Gender-Stratified Factors Associated with Stigma Toward HIV/ AIDS among Rural Communities in Sarawak, Malaysia

@#Introduction: Many factors hinder the effective responses to the HIV/AIDS epidemic. Stigma is one of the major barriers to effective responses to the HIV/AIDS epidemic. It is often considered the main reason for the low response to access proper services for prevention, treatment, and care for HIV/AIDS. In this context, we assessed the perceived level of stigmatisation towards people with HIV/AIDS among rural communities in Sarawak and determined its associated factors. Methods: This cross-sectional community-based study was conducted among the adult population aged 18 years and above among rural communities in Sarawak, Malaysia. A gender-stratified multistage cluster sampling technique was adopted to select the respondents. A total of 900 respondents were successfully interviewed using interviewer-guided questionnaires. Stepwise multiple linear regression with forward and backward selection method was used to determine the HIV/AIDS-related stigma. A p-value of ≤.05 was considered statistically significant. Results: Analysis revealed that females are more stigmatised than males (p<.05). Multivariate analysis showed that those who did not know someone had HIV and Chinese ethnicity were potential predictors in both male and female groups. Having no gainful job, and discussion of HIV/AIDS, household income less than MYR 500, history of HIV testing, knowledge on HIV transmission and exposure to HIV/AIDS information were factors that influenced HIV/ AIDS-related stigma among female respondents. On the other hand, age group 30 to 39, Bidayuh, Chinese ethnicity, and not knowing someone had HIV and media exposure on HIV were factors that influenced HIV/AIDS-related stigma among male respondents. Conclusion: HIV/AIDS-related stigma towards HIV/AIDS existed in rural communities. Enhanced health promotion related to HIV/AIDS activities in rural communities are needed to curb stigmatisation toward people with HIV/AIDS.

Prevalence and factors associated with undernutrition among Dayak children in rural areas of Sarawak, Malaysia

@#Background: Undernutrition among children has become a major public health issue due to the high risk of morbidity and mortality involving this vulnerable age group. This study focused on the rural population, especially among the Dayak children in Sarawak, Malaysia. Methodology: This community-based cross-sectional study was conducted in Sarawak’s rural areas using a multistage stratified cluster sampling technique. Data were collected through face-to-face interviews using an interviewer-guided questionnaire. The nutritional status of the under-five children was measured according to the World Health Organization guidelines. The nutritional indicators were calculated as z-scores. Multivariate logistic regression analyses were performed using SPSS to identify the factors associated with nutritional status. Results: The prevalence of undernutrition among the under-five Dayak children in the rural areas of Sarawak was 39.6%. The analysis suggested that wasting was predominantly associated with parental education levels of primary and below, poor wealth index, environmental and sanitation issues, children with history of low birth weight, shorter duration of exclusive breastfeeding, and poor appetite. Stunting was high within the age group of <3 years old and was associated with parents’ occupation and household wealth index. Low parental education, poor wealth index, environmental and sanitation issues, poor appetite, and the children’s recent illness predicted underweight. Conclusion: These findings imply that a multi-sectoral and multi-dimensional approach is essential to address undernutrition in rural settings. Improvement on households’ socioeconomy, environment and sanitation should be emphasised to reduce undernutrition among the children.

Epidemiological study of human intestinal parasites in Sarawak, East Malaysia: A review

@#Intestinal parasitic infections are endemic in rural settings and may account for asymptomatic infections to various health complications. These infections are a cause of concern for communities of lower economic status, especially in developing countries. In Sarawak, indigenous populations residing in geographically inaccessible areas are socially and economically disadvantaged. Through close association with nature, these populations are prone to intestinal parasitism. Currently, scattered information has led to a continual state of neglect at each level of parasitic infection control. This urges for a review of their distribution and transmission based on previous reports to understand the pattern of the diseases in the state which can further address the improvement of mass controlling programs. A literature search was conducted to collect previous reports on human intestinal parasites in Sarawak, East Malaysia from PubMed (Medline), SCOPUS, ScienceDirect and Web of Science from January 2019 to March 2021. Extrapolating the current data in Sarawak which is still considered limited, further interdisciplinary strategies are demanded to give insights in the epidemiology and true prevalence of intestinal parasites in Sarawak. This review addresses for redirection of attitude towards intestinal parasitic infections where it should be given with ample attention by rural populations. In tandem to that, improvement of rural livelihood such as standard of living and sanitation in Sarawak should be accredited as part of the efforts to reduce the number of intestinal parasitic infections in the state. As a control measure, mass deworming should be reconsidered especially to the rural populations.

