Assessment on Oral Health Knowledge, Attitude, and Behaviour and its Association with Sociodemographic and Habitual Factors of South Indian Population

ABSTRACT Objective: To assess the oral health knowledge, attitude, behaviour, and its association with sociodemographic and habitual factors among South Indian Population. Material and Methods: A total of 288 adults living in a residential community situated in Chennai were selected by systematic random sampling method participated in this cross-sectional study. Data collection was carried out using a validated questionnaire. Results: About 97.9% of the participants in our study had good knowledge, 33.3% had a positive attitude and 48.2% had adequate oral health behaviour. Sociodemographic and habitual factors like diet (p=0.006), education (p=0.009), and employment (p=0.003) were significantly associated with knowledge. On the other hand, diet (p=0.012) was the only factor significantly associated with attitude. Ownership of house (p= 0.030) was significantly associated with behaviour and no factor was associated with all three KAB profiles. Absence of correlation were identified between Knowledge-Attitude (r=0.11, p=0.23), Knowledge-Behaviour (r= -0.037, p= 0.68) and Attitude-Behaviour (r =0.01, p=0.94). Conclusion: It has been found a massive number of participants possessed a high knowledge level towards oral health. On the other hand, less than half of the participants had a positive attitude and adequate behaviour towards oral health. No positive linear correlation was seen among knowledge, attitude, and behaviour towards oral health.

The Median Time to Develop Recurrent Tuberculosis at a Tertiary Hospital in Kota Bharu, Kelantan, Malaysia.

This study has the intention to determine the median time to develop recurrent tuberculosis [TB] in TB patients attending the Chest Clinic at Hospital Raja Perempuan Zainab II [HRPZ II], Kelantan, Malaysia. Records of 114 recurrent TB patients from 1/1/2003-31/12/2009 were analyzed. Kaplan-Meier analysis was used to examine the median time for recurrence of TB. The overall median time to develop TB recurrence in registered TB recurrent patients was six months [95%CI: 4.58, 7.42] after the previous episode. It was found that recipients of Streptomycin (S), Isoniazid (H) and Rifampicin (R) twice weekly (S2H2R2) drug regimen [p=0.026] or daily HR drug regimen [p=0.049] during the continuation phase took a longer duration to develop recurrent TB than non-recipients of these medicines by Kaplan-Meier analysis. Moreover, there also existed a significant time difference [P = 0.006] between the defaulters and non-defaulters of treatment to develop recurrent TB. Patients should take the complete course of therapy, to reduce recurrent TB infection. The drug regimens must contain the two most potent first line drugs Isoniazid [H] and Rifampicin [R] during the continuation phase.

Development and validation of a questionnaire on the knowledge of tuberculosis and the perception of tuberculosis treatment among tuberculosis patients in Malaysia.

Background: A high level of awareness on tuberculosis (TB) is crucial for the success of the prevention and treatment among the high risk populations. Having a good perception about the treatment of TB may increase the acceptance of the control measures in decreasing the spread of the disease. Aims & Objective: To develop and validate a Questionnaire about the knowledge of the causes, mode of transmission, the prevention of TB and the perception of TB treatment among TB patients in Malaysia. Materials and Methods: A Cross-sectional study was conducted among TB patients attended the Respiratory Clinic at the Hospital Raja Perempuan Zainab II, Kelantan, Malaysia. This study used a self-administrated questionnaire that takes approximately 10 minutes to complete and was generally well received by the respondent’s. The validation involved content validity, exploratory factor analysis for the construct validity and internal consistency for reliability. Results: A total of seventy TB patients comprising of 39 males (55.7%) and 31 females (44.3%) responded. The Kaiser-Meyer-Olkin measure of sampling adequacy (KMO) was (0.827 and 0.723) and Bartlett's test of Sphericity was highly significant (P<0.001). The exploratory factor analysis was used with the extraction method of the principal component and the varimax rotation with normalization. The factor analysis showed six factors within the 28 items which were associated with TB knowledge, the cause and prevention, the mode of transmission and the perception of TB treatment. The internal consistency was [0.893, 0.552, 0.701 and 0.729] for the four factors of TB knowledge and [0.889 and, 0.697] 2 factors for the perception of TB treatment respectively. Conclusion: The questionnaire on TB knowledge, on the causes, the mode of transmission, and the prevention of TB and the perception of TB treatment was valid and reliable with good items that enables its use for assessing TB knowledge among TB patients and the community.

Reliability and construct validity of the Malay version of the Job Content Questionnaire (JCQ) among secondary school teachers in Kota Bharu, Kelantan, Malaysia.

