Infection In Malaysia Research Articles

A survey on the occurrence of papaya ringspot virus-P (PRSV-P) in Malaysia and genetic diversity assessment of the coat protein region.

Papaya ringspot virus (PRSV) is a plant virus transmitted by aphids that has spread throughout many countries, including Malaysia, causing yield losses and economic impacts to the papaya industry worldwide. PRSV infection in papaya-distinctive ring-shaped patterns on papaya leaves resulted in stunted growth and reduced fruit quality. Management strategies such as the use of resistant varieties, cultural practices, and vector control are employed to mitigate the spread of PRSV. However, the evolution of new virus strains and the uncertainties posed by climate change pose ongoing challenges for the management of PRSV worldwide. Therefore, in this present study, we aim to confirm the presence of PRSV in symptomatic papaya leaves, to depict the current status of PRSV in Malaysia. Using reverse-transcription PCR (RT-PCR) targeting PRSV partial nuclear inclusion b protein (NIb) and coat protein (CP), 13 out of 40 papaya leaves collected were found positive for the PRSV strain-P (PRSV-P). Nucleotide analysis revealed a high similarity with strains from Taiwan and India, showing 96.83%, 97.03%, and 97.03% identity with the Taiwan strains (DQ340771, AY027810) and the India strain (KJ755852), respectively. Compared to the CP gene of Malaysian isolates reported in 2016 (EU082207), several nonsynonymous mutations have been discovered suggesting genetic diversity within the PRSV population in Malaysia. Overall, this study confirms the current circulation of PRSV infection in Malaysia since it was first identified in Johore in 1991. The re-occurrence of PRSV-P in this study highlights the need for continuous monitoring and targeted management strategies to prevent the further spread of PRSV-P in Malaysia.

Epidemiological observations of invasive group B Streptococcus infections in six major hospitals in Peninsular Malaysia

Objective: To address the lack of research on invasive group B Streptococcus (GBS) infections in Malaysia and Southeast Asia through a comprehensive analysis of GBS isolates obtained from hospitals. Methods: Medical records from patients with GBS infection isolated from the sterile site, such as blood and cerebrospinal fluid from 14 July 2019 to 15 December 2020, were reviewed from six major hospitals in Peninsular Malaysia. Inclusion criteria were invasive GBS, sterile sites and non-repeated GBS isolated from the same patients in the same admission. Viable isolates were re-identified for GBS and serotyped. Results: A total of 118 patients were eligible, with a majority of non-pregnant adults (76.3%). Over half of the patients (62.7%) had underlying medical conditions, with diabetes as the most common disease, followed by respiratory disease, renal disease, cardiovascular disease and skin and soft tissue disease. The most common manifestations were sepsis, followed by soft tissue abscess, diabetic foot ulcer, wet gangrene and cellulitis. The overall mortality was 7.6%. The most common serotype was serotype V. Conclusions: Invasive GBS infection among non-pregnant adults showed a rising trend, particularly among diabetic individuals. The study underscores the importance of reducing risk factors and highlights the necessity of developing GBS vaccination as a preventive strategy for both infants and adults.

Individual and contextual factors associated with measles infection in Malaysia: a multilevel analysis.

Despite effective vaccination strategies, measles remains a global public health challenge. The study explored individual and contextual factors associated with measles infection in Malaysia from 2018 to 2022, informing the development of targeted public health interventions. This cross-sectional study utilised data from the Ministry of Health, the Department of Statistics, and the Department of Environment Malaysia. Multilevel logistic regression analysis was employed to examine individual-level factors, including age, sex, ethnicity, nationality, contact history, travel history, and vaccination status. Concurrently, contextual factors were assessed, encompassing district-level determinants such as population density, median household income, urbanisation, the number of health and rural clinics, vaccination rates, PM2.5 levels, relative humidity, and temperature, to determine their impact on measles infection risk. Measles infection was significantly associated with various individual factors. These included age (adjusted odds ratio [aOR], 1.02; 95% confidence interval [CI], 1.02-1.03), ethnicity, non-Malaysian nationality (aOR, 34.53; 95% CI, 8.42-141.51), prior contact with a measles case (aOR, 2.36; 95% CI, 2.07-2.69), travel history (aOR, 2.30; 95% CI, 1.13-4.70), and vaccination status (aOR, 0.76; 95% CI, 0.72-0.79). Among contextual factors, urbanisation (aOR, 1.56; 95% CI, 1.16-2.10) and the number of clinics (aOR, 0.98; 95% CI, 0.97-0.99) were significant determinants. This multilevel logistic regression analysis illuminates the complexities of measles transmission, advocating public health interventions tailored to individual and contextual vulnerabilities. The findings highlight the need for a synergistic approach that combines vaccination campaigns, healthcare accessibility improvements, and socioeconomic interventions to effectively combat measles.

