Displaying all 19 publications

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  1. Hardin S, Kiyu A
    Med J Malaysia, 1991 Dec;46(4):338-43.
    PMID: 1840442
    A case-control study was carried out to determine the child-minding practices and their relationships with nutritional status of children between 6 and 12 months old. Sixty-five percent of the mothers go to the farm and 25 percent of, them bring their children with them. Only 42.8 percent of the children were looked after by their mothers. The odds of being malnourished were greater among children who were not looked after by their mothers. It is suggested that nutrition education be given in the village so that the other child-minders can benefit from it.
  2. Kiyu A, Hardin S
    PMID: 8362304
    A cross-sectional survey covering 976 households in 41 rural villages covered by the Rural Health Improvement Scheme in Sarawak was carried out to determine the type of latrines they have and their usage of pourflush latrines. The survey was carried out by inspection and interview. Fifty-six percent of the households had pourflush latrines and upon inspection 91.3% of them showed signs of recent use. Based on the interview, ninety percent of the women responded that they always use the latrine for defecation. It was also reported that 86.5% of the husbands and 47.6% of the children below five years, always used the latrine for defecation. The most common reason for not using the latrine among adults was the lack of water to flush the latrines as well as not being home when the need arises. The reason for using the latrines were to keep the compound clean, convenience and health reasons. It is recommended that building latrines continue to be a prerequisite for getting water supply under the program and that non health-related reasons be emphasized in health education which aim to motivate people to build and use the latrines.
  3. Kiyu A, Hardin S
    Bull World Health Organ, 1992;70(1):125-8.
    PMID: 1568276
    A cross-sectional survey of 976 households in 41 villages covered by the Rural Health Improvement Scheme in Sarawak was carried out to determine the state of functioning and utilization of rural water supplies. The survey was carried out by inspection and interview. About one-third of the systems were functioning well, one-third imperfectly, and the remainder were no longer functioning. The coverage of households by water supply varied with the type of water supply, the overall coverage being 81.3%. Usage varied with the type of water supply and access, the overall figure being 87.1%, and the overall utilization was 70.8%. The study showed that it is important to account for water supply usage in impact evaluation because not all households have access and not all those with access use the water supply. It is also important to define water use, depending on whether the health outcome is a reduction in diseases that are water-borne or related to washing with water, because the percentage of households using the water for drinking is different from those using it for bathing.
  4. Kiyu A, Teo B, Hardin S, Ong F
    PMID: 1948281
    The nutritional status of 641 children between the ages of 0 to 4 years old, from 835 households in 41 randomly selected rural villages with water supply in Sarawak were determined. Based on Waterlow's classification and the National Center for Health Statistics (NCHS) standards, 61% of the children were stunted and 44.1% were wasted. Based on Gomez's classification and the NCHS standards 81.9% of the children were malnourished. There was no sex difference in nutritional status. The percentage of malnourished children increased continuously with age while the percentage of children who were wasted increased from 6 to 36 months and then it leveled off. The percentage of stunted children also increased with age but the increase was sharpest in children who were 12 to 23 months old. It is noted that the Gomez classification overestimates the prevalence of undernutrition.
  5. Kiyu A, Tambi Z, Ahmad Y
    Asia Pac J Clin Nutr, 1998 Dec;7(3/4):256-61.
    PMID: 24393680
    The state of Sarawak in Malaysia has a high prevalence of iodine deficiency disorders (IDD). This has been revealed through a review of goitre surveys that were carried out in the State from the early 1970s to the 1990s. The primary cause was low iodine intake. Contributory factors were low iodine content in the soil and water as well as high cassava consumption. Virtual elimination of IDD is one of the nutritional goals of the IDD prevention and control programs. The strategies adopted include the iodination of coarse salt, which is sold in the market by shopkeepers and also provided free from government health clinics; legislation requiring that salt sold in IDD-gazetted areas must be iodised; and the use of iodinators to iodise water supplied by the gravity-feed system to villages and boarding schools in rural areas. The indicators used in the monitoring and evaluation of the program include the availability of iodised salt in the market and households, iodine levels in water supply that had been fitted with iodinators, goitre volume measured by ultrasound, and urinary iodine excretion among school children.
  6. Noordin R, Muhi J, Md Idris Z, Arifin N, Kiyu A
    Trop Biomed, 2012 Mar;29(1):191-6.
    PMID: 22543621 MyJurnal
    The detection rates of brugian filariasis in three regions of Sarawak namely Central, North and South after three courses of mass drug administration (MDA) from year 2004 to 2006 was investigated. A recombinant BmR1 antigen-based IgG4 detection test, named Brugia Rapid and night blood smear for microfilaria (mf) detection were used. All three regions recorded a sharp fall in mf positive rates after a year post-MDA. Meanwhile Brugia Rapid positive rates declined more gradually to 3.8% and 5.6% of the pre-MDA levels in the Central and North regions, respectively. This study showed that in filariasis endemic areas in Sarawak, anti-filarial IgG4 antibodies to BmR1, as detected by the Brugia Rapid test, were positive for one to two years after mf disappearance.
  7. Koh KH, Chew PH, Kiyu A
    Singapore Med J, 2004 Jan;45(1):28-36.
    PMID: 14976579
    To study the clinical and demographic aspects as well as the outcomes of severe cases of malaria infections managed in the intensive care unit of the Sarawak General Hospital, Kuching from January 1996 to December 2001.
  8. Ying WK, Rahman MM, Kiyu A
    Int J Adolesc Med Health, 2024 Aug 01;36(4):399-407.
    PMID: 38997223 DOI: 10.1515/ijamh-2024-0081
    OBJECTIVES: Adolescent suicide is a significant global public health concern. Although numerous studies have investigated factors that influence the risk of suicide among adolescents around the world, limited data are available in the Malaysian context, especially among the diverse ethnic communities of Sarawak. This study aimed to determine the factors associated with the risk of suicide among adolescents in Sarawak, Malaysia.

