A report on a visit to the School of Tropical Medicine and Global Health, Nagasaki University

Introduction: In August 2018, three Master of Public Health (MPH) students from the Faculty of Medicine and Health Sciences, University Malaysia Sabah visited the School of Tropical Medicine and Global Health (TMGH), Nagasaki University in Japan. Methods: They were joined by a faculty lecturer from the Community and Family Medicine Department. The objective of the ten-day educational trip was to attend the short course on Spatial Eco-Epidemiology Technologies at Public Health at Nagasaki University, School of TMGH. Results: The trip provided students with practical and theoretical experience of the latest technologies in the field of spatial eco-epidemiology. It also provided an opportunity to learn from the Japanese culture and gave them a well-rounded foundation upon which to build their knowledge for future careers in public health. Conclusion: This fantastic opportunity would not have been possible without the generous support and funding provided by UMS Student Mobility Programme

Prevalence of malnutrition and associated factors among children aged 6–24 months under poverty alleviation policy in Shanxi province, China: A cross-sectional study

Introduction: Child malnutrition continues to be a major public health issue, accounting for 54% of all child mortality globally. This study aimed to determine the prevalence of childhood malnutrition and its associated risk factors as well as to explore the best developmental strategy among infants and young children (IYC). Methodology: This cross-sectional study was conducted six months after the distribution of nutritious YingYangBao (YYB). It involved children aged 6–24 months in Shaanxi Province, China. Data were collected via interviews with parents of IYC, followed by measurements of the children’s height and weight. Data were analyzed using EpiInfo software and SPSSv.26, which encompassed descriptive statistics, Pearson Chi-square, and multivariate logistic regression analysis. Ethics approval and parents’ informed consent were attained prior to the study. Result: A total of 3431 data were analyzed in the study. The prevalence of stunting was highest among IYC between 12 and 18 months (3.9%). Prevalence of underweight (0.5%) and wasting (1.5%) were highest among IYC aged 18–24 months while the prevalence of overweight was highest among IYC aged 6–12months (9.0%). Significant associating risk factors of malnutrition were IYC from Northern Shaanxi (aOR = 2.24; 95% CI:1.68–2.98) and mothers with parity ≥3 (aOR = 1.52; 95%CI:1.10–2.10). IYC with a higher educated father (aOR = 0.79; 95%CI:0.66–0.95), YYB intervention (aOR = 0.77; 95%CI:0.65–0.90), correct supplementary food time (aOR = 0.84; 95%CI:0.71–1.00) and separate supplementary food preparation (aOR = 0.79; 95% CI:0.66–0.95) were significantly associated with lower risk of malnutrition. Conclusion: Even though the prevalence of stunting, underweight, and wasting were relatively low (<5%), there is still a need to strengthen existing policies on child nutrition

Mumps outbreak in university students: first detection of mumps virus genotype F in Borneo

Background: In October 2016, a mumps outbreak occurred among the students living in the on-campus dormitory of a public university located in Kota Kinabalu, Sabah, Malaysia. This study aimed to investigate the outbreak and identify the genotype of the mumps virus (MuV) strain that was involved in the outbreak. Main body: During the outbreak, one 21-year-old and four 20-year-old males staying in the same dormitory building were reported to have developed symptoms of mumps. Of these, two students were available during the investigation for sample collection to detect MuV by reverse transcription polymerase chain reaction (RT-PCR) of the 639- bp fragment encompassing the entire small hydrophobic (SH) gene. Nucleotide sequencing of the amplicon and phylogenetic analysis using the neighbor-joining method was performed to determine the MuV genotype. Of the two buccal swab samples, one was positive for MuV. The MuV strain in this sample belonged to genotype F and it was clustered together with genotype F strains from China with 96.84–99.68% nucleotide identity. Conclusions: Genotype F has limited circulation and is endemic in mainland China. Genotype F strains occasionally reported from other countries were epidemiologically linked to China. This study is the first to report a case of genotype F MuV in Malaysia and no epidemiological link could be established with mainland China. The results provide important information that can assist in strategic planning to improve the prevention and control of mumps infection in Malaysia

Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures

Violence at work refers to acts or threats of violence directed against employees, either inside or outside the workplace, from verbal abuse, bullying, harassment, and physical assaults to homicide. Even though workplace violence has become a worrying trend worldwide, the true magnitude of the problem is uncertain, owing to limited surveillance and lack of awareness of the issue. As a result, if workplace violence, particularly in healthcare settings, is not adequately addressed, it will become a global phenomenon, undermining the peace and stability among the active communities while also posing a risk to the population’s health and well-being. Hence, this review intends to identify the risk factors and the implications of workplace violence in healthcare settings and highlight the collaborative efforts needed in sustaining control and prevention measures against workplace violence

A training module to empower marginalised Northern Borneo islanders for tuberculosis control

Empowering marginalised urban islanders with limited heatlh accessibility for controlling pulmonary tuberculosis (PTB) requires a specific training module. Developing a training module for knowledge transfer to empower these marginalised islanders in high PTB occurrence region can be adapted based on IMCI framework. Structuring knowledge and skills for PTB control is based on the National Strategic Plan for Tuberculosis Control 2016-2020 and the Integrated Management of Childhood Illness (IMCI) framework is adapted for developing the training module. A total of five knowledge and skills were structured: 1) PTB disease and diagnosis, 2) PTB treatment, 3) preventive PTB measures, 4) prevention of malnutrion, and 5) psychosocial discrimination. The IMCI framework was adapted in 3 ways: 1) identifying signs and symptoms of PTB, 2) emphasising 5 steps: assess, diagnose, treat, counsel and detect, as the integrated management, and 3) counseling on BCG immunisation, malnutrition, environmental modifications and stigma on PTB

