Incidence of adverse drug reactions in a paediatric ward of a Malaysian hospital: A prospective observational study

Purpose: To investigate the incidence, characteristics and risk factors of adverse drug reactions (ADRs) in hospitalized children in a Malaysian hospital.Methods: Patients admitted to the Paediatric Department of Hospital Ampang in Kuala Lumpur, Malaysia were monitored for occurrence of ADRs by spontaneous reporting or daily review of their case notes. Characteristics of ADRs were categorised and ADRs were analysed for causality, severity and preventability. Multivariate analyses were performed to determine associations between certain selected risk factors and ADR occurrence.Results: In 423 paediatric patients admitted in Hospital Ampang (436 admissions), the ADR incidence rate was 8.0 % (95 % CI, 5 - 11 %). The most commonly involved medications were systemic antibacterial drugs (77.4 %). About 61.3 % of the ADRs were of probable causality and 12.9 % were definitely preventable. No severe ADRs were detected, with 41.9 % being moderate and 58.1 % being mild, based on a severity scale. Younger children (OR = 3.387, 95 % CI, 1.377, 8.334) and the number of systemic antibacterial drugs given (OR = 1.469, 95 % CI 1.201, 1.798) were potential risk factors associated with ADRs.Conclusion: ADRs occur at a significant rate in the Malaysian children admitted to the hospital studied. Further studies are needed to provide drug safety data for the paediatric population in Malaysia.Keywords: Adverse drug reaction, Children, Paediatric, Drug safet

Comparison of access to medicines between Klang Valley and East Coast of peninsular Malaysia for children living in poor households

Purpose: To compare access to medicines in children living in poor households (income of USD1/person/day) between urbanised Klang Valley and rural East Coast of Peninsular Malaysia.Methods: A semi-structured interview was conducted with caregivers to determine demographics, access to medicines, knowledge, attitude and practice of parents in obtaining medicines for children.Results: There was no significant difference socio-demographically between poor households in Klang Valley (N = 58) and East Coast (N = 40). The study found that access to medicine for children (N = 325) in the households was adequate, where all households that reported illness in the children over the last 1 month and the last 6 month periods, obtained medicines and 99 % of the children were fully immunized. Qualitative analysis showed that poor households face several barriers in accessing medicines for their children such as financial, transportation, physical and attitudinal.Conclusion: Access to medicines for children living in poor households in both areas were similar and adequate. However, barriers to access remain and further studies are required.Keywords: Aaccess to medicine, Poor populations, Children, Klang Valley, Peninsular Malaysi

Health-related quality of life of adult with Type 2 diabetes mellitus in rural area

Introduction: Type 2 Diabetes Mellitus is one of chronic illnesses that affect patients’ quality of life. The aim of this study was to determine the HRQOL among Type 2 diabetes mellitus patients attending health clinics at Tampin district, Negeri Sembilan. Methodology: A cross-sectional study applying the Malay version SF-36 and structured validated questionnaires among Type 2 diabetes mellitus patients attending five health clinics at district of Tampin, Negeri Sembilan whose were selected using stratified sampling method. Data were analysed using SPSS version 21 of significant level α=0.05. Results: Response rate was 99.5% (430 patients participated).The mean age of the respondents was 57.5 (±8.88) years and the mean duration of having diabetes was 7 (±5.01) years. The mean score of all SF-36 health domains with exception of role emotional of respondents were significantly lower than that of the normal population scoring by Azman.(2003). Physical functioning (P<0.001), role physical (P<0.001), vitality (P<0.001), mental health (P<0.001), social functioning (P<0.001), bodily pain (P<0.001), and general health (P<0.001) were seven domains indicated lower than Malaysian norm. Conclusion: HRQOL of Type 2 Diabetes patients were lower than that of Malaysian general population in all SF-36 domains, with the exception of role emotional domain

Electronic hand hygiene quality and duration monitoring in pre-school children: a feasibility study

