Introduction: Clinical wastes produced by health facilities were considered as scheduled waste listed in the First Scheduled of the Environmental Quality (Scheduled Waste) Regulation 1989. The management of clinical waste in all government hospitals in Sabah were outsourced to private concession company. Until now, there was no research being done in Sabah to evaluate it. Methods: This cross-sectional study was carried out on eight concessionaire com-panies located inside accredited non-specialist government hospitals in West Coast Division & Interior Division of Sabah. Data collected through Clinical Waste Management (CWM) Scores and Questionnaires. CWM scores adopt 5 elements of accreditation standard produced by Malaysian Society Quality in Health (MSQH). Questionnaires were used to collect concessionaire staff’s basic personal data, services and activities related to clinical wastes ac-cording to MSQH standard. Response from questionnaires were used to compare and support result gained from CWM scores. Descriptive analysis was used to analyze the data. Results: Two concessionaire companies got overall CWM scores ranging between 86% - 90%, while the other six companies were above 95%. It happened because both companies gained 81% and 73.3% on Policies and Procedures element. Result from questionnaires answered by 67 concessionaire staffs showed 98% of staffs had attended meeting, 97% had received an orientation, 97% had received training related to clinical wastes, 95% agreed that their work was monitored and no occupational disease and injury recorded between January to April 2019. These result correlate with CWM scores gained under Orga-nization Management element (99.6%), Human Resource Management element (90.1%), Facilities and equipment element (97%) and Safety & Quality Improvement element (100%). Conclusions: All concessionaire companies were implementing excellent clinical waste management in hospitals. CWM scores can be used to rank individual conces-sionaire company and provide pattern of uniformity or non-uniformity of the clinical waste management in Sabah.
“If you hear of an outbreak of plague in a land, do not enter it; if the plague breaks out in a place while you are in it, do not leave that place”, reported by Sahih Al-Bukhari. This was the phrase quoted by Prophet Muhammad 14 centuries ago concerning both in disease spread and prevention. The relevancy of this statement is now widely seen and surge by the social media in a hashtag of “stay home” on an international level due to pandemic of COVID-19 disease.
Introduction:Obesity prevalence in Malaysian adults aged 18 and above has more than tripled over the past 20 years with 4.5% in 1996 to 17.7% in 2015. The alarming trend of the obesity epidemic in Malaysia requires im-mediate revision of public health policies. Thus this review was conducted to determine the effectiveness of latest weight reduction strategies. Methods: Literature search was conducted as guided by PICO Framework and using online databases PubMed on 22 June 2018. A total of 2,203 articles were found and screened. A total of 26 articles were reviewed. Results: Most weight loss achieved is through surgical intervention with weight reduction of 20.8 kg compared to 8.5 kg reduction in control group (95% CI, p < 0.001). Non-invasive procedures that produced greatest weight reduction include diet modification strategy consisting of isocaloric diet with large breakfast (700 kcal) which produced weight reduction of 8.7 ± 1.4 kg compared to large dinner (700 kcal) 3.6 ± 1.5 kg (95% CI, p < 0.0001, and special diet of adding 3g/day cumin supplementation into normal diet which produced weight reduction of 6.2 kg compared to 4.19 kg reduction in control group (95% CI, p < 0.05. Conclusion: In this review, most weight loss is achieved through surgical intervention. All patients should receive lifestyle therapy and additional consideration should be given for pharmacotherapy and bariatric surgery when indicated.
Introduction: In recent years, the variation in total fertility rate (TFR) has sparked public interest for demographic concerns on the global population shift towards an older age structure. This study aims to investigate the determi-nants of total fertility rate among Brunei, Indonesia, Malaysia and Philippines East Asian Growth Area (BIMP-EAGA) region. Methods: Our empirical study consists of data collected from the United Nations Development Report of the UNDP, World Development Indicators (WDI) of the World Bank and World Health Organization (WHO) report 2018. We investigated the socio-economic determinants of fertility rate by analyzing a panel data set consisting of 28 years from 1990-2017 of the four countries. A statistical and econometric software EViews version 10 (HIS Global Inc., Irvine, CA, USA) were used to run a Pearson’s Correlation and a multiple regression analysis by panel least squares method. To investigate the determinants of TFR we have selected five socio- economic factors, these are- Infant mortality rate (IMR), Gross National Income Per Capita, PPP (GNI), Human Development Index (HDI), percentage of population living in urban areas (URB) and lastly Female Labor Force Participation Rate (FLP). Results:Pearson’s correlation showed that a statistically significant negative relationship exists between TFR and the 3 vari-ables- GNI, URB and HDI. A statistically strong positive relationship exists between IMR and TFR. However, our results from the empirical multiple regression model indicates that there is a statistically significant negative relation-ship exists between TFR and two of the independent variables GNI and FLP. Conclusion: The results of present study showed that an increase in the national income and female labor participation rate in the workforce could result in a decrease in total fertility rate. These findings may have implications for countries national policy for planning, development and resource allocation.
