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1.
PLoS Negl Trop Dis ; 14(3): e0008197, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32203511

RESUMEN

BACKGROUND: Leptospirosis, commonly known as rat-urine disease, is a global but endemic zoonotic disease in the tropics. Despite the historical report of leptospirosis in Malaysia, the information on human-infecting species is limited. Determining the circulating species is important to understand its epidemiology, thereby to strategize appropriate control measures through public health interventions, diagnostics, therapeutics and vaccine development. METHODOLOGY/PRINCIPLE FINDINGS: We investigated the human-infecting Leptospira species in blood and serum samples collected from clinically suspected leptospirosis patients admitted to three tertiary care hospitals in Malaysia. From a total of 165 patients, 92 (56%) were confirmed cases of leptospirosis through Microscopic Agglutination Test (MAT) (n = 43; 47%), Polymerase Chain Reaction (PCR) (n = 63; 68%) or both MAT and PCR (n = 14; 15%). The infecting Leptospira spp., determined by partial 16S rDNA (rrs) gene sequencing revealed two pathogenic species namely Leptospira interrogans (n = 44, 70%) and Leptospira kirschneri (n = 17, 27%) and one intermediate species Leptospira wolffii (n = 2, 3%). Multilocus sequence typing (MLST) identified an isolate of L. interrogans as a novel sequence type (ST 265), suggesting that this human-infecting strain has a unique genetic profile different from similar species isolated from rodents so far. CONCLUSIONS/SIGNIFICANCE: Leptospira interrogans and Leptospira kirschneri were identified as the dominant Leptospira species causing human leptospirosis in Central Malaysia. The existence of novel clinically important ST 265 (infecting human), that is different from rodent L. interrogans strains cautions reservoir(s) of these Leptospira lineages are yet to be identified.


Asunto(s)
Leptospira interrogans/aislamiento & purificación , Leptospira/clasificación , Leptospira/aislamiento & purificación , Leptospirosis/epidemiología , Leptospirosis/microbiología , Adulto , Pruebas de Aglutinación , Animales , Femenino , Genes Bacterianos/genética , Humanos , Leptospira/genética , Leptospira/patogenicidad , Leptospira interrogans/genética , Leptospira interrogans/patogenicidad , Leptospirosis/sangre , Leptospirosis/orina , Malasia/epidemiología , Masculino , Persona de Mediana Edad , Técnicas de Diagnóstico Molecular , Tipificación de Secuencias Multilocus , Reacción en Cadena de la Polimerasa , ARN Ribosómico 16S/genética , Enfermedades de los Roedores , Roedores , Análisis de Secuencia de ADN , Pruebas Serológicas , Adulto Joven , Zoonosis
2.
PLoS One ; 15(2): e0228570, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32040497

RESUMEN

BACKGROUND: Diabetes is a metabolic disorder, characterized by hyperglycemic state of the body. A silent killer, which can take the lives of victims if undiagnosed at the earliest stage. Prediabetes has become an important health concern across countries due to its huge potential for the development of diabetes and other complications. The objectives of this study were to determine the prevalence of prediabetes and diabetes and its associated factors among rural fishing communities in Penang, Malaysia. METHODS: A cross-sectional study was conducted among fishing communities in Southwest District of Penang, Malaysia from August to November 2017. Blood sample (finger prick test) and physical examination were performed on sample of 168 participants consented in this study. Pre-validated Malay versions of International Physical Activity 7 (IPAQ-7) and Perceived Stress Scale (PSS) questionnaires were used to assess the level of physical activity and stress levels of the participants. Multinomial logistic regression models were fitted to identify factors associated with prediabetes and diabetes. RESULTS: The prevalence of diabetes and prediabetes were 19.6% (95% CI: 14.3, 26.4) and 10.12% (95% CI: 6.4, 15.7) respectively. The median physical activity (interquartile range) in MET-minutes per week for those with diabetes (1071.0 (2120.0)) and prediabetes (1314.0 (1710.0)) was generally lower as compared to non-diabetes. Majority reported moderate stress (57.3%) from PSS system. Abdominal obesity, family history of diabetes and being hypertensive were significant factors associated with diabetes; while older age, bigger waist circumference and self-perceived poor routine diet were factors associated with prediabetes. CONCLUSIONS: The screening for prediabetes in this population gives the opportunity to implement lifestyle interventions at the earliest possible, which could prevent the development of diabetes. The identification of diabetic individuals provides an opportunity to conduct health promotion and education to ensure good metabolic control and hence reduce the risks of complications.


