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

A review on illegals and the stateless in Sabah

Illegal immigrants refer to the migration of people into a country in ways that violates its immigration laws. A stateless person is a person who is not considered as a national by any state under the operation of its law. Interestingly, many who are stateless have never even crossed an international border. The term illegal is very loosely used in places like Sabah where it is interchanged with statelessness. As of 13 November 2018, it was estimated that there are about 12 million stateless people in the world. This review seeks to understand the current demographic situation in Sabah along with the public health repercussions of this demographic change and also to look into the success stories from around the world along with the recommendations from United Nation in solving this matter. Methods: The method used is reviewing of literature of previous studies conducted on statelessness and illegals. Local as well as international studies were reviewed. The data base used was ProQuest. Results: This review identified that one third of Sabah’s population consists of non-locals and in the past 27 years, about half a million illegal immigrants have been deported from Sabah. These numbers pose major public health repercussions from the economic, crime and health point of view. The way forward involves incorporating the United Nation Action plan with the local requirements and settings. Despite challenges, Sabah is trying its best to curb this issue and the Public health repercussions through various initiatives. We have also identified that more public health actions can be taken to reduce the negative effects. Conclusion: Dealing with the stateless and illegals is a delicate matter and there is no one way to solve it. Every country and every state are unique therefore the methods used must be tailor made. This is not something that can be solved within a short period of time and therefore persistence and perseverance is very much needed to tackle this global issue

Nutritional Burden in Tuberculosis and Inter-sectoral Nutritional Management for Tuberculosis Patients in Malaysia

Undernutrition and tuberculosis (TB) are a vital issue in most developing countries of the world. Both of these medical problems tend to have interacted with each other and bidirectional. The undernutrition creates a more significant problem in patients with active TB rather than among healthy individuals. Despite that, there is no protocol available on nutritional support in Malaysia to tackle on this issue. The objective of this review is to explore the nutrition burden of TB disease and the management available in Malaysia. The treatment for TB lasts for six months and above. Hence, it causes a financial burden not only for the healthcare provider but for the patient and the family members. If treatment is not successful and extends to a few months, it will increase the cost of the treatment. Malnutrition in TB patients will cause a problem in the outcome of TB treatment. It includes worsening of the disease, delayed sputum conversion, and increased risk of mortality. Other problems include malabsorption of Rifampicin, drug-induced hepatotoxicity, increased rate of relapse, and persistent of positive cultures in MDR-TB. Benefits of nutritional support for tuberculosis patients include improved body weight, increase in adherence/compliance to the tuberculosis treatment and increase in the success of the treatment. Implementation of nutritional support protocol by the government and Non-profit organization (NGO) will be beneficial and improve the quality of life of tuberculosis patients

Dengue outbreak management - Field experience in managing dengue involving an urban residential area in Kota Kinabalu, Sabah Malaysia

Introduction: Dengue fever is endemic in Malaysia. It is a major public health challenge that has caused significant morbidity and mortality. A dengue outbreak is contributed by entomological factors, epidemiological and environmental factors. Outbreak response is crucial to reduce cases and death. This study is a descriptive dengue outbreak report in an urban residential area in Kota Kinabalu, Sabah Malaysia. Methods: This is a report of a dengue outbreak that started in middle of November 2019 and ended early December 2019. A dengue outbreak in Malaysia is defined when more than one dengue cases is reported in the same locality within 14 days from the date of notification of the first case. Cases were analysed descriptively looking at epidemiology and vector control database. Results: This outbreak involved 6 cases. The source reduction activities by elimination of breeding sites were conducted 3 times covering an area of 200 meter radius. A total of 110 premises were checked with coverage of 86%. The number of containers inspected was 923, with 454 outside the premises and 469 inside the premises with no positive results for dengue larvae. Insecticide space spraying via thermal fogging was conducted with added ultra-low volume (ULV) spraying done within the 400 meter radius with coverage of 100%. Conclusion: Effective preventive measures have to be paired with responsible communities, as both play very vital roles in the control of dengue

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

Occupational Determinants of Leptospirosis among Urban Service Workers

This study was carried out to determine the risk factors of leptospirosis infection among local urban service workers in Sabah. This is a cross-sectional study involving 394 workers in Kota Kinabalu City, Sabah, conducted from February to March 2017. Information on demography, occupational exposures and environmental factors was obtained by a modified validated questionnaire. Polymerase Chain Reaction (PCR) was used to determine the prevalence of positive leptospirae. The overall figure for positive leptospirae was 9.4% (95% CI: 6.8–12.8). Urban sweepers and lorry drivers made up the highest proportion of positive leptospirae respondents, contributing 15.5% and 9.4%, respectively. The significant risk factors for positive leptospirae were older age (p-value = 0.001), higher monthly salary (p-value = 0.039), longer duration of employment (p-value = 0.011) and working as an urban sweeper (p-value = 0.021). Leptospirae was prevalent among healthy urban service workers and relates to their working activities

