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Fulltext Prevalence of sexually transmitted diseases among female drug abusers in Malaysia

Isa AR, Sivakumaran S

Med J Malaysia, 1993 Jun;48(2):124-8.
PMID: 8350786

The prevalence of sexually transmitted diseases (STD) among female drug abusers was determined by screening 130 new inmates of a rehabilitation centre. The majority of the subjects (77.7%) were self-confessed sex workers. A high prevalence of syphilis (50.8%), hepatitis B (52.2%), moniliasis (23.8%) and trichomoniasis (19.2%) were noted. Gonorrhoea vaginitis was seen in 8.5%, which was low compared to previous studies. Six subjects were seropositive for human immunodeficiency virus (HIV), with 5 of them admitting to needle sharing and working as prostitutes. More than half of them harboured 2 or more STD. A rich reservoir of STD was seen among the drug abusers. With more evidence now available concerning the ease of HIV transmission associated with ulcerative STD, a stage could be set for greater heterosexual HIV transmission. As part of the rehabilitation process, female drug abusers need a thorough screening for STD followed by aggressive treatment regimens.
Fulltext Fireworks related injuries during Hari Raya festival in Hospital Universiti Sains Malaysia--1986 to 1990

Isa AR, Moe H

Med J Malaysia, 1991 Dec;46(4):333-7.
PMID: 1840441

A total of 38 cases of fireworks related injuries from Hospital USM over a 5-year period from 1986 to 1990 during Hari Raya festival were analysed. The majority (68.5%) of the patients were teenagers, between 10 to 19 years of age. All the cases were Malays and most of the accidents occurred before the Hari Raya Idilfitri festive seasons. Fourteen cases were caused by self-made fireworks and another 16 cases were due to modified fire-works. Twenty-four cases suffered permanent disabilities mostly finger amputations. Such injuries could be prevented by law enforcement coupled with public health education to modify social behaviour especially when the ban against the use of fireworks is lifted on religious grounds.
Fulltext Breastfeeding and weaning practices in rural communities of Kelantan

Ahmad Z, Daw W, Isa A

Malays J Nutr, 1996 Sep;2(2):148-54.
PMID: 22692137 MyJurnal

A survey of infant-feeding and weaning practices of 566 mothers, systematically sampled from 15 rural villages, randomly selected in the district of Tumpat, Kelantan was carried out. Almost all mothers (97.3%) breastfed their children, reinforcing the previously reported high incidence of breast-feeding among rural Malaysian mothers. One hundred and seventeen (21.3%) of the 551 children breastfed were also given mixed feeding with infant fomulae as well. Weaning started before 4 months of age in 28.3% of the children and after 6 months of age in 12.8% of the children. The 3 most common type of food used in weaning were Nestum (45.0%), rice porridge or paste (42.6%) and wheat porridge or cakes (11.5%). Forty eight children (12.1%) discontinued breastfeeding once weaning was initiated. The main reasons for initiating weaning was mothers' perception that there was insufficient milk and that the child was always hungry (55.7%). Most mothers were also given advice by the health clinic staff on weaning, including the timing and the suitable weaning foods to give. All of the mothers were able to name at least one commercial weaning food product available in their community.
Malaysian antenatal risk coding and the outcome of pregnancy

Geefhuysen CJ, Isa AR, Hashim M, Barnes A

J Obstet Gynaecol Res, 1998 Feb;24(1):13-20.
PMID: 9564100

Measure the effectiveness of the colour coding system in Malaysia for the prediction of risk in pregnancy.
Fulltext Cholera outbreak in Tumpat, Kelantan-1990

