Publications by authors named "Mohd Nazri Shafei"

22 Publications

  • Page 1 of 1

Perceived Severity and Susceptibility towards Leptospirosis Infection in Malaysia.

Int J Environ Res Public Health 2020 09 1;17(17). Epub 2020 Sep 1.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia.

Background: Perceived severity and susceptibility refers to one's belief of the seriousness and the risk of contracting a specific disease. It is an essential study in public health as it assists in the understanding of the motivating factors towards disease prevention. This qualitative study aimed to explore perceived severity and susceptibility towards leptospirosis infection among respondents in two states of Malaysia.

Methods: Focus group discussions using the phenomenology approach was conducted involving 72 respondents in Selangor and Kelantan. Data were examined using content analysis.

Results: Respondents perceived leptospirosis infection as severe due to its poor disease prognosis and complications. However, some rated it less severe when compared with other chronic diseases such as cancer and AIDS. Their perceptions were influenced by their knowledge about the disease, media portrayal and frequency of health campaigns by the government. All respondents believed they were not susceptible to the disease.

Conclusion: The low perceived susceptibility of leptospirosis infection is a matter of concern as it may contribute to respondents' lack of motivation towards preventing the disease. The study findings may provide the basis for health promotional activities designed to heighten public perceived threat towards leptospirosis infection and thereby improving preventive health behaviors for avoiding leptospirosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17176362DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503329PMC
September 2020

Interactive Low Back Pain Intervention Module Based on the Back School Program: A Cluster-Randomized Experimental Study Evaluating Its Effectiveness among Nurses in Public Hospitals.

Int J Environ Res Public Health 2020 08 14;17(16). Epub 2020 Aug 14.

Units of Biostatistics and Research Methodology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia.

The prevalence of low back pain (LBP) among nurses is high. The main aim of this study was to evaluate the effectiveness of an interactive LBP module based on the Back School Program in improving Oswestry Disability Scores (ODSs) among nurses in government hospitals in Penang, Malaysia. A cluster-randomized experimental study was conducted within four public hospitals. These hospitals were randomized to intervention and control groups. A total of 284 nurses from the selected hospitals were randomly selected (142 in each group). An interactive LBP intervention module based on the Back School Program was designed and prescribed. Both the intervention and control groups were assessed using the Oswestry Disability Questionnaire at baseline and at the end of the third and sixth weeks. Out of 284 participants, 281 completed this study. A between-group comparison revealed that ODSs were significantly lower in the intervention group than in the control group at the ends of the third ( = 0.006) and sixth weeks ( < 0.001). Within-group changes revealed a significant reduction in ODSs within the intervention group from baseline to the third ( < 0.001) and sixth weeks ( < 0.001) of the intervention. This simple interactive LBP module was effective in reducing symptoms of LBP among nurses as early as three weeks, and this effect was sustained until the sixth week of the intervention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17165916DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460316PMC
August 2020

Psychometric Properties of the Decisional Balance Scale: A Confirmatory Study on Malaysian University Students.

Int J Environ Res Public Health 2020 04 16;17(8). Epub 2020 Apr 16.

Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.

Decisional balance (DB) is the perceived positive aspects (advantages) and negative aspects (disadvantages) that are associated with behavioural change. Behavioural change is dependent on an individual's thoughts after considering the advantages of engaging in exercise. When the benefits exceed the barriers, people are more likely to make changes after cognitively evaluating the functional aspects. The purpose of the present study is to determine the validity and reliability of the DB scale among Malaysian university students using a confirmatory factor analysis (CFA). A cross-sectional study was carried out among students who took part in the co-curricular program. By using the purposive sampling method, students were recruited and given written informed consent forms after acknowledging they understood the purpose of the study. The DB scale, which consists of two factors, namely, advantages and disadvantages, was used as the instrument in the study. The advantages referred to the benefits of participating in exercise, whereas the disadvantages referred to the barriers to exercise. The 10-item, self-administered questionnaires were distributed to participating students. Data were analysed using Mplus 8 for the CFA. A total of 562 students (females = 444, males = 118) with a mean age of 19.81 years ( = 1.22) participated in the study. Most of the students were engaged in regular physical activity for at least three exercise sessions (mean = 2.62) per week, and the average duration per session was 43 minutes. The hypothesised measurement model of DB did not fit the data well; thus, the measurement model was re-specified. The final measurement model fit the data well (comparative fit index (CFI) = 0.960, Tucker-Lewis index (TLI) = 0.943, standardised root mean square residual (SRMR) = 0.055, root mean square error of approximation (RMSEA) (90% confidence interval (CI)) = 0.061 (0.047, 0.074), RMSEA -value = 0.096). The composite reliability values of 0.757 for the advantages and 0.792 for the disadvantages were acceptable. The 10-item DB scale with two factors displayed a good model fit for the data with good scale reliability. This could be beneficial for Malaysian undergraduate students in making decisions before engaging in physical activity. The benefits of, and barriers to, exercise could be an important component that affects their decision making.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17082748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215421PMC
April 2020

