Lead (Pb) is a heavy metal which is abundant in the environment and known to cause neurotoxicity in children even at minute concentration. However, the trace elements calcium (Ca), magnesium (Mg), zinc (Zn) and iron (Fe) are essential to children due to its protective effect on neurodevelopment. The primary objective of this study was to assess the role of Pb and trace elements in the development of autism spectrum disorder (ASD) among preschool children. A total of 81 ASD children and 74 typically developed (TD) children aged between 3 and 6 years participated in the study. Self-administered online questionnaires were completed by the parents. A first-morning urine sample was collected in a sterile polyethene urine container and assayed for Pb, Ca, Mg, Zn and Fe using an inductively coupled plasma mass spectrometry (ICP-MS). Comparisons between groups revealed that the urinary Pb, Mg, Zn and Fe levels in ASD children were significantly lower than TD children. The odds of ASD reduced significantly by 5.0% and 23.0% with an increment of every 1.0 μg/dL urinary Zn and Fe, respectively. Post interaction analysis showed that the odds of ASD reduced significantly by 11.0% and 0.1% with an increment of every 1.0 μg/dL urinary Zn and Pb, respectively. A significantly lower urinary Pb level in ASD children than TD children may be due to their poor detoxifying mechanism. Also, the significantly lower urinary Zn and Fe levels in ASD children may augment the neurotoxic effect of Pb.
This study primarily intends to determine visitors’ perception of leptospirosis health hazard warning signage and its effectiveness within natural recreational parks in the district of Hulu Langat. This cross-sectional study was conducted in four out of seven natural recreational parks, installed with leptospirosis health hazard warning signage. A total of 209 respondents were recruited purposively in this study and completed the questionnaires. Majority of the respondents were male (57.4%), 40 years old and below (89.5%), received tertiary education (68.5%), staying outside Hulu Langat district (83.2%), visited for the first time (63.6%), and noticed the presence of leptospirosis health hazard warning signage at the park entrance (69.4%) and within the recreational park (64.2%). A significant relationship was discovered between respondents’ education level and perception of the health hazard warning signage (p-value 0.034). The rate of visits and noticeability of the health hazard warning signage were significantly associated with the effectiveness of the content on the health hazard warning signage (p-value 0.002 and 0.004, respectively). The construction of health hazard warning signage at the recreational areas should suit the social and educational background of the population. Visitors’ discernment of the effectiveness of erecting leptospirosis health hazard warning signage within natural recreational parks in the district of Hulu Langat is good if the signage is perceptible even with subsequent repeated visits to the parks.
The COVID-19 pandemic has claimed numerous lives worldwide. Malaysia documented about 118 mortalities during the second wave of the outbreak. This study aims to assess associated risk factors of the COVID-19 mortalities from 18 th March until 22 nd May 2020. The majority of patients were above 60 years old (69.0%), male (78.0%), and Malaysian citizens (98.0%). The mean age of the mortalities was 64.01 years old (± SD 14.91 years). The major risk factors consist hypertension (52.0%), diabetes mellitus (43.0%), cardiovascular diseases (21.0%), extra-pulmonary solid malignancies (5.0%), cerebrovascular diseases (3.0%), pulmonary diseases (1.0%) and pulmonary malignancies (1.0%). About 23.0% of mortalities were related to established clusters while 5.0% had a history of travelling overseas. The mean survival time was 11.87 days (± SD 9.32 days). Approximately 50.0% of the patient survive until day 10 post-admission. The probability of the patients surviving beyond 30 days post-admission was less than 10.0%. There is a significant difference between groups for having a shorter duration to death for risk factors including age group, history of travelling overseas, attending mass gatherings, and having pulmonary malignancies. The hazard ratio (HR) for pulmonary malignancy is 5.512 (95% CI 0.662, 45.899), mass gathering; 3.434 (95% CI 1.375, 8.579), pulmonary disease is 2.442 (95% CI 0.314, 18.983), travelling overseas; 2.251 (95% CI 0.657, 7.711), extra-pulmonary solid malignancy; 2.165 (95% CI 0.767, 6.112), , and despite the significant result only applied for mass gathering (p-value = 0.008). COVID-19 screening should be mandatory for those who attend mass gatherings as they are the main source of COVID-19 spread in the community during the second wave outbreak in Malaysia.
Background The presence of aluminium (Al) in the human body may impact brain neurodevelopment and function, and it is thought to contribute to autism spectrum disease (ASD). The main objective of this study was to assess the association between urinary Al and the development of ASD among Malaysian preschool children in the urban city of Kuala Lumpur. Method This was an unmatched case–control study in which children with ASD were recruited from an autism early intervention center and typically developed (TD) children were recruited from government-run nurseries and preschools. Urine samples were collected at home, assembled temporarily at study locations, and transported to the laboratory within 24 h. The Al concentration in the children’s urine samples was determined using inductively coupled plasma mass spectrometry (ICP-MS). Result A total of 155 preschool children; 81 ASD children and 74 TD children, aged 3 to 6 years, were enlisted in the study. This study demonstrated that ASD children had significantly higher urinary Al levels than TD children (median (interquartile range (IQR): 2.89 (6.77) µg/dL versus 0.96 (2.95) µg/dL) (p < 0.001). Higher parental education level, non-Malay ethnicity, male gender, and higher urinary Al level were the significant ASD risk factors (adjusted odds ratio (aOR) >1, p < 0.05). Conclusion A higher urine Al level was discovered to be a significant risk factor for ASD among preschool children in the urban area of Kuala Lumpur, Malaysia.
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