ABSTRACT
Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT’s efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.
ABSTRACT
@#Introduction: Tuberculosis (TB) is a leading cause of death due to a single infectious agent. The disease is treatable by a minimum of six months of anti-TB drugs. However, prolonged duration of treatment using directly observed therapy (DOT) causes significant inconvenience to patients and is ineffective in improving treatment outcomes. Therefore, incorporating the Health Belief Model into the development of digital technology could help change behaviour and improve adherence. This study aimed to determine the effectiveness of mobile applications in improving TB medication adherence. Methods: This study proposed to conduct a randomized trial among TB patients in the Kota Kinabalu, Penampang, and Putatan districts of Sabah, Malaysia. The eligible sample will be randomly assigned to the mobile application DOT arm and standard DOT arm. The primary outcome is the adherence level calculated by the percentage of medication observed divided by the intended dose taken in two months, with 80% and more successfully observed treatment considered highly adherent. The secondary outcomes are health-related quality of life, satisfaction, and monthly household income. Multiple logistic regression and repeated measures ANCOVA will be used to determine the effectiveness of interventions to achieve primary and secondary outcomes. Discussion: The findings from this study could hopefully provide insight into rethinking TB care delivery to achieve better TB treatment outcomes. Trial Registration: This study protocol has been approved by the Medical Research Ethics Committee (MREC), Ministry of Health Malaysia (NMRR ID-21-01949-73X) and registered with ClinicalTrials. gov (NCT05259254).
ABSTRACT
@#Introduction: Postnatal is a transition process for the mother back to her non-pregnancy state and involves the changes in hormones level. During the postnatal period, many health issues need to be addressed for both mother and newborn. One of the upsetting health issues for the mother due to the increasing trend is postnatal depression and if it is not identified and treated early, it may cause further complicated problems not only to the mother but also to the baby, family, and local community. With this issue, the Ministry of Health Malaysia has taken a few initiatives to encourage the postnatal mother to also practice the non-medical approaches or traditional postnatal care (TPC) as a self-care for the prevention of postnatal depression. Aim: To systematically identify and review studies examining the influence of TPC on postnatal mothers. Design & Data Sources: A systematic search strategy on the research trend for the period between the years 2013 to 2020 through the Scopus database, Science Direct, and PubMed database. Methods: This review has identified 7 journal articles based on the preferred reporting items for the systematic reviews (PRISMA) framework. Results: There are many methods of TPC, such as traditional postnatal body massage, herbal consumption, herbal bath, body steaming, and body wrapping based on own culture and beliefs. Besides the TPC preparation and techniques, some studies also describe the effects of TPC on a mother’s health and wellness. Conclusion: TPC shows encouraging health trends, and it helps to enhance the well-being and good health of postpartum mothers.
ABSTRACT
@#Introduction: Dengue fever is caused by the dengue virus that is transmitted via Aedes mosquitoes. The lifecycle of Aedes mosquitoes is affected by the local climate (rainfall) which influences dengue transmission. Sabah is one of the states that is laden with a high incidence rate of dengue in Malaysia and the condition seems to have worsened with sudden, multiple outbreaks occurring in the year 2016. Methods: An ecological analysis was conducted in Keningau, Sabah to analyse dengue case patterns and distribution over a 5-year period and to exhibit the correlation between rainfall, larval indices, dengue incidences, and outbreaks. Results: Significant cross-correlation analysis (CCF) was discovered between rainfall and Aedes index at lag number 5 with a correlation coefficient of 0.151 (±0.063) as well as between rainfall and Breteau Index at lag number 5 with a correlation coefficient of 0.143 (±0.063). However, no significant cross-correlation analysis was found between Aedes index and dengue incidences. Associations were also seen between larval indices and outbreak cases. Conclusion: This study showed an increase of Aedes and Breteau Indices to susceptibility level five weeks after rainfall which increases the risk of dengue transmission.
ABSTRACT
@#Undernutrition is the result of complex interplay of factors such as household food security, childcare, feeding practices, nutrition and sanitation. Therefore, this study aimed to determine the prevalence of stunting, wasting, underweight based on WHO child growth standards 2006 and undernutrition based on Composite Index Anthropometric Failure (CIAF) and its association with the biological, behavioural, socio-economic and physical environment factors among children under-5 years. This was a cross sectional study involving children aged between 6 and 59 months recruited through stratified random sampling from the Tenom district. Sociodemographic background was obtained from mothers via a questionnaire. Height and weight measurements were measured using standardised instrument. The height-for-age, weight-for-age and BMI-for-age were classified according to the WHO Child Growth Standard 2006. Bivariate analysis and multivariate logistic regression analysis were conducted. The prevalence of undernutrition based on CIAF was 42.3%, underweight 34.7%, stunting 33.3% and wasting 10.0%. After adjusting for all confounders, childhood undernutrition was significantly associated with unimproved sanitation (adjusted OR 2.98, 95% CI: 1.082 to 8.225) and frequent illness (adjusted OR 2.07, 95% CI: 1.015 to 3.274). These findings support the association of biological and physical environmental factors with the nutritional status of children under-5 years old.
