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  1. Nurul, S.R., Asmah, R
    MyJurnal
    The present work sought to investigate the nutritional composition and phytochemical properties of red pitaya (Hylocereus polyrhizus) juices from Malaysia and Australia and to determine the optimum ethanol concentration (in the range of 0 – 100% ethanol) for the extraction of phenolic, flavonoid and betacyanin contents. The predominant macronutrient in red pitaya juice was carbohydrate while potassium and vitamin A were the major mineral and vitamin content. Red pitaya juice from Malaysia achieved optimal total phenolic content at 20% of ethanol (20 mL ethanol in 100 mL water, v/v); total flavonoid content at 60% (v/v); and betacyanin content at 0% (v/v). Red pitaya juice from Australia achieved the maximum total phenolic content at 60% (v/v); total flavonoid content at 20% (v/v); and betacyanin content at 80% (v/v). Nutritional composition and the phytochemical properties of red pitaya in Malaysia and Australia were significantly different suggested the role of environmental factors like soil and climate on the phytochemical properties of red pitaya.
  2. Yan, S.W., Asmah, R.
    MyJurnal
    Synthetic antioxidants are added to food in the powdered form to preserve it. However these compounds posed serious health concern since they have been associated with causing cancer. Thus using fresh herbs with antioxidant activities would be good alternative. The objectives of this study were to evaluate and compare the total phenolic contents and antioxidant activities of both powdered and fresh forms of turmeric leaf, pandan leaf and torch ginger flower. Total phenolic content (TPC) was assayed based on the redox reaction between Folin-Ciocalteu with phenolics in the sample extracts. Antioxidant activity (AA) was assayed using the ß-carotene linoleate model system and the percentage of antioxidant activity was calculated from the values of degradation rate. Scavenging activity (SA) was assayed using the DPPH radical scavenging model system whereby EC50 value was determined from the plotted graph of scavenging activity against the concentration of sample extracts. Analyses revealed that powdered forms of turmeric leaf, pandan leaf and torch ginger flower had higher TPC (2013.09 ± 5.13, 1784.25 ± 7.59 and 1937.42 ± 6.61 mg GAE/100g, respectively) than their respective fresh forms (348.75 ± 1.26, 356.42 ± 1.32 and 211.59 ± 6.29 mg GAE/100g, respectively). Similarly, powdered forms of turmeric leaf, pandan leaf and torch ginger flower possessed better AA (64.31 ± 0.99, 65.09 ± 0.74 and 11.80 ± 0.40 %, respectively) than their respective fresh forms (24.93 ± 0.71, 16.91 ± 0.70 and 1.45 ± 0.10 %, respectively). Powdered forms of turmeric leaf, pandan leaf and torch ginger flower were also better radical scavenger as compared to their respective fresh forms. In conclusion, all samples in their powdered forms have high total phenolic contents, antioxidant and scavenging activities than their respective fresh forms.
  3. Nurul, S. R., Asmah, R.
    MyJurnal
    Preservative fruits have gained popularity in recent years as part of food consumption, but their benefits towards human health are not known. This study compared total phenolic (TPC), total flavonoid (TFC), β-carotene, lycopene, ascorbic acid (AA) contents and antioxidant properties between fresh and pickled papaya. The results indicated that mean TPC (mg gallic acid equivalent/100 g dry samples), TFC (mg rutin equivalent/100 g dry samples), β-carotene (µg/100 g edible portions), lycopene (µg/100 g edible portions) and AA content (mg/100 g edible portions) were higher in fresh papaya (141.66 ± 11.71; 57.80 ± 2.11; 793.83 ± 5.47; 779.69 ± 5.55; 70.37 ± 0.65) as compared to pickled form. Antioxidant activity (%) measured by DPPH and β-Carotene-Linoleate bleaching method was higher in fresh papaya (56.83 ± 4.68; 77.56 ± 1.40). Total phenolic, total flavonoid, ascorbic acid, beta carotene and lycopene were strongly correlated with antioxidant activity and scavenging activity (0.905 ≤ r ≤ 1.00) indicating that were important contributors to antioxidant properties in papaya extracts. The pickling process of papaya caused a significant decrease in their antioxidant component and activity
