Isodose mapping of terrestrial gamma radiation in Sarawak-Borneo: Insights from surface-weathered soil analysis.

Presentation of baseline data on terrestrial gamma radiation (TGR) levels is crucial for assessing the annual effective dose received by the public due to natural radiation exposure. Cumulative doses from various sources can become significant, warranting a spatial understanding of TGR distribution. Few countries have comprehensively mapped TGR on a national scale, often facing challenges due to remote or inaccessible regions. This study investigated the influence of weathered soil groups on TGR dose rates in Sarawak-Borneo, Malaysia, to facilitate insights for TGR projection and isodose mapping. A total of 1044 TGR dose rate measurements were collected using NaI (Tl) scintillation detector survey meters, with a mean of 100 nGy h-1 and a range of 8-375 nGy h-1. Non-parametric statistical analyses of variance using Welch's ANOVA, Brown-Forsythe, and Kruskal-Wallis validated (P-sig.=.000) notable dissimilarities among six categories of superficial-weathered soil. Graphical analysis using Sinclair's cumulative plot revealed deviations at intervals of 50, 80, 100, 120, 175, and 205 nGy h-1. These deviations indicate distinct lithological influences. Skeletal soil (entisols) and podzolic soils had high mean dose rates (148 and 113 nGy h-1, respectively) due to limited development, thus preserving abundant uranium (U) and thorium (Th). Meanwhile, gleysols and thionic soils exhibited compatible means (90 and 82 nGy h-1, respectively), while alluvial (or transported soils) and organic soils displayed lower dose rate ranges (mean of 76 and 47 nGy h-1, respectively), reflecting rapid hydrolysis weathering processes. Simple linear regression analysis revealed a strong relationship between TGR dose rate and mean value of weathered soil groups (y = 0.851x + 0.141 nGy h-1), signifying the significance and magnitude of weathered soil groups' impact on TGR dose rates. The obtained R-value is 0.704, indicating a strong linear correlation among soil group variables, and a Durbin-Watson statistic of 1.41, suggesting positive autocorrelation among residuals, thus positive relationships. An isodose map was successfully developed using the Kriging technique, aligning with lithological features of the study area. Semivariogram analysis reveals spatial dependence within a range of 1.47°, supporting the Kriging technique's suitability for spatial inference. In conclusion, this study has successfully revealed the relationship between TGR dose rates and superficial-weathered soil in Sarawak-Borneo. While the linear relationship is applicable to the Sundaland-Borneo tectonic block, it has potential to be used as a valuable tool for spatial inference of TGR dose rates in isodose development with similar lithologial characteristics, aiding in radiation exposure assessment and environmental monitoring.

The land snail fauna of Batu Kudik, isolated limestone outcrop near Simunjan, Sarawak, Malaysian Borneo (Mollusca, Gastropoda).

Background: The present study provides a checklist of land snails collected from Batu Kudik, a small and isolated limestone outcrop in Simunjan, Sarawak. A total of 24 species of land snails, representing 18 genera and 14 families were recorded, including one newly-described subspecies. The most species-rich of the families in Batu Kudik are Diplommatinidae (17%) and Chronidae (17%) with four recorded species from each of the families. Based on our analysis, Plectostomawallaceikudikense subsp. nov., Opisthostomajavanica and Georissapyrrhoderma were identified as the most abundant land snails at this isolated outcrop, whereas Diplommatinaonyx and Everettiaminuta were recorded as the least abundant. All of the land snails at Batu Kudik were exclusively found sheltered between limestone boulders, underscoring the critical role of this outcrop as their refuge for survival. Consequently, conserving this biodiversity-rich limestone area becomes paramount to prevent the local extinction of these land snail species and possibly other organisms that depend on the unique attributes of the limestone for their survival. We also provide detailed descriptions of Plectostomawallaceikudikense, a new subspecies of the genus Plectostoma which is endemic to Batu Kudik. New information: A description of a new subspecies Plectostomawallaceikudikense subsp. nov.