Asunto(s)
Diabetes Mellitus/epidemiología , Estado Prediabético/epidemiología , Adulto , Anciano , Glucemia , Estudios Transversales , Complicaciones de la Diabetes/epidemiología , Ejercicio Físico , Femenino , Explotaciones Pesqueras , Humanos , Estilo de Vida , Malasia/epidemiología , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Estado Prediabético/complicaciones , Prevalencia , Análisis de Regresión , Riesgo , Población Rural , Estrés Psicológico , Encuestas y Cuestionarios , Circunferencia de la Cintura
3.
PLoS One ; 15(1): e0223235, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31971942

RESUMEN

Workplace bullying is a significant cause of stress at work. Existing studies, primarily based on Western-oriented frameworks and instruments, have largely overlooked the role of culture. This oversight questions whether understandings generated from those studies can be generalised to employees working in Eastern countries, which differ on important cultural dimensions. To date, there is no Eastern-based instrument for measuring workplace bullying. In two studies, we developed and validated such a measure: the Malaysian Workplace Bullying Index (MWBI). Study 1 entailed a content validation of bullying behaviours via written records (diaries) completed by Malaysian bullying victims. The 19 validated behaviours formed the basis of Study 2, with additions from the wider literature. Study 2 used survey data collected at three time-points from Malaysian employees exposed to bullying at work. The final result was an 18-item scale with two nine-item factors: work-related bullying and person-related bullying. Overall, the MWBI is a psychometrically sound measure of workplace bullying in Eastern workplaces.


Asunto(s)
Acoso Escolar/psicología , Emociones , Psiquiatría , Lugar de Trabajo/psicología , Adolescente , Adulto , Cultura , Empleo/psicología , Análisis Factorial , Femenino , Humanos , Malasia/epidemiología , Masculino , Persona de Mediana Edad , Psicometría/métodos , Conducta Social , Adulto Joven
4.
PLoS One ; 15(1): e0226606, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31929543

RESUMEN

BACKGROUND: The objective of this study was to assess regional and ethnic differences in an unselected patient population treated with polymer-free sirolimus-eluting stents (PF-SES) in Asia and Europe. METHODS: Two all-comers observational studies based on the same protocol (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were combined for data analysis to assure sufficient statistical power. The primary endpoint was the accumulated target lesion revascularization (TLR) rate at 9-12 months. RESULTS: Of the total population of 7243 patients, 44.0% (3186) were recruited in the Mediterranean region and 32.0% (2317) in central Europe. The most prominent Asian region was South Korea (17.6%, 1274) followed by Malaysia (5.7%, 413). Major cardiovascular risk factors varied significantly across regions. The overall rates for accumulated TLR and MACE were low with 2.2% (140/6374) and 4.4% (279/6374), respectively. In ACS patients, there were no differences in terms of MACE, TLR, MI and accumulated mortality between the investigated regions. Moreover, dual antiplatelet therapy (DAPT) regimens were substantially longer in Asian countries even in patients with stable coronary artery disease as compared to those in Europe. CONCLUSIONS: PF-SES angioplasty is associated with low clinical event rates in all regions. Further reductions in clinical event rates seem to be associated with longer DAPT regimens.


Asunto(s)
Enfermedad de la Arteria Coronaria/terapia , Stents Liberadores de Fármacos , Grupos Étnicos/estadística & datos numéricos , Inmunosupresores/uso terapéutico , Infarto del Miocardio/prevención & control , Intervención Coronaria Percutánea/métodos , Sirolimus/uso terapéutico , Anciano , Europa (Continente)/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Malasia/epidemiología , Masculino , Región Mediterránea/epidemiología , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Polímeros , Pronóstico , Estudios Prospectivos , República de Corea/epidemiología
5.
PLoS One ; 15(1): e0228217, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31990962

RESUMEN

Escherichia coli (E. coli) from the B2 phylogenetic group is implicated in colorectal cancer (CRC) as it possesses a genomic island, termed polyketide synthetase (pks), which codes for the synthesis of colibactin, a genotoxin that induces DNA damage, cell cycle arrest, mutations and chromosomal instability in eukaryotic cells. The aim of this study was to detect and compare the prevalence of E. coli expressing pks (pks+ E. coli) in CRC patients and healthy controls followed by investigating the virulence triggered by pks+ E. coli using an in-vitro model. Mucosal colon tissues were collected and processed to determine the presence of pks+ E. coli. Thereafter, primary colon epithelial (PCE) and colorectal carcinoma (HCT116) cell lines were used to detect cytopathic response to the isolated pks+ E. coli strains. Our results showed 16.7% and 4.3% of CRC and healthy controls, respectively were pks+ E. coli. Further, PCE displayed syncytia and cell swelling and HCT116 cells, megalocytosis, in response to treatment with the isolated pks+ E. coli strains. In conclusion, pks+ E. coli was more often isolated from tissue of CRC patients compared to healthy individuals, and our in-vitro assays suggest these isolated strains may be involved in the initiation and development of CRC.