Isa AR, Othman WM, Ishak A

Med J Malaysia, 1990 Sep;45(3):187-93.
PMID: 2152079

Two episodes of El Tor cholera outbreak occurred in Tumpat, Kelantan between the 13th of January and the 16th of May 1990. Every case and carrier reported were investigated to determine the source and mode of transmission and to identify specific preventive measures to break the chain of transmission. There were 109 cases and 85 carriers involved in this study. The first episode of one case only was of Inaba serotype while the second episode was caused by the imported Ogawa serotype. Two foci of spread were identified from cluster occurrence but the majority of infection had no discernible link between them. The outbreak became both explosive and protracted indicating poor basic sanitation and personal hygiene. Person-to-person transmission via food and water was the main mode of spread. The Kelantan river water and river clams were confirmed sources of reservoir during the outbreak. Recommendations for prevention are intensified surveillance throughout the year,urgent upgrading of potable water supply and concerted effort in public health education especially against the use of river water and the consumption of raw food.
Prevalence of sexually transmitted diseases among new female drug abusers in a rehabilitation centre

Nordin RB, Rahman Bin Isa A, Rusli Bin Abdullah M

Malays J Med Sci, 2001 Jul;8(2):9-13.
PMID: 22893754 MyJurnal

The prevalence of sexually transmitted diseases (STD) among female drug abusers was studied by screening 130 new inmates of a rehabilitation centre. Data was collected using a structured questionnaire, physical examination and specimen collection for laboratory investigation at the Community Medicine Clinic of HUSM. The majority (64.6%) were Malays and self-confessed sex workers (77.7%). A high prevalence of syphilis (50.8%), hepatitis B (52.2%), moniliasis (23.8%), trichomoniasis (19.2%) and gonococcal vaginitis (8.5%) was noted. More than half of them harbour 2 or more STDs. Six subjects, of whom 5 were Malays, were HIV positive. The evidence indicates that female drug abusers need a thorough screening for STD followed by an aggressive treatment regimen. Since the majority of them were born Muslims, they should have access to spiritual counselling and rehabilitation, stressing on repentance, and adopting a compassionate and forgiving approach.
An evaluation of the hydrogen sulphide water screening test and coliform counts for water quality assessment in rural Malaysia

Desmarchelier P, Lew A, Caique W, Knight S, Toodayan W, Isa AR, et al.

Trans R Soc Trop Med Hyg, 1992 7 1;86(4):448-50.
PMID: 1440833

The H2S water screening test and the membrane filtration faecal coliform count were compared with Escherichia coli counts for water samples collected from household water sources and domestic drinking water in rural Malaysia. Water samples were taken from 151 wells, 44 taps supplying water from the treated municipal supply and 192 domestic stored water supplies. E. coli were detected in 20% of the samples (42% of wells, 7% of tap water and 6% of drinking water). Excellent correlation (Spearman's rank correlation rs = 0.93) was found between the faecal coliform and E. coli counts for all sample types. The H2S method was poorly correlated whether read at 18 or 30 h. False positive rates were highest for well water, and false negative rates were highest for both well and drinking water samples, with low E. coli counts. The faecal coliform test was an excellent predictor of the presence of E. coli in these water samples, while the H2S test was very inadequate.
Fulltext Knowledge and use of oral rehydration therapy for childhood diarrhoea in Tumpat District

Shaw DD, Jacobsen CA, Konare KF, Isa AR

Med J Malaysia, 1990 Dec;45(4):304-9.
PMID: 2152051

A community based study was conducted on the understanding and knowledge of childhood diarrhoea and use of oral rehydration therapy (ORT), in four selected villages in Tumpat District, Kelantan. The calculated annual incidence of diarrhoeal disease in children aged 0 to four years in all study villages was 1.38 episodes for each child. The main care-givers of children aged 0 to four years were interviewed and asked to demonstrate how to mix a standard ORS (oral rehydration solution) sachet if they had previously used ORT. Forty percent of care-givers had heard of the locally available ORT and 30% had actually used ORT. Of those who had heard of or used ORT, 10% had good knowledge of what it was and what it was used for, 51% had some knowledge and 39% had either no knowledge or inaccurate knowledge. Of care-givers who had previously used ORT only 20.5% demonstrated the correct volume of water to add to one sachet of ORT, but 82% would discard an unused solution within 24 hours. Significantly more literate women had used ORT than those not literate (p = 0.002). Mothers, particularly those literate, are the primary target group for ORT intervention strategies. Components of health education should include advice on what ORS is, what it is used for, and how to correctly mix a standard sachet.
Fulltext Mediational effects of self-efficacy dimensions in the relationship between knowledge of dengue and dengue preventive behaviour with respect to control of dengue outbreaks: a structural equation model of a cross-sectional survey

