Displaying publications 81 - 100 of 122 in total

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  1. Chen CB, Chen KF, Chien CY, Kuo CW, Goh ZNL, Seak CK, et al.
    Sci Rep, 2021 05 10;11(1):9858.
    PMID: 33972647 DOI: 10.1038/s41598-021-89291-4
    Early recognition and rapid initiation of high-quality cardiopulmonary resuscitation (CPR) are key to maximising chances of achieving successful return of spontaneous circulation in patients with out-of-hospital cardiac arrests (OHCAs), as well as improving patient outcomes both inside and outside hospital. Mechanical chest compression devices such as the LUCAS-2 have been developed to assist rescuers in providing consistent, high-quality compressions, even during transportation. However, providing uninterrupted and effective compressions with LUCAS-2 during transportation down stairwells and in tight spaces in a non-supine position is relatively impossible. In this study, we proposed adaptations to the LUCAS-2 to allow its use during transportation down stairwells and examined its effectiveness in providing high-quality CPR to simulated OHCA patients. 20 volunteer emergency medical technicians were randomised into 10 pairs, each undergoing 2 simulation runs per experimental arm (LUCAS-2 versus control) with a loaded Resusci Anne First Aid full body manikin weighing 60 kg. Quality of CPR compressions performed was measured using the CPRmeter placed on the sternum of the manikin. The respective times taken for each phase of the simulation protocol were recorded. Fisher's exact tests were used to analyse categorical variables and median test to analyse continuous variables. The LUCAS-2 group required a longer time (~ 35 s) to prepare the patient prior to transport (p 
    Matched MeSH terms: Transportation of Patients/methods*
  2. Abdul-Manan AF, Baharuddin A, Chang LW
    Eval Program Plann, 2015 Oct;52:39-49.
    PMID: 25898073 DOI: 10.1016/j.evalprogplan.2015.03.007
    Theory-based evaluation (TBE) is an effectiveness assessment technique that critically analyses the theory underlying an intervention. Whilst its use has been widely reported in the area of social programmes, it is less applied in the field of energy and climate change policy evaluations. This paper reports a recent study that has evaluated the effectiveness of the national biofuel policy (NBP) for the transport sector in Malaysia by adapting a TBE approach. Three evaluation criteria were derived from the official goals of the NBP, those are (i) improve sustainability and environmental friendliness, (ii) reduce fossil fuel dependency, and (iii) enhance stakeholders' welfare. The policy theory underlying the NBP has been reconstructed through critical examination of the policy and regulatory documents followed by a rigorous appraisal of the causal link within the policy theory through the application of scientific knowledge. This study has identified several weaknesses in the policy framework that may engender the policy to be ineffective. Experiences with the use of a TBE approach for policy evaluations are also shared in this report.
    Matched MeSH terms: Transportation/methods; Transportation/standards*
  3. Vaithilingam RD, Safii SH, Baharuddin NA, Karen-Ng LP, Saub R, Ariffin F, et al.
    Oral Dis, 2015 Jan;21(1):e62-9.
    PMID: 24930489 DOI: 10.1111/odi.12267
    Periodontal bio-repositories, which allow banking of clinically validated human data and biological samples, provide an opportunity to derive biomarkers for periodontal diagnosis, prognosis and therapeutic activities which are expected to improve patient management. This article presents the establishing of the Malaysian Periodontal Database and Biobank System (MPDBS) which was initiated in 2011 with the aim to facilitate periodontal research. Partnerships were established with collaborating centres. Policies on specimen access, authorship and acknowledgement policies were agreed upon by all participating centres before the initiation of the periodontal biobank. Ethical approval for the collection of samples and data were obtained from institutional ethics review boards. A broad-based approach for informed consent was used, which covered areas related to quality of life impacts, genetics and molecular aspects of periodontal disease. Sample collection and processing was performed using a standardized protocol. Biobanking resources such as equipment and freezers were shared with the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). In the development of the MPDBS, challenges that were previously faced by the MOCDTBS were considered. Future challenges in terms of ethical and legal issues will be faced when international collaborations necessitate the transportation of specimens across borders.
    Matched MeSH terms: Transportation
  4. Piros Kulandasamy Pillai C, Yoshida Y, Justin Lawrence P, Yamamoto E, Reyer JA, Hamajima1 N
    Nagoya J Med Sci, 2016 02;78(1):9-17.
