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2.
Med J Malaysia ; 77(3): 313-319, 2022 May.
Article in English | MEDLINE | ID: covidwho-1871853

ABSTRACT

BACKGROUND: Acute illness and hospitalisation detriment the nutritional status of older patients. This study aimed to describe the prevalence of malnutrition, characteristics and in-hospital outcomes associated with malnutrition, and nutritional management among patients who were admitted to the Subacute Geriatric Ward. METHODS: This is a retrospective study of older patients (age ≥ 60) who were admitted to the Subacute Geriatric Ward of Kuala Lumpur Hospital from 1 March 2021 to 31 May 2021. Malnutrition was identified using the Mini Nutritional Assessment-Short Form (MNA-SF). The in-hospital outcomes evaluated were hospital-associated complications, namely delirium, functional decline, incontinence, inpatient falls, inpatient pressure injuries, hospital-acquired infection, institutionalisation, and inpatient mortality. RESULTS: Seventy-three patients were included (mean age 74.7, female 58.9%), of which 28 (38.4%) and 27 (37.0%) were malnourished and at risk of malnutrition, respectively. Poorer nutritional status was associated with increased age, comorbidity burden, frailty, immobility, impaired basic activities of daily living, history of falls, cognitive impairment, incontinence, and arthritis. About 71.2% and 60.3% of patients were offered dietitian review and oral nutritional supplements, respectively. The in-hospital outcome rates were higher among malnourished patients, but the differences were not statistically significant. However, multiple hospital-associated complications were more common with poorer nutritional status (p = 0.018). CONCLUSION: Hospital malnutrition is prevalent among older patients, and unidentified malnutrition is not justified due to its association with multiple adverse outcomes.


Subject(s)
COVID-19 , Malnutrition , Activities of Daily Living , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Female , Geriatric Assessment , Hospitalization , Humans , Malaysia/epidemiology , Malnutrition/complications , Malnutrition/epidemiology , Pandemics , Retrospective Studies , Tertiary Care Centers
3.
Med J Malaysia ; 77(3): 300-305, 2022 May.
Article in English | MEDLINE | ID: covidwho-1870942

ABSTRACT

INTRODUCTION: The COVID-19 pandemic is a global health crisis that has resulted in a massive disease burden worldwide. Mass vaccination plays an important role in controlling the spread and severity of COVID-19 infections worldwide. MATERIALS AND METHODS: A cross-sectional study was conducted in Hospital Tuanku Ja'afar Seremban between 1 March 2021 and 4 May 2021 to describe the adverse events (AE) following BNT162b2 (Pfizer-BioNTech) vaccination. Healthcare personnel who received at least one dose of the vaccine were invited to complete an online questionnaire. RESULTS: Of 2282 analysed samples, AE were experienced in up to 64.5% (n=1472) of the study participants. Most AE were encountered after the second dose (56.5%, n=832). Pain at the injection site (41.5%, n=944), fever (35.1%, n=798) and lethargy (34.8%, n=792) were the most commonly reported AE. Severe AEFI were reported in a minority (2.9%, n=68). There were no documented anaphylaxis, vaccine-induced thrombosis, or myocarditis. The proportion of female recipients and recipients with a history of allergy were higher in the AE group compared to the non-AE group. CONCLUSION: Our study reinforces the safety of the BNT162b2 mRNA vaccine in the local population. The main adverse events were mild, although they occurred in most patients.


Subject(s)
COVID-19 , Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Cross-Sectional Studies , Female , Health Personnel , Humans , Malaysia/epidemiology , Pandemics , RNA, Messenger , Vaccination/adverse effects , Vaccination/methods , Vaccines, Synthetic
4.
Med J Malaysia ; 77(3): 338-346, 2022 May.
Article in English | MEDLINE | ID: covidwho-1870596