Modelling the prognostic effect of glucose and lipid profiles on stroke recurrence in Malaysia: an event-history analysis.

PeerJ 2020 14;8:e8378. Epub 2020 Feb 14.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Background: Diabetes and dyslipidemia are significantly associated with stroke recurrence, yet the evidence for this relationship is conflicting. Consequently, the parameters in the glucose and lipid profiles may inform us regarding their relationship with stroke recurrence, thus enhancing the physicians' clinical decision-making.

Aim: This study sought to investigate whether glucose and lipid profiles could prognosticate stroke recurrence in Malaysia.

Methods: We conducted a retrospective hospital-based study where we analyzed the first-ever stroke cases regarding about which the Malaysia National Stroke Registry was informed between 2009 and 2017, that fulfilled this study's criteria, and that were followed for stroke recurrence. Using the Cox proportional hazard regression analysis, we estimated the adjusted hazard ratios (HRs), which reflected the prognostic effect of the primary variables (i.e., glucose and lipid profiles on the first-stroke admission) on stroke recurrence.

Results: Among the 8,576 first-ever stroke patients, 394 (4.6%) experienced a subsequent first stroke recurrence event. The prognostic effect measured by univariable Cox regression showed that, when unadjusted, ten variables have prognostic value with regards to stroke recurrence. A multivariable regression analysis revealed that glucose was not a significant prognostic factor (adjusted HR 1.28; 95% CI [1.00-1.65]), while triglyceride level was the only parameter in the lipid profile found to have an independent prognostication concerning stroke recurrence (adjusted HR: 1.28 to 1.36).

Conclusions: Triglyceride could independently prognosticate stroke recurrence, which suggests the role of physicians in intervening hypertriglyceridemia. In line with previous recommendations, we call for further investigations in first-ever stroke patients with impaired glucose and lipid profiles and suggest a need for interventions in these patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7717/peerj.8378DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025698PMC
February 2020

Low Back Pain and Its Associated Factors among Nurses in Public Hospitals of Penang, Malaysia.

Int J Environ Res Public Health 2019 11 1;16(21). Epub 2019 Nov 1.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia.

Objectives: To determine the prevalence of low back pain (LBP) and its associated factors among the nurses working in the public hospitals of Penang, Malaysia.

Methods: A cross-sectional study was conducted on nurses, aged 25-60 years, who had been working for at least three months at six public hospitals of Penang. A proportionate stratified random sampling method was applied to select 1292 respondents. The Malay-validated BACKS Tool questionnaire using a 5-point Likert scale was used to obtain data. Simple and multiple logistic regression analyses were performed.

Results: A total of 989 (76.5%) nurses suffered from LBP at a point of time. The factors significantly associated with LBP among the nurses included working more than seven hours [adjusted odds ratio (AOR) (95% confidence interval (CI)) 1.48 (1.06, 1.98)], twisting of the body while working [AOR (95% CI) 1.60 (1.13, 2.26)], manual handling of patients in wards [AOR (95% CI) 1.44 (1.08, 2.07)], and fatigue [AOR (95% CI) 2.63 (1.94, 3.58)].

Conclusion: The prevalence of LBP among the nurses in the public hospitals of Penang was relatively high. The factors predicting LBP included working more than seven hours a day, twisting of the body while working, manual handling, and fatigue. The findings from this study may better enable policymakers to devote resources to minimize low back pain among nurses. The nurses should be encouraged to comply with safe working procedures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph16214254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861894PMC
November 2019

Leptospirosis and its prevention: knowledge, attitude and practice of urban community in Selangor, Malaysia.

BMC Public Health 2019 May 22;19(1):628. Epub 2019 May 22.

Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.

