1
|
Mohd Fadzil M, Wan Puteh SE, Aizuddin AN, Ahmed Z, Muhamad NA, Harith AA. Cost volume profit analysis for full paying patient services in Malaysia: A study protocol. PLoS One 2023; 18:e0294623. [PMID: 37988370 PMCID: PMC10662725 DOI: 10.1371/journal.pone.0294623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/31/2023] [Indexed: 11/23/2023] Open
Abstract
Dual practice within public hospitals, characterised by the concurrent provision of public and private healthcare services within public hospitals, has become a widespread phenomenon. With the participation of selected public hospitals, dual practice within public hospitals, also known as Full Paying Patient services, was an initiative the Ministry of Health Malaysia took in 2007 to retain senior specialist physicians in Malaysia. The revenue generated from the Full Paying Patient services aims to provide an avenue for public sector specialists to supplement their incomes while alleviating the Government's burden of subsidising healthcare for financially capable individuals. However, the effectiveness of Full Paying Patient services in recouping service delivery costs and yielding a profit is still uncertain after 16 years of implementation. This study is designed to evaluate the impact of Full Paying Patient inpatient services volume, revenue, and cost on profit versus loss at selected hospitals from 2017 to 2020. From the perspective of healthcare providers, we plan to perform a cost volume profit analysis. This analysis enables us to determine the break-even point, at which total revenues match total costs, along with no-loss and no-profit thresholds for Full Paying Patient services. This study has the potential to provide insights into how variations in service volume, cost, and pricing impact healthcare providers' profitability. It also offers critical financial information regarding the volume of services required to reach the break-even point. A comprehensive understanding of service volume, cost and pricing is imperative for making informed decisions to fulfil the objectives and ensure the sustainability of the FPP services.
Collapse
Affiliation(s)
- Malindawati Mohd Fadzil
- Department of Community Medicine, University Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Sharifa Ezat Wan Puteh
- Department of Community Medicine, University Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Community Medicine, University Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Zafar Ahmed
- Department of Community Medicine and Public Health, Faculty of Medicine, University Malaysia Sarawak, Sarawak, Malaysia
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Nor Asiah Muhamad
- Evidence Based Healthcare Medicine Sector, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Abdul Aziz Harith
- Occupational Health Research Centre, Institute for Public Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| |
Collapse
|
2
|
Mahmud MAF, Abdul Mutalip MH, Lodz NA, Muhammad EN, Yoep N, Hasim MH, Abdul Rahim FA, Aik J, Rajarethinam J, Muhamad NA. The application of environmental management methods in combating dengue: a systematic review. Int J Environ Health Res 2023; 33:1148-1167. [PMID: 35642722 DOI: 10.1080/09603123.2022.2076815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/07/2022] [Indexed: 06/15/2023]
Abstract
Among several vector control methods commonly used, environmental management is one of the control measures to mitigate dengue in such vulnerable communities. Since there is no curative treatment for dengue yet, targeted environmental and ecosystem management is increasingly relevant. Hence, this review was conducted to identify the effectiveness of environmental management intervention strategy to reduce dengue cases. We searched PUBMED, CENTRAL, SCOPUS, Web of Science, CIJE, WHO ICTRP, and ClinicalTrials.gov up to January 2021. A total of 521 articles were screened. Only 16 studies were included in this review. There were 6 studies that applied all three types of environmental management interventions (manipulation, modification and behavior), 8 studies applied two types of interventions (manipulation and behavior) and 2 studies applied one type of intervention (manipulation or behavior). All included studies reported reduction of Aedes entomological indices. The studies showed reduction in dengue cases and density of Aedes population through environmental interventions. It is recommended for the health authority to incorporate environmental management intervention in dengue control activities and enhanced the community involvement to ensure sustainability with high impact on dengue reduction.
Collapse
Affiliation(s)
| | | | - Noor Aliza Lodz
- Institute for Public Health, National Institutes of Health Malaysia, Shah Alam, Malaysia
| | | | - Norzawati Yoep
- Institute for Public Health, National Institutes of Health Malaysia, Shah Alam, Malaysia
| | - Mohd Hazrin Hasim
- Institute for Public Health, National Institutes of Health Malaysia, Shah Alam, Malaysia
| | | | - Joel Aik
- Environmental Health Institute (WHO Collaboration Center for Reference and Research of Arbovirus and their Associated Vectors), National Environment Agency, Singapore, Singapore
| | - Jayanthi Rajarethinam
- Environmental Health Institute (WHO Collaboration Center for Reference and Research of Arbovirus and their Associated Vectors), National Environment Agency, Singapore, Singapore
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health Malaysia, Shah Alam, Malaysia
| |
Collapse
|
3
|
Hasani WSR, Muhamad NA, Hanis TM, Maamor NH, Chen XW, Omar MA, Cheng Kueh Y, Abd Karim Z, Hassan MRA, Musa KI. The global estimate of premature cardiovascular mortality: a systematic review and meta-analysis of age-standardized mortality rate. BMC Public Health 2023; 23:1561. [PMID: 37587427 PMCID: PMC10429077 DOI: 10.1186/s12889-023-16466-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a significant cause of premature mortality worldwide, with a growing burden in recent years. Despite this, there is a lack of comprehensive meta-analyses that quantify the extent of premature CVD mortality. Study addressed this gap by estimating the pooled age-standardized mortality rate (ASMR) of premature CVD mortality. METHODS We conducted a systematic review of published CVD mortality studies that reported ASMR as an indicator for premature mortality measurement. All English articles published as of October 2022 were searched in four electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). We computed pooled estimates of ASMR using random-effects meta-analysis. We assessed heterogeneity from the selected studies using the I2 statistic. Subgroup analyses and meta regression analysis was performed based on sex, main CVD types, income country level, study time and age group. The analysis was performed using R software with the "meta" and "metafor" packages. RESULTS A total of 15 studies met the inclusion criteria. The estimated global ASMR for premature mortality from total CVD was 96.04 per 100,000 people (95% CI: 67.18, 137.31). Subgroup analysis by specific CVD types revealed a higher ASMR for ischemic heart disease (ASMR = 15.57, 95% CI: 11.27, 21.5) compared to stroke (ASMR = 12.36, 95% CI: 8.09, 18.91). Sex-specific differences were also observed, with higher ASMRs for males (37.50, 95% CI: 23.69, 59.37) than females (15.75, 95% CI: 9.61, 25.81). Middle-income countries had a significantly higher ASMR (90.58, 95% CI: 56.40, 145.48) compared to high-income countries (21.42, 95% CI: 15.63, 29.37). Stratifying by age group indicated that the age groups of 20-64 years and 30-74 years had a higher ASMR than the age group of 0-74 years. Our multivariable meta-regression model suggested significant differences in the adjusted ASMR estimates for all covariates except study time. CONCLUSIONS This meta-analysis synthesized a comprehensive estimate of the worldwide burden of premature CVD mortality. Our findings underscore the continued burden of premature CVD mortality, particularly in middle-income countries. Addressing this issue requires targeted interventions to mitigate the high risk of premature CVD mortality in these vulnerable populations.
Collapse
Affiliation(s)
- Wan Shakira Rodzlan Hasani
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia.
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia.
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Tengku Muhammad Hanis
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia
| | - Nur Hasnah Maamor
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Xin Wee Chen
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, 47000, Selangor, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, Kubang Kerian, 16150, Kelantan, Malaysia
| | - Zulkarnain Abd Karim
- Office of The Manager to Biomedical Research Policy & Strategic Planning Unit, Institutes for Medical Research, Setia Alam 40170, Selangor, Malaysia
| | | | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia
| |
Collapse
|
4
|
Muhamad NA, Maamor NH, Leman FN, Mohamad ZA, Bakon SK, Abdul Mutalip MH, Rosli IA, Aris T, Lai NM, Abu Hassan MR. The Global Prevalence of Nonalcoholic Fatty Liver Disease and its Association With Cancers: Systematic Review and Meta-Analysis. Interact J Med Res 2023; 12:e40653. [PMID: 37467012 PMCID: PMC10398554 DOI: 10.2196/40653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/22/2023] [Accepted: 04/19/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is one of the common causes of chronic liver disease globally. Obesity, metabolic diseases, and exposure to some environmental agents contribute to NAFLD. NAFLD is commonly considered a precursor for some types of cancers. Since the leading causes of death in people with NAFLD are cardiovascular disease and extrahepatic cancers, it is important to understand the mechanisms of the progression of NAFLD to control its progression and identify its association with extrahepatic cancers. Thus, this review aims to estimate the global prevalence of NAFLD in association with the risk of extrahepatic cancers. OBJECTIVE We aimed to determine the prevalence of various cancers in NAFLD patients and the association between NAFLD and cancer. METHODS We searched PubMed, ProQuest, Scopus, and Web of Science from database inception to March 2022 to identify eligible studies reporting the prevalence of NAFLD and the risk of incident cancers among adult individuals (aged ≥18 years). Data from selected studies were extracted, and meta-analysis was performed using random effects models to obtain the pooled prevalence with the 95% CI. The quality of the evidence was assessed with the Newcastle-Ottawa Scale. RESULTS We identified 11 studies that met our inclusion criteria, involving 222,523 adults and 3 types of cancer: hepatocellular carcinoma (HCC), breast cancer, and other types of extrahepatic cancer. The overall pooled prevalence of NAFLD and cancer was 26% (95% CI 16%-35%), while 25% of people had NAFLD and HCC (95% CI 7%-42%). NAFLD and breast cancer had the highest prevalence out of the 3 forms of cancer at 30% (95% CI 14%-45%), while the pooled prevalence for NAFLD and other cancers was 21% (95% CI 12%-31%). CONCLUSIONS The review suggests that people with NAFLD may be at an increased risk of cancer that might not affect not only the liver but also other organs, such as the breast and bile duct. The findings serve as important evidence for policymakers to evaluate and recommend measures to reduce the prevalence of NAFLD through lifestyle and environmental preventive approaches. TRIAL REGISTRATION PROSPERO CRD42022321946; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=321946.
Collapse
Affiliation(s)
- Nor Asiah Muhamad
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Nur Hasnah Maamor
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Fatin Norhasny Leman
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Zuraifah Asrah Mohamad
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Sophia Karen Bakon
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Mohd Hatta Abdul Mutalip
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Izzah Athirah Rosli
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Tahir Aris
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Subang Jaya, Selangor, Malaysia
| | | |
Collapse
|
5
|
Wee LH, Galvan JAA, Patil SS, Madhavan P, Mahalingam D, Yeong CH, Wong YH, Poh HQ, Suthahar S, David SD, Tan XJ, Rosli IA, Chan CMH, Baharom N, Muhamad NA, Siau CS. Understanding Factors Associated with Motivation to Quit Vaping among Vapers in the Federal Territory of Kuala Lumpur, Malaysia. Healthcare (Basel) 2023; 11:1980. [PMID: 37510421 PMCID: PMC10379365 DOI: 10.3390/healthcare11141980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
The prevalence of vaping worldwide is showing an upward trend. This study aimed to determine the factors associated with motivation to quit vaping among vapers in the Federal Territory of Kuala Lumpur, Malaysia, through a cross-sectional, purposive sampling study. Respondents were required to complete a questionnaire consisting of vapers' sociodemographic questions, habitual behavioral pattern questions, the e-Fagerström Test of Nicotine Dependence, the Glover-Nilsson Smoking Behavioral Dependence Questionnaire, perception questions, motivation to quit questions, and withdrawal symptom questions. A total of 311 vapers participated in this study. The majority of the vapers were male (84.6%), younger (18-25 years) (55.3%), and with monthly income less than RM 4000 (USD 868; 83.9%). The level of motivation to quit vaping was found to have a significant association with the perception of vaping being as satisfying as cigarette smoking (p = 0.006) and mild to very strong nicotine dependence (p = 0.001). Participants who recorded moderate and strong habitual vaping behaviors had lower odds of having high motivation to quit vaping compared to those recording slight habitual behaviors (OR = 0.279, 95%CI(0.110-0.708), p = 0.007 and OR = 0.185, 95%CI(0.052-0.654), p = 0.009, respectively). Factors associated with higher motivation to quit vaping could be explored to gain better understanding of how to increase their motivation level for future quit attempts.
Collapse
Affiliation(s)
- Lei Hum Wee
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Jo Ann Andoy Galvan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Sapna Shridhar Patil
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Dinesh Mahalingam
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- SP Care Group, Level 3, Menara SP Care, Rawang Sentral, Rawang 48000, Malaysia
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Yin How Wong
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Hui Qi Poh
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Sanjay Suthahar
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Shamella Diya David
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Xiao Jing Tan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Izzah Athirah Rosli
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Caryn Mei Hsien Chan
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Nizam Baharom
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| |
Collapse
|
6
|
Abang Abdullah AF, Muhamad NA, Ab Ghani RM, Maamor NH, Leman FN, Too CL, Ismail IH, Mohd Zulkefli NA, Mohd Nazan AIN, Md Said S. The Effectiveness of Early Food Introduction in Preventing Childhood Allergic Diseases: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2023; 12:e46816. [PMID: 37358892 DOI: 10.2196/46816] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Allergic diseases affect around 40% of the pediatric population worldwide. The coexistence of asthma, allergic rhinitis, eczema, and food allergy renders allergy treatment and prevention challenging. Infant feeding strategies recommend avoiding allergenic foods to prevent allergy development and anaphylaxis. However, recent evidence suggests that early consumption of food allergens during weaning in infants aged 4-6 months could result in food tolerance, thus reducing the risk of developing allergies. OBJECTIVE The aim of this study is to systematically review and carry out a meta-analysis of evidence on the outcome of early food introduction for preventing childhood allergic diseases. METHODS We will conduct a systematic review of interventions through a comprehensive search of various databases including PubMed, Embase, Scopus, CENTRAL, PsycINFO, CINAHL, and Google Scholar to identify potential studies. The search will be performed for any eligible articles from the earliest published articles up to the latest available studies in 2023. We will include randomized controlled trials (RCTs), cluster RCTs, non-RCTs, and other observational studies that assess the effect of early food introduction to prevent childhood allergic diseases. RESULTS Primary outcomes will include measures related to the effect of childhood allergic diseases (ie, asthma, allergic rhinitis, eczema, and food allergy). PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines will be followed for study selection. All data will be extracted using a standardized data extraction form and the quality of the studies will be assessed using the Cochrane Risk of Bias tool. A summary of findings table will be generated for the following outcomes: (1) total number of allergic diseases, (2) rate of sensitization, (3) total number of adverse events, (4) improvement of health-related quality of life, and (5) all-cause mortality. Descriptive and meta-analyses will be performed using a random-effects model in Review Manager (Cochrane). Heterogeneity among selected studies will be assessed using the I2 statistic and explored through meta-regression and subgroup analyses. Data collection is expected to start in June 2023. CONCLUSIONS The results acquired from this study will contribute to the existing literature and harmonize recommendations for infant feeding with regard to the prevention of childhood allergic diseases. TRIAL REGISTRATION PROSPERO CRD42021256776; https://tinyurl.com/4j272y8a. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/46816.