ABSTRACT

BACKGROUND: Measuring the success of the control of COVID-19 in any country includes a review of the mortality especially to compare the deaths of those dying in hospitals and those brought in dead (BID). The objective of this study was to compare the death groups with the demographic factors that influenced the type of death. METHODS: This was a case-control study (1:1 ratio) looking at COVID-19 secondary public data from March 2020 to February 2021. Data such as the basic demographic data and comorbidities were analysed descriptively and then using a binary-logistic regression analysis to compare the independent variables against the outcome of BID. From the database, 120 cases were included as BID (4 excluded due to insufficient information) and 120 patients from the 1006 who passed away in hospital were randomly selected as comparators. The data was analysed in SPSS v21.0. RESULTS: The mean age for the BID was 59.59 (SD: 18.74), with more males (70.8%) than females (29.2%), of which 61.7% were Malaysians, 46.7% from the state of Sabah, and 64.2% having at least one co-morbidity (50% of them had hypertension). A univariate binary logistic regression analysis yielded factors such as age, nationality, and presence of any co-morbidities that are favourable to be included into the multivariate analysis. From the final analysis, the only factor that distinguished the BID from those dying in the hospital was being a foreigner (AOR: 4.32 [95%CI: 2.02-9.24], p<0.001). CONCLUSIONS: This concluded that foreigners in Malaysia were likely to die from COVID-19 outside of the hospital compared to Malaysians. Amongst the reasons that needed to be addressed were cost, accessibility issues regarding medical care, and the testing policies in Malaysia.


Subject(s)
COVID-19 , Adult , Aged , COVID-19/mortality , Case-Control Studies , Female , Hospitals , Humans , Logistic Models , Malaysia/epidemiology , Male , Middle Aged
5.
PLoS One ; 17(5): e0268926, 2022.
Article in English | MEDLINE | ID: covidwho-1862278

ABSTRACT

BACKGROUND: As the vaccination drive against the coronavirus disease (COVID-19) in Malaysia progresses rapidly, the main challenge will gradually shift from procuring and distributing vaccines to ensuring the broadest possible acceptance among all population segments. Therefore, this study used the integrated framework of the health belief model (HBM) and the theory of reasoned action (TRA) to investigate the predictors of intention to receive COVID-19 vaccines in Malaysia. METHODOLOGY: A market research company in Malaysia was engaged to collect data during June 11-20, 2021 using self-administered questionnaires via its online panel, ensuring a nationwide random sample of 804 respondents. A logistic regression was subsequently estimated to determine the significant predictors of vaccination intention. RESULTS: The predictors that significantly affect COVID-19 vaccine hesitancy in Malaysia are age, susceptibility, religious beliefs, attitude, subjective norms, and trust in the vaccine. In particular, those who are more inclined to get vaccinated are older individuals, have a higher perceived risk of infection and social pressure to get vaccinated, have a positive attitude, and have high levels of trust in the vaccine. Individuals' who perceive that their religious beliefs are against vaccination are more likely to exhibit uncertainty toward it. CONCLUSION: This study showed that although a large proportion of respondents indicated that they were willing to be vaccinated against COVID-19, there are concerns about religious barriers and trust in the vaccine that the relevant stakeholders should address. Campaigns should also focus on shaping the nation's attitude toward COVID-19 vaccines, in parallel with encouraging people to use their social influence in helping those in their close circle who are unsure of vaccination to cross the line. These measures will prove to be pertinent as the nation begins to administer booster vaccines to tackle the waning effects of COVID-19 vaccines.


Subject(s)
COVID-19 , Urinary Bladder Diseases , Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Intention , Malaysia/epidemiology , SARS-CoV-2 , Vaccination
6.
Z Evid Fortbild Qual Gesundhwes ; 171: 89-92, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1852261

ABSTRACT

Shared decision making (SDM) activities in Malaysia began around 2010. The rise in the numbers of patients with chronic disease in Malaysia underscores a growing need for doctors to practice patient-centred care and SDM as more Malaysians come into regular contact with health decision-making scenarios. Recent guidelines for medical professionalism have emphasized that options and risks be discussed in consultations, especially for procedures with risk of adverse outcomes. Although SDM is not legally required, principles of SDM are applied in legal judgements on informed consent. Research on SDM has grown to include the adoption of patient and public involvement in research, an increased emphasis on incorporating local cultural values in SDM, and implementation of SDM in Malaysia's health system and organizational culture. While COVID-19 hindered the progress of SDM research, one positive development was that vaccination choices heightened public consciousness about personal decisional autonomy and the need to discuss pros and cons with doctors before making a medical decision.