Asunto(s)
Centros Médicos Académicos/estadística & datos numéricos , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/microbiología , Escherichia coli/enzimología , Escherichia coli/fisiología , Sintasas Poliquetidas/metabolismo , Anciano , Femenino , Humanos , Malasia/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia
6.
PLoS One ; 15(1): e0227246, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31923230

RESUMEN

Generally, dietary patterns (DP)s have been linked to the risk of diabetes mellitus, however, only few studies examined the associations between DPs in early pregnancy and the risk of gestational diabetes mellitus (GDM). This study aims to determine the association between DPs before and during pregnancy and risk of GDM in Malaysian pregnant women. DPs were derived using principal component analysis of consumed 126 food and beverage items assessed using a validated semi-quantitative food frequency questionnaire collecting data retrospectively for pre-pregnancy, but prospectively for the first and second trimester. Three different DPs were identified at each time point and labelled as DP 1-3 (pre-pregnancy), DP 4-6 (first trimester), and DP 7-9 (second trimester). About 10.6% (n = 48) of pregnant women were diagnosed with GDM in our cohort. Women with high adherence (HA) to DP 2 (adjusted OR: 0.45, 95% CI: 0.20-0.91) and DP 5 (adjusted OR: 0.28, 95% CI: 0.11-0.68) showed a significantly reduced risk of GDM compared to women with low adherence (LA). Other DPs were not significantly associated with GDM risk. Compared to women with GDM, non-GDM women showed HA scores for all DPs throughout pregnancy. Overall, a relative low percentage of women with GDM was found in this cohort. The risk was lower in women with HA to a relatively unhealthy dietary pattern, i.e. DP 2 and DP 5. The lower body mass index (BMI) status and energy intake of women showing a HA to DP 2 in the first trimester may underlie the observed association with a lower GDM risk. Additionally, genetic variance might explain the less susceptibility to GDM despite HA to unhealthy DPs among non-GDM women.


Asunto(s)
Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiología , Dieta , Primer Trimestre del Embarazo , Segundo Trimestre del Embarazo , Fenómenos Fisiologicos de la Nutrición Prenatal , Adulto , Índice de Masa Corporal , Ingestión de Energía , Femenino , Estudios de Seguimiento , Humanos , Malasia/epidemiología , Embarazo , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo
7.
J Med Microbiol ; 69(1): 49-51, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31750812

RESUMEN

Introduction. Burkholderia pseudomallei (melioidosis) is an important cause of community-acquired pneumonia (CAP) in the tropics. Selective medium is recommended for laboratory diagnosis with non-sterile respiratory samples, while PCR is not routinely used due to variable reported performance. The effectiveness of these diagnostic modalities varies by site.Aim. To compare selective media and real-time PCR (qPCR) with routine media in detecting B. pseudomallei in CAP respiratory samples in a low-incidence setting in Kuala Lumpur, Malaysia.Methodology. Respiratory samples were routinely cultured on blood, chocolate and MacConkey agar (RESP-ROUTINE), and compared to culture on selective Ashdown medium (RESP-SELECTIVE) and qPCR. The gold standard was routine culture of B. pseudomallei from any site (ALL-ROUTINE).Results. B. pseudomallei was detected in 8/204 (3.9 %) samples. Overall sensitivity rates differed (P=0.03) for qPCR (100%), RESP-SELECTIVE (87.5%) and RESP-ROUTINE (50%). There was a trend towards lower median days to positive culture for RESP-SELECTIVE (1 day) compared to RESP-ROUTINE (2 days, P=0.08) and ALL-ROUTINE (2 days, P=0.06). Reagent costs for each additional detection were USD59 for RESP-SELECTIVE and USD354 for PCR.Conclusions. In a low-incidence setting, selective culture of respiratory samples on Ashdown was more sensitive and allowed quicker identification than routine media, at reasonable cost. Blood cultures are critical, confirming four cases missed by routine respiratory culture. Selective medium is useful in early pneumonia (pre-sepsis) and resource-limited settings where blood cultures are infrequently done. Real-time PCR is costly, but highly sensitive and useful for high-risk patients with diabetes, cancer or immunosuppressants, or requiring ventilation or intensive care.


Asunto(s)
Técnicas Bacteriológicas/métodos , Burkholderia pseudomallei/aislamiento & purificación , Medios de Cultivo/química , Melioidosis/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Infecciones Comunitarias Adquiridas/diagnóstico , Infecciones Comunitarias Adquiridas/epidemiología , Humanos , Incidencia , Malasia/epidemiología , Melioidosis/epidemiología , Neumonía Bacteriana/diagnóstico , Neumonía Bacteriana/epidemiología , Sensibilidad y Especificidad
8.
Acta Trop ; 201: 105183, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31542372

RESUMEN

Leptospirosis is a zoonotic disease caused by the pathogenic helical spirochetes, Leptospira. Symptoms include sudden-onset fever, severe headaches, muscle pain, nausea and chills. Leptospirosis is endemic in developing countries such as Malaysia, India, Sri Lanka, and Brazil where thousands of cases are reported annually. The disease risk factors include the high population of reservoirs, environmental factors, recreational factors, and occupational factors. To end the endemicity of leptospirosis, these factors need to be tackled. The management of leptospirosis needs to be refined. Early diagnosis remains a challenge due to a lack of clinical suspicion among physicians, its non-specific symptoms and a limited availability of rapid point-of-care diagnostic tests. The purpose of this review is to provide insight into the status of leptospirosis in developing countries focusing on the risk factors and to propose methods for the improved management of the disease.


