th

9Public Health
UN IM AS
Seminar 2023
08-09th March 2023
Public Health Transformation:
Are We Ready For The Future
Challenges?
Organised by
Doctor of Public Health Candidates
Department of Community Medicine and Public Health
Faculty Of Medicine and Health Science
Universiti Malaysia Sarawak
TABLE OF
CONTENTS
List of Speakers 3

UNIMAS 4

Welcoming Messages 5

Organizing Committee 8

Introduction of 9th UNIMAS Public Health Seminar 11

Objectives 12

Speakers Background 13

Tentatives 19

Acknowledgement 22

Contact us 23

Abstracts & e-poster 24

 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

HONOURABLE SPEAKERS
DR THILAKA A/P CHINNAYAH
DEPUTY DIRECTOR
(DISEASE SURVEILLANCE)

DR VERONICA LUGAH
SENIOR DEPUTY DIRECTOR
(PLANNING DIVISION)

DR BADRUL HISHAM BIN ABDUL SAMAD

RESEARCH FELLOW & CONSULTANT PUBLIC
HEALTH PHYSICIAN, UPNM

YBHG. DATO' SRI DR. MOHD UZIR MAHIDIN

CHIEF STATISTICIAN
THE DEPARTMENT OF STATISTICS MALAYSIA

DATO DR FADHLULLAH SUHAIMI

BIN ABDUL MALEK
FORMER CHAIRMAN OF MALAYSIAN
COMMUNICATION AND MULTIMEDIA COMMISSION

MR. DAN FADALINI SUKIA

CHIEF INFORMATION SECURITY OFFICER ,SAINS

3
 "PUBLIC HEALTH TRANSFORMATION:
ANNUAL REPORT FOR 2025

ARE WE READY FOR FUTURE

CHALLENGES?"

Since 1993, UNIMAS embodied the community-driven university principle

for a sustainable world. Located in the heart of Borneo – the world’s richest site
for biodiversity and indigenous knowledge, Universiti Malaysia Sarawak (UNIMAS)
is a prominent global player in empowering communities, nurturing creativity and
pioneering innovation for a sustainable world.
The Department of Community Medicine and Public Health, Faculty of
Medicine and Health Sciences, Universiti Malaysia Sarawak was established in
1995. Since then, the department has been involved in teaching and learning
programs at the undergraduate and postgraduate levels. The department is
committed to becoming an excellent community health center in meeting the
community needs, in terms of providing teaching and learning programs for health
care providers in relation to public health and community health disciplines at the
certificate, diploma, undergraduate, and postgraduate levels.
The department is also involved actively in research, publication and community
services, in the areas of maternal and child health, communicable and non-
communicable diseases, nutrition, healthcare management, occupational medicine,
and special needs group.

4
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Welcome Message
PROFESSOR DR. ASRI BIN SAID
DEAN
FACULTY OF MEDICINE AND HEALTH
SCIENCES, UNIMAS

Assalamualaikum Warahmatullahi Wabarakatuh dan Salam Sejahtera

It is a great pleasure and honour to welcome you all to the 9th UNIMAS
Public Health Seminar. The theme of the conference for this year is, “Public Health
Transformation Post-Pandemic: are we ready for future challenges?”

The emergence of COVID-19 in 2020, is probably the biggest disruptor and

public emergency since World War II. It has opened our eyes to the necessity to
change the way we approach health and healthcare so as to be ever-ready to face
future challenges. The pandemic has revealed gaps and weaknesses in existing
public health systems and provided a unique opportunity to transform them. In the
post-pandemic era, public health systems must be better prepared to respond to
future health threats, both anticipated and unanticipated. With the right
investments, policies, and approaches, public health systems can become more
resilient and better able to respond to health crises. I hope that this seminar can be
one of the platforms that we can use to share knowledge and best practices in the
field of public health.

I wish to thank the committee of this year’s Public Health Seminar for their
hard work in making this conference a reality. Despite being busy with their
academic workload, they have persevered to make sure this conference is a
success. They have really shown the meaning of, “Stronger Together.” I would also
like to acknowledge and say thank you to the academic supervisors and lecturers
for guiding the trainee's future public health specialists.

Thank you very much. I wish everyone a fruitful and productive seminar.
5
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Welcome Message

ASSOC. PROF. DR. JEFFERY ANAK STEPHEN

HEAD OF DEPARTMENT
DEPARTMENT OF COMMUNITY MEDICINE AND
PUBLIC HEALTH

Welcome to our 9th UNIMAS Public Health Seminar 2023, once again held as a
hybrid. This is our annual event organized by Doctor of Public Health (DrPH) final-
year candidates under the guidance of members of the Department of Community
Medicine and Public Health (CMPH), Faculty of Medicine and Health Sciences of
Universiti Malaysia Sarawak, UNIMAS.

For this 9th Seminar, the candidates have selected the theme of “Public Health
Transformation Post-Pandemic: are we ready for future challenges?”, which
highlights challenges and innovations in carrying out public health practices in this
post-pandemic Covid-19.

And to deliberate further on the theme, the Doctor of Public Health candidates
have identified and invited distinguished speakers from various sectors including
the Ministry of Health Malaysia, public and private universities, and as well as from
private sectors to speak at this Seminar. At the same time, the Organiser has
accepted scientific oral papers and e-posters submitted according to various public
health topics.

I believe all participants will benefit from this Seminar and will gain necessary
knowledge that can be utilized as well as can be shared with other colleagues.
Lastly, I would like to express my gratitude to all the distinguished speakers and
participants who support our Public Health Seminar, and to the Organising
Committee for their hard work in making this seminar a success.

Thank you.

6
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Welcome Message
PROFESSOR DR. RAZITASHAM BT SAFII
ADVISOR & COURSE COORDINATOR
9TH UNIMAS PUBLIC HEALTH SEMINAR

On behalf of the organizing committee, I would like to extend a warm welcome

to our participants and invited speakers to the “9th UNIMAS Public Health Seminar
2023”. Since the pandemic of Covid-19, this seminar has been conducted online or
via webinar mode.

This seminar is organized by students of the Doctor of Public Health Programme

(DrPH) under the course MDP71902 Public Health Seminar. The aim of this course is
to enable DrPH candidates to study contemporary issues in public health by focusing
on the aspects of situational analysis, critical appraisal, and up-to-date management
of a particular topic of interest. In successfully conducting the seminar, they need to
embrace teamwork, professionalism, communication skill, and other managerial
skills needed to become competent Public Health Medicine Specialists.

Our theme for this year is “Public Health Transformation: Are we ready for
future challenges” is timely for expert discussion to get the best practices in public
health activities in this era of pandemic and the industrial revolution (IR) 4.0

Finally, I would like to thank the Dean of the Faculty of Medicine and Health
Sciences, UNIMAS for his full support and guidance. I wish all participants an
enjoyable and fruitful session.

Thank you

7
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Welcome Message
DR. AHMAD SALIMI
ORGANIZING CHAIRMAN
9TH UNIMAS PUBLIC HEALTH SEMINAR
Assalamualaikum and salam sejahtera;

We are delighted to welcome and thank all the participants for joining us in
the 9th UNIMAS Public Health Seminar. This annual seminar is organized by year
three Doctor of Public Health candidates.

With the theme of this year, “Public Health Transformation: Are We Ready
for the Future Challenges?” this seminar aims to highlight the urgent need for
public health transformation and adaptation to face future challenges.

We want to express our sincere appreciation to the Dean of the Faculty of

Medicine and Health Sciences, the Head of the Department for the Department of
Community Medicine and Public Health, our course supervisor, and all our
lecturers for their guidance and support throughout this seminar. Their invaluable
contributions have enabled us to organize this seminar and provide a platform for
knowledge exchange and networking among public health professionals,
researchers, and students.

We greatly appreciate all our distinguished speakers that willing to share their
insights and experiences on the post-pandemic public health landscapes,
including the topics of post-pandemic transformation, healthcare system
resilience, preparedness, and responses to biothreat and digital health
innovations.

Once again, we would like to take this opportunity to express our gratitude
and appreciation to all participants attending our seminar. We hope that all of us
benefit from this event. We wish you all the best for the upcoming seminar and
hope you will enjoy a fruitful and enriching experience.

Thank You. AUSTEN TECH | PAGE 5

8
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Organizing Committee

Advisor : Prof Dr. Rasitasam@Razitasham bt. Safii

Chairman : Dr. Ahmad Salimi Bin Abu Bakar
Secretary : Dr. Teoh Wan Jool
Treasury : Dr. Wong Liang Tung
Publicity & Sponsorship : Dr. Jesica Jenah Anak Ramping
: Dr. Yassimear Anak Ugak
Logistic & Food : Dr. Lalitha Malarmaniam
Technical : Dr. Wan Muhd Noor Al Hadi Bin Ab Razak
Registration : Dr. Muhammad Najib Bin Hassan
: Dr. Izzaty Binti Hamidi
Scientific : Dr. Mardhiyyah Binti Azmi
: Dr. Micheal Pelitini Anak Ugak
: Dr. Cheah Yong Xiang

AUSTEN TECH | PAGE 5

9
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Sub-committee

Registration sub-committee Scientific sub-committee (e-poster &

Dr. Mohd Nor Faizal bin Zulkifli oral presentation)
Dr. Simon Channing Nub Dr. Voon Bui Niak

Scientific sub-committee (Emcee) Publicity & sponsorship sub-committee

Dr. Puteri Nuuraine Ayu binti Dr. Amielea Misell
Mohammad Nasir Dr. Muhamad Danial Bin Salim
Dr. Azlan Arif Bin Bolen
Dr. Sivanandhan A/L Selleyitoreea Logistic & food sub-committee
Dr. Mirunaaleni A/P Selvaraju
Scientific sub-committee (Liaison Dr. Abd Mualim Shah Bin Abd Rani
Officer)
Dr. Cherrysca Dante Anak Anthony Technical sub-committee
Dr. Zulaikha Binti Abdul Razak Mdm Nurul Izzah Binti Nasir
Mohd Khairuddin Bin Ahmad
Scientific sub-committee Tc. Siti Hajar Binti Abu Bakar
(Rapporteurs) Tc. Mohamad Hishamuddin Bin Wang
Dr. Aisyah Binti Anuar Mr. Mohammad Nazzri bin Zainudin
Dr. Nurul Amirah binti Masani
Dr. Muhamad Danial Bin Salim Pre-seminar workshop sub-committee
Dr. Nur Azimah Binti Azman Dr. Mohd Nor Faizal bin Zulkifli
Dr. Siti Romahani Binti Rahman Dr. Simon channing nub
Dr. Michael Pui Chia Shin Dr. Mohd Faizal bin Abdul Rahman

AUSTEN TECH | PAGE 5

10
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Introduction
The University of Malaysia Sarawak (UNIMAS) has set an academic requirement
for Year 3 Doctor of Public Health (DrPH) program candidates to work together
and organise a seminar event annually for audiences from the Public Health
discipline. Currently, on its 9th installation, this seminar is recognised and
adopted by the Community of Medicine and Public Health (CMPH) Department as
an annual event for the Faculty of Medicine and Health Sciences (FMHS),
UNIMAS.

In 2019, the world was shocked by the rise of the Covid-19 pandemic that
devastatingly impacted various aspects of our life. Today, after almost 4 years
post-pandemic, we are still recovering socially, economically, occupationally, in
health and many more. We have learnt a tough lesson from the occurrence of the
pandemic and realised the importance of public health transformation to move
forward into the future and prepare, if not equip ourselves, for a better public
health system.

In this 9th UNIMAS Public Health Seminar 2023, the theme centre around public
health transformation post Covid-19 pandemic to be a more resilient healthcare
system and more prepared and competent to respond to any future
outbreak/pandemic/threats. We also bring forward the importance of
digitalisation in the health system, particularly the application and challenges of
big data in the health system and the cybersecurity issues surrounding the use of
big data management.

We take this opportunity to use this seminar as a platform for discussion and
sharing knowledge, updates and experiences in issues related to public health.

AUSTEN TECH | PAGE 5

11
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Objectives

The main objective of the seminar is to provide a platform for knowledge and best
practice sharing in the field of public health. The participants are encouraged to
exchange information and knowledge through various media, such as posters and
free paper presentations. Other than that, this seminar also may create an
opportunity to experience the best practice in public health. We also would like to
encourage the public health practitioners to duplicate the best practice which
may improve our public health fields. Besides that, the seminar also will bridge
the multisectoral and multidisciplinary collaboration among public health experts
and practitioners.

Learning points from 9th UNIMAS Public Health Seminar 2023:

Pre-Seminar Workshop: Public Health Disaster Management Simulation

i. Introduction to Disaster Health Management & Disaster Management Cycle
ii. Rapid Risk Assessment & Hazard Vulnerability Analysis (HVA)

Webinar: Public Health Transformation: Are We Ready for Future Challenges?

i. Public Health Transformation Post Pandemic
ii. Resilient Healthcare System
iii. Biothreat Preparedness and Responses
iv. Digitalisation – Potentials and Risks from The Public Health Perspective.
v. Big data in health care – Applications and challenges
vi. Cybersecurity – Access control for big data management system

AUSTEN TECH | PAGE 5

12
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Speakers

DR THILAKA A/P CHINNAYAH

DEPUTY DIRECTOR
(DISEASE SURVEILLANCE)

Dr. Thilaka a/p Chinnayah@Nadarajah is currently the Director of the

Epidemic Intelligence Program (EIP Malaysia), as well as the Deputy
Director (Disease Surveillance) at the Ministry of Health Malaysia, with
expertise in the Division of Disease Control and experience as a Medical
Officer with the International Health Regulations in the Western
Pacific Regional Office (WPRO), Manila, under the WHO Health
Emergencies Programme (WHE) to manage health emergency risks
when national capacities are overwhelmed, to lead and coordinate the
international health response to contain outbreaks and to provide
effective relief and recovery to affected populations.

13
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Speakers

DR VERONICA LUGAH
SENIOR DEPUTY DIRECTOR
(PLANNING DIVISION)

Dr. Veronica Lugah is currently the Senior Deputy Director in the

Ministry of Health Malaysia's Planning Division, overseeing three
sections: Health Plan and Policy Planning, National Health Financing
(NHF), and Malaysia National Health Accounts (MNHA), with expertise
in public health and experience as the Senior Deputy Director (Health
Policy and Plan, National Health Financing, and Malaysia National
Health Accounts), Planning Division, Ministry of Health, also previous
experience working in the Occupational and Environmental Health
Section, Negeri Sembilan State Health Department and as an
Epidemiology Officer and Divisional Health Officer in Miri.

AUSTEN TECH | PAGE 5

14
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Speakers

DR BADRUL HISHAM BIN ABDUL SAMAD

RESEARCH FELLOW & CONSULTANT PUBLIC HEALTH
PHYSICIAN, UPNM

Dr. Badrul started his career in public health in 1997. Since then, he held
many posts namely Medical Officer of Health for Pontian District and Johor
Bahru District; Johor TB & Leprosy Control Officer; Johor State
Epidemiologist; and Director of the Johor Bahru Public Health Laboratory.
His expertise is in the area of communicable disease epidemiology,
prevention, surveillance, detection and outbreak control; laboratory
biosafety; biosecurity; environmental health; disaster health management;
and Chemical, Biological, Radiological, Nuclear & explosives (CBRNe)
preparedness & response. In November 2017, Dr. Badrul moved to Disease
Control Division at Ministry of Health Malaysia headquarters in Putrajaya
taking charge for CBRNe affairs.
Currently, Dr. Badrul is a Principal Fellow and Consultant Public Health
Physician at Faculty of Medicine and Defence Health, National Defence
University of Malaysia (NDUM), Sg. Besi, Kuala Lumpur. He is also a
Research Fellow at Humanitarian Assistance and Disaster Relief (HADR)
Research Centre, NDUM.

15
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Speakers

DATO DR FADHLULLAH SUHAIMI

BIN ABDUL MALEK
FORMER CHAIRMAN OF MALAYSIAN
COMMUNICATION AND MULTIMEDIA COMMISSION
(MCMC)

Dato’ Dr. Fadhlullah Suhaimi Abdul Malek previously served as

chairman of the Malaysian Communications and Multimedia
Commission (MCMC). He was also a founding member of the
Communications and Multimedia Content Forum of Malaysia
(CMCF) and Malaysia Internet Exchange (MyIX). Furthermore, he
have nearly 25 years of industry experience holding several senior
positions both in the public and private sectors.

AUSTEN TECH | PAGE 5

16
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Speakers

MR. DAN FADALINI SUKIA

CHIEF INFORMATION SECURITY OFFICER ,SAINS

Mr. Dan Fadalini Sukia is currently the Chief Information Security

Officer (CISO) of Sarawak Information Systems Sdn Bhd (SAINS).
He is an experienced Consultant with a demonstrated history of
working in the information technology and services industry. Skilled
in Analytical Skills, Market Analysis, IT Service Management,
Market Research, and Dell, Cisco Systems Products. Strong advisory
and consulting professional with a Bachelor of Science (B.Sc.)
focused in Computer Science from Universiti Sains Malaysia,with a
minor in Management.

AUSTEN TECH | PAGE 5

17
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Speakers

YBHG. DATO' SRI DR. MOHD UZIR MAHIDIN

CHIEF STATISTICIAN
THE DEPARTMENT OF STATISTICS MALAYSIA

The Chief Statistician Malaysia with over 31 years of experience in national

accounts statistics; external trade statistics; industrial and construction
statistics and services statistics. His career has spanned roles as head of the
national statistical office, Executive Committee of the International
Association of Official Statistics, Executive Committee of Institute Statistics
Malaysia, chair of the National Organising Committee of ISI World Statistics
Congress 2019 and appointed as the Sixth Census Commissioner in 2020.
For the first time, he introduced the Parliament and State Legislative
Assemblies Report; and MyLocal Statistics Report by state, which contains
statistics down to the smallest administrative level. In the history of DOSM's
statistical dissemination, he has started a huge wave of social media in the
statistical community by engaging closely with young people, users, and
stakeholders through statistics. He also has extensive involvement in national
and international statistical development.
His most recent contribution was to spearhead an initiative to strengthen the
Malaysian Statistical System and DOSM's role as a central agency by
AUSTEN TECH | PAGE 5
implementing eight key agendas by 2025.
18
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Programme Tentatives
Day 1|Pre-Seminar Workshop|07th March 2023
(Physical)

Time Scientific programmes Speakers

0800-0830 Participant registration Organizer

0830-0845 Ice-breaking Organizer

0845-1030 Introduction to Disaster

Dr. Badrul Hisham bin Abd.
Health Management &
Samad
Disaster Management Cycle

1030-1100 Tea break

1100-1200 Rapid Risk Assessment & Dr. Badrul Hisham bin Abd.
Hazard Vulnerability Analysis
Samad
(HVA)

Performing risk assessment at Dr. Badrul Hisham bin Abd.

