HIV/AIDS is a global issue and the fourth biggest killer worldwide. Report from Ministry Of Health Malaysia showed factory workers are among the social group that are mostly infected (10.4%). A cross~sectional study was carried out to determine the socio-demographic factor and its relationship with knowledge, attitude and HIV-related risk behavior among factory workers in Selangor, Negeri Sembilan and MaIacca. This study involved 3300 factory workers selected randomly and were given self-guided questionnaire. With response rate about 95.4% (3148), the level of knowledge was high (97.3%) and the attitude was positive (81 %). However there was still an amount of fear towards HIV/AlDS patient. Logistic regression showed significant difference (p<0.05) between level of knowledge and ethnic group, income and level of education and between attitude and income and level of knowledge. About 27.7% of respondents smoked cigarette. 4.2% involved with drugs of which 0.7% administered intravenously, 2.3% were homosexuals, 2.5% were bisexuals and 3.1% were hererosexuals. HIV/AIDS prevention and control intervention should take into consideration the local socio-cultural factors and commitment from the top level management in the factory·
A cross-sectional study to determine the prevalence of malnutrition and some associated factors among primary one schoolchildren, aged 7 years from rural areas of Tumpat and Bachok in Kelantan was carried out. A total of 922 chiMren from 18 primary schools were examined. The parents completed self-administered questionnaires eliciting demographic and socio-economic information. The weight and height of each child was taken. The nutritional status was assessed by the z-scores of weight-for-age (WAZ) , height- or-age (HAZ) and weight-for-height (WHZ). The prevalence of underweight was 25 .2% , stunting was 21 .1% and wasting was 6 .2%. Less than 1 .0% ofthe children were overweight. Risk factors of underweight were lueinga male (OR=l .4),
having an unemployed father (OR=2 .6) and a monthly family income of RM 251 -500 (OR=2 .0) . Being a male (OR=1 .6) was the only risk factor for stunning and working mother (OR=2 .0) was the only risk factor of wasting. In conclusion, there is still a high prevalence of undemutrition among primary one schoolchildren in rural areas of Tumpat and Bachok. This may be due to the poor socioeconomic status of the rural community and the lack of emphasis ofthe supplementary feeding program on the late preschool children. A comprehensive nutrition support program is essential, especially targeting the preschool children in these rural communities
A cross sectional study was carried amongst adolescent school children in Barat Daya, in 2000. This was to determine the characteristic features of adolescents in the district and to look into their sexual activities, substance use and psychosocial problems with the aim to plan an appropriate adolescent health program. Some 400 students from Form 2 and Form 4 were selected by purposive stratifed and systematic sampling. The study was carried out by trained nurses with an interview using a structured questionnaire. The majority of the respondents were Malays (78.8%) with a household income of less than RM2, 000.00 per if month. Family relations and parental influence were found to be strong. Mental health characteristics scored negatively significantly in this study and those particularly at risk were those who performed poorly in schools. Most claimed not to be involved in high risk behaviour though they knew of friends who did so. Adolescent health services in the district should take an integrated approach with other stakeholders. Health information should be easily available and focus should be given to poor achievers in school.
Functional dependence is common in hte life and may be due to the normal process of ageing or associated with physical disorders. This study was done to determine the prevalence and factors affecting functional dependence among the elderly in a rural community setting. A cross sectional study design using stratifed proportionate cluster sampling method was used in this study. All elderly residents aged 60 years old and above in the selected kampungs in Mukim Sepang were selected as respondents. The Barthel`s Index ( B1) was used to screen for functional dependence among the respondents. Functional dependence in basic Activities of Daily Living (ADL) implies that the respondent needs assistance in one or more of these tasks. Out of the 263 elderly residents, 223 agreed to participate givinga response rate 84.8%. The mean age was 69.7 years with a SD of 6.8 years. Age ranged from 60-99 years. Thirtyyfive (15.7%) of the respondents were dependent in at kast one function of the ADL. The most common problem identifed was urinary incontinence (9.9%). Functional dependence is common among our elderly population. This problem needs to be addressed by the health care personnel to improve the quality of life of the elderly.
