The purpose of this study is to review the literature on microsporidiosis in various high-risk groups among the Malaysian population, i.e., HIV/AIDS, cancer, hospitalised patients and Orang Asli, and to update information with regards to microsporidia prevalence, diagnosis and association of the disease with gastrointestinal symptoms in Malaysia. Hospitalised patients showed the highest prevalence (28.3%) of microsporidiosis compared to other risk groups. This review did not find any direct correlations between gastrointestinal symptoms and microsporidiosis. Since microsporidiosis is an emerging threat to the high-risk groups, greater awareness should be instilled among clinicians to consider microsporidiosis in their differential diagnosis if no other causes can be defined.
The paper puts forth the need for health care workers safety whilst undertaking their job on a daily basis. Presently there are number of factors that are directly linked to the safety of health care workers. However, Occupational Health is very important and useful for health workers that are exposed to their job hazards. Every year, many lives are lost because of the spread of infections in hospitals. Every hospital’s occupational health departments should ensure that all new staff are vaccinated to protect them against microorganisms carried by other patients, and with vaccinated against preventable diseases. This will help to prevent the health workers from occupational exposure to patients’ blood or any other bodily substances, including injury from sharp objects, and also guarantees that the new employees does not infect the patients with infectious diseases. Furthermore, all the new staff should be screened for blood borne pathogenic diseases.
Introduction: Transboundary haze occurred was primarily derived from seasonal forest fires which has highly been concerned of the health effect on the local community. As awareness of the source and dangers of smoke haze spread, Malaysian government increasingly came under pressure from the public and civil society at the national, state, and district level to address the haze issues. However, the knowledge, attitude, and practice (KAP) inequalities of urban and rural community could be a barrier in promoting awareness on haze. Objective: To determine the urban and rural inequality in KAP on haze. Methodology: A total of 400 urban and rural residents from Klang Valley was recruited to participate in this study. A validated survey form was used as the study instrument which composed of four parts: (1) Sociodemographic information, (2) Haze knowledge, (3) Attitude (concerns) during haze episodes, (4) Practices (protective behaviors) to prevent against the health effects of haze. Result: There were significant differences of KAP on transboundary haze among urban-rural population. Urban population has higher knowledge and protective behaviors on hazes; however, both the rural-urban residents presented moderate levels of concerns on hazes. Conclusion: It is necessary to provide timely information (knowledge and practices) on haze to rural residents, at the same time, improve the urban residents’ concerns (attitudes) over the haze phenomenon. This will help to raise the overall awareness level to transboundary haze by translating into a state of the resilient community.
As air travelling now becomes cheaper and available to almost all people of any walk of life, travelling across international borders is fast becoming a lifestyle of many. Having travel health service as part of health care services is important to address the issues of travel related illnesses among travellers. However, lacks of published guidelines pertaining to travel health service rendering many countries to overlook its importance. The aim of this paper is to review published literatures and authoritative websites on the components needed to develop guideline to establish travel health services. A systematic literature search was done using pre-specified keywords for literatures published between years 2000 – 2016. Literatures written in English and fully accessible were all included. No exclusion criteria was set before the search. Online authoritative websites pertaining to travel health were also referred. A total of six literatures ranging from expert opinion, review paper and original study, together with three authoritative websites related to travel health were reviewed. Among the important components needed to be considered for developing the guideline for establishing travel health services are to prioritise pre-travel health service, to set up specialised travel health clinic, to produce travel health/medicine specialist, to emphasize on continuous education and training of the practitioners and to apply multiagency and multidisciplinary approach with adequate fund for research in travel health. As a conclusion, policy makers should prioritise and select the most important components in developing guideline for travel health service.
This study aims to review existing studies on the relations between indoor dampness and mould in different public occupied buildings with the risk of adverse health effects among both children and adults. This study specifically focused on the dampness-related problems from countries with tropical climate. A systematic literature search of ScienceDirect, PubMed, Google Scholar and Wiley Online Library from 2000 through December 2015 was conducted. Furthermore, the reference lists of recent reviews and of relevant articles were identified in our search. Crosssectional, case-control, and cohort studies in children or adults were selected according to a priori criteria. The search yielded a total of 18 studies on damp buildings, dampness and mould in buildings and indoor mould. Dampness and mould exposure in buildings is a risk factors for respiratory symptoms, wheeze, cough, bronchitis, rhinitis, eczema and upper respiratory tract infection as well as general symptoms such as headache and tiredness. Evident strongly suggested increased asthma development and exacerbation of current or ever diagnosis of asthma in children. Based on the results of the review, indoor dampness and mould problems in buildings are associated with substantial and increases in prevalence of a variety of respiratory and asthma-related health outcomes.