A review on climate change and Malaysia’s actions

One of the biggest global health threats of the 21st century is climate change It is so catastrophic that the climate action has been given a platform as it is the 13th goal of the 17 United Nations Sustainable developmental goals (SDG). This review seeks to understand the factors causing climate change, followed by understanding the impact it has on individual and population health. We also identify the strategies to control and prevent further climate change. Methods: Reviews of local and international articles from the past ten years was conducted. The focus of the review was the causes health effects as well as strategies. Data base used was Pro Quest. Results: This review identified that the main contributor to climate change are man-made activities such as fossil fuels combustion, livestock farming, and deforestation. This change in climate has many repercussions from mass migrations, increase communicable diseases as well as an increase in extreme weather events and natural disasters. All this eventually leads to the deterioration of individual and population health. Strengthening adaptivity to climate-related hazard, climate change integration into national policies, education, awareness-raising, impact reduction and early warning are actions that are present in Malaysia to manage this crisis. Conclusion: Climate change is occurring globally, and its presence can no longer be denied. Actions have been put forth, but only when its importance and impact is taken seriously will the positive changes be sustainable

Spatial analysis of food poisoning cases and its environmental relations in Sabah, Malaysia

Food poisoning usually occurs with the consumption of contaminated food. Some related factors are unsafe water supply, poor sanitation, unhygienic waste disposal and unhygienic practices or poor personal hygiene by food handlers. The purpose of this study is to describe the spatial epidemiology of food poisoning cases in the four districts of Sabah. Methods: This review consists of all food poisoning cases reported from 2011 to 2014 from Kota Kinabalu, Penampang, Putatan and Papar, Sabah. The coordinates used for locations of cases are based on home addresses. Tools such as SPSS v20, ArcGIS v10 and CrimeStat IV were used for data analysis and mapping. Results: A total of 1,787 cases of food poisoning were reported during this review period. In 2011, only Kota Kinabalu and Papar illustrated significant food poisoning clusters. Meanwhile, in the year 2012 to 2014, Kota Kinabalu, Penampang and Putatan had clustering of cases. Analysis of nearest neighbour hierarchical clustering analysis showed 32 food poisoning clusters. There were 4 food poisoning points at 500 meters radius around a market place, 2 food poisoning points near a sewage plant and 1 food poisoning point near a water treatment plant. No cases were near a municipal landfill. For rivers and coastline, there were 37 points of food poisoning cases in the proximity of 500 meters. Conclusion: Food poisoning usually occurs in clusters with possible associated environmental factors

Spatial clustering of Cholera in Sabah, Malaysia

Cholera epidemics can produce devastating public health outcomes. Cholera distribution is influenced by temperature, precipitation, elevation, distance to the coastline and oceanic environmental factors such as sea surface temperature, sea surface height and ocean chlorophyll concentration. The purpose of this study is to describe the spatial epidemiology of cholera in the four districts of Sabah. Methods: This is a retrospective review of 4 years (2011 to 2014) data from the districts of Kota Kinabalu, Penampang, Putatan and Papar, Sabah. All reported cases of cholera from those areas are included. Coordinates for locations of the cases are based on home addresses. SPSS v20, ArcGIS v10 and CrimeStat IV were used for data analysis and mapping. Results: Cholera showed several clustering of cases, such as in 2011 and 2014 in Kota Kinabalu. In the year 2011 and 2013, Penampang and Papar districts had the nearest neighbour index of less than 1, but p value was not significant, meaning the pattern did not appear to be significant. Nearest neighbour hierarchical clustering analysis further revealed cholera had 7 clusters, of those 6 were first order and 1 was a second order cluster. Conclusion: Cholera shows disease clustering which could mean it is due to its common point source or localised human to human transmission. Using GIS as a tool may help in surveillance and control of cholera infections

Public health informatics in global health surveillance: A review

Background: Surveillance is the backbone for effective public health practice. Traditionally, surveillance system relies on the collection of information regarding health-related events through healthcare facilities, disease notification system from the physician, syndromic notification networks, selected sentinel healthcare facilities, or by event-based data. However, there are several limitations in using conventional surveillance. Methods: With the advancement of technology and computer science, overcoming those limitations and complementing the traditional method has been recommended. Three leading emerging technologies are applied in public health surveillance: the internet of things, artificial intelligence, and blockchain. Results: Application of informatics in public health surveillance could raise several issues including accessibility and affordability of innovations; public health informatics’ experts, law, and regulation to protect patients’ information; social and ethical considerations, norms, and standards of implementing new technologies; data ownership; privacy and sharing of information; biosecurity; biosafety; and cybersecurity. Conclusion: This article aimed to review several applications of informatics system in public health surveillance practice and its several issues related to the use of technology. Several applications of informatics could be useful for incoming challenges in public health. However, application of informatics can pose significant issues and must be taken into consideration in public health practice