Housing and indoor factor influencing spread of COVID-19 – a review

There has been growing recognition linking spread of COVID-19 with environmental factors. One of the environmental factors with robust epidemiological literature supporting its role in diseases is the housing or built environment. COVID-19 spread has been found to occur mostly at homes through secondary household transmission. As most people spend more times inside homes during the pandemic, household remains an important site of COVID-19 spread. The aim of this study is to examine how housing and indoor factors affect the transmission and spread of COVID-19. This review employed a comprehensive search strategy to gather a broad range of scholarly articles and grey literature to provide a comprehensive understanding of the housing-related aspects of COVID-19 transmission. Three electronic databases (Web of Science, Scopus, and PubMed) were searched using specific keywords related to COVID-19, housing, residents, neighborhoods, and indoor environments. Additionally, a supplementary literature survey was conducted to include relevant grey literature sources. This article summarizes the housing indoor factors involved in COVID-19 transmission, including the role of transmission from contaminated household surfaces. Indoor transmission of COVID-19 is found to be more likely due to contact transmission and close-contact aerosol transmission in a crowded, confined, and poorly ventilated indoor environment, related to poor housing condition. Whilst role of spread through contaminated household surfaces is of low probability. Based on this review, it can be suggested that besides the existing measures including avoiding crowding, close contacts and proper ventilation, specific standards for indoor environmental quality control and housing condition might be required. Housing is a public health issue and healthy housing is of universal concern

Regulatory and Policy-Making of E-Cigarettes Usage

Setting a suitable age limit of e-cigarette user should be established. This requirement considers the need for youth protection against e-cigarette misuse as such childproofing and age limits. Appropriate advertising without aiming for children to curb underage users. Advertisements could be done within sellers’ or distributors’ compound to keep vigilant control of appropriate or come of age users. Another reason for promoting e-cigarette use are to encourage smoking cessation and give information and incentives to smokers who are unable to stop to transition to less dangerous nicotine delivery methods. Addictive behaviors toward nicotine and complications from smoking e-cigarette should be warned and exposed to the public and users especially on newcomers as health warnings. Safety threshold of constituents should be complied and limit the strength of nicotine in the fluid could be done to reduce harm on users. An e-cigarette aerosol contains a variety of chemicals such as glycols, volatile organic compounds, and metals. The chemicals used have to be monitored for its safety threshold, where potential harm can be demoted. Harm causing effects of public vaping are considered for public vaping ban enforcement. While, many are opposed to the idea of vaping as medicinal treatment

Specialists’ Dual Practice within Public Hospital Setting : Evidence from Malaysia

In line with the commitment of the Malaysian government and Ministry of Health to prevent the brain drain of specialists from public hospitals, they have been permitted to perform dual practice within the public hospital setting (DPH) since 2007. DPH allowed them to hold jobs in both public and private practices within the same public hospitals that they are affiliated to, permitting these specialists to treat public and private patients. Nevertheless, the information regarding DPH in Southeast Asia region is still limited. This narrative review provides insight into the implementation of DPH in Malaysia. It highlights that DPH has been well-governed and regulated by the MOH while serving as a means to retain specialists in the public healthcare system by providing them with opportunities to obtain additional income. Such a policy has also reduced the financial burden of the government in subsidizing healthcare. However, as in other countries with similar policies, multiple challenges have arisen from the implementation of DPH in Malaysia despite its positive achievements and potentials. This paper concludes that proactive governance, monitoring, and regulation are key to ensure the success of DP

Specialists’ Dual Practice within Public Hospital Setting: Evidence from Malaysia

In line with the commitment of the Malaysian government and Ministry of Health to prevent the brain drain of specialists from public hospitals, they have been permitted to perform dual practice within the public hospital setting (DPH) since 2007. DPH allowed them to hold jobs in both public and private practices within the same public hospitals that they are affiliated to, permitting these specialists to treat public and private patients. Nevertheless, the information regarding DPH in Southeast Asia region is still limited. This narrative review provides insight into the implementation of DPH in Malaysia. It highlights that DPH has been well-governed and regulated by the MOH while serving as a means to retain specialists in the public healthcare system by providing them with opportunities to obtain additional income. Such a policy has also reduced the financial burden of the government in subsidizing healthcare. However, as in other countries with similar policies, multiple challenges have arisen from the implementation of DPH in Malaysia despite its positive achievements and potentials. This paper concludes that proactive governance, monitoring, and regulation are key to ensure the success of DPH

Full paying patient service in public hospital: An overview.