    PMID: 27019524
    Vulnerable communities in Malaysia have been facing issues of accessibility and availability for pediatric cardiac services for years due to long waiting times, high costs and a lack of pediatric cardiothoracic surgeons. To ease this situation, the government has allocated a certain amount of funds, introduced through the Pediatric Cardiothoracic Program (PCP), in which the patients are transported to the Narayana Health Institute of Cardiac Science (NH) in India to receive a heart operation following an eligibility check at MediAssist4U Sdn Bhd in Selangor, Malaysia, a facility appointed by the NH. This study aimed to determine the demographic incidence of congenital heart diseases of patients in this program and to evaluate the outcome of the program in association with post-operative mortality rate and the beneficial factors of the program. In this study, 241 patients who participated in this program from August 2008 to September 2012 were reviewed. Fisher's exact tests were applied to calculate p-values of categorical data. Out of 241, 11 patients were rejected because of their poor health condition for flight transportation to India, leaving 230 patients for analysis. The majority of patients were 1 to 4 years of age (57.8%), Malays (61.7%), from families of monthly household income less than RM 1,500 (86.5%) and with primary school-educated parents (86.5%). Patients could apply from any government hospital in Malaysia, but 34.8% of the patients were from the state of Johor. The region (Peninsular Malaysia and East Malaysia) of patients seeking pediatric cardiac services was significantly associated with race (p<0.001), low household income (p<0.001) and low education background of parents (p=0.004). The associations between the age group and diagnosis group (p=0.010) and between duration of hospitalization and outcome of medical management (p=0.013) were significant. Post-operative mortality rate was 1.7% (95% confidence interval, 0.5-4.4). In conclusion, the patients and the government were considered to have benefited from the PCP.
    Matched MeSH terms: Transportation
  5. Hauswald M, Ong G, Tandberg D, Omar Z
    Acad Emerg Med, 1998 Mar;5(3):214-9.
    PMID: 9523928
    OBJECTIVE: To examine the effect of emergency immobilization on neurologic outcome of patients who have blunt traumatic spinal injuries.

    METHODS: A 5-year retrospective chart review was carried out at 2 university hospitals. All patients with acute blunt traumatic spinal or spinal cord injuries transported directly from the injury site to the hospital were entered. None of the 120 patients seen at the University of Malaya had spinal immobilization during transport, whereas all 334 patients seen at the University of New Mexico did. The 2 hospitals were comparable in physician training and clinical resources. Neurologic injuries were assigned to 2 categories, disabling or not disabling, by 2 physicians acting independently and blinded to the hospital of origin. Data were analyzed using multivariate logistic regression, with hospital location, patient age, gender, anatomic level of injury, and injury mechanism serving as explanatory variables.

    RESULTS: There was less neurologic disability in the unimmobilized Malaysian patients (OR 2.03; 95% CI 1.03-3.99; p = 0.04). This corresponds to a <2% chance that immobilization has any beneficial effect. Results were similar when the analysis was limited to patients with cervical injuries (OR 1.52; 95% CI 0.64-3.62; p = 0.34).

    CONCLUSION: Out-of-hospital immobilization has little or no effect on neurologic outcome in patients with blunt spinal injuries.

    Matched MeSH terms: Transportation of Patients
  6. Jasni S, Zamri-Saad M, Mutalib AR, Sheikh-Omar AR
    Br. Vet. J., 1991 Jul-Aug;147(4):352-5.
    PMID: 1913132
    Twenty transport-stressed goats were divided into two groups. The first group was further stressed with steroid. Pasteurella haemolytica was found at various sites in the nasal cavity of goats in this group as early as 2 weeks post-transportation. The successful isolations continued consistently with more goats having pure growth of P. haemolytica at later stages. Mild catarrh rhinitis, loss of epithelial cilia and erosions were the main lesions observed in the nasal cavity. Goats in the second group that were not given steroid injections had inconsistent bacterial isolation and less severe pathological lesions.
