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Fulltext The burden of human influenza in Malaysia

Sam JIC

Med J Malaysia, 2015 Jun;70(3):127-30.
PMID: 26248773 MyJurnal

Seasonal and pandemic influenza causes considerable morbidity and mortality globally, but the burden of disease is understudied and underreported in developing countries such as Malaysia. Before considering the cost-effectiveness of introducing interventions such as vaccines to control influenza, it is imperative to determine clinical and socioeconomic impact of the disease. This review summarises the main available literature on human influenza in Malaysia, the possible reasons for the lack of study and awareness of influenza, and important knowledge gaps for future study.
Fulltext Pandemic influenza A (H1N1) 2009 in Malaysia--the next phase

Sam IC, Abu Bakar S

Med J Malaysia, 2009 Jun;64(2):105-7.
PMID: 20058566

In recent years, zoonotic RNA viruses such as Nipah, SARS coronavirus, avian influenza (H5N1) and Chikungunya have emerged with global impact. The latest has now been designated by World Health Organization (WHO) as pandemic (H1N1) 2009 virus. It was first reported as an outbreak in Mexico in April, and has now caused the first influenza pandemic since 1968. By July 11, 2009, there were 105,304 confirmed cases and 463 deaths in 143 countries, including 627 cases in Malaysia1 . The rapid spread of the disease has been matched by the speed of dissemination of information and protocols, co-ordinated by WHO. The experiences of SARS and H5N1 have been enormously beneficial in preparing the world for a pandemic.
Fulltext Chikungunya virus infection

Sam IC, Sulaiman AB

Med J Malaysia, 2006 Jun;61(2):264-9.
PMID: 16898330 MyJurnal

Chikungunya virus (CHIKV) is a mosquito-borne alphavirus which causes epidemic fever, rash and polyarthralgia in Africa and Asia. Two outbreaks have been reported in Malaysia, in Klang, Selangor (1998) and Bagan Panchor, Perak (2006). It is not known if the outbreaks were caused by the recent introduction of CHIKV, or if the virus was already circulating in Malaysia. Seroprevalence studies from the 1960s suggested previous disease activity in certain parts of the country. In Asia, CHIKV is thought to be transmitted by the same mosquitoes as dengue, Aedes aegypti and Ae. albopictus. Due to similarities in clinical presentation with dengue, limited awareness, and a lack of laboratory diagnostic capability, CHIKV is probably often underdiagnosed or misdiagnosed as dengue. Treatment is supportive. The prognosis is generally good, although some patients experience chronic arthritis. With no vaccine or antiviral available, prevention and control depends on surveillance, early identification of outbreaks, and vector control. CHIKV should be borne in mind in sporadic cases, and in patients epidemiologically linked to ongoing local or international outbreaks or endemic areas.
Fulltext Nutrients depictions of Barhi date palm (Phoenix dactylifera L.) kernels

Mahmud, I.A., Mirghani, M.E.S., Alkhatib, M.F.R., Yusof, F., Shahabuddin, M., Rashidi, O., et al.