Globally, the expansion of private health sectors has caused movement of specialists from the public to private sector, causing a disproportionate manpower distribution between the public and private health sector. Retention of clinical specialists in the public sector has become a major problem in Malaysia. The pressure of increasing economic burden, scarce financial resources and increasing rate of medical specialist attrition to the private sector have led the Malaysian Government to introduce Full Paying Patient (FPP) Service as the Ministry of Health Malaysia (MOH) specialists’ retention scheme in 2007. These initiatives have raised the level of payments to public sector doctors. Literature review of MOH documents and secondary data analysis was carried out to provide an overview and better understanding of FPP services implementation practices in MOH hospitals. Findings show the progress in MOH FPP Services’ governance and service operation for achieving the service objectives and noticed an increase in the understanding of the complexities involved in implementing FPP service. As of the end of December 2020, there are 11 public hospitals implementing FPP Service. By December 2018, there were 360 registered FPP Specialists compared to 71 FPP Specialists in the year 2009. The 26,739 patients who opted for this service in 2018 contributed to more than RM22 Million revenue in 2018. Thus, the establishment and operation of FPP Service has brought a considerable number of specialist retention, contributing to the government revenue, indirectly reducing the government subsidy for patients who can afford to pay, and giving patients alternatives in health service options at public hospitals

Helicobacter pylori related dyspepsia: prevalence and treatment outcomes at University Kebangsaan Malaysia-Primary Care Centre

<p>Abstract</p> <p>Background</p> <p>Optimum management of dyspepsia in primary care is a debatable subject. Testing for Helicobacter pylori (HP) has been recommended in primary care as this strategy will cure most underlying peptic ulcer disease and prevent future gastro duodenal disease.</p> <p>Methods</p> <p>A total of 98 patients completed Modified Glasgow Dyspepsia Severity Score Questionnaire (MGDSSQ) at initial presentation before undergoing the ¹³Carbon Urea Breath Test (UBT) for HP. Those with positive UBT received Eradication Therapy with oral Omeprazole 20 mg twice daily, Clarithromycin 500 mg daily and Amoxycillin 500 mg twice daily for one week followed by Omeprazole to be completed for another 4 to 6 weeks. Those with negative UBT received empirical treatment with oral Omeprazole 20 mg twice daily for 4 to 6 weeks. Patients were assessed again using the MGDSSQ at the completion of treatment and one month after stopping treatment.</p> <p>Results</p> <p>The prevalence of dyspepsia at Universiti Kebangsaan Malaysia-Primary Care Centre was 1.12% (124/11037), out of which 23.5% (23/98) was due to HP. Post treatment assessment in both HP (95.7%, 22/23) and non HP-related dyspepsia (86.7%, 65/75) groups showed complete or almost complete resolution of dyspepsia. Only about 4.3% (1/23) in the HP related dyspepsia and 13.3% (10/75) in the non HP group required endoscopy.</p> <p>Conclusion</p> <p>The prevalence of dyspepsia due to HP in this primary care centre was 23.5%. Detection of HP related dyspepsia yielded good treatment outcomes (95.7%).</p

Psychometric evaluation of the Malay version of the Impact of Weight on Quality of Life-Lite (IWQOL-LITE) questionnaire