    Matched MeSH terms: Transportation
  7. Al-Mekhlafi AA, Isha ASN, Chileshe N, Abdulrab M, Saeed AAH, Kineber AF
    PMID: 34201674 DOI: 10.3390/ijerph18136752
    Driving fatigue is a serious issue for the transportation sector, decreasing the driver's performance and increasing accident risk. This study aims to investigate how fatigue mediates the relationship between the nature of work factors and driving performance. The approach included a review of the previous studies to select the dimensional items for the data collection instrument. A pilot test to identify potential modification to the questionnaire was conducted, then structural equation modelling (SEM) was performed on a stratified sample of 307 drivers, to test the suggested hypotheses. Based on the results, five hypotheses have indirect relationships, four of which have a significant effect. Besides, the results show that driving fatigue partially mediates the relationship between the work schedule and driving performance and fully mediates in the relationship between work activities and driving performance. The nature of work and human factors is the most common reason related to road accidents. Therefore, the emphasis on driving performance and fatigue factors would thereby lead to preventing fatal crashes and life loss.
    Matched MeSH terms: Transportation
  8. Khazani NA, Noor NZ, Yean Yean C, Hasan H, Suraiya S, Mohamad S
    J Trop Med, 2017;2017:7210849.
    PMID: 28386286 DOI: 10.1155/2017/7210849
    Klebsiella pneumoniae and Haemophilus influenzae are two common pathogens associated with respiratory tract infections. The identification of these pathogens using conventional molecular diagnostic tests requires trained personnel, cold-chain transportation, and storage-dependance, which does not render them user-friendly. The aim of this study was to develop a thermostabilized, cold-chain-free, one-step multiplex PCR for simultaneous detection of K. pneumoniae and H. influenzae. The multiplex PCR assay was designed to amplify the php gene of K. pneumoniae (202 bp) and p6 gene of H. influenzae (582 bp). In addition, the specific primer to amplify glm gene of Helicobacter pylori (105 bp) was included as an internal amplification control. Subsequently, the designed primers and all PCR reagents were thermostabilized by lyophilization. The stability of the thermostabilized PCR was evaluated using the Q(10) method. The sensitivity and specificity of performances for thermostabilized PCR were evaluated using 127 clinical isolates and were found to be 100% sensitive and specific. The thermostabilized PCR mix was found to be stable for 30 days and the Q10 accelerated stability was found to be 3.02 months. A cold-chain-free, PCR assay for easy, rapid, and simultaneous detection of K. pneumoniae and H. influenzae was successfully developed in this study.
    Matched MeSH terms: Transportation
  9. Adlina, S., Narimah, A.H.H., Hakimi, Z.A., Suthahar, A., M Nor Hisyam, R., Ruhaida, M.K., et al.
    MyJurnal
    Stress has been recognized one of the factors causing disease. About 70-80% of all diseases may be stress related. Thus, stress management can be a part of an early measure of disease prevention. A descriptive cross sectional, randomized study was conducted to determine the stress inducing factors among preclinical students (universal sampling) in a public university in Selangor, Malaysia from 24th April to May 2005. A total of 163 students (52.8% year 1, 36.8% year 2 and 10.4% year 3) were interviewed in the data collection process. The main reasons students entered - medical school was because of their own interest or ambition (65%) and family influence (20.9%). Majority (76.4%) suffered moderate to great stress over hot conditions in lecture hall, tutoriaV small group session rooms and laboratories while 53.4% suffered when using the other facilities like cafeteria, toilet and transportation:. Almost all (95.1%) felt that examination was the most stressful, followed by early clinical exposure sessions (68.1%), problem·based learning sessions (62.5%), hospital visitations (59.7%), tutoriay small group sessions (49.3%), practical class (44.5%) and attending lectures (3 8.5%). Musculoskeletal System was the most stressful module among the first year students, followed by Nervous System and Gastrointestinal System with the percentage of 94.2%, 90.7% and 88.4% respectively while, 95% of the second year students felt that General, Hemopoietic ci? Lymphoid and Nervous System are the most stressful modules. This study revealed that academic sessions and lack of conducive teaching and learning environment as the main stress inducing contributors to preclinical medical students.
    Matched MeSH terms: Transportation
  10. Medicine & Health, 2009;4(2):76-83.
    MyJurnal
    Dental students need to be equipped with skills, knowledge and positive attitudes while providing dental care to the elderly. Reports from Ministry of Health alaysia indicatedthat the prevalence of dental caries and periodontal disease was high among older people in the country. The aim of this study was to assess the knowledge and perception of final year dental students towards the elderly in relation to training of geriatric dentistry in Universiti Kebangsaan Malaysia edical Centre (UKMMC). All the final year dental students were required to complete a questionnaire that comprised of 3 sections: 1) Palmore’s Facts on Aging Quiz II, 2) Oral health and social concerns of patients, and 3) Perception towards the teaching of geriatric dentistry. A total of 83 students participated in the study. Twenty-four per cent (n=20) scored more than 70% to questions on knowledge about older people and 73% (n=61) scored between 50 -700%. The students had ranked physical disability, transportation problems andcomplex and overlapping priorities as reasons for elderly not keeping to their appointments. Majority of the students reported that lack of educational resourcematerials and very minimum clinical sites experience were the main barriers facedduring the course. In conclusion, majority of the students had moderate to goodknowledge about older people and were able to recognize issues of social oncerns that can influence their oral health. In general, there were not many changes in the perceived competencies of managing older patients following the geriatric module.  




