Northeast Peninsular Malaysia Research Articles

Spatio‐Temporal Variations and El Niño Modulation of Meteorological Droughts in Malaysia

ABSTRACTMeteorological droughts in Malaysia have significantly impacted critical sectors such as agriculture, water resources, health, the environment, tourism and various socio‐economic sectors, affecting the population's livelihood and well‐being. This study analyses drought characteristics over a 39‐year period, from 1982 to 2021, using the Standardised Precipitation Index (SPI) derived from 5‐km resolution Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS). The droughts were assessed on 3‐, 6‐, 9‐ and 12‐month timescales to investigate spatio‐temporal variations in characteristics such as frequency, duration, peak, severity and intensity. The study also provides an in‐depth analysis of large‐scale drought modulation, particularly associated with the El Niño phenomenon and its teleconnection in the Maritime Continent. Depending on the location and timescale, the number of meteorological drought occurrences varied from 10 to 22 for the 3‐month timescale and 4 to 14 for the 12‐month timescale. Generally, as the timescale of a drought increases, the peak intensity decreases, while the duration and severity increase. Additionally, drought intensity decreases over longer timescales. These characteristics show significant spatial variations. Results indicate that meteorological droughts in Malaysia were almost entirely modulated by the El Niño phenomenon through its induced teleconnection over the Maritime Continent. Drought characteristics exhibit a strong seasonality linked to changes in the Walker circulation and the strengthening and weakening of anticyclonic circulations associated with Rossby waves induced by heating in the Pacific Ocean. Very strong El Niño events had the most significant influence on the droughts. The positive Indian Ocean Dipole (pIOD) strengthened the effects of El Niño but it itself had no significant influence on the droughts. In most regions, there were no significant trends in the characteristics of meteorological droughts. However, in northeast Peninsular Malaysia and some scattered areas along the west coast of the peninsula, significant trends are observed in peak, duration and severity.

Antibiotic use in a co-infection of respiratory syncytial virus and pathogenic bacteria in children in a resource-limited setting in northeast Peninsular Malaysia

Antibiotic use in a co-infection of respiratory syncytial virus and pathogenic bacteria in children in a resource-limited setting in northeast Peninsular Malaysia

Hematological Profile of Hb Adana Among High School Students in Northeast Peninsular Malaysia.

Background Hb Adana is a non-deletional alpha (α)-thalassaemia variant resulting from mutations in α1- or α2-globin codon 59 (αCD59), leading to the production of unstable α-globin. Clinical manifestations can vary from silent carrier status to dependence on blood transfusions, hepatosplenomegaly, skeletal deformities, and spinal cord compression. Despite the significance of Hb Adana inheritance, studying this variant poses challenges due to the scarcity of molecular tests and the potential for routine diagnoses to be overlooked. This study aims to investigate the prevalence of Hb Adana among local high school students and assess the hematological parameters and hemoglobin analysis of Hb Adana in Malaysia. Methodology This retrospective study analyzed 13,721 blood samples collected from high school students participating in Malaysia's National Thalassaemia Screening Program at Hospital Raja Perempuan Zainab II (HRPZ II). Deletional α-thalassaemia was detected using multiplex gap-polymerase chain reaction (PCR), while common non-deletional α-thalassaemia was identified using multiplex amplification refractory mutation system (ARMS) PCR. Data were extracted from the HRPZ II database for analysis. Results Among the participants, 2327 individuals were found to have either common deletional (n=1037, 44.6%) or non-deletional (n=1290, 55.4%) α-thalassaemia. Hb Constant Spring was the most prevalent non-deletional α-thalassaemia, accounting for 53.03% of cases. Thirty-one participants (1.33%) exhibited αCD59α/αα, and one (0.04%) had αCD59α/-α3.7. Among the 32 subjects with Hb Adana, 87.5% were Malay, and 12.5% were Orang Asli. Additionally, seven cases of HbE/Hb Adana co-inheritance were identified. Hemoglobin levels in heterozygous Hb Adana individuals ranged from mild anemia to normal, between 95 g/L and 153 g/L. Mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were approximately 73 fL and 23 pg, respectively. Conclusion This study delineates the distribution ofα-thalassaemia mutation patterns among high school students in Kelantan, Northeast Peninsular Malaysia. Our findings indicate that Hb Adana is rare in our region and co-inheritance with an α-gene deletion results in α+-thalassaemia and with HbE, α0-thalassaemia. All heterozygous Hb Adana individuals exhibited low MCVs and MCHs.