Asunto(s)
Leptospirosis/epidemiología , Animales , Brasil/epidemiología , Países en Desarrollo , Humanos , India/epidemiología , Leptospirosis/prevención & control , Malasia/epidemiología , Masculino , Sri Lanka/epidemiología , Zoonosis
9.
J Med Microbiol ; 69(3): 451-456, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31846413

RESUMEN

Introduction. Co-infection of leptospirosis-malaria is not uncommon due to their overlapping geographical distribution in the tropics.Aim. This study aimed to describe and compare the demographic, clinical and laboratory features of leptospirosis-malaria co-infection (LMCI) against leptospirosis mono-infection (LMI) in Peninsular Malaysia.Methodology. Data of patients admitted to various hospitals in Peninsular Malaysia from 2011 to 2014 diagnosed with leptospirosis in our laboratory were obtained from their admission records. Co-infections with malaria were identified via blood film for malaria parasites (BFMP). Description with inferential statistics analysis and multiple logistic regressions were used to distinguish features between dual and mono-infections.Results. Of 111 leptospirosis-positive patients, 26 (23.4 %) tested positive for malaria. Co-infections were predominant among male patients with a mean age of 33 years and were prevalent among immigrant populations who had settled in high-density suburban areas. Chills and rigor with splenomegaly were the only significant distinguishing clinical features of LMCI while leukocytosis and raised transaminases were significant laboratory parameters. Only chills and rigor demonstrated a predictive value for LMCI from analysis of multiple logistic regressions. No death was attributed to co-infection in this study, in contrast to LMI (11.8 %, n=10).Conclusion. The significant prevalence of LMCI found in this study with overlapping demographic, clinical and laboratory parameters makes diagnosis of co-infection challenging. It is essential to evaluate co-infection in endemic areas. Strengthened awareness of LMCI, comprehensive diagnostic services and further prospective studies are warranted.


Asunto(s)
Coinfección , Leptospira/aislamiento & purificación , Leptospirosis/epidemiología , Malaria/epidemiología , Plasmodium/aislamiento & purificación , Adolescente , Adulto , Demografía , Femenino , Humanos , Leptospirosis/diagnóstico , Leptospirosis/microbiología , Modelos Logísticos , Malaria/diagnóstico , Malaria/parasitología , Malasia/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Adulto Joven
10.
BMC Public Health ; 19(1): 1685, 2019 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-31842826

RESUMEN

The purpose of this correspondence is to express our disappointment with the coverage of the BMC Public Health supplement: Vol 19 (4) titled "Health and Nutritional Issues Among Low Income Population in Malaysia", which neglected to include the fundamental health and nutrition issues that are adversely affecting the lives and livelihood of the indigenous peoples. The Supplement comprised 21 papers. Two of these papers included indigenous peoples as study subjects. These two papers addressed peripheral, albeit important health issues, namely visual impairment and quality of life, and not the persistent and rising health concerns impacting this population. We will provide evidence from research and reports to justify our critique that the Supplement missed the opportunity to spotlight on the serious extent of the health and nutritional deprivations of the indigenous peoples of Malaysia. As researchers of the indigenous peoples, we ought to lend our voice to the "silenced minority" by highlighting their plight in the media including scientific journals.


Asunto(s)
Disparidades en el Estado de Salud , Pueblos Indígenas/estadística & datos numéricos , Trastornos Nutricionales/epidemiología , Pobreza/estadística & datos numéricos , Informe de Investigación/normas , Humanos , Malasia/epidemiología
11.
Ann Clin Microbiol Antimicrob ; 18(1): 43, 2019 Dec 17.
Artículo en Inglés | MEDLINE | ID: mdl-31847847