Collapse
Affiliation(s)
- Aisha Fadhilah Abang Abdullah
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Rimah Melati Ab Ghani
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Nur Hasnah Maamor
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Fatin Norhasny Leman
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Chun Lai Too
- Immunogenetic Unit, Allergy and Immunology Research Center, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Intan Hakimah Ismail
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nor Afiah Mohd Zulkefli
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Salmiah Md Said
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| |
Collapse
|
7
|
Bakar KA, Muhamad NA, Sarpin MA, Shaharudin S, Sidhu S, Yap SL, Hussain THT, Tan HL, Ong FN, Gan WC, Ilias MI, Othman J, Eng CSY. Health-related quality of life amongst children with chronic kidney disease in Malaysia: performance of the Bahasa Melayu version of the PedsQL 3.0 ESRD Module : (PedsQL 3.0 VerBATIM: version in Bahasa Melayu. Translated for use in Malaysia). Pediatr Nephrol 2023; 38:1897-1905. [PMID: 36272027 DOI: 10.1007/s00467-022-05774-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/31/2022] [Accepted: 09/25/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The PedsQL 3.0 End Stage Renal Disease (ESRD) Module is a well-accepted instrument internationally but it is not available in the local language. We aimed to validate the Bahasa Melayu (Malay language) version and determine the health-related quality of life (HRQoL) scores amongst children with CKD in Malaysia. METHODS The source questionnaire in English was translated into Bahasa Melayu. Linguistic validation guidelines by the MAPI Research Institute were followed. The already validated Bahasa Melayu PedsQL 4.0 Generic Core Scales was used for comparison. Sociodemographic data were collected during the interview. Statistical analyses were performed using SPSS version 25.0. RESULTS Sixty-nine children aged 8 to 18 with CKD stages 4 and 5, with or without dialysis, and their caregivers were recruited. Mean age was 12.62 ± 2.77 (SD). Evaluation of the PedsQL 3.0 ESRD Module Bahasa Melayu version demonstrated good internal consistency (Cronbach alpha 0.82). There was good agreement between child self-report and parent proxy report in all domains; average intraclass correlation coefficients (ICC) were 0.78, 95% CI (0.71, 0.84). Scores obtained from Generic 4.0 scales correlated with the disease-specific ESRD 3.0 scale, Spearman's rho = 0.32, p = 0.007. The Kruskal-Wallis H test indicated that there were no significant differences between stages of CKD and their respective mean HRQoL score, χ2(2) = 2.88, p = 0.236. CONCLUSIONS The PedsQL 3.0 ESRD Module Bahasa Melayu version is a reliable and feasible tool for cross-cultural adaptation. A longer prospective study may help better illustrate the quality of life in this group of children.
Collapse
Affiliation(s)
- Kamila Abu Bakar
- Paediatric Department, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Mohamad Alwi Sarpin
- Paediatric Department, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Sangeet Sidhu
- Paediatric Department, Hospital Pulau Pinang, Pulau Pinang, Malaysia
| | - Suet Li Yap
- Paediatric Department, Hospital Umum Sarawak, Kuching, Malaysia
| | | | - Hai Liang Tan
- Paediatric Nephrology Unit, Paediatric Department, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Fen Ni Ong
- Paediatric Department, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Wen Chian Gan
- Paediatric Department, Hospital Selayang, Selangor, Malaysia
| | - Mohammad Ikram Ilias
- Department of Paediatric, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Juliana Othman
- Department of Language and Literacy Education, Universiti Malaya, Kuala Lumpur, Malaysia
| | | |
Collapse
|
8
|
Tan TL, Illa NE, Ting SY, Hwong PL, Makhtar NK, Sim YH, Muhamad NA, Chiew SC. Pulmonary thromboembolic disease associated with COVID-19 infection: a comparison between geriatric and non-geriatric populations. Med J Malaysia 2023; 78:379-388. [PMID: 37271849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The magnitude of Coronavirus Disease 2019 (COVID-19) infection among the elderly population is expected to rise. Our study compares the clinical and computed tomographical (CT) features of pulmonary thromboembolic (PTE) disease associated with COVID-19 infection in geriatric and non-geriatric cases, and explores the 60-day mortality rate in these two groups. MATERIALS AND METHODS We conducted this retrospective cross-sectional study in Hospital Tengku Ampuan Rahimah, Selangor, Malaysia. Patients admitted in April 2021 and May 2021 with concomitant COVID-19 infection and PTE disease were included. Demographic, clinical and laboratory data were retrieved, whilst CTPA images were analysed by a senior radiologist. RESULTS A total of 150 patients were recruited, comprising 45 geriatric patients and 105 non-geriatric patients. The prevalence rate of hypertension, diabetes mellitus and dyslipidaemia were higher among the geriatric cohort. Evidently, the percentage of patients with fever and diarrhoea were significantly higher among the non-geriatric cohort. The geriatric cohort also recorded a significantly lower absolute lymphocyte count at presentation and albumin level during admission. Despite earlier presentation, the geriatric cohort suffered from more severe diseases. Analysis of the CT features demonstrated that the most proximal pulmonary thrombosis specifically limited to the segmental and subsegmental pulmonary arteries in both cohorts. The elderly suffered from a significantly higher inhospital mortality rate and their cumulative probability of survival was significantly lower. CONCLUSION Typical COVID-19 symptoms may be absent among the elderly, prompting a lower threshold of suspicion during the COVID-19 pandemic. Additionally, the elderly demonstrated a higher probability of adverse outcomes despite earlier presentation and treatment.
Collapse
Affiliation(s)
- T L Tan
- Hospital Tengku Ampuan Rahimah, Internal Medicine Department, Selangor, Malaysia.
| | - N E Illa
- Hospital Tengku Ampuan Rahimah, Radiology Department, Selangor, Malaysia
| | - S Y Ting
- Clinical Research Centre, Hospital Seri Manjung, Ministry of Health, Perak, Malaysia
| | - P L Hwong
- Hospital Tengku Ampuan Rahimah, Internal Medicine Department, Selangor, Malaysia
| | - N K Makhtar
- Hospital Tengku Ampuan Rahimah, Geriatric Unit, Selangor, Malaysia
| | - Y H Sim
- Hospital Tengku Ampuan Rahimah, Haematology Unit, Selangor, Malaysia
| | - N A Muhamad
- Evidence-Based in Healthcare, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - S C Chiew
- Clinical Research Centre, Hospital Seri Manjung, Ministry of Health, Perak, Malaysia
| |
Collapse
|
9
|
Muhamad NA, Subhas N, Mustapha N, Abdullah N, Muhamad Rasat MA, AB Ghani RM, Tahir FA, Ishak ANI, Sivasubramaniam V, Hassan A, Goh WWL, Teng KL, Abdul Manan AI, Mokhtar R, Baljit Singh AK, Ng KS. METER (Mental health emergency response) program: Findings of psychological impact status and factors associated with depression, anxiety and stress among healthcare workers in public hospital in Malaysia during the COVID-19 pandemic. PLOS Glob Public Health 2023; 3:e0001823. [PMID: 37058465 PMCID: PMC10104317 DOI: 10.1371/journal.pgph.0001823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 03/21/2023] [Indexed: 04/15/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has become the greatest challenge of the new millennium. Most healthcare workers (HCWs) experienced unprecedented levels of workload since the pandemic. This study aims to identify the prevalence and factors of depression, anxiety and stress among HCWs in Malaysian healthcare facilities in the midst of the pandemic due to the SARs-CoV-2. METHODS An emergency response programme on mental health was conducted from June to September 2020. A standardized data collection form was distributed among the HCWs in the government hospital in Klang Valley. The form contained basic demographic information and the self-reported Malay version of the Depression, Anxiety and Stress scale (BM DASS-21). RESULTS Of the1,300 staff who attended the Mental Health and Psychosocial Support in Covid-19 (MHPSS COVID-19) programme, 996 staff (21.6% male, 78.4% female) completed the online survey (response rate: 76.6%). Result showed that staff aged above 40 years old were almost two times more likely to have anxiety (AOR = 1.632; 95% CI = 1.141-2.334, p:0.007) and depression (AOR = 1.637; 95% CI = 1.1.06-2.423, p:0.014) as compared to staff who were less than 40 years old. Those who had direct involvement with COVID-19 patients were likely to suffer stress (AOR = 0.596; 95% CI = 0.418-0.849, p:0.004), anxiety (AOR = 0.706; 95% Ci = 0.503-0.990, p:0.044) and depression (AOR = 0.630; 95% Ci = 0.427-0.928, p:0.019). HCWs with stress (AOR = 0.638; 95% CI of 0.476-0.856, p = 0.003), anxiety (AOR = 0.720; 95% CI 0.542-0.958, p = 0.024) and depression (AOR = 0.657; 95% CI 0.480-0.901, p = 0.009) showed less confidence to treat critically ill patients and need psychological help during outbreak. CONCLUSION This study showed the importance of psychosocial support to reduce psychological distress among HCWs when working or coping during the COVID-19 pandemic or outbreak.
Collapse
Affiliation(s)
- Nor Asiah Muhamad
- Sector for Evidence Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Natasha Subhas
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| | - Normi Mustapha
- Faculty of Science & Technology, Open University Malaysia, Petaling Jaya, Malaysia
| | - Norni Abdullah
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| | - Muhammad Arif Muhamad Rasat
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| | - Rimah Melati AB Ghani
- Sector for Evidence Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Fatin Athira Tahir
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Anne Nik Ismaliza Ishak
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| | | | - Alinazarine Hassan
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| | - William Wei Liang Goh
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| | - Kok Liang Teng
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| | - Ainul Izzah Abdul Manan
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| | - Rosmawati Mokhtar
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| | - Amrit Kaur Baljit Singh
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| | - Kher Shean Ng
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Rahimah, Ministry of Health, Klang, Malaysia
| |
Collapse
|
10
|
Muhamad NA, Ma'amor NH, Mustapha N, Leman FN, Rosli IA, Umar M, Aris T, Lai NM. Nondrug Intervention for Opportunistic Infections in Individuals With Hematological Malignancy: Systematic Review. Interact J Med Res 2023; 12:e43969. [PMID: 37000482 PMCID: PMC10132047 DOI: 10.2196/43969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Hematological malignancies disturb the blood, lymph nodes, and bone marrow. Taking medications for treating opportunistic infections (OIs) in these individuals may enhance the risk of medication interaction as well as adverse drug reactions. OBJECTIVE This review aims to evaluate the effectiveness of nondrug interventions in reducing OIs among patients with hematological cancers. METHODS The PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), and Embase databases were searched on December 26, 2022, for all randomized controlled trials (RCTs). The primary endpoint was OIs. The quality of included studies was assessed by the Cochrane Risk-of-Bias tool. RESULTS A total of 6 studies were included in this review with 4 interventions: (1) types of mouthwash received, (2) presence of coating on central venous catheters (CVCs), (3) use of well-fitted masks, and (4) types of diet consumed. The results were presented in 8 different comparisons: (1) chlorhexidine-nystatin versus saline mouth rinse, (2) chlorhexidine versus saline mouth rinse, (3) nystatin versus saline mouth rinse, (4) chlorhexidine silver sulfadiazine-coated CVCs versus uncoated catheters, (5) well-fitted masks versus no mask, (6) amine fluoride-stannous fluoride versus sodium fluoride mouthwash, (7) low-bacterial diet versus standard hospital diet, and (8) herbal versus placebo mouthwash. No clear differences were reported in any of the outcomes examined in the first 3 comparisons. There were also no clear differences in the rate of catheter-related bloodstream infection or insertion site infection between the use of chlorhexidine silver sulfadiazine-coated CVCs versus uncoated catheters in the patients. Further, no significant differences were seen between patients who used a well-fitted mask and those without a mask in the incidence of OI. The all-cause mortality and mortality due to OI were similar between the 2 groups. There was no clear difference in all-cause mortality, although common adverse effects were reported in patients who used sodium fluoride mouthwash compared with those using amine fluoride-stannous fluoride mouthwash. There was no evidence of any difference in the incidence of possible invasive aspergillosis or candidemia between patients who consumed a low-bacterial diet and a standard diet. For the last comparison, no significant difference was seen between patients who received herbal and placebo mouthwash. CONCLUSIONS Very limited evidence was available to measure the effectiveness of nondrug interventions in hematological cancers. The effectiveness of the interventions included in this review needs to be evaluated further in high-quality RCTs in a dedicated setting among patients with hematological malignancies. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020169186; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=169186.