Background: Leptospirosis is still endemic in Malaysia and has been prevalent in Selangor where cases have been underreported. Primarily, this was due to lack of awareness in the urban community in this region. This study determined the knowledge, attitude and preventive practice (KAP) of leptospirosis, and identified the significant predictors influencing KAP among urban community in Hulu Langat, Selangor.

Methods: This cross-sectional study was conducted from 2015 to 2017 using validated questionnaire. Sampling methods included multistage cluster sampling, followed by simple random sampling to obtain 315 respondents. Descriptive analysis was performed to determine the KAP while χ and the subsequent logistic regression analysis were carried out to identify associations and predictors between variables.

Results: Respondents were mainly Malaysian Bumiputra with a mean (Standard Deviation (SD)) age of 32.5 (13.0) years. Of 315 respondents, 80.3% (n = 253) had poor knowledge, 87.0% (n = 274) had good attitude, and 81.3% (n = 256) showed unacceptable practice towards leptospirosis and its prevention. Regression analysis identified age as the sole predictor influencing good knowledge (AOR 2.388; 95% CI = 1.298, 4.396; p = 0.005). Education level (AOR 2.197; 95% CI = 1.109, 4.352; p = 0.024) was also noted as the significant predictor influencing the overall practice.

Conclusions: The urban community in Selangor showed a positive attitude in waste management despite having little knowledge regarding the disease itself. The study also discovered inadequacy in preventive practice, hence marking the importance of the proper integration of knowledge and attitude into forming an acceptable practice to reduce transmission of Leptospira among urban population in Malaysia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-019-6981-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532156PMC
May 2019

Trends in stroke outcomes at hospital discharge in first-ever stroke patients: Observations from the Malaysia National Stroke Registry (2009-2017).

J Neurol Sci 2019 Jun 11;401:130-135. Epub 2019 Apr 11.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia. Electronic address:

Background: Stroke outcomes could be a quality indicator across the continuum of care and inform stroke management policymaking. However, this topic has rarely to date been studied directly.

Aims: We sought to investigate recent trends in stroke outcomes at hospital discharge among first-ever stroke patients.

Methods: This was an analysis of data from the Malaysia National Stroke Registry. Patients aged 18 years or older documented as having a first episode of stroke in the registry were recruited. Subsequently, the comparison of proportions for overall and sex-specific stroke outcomes between years (from 2009 to 2017) was conducted. The primary outcome was modified Rankin Scale score, which was assessed at hospital discharge, and each patient was categorized as follows: 1) functional independence, 2) functional dependence, or 3) death for analysis.

Results: This study included 9361 first-ever stroke patients. Approximately 36.2% (3369) were discharged in an independence state, 53.1% (4945) experienced functional dependence, and 10.8% (1006) patients died at the time of hospital discharge. The percentage of patients who were discharged independently increased from 23.3% in 2009 to 46.5% in 2017, while that of patients discharged in a disabled state fell from 56.0% in 2009 to 45.6% in 2017. The percentage of death at discharge was reduced from 20.7% in 2009 to 7.8% in 2017. These findings suggest that the proportions of stroke outcomes at hospital discharge have changed significantly over time (p < 0.001), and there was a significant sex-related difference in stroke outcomes at hospital discharge following first stroke episode (p < 0.001).

Conclusions: Our data indicate there has been a significant change in stroke outcomes over the past nine years in Malaysia. This information ought to be considered in ongoing efforts of tertiary stroke prevention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jns.2019.04.015DOI Listing
June 2019

Reply to Comments on the Study "The Sensitivity, Specificity and Accuracy of Warning Signs in Predicting Severe Dengue, the Severe Dengue Prevalence and its Associated Factors".

Int J Environ Res Public Health 2019 04 17;16(8). Epub 2019 Apr 17.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia.

Thank you for the comments received on the article "The Sensitivity, Specificity and Accuracy of Warning Signs in Predicting Severe Dengue, the Severe Dengue Prevalence and its Associated Factors" [...].
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph16081380DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518230PMC
April 2019

Co-Curricular Activities and Motives for Participating in Physical Activity among Health Sciences Students at Universiti Sains Malaysia, Malaysia.

Malays J Med Sci 2019 Jan 28;26(1):138-146. Epub 2019 Feb 28.

Institute for Sport, Exercise and Active Living, College of Sport and Exercise Science, Victoria University, Melbourne, Victoria, Australia.

Background: The purpose of the study was to compare the motives for participating in physical activity (PA) through the different types of co-curricular activities chosen by health sciences undergraduate students at Universiti Sains Malaysia (USM), Malaysia.