1200-1300
disaster hit area (Group Work) Samad

1300-1400 Lunch
Dr. Badrul Hisham bin Abd.
1400-1500 Group presentation
Samad
1500-1600 The Sphere Project

1600 End of Day 1

AUSTEN TECH | PAGE 5

19
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Programme Tentatives
Day 2|Public Health Seminar|08th March 2023
(Online Webex)
Time Scientific Programs Speakers
0830– 0900 Registration
Professor Dr. Asri Saad
0900 – 0930 Opening of 9th UNIMAS Public Dean,
Health Seminar Faculty of Medicine and Health
Sciences, UNIMAS

0930 – 1030 Plenary 1: Public Health Dr. Thilaka a/p Chinnayah

Transformation Post Pandemic Deputy Director (Disease
Surveillance),
1030 – 1045
Ministry of Health Malaysia
Tea break
1045 – 1245 Symposium 1:
Public Health – Moving Forward

Topic 1: Dr. Veronica Lugah

Resilient Healthcare System Senior Deputy Director (Planning
Division),
Ministry of Health Malaysia

Topic 2: Dr. Badrul Hisham bin Abd. Samad

Biothreat Preparedness and Research Fellow & Consultant
Responses Public Health Physician
National Defence University of
Malaysia (UPNM)
1245 – 1400 Lunch break
E-poster (slide presentation)

1400 – 1530
Oral free paper presentation 1

1530 - 1630 Oral free paper presentation 2

1630 End of Day 2

20
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Programme Tentatives
Day 3|Public Health Seminar|09th March 2023
(Online Webex)

Time Scientific programmes Speaker

0830 – 0900 Registration

Plenary 2:
0900 – 1000 Dato Dr. Fadhlullah Suhaimi bin
Digitalisation –Potentials And
Abdul Malek
Risks from The Public Health
Former Chairman,
Perspective.
Malaysian Communication and
Multimedia Commission (MCMC)
1000 – 1015 Tea break

1015 – 1200 Symposium 2: Digitalisation of

  healthcare
YBhg. Dato' Sri Dr. Mohd Uzir Mahidin
Topic 1: Big data in health care – Chief Statistician Malaysia,
Applications and challenges Department of Statistics Malaysia
(DOSM)
Topic 2: Cybersecurity – Access Mr. Dan Fadalini Sukia
control for big data management Chief Information Security Officer,
system Sarawak Information System Sdn Bhd
(SAINS)

1200 – 1230 Winner announcement

(oral and poster paper)

1230 – 1300 Adjournment ceremony Ass Prof. Dr Jeffery Anak Stephen

HOD, Department of Community
1300 End
Medicine and Public Health,
FMHS UNIMAS

21
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Acknowledgement

The Organizing Committee of 9th UNIMAS Public Health Seminar

2023 would like to express their deepest gratitude to the following
for their support in making the seminar a success:

Dean of Faculty of Medicine and Health Sciences, UNIMAS

Advisor
Speakers
Lecturers and staffs from Faculty of Medicine and Health
Sciences, UNIMAS
Faculty of Applied and Creative Arts, UNIMAS
UNIMAS Business School
Sub-comittee members;
All the participants

22
"PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Contacts Us

[email protected]

https://phsunimas.webador.co.uk

https://www.facebook.com/phsunimas

23
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Oral presentation & e-poster

Reviewers and judges
Abstract reviewers:
Prof. Datu Dr Andrew Kiyu Dawie anak Usop (Head of judge)
Prof. Dr Md Mizanur Rahman
Prof Dato’ Dr Jamilah Hashim

Oral presentation Judges:

Prof. Dr Md Mizanur Rahman
Assoc. Prof. Dr. Helmy bin Hazmi

e-Poster Judges:
Prof. Dr Rasitasam @ Razitasham bt Safii
Prof Dato’ Dr Jamilah Hashim

Professor Datu Dr Andrew Kiyu Dawie anak Usop

A Professor of Public Health in the Faculty of Medicine
and Health Sciences, University Malaysia Sarawak
(UNIMAS). He is a Fellow of the American College of
Epidemiology, and a member of the Academy of
Medicine, Malaysia. He has over 40 years of experience
in public health, initially as a district medical officer of
health, then as an epidemiologist, as Deputy Director for
Public Health in Sarawak and finally as Sarawak State
Health Director. Dr Andrew is well-known
internationally for his work in Healthy Cities and
settings and has served as WHO short-term consultant
on the subject. He is an honorary consultant
epidemiologist as well as an honorary advisor for healthy
cities for the Sarawak State government.

24
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Oral presentation & e-poster

Reviewers and judges
Professor Dato Dr Jamilah Binti Hashim
A Professor of Public Health in the Faculty of Medicine
and Health Sciences, Universiti Malaysia Sarawak
(UNIMAS). She graduated from University of Malaya and
National University of Singapore and has over 30 years of
experience in the field of public health. She has served in
various capacities, initially as head of various public
health programmes, then as a Divisional Health Officer,
later as Deputy Director of Health Services (Public Health)
in Sarawak, and finally as the Sarawak State Health
Director. Dr Jamilah has been very involved in the
formation years of HIV/AIDS in Sarawak as well as the
healthy cities/settings programmes, both in Sarawak,
Malaysia and the region. She has also served as WHO
short-term consultant on healthy cities/settings. Her
areas of interest include healthcare management,
environmental health, and infectious disease outbreak
management.

Professor Dr Rasitasam @ Razitasham bt Safii

A Professor of Public Health in the Faculty of Medicine
and Health Sciences, University Malaysia Sarawak
(UNIMAS). She specializes in Public Health Medicine
(Family Health) and is a member of the Epidemic
Intelligence of Malaysia. She is a member of various
Professional Bodies including MySEE, Academy of
Medicine, MMC, MMA, NMPHA, and IMAM. Her current
research interest is in infectious tropical diseases,
primary health care, and adolescent health issues. She
actively contributes as a consultant to Malaysia One
Health University Network.
25
 "PUBLIC HEALTH TRANSFORMATION:
ARE WE READY FOR FUTURE
CHALLENGES?"

Oral presentation & e-poster

Reviewers and judges

Professor Dr Md Mizanur Rahman

A Professor in the Department of Community Medicine
and Public Health, Faculty of Medicine and Health
Sciences, UNIMAS. He holds a Master of Philosophy in
Preventive and Social Medicine and a Doctor of
Philosophy in Statistics. His research interest is in public
health and preventive medicine.

Associate Professor Dr Helmy bin Hazmi

A Deputy Dean (Industry and Community Engagement) in
the Faculty of Medicine and Health Sciences and the
Deputy Director (Specialist Service Centre) for the
UNIMAS Teaching Hospital and Medical Centre (HPPPU).
He is active in various research works, participated in
numerous research grants and has published and co-
published several papers. He is also a reviewer for
journals and a member of the Malaysian One Health
University Network (MyOHUN). He has an interest in both
Non-Communicable (NCDs) and Communicable Diseases
(CDs), clinical epidemiology, medical sociology, mental
health, medical technology, the use of IoT in medicine and
lately in the scholarship of Teaching and Learning in
medical education.

26
 ABSTRACTS |Oral Presentation
Factor associated with risk of Tuberculosis among Diabetic Patients.
District Data from Kota Bharu & Pasir Mas Kelantan. A case Control
study
Muhammad Ikhwan Ismail1, Wan Mohamad Zahiruddin Wan Mohamad1, Rosnani Zakaria2,
Hasniza Abdullah3, Noor Hashimah Abdullah3, Mat Zuki Mat Jaeb4.
1
Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains
Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
2
Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang
Kerian 16150, Kelantan, Malaysia
3
Disease Control Unit, Kelantan Health Department, 15200 Kota Bharu Kelantan, Malaysia
4
Respiratory Medicine Unit, Hospital Raja Perempuan Zainab II, 15586 Kota Bharu Kelantan,
Malaysia

Introduction: The most prevalent infectious illness is tuberculosis (TB). Diabetes Mellitus
(DM) has been considered a high risk of TB disease from the worldwide study. However, the
effectiveness of TB screening among diabetic patients still not optimize. Therefore, this
research aimed to determine the factors associated that may influence the risk of tuberculosis
among DM patients in Kelantan. Methods: A case-control study involving 270 diabetics
patients aged ≥ 18 years old, with and without TB from Health Clinics in Kota Bharu and Pasir
Mas district, Kelantan between the years of 2019 and 2021, was carried out. Face-to-face
interviews were used to gather data, as were medical card participants who had been randomly
chosen from outpatient TB and DM patients. Variable including sociodemographic data,
duration of being diagnosed as DM, HBA1C reading within 6 months duration, and history of
DM in the family. Simple and multiple logistic regression was applied using SPSS V.26, to
identify the determinants of TB. Results: Being stay in urban (adjusted odds ratio [AOR]
0.213; 95% confidence interval [CI] [0.10-0.47]; p <0.001), being underweight
(BMI<23kg/m2); AOR: 3.64; 95% CI [1.78-7.43]; p<0.001, duration of being diagnosed as
DM; AOR: 0.91; 95% CI [0.85-0.97]; p = 0.003), HBa1C level; AOR: 1.66; 95% CI [1.42-
1.94]; p<0.001), were shown to be significant predictors for TB disease among DM patients.
Conclusion: This research identified four factors associated with the risk of TB disease among
DM patients. Diabetic control including the duration of diagnoses as DM, and HBA1C level
does associate with the risk of TB. The factors can be further discussed and validated to develop
a criteria tool for TB screening among DM patients.

Keywords: Tuberculosis; Diabetes Mellitus; diabetic control; factors associated; Case-

control.

27
Post Sharp Injury Follow-Up: Analysis on Predictors of Adherence
Among Healthcare Workers in Pahang
Nor Aimi AN1, Mohd Fahmi I1, Noor Azurah WC1, Shaiful SO1, Norazah AA1, Muhammad
Siddiq D1.
1
Pahang Health State Department

Introduction: Sharp injury is a serious occupational hazard to healthcare workers (HCWs) in

health facilities, leading to multiple consequences. Thus, HCWs must adhere to follow-up post-
incidence as per the Malaysia Ministry of Health (MOH) protocol. Objectives: This research
aimed to determine the distribution and association towards predictors of adherence to follow-
up protocol post-sharp injury among HCWs in government healthcare facilities in Pahang,
Malaysia. Methodology: This retrospective cross-sectional study includes all reported sharp
injury cases from 2020 to 2022. Data from the Sharp Injury Surveillance (SIS) system were
analysed using descriptive and multiple logistic regression. Statistical significance was
determined for associated predictors of HCWs who attended all three follow-ups at six weeks,
three months, and six months in incidence, with a p-value of less than 0.05. Result: A total of
182 cases fulfilled the study criteria. The mean age (SD) of HCWs involved with sharp injury
was 29.78 (4.93) years, and the percentage of HCW adherence to follow-up protocol was
56.6%. Multiple logistic regression showed a significant relationship between the working
duration and source related to human immunodeficiency virus (HIV) infection. HCWs who
have worked for more than three years, and sources related to HIV-positive infections, had 2.5
times and 12 times higher odds of adhering to the follow-up protocol. Conclusion: Working
duration and source related to HIV infection are the main predictors towards adherence to
follow-up post-incidence as per protocol. More advocacies towards adherence to post-sharp
injury protocol need to be focused on junior HCWs. Implications of bloodborne infections not
limited to HIV should also be addressed.

Keywords: sharp injury, healthcare workers, Pahang, post-exposure management

28
Study on Musculoskeletal Disorders Among Laboratory Staff at
Universiti Malaysia Sabah
Siti Zhahara Binti Salleh1
1
Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota
Kinabalu, Sabah, Malaysia
*Correspondence Email: [email protected]

Introduction: Laboratory workers are competent, skilled, and knowledgeable workers who
are at risk for developing work-related musculoskeletal symptoms. Because of the activities,
workers may experience musculoskeletal stress in various body regions. As a result, the study's
goal is to determine the level of MSD risk and the prevalence of MSDs among laboratory staff.
Methods: A study was conducted among 40 laboratory workers at Universiti Malaysia Sabah
by using modified Nordic Musculoskeletal Questionnaires (NMQ) and another 20 workers by
using Rapid Upper Limb Assessment (RULA). Statistical analyses were performed using the
Statistical Package for the Social Sciences software. Results: The NMQ results revealed that
the most common body regions reported by laboratory staff were the lower back (55%),
shoulder (45%), neck (42.5%), and upper back (37.5%). The main physical work-related risk
factors for MSDs are repetition, awkward postures, or long-term static postures. There is no
relationship between MSD symptoms and gender, age, marital status, or education level.
Finally, the RULA scores for various activities ranged between 4 and 7 and 5 and 12. The
RULA scores indicated that the risk was very high and that additional investigations and a
change in posture were required for a few activities. Conclusion: There is a high prevalence
of MSD among laboratory staff with the low back and shoulder being the most commonly
affected. There should be increased awareness of preventive measures and proper ergonomic
postures in the workplace of laboratory staff.

Keywords: Laboratory Workers, Musculoskeletal Disorder, Prevalence, RULA

29
Assessment Of Indoor Air Temperature on Thermal Comfort and
Behavioural Adaptations: A Systematic Review.
Fadly Syah Arsad, Rozita Hod, Norfazilah Ahmad, Mazni Baharom, and Mohd Hasni Ja’afar
1
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun
Razak, Kuala Lumpur 56000, Malaysia.

Introduction: Indoor air temperature is essential for maintaining thermal comfort, health, and
productivity. Meanwhile, behavioural adaptation is well known to be the most critical
contributor to the adaptive thermal comfort model. Objectives: This systematic review aims
to provide extensive evidence regarding the influence of indoor air temperature on thermal
comfort and behavioural adaptation. Methodology: This systematic review was conducted
according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020
flow checklist. Studies published between 2012 and 2022 that examined the indoor air
temperature of thermal comfort and behavioural adaptations were considered. Results: In this
review, the average indoor temperature for thermal comfort ranges from 18.0°C to 34.0°C. The
thermal comfort of the population depends on several factors, such as climatic features, type of
buildings, and age of the study population. The highest adaptive behaviour was the use of the
fan. Other adaptation behaviours include window opening, air-conditioner use, cloth insulation,
drinking beverages, curtain/shade, reduction of activity levels, postural changes, and tying up
hair. Conclusions and Recommendations: Evidence shows that indoor air temperature plays
an important role in determining the thermal comfort of the population. The thermal comfort
varies depending on the climatic factor, type of buildings, and age of the study population. The
adaptation behaviours also vary. Building designs should include strategies for improving
indoor thermal comfort environments. Future research on the level of awareness of thermal
comfort and behavioural adaptations is imperative for population empowerment.

Keywords: indoor air temperature, thermal comfort, behavioural adaptations, systematic

review

30
Epidemiologic Characteristics and Influencing Factors of COVID-19
Cluster Infections in the District of Temerloh, Malaysia.
Catherine Thamarai Arumugam1*, Sharifah Mahani Syed Mahar Affandi1, and Ammar Hussein
Rosly1
1
Temerloh District Health Office, Temerloh 28000 Pahang
*
Correspondence Email: [email protected]

Introduction: Since its emergence, the COVID-19 pandemic has ravaged many countries
worldwide. The strong transmissibility of SARS-CoV-2 facilitates cluster infection in various
settings. Objective: This study contributes to the effort by investigating the epidemiologic
characteristics and influencing factors of all reported COVID-19 clusters in the district of
Temerloh, Malaysia from September 2021 to February 2022. Methodology: Relevant data
were obtained from the Centre for Control Disease (CDC) Unit of Temerloh District Health
Office. COVID-19 clusters were categorized into the community, indigenous community,
educational and workplace clusters. Cluster epidemiologic characteristics in terms of the type
of cluster, cluster size, positivity rate, time interval between detection of the index case and
cluster reporting and duration of the active cluster were described. Factors influencing cluster
infections in this setting have been discussed. Results: A total of 39 clusters comprised of 2975
cases were identified. The majority of clusters were made up of workplace clusters (28.2%),
followed by educational clusters. However, the highest number of positive cases came from
the indigenous community cluster (64.7%). The number of clusters recorded was highest in
February 2022, whereas the highest number of cases involving clusters was reported in
September 2021. The interval between index case diagnosis and reporting of cluster reporting
was 7.5 days (SD 3.8). The duration of the active cluster showed a mean value of 13.4 days
(SD 12.3). Conclusion: Analysis of cluster characteristics provide the opportunity to
understand the pattern of COVID-19 outbreaks better. Identifying the factors contributing to
these clusters helps in implementing more effective suppression strategies at the local district
level.

Keywords: epidemiology, COVID-19 pandemic, cluster

31
Spatial and Temporal Intensity of P. knowlesi Malaria Cases in
Kelantan.
Ku Mohd Saifullah Ku Ismail1, Nor Azwany Yaacob1, Kamarul Imran Musa1
1
Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains
Malaysia, Kubang Kerian 16150, Kelantan, Malaysia

Introduction: P. knowlesi malaria infection is on the rising trend in Malaysia and has drawn
medical attention on a global scale over the past decade, however, this disease is not expected
to decline anytime soon. Thus, this study aimed to understand the spatial and temporal
distribution of P. knowlesi malaria infections in Kelantan using pattern point analysis to
advocate better prevention and control of this disease. Methods: This spatial analysis was
conducted using registered malaria cases in the e-Vekpro system between the year 2012 and
year 2021. The geolocation of P. knowlesi malaria infections was plotted using the spatial
points technique, and the spatial intensity of the cases was estimated using kernel density
estimation via ‘spatstat’ packages in R Software. Results: A total of 1014 cases were included
in the study. Spatial variation of case intensity demonstrated that male cases were more
scattered and dispersed towards the Kelantan border. The cases aged between 20 to 49 years
old were more abundant within the Gua Musang district, meanwhile, the other age groups tend
to be clustered in Jeli and Kuala Krai districts as well. Temporal variation revealed that the
cases become more abundant in Jeli, Kuala Krai and Gua Musang districts between October
and April, then Jeli districts in May, and Gua Musang districts between June and September.
Temporal variation by year showed that there was a shifting pattern of case intensity towards
the southern Kelantan border. Conclusion: This finding might provide a useful resource for
strategic planning for effective control measures against P. knowlesi malaria infection in the
future.

Keywords: Spatial intensity, Spatiotemporal, P. knowlesi, Malaria, Kelantan,

32
Preliminary Findings Of COVID-19 Food Insecurity Experience Scale
(COVID-19 FIES) Among Women with Malnourished Children in
Kelantan During the Pandemic.
Muhammad Zulfahmi Haron1, Rohana Abdul Jalil1, Nor Azwany Yaacob1, Norhasliza Ariffin2
1
Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains
Malaysia, Kubang Kerian 16150, Kelantan.
2
Nutrition Unit, Public Health Division, Kelantan State Health Department, Level 5, Wisma
Persekutuan Kota Bharu, Jalan Bayam, 15590 Kota Bharu, Kelantan.

