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Fulltext Factors Associated with Tuberculosis Mortality in Manjung District, Perak, Malaysia

Qamruddin AA, Xavier G, Zahid SM

Malays J Med Sci, 2023 Jun;30(3):167-175.
PMID: 37425385 DOI: 10.21315/mjms2023.30.3.15

BACKGROUND: Tuberculosis (TB) is a communicable disease which contributes to a major cause of ill health. Worldwide, it is one of the leading causes of death from a single infectious agent.
OBJECTIVES: The study aimed to describe the epidemiology and factors associated with TB mortality in Manjung district, Perak, Malaysia.
METHODS: All confirmed TB cases from 2015 to 2020 registered in Manjung district under Sistem Maklumat Tibi (MyTB) were included. Factors associated with TB mortality were analysed by using simple and multiple logistic regression analysis.
RESULTS: A total of 742 TB cases were included in the analysis, from which 121 cases (16.3%) died before completing their treatment. The highest death was reported in 2020 (25.7%) and the lowest in 2019 (12.9%). From multiple logistic regression analysis, age 45 years old-64 years old (adjusted OR = 3.62; 95% CI: 1.38, 9.54), > 65 years old (adjusted OR = 8.67; 95% CI: 3.17, 23.74), non-Malaysian (adjusted OR = 5.18; 95% CI: 2.04, 13.14), cases notified by government hospitals (adjusted OR = 6.78; 95% CI: 3.04, 15.09), HIV-positive status (adjusted OR = 8.60; 95% CI: 3.58, 20.67) and HIV testing not offered/unknown (adjusted OR = 2.58; 95% CI: 1.18, 5.62) were significantly associated with TB mortality.
CONCLUSION: This study found that TB patients who were 45 years old and above, positive HIV, late diagnosis and are foreigners had a higher risk for TB mortality. Early diagnosis, optimised screening and close monitoring should be practised to reduce TB mortality.
Fulltext Prevalence of hand-arm vibration syndrome among tyre shop workers in Kelantan, Malaysia

Qamruddin AA, Nik Husain NR, Sidek MY, Hanafi MH, Ripin ZM, Ali N

J Occup Health, 2019 Nov;61(6):498-507.
PMID: 31364246 DOI: 10.1002/1348-9585.12078

BACKGROUND: Prolonged exposure to hand-arm vibration is associated with a disorder of the vascular, neurological, and musculoskeletal systems of the upper limb known as hand-arm vibration syndrome (HAVS). Currently, the evidence of HAVS in tropical environments is limited.
OBJECTIVES: To determine the prevalence and severity of HAVS among tyre shop workers in Kelantan, Malaysia.
METHODS: A cross-sectional study involving 200 tyre shop workers from two districts in Kelantan was performed. Part one data were collected at the field using questionnaire, and hand-arm vibration was measured. Part two involved a set of hand clinical examinations. The workers were divided into high (≥5 m s-2 ) and low/moderate (<5 m s-2 ) exposure group according to their 8-hr time weighted average [A(8)] of vibration exposure. The differences between the two exposure group were then compared.
RESULTS: The prevalence of the vascular, neurological, and musculoskeletal symptoms was 12.5% (95% CI 10.16 to 14.84), 37.0% (95% CI 30.31 to 43.69), and 44.5% (95% CI 37.61 to 51.38) respectively. When divided according to their exposure statuses, there was a significant difference in the prevalence of HAVS for all three components of vascular, neurological, and musculoskeletal (22.68% vs 2.91%, 62.89% vs 12.62% and 50.52% and 38.83%) respectively. All the clinical examinations findings also significantly differed between the two groups with the high exposure group having a higher abnormal result.
CONCLUSION: Exposure to high A(8) of vibration exposure was associated with a higher prevalence of all three component of HAVS. There is a need for better control of vibration exposure in Malaysia.
Lifetime vibration dose correlates with severity of the neurological component of hand-arm vibration syndrome among tyre shop workers in Kelantan, Malaysia

Qamruddin AA, Husain NRN, Sidek MY, Hanafi MH, Ripin ZM, Ali N

Int J Occup Saf Ergon, 2021 Jun;27(2):410-415.
PMID: 30940001 DOI: 10.1080/10803548.2019.1600872