Methods: The participants were university students at USM's Health Campus, who were invited to volunteer and complete two measures: a demographic form, including the types of co-curricular activities in which the students chose to enrol (sports, uniform and art), and the Physical Activity and Leisure Motivation Scale (PALMS).

Results: A total of 588 university students (female = 79.1%, male = 20.9%) with a mean age of 19.77 (SD = 1.39) participated in the study. The results showed significant differences in the motives of affiliation ( < 0.001), appearance ( = 0.008) and physical condition ( = 0.010) across the types of co-curricular activities in which the students participated. The students who enrolled in sports generally showed higher motives of affiliation, appearance and physical condition for participating in PA than other types of co-curricular activities.

Conclusion: The study findings can provide further insights into the motives for participating in PA among health sciences students and encouragement for students to integrate PA into their daily routines.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21315/mjms2019.26.1.13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419877PMC
January 2019

Reliability of Telephone Interview for Assessment of Long-Term Stroke Outcomes: Evidence from Interrater Analysis.

Neuroepidemiology 2019 21;52(3-4):214-219. Epub 2019 Feb 21.

Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia,

Background: A comprehensive evaluation of interrater reliability is crucial when it comes to multiple coders assessing the stroke outcomes using telephone interview. The reliability between telephone raters is important, as it could affect the accuracy of the findings published.

Objective: This study aimed to establish the interrater reliability between multiple telephone interviewers when assessing long-term stroke outcomes.

Methods: Patients alive at discharge selected in a retrospective cohort stroke project were recruited in this study. Their contact numbers were obtained from the medical record unit. The patients and/or proxies were interviewed based on a standardized script in Malay or English. Stroke outcomes assessed were modified Rankin Scale (mRS) and Barthel Index (BI) at 1-year post discharge. Fully crossed design was applied and 3 assessors collected the data simultaneously. Data was analysed using the software R version 3.4.4.

Results: Out of 207 subjects recruited, 132 stroke survivors at the time of interview were analysed. We found a significant excellent interrater reliability between telephone interviewers assessing BI, with intraclass correlation coefficient at 0.996 (95% CI 0.995-0.997). Whereas substantial agreement between the telephone interviewers was revealed in assessing mRS, with Fleiss', Conger's and Light's Kappa statistics reporting 0.719 and the Nelson's model-based κm kappa statistic reporting 0.689 (95% CI 0.667-0.711).

Conclusion: It is reliable to get multiple raters in assessing mRS and BI using the telephone system. It is worthwhile to make use of a telephone interview to update clinicians on their acute clinical management towards long-term stroke prognosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000497238DOI Listing
December 2019

The Effectiveness of a Voice Care Program Among Primary School Teachers in Northeastern Malaysia.

Oman Med J 2019 Jan;34(1):49-55

Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia.

Objectives: We sought to determine the effectiveness of a voice care program among primary school teachers in a northeastern district in Malaysia.

Methods: We conducted a randomized community trial in eight primary schools in a northeastern district in Malaysia. The self-administered and validated Malay-Voice Handicap Index-10 (M-VHI-10) questionnaire was used to assess overall voice handicap scores pre-intervention and eight weeks post-intervention. Teachers with a score of five or more (n = 86) were randomized into intervention (n = 41) and control groups (n = 45). The intervention group received portable voice amplifiers and vocal hygiene instruction, which was delivered by lectures and a booklet. The control group was not prescribed any intervention.

Results: The sociodemographic, lifestyle, and occupational characteristics of the teachers (except maximum number of students per class) were similar between both groups. The baseline M-VHI-10 scores between both groups were also comparable. After the intervention phase, there was a significant effect observed in the total M-VHI-10 scores ( 0.021, F-stat (df): 5.33 (1,79)) between both groups after controlling for the maximum number of students per class.

Conclusions: Our results support the use of voice amplification in adjunct with vocal hygiene instruction as a prevention and treatment modality to reduce voice handicap among teachers. Our study demonstrated encouraging evidence on the low-cost voice care program as well as the success of group and workplace-based approaches in the school setting.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5001/omj.2019.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330182PMC
January 2019

Seroprevalence and distribution of leptospirosis serovars among wet market workers in northeastern, Malaysia: a cross sectional study.

BMC Infect Dis 2018 Nov 14;18(1):569. Epub 2018 Nov 14.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.