Background: Hand hygiene is regarded as the most important measure to prevent spread of infectious diseases. The aim of this study was to assess the feasibility of a prototype application in an electronic device in educating, stimulating and monitoring hand hygiene quality in young children. Method: A pre-school was provided with an interactive hand hygiene application for two months. The device features an online administrator dashboard for data collection and for monitoring the children's hand washing steps and duration. A good hand washing is defined as hand washing which comprise all of the steps outlined in the World Health Organization (WHO) guidelines. Results: The prototype managed to capture 6882 hand wash performed with an average of 20.85 seconds per hand wash. Washing hands palm to palm was the most frequent (79.9%) step performed, whereas scrubbing fingernails and wrists were the least (56%) steps performed. Conclusions: The device is a good prototype to educate, stimulate and monitor good hand hygiene practices. However, other measures should be undertaken to ensure sustainability of the practices

A cross-sectional study on the impact of the COVID-19 pandemic on psychological outcomes: Multiple indicators and multiple causes modeling

Although the psychological impact of coronavirus disease 2019 (COVID-19) has been evaluated in the literature, further research is needed, particularly on post-traumatic stress disorder (PTSD) and psychological outcomes, is needed. This study aims to investigate the effect of the COVID-19 pandemic on psychological outcomes (depression, anxiety, and insomnia). A cross-sectional study using an online survey was conducted using the following instruments: Impact of Event Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder (GAD-7), and Insomnia Severity Index (ISI). Confirmatory factor analysis (CFA), structural equation model (SEM), multiple indicators and multiple causes (MIMIC) modeling, and differential item functioning (DIF) were performed to analyze the collected data. According to the results, participants with PTSD (n = 360) showed a higher level of depression, anxiety, and insomnia than those without PTSD (n = 639). Among the participants, 36.5% experienced moderate to severe symptoms of depression, and 32.6% had mild depressive symptoms. Moreover, 23.7% of participants experienced moderate to severe anxiety symptoms, and 33.1% had mild anxiety symptoms. In addition, 51.5% of participants experienced symptoms of insomnia. In conclusion, the PTSD caused by COVID-19 is significantly associated with depression, anxiety, and insomnia at the level of latent constructs and observed variables.Scopu

Healthy hands: development and evaluation of a knowledge transfer program

Introduction: Children in pre-schools are at high risk of getting infections due to overcrowding, minimal awareness of basic hygiene and lack of immunity against microorganisms. Hand hygiene practice should be started at home where parents set good example, followed by formal education in pre-schools, primary and secondary school. This study aimed to develop a comprehensive program on hand hygiene practice in pre-schools. This paper presents the developmental aspects of the program material and the results of its evaluation process in a selected pre-school. Methods: Stage of development involved preparation of song, lyric, video clip, infographic and tablet application. The module was introduced during an intervention day called ‘Healthy Hands’ day. The acceptance of the module was evaluated before and after the intervention day. Evaluation was done by assessing pre-school children by face-to-face interview about knowledge on hand hygiene techniques and routine, such as before or after certain activities. Results: We managed to compose a song in three languages (Malay, English & Arabic), produced a video clip, an infographic and tablet application. A total of 227 children participated. Post intervention evaluation showed significant (p<0.001) increase of knowledge for eight out of eleven handwashing steps. The knowledge on hand hygiene routine i.e. after toilet, after playing outdoor, after sneezing and after playing with pet was also increased significantly. Conclusion: This comprehensive knowledge transfer program significantly improved the children’s hand hygiene techniques and routine and is recommended to be integrated into pre-school curriculum

Knowledge, Attitude and Practice of Hand Hygiene Among Parents: A Post COVID-19 Pandemic Survey

Hand hygiene is one of the effective measures to prevent infectious diseases such as hand, foot and mouth disease and COVID-19. Parents involvement as the child's first educator in establishing the child's sanitary behavior are crucial in nurturing good hand hygiene habit. This study aimed to assess parents' knowledge, attitudes, and practice on hand hygiene in relation to childcare during the endemic phase of COVID-19. This cross-sectional study involved parents of pre-school children from the Sepang district of Selangor, Malaysia. The parents were given a set of pre-tested, self-administered questionnaires about their knowledge, attitude, and practice of personal hand hygiene, hand hygiene practice while caring for children, and diseases caused by inadequate hand hygiene. A total of 179 parents, mostly (62%) were mothers with mean age of 37.55 (SD 21.2) involved in this study. The parents had good knowledge (99.4%), good attitude (92.7%) and good (100%) hand hygiene practice. Good attitude was significantly associated with good practice. Good knowledge, attitude, and practice on hand hygiene among parents might be due to repetitive information about the importance of hand hygiene during the COVID-19 pandemic. Efforts should be made to ensure teachers, children and parents are continuously being educated and reminded about hand hygiene not only during COVID-19.&nbsp

