Knowledge, attitudes and practice survey on Zika virus infection among pregnant women in Brunei Darussalam

Objective: To assess the knowledge, attitudes, and practices (KAP) on Zika virus infection among pregnant women in Brunei Darussalam by a cross-sectional survey. Methods: Between February and June 2017, we recruited 234 pregnant women from all government healthcare centres at Brunei-Muara district, using a modified systematic sampling approach. A pre-tested and self-administered questionnaire was used and data analysis was conducted using descriptive statistics and multiple logistic regression analyses. Results: The study participants were mainly Malay (87.2%) and their mean age was 28.0 years. The median knowledge score was 13, out of a possible score of 28. Most participants (92.7%) knew that Zika virus was transmitted by mosquito bites whereas some (34.6%) knew that sexual transmission was also possible. Media (radio, television or newspapers) was the preferred source of updated information on Zika virus, followed by healthcare workers (44.0%), government announcements (43.2%), and social media (38.0%). Pregnant women who were 25 years old or older [Adj. OR=3.62 (95% CI: 1.57, 9.51)], not Malays [Adj. OR=3.32 (95% CI: 1.35, 8.55)], and had an average monthly household income of more than BND $3 000 [Adj. OR=4.06 (95% CI: 1.81, 19.44)] were more likely to score higher for knowledge on Zika virus. The median prevention practice score was 23, out of a possible score of 36. Most participants reported wearing covering clothes (98.3%) and kept their living surroundings clean (99.6%). Most participants (88.0%) agreed that Zika is an important issue in their community. Conclusion: We found a lack of knowledge on Zika virus infection among pregnant women attending government maternal and child healthcare centres in Brunei Darussalam, in particular that Zika virus can be sexually transmitted. Such information could be well disseminated at the healthcare centre level. Health literacy studies should be conducted to understand the facilitators and barriers of KAP on Zika virus infection among pregnant women.

Knowledge, attitudes and practice survey on Zika virus infection among pregnant women in Brunei Darussalam

Objective:To assess the knowledge, attitudes, and practices (KAP) on Zika virus infection among pregnant women in Brunei Darussalam by a cross-sectional survey.Methods:Between February and June 2017, we recruited 234 pregnant women from all government healthcare centres at Brunei-Muara district, using a modified systematic sampling approach. A pre-tested and self-administered questionnaire was used and data analysis was conducted using descriptive statistics and multiple logistic regression analyses.Results:The study participants were mainly Malay (87.2%) and their mean age was 28.0 years. The median knowledge score was 13, out of a possible score of 28. Most participants (92.7%) knew that Zika virus was transmitted by mosquito bites whereas some (34.6%) knew that sexual transmission was also possible. Media (radio, television or newspapers) was the preferred source of updated information on Zika virus, followed by healthcare workers (44.0%), government announcements (43.2%), and social media (38.0%). Pregnant women who were 25 years old or older [Adj. OR=3.62 (95% CI: 1.57, 9.51)], not Malays [Adj. OR=3.32 (95% CI: 1.35, 8.55)], and had an average monthly household income of more than BND $3 000 [Adj. OR=4.06 (95% CI: 1.81, 19.44)] were more likely to score higher for knowledge on Zika virus. The median prevention practice score was 23, out of a possible score of 36. Most participants reported wearing covering clothes (98.3%) and kept their living surroundings clean (99.6%). Most participants (88.0%) agreed that Zika is an important issue in their community.Conclusion:We found a lack of knowledge on Zika virus infection among pregnant women attending government maternal and child healthcare centres in Brunei Darussalam, in particular that Zika virus can be sexually transmitted. Such information could be well disseminated at the healthcare centre level. Health literacy studies should be conducted to understand the facilitators and barriers of KAP on Zika virus infection among pregnant women.

Reporting Statistical Results in Medical Journals

Statistical editors of the Malaysian Journal of Medical Sciences (MJMS) must go through many submitted manuscripts, focusing on the statistical aspect of the manuscripts. However, the editors notice myriad styles of reporting the statistical results, which are not standardised among the authors. This could be due to the lack of clear written instructions on reporting statistics in the guidelines for authors. The aim of this editorial is to briefly outline reporting methods for several important and common statistical results. It will also address a number of common mistakes made by the authors. The editorial will serve as a guideline for authors aiming to publish in the MJMS as well as in other medical journals.

An investigation of inter-examiner reproducibility in recording malocclusion parameters during orthodontic epidemiologic studies

This study assesses inter-examiner reproducibility in recording various malocclusion parameters and Index of Orthodontic Treatment Need (IOTN) grade during patient examination by utilising the kappa statistic. Five previously calibrated orthodontists clinically examined 233 non-orthodontically treated schoolchildren aged 14-17 years for recording various malocclusion parameters. The examination was repeated twice, thirty days apart and precluded the use of study-models or radiographs. Although good inter-examiner reproducibility was observed in recording incisor class, IOTN dental health grade, type of posterior crossbite, and excellent for parameters with absolute criteria like erupted supernumeraries, etc, substantial examiner variation resulted in only fair reproducibility for recording IOTN esthetic category, canine class, overbite category, traumatic overbite and upper centre-line shift of two millimetres or more from the facial midline. Reproducibility for detecting occlusal displacement in the presence of crossbite was poor, and kappa statistic was incalculable for recording openbite and number of upper incisors rotated 30° or more. Kappa was also incalculable for recording IOTN dental health subcategory due to the creation of asymmetric tables caused by rarely chosen subcategory options. Despite prior agreement between previously calibrated examiners on evaluation criteria, detection of certain malocclusion parameters during an epidemiological examination can prove to be challenging. Epidemiological studies that report on prevalence of malocclusion in the population should always report on the kappa reproducibility, especially if the study is carried out by multiple examiners.