Background: Leptospirosis is a zoonotic disease associated with occupations which exposed workers to environments contaminated with urine of infected animals. The objective of this study was to determine the seroprevalence of leptospirosis among wet market workers in Kelantan.

Methods: A cross sectional study was conducted in two main wet markets in Kelantan and 232 wet market workers were randomly selected. Blood samples were analysed for microscopic agglutination test (MAT) against 20 live leptospirosis reference serovars. MAT titres of 1:100 or more were considered as seropositive.

Results: It was found that the overall seroprevalence for leptospirosis among the respondents was 33.6% (95% CI = 27.5, 39.7). The samples were tested positive against serovars Melaka (IMR LEP 1), Terengganu (IMR LEP 115), Sarawak (IMR LEP 175), Copenhageni (IMR LEP 803/11), Hardjobovis (IMR LEP 27), Australis, Autumnalis, Bataviae, Canicola, Grippotyphosa, Hardjoprajitno, Icterohaemorrhagiae, Javanica, Pyrogenes, Terrasovi, Djasiman, Patoc and Pomona. The predominant serovars was Autumnalis (18.2%).

Conclusion: Wet markets workers were at risk for leptospirosis infection evidenced by high seroprevalence of leptospirosis in this study. Further research need to be conducted to determine factors that favours infection in this groups.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12879-018-3470-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236877PMC
November 2018

Economic benefit of leptospirosis prevention in Kelantan, Malaysia: Willingness-to-contribute approach.

Int J Health Plann Manage 2019 Jan 25;34(1):e817-e823. Epub 2018 Oct 25.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.

Leptospirosis is an endemic disease in Malaysia. Despite the increasing incidence rate, knowledge on the economic assessment of preventing leptospirosis is still limited. This paper introduces the willingness-to-contribute (WTC) method for estimating the economic benefit of preventing leptospirosis. A cross-sectional study using the WTC method was applied to measure how much time respondents in Kelantan were willing to contribute toward preventing leptospirosis. Study respondents were wet market traders aged 18 years old and above who were fluent in the Malay language. The average WTC value was multiplied by the population of Kelantan to derive the monetary value of preventing leptospirosis. Two hundred and fifty respondents participated in the study. The mean time contribution was 6.68 hours (SD9.01) per month. The average WTC corresponded to a monthly cost savings of US$4.94 per person. Approximately between US$106.7 million to US$315 million per annum can be saved through the prevention of leptospirosis in Kelantan. Preventing leptospirosis is beneficial to Kelantan and would bring major economic savings. The findings are intended to help policy makers in the planning and management of leptospirosis policies and interventions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/hpm.2696DOI Listing
January 2019

The Sensitivity, Specificity and Accuracy of Warning Signs in Predicting Severe Dengue, the Severe Dengue Prevalence and Its Associated Factors.

Int J Environ Res Public Health 2018 09 15;15(9). Epub 2018 Sep 15.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia.

To study Malaysian dengue clinical practice guideline (CPG) warning signs (WS) in predicting severe dengue (SD) and its associated factors among confirmed cases presented to a teaching hospital in north-eastern Malaysia in 2014. A cross-sectional study was performed in February 2015 using secondary data acquired from the hospital records. There were 2607 confirmed dengue cases presented to Hospital Universiti Sains Malaysia (HUSM) in 2014. Seven hundred patients were selected after proportionate stratified random sampling conducted according to the number of cases in 12 different months in 2014. Data were collected and analysed using SPSS version 22.0. Severe dengue outcomes represented 4.9% of cases. The prevalence of any of WS in SD was 91.2%. The most common WSs prior to SD were persistent vomiting (55.9%), and abdominal pain/tenderness (52.9%). The most sensitive warning sign in detecting SD was abdominal pain (59%). Specificity of individual WS were generally good, especially of clinical fluid accumulation (99%), hepatomegaly (98%) and mucosal bleeding (93%). Factors associated with SD were persistent vomiting (Adjusted odds ratio (aOR)): 2.41), mucosal bleeding (aOR: 4.73) and haematocrit rise with rapid platelet drop (aOR: 2.74). A focus on sensitivity, specificity, predictive values and association of a number of particular WS should be emphasized in order to better predict severe dengue outcomes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph15092018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163319PMC
September 2018

A qualitative exploration of the misconceptions, knowledge gaps and constructs of leptospirosis among rural and urban communities in Malaysia.