Prevalence Trend and Clinical Profile of Leprosy Among the Indigenous Penan Community in Rural Baram, Sarawak, Malaysia: A Retrospective Study.

In Malaysia, despite achieving leprosy-elimination status in 1994, leprosy remains a public health issue among the indigenous Penan community in Sarawak. This study aimed to determine the prevalence trend and clinical profile of leprosy among the Penans in rural Baram, Sarawak, Malaysia. A retrospective records review was conducted on 10-year (2008-2018) time trend of annual prevalence rate and 5-year (2013-2018) Penan leprosy patient clinical profile. Out of the 257 new cases of leprosy reported in Sarawak, 42.8% were Penans, and 72.7% were from Baram. The annual Penan ethnic-specific prevalence rate ranged from 2.08 to 35.5/10 000. Forty-six cases were analyzed for clinical profile: There were more males, active case detection, and multibacillary leprosy. The prevalence trend of leprosy among the Penans in rural Baram exceeded recommended elimination targets. Majority of the cases were detected through active case detection, but cases were detected late. Interventions are needed to improve early diagnosis and detection to achieve elimination of leprosy.

Problem behaviours and caregiver burden among children with Autism Spectrum Disorder in Kuching, Sarawak.

Objective: Caregivers of children with Autism Spectrum Disorder (ASD) often experience emotional and psychological distress, as well as disruptions to family life and employment due to the challenges of caring for children with ASD. This study examines the relationship between problem behaviours and caregiver burden among children with ASD. Method: A cross-sectional study using convenience sampling recruited 230 caregivers of children with ASD aged 4 to 18 years from selected autism centres in Kuching, Sarawak. The caregivers completed the Aberrant Behaviour Checklist-2 and the Zarit Burden Interview. Results: Univariate analysis revealed a significant difference in caregiver burden for children with ASD receiving medications (p = 0.013), registered with the Social Welfare Department (p = 0.036), and having siblings with ASD (p = 0.046). About 40% of the children exhibited at least one domain of problem behaviour. More than half of the caregivers (53.9%) experienced burden, with the majority experiencing mild burden. Positive associations were seen between irritability (r = 0.458, p < 0.01), social withdrawal (r = 0.439, p < 0.01), stereotypic behaviour (r = 0.392, p < 0.01), hyperactivity/non-compliance (r = 0.467, p < 0.01), and caregiver burden. Child factors, including the duration of problem behaviour (r = 0.182, p = 0.007), medication use (eta = 0.187, p = 0.005), Social Welfare Department registration (eta = 0.138, p = 0.036), and the presence of siblings with ASD (eta = 0.130, p = 0.046) were associated with caregiver burden. Multiple linear regression showed that hyperactivity/noncompliance significantly predicted caregiver burden. Conclusion: Specific problem behaviours in children with ASD were associated with caregiver burden. These results highlight the need for interventions for the child with ASD and their caregivers.

Epidemiology of Nasopharyngeal Carcinoma in Sarawak, East Malaysia.

OBJECTIVES: This analysis provides an epidemiological update for nasopharyngeal carcinomas the state of Sarawak and an analysis of the trend over a 20 years period. METHOD: Data between 1996 to 2015 from a population-based cancer registry in Sarawak Malaysia was analyzed. Crude incidence rates and age-standardized rates (ASR) were calculated and compared between ethnic groups and locations (administrative division) and Joinpoint regression analysis was done to analyze trends. RESULT: A total of 3643 cases of NPC were recorded with male to female ratio of 2.5:1. Annualised age-standardized incidence rates able 2) for men is 13.2 cases per 100,000 population (95% CI: 12.6, 13.7) and for women is 5.3 cases per 100,000 population (95% CI: 5.0, 5.6). The highest incidence rates were reported among the Bidayuh population and it ranks among the highest in the world. Trend analysis noted an overall reduction of cases, with a significant decrease between 1996 and 2003 (annual percentage reduction of incidence by 3.9%). Analysis of individual ethnic groups also shows a general reduction with exception of Iban males showing an average 5.48 per cent case increase between 2009 to 2015, though not statistically significant. CONCLUSION: Comparing the incidences with other registries, the Bidayuh population in Sarawak remained among the highest in the world and warrants close attention for early screening and prevention strategies.