Subject(s)
COVID-19 , Patient Participation , COVID-19/prevention & control , Decision Making , Decision Making, Shared , Germany , Health Policy , Humans , Malaysia
7.
Int J Infect Dis ; 120: 51-58, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1851258

ABSTRACT

BACKGROUND: Several countries have implemented control measures to limit SARS-CoV-2 spread, including digital contact tracing, digital monitoring of quarantined individuals, and testing of travelers. These raise ethical issues around privacy, personal freedoms, and equity. However, little is known regarding public acceptability of these measures. METHODS: In December 2020, we conducted a survey among 3635 respondents in Singapore, Hong Kong, and Malaysia to understand public perceptions on the acceptability of COVID-19 control measures. FINDINGS: Hong Kong respondents were much less supportive of digital contact tracing and monitoring devices than those in Malaysia and Singapore. Around three-quarters of Hong Kong respondents perceived digital contact tracing as an unreasonable restriction of individual freedom; <20% trusted that there were adequate local provisions preventing these data being used for other purposes. This was the opposite in Singapore, where nearly 3/4 of respondents agreed that there were adequate data protection rules locally. In contrast, only a minority of Hong Kong respondents viewed mandatory testing and vaccination for travelers as unreasonable infringements of privacy or freedom. Less than 2/3 of respondents in all territories were willing to be vaccinated against COVID-19, with a quarter of respondents undecided. However, support for differential travel restrictions for vaccinated and unvaccinated individuals was high in all settings. INTERPRETATION: Our findings highlight the importance of sociopolitical context in public perception of public health measures and emphasize the need to continually monitor public attitudes toward such measures to inform implementation and communication strategies.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Hong Kong/epidemiology , Humans , Malaysia/epidemiology , SARS-CoV-2 , Singapore/epidemiology
8.
Front Public Health ; 10: 816530, 2022.
Article in English | MEDLINE | ID: covidwho-1834643

ABSTRACT

Introduction: Like many other countries, the federal government of Malaysia took the initiative to implement nationwide home confinement as a preventive measure in response to the pandemic COVID-19 outbreak, better known as Movement Control Order (MCO). Many have suffered economically, which led to poor states of well-being. This study investigates the relationship between lifestyle, psychological factors affecting eating habits, and physical activity among government servants in states with the highest cumulative cases during the COVID-19 pandemic. Methods: A cross-sectional online survey was conducted among 210 government servants from four states (Selangor, Sabah, Kuala Lumpur, and Johor) from May 2021 to June 2021. Three validated questionnaires were used, namely, Emotional-Eater Questionnaire (EEQ), and Malay International Physical Activity Questionnaire (IPAQ-M) from López-Moreno et al. (1). Results: There were significant gender differences (P < 0.001) for supplement intake, with 30.4% among men and 62.3% in women. Almost half (49.1%) were classified as emotional or very emotional eaters. Also, a significant difference (P < 0.005) was found in the perception of boredom and apathy between men (35.7%) and women (31.8%). A majority (56.2%) stated that their mood positively affected their eating habits. The total metabolic equivalent of task (MET) for 132 subjects was 3495.8 ± 3862.7 min/week for physical activity. Significant differences were observed between MET and gender (Mann-Whitney U-test: P = 0.019), with men showing higher MET value (5001.4 ± 5354.0 min/week men, 2864.3 ± 2754.3 min/week women). A significant difference was observed among women for body weight and body mass index (BMI) before and during MCO (P < 0.001). For the emotional eater, there were correlations with eating habits before the MCO for quantity of food intake (P = 0.003), frequency of mealtime (P < 0.001), changes of food habits (P = 0.005), cooking methods (P = 0.016), and frequency of food intake (P = 0.020). There is no correlation (P = 0.577) between psychological factors affecting eating habits and physical activity during COVID-19. Conclusion: Changes were reported before and during MCO on lifestyle, eating habits, and physical activity. Such information will help design strategies to improve the economic and health status among government servants in Malaysia during the implementation of MCO or something similar.


Subject(s)
COVID-19 , COVID-19/epidemiology , Cross-Sectional Studies , Exercise , Feeding Behavior/psychology , Female , Government , Humans , Life Style , Malaysia/epidemiology , Male , Pandemics
9.
Front Public Health ; 10: 873022, 2022.
Article in English | MEDLINE | ID: covidwho-1818028

