We investigated the immunogenicity of recombinant rMSP1 (rPbMSP1) that was
generated from Plasmodium berghei. The rPbMSP1 formulated in alum was found to be
immunogenic which induced high levels of specific anti-rPbMSP1 antibody. The IgG2a response
predominated over IgG1 during the challenge infection in the vaccinated mice. Mice vaccinated
with rPbMSP1 in alum mounted significant protective immunity against challenge infection
(P
Human papi l lomavi rus (HPV) i s wel l known as an et iological factor for the development of anogenital carcinomas. The aim of our study was to compare the performance of USFDA approved Hybrid II (HCII) Assay and recently introduced DR. HPVTM Chip Kit for
the detection of HPV DNA in clinical cervical scrapings from 40 patients. HPV DNA testing was performed using the automated HCII Assay system and DR. HPV™ Chip Kit. Taking cytological results as gold standard, it was found that HCII was more sensitive (36.4%) than DR. HPVTM Chip Kit (18.2%) although specificity was 100% with the latter method. In addition, both these molecular methods had comparable negative and positive predictive values. It was concluded that both HCII and DR. HPVTM Chip Kit have comparable specificity. However, sensitivity for detection of HPV in clinical samples with HCII is almost double as compared
to DR. HPVTM Chip Kit.
MeSH terms: DNA; Humans; Sensitivity and Specificity; United States; United States Food and Drug Administration; Oligonucleotide Array Sequence Analysis; Papillomaviridae
Fannia pusio (Wiedemann) (Diptera: Fanniidae) is newly recorded from Malaysia.
This record is based on 1♂ 1♀ from Sarawak, east Malaysia and 1♂ 2♀ from Selangor, peninsular
Malaysia. It is included in the pusio group of Fannia wherein are included Fannia femoralis
(Stein), Fannia howardi Malloch, Fannia trimaculata (Stein), Fannia leucosticta (Meigen) and
Fannia punctiventris Malloch. The male of Fannia pusio is differentiated from other members
of the group by the following features: hind femur with a swelling bearing a number of setae that
are usually curled at tip; squamae creamy; tergite 1+2 broadly grey dusted at sides.
Adults of Anopheles maculatus were tested for their residual activity to wettable
powders (WP) and water dispersible granule (WG) formulations of deltamethrin. The residual
ef fect ivenes s and l i fespan of del tamethr in WG and WP were al so as ses sed agains t the
mosquitoes using rough and smooth surfaces of bamboo. Tests were conducted once a month
up to 14 months after spraying using WHO standard method for the bioassay of insecticidal
deposits on wall surfaces. Mortality data revealed that both deltamethrin WG and WP were
effective against An. maculatus up to 14 months post-spraying. Efficacy and residual activity
of deltamethrin WG at 25mg/m2 had proved to be the longest on both rough and smooth
surfaces of bamboo.
Many finer taxonomic characters of Blomia tropicalis are not distinctly visible under conventional light microscopy. Scanning electron micrographs of this mite are therefore presented in this paper for better appreciation of the inconspicuous features of the morphology of the species. The differences in morphology of male and female B. tropicalis are also briefly discussed.
The aim of the study is to describe the usage of dietary supplemenu among doctors working in the hospitals in Kota Bharu, Kelantan. The method used was a postal questionaire survey of the doctors, both specialists and medical officers working in these hospitals. The results showed that
only 28.7% of the doctors are taking dietary supplements. Significantly more female doctors and doctors on long term medication, were taking these supplements. The dietary supplements commonly used were multivitamins and minerals (92.3%), garlic (26.9%), vitamin C (26.9%) and
lecithin (15.4%). The majority of the doctors who took dietary supplements (60%) felt their health status have improved. These supplements were mostly obtained from hospital pharmacies. Doctors who puchase their own supplements spend between RMIO to RMIZO per month. The main reasons given for taking these supplements were that the doctors jfelt healthier' and to ‘prevent or as a supplementary treatment’ for conditions like hypercholesterolaemia, hypertension, ischaemic heart disease and cancers. There were four doctors who regularly use traditional dietary supplements. Most doctors will generally advice their patients and children to take dietary supplements regularly, as they felt that it is important for health.
