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 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.
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
Breast cancer is the commonest female cancer in Malaysia with a prevalence of 86.2 cases per 100,000 women in 1996. Pronling breast cancer patients is important for better planning of preventive and screening strategies for Malaysian women. The aims of this cross-sectional study were to identify histological presentation, socio-demographic and reproductive characteristics and prevalence of risk or protective factors of breast cancer among women with breast cancer in Kelantan. A total of 175 female breast cancer patients who were diagnosed in 1991 to 2000, were interviewed using standardized questionnaires. The mean (sd) age was 47.0 (9.6) years with 77.7% Malay, 20.6% Chinese and 1.7% others. About half (52.6%) had 9 years or less of formal education, while 59.4% were housewives/unemployed and 60.6% had a monthly family income of less than RM1 ,000. The commonest histological type was innltrative ductal carcinoma (73 .7%) . Presentation of breast cancer with the stage lll or Vl was 59.4%. The prevalence of nulliparity · 13.1%, breastfeeding longer than two years - 58.9%, premenstrual period - 72.0%, menarche at 11 years old or less - 5 .7%, positive family history - 14.4%, overweight/obesity - 48.0%, oral contraceptives use 30.3%, hormone replacement therapy » 1.1%, cigarette smoking - 4.6%, consuming akohol - 3.4%, previous benign breast disease - 6.3%, previous breast biopsy - 2.9% and previous oophorectomy - 4.6%. The patients were younger compared to other studies. The ethnic distribution did not represent the population distribution of Kelantan. The prevalence of overweight/obesity and smoking were higher than the national prevalence among women, thus they should be included in the prevention strategies for breast cancer. Further studies are recommended to investigate why many of breast cancer patients in Kelantan presented at a younger age and at advanced stages of cancer.
A cross sectional study was conducted in Kelantan state with the objectives to determine the prevalence of smoking in 2004 and to determine the relationship between smoking and age, sex, educational level, family and peer influence. All residents aged 15 years and above from all the selected households were included in this study. A standardized pre-tested structured questionnaire was used in this study. Out of 1025 respondents interviewed the prevalence of ever and current smokers was 34% and 25.1% respectively.The prevalence of ever smokers and current smokers was significantly higher In males as compared to females (p.<0.001). The mean initiation age for the males current smokers was 10.4 (95% CI = 19.4, 21.5) years with a range from 7 to 66 years. For the females the mean initiation age was 31 (95% Cl =26.8, 35.2) years with a range from 15 to 64 years. The difference between the mean initiation age between male and female smokers was statistically significant (p<0.0001). The overall mean duration of smoking was 23.9 years with a median of 23 years. It ranged from less than 1 year to 66 years. There was no significant difference between the mean duration of smoking between male and females current smokers (p =0.59). There was a significant association between current smoking status and education level (p<0.01 ) and between smoking and peer influence (p<0.01). There was no significant difference in smokers whose parents were smokers as compared to non-smokers whose parents were smokers. In conclusion the prevalence of smoking in Kelantan state in 2004 is lower than the reported prevalence in 1996. However, it is still very high especially in the males.
Key words: Smoking, peer influence, Kelantan
Exposure to secondhand smoke has consistently been linked to adverse health effects in children, including reduced lung function and various respiratory diseases. There is also increasing evidence that secondhand smoke exposure is associated with cognitive impairment and behavioral problems in children, This cross sectional study was done on 795 chiildren to determine the association between secondhand smoke exposure and peak expiratory flow rate (PEFR) and cognitive performance among the primary school children in Kota Bharu Kelantan. A questionnaire was used to obtain information on socio-demography and smoking status of the household. The PEER was measured using a child Mini Wright peak expiratory flow meter while cognitive performance was assessed by four subtests of Weschler Intelligence Scale For Children (WISC III). Data analysis was done using SPSS version 11. Children were classified as exposed to secondhand smoke when at least one househoH member smoked. There were 442 (55 .6%) children exposed to secondhand smoke at home. The mean (SD) PEFR for unexposed and exposed children were 266.18 (60.80) l/min and 266 .06 (57. 70) l/min respectively, The mean (SD) scores for Digit Span Forward, Digit Span Backward Coding and Arithmetic in unexposed chiMren were 6.84 (1.80), 4.Z7(1.68), 45.25 (9,99) and 8.04 (1.04) respectively. The mean (SD) scores for exposed children were 6.73 (1 .77). 4.07 (l .65), 45.1 I (1 I ,03) and 8.13 (1 .00) respectively. Multivariate analysis of variance showed no signincant dijference in the PEFR (p=O.816) and the cognitive scores between exposed and unexposed primary school children in Kota Bharu, Kelantan
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.
