Aim Households are a significant venue for the transmission of SARS‐CoV‐2. We conducted a study to characterise the transmission dynamics and identify risk factors for household transmission of SARS‐CoV‐2 in Negeri Sembilan, Malaysia. Methods This retrospective observational study included 185 families of paediatric COVID‐19 cases from 1 February 2020 to 31 December 2020. We identified the index case for each household and gathered the socio‐demographic, epidemiological investigation results and risk factors for household transmission from medical case records. The secondary attack rate was calculated, and logistic regression analyses were used to identify risk factors associated with secondary household transmission of SARS‐CoV‐2. Results Of the 848 household contacts, 466 acquired secondary infections, resulting in a secondary attack rate of 55%. The median age of the secondary cases was 12 years. Female household contacts and household contacts who slept in the same room with the index case were significantly associated with increased risk for COVID‐19. Other independent risk factors associated with higher transmission risk in the household included an index case who was symptomatic, a household index case aged greater than 18 years and a male household index case. Conclusions High rates of household transmission of COVID‐19 were found, indicating households were a major setting of transmission of SARS‐CoV‐2. Our data provide insight into the risk factors for household transmission of SARS‐CoV‐2 in Malaysia.

No abstract

Background:  Recent retrospective studies suggest irrelevance of urine screening for neonate with prolonged jaundice. We re-evaluated the incidence of urinary tract infection (UTI) among these infants, their renal outcome and evaluated the cost incurred. Methods: This is a prospective cohort study. Asymptomatic, prolonged jaundiced infants with unconjugated hyperbilirubinemia were screened for evidence of UTI as per local guidelines. Infants with pyuria would have urine sent for culture and sensitivity. Unit cost was referenced from hospital purchase. Statistical analysis was performed using SPSS 24.0.  Results: A total of 291 cases were analyzed. Majority were term infants (93.8%). The commonest cause of prolonged jaundice was breast milk jaundice, hence an incidence rate of 0.34%. Only one infant persistently showed single uropathogen on urinary culture with concurrent pyuria. Urinary structures were normal on ultrasonography and there was no evidence of renal cortical scarring. No recurrence of UTI documented in the first year of life. Each “clean-catch” urinalysis costed RM7. This unit cost escalated to RM37 for catheterized sample.  A negative urine culture costed RM28 while a positive culture twice this price. The average cost effectiveness ratio (ACER) in this study was RM5856.56 per detection of case.    Conclusion: Incidence of UTI is low. In our study, an undesirable outcome is negligible. Unnecessary parental anxiety from the potentially laborious procedure could be avoided. This study refutes previous literature to include such screening in prolonged jaundice as this may well be irrelevant.

See https://doi.org/10.1111/jpc.2_14277