Public health care programme evaluation includes determining the programme effectiveness (outcome assessment), efficiency (economic evaluation), accessibility (reachability of services) and equity (equal provision for equal needs). The purpose of this study was to make comparison on cost·( efficiency and costeffectiveness in managing type 2 diabetes between the Ministry of Health (MOH) health clinics with family medicine specialist (FMS) and health clinics without FMS. A costeffectiveness analysis was conducted alongside across-sectional study at two government health clinics in Machang, Kelantan, one with FMS and the other without FMS. A total of 300 patients, of which 155 from the health clinic without FMS and 145 from the other group were evaluated for sociodemographic and clinical characteristics from August 2005 to May 2006. HbA1c
analysis was measured for each patient during the study period. Macrocosting and microcosting were used to determine costs. The provider cost for diabetic management ranged from RM270.56 to RM4533.04 per diabetic patient per year, withla mean cost of RM1127.91(t906.08) per diabetic patient per year in health clinic with FMS. In health clinic without FMS, the provider cost ranged from RM225.93 to RM4650.13, with a mean cost of RM802.15 (:626.26). Proportion ofgood HbA1c was 17.2% for health clinic with FMS and 10.3% for the health clinic without FMS. The annual mean provider cost per proportion of good HbA1c control (< 7%) (Costefkctiveness ratio/ CER) was RM6557.65.for health clinic with FMS and RM7787.88 for health clinic without FMS. This provider cost-epfectiveness ratio was not different statistically between the health clinic with FMS and health clinic without FMS (p=0.063). The cost of building, equipments, overheads, staff and consumables were higher for FMS group. Sensitivity analysis was performed for three discount rates (0, 5 and 7%). Relative cost-effectiveness of diabetes management in health clinic with FMS and health clinic without FMS was unchanged in all sensitivity scenarios. Even though, there was no significantly difference in provider CER in type 2 diabetes management at Malaysian MOH health clinics, but the provider CER in health clinic with FMS was lower compared to health clinic without FMS. Therefore, we can conclude that the presence of FMS in the health clinic will effectively improved the management of type 2 diabetes.
MeSH terms: Ambulatory Care Facilities; Cost-Benefit Analysis; Costs and Cost Analysis; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Government; Hemoglobin A, Glycosylated; Humans; Malaysia; Male; Physicians, Family; Public Health; Program Evaluation; Disease Management
The purpose of this study was to determine the quality of counter service at the Ministry of Health hospitals as perceived by patients. This was a cross sectional study using selfadrninistered questionnaires distributed to patients at the outpatient departments in all Ministry of Health Hospitals. By the end ofthe data collection period, 118 of 121 hospitals (total number of MOH Hospitals) participated with 93.2% response rate., The hospitals were divided into four categories, for the purpose of this study 1000 sample size were needed in each category, the number of sample size were obtained using Epi Info Program based on assumption that 30% Of patients were dissatisyded with the services provided and with a precision of 10%. In this study the quality were based on clarity and provision of services based on Client Charten deliverance of clear infomation by the healthcare personnel, priority treatment given to urgency of the cases, cleanliness of the facilities and teamwork among the staff This study revealed about 64% of patients perceived that the hospitals had provided quality services at the counter: Only about 11% of patients were not happy with the quality of the services given at the counter. The proportion of happy patients increased from the smaller to the bigger hospitals. In terms of delivering services according to the Client Charter; only about 15% said that service was not provided by the counter staff according to the Client’s Charter On the aspect of priority on the urgent cases, about 64% of the patients perceived that urgent cases were not seen immediately. About 64% of the respondents felt that the hospitah do provide quality services. Strategies should focus on the bigger hospitals because non conformance to quality occurs more frequently there. The post of Counter Supervisor should be created to ensure that quality services are delivered.
