openness (r = 0.219, P = 0.036) show significant relationships with the approach coping mechanism, while agreeableness (r = -0.257, P = 0.013) and neuroticism (r = 0.297, P = 0.004) show significant relationships with the avoidant coping mechanism. However, no significant relationship was noted between personality traits and academic performance (r = 1.000, P > 0.05).

    CONCLUSION: Knowledge of ones' personality traits may benefit students in understanding themselves and in using the best ways to cope with their stress while studying nursing.

  16. Mato L, Chankavee N, Amatachaya S, Thaweewannakij T
    Malays J Med Sci, 2022 Oct;29(5):74-82.
    PMID: 36474537 DOI: 10.21315/mjms2022.29.5.8
    BACKGROUND: Patients with incomplete spinal cord injury (iSCI) and lower extremity muscle weakness often fall while standing up from a chair. The sit-to-stand (STS) task primarily uses the strength of the knee extensor muscles. The five times sit-to-stand test (FTSST) is often applied to determine lower limb function and the results are related to lower extremity muscle strength. This study explored the cut-off point for knee extensor muscle strength in patients with iSCI to independently determine their FTSST results and the correlation between knee extensor muscle strength and FTSST results.

    METHODS: Forty-four participants were assessed for knee extensor muscle strength using a hand-held dynamometer (HHD) and the FTSST.

    RESULTS: The data indicated that knee extensor muscle strength ≥ 53.06 Newton was the best independent predictor of the FTSST results (sensitivity 72.7%, specificity 72.7%). Moreover, knee extensor muscle strength was significant and correlated with the FTSST results (r = -0.45, P = 0.035).

    CONCLUSION: The findings offer a cut-off point for the knee extensor muscle strength measured while standing up from a chair that may help medical professionals set rehabilitation goals for patients with iSCI.

  17. Norazman TA, Yusoff S, Mohd Niza Nizal H, Taib F
    Malays J Med Sci, 2023 Aug;30(4):175-192.
    PMID: 37655138 DOI: 10.21315/mjms2023.30.4.15
    BACKGROUND: Domestic violence has a significant impact on growing children. However, existing evidence is limited and often under reported. Consequently, the Child Exposure to Domestic Violence (CEDV) scale has been developed for global use. This study aims to provide a cross-cultural translation, adaptation and validation of the CEDV based on Malay language.

    METHODS: CEDV scale was translated from the original English version to Malay. Content and face validity were examined before field-testing. The study comprised a cross sectional study using the Malay version of the CEDV (CEDV-M) scale conducted at a secondary school in Perlis, Malaysia and investigated 235 children aged 13 years old-16 years old using an online platform. The construct validity, internal consistency and stability of the tool were assessed.

    RESULTS: The CEDV-M scale's content and face validity both yielded a value exceeding 0.80. Furthermore, the tool demonstrated has good stability reliability, using the intra-class correlation value for all items ranging from 0.659 to 1.00. The exploratory factor analysis of the 36 items of the CEDV scale revealed possibilities of five or six factor domains. However, the five factor domains were most conceptually equivalent. Consequently, this study found that the CEDV-M scale is reliable with a total Cronbach's alpha of 0.87.

    CONCLUSION: CEDV-M scale is a valid and reliable tool for measuring a child's experience of domestic violence. Future studies recommend confirmatory factor analysis and standard settings for scoring systems.

  18. Aldawsari M, Soh KL, Abdul Raman R, Mohd Taib N, Aboshaiqah A
    Malays J Med Sci, 2023 Aug;30(4):116-131.
    PMID: 37655141 DOI: 10.21315/mjms2023.30.4.11
    BACKGROUND: Hands are the most common vehicle of pathogen transmission in a healthcare setting. Therefore, hand hygiene is the leading method of reducing healthcare-associated infections. This study aimed to determine the knowledge, attitude and practice (KAP) of hand hygiene and predictors for poor hand hygiene practice among healthcare workers who care for children with leukaemia in the paediatric oncology ward of King Saud Medical City (KSMC) in Saudi Arabia.

    METHODS: One hundred and ninety medical doctors and nurses, who were registered with the Saudi Commission for Health Specialities, were selected to participate in this cross-sectional study using a simple sampling technique. Their KAP of hand hygiene was assessed using a self-structured questionnaire and the collected data was analysed using IBM® SPSS® version 26.0.

    RESULTS: Of the 190 healthcare workers, 74.7% were nurses and 25.3% were medical doctors. Among the participants, 53.7% (102) had good knowledge of hand hygiene, 51.6% (98) had positive attitudes towards hand hygiene and 55.8% (106) practised satisfactory hand hygiene. Bachelor education level (adjusted OR = 2.736; 95% CI = 1.101, 6.799; P = 0.030), postgraduate education level (adjusted OR = 6.256; 95% CI = 2.171, 18.028; P = 0.001), poor knowledge (adjusted OR =2.575; 95% CI = 1.263, 5.246; P = 0.009) and negative attitude (adjusted OR = 4.702; 95% CI = 1.263, 5.246; P < 0.001) were the significant predictor variables of unsatisfactory hand hygiene practice among healthcare workers.

    CONCLUSION: The performance of hand hygiene among healthcare workers is still far less than optimal, particularly in settings like oncology units. Effective programmes are needed to increase their awareness of hand hygiene KAP, while strict guidelines are needed to reduce nosocomial infections.

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