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A solution towards a viable compensation mechanism for injury from COVID-19 vaccines in Malaysia: A qualitative study

Mokhtar FS, Ariff AM, Manap NA, Mustaffa NM

Heliyon, 2024 Feb 15;10(3):e25204.
PMID: 38333837 DOI: 10.1016/j.heliyon.2024.e25204

BACKGROUND: It has been established that the existing compensation mechanism is not the favoured platform for vaccine recipients with Adverse Effects Following Immunisation (AEFI). With the mass production of vaccines during the COVID-19 pandemic, intensified by the mandatory National COVID-19 Immunisation Programme in Malaysia, an alternative resolution mechanism for compensation is long overdue. This qualitative study aims to propose a viable alternative dispute resolution (ADR) mechanism for those who suffer AEFI from COVID-19 vaccination, particularly the economically disadvantaged, older people, and disabled individuals in Malaysia.
METHODS: The researchers conducted an in-depth focus group discussion in September 2022 involving seven participants representing key stakeholders in vaccine compensations from governmental agencies, non-governmental organisations (NGOs), and private institutions who were experts in litigation and legislation, consumer protection, and medical practices in Malaysia. The study utilised ATLAS.ti 22 to conduct a thematic analysis.
FINDINGS: The analysis yielded three themes: existing mechanisms and their challenges, the role of ADR, and the solution for a vaccine injury compensation mechanism. The participants shared their knowledge and experience regarding the existing vaccine compensation mechanisms in Malaysia, i.e. the common law of Tort and Consumer Protection Act 1999, and explained how each mechanism relates to specific challenges or arguments that provide the basis on which they are unable to accord fair compensation to the vaccine recipients. The participants debated the merits and disadvantages of the types of ADR for AEFI and unanimously proposed a specific healthcare centre for compensation (SHCC) as the most viable compensation mechanism for AEFI.
CONCLUSION: SHCC offers a new ADR to serve as a compensation mechanism for claimants affected by the COVID-19 vaccines while also contributing to achieving Sustainable Development Goal 16: peace, justice, and strong institutions.
Maggot debridement therapy with Lucilia cuprina: a comparison with conventional debridement in diabetic foot ulcers

Paul AG, Ahmad NW, Lee HL, Ariff AM, Saranum M, Naicker AS, et al.

Int Wound J, 2009 Feb;6(1):39-46.
PMID: 19291114 DOI: 10.1111/j.1742-481X.2008.00564.x

This is prospective case-control study of more than 18 months performed to assess the effectiveness of maggot debridement therapy (MDT) with the sterile larvae of Lucilia cuprina (a tropical blowfly maggot) for the treatment of diabetic foot ulcers. Literature thus far has only reported results with the temperate maggot, Lucilia sericata. This study documents outcome in diabetic foot wounds treated with maggot debridement versus those treated by conventional debridement alone. In this series of 29 patients treated with MDT, 14 wounds were healed, 11 were unhealed and 4 were classified under others. The control group treated by conventional debridement had 30 patients of which 18 wounds were healed, 11 unhealed and 1 classified under others. There was no significant difference in outcome between the two groups. The conclusion that can be made from this study is that MDT with L. cuprina is as effective as conventional debridement in the treatment of diabetic foot ulcers. It would be a feasible alternative to those at high risk for surgery or for those who refuse surgery.
Fulltext Predicting healthcare professionals' intention to use poison information system in a Malaysian public hospital

Iskandar YHP, Subramaniam G, Majid MIA, Ariff AM, Rao GKL

Health Inf Sci Syst, 2020 Dec;8(1):6.
PMID: 31949893 DOI: 10.1007/s13755-019-0094-0

