Translation, Cross-Cultural Adaptation to Malay, and psychometric evaluation of the AIM-IAM-FIM questionnaire: Measuring the implementation outcome of a community-based intervention programme.

BACKGROUND: The implementation outcomes determine the success and progress of a community-based intervention programme. The community is an important stakeholder whose effects should be assessed. Nevertheless, Malaysia has limited instruments for determining outcome measurements. This research aimed to develop Malay versions of the Acceptability, Appropriateness, and Feasibility Intervention Measures (AIM-IAM-FIM) questionnaire, which evaluates the implementation outcome of the programme. METHODS: A methodological study of the translation and validation of the implementation outcome measures was conducted from March 2022 until December 2022. Three key analyses were conducted: (1) translation and validation; (2) factor investigation and extraction (n = 170); and (3) scale evaluation (n = 235). RESULT: The Malay version measuring the implementation outcome measures of a community-based intervention programme was produced after extensive translation and modification, and it consisted of a single dimension with seven items. The content validity index was 0.9, the exploratory factor analysis showed that the KMO measure of sample adequacy was 0.9277, and Bartlett's sphericity test was statistically significant. Cronbach's alpha was good, with a level of 0.938. The single factor structure fitted the data satisfactorily [χ2 (p-value of 0.002), SRMR = 0.030, CFI = 0.999, RMSEA = 0.079, TLI = 0.998]. Factor loading for all items was > 0.7. CONCLUSION: The 7-item Malay version of the AIM-IAM-FIM survey instrument is valid and reliable for assessing the acceptability of a community-based intervention study and is applicable to other fields. Future studies in psychometric evaluation are recommended in other states due to the variety of Malay dialects spoken across Asia. The scale may also benefit other areas where the language is spoken.

A Behavioural-Theory-Based Qualitative Study of the Beliefs and Perceptions of Marginalised Populations towards Community Volunteering to Increase Measles Immunisation Coverage in Sabah, Malaysia.

The development of the measles-containing vaccine (MCV) has rendered measles a largely preventable disease. In the state of Sabah in Malaysia, a complete course of measles immunisation for infants involves vaccinations at the ages of six, nine, and twelve months. However, it is difficult for marginalised populations to receive a complete course of measles immunisation. This present study used behavioural theory (BT) to examine the beliefs and perceptions of a marginalised population towards community volunteering as a method of increasing the immunisation coverage of measles. Marginalised populations living in Kota Kinabalu, Sabah, more specifically, Malaysian citizens living in urban slums and squatter areas, as well as legal and illegal migrants, were extensively interviewed in person for this qualitative study. The 40 respondents were either the parents or primary caregivers of at least one child under the age of five. The components of the Health Belief Model were then used to examine the collected data. The respondents had poor awareness of the measles disease and perceived the disease as not severe, with some even refusing immunisation. The perceived barriers to receiving vaccinations included a nomadic lifestyle; issues with finances, citizenship status, language, and weather; failing to remember immunisation schedules; a fear of health care personnel; having too many children; and a lack of female autonomy in vaccine decision-making. However, the respondents were receptive towards community-based programmes and many welcomed a recall or reminder system, especially when the volunteers were family members or neighbours who spoke the same language and knew their village well. A few, however, found it awkward to have volunteers assisting them. Evidence-based decision making may increase measles immunisation coverage in marginalised populations. The components of the Health Belief Model validated that the respondents lacked awareness of the measles disease and viewed it and its effects as not severe. Therefore, future volunteer programmes should prioritise increasing the receptivity and self-control of marginalised populations to overcome barriers that hinder community involvement. A community-based volunteer programme is highly recommended to increase measles immunisation coverage.

Improving Tuberculosis Medication Adherence: The Potential of Integrating Digital Technology and Health Belief Model.

Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT's efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.

Predictors of severe COVID-19 among healthcare workers in Sabah, Malaysia.

