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.
Rural health clinics in Sri Aman Division in Sarawak, Malaysia lack diagnostic tests for malaria. Many of the medical assistants in the clinic diagnose malaria solely on clinical ground. The study was to determine the sensitivity, specificity and positive predictive value of clinical diagnosis of rnahtria made by medical assistants using results of microscopy examination as gold standard. The study period was from September to December 2003. Three rural clinics without laboratory or diagnostic tests services and one urban clinic with laboratory facility serving malarious areas were selected. All patients clinically diagnosed as malaria by the attending medical assistants were included as clinical malaria cases. Blood slides were taken for examination of malaria parasites. Non clinical malaria cases were all other patients without clinical malaria for whom blood slides were taken for malaria parasites. Out of 362 patients included in the study, 75 were clinically diagnosed as having mahria. The sensitivity of headache, history of fever and chills/rigors to detect malaria cases was above 90% but the specificity and positive predictive value was low, below 40% and 20% respectively. The sensitivity, specificity and positive predictive value of malaria clinical diagnosis made by medical assistants was 82.1 %, 84 .4% and 30.7% respectively. Clinical diagnosis of malaria increases the slide positive rate by four folds. However the sensitivity, specincity and positive predictive value of clinical diagnosis by medical assistant and clinical characteristics was insufficient to enable each of them to be used alone to differentiate true malaria cases from non mahiria cases.
This study was done to determine the relationship between indoor air quality and Sick Building Syndrome (SBS) among students in Retrofitting Building (Building A) located in Kuala Lumpur and Purposed-built Building (Building B) located in Selangor. A cross sectional study was conducted among student from selected buildings with the total number of 130 respondents. Modified questionnaire based on Indoor Air Quality and Work Symptoms Survey, NIOSH, Indoor Environmental Quality Survey, 1991 was used to record the number of students experienced SBS. Measurement of indoor air quality was performed using instruments recommended by the IAQ Code of Practice, Department of Occupational Safety and Health, Malaysia. There was a significantly higher number of occupants experienced SBS in Building A (60 of 65 respondents) compared to Building B (50 of 65 respondents) (Χ2= 4.127, p = 0.042). It was also found that there is a significant difference between the numbers of respondents having SBS between Building A and Building B (p < 0.045). Building A had higher CO2, bacteria, fungi, and UFP significantly as compared to Building B. However, only CO was significantly higher in Building B compared to Building A. It is suggested thatregular maintenance of both buildings is compulsory as ventilation played an important role in maintaining good indoor air quality in a building.
A study was conducted in Kelantan, Mabysia, in the year 2001 , to assess the typhoid reporting coverage and timeliness, and to estimate the annual incidence. Cases were persons given the diagnosis of typhoid clinically, and conhrmed cases are those with positive laboratory results. In all, 174/252 (69%) cases (95% CI = 63%-75%) were reported, ofwhich 89/131 (83%) within 7 days of diagnosis. The estimated annual typhoid incidence in Kelantan is 37/ 1 00,000.
This study is aimed at seat design optimization for high-speed train based on the Malaysians sitting anthropometry
data focusing on seat fit parameters. An analysis of anthropometry data composed of 15 dimensions that are
required in seat design was done with 50 male subjects. These data were collected through direct measuring
methods with standard equipment. According to the Malaysian automotive seat fit parameters, the backrest width,
backrest height, cushion width, and cushion length were established based on these anthropometric dimensions:
interscye breadth (5th percentile female and 95th percentile male), hip breadth (95th percentile female), sitting
shoulder height (5th percentile female), and buttock-popliteal length (5th percentile female), respectively. This
study uses the CATIA software to design and analyse the proposed seat design. The fit parameters proposed for the
new design are seat height, 380mm; cushion width, 450mm; backrest width, 450mm and backrest height, 850mm.
The CATIA human activity analysis (based on Rapid Upper Limb Analysis, RULA) was also executed. From the study,
the new conceptual seat design gives the most optimized fit when compared to the current seat.