Gastrointestinal parasitic infections of buffaloes (Bubalus bubalis) in Sarawak Borneo: Prevalence, risk factors, and farming practices

@#The objectives of this study were to investigate the prevalence and associated risk factors for gastrointestinal (GI) parasites in buffaloes from various areas of Sarawak, and to assess current management practices of GI parasites among farmers. Faecal samples were collected from 15 farms and 129 animals, as well as data on farm and animal-based characteristics. A total of 129 faecal samples were examined for GI parasites using a modified McMaster and sedimentation. Association between potential risk factors and the prevalence of GI parasites was investigated using Chi-square statistic. The prevalence of Paramphistomum sp., strongyles, and coccidia were 75.2% (95% CI±7.5), 52.7% (95% CI±8.6) and 48.1% (95% CI±8.6), respectively. Farms which had a grazing area less than 50 acres in size had significantly higher prevalence of strongyles (70.5%, χ² = 8.34, P = 0.004) and paramphistomes (88.6%, χ² = 6.46, P = 0.01) relative to farms with a larger grazing area (43.5% and 68.2%, respectively). Prevalence of strongyles was lower in farms that did not implement a cut- and-carry system (45.6%, χ² = 4.17, P = 0.04) in comparison to those that did (64%). The prevalence of paramphistomes was higher on farms with more than 40 animals (80.6%, χ² = 3.18, P = 0.05) relative to farms with fewer animals. The majority of farmers surveyed (67.9%) showed awareness of GI parasite infection and reported that they recognized the associated symptoms. Most farmers practised deworming, and ivermectin was the most commonly used anthelminthic (60.4%); only 1.9% of farmers used albendazole. Overall this study revealed a high prevalence of GI parasites in buffalo in Sarawak. Although farmers report they are aware of parasitic diseases, further education is still required. This could include how they can successfully implement on-farm changes to reduce the prevalence of GI parasites in their herds.

Phylogenetic analysis of nucleoprotein gene of Rabies virus in Malaysia from 2015 to 2018

@#Rabies is a fatal zoonotic disease caused by rabies virus (RABV) and remains a public health problem in Malaysia. Malaysia was declared rabies-free in 2012, however rabies outbreaks occurred at few states in Peninsular Malaysia three years later; and for the first time, in Sarawak (East Malaysia) in 2017 which has caused more than 20 human deaths. This study describes the phylogenetic analysis of the complete nucleoprotein (N) gene of RABV from animal samples in Malaysia from year 2015 to 2018. The N gene of 17 RABVs from Perlis, Kedah and Sarawak were amplified and sequenced. The nucleotide and deduced amino acid similarities of N gene analysis indicated that there is high similarity among the local RABVs. Phylogenetic analysis of the N gene revealed that all Malaysia RABVs belonged to the Asian clade. Among these, RABVs from Peninsular Malaysia were clustered together with RABVs from Thailand, Vietnam and other Southeast Asia countries except Indonesia. However, RABVs from Sarawak were grouped together with Indonesian strains from Kalimantan. Our study provides baseline genetic information of the potential origins of the circulating RABVs in Malaysia. This crucial information helped the authority in policies making and strategies to be taken in outbreak control. Continuous surveillance program to monitor the disease trend, strict border control, vaccination of dog and cat population and public awareness are important steps to control the spread of the RABV.