The epidemiology of haematological cancers in Sarawak, Malaysia (1996 to 2015).

BACKGROUND: Published epidemiological studies of haematological cancers are few. Hereby we present a 20-year epidemiological data of haematological cancers in Sarawak from a population-based cancer registry. METHODS: Haematological cancer cases with ICD-10 coded C81-C96 and ICD-O coded /3 diagnosed from 1996 to 2015 were retrieved from Sarawak Cancer Registry. Adult was defined as those 15 years and above. Incidence rate (IR) was calculated based on yearly Sarawak citizen population stratified to age, gender, and ethnic groups. Age-standardised IR (ASR) was calculated using Segi World Standard Population. RESULTS: A total of 3,947 cases were retrieved and analysed. ASR was 10 and male predominance (IR ratio 1.32, 95%CI 1.24,1.41). Haematological cancers generally had a U-shaped distribution with lowest IR at age 10-14 years and exponential increment from age 40 years onwards, except acute lymphoblastic leukaemia (ALL) with highest IR in paediatric 2.8 versus adult 0.5. There was a significant difference in ethnic and specific categories of haematological cancers, of which, in general, Bidayuh (IR ratio 1.13, 95%CI 1.00, 1.27) and Melanau (IR ratio 0.54, 95%CI 0.45, 0.65) had the highest and lowest ethnic-specific IR, respectively, in comparison to Malay. The ASR (non-Hodgkin lymphoma, acute myeloid leukaemia, ALL, chronic myeloid leukaemia, and plasma cell neoplasm) showed a decreasing trend over the 20 years, -2.09 in general, while Hodgkin lymphoma showed an increasing trend of + 2.80. There was crude rate difference between the 11 administrative divisions of Sarawak. CONCLUSIONS: This study provided the IR and ASR of haematological cancers in Sarawak for comparison to other regions of the world. Ethnic diversity in Sarawak resulted in significant differences in IR and ASR.

Profiling the imported human malaria in Sarawak, Malaysia in 2011-2019.

OBJECTIVES: Malaysia has achieved the status of zero indigenous human malaria cases. Nevertheless, imported human malaria has increasingly been reported in Sarawak, Malaysian Borneo. As zoonotic malaria caused by Plasmodium knowlesi remains a major public health problem in Sarawak, the threat of imported malaria must be addressed as it can cause human malaria reintroduction, sustain transmission, and lead to complications. The objectives of this study were to investigate the epidemiological characteristics of imported malaria cases reported in Sarawak and to underline the challenge posed by imported malaria towards malaria elimination efforts. METHODS: Imported malaria cases reported in Sarawak from 2011 to 2019 were collected from Sarawak State Health Department and analysed in this longitudinal retrospective study. RESULTS: A total of 2058 imported malaria cases were registered in all districts in Sarawak. Highest number of cases were reported in Kapit (n = 559; 27.16%), followed by Sibu (n = 424; 20.6%), and Miri (n = 166; 8.07%). Based on the demographic profile, most of the patients constituted of either male sex (98.49%), age group of 40-49 years (39.6%), Iban ethnic (57.92%), worked in logging industry (88.58%), Malaysian nationals (91.84%), contracted malaria in Papua New Guinea (46.11%), uncomplicated disease (77.89%), or hospitalised cases (97.86%). The most prominent Plasmodium species diagnosed were P. vivax (52.67%) and P. falciparum (35.81%). CONCLUSIONS: Surveillance, disease detection, and medical follow-up must be carried out thoroughly for individuals who returned from malaria-endemic countries. It is also necessary to promote pre-travel preventive education as well as chemoprophylaxis to travellers heading to endemic areas.

