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Fulltext Laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Malaysia: preparedness and response, April 2014

Premila Devi J, Noraini W, Norhayati R, Chee Kheong C, Badrul AS, Zainah S, et al.

Euro Surveill, 2014 May 08;19(18).
PMID: 24832116

On 14 April 2014, the first laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection was reported in Malaysia in a man in his mid-fifties, who developed pneumonia with respiratory distress, after returning from a pilgrimage to Saudi Arabia. The case succumbed to his illness three days after admission at a local hospital. The follow-up of 199 close contacts identified through contact tracing and vigilant surveillance did not result in detecting any other confirmed cases of MERS-CoV infection.

Matched MeSH terms: Respiratory Tract Infections/diagnosis*; Respiratory Tract Infections/drug therapy; Respiratory Tract Infections/virology
Bacteriology and antimicrobial susceptibility of ENT infections in a tropical hospital

Chew YK, Cheong JP, Ramesh N, Noorafidah MD, Brito-Mutunayagam S, Khir A, et al.

Ear Nose Throat J, 2014 Jun;93(6):E5-8.
PMID: 24932831

We conducted a retrospective observational study to determine the spectrum and antibiotic sensitivity pattern of organisms isolated in otorhinolaryngologic (ORL) infections. We reviewed the laboratory culture and sensitivity records of 4,909 patients-2,773 males (56.5%) and 2,136 females (43.5%), aged 2 to 90 years (mean: 45.3 ± 12.6)-who had been seen at two government hospitals in Malaysia. Of this group, 4,332 patients had a respiratory tract infection (88.2%), 206 had an ear infection (4.2%), 188 had a deep neck infection (3.8%), and 183 had an oropharyngeal infection (3.7%). The most common isolated organisms were Klebsiella spp, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, methicillin-susceptible S aureus, coagulase-negative S aureus, and Acinetobacter baumannii. We also identified the antimicrobial susceptibility of these organisms. We conclude that since the spectrum of causative pathogens in some infections differs between tropical and nontropical areas of the world, tropical hospitals should not completely adopt the antibiotic guidelines for ORL infections that have been recommended for hospitals in nontropical regions. We hope that our review and analysis of local data will help practitioners in Malaysia develop an appropriate prescribing policy with respect to ORL pathogens and antimicrobial susceptibility. The goal is to reduce the morbidity and mortality associated with these infections.

Matched MeSH terms: Respiratory Tract Infections/microbiology*
Fulltext A case of recurrent respiratory papillomatosis successfully removed via endoscopic argon plasma coagulation (APC) with no evidence of recurrence

Wong JL, Tie ST, Lee J, Kannan SK, Rashid Ali MR, Ibrahim A, et al.

Med J Malaysia, 2014 Aug;69(4):195-6.
PMID: 25500852 MyJurnal

Recurrent respiratory papillomatosis (RRP) is a benign disease caused by the human papilloma virus (HPV), characterized by the formation of recurrent, epithelial neoplastic lesions in the airways. While benign, they can cause significant airway obstruction in some cases. Difficulties in treatment arise from the recurrent nature of the lesions despite repeated procedures. Other known procedures that result in deep tissue damage also cause unacceptable collateral damage to the underlying airway mucosa. We describe a case of recurrent papillomatosis that was successfully treated with argon plasma coagulation ( APC) when laser and electrocautery ablation had failed in the past. After the papillomatasis was treated with APC, there is no recurrence on repeat scope at 4 months and 9 months after the initial procedure. The procedure was done as a day case and there is no complication from the procedure. The property of the APC that allows it to cause only superficial thermal damage to the tissue makes it a suitable adjunct therapy to the treatment of papillomas, which are usually superficial lesions.

Matched MeSH terms: Respiratory Tract Infections
Fulltext Phylogenetic analysis of human metapneumovirus among children with acute respiratory infections in Kuala Lumpur, Malaysia

Nor'e SS, Sam IC, Mohamad Fakri EF, Hooi PS, Nathan AM, de Bruyne JA, et al.