Perceived Body Image And Its Relationship With Body Mass Index, Self-Esteem, Body Change Strategy, And Social Network Usage Among Rural Adolescents In Sarawak, Malaysia

@#Body image is a complex and multifaceted construct with multiple associated factors determining its perception among adolescents. This study aimed to determine the perceived body image and its relationship with body mass index, self-esteem, body change strategy, and social network usage among rural adolescents. This study was a cross-sectional study design using a multistage random sampling technique to select adolescents aged 10 to 19 years. A total of 318 adolescents’ data were collected using a self-administered questionnaire. Data analysis was done using SPSS version 22.0 with a p-value of <0.05 was considered statistically significant. The mean (SD) age of adolescents was 14.6 (2.7) years with a male and female ratio of 1.09:1. The mean score (SD) of perceived body image was 3.63 (0.87). Multiple linear regression analysis revealed that gender, body mass index, and strategy to increase weight could predict perceived body image among adolescents. However, self-esteem did not correlate with perceived body image. Although, the body image dissatisfaction level was low among rural adolescents compared to other studies in Malaysia. However, it can still pose a threat to adolescents’ health if not addressed accordingly.

Association Between Preventive Behaviour On Colorectal Cancer And Health Literacy Among The Adult Population In Sarawak, Malaysia

@#Health literacy has shown to have some influence in preventive behaviour, including on colorectal cancer. Such a relationship, however, is not well established in Malaysia, particularly Sarawak. This study is aimed to estimate the level of health literacy and preventive practice against colorectal cancer and factors associated with it. This was a cross-sectional study conducted in Sarawak, among adults aged 50 years and above. Data was collected by face to face interviews using a validated questionnaire. Descriptive statistics were used to determine the health literacy and preventive behaviour on colorectal cancer. Multiple linear regression was used to determine the factors associated with preventive behaviour on colorectal cancer and also to examine its relationship with health literacy. A p-value of ≤0.05 was considered as statistically significant. A total of 829 respondents were included in the analysis. Mean age (standard deviation) of the respondents was 55.78 (5.01) years. A large proportion had an educational background of upper secondary school and above (41%) and from Iban ethnicity (32.4%). Only 1.1% of them had a family history of colorectal cancer. Multiple linear regression analysis revealed that gender (p<0.01), ethnicity (p<0.05), functional health literacy (p<0.05), and knowledge on colorectal cancer (p<0.05) appeared to be significant predictors for preventive behaviour on colorectal cancer. Health literacy has a positive effect on preventive behaviour on colorectal cancer. The findings assist in designing and developing targeted informational campaigns to promote preventive behaviour, particularly among low health literate group.

Demographics and outcome of patients with congenital haemophilia in Sarawak, Malaysia

@#Introduction: Sarawak has a population that is geographically and characteristically widely varied. This study aimed to determine the demographic profile of patients in Sarawak, Malaysia. Materials and Methods – A cross-sectional study was conducted in 2019 at four major haemophilia treatment centres in Kuching, Sibu, Bintulu and Miri Hospitals, Sarawak. Demographic and clinical data were collected with consents from patients. Results and Discussion: Ninety-six haemophilia patients were identified - 79(82.3%) haemophilia A(HA) and 17(17.7%) haemophilia B(HB). Severe haemophilia patients were noted in 45.6% (36/79) of HA and 64.7% (11/17) of HB. In all 44.3% of the HA and 52.9% of the HB population had no identifiable family history of haemophilia. Two-thirds of the patients with severe HA were on prophylaxis [24/36 (66.7%)] and only onethird [4/11 (36.4%)] in severe HB. Inhibitors developed in 9/79 (11.4%) of the HA population [3/79 (3.8%) high responders]. The median inhibitor titre was not significantly different between the different treatment groups – on demand versus prophylaxis (1.0BU versus 2.0BU; z statistic -1.043, p-value 0.297, Mann-Whitney test). None of the patients developed inhibitory alloantibodies to factor IX. Four HA patients (5.1%) underwent immune tolerance induction where one case had a successful outcome. Three severe HA patients received emicizumab prophylaxis and showed remarkable reduction in bleeding events with no thromboembolic events being reported. One female moderate HA patient received PEGylated recombinant anti-haemophilic factor. Eleven patients underwent radiosynovectomy. One mild HB patient succumbed to traumatic intracranial bleeding. Our data reported a prevalence (per 100,000 males) of 5.40 cases for all severities of HA, 2.46 cases for severe HA; 1.16 cases for all severities of HB, and 0.75 cases for severe HB. The overall incidence of HA and HB was 1 in 11,500 and 1 in 46,000, respectively. Conclusion: This study outlines the Sarawakian haemophilia landscape and offers objective standards for forward planning. Shared responsibilities among all parties are of utmost importance to improve the care of our haemophilia population.

