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Fulltext Island health review, progress and the way forward in the Western Pacific region

Zin, Thant, Myint, Than, Htay, Kyaw, Shamsul, B. S.

Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
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Island health differs from other health care systems, particularly in that there are limited resources and referral faculties available. With globalisation and climate change, island populations have become increasingly vulnerable to natural disasters and global pandemics. This study will identify, explore, compare and report on island health issues facing in the western Pacific, before making appropriate recommendations. A review of selected health indicators in Pacific islands was collected from the World Health Organization (WHO) and other publicly available resources. In the Pacific region, 15 islands saw lower health expenditure (
Fulltext Influencing factors for cholera and diarrhoea: water sanitation and hygiene in impoverished rural villages of Beluran District, Sabah Malaysia

Zin, Thant, SabaiAung, Tin, Sahipudin Saupin, Myint, Than, KhinSN, Daw, Aung, Meiji Soe, et al.

Malaysian Journal of Public Health Medicine, 2015;15(1):0-0.
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The lower percentage of water, sanitation and hygiene are the root causes of diarrhoea and cholera. Cholera is a sudden onset of acute watery diarrhoea which can progress to severe dehydration and death if untreated. The current pandemic, Vibrio Cholera O1 started in 1961. This study explores water, sanitation, hygiene and cholera and diarrhoea in three affected villages of Beluran District, Sabah Malaysia to support effective and timely public health intervention. This cross sectional study uses purposive sampling. All (114) households were interviewed and household water samples collected. The study reported lower coverage improved sanitation facilities (35.3% to 52.3%), no latrine at home (37% to 63%), improved water supply (52% to 60%), and prevalence of hand washing after toilet (57% - 74%). For water quality, Ecoli was present in household water (32% to 37%) but Vibrio cholerae was not isolated in any of the water samples tested. Statistically significant associations were found for; 1) occupation−nonagriculture and unimproved sanitation facility and 2) house ownership and correct knowledge of ORS preparation. Predictors for household water quality were: latrine at home, and improved household toilet. Aggressive strategies to improve water supply, sanitation and hygiene−hand washing after toilet−were recommended for future prevention of cholera and diarrhoea in the affected area.
Fulltext Assessment of inter-examiner agreement on double marking of essay papers

Myint, Than, Zin, Thant, Htay, Kyaw, Min, Kyaw, Zainal Arifin Mustapha, Ahmad Faris Abdullah

Borneo Journal of Medical Sciences, 2015;9(1):23-28.
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Assessment method of medical students by conducting examination is to identify the quality and quantity of their academic performance. Essay paper is one of the most common assessment tools in the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah. Double marking is a means by which academic staff attempts to produce fair results for the students. Eighty eight medical students sat for three sets of Essay Papers of Professional I examination in March 2012. The double marking on the essay papers was done by two lecturers of each clinical department concerned for each discipline. Inter-examiner agreement and its effect on the reliability of the final score for the students were calculated by using Kappa statistics and Intra-class Correlation Coefficient (ICC). Reliability coefficient of the scores were also calculated for the different disciplines. In Part A essay paper, Cohan’s Kappa was 0.48 (p
Fulltext Knowledge and utilization of laboratory services among employees of University Malaysia Sabah. [Abstract]

Wynn AA, Myint O, Mya NK, Aung TS, Myint T

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):39.
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Abstracts For The 1st International Borneo Healthcare And Public Health Conference And 4th Borneo Tropical Medicine And Infectious Disease Congress. Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia On 3rd-5th September 2019
Introduction: Laboratory screening tests are common elements of health care. Comprehensive care of patients is dependent on the results of laboratory investigations. Dissemination of knowledge and improving attitude of com-munity for utilization of laboratory services are utmost important in community health care. This study aimed to assess the knowledge and utilization of the laboratory services among the employees of University Malaysia Sabah, determine their expectations of employees on the medical laboratory services.
Methods: A total of 200 UMS staff participated. The data were collected using a cross-sectional self-administered questionnaires and descriptive data analysis was done.
Results: 5% of the participants in this study agreed to have the health check and blood screening tests every year. Less than 10% of respondents agreed to do more frequent blood tests check if they are at high risk such as family history of cancer, hypertension and diabetes 181 out of 200 respondents do not agree that doing laboratory tests can help for early diagnosis of some diseases. The most used laboratory tests were plasma sugar (70.8%), blood grouping (60.4%), urine examination (50%) and serum lipid (46%).
Conclusion: Based on the results, recommendations were made to improve the knowledge, attitude and utilization of the laboratory services and set up laboratory services easily accessible by the university community. This will lead to positive health benefits in people and improve associated health outcomes.
Fulltext Assessment of risk factors for ovarian cancer in UMS students. [Abstract]