Trop Biomed, 2014 Sep;31(3):562-6.
PMID: 25382484 MyJurnal

Human metapneumovirus (HMPV) is a recently discovered cause of viral respiratory infections. We describe clinical and molecular epidemiology of HMPV cases diagnosed in children with respiratory infection at University of Malaya Medical Centre, Kuala Lumpur, Malaysia. The prevalence rate of HMPV between 2010 and 2012 was 1.1%, and HMPV contributed 6.5% of confirmed viral respiratory infections. The HMPV patients had a median age of 1.6 years, and a median hospital admission of 4 days. The most common clinical presentations were fever, rhinitis, pneumonia, vomiting/diarrhoea, and bronchiolitis. Based on the partial sequences of F fusion gene from 26 HMPV strains, 14 (54%) were subgenotype A2b, which was predominant in 2010; 11 (42%) were subgenotype B1, which was predominant in 2012; and 1 (4%) was subgenotype A2a. Knowledge of the circulating subgenotypes in Malaysia, and the displacement of predominant subgenotypes within 3 years, is useful data for future vaccine planning.

Matched MeSH terms: Respiratory Tract Infections/epidemiology; Respiratory Tract Infections/pathology; Respiratory Tract Infections/virology*
Prevalence, characterization and antibiotic resistance of Pasteurella multocida isolated from bovine respiratory infection

Jamali H, Rezagholipour M, Fallah S, Dadrasnia A, Chelliah S, Velappan RD, et al.

Vet J, 2014 Nov;202(2):381-3.
PMID: 25201254 DOI: 10.1016/j.tvjl.2014.07.024

The objectives of this study were to determine the prevalence, characterization and antibiotic resistance of Pasteurella multocida isolated from calves with respiratory infection in Iran. P. multocida was detected in 141/169 bovine respiratory infection cases on Iranian dairy and beef farms. P. multocida were grouped into serogroups A (126/141), D (12/141), and B (3/141). Of the P. multocida isolates, all harboured the psl, ompH, oma87, fimA, ptfA, nanB, and nanH genes, 139/141 had hsf-2, and 115/141 pfhA, and tadD. The isolates were most frequently resistant to penicillin G (43/141 resistant isolates; 30.5%) and streptomycin (31/141; 22%).

Matched MeSH terms: Respiratory Tract Infections/microbiology; Respiratory Tract Infections/epidemiology; Respiratory Tract Infections/veterinary*
Fulltext Clinical risk factors for life-threatening lower respiratory tract infections in children: a retrospective study in an urban city in Malaysia

Nathan AM, Rani F, Lee RJ, Zaki R, Westerhout C, Sam IC, et al.

PLoS One, 2014;9(10):e111162.
PMID: 25360811 DOI: 10.1371/journal.pone.0111162

Lower respiratory tract infections (LRTIs) are an important cause of morbidity and mortality, especially in low income countries. The aim of this study was to determine risk factors of life-threatening LRTIs in hospitalised children in Malaysia.

Matched MeSH terms: Respiratory Tract Infections/microbiology; Respiratory Tract Infections/mortality*
Fulltext Imported case of acute respiratory tract infection associated with a member of species nelson bay orthoreovirus

Yamanaka A, Iwakiri A, Yoshikawa T, Sakai K, Singh H, Himeji D, et al.

PLoS One, 2014;9(3):e92777.
PMID: 24667794 DOI: 10.1371/journal.pone.0092777

A Japanese man suffered from acute respiratory tract infection after returning to Japan from Bali, Indonesia in 2007. Miyazaki-Bali/2007, a strain of the species of Nelson Bay orthoreovirus, was isolated from the patient's throat swab using Vero cells, in which syncytium formation was observed. This is the sixth report describing a patient with respiratory tract infection caused by an orthoreovirus classified to the species of Nelson Bay orthoreovirus. Given the possibility that all of the patients were infected in Malaysia and Indonesia, prospective surveillance on orthoreovirus infections should be carried out in Southeast Asia. Furthermore, contact surveillance study suggests that the risk of human-to-human infection of the species of Nelson Bay orthoreovirus would seem to be low.

Matched MeSH terms: Respiratory Tract Infections/transmission; Respiratory Tract Infections/virology*
Fulltext Endotoxin, ergosterol, fungal DNA and allergens in dust from schools in Johor Bahru, Malaysia- associations with asthma and respiratory infections in pupils

Norbäck D, Markowicz P, Cai GH, Hashim Z, Ali F, Zheng YW, et al.