The hand, foot, and mouth disease (HFMD) outbreak occurred in the state of Johor, Malaysia in the months 0f October and November 2000 aber the HFMD outbreak started in Singapore in September 2000. The HFMD notification and investigation forms sent to the Epidemiology Unit of the Johor Health Department from district health offices and hospitals during the outbreak were analysed. Patients’ specimens were sent to the Institute for Medical Research, Kuala Lumpur and the Universiti Malaya Medical Centre, Kuala Lumpur for viral isolation. A total of 1,122 HFMD cases were notified during the outbreak period with 2 deaths giving 0.2% casefatality rate. From all the cases, 544 (48.5%) patients were admitted to the hospital while the rest were treated as outpatients. Majority (81.7%) of children with HFMD were aged below 5 years old with the commonest age group (46.9%) being between 1 to 2 years old. Sixty-eight patients had positive specimens for viral isolation belonging to enteroviruses namely Enterovirus 71 (43 cases), Coxsackievirus Type A16 (11), Echovirus 7 (3), and Coxsackievirus Type B (2); and non-enteroviruses namely Herpes Simplex Virus Type 1
(5), and Adenovirus (4). Fever and mouth ulcer were the two most common symptoms among HFMD children but vesicles on palms and soles were more common than rashes in children with positive enteroviral isolation.
Study site: University Malaya Medical Centre (UMMC)
Occupational cancers, including mesothelioma and lung cancer are linked to the use of asbestos. Annually, at least 100,000 global deaths are attributed to asbestos exposure putting a heavy burden on national budgets. Expenses incurred on treatment of asbestos related diseases (ARDs) reduce households and national resource savings, while ARDs culminate in terminal burdens. The objective of this study is to measure the economic burden of ARDs and to assess the economic impact of asbestos consumption. The health and economic burden of asbestos was estimated in macro-global consumption-production model using production function frontier-based and generalized least squared approach for asbestos products and cost tabulation. Production, in metric tons (Mt) was adopted as a dependent variable among explanatory variables, including consumption. Information on treatment cost of asbestos related diseases (mesothelioma, asbestosis and lung cancer) was obtained from costing information and published literatures. Annual total economic burden of asbestos is at USD 11.92 billion. Out of this cost, USD 4.34 billion per annum is the economic burden of managing three common ARDs. The cost of compensation for patients suffering ARDs is USD 4.28 billion. From the remaining USD 3.3 billion, USD 2.93 billion is the value of asbestos consumed in 2003 and USD372.15 million is the loss of earning due to hospital visits and admissions. For every USD 1 spent on consumption of asbestos, global economy has to absorb almost USD 4 due to health consequences of ARDs. Banning of asbestos production and usage in production of goods has far-reaching impacts on household welfare, health and economic development. The insights revealed are expected to inform decision makers the need to ban all forms of asbestos, especially in developing countries where usage is increasing.
Social security traditionally means a social insurance program providing social protection, or protection against socially recognized conditions, including poverty, old age, disability, unemployment and others. It also hovers around the subject of social insurance, where people receive benefits or services in recognition of contributions to an insurance scheme. Providing services for medical care, aspects of social work and even industrial relations may be included as part of social security services. Lately, the term is also used to refer to basic security, a term roughly equivalent to access to basic necessities. The 1 World Conference on Social Security organised by the Brazilian Government on 1st to 5th of December 2010 stimulates the countries to adopt universal, comprehensive and equitablesocial security systems as a valid, ethical and feasible option in the process of national reforms and regional integration. The main challenge to achieving the noble objective of universal social security system is financial sustainability and social cohesion supported by political will. As seen in a number of countries, Malaysia has a mixed social security schemes comprising state and private schemes, statutory obligatory requirements on the part of
employers as well as state social assistance programmes. Maintaining the quality of life of the individuals and their dependents has become the primary focus of policies and programmes in providing social security. Among the critical pressures on the population’s standard of living is the provision of health care. Extension of the coverage for social security is critical in ensuring social inclusion.
