Knowledge, attitude and practice about leptospirosis prevention among town service workers in northeastern Malaysia: a cross sectional study.

INTRODUCTION: Many efforts have been done to reduce leptospirosis infections in Malaysia especially among high risk groups including town service workers. Town service workers are more likely to be exposed to the leptospiral infection resulting from their occupational activities. METHODS: A cross sectional study was conducted in northeastern Malaysia involving 321 town service workers who were subjected to answer an interviewer-guided validated questionnaire which consists of sociodemographic, knowledge, attitude and practice information. Data were entered and analyzed using SPSS Version 20. RESULTS: All of the respondents were Malay with mean (SD) age of 40.6 (10.28) years old. The mean (SD) duration of employment was 12.1 (9.62) years. Fifty four respondents (16.8%) had never heard of leptospirosis. Among the respondents, 215 (67.0%) of them had poor knowledge on leptospirosis. Meanwhile, 167 (52.0%) and only 128 (39.9%) of them had satisfactory attitude and practice respectively. It was found that knowledge on risk factors for leptospirosis was lacking. There were high risk attitudes such as drinking habit and protective equipment used during working with the favourable answers ranged from 67.3% to 89.1%. The weakest area identified in their practice was also on the use of protective equipment. CONCLUSIONS: The workers' level of knowledge and practice were relatively poor despite an overall good practice on leptospirosis. This finding might expose them to an increased risk of contracting leptospirosis. Identified weak areas in their knowledge, attitude and practice will assist the policy makers to develop a focused and well-directed intervention program on leptospirosis infection.

Seroprevalence of leptospiral antibodies among market workers and food handlers in the central state of Malaysia.

OBJECTIVE: The high prevalence of leptospirosis in humans is of great public health concern, particularly in tropical and subtropical regions. This study aimed to determine the seroprevalence of leptospiral antibodies and distribution of serovars, and to assess the usefulness of enzyme-linked immunosorbent assay (ELISA) as a screening method for leptospiral antibodies in a high-risk healthy community. METHODS: Cross-sectional study of 231 market workers and food handlers in wet markets and food premises from two localities in central Malaysia. Respondents' background information was obtained using a questionnaire. Serum samples were tested for leptospiral antibodies using ELISA and microscopic agglutination test (MAT). RESULTS: Seroprevalence of leptospirosis among healthy workers was 46.3%. Detection of seropositivity was higher by MAT (46%) than ELISA (15%). We observed high seropositivity among local workers (49%), food handlers (49.5%), females (60.8%) and those aged 34 years and older (46.3%). Local strain LEP175 was the predominant serovar, followed by WHO strain Patoc. CONCLUSION: Overall seroprevalence among healthy food handlers and market workers was high in this study. The workplace places susceptible individuals at risk of leptospirosis.

Work Environment-Related Risk Factors for Leptospirosis among Plantation Workers in Tropical Countries: Evidence from Malaysia.

BACKGROUND: Leptospirosis is a zoonotic disease that is recognized as a re-emerging global public health issue, especially in tropical and subtropical countries. Malaysia, for example, has increasingly registered leptospirosis cases, outbreaks, and fatalities over the past decade. One of the major industries in the country is the palm oil sector, which employs numerous agricultural workers. These laborers are at a particularly high risk of contracting the disease. OBJECTIVE: To identify the work environment-related risk factors for leptospirosis infection among oil palm plantation workers in Malaysia. METHODS: A cross-sectional study involving 350 workers was conducted. The participants were interviewed and administered a microscopic agglutination test. Seropositivity was determined using a cut-off titer of ≥1:100. RESULTS: 100 of 350 workers tested positive for leptospiral antibodies, hence, a seroprevalence of 28.6% (95% CI 23.8% to 33.3%). The workplace environment-related risk factors significantly associated with seropositive leptospirosis were the presence of cows in plantations (adjusted OR 4.78, 95% CI 2.76 to 8.26) and the presence of a landfill in plantations (adjusted OR 2.04, 95% CI 1.22 to 3.40). CONCLUSION: Preventing leptospirosis incidence among oil palm plantation workers necessitates changes in policy on work environments. Identifying modifiable factors may also contribute to the reduction of the infection.

Study on Seroprevalence and Leptospiral Antibody Distribution among High-risk Planters in Malaysia.