Collapse
Affiliation(s)
- Nor Asiah Muhamad
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nur Hasnah Ma'amor
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Normi Mustapha
- Faculty Science and Technology, Open University, Kuala Lumpur, Malaysia
| | - Fatin Norhasny Leman
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Izzah Athirah Rosli
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Marilyn Umar
- Non-Communicable Disease Section, Sarawak State Health Department, Ministry of Health, Sarawak, Malaysia
| | - Tahir Aris
- Director's Office, Institutes for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nai Ming Lai
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| |
Collapse
|
11
|
Ngah NF, Muhamad NA, Aziz RAA, Hussein E, Salowi MA, Kamarudin Z, Abdullah NH, Aris T. Evaluating Cataract Surgical Rate through Smart Partnership between Ministry of Health, Malaysia and Federal Territory Islamic Religious Council. Medicines (Basel) 2023; 10:medicines10010012. [PMID: 36662496 PMCID: PMC9860600 DOI: 10.3390/medicines10010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Cataract is the leading cause of blindness. About 90% of cataract blindness occurs in low- and middle-income countries. The prevalence of blindness and low vision in any country depends on the socioeconomic status, the availability of medical and healthcare facilities, and the literacy of the population. AIM This paper aims to estimate the cataract surgery rate (CSR) at Pusat Pembedahan Katarak, MAIWP-Hospital Selayang (Cataract Operation Centre), and provide descriptive assessments of the patients who received eye treatments in the center. METHODS The data were retrieved from the clinical database from 2013 to 2016. Information on the patient's sociodemographic and clinical and treatment history was collected. RESULTS The cataract surgery rate for 2013 was about 27 and increased to 37.3 in 2014. However, it declined to 25 in 2015 before it resumed to 36 in 2016. For female patients who received eye treatments at Pusat Pembedahan Katarak, MAIWP-Hospital Selayang, the rate was higher (53.7%) compared to male patients (46.3%). The mean duration of cataract surgery from 2013 to 2016 was 21.25 ± 11.071 min. CONCLUSION The increased cataract surgery rate for MAIWP-HS through smart partnerships for day care cataract surgery proved that better accessibility makes the short- and long-term strategies for the reduction and prevention of blindness in Malaysia possible to achieve.
Collapse
Affiliation(s)
- Nor Fariza Ngah
- Institutes for Clinical Research, Ministry of Health, Shah Alam 40170, Malaysia
- Department of Ophthalmology, Shah Alam Hospital, Shah Alam 40000, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
- Correspondence:
| | | | - Elias Hussein
- Department of Ophthalmology, Kuala Lumpur Hospital, Kuala Lumpur 50586, Malaysia
| | | | - Zabri Kamarudin
- Department of Ophthalmology, Selayang Hospital, Shah Alam 68100, Malaysia
| | - Noor Hisham Abdullah
- Office of Director General of Health, Ministry of Health, Putrajaya 62590, Malaysia
| | - Tahir Aris
- National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| |
Collapse
|
12
|
Rodzlan Hasani WS, Muhamad NA, Hanis TM, Maamor NH, Wee CX, Omar MA, Ganapathy SS, Abdul Karim Z, Musa KI. The burden of premature mortality from cardiovascular diseases: A systematic review of years of life lost. PLoS One 2023; 18:e0283879. [PMID: 37083866 PMCID: PMC10121009 DOI: 10.1371/journal.pone.0283879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/19/2023] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION Premature mortality refers to deaths that occur before the expected age of death in a given population. Years of life lost (YLL) is a standard parameter that is frequently used to quantify some component of an "avoidable" mortality burden. OBJECTIVE To identify the studies on premature cardiovascular disease (CVD) mortality and synthesise their findings on YLL based on the regional area, main CVD types, sex, and study time. METHOD We conducted a systematic review of published CVD mortality studies that reported YLL as an indicator for premature mortality measurement. A literature search for eligible studies was conducted in five electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The synthesis of YLL was grouped into years of potential life lost (YPLL) and standard expected years of life lost (SEYLL) using descriptive analysis. These subgroups were further divided into WHO (World Health Organization) regions, study time, CVD type, and sex to reduce the effect of heterogeneity between studies. RESULTS Forty studies met the inclusion criteria for this review. Of these, 17 studies reported premature CVD mortality using YPLL, and the remaining 23 studies calculated SEYLL. The selected studies represent all WHO regions except for the Eastern Mediterranean. The overall median YPLL and SEYLL rates per 100,000 population were 594.2 and 1357.0, respectively. The YPLL rate and SEYLL rate demonstrated low levels in high-income countries, including Switzerland, Belgium, Spain, Slovenia, the USA, and South Korea, and a high rate in middle-income countries (including Brazil, India, South Africa, and Serbia). Over the past three decades (1990-2022), there has been a slight increase in the YPLL rate and the SEYLL rate for overall CVD and ischemic heart disease but a slight decrease in the SEYLL rate for cerebrovascular disease. The SEYLL rate for overall CVD demonstrated a notable increase in the Western Pacific region, while the European region has experienced a decline and the American region has nearly reached a plateau. In regard to sex, the male showed a higher median YPLL rate and median SEYLL rate than the female, where the rate in males substantially increased after three decades. CONCLUSION Estimates from both the YPLL and SEYLL indicators indicate that premature CVD mortality continues to be a major burden for middle-income countries. The pattern of the YLL rate does not appear to have lessened over the past three decades, particularly for men. It is vitally necessary to develop and execute strategies and activities to lessen this mortality gap. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021288415.
Collapse
Affiliation(s)
- Wan Shakira Rodzlan Hasani
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Tengku Muhammad Hanis
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nur Hasnah Maamor
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Chen Xin Wee
- Department of Public Health Medicine, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Shubash Shander Ganapathy
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Zulkarnain Abdul Karim
- Office of The Manager, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
13
|
Rodzlan Hasani WS, Muhamad NA, Maamor NH, Hanis TM, Xin Wee C, Abu Hassan MR, Abdul Karim Z, Musa KI. Premature mortality and years of potential life lost from cardiovascular diseases: Protocol of a systematic review and meta-analysis. PLoS One 2023; 18:e0284052. [PMID: 37134125 PMCID: PMC10155956 DOI: 10.1371/journal.pone.0284052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/03/2023] [Indexed: 05/04/2023] Open
Abstract
INTRODUCTION Despite the burden of cardiovascular disease (CVD) continuing to increase globally, no comprehensive meta-analyses have been conducted quantifying premature CVD mortality. This paper reports the protocol for a systematic review and meta-analysis to derive updated estimates of premature CVD mortality. METHODS AND EXPECTED OUTPUTS This review will include the studies that reported premature CVD mortality based on standard premature mortality indicators, including years of life lost (YLL), age standardized mortality rate (ASMR) or standardised mortality ratio (SMR). PUBMED, Scopus, Web of Science (WoS), CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) will be used as the literature databases. The study selection as well as the evaluation of the quality of the included articles will be done independently by two reviewers. Pooled estimates of YLL, ASMR, and SMR will be computed by applying random-effects meta-analysis. Heterogeneity among selected studies will be assessed using the I2 statistic and Q statistic with associated p-values. A funnel plot analysis and Egger's test will be conducted to assess the potential impact of publication bias. Depending on data availability, we propose to conduct subgroup analyses by sex, geographic location, main CVD types, and study time. Reporting of our findings will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. CONCLUSION Our meta-analysis will provide a comprehensive synthesis of the available evidence on premature CVD mortality, which is a major public health concern worldwide. The results of this meta-analysis will have important implications for clinical practice and public health policy, providing insights into strategies to prevent and manage premature CVD mortality. TRIAL REGISTRATION Systematic review registration: PROSPERO CRD42021288415. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021288415.
Collapse
Affiliation(s)
- Wan Shakira Rodzlan Hasani
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Nur Hasnah Maamor
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Tengku Muhammad Hanis
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Chen Xin Wee
- Faculty of Medicine, Department of Public Health Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | | | - Zulkarnain Abdul Karim
- Office of The Manager, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
14
|
Ngah NF, Muhamad NA, Mohamed SO, Abdul Aziz RA, Ma'amor NH, Ahmad Tarmidzi NA, Hashim H, Ishak H, Wan Muda WN, Muda R, Adnan A, Saleh RM, Wong HS, Mohd Jamil N, George TM, Koh A. Guidelines from an expert panel for the management of diabetic macular edema in the Malaysian population. Int J Ophthalmol 2023; 16:712-720. [PMID: 37206185 PMCID: PMC10172084 DOI: 10.18240/ijo.2023.05.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/23/2023] [Indexed: 05/21/2023] Open
Abstract
AIM To derive a Malaysia guideline and consensus as part of the Malaysia Retina Group's efforts for diagnosis, treatment, and best practices of diabetic macular edema (DME). The experts' panel suggests that the treatment algorithm to be divided into groups according to involvement the central macula. The purpose of DME therapy is to improve edema and achieve the best visual results with the least amount of treatment load. METHODS On two different occasions, a panel of 14 retinal specialists from Malaysia, together with an external expert, responded to a questionnaire on management of DME. A consensus was sought by voting after compiling, analyzing and discussion on first-phase replies on the round table discussion. A recommendation was deemed to have attained consensus when 12 out of the 14 panellists (85%) agreed with it. RESULTS The terms target response, adequate response, nonresponse, and inadequate response were developed when the DME patients' treatment responses were first characterized. The panelists reached agreement on a number of DME treatment-related issues, including the need to classify patients prior to treatment, first-line treatment options, the right time to switch between treatment modalities, and side effects associated with steroids. From this agreement, recommendations were derived and a treatment algorithm was created. CONCLUSION A detail and comprehensive treatment algorithm by Malaysia Retina Group for the Malaysian population provides guidance for treatment allocation of patients with DME.
Collapse
Affiliation(s)
- Nor Fariza Ngah
- Institute for Clinical Research, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia
- Department of Ophthalmology, Shah Alam Hospital, Ministry of Health, Selangor 40000, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia
| | - Shelina Oli Mohamed
- Department of Ophthalmology, Shah Alam Hospital, Ministry of Health, Selangor 40000, Malaysia
| | - Roslin Azni Abdul Aziz
- Department of Ophthalmology, Shah Alam Hospital, Ministry of Health, Selangor 40000, Malaysia
| | - Nur Hasnah Ma'amor
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia
| | - Nor Azita Ahmad Tarmidzi
- Department of Ophthalmology, Kuala Lumpur Hospital, Ministry of Health, Federal Territory 50586, Malaysia
| | - Hanizasurana Hashim
- Department of Ophthalmology, Selayang Hospital, Ministry of Health, Selangor 61800, Malaysia
| | - Hamisah Ishak
- Department of Ophthalmology, Kuala Lumpur Hospital, Ministry of Health, Federal Territory 50586, Malaysia
| | - Wan Norliza Wan Muda
- Department of Ophthalmology, Tengku Ampuan Afzan Hospital, Ministry of Health, Pahang 25100, Malaysia
| | - Rosiah Muda
- Department of Ophthalmology, Sultanah Nur Zahirah Hospital, Ministry of Health, Kuala Terengganu 20400, Malaysia
| | - Azian Adnan
- KPJ Selangor Specialist Hospital, Selangor 40300, Malaysia
| | | | - Hon Seng Wong
- Gleneagles Kuala Lumpur, Federal Territory 50450, Malaysia
| | - Nurfahzura Mohd Jamil
- Department of Ophthalmology, Sungai Buloh Hospital, Ministry of Health, Selangor 47000, Malaysia
| | | | - Adrian Koh
- Camden Medical Centre, Singapore 248649, Singapore
| |
Collapse
|
15
|
Mat Rifin H, Jane Ling MY, Robert Lourdes TG, Saminathan TA, Rodzlan Hasani WS, Ab Majid NL, Hamid HAA, Riyadzi MR, Ahmad A, Mohd Yusoff MF, Muhamad NA. Small/Kiddie Cigarette Packaging Size and Its Impact on Smoking: A Systematic Review. Int J Environ Res Public Health 2022; 19:12051. [PMID: 36231349 PMCID: PMC9566128 DOI: 10.3390/ijerph191912051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/23/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
Background: Small cigarette pack sizes contain less than 20 cigarette sticks in a pack. Smaller packs may suggest lower costs, increasing affordability among lower-income users, especially the younger generation, which could lead to tobacco-related diseases and economic costs, including human capital lost results from tobacco-attributable morbidity and mortality. This concern has caused many countries to ban the sale of single cigarette sticks or kiddie packs. However, small cigarette pack sizes were proposed recently to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. This would demean efforts in combating tobacco consumption based on the existing tobacco control policies to prevent minors from purchasing cigarettes. Given the competing influences of affordability and availability of tobacco on consumption and the dearth of evidence-based review on the impact of pack size on smoking, this systematic review was conducted to identify the link between kiddie packs and smoking specifically on the initiation of smoking, urge/tendency to buy cigarettes among the general population and attempt to reduce cigarette consumption and prevalence of smoking using kiddie packs among current smokers. Methods: We include all studies except for reviews, guidelines, conference papers, commentaries, editorials, or opinion pieces. A database search was conducted in PubMed, EMBASE, CENTRAL, Web of Science and Scopus on 27 November 2021. The results were presented in the form of narrative synthesis under four groups: initiation of smoking; urge/tendency to buy cigarettes; the prevalence of smoking, and attempt to reduce cigarette consumption. The literature search identified 1601 articles, of which 21 articles had met the inclusion criteria. The methodological quality of all included articles was determined using a validated 16-item quality assessment tool (QATSDD). The average quality score for all papers was 34.8%. Discussion: Given the diverse study settings of the articles and despite the challenges of the methodological quality of some articles, this review provides some evidence that kiddie packs may increase the urge/tendency to buy cigarettes and mixed evidence on the attempt to reduce cigarette consumption. This review also found some evidence that kiddie pack purchasing among teenage smokers was higher compared to adults. However, we are uncertain about the link between kiddie packs and smoking initiation. Nevertheless, since most studies were of low quality, further high-quality studies are needed to conclude about the impact of kiddie packs on smoking to assist the policymakers and stakeholders in formulating new policies and strengthening existing strategies related to the kiddie packs.