Myint O, Azizan N, Mohd Hayati MF, Wynn AA, Myint T

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):37.
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Abstracts For The 1st International Borneo Healthcare And Public Health Conference And 4th Borneo Tropical Medicine And Infectious Disease Congress. Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia On 3rd-5th September 2019
Introduction: Cancer is a major public health problem and the third leading cause of death in Malaysia. Ovarian cancers are the fifth most common cancer among women in Peninsular Malaysia. Our aim is to assess the risk factors in healthy young adult female students from UMS and will act as an input for further prevention of ovarian cancer. Methods: Cross sectional, questionnaire-based study was done on total 278 Medical and Nursing students from Faculty of Medicine and Health Sciences and received the answers based on genetic assessment of ovarian cancers whether gives positive history of ovarian cancers in first degree, second degree and third-degree relatives. The life-time risk of a woman who has a first degree relative with ovarian cancer is five percent (the average woman’s lifetime risk is 1.4 percent). Results: Assessing the hereditary risk factor, total 1.8% gives positive results for ovarian cancer in first degree relatives. The lifetime risk of ovarian cancer among female mutation carriers was 39-46% for BRCA1 and 12-20% for BRCA2 mutation carriers. In our study, regarding physical activity,63.7% is not meeting with WHO recommendation for Metabolic Equivalent Task (MET) and remaining 36.3% meets WHO recommendation. By using International Physical Activity Questionnaire (IPQA)Score Protocol, only 2.6 % of Medical students showed Health Enhancing Physical Activity (HEPA) active,36.4 % showed minimally active and 60.9% showed inactive. Among nursing students only 5.5% showed HEPA active, 35.4% showed minimally active and 59.1% are inactive. Conclu-sion: Primary prevention through behavioural and lifestyle modification is a cost-effective means of preventing the large burden cancer has on societies world-wide.
Surveillance Evaluation of the National Cancer Registry in Sabah, Malaysia

Jeffree SM, Mihat O, Lukman KA, Ibrahim MY, Kamaludin F, Hassan MR, et al.

Asian Pac J Cancer Prev, 2016;17(7):3123-9.
PMID: 27509940

BACKGROUND: Cancer is the fourth leading cause of death in Sabah Malaysia with a reported agestandardized incidence rate was 104.9 per 100,000 in 2007. The incidence rate depends on nonmandatory notification in the registry. Underreporting will provide the false picture of cancer control program effectiveness. The present study was to evaluate the performance of the cancer registry system in terms of representativeness, data quality, simplicity, acceptability and timeliness and provision of recommendations for improvement.
MATERIALS AND METHODS: The evaluation was conducted among key informants in the National Cancer Registry (NCR) and reporting facilities from FebMay 2012 and was based on US CDC guidelines. Representativeness was assessed by matching cancer case in the Health Information System (HIS) and state pathology records with those in NCR. Data quality was measured through case finding and reabstracting of medical records by independent auditors. The reabstracting portion comprised 15 data items. Selfadministered questionnaires were used to assess simplicity and acceptability. Timeliness was measured from date of diagnosis to date of notification received and data dissemination.
RESULTS: Of 4613 cancer cases reported in HIS, 83.3% were matched with cancer registry. In the state pathology centre, 99.8% was notified to registry. Duplication of notification was 3%. Data completeness calculated for 104 samples was 63.4%. Registrars perceived simplicity in coding diagnosis as moderate. Notification process was moderately acceptable. Median duration of interval 1 was 5.7 months.
CONCLUSIONS: The performances of registry's attributes are fairly positive in terms of simplicity, case reporting sensitivity, and predictive value positive. It is moderately acceptable, data completeness and inflexible. The usefulness of registry is the area of concern to achieve registry objectives. Timeliness of reporting is within international standard, whereas timeliness to data dissemination was longer up to 4 years. Integration between existing HIS and national registration department will improve data quality.
Fulltext Antenatal care (ANC) services utilization in maternal and child health (MCH) clinics of Kinabatangan (rural) and Sandakan (urban) of Sabah, Malaysia

Win SS, Aung S, Tha TO, Myint T, Awang Besar J, Yayaha Z

Malaysian Journal of Public Health Medicine, 2017;17(2):42-51.