Structural and Geochemistry of Air Piau Gold Mineralisation in Kelantan, North-East Peninsular Malaysia

The formation of the Air Piau Gold Deposit in North-East Peninsular Malaysia due to Permo–Triassic subduction and collision between Sibumasu and East Malaya blocks and resulted in several phases of deformation, contraction, and metamorphism. Kinematic and petrography study of quartz veins in Air Piau area observed whether following the foliation of metamorphic rock or crosscut the foliation. Early generation of veining system in Air Piau follow the host rock foliation (V1). Meanwhile the later formation of the hydrothermal vein has a cross-cutting relationship with foliation (V2). Some veins observed were sheared and brecciated (V3). Positive correlation between Au and As concentration that can be characterized these deposit formed at mesozonal zone. V3 vein type showed the brecciated texture of vein indicates the brittle structure deformation. The conceptual model of orogenic gold, this type of V3 vein can be classified as epizonal zone. Regionally, the Air Piau gold deposit shares geologically similarities (in term of tectonic setting, geological structures controlled, host rock, ore gechemistry) with many other sediment/metasediment- hosted, orogenic gold deposits in Peninsular Malaysia such as Tersang, Selinsing and Penjom. Furthermore, Air Piau gold deposit characteristics as discussed before supported the theory related with orogenic/mesothermal gold from various researchers However, a number of inferences on classified Air Piau gold deposit model as orogenic gold deposit remains speculative in the absence importance data like ore geochemistry data (Hg, Sb and Te element concentrations) and fluid inclusion data.

Tiger Habitat Quality Modelling in Malaysia with Sentinel-2 and InVEST

Deforestation is a threat to habitat quality and biodiversity. In intact forests, even small levels of deforestation can have profound consequences for vertebrate biodiversity. The risk hotspots are Borneo, the Central Amazon, and the Congo Basin. Earth observation (EO) now provides regular, high-resolution satellite images from the Copernicus Sentinel missions and other platforms. To assess the impact of forest conversion and forest loss on biodiversity and habitat quality, forest loss in a tiger conservation landscape in Malaysia is analysed using Sentinel-2 imagery and the InVEST habitat quality model. Forest losses are identified from satellites using the random forest classification and validated with PlanetScope imagery at 3–5 m resolution for a test area. Two scenarios are simulated using InVEST, one with and one without the forest loss maps. The outputs of the InVEST model are maps of tiger habitat quality and habitat degradation in northeast Peninsular Malaysia. In addition to forest loss, OpenStreetMap road vectors and the GLC2000 land-cover map are used to model habitat sensitivity to threats from roads, railways, water bodies, and urban areas. The landscape biodiversity score simulation results fall sharply from ~0.8 to ~0.2 for tree-covered land cover when forest loss is included in the habitat quality model. InVEST makes a reasonable assumption that species richness is higher in pristine tropical forests than in agricultural landscapes. The landscape biodiversity score is used to compare habitat quality between administrative areas. The coupled EO/InVEST modelling framework presented here can support decision makers in reaching the targets of the Kunming-Montreal Global Biodiversity Framework. Forest loss information is essential for the quantification of habitat quality and biodiversity in tropical forests. Next generation ecosystem service models should be co-developed alongside EO products to ensure interoperability.