Collapse
Affiliation(s)
- Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Miaw Yn Jane Ling
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Tania Gayle Robert Lourdes
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Thamil Arasu Saminathan
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Wan Shakira Rodzlan Hasani
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Nur Liana Ab Majid
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Hamizatul Akmal Abd Hamid
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Mohd Ruhaizie Riyadzi
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Ahzairin Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | | | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| |
Collapse
|
16
|
Bakon SK, Mohamad ZA, Jamilan MA, Hashim H, Kuman MY, Shaharudin R, Ahmad N, Muhamad NA. Prevalence of antibiotics resistant pathogenic bacteria and level of antibiotic residues in the hospital effluents in Selangor: study protocol (Preprint). JMIR Res Protoc 2022; 12:e39022. [DOI: 10.2196/39022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
|
17
|
Ahmad Fauzi A, Ahmad Adlan AS, Jayanath S, Yamamoto T, Yoshizaki A, Tachibana M, Muhamad NA, Hamzah N. Challenges Faced by Children With Developmental Disorders During the COVID-19 Pandemic in Malaysia. Asia Pac J Public Health 2022; 34:716-718. [PMID: 35775599 DOI: 10.1177/10105395221107127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Aishah Ahmad Fauzi
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Aida Syarinaz Ahmad Adlan
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Subhashini Jayanath
- Department of Pediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tomoka Yamamoto
- United Graduate School of Child Development, Department of Pediatrics, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Arika Yoshizaki
- United Graduate School of Child Development, Department of Pediatrics, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Masaya Tachibana
- United Graduate School of Child Development, Department of Pediatrics, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Nor Asiah Muhamad
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Norhamizan Hamzah
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
18
|
Maamor NH, Muhamad NA, Mohd Dali NS, Abdul Mutalip MH, Leman FN, Aris T, Lai NM, Abu Hassan MR. Seroprevalence of Hepatitis B Among Healthcare Workers in Asia and Africa and Its Association With Their Knowledge and Awareness: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:859350. [PMID: 35570890 PMCID: PMC9096243 DOI: 10.3389/fpubh.2022.859350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/04/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction The hepatitis B virus (HBV) is a blood-borne virus that can be transmitted by percutaneous and mucocutaneous contact with infected bodily fluid. Healthcare workers (HCWs) are more exposed to HBV infection. They must have a thorough understanding of HBV infection since they can contract and spread the virus. In this study, we systematically reviewed all published evidence on the seroprevalence of Hepatitis B virus (HBV) infection among HCWs. and synthesize evidence on the association between knowledge and awareness with HBV infection. Methods We searched PubMed, EMBASE, Cochrane Library and Scopus for studies reporting on HBV seroprevalence from January 1997 to September 2021 among healthcare workers. We used random-effects meta-analyses to estimate the pool prevalence of HBV infection. Results We identified 25 studies that met our inclusion criteria, with data on 10,043 adults from 11 countries and two regions: Africa and Asia. The overall seroprevalence of HBV was 5.0% (95% confidence interval [CI] 3.6%), with Africa reporting higher estimates (5.0%, 95% CI 3.7%) than Asia population (4.0%, 95% CI 1.9%). The highest pooled prevalence estimate in African countries came from studies published in the Cameroon region (8.0%, 95% CI 5–10%) while the lowest came from Ethiopia (4.0%, 95% CI 2.6%). The overall seroprevalence estimates in the African population were significantly higher than those in the Asian group. Studies in Africa found that the average knowledge and seroprevalence were 1.4% and 11.0%, respectively where, eight studies (53.3%) reported good knowledge and seven studies (46.7%) reported average knowledge. In Asia, two studies (40.0%) reported good knowledge, one study (20.0%) reporting average knowledge, and two studies (40.0%) reporting poor knowledge. African studies demonstrated good knowledge despite the fact that their HBV infection rate was higher than 6.7%. Conclusion Africa and Asia have the highest seroprevalence of HBV infection. Improving the comparability of epidemiological and clinical studies constitutes an important step forward. More high-quality data is needed to improve the precision of burden estimates. Systematic Review Registration PROSPERO CRD42021279905.
Collapse
Affiliation(s)
- Nur Hasnah Maamor
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Nor Soleha Mohd Dali
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Mohd Hatta Abdul Mutalip
- Institute for Public Health, National Institute of Health, Ministry of Health, Setia Alam, Malaysia
| | - Fatin Norhasny Leman
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Tahir Aris
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Subang Jaya, Malaysia
| | - Muhammad Radzi Abu Hassan
- Department of Medicine, Sultanah Bahiyah Hospital, Ministry of Health, Alor Setar, Malaysia.,Clinical Research Centre, Sultanah Bahiyah Hospital, Ministry of Health, Alor Setar, Malaysia
| |
Collapse
|
19
|
Makeswaran P, Shah SA, Safian N, Muhamad NA, Harith AA. Determinants of delayed tuberculosis treatment among patients in Selangor: A study protocol. PLoS One 2022; 17:e0266746. [PMID: 35468167 PMCID: PMC9037902 DOI: 10.1371/journal.pone.0266746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 03/27/2022] [Indexed: 11/19/2022] Open
Abstract
The high prevalence rate and ever-increasing incidence of tuberculosis (TB) worldwide remain a significant issue in healthcare. In Malaysia, the incidence and mortality rate of TB is increasing due to the delayed presentation of TB patients to healthcare facilities. However, there is a lack of local studies on the contributing factors of delayed presentation of TB patients in Malaysia. This study aims to establish a social epidemiology framework by analysing social factors including socio-epidemiological, socio-cultural, and health-seeking behaviours associated with the delay in seeking TB treatment among patients in Selangor, Malaysia. A sequential exploratory mixed-method study design that combines qualitative and quantitative research methods will be employed. This study will recruit adult patients who have been diagnosed with TB using chest X-ray and sputum smear microscopy. Four districts with the highest recorded cases in the state of Selangor will be selected as study locations. The qualitative study will involve a Focus Group Discussion (FGD) to explore six components, namely demographic, socio-cultural, health-seeking behaviours, social support and resources, previous knowledge and experience with illness, and treatment pathway. Meanwhile, the quantitative study will incorporate a structured survey that will be developed based on the themes identified in the qualitative phase and a review of several studies in the literature. Several quality control measures will be taken while ensuring that the survey questionnaires are anonymised and participants' confidentiality is maintained. The data obtained from both qualitative and quantitative approaches will be combined to provide a more robust assessment of the study. Given that this study will focus on districts with high recorded cases of TB in Selangor, the findings might assist to address TB-related issues such as the increasing incidence and mortality rates, which are mainly attributed to the delayed presentation of TB patients to healthcare facilities.
Collapse
Affiliation(s)
- Punitha Makeswaran
- Department of Community Medicine, UKM Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Shamsul Azhar Shah
- Department of Community Medicine, UKM Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Nazarudin Safian
- Department of Community Medicine, UKM Medical Centre, Cheras, Kuala Lumpur, Malaysia
| | - Nor Asiah Muhamad
- Evidence Based Healthcare Medicine Sector, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Abdul Aziz Harith
- Occupational Health Research Centre, Institute for Public Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| |
Collapse
|
20
|
Muhamad NA, Selvarajah V, Dharmaratne A, Inthiran A, Mohd Dali NS, Chaiyakunapruk N, Lai NM. Online Searching as a Practice for Evidence-Based Medicine in the Neonatal Intensive Care Unit, University of Malaya Medical Center, Malaysia: Cross-sectional Study. JMIR Form Res 2022; 6:e30687. [PMID: 35384844 PMCID: PMC9021944 DOI: 10.2196/30687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 12/29/2021] [Accepted: 01/19/2022] [Indexed: 11/22/2022] Open
Abstract
Background The use of the internet for research is essential in the practice of evidence-based medicine. The online search habits of medical practitioners in clinical settings, particularly from direct observation, have received little attention. Objective The goal of the research is to explore online searching for information as an evidence-based practice among medical practitioners. Methods A cross-sectional study was conducted to evaluate the clinical teams’ use of evidence-based practice when making clinical decisions for their patients' care. Data were collected through online searches from 2015 to 2018. Participants were medical practitioners and medical students in a Malaysian public teaching hospital’s neonatal intensive care unit who performed online searches to find answers to clinical questions that arose during ward rounds. Results In search sessions conducted by the participants, 311 queries were observed from 2015 to 2018. Most participants (34/47, 72%) were house officers and medical students. Most of the searches were conducted by house officers (51/99, 52%) and medical students (32/99, 32%). Most searches (70/99, 71%) were directed rather than self-initiated, and 90% (89/99) were completed individually rather than collaboratively. Participants entered an average of 4 terms in each query; three-quarters of the queries yielded relevant evidence, with two-thirds yielding more than one relevant source of evidence. Conclusions Our findings suggest that junior doctors and medical students need more training in evidence-based medicine skills such as clinical question formulation and online search techniques for performing independent online searches effectively. However, because the findings were based on intermittent opportunistic observations in a specific clinical setting, they may not be generalizable.
Collapse
Affiliation(s)
- Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Vinesha Selvarajah
- School of Information Technology, Monash University Malaysia, Selangor, Bandar Sunway, Malaysia
| | - Anuja Dharmaratne
- School of Information Technology, Monash University Malaysia, Selangor, Bandar Sunway, Malaysia
| | - Anushia Inthiran
- Department of Accounting and Information Systems, University of Canterbury, Christchurch, New Zealand
| | - Nor Soleha Mohd Dali
- Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam, Malaysia
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Subang Jaya, Malaysia
| |
Collapse
|
21
|
Mohamad ZA, Bakon SK, Jamilan MA, Daud N, Ciric L, Ahmad N, Muhamad NA. Prevalence of antibiotic resistance in pre-and post-treatment of drinking water treatment plant (DWTPs) in Malaysia: protocol for a cross-sectional study (Preprint). JMIR Res Protoc 2022; 11:e37663. [DOI: 10.2196/37663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
|
22
|
Suhaimi SMI, Muhamad NA, Bashir N, Mohd Jamil MK, Abdul Rahman MN. Harmonic Components Analysis of Emitted Ultraviolet Signals of Aged Transmission Line Insulators under Different Surface Discharge Intensities. Sensors (Basel) 2022; 22:s22030722. [PMID: 35161466 PMCID: PMC8838501 DOI: 10.3390/s22030722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 02/01/2023]
Abstract
Flashover on transmission line insulators is one of the major causes of line outages due to contamination from the environment or ageing. Power utility companies practicing predictive maintenance are currently exploring novel non-contact methods to monitor insulator surface discharge activities to prevent flashover. This paper presents an investigation on the UV pulse signals detected using UV pulse sensor due to the discharges on the insulator surfaces under varying contamination levels and insulator ages. Unaged and naturally aged insulators (0 to >20 years) were artificially contaminated (none, light to heavy contamination). The electrical stresses on the insulator surfaces were varied to generate varying discharge intensity levels on the surfaces of the insulator. The DC and harmonic components of UV pulse signals detected during surface discharges were recorded and analysed. Results show a positive correlation between the discharge intensity level of contaminated and aged transmission insulators with the DC and harmonic components of the UV pulse signals. Furthermore, the study revealed that under dry insulator surface conditions, insulator ageing has a more profound effect during discharges than contamination level. The findings from this study suggest that the use of UV pulse sensors to monitor UV pulse signals emitted during insulator surface discharges can be another novel non-contact method of monitoring transmission line insulator surface conditions.
Collapse
Affiliation(s)
- Saiful Mohammad Iezham Suhaimi
- School of Electrical and Electronic Engineering, Engineering Campus, Universiti Sains Malaysia, Nibong Tebal 14300, Malaysia; (S.M.I.S.); (M.K.M.J.)
| | - Nor Asiah Muhamad
- Faculty of Engineering, Universiti Teknologi Brunei, Gadong BE1410, Brunei
- Correspondence: (N.A.M.); (N.B.)
| | - Nouruddeen Bashir
- Department of Electrical Engineering, Faculty of Engineering, Kano University of Science and Technology, Wudil P.M.B. 3244, Kano State, Nigeria
- Correspondence: (N.A.M.); (N.B.)
| | - Mohamad Kamarol Mohd Jamil
- School of Electrical and Electronic Engineering, Engineering Campus, Universiti Sains Malaysia, Nibong Tebal 14300, Malaysia; (S.M.I.S.); (M.K.M.J.)