    Matched MeSH terms: Transportation
  11. Khoo LS, Lai PS, Saidin MH, Noor Z, Mahmood MS
    Forensic Sci Int, 2018 Jul;288:242-255.
    PMID: 29783180 DOI: 10.1016/j.forsciint.2018.04.017
    Cadaver body bags are the conventional method to contain a human body or human remains, which includes the use for storage and transportation of the deceased at any crime scene or disaster scene. During disasters, most often than not, the first responders including the police will be equipped with cadaver body bags to do scene processing of human remains and collection of personal belongings at the disaster site. However, in an unanticipated large scale disasters involving hundreds and thousands of fatalities, cadaver body bags supplies may be scarce. The authors have therefore innovated the cling film plastic wrap as an alternative for the cadaver body bag used at the disaster site. The plastic wrap was tested on six different experimental subjects, i.e. both adult and child mannequins; body parts of the mannequin figure (arm and hand); a human adult subject and an unknown dead body. The strengths of the cling film plastic wrap are discussed in comparison with the cadaver body bag in the aspects of costing, weight, duration of the wrap, water and body fluid resistant properties, visibility and other advantages. An average savings of more than 5000% are noted for both adult body wrap and child body wrap compared to the cadaver body wrap. This simply means that the authors can either wrap 25 adult dead bodies or 80 children dead bodies with the cost of 1 cadaver body bag. The cling film plastic wrap has proven to have significant innovation impact for dead body management particularly by the first responders in large scale disasters. With proper handling of dead bodies, first responders can manage the dead with dignity and respect in an overwhelmed situation to facilitate the humanitarian victim identification process later.
    Matched MeSH terms: Transportation
  12. Jaafar F, Abdullah A, Makpol S
    Sci Rep, 2018 Jul 11;8(1):10471.
    PMID: 29992988 DOI: 10.1038/s41598-018-28708-z
    Tocotrienol-rich fraction (TRF) is palm vitamin E that consists of tocopherol and tocotrienol. TRF is involved in important cellular regulation including delaying cellular senescence. A key regulator of cellular senescence, Sirtuin 1 (SIRT1) is involved in lipid metabolism. Thus, SIRT1 may regulate vitamin E transportation and bioavailability at cellular level. This study aimed to determine the role of SIRT1 on cellular uptake and bioavailability of TRF in human diploid fibroblasts (HDFs). SIRT1 gene in young HDFs was silenced by small interference RNA (siRNA) while SIRT1 activity was inhibited by sirtinol. TRF treatment was given for 24 h before or after SIRT1 inhibition. Cellular concentration of TRF isomers was determined according to the time points of before and after TRF treatment at 0, 24, 48, 72 and 96 h. Our results showed that all tocotrienol isomers were significantly taken up by HDFs after 24 h of TRF treatment and decreased 24 h after TRF treatment was terminated but remained in the cell up to 72 h. The uptake of α-tocopherol, α-tocotrienol and β-tocotrienol was significantly higher in senescent cells as compared to young HDFs indicating higher requirement for vitamin E in senescent cells. Inhibition of SIRT1 gene increased the uptake of all tocotrienol isomers but not α-tocopherol. However, SIRT1 inhibition at protein level decreased tocotrienol concentration. In conclusion, SIRT1 may regulate the cellular uptake and bioavailability of tocotrienol isomers in human diploid fibroblast cells while a similar regulation was not shown for α-tocopherol.