  4. Yan, S. W.., Asmah, R.
    MyJurnal
    Practiced as folk medicine since ancient times, bilimbi (Averrhoa bilimbi) is commonly
    consumed and widely cultivated in Malaysia. In search for naturally occurring anticancer
    agents, a potential fruit extract was found to exert anticancer properties in vitro without any
    cytotoxic effect on normal cells. This study investigated the anti-proliferative effect and
    underlying cell death pathway induced by bilimbi ethanolic extract on human non-hormonedependent
    breast cancer cell line, MDA-MB-231. Anticancer potential of bilimbi extract was
    conducted by investigating the in vitro growth inhibitory effect, DNA fragmentation, cell cycle
    progression and anti-proliferation assay. Release of caspases, cytochrome c and apoptotic
    proteins were demonstrated to determine the mechanism of cell death pathway. Findings
    revealed that bilimbi inhibited growth of MDA-MB-231 cells through the induction of
    apoptosis mediated by cell cycle arrest at G0/G1 checkpoint. Released of cytochrome c coupled
    with up-regulation of caspase-3/7, caspase-9 and Bax pro-apoptotic proteins in addition to
    down-regulation of dysfunctional p53 and Bcl-2 anti-apoptotic proteins implied that bilimbi
    induced a p53-independent mitochondrial apoptosis pathway in MDA-MB-231. These results
    suggest that bilimbi could induce tumor cell anti-proliferation through apoptosis. As a natural
    product, bilimbi could be a promising anticancer agent and an inexpensive approach to cancer
    chemoprevention strategy.
  5. Asmah, R., Siti Sumaiyah, S.A., Nurul, S.R.
    MyJurnal
    Omega-3 fatty acids have been shown to reduce the risk of chronic diseases like cardiovascular disease and cancer as well as promote brain development among infants and children. This study was carried out to compare total protein, fat and omega-3 fatty acids content of raw and pressurized fish of P. pangasius (yellowtail catfish) and H. macrura (long tail shad). The fish was cooked using pressure cooker for six minute to be pressurized. The protein content was determined by using Kjedahl method while total fat was determined using solvent extraction using chloroform and methanol. Fatty acid methyl esters (FAME) were prepared by a direct transesterification method, and quantified by gas chromatography using external standard. Results showed that marine fish H. macrura (long tail shad) had higher content (p < 0.05) of protein (18.30 ± 0.040 g/100 g), fat (10.965 ± 1.610 g/100 g), EPA (11.83 ± 0.02 g/100 g) and DHA (5.96 ± 0.31 g/100 g) compared to freshwater fish P. pangasius (yellowtail catfish). The protein content of pressurized fish was higher compare to raw fish, but there was no difference in total fat and omega-3 fatty acids content between raw and pressurized of freshwater fish P. pangasius and marine fish, H. macrura. In conclusion, marine fish are better source of protein, fat and omega-3 content, while pressurized fish shown to have comparable amount of protein, fat and omega-3 fatty acids content with raw fish. The result obtained assist the consumers to prepare a healthy menu in order to retain the protein and omega-3 fatty acids content of fish through healthy way of cooking.