| | | |
Collapse
|
23
|
Mohd Hisham MF, Ahmad FH, Mohamed Haris H, Lodz NA, Yoep N, Muhammad EN, Ali R, Muhamad NA. Soil-transmitted helminths (STH) infection in Malaysia : A scoping review protocol (Preprint). JMIR Res Protoc 2022; 11:e36077. [PMID: 36197715 PMCID: PMC9582912 DOI: 10.2196/36077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 12/03/2022] Open
Abstract
Background Soil-transmitted helminth (STH) infection is 1 of the 20 notable neglected tropical diseases according to the Centers for Disease Control and Prevention and World Health Organization. In 2010, it is estimated that 1.73 billion people are infected with STH globally, of which 70% of cases occur in Asia. To date, there is a dearth of published literature on the prevalence of STH infection throughout Malaysia. Objective The objectives of this study are to review research activity on STH infection in Malaysia, to estimate the prevalence of STH infection among Malaysians, and to identify significant risk factors associated with the infection. This review aims to provide the current state of evidence pertaining to STH infections, focusing on the main areas, limitations, and biases of research and mapping out the morbidity distribution of the diseases and their causative agents, and to identify significant risk factors for preventive measures. Methods We will conduct a scoping review based on the 6-stage structured framework developed by Arksey and O’Malley. A comprehensive search strategy focusing on STH infection will be executed using electronic databases (Scopus, PubMed, Web of Science, and Embase). A systematic approach for searching, screening, reviewing, and data extraction will be applied based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Mendeley software and Microsoft Excel will be used to manage the references and to remove duplicates. Relevant data from selected articles will be extracted using a standardized data extraction form. Results A total of 164 potential manuscripts were retrieved. Data extraction is currently in progress and completion is expected by the end of 2022. Conclusions Our scoping review will summarize the current state of research in this field and provide comprehensive information regarding STH infections in Malaysia for future reference. Trial Registration National Medical Research Register NMRR-20-2889-54348; https://nmrr.gov.my/research-directory/e52ea778-d31c-4eb4-9163-a45bb3680bbf International Registered Report Identifier (IRRID) DERR1-10.2196/36077
Collapse
Affiliation(s)
| | | | | | - Noor Aliza Lodz
- Institute for Public Health, National Institute of Health, Shah Alam, Malaysia
| | - Norzawati Yoep
- Institute for Public Health, National Institute of Health, Shah Alam, Malaysia
| | | | - Rafidah Ali
- Institute for Public Health, National Institute of Health, Shah Alam, Malaysia
| | - Nor Asiah Muhamad
- Evidence Based Healthcare, National Institute of Health, Shah Alam, Malaysia
| |
Collapse
|
24
|
Jayanath S, Hamzah N, Ahmad Fauzi A, Ahmad Adlan AS, Muhamad NA, Zainal AZ, Mohri I, Tachibana M. The Japanese Sleep Questionnaire for preschoolers within a Malaysian context. Pediatr Int 2022; 64:e15123. [PMID: 35831264 DOI: 10.1111/ped.15123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/24/2021] [Accepted: 01/11/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Childhood sleep practices impact growth, development, and long-term health. There is a paucity of sleep data pertaining to preschool children in Asia, especially South-East Asia. METHODS This cross-sectional study involved parents of well siblings, aged 2-6 years. It aimed to: (i) test the reliability of the English version of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P), and (ii) obtain the prevalence, as well as describe, sleep-related issues. Ninety-one (91) parents (74.7%; mothers) self-administered the questionnaire in the pediatric clinic waiting area of a Malaysian tertiary hospital. Recruitment was from August to November 2020. RESULTS The English version of the JSQ-P has good internal consistency (Cronbach alpha = 0.85). Range of Cronbach alpha values for each item: 0.36-0.87. Many (77%) children slept at 10:00 p.m. or later, similar to parents' late bedtimes. One-third had difficulty waking up in the morning. There were significant strong positive correlations between some features of restless leg syndrome, daytime tiredness, morning symptoms, and obstructive sleep apnea symptoms. Co-sleeping was prevalent (97.9%). Mean screen time for those who had set time limits was 2.35 ± 1.68 h. CONCLUSIONS The English-language translation of the JSQ-P is a questionnaire with good internal consistency that can be used in non-Japanese speaking countries. Parents need to be educated on healthy sleep and screen time practices to optimize children's sleep quality and quantity.
Collapse
Affiliation(s)
- Subhashini Jayanath
- Developmental Paediatrics Unit, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norhamizan Hamzah
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Aishah Ahmad Fauzi
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Aida Syarinaz Ahmad Adlan
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Azlin Zaiti Zainal
- Faculty of Languages and Linguistics, University of Malaya, Kuala Lumpur, Malaysia
| | - Ikuko Mohri
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Department of Child Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masaya Tachibana
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Department of Child Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| |
Collapse
|
25
|
Halim I, Reffin N, Sharifa Ezat WP, Muhamad NA, Harith AA. Compliance of Malaysian healthcare workers towards tuberculosis prevention programmes in workplace: An exploratory sequential mixed method study protocol. Med J Malaysia 2021; 76:857-864. [PMID: 34806673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The World Health Organization (WHO) stated that the incidence of tuberculosis among healthcare workers is increasing yearly and exceeds the incidence of tuberculosis in the community in almost all the countries that report to the WHO. The problem is greater in countries with high burden of tuberculosis disease in the community. The cause of this problem may be contributed by the attitudes of the healthcare workers themselves, such as non-compliance of the procedures at their work tasks meant to prevent them from contracting the disease. Therefore, this study aims to assess the perceptions and the behaviours of healthcare workers in relation to compliance towards prevention activities on tuberculosis at their workplace. MATERIALS AND METHODS We plan to conduct a two-phase exploratory sequential mixed method study to determine the factors affecting compliance of Malaysian healthcare workers towards tuberculosis prevention programmes in their workplace based on the guidelines of the Ministry of Health, Malaysia. Phase one is a qualitative study with a focus group discussion and questionnaire development and phase two is a quantitative study where data will be collected among healthcare workers in government clinics and hospitals in Selangor. The data from phase one will be analysed using Atlas.Ti software for thematic analysis and data from phase two will be analysed using SEM AMOS software for structural equation modelling.
Collapse
Affiliation(s)
- I Halim
- Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Community Health, Kuala Lumpur, Malaysia
| | - N Reffin
- Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Community Health, Kuala Lumpur, Malaysia. ;
| | - W P Sharifa Ezat
- Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Community Health, Kuala Lumpur, Malaysia
| | - N A Muhamad
- National Institutes of Health, Ministry of Health Malaysia
| | - A A Harith
- National Institutes of Health, Ministry of Health Malaysia
| |
Collapse
|
26
|
Muhamad NA, Faizal Bakhtiar M, Mustapha N, Adon MY, Arip M, Aris T. Workplace interventions for preventing work-related rhinitis and rhinosinusitis. Hippokratia 2021. [DOI: 10.1002/14651858.cd011816.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nor Asiah Muhamad
- Sector for Evidence-based Healthcare; National Institutes of Health, Ministry of Health; Shah Alam Malaysia
| | - Mohamed Faizal Bakhtiar
- Institute for Medical Research; National Institutes of Health, Ministry of Health; Shah Alam Malaysia
| | - Normi Mustapha
- Faculty Science and Technology; Open University Malaysia; Kuala Lumpur Malaysia
| | | | - Masita Arip
- Institute for Medical Research; National Institutes of Health, Ministry of Health; Shah Alam Malaysia
| | - Tahir Aris
- Institute for Medical Research; National Institutes of Health, Ministry of Health; Shah Alam Malaysia
| |
Collapse
|
27
|
Muhamad NA, Faizal Bakhtiar M, Mustapha N, Adon MY, Airaksinen L, Bakon SK, Mohamad ZA, Aris T. Workplace interventions for treating work-related rhinitis and rhinosinusitis. Hippokratia 2021. [DOI: 10.1002/14651858.cd011815.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Nor Asiah Muhamad
- Sector for Evidence-based Healthcare; National Institutes of Health, Ministry of Health; Shah Alam Malaysia
| | - Mohamed Faizal Bakhtiar
- Institute for Medical Research; National Institutes of Health, Ministry of Health; Shah Alam Malaysia
| | - Normi Mustapha
- Faculty Science and Technology; Open University Malaysia; Kuala Lumpur Malaysia
| | | | - Liisa Airaksinen
- Occupational Medicine; Finnish Institute of Occupational Health; Helsinki Finland
| | - Sophia K Bakon
- Institute for Medical Research; National Institutes of Health, Ministry of Health; Shah Alam Malaysia
| | - Zuraifah Asrah Mohamad
- Institute for Medical Research; National Institutes of Health, Ministry of Health; Shah Alam Malaysia
| | - Tahir Aris
- Institute for Medical Research; National Institutes of Health, Ministry of Health; Shah Alam Malaysia
| |
Collapse
|
28
|
Sahril N, Shahein NA, Yoep N, Mahmud NA, Sooryanarayana R, Maw Pin T, Muhamad NA, Ismail H. Prevalence and factors associated with falls among older persons in Malaysia. Geriatr Gerontol Int 2020; 20 Suppl 2:33-37. [PMID: 33370863 DOI: 10.1111/ggi.13980] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/18/2020] [Accepted: 05/31/2020] [Indexed: 11/29/2022]
Abstract
AIM Falls are a common problem among older people, leading to major morbidity and increased mortality. The study aimed to determine the prevalence of falls among older persons in Malaysia and its associated factors. METHODS Data were obtained from the National Health and Morbidity Survey 2018 (NHMS 2018), a cross-sectional study using stratified cluster sampling design. Older persons were defined as aged ≥60 years in this study. Descriptive and logistic regression analyses were conducted using SPSS version 25.0. RESULTS Overall, 14.1% (95% confidence interval [CI]: 12.46, 15.84) of older persons reported having experienced at least one fall during the past 12 months. Univariate analyses revealed an association between the history of falls with not being employed (odds ratio [OR]: 1.35 [95% CI: 1.03, 1.77]), diabetes mellitus (OR: 1.65 [95% CI: 1.33, 2.04]), limitation in activities of daily living (ADL) (OR: 1.90 [95% CI: 1.43, 2.54]) or instrumental ADL (OR: 1.47 [95% CI: 1.16, 1.84]). Multiple logistic regression revealed that falls were positively associated with those who had diabetes mellitus (OR: 1.55 [95% CI: 1.23, 1.94]) and limitation in ADL (OR: 1.56 [95% CI: 1.14, 2.15]); 43.9% of falls occurred outdoors. CONCLUSION One in six older Malaysian people experience at least one fall over a 12-month period. Diabetes mellitus and limitation in ADL were the factors associated with falls among older persons. A comprehensive and targeted program designed to reduce risk of falls is urgently needed. Future research should identify suitable programs for our setting to reduce the potential society burden of falls in older Malaysians. Geriatr Gerontol Int 2020; 20: 33-37.
Collapse
Affiliation(s)
- Norhafizah Sahril
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nik Adilah Shahein
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Norzawati Yoep
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nor Azna Mahmud
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Rajini Sooryanarayana
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia.,Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Tan Maw Pin
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nor Asiah Muhamad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Hasimah Ismail
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| |
Collapse
|
29
|
Muhamad NA, Ab Ghani RM, Abdul Mutalip MH, Muhammad EN, Mohamad Haris H, Mohd Zain R, Abdullah N, Muhammad Azami NA, Abd Jalal N, Ismail N, Mhd Yusuf NA, Othman R, Kamalul Arifin AS, Abdullah MS, Kamaruddin MA, Abu Hassan MR, Aris T, Jamal R. Seroprevalence of hepatitis B virus and hepatitis C virus infection among Malaysian population. Sci Rep 2020; 10:21009. [PMID: 33273475 PMCID: PMC7713078 DOI: 10.1038/s41598-020-77813-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/21/2020] [Indexed: 11/25/2022] Open
Abstract
Malaysia is a country with an intermediate endemicity for hepatitis B. As the country moves toward hepatitis B and C elimination, population-based estimates are necessary to understand the burden of hepatitis B and C for evidence-based policy-making. Hence, this study aims to estimate the prevalence of hepatitis B and C in Malaysia. A total of 1458 participants were randomly selected from The Malaysian Cohort (TMC) aged 35 to 70 years between 2006 and 2012. All blood samples were tested for hepatitis B and C markers including hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibody (anti-HBc), antibodies against hepatitis C virus (anti-HCV). Those reactive for hepatitis C were further tested for HCV RNA genotyping. The sociodemographic characteristics and comorbidities were used to evaluate their associated risk factors. Descriptive analysis and multivariable analysis were done using Stata 14. From the samples tested, 4% were positive for HBsAg (95% CI 2.7–4.7), 20% were positive for anti-HBc (95% CI 17.6–21.9) and 0.3% were positive for anti-HCV (95% CI 0.1–0.7). Two of the five participants who were reactive for anti-HCV had the HCV genotype 1a and 3a. The seroprevalence of HBV and HCV infection in Malaysia is low and intermediate, respectively. This population-based study could facilitate the planning and evaluation of the hepatitis B and C control program in Malaysia.
Collapse
Affiliation(s)
- Nor Asiah Muhamad
- Evidence-Based Healthcare Sector, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia.,Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Rimah Melati Ab Ghani
- Evidence-Based Healthcare Sector, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia.,Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Mohd Hatta Abdul Mutalip
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Eida Nurhadzira Muhammad
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Hasmah Mohamad Haris
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Rozainanee Mohd Zain
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Noraidatulakma Abdullah
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Azila Muhammad Azami
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nazihah Abd Jalal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norliza Ismail
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Ain Mhd Yusuf
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Raihannah Othman
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Mohd Shaharom Abdullah
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Arman Kamaruddin
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Tahir Aris
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia.,Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| |
Collapse
|
30
|
Ngah NF, Muhamad NA, Asnir ZZ, Abdul Aziz RA, Mhad Kassim Z, Sahar SA, Ahmad Tarmidzi NA, Chan LY, Uthman R, Satar N, Husain NZ, Adnan A, Kayalakakathu JM, Kadas B, Mohamad NS, Kassim SA. Descriptive assessment on diabetic retinopathy screening in an awareness programme in Malaysia. Int J Ophthalmol 2020; 13:1808-1813. [PMID: 33215014 DOI: 10.18240/ijo.2020.11.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/13/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the prevalence of diabetic retinopathy (DR) among diabetic patients at the primary health clinics in Selangor, Malaysia. METHODS All diabetic patients were screened in Retinal Disease Awareness Programme (RDAP) and those who had significant DR changes were referred to the hospital for further management. Descriptive analyses were done to determine the prevalence of DR and sociodemographic characteristics among patients with diabetic. Univariate and multivariable analysis using Logistic regression were performed to find association and predictor factors in this screening. RESULTS A total of 3305 patients aged 40y and above were screened for DR. Of the patients screened, 9% patients were found to have DR and other visual complication such as maculopathy (0.9%), cataract (4.8%) and glaucoma (0.4%). The mean age of patients without retinopathy was 57.82±8.470y and the mean age of patients with DR was 63.93±9.857y. About 61.5% of the patients screened were aged below 60y and 38.5% were aged 60y and above. Majority of the patients screened were women 58.5% and Malay in the age group of 50-59y, while 27% were aged 60-69y. Significant association were found between age, sex, race, visual loss and DR. CONCLUSION Although the prevalence of DR among patients is not alarming, effective interventions need to be implemented soon to avert a large burden of visual loss from DR.