How the Use of prep (Pre-exposure Prophylaxis) Helps to Prevent HIV Infection in Malaysia

Background: HIV remains a significant public health challenge in Malaysia, affecting key populations such as men who have sex with men (MSM), transgender individuals, sex workers, and people who inject drugs (PWID). Despite advancements in prevention and treatment, HIV continues to be a leading cause of morbidity and mortality. Pre-exposure prophylaxis (PrEP) has emerged as a promising biomedical intervention, utilizing antiretroviral tablets (ARVs) to significantly reduce the risk of HIV infection in HIV-negative individuals. Methods and Materials: This study investigates the effectiveness of PrEP in preventing HIV transmission among high-risk groups in Malaysia. The research examines the mechanism of action of the two primary drugs used in PrEP—tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC)—and analyzes data from various studies, including the iPrEx, Partners PrEP, PROUD, and IPERGAY studies. Additionally, it addresses the challenges of implementing PrEP in Malaysia, such as stigma, adherence issues, and integration with existing HIV services. Results: PrEP has shown to reduce the risk of HIV infection by more than 90% when used consistently. The iPrEx study demonstrated a 44% reduction in HIV risk, increasing to 92% with consistent use. The Partners PrEP study indicated a 75% reduction, with a potential 90% decrease with strict adherence. The PROUD and IPERGAY studies reinforced these findings, showing 86% reductions in HIV risk. Despite its proven efficacy, the implementation of PrEP in Malaysia faces barriers such as stigma, prejudice, and adherence challenges. Conclusion: PrEP is a highly effective strategy for reducing HIV transmission among high-risk populations in Malaysia. To maximize its potential impact, it is crucial to address barriers to implementation, including stigma, adherence issues, and integration with existing healthcare services. Mathematical modeling suggests that widespread PrEP use could lead to a significant decrease in new HIV infections, potentially reducing cases among MSM by 30% over a decade. Learning from successful PrEP programs in other countries, Malaysia should focus on supportive policies, community engagement, affordability, and adherence support to effectively combat the HIV epidemic.

Knowledge and attitude towards home quarantine instructions and associations with history of Covid-19 infection in Malaysia

IntroductionAlthough COVID-19 has entered the endemic phase, individuals infected with COVID-19 are required to adhere to home quarantine measures. By exploring the public’s knowledge and attitude towards recommended home quarantine measures, their readiness in containing potential COVID-19 outbreak can be determined. This study aimed to assess the public knowledge and attitude towards home quarantine instructions and their association with history of COVID-19 infections.MethodsThis was a web-based cross-sectional study conducted among the public in Malaysia between August to October 2022. All Malaysian adults over 18 years of age were included. Knowledge on home quarantine instructions and COVID-19 warning signs were measured using “True,” “False,” or “I’m not sure”, while attitude towards home quarantine instructions was measured using a five-point Likert Scale. The questionnaire was initially constructed in English and then translated into the national language, Bahasa Malaysia. Face and content validation were performed. The internal consistency of the questionnaire was found to be satisfactory.Results1,036 respondents were analyzed, comprised mostly of females (743, 71.6%) with a history of COVID-19 (673, 64.9%). In the knowledge domain, more than 80% of the respondents answered 9 out of 11 home quarantine instructions statements correctly. 457 (44.1%) were unaware or unsure about the minimum distance of the infected individual’s bed from the rest of the occupants in a shared bedroom. The respondents reported relatively weaker knowledge in identifying uncommon warning signs of COVID-19 deterioration, including anuria (162, 44.5%), ingestion problems (191, 52.5%), and immobility (195, 53.6%). In the attitude domain, more than 90% of respondents answered correctly in 8 out of 9 questions. Respondents with a previous history of COVID-19 infections had better knowledge than COVID-19 infection-naïve individuals towards both home quarantine instructions and COVID-19 warning signs.ConclusionMost respondents had good knowledge and attitude towards home quarantine instructions, with those previously infected with COVID-19 showing greater awareness of uncommon warning signs. However, there was a notable lack of awareness regarding physical distancing within shared rooms, appropriate disinfectant use and mobility limitation within the household. This study highlights the knowledge gaps to be improved in future educational campaigns.