  6. Noor Atiqah, A.A.K., Maisarah, A.M., Asmah, R.
    MyJurnal
    The emerging studies suggest antioxidant may represent an important role in defence against certain diseases outlined the necessity of determining their contents in tamarillo (Cyphomandra betacea), cherry tomato (Solanum lycopersicum var. cerasiforme), and tomato (Lycopersicon esculentum). This study aims to determine the antioxidant capacity, total phenolic content and total flavonoid content in tamarillo, yellow cherry tomato, red cherry tomato, and tomato in 70% ethanol and water extracts. The ethanol extract showed the highest scavenging activity, ferric reducing activity, phenolic and flavonoid contents, whereas, the water extract showed higher value for antioxidant activity in β-Carotene bleaching assay. Tamarillo showed the highest antioxidant activity (22.92 ± 3.60%, 28.89 ± 3.85%), scavenging activity (44.25 ± 0.82 μg/ml, 47.38 ± 1.11 μg/ml), ferric reducing activity (12.17 ± 0.53 μM Fe (II)/g, 3.72 ± 0.20 μM Fe (II)/g), phenolic content (7.63 ± 0.37 mg GAE/g edible portion, 1.83 ± 0.50 mg GAE/g edible portion) and flavonoid content (6.44 ± 0.16 mg CE/g edible portion, 2.22 ± 0.31 mg CE/g edible portion) in ethanol and water extracts respectively. For ethanol extracts a positive correlations existed (0.66 ≤ r ≥ 0.97) between ferric reducing activity, antioxidant activity, phenolic content and flavonoid content. While, in water extract correlation test revealed a positive correlations between antioxidant activity, ferric reducing activity and phenolic content (0.645 ≤ r ≥ 0.706) and between antioxidant activity and flavonoid content (r = 0.820). In conclusion, tamarillo exhibits the highest antioxidant capacity, phenolic content and also flavonoid content.
  7. Gan, C.H., Nurul Amira, B., Asmah, R.
    MyJurnal
    Consumption of mushroom has increased remarkably because of their desirable aroma, taste and high nutritional content. This study was undertaken to measure and compare the antioxidant activity, total phenolic content (TPC) and total flavonoid content (TFC) of Agaricus bisporous (white button mushroom) and Agaricus brasiliensis (Brazilian mushroom) in aqueous and 60% ethanol extract. Results showed that button mushroom (21.47 ± 0.48 mg GAE/g of dry weight) had significant higher TPC in aqueous whereas Brazilian mushroom (12.50 ± 0.22 mg GAE/g of dry weight) had significant higher TPC in 60% ethanol (p< 0.05). In terms of TFC, Brazilian mushroom had higher content than button mushroom in both types of solvents. For FRAP assay, Brazilian mushroom had significantly higher total antioxidant activity than the button mushroom in 60% ethanol (p < 0.05) but opposite trend with aqueous. For DPPH radical scavenging activity, Brazilian mushroom (60% ethanol) had the lowest EC50 value, followed by button mushroom (60% ethanol), Brazilian mushroom (aqueous) and button mushroom (aqueous). Pearson correlation test (p < 0.05) showed strong positive correlation between TPC and FRAP assay in both extracts (r = 0.969 for 60% ethanol extract; r = 0.973 for aqueous extract). For TFC, there was a strong positive, correlation with FRAP assay (r = 0.985) in aqueous extract. In conclusion, high antioxidant activity in ethanol extract of mushrooms due to presence of phenolic content can potentially be used as a source of natural antioxidants.
  8. Nurul Shazini, R., Asmah, R., Patimah, I.
    MyJurnal
    Betacyanins are water soluble pigment commonly detected in plants. The most studied betacyanins pigment is betanin group. Betanin has been shown to inhibit lipid peroxidation and heme decomposition, suggesting that these pigments may provide protection against certain oxidative stress-related disorders. The aim of this study was to investigate the changes in hepatic and heart structure in high-carbohydrate, high-fat diet-induced obese rats following supplementation of betanin. A total of 48 male Wistar rats were divided into 4 groups: corn-starch group (C), corn-starch + betanin group (CB), high-carbohydrate, high fat group (H) and high-carbohydrate, high fat + betanin (HB).The intervention with 50 mg betanin/kg of food was started for 8 weeks after 8 weeks initiation of the diet. Liver and cardiac structures were defined by histology. Results showed that betanin supplemented rats showed normalized inflammatory state with no change in collagen deposition in the heart but did not normalize the macrovesicular steatosis in the liver. The effects of betanin supplementation were more prominent in corn starch fed rats suggesting its potential in preventing fat accumulation possibly by its potent scavenging ability from the pigment, but not reversing the abnormalities related to obesity.