OBJECTIVES: To determine the leptospirosis seroprevalence and to identify the predominant infecting serovars among oil palm plantation workers. METHODS: The cross-sectional study involved 350 asymptomatic oil palm plantation workers in Melaka and Johor. A serological test using the microscopic agglutination test was conducted in the Institute of Medical Research with a cut-off titre for seropositivity of ≥1:100. RESULTS: The overall seroprevalence of leptospiral antibodies was 28.6%. The job category with the highest seroprevalence was the fruit collector with 59.2%. The predominant serovar identified was serovar Sarawak (Lepto 175) (62%). CONCLUSION: A high seroprevalence of leptospiral antibodies was detected among oil palm plantation workers and specifically among fruit collectors. The predominant infecting serovar among the workers was serovar Sarawak (Lepto 175). The findings suggest that more studies are needed to determine the reasons for the high seroprevalence and the transmission and pathogenicity of the local serovar Sarawak (Lepto 175).

Risk factors of leptospirosis among febrile hospital admissions in northeastern Malaysia.

BACKGROUND: Leptospirosis is a worldwide zoonotic disease. Risk factors for the disease may vary among countries. OBJECTIVE: This study was conducted to determine the risk factors of leptospirosis among febrile cases. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted among 999 febrile patients admitted to 10 hospitals in northeastern Malaysia, from August 2010 to February 2011. An interviewer-guided proforma sheet on sociodemography, type of occupation and social history data was distributed to all adult patients with fever on admission. Serum sample for leptospirosis was screened by IgM Enzyme-linked Immunosorbent Assay (IgM ELISA) test and confirmed by Microscopic Agglutination Test (MAT). The cut-off point for positive MAT was ≥ 1:400 titer in single acute specimens. RESULTS: Seroprevalence of leptospirosis was 8.4% (95% CI: 6.8, 10.3) (n=84/999) by MAT. Multiple logistic regression analysis showed that the high risk occupation group (OR: 1.95, 95% CI: 1.22, 3.13) (p=0.005) and history of recent recreational activity (OR: 2.36, 95% CI: 1.46, 3.85) (p<0.001) were significant associated factors for leptospirosis. CONCLUSION: This study shows a relatively high seroprevalence of leptospirosis in northeastern Malaysia. Identification of high risk occupational group and history of recent recreational activity will help to increase the index of suspicion to diagnose leptospirosis among febrile inpatients due to its mimicking other common febrile illnesses in Malaysia.

A hospital-based study on seroprevalence of leptospirosis among febrile cases in northeastern Malaysia.

OBJECTIVE: To determine the seroprevalence of leptospirosis among febrile inpatient cases in northeastern Malaysia. METHODS: A hospital-based cross-sectional study was conducted among 999 febrile cases admitted to 10 hospitals in northeastern Malaysia. A survey using a proforma sheet was used to obtain sociodemographic and occupational information. Serum samples were screened for leptospirosis by IgM enzyme-linked immunosorbent assay test (IgM ELISA) and confirmed by microscopic agglutination test (MAT). RESULTS: There was an equivalent distribution of males and females in the 999 respondents enrolled in the study. The majority were Malay (94.7%) and their mean age was 39.4 (standard deviation 17.6) years. The overall seroprevalence of leptospirosis was 8.4% (95% confidence interval (CI) 6.8-10.3) (n=84). The high-risk occupational group was found to have a higher seroprevalence, which was 56% (95% CI 45.3-66.1) (n=47). The predominant serogroup was Sejroe (82.1%, 95% CI 72.6-88.8) (n=69). CONCLUSIONS: This study revealed a possible high seroprevalence of leptospirosis among febrile cases, indicating the need to review the importance of adding leptospirosis to the case investigation of febrile illness, especially among high-risk occupational groups in Malaysia, as well as in other endemic countries.

Indoor air quality in an automotive assembly plant in Selangor, Malaysia.

The purpose of this study was to determine the indoor air quality (IAQ) status of an automotive assembly plant in Rawang, Selangor, Malaysia using selected IAQ parameters, such as carbon dioxide (CO2), carbon monoxide (CO), temperature, relative humidity (RH) and respirable particulate matter (PM10). A cross-sectional study was conducted in the paint shop and body shop sections of the plant in March 2005. The Q-TRAK Plus IAQ Monitor was used to record the patterns of CO, CO2, RH and temperature; whilst PM10 was measured using DUSTTRAK Aerosol Monitor over an 8-hour time weight average (8-TWA). It was found that the average temperatures, RH and PM10 in the paint shop section and body shop sections exceeded the Department of Safety and Health (DOSH) standards. The average concentrations of RH and CO were slightly higher in the body shop section than in the paint shop section, while the average concentrations of temperature and CO2 were slightly higher in the paint shop section than in the body shop section. There was no difference in the average concentrations of PM10 between the two sections.