Recent Incidence of Human Malaria Caused by Plasmodium knowlesi in the Villages in Kudat Peninsula, Sabah, Malaysia: Mapping of The Infection Risk Using Remote Sensing Data

Plasmodium knowlesi (Pk) is a malaria parasite that naturally infects macaque monkeys in Southeast Asia. Pk malaria, the zoonosis transmitted from the infected monkeys to the humans by Anopheles mosquito vectors, is now a serious health problem in Malaysian Borneo. To createa strategic plan to control Pk malaria, it is important to estimate the occurrence of the disease correctly. The rise of Pk malaria has been explained as being due to ecological changes, especially deforestation. In this research, we analysed the time-series satellite images of MODIS (MODerate-resolution Imaging Spectroradiometer) of the Kudat Peninsula in Sabah and created the “Pk risk map” on which the Land-Use and Land-Cover (LULC) information was visualised. The case number of Pk malaria of a village appeared to have a correlation with the quantity of two specific LULC classes, the mosaic landscape of oil palm groves and the nearby land-use patches of dense forest, surrounding the village. Applying a Poisson multivariate regression with a generalized linear mixture model (GLMM), the occurrence of Pk malaria cases was estimated from the population and the quantified LULC distribution on the map. The obtained estimations explained the real case numbers well, when the contribution of another risk factor, possibly the occupation of the villagers, is considered. This implies that the occurrence of the Pk malaria cases of a village can be predictable from the population of the village and the LULC distribution shown around it on the map. The Pk risk map will help to assess the Pk malaria risk distributions quantitatively and to discover the hidden key factors behind the spread of this zoonosis

Changing new normal lifestyle in COVID-19 pandemic: Sabah, Malaysia

The COVID-19 pandemic threatens the world in the beginning of the 2020 [1,2]. The second wave of the Covid-19 infection in Malaysia during the 2nd week of March which was due to a mass religious gathering involving over 10,000 people from South East Asian countries in a confined area where a lot of close contacts took place, was the turning point for Malaysia when positive cases rocketed as a consequence of sporadic cases of transmission within local community all over Malaysia [3-5]. The need from that time was to break the chain of the virus and to further contain the spread of the virus especially among the vulnerable groups like the elderly people, individuals who have underlying chronic diseases, and also children population. On 10th April 2020, a further extension of the Movement Control Order (MCO) in the country was announced at that time. There were reminders from Ministry of Health endlessly to adapt to the new norms in the long run, for at least the coming 2 years in order to prevent the formation of new clusters

Analysis of Plasmodium knowlesi mitochondrial DNA aiming to identify molecular markers useful for epidemiological analysis of the zoonotic malaria in Sabah

Introduction: Although no indigenous human malaria cases have been recorded since 2018 in Malaysia, people in the country, especially those in the two states in Borneo, are still at the risk of zoonotic malaria caused by Plasmodium knowlesi. For better control of P. knowlesi malaria, epidemiological understanding of the disease is essential. Molecular markers in the mitochondrial DNA are expected to be useful, but characterisation of the parasite’s mitochondrial genome remains limited. Methods: From the total DNA extracted from P. knowlesi malaria blood samples collected in various districts in Sabah in 2020 and 2022, two overlapping DNA fragments covering a 2.3 kb region containing the parasite’s entire cox3 coding sequence were PCR amplified. Fragments of 12 different parasite strains were sequenced by direct Sanger sequencing and variations in the 2.3 kb region were identified by comparison with the reference sequence in the database. Results: Nine single nucleotide polymorphisms (SNPs)were identified in 10 strains investigated in this study. Seven of these SNPs were strain-specific, while remaining 2 were shared by 3 different strains each. In addition, one of the A clusters present in the reference sequence was extended in all the 12 strains investigated. Conclusion: The SNPs identified here will probably serve as useful molecular markers in epidemiological study of P. knowlesi in Sabah. The fact that 9 SNPs were identified in the 2.3 kb region of only 12 strains analysed proves that the mitochondrial DNA is a good source of molecular markers useful in P. knowlesi research

Factors associated with uncontrolled hypertension among hypertensive patients reported from different primary health clinics in Tuaran, Sabah, Malaysia: a cross sectional study

Objective: Hypertension is a major global issue and in an increasing trend. A disproportional balance between blood pressure controls among treated hypertensive patients is a challenge in public health as uncontrolled hypertension is the main contributor to cardiovascular, cerebrovascular and kidney diseases. Aims of the study are to determine the prevalence of uncontrolled hypertension and associated factors among hypertensive patients attending hypertension clinic at primary health clinics in Tuaran district. Justification of this study is uncontrolled hypertension causing high morbidity and mortality including premature death. Material and Methods: Study included 460 participants; is a cross-sectional study among hypertensive patient registered at three primary health clinics in Tuaran district, Sabah. Data were collected using structured modified questionnaires and analyzed using SPSS version 24.0. Results: Prevalence of uncontrolled hypertension was 45.9%. The study found that male gender (OR 2.1, 95% CI: 1.442, 3.061), high BMI status (OR 1.975, 95% CI: 1.305, 2.990), presence of diabetes mellitus (OR 3.436, 95% CI: 2.104, 5.613) and lower medication adherence (OR 1.834, 95% CI: 1.256, 2.678) were significantly associated with uncontrolled hypertension with p <0.05. Conclusion: The prevalence of uncontrolled hypertension in this study population was high with nearly half of the study population had uncontrolled hypertension. Combination of associated factors such as obesity, diabetes mellitus and lower hypertensive medication compliance had a higher impact on uncontrolled hypertension among the study group. This study further needed to address an attitudinal change, extra guidance, coaching and empowerment in the treatment of hypertensio