    Matched MeSH terms: Transportation
  13. Pui, L. P., Ng. J. M. L., Wong, C. W.
    MyJurnal
    Spray drying is used widely for converting liquid food products into powder form as the dried powder is known to have a longer shelf life at ambient temperature, convenience to use and low transportation expenditure. In this study, the Sarawak pineapple puree was spray-dried and the characterization of the resulting powder was performed. The process of enzyme liquefaction was optimized with Pectinex® Ultra SP-L and Celluclast® 1.5 L (single and combined treatment) at different concentrations (0–2.5 %) and incubation time (0-2.5 hours). The combined treatment with both enzymes (1.5% v/w Pectinex® Ultra SP-L + 0.5% v/w Celluclast® 1.5 L, 1.5 hour) was found to be the best parameter, which produced purees with the lowest viscosity of 67.98 ± 4.27 cp. Optimization of spray drying process was carried out using different inlet temperatures (150-180°C) and maltodextrin concentrations (15-30 % w/w). Results indicated that the spraydried powder produced at 160°C with 15% w/w of maltodextrin has the highest yield (31.63 %). The spray-dried powder was further characterized for the moisture content (6.00 ± 0.63%), water activity (0.36 ± 0.01 Aw), hygroscopicity (17.35 ± 0.64%), bulk density (0.46 ± 0.04 g/ cm3 ) and solubility (87.33 ± 2.08 seconds). The fruit powder of this study can be incorporated into different fruit added –value products, such as fruit juice, yogurt, jelly and other beverages.
    Matched MeSH terms: Transportation
  14. Hao, Lim Zhen, Hikmat Said Al-Salim, Norida Ridzuan
    MyJurnal
    The continuous depletion of global oil reserves with the propensity for light distillates
    propels the oil and gas industry to explore heavier fractions of crude oils with significant
    amount of paraffin waxes. However, the precipitation and deposition of waxes during the
    transportation of these waxy crude oils in the pipelines contribute to several issues, such as
    the flowability reduction, excessive pumping cost, and wax gel formation, that adversely
    affect the supposedly steady offshore oil production. As a result, substantial resources are
    expended to resolve these flow assurance problems. The wax inhibitors and pour point
    depressants are developed and modified to meet the wax remediation criteria. Essentially,
    the wax crystals are formed through the nucleation, growth, and agglomeration processes,
    while the deposition of these waxes occurs via molecular diffusion and shear dispersion.
    The wax inhibitors are able to control the growth of wax crystals through nucleation, cocrystallization,
    adsorption, and dispersion interactions. This paper particularly assessed
    the following compounds: (1) polymeric wax inhibitors, (2) nano-hybrid pour point
    depressants, (3) organic solvents, and
    (4) surfactants. Given the significance of
    these compounds in the deposition and
    precipitation of waxes, it is imperative to
    comprehensively explore the types and
    nature of these compounds and their recent
    applications as well as to critically assess
    their strengths and drawbacks, which were
    addressed in this paper. Furthermore, the
    challenges of using these compounds and the factors that govern their efficiencies were also discussed. Accordingly, the carbon
    length and the molecular weight of both paraffin waxes and wax inhibitors are among the
    most influential factors.
    Matched MeSH terms: Transportation
  15. Wan Mansor WN, Abdullah S, Che Wan Othman CWMN, Jarkoni MNK, Chao HR, Lin SL
    Data Brief, 2020 Jun;30:105440.
    PMID: 32300616 DOI: 10.1016/j.dib.2020.105440
    Energy has a significant influence on Malaysia's industry. It is used in electricity generation, refineries, gas processing plants and end-user applications such as transportation, residential, agriculture and fishing. These burning fossil fuel activities produce greenhouse gases (GHG) emissions. This article presents the emissions data of fuel used in power plants in Malaysia during the year of 1990 until 2017. The fuel used in power plants is coal and coke, natural gas, diesel oil and residual fuel oil. The energy data used in power plants were gathered from the Malaysia Energy Information Hub, published by the Malaysian Energy Commission. The GHG emissions data were calculated using the emission factors method. The climate impact of different GHGs in terms of CO2-equivalent (CO2-e) was also calculated using global warming potentials. The article also presents population data in Malaysia during the year. A correlation between the fuels, GHG emission and the population is also investigated using statistical analysis. The data presented here may facilitate the Malaysian government to identify the source of the pollutants and undertake a climate change mitigation plan.
    Matched MeSH terms: Transportation
  16. Otuyo MK, Nadzir MSM, Latif MT, Din SAM
    Environ Sci Pollut Res Int, 2023 Dec;30(58):121306-121337.