  9. Anahita, A., Asmah, R., Fauziah, O.
    MyJurnal
    This study aimed to determine total phenolic content (TPC), total antioxidant activity (TAA), antioxidant vitamin composition (A, C, and E) of pomegranate fruit. In addition, two edible parts of pomegranate juice, pomegranate seed, and combination of them were compared based on antioxidant properties. TPC was determined by using Folin-Ciocalteu (FC) method based on colorimetric reduction. Ferric reduction ability power (FRAP assay) was used to test the antioxidant activity. Vitamin assessments were conducted by using high performance liquid chromatography (HPLC). Results for antioxidant vitamin composition in pomegranate juice (PJ) showed that the concentration of vitamin A was 22.8 ± 0.69 μg/100 g, vitamin C was 57.8 ± 0.59 mg/100 g, and vitamin E was 0.07 ± 0.01 mg/100 g. Besides, TPC in PJ, pomegranate seed (PS), and pomegranate seed-juice (PSJ) was 2502 ± 54, 165 ± 49, and 2696 ± 49 mg GAE/L, and TAA was 32 ± 5.1, 20 ± 2.8, and 47 ± 5.5 mmol/L respectively. This study revealed that PSJ contained high level of phenolic compounds, antioxidant activity, and vitamin C. In addition, TPC was as main contributor to antioxidant activities, and positively correlated with TAA (r2 = 0.91, p
  10. Noratirah Shazlin, M.A., Asmah, R., Nurul Shazini, R., Hawa, Z.E.J.
    MyJurnal
    Mangosteen is a native fruit from Southeast Asia. It is rich in phenolic compounds like xanthones, anthocyanins and phenolic acids and also a good source of fibre and minerals. The present study aim to investigate the effects of mangosteen aril supplementation on the histopathological changes of liver and kidney in rats fed with high fat diet. Forty male Sprague Dawley rats were divided into five groups (n=8), which consisted of normal control group (NC), obese control group (OC), obese supplemented with 200 mg/kg mangosteen group (M200), obese supplemented with 400 mg/kg mangosteen group (M400) and obese supplemented with 600 mg/kg mangosteen group (M600). At the end of seven weeks, obese groups supplemented with mangosteen aril were force feed to correspond mangosteen dosage while the control groups were force feed with distilled water as placebo. At the end of seven weeks of supplementation period, all rats were sacrificed and liver and kidney were collected. All data were analyzed using one way ANOVA and the differences between groups were considered significant at p < 0.05. Results showed that supplementation of mangosteen aril in obese rats able to ameliorate the abnormalities in their liver and kidney tissue caused by high fat diet.
  11. Maisarah, A.M., Nurul Amira, B., Asmah, R., Fauziah, O.
    MyJurnal
    This study was conducted to compare the total antioxidant activity (TAA), total phenolic content (TPC) and total flavonoid content (TFC) from the different parts of papaya tree including their ripe and unripe fruit, seeds and the young leaves. Two methods namely DPPH radical scavenging activity and ß-carotene bleaching assay were used to determine the TAA, whereas TPC was determined by Folin-Ciocalteu’s method while TFC by aluminium trichloride (AlCl3). For these purposes, methanolic extracts (80%) were prepared. The results showed that the highest antioxidant activity through ß-carotene bleaching assay was observed in unripe fruit (90.67 ± 0.29%) followed by young leave, ripe fruit and the seed. In other hand, young leaves exhibited a significant higher scavenging effect compared to others and the dose required in reducing the absorbance of DPPH control solution by 50% (EC50) was calculated at 1.0 ± 0.08mg/ml. The EC50 values were 4.3 ± 0.01mg/ml, 6.5 ± 0.01mg/ml and 7.8 ± 0.06mg/ml for unripe fruit, ripe fruit and seeds respectively. Interestingly, both TPC and TFC also showed that young leaves had the highest antioxidant content (424.89 ± 0.22mg GAE/ 100 g dry weight and 333.14 ± 1.03mg rutin equivalent/ 100 g dry weight, respectively). Statistically, Pearson correlation showed there were positive correlations between TPC and TFC with antioxidant activity assayed by DPPH radical scavenging assay (r=0.846 and r=0.873, respectively). However there was no correlation between TPC and TFC with ß-carotene bleaching activity. In brief, taken into account all the parameters measured, antioxidants were highly remarkable in the sequence of young leaves > unripe fruit > ripe fruit > seed. Nevertheless, further investigation for isolation and identification of the phytoconstituents responsible for antioxidant activity is desirable.