Assessing the impact of COVID-19 on epidemiological changes of severe pediatric respiratory syncytial virus infections in Malaysia.

Respiratory syncytial virus (RSV) is one of the leading causes of hospitalization and mortality among children with respiratory tract infections. The non-pharmaceutical preventive measures against severe acute respiratory syndrome coronavirus (COVID-19) may have reduced the transmission of RSV, altering its tropical epidemiological seasonality. Thus, this study represents the first attempt to evaluate changes in RSV epidemiology in the context of COVID-19 pandemic in Malaysia. Conducted at a tertiary hospital in Kuala Lumpur, Malaysia, this retrospective study analyzed collated data of children aged <12 years who were admitted for severe respiratory infections from 2017 to 2022. Time series models were used to predict the differences between actual and forecasted RSV cases, while logistic regression assessed the statistical association between RSV and COVID-19. Among the 4,084 children analyzed, we reported a significant inverse relationship between RSV and COVID-19 infections during the pandemic (2020-2021) (p < 0.05). In 2020, the RSV positivity rate sharply declined to 8.3 and 5.9%, respectively, in the two prominent seasons. Time series analysis showed a tremendous decrease in cases compared to the expected values, with reductions of 98.3% in the first season and 95.7% in the second season. However, following the lifting of the restriction order in 2022, RSV infections rose sharply with a positivity rate of 36.3%, higher than pre-COVID-19 pandemic levels. This study provides evidence of increasing RSV cases post-COVID-19 pandemic, due to immunity debt. Hence, the healthcare system must be prepared to address future RSV outbreaks with the appropriate implementation of prophylaxis and public health measures.

Prevalence of Soil-Transmitted Helminth Infections in Malaysia: A Systematic Review and Meta-Analysis

BACKGROUND: Prevention and control of soil-transmitted helminth (STH) infections in Malaysia remain a challenge, especially among aborigine and rural population. Despite several community-based reports, there are lacking national data on the overall prevalence for STH infection. AIM: The study aimed to determine the prevalence, endemic species, and distribution and risk zones (RZs) for STH infections in Malaysia through a systematic review and meta-analysis of the data published between 1999 and 2019. METHODS: This study employed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The databases used in this review include SCOPUS, WEB OF SCIENCE, OVID MEDLINE, and PUBMED. The random-effects model determined the pooled prevalence estimate (PPE) while Cochran’s Q-test evaluated the heterogeneity. RESULTS: A total of 13240 samples were examined during the period under review with 6235 were infected with one or more species of STHs. The overall PPE for STH infections was 51% (95% Confidence interval [CI]: 34, 67). PPEs for sub-groups ranged between 13% (95% CI: 5, 22) and 69% (95% CI: 50, 87). Highest PPEs for STH infections were observed among aborigine children (69% 95% CI: 50, 87). Trichuris trichiura was the most prevalent species (46%, 95% CI: 27, 65). Over 46% (17/37) of the studies, especially among aborigine community and their area showed high-HRZ for STH infections. CONCLUSION: STH infections involving T. trichiura, Ascaris lumbricoides, hookworms and Strongyloides stercoralis are highly prevalent among aborigine community. Primary and secondary prevention such as the use of anthelmintic, health education, and adequate sanitation was essential in the control of these infections in Malaysia to improve individual and community health.

Entry of Migrant Workers to Malaysia: Consideration to Implement Mass Drug Administration Against Intestinal Parasitic Infections.

Over the last five decades, widespread industrialisation and urbanisation have resulted in the influx of low-skilled workers, particularly from Southeast and West Asia to Malaysia. The current practice for migrant workers entry for employment requires mandatory medical screening for infectious diseases. However, screening for parasitic infections in Malaysia is woefully inadequate. Many migrants come from low-income countries where parasitic infections are common, which may have public health implications for their overall well-being as parasitic infections, although not critical, may impact their overall productivity. The high prevalence of intestinal parasitic infections (IPIs) recorded among migrant workers in Malaysia necessitates improvement in the national health policy to include mandatory mass administration of a single dose of anthelmintic drugs to all low-skilled migrant labourers, particularly upon entry into the country, admission, and encourage continuous surveillance. A constant stream of migrant labourers is anticipated, potentially resulting in an ongoing occurrence of parasitic infections within the population. The implementation of economic measures like health awareness initiatives, routine deworming campaigns, and improved sanitation facilities holds the potential to reduce the spread of these infections notably. More often than not, taking preventive actions proves to be more financially efficient over time compared to addressing severe infections at a later stage.