Emotional and Behavioural Problems among Preschool Children in Northeast Peninsular Malaysia: Parent Report Version

The rising prevalence of mental health disorders among children is a serious concern. Young children who exhibit early warning signs of mental health issues are more likely to develop symptoms in the same or overlapping regions years later. The research aimed to identify emotional and behavioural problems and associated factors in Malaysian preschools. A sample of young children aged 4–6 years from public and private preschools was chosen using a multistage random sampling method. Data were collected from 18 preschools via a parent survey using the Strengths and Difficulties Questionnaire (SDQ). The sample involved 557 children in the SDQ assessment (92%). The overall estimated prevalence of emotional and behavioural problems was 8.4%. Peer problems were the most prevalent attribute, with a percentage of 19.7%. Conduct problems were found in 5.2%, hyperactivity problems in 5.6%, prosocial behaviours in 13.5%, and emotional problems in 6.8%. Girls showed a significant increase in behavioural and emotional problems compared to boys. Having one parent working, having more than two siblings, and having a single-parent family were associated with emotional and behavioural problems. The prevalence of emotional and behavioural problems in Malaysian children was relatively low compared to data from previous studies and other Asian countries but consistent with European studies. Measuring mental health disparities in young children helps stakeholders launch local early intervention programmes.

Gene Mutation Spectrum among Alpha-Thalassaemia Patients in Northeast Peninsular Malaysia.

(1) Background: Alpha (α)-thalassaemia is a genetic disorder that affects 5% of the world population. Deletional or nondeletional mutations of one or both HBA1 and HBA2 on chromosome 16 will result in reduced production of α-globin chains, a component of haemoglobin (Hb) that is required for the formation of red blood cells (RBCs). This study aimed to determine the prevalence, haematological and molecular characterisations of α-thalassaemia. (2) Method: The parameters were based on full blood count, high-performance liquid chromatography and capillary electrophoresis. The molecular analysis involved gap-polymerase chain reaction (PCR), multiplex amplification refractory mutation system-PCR, multiplex ligation-dependent probe amplification and Sanger sequencing. (3) Results: With a total cohort of 131 patients, the prevalence of α-thalassaemia was 48.9%, leaving the remaining 51.1% with potentially undetected α gene mutations. The following genotypes were detected: -α3.7/αα (15.4%), -α4.2/αα (3.7%), --SEA/αα (7.4%), αCSα/αα (10.3%), αAdanaα/αα (0.7%), αQuong Szeα/αα (1.5%), -α3.7/-α3.7 (0.7%), αCSα/αCSα (0.7%), -α4.2/αCSα (0.7%), -SEA/αCSα (1.5%), -SEA/αQuong Szeα (0.7%), -α3.7/αAdanaα (0.7%), --SEA/-α3.7 (2.2%) and αCSα/αAdanaα (0.7%). Indicators such as Hb (p = 0.022), mean corpuscular volume (p = 0.009), mean corpuscular haemoglobin (p = 0.017), RBC (p = 0.038) and haematocrit (p = 0.058) showed significant changes among patients with deletional mutations, but not between patients with nondeletional mutations. (4) Conclusions: A wide range of haematological parameters was observed among patients, including those with the same genotype. Thus, a combination of molecular technologies and haematological parameters is necessary for the accurate detection of α-globin chain mutations.

Social support and associated factors among family caregivers of older people in North-East Peninsular Malaysia.

The negative health results associated with the family caregivers of older people can be alleviated with social support, which is considered a valuable resource. Hence, the factors contributing to social support need to be understood. This study aimed to evaluate the social support associated with the family caregivers of older people. A cross-sectional study was conducted among 231 family caregivers of older people conveniently selected from two districts in Kelantan, a state in the North-East Region of Peninsular Malaysia. Data were gathered between June to December 2021 using a Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire. Descriptive statistics were used to summarize the data in frequencies and percentages. Independent t-test and one-way analysis of variance were used to examine correlations among variables. The mean scores of social support for family caregivers were significantly higher among their family (Mean ± SD; 5.44 ± 0.969) and other important people (5.25 ± 1.123) compared to their friends (4.84 ± 1.094). Caregivers' gender and duration of caregiving were significant factors associated with social support (p <0.05). The family caregivers received maximum support from their family and other important people, but they were less supported by their friends. This study also observed that the perceived social support of the caregivers of older people was affected by several factors, such as gender and duration of caregiving. This finding gives nurses and other healthcare workers the basic information they need to enhance nursing interventions and promote social support among those who care for older people, which can positively impact caregiving.