BACKGROUND: Healthcare workers (HCWs) is the high-risk group for COVID-19 infection due to increased workplace exposure. However, evidence of the disease burden and factors associated with severe COVID-19 infection among HCWs is limited. Therefore, this article aims to describe the prevalence of severe COVID-19 disease among HCWs in Sabah, Malaysia, and to determine the factors associated with severe COVID-19 infection. METHOD: A retrospective cross-sectional study was carried out by assessing the data of COVID-19-infected HCWs in Sabah, Malaysia, from 1st March 2021 until 30th September 2021. Logistic regression analysis was used in this study. RESULTS: Three thousand and forty HCWs were diagnosed with COVID-19 from 1st March 2021 until 30th September 2021. Of the 3040 HCWs, 2948 (97.0%) HCWs were mild, whereas 92 (3.0%) were severe. The multivariate logistic regression model showed that severe COVID-19 among HCWs in Sabah was associated with those do not receive any COVID-19 vaccination (aOR 6.061, 95% CI 3.408 - 10.780), underlying co-morbidity (aOR 3.335, 95% CI 2.183 - 5.096), and female (aOR 1.833, 95% CI 1.090 - 3.081). CONCLUSION: HCWs should strictly adhere to preventive measures, including vaccination, personal protective equipment, and early referral to a physician upon identifying severe COVID-19 infection. Early screening and aggressive co-morbidity treatment among HCWs are essential for public health practitioners to prevent severe COVID-19 disease. Regardless of co-morbidity status, HCWs should stay up to date with COVID-19 vaccination, including booster doses.

Children's eating behaviour: A comparison between normal, overweight and obese children.

Background: Childhood obesity has become a major global health concern and has been increasing dramatically over the years. Previous study has shown that specific eating behaviours may have been associated with obesity especially under-responsiveness to internal satiety cues and over-responsiveness to external food cues such as the taste, smell, availability and emotions. However, there is still inadequate number of studies present to describe the association between the children's body mass index (BMI) and their eating behaviours, especially in Sabah, Malaysia. Therefore, the objective of this study is to established the association between the children's eating behaviours with their nutritional status based on their body mass index. Materials and methods: A cross-sectional study involving 484 children aged 6-12 years old was conducted in Kota Kinabalu, which is a developing urban area in Sabah. The children were recruited from five primary schools that were selected based on multistage stratified and convenience sampling method. Sociodemographic details and anthropometric measures both parents and children, and eating behaviours of children were assessed using Children Eating Behaviour Questionnaires (CEBQ). Age-adjusted BMI z-scores were then calculated according to the World Health Organization recommendations to assess nutritional status. Results: The prevalence of childhood obesity among children aged 6-12 years old is 13.2%. The mean scores of 'Food Approach' subscales from the CEBQ showed higher mean score in overweight and obese groups as compared to the mean score in normal weight group. The mean scores of 'Food Avoidance' subscales showed lower mean score in overweight and obese groups as compared to mean score in normal weight group. Conclusion: This study provides evidence that childhood obesity is yet to be a prevalent health problem in a developing urban area considering the "Food approach" subscales were positively associated with the excess weight in children.

Ecological Study of Sick Building Syndrome among Healthcare Workers at Johor Primary Care Facilities.

INTRODUCTION: Persistent exposure to indoor hazards in a healthcare setting poses a risk of SBS. This study determines the prevalence of and risk factors for SBS among healthcare workers in health clinics. METHODS: A cross-sectional study was conducted across four health clinics from February 2022 to May 2022. As part of the study, self-administered questionnaires were completed to determine symptoms related to SBS. An indoor air quality (IAQ) assessment was conducted four times daily for fifteen minutes at five areas in each clinic (laboratory, lobby, emergency room, pharmacy, and examination room). RESULT: Most of the areas illustrated poor air movement (<0.15 m/s), except for the laboratory. The total bacterial count (TBC) was above the standard limit in both the lobby and emergency room (>500 CFU/m3). The prevalence of SBS was 24.84% (77) among the healthcare workers at the health clinics. A significant association with SBS was noted for those working in the examination room (COR = 2.86; 95% CI = 1.31; 6.27) and those experiencing high temperature sometimes (COR = 0.25; 95% CI = 0.11; 0.55), varying temperature sometimes (COR = 0.31; 95% CI = 0.003), stuffy air sometimes (COR = 0.17; 95% CI = 0.005; 0.64), dry air sometimes (COR = 0.20; 95% CI = 0.007; 0.64), and dust sometimes (COR = 0.25; 95% CI = 0.11; 0.60) and everyday (COR = 0.34; 95% CI = 0.14; 0.81). Only healthcare workers in the examination room (AOR = 3.17; 95% CI = 1.35; 7.41) were found to have a significant risk of SBS when controlling for other variables. CONCLUSION: SBS is prevalent among healthcare workers at health clinics.