ABSTRACT

Background: In Malaysia the COVID-19 disease (COVID-19) has continued to escalate since its first detection in late January 2020, despite widespread implementation of control measures. This study aims to determine the knowledge, perception and behaviors with respect to COVID-19 in the midst of the third wave of the infection. Methods: A cross-sectional study was carried out among staffs and students of Universiti Tunku Abdul Rahman (UTAR). The survey consists of basic sociodemographic information, 22 items on knowledge on COVID-19, 3 items on perceived self-risk, 2 items on preparedness & perceived self-efficacy, 10 items on preventive (own) measures, 9 items assessing unwanted and desirable behaviors during the pandemic. Simple and multiple linear regression were performed to determine the factors associated with knowledge, preventive measures adopted, self-risk perception, preparedness & perceived self-efficacy, and behaviors. Results: A total of 434 responded to the survey of whom the majority (85.1%) had high scores for knowledge (mean score of 18.72 out of 22). A significant positive association was found between knowledge and older age (adjusted B coefficient (SE) = 0.046 (0.022), p = 0.039), those from medical faculty (adjusted B coefficient (SE) = 0.870 (0.420), p = 0.039) and residence in high-risk areas (adjusted B coefficient (SE) = 0.831 (0.295), p = 0.005). Predictors for higher perception of COVID-19 risk included presence of COVID-19 cases among social contacts (adjusted B coefficient (SE) = 0.751 (0.308), p = 0.015) and living with elderly (adjusted B coefficient (SE) = 1.137 (0.296), p < 0.001), while that for perception of preparedness and self-efficacy were living with children (adjusted Beta coefficient (SE) = 0.440 (0.173), p = 0.011) and absence of positive cases among social contacts (adjusted B coefficient (SE) = 0.418 (0.183), p = 0.023). Good preventive measures among the respondents were positively associated with knowledge (adjusted B coefficient (SE) = 0.116 (0.025), p < 0.001), as well as with female gender (adjusted B coefficient (SE) = 0.348 (0.142), p = 0.014). Unwanted behavior was significantly associated with male gender (adjusted B coefficient (SE) = 0.664 (0.321), p = 0.039) and COVID-19 positive status (adjusted B coefficient (SE) = 9.736 (3.297), p = 0.003). Knowledge of COVID-19 (adjusted B coefficient (SE) = 0.069 (0.035), p = 0.048) and being married (adjusted B coefficient (SE) = 0.917 (0.462), p = 0.048) were the predictors of desirable behavior. Conclusion: Overall, the UTAR community had demonstrated a good level of knowledge and preventive behaviors, albeit with some areas for improvement.


Subject(s)
COVID-19 , Aged , COVID-19/epidemiology , Child , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Malaysia/epidemiology , Male , Universities
10.
Int J Infect Dis ; 121: 55-57, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1814523

ABSTRACT

OBJECTIVES: In this study, we aimed to investigate vaccine effectiveness (VE) against SARS-CoV-2 infections among adolescents aged 12 to 17 years in Malaysia and examine potential VE differences after full vaccination. METHODS: We consolidated data on COVID-19 testing, vaccination, and outcomes for all public school-going adolescents in Malaysia from September 1, 2021, to December 31, 2021, and estimated the VE against SARS-CoV-2 infections during this period. Cases were defined as positive tests, either by reverse transcriptase- PCR (RT-PCR) or rapid antigen (RTK-Ag) testing, while controls were negative tests. Secondarily, we restricted the analysis to all tests performed in December 2021 and compared VE by month of full vaccination. RESULTS: A total of 175,880 eligible tests (53.4% or 93,995 RT-PCR tests) were included. After full vaccination with BNT162b2, VE against SARS-CoV-2 infections was 65.7% (95% confidence interval [CI] 64.4, 66.9) over the study period. When restricted to tests in December 2021, VEs for those fully vaccinated in September 2021, October 2021, and November 2021 were comparable (60.6% [95% CI 23.7, 81.5], 56.9% [95% CI 51.1, 62.0], and 65.7% [95% CI 59.8, 70.7] respectively). CONCLUSIONS: Among adolescents, full vaccination with BNT162b2 offered considerable protection against SARS-CoV-2 infections over at least three months without substantial evidence of waning.


Subject(s)
COVID-19 , Vaccines , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing , COVID-19 Vaccines , Humans , Malaysia/epidemiology , SARS-CoV-2
11.
Int J Infect Dis ; 119: 69-76, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1814520