PLoS One, 2014;9(2):e88303.
PMID: 24523884 DOI: 10.1371/journal.pone.0088303

There are few studies on associations between respiratory health and allergens, fungal and bacterial compounds in schools in tropical countries. The aim was to study associations between respiratory symptoms in pupils and ethnicity, chemical microbial markers, allergens and fungal DNA in settled dust in schools in Malaysia. Totally 462 pupils (96%) from 8 randomly selected secondary schools in Johor Bahru, Malaysia, participated. Dust was vacuumed from 32 classrooms and analysed for levels of different types of endotoxin as 3-hydroxy fatty acids (3-OH), muramic acid, ergosterol, allergens and five fungal DNA sequences. Multiple logistic regression was applied. Totally 13.1% pupils reported doctor's diagnosed asthma, 10.3% wheeze and 21.1% pollen or pet allergy. Indian and Chinese children had less atopy and asthma than Malay. Carbon dioxide levels were low (380-690 ppm). No cat (Fel d1), dog (Can f 1) or horse allergens (Ecu cx) were detected. The levels of Bloomia tropicalis (Blo t), house dust mite allergens (Der p 1, Der f 1, Der m 1) and cockroach allergens (Per a 1 and Bla g 1) were low. There were positive associations between levels of Aspergillus versicolor DNA and daytime breathlessness, between C14 3-OH and respiratory infections and between ergosterol and doctors diagnosed asthma. There were negative (protective) associations between levels of C10 3-OH and wheeze, between C16 3-OH and day time and night time breathlessness, between cockroach allergens and doctors diagnosed asthma. Moreover there were negative associations between amount of fine dust, total endotoxin (LPS) and respiratory infections. In conclusion, endotoxin at school seems to be mainly protective for respiratory illness but different types of endotoxin could have different effects. Fungal contamination measured as ergosterol and Aspergillus versicolor DNA can be risk factors for respiratory illness. The ethnical differences for atopy and asthma deserve further attention.

Matched MeSH terms: Respiratory Tract Infections/etiology; Respiratory Tract Infections/microbiology*
Phylogenetic analysis of respiratory syncytial virus identified at Universiti Kebangsaan Malaysia Medical Centre

Rahman M, Wong K, Ishak I, Rashid Z, Alfizah H

Sains Malaysiana, 2014;43:739-744.

Human respiratory syncytial virus (RSV) is an important cause of acute respiratory tract infection in infants and young children. Phylogenetic analysis for RSV in Malaysia has not been reported before. We investigated the genetic features of RSV in respiratory specimens from March to August 2011 with molecular methods. From a total of 130 throat swab and nasopharyngeal aspirate specimens, 54 (41.5%) were positive with RSV, identified by in-house real-time reverse transcriptase polymerase chain reaction (rRT-PCR) assay. Thirty-four out of 54 (63.0%) RSV positive patients were children below two years old and two (1.4%) were adults. Phylogenetic analysis showed 39 isolates were genotype GA5, 13 genotypes GA2, one genotype GA1 and one genotype GA7. The findings indicated four genotypes of RSV circulating in the country and the predominant genotype is GA5.

Matched MeSH terms: Respiratory Tract Infections
Urban environmental Health: respiratory infection and urban factors in urban growth corridor of Petaling Jaya, Shah Alam and Klang, Malaysia

Ling OHL, Siti Nur Afiqah Mohamed Musthafa, Abdul Rauf Abdul Rasam

Sains Malaysiana, 2014;43:1405-1414.

Environmental health in general is referring to the aspect of concern on healthy environment, and the interrelations between environment and human health. Due to the urbanization, urban development is changing the natural environment into a man-made environment. Along with the process, level of environmental quality and human health are decreased. Air quality as reference shows that urban ambient air is more polluted than rural. Due to high density of human population and their activities in urban areas, it produces air pollutants with higher rate as compared to less-developed areas. Air pollutants contribute to various health problems. People suffering from respiratory diseases are the most likely to be affected by air pollution. This paper aimed to examine the rate of respiratory infection among residents in an urban growth corridor (Petaling Jaya-Shah Alam-Klang) and the relationship with the urban land uses, traffic volume and air quality. There were four major types of data used in this study i.e., respiratory infection of the respondents, air quality, land use and traffic volume. A health questionnaire survey was carried out besides the secondary data collection from the various government departments. Relationship analysis was performed between respiratory health and the urban factors (air quality, traffic volume and land uses). The study found out that the relationship between the respiratory health and the urban factors is different in city-wide land use and traffic factors, as compared to the localised air quality and land use factors. To conclude, the urban factors are potentially affecting the respiratory health.