Blood lead concentration and 6»aminolevulinic acid in urine were used as indicator for lead exposure among school children in an industrial area south of the peninsular Malaysia. A group of 1 00 Malay children which consist of 48 boys and 52 girb with the age range of 61/2 to 81/2 years from a primary school were selected as chiMren. Blood samples were collected and analyzed with Graphite Furnace Atomic Absorption Spectrophotometer. The urine 6-aminolevulinic acid concentrations were measured with UV/VIS Spectrophotometer. The mean blood lead was 3.75ug/dl. Based on the biological index, 76% of the children are in the “normal range" (
A cross sectional survey on the assessment of coronary heart disease risks was conducted on a group of security guards in a public university. The objectives were to assess the risk of coronary heart disease (CHD) among the security staff and to provide advice on CHD prevention and practice of a healthy lifestyle. A face»t0»face questionnaire was used to conduct the survey. The main outcome measure was the coronary heart disease (CHD) risk score estimates. The handings showed that 61 participants ( 5 3 .0%) have very high CHD risk factors, while the rest, 38.3% and 8.7% have moderate and low CHD risk factors respectively. With increasing age, there is an increase in total risk score among the target groups. The percentage increases almost 2-fold between the 21-30 and the 31-40 age groups. Majority of the security staff had high CHD risk factors and more efforts and preventive measures must be taken to overcome this situation. Personalised advice was given to participants based on their CHD risks estimates.
An outbreak of dengue and dengue haemorrhagic fever was studied in Bandar Baru Bangi, Hulu Langat District which started from epidemiological week 51 of December 2001 until ]anuary 2002. Altogether, 53 cases were reported to the Hulu Langat District Health Office with 24 cases detected in Section I and Section 6, and 5 cases in Section 4 of Bandar Baru Bangi respectively. Two cases were confirmed as dengue haernorrhagic fever (DHF). The majority of the cases were female Malays. The age of the cases ranged from 3 to 60 years with a mean of 29.17 : 13.18 years old. The majority of patients were mainly private sector workers from factories or companies with 29 cases (54.7%) and university students with 14 cases (26.4%). No deaths were reported in this outbreak. On the average, the duration taken for a patient to be admitted from the date of onset was about 4.4 - 2.0 days and the duration taken for notification from the date of admission was about 2.0 - 1.7 days. The majority of cases reported were based on classical clinical features of dengue fever. Only 18 cases (34%) were IgM positive for dengue. The statistical analysis showed that the majority were male (P>0.05), Malays (P>0.05) , age group of 21»30 years (P>0.05), platelets level < 100,000 per mm3 (p>0.05) and the serological specimens obtained 5 days after the date of onset (p2.0%) within residential premises in this locality with 46 Aedes mosquito breeding places identified and a total amount of RM 6500 of fines imposed.
An outbreak of pneumonia occurred among 1,491 recruits undergoing training at the Army Recruit Training Center, Port Dickson, Negeri Sembihxn, between july to August 2000. They had reported for training 2 weeks before and were placed in new modern concrete 4 floors buiMing with well ventilated dorm. A total of 70 recruits were ajjfected and one died. The attack rate was 4.7% and the case fatality rate was 1.4%. The outbreak ajfected recruits from all the jive companies; J (21/299,
30.0%) , G (19/298, 27.1 %), I (14/298, 20.0%), H (13/298, 18.6%) and F (3/298, 4.3%) . The main presenting symptoms were fever (68/70, 97.1%), cough (62/70, 88.6%), and chest pain (35/70, 50 .0%) . This was a common site outbreak with the mode of spread from person to person through infected droplet. The outbreak has three peaks, which was at lst, 4th and 6th week respectively and lasted for eight weeks. The organisms isobted through blood culture were Streptococcal pneumoniae and Klebsiella pneumoniae. All the cases were managed and treated as in-patients at four dijjferent hospitals depending on the severity of the illness. The main control activities carried out were separation of ill recruits from the healthy, reducing the number of recruits in the dormitories and encourage recruits to drink a lot of water while in training.
The prevalence of cleft lip and palate in human is 1 in 500 live births worldwide. Non·syndromic clefts are a complex trait with both genetic and environmental etiology. The aim ofthe study was to assess the association between maternal exposure to second-hand smoke during pregnancy and ruk of having cleft child. Unmatched case-control study was carried out among Malays in Kelantan.
