Antigen expression pattern of acute promyelocytic leukaemia cases in Malaysia

Introduction: Acute Promyelocytic Leukaemia (APL) is associated with devastating coagulopathy and life threatening condition which requires immediate medical attention. It is crucial to establish an expedited diagnosis as early therapeutic intervention has led to optimal patient management. In this study, we assessed the type and frequency of antigen expressions in APL and correlated these findings with genetic studies. Methods: Multiparametric immunophenotyping was performed on 30 samples and findings were correlated with karyotypes, FISH for t(15;17) translocation and RT-PCR for PML-RARα for detection of breakpoint cluster regions (bcr1,bcr2 and bcr3). Results: On SSC/CD45, APL cells displayed high to moderate SSC, with the expression of CD33 (100%), CD13 (96.8%), cMPO (71%) but lacked CD34 (3.2%) and HLA-DR (9.7%). Aberrant expression of CD4 was seen in 12.9% and CD56 in 6.5% of the cases. A significant association between cumulative aberrant antigen expression and bcr1 were observed bcr1 (X2(2) =6.833,p.05) and (X2(2)=4.599,p>.05) respectively. Conclusions: Flow cytometry is a rapid and effective tool in detecting APL. It is interesting to note that there is significant association between cumulative aberrant antigen expression and genotype analysis. Further validation is required to corroborate this relationship

Timing and prognostic factors of tuberculosis treatment interruption

The global Tuberculosis epidemic (TB) poses a significant public health threat. While the consequences of TB treatment interruption are indisputable, the knowledge about the timing and prognostic factors of TB treatment interruption is fundamental. Despite a considerable amount of evaluation, the timing and prognostic factors of TB treatment interruption have been inconsistently identified from one study to another. Therefore, this study aimed to examine the evidence obtained from published literature on the timing and prognostic factors of TB treatment interruption at different points of the treatment course. In this review, three databases namely Pubmed, Scopus, and Science Direct were used to identify articles published from January 2003 to February 2018. This was based on the inclusion criteria and keywords including ‘default’, ‘survival time’, ‘tuberculosis’, and ‘treatment interruption’. The nine selected studies were prospective and retrospective cohort studies conducted in developing countries. The diversity of the study’s participants and TB treatment interruption definition were allowed, thus delineating a heterogeneous finding. This review suggests that the interruption predominantly occurred during the maintenance phase of treatment course. Despite the finding, a considerable gap in understanding the prognostic factors at different time points of TB treatment interruption was elicited. The heterogeneity across the studies may limit the inferences and warrant further evaluation. In essence, the time-related information should be integrated into framing impactful public health strategy, while a vigorous attempt on the evaluation of the cognitive, behavioural and psychosocial aspects may be beneficial

Association between self-esteem and smoking among religous school students in Petaling District, Selangor

Introduction: According to the Youth Behaviour Risk Factor Surveillance (YBRFSS, 2011) in Malaysia, the prevalence of smokers nationally among Form 1, 2 and 4 students government secondary school students was 9.1% (ever smokers) and 8.7% (current smokers). However, there is limited information on the prevalence of smoking among religious secondary school students and self-esteem as risk factor. Thus, this study was conducted to determine the prevalence and factors associated with smoking among the religious secondary school students in Petaling district, Selangor. Methods: A cross-sectional study was conducted among 899 students. The schools were selected using cluster sampling and self-administered questionnaire was used. Data was analyzed using chi-square test and multivariate logistic regression to identify the independent factors for smoking. Results: The response rate was 94%. The prevalence of ever smoking was 10.1%; 3.9% among female and 18.6% among male. The median age (interquartile range) of smoking initiation was 12.00 (4.01) years. The results showed that independent factors for smoking were: males (OR= 5.47); age group 14-15years (OR=2.82) and 16-17 years (OR=3.63) and having low self -esteem (OR=6.24). Conclusion: prevalence of ever smokers is higher when compared to YBRFSS, (2011) and it was revealed that most of the smokers started smoking even before secondary school. The results also revealed the importance of promoting self-esteem. Efforts in smoking prevention should therefore be focused on curbing the initiation of the acts and improving students’ self-worth

Predictors of midwives’ intention to provide planned home birth services to low-risk women: a theory of planned behaviour approach

