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

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

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

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

Integrating Digital Health for Healthcare Transformation Conceptual Model of Smart Healthcare for northern Borneo

Digital health has revolutionised the delivery of healthcare globally. However, integrating digital health in the system for transforming healthcare at a larger scale needs to be contextually relevant. Sabah, a state in northern Borneo, has distinctive public health concerns on thalassaemia, colorectal cancer, ischaemic heart disease, mental health, malaria, tuberculosis, and maternal and child health. Envisioning equal access to healthcare throughout the state, a conceptual model called smart healthcare is conceived for healthcare transformation through digital health integration based on the main clinical niche. The three domains of smart healthcare model is smart hospital, smart wellness and smart uber health. Smart hospital is aimed as the central core for materialising smart healthcare model as it serves as the platform to integrate digital health for diagnostic tools and treatment modalities. The purpose of smart wellness is to ensure uninterrupted healthcare and promotes preventive medicine at home and community setting through the ecosystem feeding by the smart hospital. This ecosystem is connected with smart uber health in order to bring the healthcare services to patients and succesfully overcoming the issue on inaccessibility. Each domain is highlighted with certain niche and related healthcare technology

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

The role of human behavior in Plasmodium knowlesi Malaria infection: a systematic review

Objectives: Plasmodium knowlesi is a non-human parasite that causes zoonotic disease in humans. This systematic review aims to highlight and summarize studies describing human behaviors and activities that expose humans to mosquito bites. Design: English entries in PubMed, Web of Science, and Science Direct from 2010 to 2020 were systematically perused, and the results were synthesized. Methodological quality was assessed using the Joanna Briggs Institute quality appraisal checklists. Setting: Studies that described malaria preventive measures were included. Laboratory, in vivo, in vitro, and animal studies were excluded. Primary and secondary outcome measures: The main outcome of the review was findings from studies describing the behavior that exposed a person or a group to P. knowlesi infection. Results: Twelve eligible studies were of good or medium quality. Attitude, disease misconceptions, perceived threat of disease, lack of motivation, and supernatural or traditional beliefs causing individuals to seek treatment from traditional healers influenced the exposure of individuals or communities to P. knowlesi malaria. Other factors were forestry activities (2.48, 1.45–4.23,95% CI, p = 0.0010) and sleeping outdoors (3.611, 1.48–8.85, 95% CI, p = 0.0049). Conclusions: Future studies must consider the importance of human behavior and community perspective on the infection to provide novel information to improve the current zoonotic malaria programs. Policymakers should concentrate on understanding human behavior and activities that expose individuals or communities to mosquito bites, in order to better design socially feasible interventions

Exploring the key anthropological drivers of and barriers to zoonotic malaria preventative behaviour in a community exposed to Plasmodium knowlesi infection in Malaysia: protocol for a qualitative study with a participatory research design

Introduction: Plasmodium knowlesi malaria is a zoonotic mosquito-borne disease with complex epidemiology. According to the WHO, the prevention and control of vector-borne diseases require community participation to increase coherence between malaria interventions and sustainable public health programmes. We describe a participatory research (PR) design for a study aimed at exploring the key anthropological drivers of and barriers to zoonotic malaria preventive behaviour among communities exposed to P. knowlesi infection in Malaysia. Participatory approaches can facilitate policymakers in designing future zoonotic malaria control programmes by investigating community perspectives and concerns about zoonotic malaria in a local context. Methods and analysis: The PR will be conducted over a period of 12 months, from March 2022 to March 2023, among adults (>18 years old) who are permanent residents in a rural village exposed to P. knowlesi malaria in Sabah, Malaysia. We will select patients who were diagnosed with P. knowlesi infection from January to December 2021 for focus group discussions (FGDs), as they can provide perspectives on the disease from the point of view of those previously diagnosed with infection. In-depth interviews (IDIs) with people of importance in the community, such as village heads, will also be conducted. Both FGDs and IDIs will be conducted from March 2022 until June 2022. Concurrently, a photovoice with adults over 18 years old who reside in the community will be conducted. The target sample sizes for FGDs, IDIs and photovoice are 6–8, 12 and 10–15 participants, respectively. We will use a study framework as a theoretical lens to guide the exploration of the beliefs, social contexts, barriers and drivers surrounding zoonotic malaria preventive behaviour. Ethics and dissemination: This study has been approved by the Medical Research and Ethics Committee Ministry of Health Malaysia (NMRR ID-21-01980-JEH) and the Research and Innovation Secretariat, Faculty of Medicine, Universiti Kebangsaan Malaysia (FF-2021-462). All participants will provide consent prior to participation. The results will be reported in international peer-reviewed journals and presented at conferences and on other platforms

Effects of ambient air pollutants on cardiovascular disease hospitalization admission

BACKGROUND AND OBJECTIVES: Air pollution is associated with population growth and economic advancement. Severe cardiovascular complications that require extensive medical service are aggravated by air pollutants. This study illustrates the trend and correlation of cardiovascular disease hospital admission with air pollutants in Sabah for the past 9 years (2010–2019). The additional information obtained from this study will be useful to enhance proper environmental management and reduce air pollution in the cities of Sabah. METHODS: Ecological study design was utilized with cardiovascular disease hospital admission and ambient air pollutants in Sabah retrospective data. Data were collected from four districts with established continuous air quality monitoring stations. Collected data were analysed spatially and statistically. Autoregressive integrated moving average modelling was implemented to forecast the cardiovascular disease hospital admission. FINDINGS: Kota Kinabalu recorded the highest hospital admissions for cardiovascular disease, followed by Sandakan, Tawau and Keningau. The cardiovascular disease hospital admission prevalence rate in Kota Kinabalu was 12.45 per 1,000 population, followed by Sandakan, Tawau and Keningau (4.54; 4.18; and 5.88 per 1,000 population) in 2019. The cardiovascular hospital admissions increased in Kota Kinabalu, Sandakan and Tawau. The nitrogen dioxide (<0.04 ppm), carbon monoxide (<9 ppm), ozone (<0.05 ppm) and PM10 (<100 µg/m3 ) gases detected are below the national standard limit levels. In the later years of the series, the ozone and fine particulate gases intensify. Carbon monoxide has the highest positive correlation with cardiovascular disease hospital admission compared to other air pollutants. The autoregressive integrated moving average (0,1,1) with carbon monoxide and ozone as external regressors is the model with minimum Akaike information criterion. CONCLUSION: The carbon monoxide concentration in ambient air illustrates a potential risk for the increasing cardiovascular disease hospital admission number in Sabah. The study findings provide evidence-based source for the healthcare management team, policymakers, and community to sustain clean and safe ambient air