Board Game for School Health Education: The Development Process

Health education in schools is crucial in helping students to develop awareness, skills, and positive attitudes towards health. It assists students to improve and preserve their health, prevent illness, and avoid risky behaviors. It focuses on promoting learning skills that will help students understand the importance of their own health needs along with those of their families and communities. These abilities of learning skill ultimately provide the foundation for educating them how to advocate for their own well-being throughout their lives. The term "edutainment" describes the blending of education and entertainment. It could be in the form of media, games, toys, and experiences that mix fun and learning to motivate students.&nbsp; Among others, board game is considered suitable as a supportive tool for health education teaching in school. This paper discusses health education in schools and ideas of developing a game to improve health education delivery in schools

Understanding COVID-19 vaccine hesitancy in Malaysia: Public perception, knowledge, and acceptance.

BackgroundVaccine hesitancy has been around since the introduction of smallpox vaccine. Vaccine hesitancy has become more intense due to the rise of vaccine information in social media and mass adult vaccination during COVID-19 pandemic. This study investigated knowledge, perception, and reasons for rejection of the COVID-19 vaccine among Malaysian adults who refused to get free COVID-19 vaccination.MethodsAn online cross-sectional survey using an embedded mixed-method study [QUAN(quali)] was conducted among Malaysian adults. The quantitative section consisted of a 49-item questionnaire, whereas the qualitative sections consisted of two open-ended questions (1) "Please state your reason why you have not registered or have no intention to register at all for COVID-19 vaccines?" and (2) "Please tell us if you have any suggestions for improvement about COVID-19 vaccine delivery". Data from respondents who were not willing to get vaccination were extracted from the overall data and further analyzed in this paper.ResultSixty-one adults completed the online open-ended survey with a mean age of 34.28 years (SD = 10.30). Among factors that influenced them to get vaccinated was information on vaccine effectiveness (39.3%), death due to COVID-19 (37.7%), and recommendations from the Ministry of Health (36.1%). Most of the respondents (77.0%) were knowledgeable about vaccines, with half having high-perceived risks (52.5%) to COVID-19. While 55.7% and 52.5% had, high perceived barriers and benefits to COVID-19 vaccines respectively. The reasons for vaccine rejections included vaccine safety, indecisiveness, underlying medical conditions, herd immunity, non-transparent data, and use of traditional or complementary medicine.ConclusionThe study explored the multitude factors that drive perception, acceptance, and rejection. The qualitative approach with a small sample size provided more data point for interpretations and allowed participants to express themselves. This is important to develop strategies to create public awareness on vaccines not just for COVID-19 but any infectious diseases that can be curbed through vaccination

Intergration of Islamic input in medical curriculum - Universiti Sains Islam Malaysia (USIM) experience

Muslim doctors are those qualified doctors who practise their professional knowledge and skills in line with Islam and upholds the highest standards of ethical and professional behaviour. The medical curriculum of the Faculty of Medicine and Health Sciences of Universiti Sains Islam Malaysia (USIM) was designed with the integration of Islamic input which aims at producing doctors who are able to practise medicine that is integrated with Islamic, moral and ethical values. Halaqah Studies and Fundamental Islamic Knowledge (FIK) courses such as History of Medicine in Islam, Science and Medicine in Quran and Sunnah, Akhlak and Tasawuf, Islamic Jurisprudence and Medical Ethics and Fiqh Issues are taught to students during the pre-clinical and clinical phases. Memorization of selected Quranic verses throughout the programme aim to get the students to apply the verses of the al-Quran into practice in everyday life and especially in their clinical practice. Islamic values are emphasised during doctor-patient interactions in all clinical postings. Islamic knowledge and values integrated in the curriculum are assessed in written and clinical examinations. The outcome of the integration of the Naqli component in the medical curriculum has been demonstrated positively by the students in the patient management problems and clinical consultations. Studies on the outcome of the integrated Islamic input in the medical curriculum among the clinical students and graduates are being carried out