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Fulltext Dietary modification in a workplace health promotion program in Kuala Lumpur, Malaysia

Moy FM, Ab Sallam A, Wong ML

Asia Pac J Public Health, 2008 Oct;20 Suppl:166-72.
PMID: 19533877

Lifestyle modification is effective in the prevention of cardiovascular diseases. This study aimed to promote healthy lifestyle behaviours to prevent cardiovascular disease. This study was a quasi-experimental trial with a follow up of two years. The intervention group (n = 102) received intensive individual and group counselling on diet and physical activity. The comparison group (n = 84) was given minimal education through mail and group counselling. Following the intervention, both groups reduced their total fat intake through a replacement in carbohydrate intake. The saturated fat and cholesterol intake was also reduced with a larger magnitude in the intervention group. Fruits and vegetables consumption was increased within the intervention group. The intervention group showed a statistically significant reduction in their mean total cholesterol levels with an intervention effect of -0.38 (95% C.I. = -0.63, -0.14) mmol/l. This study has achieved moderate improvement in dietary intakes as well as the total cholesterol of the participants.

Matched MeSH terms: Cardiovascular Diseases/prevention & control*
Public awareness and knowledge of herpes zoster: results of a global survey

Paek E, Johnson R

Gerontology, 2010;56(1):20-31.
PMID: 19776543 DOI: 10.1159/000240046

BACKGROUND: Herpes zoster (HZ), the reactivation of varicella zoster virus, occurs in 1 in 5 people worldwide and may result in a variety of complications, including postherpetic neuralgia (PHN). Treatment of patients with HZ represents a considerable challenge, especially among the elderly who are prone to get a more severe form of the disease and its complications. Since May 2006, a vaccine was approved for the prevention of HZ or PHN among individuals aged 50 or 60 years and older.
OBJECTIVE: Since the success of any new vaccine initiative depends on public awareness of the disease, we conducted the HZ Global Awareness Survey to gauge existing levels of awareness and knowledge of HZ.
METHODS: The survey was conducted by telephone or face-to-face among 8,688 adults >OR=50 years of age in 22 countries between December 2006 and January 2007 and addressed awareness, knowledge, symptoms, and treatment of HZ.
RESULTS: Wide variation in HZ awareness was noted among countries. In some countries (New Zealand, Brazil, and Malaysia) nearly all individuals surveyed (97-100%) over the age of 50 years had heard of HZ. In contrast, less than 20% of individuals surveyed were aware of HZ in Turkey, India and Chile. The survey revealed almost universally poor knowledge of the causes and symptoms of HZ. Only 3% of respondents mentioned chicken pox as the cause of the disease. The majority of respondents were unaware of their risk of HZ, with 71% considering themselves unlikely or very unlikely to develop HZ. The survey also revealed that those respondents with prior HZ experience were much more likely to consider pain as the worst symptom of the disease than those without prior HZ experience. The misconception of HZ-related morbidity among individuals with no first-hand experience of the disease highlights the global educational need to raise awareness of the seriousness of HZ and its potential long-term complications.
CONCLUSIONS: This survey suggests a population-wide effort to improve global awareness of HZ would be required for a successful vaccine initiative. Further studies would be required to understand regional differences in the understanding of HZ.

Matched MeSH terms: Herpes Zoster/prevention & control
Fulltext Risk of blood-borne infection among health care workers in two Kuala Lumpur hospitals

Hesham R, Tajunisah ME, Ilina I

Med J Malaysia, 2008 Aug;63(3):222-3.
PMID: 19248694

Health care workers (HCW) are at high risk of acquiring blood-borne diseases. This study compared the risk of infection among HCW in different hospital units and also between HCW and students in medical fields. This cross-sectional study involved pre-tested questionnaires that were completed by 625 HCW and undergraduate students undergoing clinical attachments from February to August 2001. The respondents were separated into two groups: i) HCW from Hospital Kuala Lumpur, HKL (n=241) and Hospital Universiti Kebangsaan Malaysia, HUKM (n=153) ii) Medical students from Universiti Kebangsaan Malaysia, UKM (n=171) and HUKM student nurses (n=60). The results obtained showed that the risk of transmission of blood-borne infections varied significantly according to professional ranks (p<0.05) and to hospital units (p<0.05). The medical intensive care (ICU), haemodialysis, and nephrology and urology units had the highest scores for the risk of infection while the diagnostic laboratory had the lowest risk of infection (p<0.05). Preventive measures taken by the subjects in this study were not satisfactory especially with reference to the use of personal protective equipment and the practice of universal precautions.