Repetitive Strain Injury (RSI) is the most common occupational injury faced by computer users. Computer users faced
higher possibility of getting RSI due to their prolonged working time and static posture. The three main objectives of
this study are, first: to identify the prevalence of RSI among computer users; second, to investigate and determine the
RSI risk factors; and third to analyze the association between RSI risk factors and the prevalence of RSI among computer
users at a Telecommunication Company X. A total of 100 respondents were selected based on their daily exposure to
computer usage of more than 4 hours. Nordic modified questionnaire was used to gather respondents’ sociodemographic
data, job’s information, physical risk exposure, physical symptoms and their awareness level towards RSI.
Body Parts Symptoms Survey (BPSS) form were also used to identify the body parts exposed to the RSI risk among
computer users. The data was analysed using Statistic Package for Social Science (SPSS) version 22. Study results showed
that the 41% of computer users in Telecommunication Company X felt tired at the upper-back near the neck and 38%
at the shoulder region. In conclusion, the prevalence of RSI among computer users is high at upper back near the neck
and at the shoulder region. There is a significant association between risk factors of RSI and the prevalence of RSI
among the computer users at Telecommunication Company X.
This paper reviews various papers since the year 2000 until 2016 regarding visual technology in human anthropometry
study, and discusses three major points; (1) the methods and objectives of the research, (2) the subjects of the
experiments and (3) body parts involved in the anthropometrical measurements. Measurement using visual
technology is claimed to be more accurate in obtaining anthropometrical data compared to the conventional method
using manual tools. However, commercial visual technology system can be very costly. Based on the reviewed
studies, a significant amount of research has adopted various visual processing methods to predict the human’s body
measurement. All of the studies utilized the applications of enhanced technologies that are able to reduce time and
human errors that normally occur during traditional hand-operated measurement. Usually, in order to prove that
their result is promising, the studies compared their results with the results gained from manual measurement. The
finding from this review is a preliminary step towards developing a camera-based system in anthropometry
measurement for the use in automotive ergonomics design.
This study was conducted to analyses the Biceps Brachii (BB) muscle contraction during different driving postures.
Drivers’ posture is one of the factors that contribute to driving fatigue that eventually may lead to road accident
and injuries. The experiment conducted for this study is using the surface electromyography (SEMG) method for
objective evaluation of muscle involved in driving activities. A total of 14 participants are involved in the
experiment. The experiment was done on three different posture based on comfortable angles published by previous
research. From the results analysis, the RMS value for activity left turn is lower than activity for right turn for all
three postures and results also shows that posture B with elbow angle of 134° is perceived as most comfortable
based on the lowest value of muscle contraction with a value of 15.67μV. The outcomes from this study are hoped to
benefit both manufactures and also car users in ensuring better and optimum driving postures that can avoid fatigue
and injuries.
A study was undertaken amongst private primary care providers in three urban centres of Malaysia to understand the organizational structure of the facilities and to assess the cost of running such services. A total of 150 clinics were involved in the study. Data was collected through interviews with owners of the clinics using semi-structured questionnaires. Solo-practitioners owned 64.7% of the clinics while 35.3% of them were owned by group practice. This study showed that the mean number of patients visited the clinics daily was 49.3 with the average operating hours of 79.4 hours/week (range 28.0 - 168.0 hours/week). Group practice clinics operates 23.9 hours longer than solo-practice clinics. Group practice clinics were more likely to offer 24 hours service than solo-practice clinics. Most of the clinics were manned by a single doctor (57.3%), 30.0 % had two doctors and only 12.7% were run by more than two doctors. On average, group practice employed greater number of supporting staff than solo-practice clinics (6.0 vs 4.3 people). The mean annual cost to run each facility was found to be RM 444,698. The mean cost per patient was found to be RM 32.09 for solo-practice clinics and RM 38.55 for group practice. Wages represented the highest proportion in the recurrent cost (61.1%) followed by drugs (29.2%) and consumables (2.7%). Building cost (67.9%) and equipment cost (25.9%) were the major capital costs for the clinics. This study could serve as a basis to reimburse private primary care providers in the future health financing scheme in Malaysia. To improve efficiency and contain cost in primary care settings, efforts should be targeted towards cost of wages and drugs utilised by the providers in their daily practice.