Matched MeSH terms: Respiratory Tract Infections
General practitioners' knowledge, attitude and prescribing of antibiotics for upper respiratory tract infections in Selangor, Malaysia: findings and implications

Hassali MA, Kamil TK, Md Yusof FA, Alrasheedy AA, Yusoff ZM, Saleem F, et al.

Expert Rev Anti Infect Ther, 2015 Apr;13(4):511-20.
PMID: 25704246 DOI: 10.1586/14787210.2015.1012497

BACKGROUND: Antibiotics are widely prescribed especially for upper respiratory tract infections (URTIs). Their irrational use can increase costs and resistance.
AIM: Assess knowledge, attitude and prescribing of antibiotics for URTIs in Selangor, Malaysia, using a cross-sectional survey among general practitioners (GPs) working in private clinics in 2011.
RESULTS: One hundred and thirty-nine physicians completed the questionnaire (response rate = 34.8%). 49.6% (n = 69) agreed antibiotics are helpful in treating URTIs, with most GPs agreeing antibiotics may reduce URTI duration and complications. The majority of GPs reported they felt patients expected antibiotics, with 36.7% (n = 51) agreeing patients would change doctors if they did not prescribe antibiotics and 21.6% (n = 30) agreeing when requested they prescribe antibiotics even if they believe them to be unnecessary. When assessed against six criteria, most GPs had a moderate level of knowledge of prescribing for URTIs. However, antibiotic prescriptions could be appreciably reduced.
CONCLUSION: Further programs are needed to educate GPs and patients about antibiotics building on current initiatives.
KEYWORDS: Malaysia; antibiotics; education programs; irrational use of medicines; patients; physicians; respiratory tract infections

Matched MeSH terms: Respiratory Tract Infections/diagnosis; Respiratory Tract Infections/drug therapy*; Respiratory Tract Infections/microbiology; Respiratory Tract Infections/psychology*
Changes in the prevalence of influenza-like illness and influenza vaccine uptake among Hajj pilgrims: A 10-year retrospective analysis of data

Alfelali M, Barasheed O, Tashani M, Azeem MI, El Bashir H, Memish ZA, et al.

Vaccine, 2015 May 21;33(22):2562-9.
PMID: 25887084 DOI: 10.1016/j.vaccine.2015.04.006

Influenza is an important health hazard among Hajj pilgrims. For the last ten years, pilgrims are being recommended to take influenza vaccine before attending Hajj. Vaccination coverage has increased in recent years, but whether there has been any change in the prevalence of influenza-like illness (ILI) is not known. In this analysis, we examined the changes in the rate of ILI against seasonal influenza vaccine uptake among Hajj pilgrims over the last decade.

Matched MeSH terms: Respiratory Tract Infections/epidemiology; Respiratory Tract Infections/prevention & control*
Epidemiology of adenovirus respiratory infections among hospitalized children in Seremban, Malaysia

Foong Ng K, Kee Tan K, Hong Ng B, Nair P, Ying Gan W

Trans R Soc Trop Med Hyg, 2015 Jul;109(7):433-9.
PMID: 26038572 DOI: 10.1093/trstmh/trv042

There is scarcity of data regarding epidemiology and clinical aspects of human adenovirus acute respiratory infection (ARI) among children in developing countries.

Matched MeSH terms: Respiratory Tract Infections/complications; Respiratory Tract Infections/epidemiology*; Respiratory Tract Infections/therapy; Respiratory Tract Infections/virology*
Double-blind randomised controlled trial of vitamin D3 supplementation for the prevention of acute respiratory infection in older adults and their carers (ViDiFlu)

Martineau AR, Hanifa Y, Witt KD, Barnes NC, Hooper RL, Patel M, et al.