Introduction: The surge in coronavirus disease 2019 (COVID-19) transmission cases globally
and nationwide has led to the execution of the Movement Control Order (MCO) by many
countries including Malaysia. Economic activities, psychological well-being, and food security
may be negatively affected by the implementation of this MCO. Thus, this study aimed to
describe the proportion of household food insecurity experience among women with
malnourished children in Kelantan during the COVID-19 pandemic Methods: A cross-
sectional study was conducted among mothers with malnourished children at the selected
health clinics in Kota Bharu district by using validated Malay version of COVID-19 Food
Insecurity Experience Scale (COVID-19 FIES). Proportionate sampling was used as a
sampling method. To assess the food insecurity status of the women with malnourished
children, the proportion of moderate and severe food insecurity was calculated. Result: Out of
the respondents interviewed (N=68), all data obtained appeared to be normally distributed. The
proportion of moderate and severe household food insecurity during the pandemic in this study
was 46.6%, and 5.22%, respectively. Conclusion: Multilevel stakeholders together with
interagency collaboration need to pay more attention to these vulnerable mothers with
malnourished children while formulating economic stimulus programs and food insecurity
coping strategies in the post-COVID-19 period.

Keywords: food insecurity, FIES, low income, COVID-19

33
Pregnancy Physical Activity Questionnaire: Translation, Validity, and
Reliability of a Malay Version (PPAQ-M)
Siti Zubaidah Binti Zulkhairi1, Karimah Hanim Binti Abd Aziz1, Hashima E Nasreen1, Edre
Bin Mohammad Aidid1, Nurjasmine Aida Binti Jamani2, Siti Roshaidai Binti Mohd Arifin3
1
Department of Community Medicine, Kulliyyah of Medicine, International Islamic University
Malaysia, 25200, Kuantan Pahang, Malaysia
2
Department of Family Medicine, Kulliyyah of Medicine, International Islamic University Malaysia,
25200, Kuantan Pahang, Malaysia
3
Department of Special Care Nursing, Kulliyyah of Nursing, International Islamic University Malaysia,
25200, Kuantan Pahang, Malaysia

Introduction: Physical activity status among pregnant women in Malaysia remains unknown
owing to the lack of valid and reliable instruments to assess physical activity during pregnancy.
The study aimed to translate the Pregnancy Physical Activity Questionnaire (PPAQ) into
Malay language and assess its validity and reliability among Malaysian pregnant women.
Methods: All 36 items in the PPAQ were translated into Malay language (PPAQ-M) and
validated by experts as per WHO’s guidelines. The PPAQ-M was administered through an
online platform (Google Form) from July until November 2020. Content validity indices (CVI)
and test-retest reliability were assessed. Data were collected from 74 Malaysian pregnant
women and only 25 correctly completed the questionnaire within a two-week interval. Results:
The mean age of participants was 28.52± 4.25 years; 56% of them were in 2nd trimester (n=25);
and almost half of them were employed. The item content validity index was good, ranging
between 0.8-1.0. The Cronbach’s alpha coefficient of the PPAQ-M was 0.832. The two-week
ICC values for the type of activity subscales were highest for leisure/sports (0.683) and lowest
for households (0.518). For the intensity of physical activity subscales ranged from 0.133
(moderate) to 0.729 (sedentary). Conclusion: The PPAQ-M can be accepted as a reliable and
valid instrument to assess physical activity among pregnant women in Malaysia. This will
guide healthcare practitioners to identify the physical activity status of pregnant women across
three trimesters, therefore, to prescribe individualized exercise and/or develop guidelines
during pregnancy to improve overall maternal and foetal health.

Keywords: Physical activity; Pregnant women; Pregnancy Physical Activity Questionnaire;

Validity; Reliability

34
Patterns and Factors Associated with Physical Activity during
Pregnancy in Malaysia: A Qualitative Study using Thematic Analysis
Siti Zubaidah Binti Zulkhairi1, Karimah Hanim Binti Abd Aziz1, Hashima E Nasreen1, Edre
Bin Mohammad Aidid1, Nurjasmine Aida Binti Jamani2, Siti Roshaidai Binti Mohd Arifin3
1
Department of Community Medicine, Kulliyyah of Medicine, International Islamic University
Malaysia, 25200, Kuantan Pahang, Malaysia
2
Department of Family Medicine, Kulliyyah of Medicine, International Islamic University Malaysia,
25200, Kuantan Pahang, Malaysia
3
Department of Special Care Nursing, Kulliyyah of Nursing, International Islamic University Malaysia,
25200, Kuantan Pahang, Malaysia

Introduction: Being physically active during pregnancy can reduce pregnancy-related

complications and benefit both maternal and foetal health antenatally and postnatally. Yet,
there is still lacking studies in Malaysia on physical activity during pregnancy (PADP). Hence,
this study aimed to explore physical activity patterns and identify factors associated with PADP
in Malaysia. Methods: A qualitative study was conducted among 9 multi-disciplinary experts
in obstetrics and gynaecology, family medicine, nutrition and dietetics, and physiotherapy
through an online in-depth interview and analysed using thematic analysis. Participants’
responses were analytically coded into two broad themes: (1) Patterns of PADP in Malaysia,
and (2) factors affecting PADP in Malaysia. Result: The findings of this study indicated that
patterns and factors associated with PADP in Malaysia align with the literature globally.
However, limited evidence from Malaysian literature might overlook the real scenario of
physical activity participation by pregnant mothers. Conclusion: This study highlights the
importance of carrying out more research exploring physical activity participation during
pregnancy and conducting extensive interviews with Malaysian pregnant mothers for a better
understanding of their perceptions and attitude towards physical activity during their
gestational trimesters. Consequently, contributes more evidence-based literature in Malaysia
regarding PADP and subsequently emits specific guidelines relative to the benefits of physical
activity and exercise during pregnancy.

Keywords: Physical activity, Pregnant women, In-depth interview, Thematic analysis.

35
The prevalence of double burden of malnutrition among school-going
children in Tawau, Sabah
Mohd Faiz G.1, A. Abidin1, H. Sajali1, Sulaiman S.K.1, Suhaila O.2, Asits S2.
1
Tawau Area Health Office, Sabah, Malaysia.
2
Sabah State Health Department, Malaysia.
*Correspondence Email: [email protected]

Introduction: The double burden of malnutrition- undernutrition and overnutrition problems

coexist is expanding at a rapid pace in the country. This study aimed to determine the extent of
the burden among school-going children in Tawau, Sabah. Objectives: To screen school-going
children in Tawau for malnutrition by their body mass index and determine malnutrition
prevalence among the studied subjects before proceeding for early detection and prompt
referral and intervention. Methodology: A cross-sectional study was conducted among 15,810
students in schools throughout Tawau District, Sabah, from March to December 2023. Weight
and height measurement was performed on the subjects to determine their body mass index
using a standardized scale. Results: The prevalence of underweight was 10.0%, overweight
was 7.6%, obesity was 2.4%, and stunted was 0.5% among school-going children in Tawau,
Sabah. Conclusion and Recommendation: Most children with nutritional issues were utterly
unaware of their situation. Early diagnosis might aid in developing appropriate interventions.
To decrease the prevalence of the double burden of malnutrition in children, parental education
and awareness may be beneficial, apart from school health programs. Further research should
be done to identify the predictors of school-going children's nutritional status.

Keywords: Body Mass Index, Body Weight, School Health Program

27
 P01
DEVELOPMENT AND VALIDATION OF THE UNDERSTANDING,
ATTITUDE, PRACTICE AND HEALTH LITERACY TOWARDS COVID-19 INFECTION
AMONG THE MALAYSIAN PUBLIC IN MALAY LANGUAGE (MUAPHQ C-19)
1,2*Dalawi I., 2Isa M.R., 2Chen X.W., 2Azhar Z. I., 3Aimran A.N.
(*Lead presenter;1Unit Jawatan Simpanan Latihan, Bahagian Pengurusan Latihan, Kementerian Kesihatan Malaysia, Aras 6, Menara Prisma, Presint 3, 62675 Putrajaya,
Wilayah Persekutuan Putrajaya, Malaysia; 2Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh,
Selangor, Malaysia; 3Center of Statistical and Decision Sciences Studies, Faculty of Computer and Mathematical Sciences, Universiti Teknologi MARA, Shah Alam Campus, 40450 Shah Alam. Selangor, Malaysia)

INTRODUCTION • Study sampling: A judgmental sampling method was employed to iv. The understanding domain was removed due to multicollinearity
• COVID-19 is a global public health infection that terrifies the invite the expert panels for content validity based on their expertise problem with the attitude domain12,14.
physical, mental, and social health of well-being1-3. and credibility. A purposive sampling was employed to select v. Three domains (attitude, health literacy and practice) are remained
• It is essential to assess the community's knowledge, attitude, practice respondents for face validity. A systematic random sampling was and made up the 25-items MAPHQ C-19 (Ver. 5.0) shown in
(KAP), and health literacy on COVID-19 from time to time and used to select respondents in Phase 2 study. Figure 1. MAPHQ C-19
(Ver.5.0)

analyse its associated factors to assist public health authorities in • Data were analysed using Microsoft Excel for Phase 1 study; IBM
planning and implementing the appropriate preventive and control SPSS Ver.27 and IBM AMOS Ver.26 for Phase 2 study.
measures accordingly4. RESULTS & DISCUSSION
• Unfortunately, most of the existing assessments of KAP on COVID-
19 were developed by foreign country researchers, lack of validation • 6 experts and 344 Malaysian public were involved in the study. Measuring scale: Interval scale
1. Attitude: 1 (strongly disagree) to 10
reporting including the tools that Malaysia KAP study employed5. • Phase 1 study: (strongly agree).
i. 54-items MUAPHQ C-19 (Ver. 1.0) containing four domains 2. Health Literacy: 1 (strongly disagree)
to 10 (strongly agree).
OBJECTIVES (understanding, attitude, practice, and health literacy) was 3. Practice: 1 (very rare) to 10 (very
developed based on the literature review result and focus group frequent).
• To develop and validate a KAP questionnaire in the Malay language
discussion.
that measures the understanding, attitude, practice and health literacy
ii. Content validity analysis created a 52-items MUAPHQ C-19
towards COVID-19 among the general public.
(Ver. 2.0) based on six expert panel’s judgement on the item's
MATERIALS & METHODS relevancy and essentiality (I-CVI: 0.7 to 1; S-CVI/Ave: 0.97 Figure 1: The final measurement model for the pool-CFA of
to 1; CVR: 0.3 to 1)6,7,8. the attitude, practice and health literacy domain
• The study has two phases:
iii. Face validity analysis yielded a 50-items MUAPHQ C-19 vi. Composite Reliability and Convergent Validity are achieved for
i. Phase 1 – A methodological study was conducted for the
(Ver. 3.0) with better clarity and comprehensiveness of the all three domains (CR value >0.6 and AVE value >0.5)12,14.
development of the questionnaire (comprehensive literature
items (I-FVI:0.6 to 1; S-FVI/Ave: 0.87 to 0.98)9,10. vii. Discriminant Validity are achieved for all three domains12,14.
review, expert group discussion, content validity and face
• Phase 2 study:
validity).
i. EFA generated a 42-items MUAPHQ C-19 (Ver. 4.0) with 2 CONCLUSION & RECOMMENDATIONS
ii. Phase 2 – Two cross sectional studies were conducted for the
subdomains for the understanding, 3 subdomains for the • This study produced a valid and reliable new 25-items MAPHQ C-19 that
validation of the questionnaire (Exploratory Factor Analysis can be used as a tool to measure the KAP on COVID-19 among the general
attitude, 4 subdomains for the practice and no subdomains for
(EFA) & Confirmatory Factor Analysis (CFA)). public in Malaysia. Future study with a broader population using MAPHQ
the health literacy.
• Study setting: Outpatient Clinic, PPUiTM Sungai Buloh, Hospital C-19 should be conducted from time to time to monitor the public KAP on
ii. Cronbach’s alpha range from 0.677 to 0.91411,12 and ICC
UiTM Puncak Alam and Hospital Kuala Lumpur. COVID-19 and the effectiveness of the prevention and control program
values range from 0.562 to 0.75913.
• Inclusion criteria: Malaysian, aged 18 years and above, understand implemented.
iii. CFA resulted six models before it achieved best-fit indices ACKNOWLEDGEMENT REFERENCES
Malay language, consented to participate.
with a RMSEA of 0.072, CFI was 0.883, TLI was 0.867,
• Exclusion criteria: Illiterate, healthcare worker We want to thank UiTM, for providing the grant for this research (600-RMC/MYRA 5/3/LESTARI
Chi-squared/degree of freedom (ꭓ2/df) was 2.21812,14 . (109/2020)); the panel experts involved in this study for their participation, contribution, and
dedication; and the Director General of Health Malaysia for the permission to present this study.
 MENTAL HEALTH LITERACY AMONG ADOLESCENTS IN MALAYSIA
Sarbhan Singh 1*, Rafdzah Ahmad Zaki 2, Nik Daliana Nik Farid 2 and Kushilpal Kaur 3
1 Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam 40170, Malaysia ([email protected])
2 Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
3 Department of Psychiatry, Hospital Selayang, Ministry of Health Malaysia, Batu Caves 68100, Malaysia

INTRODUCTION MATERIALS AND METHODS RESULTS AND DISCUSSION

❑ Mental health literacy (MHL) is a multidimensional ❑ Independent variables assessed using the Table 1. Determinants of adequate MHL
concept first introduced by scholars in Australia in Global School Based Student Health Survey
1997 (1) included age, sex, ethnicity, risky behaviors (i.e
❑ Since then studies have reported that having alcohol/smoking/illicit drug use), bullying,
adequate MHL would significantly improve mental loneliness, parental factors (income/marital
health among individuals, however majority of these status).
studies were conducted in western countries (1) ❑ The MHL and Stigma questionnaire examined
❑ Assessing the levels of MHL and its determinants the MHL which was the dependent variable
among Malaysian adolescent would assist decision ❑ Multivariate binary logistic regression analysis
makers in making evidence informed decisions was performed to determine the factors
relating to the development of mental health policies associated with MHL
and programs to improve mental health among
young adolescents RESULTS AND DISCUSSION
❑ 122 (8.7%) of participants CONCLUSION AND RECOMMENDATIONS
OBJECTIVES was reported to have ❑ This study showed that the overall adequacy of MHL levels
❑ This study determine the level of MHL and its adequate MHL (Figure 1) were associated with gender, age, smoking, alcohol
associating factors among adolescent in Malaysia ❑ Several determinants consumption, and loneliness
were significantly ❑ Therefore, in order to improve MHL among young
MATERIALS AND METHODS associated with adequate adolescents, it is crucial that MHL policies be formulated to
MHL following immediately address the determinants of MHL
❑ A total of 1,400 adolescents schooling in nine multivariate analysis as
secondary schools in Selangor was randomly shown in Table 1 ACKNOWLEDGMENT
selected to participate in a cross sectional study Figure 1. MHL level
❑ Ours findings are in line We would like to thank the Director General of Health Malaysia for his permission to present
this poster
with previous studies
conducted in western REFERENCES
countries (1) 1. Jorm, A.F.; Korten, A.E.; Jacomb, P.A.; Christensen, H.; Rodgers, B.; Politt, P. Mental
health literacy: A survey of the public’s ability to recognize mental disorders and their beliefs
about the effectiveness of treatment. Med. J. Aust. 1997, 166, 182–186.
 THE TREND OF FATAL OCCUPATIONAL INJURY RATES IN
MALAYSIA IN THE PAST DECADE
1Vanitha Thurairasu

([email protected], Department of Public Health, Perak State Health Department,

Ministry of Health, Malaysia)

INTRODUCTION RESULTS DISCUSSION

Workplace injury is a global risk factor which has Occupational injuries in Malaysia A total number of 380233 cases of occupational
serious physical, social and economic repercussions injuries were reported in Malaysia in the past
for both employees and employers. Despite Injuries by body parts decade, with 5641 fatal injury cases. The highest rate
significant focus on occupational safety and health in (2021) of occupational injuries occurred in 2013 (3.28)
recent years, industrial accidents are still highly whereas highest rate of fatal injuries reported in
common. In 2021 alone, 15.06 million employees in
2017 (2.93). However, these trends decreased
Malaysia had suffered occupational injuries,
including expatriates and low skilled foreign workers. significantly from 2019 onwards.
CONCLUSION & RECOMMENDATIONS
OBJECTIVES
Fatal occupational injuries in The significant decrease in the overall rate of fatal
The objective of the study is to determine the trend Malaysia
of fatal occupational injury rates in Malaysia in the occupational injuries from 2019 to 2021 could be
past decade. This study also aims to show the strongly associated with closure of many industrial
pattern of overall reported occupational injuries in sectors due to Covid-19 pandemic. This study can aid
Malaysia from 2012 to 2021. It also describes the policymakers to strengthen efforts such as designing
reported occupational injuries by body parts in 2021.
specialized safety campaigns and conducting
MATERIALS AND METHODS effective targeted visits.