Prevalence and associated factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Ministry of Health Malaysia (MOH) Hospitals in Kelantan.

Karasek's job strain model postulates that workers chronically exposed to adverse psychosocial work environment (high strain job)--high psychological job demands and low job control, including poor social support, increased physical demand and hazardous work condition--will eventually develop both physical illnesses such as cardiovascular diseases and psychological disorders such as depression. In order to determine the prevalence and associated factors of job-related depression, a cross-sectional study was conducted among laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) Hospitals in Kelantan between September 2001 and February 2002. One hundred and two laboratory technicians in HUSM and 79 laboratory technicians in 7 KKM Hospitals were selected; 84/102 (82.4%) in HUSM and 71/79 (89.9%) in KKM Hospitals responded. Data was collected using self-administered questionnaires of the validated Malay version of the Job Content Questionnaire (JCQ) originally developed by Robert Karasek. Results indicated that the prevalence of high job strain in laboratory technicians in HUSM and KKM hospitals was 33.3% (28/84) and 26.8% (19/71), respectively (p>0.05). Significantly higher proportion (59.5%) (50/84) of laboratory technicians in HUSM compared to those in KKM Hospitals (39.4%) (28/71) (p = 0.016) experienced job-related depression. Significant associated factors of job-related depression were low social support (HUSM: adjusted OR 4.7, 95% CI 1.2-18.8; KKM: adjusted OR 14.8, 95%CI 2.4-89.3), high psychological demand (HUSM: adjusted OR 3.0, 95%CI 1.0-8.8), and low decision authority (KKM: adjusted OR 9.7, 95%CI 1.0-91.1). We conclude that strengthening the social support network (supervisors' and coworkers' support), reducing psychological job demand, and increasing decision-making authority of laboratory technicians may go a long way towards reducing job-related depression.

Prevalence and risk factors of job strain among laboratory technicians in Hospital Universiti Sains Malaysia.

INTRODUCTION: Several sources of job stress exist. Some of these stressors are intrinsic to the job, while some are related to psychosocial and other factors. METHODS: A cross-sectional study of the prevalence and risk factors of job strain in 84 laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) (response rate 82.4 percent) was conducted between September 2001 and February 2002. A Malay version of the validated Karasek's Job Content Questionnaire was used as the research instrument in this study. There were five scales in the questionnaire. Two scales were used to define job strain, namely: decision latitude and psychological demands. RESULTS: The prevalence of high job strain in laboratory technicians in HUSM was 33.3 percent. Job insecurity (adjusted OR 2.4; 95 percent CI 1.2-5.7), physical exertion (adjusted OR 1.7; 95 percent CI 1.1-2.9), and total psychological stressors (adjusted OR 3.6; 95 percent CI 1.8-7.1) were significantly associated with job strain. CONCLUSION: A high proportion of laboratory technicians in HUSM experienced high job strain and psychosocial factors in the workplace posed significant risks of job strain in these workers.

Risk factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) hospitals in Kelantan.

A cross-sectional study was conducted to determine the risk factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) Hospitals in Kelantan, between September 2001 and February 2002. One hundred and two laboratory technicians from HUSM and 79 from KKM Hospitals were selected and 84 (82.4%) from HUSM and 71 (89.9%) from KKM Hospitals were recruited as study subjects. Data were collected by self-administered questionnaire using the validated Malay version of the Job Content Questionnaire (JCQ), originally developed by Robert Karasek. The results indicated significant associations between the risk factors of job-related depression, and low social support, and high psychological demands (OR 3.0, 95% CI 1.1-8.8) in laboratory technicians in HUSM. However, for laboratory technicians in KKM Hospitals, the significant association was between job-related depression, and low social support and low decision authority (OR 9.7, 95% CI 1.1-91.1). Low social support was highly associated with job-related depression in laboratory technicians in HUSM and KKM Hospitals. We, therefore, conclude that low social support positively predicted depression in laboratory technicians in HUSM and KKM Hospitals. In addition, high psychological demands also significantly predicted depression in laboratory technicians in HUSM; however, for laboratory technicians in KKM Hospitals, low decision authority was the significant predictor of depression.