Chronic kidney disease patients’ views of readiness and ability to use mHealth apps

The use of mobile health (mHealth) applications, which provide opportunities to improve health and lessen health inequalities, is increasing. Studies assessing the readiness and ability of patients in Malaysia with chronic kidney disease (CKD) to use mobile phone apps to manage their health are limited. This study aimed to assess the readiness and ability to use mHealth apps among patients with CKD in north-east Peninsular Malaysia. A cross-sectional study was undertaken, using a convenience sample of 100 CKD medical inpatients in a tertiary teaching hospital. A structured, self-administered questionnaire on readiness and ability to use mHealth apps was adopted. Nearly one in five patients (18%) actively used health applications. More than three-quarters (77%) were aged >40 years and a similar proportion were ready to use mHealth apps (78%), and nearly half (46%) were confident about connecting their device to wifi. There was a correlation between ability and readiness to use mHealth apps (r=0.4; P<0.05). Fewer than half of participants had a good command of mHealth applications. Therefore, support on the use of these apps is needed, and healthcare managers need to consider this.

Prevalence and Risk Factors of Gestational Diabetes Mellitus in Malaysian Antenatal Mothers in North-East Peninsular Malaysia : A Retrospective, Cross-Sectional Study

Prevalence and Risk Factors of Gestational Diabetes Mellitus in Malaysian Antenatal Mothers in North-East Peninsular Malaysia : A Retrospective, Cross-Sectional Study

Prognostic Factor of Lower Limb Amputation among Diabetic Foot Ulcer Patients in North-East Peninsular Malaysia.

Lower limb amputation (LLA) is a common complication of diabetic foot ulcer (DFU), which can lead to a higher 5-year mortality rate compared to all cancers combined. This study aimed to determine the prognostic factors of LLA among DFU patients in Kelantan from 2014 to 2018. A population-based study was conducted using secondary data obtained from the National Diabetic Registry (NDR). There were 362 cases that fulfilled the study criteria and were further analysed. The prognostic factors were determined by Multiple Cox Proportional Hazards Regression. There were 66 (18.2%) DFU patients who underwent LLA in this study, while 296 (81.8%) were censored. The results revealed that the factor leading to a higher risk of LLA was abnormal HDL-cholesterol levels (Adj. HR 2.18; 95% CI: 1.21, 3.92). Factors that led to a lower risk of LLA include DFU in patients aged 60 or more (Adj. HR 0.48; 95% CI: 0.27, 0.89) and obesity (Adj. HR 0.45; 95% CI: 0.22, 0.89). In conclusion, our model showed that abnormal HDL cholesterol was associated with a 2 times higher risk of LLA when adjusted for age and BMI. Any paradoxical phenomena should be addressed carefully to avoid wrong clinical decision making that can harm the patient.

Malaysian nurses' knowledge and attitudes regarding BRCA genetic testing.

Breast cancer genetic (BRCA) testing for cancer susceptibility is an emerging technology in medicine. This study assessed the knowledge and attitude of nurses regarding BRCA genetic testing in a tertiary teaching hospital in Malaysia. A descriptive cross-sectional study was conducted among 150 nurses using a simple random sampling technique in a tertiary teaching hospital in northeast peninsular Malaysia. Data were collected using a self-administered questionnaire consisting of socio-demographic data, assessing nurses' knowledge and attitude regarding BRCA genetic testing. Fisher exact test analysis was used to determine the association between socio-demographic characteristics with knowledge and attitude level. In addition, the overall knowledge and attitude were analysed using the sum score of each outcome based on Bloom's cut-off point. Of the 150 nurses, 66.7% had high knowledge level about BRCA genetic testing, and 58% were positive towards genetic testing. The participants' mean age was 28.9 years (SD = 6.70). Years of working experience (p = 0.014) significantly influenced knowledge level on BRCA genetic testing, whereas speciality working experience (p <0.001) significantly influenced BRCA genetic testing attitudes. The results show that most nurses have adequate knowledge of BRCA genetic testing. However, their attitude could be termed negative. Therefore, targeted education programs on BRCA genetic testing and risk are needed to improve the knowledge and attitude of nurses and, ultimately, can educate the women and increase health-seeking behaviour among eligible women.