Cholecystectomy rate following endoscopic biliary interventions

Introduction: Gallstones disease is a common disorder and symptomatic disease is usually managed with surgery while those with common bile duct stones are usually managed with endoscopic intervention before proceeding to surgery. This study was intended to assess the rate of cholecystectomy among patients who had undergone ERC interventions, the reasons for not proceeding to cholecystectomy and related complications. Materials and Methods: Patients who had intact gallbladder and had undergone ERC for stones related complications over a two year period were retrospectively identified from the Endoscopic Unit Registry. Detailed case note reviews were conducted. Results: The overall cholecystectomy rate post-ERC interventions was 36.9% (48/130). Cholecystectomy was offered to 59.2% (n=77) and the uptake was only 58.4% (n=45/77). Among those who agreed for cholecystectomy, 11.1% (n=5/45) failed to turn up for their scheduled surgery. Three patients (6.7%) had symptoms recurrence before their scheduled surgery: two subsequently underwent cholecystectomy without ERC intervention and one who was pregnant was managed conservatively with holecystectomy. Among the patients who had declined cholecystectomy, 18.8% (n=6/32) had symptoms recurrence. Four patients required repeat ERC interventions and eventually all had cholecystectomy subsequently. The most common reason for declining cholecystectomy was 'not keen' and already asymptomatic (46.9%, n=15/32). Among patients who were not offerred cholecystectomy (n=53/130), symptoms recurrence occurred in 15.2% (n=7/53). Four patients required repeat ERC interventions and three subsequently underwent cholecystectomy. Conclusions: The cholecystectomy rate remains low after ERC interventions. Recurrence of symptoms necessating re-interventions occurred in patients offerred and not offerred cholecystectomy. The uptake rate should be improved and delay to cholecystectomy should be reduced to avoid symptoms recurrence. Patients not undergoing interventions should be advised regarding symptoms recurrence and should be monitored.

Dental caries experience and treatment needs in the mixed dentition in North East Malaysia

Dental caries is an important community dental health problem with limited studies in the mixed dentition stage. The aim of this study was to determine the caries prevalence and treatment needs among 7- 9 year old school children in Kelantan which is situated in North East Malaysia. A retrospective dental record review of fully documented dental records belonging to primary school children attending a paediatric dental clinic was conducted. Dental caries was recorded using dmft index and DMFT index for deciduous teeth and permanent teeth respectively. Three hundred and nineteen dental records of 175 (54.9%) boys’ and 144 (45.1%) girls’ were selected and subjected to a ‘dental record study’. The prevalence of dental caries was 93% (95% CI : 89,97) in primary dentition and 50.5% (95% CI : 42.2, 58.8) in permanent teeth. Mean dmft and DMFT was 6.2(SD 3.39) and 1.04(SD 1.34) respectively. Regarding treatment needs in the primary dentition, 35.4% of teeth needed one surface filling, 34.7% needed extraction, 24.5% needed two or more surfaces filling and 5.6% needed pulp care. In the permanent dentition, 54.7% required sealants and 21.9% required one surface restoration. The caries prevalence and treatment needs were high among this study population in the mixed dentition stage, particularly showing the early involvement of newly erupted permanent teeth. It appears that high caries prevalence in the primary dentition is a risk factor for caries in newly erupted permanent teeth. Oral health promotions programmes are required in the mixed dentition stage and may reduce the risk of caries in permanent dentition.

Tooth wear prevalence and sample size determination: A pilot study

Tooth wear is the non-carious loss of tooth tissue, which results from three processes namely attrition, erosion and abrasion. These can occur in isolation or simultaneously. Very mild tooth wear is a physiological effect of aging. This study aims to estimate the prevalence of tooth wear among 16-year old Malay school children and determine a feasible sample size for further study. Fifty-five subjects were examined clinically, followed by the completion of self-administered questionnaires. Questionnaires consisted of socio-demographic and associated variables for tooth wear obtained from the literature. The Smith and Knight tooth wear index was used to chart tooth wear. Other oral findings were recorded using the WHO criteria. A software programme was used to determine pathological tooth wear. About equal ratio of male to female were involved. It was found that 18.2% of subjects have no tooth wear, 63.6% had very mild tooth wear, 10.9% mild tooth wear, 5.5% moderate tooth wear and 1.8 % severe tooth wear. In conclusion 18.2% of subjects were deemed to have pathological tooth wear (mild, moderate & severe). Exploration with all associated variables gave a sample size ranging from 560 – 1715. The final sample size for further study greatly depends on available time and resources.

Knowledge, attitude and practice of sawmill workers towards noise-induced hearing loss in Kota Bharu,Kelantan

The purpose of this study was to determine the sawmill workers’ knowledge, attitude and practice (KAP) in relation to noise-induced hearing loss (NIHL). A cross-sectional study was conducted involving 83 workers from 3 factories in Kota Bharu, Kelantan. Questionnaires were distributed to obtain the socio-demography, knowledge, attitude and practice level in relation to noise-induced hearing loss (NIHL). The weak areas identified in the knowledge section were treatment aspects (15.5%), signs and symptoms of NIHL (20.2%) and risk factors (31%). As for attitude; the prevention aspects were the lowest (25.3%), followed by risk taking attitude (26.2%), and causes of hearing loss (42.1%). Overall, the practice was not encouraging at all. It is important to have an education program to raise workers’ awareness and to improve their attitude and practices towards noise-induced hearing loss.