Study site: outpatient departments in all Ministry of Health Hospitals
MeSH terms: Cross-Sectional Studies; Health Personnel; Hospitals; Humans; Malaysia; Outpatient Clinics, Hospital; Outpatients; Surveys and Questionnaires; Sample Size
Various studies have reported that excess body weight may increase the risk to various diseases and death. A study reported that adolescents who were overweight were almost 18 times more likely than their leaner peers to be obese in early adulthood and were 8.5 times more likely to have hypertension as young adults. Therefore, this study was conducted to determine the body composition and four dietary factors i.e., prudent diet habits, calorie control habits, dietary fat/ cholesterol and sodium/salt control which may affect blood pressure and the risk of heart disease among year 1 medical students in a public university in Selangor. Body composition was determined by measuring the body mass index (BMI) and body fat percentage. None of the female students showed excellent/good eating habits while majority were fair (37.7%) and poor/very poor (62.3%). Nearly half of the male students showed excellent/good eating habits (42.5%), but more than half (57.5%) were poor/very poor. Majority of the female (85.7%, 85.7% and 94.8% respectively) and male students (80.9%, 57.5% and 93.6% respectively) showed excellent/good eating habits in calorie, dietary fat and salt control. Majority of the students (64.9% female and 61.7% male) have normal BMI values while 24.7% of female and 10.6% of male students were underweight (BMI values less than 18.5). Only a small number of female students were overweight (5.2%) and obese (5.2%). However 14.9% of male students were overweight and another 12.8% were obese.
MeSH terms: Adolescent; Adult; Body Composition; Body Weight; Cholesterol, Dietary; Cross-Sectional Studies; Dietary Fats; Female; Food Habits; Humans; Malaysia; Male; Obesity; Sodium, Dietary*; Students, Medical; Thinness; Universities; Body Mass Index; Overweight; Body Fat Distribution*; Young Adult
A cross sectional study to determine general health and body composition was conducted for comparison between rural samples (Teluk Intan, Perak) and urban samples (Klang Valley, Selangor). Systematic random sampling was used in Z health clinics in Klang Valky and 4 health clinics in Telult Intan, Perak The results showed that urban population was more heterogeneous (Malay 63.7%, Indian 19.8%, Chinese 14.9%) compared with the rural population (Malay 75%, Indian 22.1%, Chinese 2.9%). Mean age for urban population was 44 2 1.6 years and for rural was 50 i 14.4 years. There was significant difference in the BMI (p < 0.05) between urban and rural populations where more people in the urban areas had higher BMI. There was a significant difference in the waist hip ratio (p < 0.05) between urban and rural areas where more people in the urban areas had above normal waist hip ratio. There was no significant difference in chronic diseases suffered and family medical history of the rural and urban samples.
MeSH terms: Adult; Ambulatory Care Facilities; Body Composition; China/ethnology; Chronic Disease; Cross-Sectional Studies; Female; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Male; Rural Population; Urban Population; Body Mass Index; Asian Continental Ancestry Group; Waist-Hip Ratio
This study was conducted to study the blood pressure pattern and the prevalence of hypertension and its associated factors in a rural community in two coastal villages in rural Kedah, Mahysia. Out of the total population 504 were above 20 years of age and were eligible to participate. There were 227 males and 252 females. The mean systolic blood pressure was found to rise with age, peaking in the 6l·70 years age group, For women the mean blood pressure rose earlier from the age group of 4-l· 50 years. Mean blood pressures rose with increasing body mass index. lt also varied with occupation and education. The retired and unemployed had a higher blood pressure than those employed and there was an inverse relationship with increasing education. The prevalence of hypertension was 33.6%. More females were hypertensive (36.5%) as compared to males (3 0.4%) and this finding was the same for both systolic and diastolic hypertension. Majority (71.4%) of the hypertensives were undiagnosed. 72.5% of hypertensives who were on treatment were not under control. Hypertension was more prevalent among retirees and illiterates. Prevalence of hypertension increased correspondingly with age. Obesity was associated with hypertension. There was no association with family history of hypertension. Multiple logistic regression showed a positive association only for obesity. ln conclusion, given the high prevalence of hypertension at
present, it appears that the prevalence will increase as each age cohort grows older. Obesity, especially among housewives is a significant assorted factor.
