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1.
Sci Total Environ ; 753: 141904, 2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-32890872

RESUMO

Sick building syndrome (SBS) is a collection of nonspecific syndromes linked with the built environment. The occurrence of SBS is associated with humidity, ventilation, moulds and microbial compounds exposure. However, no study has reported the association between indoor microbiome and SBS. In this study, 308 students were surveyed for SBS symptoms from 21 classrooms of 7 junior high schools from Johor Bahru, Malaysia, and vacuum dust from floor, desks and chairs was collected. High throughput amplicon sequencing (16S rRNA gene and ITS region) and quantitative PCR were conducted to characterize the absolute concentration of bacteria and fungi taxa. In total, 326 bacterial and 255 fungal genera were detected in dust with large compositional variation among classrooms. Also, half of these samples showed low compositional similarity to microbiome data deposited in the public database. The number of observed OTUs in Gammaproteobacteria was positively associated with SBS (p = 0.004). Eight microbial genera were associated with SBS (p < 0.01). Bacterial genera, Rhodomicrobium, Scytonema and Microcoleus, were protectively (negatively) associated with ocular and throat symptoms and tiredness, and Izhakiella and an unclassified genus from Euzebyaceae were positively associated with the throat and ocular symptoms. Three fungal genera, Polychaeton, Gympopus and an unclassified genus from Microbotryaceae, were mainly positively associated with tiredness. The associations differed with our previous study in microbial compounds (endotoxin and ergosterol) and SBS in the same population, in which nasal and dermal symptoms were affected. A higher indoor relative humidity and visible dampness or mould in classrooms were associated with a higher concentration of potential risk bacteria and a lower concentration of potential protective bacteria (p < 0.01). This is the first study to characterize the SBS-associated microorganisms in the indoor environment, revealing complex interactions between microbiome, SBS symptoms and environmental characteristics.


Assuntos
Poluição do Ar em Ambientes Fechados , Microbiota , Síndrome do Edifício Doente , Poluição do Ar em Ambientes Fechados/análise , Humanos , Malásia/epidemiologia , RNA Ribossômico 16S , Instituições Acadêmicas , Síndrome do Edifício Doente/epidemiologia
2.
PLoS Negl Trop Dis ; 14(10): e0008719, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33119609

RESUMO

An estimated 105 million dengue infections occur per year across 120 countries, where traditional vector control is the primary control strategy to reduce contact between mosquito vectors and people. The ongoing sars-cov-2 pandemic has resulted in dramatic reductions in human mobility due to social distancing measures; the effects on vector-borne illnesses are not known. Here we examine the pre and post differences of dengue case counts in Malaysia, Singapore and Thailand, and estimate the effects of social distancing as a treatment effect whilst adjusting for temporal confounders. We found that social distancing is expected to lead to 4.32 additional cases per 100,000 individuals in Thailand per month, which equates to 170 more cases per month in the Bangkok province (95% CI: 100-242) and 2008 cases in the country as a whole (95% CI: 1170-2846). Social distancing policy estimates for Thailand were also found to be robust to model misspecification, and variable addition and omission. Conversely, no significant impact on dengue transmission was found in Singapore or Malaysia. Across country disparities in social distancing policy effects on reported dengue cases are reasoned to be driven by differences in workplace-residence structure, with an increase in transmission risk of arboviruses from social distancing primarily through heightened exposure to vectors in elevated time spent at residences, demonstrating the need to understand the effects of location on dengue transmission risk under novel population mixing conditions such as those under social distancing policies.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Dengue/transmissão , Pneumonia Viral/epidemiologia , Animais , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Dengue/epidemiologia , Humanos , Malásia/epidemiologia , Mosquitos Vetores , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Singapura/epidemiologia , Isolamento Social , Tailândia/epidemiologia
3.
Emerg Infect Dis ; 26(11): 2598-2606, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33035448

