Prevalence Of cardiovascular risk factors among Sabah health offices employees in 2008

Introduction: Prevalence of cardiovascular risk factors is increasing among the general population, but little is known about employee's risk factor who works in the health office. The objective was to assess the prevalence of cardiovascular risk factors among health office employees and relationship to other contributing factors. Method: Cross sectional data were obtained from Feb-March 2008 as part of the non-communicable disease employee screening program. Universal sampling method was used. 341 employees were agreed to participate in Sabah state health offices. Data was collected through a questionnaire on risk factors, anthropometric and blood pressure measurement, random blood glucose and cholesterol analyses. Data was analyzed using SPSS version 15.0 and presented by descriptions, univariate and multivariate analyses for significant risk factors. Results: The response rate was 96.6%. The prevalence of raised blood pressure (17.9%,[95%Cl:14.1-22.5]), blood cholesterol (21. 7%, [95%CI: 17.5-26. 5]), blood glucose (10.0%, [95%Cl:7.1-13.8]), smoking (17. 3%, [95%CI: 13. 5- 21.8]), physical inactivity (29.6%,[95%Cl:24. 9-34.8]) and drink alcohol (9. 7%,[95%Cl:6. 9-13. 5]) were lower than general population studies in the National .Morbidity Survey Report Ill and Malaysian NCO surveillance of 2006. The prevalence of Overweight (BM

Tuberculosis Death Epidemiology and Its Associated Risk Factors in Sabah, Malaysia

Tuberculosis (TB) is a leading killer from a single infectious agent globally. In 2019, Malaysia’s TB incidence rate was 92 per 100,000 population, and the TB mortality rate was estimated at 4 cases per 100,000 population per year. However, the state of Sabah had a higher burden of TB with a notification rate of 128 per 100,000 population and a TB case fatality rate of 8% compared to the national figure. This study aims to provide a comprehensive report on TB deaths epidemiology and its associated factors at a sub-national level. This nested case-control study used Sabah State Health Department TB surveillance data from the Malaysia national case-based TB registry (MyTB) between 2014 and 2018. Cases were defined as all-cause TB deaths that occurred before anti-TB treatment completion from the time of TB diagnosis. Controls were randomly selected from TB patients who completed anti-TB treatment. The TB mortality rate had increased significantly from 9.0/100,000 population in 2014 to 11.4/100,000 population in 2018. The majority of TB deaths occurred in the first two months of treatment. TB-related deaths were primarily due to advanced disease or disseminated TB, whereas non-TB-related deaths were primarily due to existing comorbidities. Many important independent risk factors for TB deaths were identified which are useful to address the increasing TB mortality rate

Tuberculosis-HIV Co-infection: Factors Associated With Its Mortality in Malaysia

About ten million people were diagnosed with Tuberculosis (TB) in 2019. It has been one of the top ten causes of death worldwide with 1.4 million recorded cases, and 15% of them were people with Human Immunodeficiency Virus (HIV). This study aims to identify factors associated with mortality among patients with TB-HIV co-infection in Malaysia. Methods: A retrospective cohort study was conducted using secondary data from the TB Information System (TBIS) in Malaysia from 2015 to 2019. A Kaplan-Maier survival curve and a Cox regression analysis were applied. Results: The factors associated with mortality among TB-HIV co-infection patients regarding foreign nationality include no level of education, no directly observed therapy (DOT) supervision, passive case detection, far-advanced findings on chest radiography, no highly active antiretroviral therapy (HAART), and no co-trimoxazole preventive therapy (CPT) treatment. Conclusion: The above findings provide a better picture of the current situation of TB-HIV co-infection on a national level. Therefore, the Ministry of Health Malaysia should give more focus and priority to addressing the challenge of reducing the dual burden disease of TB and HIV in Malaysia

Factors Associated With Loss to Follow Up During Treatment of Latent Tuberculosis Infection in Children Under 5 Years of Age in Sabah, Malaysia