Isa A, Loke YK, Smith JR, Papageorgiou A, Hunter PR

PLoS Negl Trop Dis, 2013;7(9):e2401.
PMID: 24086777 DOI: 10.1371/journal.pntd.0002401

BACKGROUND: Dengue fever is endemic in Malaysia, with frequent major outbreaks in urban areas. The major control strategy relies on health promotional campaigns aimed at encouraging people to reduce mosquito breeding sites close to people's homes. However, such campaigns have not always been 100% effective. The concept of self-efficacy is an area of increasing research interest in understanding how health promotion can be most effective. This paper reports on a study of the impact of self-efficacy on dengue knowledge and dengue preventive behaviour.
METHODS AND FINDINGS: We recruited 280 adults from 27 post-outbreak villages in the state of Terengganu, east coast of Malaysia. Measures of health promotion and educational intervention activities and types of communication during outbreak, level of dengue knowledge, level and strength of self-efficacy and dengue preventive behaviour were obtained via face-to-face interviews and questionnaires. A structural equation model was tested and fitted the data well (χ(2) = 71.659, df = 40, p = 0.002, RMSEA = 0.053, CFI = 0.973, TLI = 0.963). Mass media, local contact and direct information-giving sessions significantly predicted level of knowledge of dengue. Level and strength of self-efficacy fully mediated the relationship between knowledge of dengue and dengue preventive behaviours. Strength of self-efficacy acted as partial mediator in the relationship between knowledge of dengue and dengue preventive behaviours.
CONCLUSIONS: To control and prevent dengue outbreaks by behavioural measures, health promotion and educational interventions during outbreaks should now focus on those approaches that are most likely to increase the level and strength of self-efficacy.
Fulltext Factors contributing to poor compliance with anti-TB treatment among tuberculosis patients

Naing NN, D'Este C, Isa AR, Salleh R, Bakar N, Mahmod MR

Southeast Asian J Trop Med Public Health, 2001 Jun;32(2):369-82.
PMID: 11556591

Tuberculosis (TB) has made a comeback. It has become a resurgent public health problem in developing countries in the tropics and is the leading cause of death from any single infectious agent. Non-compliance to anti-tuberculosis treatment is the most serious problem in TB control. A cross-sectional study was conducted to investigate the determinants of poor compliance with anti-tuberculosis treatment among tuberculosis patients in Kota Bharu, Kelantan, Malaysia in 1999. A total of 390 patients were included in the study of which 130 were tuberculosis patients who defaulted treatment and 260 were those compliant to treatment. Data collection was done by interviewing the patients and collecting clinical and laboratory data from their medical records. Using multiple logistic regression analysis, patients who were not on direct observed therapy (DOT) lived distant to the health facility, were non-intravenous drug users (IVDU) and were HIV positive had statistically significant higher odds of being non-compliant. Patients should be given treatment under direct supervision with special attention to IVDU and HIV positive groups. Anti-TB treatment should be accessible to patients at the nearest health center from their residence. Interventions with health education programs emphasizing the benefits of treatment compliance should be implemented by further large-scale multicentered studies.
Study site: Chest clinic, Hospital Kota Bharu, Kelantan, Malaysia
Fulltext Risk factors for retinopathy in diabetes mellitus in Kelantan, Malaysia

