Displaying all 11 publications

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  1. Mohd Hisham MF, Lodz NA, Muhammad EN, Asari FN, Mahmood MI, Abu Bakar Z
    JMIR Res Protoc, 2023 Jul 25;12:e36121.
    PMID: 37490330 DOI: 10.2196/36121
    BACKGROUND: According to the World Bank, Malaysia reported an estimated 97 tuberculosis cases per 100,000 people in 2021. Chest x-ray (CXR) remains the best conventional method for the early detection of pulmonary tuberculosis (PTB) infection. The intervention of artificial intelligence (AI) in PTB diagnosis could efficiently aid human interpreters and reduce health professionals' work burden. To date, no AI studies have been evaluated in Malaysia.

    OBJECTIVE: This study aims to evaluate the performance of Putralytica and Qure.ai software for CXR screening and PTB diagnosis among the Malaysian population.

    METHODS: We will conduct a retrospective case-control study at the Respiratory Medicine Institute, National Cancer Institute, and Sungai Buloh Health Clinic. A total of 1500 CXR images of patients who completed treatments or check-ups will be selected and categorized into three groups: (1) abnormal PTB cases, (2) abnormal non-PTB cases, and (3) normal cases. These CXR images, along with their clinical findings, will be the reference standard in this study. All patient data, including sociodemographic characteristics and clinical history, will be collected prior to screening via Putralytica and Qure.ai software and readers' interpretation, which are the index tests for this study. Interpretation from all 3 index tests will be compared with the reference standard, and significant statistical analysis will be computed.

    RESULTS: Data collection is expected to commence in August 2023. It is anticipated that 1 year will be needed to conduct the study.

    CONCLUSIONS: This study will measure the accuracy of Putralytica and Qure.ai software and whether their findings will concur with readers' interpretation and the reference standard, thus providing evidence toward the effectiveness of implementing AI in the medical setting.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/36121.

  2. Abdul Mutalip MH, Mahmud MAF, Lodz NA, Yoep N, Muhammad EN, Ahmad A, et al.
    BMJ Open, 2019 01 21;9(1):e023359.
    PMID: 30670512 DOI: 10.1136/bmjopen-2018-023359
    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.

  3. Mahmud MAF, Abdul Mutalip MH, Lodz NA, Muhammad EN, Yoep N, Hashim MH, et al.
    BMJ Open, 2019 05 15;9(5):e026101.
    PMID: 31097485 DOI: 10.1136/bmjopen-2018-026101
    INTRODUCTION: Dengue is among the most important mosquito-borne diseases, with more than half of the world's population at risk of infection in dengue endemic countries. Environmental management, which includes any activities that involve environmental modification, environmental manipulation and changes to human behaviour have been used to mitigate the risk of dengue transmission. In this protocol, we will integrate the data from various sources to assess the overall effect of environmental management on the incidence of dengue and other entomological indices.

    METHODS AND ANALYSES: We will conduct a systematic review of intervention that assess the effect of environmental management on the incidence of dengue and/or entomological indices. We will include any studies that include intervention through environmental management for dengue control, involving environmental modification, environmental manipulation and changes to human behaviour. A comprehensive search will be performed in electronic databases PUBMED, CENTRAL, SCOPUS, Web of Science and relevant research websites such as PROPSERO, WHO ICTRP and ClinicalTrials.gov to identify studies that meet our inclusion criteria. A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic reviews and Meta-Analysis. Titles, abstract, keywords for eligibility will be examined independently by researchers. The quality of the included studies will be assessed using quality assessment tool for studies with diverse design and Cochrane risk of bias tool. The characteristics of the selected articles will be described based on the study design, types of intervention and outcomes of the study in various countries. These include the types of environmental management intervention methods and the effectiveness of the intervention in reducing dengue cases or incidence and impact on entomological indices.

    ETHICS AND DISSEMINATION: We will register this systematic review with the National Medical Research Register, Ministry of Health Malaysia. This protocol also had been registered with the PROSPERO. No ethical approval is necessary, as there will be no collection of primary data. The results will be disseminated though a peer-reviewed publication and conference presentation.

    TRIAL REGISTRATION NUMBER: CRD42018092189.