PLoS One 2018 18;13(7):e0200871. Epub 2018 Jul 18.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

This qualitative study aimed to explore the misconceptions, knowledge gaps and constructs of leptospirosis among 72 respondents from rural and urban districts in two states of Malaysia. We conducted focus group discussions and data were examined using thematic analyses. The layman term of 'rat urine disease' contributed the most to the misconceptions regarding leptospirosis. There were gaps in the knowledge among urban and rural respondents in the two states, with the majority of subjects demonstrating a poor understanding of the disease. Construction of knowledge about leptospirosis relied mostly on the information provided by mass and social media; reading materials; word-of-mouth publicity; observations; experiences; and knowledge sharing among families, friends, and communities. The study findings may provide the foundation for the development of educational materials that may reduce the gaps in knowledge, and thereby improve health literacy and enhance preventive health behaviours for avoiding leptospirosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200871PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051666PMC
January 2019

Leptospirosis Health Intervention Module Effect on Knowledge, Attitude, Belief, and Practice among Wet Market Workers in Northeastern Malaysia: An Intervention Study.

Int J Environ Res Public Health 2018 07 3;15(7). Epub 2018 Jul 3.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia.

Leptospirosis is an infectious disease which can be prevented by increasing awareness and promoting preventive health behaviours among high risk groups including wet market workers. Thus, the aim of this study was to determine the effectiveness of Leptospirosis Health Intervention Program (LHIP) in improving knowledge, attitude, belief and practice towards leptospirosis among wet market workers in Kelantan. This intervention study was conducted in two main wet markets in Kelantan involving 116 participants in each control and intervention groups. The health education intervention was based on Leptospirosis Health Intervention Module. The knowledge, attitude, belief and practice scores were measured before and six weeks after the intervention to examine the effect of the program. The results showed that knowledge ( < 0.001), attitude ( = 0.001), belief ( < 0.001) and practice ( < 0.001) scores changes were significantly higher in the intervention group compared to the control group. The adjusted mean differences were 12.93 (95% CI: 8.47, 17.39) for knowledge, 5.55 (95% CI: 2.28, 8.81) for attitude, 7.21 (95% CI: 3.43, 10.99) for belief and 7.35 (95% CI: 3.64, 11.05) for practice scores. Leptospirosis Health Intervention Program was an effective health educational tools to improve awareness and preventive behaviours among risk groups such as wet market workers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph15071396DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069487PMC
July 2018

Low Levels of Knowledge, Attitudes and Preventive Practices on Leptospirosis among a Rural Community in Hulu Langat District, Selangor, Malaysia.

Int J Environ Res Public Health 2018 04 6;15(4). Epub 2018 Apr 6.

Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia.

Little is known on the knowledge, attitudes and preventive practices (KAP) of leptospirosis worldwide. This study embarked on assessing the KAP of leptospirosis among rural communities in Malaysia. A total of 444 participants (223 male; 221 female) aged between 18 and 81 years old were surveyed by using a self-administered questionnaire. A majority of participants had poor knowledge level (57.0%), unacceptable attitudes (90.3%) and unacceptable preventive practices (69.1%) on leptospirosis, and only 29.7% knew "rat-urine disease" as leptospirosis. Only 34.2% of the participants knew the bacteria could enter via wound lesions. Ethnicity and income were strongly associated with knowledge level and preventive practices, respectively (-values < 0.05). As for attitudes, ethnicity, income and education type were significantly associated (-values < 0.05). Only 36.5% of the participants were willing to see a doctor and did not mind if their house or surrounding area is dirty (59.7%). Surprisingly, only 32.9% had used rubber boots during floods. By logistic regression analysis, ethnicity was the only significant predictor for both knowledge level (an odds ratio (AOR) = 0.39, 95% confidence interval (CI) = 0.222-0.680) and preventive practices (AOR = 1.81, 95% CI = 1.204-2.734). Ethnicity (AOR = 0.40, 95% CI = 0.239-0.665), income (AOR = 1.58, 95% CI = 1.041-2.385) and education type (AOR = 3.69, 95% CI = 1.237-10.986) were strong predictors for attitudes. Among the KAP variables, attitude (AOR = 4.357, 95% CI = 2.613-7.264) was the only predictor for the preventive practices by logistic regression analysis. The KAP elements on leptospirosis are still lacking and poor health seeking behavior and attitudes are of our utmost concern. Thus, effective strategies should be planned to impart knowledge, and develop proactive approaches and good preventive modules on leptospirosis to this leptospirosis-prone community.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph15040693DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5923735PMC
April 2018

Development and validation of a new knowledge, attitude, belief and practice questionnaire on leptospirosis in Malaysia.