Survival Rate and Prognostic Factors for Colorectal Cancer in Sabah, Borneo, Malaysia: A Retrospective Cohort of a Population-Based Study.

BACKGROUND: Colorectal cancer is a major public health problem with significant number of cases and death in the population. This study aimed to determine the 5-year overall survival rate and the prognostic factors for colorectal cancer patients in Sabah. METHODS: This was a retrospective cohort study conducted using secondary data from Malaysian National Cancer Registry (MNCR) database. A 5-year overall survival and the median survival time were determined with Kaplan-Meier survival curve. Cox regression analysis was done to determine the prognostic factors on survival. RESULTS: A total of 1,152 patients were included in this study. The majority of the patients had colon cancer and presented at late stage (stage III and IV) as compared to early stage (stage I and II). From the analysis, the 5-year overall survival for colorectal cancer was 23.2% (95% CI: 21.8, 24.6) and the median survival time was 16 months (95% CI: 14.3, 17.7).  Higher survivals are seen in males (23.6%, 95% CI: 20.4, 24.7), aged 50-74 years old (24.2%, 95% CI: 22.4, 26.0), Chinese (25.5%, 95% CI: 23.0, 28.0), lived in Keningau (25.6%, 95% CI: 20.8, 30.4), colon as primary tumor site (24.5%, 95% CI: 22.5, 26.4), diagnosed with stage I (55.6%, 95% CI: 48.7, 62.5) and received surgery with chemotherapy or radiotherapy (31.3%, 95% CI: 27.8, 34.8). The significant prognostic factor was the stage at diagnosis. Patients with stage IV colorectal cancer (HR: 11.18; 95% CI: 3.48, 35.93) had eleven times risk of dying as compared to stage I. CONCLUSION: The survival rate for colorectal cancer patients in Sabah was comparatively lower than other states in Malaysia and in some Asian countries. Those patients who presented at later stage had poorer survival. Health promotion and community-based screening program should be emphasized in addition to encouraging early diagnosis to improve survival.

Electrical safety in a hospital setting: A narrative review.

Electrical hazard is a significant threat in hospitals that require sustainable assessment and improvement. Workplace assessment and medical surveillance systems are often overlooked, and employees fail to comply with the necessary measures that have been instructed at the workplace. The incidents are attributed to a lack of knowledge regarding occupational safety and health and a lack of awareness regarding electrical hazards importance. The consequences of neglecting these assessments may result in health deterioration and low work quality and may also cause disability and impairment. This review describes occupational safety and health perspective about electrical hazards in hospital settings. Further preventive measures were recommended to outline practical and feasible steps resulting in a safer and healthier working environment.

Analysis of serum and gene expression profile of cytokines (IL-6, TNF-α and TGF-ß1) in chronic hepatitis C virus infection.

