A multistage random sampling method was used to select the community sample in the district of Kudat, Sabah. A total of 205 respondents from 210 selected houses were interviewed using a standardised questionnaire to ascertain their knowledge and attitude towards tuberculosis. Generally the knowledge about tuberculosis was poor. The well known symptoms that the respondents knew were coughing blood (46.2%), cough (37.1%), loss of weight (34.5%), and loss of appetite (32.0%). Only 51% thought that the disease was caused by germs and it was transmitted by air. TB sufferers were thought to be dirty (22%) and the majority (51%) were not keen to mix with TB patients. Although more than 90% of the respondents considered TB as socially acceptable within their family and community, a large proportion (41%) expressed that getting TB was embarrassing, 4% said it was a disgrace to the family, and 16% said that it was too sensitive to discuss about it. These behaviours suggest that at the private level, the respondents were still perceived negative social attitudes towards tuberculosis.
From October 13 to October 21, 1999, a total of 46 males, aged 8 to 19 years, were admitted to Beaufort Hospital after swimming in the creek near an oil palm plantation in Kampung (Kg) Kebatu, Beaufort. Thirty (30) presented with symptoms including fever, vomiting, bodyache, giddiness, headache, chest pain and cough, while 16 others, were asymptomatic. One, a 15 year old boy, died from haemorrhagic shock secondary to pulmonary haemorrhage. The onset of the illness was from 11 October to 19 October 1999. A case-control study found that the outbreak was associated with swimming in the creek (p<0.0001). A total of 44 paired sera samples were sent for microscopic agglutination test (MAT), 5 pairs showed sero-conversion, 3 pairs had 4 fold rise in titre and 18 pairs were positive at >320. The findings indicated that Leptospirosis was the cause of the outbreak of this illness and the contaminated creek water was the source of the infection. The occurrence of flooding and stagnation in the creek following the heavy rainfall during the first week of October 1999 could have contributed to the timing of the outbreak.