Objective: Planned home birth may increase women’s access to skilled midwives in all settings. Using theory to understand and predict midwives’ intention regarding planned home birth services is rare. Therefore, using the theory of planned behaviour, we determined the factors associated with midwives’ intention to provide planned home birth services to low-risk women. Design: This cross-sectional study adopted a quantitative approach and a survey. Stratified random sam- pling was used to recruit 226 midwives in Sokoto, Nigeria. Data—including descriptive statistic and mul- tiple linear regression analyses—were analysed using SPSS 23 and significant was set at 0.05. Setting: Ten public health facilities in Sokoto, northwestern Nigeria. Participants: Among all 460 midwives (women aged 20–60 years), working in the maternity wards of health facilities in Sokoto, a sample of 226 midwives was calculated using a power of 0.80 and a 95% confidence interval. Findings: The multiple linear regression analyses confirmed that the major factors associated with mid- wives’ intention to provide planned home birth services were midwives’ attitude towards planned home birth (p < .001) and midwives’ previous experience with planned home birth practice (p = .008). Conclusions and implications: The theory of planned behaviour is a useful framework for identifying fac- tors that affect midwives’ intention to provide planned home birth services. While future research may employ a qualitative approach to explore other factors, planned home birth education campaigns should target information that enhances positive attitude and encourages midwives to provide planned home birth services

Identifying self-care behaviour and its predictors among type 2 diabetes mellitus patients at a district of Northern Peninsular Malaysia

Introduction: The prevalence of diabetes mellitus among Malaysian aged ≥ 18 years increased from 11.6% (2006) to 17.5% (2015). Positive self–care behaviour leads to good glycaemic control. The objective of this study is to determine the self-care behaviour, its associated factors and predictors among type 2 diabetes mellitus (T2DM) patients in government health clinics at a district of Northern Peninsular Malaysia. Methodology: A cross-sectional study was conducted on 546 T2DM patients aged ≥ 18 years, recruited by simple random sampling method. A validated self-administered questionnaire including socio-demographic characteristics, diabetes profile, knowledge, Health Belief Model (HBM) and Summary of Diabetes Self-care Activity Scale (SDSCA) was used. Data were analysed using SPSS version 22.0. Self-care behaviour is the dependent variable. Results: The respondents practised 3.4 (SD = 1.11) days self-care behaviour past 1 week. The predictors of self-care behaviour were self-efficacy (standardized β= 0.257, p< 0.001), knowledge (standardized β= 0.112, p= .007), female (standardized β= 0.107, p= 0.010), combination oral hypoglycaemic agents (OHA) and insulin (standardized β= -0.182, p= 0.002), and monthly income < RM1,000 (standardized β= -0.129, p= 0.002). The entire group of variables significantly predicted self-care behaviour [F (6, 539) = 15.79, p< 0.001, adjusted R2 = 0.140] with total variance of 14.9%. Self-efficacy was the strongest predictor in self-care behaviour. Conclusion: The findings enable us to identify the specific groups with predicted lower self-care behaviour which are useful in future planning and implementation of intervention

Do psychological factors and sedentary activities influence physical activity level? Findings from Malaysian adolescents

Regular physical activity provides important health benefits. However, adolescents reduced their physical activity level as they grown up and eventually may develop chronic diseases. Psychological factors and sedentary activities influence physical activity level. A cross-sectional study using a clustered random sampling method was conducted to identify the association between sedentary activities and psychological factors on physical activity level among 1158 Malaysian adolescents (aged 16–17 years) in Selangor. Participants completed a self-administered questionnaire. The prevalence of physical activity level was 47.40%, 39.40% and 13.20% for high, moderate and low levels, respectively. The psychological factors of self-esteem (χ2 = 17.927, df = 2, p < 0.001) and physical activity self-efficacy (F (2, 1155) = 43.570, p < 0.001) were significantly related to physical activity level but not for sedentary activities. The predictor variables for physical activity are suggesting that physical activity self-efficacy may take into consideration for future health programme implementation

Prevalence and Associated Factors of Current Depressive Symptoms among Staff of a Public University in Malaysia

Introduction: Depression is an important global public health problem and one of the most common and serious mental disorders. It initiates with the presentation of symptoms before it progresses to a lifetime disorder. The aim of the study was to determine the prevalence of and factors associated with current depressive symptoms among university staff of a public university in Malaysia. Methodology: A cross-sectional study design was employed using a probability proportionate to size sampling method to select 683 academic and non-academic staff. A structured validated questionnaire was used for data collection. Results: The prevalence of current depressive symptoms was 14.9% (19.0% among males, 12.5% among females). Gender, age, marital status, monthly family income and self-esteem were significantly associated with current depressive symptoms (p<0.05). The logistic regression model showed that male gender (AOR = 2.04; 95%CI 1.29, 3.20) and younger age (AOR = 2.79; 95%CI 1.16, 6.76) were predictors of current depressive symptoms. Conclusion: The prevalence of current depressive symptoms was 14.9% (19.0% among males, 12.5% among females) among university staff. A mental health promotion intervention is needed to prevent the threat depression poses on the health of the university staff