Purpose: The main objective of this paper is to determine the predicting factors that influence the intention to use Poison Information System (PIS) among healthcare professionals.
Methods: A quantitative approach was applied, using a five-point Likert scale questionnaire, adapted from previous studies. Data were collected from 167 healthcare professionals working for Malaysian Public Hospitals in Penang. Smart Partial Least Square (PLS) version 3.2.7 were used to analyse the proposed relationships.
Results: The results indicated that attitude and computer anxiety had a significant positive relation to the intention to use PIS among healthcare professionals wherein computer knowledge was found to have had a significant relationship with attitude and computer habit. Apart from that, technical support and training had a positive relationship with perceived ease of use. Surprisingly, computer habit, perceived usefulness, perceived ease of use, compatibility and facilitating condition did not significantly influence intention to use PIS.
Conclusion: The results of this study provided useful insights for healthcare agencies to understand the underlying elements that could improve the poison information management. The results proved that attitude and computer anxiety were critical factors among healthcare professionals managing poisoning cases in a highly stressful and unpredictable work environment. These factors must, therefore, be considered before implementing PIS in managing poisoning cases. The study also provided an understanding of how to improve system development by utilising the end user's expectation on the implementation of the system.
Paraquat poisoning calls to the Malaysia National Poison Centre following its ban and subsequent restriction of the herbicide from 2004 to 2015

Leong YH, Ariff AM, Khan HRM, Rani NAA, Majid MIA

J Forensic Leg Med, 2018 May;56:16-20.
PMID: 29525581 DOI: 10.1016/j.jflm.2018.03.007

This study analyses the incidences and patterns of paraquat poisoning from calls received at the Malaysia National Poison Centre (NPC) since 2004 following the ban of the herbicide (2004-2006) and subsequent restriction up to year 2015. Related reported cases to the centre over twelve years (2004-2015) were retrieved and studied in respect to socio-demographic characteristics, mode and type of poisonings, exposure routes and location of incident. Ages of poisoned victims range from 10 months old to 98 years with males being intoxicated more frequently than females (ratio male to female = 2.7). The age group mainly involved in the poisoning was 20-39 years. The most common mode was intentional (62.8%) followed by unintentional (36.9%). Among the 1232 reported cases, suicidal poisoning was the highest (57.2%); accidental poisoning (30.8%) and occupational poisoning (3.3%). The findings showed an upward trend of suicidal poisoning over the years, clearly emphasizing the need for more stringent and effective enforcement to ensure the safe use of paraquat.
Fulltext Evaluation of types of poisoning exposure calls managed by the Malaysia National Poison Centre (2006-2015): A retrospective review

Tangiisuran B, Jiva M, Ariff AM, Abdul Rani NA, Misnan A, Rashid SM, et al.

BMJ Open, 2018 12 31;8(12):e024162.
PMID: 30598487 DOI: 10.1136/bmjopen-2018-024162

OBJECTIVE: Accidental or intentional poisoning is a public health concern requiring intervention. The current study designs to evaluate the types of poisoning exposure calls received by the Malaysia National Poison Centre (NPC) over a 10-year period.
SETTINGS AND DATA SOURCES: The poisoning enquiries database (2006-2015) from the Malaysia NPC was used for the analysis.
PARTICIPANTS: The NPC records all telephone calls that it manages using a validated and standardised form. Demographics and types of the poisoning exposure calls were extracted and descriptive analysis was applied.
PRIMARY AND SECONDARY OUTCOMES: The primary outcome of this study is to evaluate NPC data for trends in the poisoning exposure calls based on the types and modes of poisoning over a 10-year period. The secondary outcome is to evaluate the characteristics of human exposure cases based on the calls received by the NPC.
RESULTS: There was a notable increase in the number of poisoning exposure calls noticed during the 10-year period but dropped significantly in 2012. The highest number of poisoning exposure calls came from Selangor (21.0%), Perak (18.0%) and Negeri Sembilan (9.8%). More than half of the exposure was intentional (53.8%) involving more women (50.3%) as compared with men (41.9%), and in the 20-29 years age group category (33.5%). Exposure mostly occurred at home (96%) through the ingestion route (94.1%). Pharmaceutical products (40.5%), pesticides (31.7%) and household products (20.1%) were the common agents implicated for intentional exposure.
CONCLUSIONS: There is an increasing trend in enquiries on poisoning exposure calls made to the NPC. Most of the intentional poisoning exposures occurred among younger women and involved pharmaceuticals, pesticides or household products. Poisoning safety education and other interventions are needed to curb poisoning incidents.