International Food Research Journal, 2017;24(101):0-0.
MyJurnal

Phoenix dactylifera L (Date palm) is one of the oldest known fruit crops in the world, and
the consumption of date fruits is no longer restricted to the Middle Eastern countries. Date
palm kernels are waste products of date fruit industry which are normally being discarded.
Based on their dietary fiber content; date palm kernels (DPK) have been proposed to be used
as fiber-based food supplement, caffeine free coffee alternative and animal feed ingredient.
Hence, utilization of such waste is highly desirable for the date industry. To accommodate these
benefits, and subsequent to some uses associated with DPK, this study sought to investigate the
biochemical and nutritional values of the Barhi date palm kernels (BDPK) grown in Iraq. The
results show that BDPK is an excellent source of dietary fiber (66.24 g/100g). Glutamic acid
was found to be the predominant amino acid, (0.674 g/100g), followed by Arginine and aspartic
acid (0.437 g/100g and 0.320 g/100g, respectively). Potassium was the most occurring mineral
in BDPK (2.39 g/kg), and the main sugars were sucrose and fructose (0.548 g/100g and 0.249
g/100g, respectively). Gas-liquid chromatography revealed that the main unsaturated fatty acid
(USFA) was oleic acid (40.927 mg/100g), while the main saturated fatty acid (SFA) were lauric
acid (20.270 mg/100g) and myristic acid (12.288 mg/100g). Furthermore, the BDPK depicted
considerable concentrations of vitamins, in which vitamin B5 (40.4 mg/100g) showed the
highest value. The results obtained indicate a strong potential for BDPK to be used in human
nutrition, cosmetics, and pharmaceutical applications and may provide an important economic
advantage through increasing the utilization of BDKP while also additive value will be added
to the residue.
Macrorestriction analysis and antimicrobial susceptibility profiling of Salmonella enterica at a University Teaching Hospital, Kuala Lumpur

Tiong V, Thong KL, Yusof MY, Hanifah YA, Sam JI, Hassan H

Jpn J Infect Dis, 2010 Sep;63(5):317-22.
PMID: 20858996

The genetic diversity and antimicrobial resistance rates of clinical Salmonella isolates (2007-2008) at the University of Malaya Medical Centre, Kuala Lumpur, were investigated and the genetic diversity of the isolates was determined by pulsed-field gel electrophoresis (PFGE) and repetitive extragenic palindromic (REP)-PCR. XbaI-PFGE analysis generated 57 profiles (Dice coefficient, F=0.08-1.00), whereas REP-PCR using the REP primer generated only 35 (F=0.34-1.00). PFGE was therefore the more discriminative and reproducible method for assessing the genetic diversity of salmonellae. The antibiograms of 78 Salmonella isolates were assessed against 19 antimicrobials using the disk diffusion method. Twenty serotypes were identified, with the most common being S. Enteritidis (18%) followed by S. Typhimurium (14%), S. Paratyphi B var Java (9%), S. Weltevreden (9%), and S. Corvallis (9%). A total of 38 resistant profiles were defined, with 53.8% of the isolates being resistant to three or more antimicrobials. The highest resistance rates were observed for cephalothin (55.1%), tetracycline (47.4%), and nalidixic acid (35.9%). The presence of multidrug-resistant Salmonella strains is a cause for concern as it may limit the treatment of severe salmonellosis. One multidrug-resistant S. Enteritidis strain was a putative extended-spectrum beta-lactamase producer, based on a double disk diffusion analysis, and was resistant to ceftriaxone (MIC>32 microg/mL). The data generated by this study will contribute towards epidemiological monitoring and investigations of Salmonella infections in Malaysia.
Fulltext New Paradigms for Virus Detection, Surveillance and Control of Zika Virus Vectors in the Settings of Southeast Asia

Vythilingam I, Sam JI, Chan YF, Khaw LT, Sulaiman WY

Front Microbiol, 2016;7:1452.
PMID: 27679623 DOI: 10.3389/fmicb.2016.01452

Zika virus (ZIKV) has now become a global public health concern. The vectors for ZIKV are Aedes aegypti and A. albopictus. Both these mosquitoes are predominant in Southeast Asia and are also responsible for the spread of other arboviral diseases like dengue virus and chikungunya virus. The incidence of dengue has been increasing over the years and this is of concern to public health workers. Simple laboratory tools for the detection of ZIKV is also lacking. In the absence of drugs and vaccine for these arboviral diseases, vector control is the main option for surveillance and control. Aedes larval surveys have been the hallmark of dengue control along with larviciding and fogging when cases are reported. However, we need new paradigms and options for control of these vectors. The current situation in Southeast Asia clearly proves that effective strategies for vector control need to be proactive and not reactive. This will be the way forward to control epidemics of these diseases inclusive of ZIKV until a vaccine becomes available.
Fulltext Cross-sectional study of influenza trends and costs in Malaysia between 2016 and 2018

Wan Puteh SE, Aazmi MS, Aziz MN, Kamarudin N', Sam JI, Thayan R, et al.