This study was conducted to assess the reliability and construct validity of the Malay version of Job Content Questionnaire (JCQ) among secondary school teachers in Kota Bharu, Kelantan. A total of 68 teachers consented to participate in the study and were administered the Malay version of JCQ. Reliability was determined using Cronbach's alpha for internal consistency whilst construct validity was assessed using factor analysis. The results indicated that Cronbach's alpha coefficients revealed decision latitude (0.75), psychological job demand (0.50) and social support (0.84). Factor analysis showed three meaningful common factors that could explain the construct of Karasek's demand-control-social support model. The study suggests the JCQ scales are reliable and valid tools for assessing job stress in school teachers.

A review of dengue fever incidence in Kota Bharu, Kelantan, Malaysia during the years 1998-2003.

Dengue is the most common and widespread arthropod borne arboviral infection in the world today. It is estimated that there are at least 100 million cases of dengue fever (DF) annually and 500,000 cases of dengue hemorrhagic fever (DHF) which require hospitalization. In Malaysia, it has become a major public health problem. Malaysia recorded 19,544 dengue cases in 1997, the highest recorded since the disease was made notifiable in the country. Of 19,544 cases, 806 were DHF with 50 deaths. The objectives of this analysis were to describe the incidence of dengue fever and dengue hemorrhagic fever in Kota Bharu, Kelantan, Malaysia for the years 1998-2003 and to explore the characteristics of dengue fever and dengue hemorrhagic fever in Kota Bharu, Kelantan, Malaysia for years 1998-2003. A total of 4,716 dengue cases were notified involving 4,476 (94.9%) DF and 240 (5.1%) DHF cases, which increased though the years. The highest incidence was in January (701 or 14.9%), while the lowest was in May (188 or 4.0%). Forty percent of cases (n=1,890) were in the 15-29 year old group. The Majority were Malays (4,062 or 86.1%) and 2,602 or 55.2% were male. A total of 4,477 cases (95%) were local cases and 4,289 or 91% came from the urban area. For priority areas, 3,772 (80%) were from priority 1. More than half the cases had positive serology results. All symptoms occurred in more than 96% of cases and fever was the commonest (99.7%). The mean values for age, temperature, systolic and diastolic blood pressure (BP) were 27.8 +/- 15.4 years, 37.9 +/- 0.90 degrees C, 115 +/- 15.2 mmHg and 73 +/- 11.1 mmHg, respectively. The mean value for the time interval between the onset of symptoms and diagnosis, onset of symptoms and notification and time of diagnosis to notification were 5.1 +/- 2.3, 5.9 +/- 2.5 and 0.8 +/- 1.1 days, respectively. There were associations between the types of dengue and classification, area and priority area. Among the symptoms, the association was only seen in joint pain. The mean significant differences between DF and DHF were found in age and systolic blood pressure. The incidence of dengue in Kota Bharu is comparable to that in Malaysia. The increase in the number of cases needs to be addressed promptly with effective surveillance, prevention and control programs.

Rapid diagnosis of Helicobacter pylori infection in gastric imprint smears.

The objective of this study was to determine the sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of Diff-Quik-stained gastric imprint cytology smears in the detection of H. pylori compared with histology. Air-dried imprint smears of gastric biopsies from 150 patients were stained by the Diff-Quik method in the endoscopy suite and examined for H. pylori, providing results within minutes. The presence of inflammation and intestinal metaplasia were documented. The same biopsy was processed and stained with H&E and Warthin-Starry stains, and reviewed by a different pathologist blind to the imprint cytology results. Ninety-four of the 150 patients were male with a mean age of 50 years. Based on histology, the H. pylori prevalence was very low at 8%. The sensitivity and specificity of imprint cytology in the detection of H. pylori were 83.3% and 100%, respectively. The PPV and NPV were 100% and 98.6%, respectively. There were two false negatives and no false positives. A combination of imprint cytology and histology achieved 100% sensitivity. Imprint smears did not provide added value over histology with regards to inflammation and metaplasia. Gastric imprint smears stained with Diff-Quik method is a rapid, cheap, and reliable method for the detection of H. pylori and have their best results when complemented with histology.

Characteristics of HIV-infected tuberculosis patients in Kota Bharu Hospital, Kelantan from 1998 to 2001.

To characterize the demographic profiles, clinical features, radiological patterns and outcomes of treatment of HIV-infected TB patients, a descriptive study was carried out on 149 HIV-infected TB cases diagnosed from 1998 through 2001 at Kota Bharu Hospital, Kelantan, Malaysia. The majority of the patients were males (94.6%), single (45.0%), ethnic Malay (94.0%) with a mean age of 34 years (standard deviation 7.8, range 18-76). The most common HIV transmission category was through injecting drug use (73.8%) and being the inmates or former inhabitants of drug rehabilitation centers and prisons were the commonest high-risk groups. One hundred and seventeen patients were diagnosed as having pulmonary TB, while about 20% were extra-pulmonary in type with 9 cases of milliary TB. The majority (45%) presented with cough symptoms while only 51% had a positive sputum smear. Fifty-five percent were found to have pulmonary lesions on chest x-ray, such as localized, milliary or diffuse pulmonary infiltrates, or opacities. Eight (5.4%) had pleural lesions while another 8 cases had hilar or mediastinal lymph node lesions. Overall, fifty-eight (38.9%) patients had died by the completion of data collection. The median weeks or survival from the time of starting TB treatment was 13.5 (range 1-56) and the majority of them (74%) died without completing the 6-month regime of treatment.