Loss to follow up remains one of the main problems in the treatment of latent tuberculosis infection (LTBI) in the state of Sabah, Malaysia. This study aims to identify the risk factors for loss to follow-up among LTBI treated TB contacts in children under 5 years of age, who did not complete 180 dosages of treatment within 6 to 9 months. Methods: This retrospective cohort study used anonymised data taken from the Malaysia national case-based TB registry (MyTB) between 2017 and 2019. To identify factors related with loss to follow-up, a logistic regression analysis was performed. Results: Of the 1334 treated LTBI cases, 10.4% were loss-to-follow-up. The mean age of study participants was 2.3 years, with 50.2% males. Factors associated with loss to follow-up include index-contact relationship i.e., Extended family (aOR = 1.82, 95% CI = 1.19, 2.77) and PTB index in whom the treatment outcome is loss to follow up (aOR = 4.84, 95% CI = 1.96, 11.95). Rural living was associated with less loss to follow (adjusted odds ratio (aOR) = 0.40, 95% confidence interval (CI) = 0.26, 0.61). Conclusion: Despite commendable efforts, the problem of loss to follow during LTBI treatment in children persisted. In spite of the inherent limitations of the study, the associated factors identified in this study can be used as a basis for future initiatives to strengthen LTBI management

COVID-19: Need of the hour to revisit asymptomatic prevalence of coronavirus pandemic

Since the Coronavirus disease 2019 (COVID-19) pandemic unfolded in China (Huang et al., 2020) back in December 2019, thus far, more than five million people were infected with the virus and 333,401 death were recorded worldwide (WHO, 2020b). The exponential increase in number shows that COVID-19 spreads faster compared to Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS). A study (Zou et al., 2020) has shown that high viral loads of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are detected in symptomatic patients soon after the onset of symptoms, wherein the load content is higher in their nose than in their throat. Furthermore, the same study has revealed similar viral loads between symptomatic and asymptomatic patients. Therefore, these findings may suggest the possibility of COVID-19 transmission earlier before the onset of symptoms itself. In the early stages of the pandemic, the control measures carried out have focused on screening of symptomatic person; at the time, the whole world thought that the spread of SARS-Cov-2 would only occur through symptomatic person-to-person transmission. In comparison, transmission in SARS would happen after the onset of illness, whereby the viral loads in the respiratory tract peaked around ten days after the development of symptoms by patients (Peiris et al., 2003). However, case detection for SARS (i.e. screening of symptomatic persons) will be grossly inadequate for the current COVID-19 pandemic, thus requiring different strategies to detect those infected with SARS-CoV-2 before they develop the symptoms

Exposure risk assessment of the municipal waste collection activities during COVID-19 pandemic

An increasing amount of waste concurrently further extends the risk of exposure to hazardous material among waste collectors. In light of the COVID-19 crisis, municipal waste collectors are one of the most at-risk groups of SARS-Cov-2 exposure. Risk assessment included hazard identification, evaluation of existing control level at the workplace, estimation of likelihood and severity of hazard, risk determination, and control measure recommendations. Five waste collection activities were identified and reviewed. High-risk exposure includes collection of garbage, mechanical manipulation of compactor lorries and unloading of garbage at the disposal site. There is poor practice of personal hygiene and unestablished continuous monitoring of personal protective equipment supplies. The preventive measures in the waste collection industry are influenced by several factors. Until the preventive measures are adopted into practice and adapted according to each company’s requirements, biological agents continue to be risk factor to the health workers

Electrical safety in a hospital setting: A narrative review

Electrical hazard is a significant threat in hospitals that require sustainable assessment and improvement. Workplace assessment and medical surveillance systems are often overlooked, and employees fail to comply with the necessary measures that have been instructed at the workplace. The incidents are attributed to a lack of knowledge regarding occupational safety and health and a lack of awareness regarding electrical hazards importance. The consequences of neglecting these assessments may result in health deterioration and low work quality and may also cause disability and impairment. This review describes occupational safety and health perspective about electrical hazards in hospital settings. Further preventive measures were recommended to outline practical and feasible steps resulting in a safer and healthier working environment

An Epidemiology of Reported Needlestick Injuries among Health Care Workers in Sabah Health Government Facilities from 1999 – 2008