  4. Mahmud MA, Hazrin M, Muhammad EN, Mohd Hisyam MF, Awaludin SM, Abdul Razak MA, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:63-67.
    PMID: 33370852 DOI: 10.1111/ggi.14033
    AIM: This study aimed to determine the factors that influence perceived social support among older adults in Malaysia.

    METHODS: We used the 11-item Duke Social Support Index to assess perceived social support through a face-to-face interview. Higher scores indicate better social support. Linear regression analysis was carried out to determine the factors that influence perceived social support by adapting the conceptual model of social support determinants and its impact on health.

    RESULTS: A total of 3959 respondents aged ≥60 years completed the Duke Social Support Index. The estimated mean Duke Social Support Index score was 27.65 (95% CI 27.36-27.95). Adjusted for confounders, the factors found to be significantly associated with social support among older adults were monthly income below RM1000 (-0.8502, 95% CI -1.3523, -0.3481), being single (-0.5360, 95% CI -0.8430, -0.2290), no depression/normal (2.2801, 95% CI 1.6666-2.8937), absence of activities of daily living (0.9854, 95% CI 0.5599-1.4109) and dependency in instrumental activities of daily living (-0.3655, 95% CI -0.9811, -0.3259).

    CONCLUSION: This study found that low income, being single, no depression, absence of activities of daily living and dependency in instrumental activities of daily living were important factors related to perceived social support among Malaysian older adults. Geriatr Gerontol Int 2020; 20: 63-67.

  5. Taufik Ramli MH, Lodz NA, Abdul Aziz FA, Maw Pin T, Alias N, Abdul Mutalip MH, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:38-42.
    PMID: 33370861 DOI: 10.1111/ggi.14028
    AIMS: As the Malaysian population is aging rapidly, there is an urgent need for an effective management plan for healthy aging, to extend life expectancy and to improve quality of life (QoL). Urinary incontinence (UI), which is common in older persons, is often linked to reduced QoL. This study aimed to determine the effects of UI on QoL among older persons in Malaysia.

    METHODS: This study was based on data obtained from 3716 Malaysians aged ≥60 years as part of the National Health and Morbidity Survey (NHMS) 2018. QoL was measured using the Control, Autonomy, Self-realization and Pleasure 19-item (CASP-19) questionnaire. UI was measured using the Questionnaire Urinary Incontinence Diagnosis (QUID) score. Association between UI and QoL were examined using linear regression analysis, after controlling socio-demographic variables and comorbidities.

    RESULTS: Overall, the prevalence of UI was 5.2%. By subtypes, the prevalence of stress UI and urge UI were both 2.0%, while that of mixed UI was 1.3%. The UI group rated their lives more negatively in all four domains of QoL compared with non-UI group. Those who were incontinent had lower standardized scores on control and autonomy domains of CASP-19 as well as total score. Results from linear regression analysis indicated that UI had a significantly negative impact on control and autonomy domains of QoL after controlling for socio-demographic factors and comorbidities.

    CONCLUSION: UI contributes to a significant reduction on QoL of older persons. Healthcare providers need to be sensitive in evaluating and discussing UI, particularly with their older patients. Geriatr Gerontol Int 2020; 20: 38-42.

  6. Awaluddin SMB, Ying Ying C, Yoep N, Paiwai F, Lodz NA, Muhammad EN, et al.
    Asia Pac J Public Health, 2019 Nov;31(8_suppl):57S-64S.
    PMID: 31523984 DOI: 10.1177/1010539519872642
    Parental protective factors do play an important role in preventing Internet addiction. A self-administered questionnaire was used to measure health risk behaviors among Malaysian adolescents. The prevalence of Internet addiction was significantly higher among adolescents with perceived lack of parental supervision (30.1% [95% confidence interval (CI) = 28.7-31.4]) and lack of parental connectedness (30.1% [95% CI = 28.5-31.7]), compared with their counterparts. Adolescents who perceived a lack of parental supervision, respect for privacy, connectedness, and bonding were more likely to have Internet addiction: (adjusted odds ratio [aOR] = 1.39; 95% CI = 1.27-1.52), (aOR = 1.23; 95% CI = 1.16-1.31), (aOR = 1.09; 95% CI = 1.02-1.16), (aOR = 1.06; 95% CI = 1.00-1.12), respectively. Among girls, Internet addiction was associated with those who perceived lack in all 4 parental factors, while among boys, those who perceived lack of parental supervision and respect for privacy were more prone to Internet addiction.
  7. Chong ZL, Rodzlan Hasani WS, Noor Asari F, Muhammad EN, Mutalip MHA, Robert Lourdes TG, et al.
    Influenza Other Respir Viruses, 2023 Oct;17(10):e13193.
    PMID: 37789877 DOI: 10.1111/irv.13193
    BACKGROUND: From the beginning of the COVID-19 pandemic until mid-October 2020, Malaysia recorded ~15,000 confirmed cases. But there could be undiagnosed cases due mainly to asymptomatic infections. Seroprevalence studies can better quantify underlying infection from SARS-CoV-2 by identifying humoral antibodies against the virus. This study was the first to determine the prevalence of SARS-CoV-2 infection in  Malaysia's general population, as well as the proportion of asymptomatic and undiagnosed infections.