Shriwas SR, Rahman Isa AB, Reddy SC, Mohammad M, Mohammad WBW, Mazlan M

Med J Malaysia, 1996 Dec;51(4):447-52.
PMID: 10968032

Few attempts have been made to determine the risk factors for diabetic retinopathy which is a major cause of visual impairment and blindness. One hundred and forty patients of diabetes mellitus were studied to determine the prevalence and types of retinopathy, and its relation to various risk factors. Nearly half (48.6%) of the patients suffered from retinopathy. The significant associated risk factors were long duration of diabetes, proteinuria and elevated serum creatinine level. However, there was no significant association between the prevalence of retinopathy and high levels of serum cholesterol, C-peptide levels, associated hypertension, and glycaemic control of diabetes mellitus. An effective screening programme for detection of retinopathy in the patients of diabetes as a regular practice is encouraged.
Study site: Diabetic clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Fulltext Real Time Microwave Biochemical Sensor Based on Circular SIW Approach for Aqueous Dielectric Detection

Mohd Bahar AA, Zakaria Z, Md Arshad MK, Isa AAM, Dasril Y, Alahnomi RA

Sci Rep, 2019 04 02;9(1):5467.
PMID: 30940843 DOI: 10.1038/s41598-019-41702-3

In this study, a critical evaluation of analyte dielectric properties in a microvolume was undertaken, using a microwave biochemical sensor based on a circular substrate integrated waveguide (CSIW) topology. These dielectric properties were numerically investigated based on the resonant perturbation method, as this method provides the best sensing performance as a real-time biochemical detector. To validate these findings, shifts of the resonant frequency in the presence of aqueous solvents were compared with an ideal permittivity. The sensor prototype required a 2.5 µL volume of the liquid sample each time, which still offered an overall accuracy of better than 99.06%, with an average error measurement of ±0.44%, compared with the commercial and ideal permittivity values. The unloaded Qu factor of the circular substrate-integrated waveguide (CSIW) sensor achieved more than 400 to ensure a precise measurement. At 4.4 GHz, a good agreement was observed between simulated and measured results within a broad frequency range, from 1 to 6 GHz. The proposed sensor, therefore, offers high sensitivity detection, a simple structural design, a fast-sensing response, and cost-effectiveness. The proposed sensor in this study will facilitate real improvements in any material characterization applications such as pharmaceutical, bio-sensing, and food processing applications.
Individual, Host-Vector Interactions, and Environmental Risk Factors for Plasmodium knowlesi Malaria Among At-Risk Communities in Peninsular Malaysia: A Case-Control Study

Pasi H, Mohamad E, Azlan AA, Hamzah MR, Sulong MR, Isa A, et al.

Vector Borne Zoonotic Dis, 2024 Nov 25.
PMID: 39585202 DOI: 10.1089/vbz.2024.0023

Background: Highlighting the individual, host-vector interactions, and environmental risk factors for knowlesi malaria were consequential toward more focused and effective prevention and control strategies. This study aims to identify the individual, host-vector interactions, and environmental risk factors for Plasmodium knowlesi malaria among at-risk communities in Peninsular Malaysia. Materials and Methods: A case-control study was conducted involving laboratory-confirmed cases of P. knowlesi malaria, while a locality-matched individual with no history of fever and tested negative for malaria was taken as control. Univariate and multiple logistic regression were applied to evaluate the potential risk factors among respondents using IBM SPSS Statistics for Windows, Version 26.0. Results: Results showed higher cases among males as compared to females (76.1% vs. 23.9%). Multiple logistic regression analysis showed being male is 3.51 higher risk (p < 0.001) to become a case. Respondents whose place of work or study is near the forest edge have 44.0% lower risk (p = 0.030), while those living in the Orang Asli village were 56.0% lower risk as compared to the organized village to become a case (p = 0.035). Conclusion: These findings demonstrated that gender emerges as an independent individual risk factor while residing near a forest edge, in an Orang Asli village, or occupying workers' longhouses situated in hilly areas lowered the environmental risk among respondents. These findings attested that alternative directions must be considered in addressing the known risk factors associated with this type of malaria and the design of prevention and control programs should be tailored to the unique characteristics of each population.
Development of a health information service using a videotex system

Dzulkifli AR, Aishah AL, Ch'ng HS, Rose A, Rahmat A, Isa AM, et al.