Introduction: Health care workers (HCWs) are at a high risk of occupational exposure to blood and body fluids of patients, resulting in possible transmission of blood- borne pathogens such as hepatitis B virus, hepatitis C virus and human immunodeficiency virus. The information on epidemiology of needle stick injury among HCWs is useful in recommending safer work practices. Materials and Methods: All cases of NSI reported within the period 1999 to 2008 from public health care facilities to the Sabah State Health Department were identified and analyzed accordingly. NSI is defined as any injury caused by hollow- bore needles or suture needles regardless of whether they are contaminated by blood/ body fluids or not. Health care worker is defined as Ministry of Health staff, trainees and health facilities support service workers. The software used for data analysis was SPSS version 15.0. Results: A total of 378 cases of NSI were notified after considering NSI definition. Majority of HCWs involved in NSI were from the younger age group (20-29 years old, 61.9%), female gender (76.1%), Kadazan Dusun Murut ethnicity (33.5%), nurses (41.1%) and those who had worked for more than one year (66.6%). The place of occurrence was mostly in Kota Kinabalu district (25.3%), hospital setting (90.5%) and in- patient wards (60.8%). Of this in– patient ward, 64.5% was in medical and surgical wards. About 60% of NSI occurred during the morning shift (7am-2pm) and mostly among the nurses (54.0%). The duration of seeking treatment from injury was mostly within 24 hours (83.3%). The mechanism of accident happens while performing disposal activity (35.3%) and followed by any clinical procedure involving needle (31.1%). Other mechanism of accident was recapping (17.6%) and jolted/ accident (16.1%). Of all the reported NSI, 53.1% involved intravenous procedure. The body part involved in injury was mostly the right finger (57.1%). Almost all the needles were contaminated with blood or body fluid (90.0%). Post injury management, 73.5% were given first aid treatment and 99.4% were not awarded any medical leave. Existing control measures for NSI were standard operating procedure (SOP) (47.9%), training (36.9%) and PPE (10.5%). Conclusion: NSI commonly occurred among nurses, those in the younger age group and those working in medical/ surgical ward. Working during morning shift seems to predispose nurses to NSI. Since most NSI occurred during intravenous procedure and disposal activity, safer work practices should be emphasized to minimize these injuries. Further study in hospital and primary health care setting will determine the details of contributing factors of NSI

COVID-19: Need of the hour to revisit asymptomatic prevalence of coronavirus pandemic

Since the Coronavirus disease 2019 (COVID-19) pandemic unfolded in China (Huang et al., 2020) back in December 2019, thus far, more than five million people were infected with the virus and 333,401 death were recorded worldwide (WHO, 2020b). The exponential increase in number shows that COVID-19 spreads faster compared to Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS). A study (Zou et al., 2020) has shown that high viral loads of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are detected in symptomatic patients soon after the onset of symptoms, wherein the load content is higher in their nose than in their throat. Furthermore, the same study has revealed similar viral loads between symptomatic and asymptomatic patients. Therefore, these findings may suggest the possibility of COVID-19 transmission earlier before the onset of symptoms itself. In the early stages of the pandemic, the control measures carried out have focused on screening of symptomatic person; at the time, the whole world thought that the spread of SARS-Cov-2 would only occur through symptomatic person-to-person transmission. In comparison, transmission in SARS would happen after the onset of illness, whereby the viral loads in the respiratory tract peaked around ten days after the development of symptoms by patients (Peiris et al., 2003). However, case detection for SARS (i.e. screening of symptomatic persons) will be grossly inadequate for the current COVID-19 pandemic, thus requiring different strategies to detect those infected with SARS-CoV-2 before they develop the symptoms

Ethnicity and Dietary Practices as Colorectal Cancer Risk Predictors: A Retrospective Case-control Study in Sabah, Malaysia

Introduction: The association between colorectal cancer (CRC), ethnicity, and dietary practices have been well studied. However, limited studies have been conducted to assess dietary practices and ethnicity in Sabah on risk of CRC. This study aimed to assess the risk and protective factors in dietary practices and the inclusion of ethnicity and dietary practices as risk predictors for CRC. Methods: 148 CRC patients, 609 controls were recruited in this case-control study. Logistic regression analyses were performed to determine significant predictors of CRC. Prediction model was computed using Logistic Regression (LR) and C5 Decision Tree algorithms and compared. Results: Age 60-69 (aOR = 7.44, 95% CI = 3.69-15.00); male (aOR = 4.49, 95% CI = 2.67-7.54), Chinese (aOR = 32.32, 95% CI = 7.20-145.13); moderate physical activity (aOR = 3.67, 95% CI = 2.03-6.63), pickled mango (aOR = 5.66, 95% CI = 1.62-19.81), pork (aOR = 2.29, 95% CI = 1.09-4.79) increased the odds of developing CRC. No comorbidities (aOR = 0.53, 95% CI = 0.31-0.91), tertiary education attainment (aOR = 0.18, 95% CI = 0.07-0.43) were protective against CRC. Hosmer-Lemeshow test indicated good fit of the model (p =.946) and excellent discriminatory power (AUC=0.877). LR prediction model demonstrated better overall accuracy (89.2%), discriminatory power (AUC=0.82), sensitivity (77%), and specificity (91%) than the C5 Model. Conclusion: Frequent consumption of pickled mangoes and pork increased CRC risk among the Sabah population. Inclusion of ethnicity and dietary practices as predictors could potentially improve risk stratification of the Sabah population for early CRC screenin