RESUMO

We report the transmission dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across different settings in Brunei. An initial cluster of SARS-CoV-2 cases arose from 19 persons who had attended the Tablighi Jama'at gathering in Malaysia, resulting in 52 locally transmitted cases. The highest nonprimary attack rates (14.8%) were observed from a subsequent religious gathering in Brunei and in households of attendees (10.6%). Household attack rates from symptomatic case-patients were higher (14.4%) than from asymptomatic (4.4%) or presymptomatic (6.1%) case-patients. Workplace and social settings had attack rates of <1%. Our analyses highlight that transmission of SARS-CoV-2 varies depending on environmental, behavioral, and host factors. We identify red flags for potential superspreading events, specifically densely populated gatherings with prolonged exposure in enclosed settings, persons with recent travel history to areas with active SARS-CoV-2 infections, and group behaviors. We propose differentiated testing strategies to account for differing transmission risk.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Idoso , Brunei/epidemiologia , Técnicas de Laboratório Clínico/estatística & dados numéricos , Análise por Conglomerados , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/transmissão , Doença Relacionada a Viagens
4.
Sr Care Pharm ; 35(11): 484-486, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33121570

RESUMO

The pandemic has affected all walks of life and businesses, including education at all levels. Movement controls have forced the schools and universities to migrate the teaching and learning to be fully online. Some universities in large cities in Malyasia had already implemented blended learning and thus, were better prepared to adjust to the current situation. However, the universities, which practiced mainly traditional didactic courses, were struggling to suddenly change the mode of delivery. Many relied on the creativity of the lecturers and students.


Assuntos
Infecções por Coronavirus , Educação em Farmácia/tendências , Pandemias , Pneumonia Viral , Betacoronavirus , Humanos , Indonésia/epidemiologia , Malásia/epidemiologia
5.
Environ Monit Assess ; 192(11): 703, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33057929

RESUMO

Humans can be infected by pathogenic Leptospira through contact with infected animals or contaminated environments. Recreational exposure has been associated with human leptospirosis; however, there is a lack of information on the distribution of Leptospira spp. in recreational areas. Thus, we conducted this study to detect and describe the distributions of Leptospira spp. and to determine the prevalence of pathogenic leptospires at recreational areas in Peninsular Malaysia. Soil and water samples were randomly collected from 33 recreational areas in Peninsular Malaysia from December 2018 to April 2019. Each culture was examined under dark-field microscopy prior to genus confirmation by polymerase chain reaction using primers for the 16S rRNA gene. A total of 390 water and soil samples were collected, and 131 cultures were positive for Leptospira under dark-field microscope examination. Leptospira was identified in most of the recreational areas sampled, and at least one pathogenic Leptospira species was isolated from 17 recreational areas. The prevalence of saprophytic, intermediate, and pathogenic Leptospira spp. was 19.7%, 5.6%, and 8.2%, respectively. The dominant pathogenic species found in the samples was Leptospira kmetyi. This study provides important data on the distribution and prevalence of Leptospira spp. from soil and water, as well as the dominant pathogenic species, at recreational areas in Peninsular Malaysia. Therefore, preventive measures should be taken to ensure the safety of visitors.


Assuntos
Leptospira , Animais , Monitoramento Ambiental , Humanos , Leptospira/genética , Malásia/epidemiologia , RNA Ribossômico 16S
6.
J Infect Dev Ctries ; 14(9): 971-976, 2020 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-33031083

RESUMO

INTRODUCTION: The novel coronavirus infection has become a global threat affecting almost every country in the world. As a result, it has become important to understand the disease trends in order to mitigate its effects. The aim of this study is firstly to develop a prediction model for daily confirmed COVID-19 cases based on several covariates, and secondly, to select the best prediction model based on a subset of these covariates. METHODOLOGY: This study was conducted using daily confirmed cases of COVID-19 collected from the official Ministry of Health, Malaysia (MOH) and John Hopkins University websites. An Autoregressive Integrated Moving Average (ARIMA) model was fitted to the training data of observed cases from 22 January to 31 March 2020, and subsequently validated using data on cases from 1 April to 17 April 2020. The ARIMA model satisfactorily forecasted the daily confirmed COVID-19 cases from 18 April 2020 to 1 May 2020 (the testing phase). RESULTS: The ARIMA (0,1,0) model produced the best fit to the observed data with a Mean Absolute Percentage Error (MAPE) value of 16.01 and a Bayes Information Criteria (BIC) value of 4.170. The forecasted values showed a downward trend of COVID-19 cases until 1 May 2020. Observed cases during the forecast period were accurately predicted and were placed within the prediction intervals generated by the fitted model. CONCLUSIONS: This study finds that ARIMA models with optimally selected covariates are useful tools for monitoring and predicting trends of COVID-19 cases in Malaysia.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Modelos Estatísticos , Pneumonia Viral/epidemiologia , Teorema de Bayes , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Previsões , Humanos , Malásia/epidemiologia , Pandemias , Pneumonia Viral/diagnóstico , Vigilância em Saúde Pública
7.
Artigo em Inglês | MEDLINE | ID: mdl-33050004