    METHODS: A community-based cross-sectional study was conducted among 1,344 adolescents in Sarawak using face-to-face interviews. Hierarchical binary logistic regression analysis was performed to identify factors that determine the risk of suicide among adolescents.

    RESULTS: Two predictive models were constructed. Both models revealed that being female (OR=1.578, 95 % CI: 1.191, 2.092, p=0.001), having Malay ethnicity (OR=1.733, 95 % CI: 1.236, 2.429, p=0.001) and having a disease significantly increased the risk of suicide (OR=1.895, 95 % CI: 1.221, 2.942, p=0.004). In particular, Model 2, which showed a better fit, found that occasional religious practice (OR=1.610, 95 % CI: 1.126, 2.303, p=0.009), poor parental relationships (OR=1.739, 95 % CI: 1.035, 2.922, p=0.037) and higher addiction (OR=1.015, 95 % CI: 1.008, 1.022, p=0.001), depression (OR=1.919, 95 % CI: 1.241, 2.968, p=0.003), and stress (OR=2.707, 95 % CI: 1.689, 4.340, p=0.001) scores were significantly associated with an increased risk of suicide.

    CONCLUSIONS: This study sheds light on multiple factors that contribute to the risk of suicide among adolescents in Sarawak. These findings underscore the importance of holistic prevention strategies, including psychological and social dimensions, to mitigate the risk of suicide in this population. Further research is warranted to understand the complex interplay of these factors and guide the development of targeted interventions.