Brain Tumor: A Review of Its Demographic in a Rural Hospital of Sibu in Sarawak, Malaysia.

According to World Health Organization's GLOBOCAN 2012 database, brain tumors account for about 2% of all cancers in Malaysia. It was ranked 11th and 13th most common cancer among males and females, respectively. This debilitating disease can cause a tremendous burden to patients and their families and healthcare services. The main objective of this study is to provide demographic data on the type of brain tumors and their distribution of age and gender from the cases presented to the neurosurgical department of a rural hospital in Sibu from 2018 to 2021. This is a retrospective study of the incidence and pattern of brain tumors admitted to the Neurosurgery Department in Sibu Hospital. Data were emanated from the brain tumor registry census from 2018 to 2021. Of all cases, only cases with confirmed histopathological results were included. Inoperable brain tumors that were diagnosed through radiological investigations were excluded. There were 230 patients with brain tumors included in this study. Males constituted 42.6% ( n = 98) of the cases, whereas 57.4% ( n = 132) of them were female. The brain tumor was the least common in the pediatric group (0 to 10 years old) with only 3.5% ( n = 8). The incidence of brain tumors increased with age and reached its peak in the age group of 51 to 60 years (34.8%). The commonest type of brain tumor was meningioma (38.7%), followed by a metastatic brain tumor (25.2%) and glioma (15.6%). Meningothelial WHO grade I was the most common variant that accounted for 67% ( n = 46) of all meningioma. Lung carcinoma was found to be the most common primary, accounting for more than half (69.0%) of the metastatic brain tumors, followed by breast cancer (10.3%), thyroid cancer (8.6%), female genital tract (8.6%), and malignant melanoma (3.5%). The crude incidence of the brain tumor in Sibu was 4.98 per 100,000 population/year. This study showed that the commonest brain tumor in central rural of Sarawak was meningioma, followed by metastatic brain tumor and glioma. Meningothelial is the most frequent subtype of meningioma, whereas lung carcinoma was the commonest primary in brain metastases. The peak age group was 51 to 60 years old, and females showed a higher incidence than males. This study provides a baseline profile of the brain tumor spectrum in rural Sarawak. More data should be collected to aid in future research and healthcare planning.

Prevalence of haemosporidia in Asian Glossy Starling with discovery of misbinding of Haemoproteus-specific primer to Plasmodium genera in Sarawak, Malaysian Borneo.

BACKGROUND: Plasmodium, Haemoproteus and Leucocytozoon are three mainly studied blood parasites known to cause malarial and pseudomalarial infections in avian worldwide. Although Sarawak is a biodiversity hotspot, molecular data on blood parasite diversity in birds are absent. The objective of the study is to determine the prevalence of blood parasite in Asian Glossy Starlings (AGS), an urban bird with high population density in Sarawak and to elucidate the phylogenetic relationship with other blood parasite. METHODS: Twenty-nine carcasses of juvenile AGS that were succumbed to death due to window collision were collected around the vicinity of Universiti Malaysia Sarawak. Nested-multiplex and nested PCR targeting the Cytochrome B gene were used to detect Plasmodium and Haemoproteus, and Leucocytozoon respectively. Two primer sets were used for Haemoproteus detection to increase detection sensitivity, with one being a genus-specific primer. RESULTS: Fourteen samples (prevalence rate: 48.28%) were found positive for avian Plasmodium. Phylogenetic analysis divided our sequences into five lineages, pFANTAIL01, pCOLL4, pACCBAD01, pALPSIS01 and pALPSIS02, with two lineages being novel. No Haemoproteus and Leucocytozoon was found in this study. However, Haemoproteus-specific primer used amplified our Plasmodium samples, making the primer non-specific to Haemoproteus only. CONCLUSION: This is the first blood parasite detection study on AGS using carcasses and blood clot as sample source in Sarawak. Due to the scarcity of longer sequences from regions with high genetic plasticity, usage of genus-specific primers should be validated with sequencing to ensure correct prevalence interpretation.