Introduction: Illegal immigrants refer to the migration of people into a country in ways that violates its immigra-tion laws. A stateless person is a person who is not considered as a national by any state under the operation of its law. Interestingly, many who are stateless have never even crossed an international border. The term illegal is very loosely used in places like Sabah where it is interchanged with statelessness. As of 13 November 2018, it was estimated that there are about 12 million stateless people in the world. This review seeks to understand the current demographic situation in Sabah along with the public health repercussions of this demographic change and also to look into the success stories from around the world along with the recommendations from United Nation in solving this matter. Methods: The method used is reviewing of literature of previous studies conducted on statelessness and illegals. Local as well as international studies were reviewed. The data base used was ProQuest. Results: This review identified that one third of Sabah’s population consists of non-locals and in the past 27 years, about half a million illegal immigrants have been deported from Sabah. These numbers pose major public health repercussions from the economic, crime and health point of view. The way forward involves incorporating the United Nation Action plan with the local requirements and settings. Despite challenges, Sabah is trying its best to curb this issue and the Public health repercussions through various initiatives. We have also identified that more public health actions can be taken to reduce the negative effects. Conclusion: Dealing with the stateless and illegals is a delicate matter and there is no one way to solve it. Every country and every state are unique therefore the methods used must be tailor made. This is not something that can be solved within a short period of time and therefore persistence and perseverance is very much needed to tackle this global issue.
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: Dengue fever is endemic in Malaysia. It is a major public health challenge that has caused significant morbidity and mortality. A dengue outbreak is contributed by entomological factors, epidemiological and environmental factors. Outbreak response is crucial to reduce cases and death. This study is a descriptive dengue outbreak report in an urban residential area in Kota Kinabalu, Sabah Malaysia. Methods: This is a report of a dengue outbreak that started in middle of November 2019 and ended early December 2019. A dengue outbreak in Malaysia is defined when more than one dengue cases is reported in the same locality within 14 days from the date of notification of the first case. Cases were analysed descriptively looking at epidemiology and vector control database. Results: This outbreak involved 6 cases. The source reduction activities by elimination of breeding sites were conducted 3 times covering an area of 200-meter radius. A total of 110 premises were checked with coverageof 86%. The number of containers inspected was923, with 454 outside the premises and 469 inside the premises with no positive results for dengue larvae. Insecticide space spraying via thermal fogging was conducted with added ultra-low volume (ULV) spraying done within the 400 meterradius with coverageof 100%. Conclusion: Effective preventive measures have to be paired with responsible communities, as both play very vital roles in the control of dengue.
The emergence of primate malaria known as Plasmodium knowlesi in humans, which is always misdiagnosed by microscopy as P. malariae, has contribute to the needs of nucleic acid based technology to be applied in detection and differentiation of malaria parasites. The target DNA sequence of the 18SrRNA gene was amplified by a nested PCR assay for detection and identification of Plasmodium species in 31 Giemsa-stained blood smears examined as P. malariae. The assay demonstrated three samples identified as positive to genus-specific primers but negative to all species-specific primers. Three cases of misdiagnosed species were detected. The samples were diagnosed as P. malariae microscopically, but detected as P. falciparum by PCR assay. Twenty five out of 31 samples were detected as P. knowlesi. None of the samples diagnosed microscopically as P. malariae were identified as P. malariae with the nested PCR assay. Over 80.6% of all malaria cases in this study showed naturally acquired P. knowlesi infections.
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: One of the biggest global health threats of the 21st century is climate change It is so catastrophic that the climate action has been given a platform as it is the 13th goal of the 17 United Nations Sustainable developmen-tal goals (SDG). This review seeks to understand the factors causing climate change, followed by understanding the impact it has on individual and population health. We also identify the strategies to control and prevent further cli-mate change. Methods: Reviews of local and international articles from the past ten years was conducted. The focus of the review was the causes, health effects as well as strategies. Data base used was Pro Quest. Results: This re-view identified that the main contributor to climate change are man-made activities such as fossil fuels combustion, livestock farming, and deforestation. This change in climate has many repercussions from mass migrations, increase communicable diseases as well as an increase in extreme weather events and natural disasters. All this eventually leads to the deterioration of individual and population health. Strengthening adaptivity to climate-related hazard, climate change integration into national policies, education, awareness-raising, impact reduction and early warning are actions that are present in Malaysia to manage this crisis. Conclusion: Climate change is occurring globally, and its presence can no longer be denied. Actions have been put forth, but only when its importance and impact is taken seriously will the positive changes be sustainable.