Background: Chronic hepatitis C virus (HCV) infection is one of the major causes of liver cirrhosis and liver carcinoma. Studies have indicated that an imbalance of cytokine activities could contribute to the pathogenesis of chronic HCV infection. This study aimed to investigate serum levels and gene expression of cytokines (IL-6, TNF-α and TGF-ß1) in chronic HCV infection among Malay male subjects. Methods: Thirty-nine subjects were enrolled from various health clinics in Kelantan, Malaysia, and divided into two groups: patients with chronic HCV infection (HP) and healthy control (HS). The serum cytokines IL-6, TNF-a-were measured using Luminex assay, and serum TGF-ß1 was measured by ELISA. The mRNA gene expression for IL-6, TNF-α and TGF-ß1 was measured by real-time reverse transcriptase polymerase chain reaction (RT-PCR). Results: There were statistically significant differences in the mean serum levels of IL-6, and TGF-ß1 in HP compared to HS group (p = 0.0180 and p = 0.0005, respectively). There was no significant difference in the mean serum level of TNF-α in HP compared to HS group. The gene expression for the studied cytokines showed no significant differences in HP compared to HS group. Conclusion: Serum IL-6 was significantly associated with chronic HCV infection.

A 1-year cross-sectional study on the predominance of influenza among hospitalized children in a tropical area, Kota Kinabalu, Sabah.

BACKGROUND: Children are at higher risk of influenza virus infection, and it is difficult to diagnose. They are also responsible for the transmission of influenza because of their longer viral shedding compared to adults. In Malaysia, studies on influenza in children are scarce, and as a result, policy decisions cannot be formulated to control the infection. Hence, the objective of this study is to determine the prevalence and epidemiological characteristics of influenza among children with upper respiratory symptoms in the Sabah state of Malaysia. METHODS: A cross-sectional study with a simple random sampling was conducted among children with upper respiratory symptoms in Sabah from 1 March 2019 to 29 February 2020. Patients admitted to a pediatric ward of Sabah Women and Children's Hospital who presented with a fever >38 °C and cough within 48 h of admission were enrolled in this study. A nasopharyngeal swab was taken, and influenza was diagnosed by lateral flow test. Clinical features of influenza-positive children were compared with children whose results were negative. RESULTS: A total of 323 nasopharyngeal samples were collected, and 66 (20.4%) of them were positive for influenza. Fifty-six (85%) were infected by influenza A whereas ten (15%) were by influenza B virus. Higher temperature (aOR 2.03, 95% CI 1.296-3.181), less activity (aOR 2.07, 95% CI 1.158-3.693), and seizure (aOR 4.2, 95% CI 1.614-10.978) on admission were significant risk factors associated with influenza in children. Meteorology parameters such as humidity and rainfall amount were statistically significant at 95% CI [1.133 (1.024-1.255)] and 95% CI [0.946 (0.907-0.986)]. CONCLUSION: The prevalence of influenza was high among children with upper respiratory symptoms, and they were infected predominantly with the influenza A virus. Children presented with seizures, less activity, and fever were the significant risk factors for influenza. Influenza vaccination should be prioritized as preventive measures for children.

The Association of Eating Behaviour on the Growth of Children from the Interior Districts of Sabah, Malaysia.

Background: The double burden of malnutrition among children is an emerging public health problem, especially in developing countries. Eating behaviours have been hypothesised to contribute to both being underweight and overweight in children and adults. The objective of this study was to examine the association between the Child Eating Behaviour Questionnaire (CEBQ) subscale scores and body mass index (BMI) z-scores among Malaysian children under-5 years. Methods: This was a cross-sectional study conducted in 2020 by recruiting a sample of 500 children aged 24-59 months old from clinics located in the interior districts of Sabah, Malaysia. The CEBQ was completed by the mothers on behalf of the child to assess their eating behaviour traits. The height and weight of the child were measured using standardised instrument. The BMI-for-age percentile, z-scores for BMI-for-age, height-for-age and weight-for-age were determined and classified using World Health Organization AnthroPlus software. The relationship between the CEBQ subscale scores and BMI z-scores were evaluated using multiple linear regression models adjusting for potential confounders. Results: The prevalence of underweight, stunting and wasting were 20.2%, 29.2% and 5.6%, respectively, whereas the prevalence of overweight and obese was 5.0%. There were significant positive association between Food responsiveness, Emotional overeating, Enjoyment of food with BMI z-scores (p<0.05; unstandardised regression coefficient: 0.17 to 0.38). In contrast, there were significant negative association between Satiety responsiveness, Slowness of eating, Food fussiness with BMI z-scores (p<0.01; unstandardised regression coefficient: -0.35 to -0.36). Conclusion: These findings show that specific eating behaviours can influence the growth of children under-5 years. Therefore, policymakers should formulate a nutrition policy that incorporates behavioural assessment and behavioural intervention in the prevention and management of malnutrition among children in Malaysia.