  12. Mohd Adzim Khalili, R., Norhayati, A.H, Rokiah, M.Y., Asmah, R., Siti Muskinah, M., Abdul Manaf, A.
    MyJurnal
    This study was carried out to evaluate the total phenolic content and anti-oxidant activity of methanolic extract of red pitaya, and hypocholesterolemic effect of red pitaya (Hylocereus sp.) on lipid profiles status on hypercholesterolemia induced rats. From the analysis, total phenolic content in red pitaya is 46.06 ± 1.77 mg GAE/100 g fresh weight and antioxidant activity is 76.10% using FTC method. TBA analysis also showed red pitaya extract had high antioxidant effect (72.90%). An in-vivo study also showed red pitaya has hypocholesterolemic effect on induced hypercholesterolemia rats. After 11 weeks of study, total blood cholesterol significant decrease (p
  13. Fadzelly AB, Asmah R, Fauziah O
    Plant Foods Hum Nutr, 2006 Mar;61(1):7-12.
    PMID: 16688478
    Strobilanthes crispus (Acanthaceae) has been used traditionally as antidiabetic, diuretic, antilytic, and laxative and has been proven scientifically to possess high antioxidant activity, anti-AIDS, and anticancer properties. It is commonly consumed in the form of herbal tea. The ethnopharmacological value of this plant, such as the development of nutraceutical S. crispus herbal tea (fermented and unfermented) and assessment of their antihyperglycemic properties were investigated. The antidiabetic properties of S. crispus fermented and unfermented tea was carried out in normal and streptozotocin-induced hyperglycaemic rats for 21 days. Glucose and lipid profile (total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol) were determined at day 0 (baseline), day 7, and day 21. The results showed that the hot water extract of both fermented and unfermented S. crispus tea reduced blood glucose in hyperglycaemic rats. S. crispus unfermented tea also reduced glucose level in normal rat. Both fermented and unfermented S. crispus tea also showed to improve lipid profile. Antioxidant and polyphenol content that present in the extracts might contribute to the antihyperglycemic and antilipidemic properties. Further study is needed to be carried out in pre-clinical and clinical environment to prove its efficacy in human.
  14. Amin I, Koh BK, Asmah R
    J Med Food, 2004;7(1):7-12.
    PMID: 15117546
    This study investigated the effect of cacao liquor extract (CLE) on tumor marker enzymes--alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), glutathione-S-transferase (GST), and glutathione reductase (GR) activities--in plasma and/or liver of hepatocarcinogenic rats, which were induced with diethylnitrosamine and 2-acetylaminofluorene. Twenty-nine male Sprague-Dawley rats (weighing 150-330 g) were divided into four groups (n = 6-8): normal control group (N), normal group + CLE (NE), cancer group (C), and cancer group + CLE (CE). Analysis of variance showed significant differences (P
  15. Mohd Adzim Khalili, R.,, Norhayati, A.H., Rokiah,M. Y., Asmah, R., Siti Muskinah, M., Abdul Manaf, A.
    MyJurnal
    This study was conducted to determine radical scavenging activity and vitamin antioxidant composition in red pitaya from organic plantation. For antioxidant vitamins analysis, a reverse-phase high performance liquid chromatography was used and radical scavenging activity of methanolic and water extract were determined using 1,1-diphenyl-2-pircrylhydrazyl assay. Results for radical scavenging activity, red pitaya methanolic extract achieved the highest percentage 70.13% compared with water extract (47.13%). Antioxidant vitamins composition in red pitaya showed that the concentration of vitamin A is 120.13 ± 0.69 μg/100 g freeze-dried sample, vitamin C is 540.27 ± 0.59 μg/100 g fresh samples and vitamin E is 105.67 ± 0.56 μg/100 g freeze-dried samples. This shows that red pitaya may become an alternative and potential source of natural antioxidant.