The purpose of this study was to determine aluminium (Al) concentrations in groundwater used for drinking and cooking and its related health risk among population of 28th Mile Orang Asli village in Jenderam Hilir, Selangor, Malaysia. A total of 100 respondents were recruited, comprising 51 (51.0 %) male and 49 (49.0 %) female residents. Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine Al concentration, while the LAMOTTE TRACER ORP PockeTester was used to measure pH levels. Statistical Package for Social Science (SPSS) was used to analyze the data. Results showed that Al concentration ranged from 0.041 - 0.136 mg/L with a mean of 0.136 + SD 0.041 mg/L, hence the values obtained were below the standard value (0.2 mg/L). pH levels ranged from 3.82 to 5.84, with a mean of 4.163 + SD 0.411, which is acidic and below the range permitted by the health authorities. The acidic nature may have an impact on the Al concentration in the water. The Hazard Index (HI) was found to be less than 1, thus there was no health risk of Al exposure in drinking water for the respondents involved. The study area was considered safe from having health risk associated with Al exposure.
The aim of this study was to determine the prevalence of sick building syndrome (SBS) and other factors contributing to probable mental health problems among university laboratory staffs. A cross-sectional study was conducted among 264 laboratory staffs in UPM. Data was collected using validated self-administrated questionnaires consists of Job Content Questionnaire (JCQ), General Health Questionnaire (GHQ) and SBS. Data was analyzed using SPSS version 22.0. In total, about 28% of the participants reported having probable mental health problems. The prevalence of SBS was 31.4%. After controlling for confounders, the significant factors for probable mental health problems were job insecurity (AOR 2.33, 95% CI 0.212- 0.867), job demand (AOR 1.12, 95% CI 0.445-0.921), fatigue (AOR 0.94, 95% CI 0.162-1.425), drowsiness (AOR 0.75, 95% CI 1.023-4.647) and household income (AOR 0.339, 95% CI0.166-0.995).Results visibly showed that psychosocial factors and symptoms of SBS at their working environment contribute to probable mental health problems among laboratory staffs. The strongest predictors in this study were job insecurity. Hence, further assessment and preventive measures should be carried out to reduce the risk factors of probable mental health problems and to improve working environment among university laboratory staffs.
Chemical industry is one of the important industries in the world. However, incidents happened due to the release of hazardous materials, toxic and poisonous chemicals in the chemical industries can cause fatal to human and destruction of the environment. Learning from the Bhopal disaster's experience, chemical industries have developed a program - Responsible Care, aiming to regain public trust through improving the environment, health and safety performances. Malaysia has adopted Responsible Care program since 1994 under the stewardship of the Chemical Industries Council of Malaysia (CICM). Six codes of management practices have been developed by the CICM, covering distribution, community awareness and emergency response, pollution prevention, process safety, employee health & safety and product stewardship. It has been more than 20 years since its inception. However, to date, there are only 125 companies have signed the pledge to adopt Responsible Care program. The CICM has also conducted several initiatives to encourage participation of chemical companies to adopt Responsible Care program in Malaysia. Therefore, it is the aim of this paper to review the current status of Responsible Care program in Malaysia and also deliberate the way forward of this program.
Hajj and ‘Umrah pilgrimage are a huge congregation performed by Muslims in Makkah, Saudi Arabia. The pilgrimage causes overcrowding and congestion that can lead to a high risk of health problems, especially when pilgrims have health problems. The purpose of this study is to assess the reliability of EQ-5D as a measuring tool to capture the health status of the pilgrims. Data collection was done during Ramadhan’s ‘Umrah in 2014. In this cross-sectional study, a total of 300 self-administered questionnaires attached with the EQ-5D-5L questions were distributed to Malaysian ‘Umrah pilgrims in Makkah and willing to participate in the study. The outcomes from the questionnaires and EQ-5D-5L were systematically analysed by using the SPSS software. The response rate was 64%, involved female (53%) and male (47%) respondents with the mean age of 55 years old. Hypertension (21.5%) and diabetes (16.2%) were the commonest underlying health problems suffered by the respondents in this study. Based on the EQ-5D outcomes, 53.3% of the respondents had no problem in their movement. However, the mean of EQ-VAS (visual analogue scale) presented 83 out of 100 scaling point, which means they might have problems in their health status. In addition, this study revealed, respondents with underlying illnesses had difficulty in some dimensions in EQ-5D. Hypertension was identified as the commonest underlying disease amongst the pilgrims. A contradicted outcome from the objective and subjective measuring scales of EQ-5D and EQ-VAS respectively; presented its sensitivity of EuroQol as a measuring tool for the quality of life among pilgrims living within such congestion.
