Caregiving burden is associated with short rather than long duration of care for older persons.

This is a preliminary cross-sectional study of 51 caregivers of older persons attending the Geriatric Clinic at an urban hospital in Kuala Lumpur, Malaysia. A questionnaire helped determine how the duration of caregiving affects the outcome of caregiver burden. The short version of Zarit's Burden Interview (BI) allowed the burden level to be grouped as low or high burden. The duration of caregiving was also grouped into short (two or less years) or long (more than two years) durations. One third of the caregivers, 31% (16 out of 51) reported high burden and within this group 81%, (13 out of 16) are short duration caregivers. Majority of the longer duration caregivers, 88% (21 out of 24) reported low level of burden. This was a significant finding (p-value 0.008). The study also showed that a higher proportion of caregivers are employed, working in the private sector, and earn less than RM2,000 per month. However, these findings were not significantly associated with high burden. It is concluded that although this study showed low level of caregiver burden, shorter duration of caregiving is associated with higher level of burden and longer duration of caregiving is associated with lower level of burden.

A cohort study of health care workers to assess nosocomial transmissibility of Nipah virus, Malaysia, 1999.

During 1998-1999, an outbreak of Nipah virus encephalitis occurred in Malaysia. To assess the possibility of nosocomial transmission, 338 health care workers (HCWs) exposed and 288 HCWs unexposed to outbreak-related patients were surveyed, and their serum samples were tested for anti-Nipah virus antibody. Needlestick injuries were reported by 12 (3%) HCWs, mucosal surface exposure to body fluids by 39 (11%), and skin exposure to body fluids by 89 (25%). No encephalitis occurred in either group. Three exposed and no unexposed HCWs tested positive by EIA for IgG antibodies. It is likely that these 3 were false positives; no IgM response occurred, and the serum samples were negative for anti-Nipah virus neutralizing antibodies. The risk of nosocomial transmission of Nipah virus appears to be low; however, given the high case-fatality rate and the presence of virus in respiratory secretions and urine of some patients, standard and droplet infection-control practices should be maintained with these patients.

Microbial diseases in Malaysia: recent experiences.

Microbial diseases continue to occur in Malaysia despite the marked socio-economic development that has been taking place in the country along with improvements in the medical, health, and environmental sectors. This paper highlights the continuing presence of the numerous microbial diseases including the emergence of new problems such as AIDS. Local publications dealing with work on several microbial diseases is reviewed to show that this group of diseases will pose challenges for a long while. Undoubtedly several other diseases that were relatively unrecognised in the past are increasingly being identified owing to recent availability of diagnostic facilities and equipments. The need for continued vigilance is emphasised.

Some epidemiological aspects and economic costs of injuries in Malaysia.

Injuries are one of the leading causes of death in the world. In Malaysia, injuries form one of the three main causes of mortality. They are also an important cause of permanent and temporary disability and work absenteeism in the productive age group. Increasing affluence and industrialization coupled with growing population and transportation needs in rapidly developing countries like Malaysia have resulted in a surge of road and occupational injuries. Three quarters of fatalities due to road, occupational, drowning and home injuries occur in those below 45 years of age. A majority of injuries in these categories are attributed to "human" factors and therefore can be prevented by public education and enforced training of workers. The total annual economic loss due to all types of injuries is estimated to be 2 billion Malaysian Ringgit (US$1 = MR2.76 approximately). The government is currently in the process of setting up full-time departments for road safety and occupational health and safety.

Nutritional problems of Malaysian children and approaches taken to overcome them.

Nutritional status of children is an important factor in child survival, especially in developing countries. It is therefore important that nutritional problems are addressed and overcome. This paper reviews the many studies conducted in Malaysia on nutritional problems among children. It also documents the approaches, including intersectoral approaches, that have been taken to overcome these problems. Possible actions that have to be taken in the future to further improve the nutritional status of Malaysian children are discussed.

Knowledge, attitude and practice factors in childhood acute respiratory infections in a peninsular Malaysia health district.

