Factors associated with asymptomatic COVID-19 patients in Petaling District, Selangor, Malaysia

The rapid spread of the Coronavirus disease 2019 (COVID-19) worldwide has led the World Health Organization to declare COVID-19 outbreak as a pandemic on March 11, 2020. As the local studies on factors leading to the absence or presence of clinical illness among the COVID-19 cases are sparse, the study aims to determine the factors associated with asymptomatic COVID-19 patients in Petaling District, Selangor, Malaysia. Data on COVID-19 patients were extracted from the database of confirmed cases in Petaling District Health Office, Selangor, Malaysia from 3rd February 2020 to 30th April 2020. An asymptomatic laboratory-confirmed case is a person infected with COVID-19 who does not develop any symptoms. The study included socio-demographic variables, the detailed information on clinical manifestations and co-morbidity of the patients. Descriptive and multiple logistic regression analyses were conducted to determine the factors associated with asymptomatic patients. The overall COVID-19 patients in Petaling District were 434. Approximately 70% (n= 292) of the patients were symptomatic while 32.7% (n= 142) were asymptomatic. Multivple logistic regression analyses revealed that factors significantly associated with asymptomatic patients were age below 40 years old (aOR: 1.79, 95% CI 1.11, 2.86), non-Malaysians (aOR: 3.22, 95% CI 1.44, 7.19) and local cases (aOR: 2.51, 95% CI 1.42, 4.42). Gender, ethnicity, co-morbidity and township were not significantly associated with asymptomatic patients. Approximately one-third of COVID-19 patients were asymptomatic and the risk factors identified were younger age, non-Malaysians and local cases. Rigorous epidemiological investigation is helpful in identifying COVID-19 cases among these group of people who are asymptomatic

Anti-diabetic drugs utilization pattern and its cost in managing Type 2 Diabetes patients in hospitals in Selangor, Malaysia

Introduction: Increasing prevalence of Type 2 Diabetes Mellitus (T2DM) worldwide has been reported in numerous studies. This issue has a significant effect on population quality of life as well as the economic burden in managing the disease. Policy makers have promoted the adoption of a Health Information System (HIS) to facilitate the coordination of medical care. Major hospitals in Selangor, Malaysia are using the HIS as their Electronic Medical Records (EMR). This study is the first attempt to extract data in HIS with the aim to turn data from the HIS into clinical information and to provide evidence for hospital management. Objective: The study aims to describe the antidiabetic drugs utilization pattern and its cost for T2DM in three hospitals equipped with a HIS. Methodology: This study was conducted in 2014 by using secondary data analysis of T2DM patients receiving diabetic medications in three public hospitals in Selangor, Malaysia that are utilizing the same software for their electronic HIS. Patients’ data from January to December 2013 were included in the analysis and were analyzed by using STATA v12. Outpatient, pharmacy, and laboratory dataset were cleaned and merged for data analysis. Results: The data shows prescription patterns for Hospital A are 28.5% monotherapy, 26.9% a combination of 2 oral drugs, and 22.3% a combination of insulin and oral drugs. The pattern is slightly similar to Hospital C where 29.6% of monotherapy, 24.4% of a combination of 2 oral drugs and 23.3% of a combination of insulin and oral drugs. Meanwhile for Hospital B, 30.1% of a combination of insulin and oral drugs, 29.4% of a combination of 2 oral drugs and 29% of monotherapy. The mean cost per patient in 2013 of antidiabetic agents (ADA) for Hospital A is RM 191.21 ± 269.64, Hospital B is RM 217.17 ± 385.49 and for Hospital C is RM 252.28 ± 384.35. Conclusion: Monotherapy, metformin predominantly has been prescribed as a first line treatment for T2DM. The prescribing trend was followed by using a combination therapy of oral hypoglycemic agents (OHA) an then, insulin and OHA. Therefore, this study showed that drugs at low cost have been prescribed commonly in all hospitals studied. Keywords: Utilization, Drugs, Diabetes, Malaysia, HIS, Hospita