Key words: Private practice; primary care; costs; Malaysia.
A cross sectional study was conducted to determine the perception of Hospital Directors in performing clinical duties. This was done through a postal survey which was conducted covering all public hospitals in Malaysia. The majority of Hospital Directors had read the circular at the time of the study and agreed to do clinical work besides managerial duties. Before the issuance of the directive, the majority of those directors were already doing some clinical work. However they disagreed that by doing clinical work they could help overcome the problem of shortage of doctors. They agreed that the duration of 10 hours per week is suitable to do clinical duties. In term of confidence in giving curative treatment, the Hospital Directors especially those from district hospitals without specialists were confident in giving curative care to individuals. As for the clinicians, the majority felt that the implementation of the directive for Hospital Directors to do clinical work will not disrupt the clinicians' routine duties.
Study site: University Malaya, Universiti Kebangsaan Malaysia; Hospital Kuala Lumpur, Malaysia
Client satisfaction upon health services is important for public especially for those who have to undergo treatment for tuberculosis (TB) noted for its difficult regime. The purpose of this study is to measure client dissatisfaction level towards TB treatment & services among TB patients in government outpatient health services and the factors that influenced it. This study was carried out in all the districts of West Coast Division of Sabah. It was conducted from June 2002 to November 2002. Study design is cross-sectional, with population samples taken on those who are currently receiving outpatient TB treatment in government health facilities. Questionnaires forms were used as study tool and filled by either by respondent or through the help of trained interviewer. The outcome is based on the total score obtained through Likert scales to determine the proportion of dissatisfied group from the respondents. A total of 488 patients took part in this study. Results of study showed overall percentage of 31.8% dissatisfaction level towards TB
treatment & services, while dissatisfaction towards TB treatment and upon health services alone were 54.3% and 24.0% respectively. The predictive factors for client dissatisfaction towards TB treatment and services are those without education, longer waiting time and have opinion of insufficient number of health staff.
Key words: Tuberculosis, client satisfaction, TB treatment, services, Sabah.
Study site: Outpatient clinics, hospitals, Sabah, Malaysia
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 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.
This study observed the pattern of reported dengue infections, clinical manifestations, and circulating dengue serotypes in Negeri Sembilan, Malaysia. The aim of this study was to determine the co-circulation of the four different dengue virus serotypes in Negeri Sembilan. We analyzed the surveillance data (VEKPRO) from Negeri Sembilan State Health Department and National Public Health Laboratory, Malaysia on reported dengue infections from 1st January 2010 to 31st December 2010. There were 1466 reported dengue infections, 1342 (91.5%) cases were dengue fever (DF) and 124 (8.5%) were dengue hemorrhagic fever (DHF). The mean age was 32.2± 15.8 years old and most were young adults, aged 15 years old and older. Males (p < 0.05), and those residing in Seremban district (p < 0.05) were more likely to get dengue infections. Symptoms presented upon admission were fever (100%), headache (99.9%), myalgia and arthralgia (98.8%), rash(24.2%), petechiae (16.0%),bleeding tendencies (7.0%) and neurological deficits(1.2%). All four dengue serotypes (DEN 1 – 4) were present, the pre-dominant serotype was DEN-3, noted in January, then existed together with DEN-2 until around May. DEN-1 was the most pre-dominant circulating dengue serotype afterwards, reaching a peak in December 2010. Dengue affected all age groups particularly young adults and males. Most cases reported were in urban areas and Seremban district. Most of the dengue infections occurred in the first half of the year, with the DEN-2 and DEN-3 serotypes being the most predominant.
