Prevalence of malaria and its risk factors in Sabah, Malaysia

Objectives The aim of this study was to determine the prevalence of malaria in Sabah and its potential risk factors. Methods This cross-sectional study analysed secondary data obtained from the health clinics in Sabah, Malaysia from January to August 2016. The Pearson Chi-square test was used to analyse the relationships between malaria infection and socio-demographic characteristics. Multivariable logistic regression was performed in order to determine the risk factors for malaria in Sabah. Results Out of 1222 patients, 410 (33.6%) had a laboratory-confirmed malaria infection. Infection by Plasmodium knowlesi accounted for the majority of malaria reports in Sabah (n=340, 82.9%). Multivariable analysis indicated that males (prevalence odds ratio 0.023, 95% confidence interval 0.012-0.047) and those living in a rural area (prevalence odds ratio 0.004, 95% confidence interval 0.002-0.009) were at higher risk 24.0–95.9) and those living in a rural area (adjusted odds ratio 212.6, 95% confidence interval 105.8–427.2) were at higher risk of acquiring a malaria infection. Conclusions Malaria infections in Sabah, Malaysia are common, with P. knowlesi being the most common malaria parasite. The infection was associated with several socio-demographic and geographical factors. Thus, mitigation measures should be considered to address modifiable risk factors for malaria infection

Exposure to Non-Ionizing Radiation and Childhood Cancer: A Meta-Analysis

Background: A slight increase in the childhood cancer trend has been observed for the past few decades. Non-ionizing radiation is one of the environmental factors linked to childhood cancers. This review is conducted to assess the association between non-ionizing radiation and childhood cancer based on all original studies to date. Methods: A systematic search was conducted on the titles and abstracts pertaining to non-ionizing radiation and childhood cancers using the PubMed, Scopus, SAGE and ScienceDirect databases from inception up to November 2018. Quality of each article was appraised using the Newcastle-Ottawa Scale, meta-analysis was performed with Review Manager, and fixed effects were used to estimate the pooled OR of the selected studies. Results: A total of 15 articles met all the selection criteria. Twelve articles were included in the meta-analysis. Pooled risk estimates of the 12 studies, obtained via fixed effects model, showed that children exposed to 0.2 µT or more of EMF non-ionizing radiation run 1.33 times higher risks of contracting childhood cancer compared to those with less than 0.2 µT exposure (95% CI: 1.10, 1.60). The studies were statistically homogeneous (chi-squared P=0.71, I2=0%), and there was no evidence of publication bias. Conclusion: It cannot be concluded that children exposed to non-ionizing radiation have higher risks of childhood cancer compared to those who were not exposed as claimed by the previous reviews. However, concerns about non-ionizing radiation exposure and childhood cancer should not be neglected

“Because of we are immigrants”: A focus group discussion on barriers related to maternal healthcare access among immigrant women in Kota Kinabalu, Sabah

Compromised access to maternal health facilities among immigrants contribute to the increased prevalence of maternal mortality and morbidity. By understanding barriers to healthcare access among this group can create culturally appropriate interventions for improved health outcomes to the mother and newborn baby. Despite this, the research on these areas is very limited. Focus group discussions can be used to identify key barriers among this group. This study addresses this gap by exploring the key factors on barriers related to maternal healthcare access among immigrant women in Kota Kinabalu, Sabah in order to inform future recommendations. A qualitative study was conducted in September 2021 in selected areas in Kota Kinabalu, Sabah. Focus group discussion was carried out for collecting data. Interviews were audio recorded, transcribed, and analysed according to the themes that emerged. A total of 10 immigrant women in the reproductive age group were included in this focus group discussion. This study found that respondents in this study often felt that pregnancy related problems were important to address. Three major themes emerged from the qualitative analysis. Important themes include 1) no legal documents, 2) economic and financial factors and 3) cultural beliefs. In addition, this study found that the population was more likely to access private care than public facilities. This study has identified immigrant women as a vulnerable population subgroup in terms of maternal health utilization. This study suggests that simple, culturally appropriate health programs should be provided to women and communities to generate awareness about maternal health