Introduction The availability of obesity specific quality of life measurement tool is limited. The Malay version of Impact of Weight on Quality of Life-Lite is an obesity specific quality of life questionnaire which has been translated for use in Malaysia. The aim of this study is to evaluate the validity and reliability of this questionnaire to measure quality of life among different body mass index (BMI) groups. Methods One hundred and twenty subjects with different BMI categories who attended an outpatient government clinic were recruited for this study. The translated Malay version of IWQOL-Lite was used to assess the impact of weight on quality of life of respondents. Content validity, criterion validity and construct validity were used to assess the questionnaire validity while internal consistencies and test-retest reliability were used to assess the questionnaire reliability. Results The Malay version of IWQOL-Lite showed good psychometric properties. The content validity was agreed upon by expert panels. The mean score of all IWQOL-Lite domains were able to discriminate between different BMI groups. Good internal consistency was demonstrated by Cronbach alpha of 0.936. Test-retest reliability ranged from 0.828 to 0.932. The physical function score (IWQOL-Lite) correlated positively with Physical Component Summary of Short Form-36 questionnaire. Exploratory factor analysis found that the questions loaded on their respective five domains. Conclusions The results suggested that the Malay version of IWQOL-Lite is a valid and reliable tool to measure quality of life among obese and overweight subjects in Malaysia

Full paying patient service in public hospital: What are the patients’ trend and the most visited discipline?

The Strategic Framework of the Medical Programme, Ministry of Health Malaysia (MOH) 2021-2025, has announced the expansion of Full Paying Patient (FPP) Service nationwide and this has been the priority for 12th Malaysia Plan for 2021-2025 as a specialist’s retainment scheme in the government sector. FPP Service in MOH public hospitals offer privileged quick access to clinical specialist care, private rooms, food, and other personalised care. Currently, there are 11 public hospitals implementing FPP Service. This review aims to show recent FPP patients’ trend and to identify the most visited department by FPP patients. Secondary data analysis and literature review was carried out to show recent FPP patients’ trend and to identify the most visited department by FPP patients. Review shows the number of FPP patients’ encounters has increased by an average of 54% per annum from 2008 to 2019, with 12% increase in new FPP patients from 2017 to 2019. There are more than 30 clinical services offered at 11 FPP hospitals. Obstetrics and gynaecology service topped as the service with highest patients’ encounter which accounts for more than 60% of patient’s visit compared to other services for the year 2017 to 2019. As a conclusion, Malaysian mixed public-private healthcare system has evolved to improve individual wellbeing by offering a greater choice of provider and care options, and faster access for elective treatments. FPP patients’ encouraging participation and number of visits indicate the clinical services with higher demand and potential for service expansion to other MOH hospitals

The use of casemix system to estimate providers` inpatients’ cost of influenza related sari diseases in Malaysia

Introduction; Influenza is an upper respiratory tract infection caused by the influenza virus. It occurs throughout the whole year in Malaysia with occasional outbreaks. Influenza-like illnesses (ILI) are generally treated as outpatient care while the more severe acute respiratory illness (SARI) is managed in patient care. The Casemix system, used in healthcare professionals' practices, may help in estimating the cost of influenza management. Methods; This cross-sectional study extracts the cost of influenza management from different public hospitals in years 2016, 2017 and 2018. Data used was selected based on ICD-10 codes, and the cost was abstracted from Malaysian Diagnostic Related Groups (MyDRG) software. The secondary data were from two sources, an urban teaching hospital Hospital Cancellor Tuanku Muhriz (HCTM) and Ministry of Health (MoH) inpatient hospitals database. The sample size of the study was 586, while a structured data sheet collating patients’ sociodemographic data and cost of admission, per case, was obtained from the MyDRG software. Microsoft Excel and SPSS software were used in the analysis. Results; Most influenza cases (61.8%) are between the ages of 0 and 10, Malays, and had similar gender proportions. Overall, the influenza treatment cost for inpatient care, was RM71,463,989.16 for 2017, RM78,809,565.60 for 2018 and RM143,743,557.48 for 2019. With the estimated 3.69%, 3.7% and 3.75% of GDP year 2016, 2017 and 2018 for health consumption, the three years trend of influenza consume 0.16% to 0.27% of 2017 and 2018’s GDP. The incremental cost was 40% in year 2018. Conclusions Influenza vaccination, health education and treatment compliance should be scaled-up to minimize the cost of influenza management of the public providers