Health care has emerged as one of the fastest growing industry worldwide. This induced health care costto rise tramendously. However, it is important to preserve high quality health care services that are equitable and affordable. In many countries, people are expected to contribute to the cost of the health care. Are populations ready to accept the concept and willing to pay for health financing scheme? What possible factors that may associate with their decision? This is the objective of the study, to examine the relevance evidence for this through a systematic review of literatures.We systematically searched Ovid MEDLINE and Google Schoolar databases until April 2016. We assessed the study population willingness to pay for health financing scheme and determine the significant variables that associate with WTP. 19 full-text articles were included in the review. Factors that were found significantly associated with WTP for health financing scheme by many studies were age, education, income and residential locality. Other factors that also found associated with WTP were health care services utilization and expenditure. The review findings showed that WTP for health financing scheme is beyond the households’ financial capacity and has multifactorial influences.
This paper investigates the antenatal care (ANC) services utilization in currently pregnant women during their visits to maternal and child health (MCH) clinics of rural (Kinabatangan) and urban (Sandakan), Sabah. A community clinic based, cross-sectional descriptive study was performed. In total, 800 currently pregnant women attending two MCH clinics, from April to September 2012, were participated using tested set questionnaires. Descriptive analysis was used for background characteristics and chi-square analysis was applied to identify the rural-urban differences among the variables.In both study areas, previous births delivered by skilled birth personnel were same. In pregnant women from rural, less income, more grand-multiparity, earlier antenatal care booking, more frequent post-natal care, more use of contraception compared to those in urban. In comparison, urban pregnant women had more anti-tetanus toxoid injection in their previous pregnancies, past history of antenatal care for at least four times, increase in household members. As this study found the differences in ANC services utilization at Rural and Urban, further study is needed to explore concrete reasons for above findings. By delivering services according to the needs of all clients, irrespective of their place of residence, it will improve ANC services utilization in both areas of Sabah and hence will improve more on existing health status of the Nation.
Study site: Klinik Kesihatan, Kinabatangan and Sandakan, Sabah, Malaysia
Dengue fever is the most common vector-borne disease and major concern issues in Malaysia. Thus, the present study aimed to evaluate factors influencing knowledge, attitude, and practices regarding dengue fever among patients in Hospital Taiping. A total of 300 patients were incorporated into a descriptive, public based cross-sectional study. The questionnaires were formulated to include several questions on demographic data, knowledge, attitudes, and practices concerning dengue fever. Most of the respondents were from the age group of more than 35 (43.3%). The largest representations of the participants were Malay (59.3%), married (65.7%), SPM is the highest education level (53.3%), and 60.7% of the participants were conscious about dengue fever eruption. Television/radio was voted as the frequent source of information (97.3%). There is no significant relationship between knowledge score and socio-demographic factors. However, around 57.0% of the respondents believe that abdominal pain is not a symptom of dengue fever and 32% convinced that blood transfusion can transmit dengue. No significant correlation was found between attitude and practice score to socio-demographic characters. However, a good practice towards dengue fever is associated with good knowledge (65.4 %) nevertheless it did not influence their attitude. Moreover, the attitude seems to be poor regardless of knowledge level (44.0%). Therefore, more prevention practices to raise the awareness of population toward dengue fever such as health campaigns and health education in school level should be initiated. These activities will aid in fertilizing better attitude and prevention practice towards dengue fever and bring down its incidence in Malaysia.
The purpose of this study was to determine the prevalence and factors associated with of Premature Ejaculation &Erectile Dysfunctionamong Malaysian men.A cross-sectional study was conducted in urban and rural areas using standardized and validated self-administeredquestionnaires.A total of 319 samples were recruited for PE screening. The overall prevalence of PE was 31.7% with 20.7% and 40.8% for urban and rural arearespectively. Depression, anxiety and frequent masturbation were significantly associated with PE. While For ED, infrequent sexual intercourse was the sole factor significantly associated with ED.PE and ED were highly prevalent in both urban and rural areas; with several significant preventable associated factors.