The dynamics of the microbiome in Ixodidae are shaped by tick ontogeny and pathogens in Sarawak, Malaysian Borneo.

Tick-borne diseases have recently been considered a potential emerging public health threat in Malaysia; however, fundamental studies into tick-borne pathogens and microbiome appear limited. In this study, six tick species (Ixodes granulatus, Haemaphysalis hystricis, Haemaphysalis shimoga, Dermacentor compactus, Dermacentor steini and Dermacentor atrosignatus) collected from two primary forests and an oil palm plantation in Sarawak, Malaysian Borneo, were used for microbiome analysis targeting bacterial 16S rDNA using next-generation sequencing (NGS). In addition, bacterial species were further characterized in conventional PCRs to identify potential pathogens. Sequences generated from NGS were first filtered with the Decontam package in R before subsequent microbial diversity analyses. Alpha and beta analyses revealed that the genus Dermacentor had the highest microbial diversity, and H. shimoga significantly differed in microbial composition from other tick species. Alpha and beta diversities were also significantly different between developmental stages of H. shimoga. Furthermore, we observed that some bacterial groups were significantly more abundant in certain tick species and developmental stages of H. shimoga. We tested the relative abundances using pairwise linear discriminant analysis effect size (LEfSe), which also revealed significant microbial composition differences between Borrelia-positive and Borrelia-negative I. granulatus ticks. Finally, pathogenic and potentially pathogenic bacteria circulating in different tick species, such as Rickettsia heilongjiangensis, Ehrlichia sp., Anaplasma sp. and Bartonella spp. were characterized by PCR and sequencing. Moreover, Coxiella and Francisella-like potential symbionts were identified from H. shimoga and D. steini, respectively. More studies are required to unravel the factors associated with the variations observed in this study.

Ethnobotanical study of medicinal plants used by the Kenyah community of Borneo.

ETHNOPHARMACOLOGICAL RELEVANCE: Sarawak is located in one of the world's most biodiverse regions and is home to more than 40 sub-ethnic groups that each have their own distinct culture, language and lifestyle. This has given rise to numerous, unique ethnobotanical systems. However, due to rapid urbanization, this traditional knowledge is at a risk of extinction. Yet, ethnobotanical studies in Sarawak are almost non-existent, especially among Orang Ulu communities like the Kenyah. AIM OF STUDY: Therefore, this study was conducted to document the ethnomedicinal knowledge of the Kenyah community. The main objectives of this study are: 1) To determine and document the diversity of medicinal plants used by the Kenyah community, 2) To determine whether the availability of modern medicine has affected Kenyah traditional medicine, and 3) To identify plants which have not been previously cited or used for previously unreported medical uses. MATERIALS AND METHODS: We conducted repeated interviews and field surveys at the Asap-Koyan Resettlement Area, Belaga Sarawak. A total of 24 respondents from four Kenyah longhouses were interviewed in this study. Individuals possessing extensive traditional medicinal knowledge were identified via preliminary interviews or by viva voce. Translators were employed to ensure that there was no miscommunication. The results were evaluated based on the plant's total use-reports and number of respondents citing the plant. The data was also evaluated based on use-reports by ailment category. RESULTS: Over 95% of the respondents were 40 years and older (58.21 years old ± 11.21). This was due to the younger members of the community (40 years old and below) admitting that they had almost no knowledge regarding traditional medicine, as they preferred relying on modern medicine. A total of 61 plant species were mentioned by the 24 respondents Seven plants had five or more respondents citing it, which was more than 20% of the respondents. These plants were Piper betle, Homalomena cordata, Senna alata, Annona muricata, Derris elliptica, Blumea balsamifera and Coscinium fenestratum. CONCLUSION: Almost all of the cited plants had been previously recorded to be used in either Ayurvedic, Chinese herbal medicine, Malay traditional medicine or other Asian ethnomedicinal systems. However, there were four highly cited species that were used for treatments that were scarcely reported in past literature. These were piper betle (used by Kenyah to treat fever), Sauropus andrognus (used by Kenyah to treat fever), Derris elliptica (used by Kenyah to treat fever and influenza) and Coscinuim fenestratum (used by Kenyah to treat toxic effects from non-medical substances).