1 Case and control subjects were denned as mothers of cleft children and mothers of normal children respectively. The cleft children were recruited from the Combined Cleft Clinic at Kota Bharu Dental Clinic. Normal chiMren were selected at Orthodontic Clinic, Kota Bharu. A total of 184 cases and controb with age range from 17 to 50 years were interviewed using the standard craniofacial
registration form. Multiple Logistic Regression modeling was used to estimate adjusted odds ratio of factors associated with non-syndromic oral cleft. Signijicant factors include history of miscarriage (OR: 3.40; 95% C1:1.05, 11 .08) p=0.042; duration of exposure to second-hand smoke for 15-30 minutes (OR: 2.41; 95% C1:1.42, 4.09) p 30 minutes (OR: 5.16; 95% C1:Z.87, 9.28) p
National Antenatal HIV Screening Programme has been integrated as a routine screening in antenatal care in early 1998 and in Terengganu since May 1998 involving all health centers in the state. As of December 2001, a total number of 57,882 antenatal mothers were screened (97.5% of all new antenatal mothers). The HIV prevalence rate among antenatal mothers was found to be 0.052%. All HIV positive mothers were married and majority were Malays (93 .3%). Ninety percents of them revealed that the only risk factorfor HIV was through sexual contact. HIV positive status was confirmed in 66 .7% ofthe husbands. All twenty eight mothers that managed to be followed up delivered to live birth babies. All newborns reported to have good Apgar score (9 at 5 minutes of life). Mean birth weight was 3 .08 kilograms 1- 0.45 and only 8% were premature babies. The observed rate of HIV vertical transmission was 6.25% and this is lower than the expected mother to child transmission rate of 30% without intervention.
Risks of transfusion increase with the increase in the number and volume of transfusions occurring in hospitals year after year. Knowledge and practice of the nurses on proper transfusion techniques and risk reduction procedures should always be updated to ensure that transfusions are safely carried out. The study was done to determine the levels of knowledge and practice of trained nurses regarding blood transfusion in a general hospital. The study is a cross-sectional survey using a questionnaire, distributed to all staff nurses in the medical-based wards and intensive care unit (ICU) in the hospital. The total score were added for each category of knowledge and practice. Ninety one percent of the total population of staff nurses in medical based wards anti ICU were recruited into the study. A score of 80% or more in the knowledge and score of IOO% is required for practice to consider it as a pass, The outcome of the study showed that no one respondent in the study has achieved the required level, with regard to neither knowledge nor practice. The mean knowledge score was 54.8 with SD. of 9,9; while the mean practice score was 63 .8 with S.D. of 1.4. It was found that there was no rehtionship between knowledge score, nor practice score with the clinical postings (place of work) , work experience, and nursing qualification. This survey had indicated probkms faced by the nursing population in the hospital studied that there was a need to improve knowledge and practice levels with regards to blood transfusion procedure. It is crucial that updated information concerning transfusions be communicated to these nurses since they were the ones who carry out the procedures whilst continuously observing the patients during transfusion.
A cross sectional study was carried out to identify and compare factors that contribute to patient satisfaction towards the medical care services provided at the outpatient clinic in government health clinics and private clinics in Mulcim Labu, Sepang, Selangor. Systematic sampling for government clinic and universal sampling for private clinics were done and data was collected via face-to-
face interview based on a validated Patient Satisfaction Questionnaire (PSQ). A total of 181 patients aged 15 to 75 years old were selected, comprising 90 patients from the government clinics and 91 patients from private clinics. The majority of the patients were males (62.4%), Malay (79.0%), aged between 25 to 34 years with a mean age of 34.6 years and acutely ill (80.7%). Generally, all patients were satisfied with the services provided in both government and private sectors. Patients in private clinics, however, had a significantly higher satisfaction score as compared to the respondents in government clinics. There was signilqcant correlation between patient satisfaction score and household income in government and private clinics. Significant correlation was also found between patient satisfaction score and age in government clinic. Patients in private clinics were more satisfied towards the interpersonal manners, availability and continuity of care of the clinic compared to patienw in government clinics. Whereas patients in government clinics were more satisfied towards the service charges. This study provides important in ormation that could be used by roviders o health care services to monitor and im roved the ualit o medical care in the respective sectors.
Water filters are being increasingly promoted and used in the home. There are many types of commercial water jilters available for domestic use but almost all of them employ a physical filter media and an activated substance. The study showed that water filters effectively removed suspended solids and residual chlorine. However, as far as removing colhform bacteria is concerned, in ZZ .5% of the cases, bacteria were in fact introduced into the water. And in 20% ofthe cases, the amount of bacteria introduced was “too numerous to count (TNTC)". Furthermore, water hlters can lose their ability to filter bacteria without losing their ability to filter suspended solids and residual chlorine. This highlights the necessity of some authorized body looking into the claims made by these water filter manufacturers and impose certain standards to ensure that at the very least, the water quality ofthe hltered water is not worse than the unfiltered water.