    PMID: 37993649 DOI: 10.1007/s11356-023-30923-9
    This comprehensive paper conducts an in-depth review of personal exposure and air pollutant levels within the microenvironments of Asian city transportation. Our methodology involved a systematic analysis of an extensive body of literature from diverse sources, encompassing a substantial quantity of studies conducted across multiple Asian cities. The investigation scrutinizes exposure to various pollutants, including particulate matters (PM10, PM2.5, and PM1), carbon dioxide (CO2), formaldehyde (CH2O), and total volatile organic compounds (TVOC), during transportation modes such as car travel, bus commuting, walking, and train rides. Notably, our review reveals a predominant focus on PM2.5, followed by PM10, PM1, CO2, and TVOC, with limited attention given to CH2O exposure. Across the spectrum of Asian cities and transportation modes, exposure concentrations exhibited considerable variability, a phenomenon attributed to a multitude of factors. Primary sources of exposure encompass motor vehicle emissions, traffic dynamics, road dust, and open bus doors. Furthermore, our findings illuminate the influence of external environments, particularly in proximity to train stations, on pollutant levels inside trains. Crucial factors affecting exposure encompass ventilation conditions, travel-specific variables, seat locations, vehicle types, and meteorological influences. The culmination of this rigorous review underscores the need for standardized measurements, enhanced ventilation systems, air filtration mechanisms, the adoption of clean energy sources, and comprehensive public education initiatives aimed at reducing pollutant exposure within city transportation microenvironments. Importantly, our study contributes to the growing body of knowledge surrounding this subject, offering valuable insights for policymakers and researchers dedicated to advancing air quality standards and safeguarding public health.
    Matched MeSH terms: Transportation
  17. Bauman A, Ma G, Cuevas F, Omar Z, Waqanivalu T, Phongsavan P, et al.
    J Epidemiol Community Health, 2011 Jan;65(1):35-43.
    PMID: 20943821 DOI: 10.1136/jech.2008.086710
    This study describes physical activity patterns and their association with socioeconomic factors in six countries in the Asia-Pacific region, and examines whether physical activity associations with socioeconomic status follow similar patterns across the six countries.
    Matched MeSH terms: Transportation/statistics & numerical data*
  18. Thomas N, Mariah AN, Fuad A, Kuljit S, Philip R
    Med J Malaysia, 2007 Jun;62(2):152-5.
    PMID: 18705450 MyJurnal
    Thirty-two points in Kuala Lumpur were selected where traffic personnel were on duty. Sound level readings were taken three times a day. Generally, the traffic noise levels were between 75 dBA to 85 dBA. The maximum sound level recorded was 108.2 dBA. Noise emitted by traffic equipment and vehicles were up to 133 dBA. Results of audiometric tests revealed that out of 30 who were tested, 24 or 80% were positive for noise-induced hearing loss. A questionnaire survey revealed a lack of knowledge on occupational safety and personal protective equipment.
    Matched MeSH terms: Noise, Transportation/adverse effects*
  19. Wong LP, Alias H, Aghamohammadi N, Nik Sulaiman NM
    Biomed Environ Sci, 2018 09;31(9):705-711.
    PMID: 30369349 DOI: 10.3967/bes2018.095
    Matched MeSH terms: Transportation/statistics & numerical data
  20. Mia MS, Begum RA, Er AC, Pereira JJ
    PMID: 29634177
    Dengue is endemic in all parts of Malaysia. However, there is limited data regarding the cost burden of this disease at household level. We aimed to
    examine the cost of dengue infection at the household level in Seremban District,
    Malaysia. This cost assessment can provide an insight to policy-makers about
    economic impact of dengue infection in order to guide and prioritize control strategies.
    The data were collected via interview. We evaluated120 previous dengue
    infection patients registered at the Tuanku Ja’afar Hospital, Seremban District,
    Malaysia. The average duration of dengue illness was 9.69 days. The average
    household days lost was 18.7; students lost an average of 6.3 days of school and
    patients and caregivers lost an average of 12.5 days of work. The mean total cost
    per case of dengue infection was estimated to be USD365.16 with the indirect
    cost being USD327.90 (89.8% of the total cost) and the direct cost being USD37.26
    (10.2% of the total cost). Our findings suggest each episode of dengue infection
    imposes a significant financial burden at the household level in Seremban District,
    Malaysia; most of the burden being indirect cost. This cost needs to be factored
    into the overall cost to society of dengue infection. This data can inform policy
    makers when allocating resources to manage public health problems in Malaysia.
    Matched MeSH terms: Transportation/economics
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