BMC Public Health 2018 03 7;18(1):331. Epub 2018 Mar 7.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.

Background: In Malaysia, leptospirosis is considered an endemic disease, with sporadic outbreaks following rainy or flood seasons. The objective of this study was to develop and validate a new knowledge, attitude, belief and practice (KABP) questionnaire on leptospirosis for use in urban and rural populations in Malaysia.

Methods: The questionnaire comprised development and validation stages. The development phase encompassed a literature review, expert panel review, focus-group testing, and evaluation. The validation phase consisted of exploratory and confirmatory parts to verify the psychometric properties of the questionnaire. A total of 214 and 759 participants were recruited from two Malaysian states, Kelantan and Selangor respectively, for the validation phase. The participants comprised urban and rural communities with a high reported incidence of leptospirosis. The knowledge section of the validation phase utilized item response theory (IRT) analysis. The attitude and belief sections utilized exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).

Results: The development phase resulted in a questionnaire that included four main sections: knowledge, attitude, belief, and practice. In the exploratory phase, as shown by the IRT analysis of knowledge about leptospirosis, the difficulty and discrimination values of the items were acceptable, with the exception of two items. Based on the EFA, the psychometric properties of the attitude, belief, and practice sections were poor. Thus, these sections were revised, and no further factor analysis of the practice section was conducted. In the confirmatory stage, the difficulty and discrimination values of the items in the knowledge section remained within the acceptable range. The CFA of the attitude section resulted in a good-fitting two-factor model. The CFA of the belief section retained low number of items, although the analysis resulted in a good fit in the final three-factor model.

Conclusions: Based on the IRT analysis and factor analytic evidence, the knowledge and attitude sections of the KABP questionnaire on leptospirosis were psychometrically valid. However, the psychometric properties of the belief section were unsatisfactory, despite being revised after the initial validation study. Further development of this section is warranted in future studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-018-5234-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842588PMC
March 2018

Predictors of polymyxin B treatment failure in Gram-negative healthcare-associated infections among critically ill patients.

J Microbiol Immunol Infect 2018 Dec 29;51(6):763-769. Epub 2017 Jun 29.

Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; Infection Control and Hospital Epidemiology Unit, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Electronic address:

Background: With increasing prevalence and spread of multidrug resistant Gram-negative infections, parenteral polymyxins resurged in clinical practice. The primary aim of the study was to determine the predictors of treatment failure and in-hospital mortality among critically ill patients treated with polymyxin B.

Methods: Demographic data, underlying diseases, procedures and details on polymyxin B therapy were retrospectively analyzed in a cohort of 84 patients who received intravenous polymyxin B in an intensive care unit from 2010 to 2014.

Results: Polymyxin B was used to treat bacteremia (46.4% of cases) and pneumonia (53.6%). Majority of the pathogens isolated were Acinetobacter spp. (96.4%). The mortality rate was 48.8%, of which 82.9% was attributed to polymyxin B treatment failure. The independent predictors of treatment failure were low doses of polymyxin B (p = 0.002), shorter duration of therapy (p = 0.009), not combining with cefoperazone/sulbactam (p = 0.030), female gender (p = 0.004), administered for treatment of bacteremia (p = 0.023) and renal impairment (p = 0.021). Low polymyxin B doses (p = 0.007), not combining with cefoperazone/sulbactam (p = 0.024), female gender (p = 0.048) and renal impairment (p = 0.022) were also significant predictors for in-hospital mortality.

Conclusions: To the best of our knowledge, this is the first report on the association of inadequate dose of polymyxin B (<15,000 units/kg/day) with poor outcome in critically ill patients. Besides that, further clinical studies are warranted to evaluate the use of cefoperazone/sulbactam as second antibiotic in the combination therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jmii.2017.03.007DOI Listing
December 2018

TRADITIONAL CARDIOVASCULAR RISK-FACTORS AMONG HEALTHCARE WORKERS IN KELANTAN, MALAYSIA.