J Audiov Media Med, 1994 Jul;17(3):117-20.
PMID: 7636117

A number of health databases is now available in Malaysia, but few are accessible to the general public. However, recently a service was launched nationwide via a videotex system to also target the Malaysia public. This service is provided by the School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM) in collaboration with several Malaysian Government ministries and agencies. Access to health information via videotex, be it medical, pharmaceutical or environmental is viewed as an effective means of on-line information dissemination. It provides not only rapid retrieval but is also economical and interactive, particularly suitable for a developing country.
Fulltext Behavioral and corticosterone responses to carbon dioxide exposure in reptiles

Natusch DJD, Aust PW, Khadiejah S, Ithnin H, Isa A, Zamzuri CK, et al.

PLoS One, 2020;15(10):e0240176.
PMID: 33022690 DOI: 10.1371/journal.pone.0240176

The use of carbon dioxide (CO2) exposure as a means of animal euthanasia has received considerable attention in mammals and birds but remains virtually untested in reptiles. We measured the behavioral responses of four squamate reptile species (Homalopsis buccata, Malayopython reticulatus, Python bivitattus, and Varanus salvator) to exposure to 99.5% CO2 for durations of 15, 30, or 90 minutes. We also examined alterations in plasma corticosterone levels of M. reticulatus and V. salvator before and after 15 minutes of CO2 exposure relative to control individuals. The four reptile taxa showed consistent behavioral responses to CO2 exposure characterized by gaping and minor movements. The time taken to lose responsiveness to stimuli and cessation of movements varied between 240-4260 seconds (4-71 minutes), with considerable intra- and inter-specific variation. Duration of CO2 exposure influenced the likelihood of recovery, which also varied among species (e.g., from 0-100% recovery after 30-min exposure). Plasma corticosterone concentrations increased after CO2 exposure in both V. salvator (18%) and M. reticulatus (14%), but only significantly in the former species. Based on our results, CO2 appears to be a mild stressor for reptiles, but the relatively minor responses to CO2 suggest it may not cause considerable distress or pain. However, our results are preliminary, and further testing is required to understand optimal CO2 delivery mechanisms and interspecific responses to CO2 exposure before endorsing this method for reptile euthanasia.
Fulltext Malaysian Health Literacy: Scorecard Performance from a National Survey

Jaafar N, Perialathan K, Krishnan M, Juatan N, Ahmad M, Mien TYS, et al.

Int J Environ Res Public Health, 2021 05 28;18(11).
PMID: 34071455 DOI: 10.3390/ijerph18115813

Health literacy is an indicator of a society's ability to make better health judgements for themselves and the people around them. This study investigated the prevalence of health literacy among Malaysian adults and provided an overall picture of the society's current health literacy status, which has not been previously assessed. The study also highlighted socio-demographic markers of communities with limited health literacy that may warrant future intervention. A population-based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized a two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above, drawn from the living quarter list, participated in the study. The health literacy score was divided into three levels; limited, sufficient, and excellent. Findings showed a majority of the Malaysian population had a sufficient health literacy level in all three domains-healthcare, diseases prevention and health promotion (49.1%, 44.2%, and 47.5%, respectively)-albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups were prevalent among respondents with older age (68%), lower education level (64.8%), and lower household income (49.5%). The overall health literacy status for Malaysia was categorized at a lower sufficiency level. Future health literacy improvements should focus on communities with a limited health literacy level to improve the overall score.
Fulltext When do persuasive messages on vaccine safety steer COVID-19 vaccine acceptance and recommendations? Behavioural insights from a randomised controlled experiment in Malaysia

Hing NYL, Woon YL, Lee YK, Kim HJ, Lothfi NM, Wong E, et al.