RESUMO

The COVID-19 pandemic potentially increases doctors' work demands and limits their recovery opportunity; this consequently puts them at a high risk of adverse mental health impacts. This study aims to estimate the level of doctors' fatigue, recovery, depression, anxiety, and stress, and exploring their association with work demands and recovery experiences. This was a cross-sectional study among all medical doctors working at all government health facilities in Selangor, Malaysia. Data were collected in May 2020 immediately following the COVID-19 contagion peak in Malaysia by using self-reported questionnaires through an online medium. The total participants were 1050 doctors. The majority of participants were non-resident non-specialist medical officers (55.7%) and work in the hospital setting (76.3%). The highest magnitude of work demands was mental demand (M = 7.54, SD = 1.998) while the lowest magnitude of recovery experiences was detachment (M = 9.22, SD = 5.043). Participants reported a higher acute fatigue level (M = 63.33, SD = 19.025) than chronic fatigue (M = 49.37, SD = 24.473) and intershift recovery (M = 49.97, SD = 19.480). The majority of them had no depression (69.0%), no anxiety (70.3%), and no stress (76.5%). Higher work demands and lower recovery experiences were generally associated with adverse mental health. For instance, emotional demands were positively associated with acute fatigue (adj. b = 2.73), chronic fatigue (adj. b = 3.64), depression (adj. b = 0.57), anxiety (adj. b = 0.47), and stress (adj. b = 0.64), while relaxation experiences were negatively associated with acute fatigue (adj. b = -0.53), chronic fatigue (adj. b = -0.53), depression (adj. b = -0.14), anxiety (adj. b = -0.11), and stress (adj. b = -0.15). However, higher detachment experience was associated with multiple mental health parameters in the opposite of the expected direction such as higher level of chronic fatigue (adj. b = 0.74), depression (adj. b = 0.15), anxiety (adj. b = 0.11), and stress (adj. b = 0.11), and lower level of intershift recovery (adj. b = -0.21). In conclusion, work demands generally worsen, while recovery experiences protect mental health during the COVID-19 pandemic with the caveat of the role of detachment experiences.


Assuntos
Infecções por Coronavirus/terapia , Transtornos Mentais/epidemiologia , Pandemias , Médicos/psicologia , Pneumonia Viral/terapia , Adaptação Psicológica , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Humanos , Malásia/epidemiologia , Pneumonia Viral/epidemiologia , Carga de Trabalho/psicologia
9.
Medicine (Baltimore) ; 99(37): e22067, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925742

RESUMO

INTRODUCTION: Coastal areas in Malaysia can have important impacts on the livelihoods and health of local communities. Efforts by Malaysian government to develop and improve the landscape and ecosystem have been planned; however, the progress has been relatively slow because some of the coastal areas are remote and relatively inaccessible. Thus, these coastal communities face various challenges in health, healthcare and quality of life. This paper presents a study protocol to examine the health status, healthcare utilisation, and quality of life among the coastal communities. In addition, the relationship between the community and their coastal environment is examined. METHODOLOGY AND ANALYSIS: The population of interest is the coastal communities residing within the Tun Mustapha Park in Sabah, Malaysia. The data collection is planned for a duration of 6 months and the findings are expected by December 2020. A random cluster sampling will be conducted at three districts of Sabah. This study will collect 600 adult respondents (300 households are estimated to be collected) at age of 18 and above. The project is a cross sectional study via face-to-face interview with administered questionnaires, anthropometrics measurements and observation of the living condition performed by trained interviewers.