MeSH terms: Blood Pressure; Blood Pressure Determination; Female; Humans; Hypertension; Male; Obesity; Occupations; Rural Population; Systole; Body Mass Index; Prevalence; Logistic Models; Rosa
Merokok merupakan amalan yang dimulakan sewaktu usia remaja. Beberapa kajian yang dijalankan terdahulu di negara maju mendapati keluarga mernpakan faktor penyumbang kepada amalan ini. Meskipun pelbagai kajian di negara·negara rnaju, namun tidak banyak kajian berkaitan aspek ini yang dilaporkan di negara ini. Data kajian lverkait dengan pembolehubah kekeluargaan iaitu hubungan kekeluargaan, pandangan remaja tentang reaksi ibu bapa terhadap amalan rnerokok, struktur keluarga, jumlah ahli keluarga, status merokok di kalangan ibu bapa dan jantina dengan amalan merokok diperolehi dari 251 pelajarpelajar sekolah menengah (Tingkatan 5) (48.2% lelaki dan 51.8%
perempuan} di Daerah Kota Ting?. Johon Kajian ini mendapati sikap ibu bapa yang negatif dan bapa yang tidak merokok merupakan faktor pelindung dari amalan merokok. Hasil kajian mencadangkan faktor kekeluargaan memainkan peranan dalam mempengaruhi amalan merokok di kalangan jantina. Institusi kekeluargaan hendaklah dilibatkan dalam program pencegahan amalan merokok di kalangan remaja.
To examine the reliability and construct validity of the Malay Version of the Depression Anxiety Stress Scales (DASS), a validation study was conducted in 184 automotive assembly workers. The internal consistency and construct validity were assessed using Cronbach's alpha coefficient
and exploratory factor analysis. The Cronbach's alpha coefficients for DASS-Depression, DASS-Anxiety and DASS-Stress were 0.91, 0.88 and j 0.89, respectively, indicating satisfactory internal consistency Exploratory factor analysis showed three meaningful common factors that could
explain the three theoretical constructs of this instrument. These results suggested that the Malay version DASS is reliable and valid for assessing, the self perceived depression, anxiety and stress among Malaysian automotive workers.
Study site: Two automotive assembly plants, Pahang, Malaysia
Undergoing a Pap smear screening is widely accepted as a costeffective screening for detection of cervical abnormalities. In Peninsular Malaysia, cervical cancer was the second commonest cancer among women with incidence rate of 17.8 per 100,000 populations in 2002. Despite the high incidence of cervical cancer, only 26% of eligible woman had undergone Pap smear screening. To determine the prevalence of Pap smear screening, reasons for not undergoing the screening as well as the associated sociodemographic factors among women in Mukim Jaya Setia, a crass-sectional study was conducted in ]anuary 2005. Two hundred and ninety five from 350 households were randomly selected by using a Random Digit Table. Two hundred and eighty consented married women, aged 18 years and above were interviewed by the trained interviewers using structured
questionnaires. The questionnaires consisted of socio-demographic characteristic, Pap smear screening practice and risk factors of cervical cancer. There were 280 women who responded to the questionnaires. Majority of them were housewives (75%) and with low income (84.3%). Most ofthe women completed their education up to lower secondary school only (95%). Only 144 (51.4%) women undergo Pap smear screening but not on a regular basis. Most of them were screened only once, which was more than 3 years ago. Lack of knowledge, no accommodation, feel unnecessary and shy and no time were among the reasons that deterred the women from Pop smear screening. Women who were younger and with higher education level had more Pap smear screening compared to the older and with low education level. The practices of Pap smear screening among women in these villages were still low and was associated with age and educational level.
MeSH terms: Uterine Cervical Neoplasms; Family Characteristics; Female; Humans; Malaysia; Marriage; Mass Screening; Poverty; Surveys and Questionnaires; Risk Factors; Vaginal Smears; Incidence; Prevalence; Papanicolaou Test
Stress has been recognized one of the factors causing disease. About 70-80% of all diseases may be stress related. Thus, stress management can be a part of an early measure of disease prevention. A descriptive cross sectional, randomized study was conducted to determine the stress inducing factors among preclinical students (universal sampling) in a public university in Selangor, Malaysia from 24th April to May 2005. A total of 163 students (52.8% year 1, 36.8% year 2 and 10.4% year 3) were interviewed in the data collection process. The main reasons students entered - medical school was because of their own interest or ambition (65%) and family influence (20.9%). Majority (76.4%) suffered moderate to great stress over hot conditions in lecture hall, tutoriaV small group session rooms and laboratories while 53.4% suffered when using the other facilities like cafeteria, toilet and transportation:. Almost all (95.1%) felt that examination was the most stressful, followed by early clinical exposure sessions (68.1%), problem·based learning sessions (62.5%), hospital visitations (59.7%), tutoriay small group sessions (49.3%), practical class (44.5%) and attending lectures (3 8.5%). Musculoskeletal System was the most stressful module among the first year students, followed by Nervous System and Gastrointestinal System with the percentage of 94.2%, 90.7% and 88.4% respectively while, 95% of the second year students felt that General, Hemopoietic ci? Lymphoid and Nervous System are the most stressful modules. This study revealed that academic sessions and lack of conducive teaching and learning environment as the main stress inducing contributors to preclinical medical students.