Upper respiratory tract infections (URTI) are the most common diseases treated in the primary health care centres in Kinta District, Perak. Thus, aretrospectiire study was undertaken to examine the documentation of the presentation of patients diagnosed with URTI and their antibiotic treatment at two health care centres in Kinta district, The randomly selected case notes of 700 patients documented the following symptoms, fever (43 .29%) , cough (68.14%) , no cough (24.43%), nasal symptoms (35 .29%) , sore throat (46.00%), headache (13 .57%) , bodyache (3 .57%) , earache (1 .86%) and gastrointestinal symptom (0, 14%) . Analysis of results using 'sore throat score' and isuggested appropriate management’ adopted from a study by Wawen et al. revealed poor correlation between diagnosis of URTI and the need for antibiotic therapy. Therefore, a clinical score for patients with sore throat can be introduced to overcome inappropriate prescription of antibiotics.
Klinik Kesihatan Gopeng, Klinik Kesihatan Malim Nawar, Kinta district, Perak, Malaysia
Satu kajian keratan rentas telah daalanlcan ke atas kanak-lcanak yang tinggal 0.5 km dari sebuah lcuari di Sungai Siput Utara. Objelctif kajian ini ialah untulc mengkaji hubungan PM10 dengan fungsi paru-paru kanak-kanak tersebut. Seramai 51 orang kanak-/canak yang ringgal berhampiran kuari dan terdedah dengan debu kaur tehih dipilih, manakala 37 orang kanak-kanak yang tinggal berjauhan tetapi di daerah yang sama telah dipilih sebagai perbandingan untuk lag ian ini. Borang soalselidik telah digunakan untuk mendapatlcan maklumat latarbelakang dan sejarah respiratori dari ibu bapa kanalc-kanak terlibat. Fungsi paru-paru kanak-kanak pula diukur dengan menggunakan Pony Graphic S pirometer. Min kepekatan PM1 0 selama 24 jam di dalam rumah kediaman di kawasan terdedah ialah 76.66 (g/m3 dan di kawasan perbandingan 41 .55 (g/m3. Perbezaan kepekatan PM10 di antara kedua kawasan ini adalah signifikan (p=0.01). Hasil ujian fungsi paru-paru menunjukkan perbezaan yang signifikan di antara fungsi paru-paru kanalc-kanalc terdedah dengan kanak-kanak perbandingan dari segi FVC % jangkaan (t = -8.227, p = 0.01) dan FEV1 % jangkaan (t = -8.729, p = 0.01). Min fungsi paru-paru kanak-kanak lelaki di kawasan terdedah, (FVC % jangkaan = 68.05, FEV1 % jangkaan = 73.71) adalah lebih rendah daripada kawasan perbandingan (FVC % jangkaan= 89.78, FEV1 %~ jangkaan = 86.97). Min fungsi paru-paru kanak-kanak perempuan di kawasan terdedah (FVC % jangkaan= 69.64, FEV1 % jangkaan =74.90) juga adalah lebih rendah daripada hawasan perbandingan ( F VC % jangkaan = 90.99, FEV1 % jangkaan : 87 .7 9). Prevalens kejejasan parurparu FVC % jangkaan l
A cross-sectional study on helminthiasis among rural primary schoolchildren aged 9 to 10 years Bachok, Kelaritan was perfumed. A total of 680 schoolchildren participated in the study. Stool specimens were examined for the presence of the ova of Ascaris lumbricoides, Trichuris trichiura and hoolcwonn. The worm load was then measured using the modified Stoll`s volumetric dilution
technique. The overall prevalence of helminthiasis was 77 .2%. Trichuris trichiura were the commonest type of heminth noted - 66.8%, compared with Ascaris lumlrricoides (49.7%) and hookworm (1.8%). Mixed infections with Ascaris lumlyricoides and Trichuris trichiura was the commonest type of infection 249(41 .5%) . For Ascaris lumbncoides, 34.6% had mild and 5 I .3% had moderate worm load while for Trichurb trichiura, 66.5% had mild and 30.8 % had moderate worm load. Only 14.1% and 2.7% 4 of the schoolchildren had a heavy load of Ascaris lumlwicoides and Trichuris trichiura respectively. All the schookhildren with hookworm were only mildly infected. Targeted mass treatment for rural Mahysian schoolchildren is still essential, especially in areas where poverty and malnutrition are still prevalent.