Screening of Streptococcus suis in swine workers of selected states in Peninsular Malaysia.

Streptococcus suis is a zoonotic pathogen that is highly associated with contact between live pigs and raw pig material. In view of the recent reports of human infections in Malaysia, epidemiological data on the status of S. suis in the human population, especially among people working closely with pigs and/or raw pork, should be provided. The aim of this study was to detect S. suis among individuals working in the swine industry in several major pig production areas in Peninsular Malaysia. Demographic information, exposure determinants, and oral swabs were collected from swine personnel, including farmers, butchers, and veterinarians. Oral swabs were subjected to bacterial isolation and conventional polymerase chain reaction (PCR) assays for S. suis detection. The study included 40 participants working in the swine industry, with a predominant representation of males (62.5%) and Malaysian Chinese individuals (60.0%) who consumed pork (92.5%). Notably, none of the participants reported consuming raw or partially cooked pork. In spite of their occupational exposure risk, none of the oral swabs showed positive results for S. suis infection. To the best of our knowledge, this is the first report and detection study of S. suis using oral swabs obtained from swine personnel in Peninsular Malaysia.

The Dynamics of Tuberculosis through BSEIR Model with Immigration in Malaysia

Tuberculosis or known as TB is an airborne disease that exists in Malaysia caused by Mycobacterium Tuberculosis. Despite that, TB infection is curable with early diagnosis and treatment. The disease can be prevented through Bacillus Calmette-Guérin (BCG) vaccine, which is given among infants at birth. Numerous mathematical models on infectious diseases have been formulated in earlier studies since it is crucial to comprehend infectious disease transmission patterns and predict future outcomes. However, there is minimal study on the dynamics of TB transmission, particularly in Malaysia concerning immigration. Hence, this study aims to formulate a mathematical BCG-vaccinated, susceptible, exposed, infected, and recovered (BSEIR) model for TB infection in Malaysia by considering the immigration parameter. The model parameters are obtained from the literature and some with reported data in 2013 as initial value for the simulation using MAPLE software. The obtained results revealed that the basic reproduction number, for the model is more than one. The graphical plot shows that the BSEIR model with immigration demonstrates a rise in TB-infected cases. The best strategy to lessen the number of infected individuals in Malaysia is by increasing the transmission rate and recovery rate. Additionally, the local stability analysis on the diseases-free equilibrium point and sensitivity analysis of its parameter is also provided and discussed. To conclude, a proper screening test should be mandated by the authorities before permitting new immigrants and refugees into Malaysia.

Prevalence and sociodemographic predictors of high-risk vaginal human papillomavirus infection: findings from a public cervical cancer screening registry

IntroductionHigh-risk human papillomavirus (HPV) screening is vital for early cervical cancer detection and treatment. With the introduction of the national cervical cancer screening programme and screening registry in Malaysia, there is a need to monitor population-based HPV screening uptake and high-risk HPV prevalence as part of cervical cancer surveillance.ObjectiveTo determine the prevalence and sociodemographic factors predicting high-risk HPV infection in Malaysia based on a public, community-based cervical cancer screening registry targeting women at risk of getting HPV infection.MethodsThe study used data from the Malaysian cervical cancer screening registry established by the Family Health Development Division from 2019 to 2021. The registry recorded sociodemographic data, HPV test details and results of eligible women who underwent HPV screening at public primary healthcare facilities. A vaginal sample (via self-sampling or assisted by a healthcare provider) was used for DNA extraction for HPV detection and genotyping. Registry data were extracted and analysed to determine prevalence estimates of high-risk HPV infection. Multifactorial logistic regression analysis was conducted to determine predictors of high-risk HPV infection. All analyses were performed using Stata version 14.ResultsThe programme screened a total of 36,738 women during the study period. Women who attended the screening programme were mainly from urban areas, aged 30–39 years, and of Malay ethnicity. The prevalence of high-risk HPV infection was 4.53% among women screened, with the yearly prevalence ranging from 4.27 to 4.80%. A higher prevalence was observed among urban settling women, those aged 30–49 years, those of Indian ethnicity, and those without children. The results from logistic regression showed that women from urban areas, lower age groups, of Indian or Chinese ethnicity, and who are self-employed were more likely to be infected with high-risk HPV.ConclusionTargeted and robust strategies to reach identified high-risk groups are needed in Malaysia. In addition, the registry has the potential to be expanded for an improved cervical cancer elimination plan.Trial registrationTrial registration number: NMRR ID-22-00187-DJU.

