Background: We reviewed studies on the prevalence of Chlamydia infection as a risk factor for developing cervical cancer in a meta-analysis studies published in that subject area. Methods: Cochrane Library and PubMed databases were systematically searched for articles (observational and randomized controlled trials) published from 2008-2018. A meta-analysis of studies was performed to analyse the association between chlamydia infection and cervical cancer. Results: Five articles were included in the final analysis (N=5271). All five articles were case-control studies, of which three studies sampled from population-based registries. All studies involved with sexually active women with minimum 15 years old. Three studies reported the association of C. trachomatis infection cervical cancers, two other studies reported C. trachomatis-HPV co-infection in association with cervical cancer. Result showed C. trachomatis has an overall prevalence of 31.9%, pooled OR 1.96, 95% CI 1.05 to 3.67, OR 2.13, 95% CI 1.78 to 2.54 among cervical cancer. There was a mild publication bias detected at 3.0 effect estimation. Heterogeneity detected from clinical and methodological diversities particularly from C. trachomatis-HPV co-infection subgroup analysis, including sampling bias, geographical strain diversity, and different outcome endpoint measured. Conclusion: C. trachomatis infection was significantly associated with the development of cervical cancer. Co-infection of C. trachomatis-HPV with cervical cancer is plausibly sound but temporality of C. trachomatis-HPV with the development of cervical cancer need to be proven in future prospective cohort studies.

The application of artificial intelligence (AI) is on the rise in the healthcare industry. However, the study on the physicians’ perspectives is still lacking.  The study aimed to examine physicians’ attitudes, expectations, and concerns regarding the application of AI in medicine. A cross-sectional study was conducted in October 2019 among physicians in a tertiary teaching hospital in Malaysia. The survey used a validated questionnaire from the literature, which covered: (1) socio-demographic profile; (2) attitude towards the application of AI; (3) expected application in medicine; and (4) possible risks of using AI. Comparison of the mean score between the groups using a t-test or one-way analysis of variance (ANOVA). A total of 112 physicians participated in the study: 64.3% from the clinical departments; 35.7% from the non-clinical specialties. The physicians from non-clinical departments had significantly higher mean attitude score (mean = 14.94 ± 3.12) compared to the clinical (person-oriented) departments (mean = 14.13 ± 3.10) and clinical (technique-oriented) departments (mean = 13.06 ± 2.88) (p = 0.033). The tech-savvy participants had a significantly higher mean attitude score (mean = 14.72 ± 3.55) than the non–tech-savvy participants (mean = 13.21 ± 2.46) (p = 0.01). There are differences in the expectations among the respondents and some concerns exist especially on the legal aspect of AI application in medicine. Proper training and orientation should precede its implementation and must be appropriate to the physicians’ needs for its utilization and sustainability.

BACKGROUND: Coronavirus disease (COVID)-19 has become a global pandemic with an increasing burden on healthcare. Early recognition of the trend and pattern of the chain of transmission is necessary to slow down the spread. AIM: Therefore, the study aimed to describe the epidemiology of COVID-19 at a local setting. METHODS: A retrospective cross-sectional study was done to all COVID-19 cases registered in Seremban Health District. Statistical analysis, using Chi-square test, was employed to compare the sociodemographic characteristic of COVID-19 patients between the red zone area and the non-red zone area in Seremban. RESULTS: As of April, a total of 214 number of COVID-19 cases reported in Seremban district alone. The trend of cases registered has changed as more asymptomatic infection outnumbered patients with clinical symptoms from the aggressive active case detection (ACD) activity. Majority of the cases affecting Malay ethnicity were due to a large religious gathering event held 1 month earlier than subsequently spread the infection within the community. CONCLUSION: The first wave of COVID-19 cases in Seremban was sudden and unexpected, with a skewed distribution affecting a particular race group regardless red zone area and non-red zone area. Therefore, identifying the pattern of infection in the local community is important for a focused intervention strategy. ACD strategy, isolation of patients, quarantine the exposed, tracking down the close contact, and continuous health promotion and education will ultimately break the chain of transmission.

introduction: Lymphatic filariasis (LF) is a disease caused by filarial parasites transmitted to human by mosquitoes and infecting 120 million people worldwide. Mass drug administration (MDA) involves delivering treatment to every person living in a defined geographical area, is the current practice in place and has shown to be very useful in reducing the global transmission of LF. This review aims to explore into the effectiveness of MDA in interrupting the transmission of LF in terms of the types of MDA, number of cycles, coverage, and percentage of transmission reduction. Methods: A systematic search via Scopus, PubMed, and Cochrane was done for articles published from 2015 to 2019 by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The articles identified from the databases searched and any that appeared to relate to the research questions were included. A total number of 14 articles fulfilled the criteria for review. Results: Overall, the review showed a reduction in LF indices of more than 50% and up to 100% post-MDA in endemic communities with high prevalence. The entomological assessment revealed a reduction in LF transmission post-MDA, which strongly supported the reduction of LF indices. Biannual MDA conducted further showed a marked reduction in LF indices compared to annual MDA. Double therapy of MDA significantly reduced the transmission indices to almost nil compared to single therapy. Conclusion: Review of MDA showed promising effects in which it reduced the prevalence microfilaraemia (mf) and Circulating Filarial Antigen (CFA) from baseline, as well as the clinical prevalence and entomological indices. Combination therapy showed better outcome compared to single therapy. Therefore, complementary vector control is suggested in addition to MDA, as well as education delivery to the endemic communities.

Firefighters are exposed to multiple occupational hazards, where one of the hazards is chemical hazard that can affect the respiratory system. However, little is known regarding the perception of firefighters on the source of exposure to respiratory hazards, particularly in Malaysia. This work aims to explore the firefighter’s perspective on respiratory hazard exposure and to examine the compliance of the use of personal protective equipment (PPE). In-depth interviews were employed among 12 firefighters at Fire and Rescue Department of Malaysia in September 2020. The interview recordings were transcribed verbatim and of thematic analysis done via the NVIVO 12 programme. All participants were Malay, male, and married. The respiratory hazard exposure perceived can be divided into occupational source (e.g. exposure to smoke from firefighting, fire training, firefight demonstration, commuting, firefight vehicles: chemicals and dust) and non-occupational source (e.g. smoking). Firefighter recognised both the importance of wearing PPE and the fact they are still not compliant in wearing it. They also perceived wearing PPE as burden and having only a limited stock of PPE. Education and training need to be reinforced to strengthen firefighters’ risk perception, hazard identification, and risk assessment of hazards exposure. Strict standard operating procedure (SOP) and supervision during firefighters’ task is crucial to reduce hazard exposure and increase PPE compliance. Systematic and thorough inventory management is needed to ensure adequate PPE supply. Post qualitative analysis, the firefighters’ perception on respiratory hazard exposure was obtained, demonstrating that the analysis is ready for further study.