Introduction. Cumulative lifetime exposure to vibration is believed to contribute to more severe complications of hand-arm vibration syndrome (HAVS). Objectives. To determine prevalence of the neurological component of HAVS and the correlation between lifetime vibration dose (LVD) and neurological severity of HAVS among tyre shop workers in Kelantan. Methods. The cross-sectional study involved 200 tyre shop workers from two districts in Kelantan. Part one data were collected in the field using a questionnaire and hand-arm vibration was measured. Part two involved a set of hand clinical examinations (Purdue pegboard, Semmes-Weinstein monofilament and two-point discrimination tests) carried out for neurological component severity staging. LVD for each worker was calculated from data gathered in part one. For workers who had neurological symptoms, staging according to Stockholm workshop scales was done according to part two data. The strength of correlation between LVD and neurological stages was then determined using Spearman correlation. Results. Prevalence of neurological component was 37%. Spearman correlation between LVD and the neurological stages showed a moderate positive correlation. Conclusion. Cumulative lifetime exposure to hand-transmitted vibration is likely to be related to neurological severity of HAVS and therefore must be considered when assessing workers' exposure to hand-arm vibration.
Musculoskeletal complications of hand-arm vibration syndrome among tyre shop workers in Kelantan, Malaysia

Qamruddin AA, Husain NRN, Sidek MY, Hanafi MH, Ripin ZM, Ali N

Int J Occup Saf Ergon, 2020 Dec 03.
PMID: 33148113 DOI: 10.1080/10803548.2020.1846924

Objectives. Exposure to hand-arm vibration (HAV) is associated with hand-arm vascular syndrome (HAVS), which is characterized by musculoskeletal complications. However, evidence on this matter has been inconclusive. Therefore, this study aimed to determine and compare the prevalence of musculoskeletal complications of HAVS between a high-exposure (≥5 m·s-2) group and a low-moderate-exposure (<5 m·s-2) group and to explore the factors associated with the musculoskeletal complications of HAVS among tyre shop workers in Kelantan, Malaysia. Methods. A cross-sectional study involving 200 tyre shop workers was carried out. HAV was measured by a vibration meter. The workers were divided into two exposure groups - according to their 8-h time-weighted average, A(8), of vibration exposure - and compared. Results. Almost half of the workers reported musculoskeletal complications of the upper limbs and neck. Only the lifetime vibration dose (LVD) was significantly associated with the development of musculoskeletal complications. Conclusion. The high-exposure group had a higher prevalence of musculoskeletal complications. Only the LVD was significantly associated with complications. However, all factors of the work system, such as ergonomics, handgrip force and posture, might contribute to the development of musculoskeletal complications of HAVS and should be included in assessments.
Fulltext Factors associated with vascular and neurological complications of hand-arm vibration syndrome among tire shop workers in Kelantan, Malaysia

Qamruddin AA, Nik Husain NR, Sidek MY, Hanafi MH, Mohd Ripin Z

J Occup Health, 2021 Jan;63(1):e12220.
PMID: 33942440 DOI: 10.1002/1348-9585.12220

OBJECTIVE: Prolonged exposure to hand-arm vibration (HAV) at the workplace is associated with hand-arm vascular syndrome (HAVS). This study aimed to determine the prevalence and the factors associated with the vascular and neurological complications of HAVS among tire shop workers in Kelantan, Malaysia.
METHODS: A cross-sectional study involving 200 tire shop workers from two districts in Kelantan was conducted. Data were collected at the field using Malay Translated HAVS questionnaire, and hand-arm vibration was measured. Multiple logistic regression analysis was used to determine the associated factors.
RESULTS: The prevalence of vascular and neurological complications of HAVS among the tire shop workers was 12.5% (95% CI: 10.16, 14.84) and 37.0% (95% CI: 30.31, 43.69), respectively. From multiple logistic regression analysis, only A(8) of HAV exposure was significantly associated with the development of vascular complications and A(8) of HAV exposure, age. and body mass index were significantly associated with the development of neurological complications of HAVS.
CONCLUSION: This study has identified that HAVS is a significant problem among workers exposed to HAV in a warm environment. A(8) of HAV exposure is significantly associated with the development of both vascular and neurological complications. Therefore, there is a need for better control of vibration exposure in Malaysia.