Factors affecting internet use among university students in Sarawak, Malaysia: an empirical study

Background: The internet has become an indispensable tool for communication, academic research, information and entertainment. However, heavy users of the internet lead to less confidence in social skills and the tendency to be isolated. The study aimed to assess the pattern of internet use and factors affecting problematic internet use among university students.Methods: This cross-sectional study conducted among the students of a university in Sarawak, Malaysia. A multistage cluster sampling technique was adapted to select the participants. Data were collected from 463 students by self-administered questionnaire. Hierarchical binary logistic regression analysis was done to determine the potential factors for problematic internet use.Results: The mean age of the students was 22 years, with a standard deviation of 1.6 years. Two-fifths (61.8%) of the students had no problematic internet use. However, 35.4% had moderate and 2.8% had severe problematic internet use. Hierarchical binary logistic regression analysis found that age of the students, year of study, duration of daily internet use and use of social networking like Skype appeared to be potential predictors of problematic internet use (p<0.05).Conclusions: This study was conducted in only one university, thus did not depict the overall scenarios of the country. The implications of the findings are still worth noting in the process of designing internet addiction studies among university students. Overall, this study has unearthed some useful insights which can serve as a guide to more elaborate studies.

Quality of Life and its associated factors among caregivers of patients with dementia – A crosssectional study in Kuching, Sarawak, Malaysia

@#Background: This study aimed to determine the quality of life and its associated factors among caregivers of patients with dementia in Kuching, Sarawak, Malaysia. Methods: This cross-sectional study was carried out among caregivers for dementia patients who visited three main hospitals in Kuching, Sarawak. Using a validated questionnaire, data was obtained based on socio-demographic profile, patient and caregiving characteristics, supports needs by caregivers, and quality of life (QoL) of caregivers modified from Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS) and Evaluation’s Scale of the Caregiver’s QoL. Results: A total of 217 caregivers participated with response rate of 99.6%, with 67.3% female and 63.1% Chinese. Most respondent provide care for their parents (62.7%), and stay with patients (67.3%). Average duration of care was 4.2 years (SD±3.72). Resource referral (M=3.52, SD±1.334) and education support (M=3.67, SD±1.054) was highest need. Majority respondents experienced little to no burden (59%). Most respondents were not depressed (98.1%). The QoL of respondents was satisfactory (M=41.36, SD±25.840). Gender of caregivers, patients with behavioural and psychological symptoms of dementia, duration of caregiving, respite care need, caregiver disability or illness, belonging support need, education support need were significantly associated with QoL of caregivers (p<0.05). Conclusion: This study on QoL of caregivers of dementia patients in Sarawak, Malaysia shows that it can be influenced by many factors, both at the caregivers’ level as well as the patients themselves. Therefore, intervention should aim at patients and their caregivers, and within community and healthcare settings.

Do Medical Students Know, Bother About, And Practise Preventive Measures In Malaysia?

@#Since December 2019, a novel coronavirus disease (COVID-19) creates a global threat. Medical students are more susceptible to be infected by the virus. This study aimed to assess COVID-19 related knowledge, attitude towards COVID-19, and preventive behaviours against COVID-19 among medical students within the first month of the onset of the outbreak in Malaysia. We collect data from medical students using an online Google survey form. Out of 696 students, 467 responded to the questionnaire. The analysis revealed that the mean percentage of knowledge was (85.04), attitude (84.12), and preventive practice (77.75) respectively. Hierarchical multiple linear regression analysis revealed that living with family (p<0.01) and knowledge of COVID-19 (p<0.001) appeared to be important predictors of attitude toward COVID-19. However, gender (p<0.001), living status (p<0.001), frequency of travel during movement control order (p<0.01), attitude towards COVID-19 (p<0.001) have appeared significant predictors for preventive practice against COVID-19. But knowledge of COVID-19 had no impact on preventive practice against COVID-19 (p>0.05). We found a high level of COVID-19 related knowledge, attitude, and preventive practice against COVID-19 among medical students. A sustained knowledge, attitude, and preventive behavioural strategy could play an ingredient in upholding the student’s learning and practice against any disease like COVID-19.