This study compares the knowledge, attitudes and practice of mothers in two ethnic groups with regard to acute respiratory infections (ARI) in their child. Most had traditional beliefs as to the cause of ARI with only a minority knowing the causes. Most mothers were aware of the effect of frequent attacks of ARI on the health status of their child and of the importance of early treatment. Reasons for their becoming worried during an episode of ARI in their child indicated that problems of distance, transportation and arrangements for care of their other children predominate. A large proportion of the respondents felt that their present knowledge of ARI was inadequate and were thus interested in obtaining more information.

PIP: Nurses interviewed 100 Malay and 100 Chinese mothers with a child 5 years old who attended child health clinics in Negri Sembilan, Malaysia about acute respiratory infections (ARIs). The mean age and family size, educational status, and income levels were similar between the 2 groups. The mothers believed the leading causes of ARIs in children to be germs, food, and change in climate. 70% of Malays worried when their child had a mild ARI and 85% would seek treatment as soon as possible. 57% of the Chinese worried when their child had a mild ARI and 70% would seek treatment as soon as possible. No mother would wait to seek treatment in a case of severe ARI. The leading reason for worry for both the Malays and Chinese was that the child could become weak. The 2nd reason for the Malays was that the child could die whereas for the Chinese it was that the ill child could infect others. 68% of the Malays and 57% of the Chinese would not give cooling foods (fruits and vegetables) to their ill child. 20% of the Malays and 36% of the Chinese did not believe in food taboos. Most mothers had some knowledge about the type of diet suitable during an ARI. 93% of the Malays would take their child to a health center or hospital for treatment, while only 69% of the Chinese would do so. 24% of the Chinese would purchase medicine to treat their child. The Chinese had more problems taking their child for treatment of ARI than the Malays. For the Chinese, the health was too far or they had no time. Most mothers (Malays 68%, Chinese 71%) admitted not knowing much about ARIs and wished to learn more (Malays 89%, Chinese 92%). Most mothers wanted the information from health personnel. 21% of the Chinese could obtain information from reading. Health personnel should inform mothers more often about ARIs.

Attitudes of 110 married men towards family planning.

PIP: A study was conducted at the Army Garrison Hospital at Port Dickson in Peninsular Malaysia to determine the attitudes of 110 married men towards family planning. The sample included 80 Malays and 30 Indians who are army personnel attending the hospital either for medical treatment or a check-up. The study instrument was a pre-tested questionnarie administered by 2 male nurses during the November-December 1975 period. 76 of the respondents were between the ages of 20-34 years. 81 of the respondents had been married for a duration of up to 11 years. A breakdown by religion showed that 80 were Muslims, 25 were Hindus, and 5 were Christians, the latter being all Roman Catholics. All of the respondents were able to read and write in at least 1 language, 36 had had schooling varying from standard 1-6, 40 had had schooling varying between Form 1-Form 3, and 34 had had schooling varying from Form 4-to either Malaysian Certificate of Education Level or Higher School Certificate Level. 103 of the respondents approved of family planning, and of these 63 had always felt this way in the past. 6 respondents indicated that they had not thought about family planning in the past. 87 respondents did not approve of the practice of family planning before having the 1st child. Only 7 of 80 Malays in contrast to 16 of 30 Indian respondents -- a significant difference -- approved of family planning before the 1st child. 89 of the 110 respondents had discussed family planning with their wives; 21 respondents had not. 93 respondents disapproved of induced abortion; 17 approved of it. Only 3 of 80 Malay respondents approved induced abortion, but 14 of 30 Indian respondents indicated approval. 98 of the respondents indicated that they were interested in learning more about family planning, and 96 approved of their wife practicing family planning. 56 respondents were practicing family planning, and 20 indicated that they would do so in the future. 6 said they would not practice family planning, and 28 were uncertain as to whether they would practice family planning. It appears that the better educated approve as well as practice family planning more than those with less education.^ieng