BMJ Glob Health, 2022 Jul;7(7).
PMID: 35906015 DOI: 10.1136/bmjgh-2022-009250

INTRODUCTION: Vaccine safety is a primary concern among vaccine-hesitant individuals. We examined how seven persuasive messages with different frames, all focusing on vaccine safety, influenced Malaysians to accept the COVID-19 vaccine, and recommend it to individuals with different health and age profiles; that is, healthy adults, the elderly, and people with pre-existing health conditions.
METHODS: A randomised controlled experiment was conducted from 29 April to 7 June 2021, which coincided with the early phases of the national vaccination programme when vaccine uptake data were largely unavailable. 5784 Malaysians were randomly allocated into 14 experimental arms and exposed to one or two messages that promoted COVID-19 vaccination. Interventional messages were applied alone or in combination and compared against a control message. Outcome measures were assessed as intent to both take the vaccine and recommend it to healthy adults, the elderly, and people with pre-existing health conditions, before and after message exposure. Changes in intent were modelled and we estimated the average marginal effects based on changes in the predicted probability of responding with a positive intent for each of the four outcomes.
RESULTS: We found that persuasive communication via several of the experimented messages improved recommendation intentions to people with pre-existing health conditions, with improvements ranging from 4 to 8 percentage points. In contrast, none of the messages neither significantly improved vaccination intentions, nor recommendations to healthy adults and the elderly. Instead, we found evidence suggestive of backfiring among certain outcomes with messages using negative attribute frames, risky choice frames, and priming descriptive norms.
CONCLUSION: Message frames that briefly communicate verbatim facts and stimulate rational thinking regarding vaccine safety may be ineffective at positively influencing vaccine-hesitant individuals. Messages intended to promote recommendations of novel health interventions to people with pre-existing health conditions should incorporate safety dimensions.
TRIAL REGISTRATION NUMBER: NCT05244356.
Lung computed tomography patterns of a cluster of asymptomatic young males with COVID-19 admitted to a teaching hospital in Kuala Lumpur

Ng BH, Nuratiqah NA, Andrea YLB, Faisal AH, Soo CI, Najma K, et al.

Med J Malaysia, 2020 07;75(4):368-371.
PMID: 32723996

BACKGROUND AND OBJECTIVE: Coronavirus Disease 2019 (COVID- 19) was first reported in Malaysia in March 2020. We describe here the clinical characteristics and computed tomography (CT) patterns in asymptomatic young patients who had laboratory-confirmed COVID-19.
METHODS: This is a retrospective observational study where 25 male in-patients with laboratory-confirmed COVID-19 in Hospital Canselor Tuanku Muhriz. Demographics, clinical data and CT images of these patients were reviewed by 2 senior radiologists.
RESULTS: In total there were 25 patients (all males; mean age [±SD], 21.64±2.40 years; range, 18-27 years). Patients with abnormal chest CT showed a relatively low normal absolute lymphocytes count (median: 2.2 x 109/L) and absolute monocyte count (median: 0.5 x 109/L). Lactate dehydrogenase was elevated in 5 (20%) of the patients. The procalcitonin level was normal while elevated levels of alanine aminotransferase, total bilirubin, platelet and C-reactive protein were common. Baseline chest CT showed abnormalities in 6 patients. The distribution of the lesions were; upper lobe 3 (12%) lower lobe 3 (12%) with peripheral distribution 4 (16%). Of the 25 patients included, 4 (16%) had ground glass opacification (GGO), 1 (4%) had a small peripheral subpleural nodule, and 1 (4%) had a dense solitary granuloma. Four patients had typical CT features of COVID-19.
CONCLUSION: We found that the CT imaging showed peripheral GGO in our patients. They remained clinically stable with no deterioration of their respiratory symptoms suggesting stability in lung involvement. We postulate that rapid changes in CT imaging may not be present in young, asymptomatic, non-smoking COVID-19 patients. Thus the use of CT thoraxfor early diagnosis may be reserved for patients in the older agegroups, and not in younger patients.

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