Colorectal Cancer Screening: Knowledge and Practice among Private General Practitioners in Northeast Peninsular Malaysia

Colorectal cancer screening is an important screening to detect colorectal cancer. Thus, the aim of this study is to determine the knowledge, practice and its associated factors of colorectal cancer screening among private general practitioners (PGPs) in Northeast Peninsular Malaysia. Crosssectional study was conducted involving 127 PGPs in Kelantan. The study used a validated selfadministrated questionnaire that contained three domains. The domains were sociodemographic, knowledge and practice of colorectal cancer screening. The inclusion criterion was doctors working in a private clinic for more than six months, while the exclusion criteria were non-residential doctors and doctors practicing in private specialised clinics. Only 21.3% of PGPs had good knowledge and 3.9% had good practice on colorectal cancer screening. The duration of practice as a PGP was significantly associated with good practice for colorectal cancer screening. Only 58.3% were aware of the current recommendation on colorectal cancer screening. Most PGPs would refer patients for a colonoscopy, but screening with faecal occult blood test (FOBT) in average-risk patients was low. Only 4% of PGPs followed the recommended guidelines for colorectal cancer screening. The main reasons for not offering FOBT screening were patients’ refusal, patients were not regular patients of the doctor and the referral system for colonoscopy was found to be difficult. This study noted that knowledge and practice of colorectal cancer screening among PGPs were inadequate. Overcoming barriers for screening is important to promote colorectal cancer screening.

PETROGRAPHY AND GEOCHEMISTRY OF METASEDIMENTARY ROCKS FROM THE TAKU SCHIST IN KELANTAN, NORTH-EAST PENINSULAR MALAYSIA.

The Taku Schist, which is located in the north-east Peninsular Malaysia, is characterized by its North-South oriented elongated body. It forms part of the Indonesian orogenic build-up that was generated via the convergence of the Sibumasu continental unit and Sukhothai Arc. Subsequent petrography analyses of the metasedimentary rocks sourced from the Taku Schist revealed that their formation was attributable to the metamorphism of greenschist into amphibolite facies, which could be observed near the Triassic and Cretaceous intrusions of the Kemahang Granite. The evolutionary process of the rocks could be linked with the interactions occurring between contact and regional metamorphisms. The resulting chemical classification upon their assessment disclosed that the metasedimentary rocks of Taku Schist were made up of greywacke and shale, grouped into the quartzose sedimentary provenance, and belonged to the Continental Island Arc (CIA). This information is required for the tectonic setting discrimination purpose. It is a reflection of the episodic contractions underwent by the Taku Schist, wherein they would lead to the Sibumasu sedimentary cover along with both an accretionary wedge and the genetically-correlated Bentong-Raub melange to different greenschist. Otherwise associated with amphibolite facies, the conditions and depths of the facies were determined according to their position in relation to the upper plate of the Sukhothai Arc.

Relapsed/Progressive Disease and Its Prognostic Factors among Multiple Myeloma Patients Receiving Novel Agent Treatment in North East Peninsular Malaysia: A Single Centre Experience.

BackgroundSome multiple myeloma (MM) patients still relapse/progress despite novel agent therapy and relapse/progression in MM is therefore a vital area of ongoing research in the novel treatment era. This retrospective cohort study aimed to evaluate the time to relapse/progression (TTP) among MM patients who received novel agents and to determine the associated prognostic factors.MethodsThis study included 89 MM patients treated at Hospital Universiti Sains Malaysia. We analysed the TTP and the type of relapse/progression (biochemical versus clinical), and a Cox proportional hazard model was used to identify the significant prognostic factors.ResultsSixty-four percent of patients had biochemical relapse/progression. The overall median TTP among MM patients who received the novel agent(s) was 29.33 months (95% CI: 21.36–37.29). The type of paraprotein at diagnosis (P = 0.026, P = 0.228), International Staging System (ISS) score (P = 0.036, P = 0.067) and autologous stem cell transplant (ASCT) (P = 0.002) were prognostic factors for relapse/progression by simple Cox regression, but ASCT was the only significant predictor detected by multiple Cox regression (P = 0.003).ConclusionOur study reflects the importance of paraprotein monitoring to detect early features of relapse/progression. ASCT is the most prognostic factor that may lengthen the TTP.