An Interesting Case Report on Calcaneal Tuberculosis as a Rare Presentation of Disseminated Tuberculosis

Despite the high prevalence rate of tuberculosis infection in Malaysia, calcaneal tuberculosis (TB) is rare. In this article, we present a case of a 53-year-old Malay female who initially presented with left calcaneal swelling for 3 months. Surgical drainage was performed and affected calcaneal was biopsied for histological examination which findings reported as consistent with tuberculosis infection. Further history revealed concomitant respiratory symptoms with the diagnosis of disseminated TB is supported by positive Mantoux test, detection of Acid-Fast bacilli in sputum and CT imaging showing lung and vertebral involvement. Anti-tuberculosis medication is the first line of treatment in calcaneal TB and surgery is usually reserved for patient with severe, intractable disease. Bangladesh Journal of Infectious Diseases, June 2023;10(1):52-55

Demystifying re-emergence zoonotic threat: A 5-year epidemiology of leptospirosis in Negeri Sembilan, Malaysia

IntroductionLeptospirosis is a re-emergence of zoonotic disease with significant morbidity and mortality. As a tropical country, there is a concerning trend of leptospirosis infection in Malaysia. However, the epidemiological study of the infection remains scarce and does not reflect the current information. Therefore, the study aimed to describe its epidemiology within the last 5-year in the state of Negeri Sembilan. MethodsA cross-sectional study was done using dataset from national electronic surveillance registry from year 2018–2022. Descriptive statistics method was applied to build the epidemiological narrative of leptospirosis infection. All data was kept confidential and abide to Helsinki declaration. ResultsA total of 1290 cases of leptospirosis was registered and included in the analysis. Majority of the cases were from adults’ group (68.4 %), male (68.4 %), of Malay ethnicity (69.8 %), unemployed (56.7 %), and from rural area (54.4 %). The possible risk exposure was from rat infestation (15.1 %), water-based activity (12.5 %), and contact with contaminated soil (7.7 %). The proportion of cases registered in the densely populated areas were comparable among those who are employed and unemployed There were overall 21 (1.6 %) mortality cases from the data. ConclusionLeptospirosis is a public health threat and need to be approached holistically. Awareness of the disease need to be continuously advocated to the public as well as to the healthcare providers. Strengthening the surveillance system at the local and national level is important as it can act as an early warning system to prevent outbreak to happen.

The seroprevalence of SARS-CoV-2 infection in Malaysia: 7 August to 11 October 2020.

From the beginning of the COVID-19 pandemic until mid-October 2020, Malaysia recorded ~15,000 confirmed cases. But there could be undiagnosed cases due mainly to asymptomatic infections. Seroprevalence studies can better quantify underlying infection from SARS-CoV-2 by identifying humoral antibodies against the virus. This study was the first to determine the prevalence of SARS-CoV-2 infection in Malaysia'sgeneral population, as well as the proportion of asymptomatic and undiagnosed infections. This cross-sectional seroprevalence study with a two-stage stratified random cluster sampling design included 5,131 representative community dwellers in Malaysia aged ≥1year. Data collection lasted from 7 August to 11 October 2020 involving venous blood sampling and interviews for history of COVID-19 symptoms and diagnosis. Previous SARS-CoV-2 infection was defined as screened positive using the Wantai SARS-CoV-2 Total Antibody enzyme-linked immunosorbent assay and confirmed positive using the GenScript SARS-CoV-2 surrogate Virus Neutralization Test. We performed a complex sampling design analysis, calculating sample weights considering probabilities of selection, non-response rate and post-stratification weight. The overall weighted prevalence of SARS-CoV-2 infection was 0.49% (95%CI 0.28-0.85) (N = 150,857). Among the estimated population with past infection, around 84.1% (95%CI 58.84-95.12) (N = 126 826) were asymptomatic, and 90.1% (95%CI 67.06-97.58) (N = 135 866) were undiagnosed. Our study revealed a low pre-variant and pre-vaccination seroprevalence of SARS-CoV-2 infection in Malaysia up to mid-October 2020, with a considerable proportion of asymptomatic and undiagnosed cases. This led to subsequent adoption of SARS-CoV-2 antigen rapid test kits to increase case detection rate and to reduce time to results and infection control measures.

