ABSTRACT
Background@#Dengue patients in Malaysia have the choice to seek care from either public or private sector providers. This study aims to analyse the pattern of health facility use among dengue patients to provide input for the ongoing policy discussion regarding public–private integration. The focus of this study is in the Klang Valley, which has a high dengue burden as well as a high number of private facilities.@*Methods@#This is a cross-sectional study using an available secondary data source – the Malaysian national dengue passive surveillance system, e-Dengue registry. A total of 61 455 serologically confirmed dengue cases from the Klang Valley, registered in year 2014, were included. We retrospectively examined the relationship between demographic factors and the choice of health-care sector by logistic regression.@*Results@#The median age of the cohort was 26 (interquartile range: 17 to 37) years. More private facilities (54.4%) were used for inpatient care; more public facilities (68.2%) were used for outpatient care. The Chinese and urban populations showed significantly higher use of the private health-care sector with an adjusted odds ratio of 4.8 [95% confidence interval (CI): 4.6–5.1] and 2.3 (95% CI: 2.2–2.4), respectively.@*Conclusion@#Both public and private health facilities bear significant responsibilities in delivering health-care services to dengue patients. The workload of both sectors should be included in future health policy planning by public agencies.
ABSTRACT
@#Introduction: A methanol outbreak occurred in the district of Hulu Langat on 16 September 2018. The Hulu Langat District Health Office received 25 notifications of a suspected methanol poisoning from Kajang and Ampang Hospital. An outbreak investigation was done to determine the source followed by a preventive and control measure. Method: Active case detection was done on cases living quarters and workplaces. Patients were interviewed, and their blood and urine samples were sent for methanol analysis. Samples of suspected alcoholic beverages were also sent for analysis. A suspected case was defined as any person presented with clinical symptoms with a history of consuming alcoholic beverages within five days before symptoms and high anion gap metabolic acidosis. A confirmed case was defined as a suspected case with positive blood and urine methanol. Results: In total, there were 25 suspected cases, of which 12 cases were confirmed. The calculated attack rate was 48%. There were six mortalities (50%) secondary to severe metabolic acidosis. The most common presenting symptom was vomiting (75%) and abdominal pain (41.7%). These cases were linked to consumption of illicitly produced alcohol. Samples of the alcoholic drinks were positive containing high level of methanol. Conclusion: The methanol outbreak in the Hulu Langat was successfully managed. Appropriate control and prevention measures were taken, including health promotion and joint enforcement activities. Steps were taken successfully through collaborations with multiple agencies and cooperation with Selangor Health Departments and the Ministry of Health. Continuous surveillance on the product of liquor, and health promotion are essential to prevent a similar outbreak from happening again in future.
ABSTRACT
Dengue is a disease propagated by vectors namely Aedes spp. mosquitoes. One of the effective approaches to control dengue is through integrated vector management and intervention programs. COMBI or Communication for Behavioral Impact is a strategic approach to control the Aedes population as well as dengue cases. This study was conducted at Taman Desa Kolej, Nilai, Negeri Sembilan, an suburban residential area to determine the effectiveness of COMBI, by using questionnaire and entomological survey as well as implementation of an intervention program. We carried out activities such as the establishment of COMBI promoter team, clean up events, talk shows with the residential community and distributed pamphlets containing information about dengue. Results indicated significant difference (p<0.05) on the knowledge, opinion and practices about dengue among the residents, for the pre and post intervention program. The entomological survey showed that, the primary mosquito species in this area was Aedes albopictus which comprised of 78 (31%) of the total mosquitoes examined, followed by Culex gelidus of 58 (23%), Culex quinquefasciatus of 37 (14.7%) and Aedes aegypti of 21 (8.3%). The density of Aedes population did not show any significant difference. In conclusion, COMBI intervention was effective in controlling dengue cases in Taman Desa Kolej.