RESUMEN

BACKGROUND: Staphylococcus has replaced streptococcus as the most common cause of infective endocarditis (IE) in developed health care systems. The trend in developing countries is less clear. AIM: To examine the epidemiological trends of infective endocarditis in a developing nation. METHODS: Single-centre, retrospective study of patients admitted with IE to a tertiary hospital in Malaysia over a 12-year period. RESULTS: The analysis included 182 patients (n = 153 Duke's definite IE, n = 29 possible IE). The mean age was 51 years. Rheumatic heart disease was present in 42%, while 7.6% were immunocompromised. IE affected native valves in 171 (94%) cases. Health-care associated IE (HCAIE) was recorded in 68 (37.4%). IE admission rates increased from 25/100,000 admissions (2012) to 59/100,000 admissions (2017). At least one major complication on admission was detected in 59 (32.4%) patients. Left-sided IE was more common than right-sided IE [n = 159 (87.4%) vs. n = 18 (9.9%)]. Pathogens identified by blood culture were staphylococcus group [n = 58 (40.8%)], streptococcus group [n = 51 (35.9%)] and Enterococcus species [n = 13 (9.2%)]. staphylococcus infection was highest in the HCAIE group. In-hospital death occurred in 65 (35.7%) patients. In-hospital surgery was performed for 36 (19.8%) patients. At least one complication was documented in 163 (85.7%). CONCLUSION: Staphylococcus is the new etiologic champion, reflecting the transition of the healthcare system. Streptococcus is still an important culprit organism. The incidence rate of IE appears to be increasing. The rate of patients with underlying rheumatic heart disease is still high.


Asunto(s)
Endocarditis Bacteriana , Staphylococcus aureus/aislamiento & purificación , Adulto , Anciano , Antibacterianos/uso terapéutico , Infección Hospitalaria , Países en Desarrollo , Endocarditis Bacteriana/tratamiento farmacológico , Endocarditis Bacteriana/microbiología , Endocarditis Bacteriana/mortalidad , Femenino , Humanos , Malasia/epidemiología , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Infecciones Estafilocócicas/microbiología , Streptococcus/aislamiento & purificación , Adulto Joven
12.
Artículo en Inglés | MEDLINE | ID: mdl-31877917

RESUMEN

The aim of this study was to describe the employment experiences of persons with learning disabilities (LDs) in developing countries, such as Malaysia. Factors associated with respondents' employment were also determined. A cross-sectional survey was conducted among young adults with LD who left the special education programs in secondary schools in Kuala Lumpur and Selangor. Ninety young adults with LD, aged 18 to 25 years were interviewed face-to-face at an agreed upon convenient place on their working experiences after leaving secondary schools. A total of 13 respondents were excluded from the analysis because their intellectual quotient (IQ) score demonstrated a high possibility of intellectual disability with IQ estimation <70. Of the 77 young adults analyzed, 74.0% reported having work experience and 64.9% were working at the time of interview. Statistical analysis showed significant associations between individual, family, and community factors with respondents' employment. Two factors made a unique statistically significant contribution to the model (gender, p = 0.043 and adult service: Financial support p = 0.012). This study suggests the current school-to-work transition program at secondary and post-secondary schools should be improved to better prepare young adults with LD with necessary skills relevant for the current job market so that they could improve their employability.


Asunto(s)
Personas con Discapacidad , Empleo , Discapacidades para el Aprendizaje/epidemiología , Adolescente , Adulto , Estudios Transversales , Educación Especial , Femenino , Humanos , Discapacidad Intelectual , Malasia/epidemiología , Masculino , Instituciones Académicas , Adulto Joven
13.
East Asian Arch Psychiatry ; 29(4): 118-123, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31871308

RESUMEN

OBJECTIVE: To determine the prevalence of adult attention deficit hyperactivity disorder (ADHD) and comorbid mental disorders in a Malaysian forensic mental hospital. METHODS: All adult patients admitted to the forensic wards who were able to understand Malay or English language and give written informed consent were included. Participants were assessed using the Conners Adult Attention-Deficit Diagnostic Interview for DSM-IV (for presence of adult ADHD and a history of childhood ADHD) and the Mini International Neuropsychiatric Interview (for psychiatric comorbidities). Sociodemographic and offence-related data were also collected. RESULTS: Of 199 patients admitted, 120 were included for analysis. The mean age of participants was 36.3 years. 94.2% were men. 81.7% were single, divorced, or separated. 25% had a history of childhood ADHD. The prevalence of adult ADHD was 15.8%. The persistence rate was 63%. Among the 19 participants with adult ADHD, the most common psychiatric comorbidities were substance dependence (68.4%), lifetime depression (63.2%), and generalised anxiety disorder (47.4%). Compared with participants without ADHD, participants with adult ADHD were less likely to be married (0% vs 21.8%, p = 0.022) and more likely to have alcohol abuse (15.8% vs 2%, p = 0.028), lifetime manic/hypomanic episodes (42.1% vs 7.9%, p = 0.001), and generalised anxiety disorder (47.4% vs 19.8%, p = 0.017), and were of younger age at first offence (21.8 years vs 26.9 years, p = 0.021). CONCLUSIONS: Adult ADHD is common in a Malaysian forensic mental hospital and is associated with unmarried status, alcohol abuse, lifetime manic/hypomanic episodes, generalised anxiety disorder, and younger age at first offence.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Psiquiatría Forense , Hospitales Psiquiátricos , Pacientes Internos/psicología , Pacientes Internos/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Malasia/epidemiología , Masculino , Prevalencia , Escalas de Valoración Psiquiátrica
14.
BMC Public Health ; 19(1): 1432, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31675946