ABSTRACT

OBJECTIVES: We aimed to investigate and compare waning vaccine effectiveness (VE) against COVID-19 infection, COVID-19 related ICU admission, and COVID-19-related death for BNT162b2 and CoronaVac vaccines. METHODS: We consolidated national data on COVID-19 vaccination and outcomes, and used cases from September 1st-30th, 2021 to compare VE between the 'early' (fully vaccinated in April-June 2021) and 'late' (July-August 2021) groups. We estimated VE against COVID-19 infection with a negative binomial regression and VE against ICU admission and death among confirmed COVID-19 cases with a logistic regression. RESULTS: For BNT162b2, VE against COVID-19 infections declined from 90.8% (95% CI 89.4, 92.1) in the 'late' group to 79.3% (95% CI 76.1, 82.1) in the 'early' group. VE for BNT162b2 against ICU admission and death were stable. For CoronaVac, VE waned against COVID-19 infections from 74.5% (95% CI 70.6, 78.0) to 30.4% (95% CI 18.8, 40.3). Effectiveness against ICU admission waned from 56.0% (95% CI 51.2, 60.2) to 28.7% (95% CI 12.2, 42.1). CoronaVac's effectiveness against death remained stable. CONCLUSION: VE against COVID-19 infection waned after 3-5 months of full vaccination for both BNT162b2 and CoronaVac vaccines in Malaysia. For CoronaVac, protection against ICU admission also declined.


Subject(s)
COVID-19 Vaccines , COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Malaysia/epidemiology , SARS-CoV-2
12.
Biomed Res Int ; 2022: 9123887, 2022.
Article in English | MEDLINE | ID: covidwho-1807712

ABSTRACT

The COVID-19 pandemic has accelerated implementation of telemedicine in healthcare facilities for delivery of care. Healthcare providers' acceptance of the telemedicine services is important for successful implementation of this new system. A questionnaire based on the Technology Acceptance Model (TAM) has been used to measure user acceptance of telemedicine service. The aim of this study was to translate and validate the English version of the questionnaire into Malay, to extend the availability and utilization of this questionnaire in Malaysia. A forward and backward translation of the questionnaire was conducted to produce the TAM in the Malay version (Malay-TAM). Panel experts assessed content validity. Internal consistency reliability was determined using Cronbach's alpha. Confirmatory factor analysis based on structural equation modelling was performed to validate the factor structure. The questionnaire was then tested on and completed by 149 healthcare workers from several public health clinics across Malaysia. The Malay-TAM demonstrated good reliability with Cronbach's alphas ranging from 0.823 to 0.912. Factor analysis showed good convergent validity but relatively poor discriminant validity. All five constructs were retained to preserve content validity. The findings suggest that the Malay-TAM can serve as a reliable and valid instrument to measure acceptance to telemedicine.


Subject(s)
COVID-19 , Telemedicine , Humans , Malaysia , Pandemics , Psychometrics , Reproducibility of Results , Surveys and Questionnaires , Technology
13.
BMC Public Health ; 22(1): 638, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1793965

ABSTRACT

BACKGROUND: The increased risk of loss to follow-up among TB smokers raises concern over the secondary spread within the community. This study aimed to determine the factors associated with loss to follow-up among TB patients who smoke. METHODS: All registered TB patients who smoke in the state of Selangor between 2013 and 2017 via the Malaysian Tuberculosis Information System (MyTB) database were included for analysis. TB patients who smoke were considered those who are "current smoker" during the notification, while loss to follow-up was defined as a TB patient who had interrupted treatment for 2 months or longer. There were 3 main variable domains included for analysis: sociodemographic profiles, disease profiles, and comorbidities. Logistic regression analysis was used to identify determinants of loss to follow-up among TB patients who smoke. RESULTS: A total of 14.1% (N = 813) of TB patients who smoke loss to follow-up. The determinants of loss to follow-up among TB smokers were working age population aged 32-41 and 42-53 years old (AOR 1.08; 95%CI 1.23,2.08) and (AOR 1.44; 95%CI 1.11,1.87) respectively, Malaysian nationality (AOR 2.34; 95%CI 1.66,3.30), patients staying in urban area (AOR 1.55; 95% CI 1.23,1.97), income level less than RM2160 (AOR 1.59; 95% CI 1.14,2.20), un-employed (AOR 1.30; 95%CI 1.09-1.55), have low education level i.e., secondary school education, primary school education and no formal education (AOR 1.60; 95%CI 1.22,2.10), (AOR 1.73; 95%CI 1.16,2.57) and (AOR 2.29; 95% CI 1.57,3.33) respectively, previously treated TB cases (AOR 2.19; 95% CI 1.71,2.81), active TB case detection methods (AOR 2.06; 95%CI 1.40,3.02), moderate lesion x-ray (AOR 1.60; 95%CI 1.13,2.27) and HIV positive (AOR 1.36; 95%CI 1.02,1.82). All the significant factors gave rise to the final model of determinants, with a predictability of 67.2% (95% CI 65.0,69.3). CONCLUSIONS: The high proportion of loss to follow-up among TB patients who smoke highlight the importance of providing early risk detection that examines the three main domains of risk factors such as socioeconomic, disease profiles and comorbidities. Potential integrated intervention should aim to reduce the proportion of smoking among TB patients through the stop smoking programme together with directly observed therapy (DOT).