Respiratory disorders associated with dust exposure among construction workers at Bornean higher learning institution teaching hospital

Respiratory disorders can occur due to dust exposure at workplace. Dust exposure which consists of silica, asbestos and other type of mineral dust are very common. The high dust exposure can increase the workers risk of having respiratory disorders. The association between dust exposure and respiratory disorders among construction workers in Sabah are not well studied. This study aims to establish the association between respiratory disorders and dust exposure among construction workers of a Bornean higher learning institution teaching hospital. A cross-sectional study was done among the said construction workers. A standardised respiratory disorders questionnaire and spirometry machine were used. Dust exposure were measured using gravimetric method after sampled using personal air sampler. Age, smoking status, and marital status was significantly associated with respiratory symptoms. A higher prevalence of respiratory symptoms was higher among males (42.7%) compared to their female counterpart (21.4%). A higher prevalence of respiratory disorders among widow/widower/divorced workers (50.0%) compared to married (45.8%) and single workers (25.0%). A higher prevalence of respiratory symptoms among workers who smoke (51.2%) compared to workers who does not smoke (22.7%) also observed. Piping workers had the highest dust exposure and followed by the cement and plastering workers

Occupational Exposure to Dust and the Relationship with the Respiratory Symptoms, Lung Function among Construction Workers of the University of Malaysia Sabah

BACKGROUND: The respiratory tract often becomes the site of injury from occupational exposure. All construction sites generate high levels of dust, typically from concrete, silica, asbestos, cement, wood, and stone, sand, and therefore, the workers are exposed to this airborne dust and increased their risk of developing respiratory disorders. Limited studies have been conducted to assess the relationship between respiratory symptoms, lung function, and occupational dust exposure among construction workers in Sabah. AIM: The objectives of this study are to determine the occupational exposure to dust and the relationship with the respiratory symptoms as well as lung function among construction workers in UMS Teaching Hospital. MATERIALS AND METHODS: This cross-sectional study consisted of construction workers working in all sections in the development of UMS Teaching Hospital. A standard respiratory questionnaire was distributed to construction workers and lung function measurement was performed using Spirometry and the results of their respiratory status were compared between workers who were exposed and unexposed to dust. Occupational dust exposure was determined by the gravimetric method using an air sampler. The total duration of the collection was 8 h and the filters with the dust samples were analyzed in the laboratory. RESULTS: The result showed three parameters that were significantly associated with respiratory symptoms, namely, age, marital status, and smoking status. Male workers had a higher prevalence (42.7%) of having respiratory symptoms compared to female workers (21.4%). Widow/widower/divorced (50.0%) had a higher prevalence of having respiratory symptoms compared to married (45.8%) or single workers (25.0%). Workers who smoke had a higher prevalence (51.2%) of having respiratory symptoms compared to non-smoker’s workers (22.7%). CONCLUSION: The highest dust exposure is the piping workstation, followed by the cement and plastering workstations. These warrant the compulsory use of personal protective equipment by construction workers during work, improving the quality of dust masks, and standardizing their usage. Effective engineering controls should also be promoted on construction sites

Knowledge, attitude and practice on COVID-19 among students during the early phase of pandemic in a university in Borneo, Malaysia

Background: COVID-19 related knowledge, attitude and practice plays a major role in determining the readiness of the community to adopt the behavioural change towards recommended preventive measures outlined by public health officials. This study aims to assess the knowledge, attitude, and practice regarding COVID-19 among university students as well as its associated factors. Method: This is a cross sectional study that was conducted among students in a public university during the early phase of COVID-19 pandemic in Malaysia. An online validated self-administered questionnaire was used to collect the data. Mann-Whitney U and Kruskal Wallis test was used to determine the association between independent variables with knowledge, attitude, and practice score.Results: Overall response rate of this study was 92.9 (n=524). Median score of knowledge domain was 78.0 (IQR= ±12.0), median attitude score of 49.0 (IQR= ±5.0), and median practice score of 80.0 (IQR= ±11.0). The mean knowledge, attitude and practice score were significantly higher among diploma holder (vs degree holder, p<0.05), residing in main Kota Kinabalu campus (vs non-KK campus, p<0.001), studying in medical faculty (vs non-medical faculty, p<0.001), and attended COVID-19 education (vs non-attendance; p<0.05).Conclusion: COVID-19 related knowledge and attitude were below satisfactory level during earlier phase of the pandemic. However, majority of respondents have positive behaviour towards COVID-19 prevention. This highlights the importance of accurate and tailored health education to improve the level of knowledge, attitude and practice of recommended measures to prevent COVID-19 spread