Assuntos
Utilização de Instalações e Serviços , Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Vigilância em Saúde Pública , Qualidade de Vida , Saúde da População Rural , Estudos Transversais , Ecossistema , Programas Governamentais , Acesso aos Serviços de Saúde , Humanos , Malásia/epidemiologia
10.
PLoS One ; 15(9): e0238780, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32911521

RESUMO

BACKGROUND: Hypertension is one of the most important risk factors for cardiovascular diseases. Thus, it is an important public health challenge worldwide. In Malaysia, only a few studies have focused on the trends of hypertension specifically for the aging population. In view of the rapid growth of the elderly population in Malaysia, there is an urgent need to explore the condition of hypertension in this aging population. Hence, the objectives of this study were to determine the trends of population mean systolic and diastolic blood pressure (BP) levels, the prevalence, awareness, treatment and control of hypertension, and its' associated factors among older persons in two cross-sectional national surveys that were conducted in 2006 and 2015 in Malaysia. METHODS: This was a subanalysis of secondary data collected from the two cross-sectional national population-based surveys conducted in Malaysia in 2006 and 2015. Adults aged 60 and older who had participated in these two surveys were included in the study. RESULTS: A total of 4954 (2295 males and 2659 females) and 3790 (1771 males and 2019 females) respondents completed the hypertension module surveys in 2006 and 2015, respectively. The mean age of the respondents was 68.5±6.9 years in 2006 and 68.6±7.1 years in 2015 and the difference was not significant. The prevalence of hypertension significantly reduced from 73.8% in 2006 to 69.2% in 2015 (p<0.001). Among the respondents with hypertension, the awareness, treatment and control of hypertension significantly increased from 49.7% to 60.2%, 86.7% to 91.5% and 23.3% to 44.8%, respectively, from 2006 to 2015. Logistic regression analysis showed that female sex and unemployed/retiree were significantly associated with higher hypertension prevalence in both 2006 and 2015. Being unemployed/ retiree was significantly associated with higher awareness of hypertension in both 2006 and 2015. In both 2006 and 2015, Chinese ethnicity were significantly associated with higher awareness and control of hypertension. CONCLUSIONS: The mean population BP levels and hypertension prevalence among the elderly population in Malaysia have reduced significantly over the past decade. Although the awareness, treatment and control of hypertension among older adults have improved significantly, the awareness and control rates remain suboptimal. As population aging is inevitable, appropriate public health programs and optimal treatment strategies targeting this vulnerable group are urgently needed to improve the overall awareness and control of hypertension and to prevent hypertension-related complications.


Assuntos
Hipertensão/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Pressão Sanguínea/fisiologia , Estudos Transversais , Grupos Étnicos , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência
11.
J Stroke Cerebrovasc Dis ; 29(10): 105173, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32912507

RESUMO

BACKGROUND: Diabetes and obesity are established risk factors for stroke. The current study aimed to assess risk factors of ischemic stroke recurrence in diabetic patients based on their body mass index (BMI). METHODS: A total of 4005 diabetic patients who had a history of ischemic stroke were identified in a retrospective cross-sectional dataset from the Malaysian National Neurology Registry. Patients were classified based on BMI, and multivariable regression analysis was used to evaluate the association between risk factors and recurrent ischemic stroke. RESULTS: Among obese patients, those with ischemic heart disease (aOR, 1.873; 95% CI, 1.131-3.103), received formal education (aOR, 2.236; 95% CI, 1.306-3.830), and received anti-diabetic medication (aOR, 1.788; 95% CI, 1.180-2.708) had a higher stroke recurrence risk, while receiving angiotensin receptors blockers (aOR, 0.261; 95% CI, 0.126-0.543) lowered the odds of recurrence. Overweight patients with hypertension (aOR, 1.011; 95% CI, 1.002-1.019) for over 10 years (aOR, 3.385; 95% CI, 1.088-10.532) and diabetes prior to the first stroke (aOR, 1.823; 95% CI, 1.020-3.259) as well as those received formal education (aOR, 2.403; 95% CI, 1.126-5.129) had higher odds of stroke recurrence, while receiving angiotensin-converting enzyme inhibitors (aOR, 0.244; 95% CI, 0.111-0.538) lowered the recurrence risk. Normal weight East Malaysians (aOR, 0.351; 95% CI, 0.164-0.750) receiving beta-blockers (aOR, 0.410; 95% CI, 0.174-0.966) had lower odds of stroke recurrence. CONCLUSIONS: Ischemic heart disease, hypertension, receiving anti-hypertensive agents, and educational level were independent predictors of recurrent stroke in obese patients. Managing the modifiable risk factors can decrease the odds of stroke recurrence.