Concentrated specimen smear microscopy utilising a polymer membrane sandwich filtration vessel for the detection of acid-fast bacilli in health facilities in Sabah, East Malaysia.

A simple, ready-to-use concentrated specimen smear microscopy method employing a nanometer silicon polyvinylidene fluoride (PVDF) polymer membrane sandwich filtration vessel to concentrate acid-fast bacilli (AFB) in samples (SFV-CSSM, Hunan-Tech New Medical System Co. Ltd. China) was compared with direct sputum smear microscopy (DSSM) to determine its performance using culture on modified Ogawa agar as reference. The results for 4114 clinical samples collected from health facilities in Sabah were interpreted with reference to culture results, sample collection-transportation conditions and clinical data including responses to anti-TB drug treatment. The SFV-CSSM showed higher sensitivity than DSSM (79.4% versus 60.5%) and less background interference. Its ability to detect low levels of AFB at an affordable cost makes it an excellent tool for the screening of pauci-bacillary samples as well as for active case finding in TB control programs.

Prevalence of upper limb musculoskeletal disorders and its associated risk factors among janitorial workers: A cross-sectional study.

INTRODUCTION: Janitorial workers are considered a high-risk group to develop WRMSDs based on their numerous hazardous job tasks and frequent non-fatal injuries being reported. This study aimed to determine the prevalence of upper limb musculoskeletal disorders (ULMSDs) and its associated risk factors among janitorial workers. METHODS: This cross-sectional study involved janitorial workers in a university in Sabah, Malaysia. The participants, who included supervisors, cleaners, and landscape workers, were recruited via universal sampling. Those with at least 12-months of experience in their present employment were included, while those with prior musculoskeletal injuries were excluded. Data were collected through interviews using the Malay version of Standardized Nordic Musculoskeletal Questionnaire (SNMQ), and Job Content Questionnaire (JCQ), followed by Ergonomic Risk Assessment (ERA). Data were analyzed and produced using SPSSv.26, encompassing descriptive statistics, Pearson's Chi-Square, and Multiple Logistic Regression analysis. Ethical approval and respondents' informed consents were obtained prior to the study. RESULTS: Among 142 respondents, ULMSDs were found to be prevalent in 76.8% of janitorial workers, with the highest prevalence (71.6%) reported in the shoulder regions. None was at negligible risk, with 95.1% in the medium or high-risk categories for RULA assessment. The significant associated factors were landscape workers [aOR = 3.07,95% CI = 1.04, 9.91], more than three years of employment [aOR = 2.47,95% CI = 1.06, 5.79], and low job control [aOR = 2.69,95% CI = 1.16, 6.23]. CONCLUSIONS: Given the high prevalence of ULMSDs, risky awkward postures, and low job control, amendments in working apparatuses and improvements in administrative procedures, are highly recommended to prevent the occurrence of ULMSDs.

Prevalence and risk factors for positive lymphatic filariasis antibody in Sabah, Malaysia: a cross-sectional study.