    METHODS: This cross-sectional seroprevalence study with a two-stage stratified random cluster sampling design included 5,131 representative community dwellers in Malaysia aged ≥1 year. Data collection lasted from 7 August to 11 October 2020 involving venous blood sampling and interviews for history of COVID-19 symptoms and diagnosis. Previous SARS-CoV-2 infection was defined as screened positive using the Wantai SARS-CoV-2 Total Antibody enzyme-linked immunosorbent assay and confirmed positive using the GenScript SARS-CoV-2 surrogate Virus Neutralization Test. We performed a complex sampling design analysis, calculating sample weights considering probabilities of selection, non-response rate and post-stratification weight.

    RESULTS: The overall weighted prevalence of SARS-CoV-2 infection was 0.49% (95%CI 0.28-0.85) (N = 150,857). Among the estimated population with past infection, around 84.1% (95%CI 58.84-95.12) (N = 126 826) were asymptomatic, and 90.1% (95%CI 67.06-97.58) (N = 135 866) were undiagnosed.

    CONCLUSIONS: Our study revealed a low pre-variant and pre-vaccination seroprevalence of SARS-CoV-2 infection in Malaysia up to mid-October 2020, with a considerable proportion of asymptomatic and undiagnosed cases. This led to subsequent adoption of SARS-CoV-2 antigen rapid test kits to increase case detection rate and to reduce time to results and infection control measures.

  8. Muhammad EN, Abdul Mutalip MH, Hasim MH, Paiwai F, Pan S, Mahmud MAF, et al.
    BMC Infect Dis, 2020 Nov 16;20(1):843.
    PMID: 33198646 DOI: 10.1186/s12879-020-05500-x
    BACKGROUND: Typhoid fever causes global morbidity and mortality and is a significant health burden, particularly in low- and middle-income countries. The direct fecal-oral route is the main transmission mode, but indirect environmental transmission could occur, particularly in urban settings. This study aimed to investigate the burden and trend of typhoid fever, reporting the coverage system between government and private practice and pattern of multidrug-resistant (MDR) typhoid cases in the urban Klang Valley area from 2011 to 2015.

    METHODS: The data from a cross-sectional study retrieved from the e-Notifikasi System, a national reporting system for communicable diseases provided by the Disease Control Division, Ministry of Health Malaysia and secondary data of all the typhoid cases were obtained from the public and private hospitals and laboratories in Klang Valley. Descriptive analysis was performed to examine the sociodemographic characteristics, spatial mapping was conducted to examine trends, and the crude incidence rates of confirmed typhoid cases and percentage of reporting coverage were calculated. Significant differences between MDR and non-MDR Salmonella typhi were determined in the patient's sociodemographic characteristics, which were analyzed using χ2 test. P values

  9. Mahmud MAF, Abdul Mutalip MH, Lodz NA, Muhammad EN, Yoep N, Hasim MH, et al.
    Int J Environ Health Res, 2023 Nov;33(11):1148-1167.
    PMID: 35642722 DOI: 10.1080/09603123.2022.2076815
    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.
  10. Muhamad NA, Ab Ghani RM, Abdul Mutalip MH, Muhammad EN, Mohamad Haris H, Mohd Zain R, et al.
    Sci Rep, 2020 12 03;10(1):21009.
    PMID: 33273475 DOI: 10.1038/s41598-020-77813-5
    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.
    Study name: The Malaysian Cohort (TMC) project
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