RESUMEN

BACKGROUND: With the rise in prevalence of childhood tuberculosis (TB) globally, contact tracing should be a powerful strategy for early diagnosis and management, especially in children who are household contacts of active TB cases. Here, we aimed to determine the prevalence and factors associated with TB disease in children who are household contacts of TB cases. METHODS: We used a cross-sectional study with data from the Malaysian TB Information System (TBIS) recorded from 1 January 2014 to 31 December 2017. All children aged 0-14 years who were registered in the TBIS with at least one household contact of TB cases were included in the study. Multiple logistic regression analysis was performed to calculate the adjusted odds ratio (adj. OR) and for adjusting the confounding factors. RESULTS: A total of 2793 children were included in the study. The prevalence of active TB was 1.5% (95% confidence interval [CI]: 1.31, 1.77%). Children aged < 5 years [adj. OR 9.48 (95% CI: 3.41, 26.36) p < 0.001] with positive tuberculin skin test [adj. OR 395.73 (95% CI: 134.17, 1167.13), p < 0.001] and investigation period of > 6 weeks [adj. OR 7.48 (95% CI: 2.88, 19.43), p < 0.001] had significantly higher odds for TB disease. CONCLUSIONS: The prevalence of TB disease in children who were household contacts of TB cases is relatively low. However, contact tracing programmes should not only focus on children aged < 5 years and with positive tuberculin skin test results, but also be empowered to reduce the investigation period.


Asunto(s)
Trazado de Contacto , Composición Familiar , Tuberculosis/epidemiología , Adolescente , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Malasia/epidemiología , Masculino , Factores de Riesgo , Población Urbana/estadística & datos numéricos
15.
BMC Public Health ; 19(1): 1473, 2019 Nov 07.
Artículo en Inglés | MEDLINE | ID: mdl-31699061

RESUMEN

BACKGROUND: Men who inject drugs (MWIDs) comprise the highest percentage of diagnosed HIV cases in Malaysia. Their female partners risk being infected through unprotected sexual contact. This paper reports the prevalence of consistent condom use and its predictors among the wives and regular sexual partners of MWIDs in Klang Valley, Malaysia. METHODS: A cross-sectional study using a self-administered questionnaire was conducted among the wives and regular sexual partners of MWIDs in the study location; 221 women were recruited through respondent-driven sampling. Data were analysed descriptively for the prevalence of consistent condom use, HIV status and HIV risk-related behaviour. Subsequently, simple and multiple logistic regressions were undertaken to identify the predictors of consistent condom use. RESULTS: The prevalence of consistent condom use among respondents was 19.5%. Slightly more than half (52.5%) of respondents had never used condoms with their partner. Fourteen women (6.3%) reported being HIV positive. While 7.7% had HIV-positive partners, 45.7% were unaware of their partner's HIV status. Consistent condom use was significantly higher among single women (AOR = 4.95; 95% CI: 2.45, 9.99), women who lived in urban areas (AOR = 2.97; 95% CI: 1.30, 6.78), HIV-positive women (AOR = 3.45; 95% CI: 1.13, 10.5) and women involved in sex work (AOR = 3.55, 95% CI: 1.45, 8.67). CONCLUSIONS: Inconsistent condom use among the majority of female sexual partners of MWIDs underscores the heightened risk faced by these women and calls for alternative prevention methods that women are able to control.


Asunto(s)
Condones/estadística & datos numéricos , Conducta Anticonceptiva/estadística & datos numéricos , Consumidores de Drogas/estadística & datos numéricos , Parejas Sexuales/psicología , Adolescente , Adulto , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Seropositividad para VIH/epidemiología , Humanos , Modelos Logísticos , Malasia/epidemiología , Masculino , Prevalencia , Trabajo Sexual/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven
16.
Vet Microbiol ; 237: 108408, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31585650