Physical Activity and Its Associated Factors among Adolescents in Secondary Schools in Northeast Peninsular Malaysia

Background: The World Health Organization has estimated that 81% of adolescents worldwide are not sufficiently physically active. This study aimed to determine the level of physical activity and its associated factors among adolescents in secondary schools in northeast Peninsular Malaysia. Methods: A cross-sectional study was conducted that involved Form 1 and Form 2 students from six public secondary schools. The study included a multistage stratified cluster sampling and used the Malay version of the Physical Activity Questionnaire for Children and Body Image Contour Drawing Rating Scale. Data were analyzed by simple and multiple logistic regressions using IBM SPSS Statistics Version 22. Results: The study involved a total of 603 students who had a response rate of 89.7%. About 53% of the students were physically inactive. Being female [adjusted OR (95% CI): 5.07 (3.57, 7.20)] and allocating time for studying [adjusted OR (95% CI): 0.86 (0.75, 0.98)] were associated with physical inactivity. Conclusions: The majority of adolescents were physically inactive. To achieve a higher level of physical activity, intervention programs must consider the sex of adolescents and the amount of time they allocate for activities. Objective assessment of physical activity using pedometer or accelerometer is recommended.

Effectiveness of an Antenatal-Exercise Counseling Module on Knowledge and Self-Efficacy of Nurses in Northeast Peninsular Malaysia: A Quasi-Experimental Study.

BackgroundBecause of their frequent, regular contact with antenatal mothers, healthcare providers play an important role in promoting the health benefits of antenatal exercise. This study aimed to determine the effectiveness of an antenatal-exercise counseling module on knowledge and self-efficacy of staff nurses.MethodsA quasi-experimental design was conducted. The intervention and control groups consisted of 66 nurses randomly selected from the Tumpat and Pasir Mas districts, respectively, in Kelantan. The intervention group received an antenatal-exercise counseling module, and the control group performed counseling based on self-reading. Knowledge and self-efficacy were assessed at the baseline and at week 4. Analysis of variance and repeated measure analysis of covariance were performed using SPSS.ResultsThere was a significant difference in the knowledge scores [estimated marginal mean (95% confidence interval, CI): 33.9 (33.29, 34.53) versus 27.4 (26.52, 28.29); P < 0.001)] and the self-efficacy scores [estimated marginal mean (95% CI): 31.3 (30.55, 32.03) versus 27.4 (26.03, 28.74); P = 0.005)] between intervention and control groups at week 4 after adjusting for duration of practice and formal training.ConclusionThe antenatal-exercise counseling module is recommended for use in routine counseling in health centers to promote healthy lifestyles among pregnant women.

Periodontal Health of Pre-Dialysis Chronic Kidney Disease Patients in a Northeast Peninsular Malaysia Tertiary Hospital.