Tuberculosis (TB) is one of the main public health problems in Sabah; 30% of the total number of TB cases reported in Malaysia every year occur in Sabah. The average incidence of TB among health care workers over the past 5 years is 280.4 per 100,000 population (1, Annual Report of Sabah State TB Control Programme, 1998). At present, there are no specific measures for the prevention of TB transmission in health care facilities. A case-control study was conducted among health care workers in Sabah in 2000-2001. Cases were health care workers with TB diagnosed between January 1990 and June 2000. Controls were health care workers without TB and working in the same facility as cases during the disease episode. The study attempted to identify risk factors for TB among the study population. Data were collected through structured interviews and review of patients' records. The notification rate of TB among health care workers was significantly higher than that to the general population (Z=4.893, p<0.01). The average notification rate of TB among health care workers over the last 5 years was two times higher than in the general population (280.4/100,000 compared to 153.9/100,000). Regression results showed that ethnicity, designation, family contact and TB related knowledge did not significantly contribute to the risk of contracting TB in this study. However, after controlling for the above factors, age, gender, history of TB contact outside the workplace (other than family contact), duration of service and failure to use respiratory protection when performing high-risk procedures, were the main risk factors of TB among health care workers. This study succeeded in identifying some of the risk factors of TB among health care workers. We managed to include the large ratio of controls to case (3:1) and those cases spanned over a period of 10 years. However, the findings from the study have to be applied with caution due to the limitations of this study, which include recall bias, dropouts, and small sample size. Based on the study findings, we recommend that health care workers in the first 10 years of service should take extra precautions, such as using respiratory protection when performing procedures that are considered to be of high risk with respect to TB infection. They should also undergo TB screening at least once every 2 years and, if symptomatic, offered prophylactic treatment. The Respiratory Protection Programme should be fully implemented to help reduce the risk of TB among health care workers in Sabah.
Food related disease or food poisoning is prevalent worldwide and is associated with high mortality. It can be caused by bacteria, viruses, parasites, enterotoxins, mycotoxins, chemicals, histamine poisoning (scombroid) ciguatera and harmful algal bloom (HAB). Illness can also result by red tide while breathing in the aerosolized brevitoxins (i.e. PbTx or Ptychodiscus toxins). Bacterial toxin food poisoning can affect within 1-6 hours and 8-16 hours, and illness can be with or without bloody diarrhea. The common symptoms of food poisoning include abdominal cramps, vomiting and diarrhea. Diagnosis includes examination of leftover food, food preparation environment, food handlers, feces, vomitus, serum and blood. Treatment involves oral rehydration, antiemetic, and anti-peristaltic drugs. Antimicrobial agents may be needed in the treatment of shigellosis, cholera, lifesaving invasive salmonellosis and typhoid fever. Proper care in handling and cooking is important to prevent any food borne diseases.
Introduction: Hypertension prevalence is increasing globally and has become a major issue of disease as it is a major cause for cerebrovascular, kidney and cardiovascular diseases. Even among treated patients, there is a dispropor-tional of blood pressure control causing a major public health challenge. This study is aimed to decide on the prev-alence of uncontrolled hypertension and its associated factors among hypertensive patient attending hypertension clinic at primary health clinics in Tuaran district. This study is justified by the fact that uncontrolled hypertension leads to high mortality, morbidity and even premature death. Methods: This study is a cross-sectional study among 460 hypertensive patients attending three primary health clinics in Tuaran district, Sabah. Data were collected using structured modified questionnaires through interviews, physical examinations and patient’s medical records. Types of data collected include socio-demography, lifestyle behavior, physical examination, co-morbidity status and med-ical adherence. Data analysis done using SPSS version 24.0. Results: Prevalence of uncontrolled hypertension was 45.9%. The study found that factors significantly associated with uncontrolled hypertension with p
Introduction: Role of nurses is very important in raising awareness, motivation level and increasing rate of organ donation subsequently. There are many studies on critical care nurses’ roles and education affect organ donation. Methods: A narrative literature review article of published research. Twelve published articles from ten different countries were found using different renowned online search engines. Results: Knowledge about organ donation among nursing students almost all over the world is inadequate than expectation and requirement in respective country. Marlene R et al showed that scores on the knowledge, attitudes, and beliefs subscales were positively cor- related with the number of requests for tissue and organs and consents obtained (0.76); and consents obtained for tissues and consents obtained for organs (0.72). Professional education was indicated in 43% of nurses surpassing family beliefs, religion and mass media. The cognitive part (knowledge) is directly depends on non-cognitive (Aware- ness and Attitude). Findings from almost all articles suggest the need of adding organ donation topic in the nursing and medical curriculum to prepare competent nurses and health care providers for future. Conclusion: This study suggests that there is a need to integrate organ donation aspects into the educational program to prepare nurses for their roles in organ and tissue procurement as well as awareness among policy makers in this regard for the well-be- ing of our patients.