Matched MeSH terms: Hepatitis B/prevention & control
Fulltext An Audit of Diabetes Control and Management (ADCM)

Mastura I, Zanariah H, Fatanah I, Feisul Idzwan M, Wan Shaariah MY, Jamaiyah H, et al.

Med J Malaysia, 2008 Sep;63 Suppl C:76-7.
PMID: 19227679

Diabetes is a chronic condition that is one of the major causes of illness, disability, and death in Malaysia. Cost in managing diabetes plus indirect cost of lost work, pain, and suffering have all increased. The optimal management of patients with diabetes require the tracking of patients over time to monitor the progression of the disease, compliance with treatment, and preventive care. Diabetes care can be improved by standardizing access to, and improving the use of, clinical information. Access to timely, accurate and well-organized electronic data will improve the quality of care for patients with diabetes. Clinical Research Center convened an expert workshop to forecast how physicians, hospitals and clinics will employ clinical information technology (IT) applications to diabetes care over the next year. Workshop participants included experts from research organizations, government, and the IT vendor. This is a summary of the workshop organised for the purpose of the Audit of Diabetes Control and Management (ADCM) project. We hope to identify the gaps, if any, that exists in delivering diabetes care and to improve the quality of care. In future, we hope to develop an expansion of this project for the Adult Diabetes Registry that will be implemented for the whole country.

Matched MeSH terms: Diabetes Mellitus/prevention & control*
Carbetocin versus syntometrine in prevention of post-partum hemorrhage following vaginal delivery

Nirmala K, Zainuddin AA, Ghani NA, Zulkifli S, Jamil MA

J Obstet Gynaecol Res, 2009 Feb;35(1):48-54.
PMID: 19215547 DOI: 10.1111/j.1447-0756.2008.00829.x

To compare the efficacy of a single dose of 100 microg intramuscular carbetocin to a single dose of intramuscular syntometrine (0.5 mg ergometrine and 5IU oxytocin), in preventing post-partum hemorrhage (PPH) in high risk patients following vaginal delivery.

Matched MeSH terms: Postpartum Hemorrhage/prevention & control*
Fulltext A quality assurance study on the administration of medication by nurses in a neonatal intensive care unit

Raja Lope RJ, Boo NY, Rohana J, Cheah FC

Singapore Med J, 2009 Jan;50(1):68-72.
PMID: 19224087

This study aimed to determine the rates of non-adherence to standard steps of medication administration and medication administration errors committed by registered nurses in a neonatal intensive care unit before and after intervention.

Matched MeSH terms: Medication Errors/prevention & control*
Fulltext Knowledge and awareness of cervical cancer and screening among Malaysian women who have never had a Pap smear: a qualitative study

Wong LP, Wong YL, Low WY, Khoo EM, Shuib R

Singapore Med J, 2009 Jan;50(1):49-53.
PMID: 19224084

INTRODUCTION: Cervical cancer is one of the commonest cancers in women worldwide. Despite the existence of effective screening using Pap smear, the uptake of screening is poor. A qualitative study was undertaken using face-to-face in-depth interviews to investigate knowledge, attitudes and beliefs on cervical cancer screening of Malaysian women.
METHODS: In-depth interviews were conducted with 20 Malaysian women aged 21-56 years and who have never had a Pap smear test, with the aim to explore their knowledge and awareness of cervical cancer and its screening.
RESULTS: A lack of knowledge on cervical cancer and the Pap smear test was found among the respondents. Many women did not have a clear understanding of the meaning of an abnormal cervical smear and the need for the early detection of cervical cancer. Many believe the purpose of the Pap smear test is to detect existing cervical cancer, leading to the belief that Pap smear screening is not required because the respondents had no symptoms. Despite considerable awareness of a link between cervical cancer and sexual activity, as well as the role of a sexually-transmitted infection, none of the respondents had heard of the human papillomavirus.
CONCLUSION: The findings highlight the importance of emphasising accurate information about cervical cancer and the purpose of Pap smear screening when designing interventions aimed at improving cervical cancer screening for Malaysian women.

Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
Comparative study between Pap smear cytology and FTIR spectroscopy: a new tool for screening for cervical cancer

El-Tawil SG, Adnan R, Muhamed ZN, Othman NH

Pathology, 2008 Oct;40(6):600-3.
PMID: 18752127 DOI: 10.1080/00313020802320622

AIMS: To evaluate Fourier transform infrared (FTIR) spectroscopy as new tool for screening of cervical cancer in comparison with cervical cytology.
METHODS: A total of 800 cervical scrapings were taken by cytobrush and placed in ThinPrep medium. The samples were dried over infrared transparent matrix. Beams of infrared light were directed at the dried samples at frequency of 4000 to 400 cm(-1). The absorption data were produced using a Spectrum BX II FTIR spectrometer. Data were compared with the reference absorption data of known samples using FTIR spectroscopy software. FTIR spectroscopy was compared with cytology (gold standard).
RESULTS: FTIR spectroscopy could differentiate normal from abnormal cervical cells in the samples examined. The sensitivity was 85%, specificity 91%, positive predictive value 19.5% and negative predictive value of 99.5%.
CONCLUSION: This study suggests that FTIR spectroscopy could be used as an alternative method for screening for cervical cancer.

Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*
Fulltext Endoscopic cauterization of the sphenopalatine artery in persistent epistaxis

Harvinder S, Rosalind S, Gurdeep S

Med J Malaysia, 2008 Dec;63(5):377-8.
PMID: 19803294 MyJurnal

The management of epistaxis remains to be a challenging problem for most ENT surgeon especially posterior epistaxis. Most cases are managed by placement of posterior nasal packs or balloons and failure leads to more invasive techniques, involving ligation of the internal maxillary artery. The above management is associated with significant patient complication and morbidity. Endoscopic ligation or cauterization of the sphenopalatine artery has emerged as a viable and minimally invasive alternative. We have performed endoscopic cauterization of nine sphenopalatine arteries in eight patients with no further episodes of epistaxis and complications, with an average follow-up of 25 months. The mean age of the patients was 52.75 years. Fifty percent of the patients had a history of hypertension.

Matched MeSH terms: Epistaxis/prevention & control
Value-added utilization of oil palm ash: a superior recycling of the industrial agricultural waste

Foo KY, Hameed BH

J Hazard Mater, 2009 Dec 30;172(2-3):523-31.
PMID: 19695771 DOI: 10.1016/j.jhazmat.2009.07.091

Concern about environmental protection has increased over the years from a global viewpoint. To date, the infiltration of oil palm ash into the groundwater tables and aquifer systems which poses a potential risk and significant hazards towards the public health and ecosystems, remain an intricate challenge for the 21st century. With the revolution of biomass reutilization strategy, there has been a steadily growing interest in this research field. Confirming the assertion, this paper presents a state of art review of oil palm ash industry, its fundamental characteristics and environmental implications. Moreover, the key advance of its implementations, major challenges together with the future expectation are summarized and discussed. Conclusively, the expanding of oil palm ash in numerous field of application represents a plausible and powerful circumstance, for accruing the worldwide environmental benefit and shaping the national economy.

Matched MeSH terms: Industrial Waste/prevention & control
Fulltext Adult smokers' perception of the role of religion and religious leadership on smoking and association with quitting: a comparison between Thai Buddhists and Malaysian Muslims

Yong HH, Hamann SL, Borland R, Fong GT, Omar M, ITC-SEA project team

Soc Sci Med, 2009 Oct;69(7):1025-31.
PMID: 19695758 DOI: 10.1016/j.socscimed.2009.07.042

In recent years, attempts have been made to incorporate religion into tobacco control efforts, especially in countries like Malaysia and Thailand where religion is central to the lives of people. This paper is a prospective examination of the perceived relevance and role of religion and religious authorities in influencing smoking behaviour among Muslims in Malaysia and Buddhists in Thailand. Data were collected from 1482 Muslim Malaysian and 1971 Buddhist Thai adult smokers who completed wave 1 (early 2005) of the International Tobacco Control Southeast Asia Survey (ITC-SEA). Respondents were asked about the role of religion and religious leadership on smoking at Wave 1 and among those recontacted, quitting activity at Wave 2. Results revealed that over 90% of both religious groups reported that their religion guides their day-to-day behaviour at least sometimes, but Malaysian Muslims were more likely to report that this was always the case. The majority (79% Muslims and 88% Buddhists) of both groups believed that their religion discourages smoking. About 61% of the Muslims and 58% of the Buddhists reported that their religious leaders had encouraged them to quit before and a minority (30% and 26%, respectively) said they would be an influential source to motivate them to quit. Logistic regression models suggest that these religious factors had a clear independent association with making quitting attempts in both countries and this translated to success for Malaysian Muslims but not for the Thai Buddhists. Taken together, results from this study indicate that religion and religious authorities are both relevant and important drivers of quitting, but whether this is always enough to guarantee success is less clear. Religion can be a culturally relevant vehicle to complement other tobacco control efforts.