Coping Strategies By Stroke Caregivers: Evidence From A Qualitative Study In Sarawak, Malaysia

@#Caring for stroke survivors is inevitably a burden to caregivers. It is not uncommon for stroke survivors who are discharged from the hospital and found themselves at home without any help and care from the supposed caregivers. However, in instances where there are available and willing caregivers, a sudden and unpredictable task of caring for stroke survivors require the stroke caregivers to apply their coping strategies due to the demanding nature of looking after a survivor. This study aimed to determine coping strategies undertaken by stroke caregivers in caring for stroke survivors. This was an exploratory qualitative study and data was collected from the caregivers of stroke survivor using a semi-structured guided questionnaire. A total of 18 caregivers were included in the study. The data were collected from November 2015 until June 2016 at a selected community rehabilitation centre in Kuching, Sarawak. The qualitative data analysis revealed that the coping strategies undertaken by stroke caregivers include change of role in life, self-motivation, sharing with other people, crying, trying to forget things that happen, hoping survivors will get better, emotion suppression and self-blame. The study highlighted the experiences by the caregivers for caring for stroke patients and focused on the coping strategies undertaken by the caregivers. Better ununderstanding of these experiences does help the service providers to provide better support and resources for caregivers in caring for stroke survivors.

Isolation and characterization of Pyricularia oryzae isolated from lowland rice in Sarawak, Malaysian Borneo

@#Aims: Rice blast disease caused by Pyricularia oryzae is one of the major biotic diseases of rice in Sarawak, Malaysian Borneo. This study aims to isolate and characterize rice blast fungus obtained from infected leaf collected from four different divisions in Sarawak, viz, Miri, Serian, Sri Aman, and Kuching. Methodology and results: Twelve succeeded isolates were pre-identified as P. oryzae by morphological characteristics of spores, followed by verification through (internal transcribed spacer) ITS sequencing. The isolates were evaluated for morphological characteristics, growth rate and sporulation rate, which were grown on two types of media, (filtered oatmeal agar) FOMA and (potato dextrose agar) PDA. Morphological characterization showed that the colony surface of the different isolates varied from smooth and fluffy to rough and flattened mycelia; some were with the present of concentric rings, and some with aerial mycelia. The growth rate and sporulation rate of each isolate varied based on types of media used. Most of the isolates grew faster on PDA than on FOMA but produced higher number of spores on FOMA as compared to PDA. Conclusion, significance and impact of study: This preliminary study showed that there were variations observed based on morphological and physiological characterization for the different isolates collected in Sarawak, Malaysian Borneo. This study is the first step towards understanding variation in the population of P. oryzae from Sarawak.

Factors associated with knowledge, attitude and practice of e-cigarette among adult population in KOSPEN areas of Kuching district, Sarawak, Malaysia

Background: Smoking electronic cigarette is a current world phenomenon, however, the vaping community had ignorant about its health effects. Considering this view, this study was conducted to determine the level of knowledge and attitude toward e-cigarette and factors associated with it.Methods: This cross-sectional study was conducted among adults in the KOSPEN locality in Kuching district. Six out of the 64 KOSPEN localities had been chosen randomly as study locations. Systematic random sampling with replacement method was used to select the respondent. A total of 354 adults were interviewed by face to face interview using adapted and validated questionnaire. The data entry and analysis were done by IBM SPSS Version 22.0. A p<0.05 was considered as statistically significant.Results: Data revealed that 66% of the respondents admitted that they heard about e-cigarette. Among them 54.3% of the respondent had good knowledge about e-cigarette. However, more than half (52.8%) do not support the use of e-cigarette. Bi-variate analysis revealed that male gender and attitude towards supporting e-cigarette was significantly associated with practice of e-cigarette (p<0.05). However, for the conventional practice of smoking, age, gender, marital status, level of education and occupation found to be significantly associated with practice of conventional smoking.Conclusions: Though the study did not depict the national scenarios of e-smoking and conventional cigarette smoking as well, but the factors identified in this study appeared to be policy options for the programme managers, health administration, and health educators designing the preventive programmes against e-smoking and conventional smoking

