Melioidosis is an infectious disease that is initiated by a bacteria recognized as Burkholderia pseudomallei . Despite the high fatality rate from melioidosis, there is a minimal published study about the disease in Malaysia. This study aimed to identify the prognostic factors of mortality among melioidosis patients in northern Malaysia. All inpatient patients who were admitted to Hospital Sultanah Bahiyah, Kedah and Hospital Tuanku Fauziah, Perlis with culture-confirmed melioidosis during the period 2014 to 2017 were included in the study. The study retrospectively collected 510 melioidosis patients from the Melioidosis Registry. Hazard ratio (HR) used in advanced multiple Cox regression was used to obtain the final model of prognostic factors of melioidosis. The analysis was performed using STATA/SE 14.0 for Windows software. From the results, among the admitted patients, 50.1% died at the hospital. The mean age for those who died was 55 years old, and they were mostly male. The most common underlying disease was diabetes mellitus (69.8%), followed by hypertension (32.7%). The majority of cases (86.8%) were bacteremic. The final Cox model identified 5 prognostic factors of mortality among melioidosis patients. The factors were diabetes mellitus, type of melioidosis, platelet count, white blood cell count, and urea value. The results showed that bacteremic melioidosis increased the risk of dying by 3.47 (HR: 3.47, 95% confidence intervals [CI]: 1.67–7.23, P = .001) compared to non-bacteremic melioidosis. Based on the blood investigations, the adjusted HRs from the final model showed that all 3 blood investigations were included as the prognostic factors for the disease (low platelet: HR = 1.76, 95% CI: 1.22–2.54, P = .003; high white blood cell: HR = 1.49, 95% CI 1.06–2.11, P = .023; high urea: HR = 2.92, 95% CI: 1.76–4.85, P < .001; and low level of urea: HR = 2.69, 95% CI: 1.69–4.29, P < .001). By contrast, melioidosis patients with diabetic had 30.0% lower risk of dying from melioidosis compared to those with non-diabetic (HR = 0.70, 95% CI: 0.52–0.94, P = .016). Identifying the prognostic factors of mortality in patients with melioidosis allows a guideline of early management in these patients, which may improve patient's survival.
Purpose This study was conducted to determine the direct medical cost of treating melioidosis patients. The calculation was made according to the variables extracted from medical records. Materials and Methods Data collection was performed retrospectively on a total of 293 cases from Hospital Sultanah Bahiyah, Kedah, Malaysia. The data consisted of personal information, treatment history, and investigation findings, including blood results, USG abdomen results, and CT scan results. The site of culture and sensitivity were also obtained. The total direct medical cost was based on the antibiotics/treatments received by the patients, diagnostic test and investigations performed. The trend analysis used to see the pattern of costs from 2014 to 2017. All the costs were compared based on patients’ status and duration of stay at the hospital using the independent t -test. Results The overall mean of direct medical cost for melioidosis amounted to US $233.61 (RM931.33). Overall, the finding confirms a huge reduction (44.7%) of direct medical cost from 2014 to 2017 ( P = 0.001). From 2015 to 2016, there was a 19.1% reduction of direct medical cost ( P >0.95), followed by a 38.8% reduction in costs from 2016 to 2017 ( P = 0.019). In the case of the duration of stay, the mean of total direct medical cost among patients with ≥14 duration of stay was higher compared to those with <14 duration of stay ( p < 0.001). There was no significant mean difference of direct medical cost between patients who were cured and died. Conclusion Despite the higher mortality of melioidosis cases compared to other infectious diseases, there is a limitation in the amount of published data on the management cost of melioidosis. The importance of cost in managing this disease should be underlined to perform a fully prepared management toward the disease.
This paper aimed to study the effect between attitude, brand awareness, consumer experiences and price on young female purchase intention towards local cosmetic products in Malaysia. The main factor of consumer behaviour that used in this study was to analyse customer female purchase intention were attitude, brand awareness, consumer experience, and price. We used a survey questionnaire to collect 226 valid responses from a female student of Bachelor of Entrepreneurship (Retailing) with Honours in UMK. These collected data were analysed using Statistical Package for Social Science (SPSS) version 24 and the result gathered through the Pearson Correlation Coefficient and Multiple Regression. The findings revealed that attitude, brand awareness, consumer experiences, and price emerged with a significant influence on female intention toward local cosmetics among young female consumers. The implication from this study is for the female consumer who is wearing a cosmetic product, an industry or organization who involve in produce local cosmetic product and retailer who sale a local cosmetic product. Finally, the result shows that attitude influences young female purchase intention the most compared to brand awareness, consumer experiences, and price.
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