PLoS One, 2024;19(3):e0301068.
PMID: 38517867 DOI: 10.1371/journal.pone.0301068

BACKGROUND AND OBJECTIVES: While influenza circulates year-round in Malaysia, research data on its incidence is scarce. Yet, this information is vital to the improvement of public health through evidence-based policies. In this cross-sectional study, we aimed to determine the trends and financial costs of influenza.
METHODS: Data for the years 2016 through 2018 were gathered retrospectively from several sources. These were existing Ministry of Health (MOH) influenza sentinel sites data, two teaching hospitals, and two private medical institutions in the Klang Valley, Malaysia. Expert consensus determined the final estimates of burden for laboratory-confirmed influenza-like illness (ILI) and severe acute respiratory infection (SARI). Economic burden was estimated separately using secondary data supplemented by MOH casemix costing.
RESULTS: Altogether, data for 11,652 cases of ILI and 5,764 cases of SARI were extracted. The influenza B subtype was found to be predominant in 2016, while influenza A was more prevalent in 2017 and 2018. The distribution timeline revealed that the highest frequency of cases occurred in March and April of all three years. The costs of influenza amounted to MYR 310.9 million over the full three-year period.
CONCLUSIONS: The study provides valuable insights into the dynamic landscape of influenza in Malaysia. The findings reveal a consistent year-round presence of influenza with irregular seasonal peaks, including a notable influenza A epidemic in 2017 and consistent surges in influenza B incidence during March across three years. These findings underscore the significance of continuous monitoring influenza subtypes for informed healthcare strategies as well as advocate for the integration of influenza vaccination into Malaysia's national immunization program, enhancing overall pandemic preparedness.
Fulltext Nurses' Perceptions, Involvement, Confidence and Perceived Barriers Towards Antimicrobial Stewardship Program in Pakistan: Findings from a Multi-Center, Cross-Sectional Study

Mustafa ZU, Manzoor MN, Shahid A, Salman M, Hayat K, Yasmin K, et al.

J Multidiscip Healthc, 2022;15:2553-2562.
PMID: 36388630 DOI: 10.2147/JMDH.S376664

PURPOSE: Antimicrobial resistance (AMR) is leading to greater therapeutic cost, length of hospital stays, adverse events, morbidity and mortality. Hospital-based antimicrobial stewardship programs (ASPs) engaging physicians, pharmacists, microbiologists and nurses are considered as effective way to ensure appropriate use of antimicrobial agents. The aims of our study were to assess nurses' perception, involvement, confidence and barriers towards hospital-based ASPs, and use the findings to provide future guidance.
METHODS: A web-based, cross-sectional study was conducted among the nurses serving at eleven hospitals of Punjab province of Pakistan during a period of two months (December 2021-January 2022). Data were collected using a validated self-administered questionnaire. All data were analyzed using SPSS version 22.
RESULTS: A total of 583 nurses participated in the study (response rate = 77.7%). All the participants were female staff nurses and 86% had a minimum of 3 years of working experience. The overall median score on the perception towards ASPs among the nurses was 18 (IQR: 16, 19) on a 0 to 20 scale whereas median score on the involvement in ASPs was 18 (IQR: 15, 37) on a 0 to 64 scale. Median perception and involvement score were statistically significantly differed by age (p < 0.001) and years of experience (p < 0.001). The overall median score on the confidence to perform ASP activities was 22 (IQR: 14, 24) on a 0 to 28 scale. Lack of knowledge, insufficient support from administration, and heavy workload were found to be the common barriers to perform ASP.
CONCLUSION: Our study concluded that Pakistani nurses have positive perception but limited involvement in ASPs. Moreover, they are confident to perform ASP besides many barriers.