The prevalence of non-communicable diseases (NCDs) and NCD risk factors in Malaysia have risen substantially in the last two decades. The Malaysian Ministry of Health responded by implementing, “The National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2010-2014”, and the “NCD Prevention 1Malaysia” (NCDP-1M) programme. This paper outlines the primary health system context in which the NCDP-1M is framed. We also discuss the role of community in facilitating the integration of this programme, and outline some of the key challenges in addressing the sustainability of the plan over the next few years. The paper thus provides an analysis of an integration of a programme that involved a multi-sectoral approach with the view to contributing to a broader discourse on the development of responsive health systems.
Sabah is a Malaysian state situated in the northern part of Borneo, and it is endemic for malaria. The incidence of malaria is the lowest (0.05/1,000 population) in Penampang districts of Sabah. In June 26, 2012, two malaria cases were notified to public health department from a village in Penampang. Immediate investigation was initiated to identify the risk factors and to institute control measures. We performed active case finding by asking household members of all houses in the village regarding malaria symptoms and by examining blood smears. Environmental investigation was performed by collecting samples to detect mosquito breeding sites and to identify malaria transmitting vector mosquitoes. A case-control study with a ratio of 1:4 (11 cases and 44 controls) was conducted using self-administered questionnaire. The microscopic examination of blood smear for malarial parasite and entomology sampling was carried out. The malarial attack rate was 2.3%, 6/11 smears have gametocyte, and the case fatality rate was 9.1%. One case was a migrant rubber tapper from Indonesia which happened to be the first case with gametocyte positive. Overall, the incidence of malaria was higher (6/11) among rubber tappers. The odds of cases for those living nearby stagnant water were 7.3 [95% confidence interval: 1.2-43.5] times higher. In conclusion, an outbreak of malaria was introduced into a malaria-free village by a migrant rubber tapper, by whom the imported parasite was introduced to the community via vector . Living near stagnant water bodies was the risk factor in this outbreak.
Introduction: A psychoactive substance has become an overwhelming public health burden globally. It causes social problems for the user and surrounding people which may affect work or study and cause negative economic impact. Objective: This study aims to translate and culturally adapt the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) into Malay and to assess its reliability and validity. Methods: The Malay version of the ASSIST v 3.1 was developed after the translation and back-translation, which included the stages recommended by Beaton. The ASSIST v 3.1 was administered to 125 respondents. The Malay ASSIST v 3.1 was completed twice by each respondent 7 to 14-day intervals to assess test-retest reliability based on the intra-rater and interrater correlation coefficient. Results: Majority of the respondents were male, Malay and currently employed. The intra-rater reliability is 0.84 and the test-retest reliability (ICC = 0.97) were excellent. Conclusion: Malay ASSIST v3.1 was a valid and reliable tool to screen substances abuse at varying degree. Nonetheless, further studies are needed to assess its responsiveness.
Introduction: Diseases due to unhealthy lifestyles such as heart diseases and diabetes are increasing in Malaysia. Heart diseases are the leading cause of deaths of patients in government hospitals, i.e. 16.1% of total deaths in 2009. A customised exercise regime called Exercise for Medicine (EXFOME) was introduced to improve and prevent chronic diseases such as diabetes, heart disease, obesity and hypertension. Material and Methods:A total of 126 participants from government health clinics in three states of Peninsular Malaysia were selected to participate in the EXFOME. Each participant was evaluated prior to the program using an assessment protocol. Fitness assessment and evaluation with body composition measurement were taken. Exercise therapist prescribed a personalized exercise program according to conditions. Results: Effect of exercise was measured in terms of improvement in hypertension and diabetes, body weight, body fat, lipid profile and physical fitness at three and six months.Conclusion: EXFOME is beneficial to improve the status of hypertension, diabetes, body weight and lipid profile when it is carried out for longer period.
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