  9. Lemin AS, Rahman MM, Pangarah CA, Kiyu A
    J Family Reprod Health, 2020 Mar;14(1):45-51.
    PMID: 32863838
    Objective: Voluntary HIV testing is one of the key strategies in the HIV/AIDS prevention and control program. New National Strategic Plan for 2016-2030 in Malaysia, adapt three zeros viz. 'zero new infections of HIV/AIDS, zero discrimination and zero AIDS-related deaths'. This study aimed to determine the predictors of voluntary HIV testing in Sarawak. Materials and methods: A cross-sectional study was conducted with a total of 900 respondents (450 males and 450 females) from the state of Sarawak, aged 18 years and above, who were selected by gender-stratified multistage cluster sampling. Data were obtained by face-to-face interview using a pretested questionnaire. Binary logistic regression analysis was done to determine the potential predictors for voluntary HIV testing. Results: The prevalence of HIV testing was higher among female respondents (26%) compared to male respondents (14.2%), and the difference was statistically significant (p < 0.001). Binary logistic regression analysis revealed that household income more than MYR 1501 (p = 0.009), not living with a partner (p < 0.001) and discussion on HIV/AIDS (p = 0.019) appeared to be predictors for the male respondents, while, ethnicity was statistically significant for female respondents (p < 0.001). Conclusion: The utilisation of HIV testing was low in both males and females. Thus, the finding of this study could be considered when designing HIV education and screening program in Sarawak.
  10. Toh TH, Tan VW, Lau PS, Kiyu A
    J Autism Dev Disord, 2018 01;48(1):28-35.
    PMID: 28866856 DOI: 10.1007/s10803-017-3287-x
    This study determined the accuracy of Modified Checklist for Autism in Toddlers (M-CHAT) in detecting toddlers with autism spectrum disorder (ASD) and other developmental disorders (DD) in community mother and child health clinics. We analysed 19,297 eligible toddlers (15-36 months) who had M-CHAT performed in 2006-2011. Overall sensitivities for detecting ASD and all DD were poor but better in the 21 to <27 months and 27-36-month age cohorts (54.5-64.3%). Although positive predictive value (PPV) was poor for ASD, especially the younger cohort, positive M-CHAT helped in detecting all DD (PPV = 81.6%). This suggested M-CHAT for screening ASD was accurate for older cohorts (>21 months) and a useful screening tool for all DD.
  11. Utap MS, Ng CJ, Lee YK, Kiyu A
    Asia Pac J Public Health, 2024 Mar;36(2-3):219-224.
    PMID: 38258742 DOI: 10.1177/10105395241227507
    In Malaysia, despite achieving leprosy-elimination status in 1994, leprosy remains a public health issue among the indigenous Penan community in Sarawak. This study aimed to determine the prevalence trend and clinical profile of leprosy among the Penans in rural Baram, Sarawak, Malaysia. A retrospective records review was conducted on 10-year (2008-2018) time trend of annual prevalence rate and 5-year (2013-2018) Penan leprosy patient clinical profile. Out of the 257 new cases of leprosy reported in Sarawak, 42.8% were Penans, and 72.7% were from Baram. The annual Penan ethnic-specific prevalence rate ranged from 2.08 to 35.5/10 000. Forty-six cases were analyzed for clinical profile: There were more males, active case detection, and multibacillary leprosy. The prevalence trend of leprosy among the Penans in rural Baram exceeded recommended elimination targets. Majority of the cases were detected through active case detection, but cases were detected late. Interventions are needed to improve early diagnosis and detection to achieve elimination of leprosy.
  12. Chua KB, Chua BH, Lee CS, Chem YK, Ismail N, Kiyu A, et al.
    Malays J Pathol, 2007 Dec;29(2):69-78.
    PMID: 19108398
    All known field isolates of enterovirus 71 (EV71) can be divided into three distinct genogroups (A, B, C) and 10 subgenogroups (A, B1-5, C1-4) based on VP1 gene sequences. We examined VP1 gene sequences of 10, 12 and 11 EV71 strains isolated in peninsular Malaysia during the outbreaks of hand, foot and mouth disease in 1997, 2000 and 2005 respectively. Four EV71 strains isolated in the hand, foot and mouth disease outbreak of 2006 in Sarawak (Malaysian Borneo) were included to describe their genetic relationship. Four subgenogroups (C1, C2, B3 and B4) of EV71 co-circulated and caused the outbreak of hand, foot and mouth disease in peninsular Malaysia in 1997. Two subgenogroups (C1 and B4) were noted to cause the outbreak in 2000. In the 2005 outbreak, besides EV71 strains of subgenogroup C1, EV71 strains belonged to subgenogroup B5 were isolated but formed a cluster which was distinct from EV71 strains of the subgenogroup B5 isolated in 2003. The four EV71 strains isolated from clinical specimens of patients with hand, foot and mouth disease in the Sarawak outbreak in early 2006 also belonged to subgenogroup B5. Phylogenetic analysis of the VP1 gene sequences showed that the four Sarawak EV71 isolates belonged to the same cluster as the EV71 strains that were isolated in peninsular Malaysia as early as May 2005. The data suggested that the EV71 strains causing the outbreak in Sarawak could have originated from peninsular Malaysia.
  13. Kiyu A, Steinkuehler AA, Hashim J, Hall J, Lee PF, Taylor R
    Health Promot Int, 2006 Mar;21(1):13-8.
    PMID: 16394026