This was a cross-sectional study which attempt; tu determine the prevalence of breastfeeding practice among mothers in Klcmg district, Malaysia and the association between lyrcastfceding practice with place of delivery and knowledge 011 breastfeeding. Dam collection was conducted by face·t0·face interview using a premuded structured questionnaire amung mothers with fum month old infants only who attended che government clinics in Klang, A total of 508 mothers were recruited ima the study. The study showed 92.9% ever breastfed, 55.1% exclusively lareastfed fur one month and 20.5% exclusively bremtfcd for four months. Malays brcastfed the most, while
Chinese the least. Breastfeeding was more common among mothers with lower education, delivered in government hospitals and with good knowledge on breastfeeding. A high proportion uf mothers in Klang wouki initiate breastfeeding and the [neualence of exclusive breastfeeding was comparable nationally. Breastfeeding was associated with mothers delivered in government hospitals and with good knowledge on breastfeeding. Continued promotional efforts targeted at private hospitals with information on breastfeeding should result in further increase in breastfeeding prevalence.
Study site: Klinik Kesihatan, Kelang district, Selangor, Malaysia
MeSH terms: Ambulatory Care Facilities; Breast Feeding; Cross-Sectional Studies; Female; Hospitals, Public; Humans; Infant; Malaysia; Mothers; Pregnancy; Surveys and Questionnaires; Prevalence; Hospitals, Private; Delivery, Obstetric
In recent years, there has been concern that non-smokers may also be at risk from secondhand smoke exposure, especially children. This study was done to determine the prevalence of secondhand smoke exposure at home and the association between secondhand smoke exposure and respiratory symptoms among primary schoolchildren in Kota Bharu, Kelantan. This was a comparative cross-sectional study involving children, aged 10·12 years. A structured questionnaire was used to obtain the information on sociodemographic, respiratory symptoms and smokers in the house. A random sample of 10 from 95 primary schools in Kota Bharu was included. Six classes were randomly selected from each school, two classes each from each school year of primary 4·6. A total of 795 children completed the questionnaire during September 2003 till March 2004. 386 of children (48.6%) were boys and 409 children (51.4%) were girls. Most of the children were Malay (99.9%). A total of 442 (55.6%) children lived with at least 1 smoker in the house mainly from the smoking fathers. Significantly increased odds ratios due to secondhand smoke exposure were observed for most of the respiratory symptoms. The odds ratios (95% confidence interval) were 1.67 (1.18, 2.39) for cough in the morning, 1.59 (1.10, 2.30) for cough at night, 1.76 (1.16, 2.65) for cough most days for the previous 3 months, 1.57 (1.14, 2.17) for phlegm in the morning, 1.49 (1.08, Z.07) for phlegm during daytime or at night, 1.38 (1.03, 1.86) for nose problems in the morning, 1.40 (1.03, 1.90) for nose problems at night and 1.78 (1.14, 2.78) for throat problems at night, 1.55 (1.06, 2.26) for ever wheeze or diagnosed asthma by doctor, 1.57 (1.05, 2.36) for throat problems in the morning and 1.81 (1.15, 2.85) for throat problems during daytime. The odds ratios increased with increasing number of smokers at home for cough in the morning, cough most days for the previous 3 months, phlegm in the morning, ever wheeze or diagnosed asthma by doctor, throat problems in the morning, throat problems during daytime and throat problems at night. In view of the significant health risks posed to children by secondhand smoke, public health policies are needed to protect this vulnerable population. The aim of such policies Ls to ensure the right of every child to grow up in an environment free of tobacco smoke.