Collapse
Affiliation(s)
- Nor Fariza Ngah
- Department of Ophthalmology, Shah Alam Hospital, Selangor 40000, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence Based Healthcare, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia.,Institute for Public Health, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia
| | | | | | | | - Siti Aishah Sahar
- Department of Ophthalmology, Putrajaya Hospital, Federal Territory 62250, Malaysia
| | | | - Li Yen Chan
- Department of Ophthalmology, Tengku Ampuan Rahimah Hospital, Selangor 41200, Malaysia
| | - Rosmawati Uthman
- Department of Ophthalmology, Selayang Hospital, Selangor 68100, Malaysia
| | - Narjis Satar
- Department of Ophthalmology, Sungai Buloh Hospital, Selangor 47000, Malaysia
| | - Noor Zahirah Husain
- Department of Ophthalmology, Kuala Lumpur Hospital, Federal Territory 50586, Malaysia
| | - Azian Adnan
- Department of Ophthalmology, Selayang Hospital, Selangor 68100, Malaysia
| | | | - Bariyah Kadas
- Selangor State Health Department, Ministry of Health, Selangor 40100, Malaysia
| | - Noor Suriani Mohamad
- Department of Ophthalmology, Tengku Ampuan Rahimah Hospital, Selangor 41200, Malaysia
| | - Shaiful Azlan Kassim
- Institute for Public Health, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia
| |
Collapse
|
31
|
Jeevananthan C, Muhamad NA, Jaafar MH, Hod R, Ab Ghani RM, Md Isa Z. Effects of temperature, humidity, air quality and anthropic activities on the transmission of SARS-CoV-2: a systematic review protocol. BMJ Open 2020; 10:e039623. [PMID: 33148753 PMCID: PMC7643413 DOI: 10.1136/bmjopen-2020-039623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The current global pandemic of the virus that emerged from Hubei province in China has caused coronavirus disease in 2019 (COVID-19), which has affected a total number of 900 036 people globally, involving 206 countries and resulted in a cumulative of 45 693 deaths worldwide as of 3 April 2020. The mode of transmission is identified through airdrops from patients' body fluids such as during sneezing, coughing and talking. However, the relative importance of environmental effects in the transmission of the virus has not been vastly studied. In addition, the role of temperature and humidity in air-borne transmission of infection is presently still unclear. This study aims to identify the effect of temperature, humidity and air quality in the transmission of SARS-CoV-2. METHODS AND ANALYSIS We will systematically conduct a comprehensive literature search using various databases including PubMed, EMBASE, Scopus, CENTRAL and Google Scholar to identify potential studies. The search will be performed for any eligible articles from the earliest published articles up to latest available studies in 2020. We will include all the observational studies such as cohort case-control and cross-sectional studies that explains or measures the effects of temperature and/or humidity and/or air quality and/or anthropic activities that is associated with SARS-CoV-2. Study selection and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Meta-Analysis of Observational Studies in Epidemiology guideline. All data will be extracted using a standardised data extraction form and quality of the studies will be assessed using the Newcastle-Ottawa Scale guideline. Descriptive and meta-analysis will be performed using a random effect model in Review Manager File. ETHICS AND DISSEMINATION No primary data will be collected, and thus no formal ethical approval is required. The results will be disseminated through a peer-reviewed publication and conference presentation. PROSPERO REGISTRATION NUMBER CRD42020176756.
Collapse
Affiliation(s)
- Chandrika Jeevananthan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Sector for Evidence-based Healthcare,National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-based Healthcare,National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Mohd Hasni Jaafar
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rimah Melati Ab Ghani
- Sector for Evidence-based Healthcare,National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Zaleha Md Isa
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
32
|
Rao V, Muhamad NA, Nordin S, Hasim R, Rafan SN, Shafie H, Muzaid A, Ayadurai V, Abdullah N, Chemi N, Mohamed H, Hassan NH, Ghani RMA, Ibrahim K. Describing the Programme on Methadone Maintenance Therapy in Selangor, Malaysia. Glob J Health Sci 2020. [DOI: 10.5539/gjhs.v12n9p151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION: Drug addiction and drug abuse is a serious public health problem worldwide. Millions of people worldwide suffered from drug use disorders, directly and indirectly, attributable to drug use and included deaths related to HIV and hepatitis C acquired through unsafe injecting practices. Many parts of the world have a shortfall in prevention and treatment for drug use disorders, with only less than 10% of people with drug use disorders receiving treatment yearly. Medication-assisted treatment of opioid dependence like Methadone is used in maintenance therapy or detoxification helps people with drug use disorders.
MATERIAL AND METHODS: Secondary data from an existing electronic dataset in Ministry of Health (MOH) from 2015 until 2019, which includes registered patients who had undergone Methadone Maintenance Therapy (MMT) either government or private facilities were included. The dataset divided into few domains namely socio-demographic, treatment modalities, clinic location and history of infection.
RESULTS: A total of 37 various government and private facilities deliver MMT programme in the state of Selangor offered to a total of 5337 patients. The youngest patients were in the early twenties and oldest were in late seventies. The median age of patients was 45 years and the majority were males. Most of them were having secondary education (SPM holder) and below. Most of MMT programme takers were opioid drug users then followed by Amphetamine Type Stimulant (ATS) as the second most used. Among MMT programme takers, about 34.1% were reactive for Hepatitis C, 6.6% reactive for HIV, 4.2% reactive for Hepatitis B and 1.7% acquired tuberculosis infection. Almost 5% of MMT takers had passed away, which the three main causes of death were AIDS, alleged motor vehicle accident and septic shock. None of MMT takers was died due to methadone.
CONCLUSION: It is a great concern of the nation in combating drug-related problems due to the growing number of substance abusers. This review concluded that the MMT programme that widely available had shown a positive outcome by keeping lower mortality among MMT patients.
Collapse
|
33
|
Rifin HM, Ling MYJ, Lourdes TGR, Saminathan TA, Hasani WSR, Majid NLA, Ahmad A, Yusoff MFM, Muhamad NA. Small/kiddie Cigarette Packaging Size and Its Impact on Smoking: A Systematic Review.. [DOI: 10.21203/rs.3.rs-28794/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Background:Kiddie/small packs contain less than 20 cigarette sticks in a pack.Kiddie packs were introduced by the tobacco industry to support moderation and encourage quit smoking among heavy smokers although this may in turn encourage underage smoking. Smaller packs may suggest lower costs and this may increase affordability among the younger generation. This concern has causedmany countries to ban the sale of single cigarette sticks or kiddie packs. Hence, a systematic review was conducted to identify the impact of kiddie packs on smoking as compared to regular cigarette packaging in the general population.Methods:A database search was conductedin PubMed, EMBASE, CENTRAL, Web of Science and Scopus up to31stJanuary 2020. Other sources namely Google Scholar, as well as Journal of Substance Use and Tobacco Control were also searched.The results were analysed qualitatively, under four groups: initiation of smoking;urge /tendency to buy cigarettes; prevalence of smoking and attempt to reduce cigarette consumption. The methodological quality of all articles that were includedwas determined using a validated 16-item quality assessment tool (QATSDD). The literature search identified 2253 articles, of which20articles had met theinclusion criteria. Discussion:Articles that we reviewed had some evidence that kiddie packs increase the urge/tendency to buy cigarettes and also increase the attempt to reduce cigarette consumption. However, we found no evidence on theimpact of kiddie packs on the initiation of smoking and the prevalence of smoking. The average quality score for all papers was 34.1%.Given the diverse study settings of the articles and despite the challenges of the methodological quality of some papers, this review will provideevidence that kiddie packs increase urge/tendency to buy cigarettes and also increase the attempt to reduce cigarette consumption. However, since most studies were of low quality, further high-quality studies are needed to come to a firm conclusion of the impact of kiddie packs on smoking.Systematic review registration: PROSPEROCRD42018102325
Collapse
|
34
|
Muhamad NA, Rafan SN, Mohd Dali NS, Abdullah N, Chemi N, Shafie H, Ayadurai V, Hasim R, Muzaid NA, Rao V, Bakhtiar MF, Noordin S. Determining the Effects of Psychosocial and Spiritual Support Among Patients With Substance Abuse: A Scoping Review. Glob J Health Sci 2020. [DOI: 10.5539/gjhs.v12n7p48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Substance use disorder (SUD) has both social and public health problems with a substantial burden to society. SUD is a type of mental illness and has been described as a chronic relapsing disease. Treatments for SUD may include among others, psychosocial rehabilitation as a provision to comprehensive treatment to address the social and behavioral issues. These psychosocial components can address the issues of morality, spirituality, and religion. Religion and spirituality are believed to support SUD clients in the reduction of drug use, other associated high-risk behaviors, and criminal issues. In promoting treatment retention, it is important to reduce the drug use, maintain abstinence, and influence the self-esteem and coping ability of SUD clients. Hence, this review was conducted to determine the effects of psychosocial and spiritual support towards clients with substance abuse problem. We had followed the framework from Arksey and O’Malley’s scoping review in identifying published studies from specific databases to be included in this review. A total of 8560 articles from various databases were screened. After removing duplicates, two authors independently screened 244 titles and abstracts. A total of eighteen articles were included in the final review. Out of eighteen studies, seventeen studies found that psychosocial support and spiritual needs have positive effect among substance abuse clients. Psychosocial and spiritual supports are beneficial among SUD clients due to various potential factors, such as religious reasons, personal beliefs or philosophical reasons, safety concerns, and a desire for improvements from substance abuse.
Collapse
|
35
|
Mihat O, Ghani RMA, Muhamad NA, Pheng LC, Jaafar S, Eliana Musa NS, Sapian RA, Ismail SA, Aris T. Introduction of Exercise for Medicine (Exfome) Programme Among Patients In Primary Health Clinics In Malaysia. Glob J Health Sci 2020. [DOI: 10.5539/gjhs.v12n4p104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION: Diseases due to unhealthy lifestyles such as heart diseases and diabetes are increasing in Malaysia. Heart diseases are the leading cause of deaths of patients in government hospitals, i.e. 16.1% of total deaths in 2009. A customised exercise regime called Exercise for Medicine (EXFOME) was introduced to improve and prevent chronic diseases such as diabetes, heart disease, obesity and hypertension.
MATERIAL & METHODS: A total of 126 participants from government health clinics in three states of Peninsular Malaysia were selected to participate in the EXFOME. Each participant was evaluated prior to the program using an assessment protocol. Fitness assessment and evaluation with body composition measurement were taken. Exercise therapist prescribed a personalized exercise program according to conditions.
RESULTS: Effect of exercise was measured in terms of improvement in hypertension and diabetes, body weight, body fat, lipid profile and physical fitness at three and six months.
CONCLUSION: EXFOME is beneficial to improve the status of hypertension, diabetes, body weight and lipid profile when it is carried out for longer period.
Collapse
|
36
|
Wan Jamaludin WF, Husin FR, Ab. Aziz A, Mohd Yunus MR, Azman M, Kong MH, Masir N, Ghoddoosi M, Zaider SZA, Mustapha N, Muhamad NA, Abdul Wahid SF. The Value of PET-CT Scan in Determining Remission Status in Lymphoma Patients Involving the Head & Neck Region. SAINS MALAYS 2019. [DOI: 10.17576/jsm-2019-4810-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
37
|
Hamzah N, Narayanan V, Ramli N, Mustapha NA, Mohammad Tahir NA, Tan LK, Danaee M, Muhamad NA, Drummond A, das Nair R, Goh SY, Mazlan M. Randomised controlled clinical trial of a structured cognitive rehabilitation in patients with attention deficit following mild traumatic brain injury: study protocol. BMJ Open 2019; 9:e028711. [PMID: 31537559 PMCID: PMC6756424 DOI: 10.1136/bmjopen-2018-028711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To measure the clinical, structural and functional changes of an individualised structured cognitive rehabilitation in mild traumatic brain injury (mTBI) population. SETTING A single centre study, Malaysia. PARTICIPANTS Adults aged between 18 and 60 years with mTBI as a result of road traffic accident, with no previous history of head trauma, minimum of 9 years education and abnormal cognition at 3 months will be included. The exclusion criteria include pre-existing chronic illness or neurological/psychiatric condition, long-term medication that affects cognitive/psychological status, clinical evidence of substance intoxication at the time of injury and major polytrauma. Based on multiple estimated calculations, the minimum intended sample size is 50 participants (Cohen's d effect size=0.35; alpha level of 0.05; 85% power to detect statistical significance; 40% attrition rate). INTERVENTIONS Intervention group will receive individualised structured cognitive rehabilitation. Control group will receive the best patient-centred care for attention disorders. Therapy frequency for both groups will be 1 hour per week for 12 weeks. OUTCOME MEASURES Primary: Neuropsychological Assessment Battery-Screening Module (S-NAB) scores. Secondary: Diffusion Tensor Imaging (DTI) parameters and Goal Attainment Scaling score (GAS). RESULTS Results will include descriptive statistics of population demographics, CogniPlus cognitive program and metacognitive strategies. The effect of intervention will be the effect size of S-NAB scores and mean GAS T scores. DTI parameters will be compared between groups via repeated measure analysis. Correlation analysis of outcome measures will be calculated using Pearson's correlation coefficient. CONCLUSION This is a complex clinical intervention with multiple outcome measures to provide a comprehensive evidence-based treatment model. ETHICS AND DISSEMINATION The study protocol was approved by the Medical Research Ethics Committee UMMC (MREC ID NO: 2016928-4293). The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT03237676.
Collapse
Affiliation(s)
- Norhamizan Hamzah
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vairavan Narayanan
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norlisah Ramli
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nor Atikah Mustapha
- Department of Rehabilitation Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | - Li Kuo Tan
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nor Asiah Muhamad
- Institute for Public Health, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Avril Drummond
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Roshan das Nair
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Institute of Mental Health, Nottinghamshire Healthcare Trust, Nottingham, United Kingdom
| | - Sing Yau Goh
- Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Sungai Long Campus, Malaysia
| | - Mazlina Mazlan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
38
|
Ghani RMA, Rosman A, Muhamad NA. The Suspected Child Abuse and Neglect (SCAN) Programme in Malaysia: From Inception to Present. Glob J Health Sci 2019. [DOI: 10.5539/gjhs.v11n7p148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Issues on child abuse are very critical considering the many incidents of abuse and violence against children. Experiencing abuse in childhood has lifelong impacts on the health and well-being of children, their families and communities. Suspected Child Abuse and Neglect (SCAN) service is centralised, multidisciplinary team management in the government hospital and serve as a supportive service or programme to children, families and hospital staff. This paper outlines the history and the SCAN service available in Malaysia.
