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Fulltext Knowledge and Risk Perceptions of Occupational Infections Among Health-care Workers in Malaysia

Subramanian GC, Arip M, Saraswathy Subramaniam TS

Saf Health Work, 2017 Sep;8(3):246-249.
PMID: 28951800 DOI: 10.1016/j.shaw.2016.12.007

Health-care workers are at risk of exposure to occupational infections with subsequent risk of contracting diseases, disability, and even death. A systematic collection of occupational disease data is useful for monitoring current trends in work situations and disease exposures; however, these data are usually limited due to under-reporting. The objective of this study was to review literature related to knowledge, risk perceptions, and practices regarding occupational exposures to infectious diseases in Malaysian health-care settings, in particular regarding blood-borne infections, universal precautions, use of personal protective equipment, and clinical waste management. The data are useful for determining improvements in knowledge and risk perceptions among health-care workers with developments of health policies and essential interventions for prevention and control of occupational diseases.
Empathy amongst doctors: an observational study

Subramaniam TS, Valuyeetham PS, Kamaru Ambu V

Med J Malaysia, 2023 May;78(3):344-349.
PMID: 37271844

INTRODUCTION: Empathy is the ability to put oneself in another's emotional space and experience what they feel. Either due to lack of experience or mundaness of practice, a state of empathy can become premised, and individuals become indifferent or detached. We aimed to explore the level of empathy among doctors at different levels of practice, age, gender, academics, non-academics and discipline.
MATERIALS AND METHODS: This was a cross-sectional, observational study on empathy among doctors practicing in the private, public hospital sector and faculty at a medical university in Negeri Sembilan, Malaysia that utilised convenience sampling for data collection. The Toronto Empathy Questionnaire (TEQ) a validated tool was used to measure empathy.
RESULTS: The questionnaire was completed by 127 doctors, 52% (n= 66) were males and 48% (n=61) females. There was no significant difference in empathy between male (M=46.44; SD=6.01) and female (M=45.05, SD=5.69) doctors; t (123) = 1.326, p=0.187. Pearson correlation coefficient was computed to assess the linear relationship between age and empathy and revealed no correlation between the two variables: r (125) =0.15, p=0.099. Medical-based doctors (M= 47.47, SD=5.98) demonstrated more empathy than surgicalbased (M=44.32, SD=5.41); t (123) =-3.09, p=0.002. Those already specialised in their fields (M=47.38, SD=4.57) had more empathy than those who had not (M= 44.36, SD=6.52); t (123) =-2.96, p = 0.004. Doctors in the university (M=47.97, SD=4.31) tended to have more empathy than those in the public hospitals (M= 44.63, SD=6.27); t (117) =-2.91, p=0.004. Academicians had more empathy than non-academicians but there was no difference between those who were in clinical practice and not.
CONCLUSION: Our findings indicate that medical-based doctors demonstrate more empathy than surgical-based doctors, and there appeared to be no correlation between age and empathy. However, clinical experience and growth within the specialty seem to improve empathy. Doctors teaching in the university setting demonstrated more empathy than those practicing in the hospital setting. Inclusion of empathy-related sessions in the undergraduate and post-graduate curriculum could bridge the gap in empathy noted with age, discipline, and experience in practice. Further research on empathy among doctors using a wider population in Malaysia and a TEQ questionnaire validated to the Asian population would provide better insight regarding this area of medical practice. Future research on outcomes of inclusion of programmes targeted at improving empathy to create awareness during practice would support patient satisfaction and safety.
Genetically modified mosquito: the Malaysian public engagement experience

Subramaniam TS, Lee HL, Ahmad NW, Murad S

Biotechnol J, 2012 Nov;7(11):1323-7.
PMID: 23125042 DOI: 10.1002/biot.201200282

On December 21, 2010, 6000 genetically modified (GM) mosquitoes were released in an uninhabited forest in Malaysia. The purpose of the deliberate release was a limited “marked release and recapture” (MRR) experiment, a standard ecological method in entomology, to evaluate under field conditions, the flight distance and longevity of the sterile male Aedes aegypti strain OX513A(My1), a GM strain. As with any other GM technologies, the release was received with mixed responses. As the scientific community debate over the public engagement strategies for similar GM releases, dengue incidence continues to rise with a heavy toll on morbidity, mortality and healthcare budgets. Meanwhile the wild female Aedes aegypti continues to breed offspring, surviving and evading conventional interventions for vector control.
Fulltext Viral Aetiology of Acute Flaccid Paralysis Surveillance Cases, before and after Vaccine Policy Change from Oral Polio Vaccine to Inactivated Polio Vaccine

Saraswathy Subramaniam TS, Apandi MA, Jahis R, Samsudin MS, Saat Z

J Trop Med, 2014;2014:814908.
PMID: 24772175 DOI: 10.1155/2014/814908

Since 1992, surveillance for acute flaccid paralysis (AFP) cases was introduced in Malaysia along with the establishment of the National Poliovirus Laboratory at the Institute for Medical Research. In 2008, the Ministry of Health, Malaysia, approved a vaccine policy change from oral polio vaccine to inactivated polio vaccine (IPV). Eight states started using IPV in the Expanded Immunization Programme, followed by the remaining states in January 2010. The objective of this study was to determine the viral aetiology of AFP cases below 15 years of age, before and after vaccine policy change from oral polio vaccine to inactivated polio vaccine. One hundred and seventy-nine enteroviruses were isolated from the 3394 stool specimens investigated between 1992 and December 2012. Fifty-six out of 107 virus isolates were polioviruses and the remaining were non-polio enteroviruses. Since 2009 after the sequential introduction of IPV in the childhood immunization programme, no Sabin polioviruses were isolated from AFP cases. In 2012, the laboratory AFP surveillance was supplemented with environmental surveillance with sewage sampling. Thirteen Sabin polioviruses were also isolated from sewage in the same year, but no vaccine-derived poliovirus was detected during this period.
Fulltext Sharing experiences from a reference laboratory in the public health response for Ebola viral disease, MERS-CoV and H7N9 influenza virus investigations

Saraswathy Subramaniam TS, Thayan R, Yusof MA, Suppiah J, Tg Abd Rashid TR, Zawawi ZM, et al.

Asian Pac J Trop Med, 2016 Feb;9(2):201-3.
PMID: 26919957 DOI: 10.1016/j.apjtm.2016.01.016

An efficient public health preparedness and response plan for infectious disease management is important in recent times when emerging and exotic diseases that hitherto were not common have surfaced in countries with potential to spread outside borders. Stewardship from a reference laboratory is important to take the lead for the laboratory network, to proactively set up disease surveillance, provide referral diagnostic services, on-going training and mentorship and to ensure coordination of an effective laboratory response. In Malaysia, the Institute for Medical Research has provided the stewardship for the Ministry of Health's laboratory network that comprises of hospital pathology, public health and university laboratories. In this paper we share our experiences in recent infectious disease outbreak investigations as a reference laboratory within the Ministry of Health infectious disease surveillance network.