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Fulltext Effect of hand hygiene intervention on the absenteeism of pre-school children in Klang Valley, Malaysia: a quasi-experimental study

Mohamed NA, Mohd Rani MD, Tengku Jamaluddin TZM, Ismail Z, Ramli S, Faroque H, et al.

World J Pediatr, 2020 Aug;16(4):416-421.
PMID: 31286426 DOI: 10.1007/s12519-019-00283-x

BACKGROUND: Absenteeism amongst pre-school children is often due to illnesses such as hand, foot, and mouth disease, acute gastroenteritis, cold and flu, which are easily spread amongst them. This is because of weak immunity and lack of knowledge on proper hand hygiene. This quasi-experimental study assessed the efficacy of an intervention consisting of a hand hygiene education programme, along with digital tools in bringing about a change in behaviour and health conditions amongst pre-school children in Klang Valley, Malaysia.
METHODS: A total of 377 school children, male and female, aged 5-6 years old, participated and were assigned to either the intervention or a control group. During the 2 months intervention period, children in the test group were trained on proper hand hygiene practices and techniques with the aid of the interactive android-based tablets. The numbers of absent days of all the children were recorded for 2 months before the intervention and during the intervention.
RESULTS: In the test group, there was a 25% increase in the total number of absent days from the pre-intervention period to the intervention period, a much lesser increment observed as compared to that of control group in which the increase was much higher at 89%. Results showed a significant difference (P

Matched MeSH terms: Hand Hygiene/standards*
WEO position statement on hygiene in digestive endoscopy: Focus on endoscopy units in Asia and the Middle East

Murdani A, Kumar A, Chiu HM, Goh KL, Jang BI, Khor CJ, et al.

Dig Endosc, 2017 Jan;29(1):3-15.
PMID: 27696514 DOI: 10.1111/den.12745

The aim of this position statement is to reinforce the key points of hygiene in digestive endoscopy. The present article details the minimum hygiene requirements for reprocessing of endoscopes and endoscopic devices, regardless of the reprocessing method (automated washer-disinfector or manual cleaning) and the endoscopy setting (endoscopy suite, operating room, elective or emergency procedures). These minimum requirements are mandatory for patient safety. Both advanced diagnostic and therapeutic endoscopies should be carried out in an environment that is safe for patients and staff. Particular attention is given to contaminants. Procedural errors in decontamination, defective equipment, and failure to follow disinfection guidelines are major factors contributing to transmission of infection during endoscopy. Other important risk factors include inadequate cleaning, use of older endoscopes with surface and working channel irregularities, and contamination of water bottles or irrigating solutions. Infections by multidrug-resistant organisms have become an increasing problem in health-care systems worldwide. Since 2010, outbreaks of multidrug-resistant bacteria associated with endoscopic retrograde cholangiopancreatography have been reported from the USA, France, Germany, and The Netherlands. In many endoscopy units in Asia and the Middle East, reprocessing procedures have lagged behind those of Western countries for cultural reasons or lack of financial resources. This inconsistency in standards is now being addressed, and the World Endoscopy Organization has prepared this position statement to highlight key points for quality assurance in any endoscopy unit in any country.

Matched MeSH terms: Hygiene/standards*
Bacteria in expressed breastmilk from mothers of premature infants and maternal hygienic status

Dahaban NM, Romli MF, Roslan NR, Kong SS, Cheah FC

Breastfeed Med, 2013 Aug;8(4):422-3.
PMID: 23398139 DOI: 10.1089/bfm.2012.0109
Matched MeSH terms: Hygiene/standards*
Risk factors associated with neonatal hypothermia during cleaning of newborn infants in labour rooms

Cheah FC, Boo NY

J Trop Pediatr, 2000 Feb;46(1):46-50.
PMID: 10730042

Cleaning newborn infants with coconut oil shortly after birth is a common practice in Malaysian labour rooms. This study aimed: (1) to determine whether this practice was associated with a significant decrease in the core temperature of infants; and (2) to identify significant risk factors associated with neonatal hypothermia. The core temperature of 227 randomly selected normal-term infants immediately before and after cleaning in labour rooms was measured with an infrared tympanic thermometer inserted into their left ears. Their mean post-cleaning body temperature (36.6 degrees C, SD = 1.0) was significantly lower than their mean pre-cleaning temperature (37.1 degrees C, SD = 1.0; p < 0.001). Logistic regression analysis showed that the risk factors significantly associated with pre-cleaning hypothermia (< 36.5 degrees C) were: (1) not being placed under radiant warmer before cleaning p = 0.03); and (2) lower labour room temperature (p < 0.001). Logistic regression analysis also showed that the risk factors significantly associated with post-cleaning hypothermia were: (1) lower labour room temperature (p < 0.001); (2) lower pre-cleaning body temperature (p < 0.001); and (3) longer duration of cleaning (p = 0.002). In conclusion, to prevent neonatal hypothermia, labour room temperature should be set at a higher level and cleaning infants in the labour room should be discouraged.