Hospital survey on patient safety culture in Sarawak General Hospital: A cross sectional study

@#Introduction: Patient safety is defined as ‘the prevention of harm caused by errors of commission and omission’. Patient safety culture is one of the important determining factor in safety and quality in healthcare. The purpose of this study is to assess the views and perceptions of health care professionals about patient safety culture in Sarawak General Hospital (SGH). General Hospital (SGH). Methods: A cross-sectional study, using the ‘Hospital Survey on Patient Safety Culture (HSOPSC)’ questionnaire was carried out in 2018 in SGH. Random sampling was used to select a wide range of staff in SGH. A self-administered questionnaire was distributed to 500 hospital staff consisting of doctors, nurses, pharmacist and other clinical and non-clinical staff, conducted from March to April 2018. A total of 407 respondents successfully completed the questionnaire. Therefore, the final response rate for the survey was 81.4%. This study used SPSS 22.0 for Windows and Hospital Data Entry and Analysis Tool that works with Microsoft Excel developed by United States Agency for Healthcare Research and Quality (AHRQ) to perform statistical analysis on the survey data. Results: Majority of the respondents graded the overall patient safety as acceptable (63.1%) while only 3.4% graded as excellent. The overall patient safety score was 50.1% and most of the scores related to dimensions were lower than the benchmark scores (64.8%). Generally, the mean positive response rate for all the dimensions were lower than composite data of AHRQ, except for “Organizational Learning – Continuous Improvement”, which is also the highest positive response rate (80%), higher than AHRQ data (73%). The result showed that SGH has a good opportunity to improve over time as it gains experience and accumulates knowledge. On the other hand, the lowest percentage of positive responses was “Non-punitive response to error” (18%), meaning that most of the staff perceived that they will be punished for medical error.

Iodine Deficiency Disorders among Pregnant Women in Sarawak, Malaysia

@#Iodine deficiency disorders (IDD) during pregnancy may impair the neurological development of the fetus. The aim of this study is to determine the iodine status among pregnant women (PW) in Sarawak after introduction of mandatory universal salt iodisation (USI) for seven years.

Nutritional status and complementary feeding among Penan infants and young children in rural Sarawak, Malaysia

@#Introduction: The Penan people are largely settled in rural and remote areas of Sarawak with high rates of undernutrition among the children. The study aimed to determine the nutritional status and infant and young child feeding (IYCF) practices of Penan children. Methods: Subjects consisted of 121 children, aged between 0-23 months, from 15 Penan longhouses in Belaga district. Malnutrition was assessed using anthropometric measurements of children and categorised according to the World Health Organization (WHO) Growth Standards (2006). Feeding practices were assessed using questionnaires based on WHO IYCF Indicators (2008). Results: The prevalence of underweight was 29.8%; stunting 43.0% and wasting 5.8%. Prevalence of exclusive breastfeeding under 6 months was 44.4%. About 86% of infants aged 6-8 months were already given solid, semi-solid and soft foods. The proportion of children aged 6-23 months achieving minimum dietary diversity (MDD) was 76.6%, while minimum meal frequency (MMF) was 83.0% (breastfed and non-breastfed). Among the children who achieved MDD, 64.9% of their meals were derived from 4-5 food groups. More than half (55.3%) of all subjects (breastfed and non-breastfed) received minimum acceptable diet (MAD). Achievement of iron-rich foods (IRF) indicator was 77.7%. There was no significant association between the IYCF indicators of MDD, MMF and MAD and underweight, stunting and wasting. Conclusion: A high prevalence of poor nutritional status was recorded among the Penan children. While the IYCF indicators apparently showed satisfactory complementary feeding practices, future studies should assess quantitatively the intake of complementary food among Penan infants and young children.