Assuntos
Isquemia Encefálica/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Obesidade/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Anti-Hipertensivos/uso terapêutico , Índice de Massa Corporal , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/enzimologia , Isquemia Encefálica/mortalidade , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/mortalidade , Escolaridade , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Incidência , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Obesidade/complicações , Obesidade/mortalidade , Recidiva , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Fatores de Tempo
12.
PLoS One ; 15(9): e0238566, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915860

RESUMO

BACKGROUND: Obesity is a crucial public health problem and is rising globally. This study was conducted to determine the prevalence of obesity and its associated factors among the elderly in Malaysia. METHODS: Data were obtained from the National Health and Morbidity Survey (NHMS) 2015. This was a cross sectional population-based study using a two stage stratified random sampling design. Elderly population aged 60 years and above was selected. Data were collected using pre-tested self-administered questionnaire in the form of sociodemographic profile, non-communicable diseases (NCD) comorbidities (status on hypertension, diabetes and hypercholesterolemia) and NCD risk factors (current smoker and physical activity). Obesity has been defined using the World Health Organization (WHO) Body Mass Index (BMI) guideline, 1998. A complex sampling design analysis was used for the descriptive statistics. The associated risk factors for obesity were identified using Multiple Logistic Regression analysis. RESULTS: A total of 3794 respondents were included in this study. The prevalence of obesity among Malaysian elderly was 30.2%. The prevalence of obesity among the elderly was significantly higher in females, respondents from urban areas and Indians. Approximately one third of the elderly with non-communicable diseases such as hypertension (33.1%) and diabetes (38.8%), respectively, were obese. Among elderly who were obese, majority of them (89.8%) had at least one NCD. The prevalence of obesity was 16.8% among current smokers (aOR 0.59). Multiple logistic regression analysis revealed that elderly females (aOR [adjusted odds ratio] 1.52), having secondary education (aOR 1.96) with household income of RM 3000 and above (aOR 1.57) as well as being hypertensive (aOR 1.61) and diabetic (aOR 1.50) were more likely to be obese. In contrast, the Chinese elderly respondents (aOR 0.62) and current smokers (aOR 0.59) were less likely to be obese. There were no significant associations of obesity with hypercholesterolemia or with physical activity. CONCLUSIONS: A substantial proportion of Malaysian elderly were obese, and factors associated with obesity among them were being female, having secondary education with a household income of RM 3000 and above and being hypertensive or diabetic. Enhanced health promotion and education should be targeted at younger people in order to prevent obesity in the later years.


Assuntos
Inquéritos Epidemiológicos , Obesidade/epidemiologia , Idoso , Feminino , Humanos , Modelos Logísticos , Malásia/epidemiologia , Masculino , Morbidade , Prevalência , Fatores de Risco
13.
PLoS Negl Trop Dis ; 14(9): e0008617, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32886679

RESUMO

The zoonotic malaria parasite, Plasmodium knowlesi, is now a substantial public health problem in Malaysian Borneo. Current understanding of P. knowlesi vector bionomics and ecology in Sabah comes from a few studies near the epicentre of human cases in one district, Kudat. These have incriminated Anopheles balabacensis as the primary vector, and suggest that human exposure to vector biting is peri-domestic as well as in forest environments. To address the limited understanding of vector ecology and human exposure risk outside of Kudat, we performed wider scale surveillance across four districts in Sabah with confirmed transmission to investigate spatial heterogeneity in vector abundance, diversity and infection rate. Entomological surveillance was carried out six months after a cross-sectional survey of P. knowlesi prevalence in humans throughout the study area; providing an opportunity to investigate associations between entomological indicators and infection. Human-landing catches were performed in peri-domestic, farm and forest sites in 11 villages (3-4 per district) and paired with estimates of human P. knowlesi exposure based on sero-prevalence. Anopheles balabacensis was present in all districts but only 6/11 villages. The mean density of An. balabacensis was relatively low, but significantly higher in farm (0.094/night) and forest (0.082/night) than peri-domestic areas (0.007/night). Only one An. balabacensis (n = 32) was infected with P. knowlesi. Plasmodium knowlesi sero-positivity in people was not associated with An. balabacensis density at the village-level however post hoc analyses indicated the study had limited power to detect a statistical association due low vector density. Wider scale sampling revealed substantial heterogeneity in vector density and distribution between villages and districts. Vector-habitat associations predicted from this larger-scale surveillance differed from those inferred from smaller-scale studies in Kudat; highlighting the importance of local ecological context. Findings highlight potential trade-offs between maximizing temporal versus spatial breadth when designing entomological surveillance; and provide baseline entomological and epidemiological data to inform future studies of entomological risk factors for human P. knowlesi infection.