The psychological status of patients with delayed intravitreal injection for treatment of diabetic macular edema due to the COVID-19 pandemic.

Since the enforcement of the Movement Control Order (MCO) to contain the spread of COVID -19 infection in Malaysia, most clinic appointments have been rescheduled and procedures and surgeries postponed to a later date. Clinic appointments including intravitreal endothelial growth factor (anti-VEGF) treatment for patients with diabetic macular edema (DME) were also no exception to the postponement. This measure takes a psychological toll on patients because of the overwhelming concern for their eye condition. This study was conducted to assess the psychological status of DME patients with delayed anti-VEGF treatment during the pandemic. A cross-sectional study was conducted from September 2020 to March 2021 in Ophthalmology Clinic Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia (HCTM UKM). Subjects diagnosed with center-involved DME aged between 20 to 80 years who experienced delayed anti-VEGF injection were recruited. Level of depression, anxiety and stress were assessed using DASS-21 questionnaire. Statistical analysis using non-parametric tests were performed to determine the relationship between the DASS-21 score and duration of last injection, in those whose vision was affected by delayed injection and the relationship to the impact of COVID-19 pandemic. Statistical significance was denoted as p < 0.05. A total of 86 respondents with median age of 69 years old participated in this study. Most respondents were Malays (n = 47,54.7%) males (n = 51, 59.3%), had education up to secondary level (n = 37, 43%), unemployed (n = 78, 90.7%), married (n = 72, 83.7%) and living with their family (n = 82, 95.3%). The number of intravitreal injections received was at least three times among the respondents (n = 81, 94.2%). More than half of the respondents (n = 46, 53.5%) had been postponed for more than 12 weeks and felt that their vision was affected after delayed intravitreal injection (n = 47, 54.7%). Most of the subjects did not experience depression, anxiety, or stress. However, there was a significant level of stress scores among those with delayed injection of 9 to 12 weeks (p = 0.004), and significant anxiety (p = 0.029) and stress (p = 0.014) scores found in subjects with vision affected due to delayed treatment. The level of anxiety and stress can be significant in DME patients who experienced delay in intravitreal anti-VEGF treatment. Assessment of psychosocial impacts is important to identify early mental health issues potentially leading to the onset of psychiatry illness, thus early intervention is indispensable.

Parameter estimation of HFMD infection in Malaysia with SIR model

Hand, foot and mouth disease (HFMD) is a mildly infectious disease that happens to children due to low body immunity against viruses. In this paper, a simple SIR model is employed to represent the dynamics of HFMD in Malaysia. A weekly reported data of HFMD infection from week-1 of 2017 to week-36 of 2018 is used in the mathematical analysis. The procedure of parameter estimation is implemented in order to identify the parameter of the SIR model that fits the model with the reported data. The fminsearchbnd routine is used to minimize the objective function, which is the sum of absolute error minimization. By the Chi-squared test, the estimated parameters are reasonable. Based on the average value of the basic reproduction number R0, HFMD infection will remain to exist in the population under the current condition. Overall, this finding may be useful for public health personnel to reduce disease infection risk by planning more effective prevention strategies.

Effectiveness of a multidisciplinary programme to improve functional outcomes of patients following severe COVID-19 infection in Malaysia: a retrospective study