Subject(s)
Tuberculosis , Follow-Up Studies , Humans , Malaysia/epidemiology , Registries , Smoking/epidemiology , Tuberculosis/complications , Tuberculosis/epidemiology
14.
BMC Med Educ ; 22(1): 209, 2022 Mar 28.
Article in English | MEDLINE | ID: covidwho-1793955

ABSTRACT

BACKGROUND: This study explored the user experiences of paediatric postgraduate trainees in Malaysia and Thailand in using a 2 h and 15 min online module for breastfeeding developed for Southeast Asia, which was adapted from existing European online modules for European and German Continuing Medical Education (CME) credits. METHODS: A qualitative study using focus group discussions (FGDs) was conducted with paediatric postgraduate trainees who used an online English-language breastfeeding module in two Thai universities (May 2020, done online) and two Malaysian universities (Sept- Nov 2019, in-person). FGDs explored module usability and utility. Sessions were transcribed verbatim and analysed thematically. The process of coding was done collaboratively by Thai and Malaysian researchers. RESULTS: Twenty Six resident trainees participated (Thai, n = 13; Malaysian, n = 13). Ages ranged from 29-34 years old, with 21 females. Nineteen participants had never used online learning modules prior to this. Participants took between 1 to 5 sessions to complete the breastfeeding module. Four themes emerged from their experience. 1) The online learning module was more engaging and detailed than previous lectures, courses and/or books, but lacked hands-on training. 2) Using an online platform facilitated learning as eased navigation and resource searching, however, problems were encountered navigating the module on some devices. 3) Learners preferred less words and more graphics, as this helped them capture key messages. 4) Regionally tailored content elicited a mixed reaction from participants. CONCLUSIONS: Users found that the adapted module compared favourably with previous learning experiences. However, online learning modules lack hands-on training, and implementation should ideally incorporate a mix of both. Consideration of device diversity and preferences for how content was adapted for local settings are needed for tailoring.


Subject(s)
Breast Feeding , Computer-Assisted Instruction , Adult , Child , Female , Humans , Malaysia , Qualitative Research , Thailand
15.
Emerg Microbes Infect ; 11(1): 1262-1271, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1784268

ABSTRACT

The evaluation of breakthrough infection and humoral immunity responses are important outcomes for vaccination policy for healthcare staff. This prospective cohort study collected blood samples at 5-time points; before primary vaccine doses, and at 2, 10 and 24 weeks after BNT162b2 vaccination from 551 HCWs, between March and October 2021. We investigated the association between anti-spike-1 protein receptor-binding domain (anti-S1-RBD) antibody geometric mean titre (GMT) and breakthrough infections. Two weeks post-vaccination, the GMT of anti-S1-RBD antibodies was measured at almost maximum detectable value (3115 BAU/ml [95% CI, 3051-3180]); it decreased to 1486 BAU/ml (95% CI, 1371-1610) at 10 weeks; and to 315 BAU/ml (95% CI, 283-349) at 24 weeks. Prior COVID-19 infection and age significantly affected the antibody titres. Fifty-six participants, none of whom were COVID-19 convalescents, had breakthrough infections between 10 and 24 weeks post-vaccination. Before breakthrough infections, the GMT was not different between the breakthrough and non-breakthrough individuals. After infection, the GMT was significantly higher in individuals with breakthrough infections (2038 BAU/ml [95%CI, 1547-2685]), specifically in symptomatic breakthroughs, compared to those without infection (254 BAU/ml [95%CI, 233-278]). A notable surge in breakthrough infections among healthcare workers coincided with the emergence of the Delta variant and when BNT162b2-elicited antibody responses waned in 10-24 weeks (i.e. approximately 3-6 months). Post-breakthrough, the antibody response was boosted in individuals with symptomatic presentations, but not asymptomatic individuals. The study finding supports administering booster vaccination for healthcare staff, including those who recovered from asymptomatic breakthrough infection.