IntroductionChronic kidney disease (CKD) is associated with periodontal disease due to its hyperinflammatory state. Limited studies have explored the prevalence of periodontal disease among CKD patients in Malaysia.ObjectiveTo assess the periodontal status of pre-dialysis CKD patients in Hospital Universiti Sains Malaysia.MethodsA total of 46 pre-dialysis CKD patients who attended the nephrology clinic at Hospital Universiti Sains Malaysia were enrolled in this study. Periodontal examination was performed using the periodontal probing depth (PPD), clinical attachment loss (CAL) and plaque index.ResultsThe majority of the CKD patients were Malay (95.7%) and 80.4% were males. The mean age of the patients was 58.5 years. Using PPD measurement, 37 (74.0%) of the patients had mild periodontitis, 9 (20.0%) had moderate periodontitis and 3 (6.0%) had no periodontitis. Based on CAL measurement, 12 (26%) patients had mild periodontitis, 29 (63.0%) had moderate periodontitis and 5 (11%) had severe periodontitis. The mean (standard deviation [SD]) value of mild and moderate-to-severe periodontitis by PPD measurement were 4.26 (0.26) and 5.24 (0.36), respectively. The mean of mild and moderate-to-severe periodontitis by CAL measurement were 2.66 (0.62) and 4.98 (0.73), respectively. There was no correlation between the periodontal parameters and estimated glomerular filtration rate (PPD: r = −0.160, P = 0.914; CAL: r = −0.135, P = 0.372; plaque index: r = 0.005, P = 0.974).ConclusionThis study revealed a greater prevalence and severity of chronic periodontitis among CKD patients. Thus, the periodontal health of CKD patients’ needs to be screened and monitored.

Survival Time and Prognostic Factors of Mortality among Patients with Acquired Immunodeficiency Syndrome in North-East Peninsular Malaysia.

BackgroundDeath resulting from the acquired immunodeficiency syndrome (AIDS) is a worldwide concern. This study is aimed at determining the overall median survival time, and the prognostic factors of mortality among AIDS-infected patients in North-East Peninsular Malaysia.MethodsIn 2018, a retrospective cohort study stretching from January to April was conducted. This study involved a review of data obtained from the National AIDS Registry. A total of 1,073 AIDS cases diagnosed from 1 January 2010 to 31 December 2014 were selected, and follow-up procedures were conducted until 31 March 2015 (a 3-month follow-up). The Kaplan-Meier plot and Cox’s proportional hazard regression were used for data analyses.Results564 (52.5%) patients died due to AIDS, while the remaining 509 (47.4%) were censored. The overall median survival time was 11 months. The probability of survival in 1-year, 2-year, 3-year, 4-year and 5-year periods were 49.1%, 47.8%, 47.3%, 47.0% and 46.7%, respectively. Multiple Cox regression revealed that the significant prognostic factors were age 30–49 years [adjusted hazard ratio (Adj. HR) 1.57; 95% CI: 1.14, 2.16; P = 0.006], male (Adj. HR 1.39; 95% CI: 1.07, 1.79; P = 0.012), unemployed (Adj. HR 1.40; 95% CI: 1.12, 1.75; P = 0.003) and HIV-TB co-infection (Adj. HR 1.78; 95% CI: 1.37, 2.31; P < 0.001).ConclusionThe overall median survival time among AIDS patients in North-East Peninsular Malaysia was revealed to be short, in comparison to the other studies. The chances for survival can be improved with more emphasis on early detection (to ensure early treatment) and social support, particularly for HIV-TB co-infected patients, as well as for younger and unemployed patients.

Factors Contributing to Sharp Waste Disposal at Health Care Facility Among Diabetic Patients in North-East Peninsular Malaysia.

Background: Type 2 diabetic patients are major users of medical sharps in the community. Proper sharp disposal practice among them, however, was reported to be low. The current study was aimed to determine the factors contributing to sharp waste disposal at a health care facility among Type 2 diabetic patients. Methods: In this cross-sectional study, Type 2 diabetic patients who were on insulin therapy attending health clinics were randomly selected and interviewed using a validated questionnaire. Binary logistic regression analysis was applied. Results: Out of 304 respondents, only 11.5% of them brought their used sharps to be disposed at health care facilities. Previous advice on sharp disposal from health care providers, knowledge score, and duration of diabetes were significant contributing factors for sharp waste disposal at health care facilities: (Adj. OR 6.31; 95% CI: 2.63, 15.12; p < 0.001), (Adj. OR 1.05; 95% CI: 1.03, 1.08; p < 0.001), and (Adj. OR 2.51; 95% CI: 1.06, 5.93; p = 0.036), respectively. Conclusion: Continuous education and a locally adapted safe sharp disposal option must be available to increase awareness and facilitate diabetic patients adopting proper sharp disposal behavior.