Determinants of default from tuberculosis treatment among tuberculosis patients at a hospital chest clinic in Gezira state, Sudan

Background: Default from tuberculosis (TB) treatment is a major health problem among tuberculosis patient. High rates of default are still reported all over the world, especially in Africa despite availability of effective TB treatment. This study aims to determine the determinants of default from TB treatment among tuberculosis patients at a hospital chest clinic in Gezira State, Sudan. Materials and Methods: This is a retrospective cohort study design involving newly diagnosed tuberculosis patients from 1st January 2014 to 30th June 2015. Data was collected from patients’ case file using pro-forma. Default from TB treatments refers to patient who had stopped taking anti-TB medication for a period of 2 consecutive months or more after being on anti-TB treatment. Data analysis used IBM SPSS version 22.0. Chi square test was performed to determine the association between default from TB treatment and socio-demographic factors, type of diagnosis, anatomical site of TB, TB treatment duration, follow-up sputum smear microscopy result, HIV/AIDS co-morbidity and type of referral. Binary logistic regression was conducted to identify the determinants of default from TB treatment. Result: The default rate was 15.0 % among TB patients. The determinants of default from TB treatment were age of the patients, TB site and TB treatment duration. Conclusion: The study revealed that the rate of default from TB treatment is high. Age of the TB patient, TB site and duration of treatment were determinants of default reflecting that reassurance of TB patients, health education in addition to shorter treatment regimens are important factors in preventing default from TB treatment

Prevalence of smoking and its associated factors among university staff

Globally, one person dies every six seconds as a result of tobacco use. This makes tobacco use the cause of every one out of 10 deaths in adults and the single largest and leading cause of preventable death in the world. The objective of this study was to determine the prevalence of smoking among staff of Universiti Putra Malaysia. For the purpose of this study an analytical cross sectional study design was used and a standardized, pre-tested, while a validated well-structured questionnaire was used for data collection. The prevalence of smoking was found to be 10.0% (26.5% among males and 0.5% among females). In addition, significant associations were found between smoking and gender, religion, marital status, highest educational level, occupation, and family income (p < 0.05). In particular, gender and educational level were significant predictors of smoking. In conclusion, the prevalence of smoking among university staff was shown to be considerably lower than that stated for the national level. However, the University could aim at achieving zero prevalence in the years to come

A case control study on factors associated with leptospirosis infection among residents in flood-prone area, Kuantan: a geographical information system-based approach

Background: Leptospirosis, nicknamed "The Great Mimicker", is a zoonotic disease of public health importance, particularly in temperate climate such as Malaysia where seasonal floods occur. This study aims to determine factors associated with leptospirosis transmission such as sociodemographic characteristics, knowledge, attitude and environmental risk factors such as temperature, rainfall, humidity, flood-risk area, distance from waste accumulation sites, land elevation and soil type, as well as predictors of leptospirosis transmission among residents in Kuantan, Pahang by using a Geographical Information System (GIS)-based approach. Materials and Methods: A population-based case-control study will be implemented in Kuantan, Pahang which utilizes 260 samples, where 130 confirmed cases of leptospirosis and 130 controls who will be randomly selected from neighbours living within 500 metre radius of the cases. A validated interviewer-guided questionnaire will be used to assess respondent's sociodemographic characteristics, leptospirosis status, knowledge, attitude and practice towards leptospirosis. Secondary data will be obtained from the respective departments. Data Analysis: Descriptive and inferential statistics will be used for data analysis. Knowledge, attitude, practice, and environmental risk factors such temperature, rainfall, humidity mean values, flood risk areas, distance from waste accumulation sites, soil type and land elevation will be mapped by using GIS. Finally, the predictors of leptospirosis will be determined by logistic regression. Expected Outcome: Due to the transmissibility of leptospirosis increases as the result of flooding, it is expected that the cumulative incidence of cases will come from the flood-prone areas in Kuantan. The majority of the cases could come from areas that have high risk of exposure to environmental factors such as high rainfall density, moderate temperature, high humidity, living in flood-risk areas, low land elevation, nearer to the waste accumulation sites, and moist soil type. It is also expected that even though the community might have heard of leptospirosis, the level of KAP might be low due to the increasing national incidence of the infection