Matched MeSH terms: Smoking/prevention & control*
Treatment of Terasil Red R dye wastewater using H2O2/pyridine/Cu(II) system

Lim CL, Morad N, Teng TT, Ismail N

J Hazard Mater, 2009 Aug 30;168(1):383-9.
PMID: 19303709 DOI: 10.1016/j.jhazmat.2009.02.061

The H(2)O(2)/pyridine/Cu(II) advanced oxidation system was used to assess the efficiency of the treatment of a 1 g L(-1) Terasil Red R dye solution. This system was found to be capable in reducing the concentration of chemical oxygen demand (COD) of the dye solution up to 90%, and achieving 99% in decolorization at the optimal concentration of 5.5mM H(2)O(2), 38 mM pyridine and 1.68 mM Cu(II). The final concentration of COD was recorded at 117 mg L(-1) and color point at 320 PtCo. Full 2(4) factorial design and the response surface methodology using central composite design (CCD) were utilized in the screening and optimization of this study. Treatment efficiency was found to be pH independent. The amount of sludge generation was in the range of 100-175 mg L(-1) and the sludge produced at the optimal concentration was 170 mg L(-1).

Matched MeSH terms: Industrial Waste/prevention & control*
Continuous biosynthesis of biodiesel from waste cooking palm oil in a packed bed reactor: optimization using response surface methodology (RSM) and mass transfer studies

Halim SF, Kamaruddin AH, Fernando WJ

Bioresour Technol, 2009 Jan;100(2):710-6.
PMID: 18819793 DOI: 10.1016/j.biortech.2008.07.031

This study aimed to develop an optimal continuous procedure of lipase-catalyzes transesterification of waste cooking palm oil in a packed bed reactor to investigate the possibility of large scale production further. Response surface methodology (RSM) based on central composite rotatable design (CCRD) was used to optimize the two important reaction variables packed bed height (cm) and substrate flow rate(ml/min) for the transesterification of waste cooking palm oil in a continuous packed bed reactor. The optimum condition for the transesterification of waste cooking palm oil was as follows: 10.53 cm packed bed height and 0.57 ml/min substrate flow rate. The optimum predicted fatty acid methyl ester (FAME) yield was 80.3% and the actual value was 79%. The above results shows that the RSM study based on CCRD is adaptable for FAME yield studied for the current transesterification system. The effect of mass transfer in the packed bed reactor has also been studied. Models for FAME yield have been developed for cases of reaction control and mass transfer control. The results showed very good agreement compatibility between mass transfer model and the experimental results obtained from immobilized lipase packed bed reactor operation, showing that in this case the FAME yield was mass transfer controlled.

Matched MeSH terms: Industrial Waste/prevention & control
Critical incident monitoring in anaesthesia (2)

Choy CY

Curr Opin Anaesthesiol, 2008 Apr;21(2):183-6.
PMID: 18443485 DOI: 10.1097/ACO.0b013e3282f33592

PURPOSE OF REVIEW: Updates on developments in critical incident monitoring in anaesthesia, and assesses its role in improving patient safety.
RECENT FINDINGS: Critical incident reporting has become more widely accepted as an effective way to improve anaesthetic safety, and has continued to highlight the importance of human errors and system failures. The establishment of an international database also improves critical incident reporting. Experiences from the national reporting and learning system in the UK have provided some solutions to the many problems and criticisms faced by the critical incident reporting technique. Direct observations to detect errors are more accurate than voluntary reporting of critical incidents, and may be a promising new approach.
SUMMARY: Critical incident monitoring is a valuable tool in ensuring patient safety due to its low cost and the ability to provide a comprehensive body of detailed qualitative information. The qualitative information gathered can be used to develop strategies to prevent and manage existing problems, as well as to plan further initiatives for patient safety. Novel approaches should complement existing methods to achieve better results. The development of a culture which emphasises safety should go hand in hand with current audit activities.