Sociodemographic characteristics of food handlers and their knowledge, attitude and practice towards food sanitation: a preliminary report.

Diseases spread through food still remain a common and persistent problems resulting in appreciable morbidity and occasional mortality. Food handlers play an important role in ensuring food safety throughout the chain of production, processing, storage and preparation. This study is to explore the pattern of sociodemographic distribution and to determine knowledge, attitude and practice of food handlers towards food-borne diseases and food safety. A total of 430 food handlers were randomly selected from Kota Bharu district and interviewed by using structured questionnaire. Distribution of food handlers was Malays (98.8%), females (69.5%), married (81.4%), working in food stalls (64.2%), involved in operational areas (49.3%), having no license (54.2%) and immunized with Ty2 (60.7%). The mean age was 41 +/- 12 years and the mean income was RM 465 +/- 243/month. The educational level was found as no formal education (10.5%), primary school (31.9%), secondary school (57.0%) and diploma/degree holders (0.7%). A significant number of food handlers (57.2%) had no certificate in food handlers training program and 61.9% had undergone routine medical examinations (RME). Almost half (48.4%) had poor knowledge. Multiple logistic regression showed type of premise [Odd ratio (OR) = 4.0, 95% Confidence interval (CI) =1.8-7.5, p = 0.0004], educational level (OR = 4.0, 95% CI = 1.8-7.4, p = 0.0003) and job status of food handlers (OR = 0.5, 95% CI = 0.3-0.8, p = 0.0031) significantly influenced the level score of knowledge. No significant difference of attitude and practice between trained and untrained food handlers. Findings of this preliminary study may help in planning health education intervention programs for food handlers in order to have improvement in knowledge, attitude and practice towards food-borne diseases and food safety. Furthermore, it will in turn reduce national morbidity and mortality of food-borne diseases.

Trichuriasis: localized inflammatory responses in the colon.

Most patients with trichuriasis have light worm burdens. Data regarding the inflammatory response to Trichuris worms in the colon of lightly infected persons are scant. Nine patients whose Trichuris infection was found by colonoscopy had biopsies taken from a site adjacent to visible worms and from a second site some 20 cm distally. The biopsies were studied by routine and immunohistochemical methods. None of the biopsies showed mucosal ulceration, significant congestion, fibrosis, gland distortion or goblet cell mucin depletion. There was no difference between worm and worm-free sites in terms of edema, lymphoid follicles or epithelial slough. Worm sites had higher numbers of eosinophils, neutrophils and total inflammatory cells and lower numbers of plasma cells. However there was no difference in lymphocyte, mast cell, and B- and T-cell counts between the two sites. This suggests that the T. trichiura worm incites a local inflammatory response involving eosinophils and neutrophils, even when the colon has only a light burden of worms.

A preliminary study of the influence of HIV infection in the transmission of tuberculosis.

The human immunodeficiency virus (HIV) epidemic has had a profound influence on the epidemiology of tuberculosis (TB). The potential for HIV-associated TB cases to transmit M. tuberculosis and to produce a secondary increase in TB morbidity is unknown. A cross-sectional study was carried out to compare the prevalence of M. tuberculosis infection among the household contacts of HIV-positive and HIV-negative pulmonary tuberculosis (PTB) patients. Records of tuberculin (Mantoux) tests administered during routine contact investigations at the Chest Clinic, Hospital Kota Bharu, from 1999 to 2000 were reviewed. The HIV status of the patients was based on the results of ELISA tests while information on household contacts was gathered during visits to their houses. Ninety-four contacts of 39 HIV-negative patients and 44 contacts of 17 cases of HIV-positive patients were included in this preliminary study. 30% (12/40) of the contacts of HIV-positive PTB had a positive tuberculin compared with 52.8% (47/ 94) of the contacts of HIV-negative patients [OR = 0.41, 95% Confidence interval (CI) 0.17 - 0.97; p = 0.016]. The difference was still significant after performing multivariate logistic regression analysis to adjust for variables associated with infectiousness of TB (adjusted OR = 0.24, 95% CI 0.07 - 0.87; p = 0.03). This study has shown that HIV-infected PTB patients are less infectious to their contacts than HIV-negative patients. The presence of MV in the community may not necessitate a change of the current policy of the management of contacts.