“Best of Both World”: the amalgamation of fuzzy delphi method with nominal group technique for dengue risk prioritisation decision-making

Introduction. Dengue remains a public health threat. Clarifying the characteristics of future threats and prioritizing intervention towards the highest risk potential can help to control and prevent dengue outbreaks. However, obtaining a consensus from panels of experts is certainly challenging due to the relative subjectivity of experience. Therefore, this article incorporates the fuzzy Delphi method (FDM) within a nominal group technique (NGT) as a multicriteria decision-making tool for (1) describing the characteristics of socioecological attributes (SEAs) with a high risk of causing dengue outbreak and (2) ranking those SEAs as priorities for intervention. Material and Methods. Experts were recruited using a purposive sampling technique. Informed consent was obtained before the start of the study. The NGT process began with an introductory presentation of dengue SEA by the moderator, followed by “silent generation.” Next, each participant provided information in a round-robin fashion. Ideas were collected by the moderator and displayed publicly. All experts were given ample time and space to contribute and justify their ideas without interruption during the discussion step to yield agreeable SEA characteristics. Ultimately, FDM was incorporated in the voting step to ensure rigorous analysis. The study was approved by an ethical committee before its commencement. Results. A total of 10 field experts participated in the study, with a median experience of 7.5 years working on a dengue team. The common characteristics of SEA prone to cause dengue outbreaks were the presence of human-made containers, in high quantities, left unattended, and covered from direct sunlight. Apart from that, all eight SEAs passed the triangulation of fuzzy numbers and defuzzification processes. The average fuzzy numbers ranged between 0.500 and 0.780, and the threshold value () ranged from 0.055 to 0.196. Of the potential risk factors identified, experts ranked illegal dumping sites as the most important, followed by old and unused items and construction sites. Conclusion. The NGT process successfully helped to obtain a consensus among the expert panels in describing SEA characteristics. Nevertheless, the integration of FDM offered a robust analysis that validated their ranking in dengue risk prioritization. Therefore, we strongly recommend the application of FDM to be incorporated in any public health decision-making process

Impact of social distancing on covid-19 and other related infectious disease transmission: A systematic review

Similar to other coronaviruses, COVID-19 is transmitted mainly by droplets and is highly transmissible through close proximity or physical contact with an infected person. Countries across the globe have implemented public health control measures to prevent onward transmission and reduce burden on health care settings. Social or physical distancing was found to be one of appropriate measure based on previous experience with epidemic and pandemic contagious diseases. AIM: This study aims to review the latest evidence of the impact of social or physical distancing implemented during COVID-19 pandemic toward COVID-19 and other related infectious disease transmission. The study uses PRISMA review protocol and formulation of research question was based on PICO. The selected databases include Ovid MEDLINE and Scopus. Thorough identification, screening and eligibility process were done, revealed selected 8 articles. The articles then ranked in quality through Mixed Method Appraisal Tool. A total of eight papers included in this analysis. Five studies (USA, Canada, South Korea and the United Kingdom) showed physical distancing had resulted in a reduction in Covid-19 transmission. In comparison, three other studies (Australia, South Korea and Finland) showed a similar decline on other infectious diseases (Human Immunodeficiency Virus, other sexually transmitted infections, influenza, respiratory syncytial virus, and Vaccine-Preventive Disease. The degree of the distancing policy implemented differs between strict and lenient, with both result in effectiveness in reducing transmission of infectious disease. Physical or social distancing may come in the form of extreme or lenient measure in effectively containing contagious disease such as COVID-19, however the stricter the measure will give more proportionate impact toward the economy, education, mental health issues, morbidity and mortality of non-COVID-19 diseases. Since we need this measure to ensure the reduction of infectious diseases transmission to help flattening the curve which allow much needed time for healthcare system to prepare adequately to response, “Precision physical distancing” can be implemented which will have more benefit toward the survival of the community as a whole