Collapse
|
39
|
Affiliation(s)
| | - Roslaili Khairudin
- Institute for Medical Research; Medical Research Resource Centre; Kuala Lumpur Malaysia 50588
| | - Jacqueline J Ho
- RCSI & UCD Malaysia Campus (formerly Penang Medical College); Department of Paediatrics; Jalan Sepoy Lines George Town Penang Malaysia 10450
| | - Nor Asiah Muhamad
- Ministry of Health; Institute for Public Health; Kuala Lumpur Federal Teritory Malaysia 50590
| | - Hirman Ismail
- Ministry of Health Malaysia; Office of the Director General of Health Malaysia / Medical Development Division; Level 5 Block E1 Complex E Federal Government Administrative Centre Putrajaya Malaysia 62590
| |
Collapse
|
40
|
Abdul Mutalip MH, Mahmud MAF, Lodz NA, Yoep N, Muhammad EN, Ahmad A, Hashim MH, Muhamad NA. Environmental risk factors of leptospirosis in urban settings: a systematic review protocol. BMJ Open 2019; 9:e023359. [PMID: 30670512 PMCID: PMC6347878 DOI: 10.1136/bmjopen-2018-023359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Leptospirosis is the most common zoonotic disease that causes morbidity and mortality worldwide. The disease can cause sporadic epidemics and recent epidemics have become more apparent in urban localities. There is lack of documented evidence on the specific risk factors of leptospirosis infection among the urbanites, thereby impeding initiatives for prevention in urban settings. We aim to systematically search published articles and synthesise evidence on the risk factors associated with leptospirosis infection among the susceptible populations in urban localities, particularly to identify the risk factors of non-recreational leptospirosis infection. METHODS AND ANALYSIS We will conduct a systematic review of observational studies that investigated environmental risk factors of leptospirosis in urban localities. The search will be performed for any eligible articles from selected electronic databases from 1970 until May 2018. The study will include any studies that investigated risk factors of confirmed leptospirosis cases who acquired the infection in urban locality, particularly exposures from the non-recreational and non-water-related activities. Study selection and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Meta-Analysis of Observational Studies in Epidemiology guideline. All data will be extracted using a standardised data extraction form and quality of the studies will be assessed using the Newcastle-Ottawa Scale guideline. Descriptive and meta-analysis will be performed by calculating the standardised median ORs and risk ratios for types of the non-recreational risk factors stratified by social, living conditions and environmental exposures, types of reservoirs and transmissions and types of activities and employments associated with leptospirosis infection in urban locality. ETHICS AND DISSEMINATION No primary data will be collected thus no formal ethical approval is required. The results will be disseminated though a peer-reviewed publication and conference presentation. PROSPERO REGISTRATION NUMBER CRD42018090820.
Collapse
Affiliation(s)
| | | | - Noor Aliza Lodz
- Center for Communicable Disease Research, Institute for Public Health, Kuala Lumpur, Malaysia
| | - Norzawati Yoep
- Center for Communicable Disease Research, Institute for Public Health, Kuala Lumpur, Malaysia
| | | | - Ahzairin Ahmad
- Center for Non-Communicable Disease Research, Institute for Public Health, Kuala Lumpur, Malaysia
| | - Mohd Hazrin Hashim
- Center for Communicable Disease Research, Institute for Public Health, Kuala Lumpur, Malaysia
| | - Nor Asiah Muhamad
- Center for Communicable Disease Research, Institute for Public Health, Kuala Lumpur, Malaysia
| |
Collapse
|
41
|
Muhamad NA, Buang SN, Jaafar S, Jais R, Tan PS, Mustapha N, Lodz NA, Aris T, Sulaiman LH, Murad S. Achieving high uptake of human papillomavirus vaccination in Malaysia through school-based vaccination programme. BMC Public Health 2018; 18:1402. [PMID: 30577816 PMCID: PMC6303856 DOI: 10.1186/s12889-018-6316-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/11/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In 2006, 4 years of planning was started by the Ministry of Health, Malaysia (MOH), to implement the HPV (human papillomavirus) vaccination programme. An inter-agency and multi-sectoral collaborations were developed for Malaysia's HPV school-based immunisation programme. It was approved for nationwide school base implementation for 13-year-old girls or first year secondary students in 2010. This paper examines how the various strategies used in the implementation over the last 7 years (2010-2016) that unique to Malaysia were successful in achieving optimal coverage of the target population. METHODS Free vaccination was offered to school girls in secondary school (year seven) in Malaysia, which is usually at the age of 13 in the index year. All recipients of the HPV vaccine were identified through school enrolments obtained from education departments from each district in Malaysia. A total of 242,638 girls aged between 12 to 13 years studying in year seven were approached during the launch of the program in 2010. Approximately 230,000 girls in secondary schools were offered HPV vaccine per year by 646 school health teams throughout the country from 2010 to 2016. RESULTS Parental consent for their daughters to receive HPV vaccination at school was very high at 96-98% per year of the programme. Of those who provided consent, over 99% received the first dose each year and 98-99% completed the course per year. Estimated population coverage for the full vaccine course, considering also those not in school, is estimated at 83 to 91% per year. Rates of adverse events reports following HPV vaccination were low at around 2 per 100,000 and the majority was injection site reactions. CONCLUSION A multisectoral and integrated collaborative structure and process ensured that the Malaysia school-based HPV immunisation programme was successful and sustained through the programme design, planning, implementation and monitoring and evaluation. This is a critical factor contributing to the success and sustainability of the school-based HPV immunisation programme with very high coverage.
Collapse
Affiliation(s)
- Nor Asiah Muhamad
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia. .,Disease Control Division, Ministry of Health, Kuala Lumpur, Malaysia.
| | | | - Safurah Jaafar
- Family Health Development Division, Ministry of Health, Kuala Lumpur, Malaysia.,Department of Community Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Rohani Jais
- Disease Control Division, Ministry of Health, Kuala Lumpur, Malaysia
| | - Phaik Sim Tan
- Family Health Development Division, Ministry of Health, Kuala Lumpur, Malaysia
| | - Normi Mustapha
- Faculty of Science and Technology, Open University Malaysia, Kuala Lumpur, Malaysia
| | - Noor Aliza Lodz
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Tahir Aris
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Lokman Hakim Sulaiman
- Department of Community Medicine, International Medical University, Kuala Lumpur, Malaysia.,Office of Deputy Director General of Health (Public Health), Ministry of Health, Putrajaya, Malaysia
| | - Shahnaz Murad
- Office of Deputy Director General of Health (Research and Technical Support), Ministry of Health, Putrajaya, Malaysia
| |
Collapse
|
42
|
Abdul Wahid SF, Ismail NA, Wan Jamaludin WF, Muhamad NA, Abdul Hamid MKA, Harunarashid H, Lai NM. Autologous cells derived from different sources and administered using different regimens for 'no-option' critical lower limb ischaemia patients. Cochrane Database Syst Rev 2018; 8:CD010747. [PMID: 30155883 PMCID: PMC6513643 DOI: 10.1002/14651858.cd010747.pub2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Revascularisation is the gold standard therapy for patients with critical limb ischaemia (CLI). In over 30% of patients who are not suitable for or have failed previous revascularisation therapy (the 'no-option' CLI patients), limb amputation is eventually unavoidable. Preliminary studies have reported encouraging outcomes with autologous cell-based therapy for the treatment of CLI in these 'no-option' patients. However, studies comparing the angiogenic potency and clinical effects of autologous cells derived from different sources have yielded limited data. Data regarding cell doses and routes of administration are also limited. OBJECTIVES To compare the efficacy and safety of autologous cells derived from different sources, prepared using different protocols, administered at different doses, and delivered via different routes for the treatment of 'no-option' CLI patients. SEARCH METHODS The Cochrane Vascular Information Specialist (CIS) searched the Cochrane Vascular Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), and trials registries (16 May 2018). Review authors searched PubMed until February 2017. SELECTION CRITERIA We included randomised controlled trials (RCTs) involving 'no-option' CLI patients comparing a particular source or regimen of autologous cell-based therapy against another source or regimen of autologous cell-based therapy. DATA COLLECTION AND ANALYSIS Three review authors independently assessed the eligibility and methodological quality of the trials. We extracted outcome data from each trial and pooled them for meta-analysis. We calculated effect estimates using a risk ratio (RR) with 95% confidence interval (CI), or a mean difference (MD) with 95% CI. MAIN RESULTS We included seven RCTs with a total of 359 participants. These studies compared bone marrow-mononuclear cells (BM-MNCs) versus mobilised peripheral blood stem cells (mPBSCs), BM-MNCs versus bone marrow-mesenchymal stem cells (BM-MSCs), high cell dose versus low cell dose, and intramuscular (IM) versus intra-arterial (IA) routes of cell implantation. We identified no other comparisons in these studies. We considered most studies to be at low risk of bias in random sequence generation, incomplete outcome data, and selective outcome reporting; at high risk of bias in blinding of patients and personnel; and at unclear risk of bias in allocation concealment and blinding of outcome assessors. The quality of evidence was most often low to very low, with risk of bias, imprecision, and indirectness of outcomes the major downgrading factors.Three RCTs (100 participants) reported a total of nine deaths during the study follow-up period. These studies did not report deaths according to treatment group.Results show no clear difference in amputation rates between IM and IA routes (RR 0.80, 95% CI 0.54 to 1.18; three RCTs, 95 participants; low-quality evidence). Single-study data show no clear difference in amputation rates between BM-MNC- and mPBSC-treated groups (RR 1.54, 95% CI 0.45 to 5.24; 150 participants; low-quality evidence) and between high and low cell dose (RR 3.21, 95% CI 0.87 to 11.90; 16 participants; very low-quality evidence). The study comparing BM-MNCs versus BM-MSCs reported no amputations.Single-study data with low-quality evidence show similar numbers of participants with healing ulcers between BM-MNCs and mPBSCs (RR 0.89, 95% CI 0.44 to 1.83; 49 participants) and between IM and IA routes (RR 1.13, 95% CI 0.73 to 1.76; 41 participants). In contrast, more participants appeared to have healing ulcers in the BM-MSC group than in the BM-MNC group (RR 2.00, 95% CI 1.02 to 3.92; one RCT, 22 participants; moderate-quality evidence). Researchers comparing high versus low cell doses did not report ulcer healing.Single-study data show similar numbers of participants with reduction in rest pain between BM-MNCs and mPBSCs (RR 0.99, 95% CI 0.93 to 1.06; 104 participants; moderate-quality evidence) and between IM and IA routes (RR 1.22, 95% CI 0.91 to 1.64; 32 participants; low-quality evidence). One study reported no clear difference in rest pain scores between BM-MNC and BM-MSC (MD 0.00, 95% CI -0.61 to 0.61; 37 participants; moderate-quality evidence). Trials comparing high versus low cell doses did not report rest pain.Single-study data show no clear difference in the number of participants with increased ankle-brachial index (ABI; increase of > 0.1 from pretreatment), between BM-MNCs and mPBSCs (RR 1.00, 95% CI 0.71 to 1.40; 104 participants; moderate-quality evidence), and between IM and IA routes (RR 0.93, 95% CI 0.43 to 2.00; 35 participants; very low-quality evidence). In contrast, ABI scores appeared higher in BM-MSC versus BM-MNC groups (MD 0.05, 95% CI 0.01 to 0.09; one RCT, 37 participants; low-quality evidence). ABI was not reported in the high versus low cell dose comparison.Similar numbers of participants had improved transcutaneous oxygen tension (TcO₂) with IM versus IA routes (RR 1.22, 95% CI 0.86 to 1.72; two RCTs, 62 participants; very low-quality evidence). Single-study data with low-quality evidence show a higher TcO₂ reading in BM-MSC versus BM-MNC groups (MD 8.00, 95% CI 3.46 to 12.54; 37 participants) and in mPBSC- versus BM-MNC-treated groups (MD 1.70, 95% CI 0.41 to 2.99; 150 participants). TcO₂ was not reported in the high versus low cell dose comparison.Study authors reported no significant short-term adverse effects attributed to autologous cell implantation. AUTHORS' CONCLUSIONS Mostly low- and very low-quality evidence suggests no clear differences between different stem cell sources and different treatment regimens of autologous cell implantation for outcomes such as all-cause mortality, amputation rate, ulcer healing, and rest pain for 'no-option' CLI patients. Pooled analyses did not show a clear difference in clinical outcomes whether cells were administered via IM or IA routes. High-quality evidence is lacking; therefore the efficacy and long-term safety of autologous cells derived from different sources, prepared using different protocols, administered at different doses, and delivered via different routes for the treatment of 'no-option' CLI patients, remain to be confirmed.Future RCTs with larger numbers of participants are needed to determine the efficacy of cell-based therapy for CLI patients, along with the optimal cell source, phenotype, dose, and route of implantation. Longer follow-up is needed to confirm the durability of angiogenic potential and the long-term safety of cell-based therapy.