Matched MeSH terms: Hygiene/standards
Relationship between water quality and human health: a case study of the Linggi River Basin in Malaysia

Lonergan S, Vansickle T

Soc Sci Med, 1991;33(8):937-46.
PMID: 1745918

Due to the increasingly documented prevalence of diarrhoeal diseases in Malaysia, a number of water-related programmes have been implemented in an attempt to improve health status through the reduction of incidence of waterborne communicable diseases associated with poor public water supplies. The implicit assumption underlying these projects is that the enhancement of the physical infrastructure, and subsequent improvements in the quality of the water supply, will substantially reduce water-related disease. The present study questions this hypothesis and uses a socio-ecological model as a framework to assess risk factors associated with the increased probability of waterborne disease. Research is centred on Port Dickson, a district which typifies existing water and sanitation conditions in much of semi-rural Malaysia. Health services utilization data and a 268-household diarrhoeal morbidity survey were used to measure the burden of illness of waterborne disease within the district and to identify predictors of morbidity. It was concluded that although treatment facilities will reduce the health burden in the region, a number of behavioural and sanitation factors may be more important and could act to minimize the potential impacts of improved water quality.

Matched MeSH terms: Hygiene/standards
Fulltext Investigation of hepatitis A outbreak in district of Manjung, Perak, Malaysia, October 2012

Yusoff FA, Rahman RA, May LH, Budart SB, Sulaiman LH

Western Pac Surveill Response J, 2015 May 27;6(2):27-31.
PMID: 26306213 DOI: 10.5365/WPSAR.2015.6.1.012

In September 2012, 10 cases suspected to be hepatitis A were notified to the Manjung District Health Department. An investigation was conducted to identify the possible mode of transmission, source of the outbreak and to recommend prevention and control measures.

Matched MeSH terms: Hygiene/standards
Detection of microsporidia in local HIV-positive population in Malaysia

Lono A, Kumar S, Chye TT

Trans R Soc Trop Med Hyg, 2011 Jul;105(7):409-13.
PMID: 21596411 DOI: 10.1016/j.trstmh.2011.03.006

The HIV-positive population, due to their immuno-compromised nature, is considered more susceptible to parasitic infections than other populations. However despite the reports of other opportunistic pathogens such as Cryptosporidium and tuberculosis reported in vulnerable communities, microsporidia have not been highlighted in the local HIV-positive population in Malaysia. This study aimed to provide preliminary information on the prevalence of microsporidia in the local HIV-population. Microsporidia were detected in 21/247 (8.5%) stool samples from the HIV-infected individuals, a significantly higher (P-value <0.05) prevalence than in the control group, in which 5/173 (2.9%) were positive. HIV patients were 3x more at risk for acquiring microspordium (OR: 3.12; 95% CI 1.15-8.44). Spores were ellipsoid in shape with outlines that stained dark pink with the interior a lighter shade. Approximately 21% of the positive specimens were from individuals in the 40-49 years age group. Ten individuals who were positive for microsporidia were also positive for other enteric parasites such as Blastocystis hominis and Giardia lamblia. We detected Encephalitozoon intestinalis DNA following nested PCR from three of 10 samples analysed, as demonstrated by an amplicon of 370bp. From the findings reported, it appears that microsporidial infection in humans may actually be more common than reported. We strongly advocate greater emphasis on personal hygiene through public education on personal hygiene and the consumption of boiled or filtered water.

Matched MeSH terms: Hygiene/standards
Risk factors for endemic giardiasis: highlighting the possible association of contaminated water and food

Mohammed Mahdy AK, Lim YA, Surin J, Wan KL, Al-Mekhlafi MS

Trans R Soc Trop Med Hyg, 2008 May;102(5):465-70.
PMID: 18377940 DOI: 10.1016/j.trstmh.2008.02.004

This study was conducted to reassess the risk factors for giardiasis in communities of the Orang Asli (indigenous people) in Pahang, Malaysia. Stool samples were collected from 321 individuals (2-76 years old; 160 males, 161 females). Data were collected via laboratory analysis of faecal samples and a pre-tested standard questionnaire. River water samples were tested for Giardia cysts and Cryptosporidium oocysts. The overall prevalence of G. intestinalis infection was 23.7%. Children < or =12 years old had the highest infection rate and have been identified as a high risk group (odds ratio (OR)=6.2, 95% CI 1.5-27.0, P<0.005). The risk of getting giardiasis also appeared to be significantly associated with drinking piped water (OR=5.1, 95% CI 0.06-0.7, P<0.005) and eating raw vegetables (OR=2.4, 95% CI 0.2-0.6, P<0.005). In conclusion, sociodemographic factors have always been associated with the high prevalence of Giardia infections in Malaysia. However, the present study also highlights the need to look into the possibility of other risks such as water and food transmission routes. In future, it is necessary that these two aspects be considered in control strategies.

Matched MeSH terms: Hygiene/standards