The aim of this study was to determine the pattern of health care utilization amongst the rural community and the prevalence of complementary health care in Kampung Giching, Sepang, Selangor, A cross sectional study was conducted in 2001. Out of the 154 respondents selected by universal sampling, only 131 completed the questionnaires giving a response rate of 85.1 %. The
respondents were asked to recall the presence of any illness during the past 6 months and their use of health care, Twenty-four respondents claimed to be healthy without having any illness (18,3%), 33 respondents (25,2%) reported that they had chronic illnesses, while the rest (n=74) reported having acute illnesses. There were 54.2% of the respondents admitted trying self-medication and 10.3% seelced traditional medication for their respective illnesses. Among the self»medicated respondents, 48,3% used modem medicine, 48 .3% used traditional medicine, 1.7% used both modern and traditional medicines and 1 .7% respondent used home remedies. The results of this study show that both modern and traditional practitioners play important roles in giving information on self-medication, These practitioners as well as the public should be advised on the benejits and side»e]j"ects of both types of medication (modern and traditional).
The aim of this study was to describe the sociodemographic aspect, clinical presentation and laboratory support, behaviour factor and vector situation of dengue outbreak. Data was obtained from standard investigation format of 84 cases of suspected dengue fever in two main outbreaks localities in Temerloh District from December 2001 to January 2002. The result showed that most of the cases occurred among 11 years old and above, especially in the age group of 11 to 20 years old. Students and female were the most high risk groups. Rashes and petechiae were more prevalent in Taman Sri Semantan which reflect the case incidence there. Serological result showed that seroprevalence for IgM was 66.1 %. Based on dengue rapid test, secondary infection was more prevalent in Taman Sri Kemuning whereas those in Taman Sri Semantan had more primary infection. About 25% of the cases came late to hospital for treatment. Both localities had different mosquito breeding areas. Further studies are needed to identify behaviour aspect of the population with regard to dengue fever in previous main outbreak localities. A more valid and rapid serological test is required for better case identification.
Keywords: Dengue outbreak, risk factors, patient factor, clinical finding, serological test
Cigarette smoking is so widespread that even medical workers are not exempted. A cross sectional survey was conducted among health care workers of the Institute of Respiratory Medicine, Hospital Kuala Lumpur to determine the prevalence of smoking and to assess readiness among the current smokers to quit. A total of 165 workers from all categories was surveyed using a pre-tested self-administered questionnaire, The survey began in Mac 2002 and ended in April 2002, The survey showed that 24.8% of the workers surveyed were current smokers. Only male workers were found to smoke and the prevalence among them was 60.3%. Majority were moderate smokers, smoking between 10 to 20 cigarettes a day and were mainly lower category of workers, Median age of starting to smoke was 17.6 years, There were 20 smokesr ( 52.6%) who were ready to quit. This study found the prevalence of smoking among male health care workers to be higher than males in the general population. The low level of education of these workers seemed to influence smoking status.
Adolescents who overestimate the prevalence of smoking among their peers or other teens are at higher risk to take up smoking. The purpose of this study is to elucidate the factors which are related to adolescents’ overestimation of smoking. We surveyed form four (16 years old) students in Petaling District, Selangor. A sample was selected using two-stage stratified sampling, and data were collected using standardised, self-administered questionnaires. A response rate of 80.4% (n=1045/1298) was obtained, and a total of 943 students were included in the final analysis. About 73 percent (n=688/943) of the respondents overestimated the prevalence of smoking among their peers. The odds of overestimating increased as the number of close friends who smoke increased [Two close friends, OR=3.10(1.67-5.75), three close friends OR=10.81(4.44-26.3) and four-five close friends OR= 12.91(5.31-31.43)]. Those who had an elder brother who smoked (OR=1.95 (1.18-3.24)) and females [2.08(1.37-3.33) were more likely to overestimate peer smoking prevalence. Intervention programmes to correct the misperception of peer smoking prevalence are recommended, in addition to measures to modify the other factors that are amenable to intervention, so as to reduce the risk of smoking initiation among adolescents.