A spring is a result of karsts topography where surface water has infiltrated the earth's surface recharge area, becoming part of groundwater and emerges from below to become natural spring water. From few observations, local people tend to consume this water directly for many health reasons. The objective of the study was to determine the concentration of lead (Pb) and cadmium (Cd) in natural water resources and bottled drinking water sources, and compared with the existing standard. This field assessment was carried out in 2014 as part of the educational module for public health master student. About 13 water samples were collected directly from the tubing into the pre-washed sample bottle and rinse with the sampling water in the field. Sample preservation was achieved by acidifying to pH less 4.0 with nitric acid (HNO3). Samples were stored in a cooler with temperature between 0 to 4oC. Heavy metals were analysed by standard method for graphite furnace atomic absorption spectrophotometer (GFAAS) with Zeeman’s correction. Pb and Cd content were analysed from 13 samples which consists of eight natural spring water and five flavoured bottled drinking water. The result showed that Pb content in spring water ranges between 1.8 and 37.3ppb, while the Cd content in spring water ranges between 3.0 and 23.0ppb. In the commercialised drinking water, the amount of Pb ranges between 0.4 and 2.6 ppb, while the content of Cd ranges between 0.8 and 7.0 ppb. This study indicates that there are high content of Pb and Cd in most of the natural spring water points and some bottled drinking water that are available within Klang Valley. In the absence of any specific point sources, the possibility of urban area and high traffic source leading to run off as well as rock types may result in variations observed. Hence, very worrying, especially that these sources of water were consumed directly as drinking water or eye drops without knowing its content. Further tests, coupled with supportive soil and conductivity studies, are required to test all possible similar natural sources to safeguard the health of people.
Fecal occult blood test (FOBT) screening has been shown to decrease the incidence and mortality of colorectal cancer (CRC). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the immunochemical fecal occult blood test (i-FOBT) in diagnosing CRC were assessed among the patients in a tertiary referral hospital in Malaysia. A total sample of 814 patients aged 16 to 85 years old who performed i-FOBT and endoscopic screenings was obtained. The patients were recruited for a retrospective investigation. Sensitivity, specificity, PPV, and NPV were derived for the CRC screenees. Out of the 814 patients screened using i-FOBT, half of them were above 59 years old (49.6%), and 36% had positive i-FOBT. Gender distribution was almost equal, where 53.4% of the patients were female, and 46.6% were male. Majority of the patients were Malays (56.6%), followed by Chinese (24.0%), Indians (16.5%), and others (2.9%). Among the 71 patients referred for colonoscopy, 57.7% and 42.3% corresponded to positive and negative i-FOBT cases, respectively. Polyps were found to be most common among the patients (25.6%), 7.0% were found positive for invasive CRC, and 35.2% had normal colonoscopic findings. There was a significant association between colonoscopic finding and positive i-FOBT (p=0.001). The sensitivity, specificity, PPV, and NPV for CRC detection were 66.7%, 43.0%, 9.8%, and 93.3%, respectively. The results indicate that i-FOBT is a useful tool in the detection of abnormalities in the lower gastrointestinal tract and therefore serves as a cornerstone for potential large-scale screening programmes.
Work-related upper-extremity disorders (WRUEDs) are frequently occurring among workers in general. Various researches support the empirical results of the Autogenic factors related to such problems of health and safety. Research shows the association of different aspects of work organization strengthen the possibilities of work-related stress and other psychosocial factors, which may lead towards adverse health conditions. To review the previous work done for finding the association between psychosocial factors and upper extremity disorders. Findings from different studies have been reviewed to examine the psychosocial factors association in developing WRUEDs. Published studies, which were primarily focused on WRUEDs and psychosocial factors association, were reviewed. Various studies have shown the relationship between psychosocial factors and UEDs. Due to the different nature of epidemiology of the disorder and variable differences, findings from different studies contradicts. Finally, this review presents the limitations in existing studies, and further research has been proposed for future.