Stroke is among the main cause of death and loss of work capability in Malaysia. Government hospitals statistic shows drastic increase of stroke cases and deaths resulting from it. Hospital Kuala Lumpur's statistic recorded about 30% to 35% fatality in cases of stroke. The study was carried out to identify the level of stroke recovery and its associated factors. The study was carried out at University Kebangsaan Malaysia Medical Center (UKMMC), Hospital Kuala Lumpur (HKL) and National Stroke Association of Malaysia (NASAM). The sampling method was universal sampling and respondents were interviewed using guided questionnaire. The stroke recovery was studied to identify the relationshiP with social support, age, coping, stroke severity and lifestyle. The response rate of this study was 50.3%. A total of 47.0% ofstroke patient received high stroke recovery. Among five factors studied, three factors have shown the significant relationship with stroke recovery; coping style OR 0.293 (95% Confidence Interval (CI), 0.129·0.668, P "0.004); lifestyle, OR 0.347 (95% Confidence Interval (CI), 0.154· 0.782, p" 0.01) dan social support OR 0.291 (95% Confidence Interval (CI), 0.128· 0.664, P"0.004), Establish significant relationshiP of stroke recovery with three studied factors which were social support, coping style and lifestyle. Most of the stroke patients in this study are retirees and housewives. These three factors are required further attention to ensure stroke patients recover.
Key words: Recovery, stroke, social support, coping, lifestyle
Cancer of the cervix is the second most common cancer among Malaysian women. Pap smear screening can detect precursors of cervical cancer. This paper attempts to determine the factors that influence the uptake of Pap smear screening. This was a cross sectional study with 112 Malay women recruited from a public university. A questionnaire enquiring sociademographic characteristics and health seeking behaviour based on the Health Belief Model was modified, translated and pre·tested. Testeretest reliability was also conducted. The mean age of the participants was 35.8 + 9.1 years. Majority was married and had at least secondary education. Only 62% of them had ever undergone Pap smear screening. Multiple logistic regression analysis showed women who were married or divorced (OR: 50.79, 95% C1: 4.33; 596.36), older age (OR: 1.12, 95% CI: 1.03; 1.22) or perceived higher benefits of Pap smear (OR; 4.80, 95% CI: 1.14; 20.15)
were more lilcely to have undergone Pap smear screening. Measures in reducing barriers and educating the public on the benefits of Pap smear are strongly recommended.
MeSH terms: Uterine Cervical Neoplasms; Cross-Sectional Studies; Female; Humans; Malaysia; Malaysia/ethnology; Marriage; Mass Screening; Surveys and Questionnaires; Universities; Vaginal Smears; Reproducibility of Results; Health Behavior; Logistic Models; Papanicolaou Test
This survey elucidated the perceptions and implementation 0f orthodontic Clinical Practice Guidelines (CPGs) by all ortlmduntistc and dental officers in the Ministry of Health Mahysia (MOH). Two different set: uf xelf-administered questionnaires were targeted at first·year dental officers (FYDO), dental officcrx (DO) and administrative Senior Dental Officers (SDO) in one group and unhocluntists in another group. Only 30% responded from a total of 1,327 MOH dental officers, with no participation from three States. Majority (89%) of officers have heard of CPG: although some were unsure of their purpose and usage. About 69% have read orthodontic CPG; of whom 87% have read other MOH dental CPG:. About 78.6% found CPGs 'gaud to excellenf but 16,0% did not answer this question. Same comments received included: language was confusing, inadequate details and pictures, need improvement, irrelevant, need CPG: for other orthodontic problems, need more knowledge first and requests for mare copies. Only 27.7% used them often, 53% occasionally and 15% hardly follow CPG:. About 82% felt that they were encouraged to use CPGx in their workplace and the majority (86%) knew where they were kept especially SDC: and DO; About 90% in the orthndonzist group have received hard copies of orthodontic CPGs but the majority (76%) has not seen them on the website. Although all felt that CPG; were useful to officers and encouraged their use, only 62.5% have introduced CPGs to their officers. There was generally more awareness and usage of CPGS among SDOs compared with DOs and FY DO; The dissemination and availability of orthodontic CPG: is reasonably good. However, the implementation by mthodontists and administrative officers can be improved for better awareness, understanding and usage by dental officers, especially FYDOs.