BACKGROUND: Lymphatic filariasis (LF) is a public health problem in Sabah, Malaysia. In the subdistrict of Tangkarason, nine rounds of mass drug administration (MDA) were probably not effective in reducing the prevalence of microfilaria to the <1% threshold recommended by the World Health Organization for stopping MDA. This cross-sectional study was conducted to identify the risk factors associated with positive LF antibody in Tangkarason. METHODS: Eligible adults >18 y of age in seven endemic villages in Tangkarason, Beluran, Sabah, were interviewed and tested for LF antibody using the Brugia Rapid kit. Multivariable logistic regression was employed to analyse the associated factors. RESULTS: A total of 244 respondents were included in this study. Their median age was 40 y (interquartile range 30-53). The antibody prevalence of brugian filariasis in the study population was 31.1% (95% confidence interval [CI] 25.7 to 37.2). Older age (adjusted odds ratio [aOR] 1.04 [95% CI 1.02 to 1.06]) and outdoor jobs (aOR 2.26 [95% CI 1.05 to 4.85]) were identified as independent risk factors for positive LF antibody. Participating in the MDA program previously (aOR 0.24 [95% CI 0.10 to 0.57]) was found to be a protective factor for LF infection. CONCLUSIONS: A high prevalence of microfilariae was confirmed in all the study sites, which was above the target of <1%. Important factors associated with positive LF antibody were identified, which could be used as a guide for program managers to design more focused control measures in LF-endemic areas.

Tuberculosis Death Epidemiology and Its Associated Risk Factors in Sabah, Malaysia.

Tuberculosis (TB) is a leading killer from a single infectious agent globally. In 2019, Malaysia's TB incidence rate was 92 per 100,000 population, and the TB mortality rate was estimated at 4 cases per 100,000 population per year. However, the state of Sabah had a higher burden of TB with a notification rate of 128 per 100,000 population and a TB case fatality rate of 8% compared to the national figure. This study aims to provide a comprehensive report on TB deaths epidemiology and its associated factors at a sub-national level. This nested case-control study used Sabah State Health Department TB surveillance data from the Malaysia national case-based TB registry (MyTB) between 2014 and 2018. Cases were defined as all-cause TB deaths that occurred before anti-TB treatment completion from the time of TB diagnosis. Controls were randomly selected from TB patients who completed anti-TB treatment. The TB mortality rate had increased significantly from 9.0/100,000 population in 2014 to 11.4/100,000 population in 2018. The majority of TB deaths occurred in the first two months of treatment. TB-related deaths were primarily due to advanced disease or disseminated TB, whereas non-TB-related deaths were primarily due to existing comorbidities. Many important independent risk factors for TB deaths were identified which are useful to address the increasing TB mortality rate.

Risk factor of plasmodium knowlesi infection in Sabah Borneo Malaysia, 2020: A population-based case-control study.

BACKGROUND: In the Malaysian state of Sabah, P. knowlesi notifications increased from 2% (59/2,741) of total malaria notifications in 2004 to 98% (2030/2,078) in 2017. There was a gap regarding P. knowlesi acquisition risk factors related to practice specifically in working age group. The main objective of this study was to identify the risk factors for acquiring P. knowlesi infection in Sabah among the working age group. METHODS AND METHODS: This retrospective population-based case-control study was conducted in Ranau district to assess sociodemographic, behavioural and medical history risk factors using a pretested questionnaire. The data were entered and analyzed using IBM SPSS version 23. Bivariate analysis was conducted using binary logistic regression whereas multivariate analysis was conducted using multivariable logistic regression. We set a statistical significance at p-value less than or equal to 0.05. RESULTS: A total of 266 cases and 532 controls were included in the study. Male gender (AOR = 2.71; 95% CI: 1.63-4.50), spending overnight in forest (AOR = 1.92; 95% CI: 1.20-3.06), not using mosquito repellent (AOR = 2.49; 95% CI: 1.36-4.56) and history of previous malaria infection (AOR = 49.34; 95% CI: 39.09-78.32) were found to be independent predictors of P. knowlesi infection. CONCLUSIONS: This study showed the need to strengthen the strategies in preventing and controlling P. knowlesi infection specifically in changing the practice of spending overnight in forest and increasing the usage of personal mosquito repellent.

Colorectal cancer and potential predictors of never screened for faecal occult blood test: a narrative review.

Colorectal cancer (CRC) is a major public health threat. Therefore, CRC screening uptake has been a focus with the established precancerous lesion and the strong association of early detection with staging and survival of the disease. However, CRC screening is relatively low in many countries. This article briefly discussed the current situation of CRC, recommendations, and current uptake of CRC screening in various countries. Besides that, this article also highlights the potential factors that help to predict the CRC screening uptake worldwide. Identification of those factors could guide policymakers to develop an effective strategy to improve the CRC screening uptake and ultimately improve the health outcome of the population.