  16. Jirapa P, Normah H, Zamaliah MM, Asmah R, Mohamad K
    Plant Foods Hum Nutr, 2001;56(3):203-16.
    PMID: 11442221
    Amino acid profiles, protein digestibility, corrected amino acid scores (PDCAAS), chemical scores, essential amino acid indexes, and calculated biological values of controlcowpea flour (CCF), germinated cowpea flour (GCF) prepared from cowpeas germinated at 25 degrees C for either 24 h or 48 h and weaning foods prepared from cowpea flours were determined. Locally available rice, cowpea flour, banana-pumpkin slurry, and skim milk powder and sucrose in the ratio 35:35:15:15:5 were used to formulate weaning food containing not less than 15% protein. The ingredients were cooked into a slurry and oven-dried to produce flakes. The nutritional and sensory qualities of the weaning products were evaluated. Germination had little effect on the amino acid profile of cowpeas. In vitro protein quality and starch digestibility were improved in germinated cowpea flour. The PDCAAS of 24 h germinated cowpea flour (GCF) weaning food was higher (55.49%) than CCF-weaning food (46.74%). Vitamin A activity in 24 h GCF weaning food was higher than in CCF-weaning food. In vitro starch digestibilities of 24 h GCF and 48 h GCF-weaning foods were higher than that of CCF weaning food. The 24 h GCF-weaning food which had a higher overall acceptability score by sensory panelist than 48 h GCF and CCF-weaning food is recommended for household consumption.
  17. Asmah R, Zetti Nadia MZ, Abdah MA, Mohd Fadzelly AB
    Introduction: This research was conducted to investigate the effects of Catharanthus roseus (Kemunting Cina), Kalanchoe laciniata (Setawar Kampung) and Piper longum (Kadok Kampung) on the in vitro proliferation of hormone dependent breast cancer (MCF-7) and colon cancer (Caco2) cell lines. Methodology:The effects of Catharanthus roseus, Kalanchoe laciniata and Piper longum extracts (hexane, chloroform, ethyl acetate and methanol extracts) on the cytotoxicity of MCF-7 and Caco2 cell lines were measured using (3-4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazoliumbromide) (MTT) assay. Results: Kalanchoe laciniata hexane extract showed significant inhibitions on MCF-7 carcinoma cell lines proliferation with IC50 value of 75.7 µg/ml. Catharanthus roseus extracts (hexane, chloroform and ethyl acetate) inhibited MCF-7 cells proliferation at concentrations of 80, 70 and 90 mg/ml, respectively. Discussion: IC50 value of all extracts of Piper longum and Kalanchoe laciniata chloroform, ethyl acetate and methanol extracts on the proliferation of MCF-7 cancer cells could not be determined, as it did not demonstrate any appreciable inhibition on the cellular proliferation at the concentration tested. However, Piper longum chloroform and ethyl acetate extracts showed anti-tumourigenic effect against colon cancer (Caco2) with IC50 of 87 mg/ml and 20 mg/ml, respectively. Kalanchoe laciniata hexane extracts inhibited Caco2 cellular proliferation with IC50 value of 100 mg/ml. Catharanthus roseus chloroform and ethyl acetate extracts inhibited Caco2 proliferation at IC50 of 28.2 µg/ml and 74.1 mg/ml, respectively. Conclusion: From this study, it can be concluded that only hexane extract of Kalanchoe laciniata was effective against cellular proliferations of MCF-7 while Piper longum was more effective in inhibiting Caco2 proliferations. However, both the herbs were not so effective against MCF-7 and Caco2 cell lines compared with Catharanthus roseus. Keywords: Catharanthus roseus, Kalanchoe laciniata, Piper longum, cytotoxicity
  18. Norhayati MM, Mazlyzam AL, Asmah R, Fuzina H, Aminuddin BS, Ruszymah BH, et al.
    Med J Malaysia, 2004 May;59 Suppl B:184-5.