Secondary data from National Occupational Accident REFERENCES

Statistics 2021 obtained from Department of • Hamalainen, P., Leena Saarela, K., & Takala, J. (2009). Global trend according to estimated number of
occupational accidents and fatal work-related diseases at region and country level. Journal of Safety
Statistics, Malaysia is used in this study. A qualitative Research, 40(2), 125–139. https://doi.org/10.1016/j.jsr.2008.12.010
descriptive analysis is performed on the number of • National Occupational Accident And Disease Statistics (2021). Department of Statistics, Malaysia.
https://www.dosm.gov.my/v1/index.php?r=column/pdfPrev&id=MkRoQ2IyZ0JkdElIZ0JidUhpaWxydz0
fatal and non-fatal occupational injuries in the past 9#:~:text=For%20the%20year%202021%2C%20the,1.43%20(2020%3A%202.18).
decade. • Zermane, A., Tohir, M. Z. M., Zerguine, H., & Noumeur, A. (2022). A Study to Uncover the Malaysian
Workplace Fatal Accident Patterns. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.4182804
 GAMIFIED-REAL-TIME VIDEO OBSERVED THERAPY (GRVOTS) MOBILE APPLICATION - A
USABILITY STUDY
Siti Aishah Abas1, Nurhuda Ismail 1, Yuslina Zakaria 2 , Ismassabah Binti Ismail 3, Nurul Hidayah Mat Zain4, Siti Munira Yasin 1, Khalid Ibrahim 1, Asmah Razali 5, Mas Ahmad Sherzkawi 6, Norliza Ahmad7 ,
1 Departmentof Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh Campus,2Department of Pharmacology, Faculty of Pharmacy, Universiti Teknologi MARA 3 Centre of Foundation Studies,Universiti Teknologi MARA, 4 Faculty of
Computer and Mathematical Science, Universiti Teknologi MARA 5 Sector TB/Leprosy, Disease Control Division, Ministry of Health, 6 TB/Leprosy Disease Unit, Selangor State Health Department, 7 TB/Leprosy Disease Unit, Negeri Sembilan State Health Department.
Introduction What is GRVOTS
The success rate of Tuberculosis (TB) treatment in Malaysia remains below WHO target of 90% despite A mobile app that can be used to replace the existing physical "DOTS" with gamification and reality features that can
the implementation of Direct Observed Therapy Short Course (DOTS), a drug physical monitoring system help increase medication adherence, motivation, and improve DOTS management at all levels of care.
since 1994.
Due to DOTS inconveniency, its digitalization into Video Direct Observed Therapy (VDOTS) via mobile
apps is hoped to deliver a more efficient tuberculosis system management.
A gamified VDOTS was developed that connect 3 users of patient, supervisor, and administrator virtually
and allow drug monitoring and patient tracking system to be done at the fingertips.
Objectives
To assess usability of GRVOTS mobile apps which specifically designed with a gamification and real-
time features to induce motivation of patients and supervisors as the end users.
Methodology
65 smartphone users The usability questionnaire using
Roles of each user
GRVOTS mobile apps were installed
System Usability Scale were given As the patient: As a supervisor : As the admin:
11 supervisors and 54 in their mobile apps, and patients
after one month with one-sample t Send VOTS, report Approve the Supervise the
patients participated were expected to fulfil tasks such as
test (cut off value =68) was used drug adverse effects , patient's VOTS activities between
in the 4-week providing VDOTS daily, with
to assess the usability score. and learn more about and medication patient and
usability study. supervisor approval required. Element of gamification DOTS treatment. adverse effects. supervisor
inside the GRVOTS apps
Results Conclusion
The overall mean usability score Proportion The mobility, enjoyment, and automated features of GRVOTS, as experienced by the users, may have contributed to questionnaire item
were 74.73 (1.82) which higher than 8% of positive no 3- ease of user, recorded the highest mean score. The questionnaire item no 10- for learnability, may have been the lowest due to
the minimum score for usable 15% responses multiple bugs reported interfering the apps as it appears in the trial version.
system which was 68 , with the was higher
GRVOTS apps are useful since both the patient and the supervisor can perform VDOTS virtually anywhere. Its mobility created positive
difference of 6.73 (95% CI 3.104, than that of
impacts that improve the app's perceived usefulness by the users (1).
10.358; p< 0.001). 77% negative
and neutral Gamification has the potential to increase people's engagement and encourage certain behaviors such as completing task timely due
This t-test indicates good usability responses to its playful nature (2-5).
of GRVOTS as a mobile application. Positive Neutral Negative Recommendation References
The means score of the SUS for 1.Kortum PT, Bangor A. Usability Ratings for Everyday Products Measured With
A more animated / guided tutorial and coaching session of the apps are required to
patient is 75.24 (15.29) which is Comments and suggestion by participants
the System Usability Scale. International Journal of Human-Computer
help with the learnability issue (6) Interaction. 2013;29(2):67-76
higher than the supervisor at 72.5 . 2.Kuo M-S, Chuang T-Y. How gamification motivates visits and engagement for
(11.63) with the usability mean 60 To improve the gamification element of the apps such as personal reminders in online academic dissemination – An empirical study. Computers in Human
different 2.74 (95% CI -6.6,12.14; 41 the form of alarms and the translation of internal rewards to a more tangible Behavior. 2016;55:16-27.
40 32 3. Kai Huotari JH. Defining Gamification - A Service Marketing Perspective.
p=0.281 18 reward mechanisms (i.e money/ shopping voucher). 2012.
20 9 4.Koivisto J, Hamari J. Demographic differences in perceived benefits from
The question with the least A stable internet connectivity is critical and shall be considered as pre-requisite to gamification. Computers in Human Behavior. 2014;35:179-88.
favorable responses was item 10, 0 ensure the smooth process of uploading the real time-stamped asynchronous 5.Foong Li Law ZMK, Chun Kiat Gan. Gamification towards Sustainable Mobile
about the need to learn a lot of Upload Fully Additional Reminder VDOTS. Application. 2011.
video and satisfied feature and reward 6. Roxanne Leitão PAS, Fraunhofer Portugal. A Study of Novice Older Adults and
things before I could get going with To make a full use of the ability to synthesize data and track data digitally, from the Gestural Interaction on Smartphones. 2013..
the app (21.5 % negative). technical feature
mobile apps implementation(7).This will lead to a more effective Tuberculosis 7. Sarkar U, Gourley GI, Lyles CR, Tieu L, Clarity C, Newmark L, et al. Usability of
issue Percentage Commercially Available Mobile Applications for Diverse Patients. J Gen Intern
System Management in a long run. Med. 2016;31(12):1417-26.
 QUANTIFYING THE EFFECTS OF COVID-19 VACCINATION DURING THE DELTA OUTBREAK
USING DETERMINISTIC COMPARTMENTAL MODELS IN MALAYSIA
*Mei Cheng Lim1, Sarbhan Singh1, Chee Herng Lai1, Balvinder Singh Gill1

*Mei Cheng Lim1, [email protected], Institute for Medical Research (IMR), National Institutes of Health (NIH), Malaysia
1Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Setia Alam, 40170, Malaysia CONCLUSION AND
RECOMMENDATION
INTRODUCTION METHODS RESULTS & DISCUSSION Our study demonstrates the value of
The Delta variant of concern has led to the Susceptible-Exposed-Infected-Recovered- Scenario 1 estimated highest daily cases of 19,614 and compartmental models in evaluating
largest COVID-19 outbreak in the year 2021, Vaccinated (SEIRV) models were developed using cumulative cases of 1,566,190 for forecast period (figure 2). the effects of COVID-19 vaccination on
highlighting the urgency of COVID-19 R programming software ODIN interface (figure 1). the dynamics of the outbreak by
vaccination to control and manage the providing quantitative predictions and
Scenario 2 estimated highest daily cases of 27,150 and
pandemic. Model assumptions: estimates.
• Closed population cumulative cases of 2,802,980 for forecast period (figure 2).
Deterministic compartmental models are • Initially entire Malaysia population is susceptible
• Homogenous mixing within the population Accelerating the COVID-19 vaccination by 2 months Deterministic compartmental models
mathematical tools that have been widely
• All individuals have an equal likelihood to can assist public health officers to
used to study the dynamics of infectious reduced the peak of outbreak with reduction of
diseases and the impact of interventions on contract and transmit the virus make informed decisions in terms of
highest COVID-19 daily cases by 38.4% (n=7,536) resource allocation and intervention
the dynamics of an outbreak. • Individuals who completed 2 doses of
vaccination are no longer susceptible to COVID- reduced the magnitude of outbreak with reduction of strategies to respond effectively to
19 infection cumulative COVID-19 cases by 79% (n=1,236,790). infectious disease outbreaks.
OBJECTIVES
Model development and fitting were conducted Our findings indicated that accelerated vaccine rollout with
To assess the potential impact of accelerating ACKNOWLEDGEMENT
from 21 June, 2021 to 21 July, 2021 based on appropriately weighted vaccine efficacy was able to mitigate
the COVID-19 vaccination on the COVID-19 COVID-19 case and vaccination data from GitHub
case trends during the Delta outbreak. the spread of COVID-19 cases during the Delta outbreak in We would like to thank the Director General of
Ministry of Health, Malaysia. Malaysia. Health Malaysia for his permission to present
this poster
Deterministic compartmental models are used Model parameters estimation includes incubation
to simulate the outbreak dynamics under 2 period of 5.2 days, recovery rate of 0.25 and
vaccination scenarios: REFERENCES
disease transmissibility R of 1.2.
Achieve 80% fully 1. covid19-
Scenario 1 Weighted vaccine efficacy was set as 70% after public/cases_malaysia.csv at main·
vaccinated adult population
weighting the proportion of vaccine distribution and MoH-Malaysia/covid19-public·
by 31 October, 2021 GitHub n.d.
vaccine efficacy against Delta variant.
https://github.com/MoH-
Scenario 2 Achieve 80% fully Malaysia/covid19-
vaccinated adult population Vaccination rate was represented by a polynomial public/blob/main/epidemic/cases_
by 31 December, 2021 equation function y = αt2 + ƙt + 31,667, wherein α malaysia.csv
and ƙ are multiplication factors that contribute to the 2. Sah P, Vilches TN, Moghadas
difference in vaccination rate for Scenario 1 and 2. SM, Fitzpatrick MC, Singer BH,
Hotez PJ, et al. Accelerated
Forecast of COVID-19 case trends was generated vaccine rollout is imperative to
mitigate highly transmissible
from 22 July, 2021 to 31 December, 2021 (forecast
COVID-19 variants.
period). EClinicalMedicine 2021;35:100865.
Figure 2. SEIRV model fit and forecast of COVID-19 daily cases for https://doi.org/10.1016/j.eclinm.202
Figure 1. The SEIRV model Scenario 1 and 2, Malaysia, 21 June, 2021 to 31 December, 2021 1.100865
and its differential equations
 TUBERCULOSIS OUTBREAK MANAGEMENT AMONG TAWAU DETAINEES:
CROSS-SECTIONAL STUDY
1Nurshazrah Najwa Zaini., 1Mohd Faiz Gahamat., 1Mohd Tariq MN. 1Bin Sulaiman S.K., 2Suhaila O., 2Asits S
(1Tawau District Health Office , Sabah, 2Sabah State Health Department, MALAYSIA)
*Nurshazrah Najwa Zaini 1, [email protected]

INTRODUCTION RESULTS DISCUSSION

Fig. 1 Number of TB cases in Tawau Detention Centre (Jan 2022- Jan 2023) Table 1 Clinical characteristics of TB patients (n=112)
The rate of Tuberculosis notification in institutions is This study shows majority of TB cases were detected during
Characteristics N %
higher than the general population. Intensified Case Finding (ICF) in Tawau Detention Centre from
TB Type
February 2022 until Nov 2022.
Pulmonary 111 99.1 About 99% were found to be Pulmonary Tuberculosis and the
Environmental factors like poor living conditions, Extrapulmonary 1 0.9 remaining cases were Extrapulmonary Tuberculosis.
mass imprisonment and insufficient ventilation Symptomatic Screening methods consist of symptomatic screening, chest
facilitate the TB spread among inmates1. Symptomatic 70 62.5 radiography and sputum samples ( smear, cultures and Gene Expert)
Asymptomatic 42 37.5 as the primary protocol to screen for pulmonary TB disease.
Another striking finding is that the majority (94%) of active TB cases
In addition, they serve as a reservoir for the spread CXR upon diagnosis
diagnosed in this study were not able to complete their TB treatment
Moderate 74 66.1
of TB to the wider public through released inmates as they were released back to their countries.
Severe/ advanced 38 33.9
and prison personnel. Sputum Smear
Most detainees stopped getting TB treatment soon after they were
released. Failure to complete TB medication may worsen the
Positive 50 44.6
individual's prognosis and may contribute to the spread of
Hence, failing to prevent and manage TB in Negative 62 55.4
tuberculosis in the community(4).
detention centers or prisons can have detrimental Gene expert

effects on both inmates and the wider population, Positive 21 18.8

Fig. 2 Distribution of cases by Fig. 3 Distribution of cases by age
particularly in countries with high imprisonment gender (n=112) group (n=112)
Negative
Not performed
10
81
8.9
72.3
CONCLUSION AND RECOMMENDATION
rates2. Male Female
40 32 Sputum Culture This study shows a high prevalence of undiagnosed Tuberculosis
29 among detainees.
25 Positive 22 19.6
The purposes of the study was to describe the 30
19 Negative 52 46.4 This warrants the immediate implementation of screening for
Tuberculosis outbreak in Tawau Detention Centre 20 Tuberculosis among inmates both at the point of entrance and
7 Not performed 38 33.9
and to identify the factors associated with the 10 periodic rescreening of those incarcerated(3).
Table 2: Association between TB treatment outcome among the detainees in Tawau
outcome of the Tuberculosis outbreak at Tawau 0 The ability to ensure completion of treatment is necessary for the
with socio-demographic and clinical characteristics of the detainees (n=112)
<30 30-39 40-49 50-59 ≥60 correctional Tuberculosis program to be effective, leading to a
Detention Centre. Treatment Outcome
Characteristics Count positive impact on the broader community
Successful Unsuccessful p-value
Since the majority of incarcerated individuals ultimately return to
Symptomatic
A total of 112 Tuberculosis cases were reported from 2368 total the wider community.
Symptomatic 70 16.1 46.4 <.001***
detainees screened, with a prevalence rate of 4.73% (Figure 1). Asymptomatic 42 0.0 37.5

Majority of the patients were male (105,93.8%) (Figure 2), and two- CXR upon diagnosis
MATERIALS AND METHODS thirds of the patients were Bajau (62.5%), followed by other ethnic
Moderate 74 6.3 59.8 .008**

groups such as Suluk (30.4%) and others (7.1%). The respondents’ mean
Severe/ advanced 38 9.8 24.1 REFERENCES
A cross-sectional study was conducted among 112 Sputum Smear 1. Dara M, Chorgoliani D, de Colombani P. 8. TB prevention and control care in prisons.
age (SD) was 38.96 (12.31) years (Figure 3 and Table 1). Positive 50 10.7 33.9 .04* 2. Cords O, Martinez L, Warren JL, O’Marr JM, Walter KS, Cohen T, et al. Incidence and
detainees in Tawau Detention Centre who were prevalence of tuberculosis in incarcerated populations: a systematic review and meta-
The patients who were symptomatic, with moderate CXR lesions, Negative 62 5.4 50.0
diagnosed with Tuberculosis during the outbreak. analysis. Lancet Public Health. 2021 May;6(5):e300–8.
Sputum Culture 3. Undiagnosed pulmonary tuberculosis among prisoners in Malaysia: an overlooked risk
negative smear, negative culture, and had been treated for less than six for tuberculosis in the community - Al‐Darraji - 2016
Positive 22 7.1 12.5 .001**
Data retrieved from the MyTB web and Tuberculosis months had higher proportion of unsuccessful treatment (P<.05). 4. Vries G de, Commandeur S, Erkens C, Haddad W, Jansen N, Kouw P, et al. Towards
Negative 52 8.9 37.5 selective tuberculosis screening of people in prison in a low-incidence country.
Information System (TBIS) database from 1st Otherwise, there were no statistically significant differences between Not performed 38 0.0 33.9

January 2022 until 16 January 2023. treatment outcome and other characteristics, such as age, gender,
Treatment duration
< 6 months 94 0.0 83.9 <.001***
ethnicity, TB type, and gene expert (p>.05) (Table 2). 6-12 months 18 16.1 0.0 ACKNOWLEDGEMENT
Data were analyzed through IBM SPSS Version 27.0. *p-value reached from Chi-square test, *p<0.05, **p<0.01, ***p<0.001 1. Sabah State Health Department, Tawau District Health Office, TB Unit
Tawau.
2. Tawau Detention Centre
 Translation, Cross-Cultural Adaptation, and Validation of the Miller-Smith
Lifestyle Assessment Inventory (LSI) in the Malay Language
1*Tham
Sin Wan, 1Victor CW Hoe, 1Mahmoud Danaee
*Tham Sin Wan, [email protected]
1 Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya

Validation process RESULTS AND DISCUSSION

INTRODUCTION AND OBJECTIVES The translated questionnaire was subsequently validated in terms of its content
There is a strong relationship between lifestyle and physical, including mental validity and face validity. Statistical validity and dimensionality analysis were Table 1 : Summary of Validity of LSI Malay version (LSI-M)
health. The Miller-Smith Lifestyle Assessment Inventory (LSI) is a self-report completed using exploratory factor analysis (EFA) with the application of parallel
Number of Content validation Construct validation
questionnaire that assesses an individual's lifestyle patterns and behaviours. It is analysis and polychoric approach based on the pilot study involving 155 nurses, items &
a 20-item instrument that measures six dimensions of lifestyle: health practices, followed by the reliability analysis using Cronbach’s alpha was employed. domains EFA CFA
stress management, physical activity, recreational pursuits, social support, and (Original)
environmental management.
All items were • 4 items • 1 item removed
OBJECTIVE validated; some removed • No collinearity between
The aim of this study is to translate and validate with a cross-cultural adaptation were corrected, • Two two constructs, thus the
of the LSI English version into the Malay language, the national language of 20 items achieved adequate dimension formative construct was
Malaysia. (6 CVI and adjusted correct.
domains) kappa in terms of • Left one dimension – as
MATERIALS AND METHODS clarity, relevancy & unhealthy behaviour
consistency. construct was removed
Study design: Cross-sectional study, online survey
(p=.553).
Study population:
All nurses in Hospital Banting & Hospital Tengku Ampuan Rahimah, Klang (HTAR).
Inclusion criteria:
• Fully trained nurses who had served for at least 6 months
• Able to read and write in English or Malay Figure 2: Flowchart of the validation process
Exclusion criteria:
• Nurse with pre-existing psychiatric illnesses RESULTS AND DISCUSSION
Adaptation process
The steps of cross-cultural adaptation followed strictly the procedure suggested by The Kaiser–Meyer–Olkin (KMO) measure of sampling adequacy for the 20 items
Herdman, Fox-Rushby and Badia (1998) and Beaton, Bombardier,Guillemin and was 0.837. The Bartlett’s test of sphericity of this study had a significant level of p
Ferraz (2000) involving the assessment of the following types of equivalence: < 0.001.Therefore, the data were appropriate to proceed to factor analysis. The
conceptual, item, semantic, idiomatic, operational and measurement. content validity index was 0.931, and reliability showed a Cronbach’s alpha value
of 0.882. All the intraclass correlation coefficients of the items are >0.9, indicating
that the Malay version of LSI is a reliable tool. From statistical validity and
dimensionality analysis, the results indicate that the original version of the scale
Figure 3 : Path diagram of the two-factor structure of LSI-M
was not suitable for this population. The revised version consists of 13 items in a
single dimension: healthy factors.
CONCLUSION
REFERENCES
The 13-item Malay version of the LSI is a valid and reliable tool to assess the
1. Gholamalishahi S, Mannocci A, Ettorre E, La Torre G, Okechukwu C. Lifestyle and Life Expectancy Questionnaire: validation and lifestyle of the nursing population in Malaysia.
assessment in an Italian sample. La Clinica Terapeutica. 2022;173(2).
2. Gunawan E, Deo P, Hidayat T, Pandia V, Iskandar S, Yuni P, et al. Factors correlated with occupational stress among university
lecturers. Medicine & Health. 2018;13(2). ACKNOWLEDGEMENT
3. Yusoff MSB. ABC of content validation and content validity index calculation. Education in Medicine Journal. 2019;11(2):49-54.
4. Herdman M, Fox-Rushby J, Badia X. A model of equivalence in the cultural adaptation of HRQoL instruments: the universalist
approach. Qual Life Res. 1998;7:323-35. We would like to thank the Director General of Health for his permission to present this study. We appreciate the help of all the experts for
Figure 1: Steps in the translation and cultural adaptation of a clinical measurement tool. 5. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. validating the content of the questionnaire. Acknowledgements to all staff nurses in Hospital Banting & HTAR on the success of this
Adapted from Beaton et al. Spine. 2000;25(24):3186-91. research.
 IDENTIFICATION OF HEALTH CLINIC IN KELANTAN WITH HIGH BURDEN OF
P. KNOWLESI MALARIA CASES : A SPATIAL AGGREGATION METHODS
Ku Mohd Saifullah Ku Ismail1*, Nor Azwany Yaacob1, Kamarul Imran Musa1
*Lead presenter1, email: [email protected], 1Department of Community Medicine, School of Medical Sciences, Health
Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia

INTRODUCTION RESULTS DISCUSSION

• P. knowlesi malaria become a global issue and • The incidence rate of P. knowlesi malaria infection increases from the coastal line
associated with hyperparasitemia and a greater risk Table 2: List of health clinic in Kelantan with the number of P.
towards the inland area, indicating that health clinics in the inland area have a
of developing severe illnesses1. knowlesi malaria cases above 10 cases between 2012 and 2021 by
higher burden in screening and managing P. knowlesi malaria infection.
• Kelantan reported the highest proportion of P. two- and ten-kilometers radius from the clinic.
• Kuala Betis Health Clinic in Gua Musang had the highest P. knowlesi malaria cases
knowlesi malaria infection in Peninsular Malaysia, within a two- and ten- kilometers radius (42 and 136 cases, respectively). Most of
with 812 cases reported between 2011 and 2018 Health Clinic District 2KMa 10KMb the population, including aboriginal people living or working within this health
(29.35 percent of total cases)2. clinic’s services, are plantation workers, and deforestation and mining activities
Klinik Kesihatan Kuala Betis Gua Musang 42 136
• Despite much research to identify factor association were reported in this area3,4,5.
with P. knowlesi malaria infection for public health Klinik Kesihatan Jerek Gua Musang 10 82 • Family Doctor Concept (FDC) is an optional holistic approach at health clinic level
intervention, the incidence trend of P. knowlesi Klinik Kesihatan Bertam Baru Gua Musang 9 72 to tackle targeted groups or individuals who had a higher risk of contracting P.
malaria infection does not appear to decline any knowlesi malaria infection by focusing on individual and family awareness on P.
soon. Klinik Kesihatan Dabong Kuala Krai 4 68
knowlesi malaria infection, appropriate usage of prophylaxis for P. knowlesi
OBJECTIVE Figure 1: Distribution of P. knowlesi Klinik Kesihatan Jeram Tekoh Gua Musang 9 61 malaria at various activities, and early seek treatment6.
malaria cases using geolocations, Klinik Kesihatan Biak Kuala Krai 11 61 • Addressing the Health Clinic Advisory Panels (PPKK) to focus on health promotion
• This study aimed to identify the health clinic in
signified by red dots. Darker red and prevention advocacy on P. knowlesi malaria as a disease burden at the health
Kelantan with a high burden of P. knowlesi malaria Klinik Kesihatan Gua Musang Gua Musang 7 59
dots indicate multiple cases were clinic level might promote health activities that improve community awareness
cases to justify priority setting in health care for
geocoded in a similar or nearby Klinik Kesihatan Jeli Jeli 5 58 and prevention of P. knowlesi malaria7.
CONCLUSION & RECOMMENDAT ION
disease prevention and control.