Genotype and organ effect on the occupancy of phyllosphere prokaryotes in different rice landraces.

Bacteria community provides essential ecological services to rice plants. The bacterial diversity of rice varies across host plant genotype and organs. This study employed 16S rDNA amplicon sequencing to characterise the bacterial community associated with three rice landraces using leaf blade and stem samples. The prokaryotic community found in these rice landraces comprised of two kingdoms, 12 phyla, 25 classes, 40 orders, 80 families, and 118 genera. Proteobacteria (53.9%) was the most abundant phylum. The most abundant genus was an undefined genus under Cyanobacteria (33.0%). Homogeneity of prokaryotic community was observed across the three rice landraces, which may suggest a high similarity in biological and genetical properties of the rice landraces. The difference in prokaryotic composition between leaf blade and stem was depicted based on principal coordinate analysis. This study observed that the prokaryotic inhabitants in rice plants is predominantly determined by rice plant organs.

Detection of a Babesia sp. genotype closely related to marsupial-associated Babesia spp. in male Haemaphysalis shimoga from Sarawak, Malaysian Borneo.

In this study, Babesia screening was conducted in 55 rodents and 160 tick samples collected from primary forests and an oil palm plantation in Sarawak, Malaysian Borneo. PCR targeting the 18S ribosomal DNA revealed the presence of Babesia spp. DNA detected in two questing male Haemaphysalis shimoga ticks collected from the oil palm plantation. Sequence analysis revealed that both sequences were identical and had 98.6% identity to a Babesia macropus sequence obtained from Eastern grey kangaroos (Macropus giganteus) in Australia. Phylogenetic tree revealed clustering with marsupial-associated Babesia spp. in the Babesia sensu stricto clade. Whether or not H. shimoga is the competent vector and the importance of the Babesia sp. detected in this study warrants more investigation.

Epidemiology of indigenous Plasmodium knowlesi infection in Sarawak, 2011-2019.

OBJECTIVES: To characterise the state-wide epidemiology of indigenous knowlesi malaria in Sarawak from 2011 to 2019. METHODS: Longitudinal retrospective study was conducted based on Sarawak knowlesi malaria surveillance data recorded from 2011-2019. Only indigenous cases were included and information extracted for analysis comprised age, sex, occupation, ethnicity, case severity, hospital admission and parasite density. RESULTS: Over the 9 years, 8473 indigenous knowlesi malaria cases were recorded. Age group 40-49 years, males, plantation workers and Iban communities recorded the highest percentage of cases in each demographic variable. Most of the cases were uncomplicated (n = 7292; 86.1%) and 89.6% (n = 7589) of the total cases were reported with ≤20 000 parasites/µl of blood. Age group and ethnic group are associated with the severity of knowlesi malaria in Sarawak. Multivariable logistic regression indicated that the age group 60+ years had the highest odds of developing severe knowlesi malaria compared with other age groups (AOR 2.48; 95% CI 1.22, 5.02; p = 0.012). Bidayuh patients were more likely to develop severe knowlesi malaria than Ibans, the largest ethnic group among knowlesi malaria patients (AOR 1.97; 95% CI 1.31, 2.97; p = 0.001). CONCLUSIONS: Identification of risk groups is important for the implementation of prevention programs and treatments targeting at specific group to combat knowlesi malaria effectively.

A 10-Year Impact Evaluation of the Universal Salt Iodization (USI) Intervention in Sarawak, Malaysia, 2008-2018.