Factors and outcomes in Severe Fever with Thrombocytopenia Syndrome (SFTS): A systematic review.

BACKGROUND: An emerging infectious zoonosis known as Severe Fever with Thrombocytopenia Syndrome (SFTS) is discovered mainly in Japan, South Korea and China. SFTS virus (SFTSV) which is recently recognised as bunyavirus is borne by ticks such as Haemaphysalis longicornis. It has the capabilities to spread as develop clusters and become a considerable public health threat as this virus could experience rapid evolution via gene mutation. Case fatality rate has been reported up to higher than 30%. The aim of this review is to determine the associated risk factors of SFTS and its outcome. MATERIALS AND METHODS: Literature search was conducted using online databases PubMed, ScienceDirect, and Scopus. A total of 517 records were identified from searches in PubMed, ScienceDirect, and Scopus. From the final exclusions, a total of 26 studies were included for final analysis. RESULTS: Associated risk factors to getting SFTS infection include occupation, history of bite from a tick, biological susceptibility, and owning of domestic animal. Fatality rates apart from single case reports range from 15.1% to 50% and are contributed by various factors including delay in hospital admission, high viral load, older age group and presence of comorbid and complication. CONCLUSION: A seroprevalence study can be conducted amongst the high-risk occupation group such as farmers and agricultural workers, as well as testing cases where viral fever is suspected but available tests for other diseases turns out negative.

Factors of Never Screened with Faecal Occult Blood Test in Public Primary Care Facilities.

BACKGROUND: Colorectal cancer (CRC) is still a major public health threat. In the effort to reduce CRC incidence and mortality, faecal occult blood test (FOBT) is currently the screening tools used for early detection of CRC. However, the uptake of FOBT screening is less than promising. This study aims to identify the prevalence and predictors of Never Screened with FOBT (NS-FOBT). METHODS: A cross sectional study was conducted in five health clinics under Kota Kinabalu district, Sabah, Malaysia Borneo involving 162 attendees with age of 50 years old and above. A validated self-administered questionnaire was used to collect the data. Multiple logistic regression analysis was used to determine the predictors of NS-FOBT. RESULTS: The prevalence of NS-FOBT was 85.8% (n=139). Important predictors of NS-FOBT were age (aOR: 0.922; 95% CI: 0.855, 0.995; p=0.035), Bumiputera ethnicity (vs Non Bumiputera; aOR: 4.285; 95% CI: 1.384, 13.263; p=0.012), knowledge score (aOR: 0.921; 95% CI: 0.856, 0.99; p=0.027), and attitude score (aOR: 0.801; 95% CI: 0.702, 0.913; p=0.001). CONCLUSION: There is high prevalence of NS-FOBT. Age, ethnicity, knowledge, and attitude were important predictors of NS-FOBT. Strategies are needed to improve FOBT screening rate among the public. Socio-culturally tailored health promotion strategies as well as strengthening the communication, collaboration, and education to enhance the role of family physician is vital in improving the CRC prevention and care.

Exposure risk assessment of the municipal waste collection activities during COVID-19 pandemic.

An increasing amount of waste concurrently further extends the risk of exposure to hazardous material among waste collectors. In light of the COVID-19 crisis, municipal waste collectors are one of the most at-risk groups of SARS-Cov-2 exposure. Risk assessment included hazard identification, evaluation of existing control level at the workplace, estimation of likelihood and severity of hazard, risk determination, and control measure recommendations. Five waste collection activities were identified and reviewed. High-risk exposure includes collection of garbage, mechanical manipulation of compactor lorries and unloading of garbage at the disposal site. There is poor practice of personal hygiene and unestablished continuous monitoring of personal protective equipment supplies. The preventive measures in the waste collection industry are influenced by several factors. Until the preventive measures are adopted into practice and adapted according to each company's requirements, biological agents continue to be risk factor to the health workers.