Introduction: One of the aims outlined in Malaysia’s Health Vision 2020 is to be a nation of healthy individuals, families, and communities through an equitable, affordable, efficient, environmentally adaptable, and consumer friendly healthcare system. Sabah faces tremendous challenges to provide the best care for patients. For example, Sabah's unique geographical location and landscape, such as steep hills and rivers, is one of the challenges that health staff faces. Objectives of this study aimed to examine the prevalence of geographical accessibility, types of healthcare services, and the types of health seeking behaviour in 2 northern rural areas of Sabah to assess the geographic accessibility and availability of healthcare services.
Materials and Methods: A community-based cross-sectional study was conducted in two rural areas in Sabah—Kudat and Pitas. Data collection was done by using questionnaire and face–to-face interviews
Results: It was found that 48% of the study population sought healthcare and they mainly chose healthcare services from hospitals and health clinics.
Conclusion: Half of the population in the areas studied used healthcare in the last year. The choice of using a public hospital or community health clinics was determined by distance from residence
Introduction: The Faculty of Medicine & health sciences, UMS has implemented a co-curricular programme which is aimed to be improving rural health and reducing inequalities of health in Sabah. Groups of medical students are formed and distributed in various areas of rural remote areas in Sabah. Based on the observation and interview find-ings, each student group conducted health promotion activities with the limited resources. Various health problems were explored in different areas and different ethnic groups of Sabah and students conducted their health promotion activities .There are some questions “Are they effective, how it works in implementation?” Poor implementation can lead to errors in outcome of the programmes. In this paper we focus on process evaluation for measuring the degree to which Health promotion programmes were implemented as designed by using determinant framework (active implementation framework) and process evaluation tools in yearly health promotion programmes from 2009-2018.Methods: The study measures the implementation of programmes with active implementation framework (Explo-ration, Installation, Initial implementation, Full implementation) and process evaluation tools such as validation of implementation integrity using specification of intervention areas, making guidelines and manual for intervention protocol, competency of students and supervisors and fidelity monitoring. We used 7 components of process eval-uation particularly in context( Environmental influences), reach (Target participation), dose delivered (Lectures), dose received (learned by students with assessment methods), fidelity (Adherence to intervention delivery protocol), implementation (rating of execution and receipt of intervention) and recruitment (participant engagement). Results:It was found that fidelity, implementation strategies and some lessons learned after outreach programmes are impor-tantly influence in implementing the programmes. Conclusion: The study shows process evaluation strategies is ideal tool for conducting the rural outreach health promotion programme to reduce the errors and obstacles in implement-ing the programmes to maintain the better quality of the projects.
Introduction: The objective of this presentation is to carry out a review of the historical status and possible future outlook of the practice of ethnomedicine in the State of Sabah. As in many parts of the world, there are many types of traditional medicines that have been used for hundreds of years among the various native cultural groups in Sabah. Methods: A literature survey was conducted with the aid of online database, and text books using keywords such as the current as well as previous names of Sabah and various related terminology such as ethnomedicine, CAM, complementary and alternative medicine, TCM, traditional and complementary medicine, herbalism, reflexology, spiritualism, ethnobiology ethnology, ethnoanthropology, biological activities, ethnobotanical uses, medicinal prop-erties, toxicity studies, etc. The status of ethnomedicine in Sabah is largely unknown. Results: Based on a review of previous literature, the study discovered that there is limited empirical documentation on the use of ethnomedicine in Sabah. In this preliminary review, a total number of 25 publications were recorded in the databases for the period up to 2019. There is still a need to realise the full potential of the biocultural diversity of Sabah, and that there is a strong need to focus more on socially relevant research. Ethnomedicine in Sabah consists mainly of herbalism, ma-nipulative practices and spiritualism. Plants can be said to be the central player in race-based traditional medicine. While data on ethnomedicine may be based on original field research, several are primarily derivative, drawing as they do from earlier published accounts and, importantly, anecdotes. Traditional massage and other manipula-tive-practices, based on manipulation and movement of body parts, are also popular because of their simplicity and apparent immediate relief that can be experienced by the patient or client. Spiritualism, which may be considered as a peculiar dimension of the mind-body medicine subset of traditional medicine, continues to have its adherents among the natives of Sabah. Conclusion: List and catalogs and sociological and ethnohistorical data were the fa-voured perspective of research in the past; but future evolution of ethnomedical studies need to address some of the debates related to biological, medical and social sciences . Future research should include systematic inves-tigation into efficacy and risk besides the possible incorporation of some parts of ethnomedicine into the existing healthcare services. Ethnomedicine occupies a distinct place in healthcare in the world in general, and Sabah in particular.
Emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis (XDR-TB) is one of the reasons why tuberculosis (TB) continues to cause great mortality and morbidity in less-developed countries. The development of rapid diagnostic methods targeting genetic mutations associated with resistance to the anti-tuberculous drugs is essential to fight this deadly pathogen. Isoniazid (INH) has been included in the multidrug regimens for the treatment of drug-susceptible TB for the decades. In the worldwide setting, isoniazid resistance was highly prevalent and was observed in one of every seven TB cases. Since katG315 mutation is highly prevalent, the common mutation in the enzyme essential for the activation of the INH concerned with the mechanism of drug resistance and associated with high level resistance to INH, katG315 mutation was necessary to be identified by molecular method as a molecular determinant of INH resistant Mycobacterium tuberculosis. The prevalence of katG315 mutation in various countries was discussed in this report and a new molecular method for the detection of the mutation was proposed.
Introduction: Tuberculosis (TB) is the ninth leading cause of mortality in the world while it is the most prevalent infection which is ranked abolve HIV/AIDS. In Malaysia, tuberculosis is still a public health problem. Sabah State on Malaysian Borneo had 20-30% of total TB cases of the country. In Sabah, case notification rate of almost 200 per 100,000 population was still present in the last 10 years. Hotspots are defined as TB notification rate more than 100/100.000 in a district or TB notification rate more than 100/100,000 in the squatters’ area. In this study, cycle threshold (ct) values in GeneXpertMTB/RIF (Xpert) were tried to be correlated with growth in Mycobacterim growth indicator tubes (MGIT) by measurement of time to detection (TTD). Methods: Sputum samples from six hotspots of Kota Kinabalu were studied by Xpert as well as MGIT culture after processing of sputum samples. The correlation between Mean ct value of Xpert and TTD in MGIT was analysed by using IBM SPSS Statistic 25 and the statistical test used was Pearson Correlation test. Results: The results of Xpert indicated 35 of 204 sputum samples were pos-itive whereas only one sample was rifampicin resistant. The mean ct values were very low, low and medium in all the hotspots with sputum from one hotspot showed medium ct values predominantly. The sputum from remaining hotspots showed mainly very low and low ct values. MGIT results showed no growth in five samples with two very low, two low and one medium mean ct values. Conclusion: The finding indicated that there were correlations be-tween mean ct values of Xpert and TTD in MGIT with a few exceptions.