Kidd Phenotypes in Multiple Ethnicities in Hospital Umum Sarawak, Malaysia

@#Introduction: Kidd blood group system is distributed differently within populations. In Malaysia, the prevalence of Kidd phenotypes have been reported but not in Hospital Umum Sarawak (HUS).We characterised Kidd phenotypes among regular blood donors in HUS. Methods: A cross-sectional study was done from 1st September 2015 to 10th September 2015. Blood samples were collected from 250 regular blood donors of different ethnicities in HUS. Samples were then investigated for Kidd blood group phenotypes by utilising Seraclon anti-Jka and anti-Jkb reagents employing the Diamed-ID gel card system. Results: Phenotype Jk(a+b+) was found in 110 out of 250 (44.0%) and phenotype Jk (a-b-) phenotype in seven out of 250 (2.8%) blood donors. Jk(a+b-) was detected in 60 out of 250 (24.0%) and Jk(a-b+) in 73 out of 250 (29.2%) donors. Kidd phenotype was detected in four ethnics; Chinese 50.8%, Malays 38.4%, Bidayuh 10.0% and Iban 0.8%. Jk(a-b-) phenotype was present only in the Malays; seven out of 250 (2.8%) but not found in other ethnicities. Conclusion: Jk(a+b+) is the most common Kidd phenotype found in regular blood donors in HUS in the four ethnicities studied. Only Malays exhibit the Jk(a-b-) phenotype which is a rare phenotype. The results of this study may serve as a preliminary database for Kidd blood group profile of regular blood donors in HUS.

Molecular characterisation of rice tungro bacilliform virus isolated from Bario, Sarawak

Aims@#Rice tungro disease is one of the most damaging and destructive diseases of rice in South and Southeast Asia. The disease is caused by the co-infection of two viruses, the Rice tungro bacilliform virus (RTBV) and Rice tungro spherical virus (RTSV). The symptoms and severity of the disease depend on these two viral agents, if rice is coinfected by both viruses, it will show the typical severe symptoms of yellow-orange leaf discoloration, plant stunting and reduced in yield. On the other hand, if rice is infected only with RTBV, it shows milder symptoms and in contrast, rice plants will show no symptoms if they are infected only with RTSV. The disease had been detected in Malaysia since the 1930s. However, the first incursion of the disease was only reported in Sarawak in 2012. Since the disease was not seen in the Sarawak until recently, very little information on local virus isolate is available. This study was conducted to obtain and record the nucleotide sequence of partial coat protein gene of two primary isolates of RTBV collected from Bario, Sarawak in 2012 and 2013.@*Methodology and results@#Based on the phylogenetic analysis, the isolates cluster with the Southeast Asia group with sequence identity at nucleotide and amino acid level of 91.1 to 95.1% and 98.6 to 99.5% respectively.@*Conclusion, significance and impact of study@#This study provide the first genetic information on RTBV isolates from Sarawak. This data is important for future reference of the virus variants and diversity for epidemiological and diagnosis purposes.

Barriers, Strength And Weakness Of Pre-Pregnancy Clinic Services In Sarawak: A Qualitative Analysis From Provider Perspectives

@#Pre-pregnancy Clinic (PPC) services is one the plausible efforts towards achieving the Millennium Development Goals. However, various issues still need to be addressed for improvement of the services. Considering this view, an attempt was made to explore the barriers, strength and weakness of current practice of pre-pregnancy clinic services in Sarawak, since the programme has been implemented in this state from the year 2011. This cross-sectional study was conducted at nine selected health care facilities throughout Sarawak. A multistage sampling procedure was adapted to select the health care facilities. An unstructured open-ended questionnaire was administered to get the in-depth perceived views and current practice of pre-pregnancy clinic services. A total of 322 health care providers from nine selected health care facilities gave their feedback. In the present paper, a qualitative analysis was done for the open-ended questions to get in-depth views of barriers, strength and weakness of pre-pregnancy clinic services. The results of the study were narrated in textual form and a thematic analysis was done manually. The identified themes for perceived barriers to the provision of pre-pregnancy care were perception, attitude and acceptance of PPC services, socio-economic issues, services and client factors. The perceived weaknesses of the services are listed under two main themes: working environment and service factors, while, the strength of services produced three thematic areas which are preparation for pregnancy, prevention of mortality and morbidity and comprehensive services. Though pre-pregnancy services are beneficial for society wellbeing, various issues still need to be considered for the improvement of the quality of services. Lack of awareness, no ministerial guidelines or Standard Operating Procedures (SOP) and knowledge pertaining to the services were few of the main areas which need to be pondered upon. Promotional activities and campaigns should be geared up ensuring availability the services to the general population.