RESUMEN

Information on the epidemiology of C. difficile infection (CDI) in South-East Asian countries is limited, as is data on possible animal reservoirs of C. difficile in the region. We investigated the prevalence and molecular epidemiology of C. difficile in piglets and the piggery environment in Thailand and Malaysia. Piglet rectal swabs (n = 224) and piggery environmental specimens (n = 23) were collected between 2015 and 2016 from 11 farms located in Thailand and Malaysia. All specimens were tested for the presence of C. difficile with toxigenic culture. PCR assays were performed on isolates to determine the ribotype (RT), and the presence of toxin genes. Whole genome sequencing was used on a subset of isolates to determine the evolutionary relatedness of RT038 (the most prevalent RT identified) common to pigs and humans from Thailand and Indonesia. C. difficile was recovered from 35% (58/165) and 92% (54/59) of the piglets, and 89% (8/9) and 93% (13/14) of the environmental specimens from Thailand and Malaysia, respectively. All strains from Thailand, and 30 strains from Malaysia (23 piglet and 7 environmental isolates) were non-toxigenic. To our knowledge, this is the first and only report with a complete lack of toxigenic C. difficile among piglets, a feature which could have a protective effect on the host. The most common strain belonged to RT038 (ST48), accounting for 88% (51/58) of piglet and 78% (7/9) of environmental isolates from Thailand, and all 30 isolates tested from Malaysia. Piglet RT038 isolates from Thailand and Malaysia differed by only 18 core-genome single nucleotide variants (cgSNVs) and both were, on average, 30 cgSNVs different from the human strains from Thailand and Indonesia, indicating a common ancestor in the last two decades.


Asunto(s)
Infecciones por Clostridium/veterinaria , Clostridium difficile/genética , Enfermedades de los Porcinos/microbiología , Animales , Infecciones por Clostridium/epidemiología , Infecciones por Clostridium/microbiología , Microbiología Ambiental , Variación Genética , Vivienda para Animales , Malasia/epidemiología , Epidemiología Molecular , Prevalencia , Porcinos , Tailandia/epidemiología , Secuenciación Completa del Genoma
17.
Int J Occup Environ Med ; 10(4): 159-173, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31586381

RESUMEN

BACKGROUND: The palm oil industry is the largest contributor to global production of oils and fats. Indonesia and Malaysia are the largest producers of palm oil. More than a million workers are employed in this industry, yet there is a lack of information on their occupational health and safety. OBJECTIVE: To identify and summarize occupational hazards among oil palm plantation workers. METHODS: A search was carried out in June 2018 in PubMed, Web of Science, Scopus, and Ovid. Relevant publications were identified by a systematic search of four databases and relevant journals. Publications were included if they examined occupational hazards in oil palm plantation workers. RESULTS: 941 publications were identified; of these, 25 studies were found eligible to be included in the final review. Of the 25 studies examined, 19 were conducted in Malaysia, 2 in Costa Rica, and one each in Ghana, Indonesia, Myanmar, Papua New Guinea, and Cameroon. Oil palm plantation workers were found to be at risk of musculoskeletal conditions, injuries, psychosocial disorders, and infectious diseases such as malaria and leptospirosis. In addition, they have potential exposure to paraquat and other pesticides. CONCLUSION: In light of the potential of palm oil for use as a biofuel, this is an industry with strong growth potential. The workers are exposed to various occupational hazards. Further research and interventions are necessary to improve the working conditions of this already vast and growing workforce.


Asunto(s)
Industria de Alimentos , Exposición Profesional , Salud Laboral , Aceite de Palma , Enfermedades de los Trabajadores Agrícolas/epidemiología , Camerún/epidemiología , Comorbilidad , Costa Rica/epidemiología , Industria de Alimentos/normas , Industria de Alimentos/estadística & datos numéricos , Inocuidad de los Alimentos , Ghana/epidemiología , Humanos , Indonesia/epidemiología , Malasia/epidemiología , Mianmar/epidemiología , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Salud Laboral/estadística & datos numéricos , Aceite de Palma/efectos adversos , Papúa Nueva Guinea/epidemiología , Plaguicidas/toxicidad , Aceites Vegetales/efectos adversos
18.
Int J Occup Environ Med ; 10(4): 203-215, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31586385

RESUMEN

BACKGROUND: Despite its excellent psychometric properties, St George's Respiratory Questionnaire (SGRQ) has not been previously used in measuring respiratory quality of life (RQoL) among traffic police and firefighters who are at risk of poor respiratory health by virtue of their occupations. OBJECTIVE: To assess and compare the RQoL of the occupationally exposed (firefighters and traffic police) and the occupationally unexposed populations in Penang, Malaysia. METHODS: We recruited male traffic police and firefighters from 5 districts of Penang by convenient sampling during June to September 2018. Participants completed the SGRQ. Scores (symptoms, activity, impacts, total) were derived using a scoring calculator. Higher scores indicate poorer RQoL. Univariate and multivariate linear regression models were fitted to explore the relationship of the independent predictive factors with participants' RQoL. RESULTS: We recruited 706 participants---211 firefighters, 198 traffic police, and 297 from general population. Smokers had significantly higher scores than non-smokers in all SGRQ domains. Regardless of smoking status, the "occupationally exposed group" had higher symptoms score than the "occupationally unexposed group," who had higher activity and impact scores. Smoking status, comorbidity status and monthly income were significant independent predictors of SGRQ total score. CONCLUSION: In comparison with the general population, firefighters and traffic police reported poorer RQoL; smoking further deteriorated their respiratory health. There is a need to strengthen preventive health measures against occupational disease and smoking cessation among firefighters and traffic police.