MATERIALS & METHODS

location. Blue dots indicate the Klinik Kesihatan Meranto Gua Musang 3 49
distribution of health clinics.
Klinik Kesihatan Laloh Kuala Krai 2 48 • Health clinics in Gua Musang, Jeli, and Kuala Krai districts had a higher burden of
❖ Study design: Secondary data review P. knowlesi malaria cases. Kuala Betis Health Clinic had the highest number of P.
❖ Sampling frame: List of P. knowlesi malaria cases in Klinik Kesihatan Lubok Bongor Jeli 2 37
knowlesi malaria cases within its radius.
Kelantan from 20212 until 2021 reported in e- Klinik Kesihatan Batu Melintang Jeli 4 35 • Collaborative partnerships with the local community using an available platform
Vekpro system. such as FDC and PPKK may improve control measures against P. knowlesi malaria
Klinik Kesihatan Kuala Balah Jeli 5 33
❖ Study criteria: infection at the health clinic level in the future.
• Inclusion criteria: All P. knowlesi malaria cases
with the presence of P. knowlesi malaria
Klinik Kesihatan Lebir Gua Musang 10 31
ACKNOWLEDGEMENTS
parasite through Blood Film for Malaria Parasite
Klinik Kesihatan Aring Gua Musang 6 27 • Kelantan State Health Department, Kelantan, Malaysia
and registered in the e-Vekpro. Klinik Kesihatan Chiku 3 Gua Musang 4 23 • Supervisor-Assoc. Prof Nor AzwanyYaacob & Asoc. Prof Kamarul Imran Musa
• Exclusion criteria: Imported cases and the cases Klinik Kesihatan Manik Urai Kuala Krai 1 21
1.
REFERENCES
Lee, W.-C., Cheong, F. W., Amir, A., Lai, M. Y., Tan, J. H., Phang, W. K., Shahari, S. & Lau, Y.-L. (2022). Plasmodium knowlesi: the game changer for
with missing important data such as geolocation malaria eradication. Malaria Journal, 21(1), 140. doi: 10.1186/s12936-022-04131-8
Klinik Kesihatan Ayer Lanas Jeli 0 17
of source of infection and address. 2. Phang, W. K., Hamid, M. H. A., Jelip, J., Mudin, R. N., Chuang, T.-W., Lau, Y. L. & Fong, M. Y. (2020). Spatial and temporal analysis of Plasmodium
knowlesi infection in Peninsular Malaysia, 2011 to 2018. International journal of environmental research and public health, 17(24), 9271.
❖ Tools: Line listing of P. knowlesi malaria cases were Klinik Kesihatan Bandar Kuala Krai Kuala Krai 3 16 3. Fornace, K. M., Herman, L. S., Abidin, T. R., Chua, T. H., Daim, S., Lorenzo, P. J., Grignard, L., Nuin, N. A., Ying, L. T., Grigg, M. J., William, T., Espino,
F., Cox, J., Tetteh, K. K. A. & Drakeley, C. J. (2018). Exposure and infection to Plasmodium knowlesi in case study communities in Northern Sabah,
downloaded from e-Vekpro, in .sav format. Klinik Kesihatan Pahi Kuala Krai 0 15 Malaysia and Palawan, The Philippines. PLOS Neglected Tropical Diseases, 12(6), e0006432.
4. Samsurijan, M. S., Abd Rahman, N. N., Ishak, M. I. S., Masron, T. A. & Kadir, O. (2018). Land use change in Kelantan: Review of the environmental
❖ Data analysis: Spatial joining and aggregation impact assessment (EIA) reports. Geografia, 14(4).
techniques using ‘sf’, ‘rgeos’, ‘rgdal’, ‘tmap’, Klinik Kesihatan Gual Ipoh Tanah Merah 0 12 5. Stark, D. J., Fornace, K. M., Brock, P. M., Abidin, T. R., Gilhooly, L., Jalius, C., Goossens, B., Drakeley, C. J. & Salgado-Lynn, M. (2019). Long-Tailed
Figure 2: Incidence of P. knowlesi Macaque Response to Deforestation in a Plasmodium knowlesi-Endemic Area. Ecohealth, 16(4), 638-646.
‘leaflet’, and ‘raster’ packages via R software version malaria cases in Kelantan by sub- aNumber of cases with the source of infection is within 2 kilometers radius of each health clinic.
6. Ismail, A., Reffien, M. A. M., Sulong, S., Bahanuddin, T. P. Z. T., Salleh, N. M. & Nasir, N. H. (2020). Understanding the Family Doctor Concept in
Public Primary Care Clinics in Malaysia: Objectives, Initiatives, Resources, and Expected Outcomes.
4.2.2. district.
bNumber of cases with the source of infection is within 10 kilometers radius of each health 7. Mustapha, F. I., Omar, Z. A., Mihat, O., Md Noh, K., Hassan, N., Abu Bakar, R., Abd Manan, A., Ismail, F., Jabbar, N. A. & Muhamad, Y. (2014).
clinic. Addressing non-communicable diseases in Malaysia: an integrative process of systems and community. BMC Public Health, 14(2), 1-6.
 Situational Analysis of Malaria in Sri Aman Division from the year 2011-2021: A cross-sectional study
Yassimear AU
Department of Community Medicine & Public Health, Faculty of Medicine & Health Sciences, Universiti Malaysia Sarawak, Jalan Datuk Mohammad Musa,
94300 Kota Samarahan, Sarawak
Introduction Results Conclusion
• Sarawak reported the highest average incidence
• The average incidence rate of malaria in the Sri
rate of 0.420/per 1000 population from 2013-2017¹. • There were a total of 456 malaria cases notified in Sri Aman Division from 2011-202, Aman division for year 2011-2021 is higher than
• Sri Aman division, especially Lubok Antu district is with an incidence rate of 0.077-0.345 per 1000 population, a mortality rate of 1.277- the national malaria average incidence rate
located at the border of neighbouring country that is 1.795 per 100,000 population and a case fatality rate of 4.35% (remain 0 since 2012). (0.106) from years 2013 to 2017 with cases
still categorized as red zone (having one or more • majority of the cases were among 35-44 years old (n=110, 24%), male (n=373, 81%), highly distribute to Lubok Antu district compared
indigenous malaria cases)² which increase risk of Malaysian citizens (n=423, 93%), Bumiputera Iban (n=385, 84%) and plantation workers to Sri Aman district. While mortality rate and
continuous transmission.. (n=117, 26%). case fatality remains low since 2012.
Objectives •
•
the dominant malaria species was Plasmodium Knowlesi (n=410, 90%).
majority of cases were indigenous infections (n=438, 96%).
• High risk group consist of adult within age group
General objective: of 25-54 years old, male gender, Bumiputera
To determine the epidemiology of malaria cases in Sri • There was a higher density of malaria cases in the rural area of Lubok Antu district as ethnicity and those works related to farm and
Aman from 2011-2021. compared to Sri Aman district. forest activities.
Specific objectives: • large forest area with presence of macaques
• To determine the trend of malaria cases in Sri (reservoir) may contribute to transmission of P.
Aman, 2011-2021. Knowlesi malaria in Sri Aman.
• To determine the socio-demographic of malaria
cases in Sri Aman, 2011-2021. Recommendations
• To determine the profile of plasmodium species • Health education to people at risk: those
among malaria cases in Sri Aman, 2011-2021. working/ travelling to & from at endemic area,
• To identify hotspot area of malaria cases in Sri those involves with activities or working in
Aman, 2011-2021. plantation farm and forests.
Study Area • Strengthen interborder control and prevention
activities at the Lubok Antu-Kalimantan border
Sri Aman division:
• one of the twelve divisions in Sarawak, divided • Increase screening BFMP for early detection-
into two districts:Sri Aman District and Lubok high index of suspicion among health
Antu District. professionals, especially among people in
• comprised 78,300 population in Sri Aman district Lubok Antu area
and 33,100 population in Lubok Antu district. • the need of One Health Approach to malaria
• Sri Aman district had 318kha of natural forest, P.Knowlesi cases management involving
extending over 89% of its land area while Lubok multiagency collaboration.
Antu district had 20.3Mha of natural forest
extending over 87% of its land area³, a natural
Acknowledgement
Special thanks to Sri Aman Divisional Health
habitat for macaques (reservoir for malaria
Officer, Epidemiology Officer and all Malaria
P.Knowlesi).
Control Unit staffs.
Methos and Materials References
• Design :Cross-sectional (April-May 2022)
¹ Hussin, N., Lim, Y. A. L., Goh, P. P., William, T., Jelip, J., &
• Data Sources: retrospective secondary data Mudin, R. N. (2020). Updates on malaria incidence and profile in
includes all notified malaria cases registered in Malaysia from 2013 to 2017. Malaria Journal, 19(1), 1–14.
VEKPRO from 2011-2021. https://doi.org/10.1186/s12936-020-3135-x
² WHO. (2021). World Malaria Report 2021. In Word Malaria
• Data Management & Analysis: Descriptive analysis report Geneva: World Health Organization. (2021). Licence: CC.
with Microsoft Excel, mapping of malaria cases ³World Resources Institute. (2022). Global Forest Watch, Lubok
distribution using QGIS Antu, Sarawak. Global Forest Watch Website.
 DIABETIC RETINOPATHY AND ASSOCIATED FACTORS AMONG TYPE 2 DIABETES
MELLITUS PATIENTS AT PUBLIC HEALTH CLINICS IN DUNGUN, TERENGGANU
1 Wan Soliha Wan Mohd Hanafi, 1 Fathul Hakim Hamzah, 1 Fatimah bt Mohamed Yusoff, 1 Mohammad Hilmi Hussin, 2Mohd Anuar Abd Rahman, 2Kasemani Embong
(*Wan Soliha Wan Mohd Hanafi 1, [email protected] , Dungun District Health Office, Malaysia)

RESULTS DISCUSSION
INTRODUCTION CONCLUSION
There were 747 DM patients with DR (9.3%) in Dungun, with the mean age ▪ Our study revealed significant associated factors
• Diabetic retinopathy (DR) is the most Diabetic retinopathy is a serious diabetic complication,
of cases was 59 (±11) years. of DR among type 2 DM patients were duration
common cause of reduced vision and and the identification of significant risk factors can
blindness among people aged 30-69 years Figure 1: Sex distribution of DR Table 1: Characteristics of DR cases in of DM > five years, hypertension, dyslipidemia,
Dungun (n=747) ischemic heart disease, and diabetic foot ulcer; guide clinical management proactively and formulate
old around the world.1,2 cases in Dungun (n=747)
while HbA1c > 6.5% was to be found a protective effective preventive public health strategies to
• The prevalence of DR is likely to increase factor to DR. minimize avoidable blindness due to diabetes.
with the projected increase of T2DM in
developing countries. 3 ▪ The duration of diabetes was found as the
strongest predictor for DR, in line with previous
• DR often has no early warning signs; studies as it related to the magnitude or ACKNOWLEDGEMENT
therefore, it is recommended for patients prolonged exposure, or both, to hyperglycemia
Figure 2: Age distribution of DR coupled with other risk factors. 5-8 The authors would like to thank the staff of the Dungun
with type 2 DM to have a comprehensive eye
cases in Dungun (n=747) District Health Office for their assistance and support in
examination annually to prevent its ▪ Patients with dyslipidemia have a higher
progression.4 frequency of acquiring retinal irregularities and conducting the study. We would also like to acknowledge
the formation of hard exudates. 8,9 the Director General of Health of Malaysia and the
Terengganu Department of Health, Ministry of Health,
▪ A number of studies suggested hypertension was
Malaysia.
related more to the progression rather than to
OBJECTIVES the occurrence of retinopathy.10,11
▪ Our findings on HbA1c contrast with other
This study aimed to determine the factors
studies that seemed to confirm the fact that REFERENCES
associated with diabetic retinopathy among
HbA1c is one of the most important risk factors 1) Fowler, M. (2008) Microvascular and macrovascular complications of diabetes. Clinical
type 2 diabetes mellitus patients at public Table 2: Factors associated with DR among severe DM patients using logistic for the development and progression of diabetic Diabetes, 26, 2, 77-82.
health clinics in Dungun, Terengganu. regression (n=747) 2) American Diabetic, A. (2008) Guidelines American Diabetic Association. Diabetes Care, 31,
retinopathy.12 S12- S554.
3) King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical
Adjusted Odds estimates, and projections. Diabetes Care. 1998;21(9):1414-31.
Variables (Factors) 95%CI p-valuea 4) Fong, D. S., Aiello, L., Gardner, T. W., King, G. L., Blankenship, G. & Cavallerano, J. D. et al.
Ratio (OR)
METHODOLOGY RECOMMENDATION
(2003) Diabetic retinopathy. Diabetes Care, 26, S99- S10.
Age 1.47 0.19-11.37 0.708 5) Lim MC, Lee SY, Cheng BC, et al. Diabetic retinopathy in diabetics referred to a tertiary centre
from a nationwide screening programme. Ann Acad Med Singapore. 2008;37(9):753-9.
BMI 0.79 0.61-1.04 0.090 6) Wang FH, Liang YB, Peng XY, et al. Risk factors for diabetic retinopathy in a rural Chinese
• This study was done based on type 2 DM population with type 2 diabetes: the Handan Eye Study. Acta Ophthalmol. 2011;89(4):e336-
A cross-sectional study was carried out Duration of DM > 5 years 3.79 2.02-7.11 < 0.001
outpatients in public health clinics, and the 43.
HbA1C > 6.5 0.57 0.43-0.75 <0.001 7) Tajunisah I, Nabilah H, Reddy SC. Prevalence and risk factors for diabetic retinopathy - a study
among all patients over 18 years and majority of patients were Malays. Thus, data from of 217 patients from University of Malaya Medical Centre. Med J Malaysia. 2006;61(4):451-6.
diagnosed with type 2 DM for >1 year. Hypertension 1.65 1.18-2.29 0.003 other centers are required for generalization and 8) E.N. Cetin, Y. Bulgu, S. Ozdemir, S. Topsakal, F. Akin, H. Aybek, et al. Association of serum lipid
levels with diabetic retinopathy. International Journal of Ophthalmology, 6 (3) (2013), pp.
Dyslipidemia 1.92 1.29-2.85 0.003 are equally covered. 346-349
The National Diabetic Registry was used 9) F.M. Sacks, M.P. Hermans, P. Fioretto, P. Valensi, T. Davis, E. Horton, et al. Association
Ischaemic Heart Disease 1.54 1.07-2.21 0.018
as the database for attendees at public • This study recommends regular screening of the between plasma triglycerides and high-density lipoprotein cholesterol and microvascular
Diabetic Foot Ulcer 3.37 1.75-6.52 <0.001 kidney disease and retinopathy in type 2 diabetes mellitus: A global case-control study in 13
health clinics in Dungun between January eyes for all diabetic patients, ideally, a fundus countries. Circulation, 129 (9) (2014), pp. 999-1008.
2018 and December 2022. Nephropathy 2.24 1.78-2.81 <0.001 10) Agardh E, Agardh EC, TorVvit O. A 5-year follow-up study on the incidence of retinopathy in
examination is done at least once a year. type 1 diabetes mellitus in relation to medical risk indicators. J Intern Med 1994;235:351–8.
Cerebrovascular Disease 0.85 0.45-1.62 0.639
11) Janka HU, Warram JH, Rand LI, et al. Risk factors for progression of diabetic retinopathy in
Logistic regression analysis was used to *Multiple Logistic Regression
• A selection of patients with higher risk factors long standing IDDM. Diabetes 1989;38:460–4.
assess the association of the variables. Classification table: 90.6, Hosmer Lemeshow: 12.38 (Chi Square), 6 (df), p= 0.054 should be prioritized to enable earlier DR 12)Klein, B. (2007) Overview of epidemiologic studies of diabetic retinopathy. Ophthalmic
Area under the ROC curve is 0.735 (95% CI: 0.713,0.758) Epidemiol, 14, 179-183.
No interaction, No multicollinearity detection.
 PREVALENCE AND ITS ASSOCIATED SOCIODEMOGRAPHIC FACTORS OF SMOKING
AMONG SECONDARY SCHOOL STUDENT IN TENOM, SABAH
Ahmad Syukri Radzran1, Awang Setia Musleh1, Shamsul Bahari Shamsudin1, Muhammad Hanif Mohd Deris1, Lim Mei Ching1, Hazeqa
Salleh1
1Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah,

