METHODS: A prospective multicenter observational study was performed on patients admitted for clinically suspected leptospirosis. Three hospitals namely Hospital Serdang, Hospital Tengku Ampuan Rahimah and Hospital Teluk Intan were included in the study. Among a total of 165 clinically suspected leptospirosis patients, 83 confirmed cases were investigated for clinical predictors for severe illness. Qualitative variables were performed using χ2 and the relationship between mild and severe cases was evaluated using logistic regression. Multivariable logistic regression was used to predict the independent variable for severity.
RESULTS: Among the 83 patients, 50 showed mild disease and 33 developed severe illness. The mean age of the patients was 41.92 ± 17.99 and most were males (n = 54, 65.06%). We identified mechanical ventilation, acute kidney injury, septic shock, creatinine level of > 1.13 mg/dL, urea > 7 mmol/L, alanine aminotransferase > 50 IU, aspartate aminotransferase > 50 IU, and platelet 50 IU and platelet
METHODS: We conducted a retrospective descriptive study of all children aged Malaysia, from January 2011 until December 2020. Fine-needle aspiration of head and neck lesions suspected to be due to melioidosis with inoculation in blood culture bottles (FNA + BCB) was used from the beginning of 2016.
RESULTS: Of 34 children with culture-confirmed melioidosis, 20 (59%) had an infection involving one or more sites in the head and neck. Of these, 17 (85%) were diagnosed in or after 2016. Cervical lymph nodes were the most common organ or site affected, involved in 19 (95%) children. Clinical presentations of B. pseudomallei lymph node infections were highly variable. Five (25%) children had salivary gland involvement. Lacrimal gland involvement (dacryocystitis) and skin or soft tissue infection (scalp abscess) were less frequent. B. pseudomallei was isolated from the head or neck using FNA + BCB in 15 (75%) children and by standard culture methods of direct plating of pus on agar following incision and drainage in only 2 (10%) children. B. pseudomallei was isolated from non-head or neck specimens or blood in 3 (15%) children.
CONCLUSIONS: Manifestations of pediatric head and neck melioidosis in Sarawak, Malaysia, differ from those of other regions. Fine-needle aspiration, mainly of affected cervical lymph nodes, facilitates B. pseudomallei detection and enables confirmation of melioidosis infections.
METHODS: This is a non-experimental cross-sectional design study, which was conducted using survey questionnaire to examine the incidence of burnout, posttraumatic stress disorder (PTSD) symptoms and the quality of life (QOL) among the disaster relief volunteers. And the study also examined the socio-demographic variables of the participants. In addition, the association between the sociodemographic variable and the preferred coping strategies was also investigated through self-reporting checklist.
RESULTS: The findings of this study revealed that 90.9% volunteers (n = 312) experienced some levels of recurring stress throughout their lives, which led to burnout. Also, 96.8% (n = 332) of the participants were categorized as having at least some symptoms of PTSD. However, self-reporting QOL measurements indicated that the participants are, in general, satisfied with their lives. Significant associations between the incidence of burnout, incidence of PTSD and QOL were identified. Both positive coping measures and behavioral or avoidant coping measures were also identified. Furthermore, a number of socio-demographic factors were also seen to interact significantly with burnout, PTSD and QOL.
CONCLUSION: This study provides some insights into the psychological challenges of disaster relief volunteers in Malaysia, and this impact can last a long time after the volunteers return to their hometowns. Several recommendations including practice development, policy and research were discussed in the study.
Objectives: This study investigated trends of stroke incidence and 28-day all-cause mortality after a stroke from 2008 to 2016 in Malaysia, through linkage across national data sources.
Methods: Hospital admissions with a principal diagnosis of stroke or transient ischemic attack were included. Cases with first stroke were identified through linkage of hospital admission registers where age and sex-standardized trends of stroke incidence and its subtypes were calculated. By linking hospital registers to the National Death Register, the 28-day all-cause mortality rates after a stroke were estimated. Mann-Kendall's test was used for trend evaluation.
Results: From 243,765 records, the trend of stroke incidence showed an increase of 4.9% in men and a drop of 3.8% among women. Incidences were higher in men, at 99.1 per 100,000 population in 2008 and 103.9 per 100,000 in 2016 than women (80.3 per 100,000 in 2008 and 77.2 per 100,000 in 2016). There was a substantial increase in stroke incidence among those below 65 years old, with the largest increase of 53.3% in men aged between 35-39 years and 50.4% in women of similar age group. The trend for 28-day all-cause mortality showed a decline for men at -13.1% and women, -10.6%. Women had higher mortality from stroke (22.0% in 2008 and 19.7% in 2016) than men (19.4% in 2008 to 17.2% in 2016).
Conclusion: This first empirical study on stroke trends in Malaysia revealed a worrying increase in stroke incidence among the younger population. Despite a declining trend, mortality rates remained moderately high especially in women. Comprehensive strategies to strengthen the prevention and management of stroke care are warranted.
MATERIALS AND METHODS: This observational study was conducted in Manjung, Perak and Langkawi Island to look at the pattern and incidence of jellyfish stings which occur within 1 year.
RESULTS: There were 45 sting incidents reported with the highest number of cases occurred in December and February. Cases mainly involved young adults aged 10 to 29 years old. The most common clinical symptom that presented was sudden and persistent pain. Vinegar was applied as first aid in 53.3% of reported stings. All patients were treated symptomatically and discharged well. Stings occurred at mean sea surface temperature of 29.38°C and the wind speed of 7.6 knots. All cases were mild and did not require antivenom.