Asunto(s)
Bomberos/estadística & datos numéricos , Exposición por Inhalación/estadística & datos numéricos , Ocupaciones/estadística & datos numéricos , Policia/estadística & datos numéricos , Calidad de Vida , Trastornos Respiratorios/epidemiología , Adolescente , Adulto , Estudios de Casos y Controles , Estudios Transversales , Humanos , Exposición por Inhalación/efectos adversos , Malasia/epidemiología , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Exposición Profesional/estadística & datos numéricos , Trastornos Respiratorios/etiología , Fumar/efectos adversos , Fumar/epidemiología , Encuestas y Cuestionarios , Contaminación por Tráfico Vehicular/estadística & datos numéricos , Adulto Joven
19.
Comput Math Methods Med ; 2019: 1923479, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31481976

RESUMEN

In this paper, we will start off by introducing the classical Ross-Macdonald model for vector-borne diseases which we use to describe the transmission of dengue between humans and Aedes mosquitoes in Shah Alam, which is a city and the state capital of Selangor, Malaysia. We will focus on analysing the effect of using the Mosquito Home System (MHS), which is an example of an autodissemination trap, in reducing the number of dengue cases by changing the Ross-Macdonald model. By using the national dengue data from Malaysia, we are able to estimate λ, which represents the initial growth rate of the dengue epidemic, and this allows us to estimate the number of mosquitoes in Malaysia. A mathematical expression is also constructed which allows us to estimate the potential number of breeding sites of Aedes mosquitoes. By using the data available from the MHS trial carried out in Section 15 of Shah Alam, we included the potential effect of the MHS into the dengue model and thus modelled the impact MHS has on the spread of dengue within the trial area. We then extended our results to analyse the effect of the MHSs on reducing the number of dengue cases in the whole of Malaysia. A new model was constructed with a basic reproduction number, R 0,Mala MHS, which allows us to identify the required MHSs coverage needed to achieve extinction in Malaysia. Numerical simulations and tables of results were also produced to illustrate our results.


Asunto(s)
Dengue/prevención & control , Dengue/transmisión , Control de Mosquitos/instrumentación , Aedes/virología , Animales , Número Básico de Reproducción/estadística & datos numéricos , Ciudades/epidemiología , Simulación por Computador , Dengue/epidemiología , Epidemias , Humanos , Malasia/epidemiología , Conceptos Matemáticos , Modelos Biológicos , Control de Mosquitos/estadística & datos numéricos , Mosquitos Vectores/virología
20.
Eur J Clin Microbiol Infect Dis ; 38(12): 2349-2353, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31529307

RESUMEN

Clinical manifestations of leptospirosis range from mild, common cold-like illness, to a life-threatening condition. The host immune response has been hypothesized to play a major role in leptospirosis outcome. Increased levels of inflammatory mediators, such as cytokines, may promote tissue damage that lead to increased disease severity. The question is whether cytokines levels may predict the outcome of leptospirosis and guide patient management. This study aimed to assess the association between Th1-, Th2-, and Th17-related cytokines with the clinical outcome of patients with leptospirosis. Different cytokine levels were measured in fifty-two plasma samples of hospitalized patients diagnosed with leptospirosis in Malaysia (January 2016-December 2017). Patients were divided into two separate categories: survived (n = 40) and fatal outcome (n = 12). Nineteen plasma samples from healthy individuals were obtained as controls. Cytokine quantification was performed using Simple Plex™ assays from ProteinSimple (San Jose, CA, USA). Measurements were done in triplicate and statistical analysis was performed using GraphPad software and SPSS v20. IL-6 (p = 0.033), IL-17A (p = 0.022), and IL-22 (p = 0.046) were significantly elevated in fatal cases. IL-17A concentration (OR 1.115; 95% CI 1.010-1.231) appeared to be an independent predictor of fatality of leptospirosis. Significantly higher levels of TNF-α (p ≤ 0.0001), IL-6 (p ≤ 0.0001), IL-10 (p ≤ 0.0001), IL-12 (p ≤ 0.0001), IL17A (p ≤ 0.0001), and IL-18 (p ≤ 0.0001) were observed among leptospirosis patients in comparison with healthy controls. Our study shows that certain cytokine levels may serve as possible prognostic biomarkers in leptospirosis patients.


Asunto(s)
Citocinas/sangre , Leptospirosis/sangre , Leptospirosis/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Humanos , Interleucina-17/sangre , Interleucina-6/sangre , Interleucinas/sangre , Leptospirosis/patología , Leptospirosis/fisiopatología , Malasia/epidemiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Adulto Joven
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