Background/Aims Evidence-based, specialised rehabilitation interventions are key to improving functional outcomes for patients with complications caused by severe COVID-19 infection, who often have complex needs and a wide range of functional impairments. The aims of this study were to determine the effectiveness of a structured inpatient, personalised, interdisciplinary rehabilitation programme, namely the COVID-19 Rehabilitation Inpatient Specialised Services, and to identify clinical predictors of rehabilitation effectiveness in patients after contracting COVID-19. Methods This retrospective study involved 154 patients who underwent rehabilitation under the COVID-19 Rehabilitation Inpatient Specialised Services programme at a single centre between 1 July and 31 October 2021. The modified Barthel Index, Post-COVID-19 Functional Scale, modified Medical Research Council Dyspnoea Scale scores, and actual effectiveness derived from the modified Barthel Index scores were used to measure outcomes. Results The mean age of patients was 49.8 ± 14.3 years. Overall 48.1% (n=74) had required intubation, 70.1% (n=108) had been critically ill, and 21.4% (n=33) remained dependent on oxygen therapy beyond discharge. There was a statistically significant improvement in mean modified Barthel Index scores (45.2 vs 66.3, P&lt;0.001), median post-COVID-19 Functional Scale score (4 vs 3, P&lt;0.001) and median modified Medical Research Council scores (4 vs 3, P&lt;0.001) following the rehabilitation intervention. Acute kidney injury, oxygen therapy dependency, neurological complications and initial modified Barthel Index scores were significant predictors of rehabilitation effectiveness (adjusted R2=0.23, P&lt;0.001). Conclusions The COVID-19 Rehabilitation Inpatient Specialised Services programme was effective in improving functional outcomes of hospitalised patients with severe to critical COVID-19 infection. By identifying factors that predict rehabilitation effectiveness, allied healthcare professionals can administer more focused rehabilitation efforts tailored to the specific needs of patients, thereby enabling them to achieve their maximum potential functional outcomes.

Molecular epidemiology of clinically relevant single and mixed species in a Malaysian tertiary care hospital.

The increasing rate of opportunistic infections caused by Candida and other yeasts is becoming a major health concern worldwide. However, systematic data on the epidemiology and the yeast species infections in Malaysia is still limited. In this regard, the present research aimed to identify pathogenic yeasts utilizing an economically practical and easily available molecular technique and evaluate the prevalence of pathogenic yeasts in a Malaysian tertiary care hospital. Yeast isolates were collected from Sultan Abdul Halim Hospital, Kedah, Malaysia, from October 2020 to October 2021. Molecular identification of the isolates was performed by one enzyme-based polymerase chain reaction-restriction fragment length polymorphism method. Candida albicans was the most prevalent species, accounting for 120 isolates (59%) in total. The most prevalent non-albicans Candida species were C. tropicalis (n=33, 16%), C. krusei (Pichia kudriavzevii) (n=12, 5.8%), C. glabrata (n=12, 5.8%), and C. parapsilosis (n=6, 3%). Other unusual Candida species were C. guilliermondii (2), C. metapsilosis (2), C. orthopsilosis (1), C. lusitaniae (1), C. rugosa (1), C. haemulonii (1), C. bracarensis (1), and C. dubliniensis (1). Moreover, Talaromyces marneffei (1), Kodamaea ohmeri (1), Cryptococcus neoformans (3), and Cryptococcus laurentii (1) were among the other yeasts identified. The Molecular technique used in this study identified 96% of isolates, including mixed species. According to the findings, the most prevalent species are C. albicans, C. tropicalis, C. krusei, and C. glabrata.

Hepatitis C virus (HCV) infection in Malaysia: findings from a nationwide cross-sectional study

Hepatitis C virus (HCV) infection in Malaysia: findings from a nationwide cross-sectional study

Emergence of zoonotic Brugia pahangi parasite in Thailand.

Zoonotic Brugia pahangi parasite infections in humans have emerged over two decades in Southeast Asia (SEA), including Malaysia and Thailand. The species is commonly found in domestic cats and dogs as the natural reservoir hosts. The sporadic transmission pattern of B. pahangi zoonosis causes childhood infections in Thailand and adulthood infections in Malaysia. It is crucial to understand the vulnerability in how zoonotic B. pahangi parasite is transmitted to susceptible persons in receptive settings and the exposure to the infection under impoverished environment to which the human-vector-animal interactions are related. This acquisition of knowledge will help multiple health science professions to apply One Health approach to strengthening the capacity in diagnosis and surveillance, and hence detecting and monitoring the "lingering" zoonotic B. pahangi infections present in vulnerable populations in Thailand and elsewhere in SEA. In this review article, the authors focused on articulating the concepts of plantation-related zoonotic B. pahangi filariasis by updating current knowledge of B. pahangi life cycle, vector's life cycle and current state of research on the epidemiology and ecology of B. pahangi zoonosis.