A cross-sectional study was conducted on 116 male pre-cast construction workers in Sipitang, Sabah to evaluate the association between Ergonomic Risk Level exposure and their working performances for 6 months (June to November 2014). Initially, a structured interview using a modified-Standardized Nordic Questionnaire was conducted on each study subject to determine the prevalence of Musculoskeletal Disorders (MSDs). The results showed that 93 out of 116 subjects (80.17%) complained of experiencing ache, pain or body discomfort during and after work with high percentage of MSDs prevalence affecting the wrist (78.5%), shoulder (73.1%), and lower leg (71.0%) regions of the body. Pictures and videos of workers performing their routine tasks were analyzed using Rapid Entire Body Assessment (REBA) tool to generate individual Ergonomic Risk Level classification. The results showed that all subjects were exposed to Medium (56.90%), High (29.31%) and Very High (13.79%) level of Ergonomic Risk. Pearson Correlation and One-way ANOVA test was conducted to determine the association between Ergonomic Risk Level and the subjects’ individual working performances. The results indicated that there was a significant negative association between Ergonomic Risk Level and the workers' performances in terms of tendency to work overtime (p
Community pharmacists are expected to have the necessary knowledge to give advice on safe and appropriate drug use during self-medication. However, the profession of pharmacist in Yemen has become less trustworthy and less reliable. In addition, quality of medication has been raising a lot of questions among consumers and fake medications have been entering the country without quality control checks. The aim of this study was to determine the consumer perception of health care services provided and its impact on self-medication practice in Sana’a city, Yemen. A self-administered questionnaire containing open-ended and closed-ended questions was developed and distributed among 400 consumers attending 10 community pharmacies in Sana’a City. All data obtained from the questionnaires were coded, entered, and analysed using Chi-square test and multiple logistic regressions. Prevalence of self-medication was found to be 90.7 %. The majority of respondents stated that they do not trust the health care services provided by physician (68.8%), community drug dispensers (78.2%), Ministry of Health (70.5%) or the quality of medicine dispensed by community pharmacies (59.7%). The trust of health care services provided by physicians and community drug dispensers were found to be significant predictors of self-medication practice. Those who did not trust health care services provided by physicians were more likely to use self-medication compared to those who did not (OR= 21.212, CI 95% 2.678-168.001, p= 0.004). Those who did not trust health care services provided by community drug dispensers were more likely to use self-medication compared to those who did not (OR= 2.746, CI 95% 1.048-7.195, p= 0.04). Consumers in Sana’a City have a negative overall perception of the services provided by community drug dispensers, physician and Ministry of Health and the quality of medication. An urgent intervention from health care authorities to adopt and to implement a new national drug policy with necessary laws and regulations is needed.
Complementary Alternative Medicine (CAM) is broadly used as an adjunct treatment for patients to treat various kinds of disease, prevent disease and to sustain and enhance quality of life of the users. The study is aimed to investigate the association between CAM uses, Health-Related Quality of Life (HRQoL) and anthropometric indices among workers or staffs in Universiti Sultan Zainal Abidin (UniSZA) Gong Badak Campus, Kuala Terengganu. A total of 300 subjects participated in this study and completed the malay version of modified HRQol (SF-12) questionnaires. Anthropometric measurements among the subjects were done. Independent t-test, One-way ANOVA and Pearson correlation were used to test the association and the hypotheses. The prevalence of CAM users was 37.3%. The results showed that bodily pain score domain was significantly higher among non-CAM users. Overall, male had higher Mental Health Composite Score (MCS) score than female. Physical Health Composite Score (PCS) was only correlated negatively with BMI among non-CAM users but negative correlated with body fat percentage in both CAM and non-CAM users. As conclusion, HRQoL had significant negative correlation with body fat percentage among CAM users. No association was found between CAM use and HRQoL scores.
The risks of mercury use have prompted the establishment of Minamata Convention on Mercury which placed strong emphasis on management of mercury-added products. This convention aims to reduce and phase out the use, manufacturing and trade of mercury-added products including batteries, switches and non-electronic measuring devices. This commitment will cause significant impacts especially in the developing countries in designing the right approach to achieve it. This is also true for medical industry which is well known for the utilization of mercury-added devices and dental amalgam in its services but had embarked on efforts in eliminating mercury for many years. The experiences learned within a medical facility can be useful in efforts to meet this global ambition of mercury phase out. This paper aims to provide conceptual discussion on the challenges faced by developing countries and lessons learned from medical facility that can helps the formulation of appropriate approaches to manage mercury-added products. The paper adopted medical industry as a case study and used document analysis to discuss the issue. The main challenges identified for developing countries include lacks of capacity, funding, data and newer technologies. Based on analysis of previous studies, this study proposed a mercury management framework in medical facility and identified the recommended practices, namely technological application, policy instrument, capacity building and guidelines development. These identified approaches are found to have specific relationships between cost and potential impacts, hence giving flexibility for adoption based on the available resources in promoting better mercury management system.