Thorax, 2015 Oct;70(10):953-60.
PMID: 26063508 DOI: 10.1136/thoraxjnl-2015-206996

RATIONALE: Low-dose vitamin D supplementation is already recommended in older adults for prevention of fractures and falls, but clinical trials investigating whether higher doses could provide additional protection against acute respiratory infection (ARI) are lacking.
OBJECTIVE: To conduct a clinical trial of high-dose versus low-dose vitamin D3 supplementation for ARI prevention in residents of sheltered-accommodation housing blocks ('schemes') and their carers in London, UK.
MEASUREMENTS AND METHODS: Fifty-four schemes (137 individual participants) were allocated to the active intervention (vitamin D3 2.4 mg once every 2 months +10 μg daily for residents, 3 mg once every 2 months for carers), and 54 schemes with 103 participants were allocated to control (placebo once every 2 months +vitamin D3 10 μg daily for residents, placebo once every 2 months for carers) for 1 year. Primary outcome was time to first ARI; secondary outcomes included time to first upper/lower respiratory infection (URI/LRI, analysed separately), and symptom duration.
MAIN RESULTS: Inadequate vitamin D status was common at baseline: 220/240 (92%) participants had serum 25(OH)D concentration <75 nmol/L. The active intervention did not influence time to first ARI (adjusted HR (aHR) 1.18, 95% CI 0.80 to 1.74, p=0.42). When URI and LRI were analysed separately, allocation to the active intervention was associated with increased risk of URI (aHR 1.48, 95% CI 1.02 to 2.16, p=0.039) and increased duration of URI symptoms (median 7.0 vs 5.0 days for active vs control, adjusted ratio of geometric means 1.34, 95% CI 1.09 to 1.65, p=0.005), but not with altered risk or duration of LRI.
CONCLUSIONS: Addition of intermittent bolus-dose vitamin D3 supplementation to a daily low-dose regimen did not influence risk of ARI in older adults and their carers, but was associated with increased risk and duration of URI.
TRIAL REGISTRATION NUMBER: clinicaltrials.gov NCT01069874.

Matched MeSH terms: Respiratory Tract Infections/prevention & control*
Prescribing patterns for upper respiratory tract infections: A prescription-review of primary care practice in Kota Setar district, Kedah, Malaysia. [Abstract]

Md Rezal RS, Hassali MA, Saleem F, Kumar R

Value Health, 2015 Nov;18(7):A848-9.
PMID: 26534536 DOI: 10.1016/j.jval.2015.09.420

Conference abstrract
Objectives: Antimicrobial resistance is associated with irrational use of antibiotics in general practice. We aimed to assess the frequency with which patients with Upper Respiratory Tract Infections were prescribed with antibiotics and the patterns of antibiotic prescription at primary healthcare centres in Malaysia.
Methods: The study targeted all primary public healthcare centres in the district of Kota Setar, Kedah, Malaysia. A retrospective prescription analysis was conducted whereby prescriptions from 1st January 2014 to 31st March 2014 were screened and retrieved for antibiotics prescribed for upper respiratory infections. The data was entered into Microsoft Excel spread sheet, and exported to Statistical Package for Social Sciences, version 20 for further analysis. Frequencies and percentages were used to summarize the data. The Jonckheere–Terpstra test was used to evaluate the trend of antibiotic prescription. Where significant associations were reported, effect size was calculated by using Kendall tau correlation coefficient. P value of <0.05 was considered to be of statistical significance.
Results: For the period of three months, 123,524 prescriptions were screened and analysed. 2270 (31.8%) prescriptions contained antibiotics prescribed for all URTIs visits. Among all antibiotics, macrolides were the most commonly prescribed antibiotic, constituting of 61% (n=1404) of total antibiotics prescribed for all cases. The Jonckheere–Terpstra test revealed a statistical relationship between prescribers and the diagnosis of the disease (p=0·001). Furthermore, a weak positive trend of association was reported with FMS being more accurate in diagnosis followed by MOs and AMOs (τ=0·122).
Conclusions: Practicing physicians should adhere to the standard treatment practices, as antibiotic use in viral aetiology is ineffective, and encourages the persistence development of resistance. A comprehensive development of national antibiotic stewardship program is recommended to ensure organised and regulated control of antibiotic use in Malaysia.

Matched MeSH terms: Respiratory Tract Infections*
Fulltext Pteropine orthoreovirus infection among out-patients with acute upper respiratory tract infection in Malaysia

Voon K, Tan YF, Leong PP, Teng CL, Gunnasekaran R, Ujang K, et al.