Collapse
Affiliation(s)
- S Fadilah Abdul Wahid
- Universiti Kebangsaan Malaysia Medical CentreCell Therapy CenterJalan Yaacob LatifKuala LumpurMalaysia56000
- Universiti Kebangsaan Malaysia Medical CentreClinical Haematology & Stem Cell Transplantation Services, Department of MedicineKuala LumpurMalaysia
| | - Nor Azimah Ismail
- Universiti Kebangsaan Malaysia Medical CentreCell Therapy CenterJalan Yaacob LatifKuala LumpurMalaysia56000
| | - Wan Fariza Wan Jamaludin
- Universiti Kebangsaan Malaysia Medical CentreCell Therapy CenterJalan Yaacob LatifKuala LumpurMalaysia56000
| | - Nor Asiah Muhamad
- Ministry of HealthInstitute for Public HealthKuala LumpurFederal TeritoryMalaysia50590
| | | | - Hanafiah Harunarashid
- Universiti Kebangsaan Malaysia Medical CentreUnit of Vascular Surgery, Department of SurgeryJalan Yaacob LatifKuala LumpurKuala LumpurMalaysia56000
| | - Nai Ming Lai
- Taylor's UniversitySchool of MedicineSubang JayaMalaysia
| | | |
Collapse
|
43
|
Wahid FSA, Ismail NA, Wan Jamaludin WF, Muhamad NA, Mohamad Idris MA, Lai NM. Efficacy and Safety of Autologous Cell-based Therapy in Patients with No-option Critical Limb Ischaemia: A Meta-Analysis. Curr Stem Cell Res Ther 2018. [DOI: 10.2174/1574888x13666180313141416] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Fadilah S. Abdul Wahid
- Cell Therapy Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaakob Latif, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Nor Azimah Ismail
- Cell Therapy Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaakob Latif, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Wan Fariza Wan Jamaludin
- Cell Therapy Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaakob Latif, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Nor Asiah Muhamad
- Non Communicable Disease Section, Disease Control Division, Level 2, E3, Ministry of Health, Federal Government Administrative Centre, Putrajaya, Kuala Lumpur, Malaysia
| | - Mohamad Azim Mohamad Idris
- Vascular Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaakob Latif, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Nai Ming Lai
- School of Medicine, Taylor's University Lakeside Campus, Kuala Lumpur, Malaysia
| |
Collapse
|
44
|
Muhamad NA, Mihat O, Ramly R, Aziz AA, Kamaruddin R, Mansor WNAW, Abdullah NH, Noor MAM, Ismail R, Wisman WA, Lodz NA, Yusoff MFM. Translation, Cross-Cultural Adaptation, Reliability and Validity of the Malay Version of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) V3.1. Health (London) 2018. [DOI: 10.4236/health.2018.107073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
45
|
Muhamad NA, Roslan NM, Mahdi A, Ithnain N, Mustapha N, Aliza L N, Melati AG R, SM S. Association between Health Risk Behavior and Suicidal Ideation, Continuous Sadness and Depression among Malaysian Youth. Glob J Health Sci 2017. [DOI: 10.5539/gjhs.v10n1p11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND: Suicide is a global public health importance and a second leading cause of death in adolescents. It is more common among adolescents and is considered as a serious public health problem worldwide. This study aims to determine the association between health risk behavior with suicidal ideation, continuous sadness and depression among Malaysian youth.METHODS: A cross-sectional study was carried out among 4088 youth aged 13–17 years old from 50 selected schools. A stratified random sampling was used to select respondents from different classes. The students were randomly selected using the same software throughout the country. Verbal consent was obtained from the student and parents prior to data collection. A standardized self-administered questionnaire adapted from the United States’ Youth Behaviour Risk Surveillance Survey (YBRSS) were used.RESULTS: The rates of Continuous Sadness (CS), Depression (DP) and Suicidal Ideation (SI) were 34.3%, 13.2% and 7.9% respectively. The multivariable-adjusted odds ratio showed that sexual abuse was associated with SI 8.04 (95% CI: 4.66, 13.84), CS 5.72 (95% CI: 3.21, 9.82) and DP 4.68% (95% CI: 2.80, 7.83); alcohol use was associated with SI 1.62 (95% CI: 1.06, 2.47) and DP 1.67 (95% CI: 1.20, 2.33). Female was associated with all suicidal behaviours: SI 2.48 (95% CI: 1.90, 3.24), CS 2.07 (95% CI: 1.80, 2.37) and DP 1.41 (95% CI: 2.17, 1.71). Smoking and drug was not associated with CS, DP and SI.CONCLUSIONS: Given the well-founded concern of increasing risk of suicidal behaviour among youth, preventive efforts should adopt a more comprehensive approach in dealing with sexual abuse and alcohol abuse, especially in female.
Collapse
|
46
|
Isa A, Muhamad NA, Mustapha N, Abdul Mutalip MH, Lodz NA, Mohd Royali MS, Baharin MF, Zaini Z, SM S. Association between Self-Efficacy and Health Behaviour in Disease Control: A Systematic Review. Glob J Health Sci 2017. [DOI: 10.5539/gjhs.v10n1p18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND: Self-efficacy is defined as his or her belief of their capacity to produce specific performance attainments where represent the ability of positive and negative control over their own motivation, behavior, and social environment. Interventions to increase self-efficacy are a potentially effective way of changing health behavior towards attractive results, however the subject has not been systematically reviewed. This review aims to assess the relationship between self-efficacy and change in good health behaviour.METHODS: A comprehensive and extensive search of four bibliographic data bases was conducted for papers reporting health promotion and educational interventions that explicitly targeted self-efficacy in order to change health behaviour in achieving better disease control.RESULTS: Out of 314 studies, 13 were included in the review. Of these, 8 were found to have significant association between self-efficacy and specific health behaviours. However, 5 studies failed to show any significant prediction towards health behavior. Another 6 studies showed either significant mediation effect or indirect relationship of self-efficacy and health behaviours.CONCLUSIONS: Self-efficacy appears to be an important psychosocial construct that may directly or indirectly affect health behaviour to control diseases. Self-efficacy may also function as a link between effective health promotion and educational interventions and health behaviour change in disease control.
Collapse
|
47
|
Muhamad NA, Busu P, Hum WL, Mustapha N, Ali S, Murad S, Lodz NA, Mohamed SS. Doktor Muda Competencies: Self-efficacy and Hand Washing Demonstration Skill among School Children in Malaysia. Glob J Health Sci 2017. [DOI: 10.5539/gjhs.v9n12p47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION: “Doktor Muda” (DM) programme was developed by the Ministry of Health (MOH), Malaysia to train a group of pupils as peer educator for change in motivating and assisting their peers to adopt healthy practices especially in hand washing through good knowledge, positive attitude, high self-efficacy and skill to deliver health messagesAIM: This study aims to identify the association of socio demographic, knowledge, attitude, and practices with self-efficacy in proper hand washing.METHODS: A cross-sectional study using a self-administered questionnaire and observation checklists for hand washing demonstration skills.RESULT: This study showed that the subjects` knowledge (16.7%), practice (23.8%) and self-efficacy (41.7) in proper hand washing were low. Significant association were found between gender (p=0.004), academic achievements (p=0.038) and practices (p=0.003) with self-efficacy in proper hand washing.CONCLUSION: Various strategies are needed to strengthen DM role as peer educators and health change agents in school as levels of their knowledge, practice and self-efficacy were low.
Collapse
|
48
|
Abstract
The power cable breakdown suspected due to water treeing in polymeric cables are said to be the main cause. The inconsistent and unreliable nature brings out the importance of research in water treeing detection in polymeric cables. Early detection of water tree in polymeric cables is important in order to increase the cable efficiency by reducing the timeframe of the cable failure. This paper presents a comprehensive review of water treeing detections in polymeric cables, in particular, the relation to the background of water treeing, the types of water treeing, experimental investigations on water treeing, and factors affecting the initiation and growth of water trees.
Collapse
|
49
|
Muhamad NA, Abdullah NA, Ujang N, Elias A, Ho JJ, Awang S. Community based interventions for reducing dengue incidence. Hippokratia 2016. [DOI: 10.1002/14651858.cd010184.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nor Asiah Muhamad
- Ministry of Health Malaysia; Disease Control Division; Putrajaya Malaysia 62590
| | - Nor Aini Abdullah
- Institute for Medical Research; Jalan Pahang Kuala Lumpur Malaysia 50588
| | - Noorhaida Ujang
- Institute for Health Systems Research; Jalan Rumah Sakit Bangsar Kuala Lumpur Malaysia 59000
| | - Anza Elias
- Institute for Medical Research; Jalan Pahang Kuala Lumpur Malaysia 50588
| | - Jacqueline J Ho
- Penang Medical College; Department of Paediatrics; 4 Sepoy Lines Penang Malaysia 10450
| | - Samsiah Awang
- Institute for Health Systems Research; Jalan Rumah Sakit Bangsar Kuala Lumpur Malaysia 59000
| |
Collapse
|
50
|
Lai NM, Taylor JE, Tan K, Choo YM, Ahmad Kamar A, Muhamad NA. Antimicrobial dressings for the prevention of catheter-related infections in newborn infants with central venous catheters. Cochrane Database Syst Rev 2016; 3:CD011082. [PMID: 27007217 PMCID: PMC6464939 DOI: 10.1002/14651858.cd011082.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Central venous catheters (CVCs) provide secured venous access in neonates. Antimicrobial dressings applied over the CVC sites have been proposed to reduce catheter-related blood stream infection (CRBSI) by decreasing colonisation. However, there may be concerns on the local and systemic adverse effects of these dressings in neonates. OBJECTIVES We assessed the effectiveness and safety of antimicrobial (antiseptic or antibiotic) dressings in reducing CVC-related infections in newborn infants. Had there been relevant data, we would have evaluated the effects of antimicrobial dressings in different subgroups, including infants who received different types of CVCs, infants who required CVC for different durations, infants with CVCs with and without other antimicrobial modifications, and infants who received an antimicrobial dressing with and without a clearly defined co-intervention. SEARCH METHODS We used the standard search strategy of the Cochrane Neonatal Review Group (CNRG). We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2015, Issue 9), MEDLINE (PubMed), EMBASE (EBCHOST), CINAHL and references cited in our short-listed articles using keywords and MeSH headings, up to September 2015. SELECTION CRITERIA We included randomised controlled trials that compared an antimicrobial CVC dressing against no dressing or another dressing in newborn infants. DATA COLLECTION AND ANALYSIS We extracted data using the standard methods of the CNRG. Two review authors independently assessed the eligibility and risk of bias of the retrieved records. We expressed our results using risk difference (RD) and risk ratio (RR) with 95% confidence intervals (CIs). MAIN RESULTS Out of 173 articles screened, three studies were included. There were two comparisons: chlorhexidine dressing following alcohol cleansing versus polyurethane dressing following povidone-iodine cleansing (one study); and silver-alginate patch versus control (two studies). A total of 855 infants from level III neonatal intensive care units (NICUs) were evaluated, 705 of whom were from a single study. All studies were at high risk of bias for blinding of care personnel or unclear risk of bias for blinding of outcome assessors. There was moderate-quality evidence for all major outcomes.The single study comparing chlorhexidine dressing/alcohol cleansing against polyurethane dressing/povidone-iodine cleansing showed no significant difference in the risk of CRBSI (RR 1.18, 95% CI 0.53 to 2.65; RD 0.01, 95% CI -0.02 to 0.03; 655 infants, moderate-quality evidence) and sepsis without a source (RR 1.06, 95% CI 0.75 to 1.52; RD 0.01, 95% CI -0.04 to 0.06; 705 infants, moderate-quality evidence). There was a significant reduction in the risk of catheter colonisation favouring chlorhexidine dressing/alcohol cleansing group (RR 0.62, 95% CI 0.45 to 0.86; RD -0.09, 95% CI -0.15 to -0.03; number needed to treat for an additional beneficial outcome (NNTB) 11, 95% CI 7 to 33; 655 infants, moderate-quality evidence). However, infants in the chlorhexidine dressing/alcohol cleansing group were significantly more likely to develop contact dermatitis, with 19 infants in the chlorhexidine dressing/alcohol cleansing group having developed contact dermatitis compared to none in the polyurethane dressing/povidone-iodine cleansing group (RR 43.06, 95% CI 2.61 to 710.44; RD 0.06, 95% CI 0.03 to 0.08; number needed to treat for an additional harmful outcome (NNTH) 17, 95% CI 13 to 33; 705 infants, moderate-quality evidence). The roles of chlorhexidine dressing in the outcomes reported were unclear, as the two assigned groups received different co-interventions in the form of different skin cleansing agents prior to catheter insertion and during each dressing change.In the other comparison, silver-alginate patch versus control, the data for CRBSI were analysed separately in two subgroups as the two included studies reported the outcome using different denominators: one using infants and another using catheters. There were no significant differences between infants who received silver-alginate patch against infants who received standard line dressing in CRBSI, whether expressed as the number of infants (RR 0.50, 95% CI 0.14 to 1.78; RD -0.12, 95% CI -0.33 to 0.09; 1 study, 50 participants, moderate-quality evidence) or as the number of catheters (RR 0.72, 95% CI 0.27 to 1.89; RD -0.05, 95% CI -0.20 to 0.10; 1 study, 118 participants, moderate-quality evidence). There was also no significant difference between the two groups in mortality (RR 0.55, 95% CI 0.15 to 2.05; RD -0.04, 95% CI -0.13 to 0.05; two studies, 150 infants, I² = 0%, moderate-quality evidence). No adverse skin reaction was recorded in either group. AUTHORS' CONCLUSIONS Based on moderate-quality evidence, chlorhexidine dressing/alcohol skin cleansing reduced catheter colonisation, but made no significant difference in major outcomes like sepsis and CRBSI compared to polyurethane dressing/povidone-iodine cleansing. Chlorhexidine dressing/alcohol cleansing posed a substantial risk of contact dermatitis in preterm infants, although it was unclear whether this was contributed mainly by the dressing material or the cleansing agent. While silver-alginate patch appeared safe, evidence is still insufficient for a recommendation in practice. Future research that evaluates antimicrobial dressing should ensure blinding of caregivers and outcome assessors and ensure that all participants receive the same co-interventions, such as the skin cleansing agent. Major outcomes like sepsis, CRBSI and mortality should be assessed in infants of different gestation and birth weight.
Collapse
Affiliation(s)
- Nai Ming Lai
- Taylor's UniversitySchool of MedicineSubang JayaMalaysia
| | - Jacqueline E Taylor
- Monash Medical Centre/Monash UniversityMonash Newborn246 Clayton RoadClaytonVictoriaAustralia3168
| | - Kenneth Tan
- Monash UniversityDepartment of Paediatrics246 Clayton RoadClaytonMelbourneVictoriaAustraliaVIC 3168
| | - Yao Mun Choo
- University of MalayaDepartment of PaediatricsKuala LumpurMalaysia
| | | | - Nor Asiah Muhamad
- Ministry of Health MalaysiaDisease Control DivisionPutrajayaMalaysia62590
| | | |
Collapse
|