CONCLUSIONS: The study showed that the occurrence of jellyfish stings are affected by weather conditions. Jellyfish stings occur seasonally, thus making it predictable and easily preventable with public awareness, early first aid application and use of jellyfish nets.
METHODS: This study assessed access to and use of mobile technology and acceptability of mHealth among 150 HIV-positive MSM and TGW who were prescribed antiretroviral therapy (ART) in Malaysia-an emerging economy with rapid telecommunications growth and societal stigma against these groups.
RESULTS: Findings among the 114 MSM and 36 TGW reveal high levels of depression (42%), stigma (2.53/4.00) and risky sexual behavior (30%), and suboptimal ART adherence (22%). On the other hand, the sample had excellent access to smartphones (75.3%) and the internet (78%), and had high acceptance of mHealth especially for those with suboptimal ART adherence.
CONCLUSION: In settings like Malaysia where homosexuality and cross-dressing are socially and legally stigmatized, HIV prevention and treatment strategies delivered using an mHealth platform have the potential to overcome in-person barriers.
MATERIALS AND METHODS: This retrospective study included all pregnancies seen at the SLE Clinic, Kuala Lumpur Hospital from January 2008 to May 2020. Maternal outcomes included SLE flare during pregnancy, preeclampsia and eclampsia. Foetal outcomes included foetal loss, preterm birth and small-for-gestational age (SGA) neonates. Clinical and laboratory variables were examined. Variables from univariate analysis were entered into logistic regression model. Odds ratio and 95% confidence interval were reported.
RESULTS: Of the 131 pregnancies, 106 (80.9%) were live births. Twenty-six (24.5%) babies were born preterm and 35 (33%) neonates were SGA. Twenty-four (18.3%) women had disease flare during pregnancy, with the majority (22/24) being mild to moderate flares. Four women experienced preeclampsia while none had eclampsia. Predictors of adverse maternal outcomes included high SLEDAI-2K score, proteinuria and hypocomplementemia within 6 months before conception and during pregnancy; history of lupus nephritis (LN), pre-existing hypertension, antiphospholipid syndrome (APS), antiphospholipid antibodies, anti-Ro antibody and anti-RNP antibody. Predictors of adverse foetal outcomes comprised APS, preeclampsia, anti-Sm antibody, history of neuropsychiatric systemic lupus erythematosus (NPSLE) and azathioprine use.
CONCLUSION: Pregnancy in SLE women is best deferred until disease activity is in remission for at least 6 months before conception. A history of LN is associated with a 3-fold risk of renal flare during pregnancy. Haematological abnormalities are rare in disease flare during pregnancy.
DESIGN: A population-based cross-sectional study.
SETTING: 13 states and 3 Federal Territories in Malaysia.
PARTICIPANTS: A total of 3966 adults aged 60 years and above were extracted from the nationwide National Health and Morbidity Survey (NHMS) 2018 data set.
PRIMARY OUTCOME MEASURES: Multimorbidity was defined as co-occurrence of at least two known chronic non-communicable diseases in the same individual. The chronic diseases included hypertension, type 2 diabetes mellitus, dyslipidaemia and cancer.
RESULTS: The prevalence of multimorbidity among Malaysian older adults was 40.6% (95% CI: 37.9 to 43.3). The factors associated with multimorbidity were those aged 70-79 years (adjusted OR (AOR)=1.30; 95% CI=1.04 to 1.63; p=0.019), of Indian (AOR=1.69; 95% CI=1.14 to 2.52; p=0.010) and Bumiputera Sarawak ethnicities (AOR=1.81; 95% CI=1.14 to 2.89; p=0.013), unemployed (AOR=1.53; 95% CI=1.20 to 1.95; p=0.001), with functional limitation from activities of daily livings (AOR=1.66; 95% CI=1.17 to 2.37; p=0.005), physically inactive (AOR=1.28; 95% CI=1.03 to 1.60; p=0.026), being overweight (AOR=1.62; 95% CI=1.11 to 2.36; p=0.014), obese (AOR=1.88; 95% CI=1.27 to 2.77; p=0.002) and with abdominal obesity (AOR=1.52; 95% CI=1.11 to 2.07; p=0.009).
CONCLUSION: This study highlighted that multimorbidity was prevalent among older adults in the community. Thus, there is a need for future studies to evaluate preventive strategies to prevent or delay multimorbidity among older adults in order to promote healthy and productive ageing.
METHODS: Data of 7068 participants (4418 Malays, 2080 Chinese and 570 Indians) aged ≥55 years that were collected as part of the community health survey conducted in 2013 in the South East Asia Community Observatory (SEACO) were analyzed using bivariate and multiple regressions. Analyses were stratified by ethnicity.
RESULTS: The importance of having an enriched religious/spiritual life was associated with higher scores of depression, anxiety and stress among Chinese and higher score of depression among Malays, while belief in a higher power was associated with better mental health among Malays, Chinese and Indians.
CONCLUSION: The current study showed that there were ethnic variations in the associations between religion and mental health, and the associations depended on the religious variable included in the analysis. The findings of this study showed that religion could be another potential channel to improve mental health among older adults by accommodating and understanding their religious beliefs.