J Med Virol, 2015 Dec;87(12):2149-53.
PMID: 26106066 DOI: 10.1002/jmv.24304

This study aims to assess the incidence rate of Pteropine orthreovirus (PRV) infection in patients with acute upper respiratory tract infection (URTI) in a suburban setting in Malaysia, where bats are known to be present in the neighborhood. Using molecular detection of PRVs directly from oropharyngeal swabs, our study demonstrates that PRV is among one of the common causative agents of acute URTI with cough and sore throat as the commonest presenting clinical features. Phylogenetic analysis on partial major outer and inner capsid proteins shows that these PRV strains are closely related to Melaka and Kampar viruses previously isolated in Malaysia. Further study is required to determine the public health significance of PRV infection in Southeast Asia, especially in cases where co-infection with other pathogens may potentially lead to different clinical outcomes.

Matched MeSH terms: Respiratory Tract Infections/epidemiology; Respiratory Tract Infections/virology*
Fulltext Juvenile recurrent respiratory papillomatosis: A rare masquerade of asthma

Boo WH, Rajan P, Ching SM, Lee PY

Malays Fam Physician, 2015;10(2):45-8.
PMID: 27099660 MyJurnal

Juvenile recurrent respiratory papillomatosis (JRRP) is a rare condition. The varied presentation of this condition predisposes to misdiagnosis and potential life-threatening airway obstruction. In this paper, we have reported a case of JRRP presenting as severe respiratory distress and consequently mistreated as asthmatic attack culminating in a near fatal acute airway obstruction.

Matched MeSH terms: Respiratory Tract Infections
Fulltext Post dengue neurological complication

Hasliza AH, Tohid H, Loh KY, Santhi P

Malays Fam Physician, 2015;10(2):49-51.
PMID: 27099661 MyJurnal

Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain-Barre syndrome (GBS) is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE) followed by an upper respiratory tract infection (URTI) weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

Matched MeSH terms: Respiratory Tract Infections
Prescribing patterns for upper respiratory tract infections: a prescription-review of primary care practice in Kedah, Malaysia, and the implications

Rezal RS, Hassali MA, Alrasheedy AA, Saleem F, Yusof FA, Kamal M, et al.

Expert Rev Anti Infect Ther, 2015;13(12):1547-56.
PMID: 26358203 DOI: 10.1586/14787210.2015.1085303

INTRODUCTION AND AIMS: It is necessary to ascertain current prescribing of antibiotics for upper respiratory tract infections (URTIs) to address potential overuse. A retrospective analysis was conducted of all prescriptions for URTIs among 10 public primary healthcare centers in Kedah, Malaysia, from 1 January to 31 March 2014.
RESULTS: A total of 123,524 prescriptions were screened and analyzed. Of these, 7129 prescriptions were for URTI, with 31.8% (n = 2269) containing antibiotics. Macrolides were the most commonly prescribed antibiotic, constituting 61% (n = 1403) of total antibiotics prescribed. There was a statistically significant association between different prescribers and diagnoses (p = 0.001) and a weak positive trend suggesting family medicine specialists are more competent in antibiotic prescribing, followed by medical officers and assistant medical officers (τ = 0.122).
CONCLUSIONS: Prescribing practices of some prescribers were inconsistent with current guidelines encouraging resistance development. National antimicrobial stewardship programs and further educational initiatives are ongoing in Malaysia to improve antibiotic use.
KEYWORDS: Malaysia; antibiotics stewardship programs; guidelines; inappropriate use of antibiotics; primary healthcare centres; upper respiratory tract infections
Study site: Klinik kesihatan, Kedah, Malaysia

Matched MeSH terms: Respiratory Tract Infections
Fulltext Burden of motorcycle-related injury in Malaysia

Rahman NH, Baharuddin KA, Mohamad SM

Int J Emerg Med, 2015;8:17.
PMID: 26085844 DOI: 10.1186/s12245-015-0065-4

Road traffic injury (RTI) contributes to major morbidity and mortality in both developed and developing countries. Most of the injuries are caused by road-related injuries that specifically relate to motorcycle crash. We attempted to conduct a short survey to determine the magnitude of burden related to motorcycle-related RTIs in Malaysia. We hypothesize that motorcycle-related RTI in Malaysia contributes significantly to the health burden in the country.

Matched MeSH terms: Respiratory Tract Infections

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