ABSTRACT
@#Higher education institutions face major challenges in managing the impact of the COVID-19 pandemic. The risk of exposure from the community poses a threat to campus staff and students. This study describes epidemiological characteristics of suspected COVID-19 cases among a public university’s students and staff. This is a retrospective review on data collected from the institute’s COVID-19 Preparedness and Respond Centre, located at the main campus in Kota Kinabalu, the capital city of Sabah from mid-January to April 2020. Incidence rate was calculated, and epidemiological information retrieved from interviews and relevant documents. The majority of suspected COVID-19 cases were staff (57.1%) with incidence rates higher among males (IR=40.2/1,000 population) and those working in the frontline (IR=39.6/1,000 population). Suspected COVID-19 cases were mostly related to occupation (37.3%) and social contacts (27.3%). Student cases were largely related to household (38.1%) and during travel (33.3%). One positive COVID-19 case was reported of out of the 161 suspected cases (0.6%) in the institution. An operational team must be set up to conduct situational analysis and integrate management with other departments. Suspected COVID-19 cases must be quarantined and monitored on a daily basis. A high index of suspicion and effective containment of suspected cases will prevent spread of the virus among students and staff.
ABSTRACT
The risk factors associated with mental health among adolescents are usually described by researchers at an individual level. Neighbourhood factors and health have opened a new insight into the field of epidemiology. The aim of this study was to assess the reliability and validity of a newly developed Neighbourhood Factors on Mental Health Questionnaire among Malaysian adolescents. A cross-sectional study was conducted in four secondary schools in Kuala Lumpur, Malaysia using a newly developed questionnaire which comprised of two main domains and seven items. Exploratory factor analysis and Cronbach’s alpha were used to measure the instrument’s construct validity and reliability. A total of 106 adolescents participated in this research. The majority of adolescents were 13 years old (40.6%), female (55.7%), Malays (68.9%), have parents who only studied until secondary school (66.0%) and lived in flats (32.1%). Bartlett’s Test of Sphericity was significant (Chi-square = 258.361, p<0.001) and Kaiser-Meyer-Olkin (KMO) value was 0.820. The final model of the instrument contained two domains, the neighbourhood physical environment and neighbourhood social environment factors. Factor loadings for all items were satisfactory ranging from 0.591 to 0.870. The overall Cronbach’s alpha was 0.810. The Neigbourhood Factors on Mental Health Questionnaire was found to be a valid and reliable instrument. It can be used to assess neighbourhood physical and social factors that can influence mental health of adolescents in Malaysia.
ABSTRACT
In the middle of January 2014 during the winter season, three post graduate students from Community Health Department, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) were invited to have a taste of experience on public health practice in Niigata Graduate School of Medicine & Dental Sciences (NU) under Division of International Health (Public Health). This is the fourth group which was invited through the student exchange program between both universities. The journey took almost 7 hours from Kuala Lumpur International Airport to Narita International Airport by plane; and another 2 hours by bullet train (shinkansen) ride from Tokyo City to Niigata prefecture. The cold weather, which was below 2 degree Celsius, did not stop our burning desire to step into the country which was well known for its modernization and yet still upholding its ancient and renowned tradition. Not many would know that Niigata was known as the “Rice Capital of Japan”. The large variation of seasons and temperature between night and day, the fertile soil and the pristine melting snow that feeds into the rice paddies create a natural environment for nurturing Niigata’s exquisite rice. Niigata boasts Japan's biggest harvest of rice, which is essential to Japanese cuisine, crackers and sake production. During our visit, we were made known on the Japanese code of etiquette, which governs the expectations of social behaviour in the country and is considered very essential. Bowing for example, is considered extremely important in Japan, so much so that, although children normally begin learning how to bow from a very young age, companies commonly provide training to their employees in how to execute bows correctly. There are also certain etiquette applied during eating, drinking, exchanging gifts and visiting. Giving a personal business card is essentially important and therefore we were made the effort to prepare our own cards during the visit. Upon our arrival, we were welcomed by the Head of Public Health Division; Prof. Dr. Reiko Saito and her colleague, Dr. Yugo Shobugawa. The introduction to the division was given and we were introduced to the staff in the division. The division is currently prioritising on the research related to avian influenza as well as Norvovirus through genetic study and Geographical Information System (GIS). During the first day of the visit, we were astonished to know that Niigata city possess its own “public health hospital” which was developed to cater disease outbreak and disaster. Recently it has been used for influenza outbreak as well as providing healthcare services for the victims of earthquake. During the usual operating hours, the hospital will provide a specialist health clinic ranging from internal medicine, orthopedics, pediatrics and obstetrics speciality. It has its own disaster wards, complete with laboratory as well as radiological investigation equiptments.