Assuntos
Anopheles/parasitologia , Malária/epidemiologia , Malária/transmissão , Mosquitos Vetores/parasitologia , Plasmodium knowlesi/isolamento & purificação , Animais , Bornéu/epidemiologia , Estudos Transversais , Fazendas , Florestas , Humanos , Malásia/epidemiologia , População Rural/estatística & dados numéricos , Soroconversão
14.
Arch Osteoporos ; 15(1): 142, 2020 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-32918631

RESUMO

T-score discordance between hip and spine is a common problem in the diagnosis of osteoporosis based on dual-energy X-ray absorptiometry. Not much information on the prevalence and risk factors of this problem is available in Malaysia. Our study found that factors like age, height, physical activity and menopausal status should be taken into account in the diagnosis of osteoporosis. INTRODUCTION AND OBJECTIVE: T-score discordance between hip and spine is a common problem in bone mineral density assessment. A difference ≥ 1 standard deviation (SD) (regardless of diagnostic class) is considered minor, and a difference more than one diagnostic class is considered major discordance. This study aimed to determine the prevalence and factors of hip and spine T-score discordance in a population aged ≥ 40 years in Klang Valley, Malaysia. SUBJECTS AND METHODS: In this cross-sectional study, subjects answered a demographic questionnaire and underwent body composition and bone health assessment using dual-energy X-ray absorptiometry. Chi-square and binary logistic regression analysis were used to assess the prevalence of T-score discordance among the subjects. RESULTS: A total of 786 Malaysians (382 men, 404 women) subjects were recruited. The prevalence of minor and major discordance was 30.3% and 2.3%, respectively. Overall, factors related to T-score discordance were advanced age, decreased height, and being physically active. Sub-analysis showed that decreased height and being physically active predicted T-score discordance in men, being menopausal and Indian (vs Chinese) were predictors in women. CONCLUSIONS: T-score discordance between hip and spine is common among Malaysian middle-aged and elderly population. Diagnosis of osteopenia/osteoporosis should be based on the T-score of more than one skeletal site as per the current recommendations.


Assuntos
Absorciometria de Fóton/métodos , Densidade Óssea/fisiologia , Osteoporose/diagnóstico , Coluna Vertebral/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Prevalência
15.
Ann Hematol ; 99(11): 2521-2527, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32975589

RESUMO

This study was aimed at determining the prevalence of anaemia amongst the Malaysian Cohort participants and the associated risk factors. This was a cross-sectional study that involved 102,388 participants from The Malaysian Cohort (TMC) aged between 35 and 70 years old recruited from April 2006 to September 2012. Venous blood was taken for the full blood count. The prevalence of anaemia was 13.8% with majority having the microcytic-hypochromic type (59.7%). Comparison between the ethnic groups showed that Indians have the highest prevalence of anaemia (19.9%), followed by Malays (13.1%), and Chinese (12.0%). The prevalence of anaemia was substantially higher in females (20.1%) compared to males (4.9%). Amongst the female participants, the prevalence of anaemia was highest amongst those who were younger than 49 years old and decreased as the age increased. In contrast, the prevalence of anaemia in males increased with age. Gender, ethnicity, age, marital status, presence of platelet disorders and kidney disease were significant risk factors associated with anaemia and contributed to 14.9% of the risk of developing anaemia in this population. The prevalence of anaemia amongst the Malaysian Cohort participants is 13.8% with the majority having the microcytic and hypochromic type implying iron deficiency as the main cause. It is important that those who have anaemia be further investigated and treated.