Malaysia
Introduction Results Discussions
• Globally, the estimated numbers of boys Variables Smoking Status X2 P value OR (CI 95%)
and girls 13–15 years old who smoke Smokers (n Non smokers • Prevalence of 26.1% was found to slightly higher than previous
= 66) (21.6%) (n = 187) prevalence reported for Sabah in NHMS 2017 but lower than
cigarettes or use smokeless tobacco
(88.4%) prevalence reported in other study that reach to more than 30%(Lim
products are approximately 25 million
Gender et al, 2010).
and 13 million, respectively.
• In Malaysia, according to National
Male 55 (83.3%) 67 (35.8%) 44.090 <0.001* 8.955(4.389-18.270) • Male students found to be more likely to be a smoker compared to
Female 11 (16.7%) 120 (64.2%) female student, likely related to socially acceptable norms of male
Health Morbidity Survey in 2017, it is
Household income smokers compared to female smokers and this finding is consistent
found that 22% of male Form 1 to Form 5 < RM 1180 43 (65.2%) 80 (42.8%) 9.773 0.002* 2.501(1.395-4.481)
student smoking and 5 % of female Form with other study done by Hammond et al in 2008.
> RM 1180 23 (34.8%) 107 (57.2%)
1 to Form 5 student were smoking. • Students with household income of < RM1180 are at risk of becoming
Parental Education Level
• This study aimed to determine Below College 42 (63.6%) 113 (60.4%) 7.249 0.007* 2.432(1.259-4.701)
a smoker compared to the student with household income of >
prevalence and associated College 24 (36.4%) 74 (39.6%)
RM1180,probably related to low economic status can resulted in
sociodemographic factors of smokers Parental Marital Status stress and hence using smoking as stress releasing method as shown
among secondary school students. Unmarried/Divorced 11 (16.7%) 22 (11.8%) 1.033 0.309 1.500(0.684-3.290) in other studies.(Green et al., 2018).
• Student with parents educated below college level were found to be
Method Married
Parental Smoking Status
55 (83.3%) 165 (88.2%)
more likely to become a smoker compared to student with parents
educated at college level. This could be related to inadequate
•
s
A cross sectional study was conducted at 7
Yes
No
41 (62.1%)
25 (37.9%)
85 (45.5%)
102 (54.5%)
5.420 0.020* 1.968(1.108-3.496)
knowledge concerning the danger of the smoking and it is consistent
Siblings Smoking Status with other study(Andrade et al., 2017).
secondary schools in Tenom using self- Yes 47 (71.3%) 65 (34.8%) 26.274 <0.001* 4.643(2.518-8.562) • Students who were having parent, siblings and close friends that are
administered questionnaire as study tool No 19 (28.7%) 122 (65.2%) smoking are more likely to become a smoker due to the
and 253 students involved in this study. Close Friends Smoking Status understanding from the parents as acceptable behaviors and
• Chi-square, and logistic regression to test Yes 39 (59.1%) 16 (8.6%) 73.225 <0.001* 15.438(7.594-31.383)
condoning from the siblings and finally adopting similar habits from
for the association of the variables. No 27 (40.9%) 171(91.4%)
their close friends. This finding is similar to many other studies done
References previously (Wilkinson et al., 2008; Hiemstra et al., 2011; Andrade et
1.Andrade, R.,Ferreira, D.,Ramos, D., Ramos, E., Scarabottolo, C., Saraiva, B., Christofaro, D(2017). Smoking among adolescents is associated with their own characteristics and with al., 2017; Scragg et al., 2010;).
parental smoking: Cross-sectional study. Sao Paulo Medical Journal, 135(6), 561–567.
2.Green, M. J., Stritzel, H., Smith, C., Popham, F., & Crosnoe, R. (2018). Timing of poverty in childhood and adolescent health: Evidence from the US and UK. Social Science & Medicine,
197, 136–143.
3.Hammond, D., Kin, F., Prohmmo, A., Kungskulniti, N., Lian, T. Y., Sharma, S. K., … Fong, G. T. (2008). Patterns of Smoking Among Adolescents in Malaysia and Thailand: Findings
From the International Tobacco Control Southeast Asia Survey. Asia Pacific Journal of Public Health, 20(3), 193–203 Conclusions
4.Hiemstra M.,Otten R.(2011).The Changing Role of Self-Efficacy in Adolescent Smoking Initiation. Journal of Adolescent Health, 597–603.
5.Lim Kh ., Mg, S., & Cc, K. (2010). Prevalence, Smoking Habit and Factors Related to Smoking and Nicotine Addiction Among Lower Secondary School Male Students in Kota Tinggi Smoking among secondary school student is associated with many
District, Johor, Malaysia. 10, 11.
6.Scragg, R., Glover, M., Paynter, J., Wong, G., & McCool, J. (2010). Association of parent and best friend smoking with stage of adolescent tobacco smoking. 123(1326), 11. sociodemographic factors. Family based intervention along with school close
7.Vuolo, M., & Staff, J. (2013). Parent and Child Cigarette Use: A Longitudinal, Multigenerational Study. PEDIATRICS, 132(3), e568–e577. involvement in managing smoking among secondary school students may
8.Wilkinson, A. V., Shete, S., & Prokhorov, A. V. (2008). The moderating role of parental smoking on their children’s attitudes toward smoking among a predominantly minority sample: help in reducing the prevalence.
A cross-sectional analysis. Substance Abuse Treatment, Prevention, and Policy, 3(1), 18.
 Kindergarten Teacher’s Knowledge, Attitude, and Practice Towards HFMD Control and Prevention Measures
Nuryatini binti Merali1, Muhammad Najib Bin Hasan1, Mardhiyyah Azmi1
Mohd Siddqi Bin Abidin1, Nur Fatihah Oh Abdullah1
(*Muhammad Najib1 , [email protected], PKB Samarahan, Malaysia)
INTRODUCTION RESULT AND DISCUSSION CONCLUSION AND RECOMMENDATION
Hand foot and mouth disease (HFMD) is a common The mean age of respondents was 38.8 years old, SD=9.28. The mean working Conclusion: The level of knowledge and attitude toward HFMD
infectious disease that is caused by Enterovirus. The experience was 12.0 years, SD= 9.33. Most of them are female and educated. prevention and control in the Samarahan division is at a
symptoms may present with fever, malaise, upper satisfactory level. The teacher also performs appropriate
respiratory symptoms, rashes, and lesions on the hand,
KAP SCORE OF HFMD PREVENTION
Knowledge of HFMD was good, where 24.7% of practice in order to prevent the transmission of HFMD in
foot, and mouth.1 HFMD outbreaks often occur in respondents were able to score full marks on kindergarten. Attitude is a significant predictor for good HFMD
Good Moderate Poor
nurseries, playgroups, schools, and households, where the knowledge. The mean score of knowledge prevention practice among kindergarten teachers.
young children have lots of close contact with one 12.1% 8.4% was 9.46, SD=1.26, (min=6, max=11). The Recommendations : Continuous health education emphasized in
20.0%

another.2 Notification of HFMD in the Samarahan 26.5%

11.2%
Attitude was satisfactory, the mean score was improving attitude and their knowledge towards HFMD and its
division, had increased this year. The cases mostly 20.82, SD= 5.21 (min 5, max 25). Practice of control measures. The latest and updated information should be
55.3%

occur among children ages less than 7 years old and 80.5% toward HFMD prevention, showed good made available and easily accessible to kindergarten teachers in
61.4%

most of them attend kindergarten. Hence, it is practice related to HFMD prevention among particular, and to other caregivers in general. This can be
24.7%

important for us to determine the knowledge, attitude, kindergarten teachers in the Samarahan district, achieved through regular educational talks and information
KNOWLEDGE ATTITUDE PRACTISE

and practice of the kindergarten teacher regarding the the mean score was 52.23, SD 6.87 (min=11, sharing through social media platforms. Among the key topics
HFMD prevention. Frequency of washing od children toys at max 55). that should be emphasized to the kindergarten teachers or other
facilities
100.0% In the practise, noted that the frequency of day care workers include the importance of sanitation of toys,
80.0%
OBJECTIVES 60.0% 44.7% washing children's toys in kindergarten was personal hygiene, and environmental hygiene.
40.0%
17.2% 12.6% 19.1% unsatisfactory, only 44% wash the toy every day
The objective of the study is to provide baseline 20.0% 3.3% 3.3%
On the other hand, the frequency of sanitization
information on knowledge, attitude, and practice 0.0%
and washing of the playground and classroom ACKNOWLEDGEMENTS
toward HFMD control and prevention measures among showed a better result. About 77.7% sanitized
kindergarten teachers in the Samarahan division We are very grateful to Pejabat Kesihatan Bahagian Samarahan,
the playground and classroom every day KEMAS and Kindergarten Teachers who help in this research.
MATERIALS AND METHODS The multiple regression model B SE Beta t Sig
REFERENCES
The research was conducted using a cross-sectional produces R2= 0.16, F(4, 210) = Age -0.087 0.072 -0.118 -1.214 0.226

design, with a self-administered online questionnaire. 9.994 , p< 0.001. 1. Guerra AM, Orille E, & M., W. (2022). Hand Foot And Mouth Disease. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK431082/
The report will be based on the study conducted There was a significant linear Duration of service -0.008 0.071 -0.011 -0.112 0.911
2. Charoenchokpanit, R., & Pumpaibool, T. J. J. o. H. R. (2013). Knowledge attitude and
among 215 kindergarten teachers in the Samarahan relationship between a good preventive behaviors towards hand foot and mouth disease among caregivers of
attitude and good practice Attitude 0.470 0.085 0.356 5.533 0.000* children under five years old in Bangkok, Thailand. 27(5), 281-286.
division. The questionnaire was developed based on 3. Huyen, T. T. N. (2012). Baseline survey report on knowledge, attitude, practice related
the report by Huyen, 2012.3 It consists of 5 sections. toward HFMD prevention to Hand Foot Mouth Disease of child care givers at communities. Retrieved from
The study received ethical clearance from the National (p<0.001), which suggest good Knowledge 0.370 0.349 0.068 1.058 0.291
Vietnam:
Medical Research Register (NMRR) of the Ministry of attitude as predictor for good
Health Malaysia. HFMD prevention practise.
 IMPACT OF METEOROLOGICAL FACTORS ON THE PROPAGATION OF COVID-19 IN JOHOR
1*Suriya Kumareswaran, S.K., 2Siti Umairah, S.U., 3Ng Pei Shan, N.G., 4Noor Elliza, N.E., 5Bala Murali, B.M., 6Hazim Ismail, H.I., 7Jeyanthini, J.S.
[email protected], Public Health Division, Johor State Health Department

INTRODUCTION Correlation between COVID-19 cases and Rainfall DISCUSSION

70000 25
The global distribution and severity of COVID-19 have been A total of 392,049 cases recorded from 2021 till 2022 in Johor

No. of COVID-19 Cases

60000
20
.The result shows there is positive correlation between COVID-19

Rain (mm/day)
50000
markedly heterogeneous. Seasonality has been indicated as a 40000 15
contribution to regional variability, although the relationship 30000
cases towards rainfall and temperature (p-value <0.01). Also,
10
between weather and COVID-19 is still unclear, and outside 20000 the results show there is no correlation between COVID-19 cases
5
environments have been the focus of investigation. Even though
10000 towards windspeed and humidity. The results indicate that
0 0
laboratory and epidemiological research have proven the climate characteristics are useful for minimising the uncertainty

Jan

Jan
Feb

Aug
Jul

Feb

Aug
Jul
Mar

Jun

Mar

Jun
May

Nov

May

Nov
Sep
Oct

Sep
Oct
Apr

Dec

Apr

Dec
impact of ambient temperature on the transmission and 2021 2022
surrounding the severity of future COVID-19 transmission.
survival of coronaviruses, nothing is known about the weather's COVID-19 Cases Rain
CONCLUSION AND RECOMENDATION
impact on the spread of COVID-19.
Correlation between COVID-19 cases and Temperature These correlations between climate conditions and COVID-19
70000 31
30.5 cases can be used to generate early warning for any future

No. of COVID-19 Cases

60000
OBJECTIVES 30 epidemic, allowing for the adoption of stringent regulations, the

Temperature (oC)
50000 29.5
40000 29 preparation of healthcare service plans, and the targeting of
This study investigates the effects and association of 28.5
30000 28 vaccination coverage. . The results of this study support some
temperature, humidity, precipitation, wind speed on the 20000 27.5
27 previous findings about the main climatic determinants of
increasing of COVID-19 cases in Johor, Malaysia 10000 26.5
0 26 COVID-19 transmission, which may be useful for decision-making

Jan

Jan
Feb

Aug

Feb

Aug
Mar

Jun

Mar

May
Jun
May

Jul

Jul
Sep

Nov

Sep

Nov
Apr

Oct

Dec

Apr

Oct

Dec
and management of the disease.
METHODOLOGY 2021 2022
COVID-19 Cases Temperature ACKNOWLEDGEMENTS
From January 2021 to December 2022, daily COVID-19 case
RESULTS I would like to thank Johor State Public Health Department for
data was gathered from the COVIDNOW Malaysian website
their assistance with the collection data.
dedicated to COVID-19, while satellite climate data for the Correlation Coefficient 1.117**
same period was taken from the official website of the Rain (mm/day) REFERENCES
Sig. (2-tailed) 0.001
National Aeronautics and Space Administration (NASA). A Correlation Coefficient 1.153** • Baykal, T. M., & Colak, H. E. (2022). Producing climate boundary maps using GIS interface model designed with Python.
Temperature (℃) Progress in Physical Geography, 46(1), 61–83. https://doi.org/10.1177/03091333211033223
descriptive analysis was undertaken to characterise all the Sig. (2-tailed) 0.001 • Briz-Redón, Á., & Serrano-Aroca, Á. (2020). The effect of climate on the spread of the COVID-19 pandemic: A review of
findings, and statistical and modelling techniques. Https://Doi.Org/10.1177/0309133320946302, 44(5), 591–604.
important variables across the study period. Correlation Correlation Coefficient 0.123 https://doi.org/10.1177/0309133320946302
Wind Speed • Cui, L., Shen, Z., Liu, Y., Yu, C., Lu, Q., Zhang, Z., Gao, Y., & Nie, T. (2022). Identification of driving forces for windbreak
analysis was conducted to investigate the linear relationship Sig. (2-tailed) 0.038 and sand fixation services in semiarid and arid areas: A case of Inner Mongolia, China. Progress in Physical Geography.
https://doi.org/10.1177/03091333221105403
between COVID-19 cases and climate factors. Correlation Coefficient 0.019 • Feng, Y., Wang, H., Liu, W., Sun, F., & Cui, H. (2022). Comparative study of multiple heat indices in revisiting summer heat
Humidity across China based on meteorological observations. Progress in Physical Geography, 46(2), 291–309.
Sig. (2-tailed) 0.617 http://doi.org/10.1177/03091333211057193
 EVALUATION OF TIME IN THERAPEUTIC RANGE AMONG PATIENTS PRESCRIBED WITH
WARFARIN BEFORE AND DURING COVID-19 PANDEMIC
Norhidayah K.
([email protected], Hospital Sultanah Nora Ismail, Batu Pahat, Johor, Malaysia)

INTRODUCTION Table 2: Post Hoc Test

Variable Year Year *P-value
The treatment process of patients treated with warfarin is expected to be hindered
during the COVID-19 pandemic causing the normal routine of INR monitoring could No. of visits Pre-pandemic 1st year pandemic 0.333
not be performed periodically and later might put the patient at high risk of bleeding 2nd year pandemic 0.018
and venous thromboembolism.
No. of visits with therapeutic INR Pre-pandemic 1st year pandemic 0.038

OBJECTIVES 2nd year pandemic 0.034

*Bonferroni
To evaluate the impact of COVID-19 pandemic on time in therapeutic range (TTR)
among patients attending Anticoagulant Medication Therapeutic Adherence Clinic Figure 1: Category of the quality of INR control
(AC-MTAC) in Hospital Sultanah Nora Ismail (HSNI). 80 62.8
60.6 59.8
60
39.4 37.2 40.2
MATERIALS & METHODS 40 Poor

A total of 738 patients was recruited. Pre-COVID-19 pandemic data were collected 20 Good
from January to December 2019 while COVID-19 pandemic data were separated into 0
two groups which were first year pandemic from April to December 2020 and second pre-pandemic 1st year pandemic 2nd year pandemic
*chi-square test: p = 0.772
year pandemic from January to December 2021. The TTR values were calculated
using Rosendaal’s method. The mean TTRs were compared using One-Way ANOVA
CONCLUSIONS
test. All analysis was conducted using SPSS® software application version 25.
The global issue of COVID-19 pandemic did not appear to cause reduction in safety
RESULTS & DISCUSSION and effectiveness of chronic warfarin therapy management in HSNI.
Table 1: Statistical comparison of parameters before and during COVID-19 pandemic
ACKNOWLEDGEMENT
Parameters Pre-pandemic 1st year pandemic 2nd year pandemic *P-value
Statistical comparison of parameters before and during COVID-19 pandemic I would like to thanks to all individual who were directly or indirectly involved in
No. of visits 7.55 + 3.26 8.08 + 3.90 6.63 + 3.75 0.0001 completing this study.
No. of visits with 4.52 + 2.14 4.98 + 1.97 4.05 + 2.02 0.0001
therapeutic INRs
REFERENCES
1. Dogan T, Levent F. The short-term effect of the COVID-19 pandemic on the management of warfarin therapy. Kardiologiia.
TTR 63.56 + 22.64 67.26 + 21.59 66.92 + 25.38 0.164 2021;61(7):55-59
* One-way ANOVA 2. Emren ZY, Senoz O, Ersecgin A, Emren SV. Evaluation of Bleeding Rate and Time in Therapeutic Range in Patients Using
Warfarin Before and During the COVID-19 Pandemic – Warfarin Treatment in COVID-19. Clinical and Applied
Thrombosis/Hemostasis 2021, 27; 1-6.
 INCREASING ADHERENCE TO ANTIBIOTIC PRESCRIBING GUIDELINES IN A PRIMARY HEALTH CARE SETTING:
A PRE AND POST STUDY
1Raudhatun Saadiah I., 2Faradia M., 1Pooi Yee L., 1Ee Siang H., 1*Kavinamalar P.
(*Kavinamalar P1, [email protected], Pontian Health District, MOH, Malaysia) 22

INTRODUCTION OBJECTIVE IDENTIFIES FACTOR STUDY RESULT POST INTERVENTION RESULT

11

The emergence of antimicrobial resistance worldwide calls for rational use of GENERAL SPECIFIC MANAGEMENT FACTORS CHART1 : AMCA RESULTS 10
9
antibiotics in Malaysia. Antimicrobial resistance is an urgent global public health 1. No up to date on latest antibiotic guidelines (Interview) 100% 100
8
threat, killing at least 1.27 million people worldwide and associated with nearly 5 1. To determine the magnitude of problems 93.4
2. No discussion among units (AMSA) 100%