Associations between sociodemographic and level of knowledge, attitudes and practices towards COVID-19 among nursing students of University Malaysia Sabah, Malaysia

Background: The novel coronavirus disease (COVID-19) emerged in Wuhan, China, in December 2019. Since then, it has spread to 215 countries, and 42 million people around the globe are affected. The knowledge, attitudes, and practices (KAP) toward COVID-19 play a role in determining the acceptance of behavioral change measures from health authorities to suppress this pandemic status. The KAP on COVID-19 is also important among university students during the COVID-19 pandemic to mitigate the outbreak of COVID-19. Hence, this study aimed to determine the level of knowledge, attitudes and practices towards COVID-19 and its association with sociodemographic factors among nursing students of Universiti Malaysia Sabah. Methods: A cross-sectional, questionnaire-based study was conducted among the Year 1, Year 2 and Year 3 nursing students. The questionnaire consists of four parts: 1) demographics, which surveys participants’ sociodemographic information; 2) knowledge about COVID-19; 3) attitude towards COVID-19; and 4) practices relevant to COVID-19. Statistical Package for Social Science (SPSS) version 26.0 was used for data entry and analysis. Result: A total of 113 Nursing Students participated in the study. More than half of the respondents have good general knowledge and practices of COVID-19. However, only one in three respondents have positive attitudes towards COVID-19. Older age was associated with good knowledge about COVID-19 (p=0.02). Female (P=0.02) and high household income (P=0.02) has a better attitude towards COVID-19. However, no significant association between sociodemographic and practices towards COVID-19. Conclusion: Most of the respondents demonstrate a good level of knowledge and practices towards COVID-19 but not for attitudes. Sociodemographic characteristics such as younger, male respondents and those with lower-income families have inadequate knowledge and practices towards COVID-19. Hence, health education programs such as campaigns need to be conducted to increase the knowledge and encourage adequate preventive practice towards COVID-19 should be targeted towards this group

A systematic review and meta-analysis of mobile phone messaging intervention on vaccine preventable diseases

The re-emerging of vaccine preventable diseases is a global public health burgeoning issue. The incompleteness of vaccination or low uptake rate is due to low awareness of the importance of vaccines, forgetfulness, poor counselling, and health education from the healthcare providers. Mobile phone messaging reminder was one of the most studied interventions to overcome these problems in the last decade due to increasing usage of mobile phones in daily living activities. Therefore the aim of this study was to analyse the effectiveness of mobile phone messaging intervention on vaccination programmes of preventable diseases worldwide. Methods. A systematic literature search of randomised controlled trials on Cochrane database that were published for the past 10 years was done; in which 10 articles were selected for critical appraisal and qualitative synthesis. Out of the 10 articles, 9 articles were selected and proceeded with meta-analysis based on GRADE risk of bias assessment. Results. The overall vaccination coverage of mobile phone messaging in the intervention group was higher than the control group [61,586 (47.7%) versus 61,571(45.7%)] with significant pooled vaccination prevalence difference (PD) of 0.02 (CI 0.01, 0.03). In the subgroup analysis, the pooled PD of childhood vaccination coverage was not significant although significant pooled PD of 0.03 (CI 0.01, 0.04) was detected in the influenza vaccination coverage. Conclusion. This review and meta-analysis have strengthened the evidence that mobile phone messaging is an effective intervention method to increase vaccination coverage, especially for influenza vaccination. However, its effect on childhood vaccination coverage was inconclusive and needed more high quality research