Assuntos
Anemia Hipocrômica/etnologia , Anemia Hipocrômica/epidemiologia , Adulto , Fatores Etários , Idoso , Estudos Transversais , Feminino , Humanos , Malásia/epidemiologia , Malásia/etnologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais
16.
Parasitol Res ; 119(10): 3555-3558, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32875397

RESUMO

Blastocystis sp. is a common enteric parasite of humans and animals associated with inadequate sanitation and poor personal hygiene. Over the years, the Malaysian thriving economy has been facilitated largely by migrant workers from developing countries, and there is concern that diseases endemic to their countries may be imported. Therefore, this study aimed to determine the current status of Blastocystis infection as well as subtypes (STs) from fecal samples among migrant workers in Selangor and Kuala Lumpur, Malaysia. Overall, almost a third of the study cohort (30.9%; n = 68/220) screened were infected with Blastocystis sp. predominantly with ST3 (54.5%; n = 12), followed by ST1 (36.4%; n = 8) and ST2 (9.1%; n = 2). Infection levels was almost similar among the different sectors; manufacturing (32.8%), domestic service (32.3%), and food service (27.3%) with common symptoms for infection included stomach and abdominal pain or discomfort and diarrhea (48.5%; n = 33). None of the socio-demographic risk factors evaluated were significant. Therefore, this study warrants continuous monitoring as well as understanding the impact of transmission among the migrant community with the local population especially those involved in food service sector.


Assuntos
Infecções por Blastocystis/epidemiologia , Infecções por Blastocystis/parasitologia , Blastocystis/classificação , Blastocystis/isolamento & purificação , Migrantes/estatística & dados numéricos , Adulto , Animais , Blastocystis/genética , Infecções por Blastocystis/diagnóstico , Monitoramento Epidemiológico , Fezes/parasitologia , Feminino , Humanos , Indústrias/estatística & dados numéricos , Malásia/epidemiologia , Masculino , Prevalência
17.
PLoS One ; 15(9): e0239680, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32986746

RESUMO

Geohelminthiasis is a worldwide problem, especially in low-income countries. Children from rural areas and those living in poverty, lacking basic health amenities and having poor environmental sanitation are likely to be affected. Adverse effects such as anemia, protein malnutrition, colitis are common which can affect both the children's physical and mental growing development. A cross-sectional study on geohelminthiasis was conducted among children from 238 households in 13 villages in Kota Marudu of northern Sabah, East Malaysia. The study involved interviewing villagers using questionnaires to collect demographic and socio-economic data, getting faecal samples from the children, collecting soil samples and identifying parasite eggs with microscopy and molecular methods. A total of 407 children (6 months-17 years old) enrolled in the study. Geohelminthiasis was detected in the faecal samples of children from 54% (7/13) of the villages with mean prevalence of infection per village of 9.0% (0%-34.9%). On a household basis, 18% (43/238) of the households sampled had infected children, with mean prevalence rate per household of 11% (0%-43%). The prevalence was for Ascaris lumbricoides: 9.6% (39/407), Trichuris trichiura: 2.7% (11/407) and hookworms (Necator americanus and Ancylostoma sp.): 2.7% (11/407). The overall mean infection rate of the children examined was 14.3%. Significantly higher prevalence was recorded for the children of mothers who did not have any formal education (p = 0.003); household income of less than USD119 (RM500) (p<0.001); children from homes without proper sanitation facilities (p<0.001); children who usually go about barefoot (p<0.001) and not washing feet before entering the house (p = 0.017). Soil samples were found to have geohelminth eggs or larvae which could be due to unhygienic sanitation practices. This study shows the geohelminthiasis is prevalent in the villages, and the risk factors are lack of maternal education, low income, poor sanitation facilities and irregular deworming practice. Expanding deworming coverage in the study region may help reduce the worm infections in these communities, so that the mental and physical development of the children would not be affected by geohelminthiasis. The data on the prevalence of geohelminthiasis in this study would contribute to better public health monitoring and operation to reduce the infection in rural areas.


Assuntos
Ancylostomatoidea/isolamento & purificação , Ascaríase/epidemiologia , Ascaris lumbricoides/isolamento & purificação , Infecções por Uncinaria/epidemiologia , Tricuríase/epidemiologia , Trichuris/isolamento & purificação , Adolescente , Animais , Ascaríase/parasitologia , Criança , Pré-Escolar , Estudos Transversais , Fezes/parasitologia , Feminino , Infecções por Uncinaria/parasitologia , Humanos , Lactente , Malásia/epidemiologia , Masculino , Pobreza , Prevalência , Saúde Pública , Fatores de Risco , População Rural , Saneamento , Tricuríase/parasitologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-32882876

RESUMO

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.