Southeast Asian J Trop Med Public Health 2015 May;46(3):504-11

We conducted a cross sectional study of cardiovascular risk factors among healthcare workers at four government hospitals in Kelantan, Malaysia. We randomly selected 330 subjects fulfilling the following study criteria: those who had been working for at least one year at that health facility, Malaysians citizens and those with some form of direct contact with patients. We conducted an interview, obtained physical measurements, a fasting blood sugar and fasting lipid profiles among 308 subjects. The mean age of the subjects was 43.5 years, 82% were female; 30.8%, 14.3%, 10.4%, 1.3% and 1.6% of the subjects had dyslipidemia, hypertension, diabetes mellitus, a history of stroke and a history of ischemic heart disease, respectively. Forty-two percent of subjects had at least one medical condition. The mean body mass index (BMI) was 27.0 kg/M2 (SD=4.8) and 24.3% had a BMI > or =30 kg/M2. The mean systolic and diastolic blood pressures were 121.5 mmHg (SD=14.0) and 76.5 mmHg (SD=9.7), respectively and the mean waist-hip ratio was 0.84 (SD=0.1). The mean fasting blood sugar, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein were 5.8 mmol/l (SD=2.4), 5.5 mmol/l (SD=1.0), 1.4 mmol/l (SD=0.9), 1.5 mmol/l (SD=0.3) and 3.5 mmol/l (SD=0.9), respectively. Our study population had a smaller proportion of hypertension than that of the general Malaysian population. They had higher fasting total cholesterol, slightly lower fasting blood sugar, with a large proportion of them, obese and had diabetes. Immediate intervention is needed to reduce the traditional cardiovascular risk factors in this population. Keywords: cardiovascular risk factors, health care workers, Malaysia
View Article and Find Full Text PDF

Download full-text PDF

Source
May 2015

Risk factors and outcomes of imipenem-resistant Acinetobacter bloodstream infection in North-Eastern Malaysia.

Asian Pac J Trop Biomed 2011 Aug;1(4):313-5

Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.

Objective: To determine the risk factors and outcomes of imipenem-resistant Acinetobacter baumannii (IRAB) bloodstream infection (BSI) cases, since there is very little publication on Acinetobacter baumannii infections from Malaysia.

Methods: A cross sectional study of 41 cases (73.2%) of imipenem-sensitive Acinetobacter baumanii (ISAB) and 15 cases (26.8%) of IRAB was conducted in a teaching hospital which was located at North-Eastern state of Malaysia.

Results: There was no independent risk factor for IRAB BSI identified but IRAB BSI was significantly associated with longer bacteraemic days [OR 1.23 (95% CI 1.01, 1.50)]. Although prior use of carbepenems and cephalosporin were higher among IRAB than ISAB group, statistically they were not significant. There was no significant difference in term of outcomes between the two groups.

Conclusions: Although statistically not significant, this analysis compliments previous publication highlighting the importance of appropriate empiric antibiotic usage in hospital especially carbepenems and need further evaluation with bigger subjects.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S2221-1691(11)60050-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614228PMC
August 2011

Outcomes and appropriateness of management of nosocomial Acinetobacter bloodstream infections at a teaching hospital in northeastern Malaysia.

Southeast Asian J Trop Med Public Health 2009 Jan;40(1):140-7

Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Kelantan, Malaysia.

Acinetobacter spp is a known nosocomial pathogen causing a wide range of clinical diseases such as pneumonia, wound infection and bloodstream infections (BSI). The clinical outcomes of acinetobacter BSI were determined by a 1:1 case control study involving 58 confirmed cases of acinetobacter BSI who were compared to other gram-negative infections. The crude mortality of acinetobacter BSI was 47.2%, which was significantly greater than other gram-negative BSI (OR 1.89, 95% CI 1.10-3.24) but there were no significant differences in attributed mortality between the two groups. We found that patients treated in intensive care units (ICU), who had longer ICU stays, who presented with shock or coagulopathy, had prior exposure to carbapenems, had mechanical ventilation, were on a ventilator for longer periods, had a nasogastric tube, had an arterial catheter or had parenteral nutrition at a significantly greater risk of mortality due to acinetobacter BSI. Patients presenting with septic shock (OR 17.95, 95% CI 3.36-95.84) or having a central venous catheter (OR 12.48, 95% CI 1.09-142.68) were independently at higher risk for mortality. Appropriateness of therapy reduced the mortality attributes of acinetobacter BSI (OR 0.197, 95% CI 0.040-0.967) but did not significantly reduce crude mortality in acinetobacter BSI patients. This study shows the importance of preventing acinetobacter BSI and the appropriate use of antimicrobial agents to reduce mortality.
View Article and Find Full Text PDF

Download full-text PDF

Source
January 2009