Upper Limit
90 7
million deaths in 2019. In the U.S., more than 2.8 million antimicrobial-resistant in adherence towards antibiotic guidelines 80.5

(UL)
80 6
infections occur each year. Adherence to antibiotic guidelines refers to increasing among prescribers 3. No internal audit in clinic (AMSA) 100%
5
To increase the 70
compliance with guidelines and standards. Antimicrobial resistance (AMR) has 2. To identify the factors that cause low 4. No appointment of committee members in clinic (AMSA) 100% 4
percentage of adherence 60
emerged as a major public health issue in the world resulted in prolonged Antimicrobial Stewardship Clinical Audit 56.6 3
towards Antimicrobial 5. No presentation on antibiotic achievement in clinic (AMSA) 100% 50
hospitalization, treatment failures and longer periods of infectivity (1). The (AMCA) Score 2
Stewardship Clinical Audit 6. Antibiotic guidelines always changing (Interview) 100% 40
National Infection Control and Antibiotic Committee introduced Antimicrobial 3. To formulate and practice steps of 1
(AMCA) PRE INTERVENTION PHASE 1 PHASE 2 0
Stewardship (AMS) in primary care in 2014 as a strategy to combat antibiotic improvement measures 7. No standard antibiotic guideline in clinic (Interview) 100% 2019 2020 2021 2022 2019 2020 2021 2022 2019 2020 2021 2022
resistance (2). AMS is a coordinated systematic approach to improve the 4. To evaluate the effectiveness of EES AMOXY AUGMENTIN
8. No tool to monitor clinical examination (Interview) 100% JOHOR UL LEVEL 5.38 1.79 1.34 0.51 11.4 8.86 4.13 6.12 0.22 0.23 0.24 0.32
appropriate use of antimicrobials by promoting the selection of the optimal improvement measures
STAFF FACTORS SUSTAINABILITY PHASE (SP)
antimicrobial drug regimen. The AMS activities include implementation of KKPN 1.5 0.1 0 0.01 5.4 4.75 1.5 2.06 0.1 0.18 0.15 0.16

treatment guidelines and clinical Pathways, surveillance and feedback, formulary 1. No knowledge assessment among healthcare staffs (Observation) 100%
restriction, antibiotic selection and dose optimization and education. INDICATOR FOR IMPROVEMENT FACTOR RE-IDENTIFICATION STUDY CHART 3: ANTIBIOTICS USAGE IN DEFINED DAILY DOSE (DDD) PER 100 PATIENTS
2. Inexperienced pharmacist (Observation) 72%
Pharmacists could not identify the accurate indication of antibiotic MANAGEMENT FACTORS SP OTHER IMPACT
LITERATURE REVIEW PERCENTAGE OF ANTIBIOTIC ADHERENCE AMONG PRESCRIBERS 3. (Observation) 65%
1. No up to date on latest antibiotic guidelines (Interview) 100% 0%
30,000.00
2. No discussion among units (AMSA) 100% 0%
Antibiotic guidelines is an important intervention to support clinical decision AMCA Score Criterias Achieved x 100
PHASE 1
making to tackle relevant diseases and to control antimicrobial resistance by AMCA Score Full Mark Criterias 3. No internal audit in clinic (AMSA) 100% 0% 25,000.00

RM
choosing the necessary and appropriate use of antibiotics. However non 4. No appointment of committee members in clinic (AMSA) 100% 0% 20,000.00
25,361.14
adherence to antibiotic guidelines has showed an increase in prevalence of Standard: 80% MANAGEMENT • No up to date on latest antibiotic guidelines
5. No presentation on antibiotic achievement in clinic (AMSA) 100% 0% 15,000.00 20,530.96 8,782.81
antimicrobial resistance. Escherichia coli (E.coli) being the most common Standard justification= 80%. (Interview)
• 11,995.17
bacterial infection in patients from various public hospitals in Malaysia have Establishment of adherence towards antibiotic according to Clinical Pathway In No distribution of latest updated antibiotic 6. Antibiotic guidelines always changing (Interview) 100% 40% 10,000.00

showed the highest resistance rate to penicillin ranging from 68 - 100% (3). Primary Care Ministry Of Health Of Malaysia guidelines (AMSA)
7. No standard antibiotic guideline in clinic (Interview) 100% 0% 5,000.00
EARS-Net data indicated that in the EU mean resistance rate to the 3rd • Antibiotic guidelines always changing PRE INTERVENTION PHASE 1 PHASE 2 SUSTAINABILITY
(Interview) 8. No tool to monitor clinical examination (Interview) 100% 0%
generation cephalosporins was 11.9%, ranging 4.4% in Sweden, 38.1% in PHASE
Bulgaria (4). DATA COLLECTION PROCESS • No standard antibiotic guideline in clinic STAFF FACTORS CHART 4 : ANTIBIOTIC COST OF PURCHASING

Lack of information among health care providers is one of the factors associated (Interview) No knowledge assessment among healthcare staffs Carl et. al (2014): A reduction in antibiotic consumption leads to a reduction of
• No tool to monitor clinical examination 1. 100% 30%
with non adherence to antibiotic guidelines. Prescribers generally diagnose (Observation) resistance. The classical Finnish study focusing on macrolide resistant Streptococcus
microbial infection based on sign and symptoms and select antimicrobials Study Design Cross Sectional Study (Interview) Inexperienced pharmacist (Observation) 72% 35% pyogenes clearly showed how a reduction in macrolide use could lead to a reduction
2.
empirically rather than following standard treatment guidelines (5). Some in AMR. Antibiotic resistance dropped from 9.2% in 1997 to 7.4% in 2000, with a
Pharmacists could not identify the accurate indication of
prescribers are also not aware of the update in the antibiotics guidelines. The 3. 65% 43% statistically significant association between regional macrolide resistance and
• 120 Randomized antibiotic prescription antibiotic (Observation) consumption rates
guidelines are often not properly known, especially to inexperienced staffs such Study Sample • 11 Prescribers Prescriber did not complete the clinical examination in
as replacement and temporary staff (6). • 7 Pharmacists 4. - 19%
prescription (AMCA) NEXT STEP

DEFINITION • Antimicrobial Stewardship Clinical Audit (AMCA) POST INTERVENTION RESULT SUGGESTION RATIONALE
• Antimicrobial Stewardship Structure Audit (AMSA) 1. To reduce antibiotic resistant rate in Johor
Antimicrobial Data Collection • Observation of antibiotic prescription management MANAGEMENT • Antibiotic guidelines always changing (Interview)
Clinical audit of prescribing pattern (30 cards) which is state
Stewardship Method in pharmacy Replicate project to
measured prospectively or retrospectively with real- 1. 2. To ensure patients receive accurate,
Clinical Audit • Interview of for antibiotic prescription STAFF • Prescriber did not complete the clinical entire of Johor state
time feedback to the prescribers appropriate and quality treatment from
(AMCA) management pharmacists examination in prescription (AMCA) healthcare staffs

The audit measures utilisation patterns such as the • All randomized antibiotic prescription To convert Quick
To ensure prescribers and pharmacists always
1. Production of Antibiotic Form Zon KK Pekan Nanas STRATEGY FOR IMPROVEMENT
Criteria AMCA choice of antibiotic, dose, frequency and duration, Inclusion Criteria • 11 Prescribers 2. Publication of Quick Drug Zon KK Pekan Nanas
Drug PKD Pontian in
obtain updated information regarding issue,
• 7 Pharmacists 2. a more interactive
against local or national antimicrobial guidelines. 3. Establishment of committee members in KK Pekan Nanas protocol and guidelines from time to time about
platform for example
• Prescribers from other health clinic antibiotics in a more easy, practical and user-
Exclusion Criteria smart telephone
• friendly platform.
CAUSE EFFECT ANALYSIS CHART Pharmacists from other health clinic PHASE 2 application
Replicate project to To reduce the rate of medication errors to ensure
No No
Antibiotic
STUDY DURATION STAFF • No knowledge assessment among healthcare Medication Safety patients receive safe, accurate, quality and
discussion No update No
standard
guidelines 3.
among units on latest internal
antibiotic
always staffs (Observation) Programme effective treatment.
antibiotic audit in changing
guidelines clinic guideline in • Inexperienced pharmacist (Observation)
No
clinic Verification Identifies Phase Phase Sustainability • Pharmacists could not identify the accurate 1. Modification of antibiotic form Zon KK Pekan Nanas
appointment Study Factor Study 1 2 Phase indication of antibiotic (Observation) 2. Standarization Of Antibiotic Form In PKD Pontian CONCLUSION
of committee
members in
LOW AMCA
clinic SCORE CONFUSING
3. Update Of Quick Drug In Zon KK Pekan Nanas
AMONG GUIDELINES 4. Standardization Of Quick Drug In PKD Pontian Most intervention showed positive impact towards AMCA. AMCA helps
NO WELL- Feb – April Jan – Jun Jan – Jun increases the adherence to antibiotic guidelines among prescribers in primary
ESTABLISHED PRESCRIBERS Jan 2020 Jan 2020 5. Appointment of permanent committee to update Quick Drug PKD Pontian
AMS TEAM 2020 2021 2022 health care setting thus will help curbing rising levels of AMR and maintaining
the effectiveness of antibiotics
No
LACK OF
INTERVENTION
EFFECT OF CHANGES
distribution No tool to
of latest
LACK OF
AWARENESS
REGARDING monitor VERIFICATION STUDY RESULT REFERENCES
ADHERENCE clinical
updated ON ANTIBIOTIC TOWARDS examination
antibiotic RESISTANCE 100
ANTIBIOTIC
guidelines 1) https://apps.who.int/iris/bitstream/handle/10665/205912/B4691.pdf
GUIDELINES AMCA SCORE 90
93.4 93.4
2) Protocol on antimicrobial stewardship programme in healthcare facilities Second edition 2022
AMCA SCORE FULL
No activities CRITERIAS AMCA SCORE 80 80.5 3) Naeemmudeen NM, Mohd Ghazali NAN, Bahari H, Ibrahim R, Samsudin AD, Jasni AS. Trends in
No MARK CRITERIAS antimicrobial resistance in Malaysia. Med J Malaysia. 2021 Sep;76(5):698-705. PMID: 34508377.
presentation
during Pharmacist ACHIEVED ( A/B) X 100% 70
on antibiotic
antibiotic could not (B) 4) Akova M. Epidemiology of antimicrobial resistance in bloodstream infections. Virulence. 2016 Apr
achievement
awareness identify the (A) 60 2;7(3):252-66. doi: 10.1080/21505594.2016.1159366. PMID: 26984779; PMCID: PMC4871634
week accurate 56.6
in clinic 50 5) Nahar, P., Unicomb, L.,Lucas, P.J et al. What contributes to inappropriate antibiotic dispensing among
No indication of qualified and unqualified healthcare providers in Bangladesh? A qualitative study. BMC Health Serv
knowledge
Inexperienced
antibiotic
266 470 56.6 1. Modification Of Antibiotic Form Zon KK Pekan Nanas 40 Res20, 656 (2020).
No CME assessment PRE INTERVENTION PHASE 1 PHASE 2 SUSTAINABILITY PHASE
among among pharmacist 2. Update Of Quick Drug Zon KK Pekan Nanas 6) H. Bonfait, C. Delaunay, E. de Thomasson, O. Charrois, Orthorisq, Near-miss event assessment in
healthcare orthopedic surgery: Antimicrobial prophylaxis noncompliance,Orthopaedics& Traumatology: Surgery &
healthcare
staffs
3. Staff Orientation Kit (Clinical Pharmacy) Zon KK Pekan Nanas CHART 1 : AMCA RESULTS Research,Volume 96, Issue 5,2010
staffs
 PATIENTS’ MEDICATION COMPLIANCE AND THERAPEUTIC OUTCOME IMPROVEMENT AFTER THE APPLICATION OF
CARDIOVASCULAR CARE BUNDLE-MTAC (CCB-MTAC) IN PONTIAN PRIMARY HEALTH CLINIC
1*Faradia M., 1Farahatun U., 1Stephenie L.J.K.

(*Faradia M. 1, [email protected], Pontian Primary Health Clinic, MOH, Malaysia)

INTRODUCTION RESULT DISCUSSION
Global → DM: 10.25% (2021) estimate to rise up to 12.2% (2045)(1). Male:41.8% (n:79) Female: 58.2% (n:110) There was significant decrease in Hba1c after the application of CCB-Mtac. Similarly, two study in Saudi Arabia
Hypercholesterolemia had risen by 46% over the 4 years (2). Hypertension and Malay:72% (n: 136) Chinese: 28% (n:53) and a study in Malaysia reported significant decrease in Hba1c post intervention program (p=0.04; p<0.001;
pre-hypertension in the Middle East region were 24.36% and 28.60% respectively Variables Pair Mean change SEM T value P value p<0.05) (10,11,12)
(3).
There was significant decrease in LDL & TG after the application of CCB-Mtac. Contrary a study in Malaysia
Malaysia → DM: 11% to 35% (4). Hypertension: 34.6% (2006) → 35.5% (2015) DFIT Pre -8.11481 0.9113 -8.905 <0.001 *
reported no significant changes for LDL (p:0.35) & TG (p: 0.13) after implementation of Diabetes intervention
(5). Dyslipidemia: 64%; elevated LDL: 56.7% (6). IHD: 13.7% (7).
Post program (DMTAC) (11). This different in finding might due to different module of intervention. However a Meta
It is an ambulatory care service offered by pharmacist at primary analysis reported pharmacist intervention care significant T.Chol reduction (9 studies; n:1121;95% CI: -25.5,-9.2)
CCB- Hba1c Pre 2.43651 0.14013 17.387 <0.001 *
care setting that focuses on 4 types of disease management and LDL reduction (7 studies; n:924; 95% CI: -13.4,-3.8) (13).
Mtac
(diabetes, hypertension, dyslipidemia, ischemic heart disease and Post There was no significant changes in HDL after the application of CCB-Mtac. A Meta analysis study showed
a component of Enhance Primary Healthcare (EnPHC) Program pharmacist intervention care not associated with HDL changes (6 studies; n:826) (14). HDL showed improvement
that been introduced in Malaysia since July 2017 (7). SBP Pre 7.487 1.314 5.696 <0.001 * after diet and exercise intervention. The most frequent pharmacy intervention were medication management,
educational intervention and feedback to other healthcare (14).
Assess patient Direct LDL Pre 0.71380 0.8164 8.743 <0.001 *
There was significant increase in medication understanding and compliance after the application of CCB-Mtac.
compliance Medication intervention
Process Post It is supported with two study done in Saudi Arabia (p=0.03; p=0.001) (10,12). Increase in medication
Referral to review Provide understanding and compliance can enhance patients’ clinical improvement.
FHT recommendation HDL Pre 0.03968 0.2055 1.931 0.055 There was significant decrease in blood pressure after the application of CCB-Mtac. Two Meta analysis study
reported similar finding post pharmacy intervention care (19 studies; n:10479;95% CI: -10.2,-2.3); (9 studies;
Post
Achieved: targeted outcomes for at least two consecutive n:1496; 95% CI: -6.2,-2.8) (13,14).
readings, & good medication understanding (DFIT) (assess TG Pre 0.33134 0.06052 5.475 <0.001 *
patient /caregiver), &good adherence score
Defaulted six months or two consecutive appointments, Post
Discharge There were very limited study on CCB-
whichever is longer, despite intervention being done This study can act as the baseline of Many other contributing factor can be
criteria Variables Pair Prevalence OR 95% confidence P value Mtac particularly in Malaysia. This
other intervention whether on CCB- explore in further study such as patients’
Patient requested to be discharged from CCB-MTAC or not n(%) interval study assessed the effectiveness of
Mtac service improvement of other lifestyle, body weight management and
interested to be in CCB-MTAC CCB-Mtac specifically and EnPHC in
patient-base intervention. eating habit.
Lower Upper general.
Transferred to other facilities for follow-up
Compliance L&M H
category
This study aims to evaluate the effectiveness of CCB-Mtac program
Aim in improving HbA1c, blood pressure, lipid profile, medications
Pre 128 61 0.49 0.217 1.108 <0.001* LIMITATION CONCLUSION
(67.7%) (32.3%)
understanding and medications compliance. The limitations of this study was that CCB-MTAC demonstrated improving glycemic control, lipid
Post 28 161 confounding factors, such as diet and the profile, blood pressure, medication understanding and
Retrospective Secondary data Universal (14.8%) (85.2%) quantification of sugar intake, were not compliance. It is a promising adjunct method to obviate
observational collection sampling carried out due to difficulty to obtain diabetes, hypertension, dyslipidemia and ischemic heart disease
BP Category ≤140/80 >140/80
accurate data. and its complications in future.
Material N:189 CCB- MTAC patients who registered and been
and discharged from July 2017 to November 2022 Pre 61 128 2.28 1.119 4.339 <0.001*
(32.3%) (67.7%)
REFERENCES
method 1)Sun, H., Saeedi, P., Karuranga, S., Pinkepank, M., Ogurtsova, K., Duncan, B. B., Stein, C., Basit, A., Chan, J. C., Mbanya, J. C., Pavkov, M. E., Ramachandaran, A., Wild, S. H., James, S., Herman, W. H., Zhang, P., Bommer, C.,
Pre and post analysis, mean Significant level set at Kuo, S., Boyko, E. J., & Magliano, D. J. (2021). IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Research and Clinical Practice, 183, 109119.
2)Aronow, W. S. (2021). Management of Dyslipidemia. BoD – Books on Demand. 3)Okati-Aliabad, H., Ansari-Moghaddam, A., Kargar, S. et al. Prevalence of hypertension and pre-hypertension in the Middle East region: a
differences: paired t-test alpha less than 0.05 Post 105 84 systematic review & meta-analysis. J Hum Hypertens 36, 794–804 (2022). 4)Akhtar S, Nasir JA, Ali A, Asghar M, Majeed R, Sarwar A (2022) Prevalence of type-2 diabetes and prediabetes in Malaysia: A systematic review and
meta-analysis. PLoS ONE 17(1): e0263139. 5)Health and Morbidity Survey 2006–2015. Journal of Human Hypertension, 32(8–9), 617–624. 6)Baharudin, N., Mohamed-Yassin, M., Daher, A. M., Ramli, A. S., Khan, N. M. N., &
(55.6%) (44.4%) Abdul-Razak, S. (2022). Prevalence and factors associated with lipid-lowering medications use for primary and secondary prevention of cardiovascular diseases among Malaysians: the REDISCOVER study. BMC Public Health,