Assuntos
Suscetibilidade a Doenças , Ecossistema , Leptospirose , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Leptospirose/etiologia , Malásia/epidemiologia , Índice de Gravidade de Doença
19.
Eur Rev Med Pharmacol Sci ; 24(15): 8226-8231, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32767354

RESUMO

OBJECTIVE: To explore whether the climate has played a role in the COVID-19 outbreak, we compared virus lethality in countries closer to the Equator with others. Lethality in European territories and in territories of some nations with a non-temperate climate was also compared. MATERIALS AND METHODS: Lethality was calculated as the rate of deaths in a determinate moment from the outbreak of the pandemic out of the total of identified positives for COVID-19 in a given area/nation, based on the COVID-John Hopkins University website. Lethality of countries located within the 5th parallels North/South on 6 April and 6 May 2020, was compared with that of all the other countries. Lethality in the European areas of The Netherlands, France and the United Kingdom was also compared to the territories of the same nations in areas with a non-temperate climate. RESULTS: A lower lethality rate of COVID-19 was found in Equatorial countries both on April 6 (OR=0.72 CI 95% 0.66-0.80) and on May 6 (OR=0.48, CI 95% 0.47-0.51), with a strengthening over time of the protective effect. A trend of higher risk in European vs. non-temperate areas was found on April 6, but a clear difference was evident one month later: France (OR=0.13, CI 95% 0.10-0.18), The Netherlands (OR=0.5, CI 95% 0.3-0.9) and the UK (OR=0.2, CI 95% 0.01-0.51). This result does not seem to be totally related to the differences in age distribution of different sites. CONCLUSIONS: The study does not seem to exclude that the lethality of COVID-19 may be climate sensitive. Future studies will have to confirm these clues, due to potential confounding factors, such as pollution, population age, and exposure to malaria.


Assuntos
Clima , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Estações do Ano , Tempo (Meteorologia) , Betacoronavirus , Brunei/epidemiologia , Burundi/epidemiologia , Congo/epidemiologia , Infecções por Coronavirus/epidemiologia , Equador/epidemiologia , Guiné Equatorial/epidemiologia , Europa (Continente) , França/epidemiologia , Gabão/epidemiologia , Humanos , Ilhas do Oceano Índico/epidemiologia , Indonésia/epidemiologia , Quênia/epidemiologia , Malásia/epidemiologia , Melanesia/epidemiologia , Micronésia/epidemiologia , Países Baixos/epidemiologia , Pandemias , Papua Nova Guiné/epidemiologia , Pneumonia Viral/epidemiologia , Ruanda/epidemiologia , Samoa/epidemiologia , São Tomé e Príncipe/epidemiologia , Seicheles/epidemiologia , Singapura/epidemiologia , Somália/epidemiologia , Timor-Leste/epidemiologia , Clima Tropical , Uganda/epidemiologia , Reino Unido/epidemiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-32751459

RESUMO

Research identifying adults' mental health during the coronavirus disease 2019 (COVID-19) pandemic relies solely on demographic predictors without examining adults' health condition as a potential predictor. This study aims to examine individuals' perception of health conditions and test availability as potential predictors of mental health-insomnia, anxiety, depression, and distress-during the COVID-19 pandemic. An online survey of 669 adults in Malaysia was conducted during 2-8 May 2020, six weeks after the Movement Control Order (MCO) was issued. We found adults' perception of health conditions had curvilinear relationships (horizontally reversed J-shaped) with insomnia, anxiety, depression, and distress. Perceived test availability for COVID-19 also had curvilinear relationships (horizontally reversed J-shaped) with anxiety and depression. Younger adults reported worse mental health, but people from various religions and ethnic groups did not differ significantly in reported mental health. The results indicated that adults with worse health conditions had more mental health problems, and the worse degree deepened for unhealthy people. Perceived test availability negatively predicted anxiety and depression, especially for adults perceiving COVID-19 test unavailability. The significant predictions of perceived health condition and perceived COVID-19 test availability suggest a new direction for the literature to identify the psychiatric risk factors directly from health-related variables during a pandemic.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Acesso aos Serviços de Saúde , Saúde Mental , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Adulto , Ansiedade/epidemiologia , Infecções por Coronavirus/virologia , Depressão/epidemiologia , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pneumonia Viral/virologia , Distúrbios do Início e da Manutenção do Sono , Inquéritos e Questionários , Adulto Jovem
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