Matched MeSH terms: Medical Errors/prevention & control*
Emerging HIV epidemics in Muslim countries: assessment of different cultural responses to harm reduction and implications for HIV control

Todd CS, Nassiramanesh B, Stanekzai MR, Kamarulzaman A

Curr HIV/AIDS Rep, 2007 Dec;4(4):151-7.
PMID: 18366945

Harm reduction, including needle exchange and opioid substitution therapy, has been demonstrated to reduce high-risk behavior and HIV infection among injection drug users. An increasing number of countries in the Middle East, North Africa, and Asia, including those with Muslim majorities, have experienced or are at risk for HIV epidemics initiated by burgeoning injection drug use. Although use of intoxicants is expressly forbidden within Islam, the local culture impacts the interpretation of Islamic law and influences the response to drug misuse, whether punitive or therapeutic. Harm reduction programming has received varying acceptance within this global region, which may be reflected by national trends in HIV prevalence. The purpose of this paper is to examine cultural and religious response to injecting drug use and associated HIV prevalence trends in Malaysia and Iran, with possible application of lessons learned to an emerging situation in Afghanistan.

Matched MeSH terms: HIV Infections/prevention & control*
Effect of kaolin addition on the performance of controlled low-strength material using industrial waste incineration bottom ash

Naganathan S, Razak HA, Hamid SN

Waste Manag Res, 2010 Sep;28(9):848-60.
PMID: 20852000 DOI: 10.1177/0734242X09355073

Incineration of industrial waste produces large quantities of bottom ash which are normally sent to secured landfill, but is not a sustainable solution. Use of bottom ash in engineering applications will contribute to sustainability and generate revenue. One way of using the industrial waste incineration bottom ash is in controlled low-strength material (CLSM). Use of bottom ash in CLSM has problems related to bleeding and excessive strength development and so an additive has to be used to control bleeding and strength development. The main objective of this research is to study the effect of kaolin addition on the performance of CLSM made using industrial waste incineration bottom ash. CLSM mixes were made with bottom ash, cement, and refined kaolin. Various tests were performed on the CLSM in fresh and hardened states including compressive strength, water absorption, California bearing ratio (CBR) and the tests for concentration of leachable substances on the bleed and leachate. The compressive strength of CLSM tested ranged from 0.11 to 9.86 MPa. CBR values ranged from 6 to 46, and water absorption values from 12 to 36%. It was shown that the addition of kaolin delayed the initial setting time of CLSM mixtures, reduced bleeding, lowered the compressive strength, and increased the values of water absorption, sorption, and initial surface absorption. The CLSM tested did not have corrosivity. It was shown that the hardened CLSM was non hazardous, and the addition of kaolin increased the concentration of heavy metals and salts in the bleed and leachate.

Matched MeSH terms: Environmental Pollution/prevention & control*
A multicomponent exercise program for institutionalized older adults

Justine M, Hamid TA

J Gerontol Nurs, 2010 Oct;36(10):32-41.
PMID: 20438009 DOI: 10.3928/00989134-20100330-09

This study examined the effects of a multicomponent exercise program on depression and quality of life in institutionalized older adults. A quasi-experimental pretest-posttest design was used. Participants were recruited from a publicly funded shelter home in Seremban, Negeri Sembilan Malaysia. The experimental group consisted of 23 volunteers 60 or older who performed 60 minutes of supervised exercise three times per week for 12 weeks. The control group consisted of 20 volunteers who continued with a sedentary lifestyle. At 12 weeks, the exercise group demonstrated an improvement in quality of life by 10.74% (p > 0.05) but not depression (-1.6%, p > 0.05). The control group demonstrated a decrease in both quality of life by 11.26% (p > 0.05) and level of depression by 17.7% (p > 0.05). This study suggests a multicomponent exercise program is a feasible intervention to improve quality of life in institutionalized older adults.

Matched MeSH terms: Depression/prevention & control*
Fulltext Trends in malaria research in 11 Asian Pacific countries: an analysis of peer-reviewed publications over two decades

Andersen F, Douglas NM, Bustos D, Galappaththy G, Qi G, Hsiang MS, et al.