    PMID: 15468879
    Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM) evaluation were carried out in the in vivo skin construct using fibrin as biomaterial. To investigate its progressive remodeling, nude mice were grafted and the Extracellular Matrix (ECM) components were studied at four and eight weeks post-grafting. It was discovered that by 4 weeks of remodeling the skin construct acquired its native structure.
  19. Liew SM, Khoo EM, Ho BK, Lee YK, Mimi O, Fazlina MY, et al.
    Int J Tuberc Lung Dis, 2015 Jul;19(7):764-71.
    PMID: 26056099 DOI: 10.5588/ijtld.14.0767
    OBJECTIVES: To determine treatment outcomes and associated predictors of all patients registered in 2012 with the Malaysian National Tuberculosis (TB) Surveillance Registry.
    METHODS: Sociodemographic and clinical data were analysed. Unfavourable outcomes included treatment failure, transferred out and lost to follow-up, treatment defaulters, those not evaluated and all-cause mortality.
    RESULTS: In total, 21 582 patients were registered. The mean age was 42.36 ± 17.77 years, and 14.2% were non-Malaysians. The majority were new cases (93.6%). One fifth (21.5%) had unfavourable outcomes; of these, 46% died, 49% transferred out or defaulted and 1% failed treatment. Predictors of unfavourable outcomes were older age, male sex, foreign citizenship, lower education, no bacille Calmette-Guérin (BCG) vaccination scar, treatment in tertiary settings, smoking, previous anti-tuberculosis treatment, human immunodeficiency virus infection, not receiving directly observed treatment, advanced chest radiography findings, multidrug-resistant TB (MDR-TB) and extra-pulmonary TB. For all-cause mortality, predictors were similar except for rural dwelling and nationality (higher mortality among locals). Absence of BCG scar, previous treatment for TB and MDR-TB were not found to be predictors of all-cause mortality. Indigenous populations in East Malaysia had lower rates of unfavourable treatment outcomes.
    CONCLUSIONS: One fifth of TB patients had unfavourable outcomes. Intervention strategies should target those at increased risk of unfavourable outcomes and all-cause mortality.
  20. Liew SM, Khoo EM, Ho BK, Lee YK, Mimi O, Fazlina MY, et al.
    Asia Pac J Public Health, 2019 01;31(1):61-71.
    PMID: 30541329 DOI: 10.1177/1010539518817980
    This study aims to determine tuberculosis incidence, all-cause mortality, and its associated factors among health care workers (HCWs) registered in 2012 to 2014 with the Malaysian National Tuberculosis (MyTB) Surveillance Registry. Regression analysis was used to determine factors associated with all-cause mortality. Incidence rates ranged from 135.18 to 156.50/100 000 and were higher for HCWs compared with the general population (risk ratio = 1.70-1.96). The mean age at notification was 34.6 ± 10.55 years; 68.9% were female. Most were paramedics (44.3%) followed by other HCWs (41.9%) and doctors (13.8%). Nearly a quarter (23.8%) had extrapulmonary tuberculosis. There were 23 deaths giving a case fatality rate of 2.4%. Factors associated with death were older age (odds ratio [OR] =1.05; confidence interval [CI] =1.01-1.10), diabetes (OR = 3.83; CI = 1.32-11.08), HIV positivity (OR = 18.16; CI = 4.60-71.68), and not receiving directly observed therapy (DOTS) (OR = 10.97; CI = 3.61-33.38). It is important for HCWs to be aware of these increased risks and for authorities to implement protective measures.
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