VARIABLES * P < 0.05

22(1). 7)Sivasampu S, Teh XR, Lim YMF, Ong SM, Ang SH, Husin M, Khamis N, Jaafar FSA, Wong WJ, Shanmugam S, Ismail SA, Pang SHL, Nasir NH, Ismail MS, Kusuma D, Ross-Degnan D, Atun R. (2020) Study protocol on
Enhanced Primary Healthcare (EnPHC) interventions: a quasi-experimental controlled study on diabetes and hypertension management in primary healthcare clinics. Primary Health Care Research & Development 21(e27): 1–
12. 8)Chung WW, Chua SS, Lai PSM, Morisky DE (2015) The Malaysian Medication Adherence Scale (MALMAS): Concurrent Validity Using a Clinical Measure among People with Type 2 Diabetes in Malaysia. PLoS ONE 10(4):
HbA1c, blood pressure, lipid profile (LDL, HDL, TG), medication understanding e0124275. doi:10.1371/ journal.pone.0124275. 9) Hatah E, Rahim N, Makmor-Bakry M, Mohamed Shah N, Mohamad N, Ahmad M, et al. (2020) Development and validation of Malaysia Medication Adherence Assessment
Tool (MyMAAT) for diabetic patients. PLoS ONE 15(11): e0241909. https://doi.org/10.1371/journal. pone.0241909. 10)Butt, M., A li, A. M., Bakry, M. M., & Mustafa, N. (2016). Impact of a pharmacist led diabetes mellitus
(Dose, Frequency, Indication, Time of administration - DFIT),medication intervention on HbA1c, medication adherence and quality of life: A randomised controlled study. Saudi Pharmaceutical Journal, 24(1), 40-48. 11)Karunagaran, L., Dewi, L. K. M., & Yee, L. H. (2018). Evaluation on the impact of
Diabetes Medication therapy adherence clinic (Diabetes-Mtac) towards management of type 2 diabetes mellitus patents. International Journal of Medical Toxicology & Legal Medicine, 21(3and4), 162-166. 12)Alkhoshaiban,
adherence score (Being regroup to low & medium vs high compliance. MORISKY A., Hassan, Y., Loganathan, M., Alomary, M., Morisky, D. E., & Alawwad, B. (2019). Type II Diabetic Patients' Satisfaction, Medication Adherence, and Glycemic Control after the Application of Pharmacist Counseling Program.
Archives of Pharmacy Practice, 10(4). 13)Santschi V, Chiolero A, Burnand B, Colosimo AL, Paradis G. Impact of Pharmacist Care in the Management of Cardiovascular Disease Risk Factors: A Systematic Review and Meta-
and MALMAS: ≤8 vs >8; MyMAAT: <54 vs ≥54) (8,9). analysis of Randomized Trials. Arch Intern Med. 2011;171(16):1441–1453. doi:10.1001/archinternmed.2011.399. 14)Santschi V, Chiolero A, Paradis G, Colosimo AL, Burnand B. Pharmacist interventions to improve
cardiovascular disease risk factors in diabetes: a systematic review and meta-analysis of randomized controlled trials. Diabetes Care. 2012 Dec;35(12):2706-17. doi: 10.2337/dc12-0369. PMID: 23173140; PMCID: PMC3507563

We express our gratitude to the Director General of Health, Ministry of Health Malaysia for his kind permission to present this paper. Our gratitude also to the Head of Department of Pontian Health District Dr Surinah Bt Asan. Special thanks to all the staff in the primary health clinics of the
ACKNOWLEDGEMENT
Pontian Primary Health Clinic for their support and commitment to this study. The authors declare that they have no conflict of interest.
 PREVALENCE AND PREDICTORS OF SUBOPTIMAL GLYCEMIC CONTROL AMONG PATIENTS WITH TYPE 2
DIABETES MELLITUS IN 8 PRIMARY HEALTH CLINICS UNDER PONTIAN DISTRICT HEALTH OFFICE
1*Shahrul Azrina A.R., 2 Faradia M.
(*Shahrul Azrina A.R.1, [email protected], Pontian Health District, MOH, Malaysia)

INTRODUCTION ASSOCIATIONS NEXT STEP

Variables B AOR 95% Confidence Interval p-value
Global 2021: approximately 537 millions adults has DM and rising to 643 Upper Lower To strengthen Self-
millions by 2030 and 783 millions by 2045 (1). This study can act To strengthen education
Duration of diabetes 0.092 1.096 1.063 1.129 <0.001* monitoring blood glucose
RBG 0.200 1.222 1.138 1.312 <0.001* as a baseline for on patients’ self care
(SMBG) and focusing on
Malaysia: DM →3.9 millions adults FBG 0.351 1.420 1.262 1.598 <0.001* any intervention particularly on SMBG
Local FBG
Johor: DM: 121697 , 71.4% have Hba1c > 6.5% (2) Waist measurement 0.028 1.029 1.005 1.053 0.018*
age < 60 years, male, duration of diabetes > 5 years, obesity, abnormal BMI underweight Ref
0.020*
Factor lipid profile, diet therapy alone or oral hypoglycemic agent alone (3,4) Intervention involving multidiscipline (Medical officer, pharmacist,
BMI normal 0.147 1.128
-0.897 0.408 .084 physiotherapist, dietitian, diabetic educator, counselor ect) can help
Acute: hypoglycemia, Diabetic Ketoacidosis (DKA) and Hyperosmolar BMI overweight 0.456 0.951 patient in having suboptimal glycemic control.
-0.417 0.659 .026*
Effect Hyperglycemic Non Ketonic Syndrome (HHNS).
BMI obese 0.746 1.577
Chronic: nephropathy, retinopathy, neuropathy, Coronary Artery 0.082 1.085 .669
Disease (CAD), Peripheral Artery Disease (PAD) and Cerebrovascular OHA only Since cross sectional cannot establish a cause-and-effect relationship
Disease (CVD)(5,6) No Ref or analyze behavior over a period of time, suggest to investigate
Yes 0.501 1.651 1.166 2.337 0.005* cause and effect with longitudinal study or an experimental study.
This study aims to identify prevalence and predictors for suboptimal OHA and insulin
Aim glycemic control (HbA1c≤6.5%) among patients with Type 2 Diabetes No Ref
Mellitus attending 8 primary health clinics under Pontian District Health Yes -0.571 0.565 0.396 0.807 0.002*
Office PREDICTOR LIMITATION CONCLUSION
Association: Simple logistic Variables B AOR 95% Confidence Interval p-value The limitations of this study was that
Cross- About 1 in 3 diabetic patients have
Simple Upper Lower confounding factors, such as diet and the
MATERIAL sectional
random
regression
FBG 0.243 1.275 1.004 1.619 0.047* suboptimal glycemic control. Fasting
quantification of sugar intake, were not
AND sampling Predictor: Multiple logistic *p<0.05 blood glucose was found to be the good
Secondary carried out due to difficulty to obtain
predictor of glycemic control.
METHOD data regression DISCUSSION accurate data.
collection N:729 Significant level set at alpha HbA1c ≤6.5% associate with diabetic age. It is supported with study done in Sydney
less than 0.05 and Hulu Langat where longer duration of type 2 diabetes have correlation with higher ACKNOWLEDGEMENT
HbA1c level (r = 0.26, p < 0.0001), (OR:.948; 95% CI:0.909–0.989)(7,8).
We express our gratitude to the Director General of Health, Ministry of Health Malaysia for his kind permission to
DEPENDENT HbA1c ≤6.5% associate FBG and RBG. Study in New York and Saudi Arabia showed present this paper. Our gratitude also to the Head of Department of Pontian Health District, Dr Surinah Binti Asan.
INDEPENDENT VARIABLE there significant correlation between HbA1c and RBG (R2=0.808) and FBG (R2=0.685, Special thanks to all the staff in the primary health clinics under Pontian District Health Office for their support and
VARIABLE P=0.000) respectively (9,10). commitment to this study. The authors declare that they have no conflict of interest.

HbA1c ≤6.5% associate with OHA. Study done in Hulu Langat showed quite similar REFERENCES
patients’ demographic characteristics; diabetic age; random
finding where those receiving monotherapy were more likely to have good glycemic
HbA1c ≤ 6.5% blood glucose (RBS); fasting blood glucose (FBS); lipid profile 1. International Diabetes Federation.IDF Diabetes Atlas, 10th edn. Brussels, Belgium: 2021. Available at: https://www.diabetesatlas.org
control (OR:4.797; 95% CI: 1.992–11.552) (8). The lower the number of medication taken, 2. National Health & Morbidity Survey 2019 Non-communicable Diseases, Risk factors, & Other Health Problems Volume I. 2019
-Yes (LDL, HDL, TG); body mass index (BMI); waist measurement; 3. National Diabetes Registry. NDR, Malaysia: 2022
the higher compliance reached, the better glycemic control achieved (8). 4. Mahmood MI, Daud F, Ismail A (2016) Glycaemic control and associated factors among patients with diabetes at public health clinics in Johor,
-No medication profile (took oral hyperglycemic agents (OHA) only, Malaysia. Public Health, 135(March), 56–65.
HbA1c ≤6.5% also showed association with those who took OHA and insulin. 5. Amy Hess-Fischl, Lisa ML (2019) Type 2 Diabetes Complications: How to Prevent Short- and Long-term Complications. Updated: Dec 10, 2019. Available
took insulin only, took OHA and insulin) at: https://www.endocrineweb.com/conditions/type-2-diabetes/type-2-diabetes-complications
Similarly, study done in Hulu Langat reported same finding (OR: 2.334; 95% CI: 1.018– 6. Rajeev G, Ishwarlal J (2022) Diabetes Mellitus Type 2. StatPearls
5.353). The combination of antidiabetic drugs has been shown to be effective because of 7. Hsieh A, Ong PX, Molyneaux L, McGill MJ, Constantino M, Wu T, Wong J, Yue DK, Twigg SM (2014) Age of diabetes diagnosis and diabetes duration
Total patient SOCIODEMOGRAPHIC their different modes of action and minimal adverse effects (11). 8.
associate with glycated haemoglobin. Diabetes Research and Clinical Practice. Vol 104, Issue 1:e1-e4, ISSN 0168-8227
Nur Sufiza A, Farida I, Thomas P (2014) Factors associated with good glycemic control among patients with type 2 diabetes mellitus. J Diabetes Invest.
recruited: n= 735 Excluded: Patient HbA1c ≤6.5% have association with waist measurement & BMI. It is supported with 9.
5: 563– 569
Grant T, Soriano Y, Marantz PR (2004) Community based screening for cardiovascular disease and diabetes using HbA1c. Am J Prev Med 26:271–275
Female: 66.9% (n:448) 10. Khan HA, Sobki SH, Khan SA (2007) Association between glycaemic control and serum lipids profile in type 2 diabetic patients: HbA1c predicts
without HbA1c study done in Louisiana and US (r = 0.13, P = 0.052), (OR = 1.176; 95% CI 1.132– dyslipidaemia. Clinical and Experimental Medicine, 7(1), 24–29.
Malay: 80.1% (n:583)
result: n= 6 1.222)(12,13). 11. Bailey CJ, Prato SD, Eddy D (2005) Earlier intervention in type 2 diabetes: the case for achieving early and sustained glycemic control. Int J Clin Pract,
Mean age: 64.9 (11) 59: 1309– 1316.
This finding showed those with lower FBG were more likely to have HbA1c ≤6.5%. 12. Martin Sénéchal, Damon LS, Neil MJ, Steven NB, Conrad PE, Carl JL, Timothy SC (2013) Changes in Body Fat Distribution and Fitness Are Associated
Final patients With Changes in Hemoglobin A1c After 9 Months of Exercise Training: Results from the HART-D study. Diabetes Care; 36 (9): 2843–2849
Study done in Saudi Arabia showed the concentration of FBG was significantly higher 13. Bae JP, Lage MJ, Mo D, Nelson DR, Hoogwerf BJ (2016) Obesity and glycemic control in patients with diabetes mellitus: Analysis of physician electronic
recruited: n= 729 Prevalence Hba1c ≤6.5%: health records in the US from 2009–2011. Journal of Diabetes and its Complications; Vol:30, Issue 2:212-220, ISSN 1056-8727.
(ANOVA F=252.43, P=0.000) in worst glycemic control group (HbA1c>9%) (10). HbA1c 14. Tong PC, Ko GT, So WY (2008) Use of anti-diabetic drugs and glycemic control in type 2 diabetes. The Hong Kong Diabetes Registry. Diabetes Res Clin
37.2% (n:271) Pract; 82: 346–352.
was found to had the similar sensitivity as FBG in monitoring glycemic control (14).
 Factors Determining Sexually Transmitted Infections (STIs) Healthcare-Seeking
Behaviour Among Men Who Have Sex with Men (MSM) In Malaysian Borneo – A
Qualitative Study
1*Mardhiyyah, A., 1Noorzilawati, S.
1Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak
(UNIMAS). *Email: [email protected]

INTRODUCTION Table 1 Themes and subthemes CONCLUSION

The current epidemiological study showed an Themes Subthemes This study suggested that many MSM preferred
increasing trend of sexually transmitted infections Distance NGOs for STI screening. The most frequent
(STI) incidence among men who have sex with men Accessibility and Overcrowded determinants mentioned were awareness of STIs
convenience Long waiting time and STI services, STI-related stigma and service
(MSM)1. This is due to their high-risk behaviour2.
Confidentiality and privacy
However, the use of STI-related healthcare services accessibility and convenience.
Knowledge of available services
among MSM was low3. This study aims to explore
the STI healthcare-seeking behaviours among MSM
Awareness of STIs and Attitude towards STIs service RECOMMENDATIONS
STI services utilisation
and the factors that determine that behaviour. Risk perception We recommend extending the STI services to all
Presence of symptoms government clinics and providing adequate
METHODOLOGY Clinical Condition
HIV status knowledge and skills to the healthcare workers on
Fifteen MSM were recruited for in-depth interviews Family support how to communicate with MSM during their visit to
that took place between December 2021 and April Social support Friends support the facilities. Proper engagement with MSM is
2022. The interviews were transcribed verbatim and Healthcare experience important to reduce STI-related stigma and shame
entered into ATLAS.ti. The data was analysed using Shame or shyness among them.
thematic analysis. Stigma and shame Self-stigma
External stigma
FINDINGS & DISCUSSION Acknowledgement
Thank you to the Faculty of Medicine and Health Sciences UNIMAS, Sarawak State
We identified the continuum of STI healthcare-seeking behaviour among MSM. Most of them had frequent visits Health Department, Sabah State Health Department, my supervisors, NGO KASIH,
SAGA, SACS, and healthcare workers from STI/HIV units for their support and
to STI services for screening and treatment. Many participants preferred going to the NGOs for STI screening guidance in completing this study.
rather than visiting a government clinic. Five themes were identified under the determinants of STI services References
utilisation namely, accessibility and convenience, awareness of STIs and STI services, clinical condition, social 1. Ministry of Health Malaysia. (2019). Country Progress Report On HIV / AIDS
support, and stigma and shame. Later, subthemes were grouped into these five main themes (Table 1). 2019: Malaysia.
2. Centers for Disease Control and Prevention. (2021). Men Who Have Sex with
Participants mostly showed good attitudes towards visiting STI services and high STI risk perception. They also Men ( MSM ). In Sexually Transmitted Infections Treatment Guidelines , 2021
stated that their previous healthcare experience and stigma influence their healthcare-seeking behaviour. (Issue 80, pp. 1–5).
3. Disease Control Division MOH. (2019). Malaysia: Integrated Biological and
Behavioral Surveillance Survey 2017.
 The Detection of Porphyromonas Gingivalis in Geriatric Patients
and Its Correlation with Periodontal Health
Mohd Shaiful Ehsan Shalihin1*, Nur Aina Nabilah Suhaimi2, Sulhi Abidin3, Hairul Aini Hamzah2, Edre Mohammad Aidid4 & Ramli Musa5

1Department of family Medicine, 2Department of Basic Medical Science, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Malaysia. 3Department of Prosthodontics,
Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Malaysia. 4Department of Community Medicine, 5Department of Psychiatry, Kulliyyah of Medicine, International Islamic
University Malaysia, 25200 Kuantan, Pahang, Malaysia.

INTRODUCTION RESULTS Life. We reaffirmed the high prevalence of periodontitis

• The global population of elderly among elderly people and the disease severity is highly
About 90.63% of geriatric patients were having a periodontitis with the
people is increasing by years, and associated with P. gingivalis. There are lack of periodontal
detection frequency of P. gingivalis at 65.52% (p-value = 0.035). All patients
the population is expected to data available in the WHO oral health data bank, and only
recruited were classified into three groups based on the clinical healthy
increase up to 1.4 billion in 2030 . 18 countries of periodontal disease data for elderly people
periodontal and periodontitis with periodontal pocket depth (PPD) ≥ 4 millimetre
• Porphyromonas gingivalis (P. were maintained by WHO. Therefore, the information and
(mm) and periodontitis with PPD ≥ 5 mm as below:
gingivalis) is the keystone pathogen in research towards periodontal disease among geriatric
the periodontitis development and has people is needed. Moreover, P. gingivalis has been highly
Table 1. Detection of P. gingivalis in geriatric subjects associated with diabetes, rheumatoid arthritis, and
been associated in the progression of
other chronic systemic diseases. Geriatric groups Prevalence P. gingivalis present Alzheimer’s disease by migrating though the bloodstream.

OBJECTIVES AKCNOWLEDGEMENT
I – Healthy (PPD ≤ 3 mm) 3 (9.38%) 0 (0%)
To evaluate the periodontal status in Ministry of Higher Education (MOHE) – Fundamental
II- Periodontitis (PPD ≥ 4 mm) 25 (78.13%) 15 (46.88%)
geriatrics with the presence of P. gingivalis Research Grant Scheme (FRGS); FRGS21-211-0820
and find the association with a few clinical III- Periodontitis (PPD ≥ 5 mm) 4 (12.50%) 4 (100%) FRGS/1/2021/SKK05/UIAM/03/1
periodontal parameters. Fisher’s exact test p-value = 0.035* CONCLUSION
MATERIALS AND METHODS The presence of P. gingivalis was associated with the periodontal parameters Regular oral screening since at the early age is
which are periodontal depth (PPD) and periodontal clinical attachment loss
• Subgingival samples were recommended as periodontitis is asymptomatic in the
(CAL) (p-value = 0.037 for both). early stage. Early detection of P. gingivalis and treatment
obtained from 32 geriatric
patients with no history of DISCUSSION is needed to reduce the disease severity.
antibiotics treatment from REFERENCES
The primary diagnosis of periodontitis is based on the clinical attachment level
Kuantan Health Clinics.
• Polymerase chain and periodontal pocket depth that are invaded by periodontopathogenic Nazir, Muhammad, Asim Al-Ansari, Khalifa Al-Khalifa, Muhanad
reaction analysis was done bacteria. Hence, performing the bacterial analysis along with the clinical Alhareky, Balgis Gaffar, and Khalid Almas. 2020. Global Prevalence
for the bacterial detection. periodontal parameters could provide a better insight into the disease severity. of Periodontal Disease and Lack of Its Surveillance. The Scientific
The disease could give a high impact on the overall health of elderly people, World Journal 2020.
• Fisher’s exact test and Mann How, Kah Yan, Keang Peng Song, and Kok Gan Chan. 2016.
as they may experiences difficulties in speaking due to discomfort and pain,
Whitney U test were used for Porphyromonas Gingivalis: An Overview of Periodontopathic
and lack of nutrition due to difficulties in chewing, thus, leading to low quality of Pathogen below the Gum Line. Frontiers in Microbiology
the statistical analysis.