A universal salt iodization (USI) was introduced in Sarawak, Malaysia in 2008 to control the iodine deficiency disorders (IDD) among its population. The purpose of this study is to evaluate the impact of the USI among school children in Sarawak after 10 years of implementation. The data were extracted from 2008 and 2018 Sarawak state-wide IDD surveys. Briefly, both surveys were cross-sectional surveys covering information on the socio-demographic, status of goitre, urinary iodine, and the amount of iodine in the salt samples. A total of 1104 and 988 between the ages of 8 and 10 were involved in the 2008 and 2018 surveys, respectively. The overall prevalence of goitre among the school children in Sarawak was significantly lower in 2018 (0.1%) compared to 2008 (2.9%). The median urinary iodine concentration (UIC) in urine samples had risen significantly from 102.1 µg/L in 2008 to 126.0 µg/L in 2018. In terms of iodine content in salt samples, the median concentration improved significantly in 2018 (35.5 µg/L) compared to 2008 (14.7 µg/L). After 10 years of USI implementation in Sarawak, the results from both surveys confirmed the effectiveness of mandatory USI in increasing the nutritional iodine status of school children in Sarawak.

Access to essential surgical care in district hospitals of Sarawak Malaysia: outcomes of an audit and the need for urgent attention.

BACKGROUND: Since access to essential surgical care (ESC) in rural Sarawak, Malaysia, remains subpar, this study aimed to identify pitfalls in its ESC delivery and possible solutions to improve it. METHODS: This cross-sectional study was undertaken in the Sarawak General Hospital between January 2019 and December 2019. It assessed the caseload of five essential surgical procedures referred from nearby district hospitals. It analysed the number of patients stranded in the accident and emergency department, their waiting time for ward transfer and the duration between admission day and timing of surgery for patients with appendicitis. RESULTS: There were 259 referrals for one of the five essential surgical procedures. The baseline characteristics between the referred and the local cohorts of patients for the designated procedures were comparable in terms of gender (P = 0.486), body mass index (P = 0.598) and ASA score (P = 0.284), with the exceptions being that the referred cohorts were older (43.2 vs. 39.7, P = 0.008) and with different racial composition (p < 0.001). The mean number of patients stranded in emergency department was 34.2 ± 4.9 per day and the mean bed waiting time was 21.4 ± 6.3 h. For patients who required appendicectomy, 70.8% of patients had surgery performed within 24 h of admission. CONCLUSION: The delivery of ESC in Sarawak's district hospitals demands urgent attention for improvement. The action framework proposed outlined six priorities: infrastructure development, service delivery, surgical training, finance, information management and governance.

On the prediction of methane fluxes from pristine tropical peatland in Sarawak: application of a denitrification-decomposition (DNDC) model.

Tropical peatlands have high potential function as a major source of atmospheric methane (CH4) and can contribute to global warming due to their large soil carbon stock, high groundwater level (GWL), high humidity and high temperature. In this study, a process-based denitrification-decomposition (DNDC) model was used to simulate CH4 fluxes in a pristine tropical peatland in Sarawak. To test the accuracy of the model, eddy covariance tower datasets were compared. The model was validated for the year 2014, which showed the good performance of the model for simulating CH4 emissions. The monthly predictive ability of the model was better than the daily predictive ability, with a determination coefficient (R2) of 0.67, model error (ME) of 2.47, root mean square error (RMSE) of 3.33, mean absolute error (MAE) of 2.92 and mean square error (MSE) of 11.08. The simulated years of 2015 and 2016 showed the good performance of the DNDC model, although under- and overestimations were found during the drier and rainy months. Similarly, the monthly simulations for the year were better than the daily simulations for the year, showing good correlations at R2 at 0.84 (2015) and 0.87 (2016). Better statistical performance in terms of monthly ME, RMSE, MAE and MSE at - 0.11, 3.38, 3.05 and 11.45 for 2015 and - 1.14, 5.28, 4.93 and 27.83 for 2016, respectively, was also observed. Although the statistical performance of the model simulation for daily average CH4 fluxes was lower than that of the monthly average, we found that the results for total fluxes agreed well between the observed and the simulated values (E = 6.79% and difference = 3.3%). Principal component analysis (PCA) showed that CH4, GWL and rainfall were correlated with each other and explained 41.7% of the total variation. GWL was found to be relatively important in determining the CH4 fluxes in the naturally inundated pristine tropical peatland. These results suggest that GWL is an essential input variable for the DNDC model for predicting CH4 fluxes from the pristine tropical peatland in Sarawak on a monthly basis.