Introduction: Rotary wing aircraft (RWA) or the helicopter has been used in Primary Health Care and Medical Emergency Services in the state of Sabah since the seventies. The use of RWA has distinct advantages in terms of speed, ability to access remote areas and in the transportation of patients to tertiary care. Single engine RWA was used for the last forty years which has now been replaced with twin engine RWA. The objective of this study is to compare the different type of RWA which was used and the suitability of
these machines for health services in Sabah. Methods: A detailed analysis and comparison of manufacturers’ specifications which include the performance, size, the number of power plant, passenger capacity,
safety track record, aircraft manufacturer’ s support, maintenance and operational costs of different types of RWA available in Sabah taking into account current and future demands as well as functional requirements and
the capability of the aircraft service providers were considered. Results: The choice of aircrafts depends on the type of service and its suitability. From the assessment, a single engine RWA would be adequate to support the
current and future need in Sabah. Conclusion: Adequate technical knowledge in choosing the type of aircraft to provide an effective health service is vital. These also contribute to the cost effectiveness of the program and significantly determine efficiency of the service and the interest of the rural people with poor accessibility to health care.
Marieanne Florence, Ateeqah Abdul Said, Jaya Dhaarshini Sundara Rajan, Karrthigeyan Ramachandaran, Muhamad Luqman Hakim Mohd Yamin, Nur Syahierra Azmi, et al.
Introduction: Mitigation measures are important in curbing COVID-19 infection. However, people’s adherence to the control measures is depending upon their knowledge, attitudes and practices (KAP) towards the disease. This study aims to determine the KAP onCOVID-19 and its associated factors among medical students in Malaysian Borneo during the period of the pandemic. Methods: A cross-sectional online survey of 248 medical students from University Malaysia Sabah was conducted from August to September 2020. The survey instrument was adapted from a previously validated questionnaire on COVID-19. Descriptive statistics and simple logistic regression were conducted. Results: The mean age of respondents was 22.0 (SD 1.4) years. Majority (65.7%, n= 163) were clinical students, female gender (70.6%, n= 175), and Bumiputra ethnic (46.8%, n= 116). 211 (85.1%), 191 (77.0%) and 163 (65.7%) of the respondents have good level of knowledge, positive attitude and good practice respectively.Conclusion:The medical students are updated with the current health issues especially on COVID-19. They are aware of the attributes of the disease and have concerns in taking good care of themselves. Further study needs to be implemented among the groups of non-medical student of the same institution to compare their KAP on COVID-19.
Introduction: Hypertension is a condition where there is persistently raised pressure in the blood vessels. In Malay-sia, higher prevalence of hypertension could be explained by lifestyle factors such as higher rates of obesity, excess dietary intake of sodium and fat and lack of physical activity. The main objective of this study was to determine the prevalence, risk factors and co-morbidities of hypertension in villagers aged 18 years and above in Kampung Tajau Laut, Kudat, Sabah. Methods: Non-probability convenience sampling method was used to select a total of 210 villagers for interview, anthropometric examinations and blood pressure measurements. House to house and face to face interview by trained year four medical students done using a pretested validated questionnaire. The ques-tionnaire contained data on socioeconomic status, tobacco use, physical activity, diet, extra-salt use, family history of hypertension, co-morbidity, anthropometric measurements and blood pressure. Results: Respondents noted to be hypertensive were 67.6%, and out of this, 61.3% were undiagnosed. There was a significant association between hypertension and family history (Chi-squared test=38.280, p=0.000), hypertension and smoking status (Chi-squared test=7.673, p= 0.006), hypertension and obesity (Chi-squared test= 8.731, p=0.003), hypertension and gender (Chi-squared test=5.126, p=0.024), hypertension and age (Chi-squared test=26.110, p=0.000) of respondents. There was no significant association between hypertension with vegetable intake, fruit intake, physical activity, marital status, ethnicity, economic status, level of education, and occupational status of respondents. Half of the known hyperten-sive respondents have comorbidities with most commonly being dyslipidaemia and diabetes mellitus. Conclusion: Hypertension was found to have a significant association with family history, smoking status, obesity, age and gender among the studied population.