Subject(s)
COVID-19 , Antibodies, Viral , Asymptomatic Infections , COVID-19/prevention & control , COVID-19 Vaccines , Health Personnel , Humans , Immunity, Humoral , Malaysia/epidemiology , Prospective Studies , SARS-CoV-2
16.
J Med Entomol ; 59(1): 301-307, 2022 01 12.
Article in English | MEDLINE | ID: covidwho-1784366

ABSTRACT

The efficacy of three groups of insect growth regulators, namely juvenile hormone mimics (methoprene and pyriproxyfen), chitin synthesis inhibitors (diflubenzuron and novaluron), and molting disruptor (cyromazine) was evaluated for the first time, against Aedes albopictus Skuse (Diptera: Culicidae) larvae from 14 districts in Sabah, Malaysia. The results showed that all field populations of Ae. albopictus were susceptible towards methoprene, pyriproxyfen, diflubenzuron, novaluron, and cyromazine, with resistance ratio values ranging from 0.50-0.90, 0.60-1.00, 0.67-1.17, 0.71-1.29, and 0.74-1.07, respectively. Overall, the efficacy assessment of insect growth regulators in this study showed promising outcomes and they could be further explored as an alternative to conventional insecticides.


Subject(s)
Aedes , Juvenile Hormones/pharmacology , Mosquito Control/methods , Aedes/drug effects , Aedes/growth & development , Animals , Diflubenzuron/pharmacology , Insect Vectors/drug effects , Insect Vectors/growth & development , Insecticides/pharmacology , Larva/drug effects , Larva/growth & development , Malaysia , Methoprene/pharmacology , Phenylurea Compounds/pharmacology , Pyridines/pharmacology
17.
BMC Public Health ; 22(1): 667, 2022 04 06.
Article in English | MEDLINE | ID: covidwho-1779627

ABSTRACT

INTRODUCTION: The COVID-19 pandemic placed an unprecedented overload on healthcare system globally. With all medical resources being dedicated to contain the spread of the disease, the pandemic may have impacted the burden of other infectious diseases such as dengue, particularly in countries endemic for dengue fever. Indeed, the co-occurrence of COVID-19 made dengue diagnosis challenging because of some shared clinical manifestations between the two pathogens. Furthermore, the sudden emergence and novelty of this global public health crisis has forced the suspension or slow-down of several research trials due to the lack of sufficient knowledge on how to handle the continuity of research trials during the pandemic. We report on challenges we have faced during the COVID-19 pandemic and measures that were implemented to continue the iDEM project (intervention for Dengue Epidemiology in Malaysia). METHODS: This randomized controlled trial aims to assess the effectiveness of Integrated Vector Management (IVM) on the incidence of dengue in urban Malaysia by combining: targeted outdoor residual spraying (TORS), deployment of auto-dissemination devices (ADDs), and active community engagement (CE). Our operational activities started on February 10, 2020, a few weeks before the implementation of non-pharmaceutical interventions to contain the spread of COVID-19 in Malaysia. RESULTS: The three main issues affecting the continuity of the trial were: ensuring the safety of field workers during the interventions; ensuring the planned turnover of TORS application and ADD deployment and services; and maintaining the CE activities as far as possible. CONCLUSIONS: Even though the pandemic has created monumental challenges, we ensured the safety of field workers by providing complete personal protective equipment and regular COVID-19 testing. Albeit with delay, we maintained the planned interval time between TORS application and ADDs services by overlapping the intervention cycles instead of having them in a sequential scheme. CE activities continued remotely through several channels (e.g., phone calls and text messages). Sustained efforts of the management team, significant involvement of the Malaysian Ministry of Health and a quick and smart adaptation of the trial organisation according to the pandemic situation were the main factors that allowed the successful continuation of our research. TRIAL REGISTRATION: Trial registration number: ISRCTN-81915073 . Date of registration: 17/04/2020, 'Retrospectively registered'.