Contact time was defined as the time spent by health personnel with a patient. The study was conducted for four months in 2007 to assess the contact time and to determine the appropriate contact time as perceived by patients attending clinics of various clinical disciplines as well as Out-Patient Departments and Emergency Departments at Ministry of Health Hospitals. This study was a cross-sectional study carried out on out-patients who came to the hospitals’ clinics for treatment. Information was gathered through self-administered questionnaires, distributed at twenty-one hospitals. The respondents were selected using stratified random sampling method. Out of 21,750 questionnaires distributed, 13,463 patients responded, a response rate of 61.9%. This study shows that the average contact time increases from small hospitals (8 minutes) to bigger hospitals (15 minutes). The contact time also varies between the clinics of various disciplines. Obstetrics and Gynecology (O&G) clinics and Pediatric clinics had the longest average contact time of 20 minutes and 15 minutes respectively. The percentage of patients who were satisfied with the contact time corresponded with the type of clinics and hospitals which had the longest contact time. Thus, it is suggested that clinics and hospitals, whenever possible try their best to follow the duration of contact time as perceived appropriate by the patients.
Study site: Out-Patient Departments and Emergency Departments at Ministry of Health Hospitals (21)
A cross sectional study was carried out to identify and compare factors that contribute to patient satisfaction towards the medical care services provided at the outpatient clinic in government health clinics and private clinics in Mulcim Labu, Sepang, Selangor. Systematic sampling for government clinic and universal sampling for private clinics were done and data was collected via face-to-
face interview based on a validated Patient Satisfaction Questionnaire (PSQ). A total of 181 patients aged 15 to 75 years old were selected, comprising 90 patients from the government clinics and 91 patients from private clinics. The majority of the patients were males (62.4%), Malay (79.0%), aged between 25 to 34 years with a mean age of 34.6 years and acutely ill (80.7%). Generally, all patients were satisfied with the services provided in both government and private sectors. Patients in private clinics, however, had a significantly higher satisfaction score as compared to the respondents in government clinics. There was signilqcant correlation between patient satisfaction score and household income in government and private clinics. Significant correlation was also found between patient satisfaction score and age in government clinic. Patients in private clinics were more satisfied towards the interpersonal manners, availability and continuity of care of the clinic compared to patienw in government clinics. Whereas patients in government clinics were more satisfied towards the service charges. This study provides important in ormation that could be used by roviders o health care services to monitor and im roved the ualit o medical care in the respective sectors.
The Healthy City concept was taken by Malaysia in 1994 and Malacca State has initiated this project in late 1997 and launched in September 1998. The aim of the project is to had ways of achieving a better quality of urban life. The objective of this study was to assess the views and responses of Melaka Tengah community with regards to the existing facilities and services rendered in the district. The views will be incorporated into ideas for the policymakers and planners to develop Malacca into a healthy city. Three methods were used to collect the data. Questionnaires were given to the community of Melaka Tengah District. The respondents were selected by multistage sampling, Observation was carried out at selected public places to assess the community's practices and contribution, Ten focus group discussion were conducted consisting of health staff and public to discuss on environmental, social, physical and economic issues of Malacca. There were 3 sectors that had mean scores above 3.0 (the cut off level for being satisfed). They were health, housing and environment, ln terms of dissatisfaction, there were 4 sectors scoring below 3.0, These include domestic waste dnposal, road system, public transportation and recreational park. The community
expected the services to be improved especially in terms of cleanliness, They agreed to contribute in their own ways in developing the sectors discussed except for public transportation, wet market and food premises which were beyond their control. Observation showed that some of the community members exhibit bad behaviours that can contribute to an unhealthy city. The Melaka
Tengah community expected ejficient and quality services and they agreed to contribute in making Malacca into a Healthy City.