Trend analysis of anthropogenic activities affecting trace metals deposition in core sediments from the coastal and four rivers estuary of Sarawak, Malaysia.

This study reports the concentrations of trace metals in core sediments profile from the coastal and four rivers estuary in the Kuching Division of Sarawak, Malaysia, and the controlling mechanisms influencing their availability in sediments of the studied area. The bonding of trace metals with non-mobile fractions was confirmed with the sequential extraction. Inductively coupled plasma-optical emission spectroscopy (ICP-OES) was used to measure the concentrations of the trace metals. Granulometric analyses were performed using normalized sieve apertures to determine the textural characteristics of the sediments. Enrichment factor was used to evaluate the level of metal enrichment. Heavy metals concentrations in sediment samples varied in the range: Pb (8.9-188.9 mg/kg d.w.), Zn (19.4-431.8 mg/kg d.w.), Cd (0.014-0.061 mg/kg d.w.), Ni (6.6-33.4 mg/kg d.w.), Mn (2.4-16.8 mg/kg d.w.), Cu (9.4-133.3 mg/kg d.w.), Ba (1.3-9.9 mg/kg d.w.), As (0.4-7.9 mg/kg d.w.), Co (0.9-5.1 mg/kg d.w.), Cr (1.4-7.8 mg/kg d.w.), Mg (68.8-499.3 mg/kg d.w.), Ca (11.3-64.9 mg/kg d.w.), Al (24.7-141.7 mg/kg d.w.), Na (8.8-29.4 mg/kg d.w.), and Fe (12,011-35,124.6 mg/kg d.w.). The estimated results of the enrichment factor suggested enrichments of Pb, Zn, and Cu in all the core sediment samples and depths at all sites. The other trace metals showed no enrichments in almost all the sampled stations. Continuous accumulation of Pb, Zn, and Cu metals over a period can be detrimental to living organisms and the ecology. The results obtained from the statistical analyses suggested that the deposition of trace metals in the studied sites is due to anthropogenic inputs from the adjacent land-based sources.

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.

Ecological surveillance of bat coronaviruses in Sarawak, Malaysian Borneo.

OBJECTIVE: Coronaviruses (CoVs) are natural commensals of bats. Two subgenera, namely Sarbecoviruses and Merbecoviruses have a high zoonotic potential and have been associated with three separate spillover events in the past 2 decades, making surveillance of bat-CoVs crucial for the prevention of the next epidemic. The study was aimed to elucidate the presence of coronavirus in fresh bat guano sampled from Wind Cave Nature Reserve (WCNR) in Sarawak, Malaysian Borneo. Samples collected were placed into viral transport medium, transported on ice within the collection day, and preserved at - 80 °C. Nucleic acid was extracted using the column method and screened using consensus PCR primers targeting the RNA-dependent RNA polymerase (RdRp) gene. Amplicons were sequenced bidirectionally using the Sanger method. Phylogenetic tree with maximum-likelihood bootstrap and Bayesian posterior probability were constructed. RESULTS: CoV-RNA was detected in ten specimens (47.6%, n = 21). Six alphacoronavirus and four betacoronaviruses were identified. The bat-CoVs can be phylogenetically grouped into four novel clades which are closely related to Decacovirus-1 and Decacovirus-2, Sarbecovirus, and an unclassified CoV. CoVs lineages unique to the Island of Borneo were discovered in Sarawak, Malaysia, with one of them closely related to Sarbecovirus. All of them are distant from currently known human coronaviruses.