    Sarawak, Malaysia has a large population of ethnic minorities who live in longhouses in remote rural areas where poverty, non-communicable diseases, accidents and injuries, environmental hazards and communicable diseases all contribute to a lower quality of life than is possible to achieve in these regions. To address these issues and improve the quality of life for longhouse people, the Kapit Divisional Health Office implemented the World Health Organization's Healthy Village programme in 2000. An evaluation was undertaken in 2003 to determine physical and behavioural changes resulting from the programme. The main changes evaluated were those involving smoking habits, exercise habits, health screening, fire safety, environmental improvements and food preparation and hygiene. A qualitative evaluation was conducted using participant observation and key-informant interviews, focus groups and observation. Results indicate that the programme is inspiring changes in various behavioural and physical characteristics of the study population. It is clear that the Healthy Village programme is a widely accepted way of improving health outcomes in longhouses, and that it is succeeding in making beneficial health changes.
  14. Mott JA, Mannino DM, Alverson CJ, Kiyu A, Hashim J, Lee T, et al.
    Int J Hyg Environ Health, 2005;208(1-2):75-85.
    PMID: 15881981 DOI: 10.1016/j.ijheh.2005.01.018
    We investigated the cardiorespiratory health effects of smoke exposure from the 1997 Southeast Asian Forest Fires among persons who were hospitalized in the region of Kuching, Malaysia. We selected admissions to seven hospitals in the Kuching region from a database of all hospital admissions in the state of Sarawak during January 1, 1995 and December 31, 1998. For several cardiorespiratory disease classifications we used Holt-Winters time-series analyses to determine whether the total number of monthly hospitalizations during the forest fire period (August 1 to October 31, 1997), or post-fire period (November 1, 1997 to December 31, 1997) exceeded forecasted estimates established from a historical baseline period of January 1, 1995 to July 31, 1997. We also identified age-specific cohorts of persons whose members were admitted for specific cardiorespiratory problems during January 1 to July 31 of each year (1995--1997). We compared Kaplan-Meier survival curves of time to first readmission for the 1997 cohorts (exposed to the forest fire smoke) with the survival curves for the 1995 and 1996 cohorts (not exposed, pre-fire cohorts). The time-series analyses indicated that statistically significant fire-related increases were observed in respiratory hospitalizations, specifically those for chronic obstructive pulmonary disease (COPD) and asthma. The survival analyses indicated that persons over age 65 years with previous hospital admissions for any cause (chi2(1df) = 5.98, p = 0.015), any cardiorespiratory disease (chi2(1df) = 5.3, p = 0.02), any respiratory disease (chi2(1df) = 7.8, p = 0.005), or COPD (chi2(1df) = 3.9, p = 0.047), were significantly more likely to be rehospitalized during the follow-up period in 1997 than during the follow-up periods in the pre-fire years of 1995 or 1996. The survival functions of the exposed cohorts resumed similar trajectories to unexposed cohorts during the post-fire period of November 1, 1997 to December 31, 1998. Communities exposed to forest fire smoke during the Southeast Asian forest fires of 1997 experienced short-term increases in cardiorespiratory hospitalizations. When an air quality emergency is anticipated, persons over age 65 with histories of respiratory hospitalizations should be preidentified from existing hospitalization records and given priority access to interventions.
  15. Jaafar S, Mohd Noh K, Suhaili MR, Kiyu A, Ong F, Wong M
    Int J Public Health Res, 2011;1(Special Issue):1-8.
    Public health nursingis a specialized nursing combining both nursing and public health principles with the primary focus of improving the health of the whole community rather than just an individual. Its documented history started in the 1800s and has evolved from home visiting to the varied settings that public health nurses find themselves working in as members of public health teams in clinics, schools, workplaces and government health departments.Public health nursing has been a critical component of the country’s health care system, uplifting of the health status of Malaysians and playing a dominant role in the fight against communicable diseases, and is set to face the challenges of the 21st century with public health nurses practising to the full capacity of their training in a restructured Malaysian health system – 1Care for 1Malaysia. The health sector reform allows for optimisation of scarce health care resources to deliver expansion of quality services based on needs, appropriateness, equity &allocative efficiency. The proposed model will be better than the current system, preserving the strengths of the current system but able to respond to increasing population health needs and expectations. There will be increased autonomy for healthcare providers with incentives in place for greater performance. Some of the implications of reform include allowing public- private integration, a slimmer Ministry of Health with a stronger governance role, enhancing the gatekeeping role of the primary care providers and the autonomous management of the public healthcare providers. In this restructured health system, the roles of the public health nurses are no less important than in the current one. In fact, with the increasing emphasis placed on prevention and primary care as the hub of community care with nurses as part of the primary care team delivering continuous comprehensive person-centered care,public health nurses in the future will be able to meet the challenge of refocusing on the true mission of public health: to look at the health problems of a community as a whole and work with the community in alleviating those problems by applying the nursing process to improve health, not just as providers of personal care only.
  16. Kuan JW, Su AT, Wahab M, Hamdan A, Hashim J, Kiyu A, et al.
    BMC Cancer, 2023 Jun 19;23(1):563.
    PMID: 37337159 DOI: 10.1186/s12885-023-10988-y
    BACKGROUND: Published epidemiological studies of haematological cancers are few. Hereby we present a 20-year epidemiological data of haematological cancers in Sarawak from a population-based cancer registry.