This paper investigates the antenatal care (ANC) services utilization in currently pregnant women during their visits to maternal and child health (MCH) clinics of rural (Kinabatangan) and urban (Sandakan), Sabah. A community clinic based, cross-sectional descriptive study was performed. In total, 800 currently pregnant women attending two MCH clinics, from April to September 2012, were participated using tested set questionnaires. Descriptive analysis was used for background characteristics and chi-square analysis was applied to identify the rural-urban differences among the variables.In both study areas, previous births delivered by skilled birth personnel were same. In pregnant women from rural, less income, more grand-multiparity, earlier antenatal care booking, more frequent post-natal care, more use of contraception compared to those in urban. In comparison, urban pregnant women had more anti-tetanus toxoid injection in their previous pregnancies, past history of antenatal care for at least four times, increase in household members. As this study found the differences in ANC services utilization at Rural and Urban, further study is needed to explore concrete reasons for above findings. By delivering services according to the needs of all clients, irrespective of their place of residence, it will improve ANC services utilization in both areas of Sabah and hence will improve more on existing health status of the Nation.
Study site: Klinik Kesihatan, Kinabatangan and Sandakan, Sabah, Malaysia
Fulltext Influencing factors for household water quality improvement in reducing diarrhoea in resource-limited areas

Zin T, Mudin KD, Myint T, Naing DKS, Sein T, Shamsul BS

WHO South East Asia J Public Health, 2013 Jan-Mar;2(1):6-11.
PMID: 28612817 DOI: 10.4103/2224-3151.115828

BACKGROUND AND OBJECTIVES: Water and sanitation are major public health issues exacerbated by rapid population growth, limited resources, disasters and environmental depletion. This study was undertaken to study the influencing factors for household water quality improvement for reducing diarrhoea in resource-limited areas.

MATERIALS AND METHODS: Data were collected from articles and reviews from relevant randomized controlled trials, new articles, systematic reviews and meta-analyses from PubMed, World Health Organization (WHO), United Nations Children's Fund (UNICEF) and WELL Resource Centre For Water, Sanitation And Environmental Health.

DISCUSSION: Water quality on diarrhoea prevention could be affected by contamination during storage, collection and even at point-of-use. Point-of-use water treatment (household-based) is the most cost-effective method for prevention of diarrhoea. Chemical disinfection, filtration, thermal disinfection, solar disinfection and flocculation and disinfection are five most promising household water treatment methodologies for resource-limited areas.

CONCLUSION: Promoting household water treatment is most essential for preventing diarrhoeal disease. In addition, the water should be of acceptable taste, appropriate for emergency and non-emergency use.
Fulltext Genetic diversity of toxigenic Vibrio cholerae O1 from Sabah, Malaysia 2015

Zaw MT, Emran NA, Ibrahim MY, Suleiman M, Awang Mohd TA, Yusuff AS, et al.

J Microbiol Immunol Infect, 2019 Aug;52(4):563-570.
PMID: 29428381 DOI: 10.1016/j.jmii.2018.01.003

BACKGROUND: Cholera is an important health problem in Sabah, a Malaysian state in northern Borneo; however, Vibrio cholerae in Sabah have never been characterized. Since 2002, serogroup O1 strains having the traits of both classical and El Tor biotype, designated as atypical El Tor biotype, have been increasingly reported as the cause of cholera worldwide. These variants are believed to produce clinically more severe disease like classical strains.
PURPOSE: The purpose of this study is to investigate the genetic diversity of V.cholerae in Sabah and whether V.cholerae in Sabah belong to atypical El Tor biotype.
METHODS: ERIC-PCR, a DNA fingerprinting method for bacterial pathogens based on the enterobacterial repetitive intergenic consensus sequence, was used to study the genetic diversity of 65 clinical V.cholerae O1 isolates from 3 districts (Kudat, Beluran, Sandakan) in Sabah and one environmental isolate from coastal sea water in Kudat district. In addition, we studied the biotype-specific genetic traits in these isolates to establish their biotype.
RESULTS: Different fingerprint patterns were seen in isolates from these three districts but one of the patterns was seen in more than one district. Clinical isolates and environmental isolate have different patterns. In addition, Sabah isolates harbor genetic traits specific to both classical biotype (ctxB-1, rstRCla) and El Tor biotype (rstRET, rstC, tcpAET, rtxC, VC2346).
CONCLUSION: This study revealed that V.cholerae in Sabah were genetically diverse and were atypical El Tor strains. Fingerprint patterns of these isolates will be useful in tracing the origin of this pathogen in the future.