Malar J, 2011 May 18;10:131.
PMID: 21586174 DOI: 10.1186/1475-2875-10-131

BACKGROUND: Quantitative data are lacking on published malaria research. The purpose of the study is to characterize trends in malaria-related literature from 1990 to 2009 in 11 Asian-Pacific countries that are committed to malaria elimination as a national goal.
METHODS: A systematic search was conducted for articles published from January 1990 to December 2009 in PubMed/MEDLINE using terms for malaria and 11 target countries (Bhutan, China, North Korea, Indonesia, Malaysia, Philippines, Solomon Islands, South Korea, Sri Lanka, Thailand and Vanuatu). The references were collated and categorized according to subject, Plasmodium species, and whether they contained original or derivative data.
RESULTS: 2,700 articles published between 1990 and 2009 related to malaria in the target countries. The annual output of malaria-related papers increased linearly whereas the overall biomedical output from these countries grew exponentially. The percentage of malaria-related publications was nearly 3% (111/3741) of all biomedical publications in 1992 and decreased to less than 1% (118/12171; p < 0.001) in 2009. Thailand had the highest absolute output of malaria-related papers (n = 1211), followed by China (n = 609) and Indonesia (n = 346). Solomon Islands and Vanuatu had lower absolute numbers of publications, but both countries had the highest number of publications per capita (1.3 and 2.5 papers/1,000 population). The largest percentage of papers concerned the epidemiology and control of malaria (53%) followed by studies of drugs and drug resistance (47%). There was an increase in the proportion of articles relating to epidemiology, entomology, biology, molecular biology, pathophysiology and diagnostics from the first to the second decade, whereas the percentage of papers on drugs, clinical aspects of malaria, immunology, and social sciences decreased.
CONCLUSIONS: The proportion of malaria-related publications out of the overall biomedical output from the 11 target Asian-Pacific countries is decreasing. The discovery and evaluation of new, safe and effective drugs and vaccines is paramount. In addition the elimination of malaria will require operational research to implement and scale up interventions.

Matched MeSH terms: Malaria/prevention & control*
Fulltext Influenza A (H1N1) 2009 pandemic virus: learning from the first wave, preparing for the second

Lee CK

Med J Malaysia, 2010 Mar;65(1):1-2.
PMID: 21265237

In a short period of two months, the novel influenza A/H1N1 virus has circumnavigated the entire planet leaving behind in its wake approximately 3000 reported deaths worldwide. Fortunately, in many areas around the world, September 2009 brought a lull in the number of new H1N1 infections. This brought welcomed relief in many countries that had earlier experienced high respiratory disease activity in their communities. However, based on previous influenza pandemics, this reprieve may well be short-lived. As the Northern hemisphere approaches its winter months, many experts are now predicting a second wave of influenza A/H1N1 infections. This prediction maybe well placed as all 3 influenza pandemics in the last century reported second or even subsequent waves of new infections, all of which appeared to be more severe than the primary event (ref). The timing of these second waves have varied from 6 months to 3 years and invariably seemed to be linked to the winter months. It is unclear precisely what changes caused the increased severity seen during the second waves; one possibility is the progressive adaptation of the novel influenza virus to its new human host . Molecular analysis, for example, suggests that the 1918 Spanish influenza virus that emerged during the second wave had undergone changes in the hemagglutinin binding site that increased the binding specificity for human receptors. This is thought to have increased the replicative capacity and hence, the pathogenicity of the virus. It is also evident that as the H1N1 2009 pandemic virus continues to spread, opportunities for adaptation that increases virulence will also increase. Nonetheless, the changes needed for such adaptation and for increased virulence are unpredictable and by no means inevitable

Matched MeSH terms: Influenza, Human/prevention & control
Fulltext Role of primary care providers in dengue prevention and control in the community

Ang KT, Rohani I, Look CH

Med J Malaysia, 2010 Mar;65(1):58-62.
PMID: 21265251 MyJurnal

Dengue fever is a major public health threat in Malaysia, especially in the highly urbanized states of Selangor and the Federal Territory of Kuala Lumpur. It is believed that many seek treatment at the primary care clinics and are not admitted. This study aims at establishing the fact that primary care practitioners, as the first point of patient contacts, play a crucial role in advising patients suspected of having dengue to take early preventive measures to break the chain of dengue transmission. A total of 236 patients admitted to two government hospitals for suspected dengue fever were interviewed using a structured questionnaire over a one week period in December 2008. It was found that 83.9% of the patients had sought treatment at a Primary Care (PC) facility before admission to the hospital, with 68.7% of them seeking treatment on two or more occasions. The mean time period for seeking treatment at primary care clinic was one and a half (1.4) days of fever, compared to almost five (4.9) days for admission. The majority of patients (96-98%) reported that primary care practitioners had not given them any advice on preventive measures to be taken even though 51.9% of the patients had been told they could be having dengue fever. This study showed the need for primary care providers to be more involved in the control and prevention of dengue in the community, as these patients were seen very early in their illness compared to when they were admitted.

Matched MeSH terms: Dengue/prevention & control*

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