    METHODS: Haematological cancer cases with ICD-10 coded C81-C96 and ICD-O coded /3 diagnosed from 1996 to 2015 were retrieved from Sarawak Cancer Registry. Adult was defined as those 15 years and above. Incidence rate (IR) was calculated based on yearly Sarawak citizen population stratified to age, gender, and ethnic groups. Age-standardised IR (ASR) was calculated using Segi World Standard Population.

    RESULTS: A total of 3,947 cases were retrieved and analysed. ASR was 10 and male predominance (IR ratio 1.32, 95%CI 1.24,1.41). Haematological cancers generally had a U-shaped distribution with lowest IR at age 10-14 years and exponential increment from age 40 years onwards, except acute lymphoblastic leukaemia (ALL) with highest IR in paediatric 2.8 versus adult 0.5. There was a significant difference in ethnic and specific categories of haematological cancers, of which, in general, Bidayuh (IR ratio 1.13, 95%CI 1.00, 1.27) and Melanau (IR ratio 0.54, 95%CI 0.45, 0.65) had the highest and lowest ethnic-specific IR, respectively, in comparison to Malay. The ASR (non-Hodgkin lymphoma, acute myeloid leukaemia, ALL, chronic myeloid leukaemia, and plasma cell neoplasm) showed a decreasing trend over the 20 years, -2.09 in general, while Hodgkin lymphoma showed an increasing trend of + 2.80. There was crude rate difference between the 11 administrative divisions of Sarawak.

    CONCLUSIONS: This study provided the IR and ASR of haematological cancers in Sarawak for comparison to other regions of the world. Ethnic diversity in Sarawak resulted in significant differences in IR and ASR.

  17. Wong SC, Ooi MH, Abdullah AR, Wong SY, Krishnan S, Tio PH, et al.
    Trop Med Int Health, 2008 Jan;13(1):52-5.
    PMID: 18291002 DOI: 10.1111/j.1365-3156.2007.01967.x
    Japanese encephalitis virus (JEV) is an important encephalitis virus in Asia, but there are few data on Malaysia. A hospital-based surveillance system for Japanese encephalitis (JE) has been in operation in Sarawak, Malaysia, for the last 10 years. JEV is endemic in Sarawak, with cases occurring throughout the year and a seasonal peak in the last quarter (one-way anova, P < 0.0001). Ninety-two per cent of 133 cases were children aged 12 years or younger; the introduction of JE vaccination in July 2001 reduced the number of JE cases (84 in the four seasons prior to vs. 49 in the six seasons after, McNemar's test, P = 0.0001). After implementation of the programme, the mean age of infected children increased from 6.3 to 8.0 years (Student's t-test, P = 0.0037), suggesting the need for a catch-up programme.
  18. Podin Y, Gias EL, Ong F, Leong YW, Yee SF, Yusof MA, et al.
    BMC Public Health, 2006 Jul 07;6:180.
    PMID: 16827926
    BACKGROUND: A major outbreak of human enterovirus 71-associated hand, foot and mouth disease in Sarawak in 1997 marked the beginning of a series of outbreaks in the Asia Pacific region. Some of these outbreaks had unusually high numbers of fatalities and this generated much fear and anxiety in the region.

    METHODS: We established a sentinel surveillance programme for hand, foot and mouth disease in Sarawak, Malaysia, in March 1998, and the observations of the first 7 years are described here. Virus isolation, serotyping and genotyping were performed on throat, rectal, vesicle and other swabs.

    RESULTS: During this period Sarawak had two outbreaks of human enterovirus 71, in 2000 and 2003. The predominant strains circulating in the outbreaks of 1997, 2000 and 2003 were all from genogroup B, but the strains isolated during each outbreak were genetically distinct from each other. Human enterovirus 71 outbreaks occurred in a cyclical pattern every three years and Coxsackievirus A16 co-circulated with human enterovirus 71. Although vesicles were most likely to yield an isolate, this sample was not generally available from most cases and obtaining throat swabs was thus found to be the most efficient way to obtain virological information.

    CONCLUSION: Knowledge of the epidemiology of human enterovirus 71 transmission will allow public health personnel to predict when outbreaks might occur and to plan interventions in an effective manner in order to reduce the burden of disease.

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