Client satisfaction upon health services is important for public especially for those who have to undergo treatment for tuberculosis (TB) noted for its difficult regime. The purpose of this study is to measure client dissatisfaction level towards TB treatment & services among TB patients in government outpatient health services and the factors that influenced it. This study was carried out in all the districts of West Coast Division of Sabah. It was conducted from June 2002 to November 2002. Study design is cross-sectional, with population samples taken on those who are currently receiving outpatient TB treatment in government health facilities. Questionnaires forms were used as study tool and filled by either by respondent or through the help of trained interviewer. The outcome is based on the total score obtained through Likert scales to determine the proportion of dissatisfied group from the respondents. A total of 488 patients took part in this study. Results of study showed overall percentage of 31.8% dissatisfaction level towards TB
treatment & services, while dissatisfaction towards TB treatment and upon health services alone were 54.3% and 24.0% respectively. The predictive factors for client dissatisfaction towards TB treatment and services are those without education, longer waiting time and have opinion of insufficient number of health staff.
Key words: Tuberculosis, client satisfaction, TB treatment, services, Sabah.
Study site: Outpatient clinics, hospitals, Sabah, Malaysia
The Healthy City concept was taken by Malaysia in 1994 and Malacca State has initiated this project in late 1997 and launched in September 1998. The aim of the project is to had ways of achieving a better quality of urban life. The objective of this study was to assess the views and responses of Melaka Tengah community with regards to the existing facilities and services rendered in the district. The views will be incorporated into ideas for the policymakers and planners to develop Malacca into a healthy city. Three methods were used to collect the data. Questionnaires were given to the community of Melaka Tengah District. The respondents were selected by multistage sampling, Observation was carried out at selected public places to assess the community's practices and contribution, Ten focus group discussion were conducted consisting of health staff and public to discuss on environmental, social, physical and economic issues of Malacca. There were 3 sectors that had mean scores above 3.0 (the cut off level for being satisfed). They were health, housing and environment, ln terms of dissatisfaction, there were 4 sectors scoring below 3.0, These include domestic waste dnposal, road system, public transportation and recreational park. The community
expected the services to be improved especially in terms of cleanliness, They agreed to contribute in their own ways in developing the sectors discussed except for public transportation, wet market and food premises which were beyond their control. Observation showed that some of the community members exhibit bad behaviours that can contribute to an unhealthy city. The Melaka
Tengah community expected ejficient and quality services and they agreed to contribute in making Malacca into a Healthy City.
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.
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.
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.
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.
The objectives of this study were to determine the prevalence of HI V iryfection, risk factors and to measure the knowledge on AIDS among fishermen in Terengganu. In this survey fishermen registered with the Malaysian Fishery Development Board in Terengganu were studied. There were 600 eligible fishermen based on a list provided by the Malaysian Fishery Development Board (MFDB). Study sites were at 6 loading centres where health personnel awaited returning fishermen between 4. 00pm —7. 00 pm during a period of one month, A total of 542 registeredfshermen were studied and this corresponded to a response rate of 90.3 %. The majority of the fishermen were Malays (98.6%}, Nine fishermen were tested positive to HIV antibody and this corresponds to a
g prevalence of I. 7%. Prevalence of HIV is higher among those with a positive history of drug use, single marital status and also among the unskilled workers who represented the socio-economically poorer group of fishermen. Almost 89% of respondents have heard about HIV/AIDS and among these, 93% received information through TV and radio. The mean knowledge score was significantly higher among fishermen admitting to drug taking, sex with prostitutes, and those who have had at least a secondary school education. The Prevalence of HIV infection among fishermen is higher than in the general population. Risk characterisation of HI V injection was statistically signyicant onlv among fishermen who gave positive history of drug used. Findings also suggest that poorer fishermen based on multiple indicators to socioeconomic status had a higher risk of being HIV positive as well as being less knowledgeable about AIDS, Health promotion strategies should focus on the use of TV and radio as an interactive medium to reach out to risk groups among fishermen as its popularity has been determined by this study.
The Ministry of Health had instructed all state hospitals to go for Accreditation. Accreditation is considered to be a more appropriate tool forquality assurance in a hospital setting than ISO 9000.The objective of this research was to study doctors perception towards the implementation of Accreditation in state hospital. Self-administered questionnaires were sent through mail to doctors in eight clinical departments of all state hospitals. From 832 questionnaires sent, 297 responded (36%),i.e. 84 specialists and 2/2 medical officers. The study showed that 69% doctors knew that their hospital was implementing Accreditation. There were more clinical specialist (9I%) who were involved in accreditation as compared to Medical Ojicers (73%). 83% of doctors believed that accreditation can assist in assuring quality in their hospital. Those who do not, thought that quality can be assured stajfing was adequate (67%) and accreditation does not assess patient care
(33%). The study also showed that 7I% of doctors knew that their hospital was implementing MS ISO 9000. A 77% of doctors believed that ISO 9000 can assist in assuring quality in their hospital. Those who do not, thought that quality can onhi be assured Jstajfng was adequate (27%) and ISO 9000 was only meant for industry (8%). In conclusion, doctors believed that Accreditation and MS ISO 9000 can assist in assuring quality in their hospitals. Amongst, those who do not, majority thought that quality can only be assured staffing was adequate.