Subject(s)
COVID-19 , Dengue , COVID-19/epidemiology , COVID-19 Testing , Dengue/epidemiology , Dengue/prevention & control , Humans , Malaysia/epidemiology , Pandemics/prevention & control
18.
Front Public Health ; 10: 805733, 2022.
Article in English | MEDLINE | ID: covidwho-1776003

ABSTRACT

Background: Social media activities affect every aspect of human life, be it personal, social or professional. Previous studies have confirmed the role of social media in affecting health in terms of releasing stress and providing social support. Increased occupational health disorders and increased time spent on social media activities motivate us to investigate this phenomenon in the context of occupational health. Therefore, the objective of this study is to measure the effects of social media activities related to personal and social life as well as work-life on health and wellbeing of office employees, on their job efforts and job rewards, and in moderating the effect of effort-reward imbalance on health and wellbeing. Methods: Initially, to develop constructs related to social media activities, web-based structured interviews were conducted with five office employees working in the oil and gas industry for the last 5 years. Then, using an online questionnaire survey, data was collected from 424 office employees working in the oil and gas industry in Malaysia. Using statistical software for social science (SPSS) and Smart PLS, exploratory factor analysis and confirmatory factor analysis were conducted to identify reliability and validity (discriminant validity, convergent validity and composite validity) of the constructs. Following this, path analysis was conducted and the moderating effects were identified. Results: Social media activities related to work-life decrease health and wellbeing by 11% and weaken the negative effect of effort-reward-imbalance on health and wellbeing by 17.6% at a 1% level of significance. The results of social media activities related to personal and social life strengthen the negative effect of effort-reward imbalance on health and wellbeing by 12% and negatively affects health and wellbeing and job rewards by 13, 55%, respectively. The direct effect of effort-reward imbalance and job efforts is significantly negative on health and wellbeing by 59 and 10%, respectively. Conclusion: It is concluded that social media activities of the office employees significantly moderate the effect of effort-reward imbalance on health and wellbeing and intervene in job rewards in the organizations. Hence, the effect of social media activities reduces the health and wellbeing of office employees.


Subject(s)
Health Status , Mental Health , Oil and Gas Industry , Social Media , Humans , Malaysia , Reproducibility of Results , Reward , Work-Life Balance
19.
Front Public Health ; 10: 794513, 2022.
Article in English | MEDLINE | ID: covidwho-1775996

ABSTRACT

Aquatic environments, under frequent anthropogenic pressure, could serve as reservoirs that provide an ideal condition for the acquisition and dissemination of antibiotic resistance genetic determinants. We investigated the prevalence and diversity of antibiotic-resistant Escherichia coli by focusing on their genetic diversity, virulence, and resistance genes in anthropogenic-impacted Larut River. The abundance of E. coli ranged from (estimated count) Est 1 to 4.7 × 105 (colony-forming units per 100 ml) CFU 100 ml-1 to Est 1 to 4.1 × 105 CFU 100 ml-1 with phylogenetic group B1 (46.72%), and A (34.39%) being the most predominant. The prevalence of multiple antibiotic resistance phenotypes of E. coli, with the presence of tet and sul resistance genes, was higher in wastewater effluents than in the river waters. These findings suggested that E. coli could be an important carrier of the resistance genes in freshwater river environments. The phylogenetic composition of E. coli and resistance genes was associated with physicochemical properties and antibiotic residues. These findings indicated that the anthropogenic inputs exerted an effect on the E. coli phylogroup composition, diversification of multiple antibiotic resistance phenotypes, and the distribution of resistance genes in the Larut River.


Subject(s)
Drug Resistance, Bacterial , Escherichia coli , Rivers , Anti-Bacterial Agents/pharmacology , Escherichia coli/drug effects , Escherichia coli/genetics , Malaysia , Phylogeny , Prevalence , Rivers/microbiology
20.
Front Public Health ; 9: 731554, 2021.
Article in English | MEDLINE | ID: covidwho-1775863

ABSTRACT

This study investigates the impact of the ageing population on the economic growth for short- and long-run estimations in Malaysia, by using time series data from 1981 to 2019. This study adopts the autoregressive distributed lag (ARDL) method with the Bound test approach for the long-run estimation and the vector error correction model for the short-run estimation. Several econometric diagnostic tests were applied for validation and the appropriate model specification basis. The estimated result of this work indicates that the age dependency ratio proxy for the ageing population variable has a significant negative impact on economic growth in Malaysia. A 1% increase in old age dependency will decline gross domestic product's (GDP's) growth by an average of 6.6043% at the 5% level of significance. Hence, an increase in the ageing population will impede economic growth. Although controlled variables (e.g., physical capital, labour participation, and human capital) have a significant positive impact on economic growth in Malaysia, there is evidence of a long- and short-run relationship between economic growth and the ageing population variable, and also the control variable.


Subject(s)
Economic Development , Aging , Carbon Dioxide , Humans , Malaysia
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